Search results for: poor jurisdictions

Authors: Helga Martins, Idália Matias

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

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

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Authors: Roya Kelishadi, Mostafa Amini-Rarani, Mostafa Qorbani

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Introduction: As a health-related behavior, physical activity (PA) has an unequal distribution relating to individual's socioeconomic status. This study aimed to assess socioeconomic inequality in PA among Iranian students and their parents at national level and according to socioeconomic status (SES) of the living regions. Method: This study was conducted as part of a national surveillance program conducted among 14400 Iranian students and their parents. Non-linear principal component analysis was used to construct the households' socioeconomic status, and the concentration index approach was applied to measure inequality in father, mother, and student’s PA. Results: The data of 13313 students and their parents were complete for the current study. At national level and SES regions, students had more PA than their parents (except in the lowest SES region), and fathers have more PA than mothers. The lowest means of mother and student's PA were find in the highest SES region. At national level, the concentration indices of father and mother’s PA were -0.050 (95 % CI: -0.067 ~ -0.030) and -0.028 (95% CI: -0.044 ~ -0.012), respectively; indicating pro-poor inequality and, the CI value of student PA was nearly equal to zero (P > 0.05). At SES regions, father and mother's PA were more concentrated in the poor, except for lower middle region. Regional concentration indices for students reveal that inequality not statistically significant at all regions. Conclusion: This study suggests that reliable evidence that comparing different aspects of inequality of PA, based on socioeconomic status and residence areas of students and their parents, could be used for better planning for health promotion programs. Moreover, given the average of mother's and student’s PA in the richer regions were low, it can be suggested that richer focused-PA planning may further increase the level of PA across higher SES and, consequently, reduce inequality in PA. These findings can be applied in the health system services.

Keywords: concentration index, health system services, physical activity, socioeconomic inequality

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Authors: Harsha Kumar H. N., Anshu Kumar Jha, Khushboo Kamal Taneja, Krishan Kabra, Mohamed Hafeez Sadiq

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Introduction: The increasing use of preservatives and flavouring agents has the potential to cause health problem among the people. There are no published studies from India exploring the awareness, safety perception, & practices about Food Preservatives (FPs) and Flavouring Agents (FAs). So this study was conducted with the objectives of assessing the awareness, safety perceptions & practices about Food Preservatives (FPs), Flavouring Agents (FAs) in commonly bought / purchased packed food items. Materials & method: This cross-sectional study was conducted in January 2012. Sample size of 126 was computed using the formula for infinite population. People who bought packed food items in malls were approached and requested to fill a pre-tested semi-structured questionnaire. The questionnaire explored awareness, safety perception & practices of FPs & FAs. Data was then analyzed using SPSS version 10.0. Chi-square test was used to know if the observed differences were statistically significant. ‘p’ value <0.05 was considered significant. Results: Totally 123 people (males- 48.8% and females-51.2%) participated (response rate of 97.6%) in the study. Majority of the people were aware about presence of ‘FPs’ (91.7%) and ‘FAs’ (84.9%) though their knowledge was inadequate. Breakup of the study subjects according to level of awareness about FPs was as follows (%): Good (37.4), Satisfactory (40.6), Poor (22) & FAs (%): Good (49.6), Satisfactory (36) & Poor (14). Distribution according to type of practices for FPs was as follows (%): Favourable (14), Unfavourable (86) & FAs (%): Favourable (30.5), Unfavourable (69.5). There was a gap between knowledge and practices. Conclusion: Though there was awareness, the knowledge was inadequate. Unfavourable practices were observed. The gaps in the knowledge and unhealthy practices need to be addressed by public awareness campaign.

Keywords: food preservatives, flavouring agents, knowledge and practices, general population

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Authors: Syed Asif Ali Naqvi, Muhammad Azeem Tufail

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Inadequate sanitation causes direct costs of treating illnesses and loss of income through reduced productivity. This study estimated the economic cost of health (ECH) due to poor sanitation and factors determining the lack of access to latrine for the rural, backward hamlets and slums of district Faisalabad, Pakistan. Cross sectional data were collected and analyzed for the study. As the population under study was homogenous in nature, it is why a simple random sampling technique was used for the collection of data. Data of 440 households from 4 tehsils were gathered. The ordinary least square (OLS) model was used for health cost analysis, and the Probit regression model was employed for determining the factors responsible for inaccess to toilets. The results of the study showed that condition of toilets, situation of sewerage system, access to adequate sanitation, Cholera, diarrhea and dysentery, Water and Sanitation Agency (WASA) maintenance, source of medical treatment can plausibly have a significant connection with the dependent variable. Outcomes of the second model showed that the variables of education, family system, age, and type of dwelling have positive and significant sway with the dependent variable. Variable of age depicted an insignificant association with access to toilets. Variable of monetary expenses would negatively influence the dependent variable. Findings revealed the fact, health risks are often exacerbated by inadequate sanitation, and ultimately, the cost on health also surges. Public and community toilets for youths and social campaigning are suggested for public policy.

Keywords: sanitation, toilet, economic cost of health, water, Punjab

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Authors: Rajapaksha J. S. R. L., Rajapaksha R. G. D. T., Ranawaka A. U. R., Rangalla R. D. M. P., Ranwala R. D. E. B., Chandratilake M. N.

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Introduction: Lesbian, gay, bisexual, and transgender (LGBT) patients experience discrimination, insensitivity, and ignorance about LGBT-specific health needs among healthcare providers. Developing the correct attitudes among medical students towards LGBT may help provide them with optimal healthcare. Objectives: This study aimed at assessing the attitudes of medical students towards the LBGT community. Methodology: A cross-sectional descriptive study was among all the medical students in the Faculty of Medicine, University of Kelaniya, Sri Lanka, using a validated online questionnaire. The questionnaire focused on eight areas. The data were descriptively analyzed, and the demographic groups were compared. Results: 358 students completed the survey. The response rate was 34.26%. Their attitudes on traditional gender roles and comfortability in interacting with LGBT people were moderate, and they disagreed with negative LGBT social beliefs. They knew less about the origin of sexuality/gender of LGBT. Although they accepted LGBT as a part of diversity, they discouraged normalizing the social practices of LGBT people. Their acceptance and association of LGBT were moderately positive. A minority has encountered LGBT in close social circles, and the majority of them were batch-mates. Although males’ knowledge about the origin of LGBT was higher, they favoured traditional gender roles more. The religious groups showed no differences. The favourability of attitudes towards LGBT reflected respondents’ political ideology. Conclusion: Although medical students’ knowledge on the sexuality/gender basis of LGBT is poor, they have moderately favourable attitudes towards them. They accept LGBT as a part of social diversity but not their social practices. Poor knowledge, lack of encounters, cultural influences, and political ideology may have influenced their attitudes.

