Search results for: Middle East and North Africa (MENA)

Authors: Shiliang Wu, Huanxin Zhang

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Mercury has been well-known for its negative effects on wildlife, public health as well as the ecosystem. Once emitted into atmosphere, mercury can be transformed into different forms or enter the ecosystem through dry deposition or wet deposition. Some fraction of the mercury will be reemitted back into the atmosphere and be subject to the same cycle. In addition, the relatively long lifetime of elemental mercury in the atmosphere enables it to be transported long distances from source regions to receptor regions. Global change such as climate change and land use/land cover change impose significant challenges for mercury pollution control besides the efforts to regulate mercury anthropogenic emissions. In this study, we use a global chemical transport model (GEOS-Chem) to examine the potential impacts from changes in climate and land use/land cover on the global budget of mercury as well as its atmospheric transport, chemical transformation, and deposition. We carry out a suite of sensitivity model simulations to separate the impacts on atmospheric mercury associated with changes in climate and land use/land cover. Both climate change and land use/land cover change are found to have significant impacts on global mercury budget but through different pathways. Land use/land cover change primarily increase mercury dry deposition in northern mid-latitudes over continental regions and central Africa. Climate change enhances the mobilization of mercury from soil and ocean reservoir to the atmosphere. Also, dry deposition is enhanced over most continental areas while a change in future precipitation dominates the change in mercury wet deposition. We find that 2000-2050 climate change could increase the global atmospheric burden of mercury by 5% and mercury deposition by up to 40% in some regions. Changes in land use and land cover also increase mercury deposition over some continental regions, by up to 40%. The change in the lifetime of atmospheric mercury has important implications for long-range transport of mercury. Our case study shows that changes in climate and land use and cover could significantly affect the source-receptor relationships for mercury.

Keywords: mercury, toxic pollutant, atmospheric transport, deposition, climate change

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Authors: Keping Zuo, Foad Kabinejadian, Gideon Praveen Kumar Vijayakumar, Fangsen Cui, Pei Ho, Hwa Liang Leo

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Carotid artery stenting (CAS) is the standard procedure for patients with severe carotid stenosis at high risk for carotid endarterectomy (CAE). A major drawback of CAS is the higher incidence of procedure-related stroke compared with traditional open surgical treatment for carotid stenosis - CEA, even with the use of the embolic protection devices (EPD). As the currently available bare metal stents cannot address this problem, our research group developed a novel preferential covered-stent for carotid artery aims to prevent friable fragments of atherosclerotic plaques from flowing into the cerebral circulation, and yet maintaining the flow of the external carotid artery. The preliminary animal studies have demonstrated the potential of this novel covered-stent design for the treatment of carotid atherosclerotic stenosis. The purpose of this study is to evaluate the effect of membrane coating on the stent flexibility in order to improve the clinical performance of our novel covered stents. A total of 21 stents were evaluated in this study: 15 self expanding bare nitinol stents and 6 PTFE-covered stents. 10 of the bare stents were coated with 11%, 16% and 22% Polyurethane(PU), 4%, 6.25% and 11% EE, as well as 22% PU plus 5 μm Parylene. Different laser cutting designs were performed on 4 of the PTFE covert stents. All the stents, with or without the covered membrane, were subjected to a three-point flexural test. The stents were placed on two supports that are 30 mm apart, and the actuator is applying a force in the exact middle of the two supports with a loading pin with radius 2.5 mm. The loading pin displacement change, the force and the variation in stent shape were recorded for analysis. The flexibility of the stents was evaluated by the lumen area preservation at three displacement bending levels: 5mm, 7mm, and 10mm. All the lumen areas in all stents decreased with the increase of the displacement from 0 to 10 mm. The bare stents were able to maintain 0.864 ± 0.015, 0.740 ± 0.025 and 0.597 ± 0.031of original lumen area at 5 mm, 7 mm and 10mm displacement respectively. For covered stents, the stents with EE coating membrane showed the best lumen area preservation (0.839 ± 0.005, 0.7334 ± 0.043 and 0.559 ± 0.014), whereas, the stents with PU and Parylene coating were only 0.662, 0.439 and 0.305. Bending stiffness was also calculated and compared. These results provided optimal material information and it was crucial for enhancing clinical performance of our novel covered stents.

Keywords: carotid artery, covered stent, nonlinear, hyperelastic, stress, strain

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Authors: Peace Liz Sasha Musonge

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Behavioral aspects of species nutrition such as feeding methods and food type are archetypal biological traits signifying how species have adapted to their environment. This concept of functional feeding groups (FFG) analysis is currently used to ascertain the trophic levels of the aquatic food web in a specific microhabitat. However, in Eastern Africa, information about the FFG classification of benthic macroinvertebrates in highland rivers and streams is almost absent, and existing studies have fragmented datasets. For this reason, we carried out a robust study to determine the feed type, trophic level and FFGs, of 56 macroinvertebrate taxa (identified to family level) from Albertine rift valley streams. Our findings showed that all five major functional feeding groups were represented; Gatherer Collectors (GC); Predators (PR); shredders (SH); Scrapers (SC); and Filterer collectors. The most dominant functional feeding group was the Gatherer Collectors (GC) that accounted for 53.5% of the total population. The most abundant (GC) families were Baetidae (7813 individuals), Chironomidae NTP (5628) and Caenidae (1848). Majority of the macroinvertebrate population feed on Fine particulate organic matter (FPOM) from the stream bottom. In terms of taxa richness the Predators (PR) had the highest value of 24 taxa and the Filterer Collectors group had the least number of taxa (3). The families that had the highest number of predators (PR) were Corixidae (1024 individuals), Coenagrionidae (445) and Libellulidae (283). However, Predators accounted for only 7.4% of the population. The findings highlighted the functional feeding groups and habitat type of macroinvertebrate communities along an altitudinal gradient.

Keywords: trophic levels, functional feeding groups, macroinvertebrates, Albertine rift

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Authors: Dini Dewi Heniarti

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Military Court which is a judicial institution within the military institution has a heavy duty. Military court has to ensuring a fair legal process for military personnel (due process of law) and enforces military discipline. Military justice must also ensure protects the rights of military personnel. In Indonesia tren of military court changes in vision. The debate is happened on the jurisdiction of military court that allegedly has the potential existence of impunity. The Decree of People’s Consultative Assembly Number VII/MPR/2000 which states that the army general who committed the crime should not be tried in military court is one that underlies the proposed amendment limits the jurisdiction of military court. For the identify of the background in a specific format that is limited to juridical review. The goals this research is to gain knowledge, deep understanding and the concept of jurisdiction of military courts for military members who committed general crimes in adjudication procedure from the perspective of legal reform as alternative to establish independency of military judiciary. This research using Rule of Law as Grand Theory, Development Legal Theory as a Middle Theory and Criminal Justice System and concept of jurisdiction as supporting as Applied Theory. This study using a normative juridical approach, and equipped by primary data juridical approach of historical and comparative approach. The author uses descriptive analytical specifications. The main data used in this research is secondary data, which includes primary legal materials, secondary legal material and legal materials tertiary. Analysis primary data and qualitative data is done legally. Technique checking the validity of the data in this study used multiple methods with the research triangulation. This paper will demonstrate the problems concerning the jurisdiction of military courts for military personnel who committed general crimes in perspective of military justice reform Indonesia and adjudication procedures for military member who committed general crimes in the military justice system in Indonesia, as alternative to establish independency of judiciary in military justice in Indonesia. Comparative approached the military justice system from another countries is aimed to development military justice in Indonesia.

