Search results for: aged society

Authors: Saheed A. Adekola, Mabel A. Charles-Davies, Ridwan A. Adekola

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Background: Testosterone is a known androgenic and anabolic steroid, primarily secreted in the testes. It plays an important role in the development of testes and prostate and has a range of biological actions. There is evidence that exposure to mixed chemicals in the workplace leads to the generation of free radicals and inadequate antioxidants leading to oxidative stress, which may serve as an early indicator of a pathophysiologic state. Based on findings, testosterone shows direct antioxidant effects by increasing the activities of antioxidant enzymes like glutathione peroxidase, thus indirectly contributing to antioxidant capacity. Objective: To evaluate the antioxidant role of testosterone as well as the relationship between testosterone and oxidative stress biomarkers in males exposed to mixed chemicals in the automobile repair community. Methods: The study included 43 participants aged 22- 60years exposed to mixed chemicals (EMC) from the automobile repair community. Forty (40) apparently healthy, unexposed, age-matched controls were recruited after informed consent. Demographic, sexual and anthropometric characteristics were obtained from pre-test structured questionnaires using standard methods. Blood samples (10mls) were collected from each subject into plain bottles and sera obtained were used for biochemical analyses. Serum levels of testosterone and luteinizing hormone (LH) were determined by enzyme immunoassay method, EIA (Immunometrics UK.LTD). Levels of total antioxidant capacity (TAC), total plasma peroxide (TPP), Malondialdehyde (MDA), hydrogen peroxide (H2O2), glutathione peroxide (GPX), superoxide dismutase (SOD), glutathione-S-transferase (GST), and reduced glutathione (GSH) were determined using spectrophotometric methods respectively. Results obtained were analyzed using the Student’s t-test and Chi-square test for quantitative variables and qualitative variables respectively. Multiple regression was used to find associations and relationships between the variables. Results: Significant higher concentrations of TPP, MDA, OSI, H2O2 and GST were observed in EMC compared with controls (p < 0.001). Within EMC, significantly higher levels of testosterone, LH and TAC were observed in eugonadic when compared with hypogonadic participants (p < 0.001). Diastolic blood pressure, waist circumference, waist height ratio and waist hip ratio were significantly higher in participants EMC compared with the controls. Sexual history and dietary intake showed that the controls had normal erection during sex and took more vegetables in their diet which may therefore be beneficial. Conclusion: The significantly increased levels of total antioxidant capacity in males exposed to mixed chemicals despite their exposure may probably reflect the contributory antioxidant role testosterone that prevents oxidative stress.

Keywords: mixed chemicals, oxidative stress, antioxidant, hypogonadism testosterone

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Authors: Jennifer E Simpson

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Background and purpose: The ubiquitous use of the Internet and social media by children and young people has had a dual effect. The first is to open a world of possibilities and promise that is characterized by the ability to consume and create content, connect with friends, explore and experiment. The second relates to risks such as unsolicited requests, sexual exploitation, cyberbullying and commercial exploitation. This duality poses significant difficulties for a generation of foster carers and social workers who have no childhood experience to draw on in terms of growing up using the Internet, social media and digital devices. This presentation is concerned with the findings of a small qualitative study about the use of digital devices and the Internet by care-experienced young people to stay in touch with their families and the way this was managed by foster carers and social workers using specific parental mediation strategies. The findings highlight that restrictive strategies were used by foster carers and endorsed by social workers. An argument is made for an approach that develops a series of balanced solutions that move foster carers from such restrictive approaches to those that are grounded in co-use and are interpretive in nature. Methods: Using a purposive sampling strategy, 12 triads consisting of care-experienced young people (aged 13-18 years), their foster carers and allocated social workers were recruited. All respondents undertook a semi-structured interview, with the young people detailing what social media apps and other devices they used to contact their families via an Ecomap. The foster carers and social workers shared details of the methods and approaches they used to manage digital devices and the Internet in general. Data analysis was performed using a Framework analytic method to explore the various attitudes, as well as complementary and contradictory perspectives of the young people, their foster carers and allocated social workers. Findings: The majority of foster carers made use of parental mediation strategies that erred on the side of typologies that included setting rules and regulations (restrictive), ad-hoc checking of a young person’s behavior and device (monitoring), and software used to limit or block access to inappropriate websites (technical). It was noted that minimal use was made by foster carers of parental mediation strategies that included talking about content (active/interpretive) or sharing Internet activities (co-use). Amongst the majority of the social workers, they also had a strong preference for restrictive approaches. Conclusions and implications: Trepidations on the part of both foster carers and social workers about the use of digital devices and the Internet meant that the parental strategies used were weighted more towards restriction, with little use made of approaches such as co-use and interpretative. This lack of balance calls for solutions that are grounded in co-use and an interpretive approach, both of which can be achieved through training and support, as well as wider policy change.

Keywords: parental mediation strategies, risk, children in state care, online safety

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Authors: Yulan Wu

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With the rapid development of social media, the issue of fake news has gained considerable prominence, drawing the attention of both the public and governments. The widespread dissemination of false information poses a tangible threat across multiple domains of society, including politics, economy, and health. However, much research has concentrated on supervised training models within specific domains, their effectiveness diminishes when applied to identify fake news across multiple domains. To solve this problem, some approaches based on domain labels have been proposed. By segmenting news to their specific area in advance, judges in the corresponding field may be more accurate on fake news. However, these approaches disregard the fact that news records can pertain to multiple domains, resulting in a significant loss of valuable information. In addition, the datasets used for training must all be domain-labeled, which creates unnecessary complexity. To solve these problems, an unsupervised domain knowledge discovery framework for fake news detection is proposed. Firstly, to effectively retain the multidomain knowledge of the text, a low-dimensional vector for each news text to capture domain embeddings is generated. Subsequently, a feature extraction module utilizing the unsupervisedly discovered domain embeddings is used to extract the comprehensive features of news. Finally, a classifier is employed to determine the authenticity of the news. To verify the proposed framework, a test is conducted on the existing widely used datasets, and the experimental results demonstrate that this method is able to improve the detection performance for fake news across multiple domains. Moreover, even in datasets that lack domain labels, this method can still effectively transfer domain knowledge, which can educe the time consumed by tagging without sacrificing the detection accuracy.

Keywords: fake news, deep learning, natural language processing, multiple domains

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Authors: Halima Sadia Qureshi, Urooj Sadiq, Noshi Eram Zaman

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The goal of this study was to see how cognitive behavior hypnotherapy affected nonsuicidal self-injury. DSM 5 invites the researchers to explore the newly added condition under the chapter of conditions under further study named Nonsuicidal self-injury disorder. To date, no empirical sound intervention has been proven effective for NSSI as given in DSM 5. Nonsuicidal self-injury is defined by DSM 5 as harming one's self physically, without suicidal intention. Around 7.6% of teenagers are expected to fulfill the NSSI disorder criteria. 3 Adolescents, particularly university students, account for around 87 percent of self-harm studies. Furthermore, one of the risks associated with NSSI is an increased chance of suicide attempts, and in most cases, the cycle repeats again. 6 The emotional and psychological components of the illness might lead to suicide, either intentionally or unintentionally. 7 According to a research done at a Pakistani military hospital, over 80% of participants had no intention of committing suicide. Furthermore, it has been determined that improvements in NSSI prevention and intervention are necessary as a stand-alone strategy. The quasi-experimental study took place in Islamabad and Rawalpindi, Pakistan, from May 2019 to April 2020 and included students aged 18 to 25 years old from several institutions and colleges in the twin cities. According to the Diagnostic and Statistical Manual of Mental Disorders 5th edition, the individuals were assessed for >2 episodes without suicidal intent using the intentional self-harm questionnaire. The Clinician Administered Nonsuicidal Self-Injury Disorder Index (CANDI) was used to assess the individual for NSSI condition. Symptom checklist-90 (SCL-90) was used to screen the participants for differential diagnosis. Mclean Screening Instrument for Borderline Personality Disorder (MSI-BPD) was used to rule out the BPD cases. The selected participants, n=106 from the screening sample of 600, were selected. They were further screened to meet the inclusion and exclusion criteria, and the total of n=71 were split into two groups: intervention and control. The intervention group received cognitive behavior hypnotherapy for the next three months, whereas the control group received no treatment. After the period of three months, both the groups went through the post assessment, and after the three months’ period, follow-up assessment was conducted. The groups were evaluated, and SPSS 25 was used to analyse the data. The results showed that each of the two groups had 30 (50 percent) of the 60 participants. There were 41 males (68 percent) and 19 girls (32 percent) in all. The bulk of the participants were between the ages of 21 and 23. (48 percent). Self-harm events were reported by 48 (80 percent) of the pupils, and suicide ideation was found in 6 (ten percent). In terms of pre- and post-intervention values (d=4.90), post-intervention and follow-up assessment values (d=0.32), and pre-intervention and follow-up values (d=5.42), the study's effect size was good. The comparison of treatment and no-treatment groups revealed that treatment was more successful than no-treatment, F (1, 58) = 53.16, p.001. The results reveal that the treatment manual of CBH is effective for Nonsuicidal self-injury disorder.

