Search results for: rare disease policy

Authors: Mehrnaz Mostafavi

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Nanoliposomes, minute lipid-based vesicles at the nano-scale, show promise in the realm of photothermal therapy (PTT). This study presents an extensive overview of nanoliposomes in PTT, exploring their distinct attributes and the significant progress in this therapeutic methodology. The research delves into the fundamental traits of nanoliposomes, emphasizing their adaptability, compatibility with biological systems, and their capacity to encapsulate diverse therapeutic substances. Specifically, it examines the integration of light-absorbing materials, like gold nanoparticles or organic dyes, into nanoliposomal formulations, enabling their efficacy as proficient agents for photothermal treatment Additionally, this paper elucidates the mechanisms involved in nanoliposome-mediated PTT, highlighting their capability to convert light energy into localized heat, facilitating the precise targeting of diseased cells or tissues. This precise regulation of light absorption and heat generation by nanoliposomes presents a non-invasive and precisely focused therapeutic approach, particularly in conditions like cancer. The study explores advancements in nanoliposomal formulations aimed at optimizing PTT outcomes. These advancements include strategies for improved stability, enhanced drug loading, and the targeted delivery of therapeutic agents to specific cells or tissues. Furthermore, the paper discusses multifunctional nanoliposomal systems, integrating imaging components or targeting elements for real-time monitoring and improved accuracy in PTT. Moreover, the review highlights recent preclinical and clinical trials showcasing the effectiveness and safety of nanoliposome-based PTT across various disease models. It also addresses challenges in clinical implementation, such as scalability, regulatory considerations, and long-term safety assessments. In conclusion, this paper underscores the substantial potential of nanoliposomes in advancing PTT as a promising therapeutic approach. Their distinctive characteristics, combined with their precise ability to convert light into heat, offer a tailored and efficient method for treating targeted diseases. The encouraging outcomes from preclinical studies pave the way for further exploration and potential clinical applications of nanoliposome-based PTT.

Keywords: nanoliposomes, photothermal therapy, light absorption, heat conversion, therapeutic agents, targeted delivery, cancer therapy

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Authors: Sultan Çağırıcı, Arsida Bajrami, Beyza Aslan, Hacı Ali Erdoğan, Nejla Sözer Topçular, Dilek Bozkurt, Vildan Yayla

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Objective: Corticobasal syndrome (CBS) is phenotypically characterized by asymmetric rigidity, apraxia, alien-limb phenomenon, cortical sensory loss, dystonia and myoclonus. The underlying pathologies consists of corticobasal degeneration (CBD), progressive supra nuclear palsy, Alzheimer's, Creutzfeldt-Jakob and frontotemporal degeneration. CBD is a degenerative disease with clinical symptoms related to the prominent involvement of cerebral cortex and basal ganglia. CBD is a pathological diagnosis and antemortem clinical diagnosis may change many times. In this paper, we described the clinical features and discussed a cases diagnosed with symmetric CBS because of its rarity. Case: Seventy-five-year-old woman presented with a three years history of difficulty in speaking and reading. Involuntary hand jerks and slowness of movement also had began in the last six months. In the neurological examination the patient was alert but not fully oriented. The speech was non-fluent, word finding difficulties were present. Bilateral limited upgaze, bradimimia, bilateral positive cogwheel' rigidity but prominent in the right side, postural tremor and negative myoclonus during action on the left side were detected. Receptive language was normal but expressive language and repetition were impaired. Acalculia, alexia, agraphia and apraxia were also present. CSF findings were unremarkable except for elevated protein level (75 mg/dL). MRI revealed bilateral symmetric cortical atrophy prominent in the frontoparietal region. PET showed hypometabolism in the left caudate nucleus. Conclusion: The increase of data related to neurodegenerative disorders associated with dementia, movement disorders and other findings results in an expanded range of diagnosis and transitions between clinical diagnosis. When considered the age of onset, clinical symptoms, imaging findings and prognosis of this patient, clinical diagnosis was CBS and pathologic diagnosis as probable CBD. Imaging of CBD usually consist of typical asymmetry between hemispheres. Still few cases with clinical appearance of CBD may show symmetrical cortical cerebral atrophy. It is presented this case who was diagnosed with CBD although we found symmetrical cortical cerebral atrophy in MRI.

Keywords: symmetric cortical atrophy, corticobasal degeneration, corticobasal syndrome

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Authors: Meredith Rossi, Lesley Lee, Mary Wear, Mary Van Baalen, Bradley Rhodes

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The astronaut community is unique, and may be disproportionately exposed to occupational hazards not commonly seen in other communities. The extent to which the demands of the astronaut occupation and exposure to spaceflight-related hazards affect the health of the astronaut population over the life course is not completely known. A better understanding of the individual, population, and mission impacts of astronaut occupational exposures is critical to providing clinical care, targeting occupational surveillance efforts, and planning for future space exploration. The ability to characterize the risk of latent health conditions is a significant component of this understanding. Provision of health screening services to active and former astronauts ensures individual, mission, and community health and safety. Currently, the NASA-Johnson Space Center (JSC) Flight Medicine Clinic (FMC) provides extensive medical monitoring to active astronauts throughout their careers. Upon retirement, astronauts may voluntarily return to the JSC FMC for an annual preventive exam. However, current retiree monitoring includes only selected screening tests, representing an opportunity for augmentation. The potential long-term health effects of spaceflight demand an expanded framework of testing for former astronauts. The need is two-fold: screening tests widely recommended for other aging populations are necessary to rule out conditions resulting from the natural aging process (e.g., colonoscopy, mammography); and expanded monitoring will increase NASA’s ability to better characterize conditions resulting from astronaut occupational exposures. To meet this need, NASA has begun an extensive exploration of the overall approach, cost, and policy implications of expanding the medical monitoring of former NASA astronauts under the Astronaut Occupational Health program. Increasing the breadth of monitoring services will ultimately enrich the existing evidence base of occupational health risks to astronauts. Such an expansion would therefore improve the understanding of the health of the astronaut population as a whole, and the ability to identify, mitigate, and manage such risks in preparation for deep space exploration missions.