Keywords: jurisdiction, military courts, military justice, independency of judiciary

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Authors: Larasati Zuhro, Ida F Priyanto

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Background: In March 2020, Indonesia started to be affected by Covid-19, and the number of victims increased slowly but surely until finally, the highest number of victims reached the highest—about 50,000 persons—for the daily cases in the middle of 2021. Like other institutions, schools and universities were suddenly closed in March 2020, and students had to change their ways of studying from face-to-face to online. This sudden changed affected students and faculty, including LIS students and faculty because they never experienced online classes in Indonesia due to the previous regulation that academic and school activities were all conducted onsite. For almost two years, school and academic activities were held online. This indeed has affected the way students learned and faculty delivered their courses. This raises the question of whether students are now ready for their new learning activities due to the covid-19 disruption. Objectives: this study was conducted to find out the impact of covid-19 pandemic on the LIS learning process and the effectiveness of online classes for students of LIS in Indonesia. Methodology: This was qualitative research conducted among LIS students at UIN Sunan Kalijaga, Yogyakarta, Indonesia. The population are students who were studying for masters’program during covid-19 pandemic. Results: The study showed that students were ready with the online classes because they are familiar with the technology. However, the Internet and technology infrastructure do not always support the process of learning. Students mention slow WIFI is one factor that causes them not being able to study optimally. They usually compensate themselves by visiting a public library, a café, or any other places to get WIFI network. Noises come from the people surrounding them while they are studying online.Some students could not concentrate well when attending the online classes as they studied at home, and their families sometimes talk to other family members, or they asked the students while they are attending the online classes. The noise also came when they studied in a café. Another issue is that the classes were held in shorter time than that in the face-to-face. Students said they still enjoyed the onsite classes instead of online, although they do not mind to have hybrid model of learning. Conclusion: Pandemic of Covid-19 has changed the way students of LIS in Indonesia learn. They have experienced a process of migrating the way they learn from onsite to online. They also adapted their learning with the condition of internet access speed, infrastructure, and the environment. They expect to have hybrid classes in the future.

Keywords: learning, LIS students, pandemic, covid-19

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Authors: Naomi Nathan

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Introduction Digitalization of medical education can revolutionize how medical students learn and interact with the medical curriculum across contexts. With the increasing availability of the internet and mobile connectivity in LMICs, online medical education platforms and digital learning tools are becoming more widely available, providing new opportunities for learners to access high-quality medical education and training. However, the adoption and integration of digital technologies in medical education in LMICs is a complex process influenced by various factors, including learners' perceptions and attitudes toward digital learning. In Ethiopia, the adoption of digital platforms for medical education has been slow, with traditional face-to-face teaching methods still being the norm. However, as access to technology improves and more universities adopt digital platforms, it is crucial to understand how medical students perceive this shift. Methodology This study investigated medical students' perception of the digitalization of medical education in relation to their access to the Lecturio Digital Medical Education Platform through a capacity-building project. 740 medical students from over 20 medical universities participated in the study. The students were surveyed using a questionnaire that included their attitudes toward the digitalization of medical education, their frequency of use of the digital platform, and their perceived benefits and challenges. Results The study results showed that most medical students had a positive attitude toward digitalizing medical education. The most commonly cited benefit was the convenience and flexibility of accessing course material/curriculum online. Many students also reported that they found the platform more interactive and engaging, leading to a more meaningful learning experience. The study also identified several challenges medical students faced when using the platform. The most commonly reported challenge was the need for more reliable internet access, which made it difficult for students to access content consistently. Overall, the results of this study suggest that medical students in Ethiopia have a positive perception of the digitalization of medical education. Over 97% of students continuously expressed a need for access to the Lecturio platform throughout their studies. Conclusion Significant challenges still need to be addressed to fully realize the Lecturio digital platform's benefits. Universities, relevant ministries, and various stakeholders must work together to address these challenges to ensure that medical students fully participate in and benefit from digitalized medical education - sustainably and effectively.

Keywords: digital medical education, EdTech, LMICs, e-learning

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Authors: Olanrewaju Kafayat, O., Salman Kabir, K.

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The role of organic agriculture in providing food and income is now gaining wider recognition (Van Elzakker et al 2007). The increasing public concerns about food safety issues on the use of fertilizers, pesticide residues, growth hormones, GM organisms, and increasing awareness of environmental quality issues have led to an expanding demand for environmentally friendly products (Thompson, 1998; Rimal et al., 2005). As a result national governments are concerned about diet and health, and there has been renewed recognition of the role of public policy in promoting healthy diets, thus to provide healthier, safer, more confident citizens (Poole et al., 2007), With these benefits, a study into organic vegetables is very vital to all the major stakeholders. This study analyzed the willingness of consumers to pay for organic vegetables in Oyo state, Nigeria. Primary data was collected with the aid of structured questionnaire administered to 168 respondents. These were selected using multistage random sampling. The first stage involved the selection two (2) ADP zones out of the three (3) ADP zones in Oyo state, The second stage involved the random selection of two (2) local government areas each out of the two (2) ADP zones which are; Ibadan South West and Ogbomoso North and random selection of 4 wards each from the local government areas. The third stage involved random selection of 42 household each from of the local government areas. Descriptive statistics, the principal component analysis, and the logistic regression were used to analyze the data. Results showed 55 percent of the respondents were female while 80 percent were  50 years. 74 percent of the respondents agreed that organic vegetables are of better quality. 31 percent of the respondents were aware of organic vegetables as against 69 percent who were not aware. From the logistic model, educational attainment, amount spent on organic vegetables monthly, better quality of organic vegetables and accessibility to organic vegetables were significant and had a positive relationship on willingness to pay for organic vegetable. The variables that were significant and had a negative relationship with WTP are less attractiveness of organic vegetables and household size of the respondents. This study concludes that consumers with higher level of education were more likely to be aware and willing to pay for organic vegetables than those with low levels of education, the study therefore recommends creation of awareness on the relevance of consuming organic vegetables through effective marketing and educational campaigns.