Keywords: medical students, attitude, LGBT, diversity

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Authors: Agata Zakrzewska, Dominik Kopeć, Adrian Ochtyra

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The growing number of new cameras, sensors, and research methods allow for a broader application of thermal data in remote sensing vegetation studies. The aim of this research was to check whether it is possible to use thermal infrared data with a spectral range (3.6-4.9 μm) obtained during the day and the night to assess the health condition of selected species of deciduous trees in an urban environment. For this purpose, research was carried out in the city center of Warsaw (Poland) in 2020. During the airborne data acquisition, thermal data, laser scanning, and orthophoto map images were collected. Synchronously with airborne data, ground reference data were obtained for 617 studied species (Acer platanoides, Acer pseudoplatanus, Aesculus hippocastanum, Tilia cordata, and Tilia × euchlora) in different health condition states. The results were as follows: (i) healthy trees are cooler than trees in poor condition and dying both in the daytime and nighttime data; (ii) the difference in the canopy temperatures between healthy and dying trees was 1.06oC of mean value on the nighttime data and 3.28oC of mean value on the daytime data; (iii) condition classes significantly differentiate on both daytime and nighttime thermal data, but only on daytime data all condition classes differed statistically significantly from each other. In conclusion, the aerial thermal data can be considered as an alternative to hyperspectral data, a method of assessing the health condition of trees in an urban environment. Especially data obtained during the day, which can differentiate condition classes better than data obtained at night. The method based on thermal infrared and laser scanning data fusion could be a quick and efficient solution for identifying trees in poor health that should be visually checked in the field.

Keywords: middle wave infrared, thermal imagery, tree discoloration, urban trees

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Authors: Lusia Ndahafa Nghitotelwa

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India is a home to many languages, cultures, traditions, castes and religions. This diversity, when observed in education, appears to be challenging and difficult to manage with respect to including everyone in the educational system. But in order to achieve this, attempts to understand the complexity of the issue and find some solutions for including everyone in education has been made in India since independence, regardless of the students’ background. Despite that, the challenge is still topical. Plenty of students are left out of the system due to the lack of awareness and appropriate management of these diversities. Therefore, the present paper makes an attempt to study the awareness and management of diversity in Indian schools. Existing studies on diversity in Indian schools, along with how measures and which measures have been taken to accommodate and retain everyone in school, have been looked at, and a thorough critical analysis of findings has been narrated. It was found that a lot of efforts have been conjugated to include and educate children of all castes, religions, and linguistic backgrounds. Furthermore, the awareness of inclusive education among teachers and society members is moderate, but teachers lack the necessary skills and knowledge on how to deal with students with special educational needs in regular classes. Also, the management is aware of inclusive education, but the management does not include teachers in decision-making. Moreover, it was found that the poor management of inclusion services and retention of special needs students in Indian schools results in their poor effective integration into the workforce. Finally, the management was found to have stringent admission criteria, which has the effect of hindering some students from entering the educational system. Based on the results of the study, it is clear that the implementation of inclusive education is still a challenge in India. However, there are promising results in tackling the issue. All children should be given an opportunity to learn together with other children in order to broaden their interest and challenge their potential.

Keywords: awareness, management, inclusive education, students

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Authors: Tanvir Ahmed, Nahian Fyrose Fahim, Subrata Majumder, Sarker Kibria

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English is unanimously recognized as the standard second language in the world, and no one can deny this fact. Many people believe that possessing English proficiency skills is the key to communicating effectively globally, especially for developing countries, which can bring further success to itself on many fronts, as well as to other countries, by ensuring its people worldwide access to education, business, and technology. Bangladesh is a developing country of about 160 million people. A notable number of students in Bangladesh are currently pursuing higher education, especially at the tertiary or collegiate level, in more than 150 public and private universities. English is the dominant linguistic medium through which college instruction and lectures are given to students in Bangladesh. However, many of our students who have only completed their primary and secondary levels of education in the Bangla medium or language are generally in an awkward position to suddenly take and complete many unfamiliar requirements by the time they enter the university as freshmen. As students, they struggle to complete at least 18 courses to acquire proficiency in English. After obtaining a tertiary education certificate, the students could then have the opportunity to acquire a sustainable position in the job market industry; however, many of them do fail, unfortunately, because of poor English proficiency skills. Our study focuses on students in both public and private universities (N=150) as well as education experts (N=30) in Bangladesh. We had prepared two sets of questionnaires that were based upon a literature review on this subject, as we had also collected data and identified the reasons, and arrived at probable solutions to overcoming these problems. After statistical analysis, the study suggested certain remedial measures that could be taken in order to increase student's proficiency in English as well as to ensure their employability potential.

Keywords: tertiary education, English language proficiency, employability, unemployment problems

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Authors: Michelle V. Tomczak, Reyhaneh Bakhtiari, Aaron Granley, Anthony Singhal

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Objective: Cannabis and cocaine are associated with a range of mental and physical effects that can impair aspects of human behavior. Driving is a complex cognitive behavior that is an essential part of everyday life and can be broken down into many subcomponents, each of which can uniquely impact road safety. With the growing movement of jurisdictions to legalize cannabis, there is an increased focus on impairment and driving. The purpose of this study was to identify driving-related cognitive-performance deficits that are impacted by recreational drug use. Design and Methods: With the assistance of law enforcement agencies, we recruited over 300 participants under the influence of various drugs including cannabis and cocaine. These individuals performed a battery of computer-based tasks scientifically proven to be re-lated to on-road driving performance and designed to test response-speed, memory processes, perceptual-motor skills, and decision making. Data from a control group with healthy non-drug using adults was collected as well. Results: Compared to controls, the drug group showed def-icits in all tasks. The data also showed clear differences between the cannabis and cocaine groups where cannabis users were faster, and performed better on some aspects of the decision-making and perceptual-motor tasks. Memory performance was better in the cocaine group for simple tasks but not more complex tasks. Finally, the participants who consumed both drugs performed most similarly to the cannabis group. Conclusions: Our results show distinct and combined effects of cannabis and cocaine on human performance relating to driving. These dif-ferential effects are likely related to the unique effects of each drug on the human brain and how they distinctly contribute to mental states. Our results have important implications for road safety associated with driver impairment.

