Search results for: health justice and access

Authors: A. P. Pashkov

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The number of environmental factors that adversely affect children's health is growing every year; their combination in each territory is different. The contribution of socio-economic factors to the health status of the younger generation is increasing. It is the child’s body that is most sensitive to changes in environmental conditions, responding to this with a deterioration in health. Over the past years, scientists have determined the influence of environmental factors and the incidence of children. Currently, there is a tendency to study regional characteristics of the interaction of a combination of environmental factors with the child's body. The aim of the work was to identify trends in the primary non-infectious morbidity of the children of the Altai Territory as a unique region that combines territories with different levels of environmental quality indicators, as well as to assess the effect of atmospheric air, drinking water and socio-economic indicators on the incidence of children in the region. An unfavorable tendency has been revealed in the region for incidence of such nosological groups as neoplasms, including malignant ones, diseases of the endocrine system, including obesity and thyroid disease, diseases of the circulatory system, digestive diseases, diseases of the genitourinary system, congenital anomalies, and respiratory diseases. Between some groups of diseases revealed a pattern of geographical distribution during mapping and a significant correlation. Some nosologies have a relationship with socio-economic indicators for an integrated assessment: circulatory system diseases, respiratory diseases (direct connection), endocrine system diseases, eating disorders, and metabolic disorders (feedback). The analysis of associations of the incidence of children with average annual concentrations of substances that pollute the air and drinking water showed the existence of reliable correlation in areas of critical and intense degree of environmental quality. This fact confirms that the population living in contaminated areas is subject to the negative influence of environmental factors, which immediately affects the health status of children. The results obtained indicate the need for a detailed assessment of the influence of environmental factors on the incidence of children in the regional aspect, the formation of a database, and the development of automated programs that can predict the incidence in each specific territory. This will increase the effectiveness, including economic of preventive measures.

Keywords: incidence of children, regional features, socio-economic factors, environmental factors

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Authors: Alyaa Farouk Abdelfattah Ibrahim, Samah Mohamed, Huda Jrady, Mashail Alrashidi, Alaa Mohammad, Fatimah Alotaibi, Maram Almutiri

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Participation in volunteering was associated with better mental and physical health, self-esteem, and life satisfaction. The main motivator for students in particular is the chance to gain work-related experiences, improve skills, and build on qualifications that may help them achieve their educational goals and further their careers. This study aimed to assess the effect of summer training volunteering practices in healthcare on self-confidence of nursing students in Riyadh. In a crossectional study design, 150 nursing students at King Saud bin Abdul-Aziz University for health sciences in Riyadh were included in the study. Bio-socio-demographic, self-confidence, patients’ care and skills questionnaires were used for data collection. Results: Participants’ age ranged between 20 and 26 years. The majority were from the educational level seven (80%). 40.7 % of them reported volunteering in summer training programs; 70.37% of them volunteered at least once and for a duration of at least one month. Nursing students from level 6 were less likely to have self-confidence in their patients’ care skills than those in level 7. Students who volunteered were more likely to be more interested in becoming social, professional, and independent healthcare workers. There was no difference regarding experience in clinical skills and education by volunteering status. Clinical skills improved by a level of education in this group. Conclusion: Professional self-confidence and clinical performance are related in this group of nursing students. Monitoring, arranging, and encouraging volunteering activities for nursing students are important to help them broaden their interests, their self-confidence in their capabilities, and advancement in their chosen profession. Mostly, volunteering enhanced knowledge in patient safety and quality of care and attempts to secure volunteering opportunities should be a priority on the nursing education agenda.

Keywords: volunteering, health care volunteering, nursing students, summer training

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Authors: Dr. Luigi Iannacci

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This research critically explores the current educational landscape with respect to special education and dominant deficit/medical model discourses that continue to forward unresponsive problematic approaches to teaching students with disabilities. Asset-oriented perspectives and social/critical models of disability are defined and explicated in order to offer alternatives to these dominant discourses. To that end, a framework that draws on Brian Camborne’s conditions of learning and applications of his work in relation to instruction conceptualize learning conditions and their significance to students with special needs. Methodologically, the research is designed as Critical Narrative Inquiry (CNI). Critical incidents, interviews, documents, artefacts etc. are drawn on and narratively constructed to explore how disability is presently configured in language, discourses, pedagogies and interactions with students deemed disabled. This data was collected using ethnographic methods and as such, through participant-observer field work that occurred directly in classrooms. This narrative approach aims to make sense of complex classroom interactions and ways of reconceptualizing approaches to students with special needs. CNI is situated in the critical paradigm and primarily concerned with culture, language and participation as issues of power in need of critique with the intent of change in the direction of social justice. Research findings highlight the ways in which Cambourne’s learning conditions, such as demonstration, approximation, engagement, responsibility, immersion, expectation, employment (transfer, use), provide a clear understanding of what is central to and constitutes a responsive and inclusive this instructional frame. Examples of what each of these conditions look like in practice are therefore offered in order to concretely demonstrate the ways in which various pedagogical choices and questions can enable classroom spaces to be responsive to the assets and challenges students with special needs have and experience. These particular approaches are also illustrated through an exploration of multiliteracies theory and pedagogy and what this research and approach allows educators to draw on, facilitate and foster in terms of the ways in which students with special needs can make sense of and demonstrate their understanding of skills, content and knowledge. The contextual information, theory, research and instructional frame focused on throughout this inquiry ultimately demonstrate what inclusive classroom spaces and practice can look like. These perspectives and conceptualizations are in stark contrast to dominant deficit driven approaches that ensure current pedagogically impoverished teaching focused on narrow, limited and limiting understandings of special needs learners and their ways of knowing and acquiring/demonstrating knowledge.

Keywords: asset-oriented approach, social/critical model of disability, conditions for learning and teaching, students with special needs

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Authors: Ambuja Raj

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This research will attempt to understand how documents are materially indispensable civic artifacts for migrants in their encounters with the state. Documents such as ID cards are sites of mediation and bureaucratic manifestation which reveal the inherent dynamics of power between the state and a delocalized people. While ID cards allow the holder to retain a different identity and articulate their demands as a citizen, they at the same time transform subjects into ‘objects’ in the exercise of governmental power. The research is based on the study of internal migrants in India, who are ‘visible’ to the state through its host of ID documents such as the ‘Aadhaar card’, electoral IDs, Ration cards, and a variety of region-specific documents, without the possession of which, not only are they unable to access jobs, public goods and services, and accommodation, but are liable to exploitation from state forces and mediators. Through semi-structured interviews with social actors in the processes of documentation and welfare of migrants, as well as with settlements of migrants themselves located in the state of Kerala in India, the thesis will attempt to understand the salience of documentary practices in the lives of inter-state migrants who move within Indian states in the hope of bettering their economic conditions. The research will trace the material and evolving significance of ID cards in the tenacity of states dealing with these ‘illegible’ populations. It will try to bring theories of governmentality, biopolitics and Weberian bureaucracy into the migrant issue while critically grounding itself on secondary literature by scholars who have worked on South Asian ‘governments of paper’.

