Specific Intervention Programs Research Articles

The Burden and Psychological Distress of Family Caregivers of Individuals with Autism Spectrum Disorder: A Gender Approach

Background/Objectives: Relatives play the main role as caregivers of autism spectrum disorder (ASD) individuals. Women, specifically mothers, are the majority of caregivers of ASD relatives. In addition, the literature on caregivers has shown that women have worse mental health and higher perceived burdens than men. Therefore, the aim of this work was to evaluate the relationships between psychological distress and burden using a gender approach in caregivers of ASD relatives. Methods: A cross-sectional design was applied in this study with a convenience sample of 250 caregivers of ASD relatives. Most of them were mothers caring for a child who ranged in age from 1 to 31 years. Sociodemographic variables considered were age, education level, marital status, and relation to the care recipient. Additionally, psychological distress and objective burden, in the form of hours/day caring, and subjective burden, in the form of perceived burden, were analyzed. Results: Significant gender differences were found in psychological distress and objective and subjective burden, with women showing higher scores than men. Both types of burden played a serial mediating role between gender and psychological distress. Conclusions: The results highlight the important role of gender, with women bearing the high cost of caring for their children with ASD in the form of high objective burden, caring for more hours, and subjective burden, perceiving more burden and showing poorer mental health than men. These results show the need for specific support and intervention programs targeted to women caregivers to reduce burden and improve their mental health.

Relationship History of Parenting and Antenatal Care Visits with Stunting Events in Children Aged 24-36 Months in West Aceh Regency

Stunting is the inability of children under five to grow normally due to the effects of chronic lack of nutrition so that their height is very short for their age. Data from SSGI in 2022, Aceh Province has a prevalence rate of stunting among children under five which is ranked fifth with a percentage of 31.2 percent. According to SSGI data for 2021, stunting in West Aceh Regency was 27.4 percent and increased to 30.4 percent in 2022 with a very high category. The aim of this research is to analyze the relationship between parenting styles and the incidence of stunting in children 24-36 months in West Aceh Regency. This type of research is quantitative research with a case control design. The sample size was 100 toddlers, 50 toddlers were selected for the case group and 100 toddlers for the control group. The results of the study showed that the variables that were related were parenting patterns for breastfeeding and food (p=0.016), personal hygiene parenting patterns (p=0.028) and history of antenatal care visits (p=0.007) with the incidence of stunting. Suggestions for this research to the government are expected to be able to synergize better in creating programs to overcome stunting and poverty and improve the performance of services and implementation of specific nutritional intervention programs for pregnant women. One of them is an examination program during pregnancy both in terms of quantity of visits and also inspections carried out during ANC activities.

Weight gained during treatment predicts 6-month body mass index in a large sample of patients with anorexia nervosa using ensemble machine learning.

This study used machine learning methods to analyze data on treatment outcomes from individuals with anorexia nervosa admitted to a specialized eating disorders treatment program. Of 368 individuals with anorexia nervosa (209 adolescents and 159 adults), 160 individuals had data available for a 6-month follow-up analysis. Participants were treated in a 6-day-per-week partial-hospital program. Participants were assessed for eating disorder-specific and non-specific psychopathology. The analyses used established machine learning procedures combined in an ensemble model from support vector machine learning, random forest prediction, and the elastic net regularized regression with an exploration (training; 75%) and confirmation (test; 25%) split of the data. The models predicting body mass index (BMI) at 6-month follow-up explained a 28.6% variance in the training set (n = 120). The model had good performance in predicting 6-month BMI in the test dataset (n = 40), with predicted BMI significantly correlating with actual BMI (r = .51, p = 0.01). The change in BMI from admission to discharge was the most important predictor, strongly correlating with reported BMI at 6-month follow-up (r = .55). Behavioral variables were much less predictive of BMI outcome. Results were similar for z-transformed BMI in the adolescent-only group. Length of stay was most predictive of weight gain in treatment (r = .56) but did not predict longer-term BMI. This study, using an agnostic ensemble machine learning approach in the largest to-date sample of individuals with anorexia nervosa, suggests that achieving weight gain goals in treatment predicts longer-term weight-related outcomes. Other potential predictors, personality, mood, or eating disorder-specific symptoms were relatively much less predictive. The results from this study indicate that the amount of weight gained during treatment predicts BMI 6 months after discharge from a high level of care. This suggests that patients require sufficient time in a higher level of care treatment to meet their specific weight goals and be able to maintain normal weight.