Keywords: consumers awareness, willingness to pay, organic vegetables, Oyo State

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Authors: Katarzyna Sobczak

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Over the last few years extensive research on the Lower Palaeozic of the Baltic region has been carried out, associated with growing interest in the unconventional hydrocarbon resources of the area. The present study contributes to this investigation by providing relevant microfacies analysis of Ordovician and Silurian carbonate and clastic deposits of the Polish part of the Baltic Syneclise, using data from the Kętrzyn IG-1, Henrykowo 1 and Babiak 1 boreholes. The analytical data, encompassing sedimentological, palaeontological, and petrographic indicators enables the interpretation of the sedimentary environments and their control factors. The main microfacies types distinguished within the studied interval are: bioclastic wackestone, bioclastic packstone, carbonate-rich mudstone, marlstone, nodular limestone and bituminous claystone. The Ordovician is represented by redeposited carbonate rocks formed in a relatively high-energy environment (middle shelf setting). The Upper Ordovician-Lower Silurian rocks of the studied basin represent sedimentary succession formed during a distinctive marine transgression. Considering the sedimentological and petrological data from the Silurian, a low-energy sedimentary environment (offshore setting) with intermittent high-energy events (tempestites) can be inferred for the sedimentary basin of NE Poland. Slow sedimentation of carbonate ooze and fine-grained siliciclastic rocks, formed under oxygen-deficient conditions of the seabed, favoured organic matter preservation. The presence of the storm beds suggests an episodic nature of seabed oxygenation. A significant part of the analysed depositional successions shows characteristics indicative of deposition from gravity flows, but lacks evidence of its turbidity origins. There is, however, evidence for storms acting as a mechanism of flow activation. The discussed Ordovician-Silurian transition of depositional environments in the Baltic area fits well to the global environmental changes encompassing the Upper Ordovician and the Lower Silurian.

Keywords: Baltic Syneclise, microfacies analysis, Ordovician, Silurian, unconventional hydrocarbons

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Authors: Ronli Sifris

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The last Australian Parliamentary inquiry into surrogacy took place in 2016. Since then, a number of countries have reviewed their surrogacy laws, including countries such as New Zealand and the United Kingdom, which traditionally have invoked similar legal approaches to Australia on a broad range of issues. The time is ripe to reform Australia’s surrogacy laws with a view to putting in place a system that best protects the rights of all parties to a surrogacy arrangement, and especially the rights of the child. There are two specific, linked issues which tend to be particularly contentious in the surrogacy context. The first relates to legal parentage. There are questions around whether the surrogate or the intended parents should be deemed the legal parents of a child born through surrogacy and what should be the process for any transfer of parentage. The second key issue relates to compensation and whether a surrogate should be compensated for the reproductive labour inherent in conceiving, gestating, and birthing a child. This paper will invoke a comparative analysis with a view to considering how different countries are regulating surrogacy and which approach best protects the rights all parties involved in the surrogacy arrangement, especially the rights of the children born through surrogacy. The specific countries to be considered are Australia, Canada, and California (United States). I have selected these countries for the following reasons: Australia is the jurisdiction where the author is based, it is, therefore, the jurisdiction with which she has the most familiarity. It allows altruistic surrogacy only and post-birth parentage orders in favour of the intended parents of children born through altruistic surrogacy California, as a jurisdiction allowing for compensated surrogacy and pre-birth parentage orders in favour of the intended parents, sits at the other end of the spectrum to Australia thereby providing an interesting point of comparison. Canada sits somewhere in the middle; it ostensibly allows only altruistic surrogacy, but in practice, many aspects of the Canadian process resemble compensated surrogacy. In addition to conducting a comparative analysis with other countries, the paper will also consider international human rights law as its overarching framework for determining the approach that best protects the rights of a child born through surrogacy. Particular attention will be paid to the United Nations Convention on the Rights of the Child as the key children’s rights treaty. The European Court of Human Rights will also be extensively considered as it has decided a number of cases relating to the rights of children born through surrogacy.

Keywords: surrogacy, children’s rights, australia, compensation, parentage

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Authors: Adesuyi Ayodeji Steve, Zahn Munch

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This study investigates the use of MODIS NDVI to identify agricultural land cover change areas on an annual time step (2007 - 2012) and characterize the trend in the study area. An ISODATA classification was performed on the MODIS imagery to select only the agricultural class producing 3 class groups namely: agriculture, agriculture/semi-natural, and semi-natural. NDVI signatures were created for the time series to identify areas dominated by cereals and vineyards with the aid of ancillary, pictometry and field sample data. The NDVI signature curve and training samples aided in creating a decision tree model in WEKA 3.6.9. From the training samples two classification models were built in WEKA using decision tree classifier (J48) algorithm; Model 1 included ISODATA classification and Model 2 without, both having accuracies of 90.7% and 88.3% respectively. The two models were used to classify the whole study area, thus producing two land cover maps with Model 1 and 2 having classification accuracies of 77% and 80% respectively. Model 2 was used to create change detection maps for all the other years. Subtle changes and areas of consistency (unchanged) were observed in the agricultural classes and crop practices over the years as predicted by the land cover classification. 41% of the catchment comprises of cereals with 35% possibly following a crop rotation system. Vineyard largely remained constant over the years, with some conversion to vineyard (1%) from other land cover classes. Some of the changes might be as a result of misclassification and crop rotation system.

Keywords: change detection, land cover, modis, NDVI

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Authors: Mukesh Ravi Raushan

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Despite consideration of obesity as a deadly public health issue contributing 2.6 million deaths worldwide every year developing country like India is facing malnutrition and it is more common than in Sub-Saharan Africa. About one in every three malnourished children in the world lives in India. The paper assess the nutritional health among children using data from total number of 43737 infant and young children aged 0-59 months (µ = 29.54; SD = 17.21) of the selected households by National Family Health Survey, 2005-06. The wasting was measured by a Z-score of standardized weight-for-height according to the WHO child growth standards. The impact of education with place of residence was found to be significantly associated with the complementary food diversity score (CFDS) in India. The education of mother was positively associated with the CFDS but the degree of performance was lower in rural India than their counterpart from urban. The result of binary logistic regression on wasting with WHO seven types of recommended food for children in India suggest that child who consumed the milk product food (OR: 0.87, p<0.0001) were less likely to be malnourished than their counterparts who did not consume, whereas, in case of other food items as the child who consumed food product of seed (OR: 0.75, p<0.0001) were less likely to be malnourished than those who did not. The nutritional status among children were negatively associated with the protein containing complementary food given the child as those child who received pulse in last 24 hour were less likely to be wasted (OR: 0.87, p<0.00001) as compared to the reference categories. The frequency to feed the indexed child increases by 10 per cent the expected change in child health outcome in terms of wasting decreases by 2 per cent in India when place of residence, education, religion, and birth order were controlled. The index gets improved as the risk for malnutrition among children in India decreases.

