Search results for: health transformation program

Authors: Franz Zirena Vilca, Nestor Cahui Galarza, Walter Alejandro Zamalloa Cuba, Edith Tello Palma, Teofilo Donaires Flores, Valdemar Luiz Tornisielo

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The production of rainbow trout in the Lake Titicaca represents an important economic activity for Peru. The city of Puno is responsible for 83% of this production, so the use of antibiotics within the aquaculture system is not alien to this reality. Meanwhile, the waters of Lake Titicaca represent an important source for the supply of drinking water for 80% of the population of the Puno city. In this paper, twelve antibiotics for veterinary use were monitored in water samples during two seasons: dry (July 2015) and rainy (February 2016), water samples from trout production systems, near the water catching point in the lake and drinking water in the city house of Puno were considered. The samples were analyzed using liquid chromatography coupled to mass spectrometry and solid online phase extraction (On-line SPE-LC-MS/MS), all samples analyzed showed concentrations of Ciprofloxacin up to 65.2 ng L⁻¹ at the rainy season. On the other hand, 63% of water samples from the dry season and 36 % from the rainy season showed Chlortetracycline up to 8.7 and 6.1 ng L⁻¹, respectively. The presence of residues of veterinary antibiotics in drinking water means a serious health risk for 80% of the population of Puno since all these people are supplied from this source.

Keywords: chromatography, DNA damage, environmental risk, water pollution

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Authors: Christina Tafadzwa

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Global HIV and AIDS trends show that Sub-Saharan Africa is the hardest-hit region, and women are disproportionately affected and infected by HIV. The trend is conspicuous in South Africa, where adolescent girls and young women (AGYW), female university students included, bear the burden of HIV infection. Although the female condom (FC) is the only female-oriented HIV and AIDS technology that provides dual protection against unwanted pregnancy and HIV, its uptake and use remain erratic, especially among the youth and young women in institutions of higher learning. This paper explores empirical evidence from the University of Venda (UniVen), which is in the rural areas of Limpopo Province in South Africa, and also among higher learning institutions experiencing low uptake and use of the FC. A phenomenological approach consisting of in-depth interviews was utilized to collect data from a total of 20 female university students at UniVen who were purposively sampled based on their participation in HIV and AIDS dialogues and campaigns conducted on campus. The findings that were analysed thematically revealed that notions of rurality and sociocultural beliefs surrounding women's sexual and reproductive health are key structural factors that influence the low use and uptake of the FC at the rural university. The evidence thus far revealed that female students are discouraged from collecting or initiating FC because of cultural dictates or prescripts which place the responsibility to collect and initiate condom use on men. Hence the inference that UniVen female students' realities are compounded by notions of rurality and society's patriarchal nature that intersect and limit women's autonomy in matters of sex. Guided by the women empowerment theory, this paper argues that such practices take away UniVen female students' agency to decide on their sexual and reproductive health. The normalisation of socio-cultural and harmful gender practices is also a retrogression in the women's health agenda. The paper recommends a holistic approach that engages traditional and community leaders, particularly men, to unlearn and uproot harmful gender norms and patriarchal elements that hinder the promotion and use of the FC.

Keywords: female condom, UniVen, socio-cultural factors, female students, HIV and AIDS

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Authors: Christine Marie Cocchiola

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This study assesses the relationship between coercive control and subjugation. Coercive control is the foundation of most domestic violence and a serious public health problem, having significant legal and social justice ramifications. Beyond the physical, it oftentimes is preceded by or motivated by a need for control. Subjugation, as a personality trait and a maladaptive schema, leads individuals to minimize their own needs or wants and, thereby, often to a loss of autonomy, a dismissal of what one might know to be true. This includes a dismissal of the trademarks of an abusive relationship. Subjugation may contribute to a person engaging in or remaining in a coercively controlling relationship. One hundred fifty-four female survivors of domestic violence participated in this study, assessing their own level of subjugation. Participants were limited to individuals who experienced non-physical abuse in their relationships. Subjugation was attributed as a “concern” or greater in 137 of the 154 participants. 11 participants were interviewed to determine their personal experiences in this abusive relationship. Common themes emerged from interviews, including that the participants worked diligently to fix these abusive relationships by regulating their own behaviors and attempting to please the offender. The results indicate a continued need for advocacy and support of this vulnerable population. Further education is indicated for mental health professionals and for individuals in or having left an abusive relationship on how to identify signs of subjugation, thereby empowering individuals to avoid future experiences of abuse.

Keywords: coercive control, intimate partner violence, subjugation, schemas, gender oppression, autonomy, gaslighting

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Authors: Sarthak Kumar Jena, Chandra Sekhar Mishra, Prabina Rajib

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Purpose: This paper aims to derive undervaluation signal from the insiders trading of Indian companies where the ownership is complex and concentrated, investors protection is weak, and the insider rules and regulations are not stringent like developed country. This study examines the relationship between insider trading with short term and long term abnormal return. The study also examines the relationship between insider trading and the actual share repurchase by the firm. Methodology: A sample of 78 companies over the period 2008-2013 are analyzed in the study due to not availability of insider data in Indian context. For preliminary analysis T-test and Wilcoxon rank sum test is used to find the difference between the insider trading before and after the share repurchase announcement. Tobit model is used to find out whether insider trading influence shares repurchase decisions or not. Return on the basis of market model and buy hold are calculated in the previous year and the following year of share repurchase announcement. Findings: The paper finds that insider trading around share repurchase is more than control firms and there is positive and significant difference in insider buying between the previous year of share buyback announcement and the following year of buyback announcement. Insider buying before share repurchase announcement has a positive influence on share repurchase decisions. We find insider buying has a positive and significant relationship with announcement return, whereas insider selling has a negative significant relationship with announcement return. Actual share repurchase and program completion also depend on insider trading before share repurchase. Research limitation: The study is constrained by the small sample size, so the results should be viewed by keeping this limitation in mind. Originality: The paper is to our best knowledge the first study based on Indian context to extend the insider trading literature to share repurchase event and examine insider trading to find out undervaluation signal associated with insider buying.

