Search results for: population ethics

Authors: Iram Zahair, Tanith Rose, Oyinlola Oyebode, Stephen Clayton, Iman Ghosh, Michelle Maden, Ben Barr

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Background: Gastrointestinal infections exert a significant public health burden on UK healthcare services and the community. However, there are conflicting findings on where ethnic inequalities are likely to persist. This systematic review aimed to identify studies that ascertain differences in the incidence and prevalence of gastrointestinal infections within and between UK ethnic groups and explore possible explanations for heterogeneity observed within the literature. Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance, a systematic review methodology was used. Medline, Web of Science, CINAHL Plus, and grey literature were searched from 1980 to 2021 for studies reporting an association between ethnicity and gastrointestinal infections in UK population samples. Two reviewers independently screened the articles and conducted quality appraisals; data extraction was undertaken by one reviewer and verified by two reviewers (PROSPERO CRD 42021240714). A narrative synthesis was undertaken to synthesise the study findings. Results: The searches identified 8134 studies; 13 met the inclusion criteria. 12 out of 13 studies found a difference in the prevalence of gastrointestinal infections between different ethnic groups. UK ethnic minorities, predominantly men and children of Asian ethnicity, had an increased risk of infection than the white British majority in 12 studies; the Pakistani ethnic group had a higher risk of infection in three out of 13 studies. Studies reported that age and sex confounded the relationship between ethnicity and gastrointestinal infections. At the same time, the country of birth, socioeconomic status, and geographical location of ethnic groups mediated this association and significantly explained the heterogeneity observed across the studies. Harvest plots supported the textual synthesis. Conclusion: This systematic review elucidates the lack of extensive UK quantitative evidence examining the association between ethnicity and gastrointestinal infections. Insights into gastrointestinal infections and ethnicity's association can help address policy actions to mitigate the inequalities identified within and between UK ethnic groups.

Keywords: ethnic and racial populations, public health, public health policy, systematic review

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Authors: Sirajdin Olagoke Adeshina, Haidi Ibrahim, Akeem Salawu

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large lecture theatres cannot be covered by a single camera but rather by a multicamera setup because of their size, shape, and seating arrangements. Although, classroom capture is achievable through a single camera. Therefore, a design and implementation of a multicamera setup for a large lecture hall were considered. Researchers have shown emphasis on the impact of class attendance taken on the academic performance of students. However, the traditional method of carrying out this exercise is below standard, especially for large lecture theatres, because of the student population, the time required, sophistication, exhaustiveness, and manipulative influence. An automated large classroom attendance system is, therefore, imperative. The common approach in this system is face detection and recognition, where known student faces are captured and stored for recognition purposes. This approach will require constant face database updates due to constant changes in the facial features. Alternatively, face counting can be performed by cropping the localized faces on the video or image into a folder and then count them. This research aims to develop a face localization-based approach to detect student faces in classroom images captured using a multicamera setup. A selected Haar-like feature cascade face detector trained with an asymmetric goal to minimize the False Rejection Rate (FRR) relative to the False Acceptance Rate (FAR) was applied on Raspberry Pi 4B. A relationship between the two factors (FRR and FAR) was established using a constant (λ) as a trade-off between the two factors for automatic adjustment during training. An evaluation of the proposed approach and the conventional AdaBoost on classroom datasets shows an improvement of 8% TPR (output result of low FRR) and 7% minimization of the FRR. The average learning speed of the proposed approach was improved with 1.19s execution time per image compared to 2.38s of the improved AdaBoost. Consequently, the proposed approach achieved 97% TPR with an overhead constraint time of 22.9s compared to 46.7s of the improved Adaboost when evaluated on images obtained from a large lecture hall (DK5) USM.

Keywords: automatic attendance, face detection, haar-like cascade, manual attendance

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Authors: Amulya P. Rao, Prathima S., Sreedevi N.

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Speech sound disorders (SSD) encompass the major concern in younger population of India with highest prevalence rate among the speech disorders. Children with SSD if not identified and rehabilitated at the earliest, are at risk for academic difficulties. This necessitates early identification using screening tools assessing the frequently misarticulated speech sounds. The literature on frequently misarticulated speech sounds is ample in English and other western languages targeting individuals with various communication disorders. Articulation is language specific, and there are limited studies reporting the same in Kannada, a Dravidian Language. Hence, the present study aimed to identify the frequently misarticulated consonants in Kannada and also to examine the error type. A retrospective, descriptive study was carried out using secondary data analysis of 41 participants (34-phonetic type and 7-phonemic type) with SSD in the age range 3-to 12-years. All the consonants of Kannada were analyzed by considering three words for each speech sound from the Kannada Diagnostic Photo Articulation test (KDPAT). Picture naming task was carried out, and responses were audio recorded. The recorded data were transcribed using IPA 2018 broad transcription. A criterion of 2/3 or 3/3 error productions was set to consider the speech sound to be an error. Number of error productions was calculated for each consonant in each participant. Then, the percentage of participants meeting the criteria were documented for each consonant to identify the frequently misarticulated speech sound. Overall results indicated that velar /k/ (48.78%) and /g/ (43.90%) were frequently misarticulated followed by voiced retroflex /ɖ/ (36.58%) and trill /r/ (36.58%). The lateral retroflex /ɭ/ was misarticulated by 31.70% of the children with SSD. Dentals (/t/, /n/), bilabials (/p/, /b/, /m/) and labiodental /v/ were produced correctly by all the participants. The highly misarticulated velars /k/ and /g/ were frequently substituted by dentals /t/ and /d/ respectively or omitted. Participants with SSD-phonemic type had multiple substitutions for one speech sound whereas, SSD-phonetic type had consistent single sound substitutions. Intra- and inter-judge reliability for 10% of the data using Cronbach’s Alpha revealed good reliability (0.8 ≤ α < 0.9). Analyzing a larger sample by replicating such studies will validate the present study results.

Keywords: consonant, frequently misarticulated, Kannada, SSD

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Authors: Claudia Aguilar, Amen Farooq

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Among other cities in the United States, the city of Atlanta is experiencing levels of growth that surpass anything we have witnessed in the last century. With the surge of population influx, the available housing is practically bursting at the seams. Supply is low, and demand is high. In effect, the average one-bedroom apartment runs for 1,800 dollars per month. The city is desperately seeking new opportunities to provide affordable housing at an expeditious rate. This has been made evident by the recent updates to the city’s zoning. With the recent influx in the housing market, young professionals, in particular millennials, are desperately looking for alternatives to stay within the city. To remedy Atlanta’s affordable housing crisis, the city of Atlanta is planning to introduce 40 thousand of new affordable housing units by 2026. To achieve the urgent need for more affordable housing, the architectural response needs to adapt to overcome this goal. A method that has proven successful in modern housing is to practice modular means of development. A method that has been constrained to the dimensions of the max load for an eighteen-wheeler. This approach has diluted the architect’s ability to produce site-specific, informed design and rather contributes to the “cookie cutter” stigma that the method has been labeled with. This thesis explores the design methodology for modular housing by revisiting its constructability and adaptability. This research focuses on a modular housing type that could break away from the constraints of transport and deliver adaptive reconfigurable assemblies. The adaptive assemblies represent an integrated design strategy for assembling the future of affordable dwelling units. The goal is to take advantage of a component-based system and explore a scalable solution to modular housing. This proposal aims specifically to design a kit of parts that are made to be easily transported and assembled but also gives the ability to customize the use of components to benefit all unique conditions. The benefits of this concept could include decreased construction time, cost, on-site labor, and disruption while providing quality housing with affordable and flexible options.