Keywords: CFDS, food diversity index, India, logistic regression

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Authors: Shamila Manie, Soraya Maart, Ayesha Osman

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Introduction: People diagnosed with multidrug resistant pulmonary tuberculosis (MDR-PTB) is subjected to prolonged hospitalization in South Africa. It has thus become essential for research to shift its focus from a purely medical approach, but to include social and environmental factors when looking at the impact of the disease on those affected. Aim: To explore the factors affecting individuals with multi-drug resistant pulmonary tuberculosis during long-term hospitalization using the comprehensive ICF core-sets for obstructive pulmonary disease (OPD) and cardiopulmonary (CPR) conditions at Brooklyn Chest Hospital (BCH). Methods: A quantitative descriptive, cross-sectional study design was utilized. A convenient sample of 19 adults at Brooklyn Chest Hospital were interviewed. Results: Most participants reported a decrease in exercise tolerance levels (b455: n=11). However it did not limit participation. Participants reported that a lack of privacy in the environment (e155) was a barrier to health. The presence of health professionals (e355) and the provision of skills development services (e585) are facilitators to health and well-being. No differences exist in the functional ability of HIV positive and negative participants in this sample. Conclusion: The ICF Core Sets appeared valid in identifying the barriers and facilitators experienced by individuals with MDR-PTB admitted to BCH. The hospital environment must be improved to add to the QoL of those admitted, especially improving privacy within the wards. Although the social grant is seen as a facilitator, greater emphasis must be placed on preparing individuals to be economically active in the labour for when they are discharged.

Keywords: multidrug resistant tuberculosis, MDR ICF core sets, health-related quality of life (HRQoL), hospitalization

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Authors: Johanna Gamboa-Kroesen

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School connectedness, or the sense of belonging at school, is a critical factor in adolescent health, academic achievement, and socioemotional well-being. In educational research, the construct of the psychological sense of school membership is often referred to as school engagement, school bonding, or school attachment. While current research recognizes school connectedness as integral to a child’s mental health and academic success, many schools have yet to develop adequate interventions to promote a child’s overall sense of belonging at school. However, prior researches in music education indicates that, among other benefits, music classrooms may provide an environment where students feel they belong. While studies indicates that music learning environments, specifically performing ensemble learning environments, instill a sense of school connectedness and, more broadly, contribute to a student’s socio-emotional development, there has been inadequate research on how the actions of music teachers contribute to this phenomenon. The purpose of this study was to examine the relationship between school connectedness and music learning environments with middle school music students enrolled in a school-based music ensemble. In addition, the study aimed to provide a descriptive analysis of the instructional practices that music teachers use to promote an inclusive environment in their classrooms and an overall sense of belonging in their students. Using 191 student surveys of school membership, student reflective writings, 5 teacher interviews, and 10 classroom observations, this study examined the relationship between 7th and 8th-grade student-reported levels of connectedness within their school-based music ensemble and teacher instructional practice. The study found that students reported high levels of positive school membership within their music classes. Students who participate in school-based orchestra ensembles reported a positive change in emotional state during music instruction. In addition, evidence in this study found that music teachers use instructional practices to build connectedness through de-emphasizing competition and strengthening a student’s sense of relational value within their music learning experience. The findings offer implications for future music teacher instruction to create environments of inclusion, strengthen student-teacher relationships, and promote strategies that enhance student connection to school.

Keywords: music education, belonging, instructional practice, school connectedness

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Authors: S. Beekrum, B. Odhav, R. Lalloo, E. A. Amonsou

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Marine microalgae are rich sources of novel and biologically active metabolites; therefore they may be used in the food industry as natural food ingredients and functional foods. They have several biological applications related to health benefits, among others. The aim of the study focused on the screening of phytochemicals from Amphora sp. biomass extracts, and to examine the in vitro antioxidant and antimicrobial potential. Amphora sp. biomass was obtained from CSIR (South Africa) and methanol, hexane and water extracts were prepared. The in vitro antimicrobial effect of extracts were tested against some pathogens (Staphylococcus aureus, Listeria monocytogenes, Bacillus subtilis, Salmonella enteritidis, Escherichia coli, Pseudomonas aeruginosa and Candida albicans), using the disc diffusion assay. Qualitative analyses of phytochemicals were conducted by chemical tests. The present investigation revealed that all extracts showed relatively strong antibacterial activity against most of the tested bacteria. The highest phenolic content was found in the methanolic extract. Results of the DPPH assay showed that the biomass contained strong antioxidant capacity, 79% in the methanolic extract and 85% in the hexane extract. Extracts have displayed effectively reducing power and superoxide anion radical scavenging activity. Results of this study have highlighted potential antioxidant activity in the methanol and hexane extracts. The results of the phytochemical screening showed the presence of terpenoids and sterols with potential applications as food flavorants and functional foods, respectively. The use of Amphora sp. as a natural antioxidant source and a potential source of antibacterial compounds and phytochemicals in the food industry appears promising and should be investigated further.

Keywords: antioxidants, antimicrobial, microalgae, phytochemicals, cymbella

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Authors: Abeer A. Aljohani

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COVID-19 virus spread has been one of the extreme pandemics across the globe. It is also referred to as coronavirus, which is a contagious disease that continuously mutates into numerous variants. Currently, the B.1.1.529 variant labeled as omicron is detected in South Africa. The huge spread of COVID-19 disease has affected several lives and has surged exceptional pressure on the healthcare systems worldwide. Also, everyday life and the global economy have been at stake. This research aims to predict COVID-19 disease in its initial stage to reduce the death count. Machine learning (ML) is nowadays used in almost every area. Numerous COVID-19 cases have produced a huge burden on the hospitals as well as health workers. To reduce this burden, this paper predicts COVID-19 disease is based on the symptoms and medical history of the patient. This research presents a unique architecture for COVID-19 detection using ML techniques integrated with feature dimensionality reduction. This paper uses a standard UCI dataset for predicting COVID-19 disease. This dataset comprises symptoms of 5434 patients. This paper also compares several supervised ML techniques to the presented architecture. The architecture has also utilized 10-fold cross validation process for generalization and the principal component analysis (PCA) technique for feature reduction. Standard parameters are used to evaluate the proposed architecture including F1-Score, precision, accuracy, recall, receiver operating characteristic (ROC), and area under curve (AUC). The results depict that decision tree, random forest, and neural networks outperform all other state-of-the-art ML techniques. This achieved result can help effectively in identifying COVID-19 infection cases.

Keywords: supervised machine learning, COVID-19 prediction, healthcare analytics, random forest, neural network

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Authors: Ebenezer Amoquandoh, Daniel Bruce Sarpong, Godfred K. Ofosu-Budu, Andreas Fliessbach

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Soil quality is at stake globally, but under tropical conditions, the loss of soil fertility may be existential. The current rates of soil nutrient depletion, erosion and environmental degradation in most of Africa’s farmland urgently require methods for soil fertility restoration through affordable agricultural management techniques. The study assessed the effects of locally available organic resources to improve soil fertility, crop yield and profitability compared to business as usual on farms in the Eastern and Greater Accra regions of Ghana. Apart from this, we analyzed the change of farmers’ perceptions and knowledge upon the experience with the new techniques; the effect of using locally available organic resource on farmers’ yield and determined the factors influencing the profitability of farming. Using the Difference in Mean Score and Proportion to estimate the extent to which farmers’ perceptions, knowledge and practices have changed, the study showed that farmers’ perception, knowledge and practice on the use of locally available organic resources have changed significantly. This paves way for the sustainable use of locally available organic resource for soil fertility improvement. The Propensity Score Matching technique and Endogenous Switching Regression model used showed that using locally available organic resources have the potential to increase crop yield. It was also observed that using the Profit Margin, Net Farm Income and Return on Investment analysis, it is more profitable to use locally available organic resources than other soil fertility amendments techniques studied. The results further showed that socioeconomic, farm characteristics and institutional factors are significant in influencing farmers’ decision to use locally available organic resources and profitability.

