Search results for: cross protection

Authors: Tyler D. Cesarone, Tatiana M. Wugalter

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The movement of patients from the Global North to the Global South in pursuit of inexpensive healthcare and touristic experiences dominates the academic discourse on international medical travel (IMT). However, medical travel exists in higher numbers between Global South countries as patients who lack trust in, and feel disenfranchised by, their national healthcare systems seek treatment in nearby countries. Through a review of the existing literature, this paper examines patterns of IMT in the Middle East, Southeast Asia, and Southern Africa, distinguishing North-South medical tourism from South-South intra-regional medical mobility (IRMM). Evidence from these case studies demonstrates that notions of medical distrust and disenfranchisement, rooted in low-resourced and poor quality healthcare systems, are key drivers of IRMM in the Global South. The movement of patients from lower income to proximate higher income countries not only reveals tensions between patients and their healthcare systems but widens gaps in the quality of healthcare between departing and destination countries. In analyzing these cross-regional similarities, the paper moves beyond the current literature’s focus on singular case studies to expose global patterns of South-South IRMM. This presents a shift from the traditional focus on North-South medical tourism, demonstrating how disparities in healthcare systems both influence and are influenced by IRMM.

Keywords: global South, healthcare quality, international medical travel (IMT), intra-regional medical mobility (IRMM), medical disenfranchisement, medical distrust, medical tourism

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Authors: H. W. Meerveld, R. H. A. Lindelauf

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In contemporary warfare, data science is crucial for the military in achieving information superiority. Yet, to the authors’ knowledge, no extensive literature survey on data science in military decision-making has been conducted so far. In this study, 156 peer-reviewed articles were analysed through an integrative, semi-systematic literature review to gain an overview of the topic. The study examined to what extent literature is focussed on the opportunities or risks of data science in military decision-making, differentiated per level of war (i.e. strategic, operational, and tactical level). A relatively large focus on the risks of data science was observed in social science literature, implying that political and military policymakers are disproportionally influenced by a pessimistic view on the application of data science in the military domain. The perceived risks of data science are, however, hardly addressed in formal science literature. This means that the concerns on the military application of data science are not addressed to the audience that can actually develop and enhance data science models and algorithms. Cross-disciplinary research on both the opportunities and risks of military data science can address the observed research gaps. Considering the levels of war, relatively low attention for the operational level compared to the other two levels was observed, suggesting a research gap with reference to military operational data science. Opportunities for military data science mostly arise at the tactical level. On the contrary, studies examining strategic issues mostly emphasise the risks of military data science. Consequently, domain-specific requirements for military strategic data science applications are hardly expressed. Lacking such applications may ultimately lead to a suboptimal strategic decision in today’s warfare.

Keywords: data science, decision-making, information superiority, literature review, military

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Authors: S. P. Singh, Priya, Komal Sajwan

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With the increasing spread of organic farming in India, costs, returns, efficiency, and social and environmental sustainability of organic vis-a-vis conventional farming systems have become topics of interest among agriculture scientists, economists, and policy analysts. A study on technical efficiency estimation under these farming systems, particularly in the Ganga River Basin, where the promotion of organic farming is incentivized, can help to understand whether the inputs are utilized to their maximum possible level and what measures can be taken to improve the efficiency. This paper, therefore, analyses the technical efficiency of wheat farms operating under organic and conventional farming systems. The study is based on a primary survey of 600 farms (300 organic ad 300 conventional) conducted in 2021 in two districts located in the Middle Ganga River Basin, India. Technical, managerial, and scale efficiencies of individual farms are estimated by applying the data envelopment analysis (DEA) methodology. The per hectare value of wheat production is taken as an output variable, and values of seeds, human labour, machine cost, plant nutrients, farm yard manure (FYM), plant protection, and irrigation charges are considered input variables for estimating the farm-level efficiencies. The post-DEA analysis is conducted using the Tobit regression model to know the efficiency determining factors. The results show that technical efficiency is significantly higher in conventional than organic farming systems due to a higher gap in scale efficiency than managerial efficiency. Further, 9.8% conventional and only 1.0% organic farms are found operating at the most productive scale size (MPSS), and 99% organic and 81% conventional farms at IRS. Organic farms perform well in managerial efficiency, but their technical efficiency is lower than conventional farms, mainly due to their relatively lower scale size. The paper suggests that technical efficiency in organic wheat can be increased by upscaling the farm size by incentivizing group/collective farming in clusters.

Keywords: organic, conventional, technical efficiency, determinants, DEA, Tobit regression

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Authors: Mohammad Reza Dousti, Yaman Boluk, Vivek Bindiganavile

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Well cementing is one of the most crucial and important steps in any well completion. Oil well cement paste is employed to fill the annulus between the casing string and the well bore. However, since the cementing process takes place at the end of the drilling process, a satisfying and acceptable job may not be performed. During the cementing process, the cement paste must be pumped in the annulus, therefore concerns arise both in the workability and the flowability associated with the paste. On the other hand, the cement paste around the casing must demonstrate the adequate compressive strength in order to provide a suitable mechanical support for the casing and desirably prevent collapse of the formation. In this experimental study, the influence of cellulose nanocrystal particles on the workability, flowability and also mechanical properties of oil well cement paste has been investigated. The cementitious paste developed in this research is composed of water, class G oil well cement, bentonite and cellulose nanocrystals (CNC). Bentonite is used as a cross contamination component. Two method of testing were considered to understand the flow behavior of the samples: (1) a mini slump test and (2) a conventional flow table test were utilized to study the flowability of the cementitious paste under gravity and also under applied load (number of blows for the flow table test). Furthermore, the mechanical properties of hardened oil well cement paste dosed with CNC were assessed by performing a compression test on cylindrical specimens. Based on the findings in this study, the addition of CNC led to developing a more viscous cement paste with a reduced spread diameter. Also, by introducing a very small dosage of CNC particles (as an additive), a significant increase in the compressive strength of the oil well cement paste was observed.