Keywords: adaptive assemblies, modular architecture, adaptability, constructibility, kit of parts

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Authors: Gal Zagron, Nitza Abramson, Deena R. Zimmerman, Chen Stein-Zamir

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Background: Salmonella enteritidis is a common cause of foodborne outbreaks, primarily associated with poultry eggs. S. enteritidis This is the only Salmonella type that is found inside the eggshell. A rise in Salmonella enteritidis notifications was noted in spring 2017. Aims: The aim of this study is to describe the epidemiological investigation of the outbreak in the Jerusalem district, along with the containment measures taken. Methods: This study is a population-based epidemiological study with a description of environmental control activities. Results: During the months May - July, 2017 848 salmonellosis cases were reported to the Jerusalem district health office compared to 294 cases May - July 2016. Salmonella enteritidis was isolated in 58% of reported cases. Clusters and outbreaks ( > 2 cases) were reported among nursery schools, nursing homes, persons residing in one kibbutz and several cases in different food service establishments in the Jerusalem district. Epidemiological investigations revealed eggs consumption as a common feature among the cases (uncooked or undercooked eggs in most cases). A national investigation among egg suppliers revealed that most cases consumed eggs provided by a single provider with isolation of Salmonella enteritidis at the source as well. Containment measures were taken to control the epidemic including distributing information via electronic and written media to the public, searching for all egg distribution centers, informing local authorities, the poultry council and food stores. The eggs originating from the provider were recalled and extinguished. Written instructions to all food preparation facilities in the district were distributed regarding the proper storage and preparation of eggs. The number of reported cases declined and the outbreak vanished during correlating months of 2018. Conclusions: The investigation of Salmonella enteritidis outbreaks should include epidemiological and laboratory investigations, tracing the source of the eggs and testing the eggs and the source of eggs. Health education activities are essential as to the proper handling of eggs and egg products aiming to minimize susceptibility to Salmonella infection.

Keywords: epidemiological investigation, food-borne disease, food safety, Salmonella enteritidis

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Authors: Silvia Miele, Patrice Rusconi, Harriet Tenenbaum

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An increasingly multi-ethnic Europe has been pushing citizens’ boundaries on who should be entitled and to what extent to practise their own diversity. Indeed, according to a Standard Eurobarometer survey conducted in 2017, immigration is seen by Europeans as the most serious issue facing the EU, and a third of respondents reported they do not feel comfortable interacting with migrants from outside the EU. Many of these come from Muslim countries, accounting for 4.9% of Europe population in 2016. However, the figure is projected to rise up to 14% by 2050. Additionally, political debates have increasingly focused on Muslim immigrants, who are frequently portrayed as difficult to integrate, while nationalist parties across Europe have fostered the idea of insuperable cultural differences, creating an atmosphere of hostility. Using a 3 X 3 X 2 between-subjects design, it was investigated how people reason about endorsing religious and non-religious rights to minorities. An online survey has been administered to university students of three different countries (Italy, Spain and the UK) via Qualtrics, presenting hypothetical scenarios through a vignette methodology. Each respondent has been randomly allocated to one of the three following conditions: Christian, Muslim or non-religious (vegan) target. Each condition entailed three questions about children self-determination rights to exercise some control over their own lives and 3 questions about children nurturance rights of care and protection. Moreover, participants have been required to further elaborate on their answers via free-text entries and have been asked about their contact and quality of contact with the three targets, and to self-report religious, national and ethnic identification. Answers have been recorded on a Likert scale of 1-5, 1 being "not at all", 5 being "very much". A two-way ANCOVA will be used to analyse answers to closed-ended questions, while free-text answers will be coded and data will be dichotomised based on Social Cognitive Domain Theory for four categories: moral, social conventional and psychological reasons, and analysed via ANCOVAs. This study’s findings aim to contribute to the implementation of educational interventions and speak to the introduction of governmental policies on human rights.

Keywords: children's rights, Europe, migration, minority

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Authors: Songul Aktas, Turkan Pasinlioglu, Kiymet Yesilcicek Calik

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Introduction: Emphatic approach during labor increases both quality of care and birth satisfaction of mothers. Besides; maternal satisfaction statements and expressions about midwives who assist labor contribute to a positive birth perception and wish to give vaginal delivery again. Aim: The study aimed at investigating the effect of empathy training given to midwives on mothers’ satisfaction with midwives and their birth perception. Material/Method: This experimental study was undertaken between February 2013 and January 2014 at a public hospital in Trabzon Province. The population of the study was composed of mothers who gave vaginal delivery and the sample was composed of 222 mothers determined with power analyzes. Ethical approval and written informed consents were obtained. Mothers who were assisted by midwives during 1st, 2nd and 3rd phases of delivery and first two postpartum hours were included. Empathy training given to midwives included didactic narration, creative drama, psychodrama techniques and lasted 32 hours. The data were collected before the empathy training (BET), right after empathy training (RAET) and 8 weeks later after birth (8WLAB). Mothers were homogenous in terms of socio-demographic, obstetric characteristics. Data were collected with a questionnaire and were analyzed with Chi-square tests. Findings: Rate of mother’s satisfaction with midwives was 36.5% in BET, 81.1% in RAET and 75.7% in 8WLAB. Key mother’s satisfaction with midwives were as follows: 27.6% of mothers told that midwives were “smiling-kind” in BET, 39.6% of them in RAET and 33.7% of them in 8WLAB; 31% of mothers told that midwives were “understanding” in BET, 38.2% of them in RAET and 33.7% of them in 8WLAB; 15.7% of mothers told that midwives were “reassuring” in BET, 44.9% of them in RAET and 39.3% of them in 8WLAB;19.5% of mothers told that midwives were “encouraging and motivating” in BET, 39.8% of them in RAET and 19.8% of mothers told that midwives were “informative” in BET, 45.6% of them in RAET and 35.1% of them in 8WLAB (p<0.05). Key mother’s dissatisfaction with midwives were as follows: 55.3% of mothers told that midwives were “poorly-informed” in BET, 17% of them in RAET and 27.7% of them in 8WLAB; 56.9% of mothers told that midwives were “poorly-listening” in BET, 17.6% of them in RAET and 25.5% of them in 8WLAB; 53.2% of mothers told that midwives were “judgmental-embarrassing” in BET, 17% of them in RAET and 29.8% of them in 8WLAB; 56.2% of mothers told that midwives had “fierce facial expressions” in BET, 15.6% of them in RAET and 28.1% of them in 8WLAB. Rates of mothers’ perception that labor was “easy” were 8.1% in BET, 21.6% in RAET and 13.5% in 8WLAB and rates of mothers’ perception that labor was “very difficult and tiring” were 41.9% in BET, 5.4% in RAET and 13.5% in 8WLAB (p<0.05). Conclusion: The effect of empathy training given to midwives upon statements that described mothers’ satisfaction with midwives and their birth perception was positive. Note: This study was financially funded by TUBİTAK project with number 113S672.