Keywords: insider trading, buyback, open market share repurchase, signalling

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Authors: Maha Atout, Pippa Hemingway, Jane Seymour

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A preliminary systematic review shows that health professionals experience a tension when communicating with the parents and family members of children with life-threatening and life-limiting conditions. On the one hand, they want to promote open and honest communication, while on the other, they are apprehensive about fostering an unrealistic sense of hope. Defining the boundaries between information that might offer reasonable hope versus that which results in false reassurance is challenging. Some healthcare providers worry that instilling a false sense of hope could motivate parents to seek continued aggressive treatment for their child, which in turn might cause the patient further unnecessary suffering. To date, there has been a lack of research in the Middle East regarding how healthcare providers do or should communicate bad news; in particular, the issue of hope in the field of paediatric palliative care has not been researched thoroughly. This study aims to explore, from the perspective of patients’ mothers, physicians, and nurses, the experience of communicating and receiving bad news in the care of children with palliative care needs. Data were collected using a collective qualitative case study approach across three paediatric units in a Jordanian hospital. Two data collection methods were employed: participant observation and semi-structured interviews. The overall number of cases was 15, with a total of 56 interviews with mothers (n=24), physicians (n=12), and nurses (n=20) completed, as well as 197 observational hours logged. The findings demonstrate that mothers wanted their doctors to provide them with hopeful information about the future progression of their child’s illness. Although some mothers asked their doctors to provide them with honest information regarding the condition of their child, they still considered a sense of hope to be essential for coping with caring for their child. According to mothers, hope was critical to treatment as it helped them to stay committed to the treatment and protected them to some extent from the extreme emotional suffering that would occur if they lost hope. The health professionals agreed with the mothers on the importance of hope, so long as it was congruent with the stage and severity of each patient’s disease. The findings of this study conclude that while parents typically insist on knowing all relevant information when their child is diagnosed with a severe illness, they considered hope to be an essential part of life, and they found it very difficult to handle suffering without any glimmer of it. This study finds that using negative terms has extremely adverse effects on the parents’ emotions. Hence, although the mothers asked the doctors to be as honest as they could, they still wanted the physicians to provide them with a positive message by communicating this information in a sensitive manner including hope.

Keywords: health professionals, children, communication, hope, information, mothers, palliative care

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Authors: Armando T. Zúñiga

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As the number of English Language Learners (ELLs) in public schools continues to grow, so does the achievement gap between ELLs and other student populations. In an effort to support classroom teachers with effective instructional strategies for this student population, many districts have created instructional coaching positions specifically to support classroom teachers of ELLs—ELL Teachers on Special Assignment (ELL TOSAs). This study employed a gap analysis framework to the ELL TOSA professional support program in one California school district to examine knowledge, motivation, and organizational influences (KMO) on the ELL TOSAs’ goal of supporting classroom teachers of ELLs. Three themes emerged as a result of data analysis. First, there was evidence to illustrate the interaction between knowledge and the organization. Data from ELL TOSAs indicated an understanding of the role that collaboration plays in coaching and how to operationalize it in their support of teachers. Further, all of the ELL TOSAs indicated they have received professional development on effective strategies for instructional coaching. Additionally, a large percentage of the ELL TOSAs indicated a knowledge of modeling as an effective coaching practice. Accordingly, all of the ELL TOSAs indicated that they had knowledge of feedback as an effective coaching strategy. However, there was not sufficient evidence to support that they learned the latter two strategies through professional development. A second theme surfaced as there was evidence to illustrate an interaction between motivation and the organization. Some ELL TOSAs indicated that their sense of self-efficacy was affected by conflicting roles and expectations for the job. Most of the ELL TOSAs indicated that their sense of self-efficacy was affected by an increased workload brought about by fiscal decision making. Finally, there was evidence illustrating the interaction between the organization and motivation. The majority of the of ELL TOSAs indicated that there is confusion about how their roles are perceived, leaving the ELL TOSAs to feel that their actions did not contribute to instructional change. In conclusion, five research-based recommendations to support ELL TOSA goal attainment and considerations for future research on instructional coaches for classroom teachers of ELLs are provided.

Keywords: English language development, English language acquisition, language and leadership, language coaching, English language learners, second language acquisition

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Authors: Sadia H. Syeda, Zain H. Malik

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As systems continue to become more complex and the interdependencies of processes and sub-systems continue to grow and transform, the need for a comprehensive method of tracking and linking the lifecycle of the systems in a digital form becomes ever more critical. Digital Engineering (DE) provides an approach to managing an authoritative data source that links, tracks, and updates system data as it evolves and grows throughout the system development lifecycle. DE enables the developing, tracking, and sharing system data, models, and other related artifacts in a digital environment accessible to all necessary stakeholders. The DE environment provides an integrated electronic repository that enables traceability between design, engineering, and sustainment artifacts. The DE activities' primary objective is to develop a set of integrated, coherent, and consistent system models for the program. It is envisioned to provide a collaborative information-sharing environment for various stakeholders, including operational users, acquisition personnel, engineering personnel, and logistics and sustainment personnel. Examining the processes that DE can support in the systems engineering life cycle (SELC) is a primary step in the DE adoption and implementation journey. Through an analysis of the U.S Department of Defense’s (DoD) Office of the Secretary of Defense (OSD’s) Digital Engineering Strategy and their implementation, examples of DE implementation by the industry and technical organizations, this paper will provide descriptions of the current DE processes and best practices of implementing DE across an enterprise. This will help identify the capabilities, environment, and infrastructure needed to develop a potential roadmap for implementing DE practices consistent with its business strategy. A capability maturity matrix will be provided to assess the organization’s DE maturity emphasizing how all the SELC elements interlink to form a cohesive ecosystem. If implemented, DE can increase efficiency and improve the systems engineering processes' quality and outcomes.

Keywords: digital engineering, digital environment, digital maturity model, single source of truth, systems engineering life-cycle

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Authors: Naznine Anwar, Kim Cornish, Izelle Labuschagne, Nellie Georgiou-Karistianis

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Falls and subsequent injuries are common features in symptomatic Huntington’s disease (symp-HD) individuals. As part of daily walking, navigating around obstacles may incur a greater risk of falls in symp-HD. We designed obstacle-crossing experiment to examine adaptive gait dynamics and to identify underlying spatiotemporal gait characteristics that could increase the risk of falling in symp-HD. This experiment involved navigating around one or two ground-based obstacles under two conditions (walking while navigating around one obstacle, and walking while navigating around two obstacles). A total of 32 participants were included, 16 symp-HD and 16 healthy controls with age and sex matched. We used a GAITRite electronic walkway to examine the spatiotemporal gait characteristics and inter-trail gait variability when participants walked at their preferable speed. A minimum of six trials were completed which were performed for baseline free walk and also for each and every condition during navigating around the obstacles. For analysis, we separated all walking steps into three phases as approach steps, navigating steps and recovery steps. The mean and inter-trail variability (within participant standard deviation) for each step gait variable was calculated across the six trails. We found symp-HD individuals significantly decreased their gait velocity and step length and increased step duration variability during the navigating steps and recovery steps compared with approach steps. In contrast, HC individuals showed less difference in gait velocity, step time and step length variability from baseline in both respective conditions as well as all three approaches. These findings indicate that increasing spatiotemporal gait variability may be a possible compensatory strategy that is adopted by symp-HD individuals to effectively navigate obstacles during walking. Such findings may offer benefit to clinicians in the development of strategies for HD individuals to improve functional outcomes in the home and hospital based rehabilitation program.