Keywords: migration, historiography of documents, anthropology of state, documentary practices

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Authors: Tanusha Raniga, Michael Boecker, Maud Mthembu

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This paper considers the formal employment sector, human capacity development and economic capital of single-mother households’ as they strive to sustain livelihoods. This paper advances empirical data in the field of economic and social development policy. The correlation between educational level, human capacity development and economic self-reliance of single-mother households is considered. This paper presents empirical evidence obtained from qualitative in-depth interviews conducted with twenty-five single mothers who were working in the formal work sector in Hagen, Germany and two provinces, namely KwaZulu-Natal and Gauteng in South Africa. This is an underexplored research area as most of the international literature focuses on pathology and victimhood related to single-mother households. Instead, this paper presents the biographic profiles and discusses two key themes that emerged from the data analysis namely; formal and informal streams of income enhanced human capital development through access to further education and training opportunities. The women perceived these themes as facilitating factors which helped them sustain their households. The paper presents some suggestions for policymakers and social work practitioners to consider to improve support systems and avoid economic exclusion of single mothers who work within the first economy.

Keywords: single mothers, formal work sector, economic capital, human capital

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Authors: Reihaneh Rafiemanzelat

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due to towards the rapid urbanization, cities throughout the world faced to rapid growth through gray infrastructure. Therefore designing cities based on green and blue infrastructure can offer the best solution to support healthy urban environment. This conformation with a wide range of ecosystem service has a positive impact on the regulation of air temperature, noise reduction, air quality, and also create a pleasant environment for humans activities. Research mainly focuses on the concept and principles of green and blue infrastructure in the city of Esfahan at the center of Iran in order to create a livable and healthy environment. Design principles for green and blue infrastructure are classified into two different but interconnect evaluations. Healthy green infrastructure assessing based on; volume, shape, location, dispersion, and maintenance. For blue infrastructure there are three aspects of water and ecosystem which are; the contribution of water on medical health, the contribution of water on mental health, and creating possibilities to exercise.

Keywords: healthy cities, livability, urban landscape, green and blue infrastructure

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Authors: Ahmed Boutejdar, Bishoy I. Halim, Soumia El Hani, Larbi Bellarbi, Amal Afyf

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In this paper, a planar monopole antenna for multi band applications is proposed. The antenna structure operates at three operating frequencies at 3.7, 6.2, and 13.5 GHz which cover different communication frequency ranges. The antenna consists of a quasi-modified rectangular radiating patch with a partial ground plane and two parasitic elements (open-loop-ring resonators) to serve as coupling-bridges. A stepped cut at lower corners of the radiating patch and the partial ground plane are used, to achieve the multiband features. The proposed antenna is manufactured on the FR4 substrate and is simulated and optimized using High Frequency Simulation System (HFSS). The antenna topology possesses an area of 30.5 x 30 x 1.6 mm³. The measured results demonstrate that the candidate antenna has impedance bandwidths for 10 dB return loss and operates from 3.80 – 3.90 GHz, 4.10 – 5.20 GHz, 11.2 – 11.5 GHz and from 12.5 – 14.0 GHz, which meet the requirements of the wireless local area network (WLAN), worldwide interoperability for microwave access (WiMAX), C- (Uplink) and Ku- (Uplink) band applications. Acceptable agreement is obtained between measurement and simulation results. Experimental results show that the antenna is successfully simulated and measured, and the tri-band antenna can be achieved by adjusting the lengths of the three elements and it gives good gains across all the operation bands.

Keywords: planar monopole antenna, FR4 substrate, HFSS, WLAN, WiMAX, C and Ku

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Authors: Kenneth N. Ohei, Roelien Brink

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For decades, teaching and learning processes have centered on the traditional approach (Web 1.0) that promoted teacher-directed pedagogical practices. Currently, there is a realization that the traditional approach is not adequate to effectively address and improve all student-learning outcomes. The subsequent incorporation of social software, Information, and Communication Technology (ICT) tools in universities may serve as complementary to support educational goals, offering students the affordability and opportunity to educational choices and learning platforms. Consequently, educators’ inability to incorporate these instructional ICT tools in their teaching and learning practices remains a challenge. This will signify that educators still lack the ICT skills required to administer lectures and bridging learning gaps. This study probes a methodological concept with the aim of developing a framework towards the adoption of social software in HES to help facilitate business processes and can build social presence among students. A mixed method will be appropriate to develop a comprehensive framework needed in Higher Educational System (HES). After research have been conducted, the adoption of social software will be based on the developed comprehensive framework which is supposed to impact positively on education and approach of delivery, improves learning experience, engagement and finally, increases educational opportunities and easy access to educational contents.

Keywords: blended and integrated learning, learning experience and engagement, higher educational system, HES, information and communication technology, ICT, social presence, Web 1.0, Web 2.0, Web 3.0

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Authors: Minjeong Kim, Seungchul Lee, Iman Janghorban Esfahani, Jeong Tai Kim, ChangKyoo Yoo

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A trajectory of set-point of ventilation control systems plays an important role for efficient ventilation inside subway stations since it affects the level of indoor air pollutants and ventilation energy consumption. To maintain indoor air quality (IAQ) at a comfortable range with lower ventilation energy consumption, the optimal trajectory of the ventilation control system needs to be determined. The concentration of air pollutants inside the station shows a diurnal variation in accordance with the variations in the number of passengers and subway frequency. To consider the diurnal variation of IAQ, an iterative dynamic programming (IDP) that searches for a piecewise control policy by separating whole duration into several stages is used. When outdoor air is contaminated by pollutants, it enters the subway station through the ventilation system, which results in the deteriorated IAQ and adverse effects on passenger health. In this study, to consider the influence of outdoor air quality (OAQ), a new performance index of the IDP with the passenger health risk and OAQ is proposed. This study was carried out for an underground subway station at Seoul Metro, Korea. The optimal set-points of the ventilation control system are determined every 3 hours, then, the ventilation controller adjusts the ventilation fan speed according to the optimal set-point changes. Compared to manual ventilation system which is operated irrespective of the OAQ, the IDP-based ventilation control system saves 3.7% of the energy consumption. Compared to the fixed set-point controller which is operated irrespective of the IAQ diurnal variation, the IDP-based controller shows better performance with a 2% decrease in energy consumption, maintaining the comfortable IAQ range inside the station.

