Search results for: elderly care facilities

Authors: Mairo H. Ipadeola, Catherine James Atteng

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The term social inclusion refers to a process by which those disadvantaged in society can have access to fully participate in education like others. Student with special needs are expected to learn along with their peers within the some educational institutions which provide adequate access for all. There for, the study sort to understand the typical ways in which students with disabilities (SWD) were denied from fully participating as students in Kaduna Polytechnic. In doing this, two (2) objectives and research questions were raised. Firstly, to explore the attitudes of others towards students with disabilities in the institutions and secondly, to ascertain the extent of social participation and physical accessibility for students with disabilities (SWD) while in the institutions. Based on the objectives the paper postulated the research questions: what are the attitudes of management, teachers, and students towards students with special need in Kaduna Polytechnic and to what extent did the students with disabilities experience social participation and physical accessibility within Kaduna Polytechnic school environment? The study area was Kaduna Polytechnic. The study engaged the interview for the data collected which were transcribed and analyzed by thematic coding. The findings were categorized under themes, sub-themes, and codes. The findings revealed that the perception, behavior, and association experiences of students with disabilities within Kaduna Polytechnic were not encouraging. Their experiences were characterized by negative attitudes, feelings of rejection, neglect, and bullying. Data generated on social participation indicated that 71% of the respondents believed that learning, school activities, recreations, and student politics between SWD and the other student were in the direction of low / very low. All the respondents, particularly students with blindness and physical challenges faced difficulty with environmental and physical access above all within the school environment, classroom, walkways and ramps, Also, directions were none existent in most departments with physical access to classrooms, toilets, cafeterias, and school shops absent or very low (71% and 29% of the respondents). The conclusion was that the physical barriers limited the possibilities of social participation of SWD.The paper made some recommendations such as mass public enlightenment on radio and television to change the perception of society about people with disability. Also, the federal, state, and local governments enact building acts for fresh builders and adopted measures and time frames for existing public buildings to be made accessible for people with disabilities. All stakeholders should ensure that the five (5) percent budget set aside by State Universal Basic Education Board (SUBEB) and/or Tertiary Education Trust Fund (TETFUND) for the provision of specialized equipment and facilities for the student with special needs should be used prudently spent and monitored by the board.cm.

Keywords: social inclusion, students with disability, social participation, environmental/physical access

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Authors: Takeo Shibata, Arihito Endo, Akemi Kunimatsu, Chika Hiraga, Yoko Shimizu

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Introduction: Yuzawa Town, located in the Niigata prefecture of Japan, is famous for its hot springs. A health promotion program, Yuzawa family health plan, was initiated in 2002. It has been held for fifteen years. We evaluated the profiles of brushing teeth in adults. Subjects: 368 questionnaires were corrected from people who live in Yuzawa town. The range of age was between nineteen and sixty-four years old. Methods: Mann-Whitney’s U test and Kruskal-Wallis test were used to evaluate significant differences in frequencies of brushing teeth per a day. Chi-square test and the adjusted residuals were used to evaluate when they brush their teeth. Results: Women showed greater frequencies of brushing teeth per a day than men. No difference was shown by age. Construction workers showed fewer frequencies of brushing teeth. Specialized technicians, clerical workers, and housewives showed greater frequencies. People who know Yuzawa family health plan, take a regular life, or take a breakfast every day showed greater frequencies. People who think not healthy, don’t care a balance of foods, don’t take yearly health check-up, or smoke showed fewer frequencies. After breakfast, women and specialized technicians showed greater frequencies, and construction workers and self-employed workers showed fewer frequencies. After lunch, clerical workers and specialized technicians showed greater frequencies. There was no significant difference at after waking up, after dinner, and before going to bed. Construction workers showed a lower rate of having a marital partner and having information of health. Conclusion: Gender and occupational differences were shown in frequencies of brushing teeth per a day. A promotion of teeth brushing for male, especially construction workers and self-employed workers, is needed.

Keywords: health promotion, Yuzawa family health plan, brushing teeth, occupational difference

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Authors: Kehabtimer Shiferaw Kotiso, Getachew Hailemariam, Abiy Seifu Estifanos

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Introduction: Despite the highest share of low birth weight (LBW) for neonatal mortality and morbidity, predicting births with LBW for better intervention preparation is challenging. This study aims to predict LBW using a dataset encompassing 53,637 birth cohorts collected from 36 primary hospitals across seven regions in Ethiopia from February 2022 to June 2024. Methods: We identified ten explanatory variables related to maternal and neonatal characteristics, including maternal education, age, residence, history of miscarriage or abortion, history of preterm birth, type of pregnancy, number of livebirths, number of stillbirths, antenatal care frequency, and sex of the fetus to predict LBW. Using WEKA 3.8.2, we developed and compared seven machine learning algorithms. Data preprocessing included handling missing values, outlier detection, and ensuring data integrity in birth weight records. Model performance was evaluated through metrics such as accuracy, precision, recall, F1-score, and area under the Receiver Operating Characteristic curve (ROC AUC) using 10-fold cross-validation. Results: The results demonstrated that the decision tree, J48, logistic regression, and gradient boosted trees model achieved the highest accuracy (94.5% to 94.6%) with a precision of 93.1% to 93.3%, F1-score of 92.7% to 93.1%, and ROC AUC of 71.8% to 76.6%. Conclusion: This study demonstrates the effectiveness of machine learning models in predicting LBW. The high accuracy and recall rates achieved indicate that these models can serve as valuable tools for healthcare policymakers and providers in identifying at-risk newborns and implementing timely interventions to achieve the sustainable developmental goal (SDG) related to neonatal mortality.

Keywords: low birth weight, machine learning, classification, neonatal mortality, Ethiopia

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Authors: Lai Gwen Chan, Yining Ong, Audrey Yoke Poh Wong

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Background. The efficacy of electroconvulsive therapy (ECT) as a form of treatment to a range of mental disorders is well-established. However, ECT is often associated with either temporary or persistent cognitive side-effects, resulting in the failure of wider prescription. Of which, retrograde amnesia is the most commonly reported cognitive side-effect. Most studies found a recalling deficit in autobiographical memories to be short-term, although a few have reported more persistent amnesic effects. Little is known about ECT-related amnesic effects in Asian population. Hence, this study aims to resolve conflicting findings, as well as to better elucidate the effects of ECT on cognitive functioning in a local sample. Method: 12 patients underwent bilateral ECT under the care of Psychological Medicine Department, Tan Tock Seng Hospital, Singapore. Participants’ cognition and level of functioning were assessed at four time-points: before ECT, between the third and fourth induced seizure, at the end of the whole course of ECT, and two months after the index course of ECT. Results: It was found that Global Assessment of Functioning scores increased significantly at the completion of ECT. Case-by-case analyses also revealed an overall improvement in Personal Semantic and Autobiographical memory two months after the index course of ECT. A transient dip in both personal semantic and autobiographical memory scores was observed in one participant between the third and fourth induced seizure, but subsequently resolved and showed better performance than at baseline. Conclusions: The findings of this study suggest that ECT is an effective form of treatment to alleviate the severity of symptoms of the diagnosis. ECT does not affect attention, language, executive functioning, personal semantic and autobiographical memory adversely. The findings suggest that Asian patients may respond to bilateral ECT differently from Western samples.