Keywords: Huntington’s disease, gait variables, navigating around obstacle, basal ganglia dysfunction

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Authors: Dennis Okora Amima Ondieki

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Fertility transition has been identified to be affected by numerous factors. This research aimed to investigate the most real factors affecting fertility transition in Kenya. These factors were firstly extracted from the literature convened into demographic features, social, and economic features, social-cultural features, reproductive features and modernization features. All these factors had 23 factors identified for this study. The data for this study was from the Kenya Demographic and Health Surveys (KDHS) conducted in 1999-2003 and 2003-2008/9. The data was continuous, and it involved the mean birth order for the ten periods. Principal component analysis (PCA) was utilized using 23 factors. Principal component analysis conveyed religion, region, education and marital status as the real factors. PC scores were calculated for every point. The identified principal components were utilized as forecasters in the multiple regression model, with the fertility level as the response variable. The four components were found to be affecting fertility transition differently. It was found that fertility is affected positively by factors of region and marital and negatively by factors of religion and education. These four factors can be considered in the planning policy in Kenya and Africa at large.

Keywords: fertility transition, principal component analysis, Kenya demographic health survey, birth order

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Authors: Erinma Chibuzo Nwandu

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Graduates unemployment has risen astronomically in spite of the emphasis on teaching of small scale business and Entrepreneurship in schools. This study sets out to evaluate the effect of teaching small scale business and Entrepreneurship on graduates’ unemployment in Nigeria. This study adopted the survey research design. Thus the nature of data for this study is primary, sourced by the use of a questionnaire administered to a sample of two thousand and sixty-five (2065) respondents drawn from groups of graduates who are employed, unemployed and self-employed in South East Nigeria. Simple percentages, Chi-square and regression analysis were used to derive useful and meaningful information and test the hypotheses respectively. Findings from the study suggest that Nigeria graduates are ill prepared to embark on small-scale business and entrepreneurship after graduation, and that teaching of small scale business and entrepreneurship in Nigeria tertiary institutions is ineffective on graduate unemployment reduction. Findings also suggest that while a lot of graduates agreed that they have taken a class(s) on small scale or entrepreneurship, they received more theoretical teachings than practical, more so while teachings on small scale business or entrepreneurship motivated graduates to think of self-employment, most of them cannot do a good business plan and hence could not benefit from some kind of Government assisted program for small-scale business and bank loan for the sake of small scale business. Thus, so many graduates are not interested in small scale business or entrepreneurship development as a result of lack of startup capital. The study thus recommends that course content and teaching method of entrepreneurship education needs to be reviewed and re-structured to constitute more practical teachings than theoretical teachings. Also, graduates should be exposed to seminar /workshop for self-employment at least once every semester. There should be practical teaching and practice of developing a business plan that will be viable to attract government or private sponsorship as well for it to be viable to attract financing from financing institutions. Government should provide a fund such as venture capital financing arrangement to empower business startups in Nigeria by graduates’.

Keywords: entrepreneurship, small scale business, startup capital, unemployment

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Authors: Smita Lahkar

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Sattriya, the youngest of the eight principal Classical Indian dance traditions, has undergone too many changes and modifications to arrive at its present stage of performing art form extracting itself from age-old religious confinement. Although some of the other traditions have been revived in the recent past, Sattriya has a living tradition since its inception in the 15th century by Srimanta Sankardeva, the great Vaishnavite saint, poet, playwright, lyricist, painter, singer and dancer of Assam, a primary north-eastern state of India. This living dance tradition from the Sattras, the Vaishnavite monasteries, has been practiced for over five hundred years by celibate male monks, as a powerful medium for propagating the Vaishnava religious faith. Sankardeva realised the potential of the vocalised word integrated with the visual image as a powerful medium of expression and communication. So he used this principal medium for propagating his newly found message of devotion among the people of his time. Earlier, Sattriya was performed by male monks alone in monasteries (Sattras) as a part of daily rituals. The females were not even allowed to learn this art form. But, in present time, Sattriya has come out from the Sattras to proscenium stage, performed mostly by female as well as few male dancers also. The technique of performing movements, costumes, ornaments, music and style of performance too have experienced too many changes and modifications. For example, earlier and even today in Sattra, the ‘Pataka’ hand gesture is depicted in conformity with the original context (religious) of creation of the dance form. But, today stage-performers prefer the instructions of the scripture ‘Srihastamuktavali’ and depict the ‘Pataka’ in a sophisticated manner affecting decontextualisation to a certain extent. This adds aesthetic beauty to the dance form as an art distancing it from its context of being a vehicle for propagating Vaishnava religion. The Sattriya dance today stands at the crossroads of past and future, tradition and modernity, devotion and display, spirituality and secularism. The traditional exponents trained under the tutelage of Sattra maestros and imbibing a devotionally inspired rigour of the religion, try to retain the traditional nuances; while the young artists being trained outside the monasteries are more interested in taking up the discipline purely from the perspective of ‘performing arts’ bereft of the philosophy of religion or its sacred associations. Hence, this paper will be an endeavor to establish the hypothesis that the Sattriya, whose origin was for propagating Vaishnava faith, has now entered the world of performing arts with highly aesthetical components. And as a transformed art form, Sattriya may be expected to carve a niche in world dance arena. This will be done with the help of historical evidences, observations from the recorded past and expert rendezvous.

Keywords: dance, performing art, religion, Sattriya

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Authors: Yuri Laevsky, Tatyana Nosova

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The phenomenon of filtration gas combustion (FGC) had been discovered experimentally at the beginning of 80’s of the previous century. It has a number of important applications in such areas as chemical technologies, fire-explosion safety, energy-saving technologies, oil production. From the physical point of view, FGC may be defined as the propagation of region of gaseous exothermic reaction in chemically inert porous medium, as the gaseous reactants seep into the region of chemical transformation. The movement of the combustion front has different modes, and this investigation is focused on the low-velocity regime. The main characteristic of the process is the velocity of the combustion front propagation. Computation of this characteristic encounters substantial difficulties because of the strong heterogeneity of the process. The mathematical model of FGC is formed by the energy conservation laws for the temperature of the porous medium and the temperature of gas and the mass conservation law for the relative concentration of the reacting component of the gas mixture. In this case the homogenization of the model is performed with the use of the two-temperature approach when at each point of the continuous medium we specify the solid and gas phases with a Newtonian heat exchange between them. The construction of a computational scheme is based on the principles of mixed finite element method with the usage of a regular mesh. The approximation in time is performed by an explicit–implicit difference scheme. Special attention was given to determination of the combustion front propagation velocity. Straight computation of the velocity as grid derivative leads to extremely unstable algorithm. It is worth to note that the term ‘front propagation velocity’ makes sense for settled motion when some analytical formulae linking velocity and equilibrium temperature are correct. The numerical implementation of one of such formulae leading to the stable computation of instantaneous front velocity has been proposed. The algorithm obtained has been applied in subsequent numerical investigation of the FGC process. This way the dependence of the main characteristics of the process on various physical parameters has been studied. In particular, the influence of the combustible gas mixture consumption on the front propagation velocity has been investigated. It also has been reaffirmed numerically that there is an interval of critical values of the interfacial heat transfer coefficient at which a sort of a breakdown occurs from a slow combustion front propagation to a rapid one. Approximate boundaries of such an interval have been calculated for some specific parameters. All the results obtained are in full agreement with both experimental and theoretical data, confirming the adequacy of the model and the algorithm constructed. The presence of stable techniques to calculate the instantaneous velocity of the combustion wave allows considering the semi-Lagrangian approach to the solution of the problem.