Keywords: cellulose nanocrystal, cement workability, mechanical properties, oil well cement

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Authors: Troy A. Tyre

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Organizational behavior and organizational change are elements of the ever-changing global business environment. Leadership and organizational behavior are 21st century disciplines. Network marketing organizations need to understand the ever-changing nature of global business and be ready and willing to adapt to the environment. Network marketing organizations have a challenge keeping up with a rapid escalation in global growth. Network marketing growth has been steady and global. Network marketing organizations have been slow to develop a 21st century global strategy to manage the rapid escalation of growth degrading organizational behavior, job satisfaction, increasing attrition, and degrading customer service. Development of an organizational behavior and leadership theory for the 21st century to help network marketing develops a global business strategy to manage the rapid escalation in growth that affects organizational behavior. Managing growth means organizational leadership must develop and adapt to the organizational environment. Growth comes with an open mind and one’s departure from the comfort zone. Leadership growth operates in the tacit dimension. Systems thinking and adaptation of mental models can help shift organizational behavior. Shifting the organizational behavior requires organizational learning. Organizational learning occurs through single-loop, double-loop, and triple-loop learning. Triple-loop learning is the most difficult, but the most rewarding. Tools such as theory U can aid in developing a landscape for organizational behavioral development. Additionally, awareness to espoused and portrayed actions is imperatives. Theories of motivation, cross-cultural diversity, and communications are instrumental in founding an organizational behavior suited for the 21st century.

Keywords: global, leadership, network marketing, organizational behavior

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Authors: Haruo Okabayashi

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The mutual understanding in conversation is very important for human relations. This study investigates the mental function of the formation of mutual understanding between two people in conversation using the embodied approach. Forty people participated in this study. They are divided into pairs randomly. Four conversation situations between two (make/listen to fun or pleasant talk, make/listen to regrettable talk) are set for four minutes each, and the finger plethysmogram (200 Hz) of each participant is measured. As a result, the attractors of the participants who reported “I did not understand my partner” show the collapsed shape, which means the fluctuation of their rhythm is too small to match their partner’s rhythm, and their cross correlation is low. The autonomic balance of both persons tends to resonate during conversation, and both LLEs tend to resonate, too. In human history, in order for human beings as weak mammals to live, they may have been with others; that is, they have brought about resonating characteristics, which is called self-organization. However, the resonant feature sometimes collapses, depending on the lifestyle that the person was formed by himself after birth. It is difficult for people who do not have a lifestyle of mutual gaze to resonate their biological signal waves with others’. These people have features such as anxiety, fatigue, and confusion tendency. Mutual understanding is thought to be formed as a result of cooperation between the features of self-organization of the persons who are talking and the lifestyle indicated by mutual gaze. Such an entanglement phenomenon is called a nonlinear relation. By this research, it is found that the formation of mutual understanding is expressed by the rhythm of a biological signal showing a nonlinear relationship.

Keywords: embodied approach, finger plethysmogram, mutual understanding, nonlinear phenomenon

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Authors: Yung-Chung Chuang

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The cultural layers of archaeological sites are mainly affected by surface land use, land cover, and root system of surface vegetation. For this reason, continuous monitoring of land use and land cover change is important for archaeological sites protection and management. However, in actual operation, on-site investigation and orthogonal photograph interpretation require a lot of time and manpower. For this reason, it is necessary to perform a good alternative for surface vegetation survey in an automated or semi-automated manner. In this study, we applied semi-automatic digital aerial survey technology and canopy characters classification with very high-resolution aerial photographs for surface vegetation interpretation of archaeological sites. The main idea is based on different landscape or forest type can easily be distinguished with canopy characters (e.g., specific texture distribution, shadow effects and gap characters) extracted by semi-automatic image classification. A novel methodology to classify the shape of canopy characters using landscape indices and multivariate statistics was also proposed. Non-hierarchical cluster analysis was used to assess the optimal number of canopy character clusters and canonical discriminant analysis was used to generate the discriminant functions for canopy character classification (seven categories). Therefore, people could easily predict the forest type and vegetation land cover by corresponding to the specific canopy character category. The results showed that the semi-automatic classification could effectively extract the canopy characters of forest and vegetation land cover. As for forest type and vegetation type prediction, the average prediction accuracy reached 80.3%~91.7% with different sizes of test frame. It represented this technology is useful for archaeological site survey, and can improve the classification efficiency and data update rate.

Keywords: digital aerial survey, canopy characters classification, archaeological sites, multivariate statistics

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Authors: Mangala Kohli, P. A. Athira, Reeha Mahajan

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The subthalamic nucleus (STN) is a biconvex nucleus situated in the diencephalon. The knowledge of the morphometry of the subthalamic nucleus is essential for accurate targeting of the nucleus during Deep Brain Stimulation. The present study aims to note the morphometry of the subthalamic nucleus in both the cerebral hemispheres which will prove to be of great value to radiologists and neurosurgeons. A cross‐sectional observational study was conducted in the Departments of Anatomy and Forensic Medicine, Lady Hardinge Medical College & Associated Hospitals, New Delhi on thirty adult cadaveric brain specimens of unclaimed and donated corpses. The specimens were categorized into 3 age groups: 20-35, 35-50 and above 50 years. All samples were collected after following the standard protocol for ethical clearance. The morphometric study of 60 subthalamic nucleus was thus conducted. Transverse section of the brain was made at a plane 4mm ventral to the plane containing mid commissural point. The dimensions of the subthalamic nucleus were measured bilaterally with the aid of digital Vernier caliper and magnifying glass. In the present study, the mean length and width and AC-PC length of the subthalamic nucleus was recorded on the right and left side in Group A, B and C. On comparison of mean of subthalamic nucleus dimensions between the right and left side in Group C, no statistically significant difference was observed. The length and width of subthalamic nucleus measured in the 3 age groups were compared with each other and the p value calculated. There was no statistically significant difference between the dimensions of Group A and B, Group B and C as well as Group A and C. The present study reveals that there is no significant reduction in the size of the nucleus was noted with increasing age. Thus, the values obtained in the present study can be used as a reference for various invasive and non-invasive procedures on subthalamic nucleus.

