Search results for: health behaviors

Authors: Anandita Mitro, Archana Srivastava, Bidisha Banerjee

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The present paper attempts to analyze the hierarchy and interconnection of factors responsible for the uptake of BCG vaccination in India. The study uses National Family Health Survey (NFHS-5) data which was conducted during 2019-21. The univariate logistic regression method is used to understand the univariate effects while the interconnection effects have been studied using the Categorical Inference Tree (CIT) which is a non-parametric Machine Learning (ML) model. The hierarchy of the factors is further established using Conditional Inference Forest which is an extension of the CIT approach. The results suggest that BCG vaccination coverage was influenced more by system-level factors and awareness than education or socio-economic status. Factors such as place of delivery, antenatal care, and postnatal care were crucial, with variations based on delivery location. Region-specific differences were also observed which could be explained by the factors. Awareness of the disease was less impactful along with the factor of wealth and urban or rural residence, although awareness did appear to substitute for inadequate ANC. Thus, from the policy point of view, it is revealed that certain subpopulations have less prevalence of vaccination which implies that there is a need for population-specific policy action to achieve a hundred percent coverage.

Keywords: vaccination, NFHS, machine learning, public health

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Authors: Maylen Villamanan Alba

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Latin America is marked by its history: conquest, colonialism, and slavery left deep footprints in most Latin American countries. Also, the past century has been affected by wars, military dictatorships, and political violence, which profoundly influenced Latin American popular culture. Consequently, reminiscences of historical crimes are frequently present in daily life, media, public opinion, and arts. This legacy is remembered in novels, paintings, songs, and films. In fact, Latin American cinema has a trend which refers to the verisimilitude with reality in fiction films. These films about historical violence are narrated as fictional characters, but their stories are based on real historical contexts. Therefore, cultural criminology has considered films as a significant field to understand social representations of violence related to historical crimes. The aim of the present contribution is to analyze the legacy of past and historical memory in social representations of violence in Latin American cinema as a critical approach to historical crimes. This qualitative research is based on content analysis. The sample is seven multi-award winning films of the International Festival of New Latin American Cinema of Havana. The films selected are Kamchatka, Argentina (2002); Carandiru, Brazil (2003); Enlightened by fire, Argentina (2005); Post-mortem, Chile (2010); No, Chile (2012) Wakolda; Argentina (2013) and The Clan, Argentina (2015). Cultural criminology highlights that cinema shapes meanings of social practices such as historical crimes. Critical criminology offers a critical theory framework to interpret Latin American cinema. This analysis reveals historical conditions deeply associated with power relationships, policy, and inequality issues. As indicated by this theory, violence is characterized as a structural process based on social asymmetries. These social asymmetries are crossed by social scopes, including institutional and personal dimensions. Thus, institutions of the states are depicted through personal stories of characters involved with human conflicts. Intimacy and social background are linked in the personages who simultaneously perform roles such as soldiers, policemen, professionals or inmates and they are at the same time depict as human beings with family, gender, racial, ideological or generational issues. Social representations of violence related to past legacy are a portrait of historical crimes perpetrated against Latin American citizens. Thereby, they have contributed to political positions, social behaviors, and public opinion. The legacy of these historical crimes suggests a path that should never be taken again. It means past legacy is a reminder, a warning, and a historic lesson for Latin American people. Social representations of violence are permeated by historical memory as denunciation under a critical approach.

Keywords: Latin American cinema, historical memory, social representation, violence

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Authors: Folajinmi Oluwasina, Towolawi Adetayo, Kate Ssamula, Penninah Iutung, Daniel Reijer

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Objective: Routine HIV screening has been promoted as an essential component of efforts to reduce incidence, morbidity, and mortality. The objectives of this study were to identify the optimal annual volume needed to realize the public health goals of HIV screening in the AIDS Healthcare Foundation supported hospitals and establish an implementation process to realize that optimal annual volume. Methods: Starting in 2011 a program was established to routinize HIV screening within communities and government hospitals. In 2016 Five-years of HIV screening data were reviewed to identify the optimal annual proportions of age-eligible patients screened to realize the public health goals of reducing new diagnoses and ending late-stage diagnosis (tracked as concurrent HIV/AIDS diagnosis). Analysis demonstrated that rates of new diagnoses level off when 42% of age-eligible patients were screened, providing a baseline for routine screening efforts; and concurrent HIV/AIDS diagnoses reached statistical zero at screening rates of 70%. Annual facility based targets were re-structured to meet these new target volumes. Restructuring efforts focused on right-sizing HIV screening programs to align and transition programs to integrated HIV screening within standard medical care and treatment. Results: Over one million patients were screened for HIV during the five years; 16, 033 new HIV diagnoses and access to care and treatment made successfully for 82 % (13,206), and concurrent diagnosis rates went from 32.26% to 25.27%. While screening rates increased by 104.7% over the 5-years, volume analysis demonstrated that rates need to further increase by 62.52% to reach desired 20% baseline and more than double to reach optimal annual screening volume. In 2011 facility targets for HIV screening were increased to reflect volume analysis, and in that third year, 12 of the 19 facilities reached or exceeded new baseline targets. Conclusions and Recommendation: Quantifying targets against routine HIV screening goals identified optimal annual screening volume and allowed facilities to scale their program size and allocate resources accordingly. The program transitioned from utilizing non-evidence based annual volume increases to establishing annual targets based on optimal volume analysis. This has allowed efforts to be evaluated on the ability to realize quantified goals related to the public health value of HIV screening. Optimal volume analysis helps to determine the size of an HIV screening program. It is a public health tool, not a tool to determine if an individual patient should receive screening.

Keywords: HIV screening, optimal volume, HIV diagnosis, routine

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Authors: Berger Saintius, Edna Ariste, Djeamsly Salomon

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Background: Maternal mortality is a preventable global health problem that affects developed, developing, and underdeveloped countries alike. Globally, maternal mortality rates have declined since 1990, but 830 women die every day from pregnancy and childbirth-related causes that are often preventable. Haiti, with a number of 529 maternal deaths per 100,000 live births, is one of the countries with the highest maternal mortality rate in the Caribbean. This study consists of analyzing maternal death surveillance data in Haiti from 2017-2020. Method : A descriptive study was conducted; data were extracted from the National Epidemiological Surveillance Network of maternal deaths from 2017 to 2020. Sociodemographic variables were analyzed. Excel and Epi Info 7.2 were used for data analysis. Frequency and proportion measurements were calculated. Results: 756 deaths were recorded for the study period: 42 (6%) in 2017, 168 (22%) in 2018, 265 (35%) in 2019, and 281 (37%) in 2020. The North Department recorded the highest number of deaths, 167 (22%). 83(11%) in Les Cayes. 96% of these deaths are people aged between 15 and 49. Conclusion. Maternal mortality is a major health problem in Haiti. Mobilization, participation, and involvement of communities, increase in obstetric care coverage and promotion of Family Planning are among the strategies to fight this problem.