Keywords: filtration gas combustion, low-velocity regime, mixed finite element method, numerical simulation

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Authors: Gadanya, A.M., Ponfa, S., Jibril, M.M., Abubakar, S. M.

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Background: Edible insects such as grasshopper are important sources of food for humans, and have been consumed as traditional foods by many indigenous communities especially in Africa, Asia, and Latin America. These communities have developed their skills and techniques in harvesting, preparing, consuming, and preserving edible insects, widely contributing to the role played by the use of insects in human nutrition. Aim/ objective: This study was aimed at determining the effect of insect enriched sprouted soyabean /millet based food on some gut health markers in albino rats. Methods. Four different formulations of Complementary foods (i.e Complementary Food B (CFB): sprouted millet (SM), Complementary Food C (CFC): sprouted soyabean (SSB), Complementary Food D (CFD): sprouted soybean and millet (SSBM) in a ratio of (50:50) and Complementary Food E (CFE): insect (grasshopper) enriched sprouted soybean and millet (SSBMI) in a ratio of (50:25:25)) were prepared. Proximate composition and short chain fatty acid contents were determined. Thirty albino rats were divided into5 groups of six rats each. Group 1(CDA) were fed with basal diet and served as a control group, while groups 2,3,4 and 5 were fed with the corresponding complimentary foods CFB, CFC, CFD and CFE respectively daily for four weeks. Concentrations of fecal protein, serum total carotenoids and nitric oxide were determined. DNA extraction for molecular isolation and characterization were carried out followed by PCR, the use of mega 11 software and NCBI blast for construction of the phylogenetic tree and organism identification respectively. Results: Significant increase (P<0.05) in percentage ash, fat, protein and moisture contents, as well as short chain fatty acid (acetate, butyrate and propionate) concentrations were recorded in the insect enriched sprouted composite food (CFE) when compared with the CFA, CFB, CFC and CFD composite food. Faecal protein, carotenoid and nitric oxide concentrations were significantly lower (P>0.05) in group 5 in comparison to groups 1to 4. Ruminococcus bromii and Bacteroidetes were molecularly isolated and characterized by 16s rRNA from the sprouted millet/sprouted soybean and the insect enriched sprouted soybean/sprouted millet based food respectively. The presence of these bacterial strains in the feaces of the treated rats is an indication that the gut of the treated rats is colonized by good gut bacteria, hence, an improved gut health. Conclusion: Insect enriched sprouted soya bean/sprouted millet based complementary diet showed a high composition of ash, fat, protein and fiber. Thus, could increase the availability of short chain fatty acids whose role to the host organism cannot be overemphasized. It was also found to have decrease the level of faecal protein, carotenoid and nitric oxide in the serum which is an indication of an improvement in the immune system function.

Keywords: gut-health, insect, millet, soybean, sprouted

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Authors: Kehinde Joseph Awosan, Balarabe Adami Isah, Edzu Usman Yunusa, Sarafadeen Adeniyi Arisegi, Izuchukwu Obasi, Oluchi Solomon-Anucha

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Background: Metabolic syndrome (MetS) is prevalent in patients with diabetes mellitus and a significant risk for major cardiovascular events. Identifying its burden and peculiarities is crucial to preventing complications among those at risk. Aim: This study was conducted to determine the prevalence and predictors of metabolic syndrome among diabetes clinic attendees in Sokoto, Nigeria. Materials and Methods: A cross-sectional study was conducted among 365 patients with type 2 diabetes attending the diabetes clinic of Specialist Hospital, Sokoto, Nigeria. A structured questionnaire was used to obtain data on the respondents’ socio-demographic variables, treatment history, and lifestyle. Blood pressure and anthropometric measurements (including weight, height, and waist circumference) were done for the patients. Likewise, biochemical assessment (including fasting plasma glucose, high-density lipoprotein cholesterol (HDL-c), and triglyceride (TG) was done. Metabolic syndrome was defined according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III). Data were analyzed using the IBM Statistical Package for Social Sciences (SPSS) version 25. Results: The ages of the patients ranged from 30 to 78 (mean = 50.9 ±11.7) years. The overall prevalence of MetS was 57.3%, with a higher prevalence in females (68.1%) than males (43.0%). The most common components of MetS observed were hypertension (69.2%), and elevated fasting plasma glucose (65.7%); while the predictors of MetS were age > 50 years (OR 6.960, 95% CI: 3.836-12.628, p < 0.001), female sex (OR 2.300, 95% CI: 1.355-3.903, p = 0.002), physical activity (OR 0.214, 95% CI: 0.126-0.363, p < 0.001), and overweight/obesity (OR 3.356, 95% CI: 1.838-6.127, p < 0.001). Conclusion: Metabolic syndrome is prevalent among patients with type 2 diabetes in Sokoto, Nigeria, and the predictors were age > 50 years, female sex, physical activity, and overweight/obesity. Diabetes care providers should screen their patients for MetS to prevent adverse cardiovascular events.

Keywords: prevalence, predictors, metabolic syndrome, diabetes

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Authors: Chung-Yuan Wang, Kai-Chun Lee, Min-Hung Wang, Yu-Ren Chen, Hung-Sheng Lin, Sen-Shan Fan

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Taiwan National Health Insurance (NHI) was launched in 1995. It is an important social welfare policy in Taiwan. Regardless of the diversified social and economic status, universal coverage of NHI was assured. In order to regain better self-care performance, stroke people received in-patient and out-patient rehabilitation. Though NHI limited the rehabilitation frequency to one per day, the cost of rehabilitation still increased rapidly. Through the intensive rehabilitation during the post-stroke rehabilitation golden period, stroke patients might decrease their disability and shorten the rehabilitation period. Therefore, the aim of this study was to investigate the effect of intensive post-acute stroke rehabilitation in hospital under per diem payment. This study was started from 2014/03/01. The stroke patients who were admitted to our hospital or medical center were indicated to the study. The neurologists would check his modified Rankin Scale (mRS). Only patients with their mRS score between 2 and 4 were included to the study. Patients with unclear consciousness, unstable medical condition, unclear stroke onset date and no willing for 3 weeks in-patient intensive rehabilitation were excluded. After the physiatrist’s systemic evaluation, the subjects received intensive rehabilitation programs. The frequency of rehabilitation was thrice per day. Physical therapy, occupational therapy and speech/swallowing therapy were included in the programs for the needs of the stroke patients. Activity daily life performance (Barthel Index) and functional balance ability (Berg Balance Scale) were used to measure the training effect. During 3/1 to 5/31, thirteen subjects (five male and eight female) were included. Seven subjects were aged below 60. Three subjects were aged over 70. Most of the subjects (seven subjects) received intensive post-stroke rehabilitation for three weeks. Three subjects drop out from the programs and went back home respectively after receiving only 7, 10, and 13 days rehabilitation. Among these 13 subjects, nine of them got improvement in activity daily life performance (Barthel Index score). Ten of them got improvement in functional balance ability (Berg Balance Scale). The intensive post-acute stroke rehabilitation did help stroke patients promote their health in our study. Not only their functional performance improved, but also their self-confidence improved. Furthermore, their family also got better health status. Stroke rehabilitation under per diem payment was noted in long-term care institution in developed countries. Over 95% populations in Taiwan were supported under the Taiwan's National Health Insurance system, but there was no national long-term care insurance system. Most of the stroke patients in Taiwan live with his family and continue their rehabilitation programs from out-patient department. This pilot study revealed the effect of intensive post-acute stroke rehabilitation in hospital under per diem payment. The number of the subjects and the study period were limited. Thus, further study will be needed.