Keywords: electroconvulsive therapy (ECT), autobiographical memory, cognitive impairment, psychiatric disorder

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Authors: Abdul-Razak Saeed

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Addressing the climate change crisis that this generation faces has evolved to include the consideration of a policy mechanism referred to as reduced emissions from deforestation and forest degradation with plus components of conservation, sustainable forest management and enhancement of forest carbon stocks (REDD+). REDD+ emerged from the International level of UNFCCC but its implementation is by developing countries. It challenges the development paradigm of nations that depend on the unsustainable clearing of forests and land use change for economic development whilst posing as an opportunity or risk for forest community livelihoods, institutions and their interaction with the forest resources. As a novel policy mechanism, it is imperative to gain global insight into local contexts of its implementation and to understand local level mobilization of their agency for institutional sustainability as reconfigured by new carbon economy initiatives like REDD+. Using a systematic review process, as the initial stages of this study, secondary data of REDD+ projects across the globe were evaluated to pick up gaps in research and that of on ground REDD+ implementation. Primary data was gathered from 30 actors in the government, NGO, private sector and traditional authorities using face-to-face semi structured interviews in Ghana; participation in meetings and workshops and policy and strategy document reviews. Preliminary findings of the study include REDD+ knowledge being a key determinant of power distribution and affects who shapes the process; in Ghana, informal relationships are playing key roles in advancing REDD+ unlike in traditional forestry and a subjectivity shift of local communities from an 'emotive-link' of environmental care to one of 'economic self-seeking and enriching' domain of thought.

Keywords: climate change, communities, forests, REDD+

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Authors: Krima M. Rohela, Raja Sabarinath Sundaralingam

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Humans have been launching rockets since the beginning of the space age in the late 1950s. We have come a long way since then, and the success rate for the launch of rockets has increased considerably. With every successful launch, there is a large amount of junk or debris which is released into the upper layers of the atmosphere. Space debris has been a huge concern for a very long time now. This includes the rocket shells released from the launch and the parts of defunct satellites. Some of this junk will come to fall towards the Earth and burn in the atmosphere. But most of the junk goes into orbit around the Earth, and they remain in orbits for at least 100 years. This can cause a lot of problems to other functioning satellites and may affect the future manned missions to space. The main concern of the space-debris is the increase in space activities, which leads to risks of collisions if not taken care of soon. These collisions may result in what is known as Kessler Syndrome. This debris can be removed by a space-based laser targeting system. Hence, the matter is investigated and discussed. The first step in this involves launching a satellite with a high-power laser device into space, above the debris belt. Then the target material is ablated with a focussed laser beam. This step of the process is highly dependent on the attitude and orientation of the debris with respect to the Earth and the device. The laser beam will cause a jet of vapour and plasma to be expelled from the material. Hence, the force is applied in the opposite direction, and in accordance with Newton’s third law of motion, this will cause the material to move towards the Earth and get pulled down due to gravity, where it will get disintegrated in the upper layers of the atmosphere. The larger pieces of the debris can be directed towards the oceans. This method of removal of the orbital debris will enable safer passage for future human-crewed missions into space.

Keywords: altitude, Kessler syndrome, laser ablation, Newton’s third law of motion, satellites, Space debris

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Authors: Dana R. Thomson, Catherine Linard, Sabine Vanhuysse, Jessica E. Steele, Michal Shimoni, Jose Siri, Waleska Caiaffa, Megumi Rosenberg, Eleonore Wolff, Tais Grippa, Stefanos Georganos, Helen Elsey

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The Sustainable Development Goals (SDGs) and Urban Health Equity Assessment and Response Tool (Urban HEART) identify dozens of key indicators to help local decision-makers prioritize and track inequalities in health outcomes. However, presentations and discussions at the International Conference on Urban Health (ICUH) 2017 suggested that additional indicators are needed to make decisions and policies. A local decision-maker may realize that malaria or road accidents are a top priority. However, s/he needs additional health determinant indicators, for example about standing water or traffic, to address the priority and reduce inequalities. Health determinants reflect the physical and social environments that influence health outcomes often at community- and societal-levels and include such indicators as access to quality health facilities, access to safe parks, traffic density, location of slum areas, air pollution, social exclusion, and social networks. Indicator identification and disaggregation are necessarily constrained by available datasets – typically collected about households and individuals in surveys, censuses, and administrative records. Continued advancements in earth observation, data storage, computing and mobile technologies mean that new sources of health determinants indicators derived from 'big data' are becoming available at fine geographic scale. Big data includes high-resolution satellite imagery and aggregated, anonymized mobile phone data. While big data are themselves not representative of the population (e.g., satellite images depict the physical environment), they can provide information about population density, wealth, mobility, and social environments with tremendous detail and accuracy when combined with population-representative survey, census, administrative and health system data. The aim of this paper is to (1) flag to data scientists important indicators needed by health decision-makers at the city and sub-city scale - ideally free and publicly available, and (2) summarize for local decision-makers new datasets that can be generated from big data, with layperson descriptions of difficulties in generating them. We include SDGs and Urban HEART indicators, as well as indicators mentioned by decision-makers attending ICUH 2017.