Keywords: driving, cognitive impairment, recreational drug use, cannabis and cocaine

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Authors: Junaid Asimiyu Mohammed, Olakunle Docas Tosin

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The housing environment in many developing countries is fraught with risks that have potential negative impacts on the lives of the residents. The study examined the risk factors in residential areas of two neighborhoods in Bosso Local Government Areas of Minna in Nigeria with a view to determining the level of their potential impacts. A sample of 378 households was drawn from the estimated population of 22,751 household heads. The questionnaire and direct observation were used as instruments for data collection. The data collected were analyzed using the Relative Importance Index (RII) rule to determine the level of the potential impact of the risk factors while ArcGIS was used for mapping the spatial distribution of the risks. The study established that the housing environment of Angwan Biri and El-Waziri areas of Bosso is poor and vulnerable as 26% of the houses were not habitable and 57% were only fairly habitable. The risks of epidemics, building collapse and rainstorms were evident in the area as 53% of the houses had poor ventilation; 20% of residents had no access to toilets; 47% practiced open waste dumping; 46% of the houses had cracked walls while 52% of the roofs were weak and sagging. The results of the analysis of the potential impact of the risk factors indicate a RII score of 0.528 for building collapse, 0.758 for rainstorms and 0.830 for epidemics, indicating a moderate to very high level of potential impacts. The mean RII score of 0.639 shows a significant potential impact of the risk factors. The study recommends the implementation of sanitation measures, provision of basic urban facilities and neighborhood revitalization through housing infrastructure retrofitting as measures to mitigate the risks of disasters and improve the living conditions of the residents of the study area.

Keywords: assessment, risk, residential, Nigeria

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Authors: Chun Yu, Tahlia M. Farrant, Max G. Marschall

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Most of Australia’s school classrooms are equipped with operable windows and occupant-controlled air-conditioners that do not provide fresh air. This can result in insufficient ventilation and high indoor CO₂ levels, which comes at a detriment to occupant productivity and health. This paper reports on the results of an in-situ study capturing indoor CO₂ levels in classrooms at a school in Victoria, Australia. The study consisted of 3 measurement periods: First, CO₂ levels pre-pandemic were measured, finding that the readings exceeded the recommended ASHRAE threshold of 1000 ppm more than 50% of the time, with levels often rising as high as 5000 ppm. Then, after the staff had been informed of the poor indoor air quality and the Victorian government had put COVIDSAFE measures in place, a second data set was captured; the impact was significant, with now only about 30% of readings above the ASHRAE threshold, and values rarely exceeding 2500 ppm. Finally, devices were installed that gave the occupants visual feedback when CO₂ levels were high, thus prompting them to open the windows; this further improved the air quality, with now less than 20% of readings above the threshold and values rarely exceeding 1500 ppm. The study suggests that, while relying on occupants to operate windows can lead to poor indoor air quality due to insufficient ventilation, it is possible to considerably influence occupant behavior through education and feedback devices. While these interventions alone did not mitigate the problem of inadequate ventilation entirely, they were sufficient to keep CO₂ levels within a generally healthy range. Considering the large energy savings that are possible by foregoing mechanical ventilation, it is evident that natural ventilation is a feasible operation method for school buildings in temperate climates, as long as classrooms are equipped with CO₂ feedback devices.

Keywords: COVID, CO₂, education, feedback devices, health, indoor air quality, natural ventilation, occupant behaviour

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Authors: Hisham Mousa Mohammed Ahmed, Ahmed Wali Mohamed Salad, Yousif Hamed Dldom Gomaa

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A drip or Trickle irrigation system is designed to apply a precise amount of water near the plant with a certain degree of uniformity. This study was conducted at the Experimental Farm of the Faculty of Agricultural Sciences, University of Gezira, in March 2018. The study aimed to design and evaluate the hydraulic performance of three drip emitter types using: average discharge (Qavg), discharge variation (Qvar %), coefficient of uniformity (CU %), coefficient of manufacturer variation (CV %), distribution uniformity (DU %), statistical uniformity (Us %), clogging (%) wetted diameter (cm) and wetted depth (cm). The emitter types used are regular gauges (RG), high compensating pressure (HCP) and low compensating pressure (LCP). The treatments were laid out in a randomized complete block design (RCBD) with four replications. Results showed that there were significant differences (P≤0.05) in all tested parameters except clogging, wetted diameter and wetted depth. Discharge variation (Qvar %) values were 12.71, 15.57 and 19.17 for RG, LCP, and HCP, respectively. The variation is quite good and within the acceptable range. Results of coefficient of manufacture variation (CV %) were 10.9, 27.8 and 52.7 for RG, LCP and HCP, respectively. It is considered within the unacceptable range except for RG type, which is excellent. Statistical uniformity (Us %) values were 89.1, 72.2 and 45.7 for RG, LCP and HCP, respectively. It is considered good, acceptable and unacceptable, respectively. Results of the coefficient of uniformity (CU %) were 91.3, 77.7 and 56.7 for RG, LCP and HCP, respectively. It is considered excellent, fair and unacceptable, respectively. Distribution uniformity (DU %) was 90.2, 67.9 and 36.5 for RG, LCP and HCP, respectively. It is considered excellent, poor and poor, respectively. The study recommended regular gauges (RG) type emitters under the heavy clay soil conditions of the Gezira State, Sudan.