Keywords: indoor air quality, iterative dynamic algorithm, outdoor air information, ventilation control system

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Authors: Shahed, Tala, Ahlam, Marah, Sara, Shaden

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Research on fear of crime has shown that there are many influences on it, including gender, age, and geographic location. For example, women are more afraid of crime than men. The campus has a high crime rate and fear of crime due to many hiding places and blind spots; women are more likely than men to be victims of certain types of crime, such as rape and verbal and sexual harassment. And it became clear that older female students have a different perception of the place over time and other knowledge and fear of it, another study at Hashemite University. This study aims to understand better how the environment affects the negative experiences of female students and how their age and familiarity environment affects their sense of safety. This study also examines whether CPTED can be used to help prevent crime. The Broken Windows Theory also states that crime occurs in areas with overt indications of criminal activity, antisocial behavior, and civil unrest. This is related to the principle of CPTED maintenance and monitoring, activity support, regional development, and access control. Given their increased vulnerability to harassment, “sexual harassment” can refer to different behaviors. On campuses, harassment was happening everywhere, but it was most prevalent in "blind spots" that were out of sight and deserted. This study uses a methodology based on quantitative data that depends on putting a number on the amount of a particular phenomenon that exists in the world. The main finding shows how CPTED works in an academic context and what adjustments need to be made.

Keywords: Hashmite University, CPTED, crime prevention, university campus, fear of crime, female faer, broken window theory

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Authors: Ridwan Kiay Demak, Firmansyahrullah, Muchammad Sibro Mulis, Eko Tri Wasisto, Nixon Poltak Frederic, Agung Putu Andika, Lapo Ajis Kamamu, Muhammad Sobirin, Kornelius Eppang

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PC Prove LSM successfully improved the efficiency of Own Used Fuel Gas with the "Lotion" method in the PT Pertamina EP Cepu Donggi Matindok Generating System. The innovation of using the "LOTION" (LOAD PRIORITY SELECTION) method in the generating system is modeling that can provide a priority qualification of main and non-main equipment to keep gas processing running even though it leaves 1 GTG operating. GTG operating system has been integrated, controlled, and monitored properly through PC programs and web-based access to answer Industry 4.0 problems. The results of these improvements have succeeded in making Donggi Matindok Field Production reach 98.77 MMSCFD and become a proper EMAS candidate in 2022-2023. Additional revenue from increasing the efficiency of the use of own used gas amounting to USD USD 5.06 Million per year and reducing operational costs from maintenance efficiency (ABO) due to saving running hours GTG amounted to USD 3.26 Million per year. Continuity of fuel gas availability for the GTG generation system can maintain the operational reliability of the plant, which is 3.833333 MMSCFD. And reduced gas emissions wasted to the environment by 33,810 tons of C02 eq per year.

Keywords: LOTION method, load priority selection, fuel gas efficiency, gas turbine generator, reduce emissions

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Authors: N. Hachemi, I. Benmehdi, O. Hasnaoui

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The air like water is an essential element for living beings. Each day, a man breathes about 20m3 of air. It originally consists of a set of gas whose presence and concentrations correspond to the needs of life. This study focuses on air pollution by smoke and dust emitted from the chimney of the cement works of Beni Saf, pathological and their impact on the environment. Dust of the cement plant are harmless to permissible levels for living organisms, but the two combined phenomena namely the release of dust and aridity of the climate, which severely marked area of Beni Saf; have contributed adverse effects in on human health and the degradation of vegetation cover and species especially weakened by environmental stress. The most visible impact is certainly the deposition of dust on the surrounding areas of the cement factory, and seriously affecting the aesthetics of the landscape. Health problems are more important inside and outside the factory. Among the diseases notable caused by the cement works are: deafness, heart disease, asthma and mental. The dust of the cement works is mainly composed of fine particles of limestone, clay, free lime, silicates and also loaded of the gases such as carbon dioxide gas CO2. The accumulation of this gas in the atmosphere is directly involved in the phenomenon of increasing of greenhouse effect. Some gases, for example, are directly toxic. They can change the climate, changing precipitation types and become a greater source of stress by drought, etc. The environment also suffers from air pollution indirectly; it is more precisely the acid rain. They are produced by the combustion of non-metals in air. Acid rain has consequences for contaminating the soil, weakening the flora, fauna and acidifies lakes. Finally, the pollution problems are multiple and specific dust. It can worsen and change, it has reached epidemic proportions quantitatively and qualitatively disturbing and unpredictable.

Keywords: atmospheric pollution, cement, dust, environment

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Authors: Staci McGill, Morgan Hayes, Robert Coleman, Kimberly Tumlin

