Search results for: poor jurisdictions

Authors: Prakash Singh

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Many schools throughout the world are facing constant pressure to cope with the violence and drug abuse of learners who show little or no respect for acceptable and desirable social norms. These delinquent learners tend to harbour feelings of being beyond reproach because they strongly believe that it is well within their rights to engage in violent and destructive behaviour. Knives, guns, and other weapons appear to be more readily used by them on the school premises than before. It is known that learners smoke, drink alcohol, and use drugs during school hours, hence, their ability to concentrate, work, and learn, is affected. They become violent and display disruptive behaviour in their classrooms as well as on the school premises, and this atrocious behaviour makes it possible for drug dealers and gangsters to gain access onto the school premises. The primary purpose of this exploratory quantitative study was therefore to establish how tobephobia (TBP), caused by school violence and drug abuse, affects teaching and learning in schools. The findings of this study affirmed that poor discipline resulted in producing poor quality education. Most of the teachers in this study agreed that educating learners who consumed alcohol and other drugs on the school premises resulted in them suffering from TBP. These learners are frequently abusive and disrespectful, and resort to violence to seek attention. As a result, teachers feel extremely demotivated and suffer from high levels of anxiety and stress. The word TBP will surely be regarded as a blessing by many teachers throughout the world because finally, there is a word that will make people sit up and listen to their problems that cause real fear and anxiety in schools.

Keywords: aims and objectives of quality education, debilitating effects of tobephobia, fear of failure associated with education, learners' violent behaviour and drug abuse

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Authors: Vladimir Sharapaev

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This paper seeks to address the question of the authorship of copyrighted works created solely by the artificial intelligence or with the use thereof, and proposes possible interpretational or legislative solutions to the problems arising from the plurality of the persons potentially involved in the ultimate creation of the work and division of tasks among such persons. Being based on the commonly accepted assumption that a copyrighted work can only be created by a natural person, the paper does not deal with the issues regarding the creativity of the artificial intelligence per se (or the lack thereof), and instead focuses on the distribution of the intellectual property rights potentially belonging to the creators of the artificial intelligence and/or the creators of the content used for the formation of the copyrighted work. Moreover, the technical development and rapid improvement of the AI-based programmes, which tend to be reaching even greater independence on a human being, give rise to the question whether the initial creators of the artificial intelligence can be entitled to the intellectual property rights to the works created by such AI at all. As the juridical practice of some European courts and legal doctrine tends to incline to the latter opinion, indicating that the works created by the AI may not at all enjoy copyright protection, the questions of authorships appear to be causing great concerns among the investors in the development of the relevant technology. Although the technology companies dispose with further instruments of protection of their investments, the risk of the works in question not being copyrighted caused by the inconsistency of the case law and a certain research gap constitutes a highly important issue. In order to assess the possible interpretations, the author adopted a doctrinal and analytical approach to the research, systematically analysing the European and Czech copyright laws and case law in some EU jurisdictions. This study aims to contribute to greater legal certainty regarding the issues of the authorship of the AI-created works and define possible clues for further research.

Keywords: artificial intelligence, copyright, authorship, copyrighted work, intellectual property

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Authors: Kyle Burke Pfeiffer, Carmella Burdi, Karen Marsh

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The evacuation and shelter-in-place planning process employed by most jurisdictions within the United States is not informed by a scientifically-derived framework that is inclusive of the behavioral and policy-related indicators of public compliance with evacuation orders. While a significant body of work exists to define these indicators, the research findings have not been well-integrated nor translated into useable planning factors for public safety officials. Additionally, refinement of the planning factors alone is insufficient to support science-based evacuation planning as the behavioral elements of evacuees—even with consideration of policy-related indicators—must be examined in the context of specific regional transportation and shelter networks. To address this problem, the Federal Emergency Management Agency and Argonne National Laboratory developed an agent-based model to support regional analysis of zone-based evacuation in southeastern Georgia. In particular, this model allows public safety officials to analyze the consequences that a range of hazards may have upon a community, assess evacuation and shelter-in-place decisions in the context of specified evacuation and response plans, and predict outcomes based on community compliance with orders and the capacity of the regional (to include extra-jurisdictional) transportation and shelter networks. The intention is to use this model to aid evacuation planning and decision-making. Applications for the model include developing a science-driven risk communication strategy and, ultimately, in the case of evacuation, the shortest possible travel distance and clearance times for evacuees within the regional boundary conditions.

Keywords: agent-based modeling for evacuation, decision-support for evacuation planning, evacuation planning, human behavior in evacuation

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Authors: Abdullah Malek, Muzn Al Khaldi, Lian Odeh, Atheer Tariq, Mohammad Al Fardan, Hiba Barqawi

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H. pylori bacterium is a known underlying agent for gastritis, peptic ulcer disease, and gastric cancer and is believed to infect half of the world’s population. Even with the ubiquity of H. pylori bacterium, there is lack of knowledge regarding its modes of transmission, associated diseases, carcinogenic effect and means of prevention; especially in the UAE. A cross sectional study of 500 participants, of which 58% (n= 289) of the respondents were female, and 42% (n=210) were male, was conducted in Sharjah to assess the knowledge, and explore the attitudes and practices among UAE residents towards Helicobacter Pylori and its associated PUD as well as its carcinogenic nature. A structured self-administered questionnaire was distributed to the target population to establish their demographic background and selected aspects of their lifestyle. General knowledge about H. Pylori was poor, only 24.6% stated they have heard of H. pylori. Attitudes towards prevention and practices were relatively poor as well. Subjects who suffered from severe symptoms (ALARM symptoms) had significantly lower habit scores than those with mild and moderate symptoms (p=0.0078**). To the authours’ knowledge, no previous studies were conducted in the United Arab Emirates regarding the epidemiology of the infection to detect the extent of H. Pylori’s impact on the public health. The results of this study can be used to draw conclusions about the average knowledge of the UAE population regarding H. pylori. It can also be a starting point to devise new education programs and campaigns that raise awareness of this health issue which could be easily avoided with early diagnosis and antibiotic treatment.