Keywords: drip irrigation, uniformity, clogging, coefficient, performance

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Authors: Champika Amarasinghe

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Introduction: Covid 19 pandemic was badly hit to the Sri Lankan economy during the year 2021. More than 65% of the Sri Lankan work force is engaged with small and medium scale businesses which no doubt that they had to struggle for their survival and business continuity during the pandemic. Objective: To assess the association of adherence to the new norms during the Covid 19 pandemic and maintenance of healthy working environmental conditions for business continuity. A cross sectional study was carried out to assess the OSH status and adequacy of Covid 19 preventive strategies among the 200 SME’S in selected two districts in Sri Lanka. These two districts were selected considering the highest availability of SME’s. Sample size was calculated, and probability propionate to size was used to select the SME’s which were registered with the small and medium scale development authority. An interviewer administrated questionnaire was used to collect the data, and OSH risk assessment was carried out by a team of experts to assess the OSH status in these industries. Results: According to the findings, more than 90% of the employees in these industries had a moderate awareness related to COVID 19 disease and preventive strategies such as the importance of Mask use, hand sainting practices, and distance maintenance, but the only forty percent of them were adhered to implementation of these practices. Furthermore, only thirty five percent of the employees and employers in these SME’s new the reasons behind the new norms, which may be the reason for reluctance to implement these strategies and reluctance to adhering to the new norms in this sector. The OSH risk assessment findings revealed that the working environmental organization while maintaining the distance between two employees was poor due to the inadequacy of space in these entities. More than fifty five percent of the SME’s had proper ventilation and lighting facilities. More than eighty five percent of these SME’s had poor electrical safety measures. Furthermore, eighty two percent of them had not maintained fire safety measures. Eighty five percent of them were exposed to heigh noise levels and chemicals where they were not using any personal protectives nor any other engineering controls were not imposed. Floor conditions were poor, and they were not maintaining the occupational accident nor occupational disease diseases. Conclusions: Based on the findings, proper awareness sessions were carried out by NIOSH. Six physical training sessions and continues online trainings were carried out to overcome these issues, which made a drastic change in their working environments and ended up with hundred percent implementation of the Covid 19 preventive strategies, which intern improved the worker participation in the businesses. Reduced absentees and improved business opportunities, and continued their businesses without any interruption during the third episode of Covid 19 in Sri Lanka.

Keywords: working environment, Covid 19, occupational diseases, occupational accidents

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Authors: Ibrahim Magaji

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WhatsApp messaging platform brings about new opportunities for users to participate in unique storytelling experiences and audience engagement, particularly to Students of Mass communication who receive training to report events and issues accurately and objectively in accordance with official controls. Also, the complex nature of society today made it possible to use the WhatsApp platform that revolutionizes the means of sharing information, ideas, and experiences. This paper examined the WhatsApp messaging platform and how it influenced the academic performance of students in the Department of Mass Communication, Abdu Gusau Polytechnic, Talata Mafara. It used in-depth interview techniques and focus group discussion with students, as well as the use of published materials as well as unpublished materials to gather related and relevant data. Also, the paper used procedures involved to analyze long interview content. This procedure includes observation of a useful utterance, development of expanded observation, the examination of the interconnection of observed comments, collective scrutiny of observation for patterns and themes, and review and analysis of the themes across all interviews for development of the thesis. The result revealed that the majority of students used WhatsApp messenger for making friends and chatting. Also, the students experienced negative effects such as poor grammar and spelling, less study time, and poor academic performance because of active participation in the use of WhatsApp messaging platform. Surprisingly, there was a high addiction rate among students in the usage of WhatsApp messenger. However, other students experienced an improvement in their readings skills as a result of participation in the use of the platform. Also, students shared ideas, discussed, and shared examination questions among themselves on WhatsApp messenger.

Keywords: WhatsApp messenger, students, participation, group

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Authors: Padma Chutoo, Elena Kulinskaya, Ilyas Bakbergenuly, Nicholas Steel, Dmitri Pchejetski

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Stroke is associated with a significant risk of morbidity and mortality. There is scarcity of research on the long-term survival after first-ever ischaemic stroke (IS) events in England with regards to effects of different medical therapies and comorbidities. The objective of this study was to model the all-cause mortality after an IS diagnosis in the adult population of England. Using a retrospective case-control design, we extracted the electronic medical records of patients born prior to or in year 1960 in England with a first-ever ischaemic stroke diagnosis from January 1986 to January 2017 within the Health and Improvement Network (THIN) database. Participants with a history of ischaemic stroke were matched to 3 controls by sex and age at diagnosis and general practice. The primary outcome was the all-cause mortality. The hazards of the all-cause mortality were estimated using a Weibull-Cox survival model which included both scale and shape effects and a shared random effect of general practice. The model included sex, birth cohort, socio-economic status, comorbidities and medical therapies. 20,250 patients with a history of IS (cases) and 55,519 controls were followed up to 30 years. From 2008 to 2015, the one-year all-cause mortality for the IS patients declined with an absolute change of -0.5%. Preventive treatments to cases increased considerably over time. These included prescriptions of statins and antihypertensives. However, prescriptions for antiplatelet drugs decreased in the routine general practice since 2010. The survival model revealed a survival benefit of antiplatelet treatment to stroke survivors with hazard ratio (HR) of 0.92 (0.90 – 0.94). IS diagnosis had significant interactions with gender and age at entry and hypertension diagnosis. IS diagnosis was associated with high risk of all-cause mortality with HR= 3.39 (3.05-3.72) for cases compared to controls. Hypertension was associated with poor survival with HR = 4.79 (4.49 - 5.09) for hypertensive cases relative to non-hypertensive controls, though the detrimental effect of hypertension has not reached significance for hypertensive controls, HR = 1.19(0.82-1.56). This study of English primary care data showed that between 2008 and 2015, the rates of prescriptions of stroke preventive treatments increased, and a short-term all-cause mortality after IS stroke declined. However, stroke resulted in poor long-term survival. Hypertension, a modifiable risk factor, was found to be associated with poor survival outcomes in IS patients. Antiplatelet drugs were found to be protective to survival. Better efforts are required to reduce the burden of stroke through health service development and primary prevention.

Keywords: general practice, hazard ratio, health improvement network (THIN), ischaemic stroke, multiple imputation, Weibull-Cox model.