Keywords: cerebral hemisphere, deep brain stimulation, morphometry, subthalamic nucleus

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Authors: Noemia Bessa Vilela, Jose Caramelo Gomes

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All law student are familiarized, in the first years of their bachelor of laws with the concepts of “public goods” and “ private goods”; often, such legal concept does not exactly match such economic concept, and there are consequences are some sort of confusion being created. The list of goods that follow under each category is not exhaustive, nor are students given proper mechanisms to acknowledge that some legal fields can, on its own, be considered as a “public good”; this is the case of Competition. Legal authors consider that “competition law is used to promote public interest” and, as such, it is a “public good”; in economics theory, Competition is the first public good in a market economy, as the enabler of allocation efficiency. Competition law is the legal tool to support the proper functioning of the market economy and democracy itself. It is fact that Competition Law only applies to economic activities, still, competition is object of private litigation as an integral part of Public Law. Still, regardless of the importance of Competition Law in the economic activity and market regulation, most student complete their studies in law, join the Bar Associations and engage in their professional activities never having been given sufficient tools to deal with the increasing demands of a globalized world. The lack of knowledge of economics, market functioning and the mechanisms at their reach in order to ensure proper realization of their duties as lawyers/ attorneys-at-law would be tackled if Competition Law would be included as part of the curricula of Law Schools. Proper teaching of Competition Law would combine the foundations of Competition Law, doctrine, case solving and Case Law study. Students should to understand and apply the analytical model. Special emphasis should be given to EU Competition Law, namely the TFEU Articles 101 to 106. Damages Directive should also be part of the curriculum. Students must in the first place acquire and master the economic rationale as competition and the world of competition law are the cornerstone of sound and efficient market. The teaching of Competition Law in undergraduate programs in Law would contribute to fulfill the potential of the students who will deal with matters related to consumer protection, economic and commercial law issues both in private practice and as in-house lawyers for companies.

Keywords: higher education, competition law, legal education, law, market economy, industrial economics

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Authors: P. G. S. Madushani, L. D. Illeperuma

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Abstract Noise is one of the most common physical hazards in industrial settings. The prevalence of Noise Induced Hearing Loss (NIHL) is on the rise with increasedduration of exposure and the increase in the severity of hearing loss. The purpose of the study was to determine auditory effects among textile workers and to establish associations between the degree of hearing loss and exposure duration, degree of hearing loss and noise level and the proportion of hearing related complaints. A cross sectional descriptive study using purposive sampling was carried out. An interviewer administered questionnaire and Distortion Product Oto Acoustic Emission (DPOAE) hearing screening on 127 (72 female and 55 male) textile workers of the selected textile plant in Seeduwa, Sri Lanka was done (Age: M= 31.16, SD=7.75). Noise measurements were done in six sections of the factory and average noise levels were obtained. Diagnostic hearing evaluations were done for 60 (57.75%) subjects, referred from the DPOAE hearing screening test. The degree of hearing loss and the exposure duration had a significant association in the high frequency region of 4 kHz to 8 kHz (p < 0.05). Noise levels fluctuated between 90.3±0.8 dBA and 50.6. ±0.52 dBA. 30.83% of workers reported having NIHL. Most of the workers (33.9%) complained difficulty in conversing in noisy backgrounds. Other complaints as tinnitus, dizziness, ear fullness and headache were reported in less than 30%. workers who were exposed to noise for more than 15 years were affected with NIHL in the high frequency region. Administrative controls and engineering controls need to be implemented to manage hazardous noise levels in industrial settings. Hearing Conservation Programs should be initiated and implemented for textile workers.

Keywords: textile industry, NIHL, degree of hearing loss, noise levels, auditory effects

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Authors: Khitam Ibrahem Shlash Mohammad

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Background: Postnatal depression is a focus of considerable research attention, but little is known about the pattern of stress across this period. Objective: to investigate the prevalence of stress after childbirth for Jordanian women and identify associated risk factors. Method: Design: A descriptive cross-sectional study. Participants were recruited six to eight weeks postpartum, provided personal, social and obstetric information, and completed the stress subscale of Depression Anxiety and Stress Scale (DASS-S), the Maternity Social Support Scale (MSSS), and Perceived Self-Efficacy Scale (PSES). Setting: maternal and child health care clinics in four health care centres in Maan city in Southern Jordan. Participants: Arabic speaking women (n = 324) between the ages of 18 and 45 years, six to eight weeks postpartum, primiparous or multiparous at low risk for obstetric complications. Data collection took place between October 2015 and January 2016. Ethical clearance was obtained prior to data collection. Results: The prevalence of postpartum stress among Jordanian women was 39.8 %. A regression analysis revealed that occupation, low social support, financial problems, difficult marital relationships, difficult relationship with family-in-law, giving birth to a female baby, difficult childbirth, and low self-efficacy were associated with postpartum stress. Conclusions and implications for practice: Jordanian women need support during pregnancy, during and after childbirth. Postpartum emotional support and assessment of symptoms of stress need to be incorporated into routine practice. The opportunity for open discussion along with increased awareness and clarification of common misconceptions about postpartum stress is necessary.