Keywords: chronic gastritis, community health, gastric cancer, Helicobacter pylori, peptic ulcers

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Authors: Anan Jarab, Riham Almrayat, Salam Alqudah, Maher Khdour, Tareq Mukattash, Sharell Pinto

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Background: The prevalence of diabetes in Jordan is among the highest in the world, making it a particularly alarming health problem there. It has been indicated that poor adherence to the prescribed therapy lead to poor glycemic control and enhance the development of diabetes complications and unnecessary hospitalization. Purpose: To explore factors associated with medication non-adherence in patients with type 2 diabetes in Jordan. Materials and Methods: Variables including socio-demographics, disease and therapy factors, diabetes knowledge, and health-related quality of life in addition to adherence assessment were collected for 171 patients with type 2 diabetes using custom-designed and validated questionnaires. Logistic regression was performed to develop a model with variables that best predicted medication non-adherence in patients with type 2 diabetes in Jordan. Results: The majority of the patients (72.5%) were non-adherent. Patients were found four times less likely to adhere to their medications with each unit increase in the number of prescribed medications (OR = 0.244, CI = 0.08-0.63) and nine times less likely to adhere to their medications with each unit increase in the frequency of administration of diabetic medication (OR = 0.111, CI = 0.04-2.01). Patients in the present study were also approximately three times less likely (OR = 0.362, CI = 0.24-0.87) to adhere to their medications if they reported having concerns about side effects and twice more likely to adhere to medications (OR = 0.493, CI = 0.08-1.16) if they had one or more micro-vascular complication. Conclusion: The current study revealed low adherence rate to the prescribed therapy among Jordanians with type 2 diabetes. Simplifying dosage regimen, selecting treatments with lower side effects along with an emphasis on diabetes complications should be taken into account when developing care plans for patients with type 2 diabetes.

Keywords: type 2 diabetes, adherence, glycemic control, clinical pharmacist, Jordan

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Authors: Amenawo I. Offiong, Hodo B. Riman

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Public debt profile of Nigeria has continuously been on the increase over the years. The drop in international crude oil prices has further worsened revenue position of the country, thus, necessitating further acquisition of public debt to bridge the gap in revenue deficit. Yet, when we look back at the increasing public sector spending, there are concerns that the government spending do not amount to increase in public goods provided for the country. Using data from 1980 to 2014 the study therefore seeks to investigate the factors responsible for the poor provision of public goods in the face of increasing public debt profile. Using the unrestricted VAR model Governance and Tax revenue were introduced into the model as structural variables. The result suggested that governance and tax revenue were structural determinants of the effectiveness of public goods provisioning in Nigeria. The study therefore identified weak governance as the major reason for the non-provision of public goods in Nigeria. While tax revenue exerted positive influence on the provisions of public goods, weak/poor governance was observed to crowd the benefits from increase tax revenue. The study therefore recommends reappraisal of the governance system in Nigeria. Elected officers in governance should be more transparent and accountable to the electorates they represent. Furthermore, the study advocates for an annual auditing of all government MDAs accounts by external auditors to ensure (a) accountability of public debts utilization, (b) transparent in implementation of program support funds, (c) integrity of agencies responsible for program management, and (d) measuring program effectiveness with amount of funds expended.

Keywords: impulse response function, public debt shocks, governance, public goods, tax revenue, vector auto-regression

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Authors: I. Bochev, A. Shterev, S. Kyurkchiev

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One of the factors associated with poor success rates in human in vitro fertilization (IVF) is the suboptimal culture conditions in which fertilization and early embryonic growth occur. Co-culture systems with helper cell lines appear to enhance the in vitro conditions and allow embryos to demonstrate improved in vitro development. The co-culture of human embryos with monolayers of autologous endometrial stromal cell (EnSCs) results in increased blastocyst development with a larger number of blastomeres, lower incidence of fragmentation and higher pregnancy rates in patients with recurrent implantation failure (RIF). The aim of the study was to examine the influence of autologous endometrial stromal cell (EnSC) co-culture on day 3 embryo quality by comparing the morphological status of the embryos from the same patients undergoing consecutive IVF/Intracytoplasmic sperm injection (ICSI) cycles without and with EnSC co-culture. This retrospective randomized study (2015-2017) includes 20 couples and a total of 46 IVF/ICSI cycles. Each patient couple included had at least two IVF/ICSI procedures – one with and one without autologous EnSC co-culture. Embryo quality was assessed at 68±1 hours in culture, according to Istanbul consensus criteria (2010). Day 3 embryos were classified into three groups: good – grade 1; fair – grade 2; poor – grade 3. Embryos from all cycles were divided into two groups (A – co-cultivated; B – not co-cultivated) and analyzed. Second, for each patient couple, embryos from matched IVF/ICSI cycles (with and without co-culture) were analyzed separately. When an analysis of co-cultivated day 3 embryos from all cycles was performed (n=137; group A), 43.1% of the embryos were graded as “good”, which was not significantly different from the respective embryo quality rate of 42.2% (p = NS) in group B (n=147) with non-co-cultivated embryos. The proportions of fair and poor quality embryos in group A and group B were similar as well – 11.7% vs 10.2% and 45.2% vs 47.6% (p=NS), respectively. Nevertheless, the separate embryo analysis by matched cycles for each couple revealed that in 65% of the cases the proportion of morphologically better embryos was increased in cycles with co-culture in comparison with those without co-culture. A decrease in this proportion after endometrial stromal cell co-cultivation was found in 30% of the cases, whereas no difference was observed in only one couple. The results demonstrated that there is no marked difference in the overall morphological quality between co-cultured and non-co-cultured embryos on day 3. However, in significantly greater percentage of couples the process of autologous EnSC co-culture could increase the proportion of morphologically improved day 3 embryos. By mimicking the in vivo relationship between embryo and maternal environment, co-culture in autologous EnSC system represents a perspective approach to improve the quality of embryos in cases with elevated risk for development of embryos with impaired morphology.

Keywords: autologous endometrial stromal cells, co-culture, day 3 embryo, morphological quality

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Authors: Sandeep J. Kumar

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Urbanisation is considered as the primary driver of land use and land cover change that has direct link to population and economic growth. In India, as well as in other developing countries, cities are urbanizing at an alarming rate. This unprecedented and uncontrolled urbanisation can result in urban sprawl. Due to a number of factors, urban sprawl is recognised to be a result of poor planning, inadequate policies, and poor governance. Urban sprawl may be seen as posing a threat to the development of sustainable cities. Hence, it is very essential to manage this. Planning for predicted future growth is critical to avoid the negative effects of urban growth at the local and regional levels. Thiruvananthapuram being the capital city of Kerala is a city of economic success, challenges, and opportunities. Urbanization trends in the city have paved way for Urban Sprawl. This thesis aims to formulate a framework to combat the emerging urban sprawl in the city of Thiruvananthapuram. For that, the first step was to quantify trends of urban growth in Thiruvananthapuram city using Geographical Information System(GIS) and remote sensing techniques. The technique and results obtained in the study are extremely valuable in analysing the land use changes. Secondly, these change in the trends were analysed through some of the critical factors that helped the study to understand the underlying issues of the existing city structure that has resulted in urban sprawl. Anticipating development trends can modify the current order. This can be productively resolved using regional and municipal planning and management strategies. Hence efficient strategies to curb the sprawl in Thiruvananthapuram city have been formulated in this study that can be considered as recommendations for future planning.