Applicability of the Cumberland Ankle Instability Tool in Elite Volleyball Athletes: A Cross-Sectional Observational Study.

The ease of administration of the Cumberland Ankle Instability Tool (CAIT) could represent a methodology for periodically evaluating athletes, preventing ankle instability injuries. This study aimed to achieve three objectives: (a) to evaluate the applicability of the CAIT scale in volleyball; (b) to explore whether ankle instability presents a greater risk in lower-level volleyball categories and whether elite athletes demonstrate an ability to mitigate this risk; and (c) to identify potential predictors of ankle instability. Eighty female volleyball players participated in this cross-sectional observational study. The CAIT was administered to evaluate the athletes belonging to some teams in Series A, B, and C. The Spearman's ranks correlation coefficient showed significant correlations between CAIT items. Additionally, the Cronbach's α showed a high internal consistency. Our results showed a significant difference between athletes who reported pain and those who did not (p < 0.001). The multiple linear regression model analysis showed that pain was a predictor of ankle instability (p < 0.001). Our findings suggest that the CAIT can be used to evaluate ankle stability in volleyball players. This scale could represent a valuable tool for implementing specific intervention programs to prevent ankle injuries in athletes.

Associations between internet addiction and school engagement among Turkish college students: mediating role of psychological distress.

Internet addiction has become a subject of growing concern with adverse consequences. This study aimed to investigate the mediating effect of psychological distress in the relationship between internet addiction and school engagement. Data were obtained from 732 Turkish college students (M = 20.98, SD = 2.58). The data were collected through Young's Internet Addiction Test, Depression, Stress and Anxiety Scale (DASS21)-Short Form, and University Student Engagement Inventory. Mediation analysis was performed to investigate the mediating effects of depression, anxiety, and stress in the association between internet addiction and school engagement. The results of the study showed that internet addiction was positively associated with psychological distress and negatively associated with school engagement, whereas psychological distress had a negative relationship with school engagement. This study also found that depression, anxiety, and stress acted as mediators in the relationship between internet addiction and behavioral engagement, emotional engagement, and cognitive engagement. This study has provided evidence that young adults with tendency of internet addiction may experience school engagement problems as well as psychological problems. Our findings underscore the need for special educational intervention programs aimed at encouraging college youth to limit their internet use for their future due to its negative consequences and raising awareness in this vulnerable group and their families.

Is functional mobility associated with quality of sitting in cerebral palsy? A cross-sectional study.

A group of neuromuscular system anomalies associated with non-progressive issues in the developing fetal or newborn brain are known as cerebral palsy (CP). These abnormalities are typified by poor posture and motor development, which limits the execution of functional activities. Consequently, to achieve the same goals as peers who are typically developing, children with CP employ a variety of compensatory postures and techniques. Given that both sitting and mobility are essential for functioning, assessing each skill alone and in relation to the other is necessary. This study aims to determine if a child's functional mobility affects their sitting ability. Twenty CP (Gross Motor Function Classification System [GMFCS] levels I and II) children, aged 6-12, were enrolled in the research. The level of sitting scale (LSS) and the modified timed up and go (mTUG) test were utilized to evaluate sitting and functional mobility, respectively. The quality of sitting was shown to have a substantial effect on functional mobility, as a significant difference in mTUG durations was established between LSS levels (P < 0.001) and persisted when analyzed within the same GMFCS level (P = 0.007). The importance of trunk control in functional mobility can be inferred from the link between sitting quality and mobility. To improve children with CP's functional mobility, this evidence may be utilized to design a well-informed and specific intervention program incorporating trunk control.