Keywords: empathy training, labor perception, mother’s satisfaction with midwife, vaginal delivery

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Authors: Soumita Mitra, Santosh Kumar Sarkar

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Hooghly river estuary (HRE), situated at the north eastern part of Bay of Bengal has global significance due to its holiness. It is of immense importance to the local population as it gives perpetual water supply for various activities such as transportation, fishing, boating, bathing etc. to the local people who settled on both the banks of this estuary. This study was done to assess the dissolved and particulate trace metal in the estuary covering a stretch of about 175 Km. The water samples were collected from the surface (0-5 cm) along the salinity gradient and metal concentration were studied both in dissolved and particulate phase using Graphite Furnace Atomic Absorption Spectrophotometer (GF-AAS) along some physical characteristics such as water temperature, salinity, pH, turbidity and total dissolved solids. Although much significant spatial variation was noticed but little enrichment was found along the downstream of the estuary. The mean concentration of the metals in the dissolved and particulate phase followed the same trend and as follows: Fe>Mn>Cr>Zn>Cu>Ni>Pb. The concentration of the metals in the particulate phase were much greater than that in dissolved phase which was also depicted from the values of the partition coefficient (Kd)(ml mg-1). The Kdvalues ranged from 1.5x105 (in case of Pb) to 4.29x106 (in case of Cr). The high value of Kd for Cr denoted that the metal Cr is mostly bounded with the suspended particulate matter while the least value for Pb signified it presence more in dissolved phase. Moreover, the concentrations of all the studied metals in the dissolved phase were many folds higher than their respective permissible limits assested by WHO 2008, 2009 and 2011. On the other hand, according to Sediment Quality Guidelines (SQGs), Zn, Cu and Ni in the particulate phase lied between ERL and ERM values but Cr exceeded ERM values at all the stations confirming that the estuary is mostly contaminated with the particulate Cr and it might cause frequent adverse effects on the aquatic life. Multivariate statistics Cluster analysis was also performed which separated the stations according to the level of contamination from several point and nonpoint sources. Thus, it is found that the estuarine system is much polluted by the toxic metals and further investigation, toxicological studies should be implemented for full risk assessment of this system, better management and restoration of the water quality of this globally significant aquatic system.

Keywords: dissolved and particulate phase, Hooghly river estuary, partition coefficient, surface water, toxic metals

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Authors: Hendri Purwadi, Christine McCloud

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Triage is a complex decision-making process that aims to categorize a victim’s level of acuity and the need for medical assistance. Two common triage systems have been widely used in Mass Casualty Incidents (MCIs) and disaster situation are START (Simple triage algorithm and rapid treatment) and SALT (sort, asses, lifesaving, intervention, and treatment/transport). There is currently controversy regarding the effectiveness of SALT over START triage system. This systematic review aims to investigate and compare the effectiveness between SALT and START triage system in disaster and MCIs setting. Literatures were searched via systematic search strategy from 2009 until 2019 in PubMed, Cochrane Library, CINAHL, Scopus, Science direct, Medlib, ProQuest. This review included simulated-based and medical record -based studies investigating the accuracy and applicability of SALT and START triage systems of adult and children population during MCIs and disaster. All type of studies were included. Joana Briggs institute critical appraisal tools were used to assess the quality of reviewed studies. As a result, 1450 articles identified in the search, 10 articles were included. Four themes were identified by review, they were accuracy, under-triage, over-triage and time to triage per individual victim. The START triage system has a wide range and inconsistent level of accuracy compared to SALT triage system (44% to 94. 2% of START compared to 70% to 83% of SALT). The under-triage error of START triage system ranged from 2.73% to 20%, slightly lower than SALT triage system (7.6 to 23.3%). The over-triage error of START triage system was slightly greater than SALT triage system (START ranged from 2% to 53% compared to 2% to 22% of SALT). The time for applying START triage system was faster than SALT triage system (START was 70-72.18 seconds compared to 78 second of SALT). Consequently; The START triage system has lower level of under-triage error and faster than SALT triage system in classifying victims of MCIs and disaster whereas SALT triage system is known slightly more accurate and lower level of over-triage. However, the magnitude of these differences is relatively small, and therefore the effect on the patient outcomes is not significance. Hence, regardless of the triage error, either START or SALT triage system is equally effective to triage victims of disaster and MCIs.

Keywords: disaster, effectiveness, mass casualty incidents, START triage system, SALT triage system

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Authors: Anyimc, C. J. Aneke, J. O. Orji, O. Nworie, U. C. C. Egbule

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The microbial examination and antimicrobial susceptibility profile of microorganism isolated from the salt mining site in Ebonyi state were evaluated in the present study using a standard microbiological technique. A total of 300 samples were randomly collected in three sample groups (A, B, and C) of 100 each. Isolation, Identification and characterization of organization present on the soil samples were determined by culturing, gram-staining and biochemical technique. The result showed the following organisms were isolated with their frequency as follow: Bacillus species (37.3%) and Staphylococcus species(23.5%) had the highest frequency in the whole Sample group A and B while Klebsiella specie (15.7%), Pseudomonas species(13.7%), and Erwinia species (9.8%) had the least. Rhizopus species (42.0%) and Aspergillus species (26.0%) were the highest fungi isolated, followed by Penicillum species (20.0%) while Mucor species (4.0%), and Fusarium species (8.0%) recorded the least. Sample group C showed high microbial population of all the microbial isolates when compared to sample group A and B. Disc diffusion method was used to determine the susceptibility of isolated bacteria to various antibiotics (oxfloxacin, pefloxacin, ciprorex, augumentin, gentamycin, ciproflox, septrin, ampicillin), while agar well diffusion method was used to determine the susceptibility of isolated fungi to some antifungal drugs (metronidazole, ketoconazole, itraconazole fluconazole). The antibacterial activity of the antibiotics used showed that ciproflux has the best inhibitory effect on all the test bacteria. Ketoconazole showed the highest inhibitory effect on the fungal isolates, followed by itraconazole, while metronidazole and fluconazole showed the least inhibitory effect on the entire test fungal isolates. Hence, the multiple drug resistance of most isolates to appropriate drugs of choice are of great public health concern and cells for periodic monitoring of antibiograms to detect possible changing patterns. Microbes isolated in the salt mining site can also be used as a source of gene(s) that can increase salt tolerance in different crop species through genetic engineering.

Keywords: microorganisms, antibacterial, antifungal, resistance, salt mining site, Ebonyi State

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Authors: R. S. Dinesh Madhavan, M. Logaraj

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Background: Recent studies have documented an increase in the risk of cardiovascular diseases (CVD) and a high rate of progression to hypertension in persons with pre hypertension. The risk factors for the growing burden of cardiovascular diseases especially hypertension, diabetes, overweight or obesity and waist hip ratio are increasing. Much study has not been done on cardiovascular risk factors associated with blood pressure (BP) among college students in Indian population. Objectives: The objective of our study was to estimate the prevalence of prehypertension among male students and to assess the association between prehypertension and risk factors for cardiovascular diseases. Material and Methods: A cross-sectional study was conducted among students of a university situated in the suburban area of Chennai. A total of 403 students was studied which included 200 medical and 203 engineering students. The information on selected socio-demographic variables were collected with the help of pre tested structured questionnaire. Measurements of height, weight, blood pressure and postprandial blood glucose were carried out as per standard procedure. Results: The mean age of the participants was 19.56 ± 1.67years. The mean systolic and diastolic blood pressure were 125.80±10.03 mm of Hg and 78.96 ±11.75mm of Hg. The average intake of fruits and vegetable per week were 4.34 ±3.47days and 6.55±4.39 days respectively. Use of smoke and smokeless tobacco were 27.3% and 3% respectively. About 30.3% of the students consume alcohol. Nearly 45.9 % of them did not practice regular exercise. About 29 % were overweight and 5.7% were obese, 24.8% were with waist circumference above 90 centimeters. The prevalence of pre hypertension and hypertension was 49.6% and 19.1% among male students. The prevalence of pre hypertension was higher in medical students (51.5%) compared to engineering students (47.8%). Higher risk of being pre hypertensive were noted above the age of 20 years (OR=4.32), fruit intake less than 3 days a week (OR= 1.03), smokers (OR= 1.13), alcohol intake (OR=1.56), lack of physical exercise (OR=1.90), BMI of more than 25 kg/m2 (OR=1.99). But statistically significant difference was noted between pre hypertensive and normotensive for age (p<0.0001), lack of physical exercise (p=0.004) and BMI (p=0.015). Conclusion: In conclusion nearly half of the students were pre hypertensive. Higher prevalence of smoking, alcohol intake, lack of physical exercise, overweight and increased waist circumference and postprandial blood sugar more than 140 mg/dl was noted among pre-hypertensive compared to normotensive.

