Journal of Health and Social Sciences 2019, 4(1) Click Free Full Open Access

15 March 2019

Table of Contents

JHSS 2019,4(1):9-12

Editorial in Academic Publishing

Journal of Health and Social Sciences: A reputable, DOAJ-indexed, free, open access journal

Author: Francesco Chirico1

MD, Health Service Department, State Police, Ministry of Interior, Italy. Prof, Department of Women/Child and Public Health Sciences, Università Cattolica del Sacro Cuore, Rome, Italy.

Keywords: Academic publishing; DOAJ; editorial policies; index; medicine; psychology; open access publishing; peer review, research; public health; social development.

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JHSS 2019,4(1):13-16

Editorial in Health Psychology

It is time to tackle psychological determinants of obesity and eating disorders 

Author: Pietro Crescenzo1

 PsyD, PhD, University of Salerno, Department of Human, Philosophical and Educational Science, University of Salerno, Italy.

Keywords: Eating disorders; health psychology; mental health; multidisciplinary approach; obesity.

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JHSS 2019,4(1):17-42

Systematic Review in Cardiology

A systematic review of Randomized Controlled Trials about some non-pharmacological interventions for treatment of hypertension: Physical exercise, sodium restriction, weight and alcohol use reduction

Authors: Amobi Akonobi1, Jawad Khan2


1 Specialist Registrar Cardiology, MBBS, Msc, MRCP, Department of Cardiology, City Hospital Birmingham, Birmingham,United Kingdom.
2 Consultant Interventional Cardiologist and Honorary Senior Lecturer, BMedSci, MBBS, PGDipMEd, MMEd, FHEA, FAcMEd, FRCP, City Hospital Birmingham, Birmingham,United Kingdom.


Introduction: Aim of this study was to systematically review available evidence to analyse how effective are some non-pharmacological interventions such as physical exercise, sodium restriction, weight reduction and alcohol reduction in the management of hypertension and to study which of them produce the greatest reduction in blood pressure.
Method: A systematic literature search was carried out on Pubmed, Medline, EBSCO and EMBASE, by using several key terms and following the PRISMA statement. Original papers and randomized clinical trials, published in English between 1988 and 2010 and regarding hypertensive individuals as participants were included. The narrative synthesis system of analysis was used and the Revman 5.0 software was used to carry out heterogeneity analysis.
Results: A total of 51 RCT on salt restriction (n = 11, 22%), weight loss (n = 6, 12%), alcohol reduction
(n = 7, 14%), physical exercise (n = 15, 29%), or a combination of these intervention modalities (n = 12, 23%) were included in our review. 94% of them reported a significant improvement on blood pressure following these interventions, whereas 6% of them reported a statistically non-significant improvement. None of the papers reported a post-intervention deterioration. Salt restriction was found to give the greatest reduction in blood pressure. However, significant heterogeneity exists among the results of the papers reviewed in our study.
Discussion and Conclusions: Our findings confirm that physical exercise, sodium restriction, weight and alcohol use reduction are four non-pharmacological interventions effective in the control of hypertension. As they involve lifestyle modification, policy interventions for primary prevention are recommended in this area. 

Keywords: Alcohol drinking; body weight; exercise; hypertension; systematic review; treatment.

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JHSS 2019,4(1):43-58

Original Article in Behavioral Psychology

Emotion dysregulation and loneliness as predictors of food addiction

Authors: Eirini Tatsi1, Atiya Kamal2, Alistar Turvill3, Regina Holler4

Academic Lead, Office of The Vice-Chancellor, Strategic Planning Department, University of West London, London, UK.
Lecturer in Health Psychology, School of Social Sciences, Birmingham City University, Birmingham, UK.
Lecturer in Early Childhood Health, College of Arts, Humanities and Education, University of Derby, Derby, UK
PG Health Psychology student, School of Life and Health Sciences, Aston University, Aston St, Birmingham, UK.