Keywords: prevalence, postpartum, stress, Jordanian women

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Authors: Anna Keuchenius

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Broadly speaking, scientific development is studied in either a qualitative manner with a focus on the behavior and interpretations of academics, such as the sociology of science and science studies or in a quantitative manner with a focus on the analysis of publications, such as scientometrics and bibliometrics. Both come with a different set of methodologies and few cross-references. This paper contributes to the bridging of this divide, by on the on hand approaching the process of scientific progress from a qualitative sociological angle and using on the other hand quantitative and computational techniques. As a case study, we analyze the diffusion of Granovetter's hypothesis from his 1973 paper 'On The Strength of Weak Ties.' A network is constructed of all scientists that have referenced this particular paper, with directed edges to all other researchers that are concurrently referenced with Granovetter's 1973 paper. Studying the structure and growth of this network over time, it is found that Granovetter's hypothesis is used by distinct communities of scientists, each with their own key-narrative into which the hypothesis is fit. The diffusion within the communities shares similarities with the diffusion of an innovation in which innovators, early adopters, and an early-late majority can clearly be distinguished. Furthermore, the network structure shows that each community is clustered around one or few hub scientists that are disproportionately often referenced and seem largely responsible for carrying the hypothesis into their scientific subfield. The larger implication of this case study is that the diffusion of scientific hypotheses and ideas are not the spreading of well-defined objects over a network. Rather, the diffusion is a process in which the object itself dynamically changes in concurrence with its spread. Therefore it is argued that the methodology presented in this paper has potential beyond the scientific domain, in the study of diffusion of other not well-defined objects, such as opinions, behavior, and ideas.

Keywords: diffusion of innovations, network analysis, scientific development, sociology of science

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Authors: Ossama Salman

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Background and objective: Sacroiliac joint pain is a common cause for chronic axial low back pain, with up to 20% prevalence rate. To date, no effective long-term treatment intervention has been embarked on yet. The aim of our study was to compare steroid block to radiofrequency ablation for SIJ pain conditions. Methods: A randomized, blind, study was conducted in 30 patients with sacroiliac joint pain. Fifteen patients received radiofrequency denervation of L4-5 primary dorsal rami and S1-3 lateral sacral branch, and 15 patients received steroid under fluoroscopy. Those in the steroid group who did not respond to steroid injections were offered to cross over to get radiofrequency ablation. Results: At 1-, 3- and 6-months post-intervention, 73%, 60% and 53% of patients, respectively, gained ≥ 50 % pain relief in the radiofrequency (RF) ablation group. In the steroid group, at one month post intervention follow up, only 20% gained ≥ 50 % pain relief, but failed to show any improvement at 3 months and 6 months follow up. Conclusions: Radiofrequency ablation at L4 and L5 primary dorsal rami and S1-3 lateral sacral branch may provide effective and longer pain relief compared to the classic intra-articular steroid injection, in properly selected patients with suspected sacroiliac joint pain. Larger studies are called for to confirm our results and lay out the optimal patient selection and treatment parameters for this poorly comprehended disorder.

Keywords: lateral branch denervation, LBD, radio frequency, RF, sacroiliac joint, SIJ, visual analogue scale, VAS

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Authors: Harriet Kebirungi, Majaliwa Jackson-Gilbert Mwanjalolo, S. Livingstone Luboobi, Richard Joseph Kimwaga, Consolata Kabonesa

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This paper assessed gender responsiveness of water and sanitation policies and legal frameworks at Makerere University, Uganda. The objectives of the study were to i) examine the gender responsiveness of water and sanitation related policies and frameworks implemented at Makerere University; and ii) assess the challenges faced by the University in customizing national water and sanitation policies and legal frameworks into University policies. A cross-sectional gender-focused study design was adopted. A checklist was developed to analyze national water and sanitation policies and legal frameworks and University based policies. In addition, primary data was obtained from Key informants at the Ministry of Water and Environment and Makerere University. A gender responsive five-step analytical framework was used to analyze the collected data. Key findings indicated that the policies did not adequately address issues of gender, water and sanitation and the policies were gender neutral consistently. The national policy formulation process was found to be gender blind and not backed by situation analysis of different stakeholders including higher education institutions like Universities. At Makerere University, due to lack of customized and gender responsive water and sanitation policy and implementation framework, there were gender differences and deficiencies in access to and utilization of water and sanitation facilities. The University should take advantage of existing expertise within them to customize existing national water policies and gender, and water and sanitation sub-sector strategy. This will help the University to design gender responsive, culturally acceptable and environmental friendly water and sanitation systems that provide adequate water and sanitation facilities that address the needs and interests of male and female students.

Keywords: gender, Makerere University, policies, water, sanitation

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Authors: Ayse Inel Manav, Saliha Bozdogan Yesilot, Pinar Yesil Demirci, Gursel Oztunc

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Introduction: This study was conducted with a view to evaluating cognitive function level, depression, and quality of life of elderly people living in a nursing home. Methods: This study, which is cross-sectional and descriptive in nature, was conducted in the Nursing and Rehabilitation Center for the Elderly in Adana/Turkey between 1st of May and 1st of August, 2016. The participants included 118 elderly people who were chosen using simple random sampling method. The data were collected using the Personal Information Form, the Standardized Mini Mental State Exam (SMMSE), the Geriatric Depression Scale (GDS), and the World Health Organization Quality of Life-OLD (WHOQOL-OLD) module. The data were analyzed using IBM SPSS Statistics 22 (IBM, SPSS, Turkey) program. Results: Of all the participants, 36,4% (n=43) were female, 63,6% (n=75) were male, and average age was 74,08 ± 8,23 years. The participants’ SMMSE mean score was found 20,37 ± 7,08, GDS mean score was 14,92 ± 4,29, and WHOQOL-OLD module mean score was 69,76 ± 11,54. There was a negative, significant relationship between SMMSE and GDS scores, a positive relationship between WHOQOL-OLD module total scores and a negative, significant relationship between GDS scores and WHOQOL-OLD module total scores. Discussıon and Conclusion: Results showed that more than half of the elderly people living in the nursing home experienced cognitive deterioration and depression; and cognitive state, depression, and quality of life were found to be significantly related to each other.

Keywords: depression, cognitive function level, quality of life

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Authors: Dalma Varga, Nora Hubayne H.

