Search results for: child morbid obesity
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 238

Search results for: child morbid obesity

28 Variables for Measuring the Impact of the Social Enterprises in the Field of Community Development

Authors: A. Irudaya Veni Mary, M. Victor Louis Anthuvan, P. Christie, A. Indira

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In India, social enterprises are working to create social value in various fields including education; health; women and child development; environment protection and community development. Although social enterprises have brought about tremendous changes in the lives of beneficiaries, the importance of their works is not understood thoroughly. One of the ways to prove themselves is to measure the impact, which in recent times has received much attention. This paper focuses on the study of social value created by the social enterprises in the field of community development. It also aims to put forth a research tool for measuring the social value created by the social enterprises in the field of community development. A close-ended interview schedule was prepared to measure the social value creation and it was administered among 60 beneficiaries of two social enterprises who work in the field of community development. The study results show that the social enterprises have brought four types of impact in the life of their beneficiaries; economic impact, social impact, political impact and cultural impact. This study is limited to the social enterprises those who work towards community development. This empirical finding will enable the reader to understand various types of social value created by the social enterprises working in the field of community development. This study will also serve as guide for social enterprises in community development activities to measure their impact and thereby improve their operation towards the betterment of the society. This paper is derived from an empirical research carried out to describe the different types of social value created by the social enterprises in India.

Keywords: Social enterprise, social entrepreneurs, social impact, social value, tool for social impact measurement.

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27 Interdisciplinary Integrated Physical Education Program Using a Philosophical Approach

Authors: Ellie Abdi, Susana Juniu

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The purpose of this presentation is to describe an interdisciplinary teaching program that integrates physical education concepts using a philosophical approach. The presentation includes a review of: a) the philosophy of American education, b) the philosophy of sports and physical education, c) the interdisciplinary physical education program, d) professional development programs, (e) the Success of this physical education program, f) future of physical education. This unique interdisciplinary program has been implemented in an urban school physical education discipline in East Orange, New Jersey for over 10 years.

During the program the students realize that the bodies go through different experiences. The body becomes a place where a child can recognize in an enjoyable way to express and perceive particular feelings or mental states. Children may distinguish themselves to have high abilities in the social or other domains but low abilities in the field of athletics.

The goal of this program for the individuals is to discover new skills, develop and demonstrate age appropriate mastery level at different tasks, therefore the program consists of 9 to 12 sports, including many game. Each successful experience increases the awareness ability. Engaging in sports and physical activities are social movements involving groups of children in situations such as teams, friends, and recreational settings, which serve as a primary socializing agent for teaching interpersonal skills. As a result of this presentation the audience will reflect and explore how to structure a physical education program to integrate interdisciplinary subjects with philosophical concepts.

Keywords: Interdisciplinary disciplines, philosophical concepts, physical education.

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26 Well-Being of Lagos Urban Mini-Bus Drivers: The Influence of Age and Marital Status

Authors: Bolajoko I. Malomo, Maryam O. Yusuf

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Lagos urban mini bus drivers play a critical role in the transportation sector. The current major mode of transportation within Lagos metropolis remains road transportation and this confirms the relevance of urban mini-bus drivers in transporting the populace to their various destinations. Other modes of transportation such as the train and waterways are currently inadequate. Various threats to the well-being of urban bus drivers include congested traffic typical of modern day lifestyles, dwindling financial returns due to long hours in traffic, fewer hours of sleep, inadequate diet, time pressure, and assaults related to fare disputes. Several healthrelated problems have been documented to be associated with urban bus driving. For instance, greater rates of hypertension, obesity and cholesterol level have been reported. Research studies are yet to identify the influence of age and marital status on the well-being of urban mini-bus drivers in Lagos metropolis. A study of this nature is necessary as it is culturally perceived in Nigeria that older and married people are especially influenced by family affiliation and would behave in ways that would project positive outcomes. The study sample consisted of 150 urban mini-bus drivers who were conveniently sampled from six (6) different terminuses where their journey begins and terminates. The well-being questionnaire was administered to participants. The criteria for inclusion in the study included the ability to read in English language and the confirmation that interested participants were on duty and suited to be driving mini-buses. Due to the nature of the job of bus driving, the researcher administered the questionnaires on participants who were free and willing to respond to the survey. All participants were males of various age groups and of different marital statuses. Results of analyses conducted revealed no significant influence of age and marital status on the well-being of urban mini-bus drivers. This indicates that the well-being of urban mini bus drivers is not influenced by age or marital status. The findings of this study have cultural implications. It negates the popularly held belief that older and married people care more about their well-being than younger and single people. It brings to fore the need to also identify and consider other factors when certifying people for the job of urban bus driving.

Keywords: Age, Lagos metropolis, marital status, well-being of urban mini bus drivers.

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25 Identification of Common Indicators of Family Environment of Pupils of Alternative Schools

Authors: Yveta Pohnětalová, Veronika Nováková, Lucie Hrašová

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The paper presents the results of research in which we were looking for common characteristics of the family environment of students alternative and innovative education systems. Topicality comes from the fact that nowadays in the Czech Republic there are several civic and parental initiatives held with the aim to establish schools for their children. The goal of our research was to reveal key aspects of these families and to identify their common indicators. Among other things, we were interested what reasons lead parents to decide to enroll their child into different education than standard (common). The survey was qualitative and there were eighteen respondents of parents of alternative schools´ pupils. The reason to implement qualitative design was the opportunity to gain deeper insight into the essence of phenomena and to obtain detailed information, which would become the basis for subsequent quantitative research. There have been semi structured interviews done with the respondents which had been recorded and transcribed. By an analysis of gained data (categorization and by coding), we found out that common indicator of our respondents is higher education and higher economic level. This issue should be at the forefront of the researches because there is lack of analysis which would provide a comparison of common and alternative schools in the Czech Republic especially with regard to quality of education. Based on results, we consider questions whether approaches of these parents towards standard education come from their own experience or from the lack of knowledge of current goals and objectives of education policy of the Czech Republic.

Keywords: Alternative schools, family environment, quality of education, parents´ approach.