Introduction: This study aimed to investigate whether multiple aspects of emotion dysregulation contribute to the etiology of Food Addiction (FA); as well as to provide further evidence and clarity regarding the role of loneliness on the development of addictive behaviour towards food.
Methods: A correlational study was employed to assess associations within 162 participants which were recruited via online forums on FA and student population. The Yale Food Addiction Scale (YFAS), Difficulties in Emotion Regulation Scale (DERS), and UCLA Loneliness Scale, and a demographic and personal information questionnaire were all completed online. A Poisson regression analysis was carried out and statistical significance was set at P <0.05.
Results: 79% of the sample endorsed a persistent desire or repeated unsuccessful attempts to cut down or control their use of highly processed foods, while 21% met diagnostic criteria for food addiction. Poisson regression analysis demonstrated that the model predicts food addiction (P <0.001). Specifically, food addiction symptom count was positively predicted by difficulty engaging in goal-directed behaviour, impulse control difficulties, lack of emotional awareness and limited access to emotion regulation strategies (P <0.05); DERS total, nonacceptance of emotional responses and lack of emotional clarity were not significant predictors. Loneliness positively predicted food addiction (P =0.002).
Discussion and Conclusions: The findings of this research provide further evidence on the etiology of food addiction, as multiple aspects of emotion dysregulation, including difficulty in engaging in goal-directed behaviour, impulsiveness, emotional awareness and limited access to emotion regulation strategies, and loneliness were found to influence the development of an addictive behaviour towards certain types of food. Future research will need to understand possible causality between these factors and insights into the potential role addictive behaviour of food has in overeating phenomena, such as binge-eating.

Keywords: Addictive behaviours; food addiction; emotional dysregulation; loneliness; unhealthy eating habits.

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JHSS 2019,4(1):59-72

Original Article in Behavioral Psychology

Relationship between social media use and disordered eating behavior among female university students in Qatar

Authors: Yara Qutteina1, Catherine Nasrallah2, Linda Kimmel3, Salma M Khaled4

Master of Public Health, KU Leuven, Leuven, Belgium (Work completed at Social and Economic Survey Research Institute, Qatar University, Qatar)
Master of Public Health, Palo Alto Medical Research Foundation Research Institute, Palo Alto, California, United States (Work completed at Social and Economic Survey Research Institute, Qatar University, Qatar)
PhD, Center for Political Studies, University of Michigan, Institute for Social Research, Ann Arbor, Michigan, United States
PhD, Social and Economic Survey Research Institute, Qatar University, Qatar


Introduction: Abundant literature has established the negative impact of traditional media on body image and disordered eating behaviors among young women. In the past few years, social media use has soared especially among youth, yet the influence of social media in relation to disordered eating has not been fully explored. The aim of this study was to assess the relationship between social media use and disordered eating outcomes among young Arab women.
Methods: A cross-sectional study was carried out using a probability sample of 1,418 undergraduate female students living in Qatar, a rapidly developing nation in the Middle East. Popular social media platforms were assessed including Instagram, Snapchat, Facebook, and Twitter. Other covariates assessed included body image, body mass index, and socioeconomic status. To assess the multivariate association between social media (main predictor or exposure variable), and disordered eating as measured by three levels of the 26-item Eating Attitudes Test (EAT-26) (dependent variable), stepwise backward ordinal regression models were fit to the data. Data analysis was performed using Stata 14 software.
Results: Findings confirmed that intensive use of social media, particularly Instagram, was positively associated with increased disordered eating behaviors among young women. Social media use intensity showed a significant association with increased disordered eating [(OR 1.207, SE (0.075), P < 0.01, 95% Confidential Interval [CI] 1.068 to 1.363)]. Among the four social media platforms measured, Instagram use had a significant association with disordered eating [OR 1.387, SE (0.186), P < 0.05, 95% CI 1.107 to 1.804)].
Discussion and Conclusions: This study highlights the significant role of social media on the behavior of young women, and supports the sociocultural theory linking media to disordered eating.  Such an understanding of social media’s role is instrumental for the promotion and prevention of disordered eating among young women. 

Keywords: Arabs; body image; eating disorders; social media; women.

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JHSS 2019,4(1):73-84

Original Article in Behavioral Psychology

Understanding emotional issues of clients approaching to nutrition counseling: A qualitative, exploratory study in Italy

Authors: Angelo R Pennella1, Cristina Rubano2

Psychologist, “La Sapienza” University, Rome, Italy
Psychologist, Gruppo di Ricerca IntegralMente, Rome, Italy 


