Search results for: double extreme ranked set sampling

Authors: Man Kumar Tamang, Uday Narayan Yadav

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Background and objectives: Every country in the world is facing a demographic challenge due to drastic growth of population over 60 years. Adequate diet and nutritional status are important determinants of health in elderly populations. This study aimed to assess the nutritional status among the elderly population and factors associated with malnutrition at the community setting in rural Nepal. Methods: This is a community-based cross-sectional study among elderly of age 60 years or above in the three randomly selected VDCs of Morang district in eastern Nepal, between August and November, 2016. A multi stage cluster sampling was adopted with sample size of 345 of which 339 participated in the study. Nutritional status was assessed by MNA tool and associated socio-economic, demographic, psychological and nutritional factors were checked by binary logistic regression analysis. Results: Among 339 participants, 24.8% were found to be within normal nutritional status, 49.6% were at risk of malnutrition and 24.8% were malnourished. Independent factors associated with malnutrition status among the elderly people after controlling the cofounders in the bivariate analysis were: elderly who were malnourished were those who belonged to backward caste according to traditional Hindu caste system [OR=2.69, 95% CI: 1.17-6.21), being unemployed (OR=3.23, 95% CI: 1.63-6.41),who experienced any mistreatment from caregivers (OR=4.05, 95% CI: 1.90-8.60), being not involved in physical activity (OR=4.67, 95% CI: 1.87-11.66) and those taking medication for any co-morbidities. Conclusion: Many socio-economic, psychological and physiological factors affect nutritional status in our sample population and these issues need to be addressed for bringing improvement in elderly nutrition and health status.

Keywords: elderly, eastern Nepal, malnutrition, nutritional status

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Authors: Lujain Khraiba

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Recently, there is a broad recognition that micro-climate conditions contribute to the quality of life in urban spaces outdoors, both from economical and social viewpoints. The consideration of urban micro-climate and outdoor thermal comfort in urban design and planning processes has become one of the important aspects in current related studies. However, these aspects are so far not considered in urban planning regulations in practice and these regulations are often poorly adapted to the local climate and culture. Therefore, there is a huge need to adapt the existing planning regulations to the local climate especially in cities that have extremely hot weather conditions. The overall aim of this study is to point out the complexity of the relationship between urban planning regulations, urban design, micro-climate and outdoor thermal comfort in the hot dry city of Damascus, Syria. The main aim is to investigate the temporal and spatial effects of micro-climate on urban surface temperatures and outdoor thermal comfort in different urban design patterns as a result of urban planning regulations during the extreme summer conditions. In addition, studying different alternatives of how to mitigate the surface temperature and thermal stress is also a part of the aim. The novelty of this study is to highlight the combined effect of urban surface materials and vegetation to develop the thermal environment. This study is based on micro-climate simulations using ENVI-met 3.1. The input data is calibrated according to a micro-climate fieldwork that has been conducted in different urban zones in Damascus. Different urban forms and geometries including the old and the modern parts of Damascus are thermally evaluated. The Physiological Equivalent Temperature (PET) index is used as an indicator for outdoor thermal comfort analysis. The study highlights the shortcomings of existing planning regulations in terms of solar protection especially at street levels. The results show that the surface temperatures in Old Damascus are lower than in the modern part. This is basically due to the difference in urban geometries that prevent the solar radiation in Old Damascus to reach the ground and heat up the surface whereas in modern Damascus, the streets are prescribed as wide spaces with high values of Sky View Factor (SVF is about 0.7). Moreover, the canyons in the old part are paved in cobblestones whereas the asphalt is the main material used in the streets of modern Damascus. Furthermore, Old Damascus is less stressful than the modern part (the difference in PET index is about 10 °C). The thermal situation is enhanced when different vegetation are considered (an improvement of 13 °C in the surface temperature is recorded in modern Damascus). The study recommends considering a detailed landscape code at street levels to be integrated in urban regulations of Damascus in order to achieve a better urban development in harmony with micro-climate and comfort. Such strategy will be very useful to decrease the urban warming in the city.

Keywords: micro-climate, outdoor thermal comfort, urban planning regulations, urban spaces

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Authors: A. B. Elistina, S. Norhafifah, R. N. Nashaqilla, M. A. Afida Mastura., O. Mohhidin

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The issue of halal, especially in food products, raises lots of concern among Muslim consumers. Halal is often associated with safe, clean and nutritious food, according to the principle of halal toyyiban. Apart from that, the importance of halal food is not only emphasized by Muslim consumers but also non-Muslims. This is because the halal product is something that has been recognized for its cleanliness and safety. Nevertheless, consumers often face problems to ensure that the products they buy are genuinely halal as they can only rely on the certification of the authorities. However, the issue is the extent to which consumers place trust in the responsible certification authorities to determine the status of halal for a product. Therefore, this paper is intended to identify the relationship between consumer values and trust towards responsible parties such as Department of Islamic Development Malaysia (JAKIM), the Ministry of Health (MOH), foreign halal certification body and producers with consumers’ behavior. Apart from that, this study will also determine the value which consumers hold when choosing halal food and its relationship with consumers’ behavior. The total of 400 respondents who had been selected through stratified random sampling had participated in this study, and the data were collected through a set of self-administered questionnaire. The results showed that trust towards JAKIM is the highest, followed by trust towards MOH, foreign Halal certification agency and lastly the producers. Meanwhile, the values associated with halal foods are the quality, followed by emotional, economic and lastly social values. Results show that all factors can explain 20.3% variance in consumers’ behavior when consuming halal food products and trust towards the producers become the main determinant factor. Therefore, this study is expected to help the certification authorities local or abroad to inculcate trust among consumers as well as assisting food products manufacturers to enhance the halal food industry in Malaysia.

Keywords: behavior, consumers, halal food, trust, value

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Authors: Witthaya Mekhum, Jinjutha Srihera

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This research aims to study customer satisfaction towards the services of Baan Bueng Resort in Nongprue Subdistrict, Baanlamung District, Chonburi Province. 108 sample were drawn by random sampling from Thai and foreign tourists at Baan Bueng Resort. Questionnaires were distributed. Data were analyzed using frequency, percentage, mean (X) and standard deviation (S.D.). The tool used in this research was questionnaire on satisfaction towards the services of Baan Bueng Resort in Nongprue Subdistrict, Baanlamung District, Chonburi Province. The questionnaire can be divided into 3 parts; i.e. Part 1: General information i.e. gender, age, educational level, occupation, income, and nationality, Part 2: Customer satisfaction towards the services of Baan Bueng Resort; and Part 3: Suggestions of respondents. It can be concluded that most of the respondents are male, aged between 25 – 35 years old with bachelor degree. Most of them are private company employees with income 10,000–20,000 Baht per month. The majority of customers are satisfied with the services at Baan Beung Resort. Overall satisfaction is at good level. Considering each item, the item with the highest satisfaction level is personality and manner of employees and promptness and accuracy of cashier staff. Overall satisfaction towards the cleanliness of the rooms is at very good level. When considering each item, the item with the highest satisfaction level is that the guest room is cleaned everyday, while the satisfaction towards the quality of food and beverages at Baan Bueng Resort in Nongprue Subdistrict, Baanlamung District, Chonburi Province is at very good level. The item with the highest satisfaction is hotel facilities.