Keywords: urbanisation, urban sprawl, geographical information system(GIS), thiruvananthapuram

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Authors: Muhammad Tahir Riaz, Khalid Mehmood, Ahmad Waseem Akhtar, Tariq Abbas, Sadaqat Ali, Muhammad Altaf

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Livestock sector contributes around 55.9 and 11.8% to agriculture and GDP respectively, according to economic survey of Pakistan 2013-2014. The goats population has been estimated about 66.6 million (M). Parasitic infestation is a major health problem in goats causing loss in body weight, poor body condition, low birth weights, and difficulty in kidding. Keeping in view the utilization of these animals in the country, a pilot epidemiological survey was conducted to find out the major parasitic problems of goats in and around Derawar fort area, Cholistan. Data regarding 662 fecal samples of goats was collected from 25 tobas of Cholistan during June 2012 to June 2013. All the fecal samples were examined through Direct Smear Method and Salt Flotation Technique for the presence of helminth eggs. External parasites were taken from the various components of the carcass of goat and were conserved in 70% alcohol in hygienic, properly enclosed glass jars that were tagged thoroughly. The collected date was analyzed statistically by Chi-square test to find out the prevalence in goats. Out of 662 goats, 261 (39.42%) were found positive for parasites. 233 (35.20%) goats were found positive for gastrointestinal parasites while 28 (4.23%) were positive for external parasites including ticks 20 (3.02%) and mange 8 (1.21%). The higher prevalence of parasites in the study area may be due to pasture grazing, poor management and lack of extension work. In this regards proper management and control measures should be adopted to minimize the Parasitic Problems.

Keywords: Cholistan, goats, parasite, surveillance

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Authors: Theresia F. Mrema, Innocent Semali

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Food insecurity to pregnant women seriously impedes efforts to reduce maternal mortality in resource poor countries. This study was carried out to assess determinants food insecurity among pregnant women in urban areas. A cross sectional study design was used to collect data for the period of two weeks. A structured questionnaire with both closed and open ended questions was used to interview a total of 225 randomly selected pregnant women who attend the three randomly selected antenatal care clinics in Temeke Municipal council. The food insecurity was measured using a modified version of the USDA’s core food security module which consists of 15questions. Logistic regression analysis was used to obtain strength of association between dependent and independent variables. Among 225 pregnant women attending antenatal care (ANC) interviewed 55.1% were food insecure. Food insecurity declined with increasing household wealth, it was also significantly low among those with less than three children compared with having more. Low level of food insecurity was associated with having Secondary education (Adjusted OR=0.24; 95%CI, 0.12–0.48), College Education (OR=0.156; 95%CI, 0.05-0.46), paid employment (OR=0.322; 95%CI, 0.11-0.96) and high income (OR=0.031; 95%CI, 0.01–0.07). Also, having head of the household with secondary education (OR=0.51; 95%CI, 0.07-0.32) college education (OR=0.04; 95%CI, 0.01-0.13) and paid employment (OR=0.225; 95%CI, 0.12-0.42). Food insecurity is a significant problem among pregnant women in Temeke Municipal which might significantly affect health of the pregnant woman and foetus due to higher maternal malnutrition which increases risk of miscarriage, maternal and infant mortality, and poor pregnancy outcomes. The study suggests a multi-sectoral approach in order to address this problem.

Keywords: food security, nutrition, pregnant women, urban settings

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Authors: Bernice Badal

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The South African English curriculum emphasizes the adoption of the Communicative Approach (CA) using Communicative Language Teaching (CLT) methodologies to develop English as a second language (ESL) learners’ communicative competence in contexts such as township schools in South Africa. However, studies indicate that the adoption of the approach largely remains a rhetoric. Poor English language proficiency among learners and poor student performance, which continues from the secondary to the tertiary phase, is widely attributed to a lack of English language proficiency in South Africa. Consequently, this qualitative study, using a mix of classroom observations and interviews, sought to investigate teacher knowledge of Communicative Competence and the methods and strategies ESL teachers used to develop their learners’ communicative competence. The success of learners’ ability to develop communicative competence in contexts such as township schools in South Africa is inseparable from materials, tasks, teacher knowledge and how they implement the approach in the classrooms. Accordingly, teacher knowledge of the theory and practical implications of the CLT approach is imperative for the negotiation of meaning and appropriate use of language in context in resource-impoverished areas like the township. Using a mix of interviews and observations as data sources, this qualitative study examined teachers’ definitions and knowledge of Communicative competence with a focus on how it influenced their classroom practices. The findings revealed that teachers were not familiar with the notion of communicative competence, the communication process, and the underpinnings of CLT. Teachers’ narratives indicated an awareness that there should be interactions and communication in the classroom, but a lack of theoretical understanding of the types of communication necessary scuttled their initiatives. Thus, conceptual deficiency influences teachers’ practices as they engage in classroom activities in a superficial manner or focus on stipulated learner activities prescribed by the CAPS document. This study, therefore, concluded that partial or limited conceptual and coherent understandings with ‘teacher-proof’ stipulations for classroom practice do not inspire teacher efficacy and mastery of prescribed approaches; thus, more efforts should be made by the Department of Basic Education to strengthen the existing Professional Development workshops to support teachers in improving their understandings and application of CLT for the development of Communicative competence in their learners. The findings of the study contribute to the field of teacher knowledge acquisition, teacher beliefs and practices and professional development in the context of second language teaching and learning with a recommendation that frameworks for the development of communicative competence with wider applicability in resource-poor environments be developed to support teacher understanding and application in classrooms.

Keywords: communicative competence, CLT, conceptual understanding of reforms, professional development

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Authors: Sayed Ali Garossi, Azar Heidarizadi, Shahla Mohammad Ganji

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Context: Colorectal cancer is the second type of cancer-related mortality globally. Expression of cas8 (caspase 8) is closely connected to growth and metastasis of colorectal cancer.Cas8/Rip1 plays a vital role in the apoptosis pathway and resistance to chemotherapy. The aim of the present study is to investigate the pattern of gene expression in colorectal cancer and compare the differences using Real-Time PCR to find a potential biomarker candidate for colorectal cancer. Methodology: This study conducted real-time PCR to evaluate gene expression of Cas8 in colorectal cancer patients. The gene-specific primer sequences exon–exon junction was designed by OLIGO7 software for the expression of the gene under investigation. Forty-six patient samples without any chemotherapy were selected, including tumoral tissue and adjacent normal tissue samples. The age of the patients was 50 and the size of the tumors was 5.5 cm. The categories were before and after age 50. Findings: Here, we found that Caspase 8 was overexpressed in CRC tissues compared to corresponding adjacent colon tissues (Cas8: 5.2 vs. 1 ratio); high expression of Cas8 was associated with poor overall survival and independent risk factors for the prognosis of CRC patients. Conclusion: In conclusion, our study pioneered the reporting of high Casp8 expression as a predictor of poor prognosis and chemical resistance in CRC patients.Cas8 overexpression suppressed Cas 8 / Rip1-dependent apoptosis and activated the proliferation of tumor cells by activating necroptosis. The necroptosis pathway has also emerged as a new approach to anti-tumor in cancer treatment.