Introduction: This study aimed to explore how stressful file events and clients’ emotional feelings may affect their approach towards diet intervention, the client-nutritionist relationship, and dietary outcomes.
Methods: Semi-structured interviews were administered to a purposive sample of clients (n = 15; F = 15) and nutritionist/dietitians (n = 14; M = 2, F = 12). All interviews were conducted using an ad hoc track, and the analysis of transcripts was referenced to the Grounded Theory (GT) and to its qualitative analysis methodology.
Results: Our findings showed all clients experienced stressful life events and used food as emotional crutch, albeit with three levels of emotional self-awareness: 1) Clients with poor level of emotional self-awareness, emotionally vulnerable, who were diagnosed as ‘emotional eaters’. In this case, the paternalist model in the therapeutic interpersonal relationship between client and nutritionists was prevalent; 2) ‘emotional eaters’ who were partially aware of their disorder and sough emotional support from nutritionist. In this case, the client-nutritionist relationship was more balanced; 3) no ‘emotional eaters’ clients, who well-recognized the risk of ‘emotional eating’ as a maladaptive strategy used to cope with emotionally negative life events and in turn were able to use adaptive coping strategies. In this case, the patient-centred approach in the client-nutritionist relationship was dominant. Conversely, nutritionists all understood that emotional feelings of their clients may impact on the effectiveness of diet and client-nutritionist relationship. Despite this, they all followed the biomedical approach to some degree, yet emphasizing the need to acquire new and more relevant competences in this area, as well as the importance of cooperation between nutritionists and psychologists.
Discussion and Conclusions: Having an holistic approach in order to meet the emotional needs of clients may enable nutritionists and dietitians to improve dietary outcomes through a more active, autonomous and patient-centred role for the client. Therefore, nutritionists and dietitians should acquire specific psychological skills and work together with psychologists for an integrative and interdisciplinary approach in the nutrition counselling.

Keywords: Dietary outcomes; doctor-client relationship; emotional dysregulation; Grounded Theory; Nutrition.

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JHSS 2019,4(1):85-100

Original Article in Behavioral Psychology

Initiation and sustenance of small portion size consumption behavior in rural Appalachia, USA: Application of multi-theory model (MTM)

Authors: Ram Lakhan1, Sierra Turner2, Sangyal Dorjee3, Manoj Sharma4

1 DrPH, Assistant Professor, Department of Health and Human Performance, Berea College, KY, USA.
2 Senior, Health Studies Major, Berea College, Berea, KY, USA.
3 Sophomore, Biology Major, Berea College, Berea, KY, USA.
4 MBBS, Ph.D. Professor, Department of Behavioral and Environmental Health, School of Public Health, Jackson State University, MS; President, Health for All, NE; Faculty, Walden University, MN, USA.


Introduction: About 81% counties of the central Appalachia in USA are experiencing the nation’s highest obesity rates. It is generally accepted that the consumption of large food portion sizes is associated with obesity which in turn is related to the etiopathogenesis of several chronic diseases. Developing consumption of small portion size behavior can address obesity and related consequences. This study aimed to assess the likelihood of initiation and sustenance of small portion size consumption behavior based on application of multi-theory model (MTM) among residents from rural Appalachia.
Methods: The study utilized a cross-sectional research design (n = 156). A previously validated Multi-theory Model for Small Portion Size (MTM-SPS) questionnaire with acceptable reliability and validity for food portion size consumption behavior was adapted and used for data collection. Six counties of the rural Appalachian region of Kentucky defined as distressed, at risk, and transitional on socio-economic indicators by the Appalachians Research Commission (ARC) were selected for data collection. Stepwise multiple regression modeling was applied to predict the likelihood of initiation and sustenance of small portion size consumption behavior.
Results: Stepwise multiple regression demonstrated that initiation of small portion size consumption was explained by participatory dialogue (advantages outweighing disadvantages), behavioral confidence, and changes in physical environment (R2 = 47.9%, P < 0.001) and continuation of behavior by emotional transformation and practices for change (R2 = 40.2%, P < 0.001). Sociodemographic factors including age, gender, education, and ethnicity did not significantly contribute towards initiation and sustenance of small portion size consumption behavior in rural Appalachia (P > 0.05).
Conclusion: The MTM was found to be a useful theoretical framework that has the ability to predict initiation and sustenance of small portion size consumption. Findings of this study can be considered for designing an appropriate intervention in rural Appalachia.       

Keywords: Food; multi-theory model; portion size consumption; rural Appalachia; obesity; USA.

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JHSS 2019,4(1):101-116

Original Article in Social Psychology

Tarred with the same brush: An initial inquiry into courtesy stigma and problem gambling

Authors: Matthew D Sanscartier1, Jason D Edgerton2, Derek Chadee3, lance W Roberts4

PhD Candidate, Department of Sociology and Anthropology, Carleton University, Ottawa, ON, Canada.
Associate Professor, Department of Sociology, University of Manitoba, Winnipeg, MB, Canada.
Senior Lecturer, Department of Behavioural Sciences, The University of the West Indies, St Augustine, Trinidad & Tobago.
Full Professor, Department of Sociology, University of Manitoba, Winnipeg, MB, Canada.