Management of pediatric obesity as a pathway towards kidney transplantation.

Obesity is an increasing problem in pediatrics, leading to cardiovascular, metabolic and psychosocial complications. Additionally, for patients with chronic kidney disease (CKD), obesity can lead to CKD progression towards end-stage renal disease (ESRD) needing renal-replacement therapy (RRT). It is well-established that the optimal type of RRT for children with ESRD is kidney transplantation, as it provides significantly better life expectancy and quality of life. Unfortunately, pediatric patients with CKD/ESRD and obesity face barriers getting to kidney transplantation and often remain on dialysis for a long time, which negatively impacts their life expectancy and quality of life. One barrier to kidney transplant is that Body Mass Index (BMI) is still considered by most transplant centers as the main criterion for obesity assessment, although more recent evidence suggests that BMI is not the best measure of adiposity. Clearcut evidence is lacking that obesity has a long-term negative impact upon the graft. Another barrier to transplant can be bias on the part of referring providers that can deter or delay referral to an obesity treatment program. Our article describes the barriers that pediatric obese patients with CKD and ESRD face in their way towards kidney transplantation. In addition, our article encourages pediatric nephrologists to early refer their patients with CKD and ESRD who suffer from obesity to a specialized obesity treatment program and/or bariatric surgery. Our article also describes the treatment options for pediatric patients with CKD and ESRD who suffer from obesity in order to make them eligible for a kidney transplant.

Parenting stress in parents with and without a mental illness and its relationship to psychopathology in children: a multimodal examination.

Children of parents with a mental illness are at heightened risk to develop a mental illness themselves due to genetics and environmental factors. Although parenting stress (PS) is known to be associated with increased psychopathology in parents and children, there is no study investigating PS multimodally in a sample of parents with a mental illness. This study aims to compare PS of parents with and without a mental illness and further to examine the relationship between PS and psychopathology of children. Participants were parents with a mental illness and parents without a mental illness and their children aged four to sixteen years. We assessed PS multimodally using a questionnaire, parents' evaluation of children's behavior (relational schemas) and psychophysiological arousal of parents during free speech task. Self-reported PS was increased, and evaluation of children's behavior was more negative and less positive in parents with a mental illness compared to parents without a mental illness. Children's psychopathology was associated with self-reported PS and relational schemas of parents. Regarding psychophysiological arousal, parents with a mental illness showed reduced reactivity in heart rate from baseline to free speech task in comparison to parents without a mental illness. Our findings highlight the importance of implementing intervention programs to reduce PS for parents and children. In particular, parents with a mental illness might benefit from specific intervention programs in order to interrupt the transgenerational transmission of mental disorders.

Intervention Needs in Prison With Pedophile Inmates

There are specific treatment programs in prisons for those convicted of sexually assaulting minors; however, those who also have pedophilia require specific attention. The aim of this study is twofold: first, to offer a specific intervention proposal for pedophilia in the prison setting based on the available scientific evidence, and complementary to the Sexual Assault Control Program, and second, to justify this proposal through the case of an inmate with pedophilia. Specifically, we propose an individual intervention focused on people with pedophilia; working on low self-esteem, assessing suicidal ideation, and restructuring cognitive distortions with minors, facilitating the creation of functional personal relationships with adults, assessing past polyvictimization and its possible influence on subsequent sexual behavior, providing inmates with psychoeducation on pedophilia; specifically addressing sexual fantasies with minors, avoiding dissexual behavior, and eliminating the consumption of abusive material.