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The interaction and relationships between horses and humans have been shown to be positive for physical, mental, and emotional wellbeing, however equine spaces where these interactions occur do include some environmental risks. There are 1.7 million jobs associated with the equine industry in the United States in addition to recreational riders, owners, and volunteers who interact with horses for substantial amounts of time daily inside built structures. One specialized facility, an “indoor arena” is a semi-indoor structure used for exercising horses and exhibiting skills during competitive events. Typically, indoor arenas have a sand or sand mixture as the footing or surface over which the horse travels, and increasingly, silica sand is being recommended due to its durable nature. It was previously identified in a semi-qualitative survey that the majority of individuals using indoor arenas have environmental concerns with dust. 27% (90/333) of respondents reported respiratory issues or allergy-like symptoms while riding with 21.6% (71/329) of respondents reporting these issues while standing on the ground observing or teaching. Frequent headaches and/or lightheadedness was reported in 9.9% (33/333) of respondents while riding and in 4.3% 14/329 while on the ground. Horse respiratory health is also negatively impacted with 58% (194/333) of respondents indicating horses cough during or after time in the indoor arena. Instructors who spent time in indoor arenas self-reported more respiratory issues than those individuals who identified as smokers, highlighting the health relevance of understanding these unique structures. To further elucidate environmental concerns and self-reported health issues, 35 facility assessments were conducted in a cross-sectional sampling design in the states of Kentucky and Ohio (USA). Data, including air speeds, were collected in a grid fashion at 15 points within the indoor arenas and then mapped spatially using krigging in ARCGIS. From the spatial maps, standard variances were obtained and differences were analyzed using multivariant analysis of variances (MANOVA) and analysis of variances (ANOVA). There were no differences for the variance of the air speeds in the spaces for facility orientation, presence and type of roof ventilation, climate control systems, amount of openings, or use of fans. Variability of the air speeds in the indoor arenas was 0.25 or less. Further analysis yielded that average air speeds within the indoor arenas were lower than 100 ft/min (0.51 m/s) which is considered still air in other animal facilities. The lack of air movement means that dust clearance is reliant on particle size and weight rather than ventilation. While further work on respirable dust is necessary, this characterization of the semi-indoor environment where animals and humans interact indicates insufficient air flow to eliminate or reduce respiratory hazards. Finally, engineering solutions to address air movement deficiencies within indoor arenas or mitigate particulate matter are critical to ensuring exposures do not lead to adverse health outcomes for equine professionals, volunteers, participants, and horses within these spaces.

Keywords: equine, indoor arena, ventilation, particulate matter, respiratory health

Procedia PDF Downloads 116

Authors: Jiashu Shen

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This study aims at exploring the characteristics of sexual knowledge, attitudes, and behaviors of Chinese college students from the 'one-child' families compared with those with siblings. This study utilized the data from the 'National College Student Survey on Sexual and Reproductive Health 2019'. Multiple logistic regression analyses were used to assess the association between the 'only-child' and their sexual knowledge, sexual attitudes, sexual behaviors, and risky sexual behaviors (RSB) stratified by sex and home regions, respectively. Compared with students with siblings, the 'only-child' students scored higher in sex-related knowledge (only-child students: 4.49 ± 2.28, students with siblings: 3.60 ± 2.27). Stronger associations between only-child and more liberal sexual attitudes were found in urban areas, including the approval of premarital sexual intercourse (OR: 1.51, 95% CI: 1.50-1.65) and multiple sexual partners (OR: 1.85, 95% CI: 1.72-1.99). For risky sexual behaviors, being only-child is more likely to use condoms in first sexual intercourse, especially among male students (OR: 0.68, 95% CI: 0.58-0.80). Only-child students are more likely to have more sexual knowledge, more liberal sexual attitude, and less risky sexual behavior. Further health policy and sex education should focus more on students with siblings.

Keywords: attitudes and behaviors, only-child students, sexual knowledge, students with siblings

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Authors: Gurkirat Kaur, Manoj Kumar, Manju Bala

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Ethernet is the most influential and widely used technology in the world. With the growing demand of low latency and high throughput technologies like InfiniBand and RoCE, unique features viz. RDMA (Remote Direct Memory Access) have evolved. RDMA is an effective technology which is used for reducing system load and improving performance. InfiniBand is a well known technology which provides high-bandwidth and low-latency and makes optimal use of in-built features like RDMA. With the rapid evolution of InfiniBand technology and Ethernet lacking the RDMA and zero copy protocol, the Ethernet community has came out with a new enhancements that bridges the gap between InfiniBand and Ethernet. By adding the RDMA and zero copy protocol to the Ethernet a new networking technology is evolved, called RDMA over Converged Ethernet (RoCE). RoCE is a standard released by the IBTA standardization body to define RDMA protocol over Ethernet. With the emergence of lossless Ethernet, RoCE uses InfiniBand’s efficient transport to provide the platform for deploying RDMA technology in mainstream data centres over 10GigE, 40GigE and beyond. RoCE provide all of the InfiniBand benefits transport benefits and well established RDMA ecosystem combined with converged Ethernet. In this paper, we evaluate the heterogeneous Linux cluster, having multi nodes with fast interconnects i.e. gigabit Ethernet and Soft RoCE. This paper presents the heterogeneous Linux cluster configuration and evaluates its performance using Intel’s MPI Benchmarks. Our result shows that Soft RoCE is performing better than Ethernet in various performance metrics like bandwidth, latency and throughput.

Keywords: ethernet, InfiniBand, RoCE, RDMA, MPI, Soft RoCE

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Authors: Oluwole Durodolu

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The rationale for this study is to explore the adaptive strategy that librarians adopt in performing night shifts in a mega-city like Lagos state. Maslach Burnout Theory would be used to measure the three proportions of burnout in understanding emotional exhaustion, depersonalisation, and individual accomplishment to scrutinise job-related burnout syndrome allied with longstanding, unsolved stress. The qualitative methodology guided by a phenomenological research paradigm, which is an approach that focuses on the commonality of real-life experience in a particular group, would be used, focus group discussion adopted as a method of data collection from library staff who are involved in night-shift. The participant for the focus group discussion would be selected using a convenience sampling technique in which staff at the cataloguing unit would be included in the sample because of the representative characteristics of the unit. This would be done to enable readers to understand phenomena as it is reasonable than from a remote perspective. The exploratory interviews which will be in focus group method to shed light on issues relating to security, housing, transportation, budgeting, energy supply, employee duties, time management, information access, and sustaining professional levels of service and how all these variables affect the productivity of all the 149 library staff and their work-life balance.

Keywords: nightshift, work-life balance, mega-city, academic library, Maslach Burnout Theory, Lagos State, University of Lagos

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Authors: J. George, M. Al Mutairi, W. Aljuryyad, A. Alhussanan, A. Alkashan, T. Aldoghiri, Z. Alamari, A. Albakr

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Introduction: Students make plans for their career and are keen in exploring options of employment in those carriers. They make their employment choice based on their desires and preferences. This study aims to identify if students of King Saud Bin Abdulaziz for Health Sciences, College of Applied Medical Sciences after obtaining appropriate education prefer to work as clinicians, university faculty, or full-time researchers. There are limited studies in Saudi Arabia exploring the university student’s employment choices and preferences. This study would help employers to build the required job positions and prevent misleading employers from opening undesired positions in the job market. Methodology: The study included 394 students from third and fourth years both male and female among the eighth programs of college of applied medical sciences, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh campus. A prospective quantitative cross-sectional study was conducted; data were collected by distributing a seven item questionnaire and analyzed using SPSS. Results: Among the participants, 358 (90.9%) of them chose one of the three listed career choices, 263 (66.8%) decided to work as hospital staff after their education, 75 students (19.0%) chose to work as a faculty member in a university after obtaining appropriate degree, 20 students (5.1%) preferred to work as full-time researcher after obtaining appropriate degree, the remaining 36 students (9.1%) had different career goals, such as obtaining a master degree after graduating, to obtain a bachelor of medicine and bachelor in surgery degree, and working in the private sector. The most recurrent reason behind the participants' choice was "career goal", where 276 (70.1%) chose it as a reason. Conclusion: The findings of the study showed that most student’s preferred to work in hospitals as clinicians, followed by choice of working as a faculty in a university, the least choice was to be working as full-time researchers.