Introduction: This study explores the relative intensity of courtesy stigma around problem gambling to other stigmatized conditions, and the ways in which courtesy stigma (or fear thereof) impacts problem gambling.
Method: We draw on data from a government-commissioned national survey in a southern Caribbean country (n = 1,008). Comparative t-tests and multiple regression (ordinary least squares) were used to identify relative intensity and what impacts courtesy stigma of problem gambling, respectively. Statistical significance was set up at P < 0.05.
Results: Problem gambling by a family member elicits more shame/embarrassment (M = 1.75) than using a wheelchair (M = 1.15) and having a mental illness (M = 1.22), but less shame than having a drug problem (M = 2.12) and on par with having an alcohol problem (M = 1.79, ns). With respect to courtesy stigma around problem gambling, the extents to which one considers various activities ‘gambling’ (b = -0.031, B = -0.068), one gambles him or herself (b = -0.015, B = -0.127), and the quality of experience with gambling (i.e. positive/negative; b = -0.038 B = -0.095) impacts potential embarrassment of a family member with a gambling problem. Catholics (b = 0.357, B = 0.355) and Hindus (b = 0.378, B = 0.376) were more likely to be embarrassed or ashamed than Anglicans, Muslims, Protestants, and other religions. Additionally, the unemployed (b = 0.282, B = 0.150) and the self-employed (b = 0.292, B = 0.290) were more likely to be embarrassed of a family member with a gambling problem.
Discussion and conclusions: Normalization of gambling in the family impacts how much shame or embarrassment one feels about their problem-gambling family member. Moreover, some religions (Catholic and Hindu) and economic positioning (unemployed and self-employed) may affect embarrassment or shame of problem gambling family members.

Keywords: Courtesy stigma; problem gambling; shame; stigmatization.

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JHSS 2019,4(1):117-122

Case Report in Legal Medicine

An explanatory case report about critical differences of ‘inability to work’ in Italian welfare and social security systems

Authors: Michele Sammicheli1, Marcella Scaglione1

Medical Doctor, Medical Legal Department, Italian Institute of Social Security (INPS), Siena, Italy.


In Italy, there is a different status of ‘inability to work’ in civil invalidity and INPS social security insurance systems. These differences and overlaps cause some concerns. We show a case report of a 55-year-old woman with a recent left radical mastectomy and ipsilateral lymphadenectomy, for infiltrating ductal and lobular carcinoma. The woman, showing no radiological evidence of metastases, was undergoing chemotherapy with taxanes and cisplatin. The patient reported no significant osteo-articular functional limitations, with the exception of a reduction in left shoulder movements at extreme degrees in a right-handed person, due to the recent mastectomy and complained nausea and vomiting due to chemotherapy. The civil invalidity committee assessed her as being disabled, with a total and permanent incapacity for work as 100%, whereas the INPS Medical Legal Department (C.M.L.) recognised her as disabled in employments suitable for her capabilities (article 1 of Law no 222/1984), but not incapable of carrying out any works (article 2 of Law no 222/1984). Progress in medicine and workplace adjustments may enable employees with disabilities to come back work. Therefore, knowledge of these differences and overlaps and the role of legal practitioners and policymakers could be decisive resulting in a source of savings for the Italian welfare system.

Keywords: Inability; civil invalidity; law; medicine, legal; social security.

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JHSS 2019,4(1):123-130

Case Report in Emergency Medicine

A case of silent myocardial ischemia associated with severe and prolonged hypoglycemia

Authors: Antonio Villa1, Donata Saltafossi2, Annalisa Re1, Silvia Garavaglia1

Medical Doctor, Department of Emergency, ASST Monza, PO Desio, Monza, Italy.
Medical Doctor, Department of Cardiology, ASST Monza, PO Desio, Monza, Italy. 


The scientific literature on treatment options and complications following large insulin overdoses is limited to case reports and few retrospective, epidemiological reports providing limited clinical insights. The effect of hypoglycemia on the heart is uncertain. There are two main factors that are commonly associated with electrocardiographic changes during hypoglycemia, of which the first is linked to the rapid decrease in blood glucose levels, and the other to the decrease in potassium serum levels.
We report a case of severe and prolonged hypoglycemia due to deliberate misuse of long-acting insulin associated with transient electrocardiographic ischemic changes without symptoms of myocardial ischemia. We diagnosed and treated this patient as a case of silent cardiac ischemia.
Hypoglycemia is a common event in patients affected by insulin dependent diabetes mellitus. The emergency physicians should be aware of aspecific or ischemic ECG alterations associated with severe hypoglycemia. As shown in this case report, ECG monitoring is crucial for early detection of ischemic electrocardiographic changes suggestive of myocardial ischemia in diabetic patients. 

Keywords: Diabetes mellitus; hypoglycemia; insulin overdose; myocardial ischemia.

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