Keywords: cardiovascular diseases, prehypertension, risk factors, undergraduate Students

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Authors: Sujit Kumar

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Historicity of inter-caste relations can be traced in the early stages of evolution of rural community in the Indian society. These have witnessed vicissitudes during long drawn interactions between caste groups. Inter-caste relations evolved in a more organized form in the guise of Jajmani system. This is a system of permanent and hereditary inter-caste relations and gives a kaleidoscopic view of socio-economic relations among various caste groupings. Universality of its prevalence in rural India for centuries is well recognized and documented. But it has been undergoing metamorphic change in some regions and changing at a slower pace in the others during post-independence period. An empirical study was conducted with the objectives to know whether Jajmani system is in vogue in the rural areas and type and intensity of socio-economic ties among different caste categories and to find out the change in inter-caste relations, if any owing to industrialization and modernization. Information was elicited from 225 respondents using interview schedule designed for this purpose. It is discernible that in majority of cases, inter-caste social relations which find better expression on the occasions like marriage, death, birth and festivals etc. among Brahmins and lower castes vis-à-vis other caste categories have grown weak. The data further unearth that economic relations as maintained on the occasions of marriage, sacred thread ceremony, mundan sacrament, birthday, death, yajna, katha, routine hair cut, manufacture and repair of various iron, earthen, wooden and leather articles between members of higher castes (general category) and lower castes (scheduled castes) are moderate but weak in case of Other Backward Classes vis-à-vis all other caste categories. Overwhelming majority of informants believe that decline in hereditary occupations, depreciation of old products and services and their availability from the market being made by industry are main reasons in descending order for change in inter caste relations. Modernization, westernization, industrialization, transportation and communications, growing materialism and consumerism together have brought change in relations among caste groups affecting about a billion population inhabiting rural India.

Keywords: inter-caste, Jajmani, sacrament, Yajna

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Authors: Bagweneza Vedaste, Rugema Joselyne, Twagirayezu Innocent, Nikuze Bellancille, Nyirazigama Alice, Ishimwe Bazakare Marie Laetitia, Kaberuka Gerard, Mukeshimana Madeleine

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Background: Teen pregnancies have dramatically increased across the country in the past few years. Teen mothers usually face difficulties accessing the reproductive health (RH) services due to different reasons that include fear of getting discriminated or seen by other people. Some teen mothers do not also know their rights regarding the RH services, and they sometimes get discriminated. Little is known in Rwanda regarding how these teen mothers access the RH services compared to the general population, and views of teen mothers on their rights to access these services have not been clearly documented in the country. Specific Aims: To explore baseline information about SRH services among teen mothers; to explore factors that contribute to the use of SRH services among teen mothers; to identify strategies to increase awareness on SRHR (Sexual and Reproductive Health and Rights) among teen mothers in targeted area; and to explore views of teen mothers on rights for SRH services. Research design/Methodology: The qualitative exploratory descriptive research will be used among the teen mothers in five selected health centers of Rwamagana district. The study will use the qualitative descriptive study design. Setting: The study will be conducted in five selected health centers of Rwamagana district, which has been chosen due to a higher number of adolescent pregnancies in Eastern Province according to the DHS 2019-2020. Participants: The participants in this study will be teenage mothers who conceived after turning 11 but have delivered before turning 19. As the upper age for teenage is 19 years, this means that the researchers anticipated that those conceiving at 19 years may deliver in their twenties, which was the upper age limit in this study. Data collection measures: A semi-structured interview guide will be used to gather information from the respondents in focus group discussions. Significance: The findings of this study will provide a picture regarding the access of teen mothers to SRHS and their rights to SRH services. They will increase their awareness regarding SRH services and rights. Finally, the findings may help to address barriers faced by teen mothers to reach, pay and utilize SRHS.

Keywords: sexual and reproductive health services, inclusiveness, qualitative study, adolescent mothers

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Authors: Alireza Monzavi Chaleshtari, Maryam Aliakbari

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Objective: The aim of this study was to investigate the prediction of child attachment style based on a positive and safe combination parenting method mediated by maternal attachment styles in children with attention deficit hyperactivity disorder. Method: The design of the present study was descriptive of correlation and structural equations and applied in terms of purpose. The population of this study includes all children with attention deficit hyperactivity disorder living in Chaharmahal and Bakhtiari province and their mothers. The sample size of the above study includes 165children with attention deficit hyperactivity disorder in Chaharmahal and Bakhtiari province with their mothers, who were selected by purposive sampling method based on the inclusion criteria. The obtained data were analyzed in two sections of descriptive and inferential statistics. In the descriptive statistics section, statistical indices of mean, standard deviation, frequency distribution table and graph were used. In the inferential section, according to the nature of the hypotheses and objectives of the research, the data were analyzed using Pearson correlation coefficient tests, Bootstrap test and structural equation model. findings:The results of structural equation modeling showed that the research models fit and showed a positive and safe combination parenting style mediated by the mother attachment style has an indirect effect on the child attachment style. Also, a positive and safe combined parenting style has a direct relationship with child attachment style, and She has a mother attachment style. Conclusion:The results and findings of the present study show that there is a significant relationship between positive and safe combination parenting methods and attachment styles of children with attention deficit hyperactivity disorder with maternal attachment style mediation. Therefore, it can be expected that parents using a positive and safe combination232 parenting method can effectively lead to secure attachment in children with attention deficit hyperactivity disorder.

Keywords: child attachment style, positive and safe parenting, maternal attachment style, ADHD

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Authors: Luís R. Silva, Catarina Bento, Ana C. Gonçalves, Fábio Jesus, Branca M. Silva

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Nowadays, the general population is more and more concerned about nutrition and the health implications of an unbalanced diet. Current knowledge regarding the health benefits and antioxidant properties of certain foods such as fruits and vegetables has gained the interest of both the general public and scientific community. Peach (Prunus persica (L.) Batsch) is one of the most consumed fruits worldwide, with low sugar contents and a broad range of nutrients essential to the normal functioning of the body. Six different peach cultivars from the Fundão region in Portugal were evaluated regarding their phenolic composition by LC-DAD and biological activity. The prepared extracts’ capacity to scavenge free-radicals was tested through the stable free radical DPPH• and nitric oxide (•NO). Additionally, antidiabetic potential and protective effects against peroxyl radical (ROO•) induced damage to erythrocytes were also tested. LC-DAD analysis allowed the identification of 17 phenolic compounds, among which 5-O-caffeoylquinic acids and 3-O-caffeoylquinic acids are pointed out as the most abundant. Regarding the antioxidant activity, all cultivars displayed concentration-dependent free-radical scavenging activity against both nitrogen species and DPPH•. In respect to α-glucosidase inhibitory activity, Royal Magister and Royal Glory presented the highest inhibitory activity (IC50 = 11.7 ± 1.4 and 17.1 ± 1.7 μg/mL, respectively), nevertheless all six cultivars presented higher activity than the control acarbose. As for the protective effect of Royal Lu extract on the oxidative damage induced in erythrocytes by ROO•, the results were quite promising showing inhibition IC50 values of 110.0 ± 4.5 μg/mL and 83.8 ± 6.5 μg/mL for hemolysis and hemoglobin oxidation, respectively. The demonstrated activity is of course associated to the peaches’ phenolic profile, rich in phenolic acids and flavonoids with high hydrogen donating capacity. These compounds have great industrial interest for the manufacturing of natural products. The following step would naturally be the extraction and isolation from the plant tissues and large-scale production through biotechnology techniques.