Keywords: Cas8, necroptosis, apoptosis, Real-Time PCR

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Authors: Cheryl Teelucksingh

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Toronto is in the midst of an urban development and infrastructure boom. Population growth and concerns about urban sprawl and carbon emissions have led to pressure on the municipal and the provincial governments to re-think urban development. Toronto’s approach to climate change mitigation and adaptation has positioning of the emerging green economy as part of the solution. However, the emerging green economy many not benefit all Torontonians in terms of jobs, improved infrastructure, and enhanced quality of life. Community benefits agreements (CBAs) are comprehensive, negotiated commitments, in which founders and builders of major infrastructure projects formally agree to work with community interest groups based in the community where the development is taking place, toward mutually beneficial environmental and labor market outcomes. When community groups are equitably represented in the process, they stand not only to benefit from the jobs created from the project itself, but also from the longer-term community benefits related to the quality of the completed work, including advocating for communities’ environmental needs. It is believed that green employment initiatives in Toronto should give greater consideration to best practices learned from community benefits agreements. Drawing on the findings of a funded qualitative study in Toronto (Canada), “The Green Gap: Toward Inclusivity in Toronto’s Green Economy” (2013-2016), this paper examines the emergent CBA in Toronto in relation to the development of a light rail transit project. Theoretical and empirical consideration will be given to the research gaps around CBAs, the role of various stakeholders, and discuss the potential for CBAs to gain traction in the Toronto’s urban development context. The narratives of various stakeholders across Toronto’s green economy will be interwoven with a discussion of the CBA model in Toronto and other jurisdictions.

Keywords: green economy in Toronto, equity, community benefits agreements, environmental justice, community sustainability

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Authors: Floris Burgers, Arjan Verschoor

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Poor farmers in developing countries typically do not have the resources or access to institutions to protect themselves against all kinds of income shocks, which makes their farm income highly sensitive to weather and crop price fluctuations, and various other intervening forces. Consequently, the relationship between farming effort and farming outcomes can be noisy, potentially resulting in a situation in which farmers perceive little personal control over the outcomes of their farming efforts. This perceived lack of control can result in learned helplessness in some farmers, who would then be less motivated to invest in their farm. This paper presents the results of a household survey and controlled field experiment conducted in ten villages in a farming area in eastern Uganda with a view to examining the link between learned helplessness and agricultural investment. The results show that (I) farmers with a more pessimistic attributional style for negative life events invest less in their farm, (II) an experience of uncontrollability over income in a priming task increases investment in the farm in a subsequent task if losses in the priming task are small, and decreases investment in the subsequent task if losses are moderate or big, and (III) the relationship between the number of income shocks experienced in the past two years and investment in the farm is more negative among farmers with a more pessimistic attributional style. These results are in line with the reformulated learned helplessness theory underlying this research, which leads this paper to conclude that learned helplessness can cause agricultural underinvestment in a developing country context, potentially contributing to a poverty trap.

Keywords: agricultural investment, attributional style, farmers, learned helplessness, poverty, income shocks

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Authors: Adewale Oladapo, C. A. Afolami

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The study analyzed the effect of micro credit access on poverty reduction among small scale women entrepreneurs in Ondo state, Nigeria. Primary data were collected in a cross-sectional survey of 100 randomly selected woman entrepreneurs. These were drawn in multistage sampling process covering four local government areas (LGAS). Data collected include socio economics characteristics of respondents, access to micro credit, sources of micro credit, and constraints faced by the entrepreneur in sourcing for micro credit. Data were analyzed using descriptive statistics, Foster, Greer and Thorbecke (FGT) index of poverty measure, Gini coefficients and probit regression analysis. The study found that respondents sampled for the survey were within the age range of 31-40 years with mean age 38.6%. Mostly (56.0%) of the respondents were educated to the tune of primary school. Majority (87.0%) of the respondents were married with fairly large household size of (4-5). The poverty index analysis revealed that most (67%) of the sample respondents were poor. The result of the Probit regression analyzed showed that income was a significant variable in micro credit access, while the result of the Gini coefficient revealed a very high income inequality among the respondents. The study concluded that most of the respondents were poor and return on investment (income) was an important variable that increased the chance of respondents in sourcing for micro-credit loan and recommended that income realized by entrepreneur should be properly documented to facilitate loan accessibility.

Keywords: entrepreneurs, income, micro-credit, poverty

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Authors: Sara Vora (Hoxha)

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Defamation, invasion of privacy, and cyberbullying have all increased in tandem with the growth of the internet. European international private law may struggle to deal with such transgressions if they occur in many jurisdictions. The current study examines how effectively the legal system of European international private law addresses abuses of personality rights in cyberspace. The study starts by discussing how established legal frameworks are being threatened by online personality rights abuses. The article then looks into the rules and regulations of European international private law that are in place to handle overseas lawsuits. This article examines the different elements that courts evaluate when deciding which law to use in a particular case, focusing on the concepts of jurisdiction, choice of law, and recognition and execution of foreign judgements. Next, the research analyses the function of the European Union in preventing and punishing online personality rights abuses. Key pieces of law that control the collecting and processing of personal data on the Internet, including the General Data Protection Regulation (GDPR) and the e-Commerce Directive, are discussed. In addition, this article investigates how the ECtHR handles cases involving the infringement of personal freedoms, including privacy and speech. The article finishes with an assessment of how well the legal framework of European international private law protects individuals' right to privacy online. It draws attention to problems with the present legal structure, such as the inability to enforce international judgements, the inconsistency between national laws, and the necessity for stronger measures to safeguard people' rights online. This paper concludes that while European international private law provides a useful framework for dealing with violations of personality rights online, further harmonisation and stronger enforcement mechanisms are necessary to effectively protect individuals' rights in the digital age.