Keywords: health determinant, health outcome, mobile phone, remote sensing, satellite imagery, SDG, urban HEART

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Authors: Yetunde M. Dairo, Johnny Collett, Helen Dawes

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Background and Aim: Engagement with physical activity (PA) research is poor among adults with intellectual disabilities (ID), particularly in those from residential homes. This study explored why, by asking managers of residential homes, adults with ID and their carers. Methods: Participants: A convenient sample of 23 individuals from two UK local authorities, including a group of ID residential home managers, adults with ID and their support staff. Procedures: A) Residential home managers (n=6) were asked questions about their willingness to allow their residents to participate in PA research; B) eleven adults with ID and their support workers (n=6) were asked questions about their willingness to accept 7-day accelerometer monitoring and/or the International Physical Activity Questionnaire-short version (IPAQ-s) as PA measures. The IPAQ-s was administered by the researcher and they were each provided with samples of accelerometers to try on. Results: A) Five out of six managers said that the burden of wearing the accelerometer for seven days would be too high for the people they support, the majority of whom might be unable to express their wishes. They also said they would be unwilling to act as proxy respondents for the same reason. Additionally, they cited time pressure, understaffing, and reluctance to spend time on the research paperwork as further reasons for non-participation. B) All 11 individuals with ID completed the IPAQ-s while only three accepted the accelerometer, one of whom was deemed inappropriate to wear it. Reasons for rejecting accelerometers included statements from participants of: ‘too expensive’, ‘too heavy’, ‘uncomfortable’, and two people said they would not want to wear it for more than one day. All adults with ID (11) and their support workers (6) provided information about their physical activity levels through the IPAQ-s. Conclusions: Care home managers are a barrier to research participation. However, adults with ID would be happy for the IPAQ-s as a PA measure, but less so for the 7-day accelerometer monitoring. In order to improve participation in this population, the choice of PA measure is considered important. Moreover, there is a need for studies exploring how best to engage ID residential home managers in PA research.

Keywords: intellectual disability, physical activity measurement, research engagement, research participation

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Authors: Changaiz Khan

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Pakistan has the highest rates of maternal mortality in South Asia. From the year 2000 to 2017 the global rate of maternal mortality has decreased up to 39 %. In the context of South Asia, it has decreased by 59% since 2000s. Pakistan has also reduced the rate of maternal mortality, but there is a difference on the provincial level. According to the report of the National Institute of Population Studies (NIPS) conducted in 2020, the MMR in Balochistan has crossed the ratio of most of the South Asian countries, i.e., 298 maternal deaths per 100,000 live births. In comparison, the province of Punjab has the lowest maternal mortality rate i.e. 157 deaths (per 100,000 live births). The rate of maternal mortality is much higher in Balochistan as compared to the other provinces. This research is aimed to discuss the supply side barriers and utilization of maternal healthcare services in the District Gwadar. Likert scale survey method has been used to collect data from the Healthcare Professionals from hospitals -private and government- and the maternal healthcare receiver, that is patient. Semi-structured interviews of healthcare professionals such as doctors, nurses, and Lab technicians have also been conducted. It has been found in this research study that the hospitals in Gwadar district are lagging behind in providing modern maternal healthcare to women due to the lack of staff training, medicine supply, and Laboratories. Moreover, the system of the lady health worker is also not catering to the needs of the women in District Gwadar. It has been recommended in the study that first of all the government should fulfill the supply of the medicine in the hospital. Secondly, the government should open laboratories in the hospitals. Thirdly, the government should increase the funding of the government hospital and the allocation of lady health workers in District Gwadar, Balochistan should be increased.

Keywords: maternal mortality, neonatal, postnatal, supply barriers, patients, healthcare professionals, laboratory, medical supply, training

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Authors: Mary-Ellen Hooper, Graeme Browne, Anthony Paul O'Brien

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Background: It has been reported that the experience of the organisational workplace culture for new graduate mental health nurses plays an important role in their attraction and retention to the discipline. Additionally, other research indicates that a negative workplace culture contributes to their dissatisfaction and attrition rate. Method: An ethnographic research design was applied to explore the subcultural experiences of new graduate nurses as they encounter mental health nursing. Data was collected between April and September 2017 across 6 separate Australian, NSW, mental health units. Data comprised of semi-structured interviews (n=24) and 31 episodes of field observation (62 hours). A total number of 26 new graduate and recent graduate nurses participated in the study – 14 new graduate nurses and 12 recently graduated nurses. Results: A key finding from this study was the New Graduate difficulty in articulating the role the of mental health nurse. Participants described a dichotomy between their ideological view of the mental health nurse and the reality of clinical practice. The participants’ ideological view of the mental health nurse involved providing holistic and individualised care within a flexible framework. Participants, however, described feeling powerless to change the recovery practices within the mental health service(s) because of their low status within the hierarchy. Resulting in participants choosing to fit into the existing culture, or considering leaving the field altogether. Conclusion: An incongruence between the values and ideals of an organisational culture and the reality shock of practice are shown to contribute to role ambiguity within its members. New graduate nurses entering the culture of mental health nursing describe role ambiguity resulting in dissatisfaction with practice. The culture and philosophy inherent to a service are posited to be crucial in creating positive experiences for graduate nurses.

Keywords: culture, mental health nurse, mental health nursing role, new graduate nurse

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Authors: Noor Ashikin Omar

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The rapid growth and advancement in information and communication technology (ICT) at a global scene has greatly influenced and revolutionised interaction amongst society. The use of ICT has become second nature in managing everyday lives, particularly in the education environment. Traditional learning methods of using blackboards and chalks have been largely improved by the use of ICT devices such as interactive whiteboards and computers in school. This paper aims to explore the impacts of virtual learning environments (VLE) on teacher’s pedagogy and student’s learning in primary school settings. The research was conducted in two phases. Phase one of this study comprised a short interview with the school’s senior assistants to examine issues and challenges faced during planning and implementation of FrogVLE in their respective schools. Phase two involved a survey of a number of questionnaires directed to three major stakeholders; the teachers, students and parents. The survey intended to explore teacher’s and student’s perspective and attitude towards the use of VLE as a teaching and learning medium and as a learning experience as a whole. In addition, the survey from parents provided insights on how they feel towards the use of VLE for their child’s learning. Collectively, the two phases enable improved understanding and provided observations on factors that had affected the implementation of the VLE into primary schools. This study offers the voices of the students which were frequently omitted when addressing innovations as well as teachers who may not always be heard. It is also significant in addressing the importance of teacher’s pedagogy on students’ learning and its effects to enable more effective ICT integration with a student-centred approach. Finally, parental perceptions in the implementation of VLE in supporting their children’s learning have been implicated as having a bearing on educational achievement. The results indicate that the all three stakeholders were positive and highly supportive towards the use of VLE in schools. They were able to understand the benefits of moving towards the modern method of teaching using ICT and accept the change in the education system. However, factors such as condition of ICT facilities at schools and homes as well as inadequate professional development for the teachers in both ICT skills and management skills hindered exploitation of the VLE system in order to fully utilise its benefits. Social influences within different communities and cultures and costs of using the technology also has a significant impact. The findings of this study are important to the Malaysian Ministry of Education because it informs policy makers on the impact of the Virtual Learning Environment (VLE) on teacher’s pedagogy and learning of Malaysian primary school children. The information provided to policy makers allows them to make a sound judgement and enables an informed decision making.