Keywords: satisfaction study, service, hotel, customer

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Authors: Umaiza Bashir, Ushna Farukh

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The present study examined the perspective of school students regarding teacher’s behavioral pattern during a teaching in classroom and its influence on the students’ socialization particularly forming peer relationships with the development of emotional, behavioral problems in school children. To study these dimension of teacher-student classroom relationship, 210 school children (105 girls and 105 boys) within the age range of 14 to 18 years were taken from the government, private schools. The cross-sectional research design was used in which stratified random sampling was done. Teacher-student interaction scale was used to assess the teacher-student relationship in the classroom, which had two factors such as positive and negative interaction. Peer relationship scale was administered to investigate the socialization of students, and School Children Problem Scale was also given to the participants to explore their emotional, behavioral issues. The analysis of Pearson correlation showed that there is a significant positive relationship between negative teacher-student interaction and student’s emotional-behavioral as well as social problems. Another analysis of t-test revealed that boys perceived more positive interaction with teachers than girls (p < 0.01). Girls showed more emotional behavioral problems than boys (p < 0.001) Linear regression explained that age, gender, negative teacher’s interaction with students and victimization in social gathering predicts mental health problems in school children. This study suggests and highlights the need for the school counselors for the better mental health of students and teachers.

Keywords: teacher-student interaction, school psychology, student’s emotional behavioral problems

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Authors: K. Alaka, A. Obi

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Home garden has proved to be significant to rural inhabitants by providing a wide range of useful products such as fruits, vegetables and medicine. There is need for quantitative information on its benefits and contributions to rural household. The main objective of this study is to investigate contributions of home garden to income of rural households in Raymond Mhlaba Local Municipality, formerly Nkonkobe Local Municipality of Eastern Cape Province South Africa. The stratified random sampling method was applied in order to choose a sample of 160 households.The study was conducted among 80 households engaging in home gardens and 80 non- participating households in the study area. Data analysis employed descriptive statistics with the use of frequency table and one way sample T test to show actual contributions. The overall model shows that social grant has the highest contribution to total household income for both categories while income generated from home garden has the second largest share to total household income, this shows that the majority of rural households in the study area rely on social grant as their source of income. However, since most households are net food buyers, it is essential to have policies that are formulated with an understanding that household food security is not only a function of the food that farming households produce for their own consumption but more so a function of total household income. The results produced sufficient evidence that home gardens contribute significantly to income of rural household.

Keywords: food security, home gardening, household, income

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Authors: Sakapas Saengchai, Pichamon Chansuchai

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Research Thai- Myanmar Border Trade Promotion Policy, Mae Sai District, Chiang Rai Province The objectives of this study were to study the policy of promoting Thai- Myanmar border trade in Mae Sai district, Chiang Rai province. And suitable models for the development of border trade in Mae Sai. Chiang Rai province This research uses qualitative methodology. The method of collecting data from research papers. Participatory Observation In-depth interviews in which the information is important, the governor of Chiang Rai. Chiang Rai Customs Service Executive Office of Mae Sai Immigration Bureau Maesai Chamber of Commerce and Private Entrepreneurs By specific sampling Data analysis uses content analysis. The study indicated that Border Trade Promotion Policy The direction taken by the government to focus on developing 1. Security is further reducing crime. Smuggling and human trafficking Including the preparation to protect people from terrorism and natural disasters. And cooperation with Burma on border security. 2. The development of wealth is the promotion of investment. The transport links, logistics value chain. Products and services across the Thai-Myanmar border. Improve the regulations and laws to promote fair trade. Convenient and fast 3. Sustainable development is the ability to generate income, quality of life of people in the Thai border to increase continuously. By using balanced natural resources, production and consumption are environmentally friendly. Which featured the participation of all sectors of the public and private sectors in the region to drive the development of the border with Thailand. Chiang Rai province To be more competitive .

Keywords: Border, Trade, Policy, Promote

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Authors: Nana Katsia

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This paper explores the ways both medieval and medievalist conceptions of ugliness might be linked to the physical and spiritual transformation of the protagonists and how it is realised through specific musical rhythm, such as the dochmiac rhythm in the opera. As Eco and Henderson note, only one kind of ugliness could be represented in conformity with nature in the Middle Ages without destroying all aesthetic pleasure and, in turn, artistic beauty: namely, a form of ugliness which arouses disgust. Moreover, Eco explores the fact that the enemies of Christ who condemn, martyr, and crucify him are represented as wicked inside. In turn, the representation of inner wickedness and hostility toward God brings with it outward ugliness, coarseness, barbarity, and rage. Ultimately these result in the deformation of the figure. In all these regards, the non-beautiful is represented here as a necessary phase, which is not the case with classical (the ancient Greek) concepts of Beauty. As we can see, the understanding of disfigurement and ugliness in the Middle Ages was both varied and complex. In the Middle Ages, the disfigurement caused by leprosy (and other skin and bodily conditions) was interpreted, in a somewhat contradictory manner, as both a curse and a gift from God. Some saints’ lives even have the saint appealing to be inflicted with the disease as part of their mission toward true humility. We shall explore that this ‘different concept’ of ugliness (non-classical beauty) might be represented in Messiaen’s opera. According to Messiaen, the Leper and Saint François are the principal characters of the third scene, as both of them will be transformed, and a double miracle will take place in the process. Messiaen mirrors the idea of the true humility of Saint’s life and positions Le Baiser au Lépreux as the culmination of the first act. The Leper’s character represents his physical and spiritual disfigurement, which are healed after the miracle. So, the scene can be viewed as an encounter between beauty and ugliness, and that much of it is spent in a study of ugliness. Dochmiac rhythm is one of the most important compositional elements in the opera. It plays a crucial role in the process of creating a dramatic musical narrative and structure in the composition. As such, we shall explore how Messiaen represents the medieval idea of ugliness in the opera through particular musical elements linked to the main protagonists’ spiritual or physical ugliness; why Messiaen makes reference to dochmiac rhythm, and how they create the musical and dramatic context in the opera for the medieval aesthetic category of ugliness.