Keywords: epidemiology, maternal death, hospital, Haiti

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Authors: Aziza Al-Sawafi

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Introduction: The evidence of family interventions in schizophrenia is robust primarily in high-income settings. However, they have been adapted to other settings and cultures to improve effectiveness and acceptability. In Oman, there is limited integration of psychosocial interventions in the treatment of schizophrenia. Therefore, the adaptation of family intervention to the Omani culture may facilitate its uptake. Most service users in Oman live with their families outside the healthcare system, and nothing is known about their experience, needs, or resources. Furthermore, understanding caregivers' and mental health professionals' preferences, perceptions, and experience is a fundamental element in the process of intervention development. Therefore, this study aims to develop a culturally sensitive, feasible, and acceptable family intervention for relatives living with schizophrenia in Oman. Method: The Medical Research Council's framework for the evaluation of complex health care interventions provided the conceptual structure for the study. The development phase was carried out, which involved three stages: 1) systematically reviewing the available literature regarding culturally adapted family interventions in the Arab world 2) In-depth interviews with caregivers to explore their experience and perceived needs and preferences regarding intervention 3) A focus group study involving health professionals to explore the acceptability and feasibility of delivering the family intervention in the Omani context. Data synthesis determined the design of the proposed intervention according to the findings obtained from the previous stages. Results: Stage one: The systematic review found limited evidence of culturally-adapted family interventions in the Arab region. However, the cultural adaptation process was comprehensive, and the implementation was reported to be feasible and acceptable. Stage two: The experience of family caregivers illuminated four main themes: burden, stigma, violence, and family needs. Burdens of care included objective and subjective burdens, positive feelings, and coping mechanisms. Caregivers gave their opinion about the content and preference of the intervention from their personal experiences. Stage three: mental health professionals discussed the delivery system of the intervention from a clinical standpoint concerning issues and barriers to implementation. They recommended modifications to the components of the intervention to ensure its acceptability and feasibility in the local setting. Data synthesis was carried out, and the intervention was designed. Conclusion: This study provides evidence of the potential applicability and acceptability of a culturally sensitive family intervention for families of individuals with schizophrenia in Oman. However, more work needs to be done to test the feasibility of the study and overcome the practical challenges.

Keywords: cultural-adaptation, family intervention, Oman, schizophrenia

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Authors: Zihao He

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The majority of existing studies on the Taiping Movement (1851-1864) viewed their anti-Manchu attitudes as nationalist agendas: Taiping was aimed at revolting against the Manchu government and establishing a new political regime. To explain these aggressive and violent attitudes towards Manchu, these studies mainly found socio-economic factors and stressed the status of “being deprived”. Even the ‘demon-slaying’ narrative of the Taiping to dehumanize the Manchu tends to be viewed as a “religious tool” to achieve their political, nationalist aim. This paper argues that these studies on Taiping’s anti-Manchu attitudes and behaviors are analyzed from an external angle and have two major problems. Firstly, they distinguished “religion” from “nationalist” or “political”, focusing on the “political” nature of the movement. “Religion” and the religious experience within Taiping were largely ignored. This paper argues that there was no separable and independent “religion” in the Taiping Movement, as opposed to secular, nationalist politics. Secondly, these analyses held an external perspective on Taiping’s anti-Manchu agenda. Demonizing and killing Manchu were viewed as purely political actions. On the contrary, this paper focuses on the internal perspective of anti-Manchu narratives in the Taiping Movement. The method of this paper is mainly textual analysis, focusing on the official documents, edicts, and proclamations of the Taiping movement. It views the writing of the Taiping as a coherent narrative and rhetoric, which was attractive and convincing for its followers. In terms of the main findings, firstly, internal and external perspectives on anti-Manchu violence are different. Externally, violence was viewed as a tool and necessary process to achieve the political goal. However, internally speaking, in Taiping’s writing, violence was a result of Godlessness, which would be solved as far as the faith in God is restored in China. Having a framework of universal love among human beings as sons and daughters of the Heavenly Father and killing was forbidden, the Taiping excluded Manchus from the family of human beings and demonized them. “Demon-slaying” was not violence. It was constructed as a necessary process to achieve the Great Peace. Moreover, Taiping’s anti-Manchu violence was not merely “political.” Rather, the category “religion” and its binary opposition, “secular,” is not suitable for Taiping. A key point related to this argument is the revolutionary violence against the Manchu government, which inherited the traditional “Heavenly Mandate” model. From an internal, theological perspective, anti-Manchu was ordained and commanded by the Heavenly Father. Manchu, as a regime, was standing as a hindrance in the path toward God. Besides, Manchu was not only viewed as a regime, but they were also “demons.” Therefore, the paper examines how Manchus were dehumanized in Taiping’s writings and were situated outside of the consideration of nonviolent and love. Manchu as a regime and Manchu as demons are in a dynamic relationship. As a regime, the Manchu government was preventing Chinese people from worshipping the Heavenly Father, so they were demonized. As they were demons, killing Manchus during the revolt was justified and not viewed as being contradicted the universal love among human beings.

Keywords: anti-manchu, demon-slaying, heavenly mandate, religion and violence, the taiping movement.

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Authors: Fei Gao, Rodolfo C. Raga Jr.

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This research proposal will ascertain the major risk factors for diabetes and to design a predictive model for risk assessment. The project aims to improve diabetes early detection and management by utilizing data science techniques, which may improve patient outcomes and healthcare efficiency. The phase relation values of each attribute were used to analyze and choose the attributes that might influence the examiner's survival probability using Diabetes Health Indicators Dataset from Kaggle’s data as the research data. We compare and evaluate eight machine learning algorithms. Our investigation begins with comprehensive data preprocessing, including feature engineering and dimensionality reduction, aimed at enhancing data quality. The dataset, comprising health indicators and medical data, serves as a foundation for training and testing these algorithms. A rigorous cross-validation process is applied, and we assess their performance using five key metrics like accuracy, precision, recall, F1-score, and area under the receiver operating characteristic curve (AUC-ROC). After analyzing the data characteristics, investigate their impact on the likelihood of diabetes and develop corresponding risk indicators.