Keywords: attitudes towards virtual learning environment (VLE), parental perception, student's learning, teacher's pedagogy

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Authors: Elif Berna Var

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Cultural, physical, socio-economic, or politic changes occurred in urban areas might be resulted in the decaying period which may cause social problems. As a solution to that, urban renewal projects have been used in European countries since World War II whereas they have gained importance in Turkey after the 1980s. The first attempts were mostly related to physical or economic aspects which caused negative effects on social pattern later. Thus, social concerns have also started to include in renewal processes in developed countries. This integrative approach combining social, physical, and economic aspects promotes creating more sustainable neighbourhoods for both current and future generations. However, it is still a new subject for developing countries like Turkey. Concentrating on Trabzon-Turkey, this study highlights the importance of socially sustainable urban renewal processes especially in historical neighbourhoods where protecting the urban identity of the area is vital, as well as social structure, to create sustainable environments. Being in the historic city centre and having remarkable traditional houses, Ortahisar is an important image for Trabzon. Because of the fact that architectural and historical pattern of the area is still visible but need rehabilitations, it is preferred to use 'urban rehabilitation' as a way of urban renewal method for this study. A project is developed by the local government to create a secondary city centre and a new landmark for the city. But it is still ambiguous if this project can provide social sustainability of area which is one of the concerns of the research. In the study, it is suggested that social sustainability of an area can be achieved by several factors. In order to determine the factors affecting the social sustainability of an urban rehabilitation project, previous studies have been analysed and some common features are attempted to define. To achieve this, firstly, several analyses are conducted to find out social structure of Ortahisar. Secondly, structured interviews are implemented to 150 local people which aims to measure satisfaction level, awareness, the expectation of them, and to learn their demographical background in detail. Those data are used to define the critical factors for a more socially sustainable neighbourhood in Ortahisar. Later, the priority of those factors is asked to 50 experts and 150 local people to compare their attitudes and to find common criterias. According to the results, it can be said that social sustainability of Ortahisar neighbourhood can be improved by considering various factors like quality of urban areas, demographical factors, public participation, social cohesion and harmony, proprietorial factors, facilities of education and employment. In the end, several suggestions are made for Ortahisar case to promote more socially sustainable urban neighbourhood. As a pilot study highlighting the importance of social sustainability, it is hoped that this attempt might be the contributory effect on achieving more socially sustainable urban rehabilitation projects in Turkey.

Keywords: urban rehabilitation, social sustainability, Trabzon, Turkey

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Authors: Richard Grant, Landolf Rhode-Barbarigos, Shouraseni Sen Roy, Lucas Brittan, Change Li, Aiden Rowe

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Ports are critical for the US economy, connecting farmers, manufacturers, retailers, consumers and an array of transport and storage operators. Port facilities vary widely in terms of their productivity, footprint, specializations, and governance. In this context, Port Miami is considered as one of the busiest ports providing both cargo and cruise services in connecting the wider region of the Caribbean and Mesoamerica to the global networks. It is considered as the “Cruise Capital of the World and Global Gateway of the Americas” and “leading container port in Florida.” Furthermore, it has also been ranked as one of the top container ports in the world and the second most efficient port in North America. In this regard, Port Miami has made significant investments in the strategic and capital infrastructure of about US$1 billion, including increasing the channel depth and other onshore infrastructural enhancements. Therefore, this study involves a detailed analysis of Port Miami’s network, using publicly available multiple years of data about marine vessel traffic, cargo, and connectivity and performance indices from 2015-2021. Through the analysis of cargo and cruise vessels to and from Port Miami and its relative performance at the global scale from 2015 to 2021, this study examines the port’s long-term resilience and future growth potential. The main results of the analyses indicate that the top category for both inbound and outbound cargo is manufactured products and textiles. In addition, there are a lot of fresh fruits, vegetables, and produce for inbound and processed food for outbound cargo. Furthermore, the top ten port connections for Port Miami are all located in the Caribbean region, the Gulf of Mexico, and the Southeast USA. About half of the inbound cargo comes from Savannah, Saint Thomas, and Puerto Plata, while outbound cargo is from Puerto Corte, Freeport, and Kingston. Additionally, for cruise vessels, a significantly large number of vessels originate from Nassau, followed by Freeport. The number of passenger's vessels pre-COVID was almost 1,000 per year, which dropped substantially in 2020 and 2021 to around 300 vessels. Finally, the resilience and competitiveness of Port Miami were also assessed in terms of its network connectivity by examining the inbound and outbound maritime vessel traffic. It is noteworthy that the most frequent port connections for Port Miami were Freeport and Savannah, followed by Kingston, Nassau, and New Orleans. However, several of these ports, Puerto Corte, Veracruz, Puerto Plata, and Santo Thomas, have low resilience and are highly vulnerable, which needs to be taken into consideration for the long-term resilience of Port Miami in the future.

Keywords: port, Miami, network, cargo, cruise

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Authors: Rosalina Penaloza, Joanna Navarro, Pauline Jolly, Anna Junkins, Carlos Seas, Larissa Otero

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Background: Tuberculosis (TB) case detection in Peru relies on passive case finding. This strategy relies on the assumption that the community is aware that a persistent cough is a possible symptom of TB and that formal health care needs to be sought. Despite its importance, health knowledge specific to TB is underexplored in Peru. This study aimed to assess health literacy and level of TB knowledge among outpatients attending a referral hospital in Lima, Peru. The goal was to ascertain knowledge gaps in key areas relating to TB, to identify and prioritize subgroups for intervention, and to provide insight for policy and community interventions considering health literacy. Methods: An observational cross-sectional study was conducted using a survey to measure sociodemographic factors, tuberculosis knowledge, and health literacy. Bivariate and Multivariate logistic regression was performed to study the associations between variables and to account for potential confounders. The study was conducted at Hospital Cayetano Heredia in Lima, Peru from June – August 2017. Results: 272 participants were included in the analysis. 57.7% knew someone who had had TB before, 9% had had TB in the past. Two weeks a cough was correctly identified as a symptom that could be TB by 69.1%. High TB knowledge was found among 149 (54.8%) participants. High health literacy was found among 193 (71.0%) participants. Health literacy and TB knowledge were not significantly associated (OR 0.9 (95%CI 0.5-1.5)). After controlling for sex, age, district, education, health insurance, frequency of hospital visits and previous TB diagnosis: High TB knowledge was associated with knowing someone with TB (aOR 2.7 (95%CI 1.6-4.7)) and being a public transport driver, (aOR 0.2 (95%CI 0.05-0.9)). Not being poor was the single factor associated with high health literacy (aOR 3.8 (95%CI 1.6-8.9)). Conclusions: TB knowledge was fair, though 30% did not know the most important symptom of TB. Tailoring educational strategies to risk groups may enhance passive case detection especially amongst transport workers in Lima, Peru.