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Authors: Long Long Chen, Xinwei Liao, Shanfa Tang, Shaojing Jiang, Ruijia Tang, Rui Wang, Shu Yun Feng, Si Yao Wang

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Tight oil reservoirs have poor physical properties, insufficient formation energy, and low natural productivity; it is necessary to effectively improve their crude oil recovery. CO₂ flooding is an important technical means to enhance oil recovery and achieve effective CO₂ storage in tight oil reservoirs, but its heterogeneity is strong, which makes CO₂ flooding prone to gas channeling and poor recovery. Aiming at the problem of gas injection channeling, combined with the excellent performance of low interfacial tension viscoelastic fluid (GOBTK), the research on CO₂-low interfacial tension viscoelastic fluid synergistic oil displacement in tight reservoirs was carried out, and the synergy of CO₂ and low interfacial tension viscoelastic fluid was discussed. Oil displacement mechanism. Experiments show that GOBTK has good injectability in tight oil reservoirs (Kg=0.141～0.793mD); CO₂-0.4% GOBTK synergistic flooding can improve the recovery factor of low permeability layers (31.41%) under heterogeneous (gradient difference of 10) conditions the) effect is better than that of CO₂ flooding (0.56%) and 0.4% GOBT-water flooding (20.99%); CO₂-GOBT synergistic oil displacement mechanism includes: 1) The formation of CO₂ foam increases the flow resistance of viscoelastic fluid, forcing the displacement fluid to flow 2) GOBTK can emulsify and disperse residual oil into small oil droplets, and smoothly pass through narrow pores to produce; 3) CO₂ dissolved in GOBTK synergistically enhances the water wettability of the core, and the use of viscosity Elastomeric fluid injection and stripping of residual oil; 4) CO₂-GOBTK synergy superimposes multiple mechanisms, effectively improving the swept volume and oil washing efficiency of the injected fluid to the reservoir.

Keywords: tight oil reservoir, CO₂ flooding, low interfacial tension viscoelastic fluid flooding, synergistic oil displacement, EOR mechanism

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Authors: Dhiraj Neupane

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Decentralized policy and practices have largely concentrated on the transformation of decision-making authorities from central to local institutions (or people) in the developing world. Such policy and practices always aimed for the equitable and efficient management of resources in the line of poverty reduction. The transformation of forest decision-making autonomy has also glorified as the best forest management alternatives to maximize the forest benefits and improve the livelihood of local people living nearby the forests. However, social heterogeneity and poor decision-making capacity of local institutions (or people) pose a nexus while managing the resources and sharing the forest benefits among the user households despite the policy objectives. The situation is severe in the lowland of Nepal, where forest resources have higher economic potential and user households have heterogeneous socio-economic conditions. The study discovered that utilizing the power of decision-making autonomy, user households were putting low values of timber considering the equitable access of timber to all user households as it is the most valuable product of community forest. Being the society is heterogeneous by socio-economic conditions, households of better economic conditions were always taking higher amount of forest benefits. The low valuation of timber has negative consequences on equitable benefit sharing and poor support to livelihood improvement of user households. Moreover, low valuation has possibility to increase the local demands of timber and increase the human pressure on forests.

Keywords: decentralized forest policy, Nepal, poverty, social heterogeneity, Terai

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Authors: Celestine Odigwe, Epoke Lincoln, Rhoda-Dara Ephraim

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Background; Immunization against the childhood killer diseases is the cardinal strategy for the prevention of these diseases all over the world in under five children, these diseases include; Tuberculosis, Measles, Polio, Tetanus, Diphthria, Pertusis, Yellow Fever, Hepatitis B, Haemophilus Influenza type B. 6.9 million children die before their fifth birthday , 80% of the worlds death in children under 5 years occur in 25 countries most in Africa and Asia and 2 million children can be saved each year with routine immunization Therefore failure to achieve total immunization coverage puts several children at risk. Aim; The aim of the study was to ascertain the prevalence, Investigate the various reasons and causes why several under five children in a suburb of calabar municipal county fail to get the required immunizations as at and when due and possibly the consequences, so that efforts can be re-directed towards the solution of the problems so identified. Methods; the study was a community based cross sectional study. The respondents were the mothers/guardians of the sampled children who were all aged 0-59 months. To be eligible for recruitment into the study, the parent or guardian was required to give an informed consent, reside within the Calabar South County with his/her children aged 0-59 months. We calculated our sample size using the Leslie-Kish formula and we used a two-staged sampling method, first to ballot for the wards to be involved and then to select four of the most populated ones in the wards chosen. Data collection was by interviewer administered structured questionnaire (Appendix I), Data collected was entered and analyzed using Statistical Package for the Social Sciences (SPSS) Version 20. Percentages were calculated and represented using charts and tables Results; The number of children sampled was 159. We found that 150 were fully immunized and 9 were not, the prevalence of missed opportunity was 32% from the study. The reasons for missed opportunities were varied, ranging from false contraindications, logistical problems resulting in very poor access roads to health facilities and poor organization of health centers together with negative health worker attitudes. Some of the consequences of these missed opportunities were increased susceptibility to vaccine preventable diseases, resurgence of the above diseases and increased morbidity and mortality of children aged less than 5 years. Conclusion; We found that ignorance on the part of both parents/guardians and health care staff together with infrastructural inadequacies in the county such as- roads, poor electric power supply for storage of vaccines were hugely responsible for most missed opportunities for immunization. The details of these and suggestions for improvement and the way forward are discussed.

Keywords: missed opportunity, immunization, under five, Calabar south

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Authors: Hitalo Silva

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The most famous corruption scandals in the past four years were taken in Latin America, especially in Brazil, but besides the stain that these countries suffered in an international field, there was a huge effort to create or modernize its national anti-corruption laws. Also, the countries are implementing new standards for investigations and corporate compliance programs, in order to combat corruption and prevent the money laundering. But here is the following question: is here an invisible uniformization/transnationalization of the anti-corruption systems in Latin America? This new scenario reflects the impacts of the corruption investigations conducted in Latin America countries, such as Car Wash Operation in Brazil, Pretelt Case in Colombia, Gasoducto Sur Peruano case and the Mr. Alex Kouri’s case both in Peru. Legal and institutional pro-transparency reforms were made recently, the companies are trying to implement new standards of conduct and investing in their compliance department. In this sense, there is a huge homogeneity in Latin America concerning the structuring of corporate compliance programs, a truly transnationalization not only of laws but also corporate standards among these countries. Although legislative initiatives vary among the countries, there is a tendency to impose rigid liability standards for the companies being investigated for corruption, not only the personal punishments of their executives, which demonstrate the power of authorities to strength the investigative tools. Also, instruments such as leniency agreements and plea bargain are essential to put a central role in enforcement activities in Latin America. In other words, in a region where six former Presidents were convicted for acts of corruption, and, companies such as Odebrecht that is accused of offering bribes to politicians from Argentina to México, passing through Ecuador, Colombia, Guatemala and Panama, this demonstrates the necessity to increase strength of their legal framework in a sense that unify transnational goals. All things considered, this paper will show how anti-corruption regulators are cooperating in Latin America jurisdictions in order to unify their laws and how the private sector is dealing with this new scenario of corporate culture change.