Keywords: rehabilitation, post-acute stroke, per diem payment, NHI

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Authors: Nora Alkharji, Wafa Fallatah

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Introduction: One of the major issues to consider when is deciding on what to feed a baby is the quality of the food itself. Whilst commercially prepared infant formulas are a nutritious alternative to breast milk, and even contain some vitamins and nutrients, most major medical organizations consider breastfeeding the best nutritional option for babies. Choosing whether to breastfeed or formula feed your baby is one of the first decisions expectant parents will make. The American Academy of Pediatrics (AAP) is in agreement with other organizations such as the American Medical Association (AMA), the American Dietetic Association (ADA), and the World Health Organization (WHO) in recommending breastfeeding as the best nutrition for babies and best suited for a baby's digestive system. In addition, breastfeeding helps in the combatting of infections, prevention of allergies, and protection against various chronic conditions. The decision to breastfeed or formula feed one’s baby is a very personal one. However, certain points need to be clarified regarding the nutritional value of breastfeeding versus formula feeding to allow for informed decision-making. Methodology: -A formal debate about whether to breastfeed or formula feed babies as the better choice. -There will be two debaters, both lactation consultants -Arguments will be based on evidence-based medicine -Duration period of debated: 45 min Result: Clarification and heightened awareness of the benefits of breastfeeding. Conclusion: This debate will make the choice between breastfeeding or formula feeding a relatively easy one to make by both health worker and parents.

Keywords: breastmilk, formula milk, nutritional, comparison

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Authors: Samuel P. Prahlow, Anthony Sciuva, Katherine Bombly, Emily Wilson, Shiv Dhiman, Savita Arya

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A prevalence cohort study of atherosclerotic lesions within cadavers was performed to better understand and characterize the prevalence of atherosclerosis among Georgia residents within body donors in the Philadelphia College of Osteopathic Medicine (PCOM) - Georgia body donor program. We procured specimens from cadavers used for medical students, physical therapy students, and biomedical science students cadaveric anatomical dissection at PCOM - South Georgia and PCOM - Georgia. Tissues were prepared using hematoxylin and eosin (H&E) stainas histological slides by Colquitt Regional Medical Center Laboratory Services. One section from each of the following arteries was taken after cadaveric dissection at the site of most calcification palpated grossly (if present): left anterior descending coronary artery, left internal carotid artery, abdominal aorta, splenic artery, and hepatic artery. All specimens were graded and categorized according to the American Heart Association’s Modified and Conventional Standards for Atherosclerotic Lesions using x4, x10, x40 microscopic magnification. Our study cohort included 22 cadavers, with 16 females and 6 males. The average age was 72.54, and the median age was 72, with a range of 52 to 90 years old. The cause of death determination listing vascular and/or cardiovascular causes was present on 6 of the 22 death certificates. 19 of 22 (86%) cadavers had at least a single artery grading > 5. Of the cadavers with at least a single artery graded at greater than 5, only 5 of 19 (26%) cadavers had a vascular or cardiovascular cause of death reported. Malignancy was listed as a cause of death on 7 (32%) death certificates. The average atherosclerosis grading of the common hepatic, splenic and left internal carotid arteries (2.15, 3.05, and 3.36 respectively) were lower than the left anterior descending artery and the abdominal aorta (5.16 and 5.86 respectively). This prevalence study characterizes atherosclerosis found in five medium and large systemic arteries within cadavers from the state of Georgia.

Keywords: pathology, atherosclerosis, histology, cardiovascular

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Authors: Maria Monica D. Espinosa

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This study aimed to identify and examine the characteristics of an effective leader in a Hospital institution from the perspectives of military nurse-managers. The researcher extracted the different facets of leadership from the stories of six nurse- managers from a military hospital. The stories which are in pre-reflective stage convey an unbiased perspective from which clinical leadership may be defined. Using Phenomenology as a method of Research, the lived experiences of the military nurse-managers served as empirical data which were reflected upon until the formulation of insights. The information from the co-researchers became gallows from which the characteristics of effective leadership in the clinical area were drawn. These insights were synthesized through layers of reflection that resulted to the knowledge about clinical leadership. The reflections are the following, (a) Clinical leaders develop their skills through experiences and hardwork; (b) Clinical leaders are devoted; (c) Clinical leaders are focused; (d) Clinical leaders are good in interpersonal relationship; (e) Clinical leaders are mentors; (f) Clinical leaders seek affirmation and recognition; and (g) Clinical leaders are responsible and dependable. The common themes that emerged from the nurse manager’s stories showed that clinical leadership maybe attained if leaders possessed the following traits, (a) The gift to establish a steadfast and firm management; (b) The proficiency to guide and encourage others towards the achievement of their goals and objectives; (c) The ability to instigate participative and collaborative work among his/her subordinates and (d) The aptitude and skill to address the institutional concerns in their unit. In the future, Clinical leaders should continually adapt an evaluation program on how they can relate socially with their subordinates, the result of which can be used as a basis in developing strategies on relationship enhancement. Moreover, they should empower the nurses by allowing them to voice out their opinions and concerns regarding assignments, role expectations, and workload issues to improve and strengthen the relationships among nurses. Lastly, they can incorporate a collaborative strategy to promote professional socialization attitudes of nurse managers who work with staff nurses to improve the quality of their proficiencies and enhance a positive clinical environment.