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24 Assessment of the Illustrated Language Activities of the Portage Guide to Early Education

Authors: Ofelia A. Damag

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The study was focused on the development and assessment of the illustrated language activities of the 1996 Edition of the Portage Guide to Early Education. It determined the extent of appropriateness, applicability, time efficiency and aesthetics of the illustrated language activities to be used as instructional material not only by teachers, but parents and caregivers as well. The eclectic research design was applied in this study using qualitative and quantitative methods. To determine the applicability and time efficiency of the study, a try out was done. Since the eclectic research design was used, it made use of a researcher-made survey questionnaire and focus group discussion. Analysis of the data was done through weighted mean and ANOVA. The respondents of the study were representatives of Special Education (SPED) teachers, caregivers and parents of a special-needs child, particularly with difficulties in learning basic language skills. The results of the study show that a large number of respondents are SPED teachers and caregivers and are mostly college graduates. Many of them have earned units towards Master’s studies. Moreover, a majority of the respondents have not attended seminars or in-service training in early intervention for them to be more competent in the area of specialization. It is concluded that the illustrated language activities under review in this study are appropriate, applicable, time efficient and aesthetic for use as a tool in teaching. The recommendations are focused on the advocacy for SPED teachers, caregivers and parents of special-needs children to be more consistent in the implementation of the new instructional materials as an aid in an intervention program.

Keywords: Illustrated language activities, inclusion, portage guide to early education, special educational needs.

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23 Hacking the Spatial Limitations in Bridging Virtual and Traditional Teaching Methodologies in Sri Lanka

Authors: Manuela Nayantara Jeyaraj

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Having moved into the 21st century, it is way past being arguable that innovative technology needs to be incorporated into conventional classroom teaching. Though the Western world has found presumable success in achieving this, it is still a concept under battle in developing countries such as Sri Lanka. Reaching the acme of implementing interactive virtual learning within classrooms is a struggling idealistic fascination within the island. In order to overcome this problem, this study is set to reveal facts that limit the implementation of virtual, interactive learning within the school classrooms and provide hacks that could prove the augmented use of the Virtual World to enhance teaching and learning experiences. As each classroom moves along with the usage of technology to fulfill its functionalities, a few intense hacks provided will build the administrative onuses on a virtual system. These hacks may divulge barriers based on social conventions, financial boundaries, digital literacy, intellectual capacity of the staff, and highlight the impediments in introducing students to an interactive virtual learning environment and thereby provide the necessary actions or changes to be made to succeed and march along in creating an intellectual society built on virtual learning and lifestyle. This digital learning environment will be composed of multimedia presentations, trivia and pop quizzes conducted on a GUI, assessments conducted via a virtual system, records maintained on a database, etc. The ultimate objective of this study could enhance every child's basic learning environment; hence, diminishing the digital divide that exists in certain communities.

Keywords: Digital divide, digital learning, digitization, Sri Lanka, teaching methodologies.

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22 Working Children and Adolescents and the Vicious Circle of Poverty from the Perspective of Gunnar Myrdal’s Theory of Circular Cumulative Causation: Analysis and Implementation of a Probit Model to Brazil

Authors: J. Leige Lopes, L. Aparecida Bastos, R. Monteiro da Silva

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The objective of this paper is to study the work of children and adolescents and the vicious circle of poverty from the perspective of Guinar Myrdal’s Theory of Circular Cumulative Causation. The objective is to show that if a person starts working in the juvenile phase of life they will be classified as poor or extremely poor when they are adult, which can to be observed in the case of Brazil, more specifically in the north and northeast. To do this, the methodology used was statistical and econometric analysis by applying a probit model. The main results show that: if people reside in the northeastern region of Brazil, and if they have a low educational level and if they start their professional life before the age 18, they will increase the likelihood that they will be poor or extremely poor. There is a consensus in the literature that one of the causes of the intergenerational transmission of poverty is related to child labor, this because when one starts their professional life while still in the toddler or adolescence stages of life, they end up sacrificing their studies. Because of their low level of education, children or adolescents are forced to perform low-paid functions and abandon school, becoming in the future, people who will be classified as poor or extremely poor. As a result of poverty, parents may be forced to send their children out to work when they are young, so that in the future they will also become poor adults, a process that is characterized as the "vicious circle of poverty."

Keywords: Children, adolescents, Gunnar Myrdal, poverty, vicious circle.

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21 Gender Perspective Considerations in Disasters like Earthquakes and Floods of Pakistan

Authors: Muhammad Naseem Baig, Razia Sharif

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From past many decades human beings are suffering from plethora of natural disasters. Occurrence of disasters is a frequent process; it changes conceptual myths as more and more advancement are made. Although we are living in technological era but in developing countries like Pakistan disasters are shaped by socially constructed roles. The need is to understand the most vulnerable group of society i.e. females; their issues are complex in nature because of undermined gender status in the society. There is a need to identify maximum issues regarding females and to enhance the achievement of millennium development goals (MDGs). Gender issues are of great concern all around the globe including Pakistan. Here female visibility in society is low, and also during disasters, the failure to understand the reality that concentrates on double burden including productive and reproductive care. Women have to contribute a lot in society so we need to make them more disaster resilient. For this non-structural measures like awareness, trainings and education must be carried out. In rural and in urban settings in any disaster like earthquake or flood, elements like gender perspective, their age, physical health, demographic issues contribute towards vulnerability. In Pakistan the gender issues in disasters were of less concern before 2005 earthquake and 2010 floods. Significant achievements are made after 2010 floods when gender and child cell was created to provide all facilities to women and girls. The aim of the study is to highlight all necessary facilities in a disaster to build coping mechanism in females from basic rights till advance level including education.

Keywords: Disaster resilient, Gender cell, Millennium development.

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20 Predictive Factors of Exercise Behaviors of Junior High School Students in Chonburi Province

Authors: Tanida Julvanichpong

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Exercise has been regarded as a necessary and important aspect to enhance physical performance and psychology health. Body weight statistics of students in junior high school students in Chonburi Province beyond a standard risk of obesity. Promoting exercise among Junior high school students in Chonburi Province, essential knowledge concerning factors influencing exercise is needed. Therefore, this study aims to (1) determine the levels of perceived exercise behavior, exercise behavior in the past, perceived barriers to exercise, perceived benefits of exercise, perceived self-efficacy to exercise, feelings associated with exercise behavior, influence of the family to exercise, influence of friends to exercise, and the perceived influence of the environment on exercise. (2) examine the predicting ability of each of the above factors while including personal factors (sex, educational level) for exercise behavior. Pender’s Health Promotion Model was used as a guide for the study. Sample included 652 students in junior high schools, Chonburi Provience. The samples were selected by Multi-Stage Random Sampling. Data Collection has been done by using self-administered questionnaires. Data were analyzed using descriptive statistics, Pearson’s product moment correlation coefficient, Eta, and stepwise multiple regression analysis. The research results showed that: 1. Perceived benefits of exercise, influence of teacher, influence of environmental, feelings associated with exercise behavior were at a high level. Influence of the family to exercise, exercise behavior, exercise behavior in the past, perceived self-efficacy to exercise and influence of friends were at a moderate level. Perceived barriers to exercise were at a low level. 2. Exercise behavior was positively significant related to perceived benefits of exercise, influence of the family to exercise, exercise behavior in the past, perceived self-efficacy to exercise, influence of friends, influence of teacher, influence of environmental and feelings associated with exercise behavior (p < .01, respectively) and was negatively significant related to educational level and perceived barriers to exercise (p < .01, respectively). Exercise behavior was significant related to sex (Eta = 0.243, p=.000). 3. Exercise behavior in the past, influence of the family to exercise significantly contributed 60.10 percent of the variance to the prediction of exercise behavior in male students (p < .01). Exercise behavior in the past, perceived self-efficacy to exercise, perceived barriers to exercise, and educational level significantly contributed 52.60 percent of the variance to the prediction of exercise behavior in female students (p < .01).