Keywords: astronaut, long-term health, NASA, occupational health, surveillance

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Authors: Lu-Chiu Huang, Pei-Pei Chen, Li-Chin Yu, Chiao-Wen Kuo, Tsui-Tao Liu, Rung-Chuang Feng

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Purpose: People put increasing emphasis on demands of medical quality and protecting their interests. Patients' or family's dissatisfaction with medical care may easily lead to medical dispute. Physician-family communication plays an essential role in medical care. A sound communication cannot only strengthen patients' belief in the medical team but make patient have definite insight into treatment course of the disease. A family meeting provides an effective platform for communication between clinical staff, patients and family. Decisions and consensuses formed in family meetings can promote patients' or family's satisfaction with medical care. Clinical staff's attitudes toward family meeting may determine behavioral intentions to hold family meeting. This study aims to explore clinical staff's difficulties in holding family meeting and evaluate how their attitudes and behavior influence the effect of family meetings. Methods: This was a cross-sectional study. It was conducted at a regional teaching hospital in Taipei city. The research team developed its own structural questionnaires, whose expert validity was checked by the nursing experts. Participants filled in the questionnaires online. Data were collected by convenience sampling. A total of 568 participants were invited. They included doctors, nurses, social workers, and so on. Results: 1) The average score of ‘clinical staff’s attitudes to family meetings’ was 5.15 (SD=0.898). It fell between ‘somewhat agree’ and ‘mostly agree’ on the 7-point likert scale. It indicated that clinical staff had positive attitudes toward family meetings, 2) The average score of ‘clinical staff’s behavior to family meetings’ was 5.61 (SD=0.937). It fell between ‘somewhat agree’ and ‘mostly agree’ on the 7-point likert scale. It meant clinical staff tended to have positive behavior at the family meeting, and 3) The average score of ‘Difficulty in conducting family meetings’ was 5.15 (SD=0.897). It fell between ‘somewhat agree’ and ‘mostly agree’ on the 7-point likert scale. The higher the score was, the less difficulty the clinical staff felt. It demonstrated clinical staff felt less difficulty in conducting family meetings. Clinical staff's identification with family meetings brought favored effects. Persistent and active promotion for family meetings can bring patients and family more benefits. Implications for practice: Understanding clinical staff's difficulty in participating family meeting and exploring their attitudes or behavior toward physician-family communication are helpful to develop modes of interaction. Consequently, quality and satisfaction of physician-family communication can be increased.

Keywords: clinical staff, communication, family meeting, physician-family

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Authors: Daria Lozovskaia

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This paper is focused on the news coverage of public opinion polls about Russian full-scale invasion of Ukraine in Russian state-controlled media. After the announcement of the start of the so-called “Special Military Operation” on February 24, 2022, the number of publications of the results of public opinion polls increased many times over, and the poll numbers began to be discussed on social media and in the Kremlin’s official informational agenda. Headlines like "72 Percent of Russian Citizens Support the Operation " or "Russians Believe in Victory in the Special Military Operation" have become prominent parts of Russian state propaganda news stories and newspapers. At the same time, public opinion in Russia, as a concept and model, differs from the generally accepted democratic concept and has its own specifics. As a result, public opinion polls and their results, especially after February 24, have a number of features in the form of the dominance of the discourse of political elites in the media, which leads to a decrease in public awareness, the prevalence of the effect of joining the majority and a high number of non-responses due to fear of reprisals. The aim of this study was to determine the role of public opinion polls in the system of Russian war propaganda in Ukraine. For this purpose, were selected publications of the Russian media, the agenda of which corresponds to the official information policy of the Russian authorities. First, using frame analysis for the categories "Explicit trust", "Implicit trust", "Implicit distrust" and "Explicit distrust", provided by Irina Dusakova, the broadcast level of trust in the data of public opinion polls was determined. The results of this phase of the study showed that the Russian media broadcast an absolute level of confidence in public opinion polls regarding support for the war in Ukraine. The second stage of the study was the content analysis of publications. The categories of this analysis were derived from Anna Morelli's 10 Principles of Military Propaganda and Haavard Koppang's Definition of Propaganda to determine the purposes of the use of public opinion polls by Russian propaganda. The results of the study not only confirmed the widespread hypothesis that public opinion polls in Russia are used as a tool of state propaganda, but also showed that their purpose is to demonstrate the consolidation of society in support of the war and President Vladimir Putin.

Keywords: propaganda, public opinion, public opinion polls, Russian studies

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Authors: Rodziana M. Razali, Tamara J. Duraisingham

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Malaysia is not a signatory to the 1951 Refugee Convention and its 1967 Protocol despite receiving the largest share of refugee inflows in Southeast Asia aside from Thailand. In Peninsular Malaysia, the majority of refugees and asylum seekers are from Myanmar, with Rohingya refugees recording the highest number compared to all other ethnicities. In the eastern state of Sabah, the presence of refugees who have long established themselves in the state is connected to those who escaped military persecution in southern Philippines in the 1970’s and 1980’s. A combination of legal and non-legal factors has created and sustained an adverse atmosphere of deprivation of legal identity for children of migrants including refugees born in Malaysia. This paper aims to qualitatively analyse the barriers to birth registration as the cornerstone of every person’s legal identity for children of refugees born in this country, together with the associated human rights implications. Data obtained through semi-structured interviews with refugees in Kota Kinabalu, Sabah and Rohingya refugees in Peninsular Malaysia shall be studied alongside secondary sources. Results show that births out of medical facilities, suspension of birth records, illiteracy, lack of awareness on the importance and procedures of birth registration, inability to meet documentary requirements, as well as fear of immigration enforcement, are the key factors hindering birth registration. These challenges exist against the backdrop of restrictive integration policy to avoid destabilising demographic and racial balance, political sentiment stirring xenophobic prejudices, as well as other economic and national security considerations. With no proof of their legal identity, the affected children grow up in a legal limbo, facing multiple human rights violations across generations. This research concludes that the country’s framework and practice concerning birth registration is in need of serious reform and improvement to reflect equality and universality of access to its birth registration system. Such would contribute significantly towards meeting its commitments to the post-2015 sustainable development agenda that pledges to 'Leave no one behind', as well as its recently announced National Human Rights Action Plan.

Keywords: birth registration, children, Malaysia, refugees

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Authors: B. Rusyidi

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Since 2009, the Indonesian Ministry of Social Affairs has been implementing Program Kesejahteraan Sosial Anak (PKSA) (Child Welfare Program) a conditional cash transfer program that targets neglected children, children with disabilities, street children, children in conflict with the law, and children in need of special protection, all from poor households. PKSA integrates three elements: Transfer of cash, care and social services through social workers, and institutional childcare assistance. This qualitative study analyzed the roles and the challenges of social workers in implementing PKSA and lays out recommendations to inform policy changes. Data were collected in late 2014 from national and local government and non-government child welfare agencies, social workers, and childcare institution representatives through interviews and Focused Group Discussions (FGDs). Field work took place in six districts in the provinces of Jakarta, Central Java and South Sulawesi. The study found that the social workers’ role was significant in facilitating cash transfer, providing education and guidance, and linking children and families to basic social services. This improved utilization of basic social services enhanced children and families’ behaviors and contributed to the well being of the children. However, only a small number of childcare institutions have social workers, leaving many children and families without care and social service linkages, depriving them of rehabilitative components to help them regain their social functions. Some social workers reported their struggles with heavy workloads, lack of professional competencies and training, limited job security, and inadequate professional acknowledgment from other professions. Parts of those challenges were due to the centralized nature of the program and the lack of shared vision and commitment about the child protection system among related government agencies both at the national and local levels. The study highlights the necessity to implement an integrated child protection system, decentralize the PKSA program, and increase the number, competence, case management, and management and monitoring of social workers. The most recent progress of the program and its impacts on social workers are also discussed.