Keywords: NSSI, nonsuicidal self injury disorder, self-harm, self-injury, Cognitive behaviour hypnotherapy, CBH

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Authors: Coulibaly Fatoumata, Gragnon Biego, Aka N. David, Mbari K. Benjamin, Soro Y. René, Ndiaye Jean-louis

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Poultry is nowadays one of the most consumed sources of protein, and its livestock represents one of the few opportunities for savings, investment and protection against risk. It provides income for the most vulnerable sections of society, in particular, women (70%) and children who mainly practice this breeding. A study was conducted in the commune of Korhogo at the level of 52 poultry farms, the objective of which was to know the epidemiological situation of parasitism external and internal poultry in order to contribute to the improvement of the health status of modern poultry farms in the said commune. The method described by OIE (2005), consisting of using the standard formula (n = δ2*p*(1-p) *c /i2), made it possible to calculate the size of the sample. Then, samples of droppings and ectoparasites were taken from the affected farms. After analysis and identification, two (2) species of mallophagous lice, including Menopon gallinae (50%) and Menacanthus stramineus (33%) and a species of bug Cimex lectularius (17%) were highlighted. The laying hens were more infested than broilers. Regarding gastrointestinal parasites, different species (six) have been identified: Trichostrongylus tenuis (17%), Syngamus trachea (19%), Heterakis sp (10%), Ascaridia sp (17%), Raillietina sp (8%) and Eimeria sp (29%). In addition, coccidiosis (Eimeria sp) proved to be the dominant pathology representing 67% of pathologies in broiler farms and 33% in poultry farms. The presence of these parasitoses in these modern farms constitutes a constraint major contribution to productivity and their development In view of all these difficulties, proposals have been made in order to participate in the establishment of a good prophylaxis program (health and medical). In addition, the Ivorian government, with the support of veterinarians, must interfere more in the organization of the health monitoring of traditional chickens and poultry in general through supervision and training in order to preserve public health ( animal, human and environmental health).

Keywords: gastrointestinal parasites, ectoparasites, pathologies, poultry, korhogo.

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Authors: Sarika Gupta, Harshika Khanna, Ajay K Verma, Surya Kant

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Background: Drug-resistant tuberculosis (DR-TB) is a growing health challenge to global TB control efforts. Pediatric DR-TB is one of the neglected infectious diseases. In our previously published report, we have notified an increased prevalence of DR-TB in the pediatric population at a tertiary health care centre in North India which was estimated as 17.4%, 15.1%, 18.4%, and 20.3% in (%) in the year 2018, 2019, 2020, and 2021. Limited evidence exists about a pattern of drug resistance, side effect profile and programmatic outcomes of Paediatric DR-TB treatment. Therefore, this study was done to find out the pattern of resistance, side effect profile and treatment outcome. Methodology: This was a prospective cohort study conducted at the nodal drug-resistant tuberculosis centre of a tertiary care hospital in North India from January 2021 to December 2022. Subjects included children aged between 0-18 years of age with a diagnosis of DR-TB, on the basis of GeneXpert (rifampicin [RIF] resistance detected), line probe assay and drug sensitivity testing (DST) of M. tuberculosis (MTB) grown on a culture of body fluids. Children were classified as monoresistant TB, polyresistant TB (resistance to more than 1 first-line anti-TB drug, other than both INH and RIF), MDR-TB, pre-XDR-TB and XDR-TB, as per the WHO classification. All the patients were prescribed DR TB treatment as per the standard guidelines, either shorter oral DR-TB regimen or a longer all-oral MDR/XDR-TB regimen (age below five years needed modification). All the patients were followed up for side effects of treatment once per month. The patient outcomes were categorized as good outcomes if they had completed treatment and cured or were improving during the course of treatment, while bad outcomes included death or not improving during the course of treatment. Results: Of the 50 pediatric patients included in the study, 34 were females (66.7%) and 16 were male (31.4%). Around 33 patients (64.7%) were suffering from pulmonary TB, while 17 (33.3%) were suffering from extrapulmonary TB. The proportions of monoresistant TB, polyresistant TB, MDR-TB, pre-XDR-TB and XDR-TB were 2.0%, 0%, 50.0%, 30.0% and 18.0%, respectively. Good outcome was reported in 40 patients (80.0%). The 10 bad outcomes were 7 deaths (14%) and 3 (6.0%) children who were not improving. Adverse events (single or multiple) were reported in all the patients, most of which were mild in nature. The most common adverse events were metallic taste 16(31.4%), rash and allergic reaction 15(29.4%), nausea and vomiting 13(26.0%), arthralgia 11 (21.6%) and alopecia 11 (21.6%). Serious adverse event of QTc prolongation was reported in 4 cases (7.8%), but neither arrhythmias nor symptomatic cardiac side effects occurred. Vestibular toxicity was reported in 2(3.9%), and psychotic symptoms in 4(7.8%). Hepatotoxicity, hypothyroidism, peripheral neuropathy, gynaecomastia, and amenorrhea were reported in 2 (4.0%), 4 (7.8%), 2 (3.9%), 1(2.0%), and 2 (3.9%) respectively. None of the drugs needed to be withdrawn due to uncontrolled adverse events. Conclusion: Paediatric DR TB treatment achieved favorable outcomes in a large proportion of children. DR TB treatment regimen drugs were overall well tolerated in this cohort.

Keywords: pediatric, drug-resistant, tuberculosis, adverse events, treatment

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Authors: Adi Sharabi, Dafna Marom-Golan