Keywords: Predictive factors, exercise behaviors, junior high school.

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19 The Impact of Geophagia on the Iron Status of Black South African Women

Authors: A. van Onselen, C. M. Walsh, F. J. Veldman, C. Brand

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Objectives: To determine the nutritional status and risk factors associated with women practicing geophagia in QwaQwa, South Africa. Materials and Methods: An observational epidemiological study design was adopted which included an exposed (geophagia) and nonexposed (control) group. A food frequency questionnaire, anthropometric measurements and blood sampling were applied to determine nutritional status of participants. Logistic regression analysis was performed in order to identify factors that were likely to be associated with the practice of geophagia. Results: The mean total energy intake for the geophagia group (G) and control group (C) were 10324.31 ± 2755.00 kJ and 10763.94 ± 2556.30 kJ respectively. Both groups fell within the overweight category according to the mean Body Mass Index (BMI) of each group (G= 25.59 kg/m2; C= 25.14 kg/m2). The mean serum iron levels of the geophagia group (6.929 μmol/l) were significantly lower than that of the control group (13.75 μmol/l) (p = 0.000). Serum transferrin (G=3.23g/l; C=2.7054g/l) and serum transferrin saturation (G=8.05%; C=18.74%) levels also differed significantly between groups (p=0.00). Factors that were associated with the practice of geophagia included haemoglobin (Odds ratio (OR):14.50), serumiron (OR: 9.80), serum-ferritin (OR: 3.75), serum-transferrin (OR: 6.92) and transferrin saturation (OR: 14.50). A significant negative association (p=0.014) was found between women who were wageearners and those who were not wage-earners and the practice of geophagia (OR: 0.143; CI: 0.027; 0.755). These findings seem to indicate that a permanent income may decrease the likelihood of practising geophagia. Key Findings: Geophagia was confirmed to be a risk factor for iron deficiency in this community. The significantly strong association between geophagia and iron deficiency emphasizes the importance of identifying the practice of geophagia in women, especially during their child bearing years.

Keywords: Anaemia, anthropometry, dietary intake, geophagia, iron deficiency.

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18 Privacy Concerns and Law Enforcement Data Collection to Tackle Domestic and Sexual Violence

Authors: Francesca Radice

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It has been observed that violent or coercive behaviour has been apparent from initial conversations on dating apps like Tinder. Child pornography, stalking, and coercive control are some criminal offences from dating apps, including women murdered after finding partners through Tinder. Police databases and predictive policing are novel approaches taken to prevent crime before harm is done. This research will investigate how police databases can be used in a privacy-preserving way to characterise users in terms of their potential for violent crime. Using the COPS database of NSW Police, we will explore how the past criminal record can be interpreted to yield a category of potential danger for each dating app user. It is up to the judgement of each subscriber on what degree of the potential danger they are prepared to enter into. Sentiment analysis is an area where research into natural language processing has made great progress over the last decade. This research will investigate how sentiment analysis can be used to interpret interchanges between dating app users to detect manipulative or coercive sentiments. These can be used to alert law enforcement if continued for a defined number of communications. One of the potential problems of this approach is the potential prejudice a categorisation can cause. Another drawback is the possibility of misinterpreting communications and involving law enforcement without reason. The approach will be thoroughly tested with cross-checks by human readers who verify both the level of danger predicted by the interpretation of the criminal record and the sentiment detected from personal messages. Even if only a few violent crimes can be prevented, the approach will have a tangible value for real people.

Keywords: Sentiment Analysis, data mining, predictive policing, virtual manipulation.

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17 Factors Affecting Access to Education: The Experiences of Parents of Children Who Are Deaf or Hard of Hearing

Authors: Hanh Thi My Nguyen

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The purpose of this research is to examine the experiences of parents of children who are deaf or hard of hearing in supporting their children to access education in Vietnam. Parents play a crucial role in supporting their children to gain full access to education. It was widely reported that parents of those children confronted a range of problems to support their children to access education. To author’s best knowledge, there has been a lack of research exploring the experiences of those parents in literature. This research examines factors affecting those parents in supporting their children to access education. To conduct the study, qualitative approach using a phenomenological research design was chosen to explore the central phenomena. Ten parents of children who were diagnosed as deaf or hard of hearing and aged 6-9 years were recruited through the support of the Association of Parents of Children with Hearing Impairment. Participants were interviewed via telephone with a mix of open and closed questions; interviews were audio recorded, transcribed and thematically analysed. The research results show that there are nine main factors that affected the parents in this study in making decisions relating to education for their children including: lack of information resources, perspectives of those parents on communication approaches, the families’ financial capacity, the psychological impact on the participants after their children’ diagnosis, the attitude of family members, attitude of school administrators, lack of local schools and qualified teachers, and current education system for the deaf in Vietnam. Apart from those factors, the lack of knowledge of the participants’ partners about deaf education and the partners’ employment are barriers to educational access and successful communication with their child.

Keywords: Access to education, deaf, hard of hearing, parents experience.

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16 Working with Children and Young People as a much Neglected Area of Education within the Social Studies Curriculum in Poland

Authors: Marta Czechowska-Bieluga

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Social work education in Poland focuses mostly on developing competencies that address the needs of individuals and families affected by a variety of life's problems. As a result of the ageing of the Polish population, much attention is equally devoted to adults, including the elderly. However, social work with children and young people is the area of education which should be given more consideration. Social work students are mostly trained to cater to the needs of families and the competencies aimed to respond to the needs of children and young people do not receive enough attention and are only offered as elective classes. This paper strives to review the social work programmes offered by the selected higher education institutions in Poland in terms of social work training aimed at helping children and young people to address their life problems. The analysis conducted in this study indicates that university education for social work focuses on training professionals who will provide assistance only to adults. Due to changes in the social and political situation, including, in particular, changes in social policy implemented for the needy, it is necessary to extend this area of education to include the specificity of the support for children and young people; especially, in the light of the appearance of new support professions within the area of social work. For example, family assistants, whose task is to support parents in performing their roles as guardians and educators, also assist children. Therefore, it becomes necessary to equip social work professionals with competencies which include issues related to the quality of life of underage people living in families. Social work curricula should be extended to include the issues of child and young person development and the patterns governing this phase of life.