Keywords: ugliness in music, medieval time, saint françois d’assise, messiaen

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Authors: Joseph Osodo, Motsa Thobekani Phila

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The study investigated the impact of e-learning on the performance of history learners in Eswatini general certificate of secondary education in the Manzini region of Eswatini. The study was guided by the theory of connectivism. The study had three objectives which were to find out the significance of e-learning during the COVID-19 era in learning History subject; challenges faced by history teachers’ and learners’ in e-learning; and how the challenges were mitigated. The study used a qualitative research approach and descriptive research design. Purposive sampling was used to select eight History teachers and eight History learners from four secondary schools in the Manzini region. Data were collected using face to face interviews. The collected data were analyzed and presented in thematically. The findings showed that history teachers had good knowledge on what e-learning was, while students had little understanding of e-learning. Some of the forms of e-learning that were used during the pandemic in teaching history in secondary schools included TV, radio, computer, projectors, and social media especially WhatsApp. E-learning enabled the continuity of teaching and learning of history subject. The use of e-learning through the social media was more convenient to the teacher and the learners. It was concluded that in some secondary school in the Manzini region, history teacher and learners encountered challenges such as lack of finances to purchase e-learning gadgets and data bundles, lack of skills as well as access to the Internet. It was recommended that History teachers should create more time to offer additional learning support to students whose performance was affected by the COVID-19 pandemic effects.

Keywords: e-learning, performance, COVID-19, history, connectivism

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Authors: Keiko Yamauchi, Motoyuki Nakao, Yoko Ishihara

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The increase in the number of women with breast cancer in Japan has required hospitals to provide a higher quality of medicine so that patients are satisfied with the treatment they receive. However, patients’ satisfaction following breast cancer treatment has not been sufficiently studied. Hence, we investigated the factors influencing patient satisfaction following breast cancer treatment among Japanese women. These women underwent either breast-conserving surgery (BCS) (n = 380) or total mastectomy (TM) (n = 247). In March 2016, we conducted a cross-sectional internet survey of Japanese women with breast cancer in Japan. We assessed the following factors: socioeconomic status, cancer-related information, the role of medical decision-making, the degree of satisfaction regarding the treatments received, and the regret arising from the medical decision-making processes. We performed logistic regression analyses with the following dependent variables: extreme satisfaction with the treatments received, and regret regarding the medical decision-making process. For both types of surgery, the odds ratio (OR) of being extremely satisfied with the cancer treatment was significantly higher among patients who did not have any regrets compared to patients who had. Also, the OR tended to be higher among patients who chose to play a wanted role in the medical decision-making process, compared with patients who did not. In the BCS group, the OR of being extremely satisfied with the treatment was higher if, at diagnosis, the patient’s youngest child was older than 19 years, compared with patients with no children. The OR was also higher if patient considered the stage and characteristics of their cancer significant. The OR of being extremely satisfied with the treatments was lower among patients who were not employed on full-time basis, and among patients who considered the second medical opinions and medical expenses to be significant. These associations were not observed in the TM group. The OR of having regrets regarding the medical decision-making process was higher among patients who chose to play a role in the decision-making process as they preferred, and was also higher in patients who were employed on either a part-time or contractual basis. For both types of surgery, the OR was higher among patients who considered a second medical opinion to be significant. Regardless of surgical type, regret regarding the medical decision-making process decreases treatment satisfaction. Patients who received breast-conserving surgery were more likely to have regrets concerning the medical decision-making process if they could not play a role in the process as they preferred. In addition, factors associated with the satisfaction with treatment in BCS group but not TM group included the second medical opinion, medical expenses, employment status, and age of the youngest child at diagnosis.

Keywords: medical decision making, breast-conserving surgery, total mastectomy, Japanese

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Authors: Sawitree Wongkittirungrueang

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The objectives of this research were: 1) to study the effect of social stories on social interaction of students with autism. The sample was Pratomsuksa level 5 student with autism, Khon Kaen University Demonstration School, who was diagnosed by the Physician as High Functioning Autism since he was able to read, write, calculate and was studying in inclusive classroom. However, he still had disability in social interaction to participate in social activity group and communication. He could not learn how to develop friendship or create relationship. He had inappropriate behavior in social context. He did not understand complex social situations. In addition, he did seemed not know time and place. He was not able to understand feeling of oneself as well as the others. Consequently, he could not express his emotion appropriately. He did not understand or express his non-verbal language for communicating with friends. He lacked of common interest or emotion with nearby persons. He greeted inappropriately or was not interested in greeting. In addition, he did not have eye contact. He used inadequate language etc. He was elected by Purposive Sampling. His parents were willing to allow them to participate in this study. The research instruments were the lesson plan of social stories, and the picture book of social stories. The instruments used for data collection, were the social interaction evaluation of autistic students. This research was Quasi Experimental Research as One Group Pre-test, Post-test Design. For the Pre-test, the experiment was conducted by social stories. Then, the Post-test was implemented. The statistic used for data analysis, included the Mean, and Standard Deviation. The research findings were shown by Graph. The findings revealed hat the autistic students taught by social stories indicated better social interaction after being taught by social stories.

Keywords: social story, autism spectrum disorder (ASD), autism, social interaction

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Authors: Ha T. T. Ly, Truc B. Truc, Hai N. Truong, Mai P. T. Nguyen, Ngoc D. Ngo, Khanh V. Tran, Hai T. Le

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Beta thalassemia is one of the most common inherited blood disorders, which is characterized by decreased or absent in beta globin expression. Patients with Beta thalassemia whose anemia is not so severe as to necessitate transfusions are said to have thalassemia intermedia. Objective: The goal of this study is prenatal diagnosis for pregnancy woman with Beta thalassemia intermedia and her husband with Beta thalassemia carrier at high risk of Beta thalassemia major in Northern of Vietnam. Material and method: The family has a 6 years-old compound heterozygous thalassemia major for CD71/72(+A) and Hbb:c. -78A>G/nt-28(A>G) male child. The father was heterozygous for CD71/72(+A) mutation which is Beta plus type and the mother was compound heterozygosity of two different variants, namely, Hbb: c. -78A>G/nt-28(A>G) and CD26(A-G) HbE. Prenatal Beta thalassemia mutation detection in fetal DNA was carried out using multiplex Amplification-refractory mutation system ARMS-PCR and confirmed by direct Sanger-sequencing Hbb gene. Prenatal diagnoses were perfomed by amniotic fluid sampling from pregnant woman in the 16-18th week of pregnancy after the genotypes of parents of the probands were identified. Result: When amniotic fluid sample was analyzed for Beta globin gene (Hbb), we found that the genotype is heterozygous for CD71/72(+A) and CD26(A-G) HbE. This genotype is different from the 1st child of this family. Conclusion: Prenatal diagnosis helps the parents to know the genotype and the thalassemia status of the fetus, so they can have early decision on their pregnancy. Genetic diagnosis provided a useful method in diagnosis for familial members in pedigree, genetic counseling and prenatal diagnosis.