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Parents’ involvement in the care of their children with Autism Spectrum Disorder (ASD) and its beneficial effect on the children’s developmental and educational outcomes is well documented. At the same time, parents of children with ASD tend to experience greater psychological distress than parents of children with other developmental disabilities or with typical development. Positive social support is an important resource used by parents to reduce their psychological distress. The goal of the current research was to examine the contribution of formal and informal social support in explaining mothers’ and fathers’ involvement with their young children with ASD. The sample consisted of 107 parents who live in Israel (61 mothers and 46 fathers) of children aged between 2 and 7, all diagnosed with ASD and attending special kindergartens or special day care for children with ASD. Parental involvement and social support perception were assessed. Initial analysis focused on the relations between involvement, support, and demographic variables. In addition, analysis of variance (ANOVA) was conducted to test differences between mothers and fathers. Two hierarchical multiple regression analyses were performed to examine the predicted factors in the involvement model while controlling for group (mothers/fathers). Results indicate that mothers reported significantly higher levels of parenting involvement than fathers. Mothers reported higher levels of general involvement and all sub-types of involvement. For example, mothers reported that they were more interested in and have higher levels of attendance in their child’s educational program. They were also more collaborative in their child’s educational therapeutic program, and socialized with other parents of children from their child’s kindergarten than fathers. Mothers’ involvement was found to be related to their informal support (non-formal relatives). Findings also reveal significant differences between mothers and fathers on the formal support subscale measure of specializes services. Fathers, more than mothers, reported more specializes services support such as social workers or professional therapists. Separate hierarchical multiple regression analyses revealed a unique gender difference in the factors that explained parental involvement. Specifically, informal support only had a unique positive contribution in explaining mothers’, but not fathers’ involvement. This study highlights the central role of mothers in maintaining constant contact with the educational system and the professionals who help care for their child with ASD. At the same time, this research emphasizes the crucial role of both mothers and fathers in their child's development and well-being at every development stage, particularly in early development. Further, different kinds of social support seem to relate to the different kinds of parental involvement. It is in the best interest of educators and family therapists who work with families with children with ASD to support the cohesiveness of the family and the collaboration of the parents by understanding and respecting the way each member addresses the responsibilities of parenting a child with ASD, and her or his need for different types of social support.

Keywords: parental differences, parental involvement, social support, specialized support services

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Authors: Kever Bruno Paradelo Gomes, Rosana Carvalho Martins

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The home gardens areas are production systems, which are located near the homes and are quite common in the tropics. They consist of agricultural and forest species and may also involve the raising of small animals to produce food for subsistence as well as income generation, with a special focus on the conservation of biodiversity. Home gardens are diverse Agroforestry systems with multiple uses, among many, food security, income aid, traditional medicine. The work was carried out on rural properties of the family farmers of the Ponte Alta Rural Nucleus, Gama Administrative Region, in the city of Brasília, Federal District- Brazil. The present research is characterized methodologically as a quantitative, exploratory and descriptive nature. The instruments used in this research were: bibliographic survey and semi-structured questionnaire. The data collection was performed through the application of a semi-structured questionnaire, containing questions that referred to the perception and behavior of the interviewed producer on the subject under analysis. In each question, the respondent explained his knowledge about sustainability, agroecological practices, environmental legislation, conservation methods, forest and medicinal species, ago social and socioeconomic characteristics, use and purpose of agroforestry and technical assistance. The sample represented 55.62% of the universe of the study. We interviewed 99 people aged 18-83 years, with a mean age of 49 years. The low level of education, coupled with the lack of training and guidance for small family farmers in the Ponte Alta Rural Nucleus, is one of the limitations to the development of practices oriented towards sustainable and agroecological agriculture in the nucleus. It is observed that 50.5% of the interviewed people landed with agroforestry yards less than 20 years ago, and only 16.17% of them are older than 35 years. In identifying agriculture as the main activity of most of the rural properties studied, attention is drawn to the cultivation of medicinal plants, fruits and crops as the most extracted products. However, it is verified that the crops in the backyards have the exclusive purpose of family consumption, which could be complemented with the marketing of the surplus, as well as with the aggregation of value to the cultivated products. Initiatives such as this may contribute to the increase in family income and to the motivation and value of the crop in agroecological gardens. We conclude that home gardens of Ponte Alta are highly diverse thus contributing to local biodiversity conservation of are managed by women to ensure food security and allows income generation. The tradition of existing knowledge on the use and management of the diversity of resources used in agroforestry yards is of paramount importance for the development of sustainable alternative practices.

Keywords: agriculture, agroforestry system, rural development, sustainability

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Authors: Rasmita Mishra, Chander Shekher

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Background: Population ageing is an inevitable outcome of demographic transition. Due to increased life expectancy, the old age population in India and worldwide has increased, and it will continue to grow more alarmingly in the near future. There are redundant austerity that has been bestowed upon the widows, thus, the life of widows is never been easy in India. The loss of spouse along with other disadvantaged socioeconomic intermediaries like illiteracy and poverty often make the life of widows more difficult to live. Methodology: Ethical statement: The study used secondary data available in the public domain for its wider use in social research. Thus, there was no requirement of ethical consent in the present study. Data source: Building a Knowledge Base on Population Aging in India (BKPAI), 2011 dataset is used to fulfill the objectives of this study. It was carried out in seven states – Himachal Pradesh, Kerala, Maharashtra, Odisha, Punjab, Tamil Nadu, and West Bengal – having a higher percentage of the population in the age group 60 years and above compared to the national average. Statistical analysis: Descriptive and inferential statistics were used to understand the level of elderly widows and incidence of abuse against them in India and selected states. Bivariate and Trivariate analysis were carried out to check the pattern of abuse by selected covariates. Chi-Square test is used to verify the significance of the association. Further, Discriminant Analysis (DA) is carried out to understand which factor can separate out group of neglect and non-neglect elderly. Result: With the addition of 27 million from 2001 to 2011, the total elderly population in India is more than 100 million. Elderly females aged 60+ were more widows than their counterpart elderly males. This pattern was observed across selected states and at national level. At national level, more than one tenth (12 percent) of elderly experienced abuse in their lifetime. Incidence of abuse against elderly widows within family was considerably higher than the outside the family. This pattern was observed across the selected place and abuse in the study. In discriminant analysis, the significant difference between neglected and non-neglected elderly on each of the independent variables was examined using group mean and ANOVA. Discussion: The study is the first of its kind to assess the incidence of abuse against elderly widows using large-scale survey data. Another novelty of this study is that it has assessed for those states in India whereby the proportion of elderly is higher than the national average. Place and perpetrators involved in the abuse against elderly widows certainly envisaged the safeness in the present living arrangement of elderly widows. Conclusion: Due to the increasing life expectancy it is expected that the number of elderly will increase much faster than before. As biologically women live longer than men, there will be more women elderly than men. With respect to the living arrangement, after the demise of the spouse, elderly widows are more likely to live with their children who emerged as the main perpetrator of abuse.

Keywords: elderly abuse, emotional abuse physical abuse, material abuse, psychological abuse, quality of life

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Authors: Alyaa Farouk Ibrahim, Gehan ElSayed, Ola Mamdouh, Nazek AbdelGhany

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Background: Primary health care (PHC) can be considered the first contact between the patient and the health care system. It includes all the basic health care services to be provided to the community. Patient's satisfaction regarding health care has often improved the provision of care, also considered as one of the most important measures for evaluating the health care. Objective: This study aims to identify patient’s satisfaction with services provided at the primary health care settings in Alexandria. Setting: Seven primary health care settings representing the seven zones of Alexandria governorate were selected randomly and included in the study. Subjects: The study comprised 386 patients attended the previously selected settings at least twice before the time of the study. Tools: Two tools were utilized for data collection; sociodemographic characteristics and health status structured interview schedule and patient satisfaction scale. Reliability test for the scale was done using Cronbach's Alpha test, the result of the test ranged between 0.717 and 0.967. The overall satisfaction was computed and divided into high, medium, and low satisfaction. Results: Age of the studied sample ranged between 19 and 62 years, more than half (54.2%) of them aged 40 to less than 60 years. More than half (52.8%) of the patients included in the study were diabetics, 39.1% of them were hypertensive, 19.2% had cardiovascular diseases, the rest of the sample had tumor, liver diseases, and orthopedic/neurological disorders (6.5%, 5.2% & 3.2%, respectively). The vast majority of the study group mentioned high satisfaction with overall service cost, environmental conditions, medical staff attitude and health education given at the PHC settings (87.8%, 90.7%, 86.3% & 90.9%, respectively), however, medium satisfaction was mostly reported concerning medical checkup procedures, follow-up data and referral system (41.2%, 28.5% & 28.9%, respectively). Score level of patient satisfaction with health services provided at the assessed Primary health care settings proved to be significantly associated with patients’ social status (P=0.003, X²=14.2), occupation (P=0.011, X²=11.2), and monthly income (P=0.039, X²=6.50). In addition, a significant association was observed between score level of satisfaction and type of illness (P=0.007, X²=9.366), type of medication (P=0.014, X²=9.033), prior knowledge about the health center (P=0.050, X²=3.346), and highly significant with the administrative zone (P=0.001, X²=55.294). Conclusion: The current study revealed that overall service cost, environmental conditions, staff attitude and health education at the assessed primary health care settings gained high patient satisfaction level, while, medical checkup procedures, follow-up, and referral system caused a medium level of satisfaction among assessed patients. Nevertheless, social status, occupation, monthly income, type of illness, type of medication and administrative zones are all factors influencing patient satisfaction with services provided at the health facilities.