Keywords: health literacy, Peru, tuberculosis, tuberculosis knowledge

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Authors: Getaneh Berie Tarekegn

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A precise localization system is crucial for many artificial intelligence Internet of Things (AI-IoT) applications in the era of smart cities. Their applications include traffic monitoring, emergency alarming, environmental monitoring, location-based advertising, intelligent transportation, and smart health care. The most common method for providing continuous positioning services in outdoor environments is by using a global navigation satellite system (GNSS). Due to nonline-of-sight, multipath, and weather conditions, GNSS systems do not perform well in dense urban, urban, and suburban areas.This paper proposes a generative AI-based positioning scheme for large-scale wireless settings using fingerprinting techniques. In this article, we presented a semi-supervised deep convolutional generative adversarial network (S-DCGAN)-based radio map construction method for real-time device localization. It also employed a reliable signal fingerprint feature extraction method with t-distributed stochastic neighbor embedding (t-SNE), which extracts dominant features while eliminating noise from hybrid WLAN and long-term evolution (LTE) fingerprints. The proposed scheme reduced the workload of site surveying required to build the fingerprint database by up to 78.5% and significantly improved positioning accuracy. The results show that the average positioning error of GAILoc is less than 0.39 m, and more than 90% of the errors are less than 0.82 m. According to numerical results, SRCLoc improves positioning performance and reduces radio map construction costs significantly compared to traditional methods.

Keywords: location-aware services, feature extraction technique, generative adversarial network, long short-term memory, support vector machine

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Authors: E. Xavier, B. Nandita

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Rohingyas are an ethnic and religious minority that resides in the Rakhine State of Myanmar. Post the military coup in 1962, Rohingyas have not been recognized as one of the ethnic tribes of Burma under the legislation. They have lost citizenship, education, health care rights, and instantly became illegal immigrants. While the historicization of this conflict is crucial, this paper wants to humanize the Rohingya population’s embodiment of violence on three different levels – individual, social, and political. In addition, the study focuses on their liminal existence in refugee camps in Bangladesh and in other parts of the world, such as Malaysia and the United States of America. A multi-medium study, it includes first-hand interviews with the Rohingya community in Wisconsin and Chicago, second-hand interviews from documentaries and past ethnographies from scholars to draw meaningful conclusions about their experience as a community. In the end, it focuses on the group of Rohingyas who have managed to resettle in another country and their transitioning experience. Rohingyas embody violence on their individual, social, and political bodies in different ways. Along with rape, murder, and physical harm, the community also encounters sexually transmitted infections, post-traumatic stress disorder symptoms, and poor mental health. On a social level, they encounter heightened gender discrimination, work industry shifting, and immense, shared emotional pain. As for their political body, the news media and journalism industry uses their bodies for purposes that benefit both parties and flirts with a tone of sensationalism in their reporting. In addition, the Rohingya community fluctuates with the concept of nationality, patriotism, citizenship, and refugee when they think about the future. This study provides a framework that future aid or health programs can use to determine the type of community need and its significance in the Rohingya community.

Keywords: embodiment, liminal, refugee, Rohingya

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Authors: Elvis Nyirenda

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This research study work was done to evaluate and propose an optimum measure to enhance the uptake of clean energy technologies such as solar photovoltaics, the study also aims at enhancing the country’s energy mix from the overdependence on hydro power which is susceptible to droughts and climate change challenges The country in the years 2015 - 2016 and 2018 - 2019 had received rainfall below average due to climate change and a shift in the weather pattern; this resulted in prolonged power outages and load shedding for more than 10 hours per day. ZESCO Limited, the utility company that owns infrastructure in the generation, transmission, and distribution of electricity (state-owned), is seeking alternative sources of energy in order to reduce the over-dependence on hydropower stations. One of the alternative sources of energy is Solar Energy from the sun. However, solar power is intermittent in nature and to smoothen the load curve, investment in robust energy storage facilities is of great importance to enhance security and reliability of electricity supply in the country. The methodology of the study looked at the historical performance of the Kafue gorge upper power station and utilised the hourly generation figures as input data for generation modelling in Homer software. The average yearly demand was derived from the available data on the system SCADA. The two dams were modelled as natural battery with the absolute state of charging and discharging determined by the available water resource and the peak electricity demand. The software Homer Energy System is used to simulate the scheme incorporating a pumped storage facility and Solar photovoltaic systems. The pumped hydro scheme works like a natural battery for the conservation of water, with the only losses being evaporation and water leakages from the dams and the turbines. To address the problem of intermittency on the solar resource and the non-availability of water for hydropower generation, the study concluded that utilising the existing Hydro power stations, Kafue Gorge upper and Kafue Gorge Lower to work conjunctively with Solar energy will reduce power deficits and increase the security of supply for the country. An optimum capacity of 350MW of solar PV can be integrated while operating Kafue Gorge power station in both generating and pumping mode to enable efficient utilisation of water at Kafue Gorge upper Dam and Kafue Gorge Lower dam.

Keywords: hydropower, solar power systems, energy storage, photovoltaics, solar irradiation, pumped hydro storage system, supervisory control and data acquisition, Homer energy

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Authors: Sankalpa Satapathy

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The stigma attached to disability is very high in India and given its patriarchal society women and their interests have always been pushed to the background. The identity of disabled women is compromised under the social construction of disability which lowers their self-esteem and hampers their development. Disability policies in India have focused on provision of educational and employment opportunities to make them economically productive members of the society. This preoccupation with the materialistic spheres of lives of the disabled has led to a neglect of the private sphere concerning intimate social relationships and motherhood. This paper seeks to bring to forefront the private lives of disabled women. Semi-structured in-depth interviews were conducted with twenty seven women with physical disability (congenital/acquired) from Odisha, a state in India. Sampling was done in a manner to include women from various strata of the society to allow meaningful analysis. In a society where paramount importance is attached to wifehood and motherhood, the chances of marriage for disabled women were very low compared to disabled men. Majority believed that marriage and having a family was meant for non disabled women and had decided against getting married. Socialization process was found to be a major factor in determining the ideas and aspirations of disabled women. They were clearly sidelined by their families on the issue of marriage. Education and employment levels did not seem to increase the appeal of disabled women to prospective suitors. But not all the women interviewed were closed to the idea of intimate relationships and marriage. Disabled women who were married or hoped to get married in future were found to have a better body image and greater self motivation. It is interesting to understand the means by which these women, who have been brought up to internalize ideas of their unattractiveness, undesirability, asexuality and inability to care, established identities which have so long been denied to them. With these stories of personal triumphs an attempt is made for reclamation of private spheres which have been abandoned by disability policies and make them gender sensitive.