Keywords: beta thalassemia intermedia, Hbb gene, pedigree, prenatal diagnosis

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Authors: Dalia El Hadi, Alaa Bou Ghannam, Hala Mostafa, Hana Mansour, Ibrahim Hashim, Soubhi Tahhan, Tharwat El Zahran

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Introduction: Neuro-ophthalmological emergencies require prompt assessment and management to avoid vision or life-threatening sequelae. Some would require neuroimaging. Most commonly used are the CT and MRI of the Brain. They can be over-used when not indicated. Their yield remains dependent on multiple factors relating to the clinical scenario. Methods: A retrospective cross-sectional study was conducted by reviewing the electronic medical records of patients presenting to the Emergency Department (ED) with isolated neuro-ophthalmologic complaints. For each patient, data were collected on the clinical presentation, whether neuroimaging was performed (and which type), and the result of neuroimaging. Analysis of the performed neuroimaging was made, and its yield was determined. Results: A total of 211 patients were reviewed. The complaints or symptoms at presentation were: blurry vision, change in the visual field, transient vision loss, floaters, double vision, eye pain, eyelid droop, headache, dizziness and others such as nausea or vomiting. In the ED, a total of 126 neuroimaging procedures were performed. Ninety-four imagings (74.6%) were normal, while 32 (25.4%) had relevant abnormal findings. Only 2 symptoms were significant for abnormal imaging: blurry vision (p-value= 0.038) and visual field change (p-value= 0.014). While 4 physical exam findings had significant abnormal imaging: visual field defect (p-value= 0.016), abnormal pupil reactivity (p-value= 0.028), afferent pupillary defect (p-value= 0.018), and abnormal optic disc exam (p-value= 0.009). Conclusion: Risk indicators for abnormal neuroimaging in the setting of neuro-ophthalmological emergencies are blurred vision or changes in the visual field on history taking. While visual field irregularities, abnormal pupil reactivity with or without afferent pupillary defect, or abnormal optic discs, are risk factors related to physical testing. These findings, when present, should sway the ED physician towards neuroimaging but still individualizing each case is of utmost importance to prevent time-consuming, resource-draining, and sometimes unnecessary workup. In the end, it suggests a well-structured patient-centered algorithm to be followed by ED physicians.

Keywords: emergency department, neuro-ophthalmology, neuroimaging, risk indicators

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Authors: Zakia Hammouni

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Healthcare professionals’ well-being is becoming a priority during this Covid-19 pandemic due to stress, fatigue, and workload. Well before this pandemic, contemporary hospitals are endowed with environmental attributes that contribute to achieving well-being within their environment with the emphasis on the patient. The patient-centered care approach has been followed by the patient-centered design approach. Studies that have focused on the physical environment in hospitals have dealt with the patient's recovery process and his well-being. Prior scientific literature has placed less emphasis on the healthcare professionals’ interactions within the physical environment and to guide hospital designers to make evidence-based design choices to meet the needs and expectations of hospital users by considering, in addition to patients, healthcare professionals. This paper examines these issues related to the daily stress of professionals who provide care in a hospital environment. In this exploratory study, the interest was to grasp the issues related to this environment and explores the current realities of newly built hospitals based on design approaches and what attributes of the physical setting support healthcare professional’s well-being. Within a constructivist approach, this study was conducted in two care units in a new hospital in a big city in Canada before the Covid-19 pandemic (august 2nd to November 2nd 2018). A spatial evaluation of these care units allowed us to understand the interaction of health professionals in their work environment, to understand the spatial behavior of these professionals, and the narratives from 44 interviews of various healthcare professionals. The mental images validated the salient components of the hospital environment as perceived by these healthcare professionals. Thematic analysis and triangulation of the data set were conducted. Among the key attributes promoting the healthcare professionals’ well-being as revealed by the healthcare professionals are the overall light-color atmosphere in the hospital and care unit, particularly in the corridors and public areas of the hospital, the maintenance and cleanliness. The presence of the art elements also brings well-being to the health professionals as well as panoramic views from the staff lounge and corridors of the care units or elevator lobbies. Despite the overall positive assessment of this environment, some attributes need to be improved to ensure the well-being of healthcare professionals and to provide them with a restructuring environment. These are the supply of natural light, softer colors, sufficient furniture, comfortable seating in the restroom, and views, which are important in allowing these healthcare professionals to recover from their work stress. Noise is another attribute that needs to be further improved in the hospital work environment, especially in the nursing workstations and consultant's room. In conclusion, this study highlights the importance of providing healthcare professionals with work and rest areas that allow them to resist the stress they face, particularly during periods of extreme stress and fatigue such as a Covid-19 pandemic.

Keywords: healthcare facilities, healthcare professionals, physical environment, well-being

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Authors: Shahid Iqbal

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It is observed that international migration is increased over a time period in all over the world counties and Pakistan is not escaped. It played a pivotal role in household economy and affecting the gender roles both positive and negative in the developing countries. A vast majority of males from Pakistan migrate to other countries in search of employment and income generating activities and their families left behind, particularly nuclear families are subjected to different social problems. In this scenario, most of the responsibilities lie on the female partners as they have to play the role of male as well as female for their children and household chores. Wives of some males feel loneliness, isolation and a sense of insecurity. Keeping in mind, these realities, this study aims to explore the social impact of husbands’ absentee ship on the lives of families left behind. Particularly, wives’ own experiences will be analyzed. This study will be carried out in the District Gujrat of Punjab Pakistan. Since this study will focus on observing the social impact of male’s migration on families, so, all the households that had at least one member abroad will be the potential respondents of the study. Purposes sampling technique will be used as method to locate the respondents. A focus group discussion will be conducted as a tool for the collection of data. Those women will be approached who are taking care of their families in the absence of their husbands for last three years. For the sake of analysis Interpretative Phenomenological Analysis (IPA) will be applied and researcher will explore how participants make sense of their personal experience and social world.