Keywords: patient satisfaction, chronic illness, quality of health service, quality of service indicators

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Authors: Pavani K. Sree, Ragahava Reddy Chandri

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Independent living and living with dignity have been the hallmarks of the movement of the persons with disabilities across the globe against the oppression perpetuated by society in the form of social and physical structural barriers. Advancements in assistive technologies have been providing a new lease of life to persons with disabilities. However, access to these technologies is marred by the issues of affordability and availability. Poor from the developing countries find it difficult to make independent living or live with dignity because of lack of access and inability to afford the advance technologies. Class and gender appear to be key factors influencing the access to modern assistive technologies. The present paper attempts to understand the dynamics of class and gender in accessing advanced technologies in the Indian context. Based on an empirical study in which data were collected from persons with locomotor disabilities and service providers, the paper finds that the advance technologies are expensive and inaccessible to all persons with disabilities. The paper also finds that men with disabilities are prioritized by the members of the family for the use of advance technologies while women with disabilities are forced to live with not so advanced technologies. The paper finds that the state institutions working in the field of prosthetics and assistive technologies fail to deliver to the requirements of the poor. It was found that because of lack of facilities at the state institutions the cost of prosthetics, in the case of orthopedically challenged, is expensive and unaffordable for the poor. It was found that while rich male access the private services the poor women depend on the state institutions. It may be said that the social, cultural stereotypes extend not only to the state organizations but also to the use of prosthetics. Thus the notions of independent living and living with dignity in third world countries context are still elusive.

Keywords: accessibility, assistive technology, class, gender, state

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Authors: Glauberto S. Quirino, Emanuelly V. Pereira, Amana S. Figueiredo, Antonia T. F. Santos, Paulo R. A. Firmino, Denise F. F. Barbosa, Caroline B. Q. Aquino, Eveliny S. Martins, Cinthia G. P. Calou, Ana K. B. Pinheiro

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Introduction: During pregnancy there are adjustments in the physical, emotional, existential and sexual areas, which may contribute to changes in sexual behavior. The objective was to analyze the sexual behavior of pregnant women. Methods: Quantitative, exploratory-descriptive study, approved by the Ethics and Research Committee of the Regional University of Cariri. For data collection, it was used the Sexuality Questionnaire in Gestation and Sexual Quotient - Female Version. It was carried out in public institutions in the urban and rural areas of three municipalities of the Metropolitan Region of Cariri, south of Ceará, Brazil from February to September 2016. The sampling was proportional stratified by convenience. A total of 815 pregnant women who were literate and aged 20 years or over were broached. 461 pregnant women were excluded because of high risk, adolescence, saturation of the extract, incomplete filling of the instrument, mental and physical handicap, without sexual partner, and the sample was 354 pregnant. The data were grouped, organized and analyzed in the statistical program R Studio (version 386 3.2.4). Descriptive frequency statistics and non-parametric tests were used to analyze the variables, and the results were shown in graphs and tables. Results: The women presented a minimum age of 20, maximum 35 and average of 26.9 years, predominantly urban area residents, with a monthly income of up to one minimum wage (US$ 275,00), high school, catholic, with fixed partner, heterosexuals, multiparous, multiple sexual partners throughout life and with the beginning of sexual life in adolescence (median age 17 years). There was a reduction in sexual practices (67%) and when they were performed, they were more frequent in the first trimester (79.7%) and less frequent in the third trimester (30.5%). Preliminary sexual practices did not change and were more frequent in the second trimester (46.6%). Throughout the gestational trimesters, the partner was referred as the main responsible for the sexual initiative. The women performed vaginal sex (97.7%) and provided greater pleasure (42.8%) compared to non-penetrative sex (53.9%) (oral sex and masturbation). There was also a reduction in the sexual disposition of pregnant women (90.7%) and partner (72.9%), mainly in the first trimester (78.8%), and sexual positions. Sexual performance ranged from regular to good (49.7%). Level of schooling, marital status, sexual orientation of the pregnant woman and the partner, sexual practices and positions, preliminaries, frequency of sexual practices and importance attributed to them were variables that influenced negatively sexual performance and satisfaction. It is concluded that pregnancy negatively changes the sexual behavior of the women and it is suggested to further investigations and approach of the partner, in order to clarify the influence of these variables on the sexual function and subsidize intervention strategies, with a view to the integrality of sexual and reproductive health.

Keywords: obstetric nursing, pregnant women, sexual behavior, women's health

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Authors: Shiamaa Eltantawy, Gihan Sobhy, Alif Alaam

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Wilson disease, or hepatolenticular degeneration, is an autosomal recessive disease that results in excess copper buildup in the body. It primarily affects the liver and basal ganglia of the brain, but it can affect other organ systems. Musculoskeletal abnormalities, including premature osteoarthritis, skeletal deformity, and pathological bone fractures, can occasionally be found in WD patients with a hepatic or neurologic type. The aim was to assess the prevalence of osteoporosis and osteopenia in Wilson’s disease patients. This case-control study was conducted on ninety children recruited from the inpatient ward and outpatient clinic of the Paediatric Hepatology, Gastroenterology, and Nutrition department of the National Liver Institute at Menofia University, aged from 1 to 18 years. Males were 49, and females were 41. Children were divided into three groups: (Group I) consisted of thirty patients with WD; (Group II) consisted of thirty patients with chronic liver disease other than WD; (Group III) consisted of thirty age- and sex-matched healthy The exclusion criteria were patients with hyperparathyroidism, hyperthyroidism, renal failure, Cushing's syndrome, and patients on certain drugs such as chemotherapy, anticonvulsants, or steroids. All patients were subjected to the following: 1- Full history-taking and clinical examination. 2-Laboratory investigations: (FBC,ALT,AST,serum albumin, total protein, total serum bilirubin,direct bilirubin,alkaline phosphatase, prothrombin time, serum critine,parathyroid hormone, serum calcium, serum phosphrus). 3-Bone mineral density (BMD, gm/cm2) values were measured by dual-energy X-ray absorptiometry (DEXA). The results revealed that there was a highly statistically significant difference between the three groups regarding the DEXA scan, and there was no statistically significant difference between groups I and II, but the WD group had the lowest bone mineral density. The WD group had a large number of cases of osteopenia and osteoporosis, but there was no statistically significant difference with the group II mean, while a high statistically significant difference was found when compared to group III. In the WD group, there were 20 patients with osteopenia, 4 patients with osteoporosis, and 6 patients who were normal. The percentages were 66.7%, 13.3%, and 20%, respectively. Therefore, the largest number of cases in the WD group had osteopenia. There was no statistically significant difference found between WD patients on different treatment regimens regarding DEXA scan results (Z-Score). There was no statistically significant difference found between patients in the WD group (normal, osteopenic, or osteoporotic) regarding phosphorus (mg/dL), but there was a highly statistically significant difference found between them regarding ionised Ca (mmol/L). Therefore, there was a decrease in bone mineral density when the Ca level was decreased. In summary, Wilson disease is associated with bone demineralization. The largest number of cases in the WD group in our study had osteopenia (66.7%). Different treatment regimens (zinc monotherapy, Artamin, and zinc) as well as different laboratory parameters have no effect on bone mineralization in WD cases. Decreased ionised Ca is associated with low BMD in WD patients. Children with WD should be investigated for BMD.