Keywords: disability, gender, marriage, relationships

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Authors: Vinay Mishra, Meena Malkani

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Objectives: To study the effect of physical maternal nutritional markers (viz. weight, height, gestational weight gain, BMI) and third-trimester haemoglobin concentration on anthropometry and cord blood haemoglobin of their newborn. Methods: Study area: Post-natal ward of a tertiary care hospital in an urban area. Study population: All post-partum women and their newborns. Sample size: 100. Maternal and neonatal data and anthropometric measurements were recorded in semi-structured case proforma. Data analysis: The data obtained was analysed using SPSS 20 software.The comparison between the groups was done using One-Way Analysis of Variance for two groups. For more than two groups comparisons further posthoc analysis was done using Tukey test. Pearson correlation coefficient was used for correlating the variables. A P value less than 0.05 was considered significant. Results: 1. Out of the 100 studied mothers, 52% were anaemic. 2. Cord blood haemoglobin values decreased significantly with the order of birth. 3. Cord blood haemoglobin of normal-weight newborns is significantly higher as compared to that of LBW newborns. 4. Cord blood haemoglobin has strong statistical significance with maternal anaemia. 5. Pre-pregnancy weight and gestational weight gain significantly influence the neonates anthropometry. Conclusions: 1. Birth order has a prominent inverse effect on the cord blood haemoglobin. 2. Majority of the expectant mothers are anaemic and give birth to LBW babies with reduced anthropometric markers. 3. Pre-pregnancy weight, height and gestational weight gain has a very significant impact on the neonatal anthropometry. 4. Thus, maternal nutrition during gestation and during the crucial periods of growth in the pre-child bearing age group has a very significant impact on foetal development.

Keywords: maternal nutrition, anthropometry, cord blood hemoglobin, newborn

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Authors: Danila Zuffetti, Lorenzo Chiesa

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Background: A hospice narrative interview aims at putting the sick at the core of disease and treatment allowing them to explore their most intimate facets. The aim of this work is to favor authentic narration by leading towards awareness and acceptance of terminality and to face death with serenity. Narration in palliative care aims at helping to reduce the chaos generated by the disease and to elaborate interpretations on the course of reality, besides, the narration delivered to the doctor is fundamental and communicates the meaning given to symptoms. Methods: The narrative interview has become a regular activity in the Castellini Foundation since 2017. Patients take part every week, and for more days, in one hour sessions, in a welcoming and empathic setting and the interaction with the operator leads to a gradual awareness of their terminality. Patients are submitted with free answer questions with the purpose of facilitating and stimulating self-narration. Narration has not always been linear, but patients are left free to shift in time to revisit their disease process by making use of different tools, such as digital storytelling. Results: The answers provided by the patients show to which extent the narrative interview is an instrument allowing the analysis of the stories and gives the possibility to better understand and deepen the different implications of patient and caregiver’s background. Conclusion: The narration work in the hospice demonstrates that narrative medicine is an added value. This instrument has proven useful not only in the support of patients but also for the palliative doctor to identify wishes for accompanying them to the end with dignity and serenity. The narrative interview favors the construction of an authentic therapeutic relationship. The sick are taken wholly in charge, and they are guaranteed a high quality of life until their very last instant.

Keywords: construction of an authentic therapy relationship, gradual awareness of their terminality, narrative interview, reduce the chaos generated by the desease

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Authors: Dung Jidong, Rachel Tribe, Poul Rohlerder, Aneta Tunariu

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Cultural understandings of mental health problems are frequently overshadowed by the western conceptualizations. Research on culture and mental health in the Nigerian context seems to be lacking. This study examined the linguistic understandings and cultural beliefs that have implications for mental health among the Berom, Hausa, Yoruba and Igbo people of Nigeria. A purposive sample of 53 participants underwent semi-structured interviews that lasted approximately 55 minutes each. Of the N=53 participants, n=26 were psychology-aligned practitioners and n=27 ‘laypersons’. Participants were recruited from four states in Nigeria, Plateau, Kaduna, Ekiti, and Enugu. All participants were self-identified as members of their ethnic groups who speak and understand their native-languages, cultural beliefs, and also are domiciled within their ethnic communities. Thematic analysis using socio-constructionism from a critical-realist position was employed to explore the participants’ beliefs about mental health, and the clash between western trained practitioners’ views and the cultural beliefs of the ‘laypersons’. Data analysis found three main themes that re-emerged across the four ethnic samples: (i) beliefs about mental health problems as a spiritual curse (ii) traditional and religious healing are used more often than western mental health care (iii) low levels of mental health awareness. In addition, the Nigerian traditional and religious healing are also revealed to be helpful as the practice gives prominence to the native-languages, religious and cultural values. However, participants described the role of ‘false’ traditional or religious healers in communities as being potentially harmful. Finally, due to the current lack of knowledge about mental health problems, awareness creation and re-orientation may be beneficial for both rural and urban Nigerian communities.

Keywords: beliefs cultures, health mental, languages religions, values

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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: Sanjeev Singh

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Background: Obstructed total anomalous pulmonary venous connection (OTAPVC) typically presents with severe cardiovascular decompensation and requires urgent surgical management. Pulmonary arterial hypertension (PAH) is a major risk factor affecting mortality. Perioperative management focuses on providing inotropic support and managing potential pulmonary hypertensive episodes. The aim of this study was to determine the outcome of patients with high pulmonary arterial pressure (PAP) with milrinone alone and a combination of milrinone and inhaled nitric oxide (INO). Material and Methods: After the approval of the ethical committee, this single-center prospective randomized and observational study was conducted over a period of two years among eighty-six patients with obstructed TAPVC repair with severe PAH. Group-I patients received milrinone, and Group-II patients received both milrinone (after aortic cross-clamp removal) and INO during the post-operative period at the cardiac care unit (CCU). Clinical outcomes such as ventilation time, length of stay (LOS) in the CCU, LOS in the hospital, complications, and hospital mortality were compared between the two groups. Result: The average ventilation time, LOS in CCU, and LOS in hospital for group I were 96.82 ± 19.46 hours, 10.91 ± 7.53 days, and 14.46 ± 7.58 days, respectively, and for group II, it was 85.14 ± 15.79 hours, 7.28 ± 3.68 days, and 10.21 ± 3.14 days, respectively, which was statistically significantly lower for group II. Reintubation, RV dysfunction, and hospital mortality were 16.3%, 37.2%, and 6.9% in group I, and 4.8%, 14.6%, and 2.4% in group II, respectively. The P value for each variable was significant < 0.05 (except mortality). Conclusion: Preoperative obstruction is a risk factor for postoperative obstruction, as 235 patients with obstructed TAPVC had severe PAH (39.98%) in this study. Management of severe PAH with a combination of milrinone and INO had a better outcome than milrinone alone.