Keywords: child protection, conditional cash transfer, program decentralization, social worker, working conditions

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Authors: Lee Jin-Eui, Kim Jin-OK, Han Seung-Hoon, Kim Nam-Jo

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Recently, there has been a growing interest in wellbeing where individuals pursue a healthy life. About the half of world population is living in cities, and the urban environment is negatively affecting the mental health of modern people. The stress level of urban dwellers continues to increase, and they pursue nature-based recreation activities to relieve their stresses. It was found that activities in green spaces are improving concentration, relieving mental stress, and positively affecting physical activities and social relationship, thus enhancing the quality of life. For that reason, studies have been continuously conducted on the role of nature, which is a green space for pursuing health and relieving the stress of urban dwellers. Therefore, this study investigated the effect of experiencing a restoration from nature-based outdoor recreation activities of urban dwellers on their quality of life for the groups with high and low-stress levels. The results of the analysis against visitors who trekked and climbed Mt. Bukhan National Park in Seoul, South Korea showed that the effect of perceiving restorative environment on relaxation, calmness and subjective vitality, and the effect of relaxation and calmness on the quality of life were similar in both groups. However, it was found that subjective vitality affected the quality of life in the group with the high-stress group, while it did not show a significant result in the low-stress group. This is because the high-stress group increased their belief in the future and themselves and vitality through nature-based outdoor activities, which in turn affected their quality of life, while people in the low-stress group normally have subjective vitality in their daily lives, not affected by nature-based outdoor recreation. This result suggests that urban dwellers feel relaxed and calm through nature-based outdoor recreation activities with perceived restorative environment, and such activities enhance their quality of life. Therefore, a wellbeing policy is needed to enhance the quality of life of citizens by creating green spaces in city centers for the promotion of public health.

Keywords: healing tourism, nature-based outdoor recreation, perceived restorative environment, quality of life

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Authors: Stefan Kurbatfinski, Aliyah Dosani, Andrew F. Hayes, Deborah Dewey, Nicole Letourneau

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Background: Maternal adverse childhood experiences (ACEs) have been associated with internalizing and externalizing behavioral problems in preschool children. However, little is known about the influence of maternal adult attachment patterns on this association. Further, potential moderation by maternal mental health, maternal social support, or child sex is poorly understood. Therefore, this study examined associations between 1) maternal ACEs and preschool children’s behavioural problems, with mediation through maternal attachment patterns and moderation by maternal mental health, maternal social support, and child sex; and 2) maternal attachment patterns and children’s behavioural problems, with mediation through maternal mental health and social support and moderation by child sex. Methods: This secondary analysis used data (n=625) from a high socioeconomic, longitudinally prospective cohort (Alberta Pregnancy Outcomes and Nutrition). Child behaviour (BASC-2) and maternal adult attachment (ECR-Q) were measured at five years of child age, maternal ACEs (ACEs Questionnaire) at around 12 months, and maternal mental health (CESD and SCL-90-R) and social support (SSQ) across various prenatal and postnatal time points. All moderation and mediation analyses occurred through RStudio using PROCESS, interpreting significant interactions through Johnson-Neyman plots. Findings: Maternal ACEs interacted with maternal anxiety symptoms to predict both behavioural problems (pexternalizing=0.007; pinternalizing=0.0159). An indirect pathway via dismissive attachment was moderated by maternal social support ([0.0058, 0.0596]). Attachment patterns predicted all behavioural problems (p<0.05) and interacted with maternal anxiety symptoms to predict internalizing behaviours among male children ([0.0321, 0.1307]; [0.0321, 0.1291]). Interpretation: Maternal attachment patterns may predict children’s behavioural problems more than ACEs. Social support interventions may not always be beneficial for highly dismissively attached mothers. Implications for policy and child health include mandatory sex and gender education for teachers; assessing attachment patterns prior to recommending social support as an intervention; and anxiety-focused interventions for mothers in higher socioeconomic populations.

Keywords: maternal adverse childhood experiences, internalizing behaviours, externalizing behaviours, mediators and moderators, attachment patterns, child health

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Authors: Shehu Usman Rano Aliyu

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Despite the significance of finance as a major trade lubricant, evidence in the literature alludes to its scarcity and increasing cost, especially in developing countries where small and medium-scale enterprises are worst affected. The creation of the African Continental Free Trade Area (AFCFTA) in 2018, an organ of the African Union (AU), was meant to serve as a beacon for deepening economic integration through the removal of trade barriers inhibiting intra-African trade and movement of persons, among others. Hence, this research explores the role Islamic trade finance (ITF) could play in spurring intra- and inter-African trade. The study involves six countries; Egypt, Kenya, Malaysia, Morocco, Nigeria, and Saudi Arabia, and employs survey research, a total of 430 sample data, and SmartPLS Structural Equation Modelling (SEM) techniques in its analyses. We find strong evidence that Shari’ah, legal and regulatory compliance issues of the ITF institutions rhythm with the internal, national, and international compliance requirements equally as the unique instruments applied in ITF. In addition, ITF was found to be largely driven by global economic and political stability, socially responsible finance, ethical and moral considerations, risk-sharing, and resilience of the global Islamic finance industry. Further, SMEs, Governments, and Importers are the major beneficiary sectors. By and large, AfCFTA’s protocols align with the principles of ITF and are therefore suited for the proliferation of Islamic finance in the continent. And, while AML/KYC and BASEL requirements, compliance to AAOIFI and IFSB standards, paucity of Shari'ah experts, threats to global security, and increasing global economic uncertainty pose as major impediments, the future of ITF would be shaped by a greater need for institutional and policy support, global economic cum political stability, robust regulatory framework, and digital technology/fintech. The study calls for the licensing of more ITF institutions in the continent, participation of multilateral institutions in ITF, and harmonization of Shariah standards.

Keywords: AfCFTA, islamic trade finance, murabaha, letter of credit, forwarding

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Authors: Tigist Mekonnen Melesse

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Since rural households are basically entitled to food through own production, improving productivity might lead to enhance the welfare of rural population through higher food availability at the household level and lowering the price of agricultural products. Increasing agricultural productivity through the use of improved technology is one of the desired outcomes from sensible food security and agricultural policy. The ultimate objective of this study was to evaluate the potential impact of improved agricultural technology adoption on smallholders’ crop productivity and welfare. The study is conducted in Ethiopia covering 1500 rural households drawn from four regions and 15 rural villages based on data collected by Ethiopian Rural Household Survey. Endogenous treatment effect model is employed in order to account for the selection bias on adoption decision that is expected from the self-selection of households in technology adoption. The treatment indicator, technology adoption is a binary variable indicating whether the household used improved seeds and chemical fertilizer or not. The outcome variables were cereal crop productivity, measured in real value of production and welfare of households, measured in real per capita consumption expenditure. Results of the analysis indicate that there is positive and significant effect of improved technology use on rural households’ crop productivity and welfare in Ethiopia. Adoption of improved seeds and chemical fertilizer alone will increase the crop productivity by 7.38 and 6.32 percent per year of each. Adoption of such technologies is also found to improve households’ welfare by 1.17 and 0.25 percent per month of each. The combined effect of both technologies when adopted jointly is increasing crop productivity by 5.82 percent and improving welfare by 0.42 percent. Besides, educational level of household head, farm size, labor use, participation in extension program, expenditure for input and number of oxen positively affect crop productivity and household welfare, while large household size negatively affect welfare of households. In our estimation, the average treatment effect of technology adoption (average treatment effect on the treated, ATET) is the same as the average treatment effect (ATE). This implies that the average predicted outcome for the treatment group is similar to the average predicted outcome for the whole population.