Keywords: Social work education, social work programmes, social worker, university.

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15 Nutrition Program Planning Based on Local Resources in Urban Fringe Areas of a Developing Country

Authors: Oktia Woro Kasmini Handayani, Bambang Budi Raharjo, Efa Nugroho, Bertakalswa Hermawati

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Obesity prevalence and severe malnutrition in Indonesia has increased from 2007 to 2013. The utilization of local resources in nutritional program planning can be used to program efficiency and to reach the goal. The aim of this research is to plan a nutrition program based on local resources for urban fringe areas in a developing country. This research used a qualitative approach, with a focus on local resources including social capital, social system, cultural system. The study was conducted in Mijen, Central Java, as one of the urban fringe areas in Indonesia. Purposive and snowball sampling techniques are used to determine participants. A total of 16 participants took part in the study. Observation, interviews, focus group discussion, SWOT analysis, brainstorming and Miles and Huberman models were used to analyze the data. We have identified several local resources, such as the contributions from nutrition cadres, social organizations, social financial resources, as well as the cultural system and social system. The outstanding contribution of nutrition cadres is the participation and creativity to improve nutritional status. In addition, social organizations, like the role of the integrated health center for children (Pos Pelayanan Terpadu), can be engaged in the nutrition program planning. This center is supported by House of Nutrition to assist in nutrition program planning, and provide social support to families, neighbors and communities as social capitals. The study also reported that cultural systems that show appreciation for well-nourished children are a better way to improve the problem of balanced nutrition. Social systems such as teamwork and mutual cooperation can also be a potential resource to support nutritional programs and overcome associated problems. The impact of development in urban areas such as the introduction of more green areas which improve the perceived status of local people, as well as new health services facilitated by people and companies, can also be resources to support nutrition programs. Local resources in urban fringe areas can be used in the planning of nutrition programs. The expansion of partnership with all stakeholders, empowering the community through optimizing the roles of nutrition care centers for children as our recommendation with regard to nutrition program planning.

Keywords: Developing country, local resources, nutrition program, urban fringe.

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14 How Children Synchronize with Their Teacher: Evidence from a Real-World Elementary School Classroom

Authors: Reiko Yamamoto

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This paper reports on how synchrony occurs between children and their teacher, and what prevents or facilitates synchrony. The aim of the experiment conducted in this study was to precisely analyze their movements and synchrony and reveal the process of synchrony in a real-world classroom. Specifically, the experiment was conducted for around 20 minutes during an English as a foreign language (EFL) lesson. The participants were 11 fourth-grade school children and their classroom teacher in a public elementary school in Japan. Previous researchers assert that synchrony causes the state of flow in a class. For checking the level of flow, Short Flow State Scale (SFSS) was adopted. The experimental procedure had four steps: 1) The teacher read aloud the first half of an English storybook to the children. Both the teacher and the children were at their own desks. 2) The children were subjected to an SFSS check. 3) The teacher read aloud the remaining half of the storybook to the children. She made the children remove their desks before reading. 4) The children were again subjected to an SFSS check. The movements of all participants were recorded with a video camera. From the movement analysis, it was found that the children synchronized better with the teacher in Step 3 than in Step 1, and that the teacher’s movement became free and outstanding without a desk. This implies that the desk acted as a barrier between the children and the teacher. Removal of this barrier resulted in the children’s reactions becoming synchronized with those of the teacher. The SFSS results proved that the children experienced more flow without a barrier than with a barrier. Apparently, synchrony is what caused flow or social emotions in the classroom. The main conclusion is that synchrony leads to cognitive outcomes such as children’s academic performance in EFL learning.

Keywords: Movement synchrony, teacher–child relationships, English as a foreign language, EFL learning.

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13 Emotions Triggered by Children’s Literature Images

Authors: A. Breda, C. Cruz

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The role of images/illustrations in communicating meanings and triggering emotions assumes an increasingly relevant role in contemporary texts, regardless of the age group for which they are intended or the nature of the texts that host them. It is no coincidence that children's books are full of illustrations and that the image/text ratio decreases as the age group grows. The vast majority of children's books can be considered as multimodal texts containing text and images/illustrations, interacting with each other, to provide the young reader with a broader and more creative understanding of the book's narrative. This interaction is very diverse, ranging from images/illustrations that are not essential for understanding the storytelling to those that contribute significantly to the meaning of the story. Usually, these books are also read by adults, namely by parents, educators, and teachers who act as mediators between the book and the children, explaining aspects that are or seem to be too complex for the child's context. It should be noted that there are books labeled as children's books, that are clearly intended for both children and adults. In this work, following a qualitative and interpretative methodology based on written productions, participant observation, and field notes, we will describe the perceptions of future teachers of the 1st cycle of basic education, attending a master’s degree at a Portuguese university, about the role of the image in literary and non-literary texts, namely in mathematical texts, and how these can constitute precious resources for emotional regulation and for the design of creative didactic situations. The analysis of the collected data allowed us to obtain evidence regarding the evolution of the participants' perception regarding the crucial role of images in children's literature, not only as an emotional regulator for young readers but also as a creative source for the design of meaningful didactical situations, crossing other scientific areas, other than the mother tongue, namely mathematics.

Keywords: Children’s literature, emotions, multimodal texts, soft skills.