Keywords: antioxidants, functional food, phenolic compounds, peach

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Authors: Manjusha R. Vagal, Shyam K. Shrivastava, Umesh Mahantshetty, Sudeep Gupta, Supriya Chopra, Reena Engineer, Amita Maheshwari, Atul Buduk

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Vaginal stenosis is a common side effect associated with pelvic radiotherapy in cervical cancer patients which contributes negatively to woman’s health and prevents adequate vaginal/cervical examination. Vaginal dilation with a dilator is routine practice and is internationally advocated as a prophylactic measure to preserve vaginal patency. This retrospective study was carried out with the aim to know the usefulness of vaginal dilation following pelvic radiation therapy in cervical cancer patients in India. Data from medical records of 183 cervical cancer patients, which met the study criteria, were collected related to the stage of the disease, treatment received, commencement period of dilation post radiation therapy, sexual status and side effects associated to dilation practice. Data related to vaginal dimensions as per the length of insertion of a small, medium and large dilator were collected on regular follow-ups until 36 months and/or more. Vaginal dimensions as measured with the length of medium dilator insertion were used for analysis of dilation therapy results using paired t-test. Patients who underwent vaginal dilation with dilator maintained vaginal patency, also the mean vaginal length significantly increased, from 8.02 cm ± 2.69 to 9.96 ± 2.89 cm with a p value <0.001. There was no significant difference found on vaginal patency with different intervals of initiation of dilation therapy. At the third year and more following dilation therapy, significant increase in vaginal length observed with a p value of 0.0001 in both sexually active and inactive patients. Compilation of vaginal dosage during brachytherapy was inadequate, and hence, the secondary objective of the study to determine the effect of radiotherapy on the outcome of rehabilitation intervention was not studied in detail. This retrospective study has found that dilation therapy with vaginal dilators post pelvic radiotherapy is effective in preventing vaginal stenosis and improving vaginal patency and cannot be substituted with vaginal intercourse. Sexual quality of life assessment in the Indian population needs much attention.

Keywords: dilator, sexually active, vaginal dilation, vaginal stenosis

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Authors: Seyede Soraya Alavinezhad, Gholam Ali Afrooz, Seyedsaeid Sajjadianari

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The purpose of this study was to assess the efficacy of a family-centered sensory and motor interactive activities program in enhancing the motor and developmental abilities of infants between the ages of 12 and 24 months who have a medical history of low birth weight. The design of the study was a combined method (qualitative and quantitative). The statistical population comprised infants between the ages of 12 and 24 months who had a documented history of low birth weight in Tehran in 2022. The study sample comprised twenty-eight infants, ranging in age from twelve to twenty-four months, whose mothers were selected using a readily available sampling method. The participants were allocated into two groups—experimental and control—at random. The Children's Developmental Screening Scale, the third edition of Ages and Stages Questionnaires (ASQ3TM), was utilized in both cohorts. Two sessions of the family-centered program for mothers and sixteen sessions for children in the experimental group were taken into account. The statistical analysis software SPSS version 26 was utilized to analyze the data. Initially, the descriptive analysis of the variables, the normality of the assumptions, and the equality of the variance of the variables in the groups were examined. Subsequently, univariate analysis of covariance was employed to examine research hypotheses. The results of the covariance analysis demonstrated that the family-centered interactive activities program for sensory and motor development was effective. A significant difference has been observed between the experimental and control groups with regard to developmental skills between the pre-test and post-test (P<0.005). Motor and developmental skills among children aged 12 to 24 months with a history of low birth weight can be enhanced through entertainment programs that incorporate suitable structure, according to the findings of this study. It is recommended that future research investigate the efficacy of this program on children of average weight and conduct longitudinal studies.

Keywords: children, developmental skills, low birth weight, sensory and motor interactive games program

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Authors: Catarina Seco Matos, Miguel Amaral

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The developed world is facing falling birth rates and rising life expectancies. As a result, the overall demographic structure of societies is becoming markedly older. This leads to an economic and political pressure towards the extension of individuals’ working lives. On the other hand, evidence shows that some older workers choose to stay in the labour force as employees, whereas others choose to pursue a more entrepreneurial occupational path. Thus, entrepreneurship or self-employment may be an option for socioeconomic participation of older individuals. Previous research on senior entrepreneurship is scarce and it focuses mainly on entrepreneurship determinants and individuals’ intentions. The fact that entrepreneurship is perceived as a voluntary or involuntary decision or as a positive or a negative outcome by older individuals is, to the best of our knowledge, still unexplored in the literature. In order to analyse the determinants of entrepreneurial satisfaction among older individuals, primary data were obtained from a unique questionnaire survey, which was sent to Portuguese senior entrepreneurs who have launched their company aged 50 and over (N=181). Portugal is one of the countries in the world with the with the largest ageing population and with a high proportion of older individuals who remain active after their official retirement age – which makes it an extremely relevant case study on senior entrepreneurship. Findings suggest that non pecuniary factors (rather than pecuniary) are the main driver for entrepreneurship at older ages. Specifically, results show that the will to remain active is the main motivation of older individuals to become entrepreneurs. This is line with the activity and continuity theories. Furthermore, senior entrepreneurs tend to have had an active working life (using their professional experience as a proxy) and, thus, want to keep the same lifestyle at an older age (in line with theory of continuity). Finally, results show that even though older individuals’ companies may not show the best financial performance that does not seem to affect their satisfaction with the company and with entrepreneurship in general. The present study aims at exploring, discussing and bring new research on senior entrepreneurship to the fore, rather than assuming purely deductive approach; hence, further confirmatory analyses with larger sets from different countries of data are required.

Keywords: active ageing, entrepreneurship, older entrepreneur, Portugal, satisfaction, senior entrepreneur

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Authors: Onesimus Bulus Shiaki

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The study investigated the effect of cooperative learning strategy on mathematics achievement and retention among senior secondary school students of different abilities in Taraba State Nigeria. Cooperative learning strategy could hopefully contribute to students’ achievement which will spur the teachers to develop strategies for better learning. The quasi-experimental of pretest, posttest and control group design was adopted in this study. A sample of one hundred and sixty-four (164) Senior Secondary Two (SS2) students were selected from a population of twelve thousand, eight hundred and seventy-three (12,873) SS2 Students in Taraba State. Two schools with equivalent mean scores in the pre-test were randomly assigned to experimental and control groups. The experimental group students were stratified according to ability levels of low, medium and high. The experimental group was guided by the research assistants using the cooperative learning instructional package. After six weeks post-test was administered to the two groups while the retention test was administered two weeks after the post-test. The researcher developed a 50-item Mathematics Achievement Test (MAT) which was validated by experts obtaining the reliability coefficient of 0.87. Mean scores and standard deviations were used to answer the research questions while the Analysis of Co-variance (ANCOVA) was used to test the hypotheses. Major findings from the statistical analysis showed that cooperative learning strategy has a significant effect on the mean achievement of students as well as retention among students of high, medium and low ability in mathematics. However, cooperative learning strategy has no effect on the interaction of ability level and retention. Based on the results obtained, it was therefore recommended that the adoption of the use of cooperative learning strategy in the teaching and learning of mathematics in senior secondary schools be initiated, maintained and sustained for the benefit of senior secondary school students in Taraba State. Periodic Government sponsored in-service training in form of long vacation training programme, workshops, conferences and seminars on the nature, scope, and use of cooperative learning strategy should be organized for senior secondary school mathematics teachers in Taraba state.