Keywords: Endogenous treatment effect, technologies, productivity, welfare, Ethiopia

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Authors: Julio Silva, Lia Hasenclever, Gilson G. Silva Jr.

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The aim of this paper is to check possible convergence in health measures (aged-standard rate of morbidity and mortality) for communicable diseases between developed and developing countries, conditional to productive structures features. Understanding the interrelations between health patterns and economic development is particularly important in the context of low- and middle-income countries, where economic development comes along with deep social inequality. Developing countries with less diversified productive structures (measured through complexity index) but high heterogeneous inter-sectorial labor productivity (using as a proxy inter-sectorial coefficient of variation of labor productivity) has on average low health levels in communicable diseases compared to developed countries with high diversified productive structures and low labor market heterogeneity. Structural heterogeneity and productive diversification may have influence on health levels even considering per capita income. We set up a panel data for 139 countries from 1995 to 2015, joining several data about the countries, as economic development, health, and health system coverage, environmental and socioeconomic aspects. This information was obtained from World Bank, International Labour Organization, Atlas of Economic Complexity, United Nation (Development Report) and Institute for Health Metrics and Evaluation Database. Econometric panel models evidence shows that the level of communicable diseases has a positive relationship with structural heterogeneity, even considering other factors as per capita income. On the other hand, the recent process of convergence in terms of communicable diseases have been motivated for other reasons not directly related to productive structure, as health system coverage and environmental aspects. These evidences suggest a joint dynamics between the unequal distribution of communicable diseases and countries' productive structure aspects. These set of evidence are quite important to public policy as meet the health aims in Millennium Development Goals. It also highlights the importance of the process of structural change as fundamental to shift the levels of health in terms of communicable diseases and can contribute to the debate between the relation of economic development and health patterns changes.

Keywords: economic development, inequality, population health, structural change

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Authors: Emily Kislik, Gabriel Mantilla Saltos, Gladys Torres, Mercy Borbor-Córdova

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The Galápagos Marine Reserve (GMR) is an internationally-recognized region of consistent upwelling events, high productivity, and rich biodiversity. Despite its high-nutrient, low-chlorophyll condition, the archipelago has experienced phytoplankton blooms, especially in the western section between Isabela and Fernandina Islands. However, little is known about how climate variability will affect future phytoplankton standing stock in the Galápagos, and no consistent protocols currently exist to quantify phytoplankton biomass, identify species, or monitor for potential harmful algal blooms (HABs) within the archipelago. This analysis investigates physical, chemical, and biological oceanic variables that contribute to algal blooms within the GMR, using 4 km Aqua MODIS satellite imagery and 0.125-degree wind stress data from January 2003 to December 2016. Furthermore, this study analyzes chlorophyll-a concentrations at varying spatial scales— within the greater archipelago, as well as within five smaller bioregions based on species biodiversity in the GMR. Seasonal and interannual trend analyses, correlations, and hotspot identification were performed. Results demonstrate that chlorophyll-a is expressed in two seasons throughout the year in the GMR, most frequently in September and March, with a notable hotspot in the Elizabeth Bay bioregion. Interannual chlorophyll-a trend analyses revealed highest peaks in 2003, 2007, 2013, and 2016, and variables that correlate highly with chlorophyll-a include surface temperature and particulate organic carbon. This study recommends future in situ sampling locations for phytoplankton monitoring, including the Elizabeth Bay bioregion. Conclusions from this study contribute to the knowledge of oceanic drivers that catalyze primary productivity and consequently affect species biodiversity within the GMR. Additionally, this research can inform policy and decision-making strategies for species conservation and management within bioregions of the Galápagos.

Keywords: bioregions, ecological monitoring, phytoplankton, remote sensing

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Authors: Daniela Pisu

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The paper deals with the issue of territorial inequalities focused on the gap of the marginalization of inland areas with respect to the centrality of urban centers as they are subjected to an almost unstoppable demographic hemorrhage in a context marked by the tendency to depopulation such as the Sardinian territory, to which are added further and intense phenomena of de-anthropization. The research question is aimed at exploring the functionality of the interventions envisaged by the Piano Nazionale Ripresa Resilienza for the reduction of territorial imbalances in these areas to the extent that it is possible to identify policy strategies aimed at increasing the relational expertise of citizenship, functional to the consolidation of results in a long-term perspective. In order to answer this question, the qualitative case study on the Municipality of Ulàssai (province of Nuoro) is highlighted as the only winner on the island, with the Pilot Project ‘Where nature meets art’, intended for the cultural and social regeneration of small towns. The main findings, which emerged from the analysis of institutional sources and secondary data, highlight the socio-demographic fragility of the territory in the face of the active institutional commitment to make Ulàssai a smart community, starting from the enhancement of natural resources and the artistic heritage of fellow citizen Maria Lai. The findings drawn from the inspections and focus groups with the youth population present the aforementioned project as a generative opportunity for both the economic and social fabric, leveraging the public debates of the living labs, where the process of public communication becomes the main vector for the exercise of the rights of participatory democracy. The qualitative lunge leads to the conclusion that the repercussions envisaged by the PNRR in internal areas will be able to show their self-sustainable effect through colloquial administrations such as that of Ulàssai, capable of seeing in the interactive paradigm of public communication that natural process with which to reduce that historical sense of extraneousness attributed to the institution-citizenship relationship.

Keywords: social labs, smart community, depopulation, Sardinia, Piano Nazionale di Ripresa e Resilienza

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Authors: Siti Hajar Muhamad Rosli, Xin Yi Lim, Terence Yew Chin Tan, Muhammad nor Farhan Sa’At, Syazwani Sirdar Ali, Ami Fazlin Syed Mohamed

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A growing interest on therapeutic benefits of hemp (Cannabis sativa subsp. sativa) is evident in the pharmaceutical market, attributed to its lower levels of psychoactive constituent delta-9-tetrahydronannabidiol (THC). Deemed as a legal and safer alternative to its counterpart marijuana, the use of medicinal hemp is highly debatable as current scientific evidence on the efficacy for clinical use is yet to be established This study was aimed to provide an overview of the current landscape of hemp research, through recent clinical findings specific to the pharmacological properties of the hemp plant and its derived compounds. A systematic search was conducted following the Preferred Reporting Items for Systematic Review and Meta-Analysis-ScR (PRISMA) checklist on electronic databases (MEDLINE, OVID, Cochrane Library Central, and Clinicaltrials.gov) for articles published from 2009 to 2019. With predetermined inclusion criteria, all human trials with hemp intervention were included. A total of 18 human trials were identified, investigating therapeutic effects on the neuronal, gastrointestinal, musculoskeletal and immune system, with sample sizes ranging from one to 194 subjects. Three randomised controlled trials showed hempseed pills (in Traditional Chinese Medicine formulation MaZiRenWan) consumption significantly improved spontaneous bowel movement in functional constipation. The use of commercial cannabidiol (CBD) sourced from hemp suggested benefits in cannabis dependence, epilepsy, and anxiety disorders. However, there was insufficient evidence to suggest analgesic or anxiolytics effects of hemp being equivalent to marijuana. All clinical trials reviewed varied in terms of test item formulation and standardisation, which made it challenging to confirm overall efficacy for a specific disease or condition. Published efficacy data on hemp are still at a preliminary level, with limited high quality clinical evidence for any specific therapeutic indication. With multiple variants of this plant having different phytochemical and bioactive compounds, future empirical research should focus on uniformity in experimental designs to further strengthen the notion of using medicinal hemp.