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Nowadays, among the measures taken to offset the consequences of climate change, water resources management is one of the key tools, which can include excess water management. As a result of climate change’s effects and as a result of the frequent inappropriate landuse, more and more areas are affected by the excess water inundation. Hungary is located in the deepest part of the Pannonian Basin, which is exposed to water damage – especially lowland areas that are endangered by floods or excess waters. The periodical presence of excess water creates specific habitats in a given area, which have ecological, functional, and aesthetic values. Excess water inundation affects approximately 74% of Hungary’s lowland areas, of which about 46% is also under nature protection (such as national parks, protected landscape areas, nature conservation areas, Natura 2000 sites, etc.). These data prove that areas exposed to excess water inundation – which are predominantly characterized by agricultural land uses – have an important ecological role. Other research works have confirmed the presence of numerous rare and endangered plant species in drainage canals, on grasslands exposed to excess water, and on special agricultural fields with mud vegetation. The goal of this research is to define and analyze ecosystem services of areas exposed to excess water inundation. In addition to this, it is also important to determine the quantified indicators of these areas’ natural and landscape values besides the presence of protected species and the naturalness of habitats, so all in all, to analyze the various nature protections related to excess water. As a result, a practice-orientated assessment method has been developed that provides the ecological water demand, assimilates to ecological and habitat aspects, contributes to adaptive excess water management, and last but not least, increases or maintains the share of the green infrastructure network. In this way, it also contributes to reduce and mitigate the negative effects of climate change.

Keywords: ecosystem services, landscape architecture, excess water management, green infrastructure planning

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Authors: Aminu Bashir Mohammad, Agwu Ezera, Abdulrazaq G. Habib, Garba Iliyasu

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Background: Drug resistance tuberculosis (DR-TB) continues to be a challenge in developing countries with poor resources. Routine screening for primary DR-TB before commencing treatment is not done in public hospitals in Nigeria, even with the large body of evidence that shows a high prevalence of primary DR-TB. Data on drug resistance and its genetic determinant among follow up TB patients is lacking in Nigeria. Hence the aim of this study was to determine the prevalence and genetic determinant of drug resistance among follow up TB patients in a tertiary hospital in Nigeria. Methods: This was a cross-sectional laboratory-based study conducted on 384 sputum samples collected from consented follow-up tuberculosis patients. Standard microbiology methods (Zeil-Nielsen staining and microscopy) and PCR (Line Probe Assay)] were used to analyze the samples collected. Person’s Chi-square was used to analyze the data generated. Results: Out of three hundred and eighty-four (384) sputum samples analyzed for mycobacterium tuberculosis (MTB) and DR-TB twenty-five 25 (6.5%) were found to be AFB positive. These samples were subjected to PCR (Line Probe Assay) out of which 18(72%) tested positive for DR-TB. Mutations conferring resistance to rifampicin (rpo B) and isoniazid (katG, and or inhA) were detected in 12/18(66.7%) and 6/18(33.3%), respectively. Transmission dynamic of DR-TB was not significantly (p>0.05) dependent on demographic characteristics. Conclusion: There is a need to strengthened the laboratory capacity for diagnosis of TB and drug resistance testing and make these services available, affordable, and accessible to the patients who need them.

Keywords: drug resistance tuberculosis, genetic determinant, intensive phase, Nigeria

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Authors: Hamad Alhamad

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Introduction: The number of retirees in Kuwait is rising quickly, and this is causing more people to become concerned about their well-being. Despite the fact that loneliness and quality of life are significant indices of retiree wellbeing, little research has been done on the topic among retirees in Kuwait. The aim of this study is to explore the level of loneliness and quality of life among retirees in Kuwait. Methods: This is a a cross-sectional descriptive research targeting retirees who live in Kuwait. The UCLA loneliness scale (version 3) and the 36-Item Short Form Survey (36- SF) were utilized. Data was analyzed using SPSS. The ethical approval was obtained from Kuwait University and the Ministry of Health (286). Results: Total respondents in this research were 202 (N=202). The results indicate 77.7% (N=157) experience moderate level of loneliness, 19.8% (N=40) experience high level of loneliness, and only 205% (N=5) experience low level of loneliness. The results of the SF-36 health related questionnaire, participants scores in the eight domains: Physical functioning, general health, role limitations due to physical and emotional health, energy, social functioning, pain, and emotional wellbeing , scored low means. The average of the means was calculated and was (49.8), which indicated that all participants have moderately low Quality of life. Significant relationship with p value equal to ( p= 0.004), was found between a sociodemographic characteristic and level of loneliness in which retirees who were married indicated higher levels of loneliness compared to the single, divorced, and widowed retirees. Conclusion: The study revealed retirees in Kuwait feel moderate loneliness and have a low Quality of Time. The study indicates that retirees should be more considered emotionally and improved and help explore the negative effects on their quality of time In addition to exploring the leading factors to the feeling of loneliness.

Keywords: older adults, social isolation, work, retirement

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Authors: A. Abdulkadir, A. A. Okhimamhe, Y. M. Bello, H. Ibrahim, D. H. Makun, M. T. Usman

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Household waste form a larger proportion of waste generated across the state, accumulation of organic waste is an apparent problem and the existing dump sites could be overstressed. Niger state has abundant arable land and water resources thus should be one of the highest producers of agricultural crops in the country. However, the major challenge to agricultural sector today is the loss of soil nutrient coupled with high cost of fertilizer. These have continued to increase the use of fertilizer and decomposed solid waste for enhancing agricultural yield, which have varying effects on the soil as well a threat to human livelihood. Consequently, vegetable yield samples from poultry droppings decomposed household waste manure, NPK treatments and control from each replication were subjected to proximate analysis to determine the nutritional and anti-nutritional component as well as heavy metal concentration. Data collected was analyzed using SPSS software and Randomized complete Block Design means were compared. The result shows that the treatments do not devoid the concentrations of any nutritional components while the anti-nutritional analysis proved that NPK had higher oxalate content than control and organic treats. The concentration of lead and cadmium are within safe permissible level while the mercury level exceeded the FAO/WHO maximum permissible limit for the entire treatments depicts the need for urgent intervention to minimize mercury levels in soil and manure in order to mitigate its toxic effect. Thus, eco-agriculture should be widely accepted and promoted by the stakeholders for soil amendment, higher yield, strategies for sustainable environmental protection, food security, poverty eradication, attainment of sustainable development and healthy livelihood.