Keywords: diabetes, risk factors, predictive model, risk assessment, data science techniques, early detection, data analysis, Kaggle

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Authors: Nihaya Daoud, Adi Finkelstein

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Depression is a major public health concern and it is estimated to be the second leading cause of morbidity in 2020. One of the most consistent findings in mental health in the Western societies is inequalities in depression between men and women. Studies on differences in depression between Arab men and women are scarce. In this paper, we use data of a countrywide study on the Arab minority in Israel to compare the prevalence of depressive symptoms between men and women and examine factors that contribute to this gender inequality in the context of Arab society. The study was conducted in 2005-2006. It included a sample of Palestinian citizens of Israel, aged 30–70. The final sample included 902 respondents (381 women and 521 men) who were interviewed face-to-face using a structured questionnaire in Arabic, before which they each signed an informed consent form. The study was approved by the Institutional Review Board at Hadassah – Hebrew University Medical Center. Results show that women had significantly higher depressive symptoms (DS) than men. In addition, while Arab women had steady rates of depressive symptoms between the ages of 40-54 and a peak at the age group of 55-59, among Arab men there was a peak almost every 10 years (more results will show in the full presentation). We assume that our findings might be attributed to the specific structural changes in the Arab society in Israel in the last decades.

Keywords: Arab men, Arab women, depression, gender inequality

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Authors: Dragos Dragomir-Stanciu, Leon Marsh

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Background As a response to the gaps identified in recent research in the provision of residential care to address co-occurring health needs, including mental health problems and complexities Gamble Aware has facilitated the possibility to provide a new service which would extend the NGTS provision of residential rehabilitation for gambling disorder with complex and co-morbid presentation. Gordon Moody, together with Adferiad have been successful in securing the tender for this service and this presentation aims to introduce FOLD, the resulting model of treatment developed for the delivery of the service. Setting As a partnership, we have come together to coproduce a model which allows us to share our clinical and industry knowledge and build on our reputations as trusted treatment providers. The presentation will outline our expertise share in development of a unified approach to recovery-oriented models of care, clinical governance, risk assessment and management and aftercare and continuous recovery. We will also introduce our innovative specialist referral portal which will offer referring partners the ability to include the service user in planning their own recovery journey. Outcomes Our collaboration has resulted in the development of the FOLD model which includes three agile and flexible treatment packages aimed at offering the most enhanced and comprehensive treatment in UK, to date, for those most affected by gambling harm. The paper will offer insight into each treatment package and all recovery model stages involved, as well as into the partnership work with NGST providers, local mental health and social care providers and lived experience organisation that will enable us to offer support to more 100 people a year who would otherwise get “lost in the system”. Conclusion FOLD offers a great opportunity to develop, implement and evaluate a new, much needed, whole-person and whole-system approach to counter gambling related harms.

Keywords: gambling treatment, partnership working, integrated care pathways, NGTS, complex needs

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Authors: Quentin C.P. Bourgogne, Vanessa Bouchart, Pierre Chevrier, Emmanuel Dattoli

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This study presents an experimental and theoretical work conducted on a PolyPhenylene Sulfide reinforced with 40%wt of short glass fibers (PPS GF40) and its matrix. Thermoplastics are widely used in the automotive industry to lightweight automotive parts. The replacement of metallic parts by thermoplastics is reaching under-the-hood parts, near the engine. In this area, the parts are subjected to high temperatures and are immersed in cooling liquid. This liquid is composed of water and glycol and can affect the mechanical properties of the composite. The aim of this work was thus to quantify the evolution of mechanical properties of the thermoplastic composite, as a function of temperature and liquid aging effects, in order to develop a reliable design of parts. An experimental campaign in the tensile mode was carried out at different temperatures and for various glycol proportions in the cooling liquid, for monotonic and cyclic loadings on a neat and a reinforced PPS. The results of these tests allowed to highlight some of the main physical phenomena occurring during these solicitations under tough hydro-thermal conditions. Indeed, the performed tests showed that temperature and liquid cooling aging can affect the mechanical behavior of the material in several ways. The more the cooling liquid contains water, the more the mechanical behavior is affected. It was observed that PPS showed a higher sensitivity to absorption than to chemical aggressiveness of the cooling liquid, explaining this dominant sensitivity. Two kinds of behaviors were noted: an elasto-plastic type under the glass transition temperature and a visco-pseudo-plastic one above it. It was also shown that viscosity is the leading phenomenon above the glass transition temperature for the PPS and could also be important under this temperature, mostly under cyclic conditions and when the stress rate is low. Finally, it was observed that soliciting this composite at high temperatures is decreasing the advantages of the presence of fibers. A new phenomenological model was then built to take into account these experimental observations. This new model allowed the prediction of the evolution of mechanical properties as a function of the loading environment, with a reduced number of parameters compared to precedent studies. It was also shown that the presented approach enables the description and the prediction of the mechanical response with very good accuracy (2% of average error at worst), over a wide range of hydrothermal conditions. A temperature-humidity equivalence principle was underlined for the PPS, allowing the consideration of aging effects within the proposed model. Then, a limit of improvement of the reachable accuracy was determinate for all models using this set of data by the application of an artificial intelligence-based model allowing a comparison between artificial intelligence-based models and phenomenological based ones.

Keywords: aging, analytical modeling, mechanical testing, polymer matrix composites, sequential model, thermomechanical

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Authors: Gargi S. Kumar, Mrinmoyi Kulkarni

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Food choice behavior is complex and determined by biological, psychological, socio-cultural, and economic factors. The past two decades, have seen dramatic changes in food consumption patterns among urban Indian consumers. The objective of the current study was to evaluate perceptions about changes with respect to food choice behavior. Ten participants [urban men and women] ranging in age from 40 to 65 were selected and in-depth interviews were conducted with a set of open ended questions. The recorded interviews were transcribed and thematically analyzed using inductive, open and axial coding. The results identified themes that act as drivers and consequences of change in food choice behavior. Drivers such as globalization [sub themes of urbanization, education, income, and work environment], media and advertising, changing gender roles, women in the workforce, and change in family structure have influenced food choice, both at an individual and national level. The consequences of changes in food choice were health implications, processed food consumption, food decisions driven by children and eating out among others. The study reveals that, over time, food choices change and evolve. However it is interesting to note how market forces and culture interact to influence individual behavior and the overall food environment which subsequently affects food choice and the health of the people.