Keywords: cannabis, complementary medicine, hemp, herbal medicine.

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Authors: Orkan Ozcan, Nebiye Musaoglu, Murat Turkes

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Climate change is largely recognized as one of the real, pressing and significant global problems. The concept of ‘climate change vulnerability’ helps us to better comprehend the cause/effect relationships behind climate change and its impact on human societies, socioeconomic sectors, physiographical and ecological systems. In this study, multifactorial spatial modeling was applied to evaluate the vulnerability of a Mediterranean forest ecosystem to climate change. As a result, the geographical distribution of the final Environmental Vulnerability Areas (EVAs) of the forest ecosystem is based on the estimated final Environmental Vulnerability Index (EVI) values. This revealed that at current levels of environmental degradation, physical, geographical, policy enforcement and socioeconomic conditions, the area with a ‘very low’ vulnerability degree covered mainly the town, its surrounding settlements and the agricultural lands found mainly over the low and flat travertine plateau and the plains at the east and southeast of the district. The spatial magnitude of the EVAs over the forest ecosystem under the current environmental degradation was also determined. This revealed that the EVAs classed as ‘very low’ account for 21% of the total area of the forest ecosystem, those classed as ‘low’ account for 36%, those classed as ‘medium’ account for 20%, and those classed as ‘high’ account for 24%. Based on regionally averaged future climate assessments and projected future climate indicators, both the study site and the western Mediterranean sub-region of Turkey will probably become associated with a drier, hotter, more continental and more water-deficient climate. This analysis holds true for all future scenarios, with the exception of RCP4.5 for the period from 2015 to 2030. However, the present dry-sub humid climate dominating this sub-region and the study area shows a potential for change towards more dry climatology and for it to become a semiarid climate in the period between 2031 and 2050 according to the RCP8.5 high emission scenario. All the observed and estimated results and assessments summarized in the study show clearly that the densest forest ecosystem in the southern part of the study site, which is characterized by mainly Mediterranean coniferous and some mixed forest and the maquis vegetation, will very likely be influenced by medium and high degrees of vulnerability to future environmental degradation, climate change and variability.

Keywords: forest ecosystem, Mediterranean climate, RCP scenarios, vulnerability analysis

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Authors: Xu Feifei

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The prevalence of COVID-19 currently is the biggest challenge to improving people's quality of life. Its impact on the health-related quality of life (HRQoL) is highly uncertain and has not been summarized so far. The aim of the present systematic review was to assess and provide an up-to-date analysis of the impact of the COVID-19 pandemic on the HRQoL of participants who have been infected, have not been infected but isolated, frontline, with different diseases, and the general population. Therefore, an electronic search of the literature in PubMed databases was performed from 2019 to July 2022 (without date restriction). PRISMA guideline methodology was employed, and data regarding the HRQoL were extracted from eligible studies. Articles were included if they met the following inclusion criteria: (a) reports on the data collection of the health state utility values (HSUVs) related to COVID-19 from 2019 to 2021; (b) English language and peer-reviewed journals; and (c) original HSUV data; (d) using EQ-5D tool to quantify the HRQoL. To identify studies that reported the effects on COVID-19, data on the proportion of overall HSUVs of participants who had the outcome were collected and analyzed using a one-group meta-analysis. As a result, thirty-two studies fulfilled the inclusion criteria and, therefore, were included in the systematic review. A total of 45295 participants and provided 219 means of HSUVs during COVID-19 were included in this systematic review. The range of utility is from 0.224 to 1. The study included participants from Europe (n=16), North America (n=4), Asia (n=10), South America (n=1), and Africa (n=1). Twelve articles showed that the HRQoL of the participants who have been infected with COVID-19 (range of overall HSUVs from 0.6125 to 0.863). Two studies reported the population of frontline workers (the range of overall HSUVs from 0.82 to 0.93). Seven of the articles researched the participants who had not been infected with COVID-19 but suffered from morbidities during the pandemic (range of overall HSUVs from 0.5 to 0.96). Thirteen studies showed that the HRQoL of the respondents who have not been infected with COVID-19 and without any morbidities (range of overall HSUVs from 0.64 to 0.964). Moreover, eighteen articles reported the outcomes of overall HSUVs during the COVID-19 pandemic in different population groups. The estimate of overall HSUVs of direct COVID-19 experience population (n=1333) was 0.751 (95% CI 0.670 - 0.832, I2 = 98.64%); the estimate of frontline population (n=610) was 0.906 ((95% CI 0.854 – 0.957, I2 = 98.61%); participants with different disease (n=132) were 0.768 (95% CI 0.515 - 1.021, I2= 99.26%); general population without infection history (n=29,892) was 0.825 (95% CI 0.766 - 0.885, I2 =99.69%). Conclusively, taking into account these results, this systematic review might confirm that COVID-19 has a negative impact on the HRQoL of the infected population and illness population. It provides practical value for cost-effectiveness model analysis of health states related to COVID-19.

Keywords: COVID-19, health-related quality of life, meta-analysis, systematic review, utility value

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Authors: Fayomi Oluyemi, Ajayi Lady

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This article raises the question of political leadership in the context of womens' roles and responsibilities in Nigeria. The leadership question in Nigeria is disquieting to both academics and policy actors. In a democratic society like Nigeria, the parameters for a well-deserved leadership position is characterised by variables of equity, competence, transparency, accountability, selflessness, and commitment to the tenets of democracy, but the failure of leadership is pervasive in all spheres of socio-political sectors in Nigeria. The paper appraises the activities of Nigerian women in the socio-political arena in Nigeria. It traces their leadership roles from pre-colonial through post-colonial eras with emphasis on 1914 till date. It is argued in the paper that gender imbalance in leadership is a bane to peaceful co-existence and development in Nigeria. It is a truism that gender-blind and gender biased political agendas can distort leadership activities. The extent of their contributions of the few outstanding women’s relative tranquility is highlighted in the theoretical discourse. The methodology adopted for this study is an exploratory study employing the extended case method (ECM). The study was carried out among some selected Nigerian women politicians and academics. Because of ECM's robustness as a qualitative research design, it has helped this study in identifying the challenges of these women thematically and also in constructing valid and reliable measures of the constructs. The study made use of ethnography and triangulation, the latter of which is used by qualitative researchers to check and establish validity in their studies by analyzing a research question from multiple perspectives, specifically Investigator triangulation which involves using several different investigators in the analysis process. Typically, this manifests as the evaluation team consisting of colleagues within a field of study wherein each investigator examines the question of political leadership with the same qualitative method (interview, observation, case study, or focus groups). In addition, data was collated through documentary sources like journals, books, magazines, newspapers, and internet materials. The arguments of this paper center on gender equity of both sexes in socio-political representation and effective participation. The paper concludes with the need to effectively maintain gender balance in leadership in order to enhance lasting peace and unity in Nigeria.