Keywords: wilson disease, Bone mineral density, liver disease, osteoporosis

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Authors: Wasantha Subasinghe

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Crimes are one of big social problems in Sri Lanka. Crimes can be seen as simply way as an activity that against for the society or public law. There are offences in minor crimes and grave crimes including murder, rape, trafficking, robbery, excise, narcotic, kidnapping and so on. There are various forms of punishment such as bailing, fining, and prisoning to the death penalty. Death penalty contains the killing of an offender for an offense. There are 23 prison institutions in Sri Lanka including 03 closed prisoners and 20 remand prisons. There are 10 work camps, 02 open prison camps, 01 training school for youthful offenders and 02 correctional centers for youthful offenders. Capital punishment is legal in Sri Lanka as many other countries as India, Japan, Bangladesh, Iran and Iraq so on. When compared unconvicted prisoners from 2006-2010 there is an increase. It was 89190 in 2006 and it was 100191 in 2010. There were 28732 of convicted prisoners and it was 32128 in 2010. There were 165 Death sentences in 2006 and it was 96 in 2010. There are 540 individuals had been sentenced to death. The death penalty has not been implemented in Sri Lanka since 1976. Research problem: What are the feelings of prisoners as waiting for death?’ Objectives of the study were identifying prisoners’ point of view on their punishment and root causes for their offence. Case studies were conducted to identify the research problem and data were collected using formal interviews. Research area was Welikada prison. Stratified sampling method in probability samplings was used. Sample size was 20 cases from death penalty and life in prison prisoners and 20 from other convicted prisoners. Findings revealed causes and feelings them as offenders. They need if death penalty or freedom. Some of them need to convert death sentence to life imprisonment. They are physically and mentally damaged after their imprisonment. Lack of hope and as well as lack of welfare and rehabilitation programs they suffered their lives.

Keywords: death penalty, expectations, life imprisonment, rehabilitation

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Authors: Corlia van der Walt, Michele K. Havenga

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The study considers corporate governance regulation and practice in South African higher education institutions and makes recommendations for the improvement of current governance practices in this sector. The development of corporate governance principles and practices in South Africa, culminating in the King IV Report on Corporate Governance which was launched in November 2016, is discussed. King IV enjoys international recognition as a progressive corporate governance instrument. It was necessitated by the fundamental changes in business and society nationally and globally, as well as by the significant changes to South African company law introduced by new legislation. Corporate governance and the corporate form are narrowly associated, but there is general recognition that the principles of ethical and effective leadership are not restricted to corporations. Thus King IV was drafted with the express aim that it should apply to all organisations, regardless of their form of incorporation, and the report includes specific sector supplements in support of this aspiration. The South African higher education sector has of late been under intense scrutiny, and a few universities have been placed under administration because of poor governance practices. Universities have also been severely impacted by the consequences of what is generally known as ‘#FeesmustFall’, a student led protest movement initially aimed against the increase of fees at public universities, but which rapidly expanded to also include other concerns. It was clearly necessary to revisit corporate governance policy and practice in the sector. The review of the current higher education governance regime in light of the King IV recommendations, lessons from company law regarding the entrenchment and enforcement of corporate governance principles, and a comparison of higher education governance practices in selected other jurisdictions led to recommendations for the improvement of governance practices in South African higher education. It is further suggested that a sector supplement for higher education institutions may provide additional clarity. Some of the recommendations may be of comparative value for international higher education governance.

Keywords: committees, corporate governance, ethical leadership, higher education institutions, integrated reporting, King IV, sector supplements, sustainability

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Authors: Julius Adebayo John

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The objective of this study is to compare the use of medicinal plants and Conventional medicine intervention in the management of HBV among Ibadan populace. A purposive sampling technique was used to administer questionnaires at 2 places, namely, the University College Hospital and Total Healthcare Diagnostic Centre, Ibadan, where viral loads are carried out. A EuroQol (EQ – 5D) was adopted to collect data. Descriptive and inferential analyses were performed. Also, ANOVA, Correlation, charts, and tables were used. Findings revealed a high prevalence of HBV among female respondents and sample between ages 26years to 50years. Results showed that the majority discovered their health status through free HBV tests. Analysis indicated that the use of medicinal plant extract is cost-effective in 73% of cases. Rank order utility derived from medicinal plants is higher than other interventions. Correlation analysis performed for the current health status of respondents were significant at P<0.01 against the intervention management adopted (0.046), cost of treatment (0.549), utility (0.407) at P<0.00, duration of the treatment (0.604) at P<0.01; viral load before treatment (-0.142) not significant at P<0.01, the R2 (72.2%) showed the statistical variance in respondents current health status as explained by the independent variables. Respondents gained quality-adjusted life-years (QALYs) of between 1year to 3years. Suggestions were made for a public-private partnership effort against HBV with emphasis on periodic screening, viral load test subsidy, and free vaccination of people with –HBV status. Promoting phytomedicine through intensive research with strong regulation of herbal practitioners will go a long way in alleviating the burdens of the disease in society.

Keywords: medicinal plant, HBV management interventions, utility, QALYs, ibadan metropolis

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Authors: Mehmet Sinan Erguven

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Modern art is relatively new but a popular area in Turkish art society. Modern art museums are mainly located in big cities like Istanbul and Ankara where cultural life is more dynamic. Odunpazarı Modern Museum (OMM) will open its doors on September 2019 and be the only modern art museum located in a small town in Turkey. OMM executives declare the mission of the museum as; art must go beyond the metropolises of the world, give a new lease of life to cities that make a difference with their cultural texture, and reach a greater audience through that expansion. So OMM will not only serve as a museum but a landmark for regenerating the city brand of Eskişehir like the Guggenheim in Bilbao. OMM is located in the Odunpazarı area, the heart of Eskişehir. Named after the historical timber market it once hosted, Odunpazarı is a nominated site for the UNESCO Intangible Cultural Heritage List, and is Eskişehir’s first area of settlement. This study focuses on the complex nature of opening a modern art museum in a small town. The management and marketing dynamics of OMM are discussed in the study. Content analysis technique is used on local and national news to display the perception differences before and after the opening of OMM. In depth interviews with the executives of the museum are conducted in order to enlighten the insights of opening a modern art museum in a small town. Early findings of the content analysis point out that, the comments on the national press are mostly positive. On the other hand, different views occur on the local press. The location OMM is constructed and grandness of the museum building are criticized by some of the local newspapers. OMM’s potential as a tourist attraction is agreed by most of the media. OMM executives stated the most challenging task as reaching the different target audiences on international, national and local levels. These early findings will be improved and compared shortly before and after the opening of the museum.

Keywords: management, marketing, Odunpazarı modern museum, small town

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Authors: Ejovi Eghwubare Augustine

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This study delved into the traditional mechanisms of conflict resolution in Africa, a pathway to sustainable peace in Nigeria. It deployed the quantitative and qualitative methods of data collection and content analysis. The work adopted the Peace Process theory propounded by John Darby and Roger Macunity. It ascertained that disputes or disagreements are unarguably and necessarily an inevitable part of human existence, flowing directly from communication, interaction, and relationships which can occur at individual and national levels, even at international levels in view of the current trend of globalization. The alternative Dispute Resolution (ADR) mechanism is a basket of procedures outside the traditional process of litigation or strict determination of legal rights. It may also be elucidated as a range of procedures that serve as generally involve the intercession and assistance of a neutral and impartial third party. The traditional mechanisms of conflict resolution in Africa are alien to the Western world; this paper is of utmost importance to the Western world and also enriched their pool of literature. Nigeria is a country that is dominated by various ethnic groups anchored on diverse cultures, customs, and traditions. It is, therefore, not surprising to see conflicts arise, and despite the various attempts at resolving these conflicts through litigation, they still remained unabated. The paper investigated the lessons learned from Traditional Mechanisms of Conflict resolution; it also interrogated its impact and the way forward. In light of the lessons that were learned and the impact of the traditional mechanisms of conflict resolution, suggestions on how to attain a sustainable, peaceful society were proffered. In conclusion, the study crystallized reforms on the alternative dispute resolution introduced through the traditional mechanism, which includes, amongst others, that constitutional recognition should be given to traditional institutions of conflict resolution to enable quick dispensation of matters.