Genetic Epidemiology of Primary Congenital Glaucoma in the World. Part I

To understand the current situation with the genetic epidemiology of primary congenital glaucoma (PCG) in the world, as well as to identify genotype-phenotype correlations, 87 publications were analyzed from the Pubmed and elibrary databases, mainly the latest 5 years. This publication presents the first part of the analysis, covering Arab and African countries, Turkey, the USA, Brazil, Australia and New Zealand. The second part of the review, which will be published in early 2024, will focus on data from East and South Asia, Western Europe and Russia. The highest incidence of PCG is typical for Arab countries, which is associated with the presence of a significant number of consanguineous marriages in these countries. In most countries, boys predominated among patients with PCG, and the process was often bilateral. In Australia female patients predominate. The PCG phenotype is more severe in patients with CYP1B1 mutations (early onset, bilateral involvement) than in patients without mutations, and in patients with consanguineous parents than in children from unrelated marriages. Among the genetic causes of PCG in different populations, the most common (from 30 to 86 % of cases) in Arab countries, Brazil and Turkey are mutations in the CYP1B1 gene. The spectrum of mutations varies depending on the region. In Australia and New Zealand, biallelic mutations were identified in the CYP1B1, CPAMD8 and COL18A1 genes, as well as heterozygous mutations in the TEK, FOXC1 and ANGPT1. Mutations in rare genes were also found in patients with PCG from Lebanon (ANGPT1 (p.K186N), Mauritania (NTF4 (c.601T&gt;G, p.Cys201Gly) and WDR36 (c.2078A&gt;G, p.Asn693Ser)). In the USA, the influence of the thrombospondin gene (THBS1) on the development of PCG is being studied. Based on the results of genetic and epidemiological studies, specific treatment, rehabilitation and preventive programs can be developed, which will determine the success of PCG therapy in children, preserving their visual functions.

Cognitive functioning and life satisfaction as predictors of subjective health complaints in elderly people

Purpose Effective cognitive functioning elucidates the orchestrated interplay of diverse mental faculties in addressing daily tasks, potentially indicative of an improved state of an individual’s health. Linked to this is the potential role of life satisfaction, which may aid individuals in better managing their health-related challenges. The purpose this study is to examine whether the cognitive functioning and life satisfaction levels of elderly individuals serve as predictors of their subjective health complaints. Design/methodology/approach The research involved a cohort of 126 elderly community residents. The assessment tools used encompassed a socio-demographic questionnaire, the mini-mental state examination (MMSE), the scale of subjective health complaints and a life satisfaction scale. Findings The findings reveal that both cognitive functioning and life satisfaction are predictive variables for subjective health complaints, validated in both the original sample and simulated samples. Originality/value This study’s innovation lies in highlighting the importance of cognitive functioning and life satisfaction among the elderly population as explanatory factors for subjective health complaints. Consequently, these dimensions warrant consideration in specialized intervention programs aimed at promoting the health and quality of life among the elderly.

Early predictors in language-based learning disabilities: a bibliometric analysis.

Language-based learning disabilities (LBLD) refers to a spectrum of neurodevelopmental-associated disorders that are characterized by cognitive and behavioral differences in comprehending, processing and utilizing spoken and/or written language. The focus of this work was on identifying early predictors of three main specific LBLD including dyslexia, dyscalculia, and dysgraphia. The Web of Science (WoS) was searched for literature related to (neurocognitive, neurophysiological, and neuroimaging) measurements used to identify early predictors of LBLD from 1991 to 25 October 2021. A retrospective bibliometric analysis was performed to analyze collaboration among countries, institutions, authors, publishing journals, reference co-citation patterns, keyword co-occurrence, keyword clustering, and burst keywords using Biblioanalytics software. In total, 921 publications related to the identification of LBLD using (neurocognitive, neurophysiological, and neuroimaging) modalities were included. The data analysis shows a slow growth in research on the topic in the 90s and early 2000 and growing trend in recent years. The most prolific and cited journal is Neuroimage, followed by Neuropsychologia. The United States and Finland's Universities Jyvaskyla and Helsinki are the leading country and institution in this field, respectively. "Neuroimaging," "brain," "fMRI," "cognitive predictor," "comorbidity," "cortical thickness" were identified as hotspots and trends of (neurocognitive, neurophysiological, and neuroimaging) modalities in the identification of LBLD. Early predictors of LBLDs would be useful as targets for specific prevention and intervention programs to be implemented at very young ages, which could have a significant clinical impact. A novel finding of neuroimaging predictors combined with neurocognitive and neuropsychological batteries may have implications for future research.