Keywords: soil fertility, locally available organic resources, perception, profitability, sustainability

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Authors: Sonja Grobler

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Background: Leadership and specifically Leader, member exchange has a definite impact on employee behaviour and attitudes, and specifically their state of psychological capital. The interactionist construct of person-organisational fit (P-O fit), consisting of a combination of supplementary fit (indirect fit or value congruence) and complementary fit (direct or person-job fit, as well as needs-supply fit) may, however, impact on the relationship between LMX and psychological capital. The unique permutations of these relationships are important not only for conceptualisation purposes but also for intervention design to enhance the employees’ psychological capital; this would contribute to positive employee behaviour and attitudes. Aim: The purpose of this study was to determine whether a relationship exists between Leader, Member Exchange (LMX) and psychological capital, with possible mediation by P-O fit. Setting: The research was conducted with ± 60 employees from each of 43 private sectors and four public sector organisations in South Africa. Method: This study utilised a positivist methodology based on an empirical approach while using a cross-sectional design and quantitative analysis. The sample is relatively representative (in terms of race, gender, and the South African work force), as it consisted of 60 employees from each of the 43 South African organisations that participated in the study, with 2 486 respondents in total. Results: Significant, positive relationships were found between LMX, P-O fit, and psychological capital. Additionally, it was found that P-O fit partially mediates the relationship between ethical leadership and supervisory trust, confirming the proposed model. Conclusion: A strong, positive relationship exists between LMX (consisting of Affect, Loyalty, Contribution, and Professional Respect) and psychological capital (consisting of Self-efficacy, Hope, Resilience and Optimism) which is partially mediated by P-O fit (consisting of supplementary fit and complementary fit).

Keywords: leader and member exchange, person-organisational fit, psychological capital, positive psychology, interactionist approach

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Authors: Daijun Chen

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Affordable housing is subsidized by the government to meet the housing demand of low and middle-income urban residents in the process of urbanization and to alleviate the housing inequality caused by market-based housing reforms. It is a recognized fact that the living conditions of the insured have been improved while constructing the subsidized housing. However, the choice of affordable housing is mostly in the suburbs, where the surrounding urban functions and infrastructure are incomplete, resulting in the spatial mismatch of "jobs-housing" in affordable housing. The main reason for this problem is that the residents of affordable housing are more sensitive to the spatial location of their residence, but their selectivity and controllability to the housing location are relatively weak, which leads to higher commuting costs. Their real cost of living has not been effectively reduced. In this regard, 92 subsidized housing communities in Nanjing, China, are selected as the research sample in this paper. The residents of the affordable housing and their commuting Spatio-temporal behavior characteristics are identified based on the LBS (location-based service) data. Based on the spatial mismatch theory, spatial mismatch indicators such as commuting distance and commuting time are established to measure the spatial mismatch degree of subsidized housing in different districts of Nanjing. Furthermore, the geographically weighted regression model is used to analyze the influencing factors of the spatial mismatch of affordable housing in terms of the provision of employment opportunities, traffic accessibility and supporting service facilities by using spatial, functional and other multi-source Spatio-temporal big data. The results show that the spatial mismatch of affordable housing in Nanjing generally presents a "concentric circle" pattern of decreasing from the central urban area to the periphery. The factors affecting the spatial mismatch of affordable housing in different spatial zones are different. The main reasons are the number of enterprises within 1 km of the affordable housing district and the shortest distance to the subway station. And the low spatial mismatch is due to the diversity of services and facilities. Based on this, a spatial optimization strategy for different levels of spatial mismatch in subsidized housing is proposed. And feasible suggestions for the later site selection of subsidized housing are also provided. It hopes to avoid or mitigate the impact of "spatial mismatch," promote the "spatial adaptation" of "jobs-housing," and truly improve the overall welfare level of affordable housing residents.

Keywords: affordable housing, spatial mismatch, commuting characteristics, spatial adaptation, welfare benefits

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Authors: Estifanos H. Zeru

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Introduction: Epidemiological research is important to draw need-based rational public health policy. However, research on child and adolescent mental health in low and middle income countries, where socioeconomic, political, cultural, biological and other mental health hazards are in abundance, is almost nonexistent. To the author's knowledge, there is no published research in this field in Eritrea, whose child and adolescent population constitutes 53% of its total population. Study Aims and Objectives: The objective of this study was to determine the prevalence and patterns of DSM-IV psychiatric disorders and identify their socio-demographic correlates among children and adolescents in Mendefera, Eritrea. The study aims to provide local information to public health policymakers to guide policy in service development. Methodology: In a cross-sectional two stage procedure, both the Parent and Child versions of the SDQ were used to screen 314 children and adolescents aged 4-17 years, recruited by a multi-stage random sampling method. All parents/adult guardians also completed a socio-demographic questionnaire. All children and adolescents who screened positive for any of the SDQ abnormality sub-classes were selected for the second stage interview, which was conducted using the K-SADS-PL 2009 Working Draft version to generate specific DSM-IV diagnoses. All data gathered was entered into CSPro version 6.2 and was then transported in to and analyzed using SPSS version 20 for windows. Results: Prevalence of DSM-IV psychiatric disorders was found to be 13.1%. Adolescents 11-17 years old and males had higher prevalence than children 4-10 years old and females, respectively. Behavioral disorders were the commonest disorders (9.9%), followed by affective disorders (3.2%) and anxiety disorders (2.5). Chronic medical illness in the child, poor academic performance, difficulties with teachers in school, psychopathology in a family member and parental conflict were found to be independently associated with these disorders. Conclusion: Prevalence of child and adolescent psychiatric disorders in Eritrea is high. Promotion, prevention, treatment, and rehabilitation for child and adolescent mental health services need to be made widely available in the country. The socio-demographic correlates identified by this study can be targeted for intervention. The need for further research is emphasized.