Keywords: traditional, conflict, peace, resolution

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Authors: Lung-Lung Hu

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Ronald Dworkin offered a legal theory of ‘chain enterprise’ that all the judges in legal history altogether create a ‘law’ aiming a specific purpose. Those judges are like co-writers of a chain-story who not only create freely but also are constrained by the story made by the judges before them. The law created by Chinese traditional judges is another case, they, compared with the judges mentioned by Ronald Dworkin, have relatively narrower space of making a legal sentence according to their own discretions because the statutes in Chinese traditional law at the very beginning have been designed as panel code that leaves small room to judge’s discretion. Furthermore, because law is a representative of the authority of the government, i.e. the emperor, any misjudges and misuses deviated from the law will be considered as a challenge to the supreme power. However, different from judges as the defenders of law, Chinese litigation masters who want to win legal cases have to be offenders challenging the verdict that does not favor his or his client’s interest. Besides, litigation master as an illegal or non-authorized profession does not belong to any legal system, therefore, they are relatively freer to ‘create’ the law. According to Stanley Fish’s articles that question Ronald Dworkin and Owen Fiss’ ideas about law, he construes that, since law is made of language, law is open to interpretations that cannot be constrained by any rules or any particular legal purposes. Stanley Fish’s idea can also be applied on the analysis about the stories of Chinese litigation masters in traditional Chinese literature. These Chinese litigation masters’ legal opinions in the so-called chain enterprise are like an unexpected episode that tries to revise the fixed story told by law. Although they are not welcome to the officials and also to the society, their existence is still a phenomenon representing another version of justice different from the official’s and can be seen as a de-structural power to the government. Hence, in this present paper the language and strategy applied by Chinese litigation masters in Chinese legal stories will be analysed to see how they refute made legal judgments and challenge the official standard of justice.

Keywords: Chinese legal stories, interdisciplinary, litigation master, post-structuralism

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Authors: Anusha Edirisinghe

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Sexual Gender based violence is a most common social phenomenon in higher education institutions. It has become a hidden crime of the Universities. Masculinities norms and attitudes are more influential and serve as key drivers and risk for ragging and SGBV. This research will reveal that in Sri Lankan universities, SGBV takes from the violence and murder of women students, assault and battery coerced sex, sexual harassment including harassment via information technology. This study focus is to prevention of ragging and SGBV in University system. Main objective of this paper describes and critically analyses of plight of ragging and SGBV in higher education institutions and legal and national level policy implementation to prevent these crimes in society. This paper is with special reference to ragging case from University of Kelaniya 2016. University Grant commission introduced an Act for the prevention of Ragging and gender standing committee established in Sri Lanka in 2016. And each university has been involved in the prevention of SGBV and ragging in higher education institutions. Case study from first year female student, reported sexual harassment was reported to the police station in May in 2016. After this case, the university has been implementing emergency action plan, short term and long term action plan. Ragging and SGBV task force was established and online complaint center opened to all students and academic and non- academics. Under these circumstances student complained to SGBV and other harassment to the university. University security system was strong support with police and marshals, and vigilant committees including lecturers. After this case all universities start to several programmes to stop violence in university

Keywords: higher Education, ragging, sexual gender-based violence, Sri Lanka

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Authors: D. Songpol, K. Taweesak, T. Sookyuen

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A social enterprise is an organization that operates commercial business as a source of income with the aim of addressing social and environmental issues. Though it is clear that this kind of organization will benefit society and environment but in practice, it is found that most of social enterprises’ goals cannot be achieved. The most success factors of social enterprises usually rely on individual characteristics of entrepreneurs, especially in educational business. This study aims to find out the magnitude of influence from the components of entrepreneur competencies to social enterprises in education. There are developmental models of research demonstrating that knowledge, skills and attributes affect the success of social enterprises in term of sustainability, social opportunities and innovation leadership. The 5-scale questionnaire was used to collect data from the social entrepreneurs in education who operates in the South East Asian region of 135 samples and then processed by the methods of structural equation models. The results show that the competency of entrepreneurs in attributes has the greatest impact on the success of social enterprises while the skills and knowledge have respectively impact on the social enterprises’ success as well. The reason why attributes of entrepreneurs have the greatest impact on social enterprise success is because, social enterprise is an organization that does not motivate or provide attractive financial incentives to the entrepreneur. Entrepreneurs, who succeed in developing their organizations, therefore need attribute factor higher than normal entrepreneurs, especially those in education sector that have somewhat few human resources to operate their businesses. More importantly, attribute’s traits such as entrepreneurial passion, self-efficacy, entrepreneurial identity and, innovativeness and perseverance will significantly affect the ideology and tolerance of the entrepreneurs once facing the problem in doing business. In conclusion, the education social enterprise would be successful depending on the performance of the entrepreneurs which derives from higher attributes competency.

Keywords: education, entrepreneur competencies, social enterprise, South East Asia

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Authors: Ireen Manase Kabembo, Patrick Chanda

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Background: Substance use disorders are among the chronic conditions that affect all age groups. Worldwide, there is an increase in young people affected by SUDs, which implies that more family members are transitioning into the caregiver role. Family caregivers play a buffering role in the formal healthcare system due to their involvement in caring for persons with acute and chronic conditions in the home setting. Family carers of youth with problematic alcohol and marijuana use experience myriad challenges in managing daily care for this medically vulnerable group. In addition, the poor health-seeking behaviours of youth with SUDs characterized by eluding treatment and runaway tendencies coupled with the effects of the pandemic made caregiving a daunting task for most family caregivers. Issues such as limited and unavailable psychotropic medications, social stigma and discrimination, financial hurdles, systemic barriers in adolescent and young adult mental healthcare services, and the lack of a perceived vulnerability to Covid-19 by youth with SUDs are experiences of family caretakers. Methods: A qualitative study with 30 family caregivers of youth aged 16-24 explored their lived experiences and subjective meanings using two in-depth semi-structured interviews, a caregiving timeline, and participant observation. Findings: Results indicate that most family caregivers had challenges managing care for treatment elusive youth, let alone having them adhere to Covid-19 regulations. However, youth who utilized healthcare services and adhered to treatment regimens had positive outcomes and sustained recovery. The effects of the pandemic, such as job losses and the closure of businesses, further exacerbated the financial challenges experienced by family caregivers, making it difficult to purchase needed medications and daily necessities for the youth. The unabated stigma and discrimination of families of substance-dependent youth in Zambian communities further isolated family caregivers, leaving them with limited support. Conclusion: Since young people with SUDs have a compromised mental capacity due to the cognitive impairments that come with continued substance abuse, they often have difficulties making sound judgements, including the need to utilize SUD recovery services. Also, their tendency to not adhere to the Covid-19 pandemic requirements places them at a higher risk for adverse health outcomes in the (post) pandemic era. This calls for urgent implementation of robust youth mental health services that address prevention and recovery for these emerging adults grappling with substance use disorders. Support for their family caregivers, often overlooked, cannot be overemphasized.