El efecto de una intervención educativa de fisioterapia en la actividad física de adolescentes y adultos jóvenes con lupus eritematoso sistémico

IntroductionPatients with systemic lupus erythematosus (SLE) face barriers that limit their physical activity (PA) and can affect their physical and mental health. This study investigated the impact of a telematic educational intervention on PA and related factors, among adolescents and young people with SLE. MethodA pretest–posttest design was used in a group with 12 participants. Multiple aspects were evaluated, such as the frequency, intensity and duration of PA, intention to perform PA, quality of life and health beliefs. ResultsTwelve female adolescents between 13 and 20 years old (x̅=17.08) participated in the study. Twelve concurrent conditions were identified, including anxiety (19.44%), arthritis (13.89%), and hypertension (13.89%). There was a significant increase in quality of life assessed by the Peds-QL-RM from baseline to the fourth week of follow-up, with an increase in median of 45.39 (p=0.008). No significant changes were identified in the level of PA (PAQ-A and PAQ-C) or in the intention to perform PA. The most frequently reported physical activities after four weeks post-intervention were walking (42.36%), aerobics routine (19.21%) and exercise routine (16.75%). ConclusionThe multi-component educational intervention, with an informational and socio-behavioral approach, implemented in a community setting improved the quality of life in adolescents and young people with SLE. These findings support the importance of addressing the lack of PA in this population and underscore the need to develop specific intervention programs to improve the health and well-being of patients with SLE.

IMPLEMENTASI PROGRAM INTERVENSI GIZI SPESIFIK PADA REMAJA PUTRI DAN BALITA DI PUSKESMAS PATEAN KABUPATEN KENDAL

The scope of implementing specific nutrition intervention programs at the Patean Health Center for young women and toddlers in 2021 and 2022 was still not in line with the national target. This study aimed to analyze the implementation of a specific nutrition intervention program for girls and toddlers at the Patean Health Center. This research was a qualitative research with a descriptive approach through in-depth interviews conducted from January to July 2023. The data processing method used content analysis.The results showed that the implementation of the specific nutrition intervention program for young women and toddlers are not optimal. Obstacles in the activities of young women are caused by unclear communication, limited and inadequate support facilities and fragmentation that is not in accordance with policy. Obstacles in toddler activities are caused by limited quality of posyandu cadres, limited budget and inadequate supporting facilities. It can be concluded that the implementation of specific nutrition intervention programs for girls and toddlers at the Patean Public Health Center is not optimal because it is influenced by communication factors, resources, attitudes and bureaucratic structures

Influence of different caregiving styles on fundamental movement skills among children.

This study investigated the influence of parenting and grandparenting caregiving styles on fundamental motor skills (FMS) of preschool children. A total of 1,326 preschool children (698 boys, 628 girls) aged 4-6 years were recruited from the kindergartens of Jinhua City, China. Locomotor skills (LM), ball skills (BS), and total fundamental movement skills (TS) of children were assessed by the Test of Gross Motor Development-3rd edition (TGMD-3). There were 978 children in parenting and 348 children in grandparenting caregiving styles. The LM, BS and TS scores of children were considerably (p < 0.001) increased with age (irrespective of sex or caregiving style). For the sex comparisons, BS scores of boys were significantly higher than girls (p < 0.001), while LM and TS scores were not different between boys and girls. For the caregiving style comparison, parenting is superior to grandparenting in developing of children's FMS. Parenting boys of 4-, 5-, and 6-years old showed better BS compared to age-matched parenting girls, whereas boys of 5-years old in grandparenting only showed better BS compared to same-age grandparenting girls (p < 0.05). Furthermore, parenting boys of 6-years reported higher LM (p < 0.01), BS (p < 0.001), and TS (p < 0.001) scores compared to grandparenting boys, but girls' FMS at all ages were not significantly different between the caregiving styles. Parenting caregiving style is positively associated with proper development of FMS among children. Girl children with poor FMS in grandparenting may need a special care or intervention programs to promote their FMS.