Keywords: adolescents, children, correlates, DSM-IV psychiatric disorders, Eritrea, K-SAD-PL 2009, prevalence and correlates, SDQ

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Authors: Badamasi Tarda Ayuba

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African countries contend with many developmental challenges particularly that of overcoming ethnic and religious conflicts. There is the recent wave of terrorism which is also ascribed to religious intolerance. It is a reality that most sub-Saharan African countries/communities consist of several distinct ethnic groups. In a typical classroom, within both rural and urban contexts, children from diverse ethnic and socio-cultural backgrounds converge to learn and grow together. This implies that education has the potentials for fostering inter-communal understanding such that young people could learn, grow together and assume leadership positions to work in pursuit of common goals of nation building. However, given the spate of inter communal clashes erupting too frequently in many parts of the continent and the dangerous trend of ethnicization of serious national affairs, it is doubtful if these objectives are being realized through education. Thus, this paper argued that the current developments indicate failure of the education system in the realization of the countries’ educational goals of creating united, peaceful and indivisible nations, thus far. Further, the failure occurred and would continue to persist unless teachers are purposefully prepared in terms of professional competencies and attitudes to entrench in their students the culture of peaceful coexistence through the various professional roles they play within the schools and communities. Therefore, the paper examined the changing context and challenging roles expected of sub-Saharan African teachers in engendering peaceful coexistence and the need to purposefully develop their capacity and mindset for the new roles. The paper then recommended programs to expose and re-educate teachers towards such roles.

Keywords: sub-Saharan Africa, teacher, professional development, peaceful coexistence, multi-ethnicity, communities

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Authors: C. M. Choi, H. C. Tsang, W. K. Fong, Y. K. Cheng, T. K. Chui, L. Y. Chan, K. W. Lee, C. K. Yuen, P. W. Lau, Y. L. To, K. C. Chow

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Six-minute walk test (6MWT) is a sub-maximal exercise test to assess aerobic capacity and exercise tolerance of patients with chronic respiratory disease and heart failure. This has been proven to be a reliable and valid tool and commonly used in clinical situations. Traditional 6MWT is labour-intensive and time-consuming especially for patients who require assistance in ambulation and oxygen use. When performing the test with these patients, one staff will assist the patient in walking (with or without aids) while another staff will need to manually record patient’s oxygen saturation, heart rate and walking distance at every minute and/or carry oxygen cylinder at the same time. Physiotherapist will then have to document the test results in bed notes in details. With the use of electronic 6MWT (E-6MWT), patients wear a wireless oximeter that transfers data to a tablet PC via Bluetooth. Real-time recording of oxygen saturation, heart rate, and distance are displayed. No manual work on recording is needed. The tablet will generate a comprehensive report which can be directly attached to the patient’s bed notes for documentation. Data can also be saved for later patient follow up. This study was carried out in North District Hospital. Patients who followed commands and required 6MWT assessment were included. Patients were assigned to study or control groups. In the study group, patients adopted the E-6MWT while those in control group adopted the traditional 6MWT. Manpower and time consumed were recorded. Physiotherapists also completed a questionnaire about the use of E-6MWT. Total 12 subjects (Study=6; Control=6) were recruited during 11-12/2017. An average number of staff required and time consumed in traditional 6MWT were 1.67 and 949.33 seconds respectively; while in E-6MWT, the figures were 1.00 and 630.00 seconds respectively. Compared to traditional 6MWT, E-6MWT required 67.00% less manpower and 50.10% less in time spent. Physiotherapists (n=7) found E-6MWT is convenient to use (mean=5.14; satisfied to very satisfied), requires less manpower and time to complete the test (mean=4.71; rather satisfied to satisfied), has better data management (mean=5.86; satisfied to very satisfied) and is recommended to be used clinically (mean=5.29; satisfied to very satisfied). It is proven that E-6MWT requires less manpower input with higher efficiency and better data management. It is welcomed by the clinical frontline staff.

Keywords: electronic, physiotherapy, six-minute walk test, 6MWT

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Authors: Marizia Roberta Rasoanandrasana, Hery Lisy Tiana. Ranarijaona, Herintsitohaina Razakamanarivo, Eric Delaitre, Nandrianina Ramifehiarivo

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Madagascar is one of the producer’s countries of world's fine cocoa. Cocoa-based agroforestry systems (CBAS) plays a very important economic role for over 75% of the population in the north of Madagascar, the island's main cocoa-producing area. It is also viewed as a key factor in the deforestation of local protected areas. It is therefore urgent to establish a compromise between cocoa production and forest conservation in this region which is difficult due to a lack of accurate cocoa agro-systems data. In order to fill these gaps and to response to these socio-economic and environmental concerns, this study aims to describe CBAS by providing precise data on their characteristics and to establish a typology. To achieve this, 150 farms were surveyed and observed to characterize CBAS based on 11 agronomic and 6 socio-economic data. Also, 30 representative plots of CBAS among the 150 farms were inventoried for providing accurate ecological data (6 variables) as an additional data for the typology determination. The results showed that Madagascar’s CBAS systems are generally extensive and practiced by smallholders. Four types of cocoa-based agroforestry system were identified, with significant differences between the following variables: yield, planting age, cocoa density, density of associated trees, preceding crop, associated crops, Shannon-Wiener indices and species richness in the upper stratum. Type 1 is characterized by old systems (>45 years) with low crop density (425 cocoa trees/ha), installed after conversion of crops other than coffee (> 50%) and giving low yields (427 kg/ha/year). Type 2 consists of simple agroforestry systems (no associated crop 0%), fairly young (20 years) with low density of associated trees (77 trees/ha) and low species diversity (H'=1.17). Type 3 is characterized by high crop density (778 trees/ha and 175 trees/ha for cocoa and associated trees respectively) and a medium level of species diversity (H'=1.74, 8 species). Type 4 is particularly characterized by orchard regeneration method involving replanting and tree lopping (100%). Analysis of the potential of these four types has identified Type 4 as a promising practice for sustainable agriculture.

Keywords: conservation, practices, productivity, protect areas, smallholder, trade-off, typology

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Authors: Bharat Rawat, Shekhar Rajbhandari, Yadav Bhatta, Jay Prakash Jaiswal, Shivaji Bikram Silwal, Rajiv Shrestha, Shova Sunuwar

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Introduction: The honey produced by the bees fed on Rhobdodendron species containing grayanotoxin is known as mad honey. Grayanotoxin is found in honey obtained from the nectar of Rhododendron species growing on the mountains of the Black Sea region of Turkey and also in Japan, Nepal, Brazil, parts of North America, and Europe. Although the incidence of grayanotoxin poisoning is rare, there is concern that the number of cases per year will rise with the increasing demand for organic products. Mad honey intoxication might present with mild symptoms of cardiovascular, gastrointestinal and neurological systems or might also present with a life-threatening form with AV block and cardiovascular collapse. In this article, we describe the summary of five cases, which came to our hospital with mad honey related cardiac complications. Findings: In last one year, five cases presented in the emergency department with sudden onset of Loss of consciousness, dizziness, shortness of breath. They felt difficulty after the consumption of 1-3 teaspoonful of wild honey. The honey was brought from most of the rural parts of Nepal like khotang. Some of them also came with vomiting, dizziness, and loose stool. On examination, most of them had severe bradycardia and low blood pressure. No abnormalities were detected on systemic examinations. In one patient, ECG and cardiac enzymes showed features of the acute coronary syndrome, but his treadmill test done few days later was normal. All patients were managed with inj. Atropine, I/V normal saline, and other supportive measures and discharged in a stable condition within one or two days. Conclusions: Rhododendrons is the national flower of Nepal. The specific species of rhododendron found in Nepal which contains the toxin is not known. Bees feeding on these rhododendrons are known to transfer the grayanotoxin to the honey they produce. Most symptoms are mild and resolve themselves without medical intervention. Signs and symptoms of grayanotoxin poisoning rarely last more than 24 hours and are usually not fatal. Some signs of mad honey poisoning include Bradycardia, Cardiac arrhythmia, Hypotension, Nausea and Vomiting. They respond to close monitoring and appropriate supportive treatment. Normally, patients recover completely with no residual damage to the heart or its conduction system.