Keywords: College of Applied Medical Sciences, employment ambitions, graduating students, King Saud bin Abdulaziz University for Health Sciences

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Authors: Amber Dhoot, Tarush Gupta, Andrea Gurr, William Jenkins, Sandro Pietrunti, Alexis Tang

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Background: The COVID-19 pandemic has driven pharmacovigilance towards a new paradigm. Nowadays, more people than ever before are recognising and reporting adverse reactions from medications, treatments, and vaccines. In the modern era, with over 3.8 billion users, social media has become the most accessible medium for people to voice their opinions and so provides an opportunity to engage with more patient-centric and accessible pharmacovigilance. However, the pharmaceutical industry has been slow to incorporate social media into its modern pharmacovigilance strategy. This project aims to make social media a more effective tool in pharmacovigilance, and so reduce drug costs, improve drug safety and improve patient outcomes. This will be achieved by firstly uncovering and categorising the barriers facing the widespread adoption of social media in pharmacovigilance. Following this, the potential opportunities of social media will be explored. We will then propose realistic, practical recommendations to make social media a more effective tool for pharmacovigilance. Methodology: A comprehensive systematic literature review was conducted to produce a categorised summary of these barriers. This was followed by conducting 11 semi-structured interviews with pharmacovigilance experts to confirm the literature review findings whilst also exploring the unpublished and real-life challenges faced by those in the pharmaceutical industry. Finally, a survey of the general public (n = 112) ascertained public knowledge, perception, and opinion regarding the use of their social media data for pharmacovigilance purposes. This project stands out by offering perspectives from the public and pharmaceutical industry that fill the research gaps identified in the literature review. Results: Our results gave rise to several key analysis points. Firstly, inadequacies of current Natural Language Processing algorithms hinder effective pharmacovigilance data extraction from social media, and where data extraction is possible, there are significant questions over its quality. Social media also contains a variety of biases towards common drugs, mild adverse drug reactions, and the younger generation. Additionally, outdated regulations for social media pharmacovigilance do not align with new, modern General Data Protection Regulations (GDPR), creating ethical ambiguity about data privacy and level of access. This leads to an underlying mindset of avoidance within the pharmaceutical industry, as firms are disincentivised by the legal, financial, and reputational risks associated with breaking ambiguous regulations. Conclusion: Our project uncovered several barriers that prevent effective pharmacovigilance on social media. As such, social media should be used to complement traditional sources of pharmacovigilance rather than as a sole source of pharmacovigilance data. However, this project adds further value by proposing five practical recommendations that improve the effectiveness of social media pharmacovigilance. These include: prioritising health-orientated social media; improving technical capabilities through investment and strategic partnerships; setting clear regulatory guidelines using multi-stakeholder processes; creating an adverse drug reaction reporting interface inbuilt into social media platforms; and, finally, developing educational campaigns to raise awareness of the use of social media in pharmacovigilance. Implementation of these recommendations would speed up the efficient, ethical, and systematic adoption of social media in pharmacovigilance.

Keywords: adverse drug reaction, drug safety, pharmacovigilance, social media

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Authors: Corinna Barraco, Ornella Salimbene

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This research involves the Ethiopian locality of Jeldi (North Africa), an area particularly affected by water shortage and in which the pumping and treatment of drinking water are extremely sensitive issues. The study aims to develop and apply low-cost tools for the design of solar water pumping and water purification systems in a not developed country. Consequently, two technical tools have been implemented in Excel i) Solar photovoltaic Pumping (Spv-P) ii) Water treatment (Wt). The Spv-P tool was applied to the existing well (depth 110 [m], dynamic water level 90 [m], static water level 53 [m], well yield 0.1728 [m³h⁻¹]) in the Jeldi area, where estimated water demand is about 50 [m3d-1]. Through the application of the tool, it was designed the water extraction system of the well, obtaining the number of pumps and solar panels necessary for water pumping from the well of Jeldi. Instead, the second tool Wt has been applied in the subsequent phase of extracted water treatment. According to the chemical-physical parameters of the water, Wt returns as output the type of purification treatment(s) necessary to potable the extracted water. In the case of the well of Jeldi, the tool identified a high criticality regarding the turbidity parameter (12 [NTU] vs 5 [NTU]), and a medium criticality regarding the exceeding limits of sodium concentration (234 [mg/L Na⁺] vs 200 [mg/L Na⁺]) and ammonia (0.64 [mg/L NH³-N] vs 0.5 [mg/L NH³-N]). To complete these tools, two specific manuals are provided for the users. The joint use of the two tools would help reduce problems related to access to water resources compared to the current situation and represents a simplified solution for the design of pumping systems and analysis of purification treatments to be performed in undeveloped countries.

Keywords: drinking water, Ethiopia, treatments, water pumping

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Authors: Adeyinka Adeniran, Omowunmi Bakare, Esther Oluwole, Florence Chieme, Temitope Durojaiye, Modupe Akinyinka, Omobola Ojo, Babatunde Olujobi, Marcus Ilesanmi, Akintunde Ogunsakin

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Introduction: Globally, COVID-19 has greatly impacted the human race physically, socially, mentally, and economically. However, healthcare workers seemed to bear the greatest impact. The study, therefore, sought to assess the impact of COVID-19 on the primary healthcare workers in Ekiti, South-west Nigeria. Methods: The study was a cross-sectional descriptive study using a quantitative data collection method of 716 primary healthcare workers in Ekiti state. Respondents were selected using an online convenience sampling method via their social media platforms. Data was collected, collated, and analyzed using SPSS version 25 software and presented as frequency tables, mean and standard deviation. Bivariate and multivariate analyses were conducted using a t-test, and the level of statistical significance was set at p<0.05. Results: Less than half (47.1%) of respondents were between 41-50 age group and a mean age of 44.4+6.4SD. A majority (89.4%) were female, and almost all (96.2%) were married. More than (90%) had ever heard of Coronavirus, and (85.8%) had to spend more money on activities of daily living such as transportation (90.1%), groceries (80.6%), assisting relations (95.8%) and sanitary measures (disinfection) at home (95.0%). COVID-19 had a huge negative impact on about (89.7%) of healthcare workers, with a mean score of 22+4.8. Conclusion: COVID-19 negatively impacted the daily living and professional duties of primary healthcare workers, which reflected their psychological, physical, social, and economic well-being. Disease outbreaks are unlikely to disappear in the near future. Hence, global proactive interventions and homegrown measures should be adopted to protect healthcare workers and save lives.