Keywords: social consequences, male migration, left behind, absentee ship, Pakistan

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Authors: Martin Kleynhans, Margot Soler, Gavin Quibell

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Malawi is one of the world’s poorest nations and consequently, the design of flood risk management infrastructure comes with a different set of challenges. There is a lack of good quality hydromet data, both in spatial terms and in the quality thereof and the challenge in the design of flood risk management infrastructure is compounded by the fact that maintenance is almost completely non-existent and that solutions have to be simple to be effective. Solutions should not require any further resources to remain functional after completion, and they should be resilient. They also have to be cost effective. The Lower Shire Valley of Malawi suffers from frequent flood events. Various flood risk management interventions have been designed across the valley during the course of the Shire River Basin Management Project – Phase I, and due to the data poor environment, indigenous knowledge was relied upon to a great extent for hydrological and hydraulic model calibration and verification. However, indigenous knowledge comes with the caveat that it is ‘fuzzy’ and that it can be manipulated for political reasons. The experience in the Lower Shire valley suggests that indigenous knowledge is unlikely to invent a problem where none exists, but that flood depths and extents may be exaggerated to secure prioritization of the intervention. Indigenous knowledge relies on the memory of a community and cannot foresee events that exceed past experience, that could occur differently to those that have occurred in the past, or where flood management interventions change the flow regime. This complicates communication of planned interventions to local inhabitants. Indigenous knowledge is, for the most part, intuitive, but flooding can sometimes be counter intuitive, and the rural poor may have a lower trust of technology. Due to a near complete lack of maintenance of infrastructure, infrastructure has to be designed with no moving parts and no requirement for energy inputs. This precludes pumps, valves, flap gates and sophisticated warning systems. Designs of dykes during this project included ‘flood warning spillways’, that double up as pedestrian and animal crossing points, which provide warning of impending dangerous water levels behind dykes to residents before water levels that could cause a possible dyke failure are reached. Locally available materials and erosion protection using vegetation were used wherever possible to keep costs down.

Keywords: design of dykes in low-income countries, flood warning spillways, indigenous knowledge, Malawi

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Authors: Aleme Mekuria, Samuel Mathewos

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Background: Teenage pregnancy has long been a worldwide social, economic and educational concern for the developed, developing and underdeveloped countries. Studies on adolescent sexuality and pregnancy are very limited in our country. Therefore, this study aims at assessing the prevalence of teenage pregnancy and its determinants among school adolescents of Arba Minch town. Methods: Institution- based, cross-sectional study was conducted from 20-30 March 2014. Systematic sampling technique was used to select a total of 578 students from four schools of the town. Data were collected by trained data collectors using a pre-tested, self-administered structured questionnaire. The analysis was made using the software SPSS version 20.0 statistical packages. Multivariate logistic regression was used to identify the predictors of teenage pregnancy. Results: The prevalence of teenage pregnancy among school adolescents of Arba Minch town was 7.7%. Being grade11(AOR=4.6;95%CI:1.4,9.3) and grade12 student (AOR=5.8;95% CI:1.3,14.4), not knowing the correct time to take emergency contraceptives(AOR=3.3;95%CI:1.4,7.4), substance use(AOR=3.1;95%CI:1.1,8.8), living with either of biological parents (AOR=3.3;95%CI:1.1,8.7) and poor parent-daughter interaction (AOR=3.1;95%CI:1.1,8.7) were found to be significant predictors of teenage pregnancy. Conclusion: This study revealed a high level of teenage pregnancy among school adolescents of Arba Minch town. A significant number of adolescent female school students were at risk of facing the challenges of teenage pregnancy in the study area. School-based reproductive health education and strong parent-daughter relationships should be strengthened.

Keywords: adolescent, Arba minch, risk factors, school, southern Ethiopia, teenage pregnancy

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Authors: Adedoyin Opeyemi Osokoya

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The study assesses the influence of social media on perceived learning outcome of agricultural science students in tertiary institutions in Oyo state, Nigeria. The four-stage sampling procedure was used to select participants. All students in the seven tertiary institutions that offer agriculture science as a course of study in Oyo State was the population. A university, a college of agriculture and a college of education were sampled, and a department from each was randomly selected. Twenty percent of the students’ population in the respective selected department gave a sample size of 165. Questionnaire was used to collect information on respondents’ personal characteristics and information related to access to social media. Data were analysed using descriptive statistics, chi-square, correlation, and multiple regression at the 0.05 confidence level. Age and household size were 21.13 ± 2.64 years and 6 ± 2.1 persons respectively. All respondents had access to social media, majority (86.1%) owned Android phone, 57.6% and 52.7% use social media for course work and entertainment respectively, while the commonly visited sites were WhatsApp, Facebook, Google, Opera mini. Over half (53.9%) had an unfavourable attitude towards the use of social media for learning; benefits of the use of social media for learning was high (56.4%). Removal of information barrier created by distance (x̄=1.58) was the most derived benefit, while inadequate power supply (x̄=2.36), was the most severe constraints. Age (β=0.23), sex (β=0.37), ownership of Android phone (β=-1.29), attitude (β=0.37), constraints (β =-0.26) and use of social media (β=0.23) were significant predictors of influence on perceived learning outcomes.

Keywords: use of social media, agricultural science students, undergraduates of tertiary institutions, Oyo State of Nigeria

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Authors: Hamzat Shittu Atunnise

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This study on Assessment of the Implementation of Recommended Teaching and Evaluation Methods of the Nigeria Certificate in Education (NCE) Arabic Language Curriculum in Colleges of Education in North Western Nigeria was conducted with four objectives, four research questions and four null hypotheses. Descriptive survey design was used and the multistage sampling procedure adopted. Frequency count and percentage were used to answer research questions and chi-square was used to test all the null hypotheses at an Alpha 0.05 level of significance. Two hundred and ninety one subjects were drawn as sample. Questionnaires were used for data collection. The Context, Input, Process and Product (CIPP) model of evaluation was employed. The study findings indicated that: there were no significant difference in the perceptions of lecturers and students from Federal and State Colleges of Education on the following: extent of which lecturers employ appropriate methods in teaching the language and extent of which recommended evaluation methods are utilized for the implementation of Arabic Curriculum. Based on these findings, it was recommended among other things that: lecturers should adopt teaching methodologies that promote interactive learning; Governments should ensure that information and communication technology facilities are made available and usable in all Colleges of Education; Lecturers should vary their evaluation methods because other methods of evaluation can meet and surpass the level of learning and understanding which essay type questions are believed to create and that language labs should be used in teaching Arabic in Colleges of Education because comprehensive language learning is possible through both classroom and language lab teaching.