Keywords: ability level, cooperative learning, mathematics achievement, retention

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Authors: Salima Kerai, Muhammad Islam, Uzma Khan, Nargis Asad, Junaid Razzak, Omrana Pasha

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Background: Pre-hospital care providers are exposed to various kinds of stressors. Their daily exposure to diverse critical and traumatic incidents can lead to stress reactions like Post-Traumatic Stress Disorder (PTSD). Consequences of PTSD in terms of work loss can be catastrophic because of its compound effect on families, which affect them economically, socially and emotionally. Therefore, it is critical to assess the association between PTSD and Work performance in Emergency Medical Service (EMS) if exist any. Methods: This prospective observational study was carried out at AMAN EMS in Karachi, Pakistan. EMS personnel were screened for potential PTSD using impact of event scale-revised (IES-R). Work performance was assessed on basis of five variables; number of late arrivals to work, number of days absent, number of days sick, adherence to protocol and patient satisfaction survey over the period of 3 months. In order to model outcomes like number of late arrivals to work, days absent and days late; negative binomial regression was used whereas logistic regression was applied for adherence to protocol and linear for patient satisfaction scores. Results: Out of 536 EMS personnel, 525 were found to be eligible, of them 518 consented. However data on 507 were included because 7 left the job during study period. The mean score of PTSD was found to be 24.0 ± 12.2. However, weak and insignificant association was found between PTSD and work performance measures: number of late arrivals (RRadj 0.99; 95% CI 0.98-1.00), days absent (RRadj 0.98; 95% CI 0.96-0.99), days sick (Rradj 0.99; 95% CI 0.98 to 1.00), adherence to protocol (ORadj 1.01: 95% CI 0.99 to 1.04) and patient satisfaction (0.001% score; 95% CI -0.03% to 0.03%). Conclusion: No association was found between PTSD and Work performance in the selected EMS population in Karachi Pakistan. Further studies are needed to explore the phenomenon of resiliency in these populations. Moreover, qualitative work is required to explore perceptions and feelings like willingness to go to work, readiness to carry out job responsibilities.

Keywords: trauma, emergency medical service, stress, pakistan

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Authors: Saad Algharib, Jay Lee

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Urbanization is a complex phenomenon that occurs during the city’s development from one form to another. In other words, it is the process when the activities in the land use/land cover change from rural to urban. Since the oil exploration, Kuwait City has been growing rapidly due to its urbanization and population growth by both natural growth and inward immigration. The main objective of this study is to detect changes in urban land use/land cover and to examine the changing spatial patterns of urban growth in and around Kuwait City between 1989 and 2001. In addition, this study also evaluates the spatial patterns of the changes detected and how they can be related to the spatial configuration of the city. Recently, the use of remote sensing and geographic information systems became very useful and important tools in urban studies because of the integration of them can allow and provide the analysts and planners to detect, monitor and analyze the urban growth in a region effectively. Moreover, both planners and users can predict the trends of the growth in urban areas in the future with remotely sensed and GIS data because they can be effectively updated with required precision levels. In order to identify the new urban areas between 1989 and 2001, the study uses satellite images of the study area and remote sensing technology for classifying these images. Unsupervised classification method was applied to classify images to land use and land cover data layers. After finishing the unsupervised classification method, GIS overlay function was applied to the classified images for detecting the locations and patterns of the new urban areas that developed during the study period. GIS was also utilized to evaluate the distribution of the spatial patterns. For example, Moran’s index was applied for all data inputs to examine the urban growth distribution. Furthermore, this study assesses if the spatial patterns and process of these changes take place in a random fashion or with certain identifiable trends. During the study period, the result of this study indicates that the urban growth has occurred and expanded 10% from 32.4% in 1989 to 42.4% in 2001. Also, the results revealed that the largest increase of the urban area occurred between the major highways after the forth ring road from the center of Kuwait City. Moreover, the spatial distribution of urban growth occurred in cluster manners.

Keywords: geographic information systems, remote sensing, urbanization, urban growth

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Authors: Suja Karkada, Jayanthi Radhakrishnan, Jansi Natarajan, Gerald, Amandu Matua, Sujatha Shanmugasundaram

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Simulation-based learning is an educational strategy designed to simulate actual clinical situations in a safe environment. Globally, simulation is recognized by several landmark studies as an effective teaching-learning method. A systematic review of the literature on simulation revealed simulation as a useful strategy in creating a learning environment which contributes to knowledge, skills, safety, and confidence. However, to the best of the author's knowledge, there are no studies on assessing the anxiety of the students undergoing simulation. Hence the researchers undertook a study with the aim to evaluate the effectiveness of simulation on anxiety and knowledge among novice nursing students. This quasi-experimental study had a total sample of 69 students (35- Intervention group with simulation and 34- Control group with case scenario) consisting of all the students enrolled in the Fundamentals of Nursing Laboratory course during Spring 2016 and Fall 2016 semesters at a college of nursing in Oman. Ethical clearance was obtained from the Institutional Review Board (IRB) of the college of nursing. Informed consent was obtained from every participant. Study received the Dean’s fund for research. The data were collected regarding the demographic information, knowledge and anxiety levels before and after the use of simulation and case scenario for the procedure nasogastric tube feeding in intervention and control group respectively. The intervention was performed by four faculties who were the core team members of the course. Results were analyzed in SPSS using descriptive and inferential statistics. Majority of the students’ in intervention (82.9%) and control (89.9%) groups were equal to or below the age of 20 years, were females (71%), 76.8% of them were from rural areas and 65.2% had a GPA of more than 2.5. The selection of the samples to either the experimental or the control group was from a homogenous population (p > 0.05). There was a significant reduction of anxiety among the students of control group (t (67) = 2.418, p = 0.018) comparing to the experimental group, indicating that simulation creates anxiety among Novice nursing students. However, there was no significant difference in the mean scores of knowledge. In conclusion, the study was useful in that it will help the investigators better understand the implications of using simulation in teaching skills to novice students. Since previous studies with students indicate better knowledge acquisition; this study revealed that simulation can increase anxiety among novice students possibly it is the first time they are introduced to this method of teaching.

Keywords: anxiety, knowledge, novice students, simulation

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Authors: Kanikanun Photchong, Phusit Phukamchanoad

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The objective of this research is to study the people’s level of participation in activities of the community, their satisfaction towards the community, the attachment they have to the community, factors that influence the attachment, as well as the characteristics of the relationships of military families’ of the Royal Guards community of Dusit District. The method used was non-probability sampling by quota sampling according to people’s age. The determined age group was 18 years or older. One set of a sample group was done per family. The questionnaires were conducted by 287 people. Snowball sampling was also used by interviewing people of the community, starting from the Royal Guards Community’s leader, then by 20 of the community’s well-respected persons. The data was analyzed by using descriptive statistics, such as arithmetic mean and standard deviation, as well as by inferential statistics, such as Independent - Samples T test (T-test), One-Way ANOVA (F-test), Chi-Square. Descriptive analysis according to the structure of the interview content was also used. The results of the research is that the participation of the population in the Royal Guards Community in various activities is at a medium level, with the average participation level during Mother’s and Father’s Days. The people’s general level of satisfaction towards the premises of the Royal Guards Community is at the highest level. The people were most satisfied with the transportation within the community and in contacting with people from outside the premises. The access to the community is convenient and there are various entrances. The attachment of the people to the Royal Guards Community in general and by each category is at a high level. The feeling that the community is their home rated the highest average. Factors that influence the attachment of the people of the Royal Guards Community are age, status, profession, income, length of stay in the community, membership of social groups, having neighbors they feel close and familiar with, and as well as the benefits they receive from the community. In addition, it was found that people that participate in activities have a high level of positive relationship towards the attachment of the people to the Royal Guards Community. The satisfaction of the community has a very high level of positive relationship with the attachment of the people to the Royal Guards Community. The characteristics of the attachment of military families’ is that they live in big houses that everyone has to protect and care for, starting from the leader of the family as well as all members. Therefore, they all love the community they live in. The characteristics that show the participation of activities within the community and the high level of satisfaction towards the premises of the community will enable the people to be more attached to the community. The people feel that everyone is close neighbors within the community, as if they are one big family.