Keywords: European international private law, personality rights, internet, jurisdiction, cross-border disputes, data protection

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Authors: Nitin Jadhav, Pradeep R. Vavia

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Poor water soluble drugs are difficult to promote for oral drug delivery as they demonstrate poor and variable bioavailability because of its poor solubility and dissolution in GIT fluid. Nowadays lipid based formulations especially self microemulsifying drug delivery system (SMEDDS) is found as the most effective technique. With all the impressive advantages, the need of high amount of surfactant (50% - 80%) is the major drawback of SMEDDS. High concentration of synthetic surfactant is known for irritation in GIT and also interference with the function of intestinal transporters causes changes in drug absorption. Surfactant may also reduce drug activity and subsequently bioavailability due to the enhanced entrapment of drug in micelles. In chronic treatment these issues are very conspicuous due to the long exposure. In addition the liquid self microemulsifying system also suffers from stability issues. Recently one novel approach of solid stabilized micro and nano emulsion (Pickering emulsion) has very admirable properties such as high stability, absence or very less concentration of surfactant and easily converts into the dry form. So here we are exploring pickering dry emulsion system for dissolution enhancement of anti-lipemic, extremely poorly water soluble drug (Fenofibrate). Oil moiety for emulsion preparation was selected mainly on the basis of higher solubility of drug. Captex 300 was showed higher solubility for fenofibrate, hence selected as oil for emulsion. With Silica (solid stabilizer); Span 20 was selected to improve the wetting property of it. Emulsion formed by Silica and Span20 as stabilizer at the ratio 2.5:1 (silica: span 20) was found very stable at the particle size 410 nm. The prepared emulsion was further preceded for spray drying and formed microcapsule evaluated for in-vitro dissolution study, in-vivo pharmacodynamic study and characterized for DSC, XRD, FTIR, SEM, optical microscopy etc. The in vitro study exhibits significant dissolution enhancement of formulation (85 % in 45 minutes) as compared to plain drug (14 % in 45 minutes). In-vivo study (Triton based hyperlipidaemia model) exhibits significant reduction in triglyceride and cholesterol with formulation as compared to plain drug indicating increasing in fenofibrate bioavailability. DSC and XRD study exhibit loss of crystallinity of drug in microcapsule form. FTIR study exhibit chemical stability of fenofibrate. SEM and optical microscopy study exhibit spherical structure of globule coated with solid particles.

Keywords: captex 300, fenofibrate, pickering dry emulsion, silica, span20, stability, surfactant

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Authors: Dlir Abdullah Ahmed

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Overall aims of this study are to investigate the effects of differences of opinions among Shari’ah supervisory bodies on standardization and internationalization of Islamic banking products and services. The study has used semi-structured in-depth interview where five respondents from both the Middle East and Malaysia Shari’ah advisors participated in the interview sessions. The data were analyzed by both manual and software techniques. The findings reveal that indeed there are differences of opinions among Shari’ah advisors in different jurisdictions. These differences are due to differences in educational background, schools of thoughts, environment in which they operate, and legal requirements. Moreover, the findings also reveal that these differences in opinions among Shari’ah bodies create confusions among public and bankers, and negatively affect standardization of Islamic banking transactions. In addition, the study has explored the possibility to develop Islamic-based products. However, the finding shows that it is difficult for the industry to have Islamic-based products due to high competition from conventional counterpart, legal constraints and moral hazard. Furthermore, the findings indicate that lack of political will and unity, lack of technology are the main constraints to internationalization of Islamic banking products. Last but not least, the study found that there are possibility of convergence of opinions, standardization of Islamic banking products and services if there are unified international Shari’ah h advisory council, international basic requirements for Islamic Shari’ah h advisors, and increase training and educations of Islamic bankers. This study has several implications to the bankers, policymakers and researchers. The policymakers should be able to resolve their political differences and set up unified international advisory council and international research and development center. The bankers should increase training and educations of the workforce as well improve on their banking infrastructure to facility cross-border transactions.

Keywords: Shari’ah h views, Islamic banking, products & services, standardization.

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Authors: Rose C.Anamezie, Mishack T. Gumbo

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Physics learners’ poor retention, which culminates in poor achievement due to teaching approaches that are unrelated to learners’ in non-Western cultures, warranted the study. The tenet of this study was to determine the effectiveness of the ethnoscience-based teaching (EBT) approach on learners’ retention in the Physics concept of Optics in the Awka Education zone of Anambra State- Nigeria. Two research questions and three null hypotheses tested at a 0.05 level of significance guided the study. The design adopted for the study was Quasi-experimental. Specifically, a non-equivalent control group design was adopted. The population for the study was 4,825 SS2 Physics learners in the zone. 160 SS2 learners were sampled using purposive and random sampling. The experimental group was taught rectilinear propagation of light (RPL) using the EBT approach, while the control group was taught the same topic using the lecture method. The instrument for data collection was the 50 Physics Retention Test (PRT) which was validated by three experts and tested for reliability using Kuder-Richardson’s formula-20, which yielded coefficients of 0.81. The data were analysed using mean, standard deviation and analysis of co-variance (p< .05). The results showed higher retention for the use of the EBT approach than the lecture method, while there was no significant gender-based factor in the learners’ retention in Physics. It was recommended that the EBT approach, which bridged the gender gap in Physics retention, be adopted in secondary school teaching and learning since it could transform science teaching, enhance learners’ construction of new science concepts based on their existing knowledge and bridge the gap between Western science and learners’ worldviews.

Keywords: Ethnoscience-based teaching, optics, rectilinear propagation of light, retention

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Authors: Abdur Rahman, Saima, T. N. Pasha, Muhammad Younus, Yassar Abbas, Shahid Jaleel

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Non-starch polysaccharides (NSPs) are not completely digested by broiler endogenous enzymes and consequently the soluble NSPs in feed results in high digesta viscosity and poor retention of nutrients. Supplementation of NSPs digesting enzymes may release the nutrients from feed and reduce the anti-nutritional effects of NSP’s. The present study was conducted to determine the effects of NSPs digesting enzymes (Zympex) in broiler chicks. A total of 120 day old broiler chicks (Hubbard) were categorized into 3 treatments and each treatment was having four replicates with 10 birds in each. Dietary treatments comprised of Basal diet (2740 KCal/Kg) as control-1 (T1), low energy diet (2630 KCal/kg) control-2 (T2) and low energy diet with 0.5 gm/Kg enzyme as T3. Multi-enzymes supplementation showed significant (P < 0.05) positive effect on weight gain (last three weeks), feed intake (last two weeks), FCR (1st, 2nd, 4th and 5th) and nutrient retention in T3 when compared with control-2. Weight gain was lower (P < 0.05) in low caloric feed group C when compared with control-1 in all weeks except last week (P > 0.05), feed consumption was significantly lower (P < 0.05) in 5th week and results showed significantly poor FCR (P < 0.05) in 2nd, 3rd and 4th week but non-significant effect in 1st and 5th week when compared with control-1 group, which revealed the positive effect of enzyme supplementation in low energy diet. These results revealed that enzyme supplementation releases more energy from low energy diets and results in equal performance to normal diet.