Keywords: change, consequences, drivers, food choice, globalization

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Authors: Magda Milleyde de Sousa Lima, Letícia Lima Aguiar, Marina Guerra Martins, Erika Veríssimo Dias Sousa, Lizandra Sampaio de Oliveira, Lívia Moreira Barros, Joselany Áfio Caetano

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Patients with chronic kidney disease are vulnerable to episodes which make the safety of their health vulnerable, mainly due to the treatment process that exposes them to high rates of interventions during hemodialysis sessions. Some factors associated with health care contribute to the risk of death and complications. However, there are a small number of scientific studies evaluating the level of safety of hemodialysis clinics, and the sociodemographic characteristics of patients and professionals associated with this safety. Therefore, the present study aims to examine the level of patient safety in hemodialysis clinics in the Brazilian capital, to identify the sociodemographic and clinical factors of patients and nursing staff associated with the level of safety. This is an observational, descriptive and quantitative research conducted in three hemodialysis clinics placed in the city of Fortaleza-CE, Brazil, from September to November 2019. The sample was formed after a sample calculation for finite inhabitants of correlation with 200 chronic renal patients, 30 nursing technicians and seven nurses. Conventional sampling was used based on the inclusion criteria: being present at the hemodialysis session on the day the researcher performed the data collection and being 18 years of age or older. Participants who presented communication difficulties to listen to and/or answer the sociodemographic and clinical questionnaire were excluded. Two instruments were applied: sociodemographic and clinical characterization form and Chronic Renal Patient Safety Assessment Scale on Hemodialysis (EASPRCH). The data were analyzed using the Kruskal Walls Test for categorical variables and Spearman correlation coefficient for non-categorical variables, using the Statistical Package SPSS version 20.0. The present study respected the ethical and legal principles determined by resolution 466/2012 of the National Health Council, under the approval of the Ethics and Research Committee with an opinion number: 3,255,635. The results showed that a hemodialysis clinic presented unsafe care practices of 32 points in the EASPRCH (p=0.001). A statistical association was identified between the level of safety and the variables of the patients: level of education (p=0.018), family income (p=0.049), type of employment (p=0.012), venous access site (p=0.009), use of medication during the session (p=0.008) and time of hemodialysis (p=0.002). When evaluating the profile of nurses, a statistical association was evidenced between the level of safety with the variables: marital status (p=0.000), race (p=0.017), schooling (p= 0.000), income (p=0.013), age (p=0.000), clinic workload (p=0.000), time working with hemodialysis (p=0.000), time working in the clinic (p= 0.007) and clinic sizing (p=0.000). In order, the sociodemographic factors of nursing technicians associated with the level of patient safety were: race (p= 0.001) and weekly workload at (p=0.010). Therefore, it is concluded that there is a non-conformity in the level of patient safety in one of the clinics studied and, that sociodemographic and clinical factors of patients and health professionals corroborate the level of safety of the health unit.

Keywords: hemodialysis, nursing, patient safety, quality improvement

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Authors: Mohammad Amjad, Muhammad Iqbal Zafar, Ashfaq Ahmed Maan, Muhammad Tayyab Kashif

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Obesity is an abnormal physical condition where an increased and undesirable fat accumulates in the human body. Obesity is an international phenomenon. In the present study, 12 schools were randomly selected from each district considering the areas i.e. Elite Private Schools in the private sector, Government schools in urban areas and Government schools in rural areas. Interviews were conducted with male students studying in grade 5 to grade 9 in each school. The sample size was 600 students; 300 from Faisalabad district and 300 from Rawalpindi district in Pakistan. A well-structured and pre-tested questionnaire was used for data collection. The calibrated scales were used to attain the heights and weights of the respondents. Obesity of school-going children depends on family types, family size, family history, junk food consumption, mother’s education, weekly time spent in walking, and sports facility at school levels. Academic performance, physical health and psychological health of school going children are affected with obesity. Concrete steps and policies could minimize the incidence of obesity in children in Pakistan.

Keywords: body mass index, cardiovascular disease, fast food, morbidity, overweight

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Authors: Brigita Mieziene, Arunas Emeljanovas, Vida Cesnaitiene, Ingunn Fjortoft, Lise Kjonniksen

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Background. Health-related physical fitness refers to the favorable health status, i.e. ability to perform daily activities with vigor, as well as capacities that are associated with a low risk for development of chronic diseases and premature death. However, in school-aged children it is constantly declining, while some aspects of fitness declined as much as 50 percent during the last two decades, which prognosticates increasingly earlier onset of health problems, decreasing the quality of life of the population and financial burden for the society. Therefore, the goal of the current study was to indicate nationally representative age- and gender-specific reference values of anthropometric measures, musculoskeletal, motor and cardiorespiratory fitness in Lithuanian primary school children from 6 to 10 years. Methods. The study included 3556 students in total, from 73 randomly selected schools. Ethics approval for research by the Kaunas Regional Ethics Committee (No. BE-2-42) was obtained. Physical fitness was measured by the 9-item test battery, developed by Fjørtoft and colleagues. Height and weight were measured and body mass index calculated. Smoothed centile charts were derived using the LMS method. Results. The numerical age- and gender-specific percentile values (3rd, 10th, 25th, 50th, 75th, 90th, and 97th percentile) for anthropometric measures, musculoskeletal, motor and cardiorespiratory fitness were provided. The equivalent smoothed LMS curves were performed. The study indicated 12.5 percent of overweight and 5 percent of obese children in accordance with international gender and age specific norms of body mass index. This data could be used in clinical and educational settings in order to identify the level of individual physical fitness within its different components.

Keywords: fitness, overweight, primary school children, reference values, smoothed percentile curves

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Authors: Md Iqbal Hossain, Tahmeed Ahmed, Kenneth H. Brown