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12 Agreement between Basal Metabolic Rate Measured by Bioelectrical Impedance Analysis and Estimated by Prediction Equations in Obese Groups

Authors: Orkide Donma, Mustafa M. Donma

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Basal metabolic rate (BMR) is widely used and an accepted measure of energy expenditure. Its principal determinant is body mass. However, this parameter is also correlated with a variety of other factors. The objective of this study is to measure BMR and compare it with the values obtained from predictive equations in adults classified according to their body mass index (BMI) values. 276 adults were included into the scope of this study. Their age, height and weight values were recorded. Five groups were designed based on their BMI values. First group (n = 85) was composed of individuals with BMI values varying between 18.5 and 24.9 kg/m2. Those with BMI values varying from 25.0 to 29.9 kg/m2 constituted Group 2 (n = 90). Individuals with 30.0-34.9 kg/m2, 35.0-39.9 kg/m2, > 40.0 kg/m2 were included in Group 3 (n = 53), 4 (n = 28) and 5 (n = 20), respectively. The most commonly used equations to be compared with the measured BMR values were selected. For this purpose, the values were calculated by the use of four equations to predict BMR values, by name, introduced by Food and Agriculture Organization (FAO)/World Health Organization (WHO)/United Nations University (UNU), Harris and Benedict, Owen and Mifflin. Descriptive statistics, ANOVA, post-Hoc Tukey and Pearson’s correlation tests were performed by a statistical program designed for Windows (SPSS, version 16.0). p values smaller than 0.05 were accepted as statistically significant. Mean ± SD of groups 1, 2, 3, 4 and 5 for measured BMR in kcal were 1440.3 ± 210.0, 1618.8 ± 268.6, 1741.1 ± 345.2, 1853.1 ± 351.2 and 2028.0 ± 412.1, respectively. Upon evaluation of the comparison of means among groups, differences were highly significant between Group 1 and each of the remaining four groups. The values were increasing from Group 2 to Group 5. However, differences between Group 2 and Group 3, Group 3 and Group 4, Group 4 and Group 5 were not statistically significant. These insignificances were lost in predictive equations proposed by Harris and Benedict, FAO/WHO/UNU and Owen. For Mifflin, the insignificance was limited only to Group 4 and Group 5. Upon evaluation of the correlations of measured BMR and the estimated values computed from prediction equations, the lowest correlations between measured BMR and estimated BMR values were observed among the individuals within normal BMI range. The highest correlations were detected in individuals with BMI values varying between 30.0 and 34.9 kg/m2. Correlations between measured BMR values and BMR values calculated by FAO/WHO/UNU as well as Owen were the same and the highest. In all groups, the highest correlations were observed between BMR values calculated from Mifflin and Harris and Benedict equations using age as an additional parameter. In conclusion, the unique resemblance of the FAO/WHO/UNU and Owen equations were pointed out. However, mean values obtained from FAO/WHO/UNU were much closer to the measured BMR values. Besides, the highest correlations were found between BMR calculated from FAO/WHO/UNU and measured BMR. These findings suggested that FAO/WHO/UNU was the most reliable equation, which may be used in conditions when the measured BMR values are not available.

Keywords: Adult, basal metabolic rate, FAO/WHO/UNU, obesity, prediction equations.

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11 An Inclusion Project for Deaf Children into a Northern Italy Contest

Authors: G. Tamanza, A. Bossoni

Abstract:

84 deaf students (from primary school to college) and their families participated in this inclusion project in cooperation with numerous institutions in northern Italy (Brescia-Lombardy). Participants were either congenitally deaf or their deafness was related to other pathologies. This research promoted the integration of deaf students as they pass from primary school to high school to college. Learning methods and processes were studied that focused on encour­aging individual autonomy and socialization. The research team and its collaborators included school teachers, speech ther­apists, psychologists and home tutors, as well as teaching assistants, child neuropsychiatrists and other external authorities involved with deaf persons social inclusion programs. Deaf children and their families were supported, in terms of inclusion, and were made aware of the research team that focused on the Bisogni Educativi Speciali (BES or Special Educational Needs) (L.170/2010 - DM 5669/2011). This project included a diagnostic and evaluative phase as well as an operational one. Results demonstrated that deaf children were highly satisfied and confident; academic performance improved and collaboration in school increased. Deaf children felt that they had access to high school and college. Empowerment for the families of deaf children in terms of networking among local services that deal with the deaf also improved while family satisfaction also improved. We found that teachers and those who gave support to deaf children increased their professional skills. Achieving autonomy, instrumental, communicative and relational abilities were also found to be crucial. Project success was determined by temporal continuity, clear theoretical methodology, strong alliance for the project direction and a resilient team response.

Keywords: Autonomy, inclusion, skills, well-being.

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10 An Investigation into the Social Factors that Influence Sport Participation: A Case of Gymnastics in the Western Cape

Authors: W. C. Lucas, S. Titus, M. E. M. Young

Abstract:

Gymnastics is the umbrella term that represents seven different and unique disciplines of gymnastics. Men and women of all ages and abilities practice this sport, and participation in gymnastics can develop both gross and fine motor skills, strength, flexibility, coordination and balance. There are various social factors, such as a family’s socioeconomic status or accessibility to sports facilities that may play a role in affecting levels of participation. The aim of this study is to investigate the social factors that have an influence on gymnastics participation in the Western Cape. To this end, a qualitative approach is adopted to collect data. This study also adopts the ecological systems theory as the theoretical framework, and is used to analyze and interpret current social factors that directly or indirectly influence participation in gymnastics. The study’s objectives were to ascertain which social factors hinder participation, and which social factors promote participation, thus, coaches, parents and gymnasts participated in focus group discussions. Key informant interviews took place with experts in the field of gymnastics in the Western Cape. A thematic analysis was conducted on transcriptions from the focus group discussions and key informant interviews. Social factors investigated in this study occurred in the chronosystem, macrosystem, exosystem, mesosystem, and microsystem, and had both a direct and indirect influence on the gymnast’s continued participation. These systems are defined as the environment of the individual, in which they grow and develop. The research findings of this paper are used to draw conclusions and make specific recommendations for practice and further research. The information gathered in this study can assist all stakeholders within the field of gymnastics, such as parents, judges, coaches, gymnasts, and the supporting community which surround the participating gymnast.

Keywords: Developing child, ecological systems theory, facilities, federation, gymnastics, influence, participation, social factors, socioeconomic status, sport.

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9 Effects of School Facilities’ Mechanical and Plumbing Characteristics and Conditions on Student Attendance, Academic Performance and Health

Authors: Erica Cochran Hameen, Bobuchi Ken-Opurum, Shalini Priyadarshini, Berangere Lartigue, Sadhana Anath-Pisipati

Abstract:

School districts throughout the United States are constantly seeking measures to improve test scores, reduce school absenteeism and improve indoor environmental quality. It is imperative to identify key building investments which will provide the largest benefits to schools in terms of improving the aforementioned factors. This study uses Analysis of Variance (ANOVA) tests to statistically evaluate the impact of a school building’s mechanical and plumbing characteristics on a child’s educational performance. The educational performance is measured via three indicators, i.e. test scores, suspensions, and absenteeism. The study investigated 125 New York City school facilities to determine the potential correlations between 50 mechanical and plumbing variables and the performance indicators. Key findings from the tests revealed that elementary schools with pneumatic systems in “good” condition have 48.8% lower percentages of students scoring at the minimum English Language Arts (ELA) competency level compared with those with no pneumatic system. Additionally, elementary schools with “unit heaters/cabinet heaters” in “good to fair” conditions have 1.1% higher attendance rates compared to schools with no “unit heaters/cabinet heaters” or those in inferior condition. Furthermore, elementary schools with air conditioning have 0.6% higher attendance rates compared to schools with no air conditioning, and those with interior floor drains in “good” condition have 1.8% higher attendance rates compared to schools with interior drains in inferior condition.