Keywords: inhaled nitric oxide, milrinone, pulmonary artery hypertension, total anomalous pulmonary venous connection

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Authors: Mohamed Elkoushy, Sameer Munshi, Waseem Tayeb

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Background: Flexible ureteroscopy (fURS) has dramatically improved the minimally invasive management of complex nephrolithiasis. fUR is increasingly being used as the first-line treatment for patients with renal stones. Stone-free status (SFS) is the primary goal in the management of patients with urolithiasis. However, substantial variations exist in the reported SFS following fURS. Objectives: This study determines the predictors of SFS after a single session of fURS with holmium laser lithotripsy (HLL) for renal calculi. Methods: A retrospective review of prospectively collected data was performed for all consecutive patients undergoing fURS and HLL for renal calculi at a tertiary care center. Patients with previous ipsilateral URS for the same stones were excluded. All patients underwent JJ ureteral stent insertion at the end of the procedure. SFS was defined as the presence of no residuals or ≤4-mm non-obstructing stone and was assessed by CT/KUB imaging after 3-4 weeks post-operatively. Multivariate logistic regression was used to detect possible predictors of SFS. Results: A total of 212 patients were included with a mean age of 52.3±8.3 years and a stone burden <20 mm (49.1%), 20-30 mm (41.0%) and >30 mm (9.9%). Overall SFS after a single session of fURS was 71.7%, 92% and 52% for stones less and larger than 20 mm, respectively. Patients with stones> 20 mm need retreatment with a mean number of 1.8 (1.3-2.7) fURS. SFS was significantly associated with male gender, stone bulk <20 mm (95.7% vs. 56.2%), non-lower pole stones, hydronephrotic kidney, low stone intensity, ureteral access sheath, and preoperative stenting. SFS was associated with a lower readmission rate (5.9% vs. 38.9%) and urinary tract infections (3.8% vs. 25.9%). In multivariate regression analysis, SFS maintains its significant association with low stone burden of <20 mm (OR: 5.21), stone intensity <600 HFU (OR: 2.87), and non-lower caliceal stones (OR: 3.84). Conclusion: Best results after a single-session fURS for renal stone were obtained for the stone burden of less than 20 mm and low stone attenuation. Lower calyceal stones may influence stone clearance and need a different approach than fURS, especially for higher stone burden.

Keywords: ureteroscopy, kidney stone, lithotripsy, stone-free, predictors

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Authors: David Maman, David E. Rothem, Merav Ben Natan, Yaron Berkovich

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Introduction: Hip fractures are a major health concern due to their impact on disability, independence, and mortality. Timely rehabilitation is crucial for improving patient outcomes and reducing healthcare costs, yet delays in rehabilitation, often due to challenges in discharge processes, can lead to adverse events and increased healthcare burdens. Aim: The study aimed to investigate two primary aspects related to hip fracture older adults patients: firstly, identifying subgroups more prone to delayed discharge for further rehabilitation; and secondly, exploring the consequences of this delay on short-term outcomes and the incidence of adverse events. Methods: Conducting a retrospective analysis, we examined the medical records of 474 patients aged 65 and older, hospitalized for hip fractures between 2018 and 2022 in a major hospital in the north-central region of Israel. All patients were eligible for further rehabilitation, including options for in-patient or home-based care. Results: Of the studied patients, 61.4% experienced delayed discharge, with an average waiting period of 3.5 days. Factors such as older age, prolonged hospital stay, and the need for in-patient rehabilitation were associated with a higher likelihood of delayed discharge. Those promptly discharged demonstrated lower rates of infections, falls, and mortality. Furthermore, delayed discharge to further rehabilitation correlated with elevated hospitalization costs. Notably, no significant differences were observed in re-hospitalization or repeat surgery rates. Conclusion: This study underscores the pressing need for efficient strategies to ensure timely rehabilitation, particularly for older adults. Implementing such strategies can optimize outcomes, mitigate adverse events, and contribute to a reduction in healthcare costs.

Keywords: hip fracture rehabilitation, delayed discharge, older adults, healthcare coordination, adverse events

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Authors: Sarinra Thongmee, Krittaporn Prakobsaeng, Adithep Mingsuan, Chanyapak Polkhet, Supattra Wongsuk

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The purposes of this research and developmentwasto develop and evaluation of the clinical nursingpractice guideline (CNPG) for the prevention infection during intubation in patient with suspected or confirmedCOVID-19 patient. This study was developed by using the evidencebased practice model of Soukup (2000) asa conceptual framework. The study consisted of 4 steps: 1) situational analysis of intubation service in patientswith confirmed COVID-19; 2) development of the CNPG; 3) apply the NPG to trial; and 4) evaluation of the CNPG. The sample consisted of 52 nurse anesthetists and 25 infected or suspected COVID-19 patients. The research instrument consisted of 1) the CNPG, which was developed by the researchers; 2) the nurses anesthetist opinion questionnaire to the guideline; 3) the evaluation practice form; and 4) the nurse anesthetist knowledge test on nursing care of patients infected with COVID-19. Data were analyzed by using descriptive statistics, and Wilcoxon matched-pairs signed rank test. The results revealed this developed CNPG consists of 4 sections: 1)the CNPG for airborne precautions2) the preparation of anesthetic and intubation equipments3) the roles and duties of the intubation team, 4) the guidelines for intubation in suspected or confirmed COVID-19 patients. The results of CNPG use found that 1)the provider: using NPG in providers revealed that nurse anesthetist had a higher mean of knowledge scores than before using CNPG statistically significant at the 0.05 level (p<0.01) and able to follow the NPG 100% inall activities. The anesthetic team was not infected with COVID-19 from intubation outside the operating room. 2)the client: the patient was safe, with no complications from intubation. Summary CNPG to prevent infection during reintubation of suspected or confirmedCOVID-19patient was appropriate and applicable to practice.