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Objective: To assess the effect of community-based follow up, with or without food-supplementation and/or psychosocial stimulation, as an alternative to current hospital-based follow-up of children with moderate-acute-malnutrition (WHZ < -2 to -3) (MAM). Design/methods: The study was conducted at the ICDDR,B Dhaka Hospital and in four urban primary health care centers of Dhaka, Bangladesh during 2005-2007. The efficacy of five different randomly assigned interventions was compared with respect to the rate of completion of follow-up, growth and morbidity in 227 MAM children aged 6-24 months who were initially treated at ICDDR,B for diarrhea and/or other morbidities. The interventions were: 1) Fortnightly follow-up care (FFC) at the ICDDR,B’s outpatient-unit, including growth monitoring, health education, and micro-nutrient supplementation (H-C, n=49). 2) FFC at community follow-up unit (CNFU) [established in the existing urban primary health-care centers close to the residence of the child] but received the same regimen as H-C (C-C, n=53). 3) As per C-C plus cereal-based supplementary food (SF) (C-SF, n=49). The SF packets were distributed on recruitment and at every visit in CNFU [@1 packet/day for 6–11 and 2 packets/day for 12-24 month old children. Each packet contained 20g toasted rice-powder, 10g toasted lentil-powder, 5g molasses, and 3g soy bean oil, to provide a total of ~ 150kcal with 11% energy from protein]. 4) As per C-C plus psychosocial stimulation (PS) (C-PS, n=43). PS consisted of child-stimulation and parental-counseling conducted by trained health workers. 5) As per C-C plus both SF+PS (C-SF+PS, n=33). Results: A total of 227children (48.5% female), with a mean ± SD age of 12.6 ±3.8 months, and WHZ of - 2.53±0.28 enrolled. Baseline characteristics did not differ by treatment group. The rate of spontaneous attendance at scheduled follow-up visits gradually decreased in all groups. Follow-up attendance and gain in weight and length were greater in groups C-SF, C-SF+PS, and C-PS than C-C, and these indicators were observed least in H-C. Children in the H-C group more often suffered from diarrhea (25 % vs. 4-9%) and fever (28% vs. 8-11%) than other groups (p < 0.05). Children who attended at least five of the total six scheduled follow-up visits gained more in weight (median: 0.86 vs. 0.62 kg, p=0.002), length (median: 2.4 vs. 2.0 cm, p=0.009) than those who attended fewer. Conclusions: Community-based service delivery, especially including supplementary food with or without psychosocial stimulation, permits better rehabilitation of children with MAM compared to current hospital outpatients-based care. By scaling the community-based follow-up including food supplementation with or without psychosocial stimulation, it will be possible to rehabilitate a greater number of MAM children in a better way.

Keywords: community-based management, moderate acute malnutrition, psychosocial stimulation, supplementary food

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Authors: Chueh Chang, Chia-jung Hsieh, Fu-yu Yu, Yu-Hwa Lin

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Background:The majority of women diagnosed with breast cancer undergo treatment involving surgery and radiotherapy or chemotherapy, or both. With these major advances in breast cancer management, many patients still have to deal with short or long-term side effects and psychological distress related to the disease and treatment, which have a substantial impact on their quality of life. The Laughing Qigong Program (LQP) is an interactive laughter program that combines the physical and physiological benefits of laughter with the mental benefits of Chinese qigong. Purpose: In order to improve the quality of life for breast cancer women in the community as well as echoing the WHO 2004 “Promoting Mental Health” for every one. This study focused on how to promote the positive mental health for women of breast cancer through the “laughter program” in Taiwan. During the presentation, how to practice Laughing Qigong will be demonstrated. Method: Using nonequivalent pretest-posttest design, ix-one breast cancer patients were volunteered to enroll in this study from the Taiwan Breast Cancer Alliance (TBCA). Thirty patients were assigned to the experimental group and the other 31 patients were assigned to the control group. The women who were assigned to the experimental group received laughter program one hour per session, once a week, totally 12 sessions. All subjects were tested before and after the intervention on the following: Self-Esteem scale (RSE), Face Scale (FS), Anxiety and pain experience were measured as psychological markers; saliva cortisol (CS) as an immunological marker; blood pressure (BP), heart rate (HR),and heart rate variability (HRV) as physiological markers of the body’s response to stress. Results: After comparing the experimental and control groups, the results revealed that those breast cancer women with “laughing program” their sense of humor were improved, less uncomfortable on self report physical conditions, more positive attitudes toward stress management by using laughter, and had emotional improvement according to the face scale.

Keywords: mental health promotion, breast cancer, laughing Qigong, women

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Authors: Shamsulhaq Amin

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Unbound granular materials (UGMs) are pivotal in ensuring long-term quality, especially in the layers under the surface of flexible pavements and other constructions. This study seeks to better understand the behavior of the UGMs by looking at popular models for predicting lasting deformation under various levels of stresses and load cycles. These models focus on variables such as the number of load cycles, stress levels, and features specific to materials and were evaluated on the basis of their ability to accurately predict outcomes. The study showed that these factors play a crucial role in how well the models work. Therefore, the research highlights the need to look at a wide range of stress situations to more accurately predict how much the UGMs bend or shift. The research looked at important factors, like how permanent deformation relates to the number of times a load is applied, how quickly this phenomenon happens, and the shakedown effect, in two different types of UGMs: granite and limestone. A detailed study was done over 100,000 load cycles, which provided deep insights into how these materials behave. In this study, a number of factors, such as the level of stress applied, the number of load cycles, the density of the material, and the moisture present were seen as the main factors affecting permanent deformation. It is vital to fully understand these elements for better designing pavements that last long and handle wear and tear. A series of laboratory tests were performed to evaluate the mechanical properties of materials and acquire model parameters. The testing included gradation tests, CBR tests, and Repeated load triaxial tests. The repeated load triaxial tests were crucial for studying the significant components that affect deformation. This test involved applying various stress levels to estimate model parameters. In addition, certain model parameters were established by regression analysis, and optimization was conducted to improve outcomes. Afterward, the material parameters that were acquired were used to construct graphs for each model. The graphs were subsequently compared to the outcomes obtained from the repeated load triaxial testing. Additionally, the models were evaluated to determine if they demonstrated the two inherent deformation behaviors of materials when subjected to repetitive load: the initial phase, post-compaction, and the second phase volumetric changes. In this study, using log-log graphs was key to making the complex data easier to understand. This method made the analysis clearer and helped make the findings easier to interpret, adding both precision and depth to the research. This research provides important insight into picking the right models for predicting how these materials will act under expected stress and load conditions. Moreover, it offers crucial information regarding the effect of load cycle and permanent deformation as well as the shakedown effect on granite and limestone UGMs.

Keywords: permanent deformation, unbound granular materials, load cycles, stress level

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Authors: Giovanni Menichini, Salvatore Giacomo Morano, Gloria Terenzi, Luca Salvatori, Maurizio Orlando

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The “Guidelines for Risk Classification, Safety Assessment, and Structural Health Monitoring of Existing Bridges” were recently approved by the Italian Government to define technical standards for managing the national network of existing bridges. These guidelines provide a framework for risk mitigation and safety assessment of bridges, which are essential elements of the built environment and form the basis for the operation of transport systems. Within the guideline framework, a workflow based on three main points was proposed: (1) risk-based, i.e., based on typical parameters of hazard, vulnerability, and exposure; (2) multi-level, i.e., including six assessment levels of increasing complexity; and (3) multirisk, i.e., assessing structural/foundational, seismic, hydrological, and landslide risks. The paper focuses on applying the Italian Guidelines to specific case studies, aiming to identify the parameters that predominantly influence the determination of the “class of attention”. The significance of each parameter is determined via sensitivity analysis. Additionally, recommendations for enhancing the process of assigning the class of attention are proposed.