Association between the introduction of a national targeted intervention program and the incidence of surgical site infections in Swiss acute care hospitals

BackgroundIn Switzerland, the national surgical site infection (SSI) surveillance program showed a modest decrease in SSI rates for different procedures over the last decade. The study aimed to determine whether a multimodal, targeted intervention program in addition to existing SSI surveillance is associated with decreased SSI rates in the participating hospitals.MethodsProspective multicenter pre- and postintervention study conducted in eight Swiss acute care hospitals between 2013 and 2020. All consecutive patients > 18 years undergoing cardiac, colon, or hip/knee replacement surgery were included. The follow-up period was 30 days and one year for implant-related surgery. Patients with at least one follow-up were included. The intervention was to optimize three elements of preoperative management: (i) hair removal; (ii) skin disinfection; and (iii) perioperative antimicrobial prophylaxis. We compared SSI incidence rates (main outcome measure) pre- and postintervention (three years each) adjusted for potential confounders. Poisson generalized linear mixed models fitted to quarter-yearly confirmed SSIs and adjusted for baseline differences between hospitals and procedures. Adherence was routinely monitored through on-site visits.ResultsA total of 10 151 patients were included, with a similar median age pre- and postintervention (69.6 and IQR 60.9, 76.8 years, vs 69.5 and IQR 60.4, 76.8 years, respectively; P = 0.55) and similar proportions of females (44.8% vs. 46.1%, respectively; P = 0.227). Preintervention, 309 SSIs occurred in 5 489 patients (5.6%), compared to 226 infections in 4 662 cases (4.8%, P = 0.09) postintervention. The adjusted incidence rate ratio (aIRR) for overall SSI after intervention implementation was 0.81 (95% CI, 0.68 to 0.96, P = 0.02). For cardiac surgery (n = 2 927), the aIRR of SSI was 0.48 (95% CI, 0.32 to 0.72, P < 0.001). For hip/knee replacement surgery (n = 4 522), the aIRR was 0.88 (95% CI, 0.52 to 1.48, P = 0.63), and for colon surgery (n = 2 702), the aIRR was 0.92 (95% CI, 0.75 to 1.14, P = 0.49).ConclusionsThe SSI intervention bundle was associated with a statistically significant decrease in SSI cases. A significant association was observed for cardiac surgery. Adding a specific intervention program can add value compared to routine surveillance only. Further prevention modules might be necessary for colon and orthopedic surgery.

Predicting the Risk of Re-Offending in Child-to-Parent Violence Using the Structured Assessment of Violence Risk in Youth.

Child-to-parent violence occurs when children engage in violent behaviour towards family members; the principal victim is often the mother. The risk assessment instruments used to identify the risk and protective factors in youth offenders who perpetrate child-to-parent violence are not specific to this type of offense. This study aims to describe the child-to-parent violence group in relation to the risk and protective factors they present in comparison with the group of young people who committed an assault offence. The sample for this study consists of two groups of youth offenders. The first group committed child-to-parent violence, and the second group has committed a violent crime against individuals to whom they are not related. Young people who commit child-to-parent violence have higher scores on the SAVRY risk factors and lower scores on the SAVRY protective factor than young people who have committed an assault offence. The results reveal the importance of identifying the risk and protective factors presented by youth offenders who commit child-to-parent violence in order to create specific intervention programs for the needs and strengths presented by this group of young people.

Functional Connectivity Between Default Mode and Ventral Attention Networks Mediates the Effects of Chronotype on Daily Physical Activity