Keywords: assessment, arabic language, curriculum, methods of teaching, evaluation methods, NCE

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Authors: Luminiţa Duţică, Gheorghe Duţică

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Many of the interrogations or dilemmas of the contemporary world found the answer in what was generically called the appeal to matrix. This genuine spiritual exercise of re-connection of the present to origins, to the primary source, revealed the ontological condition of timelessness, ahistorical, immutable (epi)phenomena, of those pure essences concentrated in the archetypal-referential layer of the human existence. The musical creation was no exception to this trend, the impasse generated by the deterministic excesses of the whole serialism or, conversely, by some questionable results of the extreme indeterminism proper to the avant-garde movements, stimulating the orientation of many composers to rediscover a universal grammar, as an emanation of a new ‘collective’ order (reverse of the utopian individualism). In this context, the music of oral tradition and therefore the world of the ancient modes represented a true revelation for the composers of the twentieth century, who were suddenly in front of some unsuspected (re)sources, with a major impact on all levels of edification of the musical work: morphology, syntax, timbrality, semantics etc. For the contemporary Romanian creators, the music of rituals, existing in the local archaic culture, opened unsuspected perspectives for which it meant to be a synthetic, inclusive and recoverer vision, where the primary (archetypal) genuine elements merge with the latest achievements of language of the European composers. Thus, anchored in a strong and genuine modal source, the compositions analysed in this paper evoke, in a manner as modern as possible, the atmosphere of some ancestral rituals such as: the invocation of rain during the drought (Paparudele, Scaloianul), funeral ceremony (Bocetul), traditions specific to the winter holidays and new year (Colinda, Cântecul de stea, Sorcova, Folklore traditional dances) etc. The reactivity of those rituals in the sound context of the twentieth century meant potentiating or resizing the archaic spirit of the primordial symbolic entities, in terms of some complexity levels generated by the technique of harmonies of chordal layers, of complex aggregates (gravitational or non-gravitational, geometric), of the mixture polyphonies and with global effect (group, mass), by the technique of heterophony, of texture and cluster, leading to the implementation of some processes of collective improvisation and instrumental theatre.

Keywords: archetype, improvisation, polyphony, ritual, instrumental theatre

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Authors: Palanisamy Sivanandy, Tan Tyng Wei, Tan Wee Loon, Lim Chong Yee

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Background: Patient safety has become a major concern over recent years with elevated medication errors; particularly prescribing and dispensing errors. Meticulous prescription screening and diligent drug dispensing is therefore important to prevent drug-related adverse events from inflicting harm to patients. Hence, pharmacists play a significant role in this scenario. The evaluation of patient safety in a pharmacy setup is crucial to contemplate current practices, attitude and perception of pharmacists towards patient safety. Method: The questionnaire for Pharmacy Survey on Patient Safety Culture developed by the Agency for Healthcare and Research Quality (AHRQ) was used to assess patient safety. Main objectives of the study was to evaluate the attitude and perception of pharmacists towards patient safety in retail pharmacies setup in Malaysia. Results: 417 questionnaire were distributed via convenience sampling in three different states of Malaysia, where 390 participants were responded and the response rate was 93.52%. The overall positive response rate (PRR) was ranged from 31.20% to 87.43% and the average PRR was found to be 67%. The overall patient safety grade for our pharmacies was appreciable and it ranges from good to very good. The study found a significant difference in the perception of senior and junior pharmacists towards patient safety. The internal consistency of the questionnaire contents /dimensions was satisfactory (Cronbach’s alpha - 0.92). Conclusion: Our results reflect that there was positive attitude and perception of retail pharmacists towards patient safety. Despite this, various efforts can be implemented in the future to amplify patient safety in retail pharmacies setup.

Keywords: patient safety, attitude, perception, positive response rate, medication errors

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Authors: Abdul Rauf, Xiaoxing Liu, Rizwan Qaisar Danish, Waqas Amin

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The core intention of this study is to analyze the linkage of training, job attitudes and motivation through a mediation model in the banking sector of Pakistan. Moreover, this study is executed to answer a range of queries regarding the consideration of employees about training, job satisfaction, motivation and organizational commitment. Hence, the association of training with job satisfaction, job satisfaction with motivation, organizational commitment with job satisfaction, organization commitment as independently with motivation and training directly related to motivation is determined in this course of study. A questionnaire crafted for comprehending the purpose of this study by including four variables such as training, job satisfaction, motivation and organizational commitment which have to measure. A sample of 450 employees from seventeen private (17) banks and two (2) public banks was taken on the basis of convenience sampling from Pakistan. However, 357 questionnaires, completely filled were received back. AMOS used for assessing the conformity factor analysis (CFA) model and statistical techniques practiced to scan the collected data (i.e.) descriptive statistics, regression analysis and correlation analysis. The empirical findings revealed that training and organizational commitment has a significant and positive impact directly on job satisfaction and motivation as well as through the mediator (job satisfaction) also the impact sensing in the same way on the motivation of employees in the financial Banks of Pakistan. In this research study, the banking sector is under discussion, so the findings could not generalize on other sectors such as manufacturing, textiles, telecom, and medicine, etc. The low sample size is also the limitation of this study. On the foundation of these results the management fascinates to make the revised strategies regarding training program for the employees as it enhances their motivation level, and job satisfaction on a regular basis.

Keywords: job satisfaction, motivation, organizational commitment, Pakistan, training

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Authors: Arvind Srivastav, Tarun Kanti Bhattacharyya

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The north-eastern, Himalayan, and Eastern Ghats Belt of India comprise of earthquake-prone, remote, and hilly terrains. Earthquakes have caused enormous damages in these regions in the past. A wireless sensor network based earthquake early warning system (EEWS) is being developed to mitigate the damages caused by earthquakes. It consists of sensor nodes, distributed over the region, that perform majority voting of the output of the seismic sensors in the vicinity, and relay a message to a base station to alert the residents when an earthquake is detected. At the heart of the EEWS is a low-power two-stage seismic sensor that continuously tracks seismic events from incoming three-axis accelerometer signal at the first-stage, and, in the presence of a seismic event, triggers the second-stage P-wave detector that detects the onset of P-wave in an earthquake event. The parameters of the P-wave detector have been optimized for minimizing detection time and maximizing the accuracy of detection.Working of the sensor scheme has been verified with seven earthquakes data retrieved from IRIS. In all test cases, the scheme detected the onset of P-wave accurately. Also, it has been established that the P-wave onset detection time reduces linearly with the sampling rate. It has been verified with test data; the detection time for data sampled at 10Hz was around 2 seconds which reduced to 0.3 second for the data sampled at 100Hz.