Keywords: bridge safety assessment, Italian guidelines implementation, risk classification, structural health monitoring

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Authors: Eugene Allevato

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Developing a responsible personal worldview is central to sustainable development, but achieving quality education to promote transformative learning for sustainability is thus far, poorly understood. Most programs involving education for sustainable development rely on changing behavior, rather than attitudes. The emphasis is on the scientific and utilitarian aspect of sustainability with negligible importance on the intrinsic value of nature. Campus sustainability projects include building sustainable gardens and implementing energy-efficient upgrades, instead of focusing on educating for sustainable development through exploration of students’ values and beliefs. Even though green technology adoption maybe the right thing to do, most schools are not targeting the root cause of the environmental crisis; they are just providing palliative measures. This study explores the under-examined factors that lead to pro-environmental behavior by investigating the environmental perceptions of both college business students and personnel of green organizations. A mixed research approach of qualitative, based on structured interviews, and quantitative instruments was developed including 30 college-level students’ interviews and 40 green organization staff members involved in sustainable activities. The interviews were tape-recorded and transcribed for analysis. Categorization of the responses to the open‐ended questions was conducted with the purpose of identifying the main types of factors influencing attitudes and correlating with behaviors. Overall the findings of this study indicated a lack of appreciation for nature, and inability to understand interconnectedness and apply critical thinking. The results of the survey conducted on undergraduate students indicated that the responses of business and liberal arts students by independent t-test were significantly different, with a p‐value of 0.03. While liberal arts students showed an understanding of human interdependence with nature and its delicate balance, business students seemed to believe that humans were meant to rule over the rest of nature. This result was quite intriguing from the perspective that business students will be defining markets, influencing society, controlling and managing businesses that supposedly, in the face of climate change, shall implement sustainable activities. These alarming results led to the focus on green businesses in order to better understand their motivation to engage in sustainable activities. Additionally, a probit model revealed that childhood exposure to nature has a significantly positive impact in pro-environmental attitudes to most of the New Ecological Paradigm scales. Based on these findings, this paper discusses educators including Socrates, John Dewey and Paulo Freire in the implementation of eco-pedagogy and transformative learning following a curriculum with emphasis on critical and systems thinking, which are deemed to be key ingredients in quality education for sustainable development.

Keywords: eco-pedagogy, environmental behavior, quality education for sustainable development, transformative learning

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Authors: Sakshi Chopra, Harsimarpreet Kaur, Ashima Nehra

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Objectives: Malingering is fabricating or exaggerating the symptoms of mental or physical disorders for a variety of secondary gains or motives, which may include financial compensation; avoiding work; getting lighter criminal sentences; or simply to attract attention or sympathy. Malingering is different from somatization disorder and factitious disorder. The prevalence of malingering is unknown and difficult to determine. In an estimated study in forensic population, it can reach up to 17% cases. But the accuracy of such estimates is questionable as successful malingerers are not detected and thus, not included. Methods: The case study of a 58 years old, right handed, graduate, pre-morbidly working in a national company with reported history of stroke leading to head injury; cerebral infarction/facial palsy and dementia. He was referred for disability certification so that his job position can be transferred to his son as he could not work anymore. A series of Neuropsychological tests were administered. Results: With a mental age of < 2.5 years; social adaptive functioning was overall < 20 showing profound Mental Retardation, less than 1 year social age in abilities of self-help, eating, dressing, locomotion, occupation, communication, self-direction, and socialization; severely impaired verbal and performance ability, 96% impairment in Activities of Daily Living, with an indication of very severe depression. With inconsistent and fluctuating medical findings and problem descriptions to different health professionals forming the board for his disability, it was concluded that this patient was malingering. Conclusions: Even though it can be easily defined, malingering can be very challenging to diagnosis. Cases of malingering impose a substantial economic burden on the health care system and false attribution of malingering imposes a substantial burden of suffering on a significant proportion of the patient population. Timely, tactful diagnosis and management can help ease this patient burden on the healthcare system. Malingering can be detected by only trained mental health professionals in the clinical setting.

Keywords: disability, India, malingering, neuropsychological assessment

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Authors: Reza Eka Putra

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Pamsimas is a community based drinking water supply and sanitation program which is contributed by local community, local government, central government, and World Bank with the aim of achieving Water Supply and Sanitation - the Millennium Development Goals (WSS-MDGs) target. This program is supported by the Ministry of Public Works as the executing agency with the cooperation of Ministry of Interior and the Ministry of Health. Field observations were conducted in two rural samples of 2009 beneficiaries Pamsimas West Java, which is in Ponggang Village, Subang District. The study was evaluated through several parameters, including technical, health, and empowerment aspect. Evaluation was done by comparing the parameters of success that has been set by Pamsimas through Pamsimas book manuals with the parameters from Sanitation & Infrastructure course regarding the appropriate application of technology in society. The result of the study is that the potency of the community before the program is implemented in the village is the determining factor. Stronger cooperation pattern in Ponggang Vilage results in a successful program. Both villages showed a pattern of behavior changes from indiscriminate defecation to sanitary latrine use. Besides, there is a decline in the number of cases of diarrheal disease since the year of Pamsimas implementation.

Keywords: millenium development goals, community develpoment, water supply, sanitation

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Authors: Aschenaki Zerihun Kea, Bernt Lindtjorn, Achamyelesh Gebretsadik, Sven Gudmund Hinderaker

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Introduction: Maternal mortality studies conducted at the national level do not provide the information needed for planning and monitoring health programs at lower administrative levels. The aim of this study was to measure maternal mortality, identify risk factors and district-level variations in Sidama National Regional State, southern Ethiopia. Methods: A cross sectional population-based survey was carried out in households where women reported pregnancy and birth outcomes in the past five years. The study was conducted in the Sidama National Regional State, southern Ethiopia, from July 2019 to May 2020. Multi-stage cluster sampling technique was employed. The outcome variable of the study was maternal mortality. Complex sample logistic regression analysis was applied to assess variables independently associated with maternal mortality. Results: We registered 10602 live births (LB) and 48 maternal deaths, yielding an overall maternal mortality ratio (MMR) of 419; 95% CI: 260-577 per 100,000 LB. Aroresa district had the highest MMR with 1142 (95% CI: 693-1591) per 100,000 LB. Leading causes of death were haemorrhage 21 (41%) and eclampsia 10 (27%). Thirty (59%) mothers died during labour, or within 24 hours after delivery, 25 (47%) died at home and 17 (38%) at a health facility. Mothers who did not have formal education had a higher risk of maternal death (AOR: 4.4; 95% CI: 1.7 – 11.0). The risk of maternal death was higher in districts with a low midwife-to-population ratio (AOR: 2.9; 95% CI: 1.0-8.9). Conclusion: The high maternal mortality with district-level variations in Sidama Region highlights the importance of improving obstetric care and employing targeted interventions in areas with high mortality rates. Due attention should be given to improving access to female education. Additional midwives have to be trained and deployed to improve maternal health services and consequently save the lives of mothers.