Keywords: compliance, corruption, investigations, Latin America, transnational

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Authors: Jegede Kehinde Jacob, Ola Akeem Bayonle, Adewale Yemi Yekeen

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The rapid rate of urban growth in most developing countries of the world in recent times is alarming. Mass movement of people from rural areas to the urban centres, the consequence of the uncontrolled rapid urbanisation resulting to many un-conforming environmental challenges such as inadequate infrastructure, land, water and air pollution, poor environmental sanitation, poor and inadequate housing, urban degradation, sprawl and slums, urban violence, crime, robbery and prostitution as well as many other social vices that make the cities unsustainable. The resultant effects of all these are abysmal failure in the management of cities on the part of the governing authorities and other relevant stakeholders as well as unconducive and unwholesome condition of living of the people. This paper attempts to examine holistically the issue of environmental planning management (EPM) process development and management concept with a view for dynamic and interactive approach for various stakeholders as partners in achieving sustainable cities of our dream. The areas of discussion including conceptual and contextual issues, sustainable cities concept, good urban governance including literature review. The paper goes further to examine opportunities and challenges of built environment generally, the nature and context of environmental problems in particular, the role and duties of environmental planning and management (EPM) process in sustainable urban development. The paper further reviewed briefly the various levels of institutionalisation of EPM process with a typical case study of sustainable Ibadan project (SIP). The paper concludes with a list of recommendations to ensure effective and lasting solutions to cities problems through initiation of EPM process achievable in a sustainable manner.

Keywords: built environment, environmental planning, sustainable cities, sustainable development, urbanization

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Authors: Sylvia Mac

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This ethnographic case study examines disaster capitalism, neoliberal market-based school reforms, and disability through the lens of Disability Studies in Education. More specifically, it explores neoliberalism and special education at a small, urban charter school in a large city in California and the (re)production of social inequality. The study uses Sociology of Special Education to examine the ways in which special education is used to sort and stratify disabled students. At a time when rhetoric surrounding public schools is framed in catastrophic and dismal language in order to justify the privatization of public education, small urban charter schools must be examined to learn if they are living up to their promise or acting as another way to maintain economic and racial segregation. The study concludes that neoliberal contexts threaten successful inclusive education and normalize poor, disabled students’ continued low achievement and poor post-secondary outcomes. This ethnographic case study took place at a small urban charter school in a large city in California. Participants included three special education students, the special education teacher, the special education assistant, a regular education teacher, and the two founders and charter writers. The school claimed to have a push-in model of special education where all special education students were fully included in the general education classroom. Although presented as fully inclusive, some special education students also attended a pull-out class called Study Skills. The study found that inclusion and neoliberalism are differing ideologies that cannot co-exist. Successful inclusive environments cannot thrive while under the influences of neoliberal education policies such as efficiency and cost-cutting. Additionally, the push for students to join the global knowledge economy means that more and more low attainers are further marginalized and kept in poverty. At this school, neoliberal ideology eclipsed the promise of inclusive education for special education students. This case study has shown the need for inclusive education to be interrogated through lenses that consider macro factors, such as neoliberal ideology in public education, as well as the emerging global knowledge economy and increasing income inequality. Barriers to inclusion inside the school, such as teachers’ attitudes, teacher preparedness, and school infrastructure paint only part of the picture. Inclusive education is also threatened by neoliberal ideology that shifts the responsibility from the state to the individual. This ideology is dangerous because it reifies the stereotypes of disabled students as lazy, needs drains on already dwindling budgets. If these stereotypes persist, inclusive education will have a difficult time succeeding. In order to more fully examine the ways in which inclusive education can become truly emancipatory, we need more analysis on the relationship between neoliberalism, disability, and special education.

Keywords: case study, disaster capitalism, inclusive education, neoliberalism

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Authors: Abraham Kidane

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The study aims at assessing the prospects and challenges of community-based ecotourism development in and around the Guassa Community Conservation Area (GCCA) for the establishment of alternative sources of livelihood for local people and the conservation of natural resources. The Guassa area and its surrounding area are endowed with natural, cultural, and religious tourism resources. The study is descriptive in its design and uses both qualitative and quantitative research methods. Interviews and questionnaires were used as an instrument for data gathering. The interview was undertaken with government officials, NGO officials, and experts, with three local community representatives. The three Kebeles of Guassa were chosen using purposive sampling because of the fact that they are immediate neighbors to GCCA, and hence, 150 questionnaires were administered proportionally to the household numbers in each kebeles. The perspectives of the MoCT, EWCA, and some Tour Operation agencies were uncovered through questionnaires; for each of them, five questionnaires were administered, and all the returns were used in the analysis. Frequency, percentage, average mean, One Way-ANOVA, and independent t-test are used to analyze quantitative data. The findings revealed that food insecurity is commonplace in the study area. The local people's reliance on the conservation area’s resources has been increasing, and the area size is also dwindling from time to time. On the other hand, the local people's levels of awareness about Community-Based Ecotourism (CBET) are low. In addition, the local capacity in relation to conservation and CBET development is also low, even though there is inadequate training offered by the government and NGOs. In general, tourism is not yet considered an alternative source of income and a means of conserving natural resources. In addition, the challenges for CBET development apart from low awareness level about CBET and low capacity, poor infrastructure, and poor tourism facilities were also identified as challenges in the study area.