Keywords: clinical leadership, experiences, implications, military nurse - managers, phenomenology

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Authors: Juan Pablo Hervas-Perez, Jesus Guodemar-Perez, Montserrat Ruiz-Lopez, Elena Sonsoles Rodriguez-Lopez, Noemi Mayoral-Gonzalo, Eduardo Cimadevilla Fernandez-Pola, Mario Caballero-Corella

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Physiotherapy is a healthcare discipline that covers many fields of action within the recovery and prevention of health. Some are well known, but others, such as working with newborns and premature children are not so. Physical therapist functions are well defined, but the impression of the population is that there are other professionals who can develop them, and a large part are unknown. Objective: To evaluate the level of knowledge of the sample on the role of the physiotherapist in general, and more specifically in the neonatal intensive care (NICU) units, and estimate your level of notions on the development centered care (DCC). Method: A descriptive, transversal, observational and prospective study developed on a 125 participants' sample. Results: From the sample studied, 87.2% had already had contact with physiotherapy previously. An 80.9% believed that the physiotherapist intervention was decisive for the cure, and 84.0% would recommend physiotherapy treatment to others. Of the total surveyed, 98.0% felt that the physiotherapist is who should run the physiotherapeutic treatments, but shares with other professions 71.0% of votes. The field's best-known work is rehabilitation (94.0%); Neonatology is on the 4th place (66.0% of votes). Conclusions: Many areas of work of physical therapy are unknown to a big part of the population, including the own health workers. Less than half of the sample meets the DCC, and only 58% of the interviewed physiotherapists know them.

Keywords: functions of physiotherapist, neonatal intensive care, physiotherapy, prematurity

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Authors: Riyona Chetty, Raisuyah Bhagwan, Nalini Govender

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Background: During rehabilitation, the prosthetist establishes prosthetic and/or orthotic realistic goals and programmes as well as clinical outcome measures. They are well-positioned to improve the amputee’s physical and psychosocial well-being. Objective: This study aims to explore the ways in which the prosthetist may be able to improve the holistic well-being of the amputee. Methods: Data was collected using a focus group discussion with 16 prosthetists at a medical facility in KwaZulu-Natal, South Africa. Results: The findings indicate that amputees are encouraged to consider physical activities to improve their health. However, a major challenge experienced by the prosthetists was their lack of adequate psychosocial expertise, which affected their ability to offer emotional support. Additional factors such as language barriers, rotational systems, and unrealistic expectations further obstructed optimal service delivery. Conclusion: The prosthetists are adequately skilled in manufacturing the ideal prosthesis and encouraging physical exercise to promote the amputee’s physical health. However, their lack of psychosocial training limits them in providing emotional support during rehabilitation. It is recommended that prosthetists are provided with professional training to provide emotional support as part of holistic healthcare. Clinical relevance: The intention of this study was to provide pertinent recommendations for prosthetists, enabling them to provide holistic quality care to their patients.

Keywords: psychological, social, well-being, amputee, prosthetist

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Authors: Laila Albughayl

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The purpose of this qualitative case study was to explore Saudi females’ leadership journeys as they navigate the labyrinth of leadership in higher education. To gain a better understanding of how these leaders overcame challenges and accessed support as they progressed through the labyrinth to top positions in Saudi higher education. The significance of this research derived from the premise that leaders need to acquire essential leadership competencies such as knowledge, skills, and practices to effectively lead through economic transformation, growing globalism, and rapidly developing technology in an increasingly diverse world. In addition, understanding Saudi women’s challenges in the labyrinth will encourage policymakers to improve the situation under which these women work. The metaphor ‘labyrinth’ for Eagly and Carli (2007) encapsulates the winding paths, dead ends, and maze-like pathways that are full of challenges and supports that women traverse to access and maintain leadership positions was used. In this study, ‘labyrinth’ was used as the conceptual framework to explore women leaders’ challenges and opportunities in leadership in Saudi higher education. A proposed model for efficient navigation of the labyrinth of leadership was used. This model focused on knowledge, skills, and behaviours (KSB) as the analytical framework for examining responses to the research questions. This research was conducted using an interpretivist qualitative approach. A case study was the methodology used. Semi-structured interviews were the main data collection method. Purposive sampling was used to select ten Saudi leaders in three public universities. In coding, the 6-step framework of thematic analysis for Braun and Clarke was used to identify, analyze, and report themes within the data. NVivo software was also used as a tool to assist with managing and organizing the data. The resultant findings showed that the challenges identified by participants in navigating the labyrinth of leadership in Saudi higher education replicated some of those identified in the literature. The onset findings also revealed that the organizational barriers in Saudi higher education came as the top hindrance to women’s advancement in the labyrinth of leadership, followed by societal barriers. The findings also showed that women’s paths in the labyrinth of leadership in higher education were still convoluted and tedious compared to their male counterparts. In addition, the findings revealed that Saudi women leaders use significant strategies to access leadership posts and effectively navigate the labyrinth; this was not indicated in the literature. In addition, the resultant findings revealed that there are keys that assisted Saudi female leaders in effectively navigating the labyrinth of leadership. For example, the findings indicated that spirituality (religion) was a powerful key that enabled Saudi women leaders to pursue and persist in their leadership paths. Based on participants' experiences, a compass for effective navigation of the labyrinth of leadership in higher education was created for current and aspirant Saudi women leaders to follow. Finally, the findings had several significant implications for practice, policy, theory, and future research.

Keywords: women, leadership, labyrinth, higher education

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Authors: Gemma A. Gruyal

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Plants can contain a wide variety of substances with antioxidative properties which are associated to important health benefits. These positive health effects are of great importance at a time when the environment is laden with many toxic substances. Five selected herbal plants namely, Mimosa pudica, Phyllanthus niruri, Ceiba pentandra, Eleusine polydactyla and Trema amboinensis, were chosen for the experiment to investigate their total phenolics content and antioxidant activities using ABTS radical cation decolorization power, and ferric reducing antioxidant power. The total phenolic content of each herbal plants ranges from 0.84 to 42.59 mg gallic acid equivalent/g. The antioxidant activity in the ABTS radical cation decolorization power varies from 0.005 to 0.362 mg trolox equivalent/g and the FRAP ranges from 0.30 to 28.42 mg gallic acid equivalent/g. Among the five medicinal plants, Mimosa pudica has been an excellent performer in terms of the 3 parameters measured; it is followed by Phyllanthus niruri. The five herbal plants do not have equivalent antioxidant power. The relative high values for M. pudica and P. niruri supports the medicinal value of both plants. The total phenolics, ABTS and FRAP correlate strongly with one another.

Keywords: ABTS, FRAP, Leaf extracts, phenol

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Authors: Viknesh Kasthuri, Victoria Angenent-Mari, Jade Wexler

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The COVID-19 pandemic dramatically altered the landscape of asylum medicine. Brown Human Rights Asylum Clinic (BHRAC) is a medical-student-run asylum clinic that provides pro-bono medical evaluations and forensic affidavits for individuals seeking asylum in New England. After the outbreak of COVID-19 in March 2020, BHRAC experienced numerous changes both in the number of clients requesting services as well as in the resource needs of these clients. Uniquely, BHRAC assesses the needs of clients during their affidavit interview and seeks to address these needs by connecting clients to local community organizations and resources. Data regarding the specific needs of clients range from 2019-present day. Analysis of internal BHRAC’s internal data suggested a small increase in requests for assistance with light and gas (from 5% of total resource requests pre-COVID to 11%), as well as a decrease in requests for mental health services (from 20% of resources pre-COVID to 13% post-COVID). Furthermore, BHRAC witnessed a decline in clinic volume during the second half of 2020. In short, our data suggest that the pandemic affected asylum seekers' access to medico-legal services and the resources they need. Future research with larger sample sizes and in other geographic locations is required to determine the holistic impact of the COVID-19 pandemic on asylum seekers.