Keywords: chronic care management, Covid-19 pandemic, family caregivers, youth with substance use disorders

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Authors: Mohammed Belalia Douma

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Interactive learning is considered as the most effective strategy of learning, it is an educational philosophy based on the learner's contribution and involvement mainly in classroom and how he interacts toward his small society “classroom”, and the level of his collaboration into challenge, discovering, games, participation, all these can be provided through the interactive learning, which aims to activate the learner's role in the operation of learning, which focuses on research and experimentation, and the learner's self-reliance in obtaining information, acquiring skills, and forming values and attitudes. Whereas not based on memorization only, but rather on developing thinking and the ability to solve problems, on teamwork and collaborative learning. With the exchange or roles - teacher to student- , when the student will be more active and performing operations more than the student under the interactive learning method; we might face a several issues dealing with class controlling management, noise, and stability of learning… etc. This research paper is observing the application of the interactive learning on reality “classroom” and answers several assumptions and analyzes the issues coming up of these strategies mainly: noise, class control…etc The research sample was about 150 student of the 3rd year primary school in “Chlef” district, Algeria, level: beginners in the range of age 08 to 10 years old . We provided a questionnaire of confidential fifteen questions and also analyzing the attitudes of learners during three months. it have witnessed as teachers a variety of strategies dealing with applying the interactive learning but with a different issues; time management, noise, uncontrolled classes, overcrowded classes. Finally, it summed up that although the active education is an inevitably effective method of teaching, however, there are drawbacks to this, in addition to the fact that not all theoretical strategies can be applied and we conclude with solutions of this case study.

Keywords: interactive learning, student, learners, strategies.

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Authors: Yuki Matsumoto, Yuma Ishimoto

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Cognitive Behavior Therapy (CBT) with children has shown effective application to various problems such as anxiety and depression. Although there are barriers to access to mental health services including lack of professional services in communities and parental concerns about stigma, school has a significant role to address children’s health problems. Schools are regarded as a suitable arena for prevention and early intervention of mental health problems. In this line, CBT can be adaptable to school education and useful to enhance students’ social and emotional skills. However, Japanese school curriculum is rigorous so as to limit available time for implementation of CBT in schools. This paper describes Brief Cognitive Behavior Therapy (BCBT) with children in a Japanese school setting. The program has been developed in order to facilitate acceptability of CBT in schools and aimed to enhance students’ skills to manage anxiety and difficult behaviors. The present research used a single arm design in which 30 students aged 9-10 years old participated. The authors provided teachers a CBT training workshop (two hours) at two primary schools in Tokyo metropolitan area and recruited participants in the research. A homeroom teacher voluntarily delivered a 6-session BCBT program (15 minutes each) in classroom periods which is called as Kaerinokai, a meeting before leaving school. Students completed a questionnaire sheet at pre- and post-periods under the supervision of the teacher. The sheet included the Spence Child Anxiety Scale (SCAS), the Depression Self-Rating Scale for Children (DSRS), and the Strengths and Difficulties Questionnaire (SDQ). The teacher was asked for feedback after the completion. Significant positive changes were found in the total and five of six sub-scales of the SCAS and the total difficulty scale of the SDQ. However, no significant changes were seen in Physical Injury Fear sub-scale of the SCAS, in the DSRS or the Prosocial sub-scale of the SDQ. The effect sizes are mostly between small and medium. The teacher commented that the program was easy to use and found positive changes in classroom activities and personal relationships. This preliminary research showed the feasibility of the BCBT in a school setting. The results suggest that the BCBT offers effective treatment for reduction in anxiety and in difficult behaviors. There is a good prospect of the BCBT suggesting that BCBT may be easier to be delivered than CBT by Japanese teachers to promote child mental health. The study has limitations including no control group, small sample size, or a short teacher training. Future research should address these limitations.

Keywords: brief cognitive behavior therapy, cognitive behavior therapy, mental health services in schools, teacher training workshop

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Authors: Ditsapelo M. McFarland

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Background: Despite the availability of the Pap smear services in urban areas in Botswana, most women in such areas do not seem to screen regular for prevention of the cervical cancer disease. Reasons for non-use of the available Pap smear services are not well understood. Beliefs about cancer may influence participation in cancer screening in these women. The purpose of this study was to develop an instrument to measure beliefs about cervical cancer and Pap smear screening among Black women in Botswana, and evaluate the psychometric properties of the instrument. Significance: Instruments that are designed to measure beliefs about cervical cancer and screening among black women in Botswana, as well as in the surrounding region, are presently not available. Valid and reliable instruments are needed for exploration of the women’s beliefs about cervical cancer. Conceptual Framework: The Health Belief Model (HBM) provided a conceptual framework for the study. Methodology: The study was done in four phases: Phase 1: item generation: 15 items were generated from literature review and qualitative data for each of four conceptually defined HBM constructs: Perceived susceptibility, severity, benefits, and barriers (Version 1). Phase 2: content validity: Four experts who were advanced practice nurses of African descent and were familiar with the content and the HBM evaluated the content. Experts rated the items on a 4-point Likert scale ranging from: 1=not relevant, 2=somewhat relevant, 3=relevant and 4=very relevant. Fifty-five items were retained for instrument development: perceived susceptibility - 11, severity - 14, benefits - 15 and barriers - 15, all measuring on a 4-point Likert scale ranging from strongly disagree (1) to strongly agree (4). (Version 2). Phase 3: pilot testing: The instrument was pilot tested on a convenient sample of 30 women in Botswana and revised as needed. Phase 4: reliability: the revised instrument (Version 3) was submitted to a larger sample of women in Botswana (n=300) for reliability testing. The sample included women who were Batswana by birth and decent, were aged 30 years and above and could complete an English questionnaire. Data were collected with the assistance of trained research assistants. Major findings: confirmatory factor analysis of the 55 items found that a number of items did not adequately load in a four-factor solution. Items that exhibited reasonable reliability and had low frequency of missing values (n=36) were retained: perceived barriers (14 items), perceived benefits (8 items), perceived severity (4 items), and perceived susceptibility (10 items). confirmatory factor analysis (principle components) for a four factor solution using varimax rotation demonstrated that these four factors explained 43% of the variation in these 36 items. Conclusion: reliability analysis using Cronbach’s Alpha gave generally satisfactory results with values from 0.53 to 0.89.

Keywords: cervical cancer, factor analysis, psychometric evaluation, varimax rotation

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Authors: Soraia V. M. de Sá, Miguel A. Faria, José O. Fernandes, Sara C. Cunha

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Cereals play a vital role in fulfilling the nutritional needs of children, supplying essential nutrients crucial for their growth and development. However, concerns arise due to children's heightened vulnerability due to their unique physiology, specific dietary requirements, and relatively higher intake in relation to their body weight. This vulnerability exposes them to harmful food contaminants, particularly mycotoxins, prevalent in cereals. Because of the thermal stability of mycotoxins, conventional industrial food processing often falls short of eliminating them. Children, especially those aged 4 months to 12 years, frequently encounter mycotoxins through the consumption of specialized food products, such as instant foods, breakfast cereals, bars, cookie snacks, fruit puree, and various dairy items. A close monitoring of this demographic group's exposure to mycotoxins is essential, as toxins ingestion may weaken children’s immune systems, reduce their resistance to infectious diseases, and potentially lead to cognitive impairments. The severe toxicity of mycotoxins, some of which are classified as carcinogenic, has spurred the establishment and ongoing revision of legislative limits on mycotoxin levels in food and feed globally. While EU Commission Regulation 1881/2006 addresses well-known mycotoxins in processed cereal-based foods and infant foods, the absence of regulations specifically addressing emerging mycotoxins underscores a glaring gap in the regulatory framework, necessitating immediate attention. Emerging mycotoxins have gained mounting scrutiny in recent years due to their pervasive presence in various foodstuffs, notably cereals and cereal-based products. Alarmingly, exposure to multiple mycotoxins is hypothesized to exhibit higher toxicity than isolated effects, raising particular concerns for products primarily aimed at children. This study scrutinizes the presence of 22 mycotoxins of the diverse range of chemical classes in 148 processed cereal-based foods, including 39 breakfast cereals, 25 infant formulas, 27 snacks, 25 cereal bars, and 32 cookies commercially available in Portugal. The analytical approach employed a modified QuEChERS procedure followed by ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) analysis. Given the paucity of information on the risk assessment of children to multiple mycotoxins in cereal and cereal-based products consumed by children of Portugal pioneers the evaluation of this critical aspect. Overall, aflatoxin B1 (AFB1) and aflatoxin G2 (AFG2) emerged as the most prevalent regulated mycotoxins, while enniatin B (ENNB) and sterigmatocystin (STG) were the most frequently detected emerging mycotoxins.