Keywords: ecotourism, CBET, alternative livelihood, conservation

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Authors: Neha Gupta, Sonika Verma, Seema Puri, Nikhil Tandon, Narendra K. Arora

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The concurrent increasing prevalence of underweight and overweight/obesity among children with changing lifestyle and the rapid transitioning society has necessitated the need for a unifying/multi-level approach to understand the determinants of the problem. The present community-based cross-sectional research study was conducted to assess the associations between lifestyle behavior and food environment of the child at household, neighborhood, and school with the BMI of children (6-12 year old) (n=612) residing in three rural clusters of Palwal district, Haryana. The study used innovative and robust methods for assessing the lifestyle and various components of food environment in the study. The three rural clusters selected for the study were located at three different locations according to their access to highways in the SOMAARTH surveillance site. These clusters were significantly different from each other in terms of their socio-demographic and socio-economic profile, living conditions, environmental hygiene, health seeking behavior and retail density. Despite of being different, the quality of living conditions and environmental hygiene was poor across three clusters. The children had higher intakes of dietary energy and sugars; one-fifth share of the energy being derived from unhealthy foods, engagement in high levels of physical activity and significantly different food environment at home, neighborhood and school level. However, despite having a high energy intake, 22.5% of the recruited children were thin/severe thin, and 3% were overweight/obese as per their BMI-for-age categories. The analysis was done using multi-variate logistic regression at three-tier hierarchy including individual, household and community level. The factors significantly explained the variability in governing the risk of getting thin/severe thin among children in rural area (p-value: 0.0001; Adjusted R2: 0.156) included age (>10years) (OR: 2.1; 95% CI: 1.0-4.4), the interaction between minority category and poor SES of the household (OR: 4.4; 95% CI: 1.6-12.1), availability of sweets (OR: 0.9; 95% CI: 0.8-0.99) and cereals (OR: 0.9; 95% CI: 0.8-1.0) in the household and poor street condition (proxy indicator of the hygiene and cleanliness in the neighborhood) (OR: 0.3; 95% CI: 0.1-1.1). The homogeneity of other factors at neighborhood and school level food environment diluted the heterogeneity in the lifestyles and home environment of the recruited children and their households. However, it is evident that when various individual factors interplay at multiple levels amplifies the risk of undernutrition in a rural community. Conclusion: These rural areas in Haryana are undergoing developmental, economic and societal transition. In correspondence, no improvements in the nutritional status of children have happened. Easy access to the unhealthy foods has become a paradox.

Keywords: transition, food environment, lifestyle, undernutrition, overnutrition

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Authors: Mathew Hoyes

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This paper is a collation of data, studies and anecdotes on the way education is funded in New Zealand, the ideals which have lead to this method, as well as the issues it has created when combined with other factors and government policy on education over the last two decades. The purpose of this paper is to provide a historical perspective of this situation and to contribute to the global discussion of how to fund schools in an equitable manner, given that the world has become increasingly more globalised and the perception of widening gaps between the rich and the poor in the western world.

Keywords: education funding equity, egalitarianism, socio-economic, New Zealand colonialism

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Authors: Fatima Taqi, Abrar Alanzi

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Objectives: The objective of this study is to determine and assess the level of knowledge and attitudes of dental patients attending Kuwait University Dental Clinics (KUDC) regarding the infection control protocols practiced in the clinic. The results would highlight the importance of conducting awareness campaigns in the community to promote good oral healthcare in Kuwait. Materials and Methods: A cross-sectional descriptive survey was carried out among dental patients attending KUDC. A structured questionnaire, in both Arabic and English languages, was used for data collection about the socio-demographic characteristics, knowledge about the dental cross-infection, and attitudes and self-reported practices regarding infection transmission and control in dentistry. Results: A response rate of 80% (202/250) was reported. 47% of respondents had poor knowledge about dental infection transmission, and only 19.8% had satisfactory knowledge. Female participants obtained a higher satisfactory score (14.3%) compared to males (5.5%). Patients with a university degree or higher education had a better level of knowledge compared to patients with a lower educational level (p < 0.05). The majority of participants agreed that the dentist should wear gloves (95.5%), masks (89.6%), safety glasses (70.3%), and gowns (84.7%). Many patients believed that the protection measures are mainly to stop the infection transmission from patient to patient via the dentist. Half of the participants would ask if the instruments are sterilized and might accept treatment from non-vaccinated dentists. Conclusions: Many dental patients attending KUDC have obtained poor knowledge scores regarding infection transmission in the dental clinic. The educational level was significantly associated with their level of knowledge. An overall positive attitude was reported regarding the infection control protocols practiced in the dental clinic. Raising awareness among dental patients about dental infection transmission and protective measures is of utmost importance.

Keywords: dental infection, knowledge, dental patients, infection control

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Authors: Amani Waheed, Adel Mishriky, Rasha Farouk, Essam Abdallah, Sarah Hussein

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Background: Occupational stress plays a crucial role in professional drivers' health. They are exposed to high workloads, low physical activity, high demand and low decisions as well as poor lifestyle factors including poor diet, sedentary work, and smoking. Dyslipidemia is a well-established modifiable cardiovascular risk factor. Occupational stress and other forms of chronic stress have been associated with raised levels of atherogenic lipids. Although stress management has some evidence in improving lipid profile, the association between occupational stress and dyslipidemia is not clear. Objectives: To assess the relational between occupational stress and lipid profile among professional drivers. Methodology: A cross-sectional study conducted at a large company in Ismailia City, Egypt, where, 131 professional drivers divided into 44 car drivers, 43 bus drivers, and 44 truck drivers were eligible after applying exclusion criteria. Occupational stress index (OSI), non-occupational risk factors of dyslipidemia were assessed using interview structured questionnaire. Blood pressure, body mass index (BMI) and lipid profile were measured. Results: The mean of total OSI score was 79.98 ± 6.14. The total OSI score is highest among truck drivers (82.16 ± 4.62), then bus drivers (80.26 ± 6.02) and lowest among car drivers (77.55 ± 6.79) with statistically significant. Eighty percent had Dyslipidemia. The duration of driving hours per day, exposure to passive smoking and increased BMI were the risk factors. No statistical significance between Total OSI score and dyslipidemia. Using, logistic regression analysis, occupational stress, duration of driving hours per day, and BMI were positive significant predictors for dyslipidemia. Conclusion: Professional drivers are exposed to occupational stress. A high proportion of drivers have dyslipidemia. Total OSI score doesn't have statistically significant relation with dyslipidemia.