Daily physical activity (dPA) is closely related to circadian rhythm and chronotype. The functional connectivity (FC) within or between the default mode (DMN) and ventral attention network (vAN) were associated with dPA and chronotype. DMN-vAN FC was investigated for its role in chronotype and dPA. 153 participants completed the reduced version of the Morningness-Eveningness Questionnaire (rMEQ), dPA was measured via actigraphy (5-day), and then resting-state fMRI scans were performed. rMEQ scores and steps recorded by the actigraphic devices (with each hour as the time window to calculate steps for five consecutive days per hour, subsequently yielding the maximum number of steps and its corresponding time, ie, SM and SMT) represent chronotype and dPA respectively. The results found that the rMEQ scores were significantly negatively correlated with SMT. The positive correlation between the rMEQ scores and the DMN-vAN FC was significant. There were also significant positive correlations between SMT and DMN-vAN FC. Further analysis revealed that DMN-vAN mediates the relationship between chronotype and SMT. The FC of DMN-vAN may be the underlying neural mechanism through which chronotype influences dPA. These findings could support the development of reasonable activity schedules or specific intervention programs to improve physical health.

Path analysis model for preventing stunting in dryland area island East Nusa Tenggara Province, Indonesia.

The problem of stunting is still a fundamental problem in Indonesia's human development. East Nusa Tenggara Province is an archipelago dryland area where in 2007-2021 it has contributed to the highest number of stunting children prevalence in Indonesia. This study aims to determine the relationship of variables in individual, household and district level with the prevalence of stunting. This type of research is observational study with a cross sectional design. This study used individual secondary data from the Indonesian Nutritional Status Survey in 2021 consisting of 7,835 toddlers and National Social Economics Survey 2021. This research found that both specific & sensitive intervention programs had an influence in accelerating the decline in stunting prevalence (higher score on Z Score). Results also revealed the positive influence of the food access variable on nutritional intake. The results of the path analysis test showed that sensitive intervention program variables have a positive effect on food access variable and environmental variable (environmental sanitation) such as the habit of open defecation and healthcare. There was significant relationship on disease history, environment and intake to Height for Age (HAZ) score. In conclusion, direct and indirect factors have important roles to prevent stunting. Sensitive and specific intervention program, food access, macro determinants and environment are the indirect indicators which contribute significantly to the stunting. The risk of children under five years old experiencing malnourished nutritional status increases with a history of infectious disease (diarrhea, ARI, worms). The risk of children under five years experiencing malnourished nutritional status decreases with adequate nutritional intake. It is hoped that there will be a special model of stunting control interventions at the individual level and at the family, household and district level that are integrated and of high quality through multisectoral cooperation in the dryland areas of the islands of East Nusa Tenggara Province.

간호대학생의 전공만족도와 대학생활 적응의 관계에서 사회적 지지의 매개효과

The study was conducted to identify the effect of social support in the relations between major satisfaction and college adjustment among nursing students.&#x0D; The subjects of this study were 100 sophomore nursing students from two universities located in D and G cities. The data collection period is from March 10, 2022 to March 30, 2022, and was conducted through a self-administered questionnaire.&#x0D; The research model was designed on the basis of PROCESS Macro Model 4 proposed by Hayes (2013). The collected data was analyzed using SPSS 24.0, PROCESS Macro ver. 3.5 program.&#x0D; The mean score for major satisfaction, college adjustment and social support perceived by nursing students were 3.98, 3.45, and 4.00 points out of 5, respectively. Major satisfaction, college adjustment and social support had strong correlations with each other (p&lt;.001). The difference in adaptation to college life is when the major is chosen by oneself (t=3.41, p=.001), when the motive for selecting a major matches one's aptitude (F=5.73, p=.004), and when satisfaction with college life (F=14.01, p&lt;.001) was significantly high. To confirm the effects on social support, the covariate was adjusted for major selector, aptitude in major selection motive, and college life satisfaction. Major satisfaction had a direct effect on college adjustment (β = .574) and social support (β = .625). Social support had a direct effect on college adjustment (β = .241). There was a mediation effect of social support between major satisfaction and college adjustment (β = .619).&#x0D; Based on the results of this study, it was confirmed that nursing students' major satisfaction affects their adaptation to college life using social support as a mediating variable. Therefore, by identifying the sub-factors of social support that can increase the satisfaction of nursing students who will become future nurses, we propose the development of specific emotional, evaluative, informational, and physical intervention programs in nursing education and research to verify their effectiveness.