Keywords: rhobdodendron, honey, grayanotoxin, bradycardia

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Authors: Dolores Sucozhañay, Gustavo Pacheco, Paul Vanegas

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In the context of sustainable development and the transition towards a sustainable circular economy (CE), evaluating the social dimension remains a challenge. Therefore, developing a respective methodology is highly important. First, the change of the economic model may cause significant social effects, which today remain unaddressed. Second, following the current level of globalization, CE implementation requires targeting global material cycles and causes social impacts on potentially vulnerable social groups. A promising methodology is the Social Life Cycle Assessment (SLCA), which embraces the philosophy of life cycle thinking and provides complementary information to environmental and economic assessments. In this context, the present work uses the updated Social Life Cycle Assessment (SLCA) Guidelines 2020 to assess the social performance of the recycling system of Cuenca, Ecuador, to exemplify a social assessment method. Like many other developing countries, Ecuador heavily depends on the work of informal waste pickers (recyclers), who, even contributing to a CE, face harsh socio-economic circumstances, including inappropriate working conditions, social exclusion, exploitation, etc. Under a Reference Scale approach (Type 1), 12 impact subcategories were assessed through 73 site-specific inventory indicators, using an ascending reference scale ranging from -2 to +2. Findings reveal a social performance below compliance levels with local and international laws, basic societal expectations, and practices in the recycling sector; only eight and five indicators present a positive score. In addition, a social hotspot analysis depicts collection as the most time-consuming lifecycle stage and the one with the most hotspots, mainly related to working hours and health and safety aspects. This study provides an integrated view of the recyclers’ contributions, challenges, and opportunities within the recycling system while highlighting the relevance of assessing the social dimension of CE practices. It also fosters an understanding of the social impact of CE operations in developing countries, highlights the need for a close north-south relationship in CE, and enables the connection among the environmental, economic, and social dimensions.

Keywords: SLCA, circular economy, recycling, social impact assessment

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Authors: Timothy E. Frank, Peter J. Amaddio, Elizabeth D. Decko, Alexis M. Tri, Darcy A. Farrell, Cole M. Landes

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Ultra high performance concrete (UHPC) is a class of cementitious composites with a relatively large percentage of cement generating high compressive strength. Additionally, UHPC contains disbursed fibers, which control crack width, carry the tensile load across narrow cracks, and limit spalling. These characteristics lend themselves to a wide range of structural applications when UHPC members are reinforced with longitudinal steel. Efficient use of fibers and longitudinal steel is required to keep lifecycle cost competitive in reinforced UHPC members; this requires full utilization of both the compressive and tensile qualities of the reinforced cementitious composite. The objective of this study is to investigate the shear response of steel-reinforced UHPC beams to guide design decisions that keep initial costs reasonable, limit serviceability crack widths, and ensure a ductile structural response and failure path. Five small-scale, reinforced UHPC beams were experimentally tested. Longitudinal steel, transverse steel, and casting direction were varied. Results indicate that an increase in transverse steel in short-spanned reinforced UHPC beams provided additional shear capacity and increased the peak load achieved. Beams with very large longitudinal steel reinforcement ratios did not achieve yield and fully utilized the tension properties of the longitudinal steel. Casting the UHPC beams from the end or from the middle affected load-carrying capacity and ductility, but image analysis determined the fiber orientation was not significantly different. It is believed the presence of transverse and longitudinal steel reinforcement minimized the effect of different UHPC casting directions. Results support recent recommendations in the literature suggesting a 1% fiber volume fraction is sufficient within UHPC to prevent spalling and provide compressive fracture toughness under extreme loading conditions.

Keywords: fiber orientation, reinforced ultra high performance concrete beams, shear, transverse steel

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Authors: Mirka Januszkiewicz

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The Regional Municipality of Durham is the upper level of a two-tier municipal and regional structure comprised of eight lower-tier municipalities. With a population of 655,000 in both urban and rural settings, the Region is approximately 2,537 square kilometers neighboring the City of Toronto, Ontario Canada to the east. The Region has been focused on diverting waste from disposal since the development of its Long Term Waste Management Strategy Plan for 2000-2020. With a 54 percent solid waste diversion rate, the focus now is on achieving 70 percent diversion on the path to zero waste using local waste management options whenever feasible. The Region has an Integrated Waste Management System that consists of a weekly curbside collection of recyclable printed paper and packaging and source separated organics; a seasonal collection of leaf and yard waste; a bi-weekly collection of residual garbage; and twice annual collection of intact, sealed household batteries. The Region also maintains three Waste Management Facilities for residential drop-off of household hazardous waste, polystyrene, construction and demolition debris and electronics. Special collection events are scheduled in the spring, summer and fall months for reusable items, household hazardous waste, and electronics. The Region is in the final commissioning stages of an energy from the waste facility for residual waste disposal that will recover energy from non-recyclable wastes. This facility is state of the art and is equipped for installation of carbon capture technology in the future. Despite all of these diversion programs and efforts, there is still room for improvement. Recent residential waste studies revealed that over 50% of the residual waste placed at the curb that is destined for incineration could be recycled. To move towards a zero waste community, the Region is looking to more advanced technologies for extracting the maximum recycling value from residential waste. Plans are underway to develop a pre-sort facility to remove organics and recyclables from the residual waste stream, including the growing multi-residential sector. Organics would then be treated anaerobically to generate biogas and fertilizer products for beneficial use within the Region. This project could increase the Region’s diversion rate beyond 70 percent and enhance the Region’s climate change mitigation goals. Zero waste is an ambitious goal in a changing regulatory and economic environment. Decision makers must be willing to consider new and emerging technologies and embrace change to succeed.