Keywords: body weight, FCR, feed intake, enzyme, non-starch polysaccharides

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Authors: Hrishikesh Purandare, Ashwini Pethe

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Research from developed countries has demonstrated that the built environment can have a significant effect on children’s cognitive and socio-emotional development. A majority of the studies on the relationship between the built environment and the well-being of children have been conducted in North America and Western Europe, though most of the world’s children live in the global South. Millions of children living in urban slums in India confront issues associated with poor living conditions and lack of access to basic services. It is a well-known fact that slums are places of extreme poverty, substandard housing, overcrowding, and poor sanitation. These challenges faced by children living in slums can have a significant impact on their physical, psychological, and social development. Despite the magnitude of the problem, the area of research, particularly on the impact of the built environment of slums on children and adolescent well-being, has been understudied in India. Only a few studies in the global South have investigated the impact of the built environment on children’s well-being. Apart from issues of the limited access to health and education of these children, the perception of children regarding the built environment which they inhabit is rarely addressed. A sample of 120 children living in the slums of Pune city between the ages 7 and 16 participated in this study, which employed a concurrent embedded approach of mixed method research. Questionnaires were administered to obtain quantitative data that included attributes of crowding, noise, privacy, territoriality and housing quality in the built environment. The qualitative analysis of children’s sketches highlighted aspects of the built environment with which they associated themselves the most. The study sought to examine the perception of the deprived children living in the urban slums in the city of Pune (India) towards their built environment.

Keywords: physical environment, poverty, underprivileged children, urban Indian slums

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Authors: Natalia Oli, Abhinav Vaidya, Katja Pahkala, Gabriele Eiben, Alexandra Krettek

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The nutritional transition towards a high fat and energy dense diet, decreasing physical activity level, and poor cardiovascular health knowledge contributes to a rising burden of cardiovascular diseases in Nepal. Dietary and physical activity behaviors are formed early in life and influenced by family, particularly by mothers in the social context of Nepal. The purpose of this study was to explore knowledge, attitude and behavior of mothers regarding diet and physical activity of their pre-school children. Cross-sectional study was conducted in the semi-urban area of Duwakot and Jhaukhel communities near the capital Kathmandu. Between August and November 2014, nine trained enumerators interviewed all mothers having children aged 2 to 7 years in their homes. Questionnaire contained information about mothers’ socio-demographic characteristics; their knowledge, attitude, and behavior regarding diet and physical activity as well as their children’s diet and physical activity. Knowledge, attitude and behavior responses were scored. SPSS version 22.0 was used for data analyses. Out of the 1,052 eligible mothers, 962 consented to participate in the study. The mean age was 28.9 ± 4.5 years. The majority of them (73%) were housewives. Mothers with higher education and income had higher knowledge, attitude, and behavior scores (All p < 0.001) whereas housewives and farmers had low knowledge score (p < 0.001). They, along with laborers, also exhibited lower attitude (p<0.001) and behavior scores (p < 0.001). Children’s diet score increased with mothers’ level of education (p <0.001) and income (p=0.041). Their physical activity score, however, declined with increasing level of their mothers’ education (p < 0.001) and income (p < 0.001). Children’s overall behavior score correlated poorly with mothers’ knowledge (r = 0.009, p=0.003), attitude (r =0.012, p=0.001), and behavior (r = 0.007, p= 0.008). Such poor correlation can be due to existence of the barriers among mothers. Mothers reported such barriers as expensive healthy food, difficulty to give up favorite food, taste preference of others family members and lack of knowledge on healthy food. Barriers for physical activity were lack of leisure time, lack of parks and playgrounds, being busy by caring for children and old people, feeling lazy and embarrassed in front of others. Additionally, among the facilitators for healthy lifestyle, mentioned by mothers, were better information, family eating healthy food and supporting physical activity, advice of medical personnel regarding healthy lifestyle and own ill health. The study demonstrated poor correlation of mothers’ knowledge and attitude with children’s behavior regarding diet and physical activity. Hence improving mothers’ knowledge or attitude may not be enough to improve dietary and physical activity habits of their children. Barriers and facilitators that affect mothers’ practices towards their children should also be addressed due to future intervention.

Keywords: attitude, behavior, diet, knowledge, mothers, physical activity

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Authors: Rodriguez Diego, Del Valle Martin, Hargreaves Matias, Riveros Jose Luis

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Nutrient deficiencies due to a diet low in quantitative and qualitative terms, are prevalent throughout the developing world, especially in sub-Saharan Africa. Children and women of childbearing age are especially vulnerable. Limited availability, access and intake of animal foods at home and lack of knowledge about their value in the diet and the role they play in health, contribute to poor diet quality. Poor bioavailability of micronutrients in diets based on foods high in fiber and phytates, the low content of some micronutrients in these foods are further factors to consider. Goats are deeply embedded in almost every Sub-Saharan African rural culture, generally kept for their milk, meat, hair or leather. Goats have played an important role in African social life, especially in food security. Goat meat has good properties for human wellbeing, with a special role in lower income households. It has a high-quality protein (20 protein g/100 meat g) including all essential amino acids, good unsaturated/satured fatty acids relationship, and it is an important B-vitamin source with high micronutrients bioavailability. Mozambique has major food security problems, with poor food access and utilization, undiversified diets, chronic poverty and child malnutrition. Our objective was to design a nutritional intervention based on a dietary diversification, nutritional education, cultural beliefs and local resources, aimed to strengthen food security of children at Barrio Broma village (15°43'58.78"S; 32°46'7.27"E) in Chitima, Mozambique. Two surveys were conducted first of socio-productive local databases and then to 100 rural households about livelihoods, food diversity and anthropometric measurements in children under 5 years. Our results indicate that the main economic activity is goat production, based on a native breed with two deliveries per year in the absence of any management. Adult goats weighted 27.2±10.5 kg and raised a height of 63.5±3.8 cm. Data showed high levels of poverty, with a food diversity score of 2.3 (0-12 points), where only 30% of households consume protein and 13% iron, zinc, and B12 vitamin. The main constraints to food security were poor access to water and low income to buy food. Our dietary intervention was based on improving diet quality by increasing the access to dried goat meat, fresh vegetables, and legumes, and its utilization by a nutritional education program. This proposal was based on local culture and living conditions characterized by the absence of electricity power and drinkable water. The drying process proposed would secure the food maintenance under local conditions guaranteeing food safety for a longer period. Additionally, an ancient local drying technique was rescued and used. Moreover, this kind of dietary intervention would be the most efficient way to improve the infant nutrition by delivering macro and micronutrients on time to these vulnerable populations.