Keywords: gender, politics, leadership, women

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Authors: Jinhoa Lee

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The relationships between environmental quality, energy use and economic output have created growing attention over the past decades among researchers and policy makers. Focusing on the empirical aspects of the role of carbon dioxide (CO2) emissions and energy use in affecting the economic output, this paper is an effort to fulfill the gap in a comprehensive case study at a country level using modern econometric techniques. To achieve the goal, this country-specific study examines the short-run and long-run relationships among energy consumption (using disaggregated energy sources: Crude oil, coal, natural gas, and electricity), CO2 emissions and gross domestic product (GDP) for Iran using time series analysis from the year 1980-2010. To investigate the relationships between the variables, this paper employs the Augmented Dickey-Fuller (ADF) test for stationarity, Johansen’s maximum likelihood method for cointegration and a Vector Error Correction Model (VECM) for both short- and long-run causality among the research variables for the sample. All the variables in this study show very strong significant effects on GDP in the country for the long term. The long-run equilibrium in VECM suggests that all energy consumption variables in this study have significant impacts on GDP in the long term. The consumption of petroleum products and the direct combustion of crude oil and natural gas decrease GDP, while the coal and electricity use enhanced the GDP between 1980-2010 in Iran. In the short term, only electricity use enhances the GDP as well as its long-run effects. All variables of this study, except the CO2 emissions, show significant effects on the GDP in the country for the long term. The long-run equilibrium in VECM suggests that the consumption of petroleum products and the direct combustion of crude oil and natural gas use have positive impacts on the GDP while the consumptions of electricity and coal have adverse impacts on the GDP in the long term. In the short run, electricity use enhances the GDP over period of 1980-2010 in Iran. Overall, the results partly support arguments that there are relationships between energy use and economic output, but the associations can be differed by the sources of energy in the case of Iran over period of 1980-2010. However, there is no significant relationship between the CO2 emissions and the GDP and between the CO2 emissions and the energy use both in the short term and long term.

Keywords: CO2 emissions, energy consumption, GDP, Iran, time series analysis

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Authors: Sandra K. Enriquez, Claudia Camargo, Jesús E. Olguín, Juan A. López, German Galindo

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Currently companies have increased the number of disorders of cumulative trauma (CTDs), these are increasing significantly due to the Highly Repetitive Movements (HRM) performed in workstations, which causes economic losses to businesses, due to temporary and permanent disabilities of workers. This analysis focuses on the prevention of disorders caused by: repeatability, duration and effort; And focuses on reducing cumulative trauma disorders such as occupational diseases using sensory thermography as a noninvasive method, the above is to evaluate the injuries could have workers to perform repetitive motions. Objectives: The aim is to define rest periods or job rotation before they generate a CTD, this sensory thermography by analyzing changes in temperature patterns on wrists and elbows when the worker is performing HRM over a period of time 2 hours and 30 minutes. Information on non-work variables such as wrist and elbow injuries, weight, gender, age, among others, and work variables such as temperature workspace, repetitiveness and duration also met. Methodology: The analysis to 4 industrial designers, 2 men and 2 women to be specific was conducted in a business in normal health for a period of 12 days, using the following time ranges: the first day for every 90 minutes continuous work were asked to rest 5 minutes, the second day for every 90 minutes of continuous work were asked to rest 10 minutes, the same to work 60 and 30 minutes straight. Each worker was tested with 6 different ranges at least twice. This analysis was performed in a controlled room temperature between 20 and 25 ° C, and a time to stabilize the temperature of the wrists and elbows than 20 minutes at the beginning and end of the analysis. Results: The range time of 90 minutes working continuous and a rest of 5 minutes of activity is where the maximum temperature (Tmax) was registered in the wrists and elbows in the office, we found the Tmax was 35.79 ° C with a difference of 2.79 ° C between the initial and final temperature of the left elbow presented at the individual 4 during the 86 minutes, in of range in 90 minutes continuously working and rested for 5 minutes of your activity. Conclusions: It is possible with this alternative technology is sensory thermography predict ranges of rotation or rest for the prevention of CTD to perform HRM work activities, obtaining with this reduce occupational disease, quotas by health agencies and increasing the quality of life of workers, taking this technology a cost-benefit acceptable in the future.

Keywords: sensory thermography, temperature, cumulative trauma disorder (CTD), highly repetitive movement (HRM)

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Authors: Mariamawit T. Belete

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Cereal production and marketing are the means of livelihood for millions of households in Ethiopia. However, cereal production is constrained by technical and socio-economic factors. Among the technical factors, cereal crop diseases are the major contributing factors to the low yield. The aim of this research is to develop an integration of data mining and knowledge based system for sorghum anthracnose disease diagnosis that assists agriculture experts and development agents to make timely decisions. Anthracnose diagnosing systems gather information from Melkassa agricultural research center and attempt to score anthracnose severity scale. Empirical research is designed for data exploration, modeling, and confirmatory procedures for testing hypothesis and prediction to draw a sound conclusion. WEKA (Waikato Environment for Knowledge Analysis) was employed for the modeling. Knowledge based system has come across a variety of approaches based on the knowledge representation method; case-based reasoning (CBR) is one of the popular approaches used in knowledge-based system. CBR is a problem solving strategy that uses previous cases to solve new problems. The system utilizes hidden knowledge extracted by employing clustering algorithms, specifically K-means clustering from sampled anthracnose dataset. Clustered cases with centroid value are mapped to jCOLIBRI, and then the integrator application is created using NetBeans with JDK 8.0.2. The important part of a case based reasoning model includes case retrieval; the similarity measuring stage, reuse; which allows domain expert to transfer retrieval case solution to suit for the current case, revise; to test the solution, and retain to store the confirmed solution to the case base for future use. Evaluation of the system was done for both system performance and user acceptance. For testing the prototype, seven test cases were used. Experimental result shows that the system achieves an average precision and recall values of 70% and 83%, respectively. User acceptance testing also performed by involving five domain experts, and an average of 83% acceptance is achieved. Although the result of this study is promising, however, further study should be done an investigation on hybrid approach such as rule based reasoning, and pictorial retrieval process are recommended.