Keywords: asylum clinic, asylum medicine, COVID, social determinants of health

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Authors: Mohammed AL-Hasani

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The Pandemic COVID-19 altered the daily habits and affected the functional performance of the cities after this crisis leaving remarkable impacts on many metropolises worldwide. It is so obvious that having more densification in the city leads to more threats altering this main approach that was called for achieving sustainable development. The main goal to achieve resiliency in the cities, especially in forcing risks, is to deal with a planning system that is able to resist, absorb, accommodate and recover from the impacts that had been affected. Many Cities in London, Wuhan, New York, and others worldwide carried different planning approaches and varied in reaction to safeguard the impacts of the pandemic. The cities globally varied from the radiant pattern predicted by Le Corbusier, or having multi urban centers more like the approach of Frank Lloyd Wright’s Broadacre City, or having linear growth or gridiron expansion that was common by Doxiadis, compact pattern, and many other hygiene patterns. These urban patterns shape the spatial distribution and Identify both open and natural spaces with gentrified and gentrifying areas. This crisis paid attention to reassess many planning approaches and examine the existing urban patterns focusing more on the aim of continuity and resiliency in managing the crises within the rapid transformation and the power of market forces. According to that, this paper hypothesized that those urban planning patterns determine the method of reaction in assuring quarantine for the inhabitance and the performance of public services and need to be updated through carrying out an innovative urban management system and adopt further resilience patterns in prospective urban planning approaches. This paper investigates the adaptivity and resiliency of variant urban planning patterns regarding selected cities worldwide that affected by COVID-19 and their role in applying certain management strategies in controlling the pandemic spread, finding out the main potentials that should be included in prospective planning approaches. The examination encompasses the spatial arrangement, blocks definition, plots arrangement, and urban space typologies. This paper aims to investigate the urban patterns to deliberate also the debate between densification as one of the more sustainable planning approaches and disaggregation tendency that was followed after the pandemic by restructuring and managing its application according to the assessment of the spatial distribution and urban patterns. The biggest long-term threat to dense cities proves the need to shift to online working and telecommuting, creating a mixture between using cyber and urban spaces to remobilize the city. Reassessing spatial design and growth, open spaces, urban population density, and public awareness are the main solutions that should be carried out to face the outbreak in our current cities that should be managed from global to tertiary levels and could develop criteria for designing the prospective cities

Keywords: COVID-19, densification, resiliency, urban patterns

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Authors: Lauren B. Birney

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Summer STEM Institute for Middle and High School Students at Pace University The STEM Collaboratory NYC® Summer Fellows Institute takes place on Pace University’s New York City campus during July and provides the following key features for all participants: (i) individual meetings with Pace faculty to discuss and refine future educational goals; (ii) mentorship, guidance, and new friendships with program leaders; and (iii) guest lectures from professionals in STEM disciplines and businesses. The Summer STEM Institute allows middle school and high school students to work in teams to conceptualize, develop, and build native mobile applications that teach and reinforce skills in the sciences and mathematics. These workshops enhance students’STEM problem solving techniques and teach advanced methods of computer science and engineering. Topics include: big data and analytics at the Big Data lab at Seidenberg, Data Science focused on social and environmental advancement and betterment; Natural Disasters and their Societal Influences; Algal Blooms and Environmental Impacts; Green CitiesNYC; STEM jobs and growth opportunities for the future; renew able energy and sustainable infrastructure; and climate and the economy. In order to better align the existing Summer STEM, Institute with the CCERS model and expand the overall network, Pace is actively recruiting new content area specialists from STEM industries and private sector enterprises to participate in an enhanced summer institute in order to1) nurture student progress and connect summer learning to school year curriculum, 2) increase peer-to-peer collaboration amongst STEM professionals and private sector technologists, and 3) develop long term funding and sponsorship opportunities for corporate sector partners to support CCERS schools and programs directly.

Keywords: environmental restoration science, citizen science, data science, STEM

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Authors: Fiona Lourenco, William Allen

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Dentofacial deformities are primarily surgically treated via orthognathic surgery. Health-related quality of life is concerned with aspects of quality of life that relate specifically to an individual’s health. Design and Setting: Retrospective analysis of patients who had orthognathic surgery from January 2018 - December 2022 at the trust using the previously validated Orthognathic Quality of Life questionnaire (OQoL). Materials and Methods: 32 Patient questionnaires (which included pre-operative and post-operative separate sections) were obtained via telephone survey. The data was analysed using the two-tailed paired t-test and Wilcoxon signed-rank test. Results: The change in perception post-surgery was highly significant (both tests resulted in p<0.001 for overall analysis as well as for each domain). Overall, a 74% improvement in QoL was seen following orthognathic surgery. Reports of improvement in each domain were as follows: 71% in the social aspect of the deformity domain, 76% in facial aesthetics, 60% in function, and 57% improvement in awareness of facial deformity. Conclusion: The assessment of QoL is becoming progressively imperative in clinical research. The above data shows that orthognathic surgery has a significant improvement in the QoL of patients post-operatively. The results demonstrate improvement in all domains, with perceptions in facial aesthetics seeing the highest change post-operatively.

Keywords: dentofacial, oral, facial asymmetry, orthognathic surgery, quality of life

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Authors: W. Thongwat, B. Terakulsatit

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The study area is Kham Sakaesaeng District in Nakhon Ratchasima Province, the south section of Northeastern Thailand, located in the Lower Khorat-Ubol Basin. This region is the one of saline soil area, located in a dry plateau and regularly experience standing with periods of floods and alternating with periods of drought. Especially, the drought in the summer season causes the major saline soil and saline water problems of this region. The general cause of dry land salting resulted from salting on irrigated land, and an excess of water leading to the rising water table in the aquifer. The purpose of this study is to determine the relationship of physical and chemical properties between the soil and groundwater. The soil and groundwater samples were collected in both rainy and summer seasons. The content of pH, electrical conductivity (EC), total dissolved solids (TDS), chloride and salinity were investigated. The experimental result of soil and groundwater samples show the slightly pH less than 7, EC (186 to 8,156 us/cm and 960 to 10,712 us/cm), TDS (93 to 3,940 ppm and 480 to 5,356 ppm), chloride content (45.58 to 4,177,015 mg/l and 227.90 to 9,216,736 mg/l), and salinity (0.07 to 4.82 ppt and 0.24 to 14.46 ppt) in the rainy and summer seasons, respectively. The distribution of chloride content and salinity content were interpolated and displayed as a map by using ArcMap 10.3 program, according to the season. The result of saline soil and brined groundwater in the study area were related to the low-lying topography, drought area, and salt-source exposure. Especially, the Rock Salt Member of Maha Sarakham Formation was exposed or lies near the ground surface in this study area. During the rainy season, salt was eroded or weathered from the salt-source rock formation and transported by surface flow or leached into the groundwater. In the dry season, the ground surface is dry enough resulting salt precipitates from the brined surface water or rises from the brined groundwater influencing the increasing content of chloride and salinity in the ground surface and groundwater.