Keywords: maternal mortality variation, maternal death, Sidama, Ethiopia

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Authors: Ali Gheshmi

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The highest rate of death, after World War II, is due to the Coronavirus epidemic and more than 2 million people have died since the epidemic outbreak in December 2019, so the word “death” is one of the highest frequency words in social media; moreover, the use of social media has grown due to quarantine and successive restrictions and lockdowns. The most important aspects of the approach used by this study include the analysis of Iranian social media users’ reactions to the images of those who died due to Coronavirus, investigating if seeing such images via social media is effective on the users’ perception of the closeness of death, and evaluating the extent to which the fear of Coronavirus death is instrumental in persuading users to observe health protocols or causing mental problems in social media users. Since the goal of this study is to discover how social media users perceive and react to the images of people who died of Coronavirus, the cultural studies approach is used Receipt analysis method and in-depth interviews will be used for collecting data from Iranian users; also, snowball sampling is used in this study. The probable results would show that cyberspace users experience the closeness of “death” more than any time else and to cope with these annoying images, avoid viewing them or if they view, it will lead them to suffer from mental problems.

Keywords: death, receipt analysis method, mental health, social media, Covid-19

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Authors: Haruka Ando

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Undernutrition of children is a critical issue, especially for people in the remote areas of the Republic of Djibouti, since household food insecurity, inadequate child caring and feeding, unhealthy environment and lack of clean water, as well as insufficient maternal and child healthcare, are underlying causes which affect. Nomadic pastoralists living in the Dikhil region (Dikhil) are socio-economically and geographically more vulnerable due to displacement, which in turn worsens the situation of child stunting. A high prevalence of inappropriate complementary feeding among pastoral mothers might be a significant barrier to child growth. This study aims to identify health promotion intervention strategies that would support an increase in optimal complementary feeding among pastoral mothers of children aged 6-23 months in Dikhil. There are four objectives; to explore and to understand the existing practice of complementary feeding among pastoral mothers in Dikhil; to identify the barriers in appropriate complementary feeding among the mothers; to critically explore and analyse the strategies for an increase in complementary feeding among the mothers; to make pragmatic recommendations to address the barriers in Djibouti. This is an in-depth study utilizing a conceptual framework, the behaviour change wheel, to analyse the determinants of complementary feeding and categorize health promotion interventions for increasing optimal complementary feeding among pastoral mothers living in Dikhil. The analytical tool was utilized to appraise the strategies to mitigate the selected barriers against optimal complementary feeding. The data sources were secondary literature from both published and unpublished sources. The literature was systematically collected. The findings of the determinants including the barriers of optimal complementary feeding were identified: heavy household workload, caring for multiple children under five, lack of education, cultural norms and traditional eating habits, lack of husbands' support, poverty and food insecurity, lack of clean water, low media coverage, insufficient health services on complementary feeding, fear, poor personal hygiene, and mothers' low decision-making ability and lack of motivation for food choice. To mitigate selected barriers of optimal complementary feeding, four intervention strategies based on interpersonal communication at the community-level were chosen: scaling up mothers' support groups, nutrition education, grandmother-inclusive approach, and training for complementary feeding counseling. The strategies were appraised through the criteria of effectiveness and feasibility. Scaling up mothers' support groups could be the best approach. Mid-term and long-term recommendations are suggested based on the situation analysis and appraisal of intervention strategies. Mid-term recommendations include complementary feeding promotion interventions are integrated into the healthcare service providing system in Dikhil, and donor agencies advocate and lobby the Ministry of Health Djibouti (MoHD) to increase budgetary allocation on complementary feeding promotion to implement interventions at a community level. Moreover, the recommendations include a community health management team in Dikhil training healthcare workers and mother support groups by using complementary feeding communication guidelines and monitors behaviour change of pastoral mothers and health outcome of their children. Long-term recommendations are the MoHD develops complementary feeding guidelines to cover sector-wide collaboration for multi-sectoral related barriers.

Keywords: Afar, child food, child nutrition, complementary feeding, complementary food, developing countries, Djibouti, East Africa, hard-to-reach areas, Horn of Africa, nomad, pastoral, rural area, Somali, Sub-Saharan Africa

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Authors: Mehtap Öztürk, Adem Öğüt, Emine Öğüt

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Leader member exchange is considered as relationship-based approach to leadership. The focal point of this theory is that effective leadership processes occur when leaders and followers are able to develop mature leadership relationships and thus gain access to a variety of benefits these relationships bring. In this context, it can be claimed that the quality of leader member exchange appears to have a strong affect on perceived organizational support and reduce turnover intention. The purpose of this study is to determine the relationship between the levels of leader member exchange, perceived organizational support and turnover intention on the employees of a health institution operating in the province of Konya. A field study based on survey method on 134 physicians who are employees of a health institution operating in the mentioned sample. In accordance with this purpose, it has been observed that there is a negative and statistically significant relationship between leader member exchange and turnover intention. Furthermore, it has been also realized that there is a negative and statistically significant relationship between perceived organizational support and turnover intention.

Keywords: leader member exchange, perceived organizational support, social exchange theory, turnover intention

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Authors: Mina Adel Shokry Fahim, Jūratė Sužiedelytė Visockienė

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With the growing concern over air pollution (AP), it is clear that this has gained more prominence than ever before. The level of consciousness has increased and a sense of knowledge now has to be forwarded as a duty by those enlightened enough to disseminate it to others. This realisation often comes after an understanding of how poor air quality indices (AQI) damage human health. The study focuses on assessing air pollution prediction models specifically for Lithuania, addressing a substantial need for empirical research within the region. Concentrating on Vilnius, it specifically examines particulate matter concentrations 10 micrometers or less in diameter (PM10). Utilizing Gaussian Process Regression (GPR) and Regression Tree Ensemble, and Regression Tree methodologies, predictive forecasting models are validated and tested using hourly data from January 2020 to December 2022. The study explores the classification of AP data into anthropogenic and natural sources, the impact of AP on human health, and its connection to cardiovascular diseases. The study revealed varying levels of accuracy among the models, with GPR achieving the highest accuracy, indicated by an RMSE of 4.14 in validation and 3.89 in testing.