Keywords: anti-nutritional, healthy livelihood, nutritional waste, organic waste

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Authors: Meriem Abid, Erika Oliveria-Jardim, Andres Fullana, Joaquin Silvestre-Albero

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The rapid industrial development associated with the increase of volatile organic compounds (VOCs) has seriously impacted the environment. Among VOCs, hydrogen sulfide (H₂S) is known as a highly toxic, malodorous, flammable, and corrosive gas, which is emitted from diverse chemical processes, including industrial waste-gas streams, natural gas processing, and biogas purification. The high toxicity, corrosively, and very characteristic odor threshold of H2S call for urgent development of efficient desulfurization processes from the viewpoint of environmental protection and resource regeneration. In order to reduce H₂S emissions, effective technologies for have been performed. The general method of H₂S removal included amine aqueous solution, adsorption process, biological methods, and fixed-bed solid catalytic oxidation processes. Ecologically and economically, low-temperature direct oxidation of H₂S to elemental sulfur using catalytic oxidation is the preferred approach for removing H₂S-containing gas streams. A large number of catalysts made from carbon, metal oxides, clay, and others, have been studied extensively for this application. In this sense, activated carbon (AC) is an attractive catalyst for H₂S removal because it features a high specific surface area, diverse functional groups, low cost, durability, and high efficiency. It is interesting to stand out that AC is modified using metal oxides to promote the efficiency of H₂S removal and to enhance the catalytic performance. Based on these premises, the main goal of the present study is the evaluation of the H₂S adsorption performance in carbon-encapsulated iron nanoparticles obtained from an olive mill, thermally treated at 600, 800 and 1000 ºC temperatures under anaerobic conditions. These results anticipate that carbon-encapsulated iron nanoparticles exhibit a promising performance for the H₂S removal up to 360 mg/g.

Keywords: H₂S removal, catalytic oxidation, carbon encapsulated iron, olive mill wastewater

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Authors: Ahmad Jawad Fardin

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Over 60% of patients with breast cancer in Afghanistan present late with advanced stage III and IV, a major cause for the poor survival rate. The objectives of this study were to identify the contributing factors for the diagnosis and treatment delay and its outcome. This cross-sectional study was conducted on 318 patients with histologically confirmed breast cancer in the oncology department of Jamhoriat hospital, which is the first and only national cancer center in Afghanistan; data were collected from medical records and interviews conducted with women diagnosed with breast cancer, linear regression and logistic regression were used for analysis. Patient delay was defined as the time from first recognition of symptoms until first medical consultation and doctor form first consultation with a health care provider until histological confirmation of breast cancer. The mean age of patients was 49.2+_ 11.5years. The average time for the final diagnosis of breast cancer was 8.5 months; most patients had ductal carcinoma 260.7 (82%). Factors associated with delay were low education level 76% poor socioeconomic and cultural conditions 81% lack of cancer center 73% lack of screening 19%. The stage distribution was as follows stage IV 4 22% stage III 44.4% stage II 29.3% stage I 4.3%. Complex associated factors were identified to delayed the diagnosis of breast cancer and increased adverse outcomes consequently. Raising awareness and education in women, the establishment of cancer centers and providing accessible diagnosis service and screening, training of general practitioners; required to promote early detection, diagnosis and treatment.

Keywords: delayed diagnosis and poor outcome, breast cancer in Afghanistan, poor outcome of delayed breast cancer treatment, breast cancer delayed diagnosis and treatment in Afghanistan

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Authors: Baikunthanath Sahoo, Santosh Kumar Sahu, Krishna Malakar

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With the essence of global environmental sustainability and green business management, the wind of business research moved towards Corporate Social Responsibility. In addition to international and national treaties, businesses have also started realising environmental protection and energy efficiency through CSR as part of business strategy in response to climate change. Considering the ambitious emission reduction target and rapid economic development of India, this study is an attempt to explore the effect of CSR on the energy efficiency management of manufacturing firms in India. By using firm-level data, the panel fixed effect model shows that the CSR dummy variable is negatively influencing the energy intensity or technically, they are energy efficient. The result demonstrates that in the presence of CSR, all the production economic variables are significant. The result also shows that doing environmental expenditure does not improve energy efficiency might be because very few firms are motivated to do such expenditure and also not common to all sectors. The interactive effect model result conforms that without considering CSR dummy as an intervening variable only Manufacturers of Chemical and Chemical products, Manufacturers of Pharmaceutical, medical chemical, and botanical products firms energy intensity low but after considering CSR in their business practices all six sub-sector firms become energy efficient. The empirical result also validate that firms are continuously engaged in CSR activities they are highly energy efficient. It is an important motivational factor for firms to become economically and environmentally sustainable in the corporate world. This analysis would help business practitioners to know how to manage today’s profitability and tomorrow’s sustainability to achieve a comparative advantage in the emerging market economy. The paper concludes that reducing energy consumption as part of their social responsibility to care for the environment, will need collaborative efforts of business society and policy bodies.

Keywords: CSR, Energy Efficiency, Indian manufacturing Sector, Business strategy

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Authors: O. S. Asaolu, A. Bolorunduro

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Background: Unwanted, mistimed and unintended pregnancy is an important public health issue and the most common cause of maternal mortality in developing countries. Unintended pregnancy is a potential hazard for every sexually active woman as it most times ends in unsafe abortion. The study aimed at assessing the pre-conception contraceptive use, prevalence of unintended pregnancies and the non-contraceptive factors associated with unintended pregnancy amongst currently married women in Osun state. Methodology: A descriptive cross-sectional study among randomly selected 341 currently married pregnant women attending antenatal clinics in Ilesa town of Osun state was conducted in 5 health facilities. A random selection of 5 of the 22 health facilities in the state was done. Data was collected through a self-administered questionnaire and all completed questionnaires were analyzed with SPSS. Result: About two-fifth of the currently pregnant women (40%) who has never used an FP method reported that their current pregnancy was unintended. The results indicate that age of women, age at first sex, substance use, total children ever born of children, religion, and extramarital affairs were key predictors of unintended pregnancy. Women who have higher parity are more likely to experience unintended pregnancy compared to women with lower parity (odds ratio, 0.25). Furthermore, those women who don’t engage in extra marital affairs were less likely to experience unintended pregnancy (odds ratio, 0.3) compared to those who do not. Contribution to knowledge: The predicted probability, using logistic regression, has shown that women who engage in extramarital affairs and women with high parity are more likely to have unintended pregnancy. Conclusion: Behaviour change programs should aim to reduce unintended pregnancy by focusing mostly on identified factors so that the need for abortion is decreased and the overall well-being of the family is maintained and enhanced.