Keywords: environmental geology, soil salinity, geochemistry, groundwater hydrology

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Authors: Naziema Begum Jappie

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The internationalization of higher education has become a focal point for academic institutions worldwide, including those in South Africa. This paper explores the multifaceted implications of internationalization on management and practice within the South African higher education landscape. Universities all over the world are increasingly recognizing the challenges of globalization and the pressures towards internationalization. Internationalization in higher education encompasses a range of activities, including academic exchange programs, research collaborations, joint degree programs, and the recruitment of international students and faculty. In South Africa, this process is driven by various factors, including the quest for global competitiveness, the pursuit of academic excellence, and the promotion of cultural diversity. However, while internationalization presents numerous opportunities, it also brings forth significant challenges that require careful consideration by management and practitioners in higher education institutions. Furthermore, the internationalization of higher education in South Africa has significant implications for teaching and learning practices. With an increasingly diverse student body, educators must employ innovative pedagogical approaches that cater to the needs and preferences of a multicultural cohort. This may involve the integration of global perspectives into the curriculum, the use of technology-enhanced learning platforms, and the promotion of intercultural competence among students and faculty. Additionally, the exchange of knowledge and ideas with international partners can enrich research activities and contribute to the advancement of knowledge in various fields. The internationalization of higher education in South Africa has profound implications for management and practice within academic institutions. While it offers opportunities for enhancing academic quality, promoting cultural exchange, and advancing research agendas, it also presents challenges that require strategic planning, resource allocation, and stakeholder engagement. By addressing these challenges proactively and leveraging the opportunities presented by internationalization, South African universities can position themselves as global leaders in higher education while contributing to the socio-economic development of the country and the continent at large. This paper draws together the international experience in South Africa to explore the emerging patterns of strategy and practice in internationalizing Higher Education and will highlight some critical notions of how the concepts of internationalization and globalization in the context of higher education are understood by those who lead universities and what new challenges are being created as universities seek to become more international. Institutions cannot simply have bullet points in the strategic plan for the recruitment of international students; there has to be a complete commitment to a national strategy of inclusivity. This paper will further examine the leadership styles that ensure transformation together with the goals set out for internationalization. Discussions around adding the international relations dimension to the curriculum. Addressing the issues relevant to cross-border delivery of higher education.

Keywords: challenges, higher education, internationalization, strategic focus

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Authors: Nahid Salarkia, Nasrin Omidvar, Erfan Ghassemi, Vahideh Arab-Salari, Tirang Reza Neyestani

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Background: Household food insecurity has an adverse impact on the maternal mental health. This study was carried out to assess the relationship between household food insecurity, maternal depression and mother’s self-efficacy in Varamin, Iran, in 2014. Methods: In this cross-sectional study 423 mothers with children under 2 years old, with mean age 28.1±5.2 year; weight 66.3±13.4 kg; height 160.3± 5.7 cm and BMI 25.7±4.8 kg/m2 were selected by a multistage random sampling scheme. The instruments were: Beck Depression Inventory (BDI-III) and mother’s self-efficacy questionnaire. Data was analyzed using χ2 test, ANOVA and Pearson correlation. Results: Mildly, moderately and severely food insecure households were 39.5, 9.7 and 3.1%, respectively. Mild, moderate and sever depression was: 18.7, 13.9 and 5.7%. Mean score of depression in moderate and severe food insecure (8.6±5.3) was more than mild food insecure (4.8±4.7) and food secure (3.1±3.6) mothers. Frequency of very good, good and low mother’s self-efficacy were 62.8, 36.5, and 0.7%, respectively. Very good mother’s self-efficacy in food secure mothers (33.4%) was more than mild (25.4%) and moderate-sever food insecure groups (4%). There was a negative significant association between household food insecurity and mother’s self-efficacy (r= -0.297, p<0.01), and between mother’s depression and self-efficacy (r= -0.309, p=0.001). Conclusion: Empowerment of mothers with educational programs and social support can decrease mothers’ depression and increase self-efficacy that lead to improve maternal practices in food insecure households.

Keywords: Household food insecurity, Iran, mothers, physiological characteristics, self-efficacy

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Authors: Vidhya Venugopal, Rekha S.

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Introduction: Climate change and the growing frequency of higher average temperatures and heat waves have detrimental health effects, especially for certain vulnerable groups with limited socioeconomic status (SES) or physiological capacity to adapt to or endure high temperatures. Little research has been conducted on the effects of heat stress on pregnant women and fetuses in tropical regions such as India. Very high ambient temperatures may worsen Adverse Pregnancy Outcomes (APOs) and are a major worry in the scenario of climate change. The relationship between rising temperatures and APO must be better understood in order to design more effective interventions. Methodology: We conducted an observational cohort study involving 865 pregnant women in various districts of Tamil Nadu districts between 2014 and 2021. Physiological Heat Strain Indicators (HSI) such as morning and evening Core Body Temperature (CBT) and Urine Specific Gravity (USG) were monitored using an infrared thermometer and refractometer, respectively. A validated, modified version of the HOTHAPS questionnaire was utilised to collect self-reported health symptoms. A follow-up was undertaken with the mothers to collect information regarding birth outcomes and APOs, such as spontaneous abortions, stillbirths, Preterm Birth (PTB), birth abnormalities, and Low Birth Weight (LBW). Major findings of the study: According to the findings of our study, ambient temperatures (mean WBGT°C) were substantially higher (>28°C) for approximately 46% of women performing moderate daily life activities. 82% versus 43% of these women experienced dehydration and heat-related complaints. 34% of women had USG >1.020, which is symptomatic of dehydration. APOs, which include spontaneous abortions, were prevalent at 2.2%, stillbirth/preterm birth/birth abnormalities were prevalent at 2.2%, and low birth weight was prevalent at 16.3%. With exposures to WBGT>28°C, the incidence of miscarriage or unexpected abortion rose by approximately 2.7 times (95% CI: 1.1-6.9). In addition, higher WBGT exposures were associated with a 1.4-fold increased risk of unfavorable birth outcomes (95% Confidence Interval [CI]: 1.02-1.09). The risk of spontaneous abortions was 2.8 times higher among women who conceived during the hotter months (February – September) compared to those women who conceived in the cooler months (October – January) (95% CI: 1.04-7.4). Positive relationships between ambient heat and APOs found in this study necessitate further exploration into the underlying factors for extensive cohort studies to generate information to enable the formulation of policies that can effectively protect these women against excessive heat stress for enhanced maternal and fetal health.

Keywords: heat exposures, community, pregnant women, physiological strain, adverse outcome, interventions

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