Keywords: earthquake early warning system, EEWS, STA/LTA, polarization, wavelet, event detector, P-wave detector

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Authors: Jean Yves Trepanier, Sami Ammar, Sagnik Banik

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Lattice Boltzmann Method has been advantageous in simulating complex boundary conditions and solving for fluid flow parameters by streaming and collision processes. This paper includes the study of three different test cases in a confined domain using the method of the Lattice Boltzmann model. 1. An SRT (Single Relaxation Time) approach in the Lattice Boltzmann model is used to simulate Lid Driven Cavity flow for different Reynolds Number (100, 400 and 1000) with a domain aspect ratio of 1, i.e., square cavity. A moment-based boundary condition is used for more accurate results. 2. A Thermal Lattice BGK (Bhatnagar-Gross-Krook) Model is developed for the Rayleigh Benard convection for both test cases - Horizontal and Vertical Temperature difference, considered separately for a Boussinesq incompressible fluid. The Rayleigh number is varied for both the test cases (10^3 ≤ Ra ≤ 10^6) keeping the Prandtl number at 0.71. A stability criteria with a precise forcing scheme is used for a greater level of accuracy. 3. The phase change problem governed by the heat-conduction equation is studied using the enthalpy based Lattice Boltzmann Model with a single iteration for each time step, thus reducing the computational time. A double distribution function approach with D2Q9 (density) model and D2Q5 (temperature) model are used for two different test cases-the conduction dominated melting and the convection dominated melting. The solidification process is also simulated using the enthalpy based method with a single distribution function using the D2Q5 model to provide a better understanding of the heat transport phenomenon. The domain for the test cases has an aspect ratio of 2 with some exceptions for a square cavity. An approximate velocity scale is chosen to ensure that the simulations are within the incompressible regime. Different parameters like velocities, temperature, Nusselt number, etc. are calculated for a comparative study with the existing works of literature. The simulated results demonstrate excellent agreement with the existing benchmark solution within an error limit of ± 0.05 implicates the viability of this method for complex fluid flow problems.

Keywords: BGK, Nusselt, Prandtl, Rayleigh, SRT

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Authors: Juvanie C. Lapesigue

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Worldwide school closures result from a significant public health crisis that has affected the nation and the entire world. It has affected students, educators, educational organizations globally, and many other aspects of society. Academic institutions worldwide teach students using diverse approaches of various learning delivery modes. This paper investigates the competence and performance of physical education teachers using various learning delivery modes, including Distance learning, Blended Learning, and Homeschooling during online distance education. To identify the Gap between their age generation using various learning delivery that affects teachers' preparation for distance learning and evaluates how these modalities impact teachers’ competence and performance in the case of a pandemic. The respondents were the Senior High School teachers of the Department of Education who taught in Davao City before and during the pandemic. Purposive sampling was utilized on 61 Senior High School Teachers in Davao City Philippines. The result indicated that teaching performance based on pedagogy and assessment has significantly affected teaching performance in teaching physical education, particularly those Non-PE teachers teaching physical education subjects. It should be supplied with enhancement training workshops to help them be more successful in preparation in terms of teaching pedagogy and assessment in the following norm. Hence, a proposed unique training design for non-P.E. Teachers has been created to improve the teachers’ performance in terms of pedagogy and assessment in teaching P.E subjects in various learning delivery modes in the next normal.

Keywords: distance learning, learning delivery modes, P.E teachers, senior high school, teaching competence, teaching performance

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Authors: Shahlan Surat, Saemah Rahman, Saadiah Kummin

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When teachers reflect and evaluate whether their teaching methods actually have an impact on students’ learning, they will adjust their practices accordingly. This inevitably improves their students’ learning and performance. The approach in meta-teaching can invigorate and create a passion for teaching. It thus helps to increase the commitment and love for the teaching profession. This study was conducted to determine the level of metacognitive thinking of teachers in the process of teaching and learning in the classroom. Metacognitive thinking teachers include the use of metacognitive knowledge which consists of different types of knowledge: declarative, procedural and conditional. The ability of the teachers to plan, monitor and evaluate the teaching process can also be determined. This study was conducted on 377 graduate teachers in Klang Valley, Malaysia. The stratified sampling method was selected for the purpose of this study. The metacognitive teaching inventory consisting of 24 items is called InKePMG (Teacher Indicators of Effectiveness Meta-Teaching). The results showed the level of mean is high for two components of metacognitive knowledge; declarative knowledge (mean = 4.16) and conditional (mean = 4.11) whereas, the mean of procedural knowledge is 4.00 (moderately high). Similarly, the level of knowledge in monitoring (mean = 4.11), evaluating (mean = 4.00) which indicate high score and planning (mean = 4.00) are moderately high score among teachers. In conclusion, this study shows that the planning and procedural knowledge is an important element in improving the quality of teachers teaching in the classroom. Thus, the researcher recommended that further studies should focus on training programs for teachers on metacognitive skills and also on developing creative thinking among teachers.

Keywords: metacognitive thinking skills, procedural knowledge, conditional knowledge, meta-teaching and regulation of cognitive

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Authors: T. Sadunishvili, L. Kutateladze, T. Urushadze, R. Khvedelidze, N. Zakariashvili, M. Jobava, G. Kvesitadze