Keywords: Covid-19, health workforce, primary health care, health systems, depression

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Authors: Petar Kurecic, Josipa Penic

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The paper represents a product of mentor-graduate student cooperation, developed at the graduate study of Business Economics, major Tourism. The analysis was made through the anonymous questionnaire filled by the respondents from Croatia. Following the latest threatening events and having in mind those yet to come, it can be concluded that no country can benefit from the tourism industry if at the same time does not develop its security system as an integral part of the standard tourist offer. Analyzing the trends in contemporary tourism, the safety and security issues became the decisive factors for the choice of a certain destination. Consequently, countries must not perceive security systems and measures as an unnecessary expense but as an essential element in organizing their tourist services. All hotels and respectable tourist agencies should have a crisis management, with detailed, thoroughly elaborated procedures for emergency situations. Tourists should be timely informed about the potential dangers and risks and the measures taken to prevent them, as well as on procedures for emergency situations. Additionally, it would be good to have mobile applications that would enable tourists to make direct emergency calls with instructions on behavior in crisis situations. It is also essential to implement and put into effect sophisticated security measures such as using surveillance cameras, controlling access to buildings, information exchange with colleagues and neighbors, reporting the suspicious occurrences to the security services, and training staff for crisis management. The security issue is definitely one of the crucial factors in the development of tourism in a certain country.

Keywords: security, security measures in tourism, tourism, tourist destinations

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Authors: Shatha Ghareeb, Rawaa Al-Jumeily, Thar Baker

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In Abu Dhabi, there are many different education curriculums where sector of private schools and quality assurance is supervising many private schools in Abu Dhabi for many nationalities. As there are many different education curriculums in Abu Dhabi to meet expats’ needs, there are different requirements for registration and success. In addition, there are different age groups for starting education in each curriculum. In fact, each curriculum has a different number of years, assessment techniques, reassessment rules, and exam boards. Currently, students that transfer curriculums are not being placed in the right year group due to different start and end dates of each academic year and their date of birth for each year group is different for each curriculum and as a result, we find students that are either younger or older for that year group which therefore creates gaps in their learning and performance. In addition, there is not a way of storing student data throughout their academic journey so that schools can track the student learning process. In this paper, we propose to develop a computational framework applicable in multicultural countries such as UAE in which multi-education systems are implemented. The ultimate goal is to use cloud and fog computing technology integrated with Artificial Intelligence techniques of Machine Learning to aid in a smooth transition when assigning students to their year groups, and provide leveling and differentiation information of students who relocate from a particular education curriculum to another, whilst also having the ability to store and access student data from anywhere throughout their academic journey.

Keywords: admissions, algorithms, cloud computing, differentiation, fog computing, levelling, machine learning

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Authors: Michele L. Tilstra, Tiffany J. Peets

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Interprofessional collaboration in behavioral healthcare education is increasingly recognized for its value in training students to address diverse client needs. While interprofessional education (IPE) is well-documented in occupational therapy education to address physical health, limited research exists on collaboration with counselors to address mental health concerns and the psychosocial needs of individuals receiving care. Counseling education literature primarily examines the collaboration of counseling students with psychiatrists, psychologists, social workers, and marriage and family therapists. This pretest/posttest survey research study explored changes in attitudes toward interprofessional teams among 56 Master of Occupational Therapy (MOT) (n = 42) and Counseling and Human Development (CHD) (n = 14) students participating in the Counselors and Occupational Therapists Professionally Engaged in the Community (COPE) program. The COPE program was designed to strengthen the behavioral health workforce in high-need and high-demand areas. Students accepted into the COPE program were divided into small MOT/CHD groups to complete multiple interprofessional multicultural learning modules using videos, case studies, and online discussion board posts. The online modules encouraged reflection on various behavioral healthcare roles, benefits of team-based care, cultural humility, current mental health challenges, personal biases, power imbalances, and advocacy for underserved populations. Using the Student Perceptions of Interprofessional Clinical Education- Revision 2 (SPICE-R2) scale, students completed pretest and posttest surveys using a 5-point Likert scale (Strongly Agree = 5 to Strongly Disagree = 1) to evaluate their attitudes toward interprofessional teamwork and collaboration. The SPICE-R2 measured three different factors: interprofessional teamwork and team-based practice (Team), roles/responsibilities for collaborative practice (Roles), and patient outcomes from collaborative practice (Outcomes). The mean total scores for all students improved from 4.25 (pretest) to 4.43 (posttest), Team from 4.66 to 4.58, Roles from 3.88 to 4.30, and Outcomes from 4.08 to 4.36. A paired t-test analysis for the total mean scores resulted in a t-statistic of 2.54, which exceeded both one-tail and two-tail critical values, indicating statistical significance (p = .001). When the factors of the SPICE-R2 were analyzed separately, only the Roles (t Stat=4.08, p =.0001) and Outcomes (t Stat=3.13, p = .002) were statistically significant. The item ‘I understand the roles of other health professionals’ showed the most improvement from a mean score for all students of 3.76 (pretest) to 4.46 (posttest). The significant improvement in students' attitudes toward interprofessional teams suggests that the unique integration of OT and CHD students in the COPE program effectively develops a better understanding of the collaborative roles necessary for holistic client care. These results support the importance of IPE through structured, engaging interprofessional experiences. These experiences are essential for enhancing students' readiness for collaborative practice and align with accreditation standards requiring interprofessional education in OT and CHD programs to prepare practitioners for team-based care. The findings contribute to the growing body of evidence supporting the integration of IPE in behavioral healthcare curricula to improve holistic client care and encourage students to engage in collaborative practice across healthcare settings.