Keywords: municipal waste, residential, waste diversion, zero waste

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Authors: Rotondwa P. Gunununu, Mustapha Mohammed, Felix D. Dakora

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Common bean is the most importantly high protein grain legume grown in Southern Africa for human consumption and income generation. Although common bean can associate with rhizobia to fix N₂ for bacterial use and plant growth, it is reported to be a poor nitrogen fixer when compared to other legumes. N₂ fixation can vary with legume species, genotype and rhizobial strain. Therefore, screening legume germplasm can reveal rhizobia/genotype combinations with high N₂-fixing efficiency for use by farmers. This study assessed symbiotic performance and N₂ fixation in 63 common bean genotypes under field conditions at Malkerns Station in Eswatini, using the ¹⁵N natural abundance technique. The shoots of common bean genotypes were sampled at a pod-filling stage, oven-dried (65oC for 72h), weighed, ground into a fine powder (0.50 mm sieve), and subjected to ¹⁵N/¹⁴N isotopic analysis using mass spectrometry. At maturity, plants from the inner rows were harvested for the determination of grain yield. The results revealed significantly higher modulation (p≤0.05) in genotypes MCA98 and CIM-RM01-97-8 relative to the other genotypes. Shoot N concentration was highest in genotype MCA 98, followed by KAB 10 F2.8-84, with most genotypes showing shoot N concentrations below 2%. Percent N derived from atmospheric N₂ fixation (%Ndfa) differed markedly among genotypes, with CIM-RM01-92-3 and DAB 174, respectively, recording the highest values of 66.65% and 66.22 % N derived from fixation. There were also significant differences in grain yield, with CIM-RM02-79-1 producing the highest yield (3618.75 kg/ha). These results represent an important contribution in the profiling of symbiotic functioning of common bean germplasm for improved N₂ fixation.

Keywords: nitrogen fixation, %Ndfa, ¹⁵N natural abundance, grain yield

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Authors: Asinguza P. Allan

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The Advocacy for Better Health aims to equip citizens with enabling environment and systems to effectively advocate for strong action plans to improve health services. This is because the 2020 Government target for Uganda to transform into a middle income country will be achieved if investment is made in keeping the population healthy and productive. Citizen participation as an important foundation for change has been emphasized to gather data through participatory rural appraisal and inform evidence-based advocacy for recruitment and motivation of human resources. Citizens conduct problem ranking during advocacy forums on staffing levels and health worker absenteeism. Citizens prioritised inadequate number of midwives and absenteeism. On triangulation, health worker to population ratio in Uganda remains at 0.25/1,000 which is far below the World Health Organization (WHO) threshold of 2.3/1,000. Working with IntraHealth, the project advocated for recruitment of critical skilled staff (doctors and midwives) and scale up health workers motivation strategy to reduce Uganda’s Neonatal Mortality Rate of 22/1,000 and Maternal Mortality Ratio of 320/100,000. Government has committed to increase staffing to 80% by 2018 (10 districts have passed ordinances and revived use of duty rosters to address health worker absenteeism. On the other hand, the better health advocacy debate has been elevated with need to increase health sector budget allocations from 8% to 10%. The project has learnt that building a body of evidence from citizens enhances the advocacy agenda. Communities will further monitor government commitments to reduce Neonatal Mortality Rate and Maternal Mortality Ratio. The project has learnt that interface meeting between duty bearers and the community allows for immediate feedback and the process is a strong instrument for empowerment. It facilitates monitoring and performance evaluation of services, projects and government administrative units (like district assemblies) by the community members themselves. This, in turn, makes the human resources in health to be accountable, transparent and responsive to communities where they work. This, in turn, promotes human resource performance.

Keywords: advocacy, empowerment, evidence, human resources

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Authors: Francesca Favero, Despina Learmonth

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Carbohydrate addiction is said to be the sustained dependence on hyperpalatable foods rich in carbohydrates and sugar. This addiction manifests in increased consumption of carbohydrates through binging: a behaviour typically associated with eating disorders. There is a lack of consensus amongst relevant experts as to whether carbohydrates are physiologically or psychologically addictive. With an increased focus on carbohydrate addiction, an outpatient treatment programme, HELP, has been established in Cape Town, South Africa, to specifically address this issue. This research aimed to explore, pre-and post-intervention, the possible presence of, and subsequent shifts in, the maintaining mechanisms identified in the transdiagnostic model for eating disorders. However, the potential for the emergence of other perpetuating factors was not discounted and the nature of the analysis allowed for this possibility. Eight women between the ages of twenty-two and fifty, who had completed the outpatient treatment programme in the last six months, were interviewed. They were asked to speak retrospectively about their personal difficulties, eating and food, and their experience of the treatment. Thematic analysis was employed to identify themes arising from the data. Five themes congruent with the transdiagnostic model’s factors emerged: over-evaluation of weight and shape, core low self-esteem, interpersonal difficulties, clinical perfectionism and mood intolerance. A variety of sub-themes, elaborating upon the various ways in which the disordered eating was maintained, also emerged from the data. Shifts in these maintaining mechanisms were identified. Although not necessarily indicative of recovery, the results suggest that the outpatient HELP programme had a positive overall influence on the participants; and that the transdiagnostic model may be useful in understanding and guiding the treatment of clients who engage in this type of treatment programme.

Keywords: eating disorders, binge eating disorder, carbohydrate addiction, transdiagnostic model, maintaining mechanisms, thematic analysis, outpatient treatment

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Authors: Jamie E. Banker

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For many families, pregnancy and the postpartum time are filled with both anticipation and change. For some pregnant or postpartum women, this time is marked by the onset of a mood or anxiety disorder. Experiencing a mood or anxiety disorders during this time of life differs from depression or anxiety at other times of life. Not only because of the physical changes occurring in the mother’s body but also the mental and physical preparation necessary to redefine family roles, responsibilities, and develop new identities in the life transition. The presence of a mood or anxiety disorder can influence the way in which a mother defines herself and can complicate her understanding of her abilities and competencies as a mother. The complexity of experiencing a mood or anxiety disorder in the midst of these changes necessitates specific treatment interventions to match both the symptomatology and psychological adjustments. This study explores the use of narrative family therapy techniques when treating a mother who is experiencing postpartum depression. Externalization is a common technique used in narrative family therapy and can help client’s separate their identity from the problems they are experiencing. This is crucial to a new mom who is in the middle of defining her identity during her transition to parenthood. The goal of this study is to examine how the use of externalization techniques help postpartum women separate their mood and anxiety symptoms from their identity as a mother. An exploratory case study design was conducted in a single setting, private practice therapy office, and explored how a narrative family therapy approach can be used to treat perinatal mood and anxiety disorders. The therapy sessions were audio recorded and transcribed. Constructivism and narrative theory are used as theoretical frameworks and data from the therapy sessions, and a follow-up survey was triangulated and analyzed. During the course of the treatment, the participant reports using the new externalizing labels for her symptoms. Within one month of treatment, the participant reports that she could stop herself from thinking the harmful thoughts faster, and within three months, the harmful thoughts went away. The main themes in this study were building courage and less self-blame. This case highlights the role narrative family therapy can play in the treatment of perinatal mood and anxiety disorders and the importance of separating a women’s mood from her identity as a mother. This conceptual framework was beneficial to the postpartum mother when treating perinatal mood and anxiety disorder symptoms.

Keywords: externalizing techniques, narrative family therapy, perinatal mood and anxiety disorders, postpartum depression

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