Keywords: Academic attendance and performance, mechanical and plumbing systems, schools, student health.

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8 Robot-assisted Relaxation Training for Children with Autism Spectrum Disorders

Authors: V. Holeva, V. Aliki Nikopoulou, P. Kechayas, M. Dialechti Kerasidou, M. Papadopoulou, G. A. Papakostas, V. G. Kaburlasos, A. Evangeliou

Abstract:

Cognitive Behavioral Therapy (CBT) has been proven an effective tool to address anger and anxiety issues in children and adolescents with Autism Spectrum Disorders (ASD). Robot-enhanced therapy has been used in psychosocial and educational interventions for children with ASD with promising results. Whenever CBT-based techniques were incorporated in robot-based interventions, they were mainly performed in group sessions. Objectives: The study’s main objective was the implementation and evaluation of the effectiveness of a relaxation training intervention for children with ASD, delivered by the social robot NAO. Methods: 20 children (aged 7–12 years) were randomly assigned to 16 sessions of relaxation training implemented twice a week. Two groups were formed: the NAO group (children participated in individual sessions with the support of NAO) and the control group (children participated in individual sessions with the support of the therapist only). Participants received three different relaxation scenarios of increasing difficulty (a breathing scenario, a progressive muscle relaxation scenario and a body scan medication scenario), as well as related homework sheets for practicing. Pre- and post-intervention assessments were conducted using the Child Behavior Checklist (CBCL) and the Strengths and Difficulties Questionnaire for parents (SDQ-P). Participants were also asked to complete an open-ended questionnaire to evaluate the effectiveness of the training. Parents’ satisfaction was evaluated via a questionnaire and children satisfaction was assessed by a thermometer scale. Results: The study supports the use of relaxation training with the NAO robot as instructor for children with ASD. Parents of enrolled children reported high levels of satisfaction and provided positive ratings of the training acceptability. Children in the NAO group presented greater motivation to complete homework and adopt the learned techniques at home. Conclusions: Relaxation training could be effectively integrated in robot-assisted protocols to help children with ASD regulate emotions and develop self-control.

Keywords: Autism spectrum disorders, CBT, children relaxation training, robot-assisted therapy.

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7 Enhanced-Delivery Overlay Multicasting Scheme by Optimizing Bandwidth and Latency Discrepancy Ratios

Authors: Omar F. Hamad, T. Marwala

Abstract:

With optimized bandwidth and latency discrepancy ratios, Node Gain Scores (NGSs) are determined and used as a basis for shaping the max-heap overlay. The NGSs - determined as the respective bandwidth-latency-products - govern the construction of max-heap-form overlays. Each NGS is earned as a synergy of discrepancy ratio of the bandwidth requested with respect to the estimated available bandwidth, and latency discrepancy ratio between the nodes and the source node. The tree leads to enhanceddelivery overlay multicasting – increasing packet delivery which could, otherwise, be hindered by induced packet loss occurring in other schemes not considering the synergy of these parameters on placing the nodes on the overlays. The NGS is a function of four main parameters – estimated available bandwidth, Ba; individual node's requested bandwidth, Br; proposed node latency to its prospective parent (Lp); and suggested best latency as advised by source node (Lb). Bandwidth discrepancy ratio (BDR) and latency discrepancy ratio (LDR) carry weights of α and (1,000 - α ) , respectively, with arbitrary chosen α ranging between 0 and 1,000 to ensure that the NGS values, used as node IDs, maintain a good possibility of uniqueness and balance between the most critical factor between the BDR and the LDR. A max-heap-form tree is constructed with assumption that all nodes possess NGS less than the source node. To maintain a sense of load balance, children of each level's siblings are evenly distributed such that a node can not accept a second child, and so on, until all its siblings able to do so, have already acquired the same number of children. That is so logically done from left to right in a conceptual overlay tree. The records of the pair-wise approximate available bandwidths as measured by a pathChirp scheme at individual nodes are maintained. Evaluation measures as compared to other schemes – Bandwidth Aware multicaSt architecturE (BASE), Tree Building Control Protocol (TBCP), and Host Multicast Tree Protocol (HMTP) - have been conducted. This new scheme generally performs better in terms of trade-off between packet delivery ratio; link stress; control overhead; and end-to-end delays.

Keywords: Overlay multicast, Available bandwidth, Max-heapform overlay, Induced packet loss, Bandwidth-latency product, Node Gain Score (NGS).

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6 Serological IgG Testing to Diagnose Alimentary Induced Diseases and Monitoring Efficacy of an Individual Defined Diet in Dogs

Authors: Anne-Margré C. Vink

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Background. Food-related allergies and intolerances are frequently occurring in dogs. Diagnosis and monitoring according ‘Golden Standard’ of elimination efficiency is, however, time consuming, expensive, and requires expert clinical setting. In order to facilitate rapid and robust, quantitative testing of intolerance, and determining the individual offending foods, a serological test is implicated for Alimentary Induced Diseases and manifestations. Method. As we developed Medisynx IgG Human Screening Test ELISA before and the dog’ immune system is most similar to humans, we were able to develop Medisynx IgG Dog Screening Test ELISA as well. In this randomized, double-blind, split-sample, retro perspective study 47 dogs suffering from Canine Atopic Dermatitis (CAD) and several secondary induced reactions were included to participate in serological Medisynx IgG Dog Screening Test ELISA (within < 0,02 % SD). Results were expressed as titers relative to the standard OD readings to diagnose alimentary induced diseases and monitoring efficacy of an individual eliminating diet in dogs. Split sample analysis was performed by independently sending 2 times 3 ml serum under two unique codes. Results. The veterinarian monitored these dogs to check dog’ results at least at 3, 7, 21, 49, 70 days and after period of 6 and 12 months on an individual negative diet and a positive challenge (retrospectively) at 6 months. Data of each dog were recorded in a screening form and reported that a complete recovery of all clinical manifestations was observed at or less than 70 days (between 50 and 70 days) in the majority of dogs (44 out of 47 dogs =93.6%). Conclusion. Challenge results showed a significant result of 100% in specificity as well as 100% positive predicted value. On the other hand, sensitivity was 95,7% and negative predictive value was 95,7%. In conclusion, an individual diet based on IgG ELISA in dogs provides a significant improvement of atopic dermatitis and pruritus including all other non-specific defined allergic skin reactions as erythema, itching, biting and gnawing at toes, as well as to several secondary manifestations like chronic diarrhoea, chronic constipation, otitis media, obesity, laziness or inactive behaviour, pain and muscular stiffness causing a movement disorders, excessive lacrimation, hyper behaviour, nervous behaviour and not possible to stay alone at home, anxiety, biting and aggressive behaviour and disobedience behaviour. Furthermore, we conclude that a relatively more severe systemic candidiasis, as shown by relatively higher titer (class 3 and 4 IgG reactions to Candida albicans), influence the duration of recovery from clinical manifestations in affected dogs. These findings are consistent with our preliminary human clinical studies.