Keywords: clinical nursing practice guideline, prevention of infection, endotracheal intubation, COVID-19

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Authors: Elkington S. Mnguni

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Water and sanitation services in South Africa are characterized by both achievements and challenges. After the end of apartheid in 1994 the newly elected government faced the challenge of eradicating backlogs with respect to access to basic services, including water and sanitation. Capital investment made in the development of new water and sanitation infrastructure to provide basic services to previously disadvantaged communities has grown, to a certain extent, at the expense of investment in the operation and maintenance of new and existing infrastructure. Challenges resulting from aging infrastructure and poor plant performance highlight the need for investing in the maintenance, rehabilitation, and replacement of existing infrastructure to optimize the return on investment. Advanced water infrastructure asset management (IAM) is key to achieving adequate levels of service, particularly with regard to reliable and high quality drinking water supply, prevention of urban flooding, efficient use of natural resources and prevention of pollution and associated risks. Against this backdrop, this paper presents an appraisal of water and sanitation IAM systems in South Africa’s three utilities, being metropolitan cities in the Gauteng Province. About a quarter of the national population lives in the three rapidly urbanizing cities of Johannesburg, Ekurhuleni and Tshwane, located in a semi-arid region. A literature review has been done and field visits to some of the utility facilities are being conducted. Semi-structured interviews will be conducted with the three utilities. The following critical factors are being analysed in terms of compliance with the national Water Services IAM Strategy (2011) and other applicable legislation: asset registers; capacity of assets; current and predicted demand; funding availability / budget allocations; plans: operation & maintenance, renewal & replacement, and risk management; no-drop status (non-revenue water levels); blue drop status (water quality); green drop status (effluent quality); and skills availability. Some of the key challenges identified in the literature review include: funding constraints, Skills shortage, and wastewater treatment plants operating beyond their design capacities. These challenges will be verified during field visits and research interviews. Gaps between literature and practice will be identified and relevant recommendations made if necessary. The objective of this study is to contribute to the resolution of the challenges brought about by the backlogs in the operation and maintenance of water and sanitation assets in the country in general, and in the three cities in particular, thus improving the sustainability thereof.

Keywords: asset management, backlogs, levels of service, sustainability, water and sanitation infrastructure

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Authors: Oluwasaanmi Lawrence Adesuyi, Igbekoyi Kayode Emmanuel

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This study examined vote - commercialization during elections among the voters in Nigeria, a series of elections in Ekiti State, Southwestern Nigeria. Democracy in Nigeria that came to replace the unwanted ruling and dictating mission of the military government has been facing a societal terror “crime of votes commercialization” that stands in jeopardy against its sustainability in Nigeria. Social exchange and action-bound theories were employed as the theoretical framework. Forty-Eight in-depth interviews, key informant interviews, and case studies were conducted with purposively selected respondents in the three senatorial districts that captured the sixteen local governments of the state. The results show that really commercialization of votes has become the order of the day in all series of electioneering among Ekiti people. Also, it was recorded that true democracy is no longer allowed to triumph as a result of vote buying that allows the highest bidder to be the winner. The result also shows that this attitude is not limited to only one political party or one candidate but involved all the political parties that participated in Election. It has become a frequent idea among the electorates during every festive period of election in Ekiti State. The tyrannical attitude has been given a nickname to suit the conditional situation of votes commercialization - (Diboki o se obe), which means vote and have a pot of soup, this implies that you will get money to take care of yourself and the family when you vote and collect money on the vote you cast, notwithstanding the money is being collected from all candidates that participated in the election, but the highest bidder has the day. The main challenge this has on democracy is that the contestants challenge the result of the election results based on the act of vote commercialization. Also, those that bought people’s votes with a huge amount of money relent on their democratic promises. The study showed that the crime of vote commercialization that threatens democracy must be addressed for sustainability.

Keywords: crime, democracy, jeopardy, military, sustainability, votes-commercialization

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Authors: Hauwau Mohammed

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Research purpose: the integration of Traditional Birth Attendants (TBAs) has long been initiated into healthcare systems. This has been to help improve maternal mortality, particularly in developing countries. Nigeria is seen as one of the countries with a high maternal death rate due to common pregnancy complications and low resources. Communities with challenges of universal coverage of skilled workers rely on TBAs for pregnancy-related services, including delivery. The Sokoto State government has conducted several training programs on a significant number of TBAs to enable a formal integration of relationships with skilled healthcare for women in rural regions. This study aims to explore a standard method and develop an assessment framework for improving TBAs training programs in Sokoto State. Research Design, Methodology & Methods : Using a qualitative design, an interpretive phenomenology approach will be applied to explore the lived-experiences of 28 TBAs, who have undergone a form of training while also examining the strategies used to develop those programs through 8 policymakers and/or program trainers. For the collection stage, a focus group discussion and a face-to-face interview will be conducted, where the latter is for TBAs and the former for policymakers and training officials. Analysis: Data will be analyse through IPA format while using Nvivo to code and catalog personal experiential generated patterns. Secondary review: a scoping review of secondary data from Nigeria was used to map the knowledge gap and the extent of available data. The thematic analytic findings suggested that there are various approaches used to incorporate TBAs into the healthcare system, which include interventional programs targeted at specific health issues. In addition, incentives were used to encourage TBAs to facilitate the frequent use of skilled care for women.

Keywords: traditional birth attendants, Nigeria, training, program

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Authors: S. Hammoudeh, S. Ghuloum, A. Abdelhakam, A. AlMujalli, M. Opler, Y. Hani, A. Yehya, S. Mari, R. Elsherbiny, Z. Mahfoud, H. Al-Amin

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Introduction: Suicidal ideation and attempts are very common in patients with schizophrenia and still contributes to the high mortality in this population. The InterSePT Scale for Suicidal Thinking (ISST) is a validated tool used to assess suicidal ideation in patients with schizophrenia. This research aims to validate the Arabic version of the ISST among the Arabs residing in Qatar. Methods: Patients diagnosed with schizophrenia were recruited from the department of Psychiatry, Rumailah Hospital, Doha, Qatar. Healthy controls were recruited from the primary health care centers in Doha, Qatar. The validation procedures including professional and expert translation, pilot survey and back translation of the ISST were implemented. Diagnosis of schizophrenia was confirmed using the validated Arabic version of Mini International Neuropsychiatric Interview (MINI 6, module K) for schizophrenia. The gold standard was the module B on suicidality from MINI 6 also. This module was administered by a rater who was blinded to the results of ISST. Results: Our sample (n=199) was composed of 98 patients diagnosed with schizophrenia (age 36.03 ± 9.88 years; M/F is 2/1) and 101 healthy participants (age 35.01 ± 8.23 years; M/F is 1/2). Among patients with schizophrenia: 26.5% were married, 17.3% had a college degree, 28.6% were employed, 9% had committed suicide once, and 4.4% had more than 4 suicide attempts. Among the control group: 77.2% were married, 57.4% had a college degree, and 99% were employed. The mean score on the ISST was 2.36 ± 3.97 vs. 0.47 ± 1.44 for the schizophrenia and control groups, respectively. The overall Cronbach’s alpha was 0.91. Conclusions: This is the first study in the Arab world to validate the ISST in an Arabic-based population. The psychometric properties indicate that the Arabic version of the ISST is a valid tool to assess the severity of suicidal ideation in Arabic speaking patients diagnosed with schizophrenia.

Keywords: mental health, Qatar, schizophrenia, suicide

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