Keywords: unintended pregnancy, factors, pregnant women, Nigeria

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Authors: Mohammad Ranjbar, Mohammad Bazyar, Blake Angell, Thomas Lung, Yibeltal Assefa

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Background: Current health insurance programs in Iran suffer from low enrolment and are not sufficient to attain the country to universal health coverage (UHC). We hypothesize that improving the enrollment rate and moving towards a more sustainable UHC can be achieved by improving the benefits package and providing new incentives. The objective of this study is to assess public preferences and willingness to pay (WTP) for social health insurance (SHI) in Iran. Methods: A discrete choice experiment (DCE) was conducted in 2021, using a self-administered questionnaire on 500 participants to estimate WTP and determine individual preferences for the SHI in Yazd, Iran. Respondents were presented with an eight-choice set and asked to select their preferred one. In each choice set, scenarios were described by eight attributes with varying levels. The conditional logit regression model was used to analyze the participants' preferences. Willingness to pay for each attribute was also calculated. Results: Most included attributes were significant predictors of the choice of a health insurance package. The maximum coverage of hospitalization costs in the private sector, ancillary services such as glasses, canes, etc., as well as coverage for hospitalization costs in the public sector and drug costs, were the most important determining factors for this choice. Coverage of preventive dental care did not significantly influence respondent choices. Estimating WTP showed that individuals are willing to pay more for higher financial protection, particularly against private sector costs; the WTP to increase the coverage of hospitalization costs in the private sector from 50% to 90% is estimated at 362,068 IR, Rials per month. Conclusion: This study identifies the key factors that the population value with regard to health insurance and the tradeoffs they are willing to make between them. Hospitalization, drugs, and ancillary services were the most important determining factors for their choice. The data suggest that additional resources coming into the Iranian health system might best be prioritized to cover hospitalization and drug costs and those associated with ancillary services.

Keywords: social health insurance, preferences, discrete choice experiment, willingness to pay

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Authors: Selam Mulugeta, Barkot Milkias, Mesfin Araya, Abel Worku, Eyasu Mulugeta

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In Ethiopia, there is inadequate information on non-adherence to antidepressant treatment in patients with depressive disorders. Having awareness of the pattern of adherence is important in future prognosis, quality of life, and functionality in these patients. This hospital-based cross-sectional quantitative study was done on a sample of 216 consecutive outpatients with depressive disorders. Data were collected using questionnaires through in-person and phone call interviews. The 8-item Morisky scale was used to assess the pattern of medication adherence. Other specially developed tools were used to obtain sociodemographic and clinical information from electronic medical records and patient interviews. Data were analyzed using the Statistical Package for the Social Sciences Version - 25. Univariate and multivariable analyses were carried out to assess factors associated with non-adherence. 90% of the participants had a primary diagnosis of major depressive disorder. Based on the 8-item Morisky Medication Adherence Scale, the prevalence of non-adherence was found to be 84.7%. Living distance between 11 to 50 km from the hospital (AOR= 11, 95% CI (29,46.6)), post-secondary level of education (AOR= 8.3, 95% CI (1, 64.4)) and taking multiple medications (AOR= 6.1, 95% CI (1, 34.9)) were found to have significantly increased odds of non-adherence. Non-adherence was significantly associated with factors such as increased living distance from the hospital, relatively higher educational level, and polypharmacy. Proper and patient-centered psychoeducation, addressing the communication gap between patients and doctors, adherence to prescribing guidelines, avoiding polypharmacy unless indicated & working on accessibility of treatment is essential to decrease non-adherence.

Keywords: depressive disorders, Ethiopia, medication adherence, Addis Ababa

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Authors: Pinar Dogan, Merve Tarhan, Ahu Kurklu

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Syrian refugees who sheltering due to war has protected by the Government of Turkey since 2011. Since Syria was a medium-low income country prior to the war, it is known that chronic health problems weren’t common among citizens. However, it is also known that they frequently use health services in our country because of the spread of infectious and acute diseases due to insufficient sanitation and crowding after the war. This study was planned to compare the social distances of the community against the Syrian refugees and the perceptions of accessing health care services. The descriptive-cross sectional study was carried out on 1262 individuals living in Istanbul. A questionnaire form consisted of Personal Information Form, The Bogardus Social Distance Scale (BSDS) and The Survey of Access to Healthcare Services (AHS) was used as data collection tool. Descriptive tests and chi-square test were used for statistical analysis. It was found that the majorities of participants was satisfied with the health services and were waiting for more than 40 minutes to be examined. It was determined that participants have high scores from BSDS. At the same time, the majority of participants stated that their level of access to health care is diminishing due to refugees. Participants who experienced disruption in access to health services due to refugees were found to have higher scores from BSDS. The data collection process in the study will continue until 2400 individuals are reached. With these conclusions, it is considered necessary that the effect of the presence of the refugees in reaching the health services and nursing care of the society should be revealed through extensive researches to be conducted in Turkey.