Keywords: community attachment, community satisfaction, royal guards community, activities of the community

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Authors: Mohammad Rahim Rahnama, Amir Ali Kharazmi, Safiye Rokni

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The tourism industry will be the most important unlimited, sustainable source of income after the oil and automotive industries by 2020 and not only countries, but cities are striving to apprehend its various facets. In line with this objective, the present descriptive-analytical study, through survey and using a questionnaire, seeks to evaluate the probability of tourists’ return and their recommendation to their countrymen to travel to Mashhad, Iran. The population under study is a sample of 384 foreign tourists who, in 2016, arrived at Mashhad, the second metropolis in Iran and its biggest religious city. The Kaplan-Meier estimator was used to analyze the data. Twenty-six percent of the tourists are female and 74% are male. On average, each tourist has had 3.02 trips abroad and 2.1 trips to Mashhad. Tourists from 14 different countries have arrived at Mashhad. Kuwait (15.9%), Armenia (15.6%), and Iraq (10.9%) were the countries where most tourists originated. Seventy-six percent of the tourists traveled with family and 90% of the tourists arrived at Mashhad via airplane. Major purposes of tourists’ trip include pilgrimage (27.9%), treatment (22.1%) followed by pilgrimage and treatment combined (35.4%). Major issues for tourists, in the order of priority, include quality of goods and services (30.2%), shopping (18%), and inhabitants’ treatment of foreigners (15.9%). Main tourist attractions, in addition to the Holy Shrine of Imam Reza, include Torqabeh and Shandiz (Torqabeh 40.9% and Shandiz 29.9%), Neyshabour (18.2%) followed by Kalat, 4.4%. The average willingness to return among tourists is 3.13, which is higher than the mean 3, indicating satisfaction with the stay in Mashhad. Similarly, the average for tourists’ recommending to their countrymen to visit Mashhad is 3.42, which is also an indicator of tourists’ satisfaction with their presence in Mashhad. According to the findings of the Kaplan-Meier estimator, an increase in the number of tourists’ trips to Mashhad, and an increase in the number of tourists’ foreign trips, reduces the probability of recommending a trip to Mashhad by tourists. Similarly, willingness to return is higher among those who stayed at a relatives’ home compared with other patterns of residence (hotels, self-catering accommodation, and pilgrim houses). Therefore, addressing the issues raised by tourists is essential for their return and their recommendation to others to travel to Mashhad.

Keywords: international tourist, probability of return, satisfaction, Mashhad

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Authors: Haileyesus Tessema Alemneh, Abiyu Enyew Molla, Oluwole Daniel Makinde

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Introduction: Faba bean is one of the most important grown plants worldwide for humans and animals. Several biotic and abiotic elements have limited the output of faba beans, irrespective of their diverse significance. Many faba bean pathogens have been reported so far, of which the most important yield-limiting disease is chocolate spot disease (Botrytis fabae). The dynamics of disease transmission and decision-making processes for intervention programs for disease control are now better understood through the use of mathematical modeling. Currently, a lot of mathematical modeling researchers are interested in plant disease modeling. Objective: In this paper, a deterministic mathematical model for chocolate spot disease (CSD) on faba bean plant with an optimal control model was developed and analyzed to examine the best strategy for controlling CSD. Methodology: Three control interventions, quarantine (u2), chemical control (u3), and prevention (u1), are employed that would establish the optimal control model. The optimality system, characterization of controls, the adjoint variables, and the Hamiltonian are all generated employing Pontryagin’s maximum principle. A cost-effective approach is chosen from a set of possible integrated strategies using the incremental cost-effectiveness ratio (ICER). The forward-backward sweep iterative approach is used to run numerical simulations. Results: The Hamiltonian, the optimality system, the characterization of the controls, and the adjoint variables were established. The numerical results demonstrate that each integrated strategy can reduce the diseases within the specified period. However, due to limited resources, an integrated strategy of prevention and uprooting was found to be the best cost-effective strategy to combat CSD. Conclusion: Therefore, attention should be given to the integrated cost-effective and environmentally eco-friendly strategy by stakeholders and policymakers to control CSD and disseminate the integrated intervention to the farmers in order to fight the spread of CSD in the Faba bean population and produce the expected yield from the field.

Keywords: CSD, optimal control theory, Pontryagin’s maximum principle, numerical simulation, cost-effectiveness analysis

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Authors: Yasir Bashawri, Vincent N. Chigor James McDonald, Merfyn Williams, Davey Jones, A. Prysor Williams

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Resistance to antibiotics has become a threat to public health. As a result of their misuse and overuse, bacteria have become resistant to many common antibiotics. Βeta lactam (β-lactam) antibiotics are one of the most significant classes of antimicrobials in providing therapeutic benefits for the treatment of bacterial infections in both human and veterinary medicine, for approximately 60% of all antibiotics are used. In particular, some Enterobacteriaceae produce Extend Spectrum Beta Lactamases (ESBLs) that enable them to some break down multi-groups of antibiotics. CTX-M enzymes have rapidly become the most important ESBLs, with increases in mainly CTX-M 15 in many countries during the last decade. Global travel by intercontinental medical ‘tourists’, migrant employees and overseas students could theoretically be a risk factor for spreading antibiotic resistance genes in different parts of the world. Bangor city, North Wales, is subject to sudden demographic changes due to a large proportion (>25%) of the population being students, most of which arrive over a space of days. This makes it a suitable location to study the impacts of large demographic change on the presence of ESBLs. The aim of this study is to monitor the presence of ESBLs in Escherichia coli and faecal coliform bacteria isolated from Bangor wastewater treatment plant, before, during and after the arrival week of students to Bangor University. Over a five-week period, water samples were collected twice a week, from the influent, primary sedimentation tank, aeration tank and the final effluent. Isolation and counts for Escherichia coli and other faecal coliforms were done on selective agar (primary UTI agar). ESBL presence will be confirmed by phenotypic and genotypic methods. Sampling at all points of the tertiary treatment stages will indicate the effectiveness of wastewater treatment in reducing the spread of ESBLs genes. The study will yield valuable information to help tackle a problem which many regard to be the one of the biggest threats to modern-day society.