Keywords: cereal-based products, children´s nutrition, food safety, UPLC-MS/MS analysis

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Authors: J. Waita, S. Wamuhu, J. Makoyo, M. Rachel, T. Ngangari, W. Christine, M. Zipporah

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Contraceptive use is one of the key global strategies to alleviate maternal mortality. Global efforts through advocating for contraceptive uptake and service provision has led improved contraceptive prevalence. In Kenya maternal mortality rate has remained a challenged despites efforts by government and non-governmental organizations. Objective: To describe the uptake of contraceptives among women in Tunza Clinics, Kenya. Design and Methods: Ps Kenya through health care marketing fund is implementing a family planning program among its 350 Tunza fractional franchise facilities. Through private partnership, private owned facilities in low socio-economic areas are recruited and trained on contraceptive technology update. The providers are supported through facilitative supervision through a mobile based application Health Network Quality Improvement System (HNQIS) and interpersonal communication through 150 community based volunteers. The data analyzed in this paper was collected between January to July 2017 to show the uptake of modern Contraceptives among women in the Tunza franchise, method mix, age and distribution among the age bracket. Further analysis compares two different service delivery strategies; outreach and walk ins. Supportive supervision HNQIS scores was analyzed. Results: During the time period, a total of 132121 family planning clients were attended in 350 facilities. The average age of clients was 29.6 years. The average number of clients attended in the facilities per month was 18874. 73.7 %( n=132121) of the clients attended in the Tunza facilities were aged above 25 years while 22.1% 20-24 years and 4.2% 15-19 years. On contraceptive method mix, intra uterine device insertions clients contributed to 7.5%, implant insertions 15.3%, pills 11.2%, injections 62.7% while condoms and emergency pills had 2.7% and 0.6% respectively. Analysis of service delivery strategy indicated more than 79% of the clients were walk ins while 21% were attended to during outreaches. Uptake of long term contraceptive methods during outreaches was 73% of the clients while short term modern methods were 27%. Health Network Quality Improvement system assessment scores indicated 51% of the facilities scored over 90%, 25% scoring 80-89% while 21% scored below 80%. Conclusion: Preference for short term methods by women is possibly associated to cost as they are cheaper and easy to administer. When the cost of intra uterine device Implants is meant affordable during outreaches, the uptake is observed to increase. Making intra uterine device and implants affordable to women is a key strategy in increasing contraceptive prevalence hence averting maternal mortality.

Keywords: contraceptives, contraceptive uptake, low socio economic, supportive supervision

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Authors: Henry Prihanto Nugroho

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This paper suggests education tourism as an option into developing more sustainable mass tourism. Identifying the potential of education tourism and developing a sustainable packages will have an impact on social economic development in the area. Indonesia especially Yogyakarta can increase their tourism earnings by tapping into this growing market phenomenon. Educational tourism, a growing part in the world tourism market, has attracted great attention because of its direct impact on the community and as an alternative strategy for poverty alleviation. Tourism is considered as one of the main industries and sectors highly contributing to economic development in Indonesia especially in Yogyakarta, this region can be an ideal case for studying the issue of educational tourism in Universitas Gadjah Mada. This paper tries to introduce the educational tourism as an important alternative source of the economy accelerator in the context of Yogyakarta Indonesia. This paper also aims to discuss the education tourism potential at the University of Gadjah Mada, Yogyakarta Indonesia then to create and established an Education Tourism package at Gadjah Mada University. Education Tourism is a means to empower academics, local community, local businesses, and to improve the economic welfare. Methods: Focus group discussions, direct observation, survey and best practice method. Conclusion: There is a positive relationship between attitude, environmental impact, economic impact, and socio-cultural impacts and practice in the field when the potential is seized. The findings incorporate insights into the socio-cultural and economic potential of education tourism and practices related to community development at the University of Gadjah Mada, Yogyakarta Indonesia by creating an Education Tourism Packages that will suit the needs of the tourist. Educational tourism can create sustainable development for local communities, academic society, universities, and stakeholders.

Keywords: education tourism, Gadjah Mada, sustainable, tourism

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Authors: Elisabeth Pedersen

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Representations and interpretations of womanhood and female sexualities bring forth various questions regarding gender norms, and the implications of these norms, which are permeating and repetitive within various societies. Literature is one form of media which provides the space to represent and interpret women, their bodies, and sexualities, and also reveals the power of language as an affective and affected force. As literature allows an opportunity to explore history and the representations of gender, power dynamics, and sexuality through historical contexts, this paper uses engaged theory through a comparative analysis of two work of literature, The Duchess of Malfi by John Wester, and The Sound and the Fury by William Faulkner. These novels span across space and time, which lends to the theory that repetitive tropes of womanhood and female sexuality in literature are influenced by and have an influence on the hegemonic social order throughout history. It analyzes how the representation of the dichotomy of male chivalry and honor, and female purity are disputed and questioned when a woman is portrayed as sexually emancipated, and explores the historical context in which these works were written to examine how socioeconomic events challenged the hegemonic social order. The analysis looks at how stereotypical ideals of womanhood and manhood have damaging implications on women, as the structure of society provides more privilege and power to men than to women, thus creating a double standard for men and women in regards to sexuality, sexual expression, and rights to sexual desire. This comparative analysis reveals how strict gender norms are permeating and have negative consequences. However, re-reading stories through a critical lens can provide an opportunity to challenge the repetitive tropes of female sexuality, and thus lead to the embrace of the complexity of female sexuality and expression.

Keywords: femininity, literature, representation, sexuality

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Authors: Shazia Anwer

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The current TV Talk Shows, especially on domestic politics in Pakistan are following the Aristotelian techniques, including deductive reasoning, three modes of persuasion, and guidelines for communication. The application of “Approximate Truth is also seen when Talk Show presenters create doubts against political personalities or national issues. Mainstream media of Pakistan, being a key carrier of narrative construction for the sake of the primary function of national consensus on regional and extended public diplomacy, is failing the purpose. This paper has highlighted the Aristotelian communication methodology, its purposes and its limitations for a serious discussion, and its connection to the mistrust among the Pakistani population regarding fake or embedded, funded Information. Data has been collected from 3 Pakistani TV Talk Shows and their analysis has been made by applying the Aristotelian communication method to highlight the core issues. Paper has also elaborated that current media education is impaired in providing transparent techniques to train the future journalist for a meaningful, thought-provoking discussion. For this reason, this paper has given an overview of HEC’s (Higher Education Commission) graduate-level Mass Com Syllabus for Pakistani Universities. The idea of ethos, logos, and pathos are the main components of TV Talk Shows and as a result, the educated audience is lacking trust in the mainstream media, which eventually generating feelings of distrust and betrayal in the society because productions look like the genre of Drama instead of facts and analysis thus the line between Current Affairs shows and Infotainment has become blurred. In the last section, practical implication to improve meaningfulness and transparency in the TV Talk shows has been suggested by replacing the Aristotelian communication method with the cognitive semiotic communication approach.

Keywords: Aristotelian techniques of communication, current affairs talk shows, drama, Pakistan

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