Keywords: health care services, nursing care, social distances, Syrian refugees

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Authors: Masoud Mahdavi, Mojtaba Farzaneh Moghadam

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The seismic forces caused by the waves created in the depths of the earth during the earthquake hit the structure and cause the building to vibrate. Creating large seismic forces will cause low-strength sections in the structure to suffer extensive surface damage. The use of new steel shear walls in steel structures has caused the strength of the building and its main members (columns) to increase due to the reduction and depreciation of seismic forces during earthquakes. In the present study, an attempt was made to evaluate a type of steel shear wall that has regular holes in the inner sheet by modeling the finite element model with Abacus software. The shear wall of the steel plate, measuring 6000 × 3000 mm (one floor) and 3 mm thickness, was modeled with four different pores with a cross-sectional area. The shear wall was dynamically subjected to a time history of 5 seconds by three accelerators, El Centro, Imperial Valley and Kobe. The results showed that increasing the distance between the geometric center of the hole and the geometric center of the inner plate in the steel shear wall (increasing the R_CS index) caused the total maximum acceleration to be transferred from the perimeter of the hole to horizontal and vertical beams. The results also show that there is no direct relationship between R_CS index and total acceleration in steel shear wall and R_CS index is separate from the peak ground acceleration value of earthquake.

Keywords: hollow steel plate shear wall, time history analysis, finite element method, abaqus software

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Authors: Shalini Saini, Sharmila Ahuja

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Anaesthesia for caesarean section poses challenges unique to the obstetric patient due to changes in the airway and respiratory system. The choice of anaesthesia for caesarean section depends on various factors however general anaesthesia (GA) is necessary for certain situations. Supraglottic airway devices are an emerging method to secure airway, especially in difficult situations. Of these devices, proseal –LMA (PLMA) is designed to provide better protection of the airway. The use of PLMA has been reported successfully as a rescue device in difficult intubation situations and in patients undergoing elective caesarean section without any complications. The study was prospective and randomised and was designed to compare PLMA in patients undergoing elective lower segment caesarean section (LSCS) with the endotracheal tube (ETT). Patients undergoing LSCS under GA belonging to ASA grade 1 and 2 were included. Patients with the history of fewer than 6 hrs of fasting, known/predicted difficult airway, obesity, gastroesophageal reflux disease, hypertensive disorder were excluded. A standard anaesthesia protocol was followed. All patients received aspiration prophylaxis. The airway was secured with either PLMA or ETT. Parameters noted were- ease of insertion, adequacy of ventilation, hemodynamic changes at insertion and removal of device, incidence of regurgitation and aspiration. Data was analysed by unpaired t- test, Chi-square /Fisher’s test. The findings of our study indicated that PLMA was easy to insert (20.67±6.835 sec) with comparable insertion time to TT (18.33 ± 4.971, p 0.136) and adequate ventilation was achieved with very minimal hemodynamic changes seen with PLMA as compared to ETT at insertion and removal of devices (p 0.01). There was no incidence of regurgitation with the use of PLMA. The incidence of a postoperative sore throat was minimal (6.7%) with PLMA (p<0.05). PLMA appears to be a safe alternative to ETT for selected obstetric patients undergoing elective LSCS. Further study with a larger group of patients is required to establish the safety of PLMA in obstetric patients.

Keywords: caesarean section, general anaesthesia, proseal LMA, endotracheal tube

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Authors: Narges Ebadi, Davod Ahmadi, Hiliary Monteith, Hugo Melgar-Quinonez

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Migration cannot necessarily relieve pressure on water resources in origin communities, and male out-migration can increase the water management burden of women. However, inflows of financial remittances seem to offer possibilities of investing in improving drinking-water access. Therefore, remittances may be an important pathway for migrants to support water security. This paper explores the association between water access and the receipt of remittances in households in sub-Saharan Africa. Data from round 6 of the 'Afrobarometer' surveys in 2016 were used (n= 49,137). Descriptive, bivariate and multivariate statistical analyses were carried out in this study. Regardless of country, findings from descriptive analyses showed that approximately 80% of the respondents never received remittance, and 52% had enough clean water. Only one-fifth of the respondents had piped water supply inside the house (19.9%), and approximately 25% had access to a toilet inside the house. Bivariate analyses revealed that even though receiving remittances was significantly associated with water supply, the strength of association was very weak. However, other factors such as the area of residence (rural vs. urban), cash income frequencies, electricity access, and asset ownership were strongly associated with water access. Results from unadjusted multinomial logistic regression revealed that the probability of having no access to piped water increased among remittance recipients who received financial support at least once a month (OR=1.324) (p < 0.001). In contrast, those not receiving remittances were more likely to regularly have a water access concern (OR=1.294) (p < 0.001), and not have access to a latrine (OR=1.665) (p < 0.001). In conclusion, receiving remittances is significantly related to water access as the strength of odds ratios for socio-demographic factors was stronger.

Keywords: remittances, water access, SSA, migration

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Authors: Hsiu-Chuan Hsueh, Kuei-Feng Shen Jr., Chia-Ling Chao, Hui-Chuan Pan

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This article described a 75 years old woman who has suffered from intestinal perforation and accepted surgery with temporary enterostomy, the operation makes her depressed, refused relatives and friend's care, facing low willingness to participate in various activities due to fear of changing body appearance caused by surgery and leave enterostomy. The author collected information through observation talks, physical evaluation, and medical records during the period of care from November 14 to November 30, 2016, we used the four aspects of physiology, psychology, society and spirituality as a whole sexual assessment to establish the nursing problems of patient, included of acute pain, disturbance of body image,coping ineffective individual. For patient care issues, to encouraged case to express their inner feelings and take part in self-care programs through providing good therapeutic interpersonal relationships with their families. However, it provided clear information about the disease and follow-up treatment plan, give compliments in a timely manner, enhanced self-confidence of individual cases and their motivation to participate in self-care of stoma, further face the disease in a positive manner. At the same time, cross-section team care model and individual care measures were developed to enhance the care skills after returning home and at the same time assist the individual in facing the psychological impact caused by stoma. Hope to provide this experience, as a reference for the future care of the disease.

Keywords: enterostomy, intestinal perforation, nursing experience, ostomy

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