Keywords: extended spectrum β-lactamase, enterobacteriaceae, international travel, wastewater treatment plant

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Authors: Arij Yehya, Suhaila Ghuloum, Abdlmoneim Abdulhakam, Azza Al-Mujalli, Mark Opler, Samer Hammoudeh, Yahya Hani, Sundus Mari, Reem Elsherbiny, Ziyad Mahfoud, Hassen Al-Amin

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Introduction: The Positive and Negative Syndrome Scale (PANSS) is a valid instrument developed by Kay and colleagues6 to assess symptoms of patients with schizophrenia. It consists of 30 items that factor the symptoms into three subscales: positive, negative and general psychopathology. This scale has been translated and validated in several languages. Objective: This study aims to determine the validity and psychometric properties of the Arabic version of the PANSS. Methods: A standardized translation and cultural adaptation method was adopted. Patients diagnosed with schizophrenia (n=98), according to psychiatrist’s diagnosis based on DSM-IV criteria, were recruited from the Psychiatry Department at Rumailah Hospital, Qatar. A first rater confirmed the diagnosis using the Arabic version of Mini International Neuropsychiatric Interview (MINI 6). A second and independent rater-administered the Arabic version of PANSS. Also, a control group (n=101), with no history of psychiatric disorder was recruited from the family and friends of the patients and from primary health care centers in Qatar. Results: There were more males than females in our sample of patients with schizophrenia (68.9% and 31.6%, respectively). On the other hand, in the control group the number of females outweighed that of males (58.4% and 41.6% respectively). The scale had a good internal consistency with Cronbach’s alpha 0.91. There was a significant difference between the scores on the three subscales of the PANSS. Patients with schizophrenia scored significantly higher (p<.0001) than the control subjects on subscales for positive symptoms 20.01(SD=7.21) and 7.30(SD=1.38), negative symptoms 18.89(SD=8.88) and 7.37(SD=2.38) and general psychopathology 34.41 (SD=11.56) and 16.93 (SD=3.93), respectively. Factor analysis and ROC curve were carried out to further test the psychometrics of the scale. Conclusions: The Arabic version of PANSS is a reliable and valid tool to assess both positive and negative symptoms of patients with schizophrenia in a balanced manner. In addition to providing the Arab population with a standardized tool to monitor symptoms of schizophrenia, this version provides a gateway to compare the prevalence of positive and negative symptoms in the Arab world which can be compared to others done elsewhere.

Keywords: Arabic version, assessment, diagnosis, schizophrenia, validation

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Authors: Kathleen Cravero, Amanda Nace, Samantha Ski

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The Violence Against Children Surveys (VACS) is nationally representative surveys of male and female youth ages 13-24, designed to measure the burden of sexual, physical, and emotional violence experienced in childhood and adolescence. As of 2019, 24 countries implemented or are in the process of implementing a VACS, covering over ten percent of the world’s child population. Since the first article using VACS data from Swaziland was published in 2009, several peer-reviewed articles have been published on the VACS. However, no publications to date have analyzed the breadth of the work and analyzed how the data are represented in the peer-reviewed literature. In this study, we conducted a literature review of all peer-reviewed research that used VACS data or discussed the implementation and methodology of the VACS. The literature review revealed several important findings. Between 2009 and July 2019, thirty-five peer-reviewed articles using VACS data from 12 countries have been published. Twenty of the studies focus on one country, while 15 of the studies focus on two or more countries. Some countries are featured in the literature more than others, for example Kenya (N=14), Malawi (N=12), and Tanzania (N=12). A review of the research by gender demonstrates that research on violence against boys is under-represented. Only two studies specifically focused on boys/young men, while 11 studies focused only on violence against girls. This is despite research which suggests boys and girls experience similar rates of violence. A review of the publications by type of violence revealed significant differences in the types of violence being featured in the literature. Thirteen publications specifically focused on sexual violence, while three studies focused on physical violence, and only one study focused on emotional violence. Almost 70% of the peer-reviewed articles (24 of the 35) were first-authored by someone at the U.S. Centers for Disease Control and Prevention. There were very few first authors from VACS countries, which raises questions about who is leveraging the data and the extent to which capacities for data liberation are being developed within VACS countries. The VACS provide an unprecedented amount of information on the prevalence and past-year incidence of violence against children. Through a review of the peer-reviewed literature on the VACS we can begin to identify trends and gaps in how the data is being used as well as identify areas for further research.

Keywords: data to action, global health, implementation science, violence against children surveys

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Authors: F. Heyecan Giritli, Gizem Akgül

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Because of the raising population of world; the need for houses, buildings and infrastructures are increasing rapidly. Energy and water consumption, waste production continues to increase. If this situation of resources continues, there will be a significant loss for next generations. Therefore, there are a lot of researches and solutions developed in the world. Also sustainability criteria are collected together by some countries to serve construction industry with certification systems. Sustainable building production process’s scope requires different path from traditional building production process. Moreover, the key objective of sustainable buildings is that the process includes whole life cycle duration. The process approaches from the decision of the project to the end of it; so the project team is needed from the beginning of the integrated project delivery model. Further more, by defining project team at the beginning of the project provides communication among the team members and defined problem solving and decision making methods. In this research includes the certification systems among the world to comprehend the head lines and assessment criteria. Therefore, it is understand that usually all green building criteria have the same contents. The aim of this research is to assess the sustainable project stakeholder’ perceptions in Turkish construction industry from the point of occupation, job title and years of experience. Therefore, a survey is made to assess the perceptions of each attendant. In Turkey, sustainability criteria are not clearly defined; on the other hand some regulations like waste management, energy efficiency are made by legal agencies. LEED certification system is the most popular system in Turkey that has attended and certificated. From the LEED official data, it’s understood that 308 project registered in Turkey. Therefore, LEED sustainability criteria are used in the survey. Head lines of LEED certification criteria; sustainable sites, water efficiency, energy and atmosphere, material and resources, indoor environmental quality, innovation and regional priority are indicated to assess the perceptions of survey participants. Moreover, only surveying of criteria are not enough; so the equipment, methods, risks and benefits also considered.

Keywords: LEED, sustainability, perceptions, stakeholders, construction, Turkey, risk, benefit

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Authors: Giorgi Gaganidze, Eter Kharaishvili

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The atypical crisis has created new challenges in the education system. Globally, including in Georgia, traditional methods of managing the education system have appeared particularly vulnerable. In addition, new opportunities for the introduction of innovative management of learning processes have emerged. The aim of the research is to identify the main challenges in the field of education management in the distance learning process in Georgia and to develop recommendations on the opportunities for the introduction of innovative management. The paper substantiates the relevance of the research, in particular, it notes that in Georgia, as in many countries, distance learning in higher education institutions became particularly crucial during the Covid-19 pandemic. What is more, theoretical and practical aspects of distance learning are less proven, and a number of problems have been identified in the field of education management in Georgia. The article justifies the need to study the challenges of distance learning for the formation of a sustainable education management system. Within the bibliographic research, there are grouped the opinions of researchers on the modern problems of distance learning and education management in the article. Based on scientific papers, the expectations formed about distance learning are studied, and the main focus is on the existing problems of education management during the atypical crisis. The article discusses the forms and opportunities of distance learning in different countries, evaluates different approaches and challenges to distance learning, and justifies the role of education management in effective distance learning. The paper uses various theoretical-methodological tools of research, including desk research on the research topic; Data selection-grouping, problem identification is carried out by analysis, synthesis, sampling, induction, and other methods;SWOT analysis is used to assess the strengths, weaknesses, opportunities, and threats of distance education and management; The level of student satisfaction with distance learning is determined through the Population-based / Census-based approach; The results of the research are processed by SPSS program. Quantitative research and semi-structured interviews with relevant focus groups were conducted to identify working directions for innovative management of distance learning and education. Research has shown that the demand for distance education is growing in Georgia, but the need to introduce innovative education management remains a particular challenge. Conclusions have been made on the introduction of innovative education management, and the relevant recommendations have been developed.

Keywords: distance learning, management challenges, education management, innovative management

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