Keywords: air pollution, anthropogenic and natural sources, machine learning, Gaussian process regression, tree ensemble, forecasting models, particulate matter

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Authors: M. Dahiru, O. I. Enabulele

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The research wish to investigate the occurrence of multidrug- resistant Acinetobacter, in carrot and estimate the role of carrot in its transmission, in a rapidly growing urban population. Thus, 50 carrot samples were collected from Jakara wastewater irrigation farms and analyzed on MacConkey agar and screened by Microbact 24E (Oxoid) and susceptibility of isolates tested against 10 commonly used antibiotics. Acinetobacter baumannii and A. lwoffii were isolated in 22.00% and 16% of samples respectively. Resistance to ceporex and penicillin of 36.36% and 27.27% in A. baumannii, and sensitivity to ofloxacin, pefloxacin, gentimycin and co-trimoxazole, were observed. However, for A. lwoffii apart from 37.50% resistance to ceporex, it was also resistant to all other drugs tested. There was a similarity in the resistant shown by A. baumannii and A. lwoffii to fluoroquinolones drugs and β- lactame drugs families in addition to between sulfonamide and animoglycoside demonstrated by A. lwoffii. Interestingly, when resistant similarities to different antibiotics were compared for A. baumannii and A. lwoffii as a whole, significant correlation was observed at P < 0.05 to CPX to NA (46.2%), and SXT to AU (52.6%) respectively, and high multi drug resistance (MDR) of 27.27% and 62.50% by A. baumannii and A. lwoffii respectively and overall MDR of 42.11% in all isolates. The occurrence of multidrug-resistance pathogen in carrot is a serious challenge to public health care, especially in a rapidly growing urban population where subsistence agriculture contributes greatly to urban livelihood and source of vegetables.

Keywords: urban agriculture, public health, fluoroquinolone, sulfonamide, multidrug-resistance

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Authors: Aisha Zubair, Anila Kamal

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Leadership styles and practices greatly influence the organizational effectiveness and productivity. It also plays an important role in employees’ experiences of positive emotions at workplace and creative work behaviors. Authentic leadership as a newly emerging concept has been found as a significant predictor of various desirable work related outcomes. However, leadership practices and its work related outcomes, to a great extent, are determined by the very nature of the organizational structures (tall and flat). Tall organizations are characterized by multiple hierarchical layers with predominant vertical communication patterns, and narrow span of control; while flat organizations are featured by few layers of management employing both horizontal and vertical communication styles, and wide span of control. Therefore, the present study was undertaken to determine the work related outcomes of perceived authentic leadership; that is work related flow and creative work behavior among employees of flat and tall organizations. Moreover, it was also intended to determine the moderating role of organizational structure (flat and tall) in the relationship between perceived authentic leadership with work related flow and creative work behavior. In this regard, two types of companies have been considered; that is, banks as a form of tall organizational structure with multiple hierarchical structures while software companies have been considered as flat organizations with minimal layers of management. Respondents (N = 1180) were full time regular employees of marketing departments of banks (600) and software companies (580) including both men and women with age range of 22-52 years (M = 33.24; SD = 7.81). Confirmatory Factor Analysis yielded factor structures of measures of work related flow and creative work behavior in accordance to the theoretical models. However, model of authentic leadership exhibited variation in terms of two items which were not included in the final measure of the perceived authentic leadership. Results showed that perceived authentic leadership was positively associated with work related flow and creative work behavior. Likewise, work related flow was positively aligned with creative work behavior. Furthermore, type of organizational structure significantly moderated the relationship of perceived authentic leadership with work related flow and creative work behavior. Results of independent sample t-test showed that employees working in flat organization reflected better perceptions of authentic leadership; higher work related flow and elevated levels of creative work behavior as compared to those working in tall organizations. It was also found that employees with extended job experience and more job duration in the same organization displayed better perceptions of authentic leadership, reported more work related flow and augmented levels of creative work behavior. Findings of the present study distinctively highlighted the similarities as well as differences in the interactions of major constructs which function differentially in the context of tall (banks) and flat (software companies) organizations. Implications of the present study for employees and management as well as future recommendations were also discussed.

Keywords: creative work behavior, organizational structure, perceived authentic leadership, work related flow

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Authors: Hala Abdulhafiz, Steffi Robak

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Introduction: Refugees often arrive in Germany with traumatic experiences, leading to psy-chosocial challenges. According to the World Health Organization's definition, psychosocial life skills help individuals effectively cope with everyday challenges and enhance their overall health and well-being. This study explores life skills acquired in integration courses and their impact on the integration of Syrian migrants. Methods: Qualitative expert interviews identified crucial life skills for successful integration, followed by a qualitative content analysis of integration course textbooks. Additionally, written interviews with former participants of integration courses were conducted. Results: Expert interviews highlighted the significance of communication skills and problem-solving abilities in promoting integration. Emotional and stress management, however, ranked lower in the hierarchy of essential life skills. While many highlighted life skills were addressed and encouraged in textbooks, there was a deficiency in opportunities to strengthen empathy, creativity, emotions, and stress management. The participant survey revealed that respondents possessed some of the defined life skills positively affecting their integration. However, there was a need for enhancing self-esteem, and many struggled with handling emotions and stress situations. Conclusion: The analyzed life skills should be further developed through educational programs and initiatives, with increased emphasis on textbooks.

Keywords: life skills, integration, migration, integration course

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Authors: Dalhat Binta Dan - Ali

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The reality of the new world economic order and the ever increasing importance of biotechnology in the global economy have necessitated the ratification of the Cartagena Protocol on Biosafety and the recent promulgation of Biosafety Act in Nigeria 2015. The legal regimes are anchored on the need to create an enabling environment for the flourishing of bio-trade and also to ensure the safety of the environment and human health. This paper critically examines the legal framework on biosafety by taking a cursory look at its philosophical foundation, key issues and milestones. The paper argues that the extant laws, though a giant leap in the establishment of a legal framework on biosafety, it posits that the legal framework raises debate and controversy on the difficulties of risk assessment on biodiversity and human health, other challenges includes lack of sound institutional capacity and the regimes direction of a hybrid approach between environmental conservation and trade issues. The paper recommend the need for the country to do more in the area of stimulating awareness and establishment of a sound institutional capacity to enable the law ensure adequate level of protection in the field of safe transfer, handling, and use of genetically modified organisms (GMOs) in Nigeria.

Keywords: Cartagena protocol, biosafety, issues, challenges, biotrade, genetically modified organism (GMOs), environment

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