Keywords: behavioral healthcare, counseling education, interprofessional education, mental health education, occupational therapy education

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Authors: Rajnish Gourh, Nitesh Sharma, Nikhil Patil

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Introduction: Adequate nutrition is essential for improving pregnancy and its outcomes. Failure to comply with the required daily intake of nutrition can lead to complications threatening both mother and child survival. Objectives: To provide access to nutritious diet to mothers in antenatal and post-natal stage for supporting a healthy progressive pregnancy, positive delivery outcome, and lactation and to promote regular consumption of the foods by the mothers and help overcome the dietary gap by nutrition education during pregnancy time. Methodology: Total of 95 ANC mothers were identified from Malvada PHC area, in Palghar district of Maharashtra. This short-term cohort intended for the proposed supplementation and education was targeted for follow-up until birth and six-months of post-natal period. In month of May 2016 to June 2017. Results: Average weight of women was observed 40.01kg, (SD- 5.024) at registered for ANC at Centre in the first month. In same month, average Haemoglobin level of women was observed 9.13gm/dl. Average increase in weight of women during pregnancy in month October 2016 was 48.83kg. Birth weight of 14 babies was less than 2 kgs. 13 babies with birth weight in range of 2.1kgs to 2.4kgs. 68 babies with birth weight in range of 2.5kg to 3kg and above. Conclusion: Importance of consumption of food, improving levels of nutrient intake and outcome of delivery was excellent.

Keywords: delivery status, nutrition, pregnancy, education

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Authors: Sanusi Abubakar Sadiq, Rebecca William Chiwar

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Wildlife Park stands a chance of contributing to tourism development in different ways, but available infrastructure, and facilities required by visitors when they arrive, access road to the destination, and resources to facilitate positive experience are lacking in certain areas. The study set out to find out the need to develop Sumu Wildlife Park Bauchi State, to an international standard. The study focused on identifying the existing facilities and infrastructure at the park and to further identify the available resources used by visitors. In attempt to find out the impact of developing Sumu Wildlife Park and ways of filling the gap of the actual standard data were obtained from fifteen administrative staff of Sumu Wildlife Park, ten staff of Bauchi state Tourism Board and twenty-five residents of the community in Kafin Madaki, Bauchi. Relevant literature were reviewed in the study; data collected were organized and analyzed using Statistical Package of Social Sciences (SPSS), software for analysis. Findings revealed that though Sumu Wildlife Park has attractions to keep visitors patronage but has insufficient facilities to maintain visitors and has not been developed to an expected standard. The problem faced by the management of Sumu wildlife Park is lack of adequate facilities, infrastructure and resources. The need to develop Sumu Wildlife Park has enormous benefits in increasing patronage. Provision of more funds would help improve standard as there would be more activities within and around the park. Regular maintenance of those facilities protects the life span of the park.

Keywords: attractions, facilities, infrastructure, resources

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Authors: Pavitra Sharma, Anuradha Singh, Nupur Mathur

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There exist more than 100 trillion bacteria in the digestive system of human-beings. Such bacteria are referred to as gut microbiota. Gut microbiota comprises around 75% of our immune system. The bacteria that comprise the gut microbiota are unique to every individual and their composition keeps changing with time owing to factors such as the host’s age, diet, genes, environment, and external medication. Of these factors, the variable easiest to control is one’s diet. By modulating one’s diet, one can ensure an optimal composition of the gut microbiota yielding several health benefits. Prebiotics and probiotics are two compounds that have been considered as viable options to modulate the host’s diet. Prebiotics are basically plant products that support the growth of good bacteria in the host’s gut. Examples include garden asparagus, aloe vera etc. Probiotics are living microorganisms that exist in our intestines and play an integral role in promoting digestive health and supporting our immune system in general. Examples include yogurt, kimchi, kombucha etc. In the context of modulating the host’s diet, the key attribute of prebiotics is that they support the growth of probiotics. By developing the right combination of prebiotics and probiotics, food products or supplements can be created to enhance the host’s health. An effective combination of prebiotics and probiotics that yields health benefits to the host is referred to as synbiotics. Synbiotics comprise of an optimal proportion of prebiotics and probiotics, their application benefits the host’s health more than the application of prebiotics and probiotics used in isolation. When applied to food supplements, synbiotics preserve the beneficial probiotic bacteria during storage period and during the bacteria’s passage through the intestinal tract. When applied to the gastrointestinal tract, the composition of the synbiotics assumes paramount importance. Reason being that for synbiotics to be effective in the gastrointestinal tract, the chosen probiotic must be able to survive in the stomach’s acidic environment and manifest tolerance towards bile and pancreatic secretions. Further, not every prebiotic stimulates the growth of a particular probiotic. The prebiotic chosen should be one that not only maintains 2 balance in the host’s digestive system, but also provides the required nutrition to probiotics. Hence in each application of synbiotics, the prebiotic-probiotic combination needs to be carefully selected. Once the combination is finalized, the exact proportion of prebiotics and probiotics to be used needs to be considered. When determining this proportion, only that amount of a prebiotic should be used that activates metabolism of the required number of probiotics. It was observed that while probiotics are active is both the small and large intestine, the effect of prebiotics is observed primarily in the large intestine. Hence in the host’s small intestine, synbiotics are likely to have the maximum efficacy. In small intestine, prebiotics not only assist in the growth of probiotics, but they also enable probiotics to exhibit a higher tolerance to pH levels, oxygenation, and intestinal temperature