Keywords: sorghum anthracnose, data mining, case based reasoning, integration

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Authors: Karla Lebedoff, Susan Walsh, Michelle Bain

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Eczema is a chronic atopy condition requiring long-term daily management in children. Written action plans for other chronic atopic conditions, such as asthma and food allergies, are widely recommended and distributed to pediatric patients' parents and caregivers, seeking to improve clinical outcomes and become empowered to manage the patient's ever-changing symptoms. Written action plans for eczema, referred to as "asthma of the skin," are not routinely used in practice. Parents of children suffering from eczema rarely receive a written action plan to follow, and commendations supporting eczema action plans are inconsistent. Pediatric patients between birth and 18 years old who were followed for eczema at an urban Midwest community hospital were eligible to participate in this quality improvement project. At the initial visit, parents received instructions on individualized eczema action plans for their child and completed two validated surveys: Health Confidence Score (HCS) and Patient-Oriented Eczema Measure (POEM). Pre- and post-survey responses were collected, and clinical symptom presentation at follow-up were outcome determinants. Project implementation was guided by Institute for Healthcare Improvement's Step-up Framework and the Plan-Do-Study-Act cycle. This project measured clinical outcomes and parent confidence in self-management of their child's eczema symptoms with the responses from 26 participant surveys. Pre-survey responses were collected from 36 participants, though ten were lost to follow-up. Average POEM scores improved by 53%, while average HCS scores remained unchanged. Of seven completed in-person follow-up visits, six clinical progress notes documented improvement. Individualized eczema action plans can be seamlessly incorporated into primary and specialty care visits for pediatric patients suffering from eczema. Following a patient-specific eczema action plan may lessen the daily physical and mental burdens of uncontrolled eczema for children and parents, managing symptoms that chronically flare and recede. Furthermore, incorporating eczema action plans into practice potentially reduces the likely underestimated $5.3 billion economic disease burden of eczema on the U.S. healthcare system.

Keywords: atopic dermatitis, eczema action plan, eczema symptom management, pediatric eczema

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Authors: Kangrij Roeksiripat

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Street vending is one of the informal economy activities which considered significance to Thai people in the economic and the day-to-day social life. It had been believed that the street vendor is a group of the poor and uneducated people. With the increasing numbers of the street vendor occupying space on public sidewalks especially in central business districts, it becomes unclear whether street vending continues as a solution to unemployment for access labors. This research attempts to study and analyze types of street vendors in Bangkok under the informal economy framework. The debate on the heterogeneous informal economy has categorized into four schools; the dualism, the structuralism, the legalism and the voluntarism. The examination also embodies with market concept with Porter’s Five Forces of Competitive Position Model analysis and the interviews with the street vendors in three case study areas: Inner zone (Pathumwan district - the sidewalk on the opposite side of Siam Paragon mall), Middle zone (Ramkhamhaeng district - the sidewalk on the opposite side of Ramkhamhaeng University) and Outer zone (Minburi district- the sidewalk of Sriburanukit Road). The result indicates that most of street vendors in Siam square are voluntarily choose to make a living in vending on a sidewalk and tend to take it as a long-term occupation even though they can be in formal wage employment. Moreover, average income and positive attitude towards self-employed are the important factors that drive them to operate street vending businesses. Meanwhile, street vending is often a family enterprise in Ramkhamhaeng area and most vendors do not wish to transform their businesses into the formal sectors. Whereas the survey conducted in Sriburankit Road reveals that almost all of street vendors migrated from other provinces and were previously paid as the unskilled workers in formal sectors. They moved to informal trades because of the uncertainty of employment in the mainstream sectors and the inconsistent income with knowledge support of friends and relatives from the same hometown. In particular, the result reveals a common pattern that street vending is the very first occupation of some group of vendors and they will continue to engage in this activity. Thus, it is important for the government to design optimal policy which not only integrating informal workers into the formal economy but also monitoring the enforcement of regulations on the modern informal economy.

Keywords: informal economy, sidewalks, street vendors, occupation

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Authors: Rosa S. Wong, Keith T.S. Tung, H.W. Tsang, Frederick K. Ho, Patrick Ip

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Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by inattention and hyperactive-impulsive behavior. Evidence shows that ADHD and mood problems such as depression and anxiety often co-occur and yet not everyone with ADHD reported elevated emotional problems. Given that cholesterol is essential for healthy brain development including the regions governing emotion regulation, reports found lower cholesterol levels in patients with major depressive disorder and those with suicide attempt behavior compared to healthy subjects. This study explored whether ADHD adolescents experienced more emotional problems and whether emotional problems correlated with cholesterol levels in these adolescents. This study used a portion of data from the longitudinal cohort study which was designed to investigate the long-term impact of family socioeconomic status on child development. In 2018/19, parents of 300 adolescents (average age: 12.57+/-0.49 years) were asked to rate their children’s emotional problems and report whether their children had doctor-diagnosed psychiatric diseases. We further collected blood samples from 263 children to study their lipid profile (total cholesterol, high-density lipoprotein (HDL)-cholesterol, and low-density lipoprotein (LDL)-cholesterol). Regression analyses were performed to test the relationships between variables of interest. Among 300 children, 27 (9%) had ADHD diagnosis. Analysis based on overall sample found no association between ADHD and emotional problems, but when investigating the relationship by gender, there was a significant interaction effect of ADHD and gender on emotional problems (p=0.037), with ADHD males displaying more emotional problems than ADHD females. Further analyses based on 263 children (21 with ADHD diagnosis) found significant interaction effect of ADHD and gender on total cholesterol (p=0.038) and low LDL-cholesterol levels (p=0.013) after adjusting for the child’s physical disease history. Specifically, ADHD males had significantly lower total cholesterol and low lipoprotein-cholesterol levels than ADHD females. In ADHD males, more emotional problems were associated with lower LDL-cholesterol levels (B = -4.26, 95%CI (-7.46, -1.07), p=0.013). We found preliminary support for the association between more emotional problems and lower cholesterol levels in ADHD children, especially among males. Although larger prospective studies are needed to substantiate these claims, the evidence highlights the importance of healthy lifestyle to keep cholesterol levels in normal range which can have positive effects on physical and mental health.

Keywords: attention-deficit hyperactivity disorder, cholesterol, emotional problems, adolescents

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Authors: Josiane N. Muller, Allan K. R. Galardo, Tatiane A. Barbosa, Evan P. Ferro, Wellington M. Dos Santos, Ana Paula S. A. Correa, Edinaldo C. Rego, Jose B. P. Lima

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The susceptibility status of an insect population to any larvicide depends on several factors such includes genetic constitution, environmental conditions and others. The mosquito Aedes aegypti is the primary vector of three important viral diseases, Zika, Dengue, and Chikungunya. The frequent outbreaks of those diseases in different parts of Brazil demonstrate the importance of testing the susceptibility of vectors in different environments. Since the control of this mosquito leads to the control of disease, alternatives for vector control that value the different Brazilian environmental conditions are needed for effective actions. The aim of this study was to evaluate a new commercial formulation of Bacillus thuringiensis israelenses (DengueTech: Brazilian innovative technology) in the Brazilian Legal Amazon considering the climate conditions. Semi-field tests were conducted in the Institute of Scientific and Technological Research of the State of Amapa in two different environments, one in a shaded area and the other exposed to sunlight. The mosquito larvae were exposed to larvicide concentration and a control; each group was tested in three containers of 40 liters each. To assess persistence 50 third instar larvae of Aedes aegypti laboratory lineages (Rockefeller) and 50 larvae of Aedes aegypti collected in the municipality of Macapa, Brazil’s Amapa state, were added weekly and after 24 hours the mortality was assessed. In total 16 tests were performed, where 12 were done with replacement of water (1/5 of the volume, three times per week). The effectiveness of the product was determined through mortality of ≥ 80%, as recommend by the World Health Organization. The results demonstrated that high-water temperatures (26-35 °C) on the containers influenced the residual time of the product, where the maximum effect achieved was 21 days in the shaded area; and no effectiveness of 60 days was found in any of the tests, as expected according to the larvicide company. The test with and without water replacement did not present significant differences in the mortality rate. Considering the different environments and climate, these results stimulate the need to test larvicide and its effectiveness in specific environmental settings in order to identify the parameters required for better results. Thus, we see the importance of semi-field researches considering the local climate conditions for a successful control of Aedes aegypti.