Keywords: child malnutrition, dietary diversification, food security, goat meat

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Authors: Uttam Kumar Sahoo, K. Lalhmingsangi, J. H. Lalremruati

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Non-timber forest resources particularly the high-value, low volume NTFPs has drawn interest as an activity all over the world during the past three decades that could raise standards of living for the rural folks while being compatible with forest conservation. This is particularly true for the people living in and around or fringes of protected areas. However, the economics that plays between resources’ stock and its utilization by the humans is yet to be validated and evaluated logistically. A study was therefore designed to understand the linkages between resource (especially NTFPs) availability and their utilization, existing threats to this biodiversity conservation and the role of NTFPs within the livelihood systems of those households that are most directly involved in creating conservation threats. About 25% of the households were sampled from the two sites ‘resource-rich’ and ‘resource poor’ area of Dampa Tiger Reserve (Western boundary). Our preliminary findings suggest that the collection of relatively high-volume and low value NTFPs such as fuelwood, fodder has caused degradation of forest resources while the low-volume and high-value NTFPs such as wild edible mushrooms, vegetables, other specialty food products, inputs to crafts, medicinal plants have resulted into species promotion/conservation through their domestication in traditional agroforestry systems including home gardens and/or collateral protection of the Tiger Reserve. It is thus suggested that proper assessment of these biodiversities, their direct and indirect valuation, market and non-market profits etc be carried out in greater details which would result in prescribing effective management plans around the park.

Keywords: household economy, livelihood strategies, non-timber forest products, species conservation

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Authors: Ezinne K. Okoro, Takahiko Katoh, Yoko Kawamura, Stanley C. Meribe

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HIV infection in children is largely as a result of vertical transmission (mother to child transmission [MTCT]). Thus, elimination of mother to child transmission of HIV/AIDS is critical in eliminating HIV infection in children. In Nigeria, drawbacks such as; limited pediatric screening, limited human capital, insufficient advocacy and poor understanding of ART guidelines, have impacted efforts at combating the disease, even as treatment services are free. Prevention of Mother to Child Transmission (PMTCT) program relies on health workers who not only counsel pregnant women on first contact but can competently provide HIV-positive pregnant women with accurate information about the PMTCT program such as feeding techniques and drug adherence. In developing regions like Nigeria where health care delivery faces a lot of drawbacks, it becomes paramount to address these issues of poor PMTCT coverage by conducting a baseline assessment of the knowledge, practices and perceptions related to HIV prevention amongst healthcare workers in Nigeria. A descriptive cross-sectional study was conducted amongst 250 health workers currently employed in health facilities in Abuja, Nigeria where PMTCT services were offered with the capacity to carry out early infant diagnosis testing (EID). Data was collected using a self-administered, pretested, structured questionnaire. This study showed that the knowledge of PMTCT of HIV was poor (30%) among healthcare workers who offer this service day-to-day to pregnant women. When PMTCT practices were analyzed in keeping with National PMTCT guidelines, over 61% of the respondents reported observing standard practices and the majority (58%) had good attitudes towards caring for patients with HIV/AIDS. Although 61% of the respondents reported being satisfied with the quality of service being rendered, 63% reported not being satisfied with their level of knowledge. Predictors of good knowledge were job designation and level of educational attainment. Health workers who were more satisfied with their working conditions and those who had worked for a longer time in the PMTCT service were more likely to observe standard PMTCT practices. With over 62% of the healthcare workers suggesting that more training would improve the quality of service being rendered, this is a strong pointer to stakeholders to consider a ‘healthcare worker-oriented approach’ when planning and conducting PMTCT training for healthcare workers. This in turn will increase pediatric ARV coverage, the knowledge and effectiveness of the healthcare workers in carrying out appropriate PMTCT interventions and culminating in the reduction/elimination of HIV transmission to newborns.

Keywords: attitudes, HIV/AIDS, healthcare workers, knowledge, mother to child transmission, Nigeria, perceptions

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Authors: Faris Alkhalil, Rana Bitar, Amer Azaz, Hisham Natour, Noora Almeraikhi, Mohamad Miqdady

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Background: Children with liver transplantation are achieving very good survival and so there is now a need to concentrate on achieving good health in these patients and preventing disease. Immunosuppressive medications have side effects that need to be monitored and if possible avoided. Glucocorticoids and calcineurin inhibitors are detrimental to bone and mineral homeostasis in addition steroids can also affect linear growth. Steroid sparing regimes in renal transplant children has shown to improve children’s height. Aim: We aim to review the growth and bone health of children post liver transplant by measuring bone mineral density (BMD) using dual energy X-ray absorptiometry (DEXA) scan and assessing if there is a clear link between poor growth and impaired bone health and use of long term steroids. Subjects and Methods: This is a single centre retrospective Cohort study, we reviewed the medical notes of children (0-16 years) who underwent a liver transplantation between November 2000 to November 2016 and currently being followed at our centre. Results: 39 patients were identified (25 males and 14 females), the median transplant age was 2 years (range 9 months - 16 years), and the median follow up was 6 years. Four patients received a combined transplant, 2 kidney and liver transplant and 2 received a liver and small bowel transplant. The indications for transplant included, Biliary Atresia (31%), Acute Liver failure (18%), Progressive Familial Intrahepatic Cholestasis (15%), transplantable metabolic disease (10%), TPN related liver disease (8%), Primary Hyperoxaluria (5%), Hepatocellular carcinoma (3%) and other causes (10%). 36 patients (95%) were on a calcineurin inhibitor (34 patients were on Tacrolimus and 2 on Cyclosporin). The other three patients were on Sirolimus. Low dose long-term steroids was used in 21% of the patients. A considerable proportion of the patients had poor growth. 15% were below the 3rd centile for weight for age and 21% were below the 3rd centile for height for age. Most of our patients with poor growth were not on long term steroids. 49% of patients had a DEXA scan post transplantation. 21% of these children had low bone mineral density, one patient had met osteoporosis criteria with a vertebral fracture. Most of our patients with impaired bone health were not on long term steroids. 20% of the patients who did not undergo a DEXA scan developed long bone fractures and 50% of them were on long term steroid use which may suggest impaired bone health in these patients. Summary and Conclusion: The incidence of impaired bone health, although studied in limited number of patients; was high. Early recognition and treatment should be instituted to avoid fractures and improve bone health. Many of the patients were below the 3rd centile for weight and height however there was no clear relationship between steroid use and impaired bone health, reduced weight and reduced linear height.