Keywords: microbiota, probiotics, prebiotics, synbiotics

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Authors: Ibrahim Akkan

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This study analyses the transformation of Türkiye's Syria policy between 2002 and 2024 and the impact of domestic political dynamics in this process. Since the collapse of the Ottoman Empire, Türkiye and Syria have had a tense relationship for a long time due to reasons such as border issues, water sharing, security concerns and the activities of terrorist organizations. However, the process that started with the Adana Agreement in 1998 gained momentum with the Justice and Development Party (Ak Party) coming to power in 2002 and a historical period of rapprochement began between the two countries. During this period, Türkiye adopted the concept of “zero problems with neighbors” in its foreign policy and deepened its strategic partnerships in the region. Turkish-Syrian relations also developed within this framework, the trade volume between the two countries increased and cooperation was strengthened through mutual visits and diplomatic agreements. However, the Arab Spring that started in 2011 was a sharp turning point in Turkish-Syrian relations. The harsh stance of the Bashar Assad administration against the popular uprisings in Syria caused Türkiye to take a stance against Assad and support opposition groups. This process led to the severing of diplomatic ties between the two countries and the gradual deterioration of relations until 2024. Türkiye directly intervened in the civil war in Syria after the Arab Spring and conducted military operations in northern Syria that highlighted security policies. The main purpose of this study is to examine the transformation in Türkiye's Syria policies between 2002 and 2024 and to analyze the role of domestic political dynamics in Türkiye in this transformation. The main research question of the study is how domestic political actors in Türkiye, especially decision-makers (leaders, governments, political parties), shape foreign policy. In this context, the extent to which the leadership of the Ak Party government is decisive in decision-making processes and how the impact of domestic dynamics on foreign policy emerges will be studied. In this study, how both the pressures of the international system and domestic political dynamics shape foreign policy will be analyzed using the theoretical framework of neoclassical realism. How decision-making processes are decisive in foreign policy will be examined through a case study specific to Türkiye-Syria relations. In addition, the strategic preferences of leaders such as Recep Tayyip Erdoğan and Ahmet Davutoğlu in foreign policy and how these preferences overlap with developments in domestic politics will be evaluated using the discourse analysis method. This study aims to make a new contribution to the literature by providing a comprehensive analysis of how domestic dynamics shape foreign policy in Türkiye-Syria relations.

Keywords: decision-making mechanisms, foreign policy analysis, neoclassical realism, syria, türkiye

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Authors: Ramya Rachel S.

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For women in a developing country like India, poverty is an ever-clinging problem which has rooted itself without any trace of absolute abolition. Poverty is a deprivation of many imminent needs and must be measured accordingly. Therefore, it is important to study the dimensions of education, health, and standard of living to understand the true nature of the impoverished. The study focused on studying the deprivation on these aspects using the Alkire-Foster methodology to estimate the Multidimensional Poverty Index. The study has utilized the individual data of women aged 15 to 49 of the National Family Health Survey (NFHS) for the year 2015-16. Findings reveal that women in India still face extreme levels of deprivation in various dimensions. More than one-third of the total women aged 15 to 24 in India were multidimensionally poor. Dimensional breakdown of the levels of multidimensional poverty indicates that the dimension of Education is the highest contributor to poverty. Decomposition of the multidimensional poverty among various demographic sub-groups, reveals that the multidimensional poverty level increases with age. Results point out that deprivations were higher among widowed and married women, and among women who lived alone. There was also a huge rural-urban divide with respect to poverty. The basic needs of these women must be targeted and met so that they are withdrawn from all forms of poverty.

Keywords: deprivations, multidimensional poverty, sub-group decomposition, women

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Authors: De Castro-Pardo M., Cabello J. M., Martin J. M., Ruiz F.

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In this paper, we propose a new Water Sustainability Indicator based on a Multi-Reference methodology that permits modeling compensation between the analysed criteria and provides a participative approach. The proposed indicator provides results based on 19 variables grouped into 5 dimensions: availability, access, resilience, good governance and economic capacity. The indicator was applied to assess water sustainability in 27 European countries. The results showed that Finland, the Netherlands, Sweden and the United Kingdom obtained the best global results in terms of weak water (compensatory) sustainability. In terms of strong water (non-compensatory) sustainability, no country gained acceptable results in terms of strong sustainability. Climate change and the state of freshwater resources were detected as especially vulnerable in all the analysed countries. The results identified some eastern European countries with low GDP and good performance of availability and cost of water, with bad results in terms of governance and water productivity. These results could jeopardize water sustainability in the event of a potential economic development if these limitations are not addressed. In a context of economic and political instability due to the current armed conflict in nearby countries such as Ukraine, it is especially important to pay attention to these countries, whose good governance indicators could worsen even more. The proposed indicator allowed to the identification of warning signs and could contribute to the improvement in decision-making processes. Moreover, it could improve the monitoring of international water policies.

Keywords: water sustainability, composite indicators, compensatory approach, sustainability European policies

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Authors: Nilam Bano, Uzma Iram

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Globally, the dilemma of undernutrition has become a notable concern for the researchers, academicians, and policymakers because of its severe consequences for many centuries. The nutritional deficiencies create hurdles for the people to achieve goals related to live a better lifestyle. Not only at micro level but also at the macro level, the consequences of undernutrition affect the economic progress of the country. The initial five years of a child’s life are considered critical for the physical growth and brain development. In this regard, children require special care and good quality food (nutrient intake) to fulfill their nutritional demand of the growing body. Having the sensitive stature and health, children specially under the age of 5 years are more vulnerable to the poor economic, housing, environmental and other social conditions. Beside confronting economic challenges and political upheavals, Pakistan is also going through from a rough patch in the context of social development. Majority of the children are facing serious health problems in the absence of required nutrition. The complexity of this issue is getting severe day by day and specially children are left behind with different type of immune problems and vitamins and mineral deficiencies. It is noted that children from the well-off background are less likely affected by the undernutrition. In order to underline this issue, the present study aims to highlight the existing nutritional inequalities among the children of under five years in Pakistan. Moreover, this study strives to decompose those factors that severely affect the existing nutritional inequality and standing in the queue to capture the consideration of concerned authorities. Pakistan Demographic and Health Survey 2012-13 was employed to assess the relevant indicators of undernutrition such as stunting, wasting, underweight and associated socioeconomic factors. The objectives were executed through the utilization of the relevant empirical techniques. Concentration indices were constructed to measure the nutritional inequalities by utilizing three measures of undernutrition; stunting, wasting and underweight. In addition to it, the decomposition analysis following the logistic regression was made to unfold the determinants that severely affect the nutritional inequalities. The negative values of concentration indices illustrate that children from the marginalized background are affected by the undernutrition more than their counterparts who belong from rich households. Furthermore, the result of decomposition analysis indicates that child age, size of a child at birth, wealth index, household size, parents’ education, mother’s health and place of residence are the most contributing factors in the prevalence of existing nutritional inequalities. Considering the result of the study, it is suggested to the policymakers to design policies in a way so that the health sector of Pakistan can stimulate in a productive manner. Increasing the number of effective health awareness programs for mothers would create a notable difference. Moreover, the education of the parents must be concerned by the policymakers as it has a significant association with the present research in terms of eradicating the nutritional inequalities among children.

Keywords: concentration index, decomposition analysis, inequalities, undernutrition, Pakistan

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