Keywords: body mass index, dyslipidaemia, occupational stress, professional drivers

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Authors: Nditsheni Ramakuela, Sonto Maputle, Base Khoza, Augustine Tugli

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Inadequate health literacy can cause difficulties in understanding and compliance to treatment plan. With diabetic condition, self-care activities include behaviours of following a diet plan, avoiding high fat foods, increased exercise, self-glucose monitoring, and foot care. Patients with poor health literacy have difficulty interpreting medication warning labels, following directions on a prescription label and identifying their medications. Difficulties in understanding and performing self-care and health-related activities may ultimately lead to poor health outcomes. The study explored and described factors affecting health literacy and self-care to diabetic regimen by female patients at selected hospital in Limpopo Province of South Africa. Qualitative and explorative research design was used. Female patients who were admitted and diagnosed with diabetes in female medical ward constituted the study population. Non-probability, purposive sampling was used to select 20 female patients diagnosed with diabetes, who were above 18 years and admitted during April–November 2014. An in-depth face-to-face, unstructured interview was used to collect data. Data were analysed using open coding method. Measures to ensure trustworthiness and ethical considerations were adhered to. Findings revealed factors affecting health literacy for diabetic self-care activities amongst patients were; patient, family, disease and facility related. Proposed recommendations were; to strengthen diabetes education and patient-provider partnership. This is important and must be transferred to strengthen self-care activities to fully benefit the patient.

Keywords: compliance, diabetes mellitus, diabetic regimen, health literacy, self activities

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Authors: Yibeltal T. Bayou, Yohana S. Mashalla, Gloria Thupayagale-Tshweneagae

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Background: Maternal mortality has been shown to be lower in urban areas than in rural areas. However, disparities for the fast-growing population of urban poor who struggle as much their rural counterparts to access quality healthcare are masked by the urban averages. The aim of this paper is to report on the findings of antenatal adequacy among slum residents in Addis Ababa, Ethiopia. Methods and Materials: A quantitative and cross-sectional community-based study design was employed. A stratified two-stage cluster sampling technique was used to determine the sample and data was collected using structured questionnaire administered to 837 women aged 15-49 years. Binary logistic regression models were employed to identify predictors of adequacy of antenatal care. Results: The majority of slum residents did not have adequate antenatal care services i.e., only 50.7%, 19.3% and 10.2% of the slum resident women initiated early antenatal care, received adequate antenatal care service contents and had overall adequate antenatal care services. Pregnancy intention, educational status and place of ANC visits were important determinant factors for adequacy of ANC in the study area. Women with secondary and above educational status were 2.9 times more likely to have overall adequate care compared to those with no formal education. Similarly, women whose last pregnancy was intended and clients of private healthcare facilities were 1.8 and 2.8 times more likely to have overall adequate antenatal care compared to those whose last pregnancy was unintended and clients of public healthcare facilities respectively. Conclusion: In order to improve ANC adequacy in the study area, the policymaking, planning, and implementation processes should focus on the poor adequacy of ANC among the disadvantaged groups in particular and the slum residents in general.

Keywords: Addis Ababa, adequacy of antenatal care, slum residents, maternal mortality

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Authors: Kamil Jonski

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Last year vividly demonstrated, that populism and political instability can endanger democratic institutions in countries regarded as democratic transition champions (Poland) or cornerstones of liberal order (UK, US). So called ‘illiberal democracy’ is winning hearts and minds of voters, keen to believe that rule of strongman is a viable alternative to perceived decay of western values and institutions. These developments pose a serious threat to the democratic institutions (including rule of law), proven critical for both personal freedom and economic development. Although scholars proposed some structural explanations of the illiberal wave (notably focusing on inequality, stagnant incomes and drawbacks of globalization), they seem to have little predictive value. Indeed, events like Trump’s victory, Brexit or Polish shift towards populist nationalism always came as a surprise. Intriguingly, in the case of US election, simple rules like ‘Bread and Peace model’ gauged prospects of Trump’s victory better than pundits and pollsters. This paper attempts to compile set of indicators, in order to gauge various democracies’ vulnerability to populism, instability and pursuance of ‘illiberal’ projects. Among them, it identifies the gap between consensus assessment of institutional performance (as measured by WGI indicators) and citizens’ subjective assessment (survey based confidence in institutions). Plotting these variables against each other, reveals three clusters of countries – ‘predictable’ (good institutions and high confidence, poor institutions and low confidence), ‘blind’ (poor institutions, high confidence e.g. Uzbekistan or Azerbaijan) and ‘disillusioned’ (good institutions, low confidence e.g. Spain, Chile, Poland and US). It seems that this clustering – carried out separately for various institutions (like legislature, executive and courts) and blended with economic indicators like inequality and living standards (using PCA) – offers reasonably good watchlist of countries, that should ‘expect the unexpected’.

Keywords: illiberal democracy, populism, political instability, political risk measurement

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Authors: Engida Yisma, Berhanu Dessalegn, Ayalew Astatkie, Nebreed Fesseha

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Background: The World Health Organization (WHO) recommends using the partograph to follow labour and delivery, with the objective to improve health care and reduce maternal and foetal morbidity and death. Methods: A retrospective document review was undertaken to assess the completion of the modified WHO partograph during labour in public health institutions of Addis Ababa, Ethiopia. A total of 420 of the modified WHO partographs used to monitor mothers in labour from five public health institutions that provide maternity care were reviewed. A structured checklist was used to gather the required data. The collected data were analyzed using SPSS version 16.0. Frequency distributions, cross-tabulations and a graph were used to describe the results of the study. Results: All facilities were using the modified WHO partograph. The correct completion of the partograph was very low. From 420 partographs reviewed across all the five health facilities, foetal heart rate was recorded into the recommended standard in 129(30.7%) of the partographs, while 138 (32.9%) of cervical dilatation and 87 (20.70%) of uterine contractions were recorded to the recommended standard. The study did not document descent of the presenting part in 353 (84%). Moulding in 364 (86.7%) of the partographs reviewed was not recorded. Documentation of state of the liquor was 113(26.9%), while the maternal blood pressure was recorded to standard only in 78(18.6%) of the partographs reviewed. Conclusions: This study showed a poor completion of the modified WHO partographs during labour in public health institutions of Addis Ababa, Ethiopia. The findings may reflect poor management of labour and indicate the need for pre-service and periodic on-job training of health workers on the proper completion of the partograph. Regular supportive supervision, provision of guidelines and mandatory health facility policy are also needed in support of a collaborative effort to reduce maternal and perinatal deaths.

Keywords: modified WHO partograph, completion, public health institutions, Addis Ababa, Ethiopia

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