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Multiple repeated soil-climatic zones in Georgia determines the diversity of microorganisms. Hundreds of microscopic fungi of different genera have been isolated from different ecological niches, including some extreme environments. Biosynthetic ability of microscopic fungi has been studied. Trichoderma ressei, representative of the Ascomycetes secrete cellulolytic and xylanolytic enzymes that act in synergy to hydrolyze polysaccharide polymers to glucose, xylose and arabinose, which can be fermented to biofuels. The other mesophilic strains producing cellulases are Allesheria terrestris, Chaetomium thermophile, Fusarium oxysporium, Piptoporus betulinus, Penicillium echinulatum, P. purpurogenum, Aspergillus niger, A. wentii, A. versicolor, A. fumigatus etc. In the majority of the cases the cellulases produced by strains of genus Aspergillus usually have high β-glucosidase activity and average endoglucanases levels (with some exceptions), whereas strains representing Trichoderma have high endo enzyme and low β-glucosidase, and hence has limited efficiency in cellulose hydrolysis. Six producers of stable cellulases and xylanases from mesophilic and thermophilic fungi have been selected. By optimization of submerged cultivation conditions, high activities of cellulases and xylanases were obtained. For enzymes purification, their sedimentation by organic solvents such as ethyl alcohol, acetone, isopropanol and by ammonium sulphate in different ratios have been carried out. Best results were obtained with precipitation by ethyl alcohol (1:3.5) and ammonium sulphate. The yields of enzyme according to cellulase activities were 80-85% in both cases. Cellulase activity of enzyme preparation obtained from the strain Trichoderma viride X 33 is 126 U/g, from the strain Penicillium canescence D 85–185U/g and from the strain Sporotrichum pulverulentum T 5-0 110 U/g. Cellulase activity of enzyme preparation obtained from the strain Aspergillus sp. Av10 is 120 U/g, xylanase activity of enzyme preparation obtained from the strain Aspergillus niger A 7-5–1155U/g and from the strain Aspergillus niger Aj 38-1250 U/g. Optimum pH and temperature of operation and thermostability, of the enzyme preparations, were established. The efficiency of hydrolyses of different agricultural residues by the microscopic fungi cellulases has been studied. The glucose yield from the residues as a result of enzymatic hydrolysis is highly determined by the ratio of enzyme to substrate, pH, temperature, and duration of the process. Hydrolysis efficiency was significantly increased as a result of different pretreatment of the residues by different methods. Acknowledgement: The Study was supported by the ISTC project G-2117, funded by Korea.

Keywords: cellulase, xylanase, microscopic fungi, enzymatic hydrolysis

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Authors: Akintayo Opawole, Godwin O. Jagboro

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Research efforts on infrastructure development in Nigeria had not provided adequate assessment of issues essential for policy response by the government to address infrastructure deficiency. One major gap existing in previous studies is the assessment of challenges facing the budgetary financing model. Based on a case study of Osun State in Southwestern Nigeria, factors affecting budgetary financing of public infrastructure were identified from literature and brainstorming. Respondents were: 6 architects, 4 quantity surveyors, 6 town planners, 5 estate surveyors, 4 builders, 21 engineers and 26 economists/accountants ranging from principal to director who have been involved in policy making process with respect to infrastructure development in the public service of Osun state. The identified variables were subjected to factor analysis. The Kaiser-Meyer-Olkin measure of sampling adequacy tests carried out (KMO, 0.785) showed that the data collected were adequate for the analysis and the Bartlett’s test of sphericity (0.000) showed the data upon which the analysis was carried out was reliable. Results showed that factors such as poor collaboration between the state and local government establishments, absence of credible database system and inadequate funding of maintenance were the most significant to infrastructure development in the State. Policy responses to address challenges of infrastructure development in the state were identified to focus on creation of legal framework for liberation policy, enforcement of ‘due process’ in the procurement and establishment of monitoring system for project delivery.

Keywords: development, infrastructure, financing, procurement

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Authors: Aisha Liaquat Ali, Ghulam Sarwar Gachal, Muhammad Yusuf Sheikh

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The parrot (Rose Ringed) commonly known as tota, belongs to the order ‘psiitaciformes’ and family ‘Psittacidea’, Four species of parakeet inhabits tropical and subtropical regions of Pakistan mostly adopted parks in cities deciduous woodlands, light secondary jungles, semidesert, and scrubland and in orchards and cultivated farmlands. They are mostly feed on citrus fruits, guava, mango, green unripen seed and almond nuts as well as bud and flowers etc. the core aim of the present study was to investigate the Feeding Habitat of Parrot (Ringed Necked Parakeet) in District Mirpurkhas Sindh Pakistan. Sampling was obtained from various adjoining areas of District Mirpurkhas by Non-Random Method, which was conducted from June to Nov 2017. During the present study, a total no: of 84 specimens were collected from different localities of City Mirpurkhas (42.8%) were male ♂ and (57.1%) were female ♀. Maximum population density of Psittaculla Krameri Borealis (50.0%) was collected from Guava (Psidium Guajava) Orchards, Mango (Mangifera Indica) orchard (41.6%), chekoo (Manilkara Zapota) orchard (5.9%) and the Minimum No: of Psittaculla krameri Borealis (2.3%) collected Date (Phoenix Dactylifera) orchard. It was observed that Psittaculla krameri Borealis were highly consumed Guava (Psidium Guajava) and the minimum consume food was Date (Phoenix Dactylifera).

Keywords: district Mirpur Khas Sindh Pakistan, feeding, habitat, parrot (ringed necked parakeet)

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Authors: Robin Root

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A fundamental premise of medical anthropology is that clinical phenomena are simultaneously cultural, political, and economic: none more so than the linked acronyms HIV/AIDS. For the medical researcher, HIV/AIDS signals an epidemiological pandemic and a pathophysiology. For persons diagnosed with an HIV-related condition, the acronym often conjures dread, too often marking and marginalizing the afflicted irretrievably. Critical medical anthropology is uniquely equipped to theorize the linkages that bind individual and social wellbeing to global structural and culture-specific phenomena. This paper reports findings from an anthropological study of HIV/AIDS in Swaziland, site of the highest HIV prevalence in the world. The project, initiated in 2005, has documented experiences of HIV/AIDS, religiosity, and treatment and care as well as drought and famine. Drawing on interviews with Swazi religious and traditional leaders about their experiences of leadership amidst worsening economic conditions, environmental degradation, and an ongoing global health crisis, the paper provides uncommon insights for global health practitioners whose singular paradigm for designing and delivering interventions is biomedically-based. In contrast, this paper details the role of local leaders in mediating extreme social suffering and resilience in ways that medical science cannot model but which radically impact how sickness is experienced and health services are delivered and accessed. Two concepts help to organize the paper’s argument. First, a ‘moral economy of language’ is central to showing up the implicit ‘technologies of knowledge’ that inhere in scientific and religious discourses of HIV/AIDS; people draw upon these discourses strategically to navigate highly vulnerable conditions. Second, Paulo Freire’s ethnographic focus on a culture’s 'dangerous words' opens up for examination how ‘sex’ is dangerous for religion and ‘god’ is dangerous for science. The paper interrogates hegemonic and ‘lived’ discourses, both biomedical and religious, and contributes to an important literature on the moral economies of health, a framework of explication and, importantly, action appropriate to a wide-range of contemporary global health phenomena. The paper concludes by asserting that it is imperative that global health planners reflect upon and ‘check’ their hegemonic policy platforms by, one, collaborating with local authoritative agents of ‘what sickness means and how it is best treated,’ and, two, taking account of the structural barriers to achieving good health.

Keywords: Africa, biomedicine, HIV/AIDS, qualitative research , religion

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