Keywords: bone, growth, pediatric, liver, transplantation

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Authors: Dagem Alemayehu, Samson Gebersilassie, Jan Frank

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Climate change is impacting nutrition through reducing food quantity and access, limiting dietary diversity, and decreased nutritional food content as well as strongly affecting seasonal rainfall in Ethiopia. Nevertheless, only a few data is available on the impacts of seasonality in Infant, and Young Child Feeding (IYCF) practices undernutrition among 6-23 months old children in different agro-ecological zones of poor resource settings of Ethiopia. Methods: Socio-demographic, anthropometry, and IYCF indicators were assessed in the harvest and lean seasons among children aged 6–23 months of age randomly selected from rural villages of lowland and midland agro-ecological zones. Results: Child stunting and underweight increased from prevalence of 32.8 % and 23.9 % (lowland &midland respectively) in the lean season to 36.1% and 33.8 % harvest seasons, respectively. The biggest increase in the prevalence of stunting and underweight between harvest and lean seasons was noted in the lowland zone. Wasting decreased from 11.6% lean to 8.5% harvest, with the biggest decline recorded in the midland zone. Minimum meal frequency, minimum acceptable diet, and poor dietary diversity increased considerably in harvest compared to a lean season in the lowland zone. Feeding practices and maternal age were predictors of wasting, while women's dietary diversity and children's age was a predictor of child dietary diversity in both seasons. Conclusion: There is seasonal variation in undernutrition and IYCF practices among children 6-23 months of age with more pronounced effect lowland agro-ecological zone.

Keywords: agroecology, seasonality, stunting, wasting

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Authors: Tirtha Raj Dhakal, Brian Davidson, Bob Farquharson

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Irrigation management transfer has been taken as the important policy instrument for effective irrigation resource management in many developing countries. The change in governance of the irrigation schemes for its day-to-day operation and maintenance has been centered in recent Nepalese irrigation policies also. However, both farmer- and agency-managed irrigation schemes in Nepal are performing well below than expected. This study tries to link the present concerns of poor performance of both forms of schemes with the institutions for its operation and management. Two types of surveys, management and farm surveys; were conducted as a case study in the command area of Narayani Lift Irrigation Project (agency-managed) and Khageri Irrigation System (farmer-managed) of Chitwan District. The farm survey from head, middle and tail regions of both schemes revealed that unequal water distribution exists in these regions in both schemes with greater percentage of farmers experiencing this situation in agency managed scheme. In both schemes, the cost recovery rate was very low, even below five percent in Lift System indicating poor operation and maintenance of the schemes. Also, the institution on practice in both schemes is unable to create any incentives for farmers’ willingness to pay as well as for its economical use in the farm. Thus, outcomes from the study showed that only the management transfer programs may not achieve the goal of efficient irrigation resource management. This may suggest water professionals to rethink about the irrigation policies for refining institutional framework irrespective of the governance of schemes for improved cost recovery and better water distribution throughout the irrigation schemes.

Keywords: cost recovery, governance, institution, irrigation management transfer, willingness to pay

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Authors: Ramesh K. Adsul, V. R. Shinde, S. S. Jadhav

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The main aim of the present study was to explore the effect of various levels of parental acceptance – avoidance attitude on various areas of adjustment of urban and rural junior college students. It was hypothesized that 1. There exists no significant effect of various levels of parental acceptance attitude on adjustment of urban and rural junior college students. 2. There exists no significant effect of various levels of parental avoidance attitude on adjustment of urban and rural junior college students. 3. There would be no significant difference between urban and rural Junior College students on various areas of (home, health, social, and emotional) adjustment. The 847 students (427 boys and 420 girls) studying in 11th class of various Junior colleges in Sangli ,Satara and Kolhapur districts of Maharashtra State, India were selected by random sampling method. Study was conducted by using two psychological tests namely 1. Family Relationship Inventory. 2.Bell’s Adjustment Inventory. One way ANOVA was employed to find out the effect of parental acceptance – avoidance attitude and adjustment in various areas of urban and rural junior college students. ‘t’ test was used to find out the difference between urban and rural students on various areas of adjustment. The results of the study indicate that (1) It is observed that three groups of parental acceptance attitude (PA) are significantly varied on home and social adjustment. It means that PA affects home and social adjustment of adolescents. High PA creates excellent adjustment and low PA creates poor adjustment in adolescents. (2) Study revealed that PV significantly affects adjustment of adolescents. High PV significantly creates poor adjustment in adolescents than average and low PV. (3) There is significant difference between urban and rural adolescents on adjustment. Urban adolescents have better adjustment than rural adolescents.

Keywords: parental acceptance, avoidance attitude, adjustment, urban-rural student

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Authors: Helga Martins, Idália Matias

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Background:Multiple sclerosis is a chronic inflammatory autoimmune demyelinating disease that affects young adults. Multiple sclerosis is a chronic disease in which the patient needs to self-manage the disease and the therapeutic regimen. Consequently, the promotion of health literacy assumes a relevant role for the accessibility, understanding, and use of information in order to promote and maintain the health of patients with multiple sclerosis. Aim: To determine the impact of lower health literacy in the self-management of patients with a multiple sclerosis. Methods: Literature review based on a search on the following electronic databases: CINAHLand MEDLINE; comprising all results published between September 2016 and September 2021. The search strategy was: (“Self-management [MeSH]” AND “Multiple sclerosis[MeSH]”AND “Health literacy[MeSH]”). The inclusion criteria were: original papers reporting about multiple sclerosis patients; participants with age above 18 years old, written in English, Spanish, French, or Portuguese. Two independent reviewers have done the screening and analysis of the results. 38 citations were identified, and after duplicates removal, a total of 25 results were screened; 14 were included after the application of the inclusion criteria. Results: The lower health literacy in the self-management of patients with a multiple sclerosis is related toless healthy choices, riskier health behavior, poor health outcomes, decreased of adhering to the therapeutic regimen after discharge, less self-management of chronic illness, and increased the time of hospitalization. Conclusion: Inadequate levels of health literacy contribute to poor health outcomes, unsuccessful self-management of chronic illness, and inadequate adherence to the therapeutic regimen. Therefore, health literacy is important for health policy and the healthcare services, as it can be understood as a mediator of self-management of multiple sclerosis disease.

Keywords: health literacy, multiple sclerosis, review, self-management

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