Keywords: Allergy, canine atopic dermatitis (CAD), food allergens, IgG-ELISA, food-incompatibility.

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5 Fetal and Infant Mortality in Botucatu City, São Paulo State, Brazil: Evaluation of Maternal - Infant Health Care

Authors: Noda L. M., Salvador I. C, C. M. L. G. Parada, Fonseca C. R. B.

Abstract:

In Brazil, neonatal mortality rate is considered incompatible with the country development conditions, and has been a Public Health concern. Reduction in infant mortality rates has also been part of the Millennium Development Goals, a commitment made by countries, members of the Organization of United Nations (OUN), including Brazil. Fetal mortality rate is considered a highly sensitive indicator of health care quality. Suitable actions, such as good quality and access to health services may contribute positively towards reduction in these fetal and neonatal rates. With appropriate antenatal follow-up and health care during gestation and delivery, some death causes could be reduced or even prevented by means of early diagnosis and intervention, as well as changes in risk factors and interventions. Objectives: To study the quality of maternal and infant health care based on fetal and neonatal mortality, as well as the possible actions to prevent those deaths in Botucatu (Brazil). Methods: Classification of prevention according to the International Classification of Diseases and the modified Wigglesworth´s classification. In order to evaluate adequacy, indicators of quality of antenatal and delivery care were established by the authors. Results: Considering fetal deaths, 56.7% of them occurred before delivery, which reveals possible shortcomings in antenatal care, and 38.2% of them were a result of intra- labor changes, which could be prevented or reduced by adequate obstetric management. These findings were different from those in the group of early neonatal deaths which were also studied. Adequacy of health services showed that antenatal and childbirth care was appropriate for 24% and 33.3% of pregnant women, respectively, which corroborates the results of prevention. These results revealed that shortcomings in obstetric and antenatal care could be the causes of deaths in the study. Early and late neonatal deaths have similar characteristics: 76% could be prevented or reduced mainly by adequate newborn care (52.9%) and adequate health care for gestational women (11.7%). When adequacy of care was evaluated, childbirth and newborn care was adequate in 25.8% and antenatal care was adequate in 16.1%. In conclusion, direct relationship was found between adequacy and quality of care rendered to pregnant women and newborns, and fetal and infant mortality. Moreover, our findings highlight that deaths could be prevented by an adequate obstetric and neonatal management.

Keywords: Fetal Mortality, Infant Mortality, Maternal-Child Health Services, Program Evaluation.

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4 Ongoing Gender-Based Challenges in Post-2015 Development Agenda: A Comparative Study between Qatar and Arab States

Authors: Abdel-Samad M. Ali, Ali A. Hadi Al-Shawi

Abstract:

Discrimination against women and girls impairs progress in all domains of development articulated either in the framework of Millennium Development Goals (MDGs) or in the Post-2015 Development Agenda. Paper aspires to create greater awareness among researchers and policy makers of the challenges posed by gender gaps and the opportunities created by reducing them within the Arab region. The study reveals how Arab countries are closing in on gender-oriented targets of the third and fifth MDGs. While some countries can claim remarkable achievements particularly in girls’ equality in education, there is still a long way to go to keep Arab’s commitments to current and future generations in other countries and subregions especially in the economic participation or in the political empowerment of women. No country has closed or even expected to close the economic participation gap or the political empowerment gap. This should provide the incentive to keep moving forward in the Post-2015 Agenda. Findings of the study prove that while Arab states have uneven achievements in reducing maternal mortality, Arab women remain at a disadvantage in the labour market. For Arab region especially LDCs, improving maternal health is part of the unmet agenda for the post-2015 period and still calls for intensified efforts and procedures. While antenatal care coverage is improving across the Arab region, progress is marginal in LDCs. To achieve proper realization of gender equality and empowerment of women in the Arab region in the post-2015 agenda, the study presents critical key challenges to be addressed. These challenges include: Negative cultural norms and stereotypes; violence against women and girls; early marriage and child labour; women’s limited control over their own bodies; limited ability of women to generate their own income and control assets and property; gender-based discrimination in law and in practice; women’s unequal participation in private and public decision making autonomy; and limitations in data. However, in all Arab states, gender equality must be integrated as a goal across all issues, particularly those that affect the future of a country.

Keywords: Gender, equity, millennium development goals, post-2015 development agenda.

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3 Socio-Economic Determinants of Physical Activity of Non-Manual Workers, Including the Early Senior Group, from the City of Wroclaw in Poland

Authors: Daniel Puciato, Piotr Oleśniewicz, Julita Markiewicz-Patkowska, Krzysztof Widawski, Michał Rozpara, Władysław Mynarski, Agnieszka Gawlik, Małgorzata Dębska, Soňa Jandová

Abstract:

Physical activity as a part of people’s everyday life reduces the risk of many diseases, including those induced by lifestyle, e.g. obesity, type 2 diabetes, osteoporosis, coronary heart disease, degenerative arthritis, and certain types of cancer. That refers particularly to professionally active people, including the early senior group working on non-manual positions. The aim of the study is to evaluate the relationship between physical activity and the socio-economic status of non-manual workers from Wroclaw—one of the biggest cities in Poland, a model setting for such investigations in this part of Europe. The crucial problem in the research is to find out the percentage of respondents who meet the health-related recommendations of the World Health Organization (WHO) concerning the volume, frequency, and intensity of physical activity, as well as to establish if the most important socio-economic factors, such as gender, age, education, marital status, per capita income, savings and debt, determine the compliance with the WHO physical activity recommendations. During the research, conducted in 2013, 1,170 people (611 women and 559 men) aged 21–60 years were examined. A diagnostic poll method was applied to collect the data. Physical activity was measured with the use of the short form of the International Physical Activity Questionnaire with extended socio-demographic questions, i.e. concerning gender, age, education, marital status, income, savings or debts. To evaluate the relationship between physical activity and selected socio-economic factors, logistic regression was used (odds ratio statistics). Statistical inference was conducted on the adopted ex ante probability level of p<0.05. The majority of respondents met the volume of physical effort recommended for health benefits. It was particularly noticeable in the case of the examined men. The probability of compliance with the WHO physical activity recommendations was highest for workers aged 21–30 years with secondary or higher education who were single, received highest incomes and had savings. The results indicate the relations between physical activity and socio-economic status in the examined women and men. People with lower socio-economic status (e.g. manual workers) are physically active primarily at work, whereas those better educated and wealthier implement physical effort primarily in their leisure time. Among the investigated subjects, the youngest group of non-manual workers have the best chances to meet the WHO standards of physical activity. The study also confirms that secondary education has a positive effect on the public awareness on the role of physical activity in human life. In general, the analysis of the research indicates that there is a relationship between physical activity and some socio-economic factors of the respondents, such as gender, age, education, marital status, income per capita, and the possession of savings. Although the obtained results cannot be applied for the general population, they show some important trends that will be verified in subsequent studies conducted by the authors of the paper.

Keywords: International physical activity questionnaire, non-manual workers, physical activity, socio-economic factors, WHO.

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2 A Quasi-Systematic Review on Effectiveness of Social and Cultural Sustainability Practices in Built Environment

Authors: Asif Ali, Daud Salim Faruquie

Abstract:

With the advancement of knowledge about the utility and impact of sustainability, its feasibility has been explored into different walks of life. Scientists, however; have established their knowledge in four areas viz environmental, economic, social and cultural, popularly termed as four pillars of sustainability. Aspects of environmental and economic sustainability have been rigorously researched and practiced and huge volume of strong evidence of effectiveness has been founded for these two sub-areas. For the social and cultural aspects of sustainability, dependable evidence of effectiveness is still to be instituted as the researchers and practitioners are developing and experimenting methods across the globe. Therefore, the present research aimed to identify globally used practices of social and cultural sustainability and through evidence synthesis assess their outcomes to determine the effectiveness of those practices. A PICO format steered the methodology which included all populations, popular sustainability practices including walkability/cycle tracks, social/recreational spaces, privacy, health & human services and barrier free built environment, comparators included ‘Before’ and ‘After’, ‘With’ and ‘Without’, ‘More’ and ‘Less’ and outcomes included Social well-being, cultural coexistence, quality of life, ethics and morality, social capital, sense of place, education, health, recreation and leisure, and holistic development. Search of literature included major electronic databases, search websites, organizational resources, directory of open access journals and subscribed journals. Grey literature, however, was not included. Inclusion criteria filtered studies on the basis of research designs such as total randomization, quasirandomization, cluster randomization, observational or single studies and certain types of analysis. Studies with combined outcomes were considered but studies focusing only on environmental and/or economic outcomes were rejected. Data extraction, critical appraisal and evidence synthesis was carried out using customized tabulation, reference manager and CASP tool. Partial meta-analysis was carried out and calculation of pooled effects and forest plotting were done. As many as 13 studies finally included for final synthesis explained the impact of targeted practices on health, behavioural and social dimensions. Objectivity in the measurement of health outcomes facilitated quantitative synthesis of studies which highlighted the impact of sustainability methods on physical activity, Body Mass Index, perinatal outcomes and child health. Studies synthesized qualitatively (and also quantitatively) showed outcomes such as routines, family relations, citizenship, trust in relationships, social inclusion, neighbourhood social capital, wellbeing, habitability and family’s social processes. The synthesized evidence indicates slight effectiveness and efficacy of social and cultural sustainability on the targeted outcomes. Further synthesis revealed that such results of this study are due weak research designs and disintegrated implementations. If architects and other practitioners deliver their interventions in collaboration with research bodies and policy makers, a stronger evidence-base in this area could be generated.

Keywords: Built environment, cultural sustainability, social sustainability, sustainable architecture.

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1 Sickle Cell Disease: Review of Managements in Pregnancy and the Outcome in Ampang Hospital, Selangor

Authors: Z. Nurzaireena, K. Azalea, T. Azirawaty, S. Jameela, G. Muralitharan

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The aim of this study is the review of the management practices of sickle cell disease patients during pregnancy, as well as the maternal and neonatal outcome at Ampang Hospital, Selangor. The study consisted of a review of pregnant patients with sickle cell disease under follow up at the Hematology Clinic, Ampang Hospital over the last seven years to assess their management and maternal-fetal outcome. The results of the review show that Ampang Hospital is considered the public hematology centre for sickle cell disease and had successfully managed three pregnancies throughout the last seven years. Patients’ presentations, managements and maternal-fetal outcome were compared and reviewed for academic improvements. All three patients were seen very early in their pregnancy and had been given a regime of folic acid, antibiotics and thrombo-prophylactic drugs. Close monitoring of maternal and fetal well being was done by the hematologists and obstetricians. Among the patients, there were multiple admissions during the pregnancy for either a painful sickle cell bone crisis, haemolysis following an infection and anemia requiring phenotype- matched blood and exchange transfusions. Broad spectrum antibiotics coverage during and infection, hydration, pain management and venous-thrombolism prophylaxis were mandatory. The pregnancies managed to reach near term in the third trimester but all required emergency caesarean section for obstetric indications. All pregnancies resulted in live births with good fetal outcome. During post partum all were nursed closely in the high dependency units for further complications and were discharged well. Post partum follow up and contraception counseling was comprehensively given for future pregnancies. Sickle cell disease is uncommonly seen in the East, especially in the South East Asian region, yet more cases are seen in the current decade due to improved medical expertise and advance medical laboratory technologies. Pregnancy itself is a risk factor for sickle cell patients as increased thrombosis event and risk of infections can lead to multiple crisis, haemolysis, anemia and vaso-occlusive complications including eclampsia, cerebrovasular accidents and acute bone pain. Patients mostly require multiple blood product transfusions thus phenotype-matched blood is required to reduce the risk of alloimmunozation. Emphasizing the risks and complications in preconception counseling and establishing an ultimate pregnancy plan would probably reduce the risk of morbidity and mortality to the mother and unborn child. Early management for risk of infection, thromboembolic events and adequate hydration is mandatory. A holistic approach involving multidisciplinary team care between the hematologist, obstetricians, anesthetist, neonatologist and close nursing care for both mother and baby would ensure the best outcome. In conclusion, sickle cell disease by itself is a high risk medical condition and pregnancy would further amplify the risk. Thus, close monitoring with combine multidisciplinary care, counseling and educating the patients are crucial in achieving the safe outcome.

Keywords: Anemia, haemoglobinopathies, pregnancy, sickle cell disease.

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