Keywords: Aedes aegypti, bioassay, larvicida, vector control

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Authors: Gezahegn Bekele Welldgiyorgise

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It is obvious that the economics, politics and social conditions of a country are determined by the quality and standard of its education. Indeed, education plays a vital role in changing the consciousness and awareness of society and transforming it on a large scale. Moreover, education contributes a lot to the advancement of science and technology, information and communication, and above all, it speeds up its progress in no time if it focuses mainly on the qualitative approach to education. Education brings about universal change and transformation and lightens mankind in all dimensions. It creates an educated, enlightened and brightened generation in society. The generation will be sharped, sharpened and well-oriented if it gets modern, sophisticated and standardized education in its field of study. The main goal of education is to produce well-qualified, well-trained and disciplined young offers in a given community. If the youth is well trained and well-mannered, he will certainly be enlightened, problem solvers and solution seekers, researchers, and innovators. In this respect, we have to provide the youth with modern education, a teaching-learning process led by active learning and a participatory approach with a new curriculum preparation for the age of children supported by modern facilities (ICT).In addition to that, the curriculum should have to give attention to mathematics and science lessons that include international experience in a comfortable school and classrooms. Therefore, the generation that will be created through such kinds of the guided education system will make the students active participants, self-confident, researchers and problem solvers, besides that result in changed life standards and a developed country. Similarly, our country, Ethiopia, has aimed to get such change in youth (generation) through modern education, designing a new educational policy and curriculum which was implemented for many years, although the goal of education has not reached the required level. To get the main idea of the article, I should have answered the question of why our country's educational goal had not reached the desired level because it is necessary to lay the foundation for research in finding out problems seen through students learning performance, the first task is selecting primary-school as a sample. Therefore, we selected “Dilla primary school (5-8)” which is a workplace for a teacher and gives me a chance to recognize students’ learning performance to recognize their learning grades (internal and external) and measure performance (achievement) of students easily’.

Keywords: curriculum, performance, innovation, learning

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Authors: Fagner O. Serrano, Danielle R. Bouchard, Todd A. Duhame

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Walking cadence (steps/min) is an effective way to prescribe exercise so an individual can reach a moderate intensity, which is recommended to optimize health benefits. To our knowledge, there is no study on the required walking cadence to reach a moderate intensity for people that present chronic conditions or risk factors for chronic conditions such as Cardiovascular Diseases (CVD). The objectives of this study were: 1- to identify the walking cadence needed for people at risk of CVD to a reach moderate intensity, and 2- to develop and test an equation using clinical variables to help professionals working with individuals at risk of CVD to estimate the walking cadence needed to reach moderate intensity. Ninety-one people presenting a minimum of two risk factors for CVD completed a medically supervised graded exercise test to assess maximum oxygen consumption at the first visit. The last visit consisted of recording walking cadence using a foot pod Garmin FR-60 and a Polar heart rate monitor, aiming to get participants to reach 40% of their maximal oxygen consumption using a portable metabolic cart on an indoor flat surface. The equation to predict the walking cadence needed to reach moderate intensity in this sample was developed as follows: The sample was randomly split in half and the equation was developed with one half of the participants, and validated using the other half. Body mass index, height, stride length, leg height, body weight, fitness level (VO2max), and self-selected cadence (over 200 meters) were measured using objective measured. Mean walking cadence to reach moderate intensity for people age 64.3 ± 10.3 years old at risk of CVD was 115.8  10.3 steps per minute. Body mass index, height, body weight, fitness level, and self-selected cadence were associated with walking cadence at moderate intensity when evaluated in bivariate analyses (r ranging from 0.22 to 0.52; all P values ≤0.05). Using linear regression analysis including all clinical variables associated in the bivariate analyses, body weight was the significant predictor of walking cadence for reaching a moderate intensity (ß=0.24; P=.018) explaining 13% of walking cadence to reach moderate intensity. The regression model created was Y = 134.4-0.24 X body weight (kg).Our findings suggest that people presenting two or more risk factors for CVD are reaching moderate intensity while walking at a cadence above the one officially recommended (116 steps per minute vs. 100 steps per minute) for healthy adults.

Keywords: cardiovascular disease, moderate intensity, older adults, walking cadence

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Authors: Evgeni Baratashvili, Giorgi Sulashvili, Malkhaz Sulashvili, Bela Khotenashvili, Irma Makharashvili

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The most investment decision-making principle of regional travel firm's management and its partner is the formulation of the aims of investment programs. The investments can be targeted in order to reduce the firm's production costs and to purchase good transport equipment. In attractive region, in order to develop firm’s activities, the investment program can be targeted for increasing of provided services. That is the case where the sales already have been used in the market. The investment can be directed to establish the affiliate firms, branches, to construct new hotels, to create food and trade enterprises, to develop entertainment enterprises, etc. Economic development is of great importance to regional development. International experience shows that inclusive economic growth largely depends on not only the national, but also regional development planning and implementation of a strong and competitive regions. Regional development is considered as the key factor in achieving national success. Establishing a modern institute separate entities if the pilot centers will constitute a promotion, international best practice-based public-private partnership to encourage the use of models. Regional policy directions and strategies adopted in accordance with the successful implementation of major importance in the near future specific action plans for inclusive development and implementation, which will be provided in accordance with the effective monitoring and evaluation tools and measurable indicators combined. All of these above-mentioned investments are characterized by different levels, which are related to the following fact: How successful tourism marketing service is, whether it is able to determine the proper market's reaction according to the particular firm's actions. In the sphere of regional tourism industry and in the investment decision possible variants it can be developed the some specter of models. Each of the models can be modified and specified according to the situation, and characteristic skills of the existing problem that must be solved. Besides, while choosing the proper model, the process is affected by the regulation system of economic processes. Also, it is influenced by liberalization quality and by the level of state participation.

Keywords: net income of travel firm, economic growth, Investment profitability, regional development, tourist product, tourism development

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Authors: Mompi Sharma, Labananda Choudhury, Anjana M. Saikia

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Background: The period life table is entirely based on the assumption that the mortality patterns of the population existing in the given period will persist throughout their lives. However, it has been observed that the mortality rate continues to decline. As such, if the rates of change of probabilities of death are considered in a life table then we get a dynamic life table. Although, mortality has been declining in all parts of India, one may be interested to know whether these declines had appeared more in an urban area of underdeveloped regions like North-Eastern India. So, attempt has been made to know the mortality pattern and the life expectancy under dynamic scenario in Guwahati, the biggest city of North Eastern India. Further, if the probabilities of death changes then there is a possibility that its different constituent probabilities will also change. Since cardiovascular disease (CVD) is the leading cause of death in Guwahati. Therefore, an attempt has also been made to formulate dynamic cause specific death ratio and probabilities of death due to CVD. Objectives: To construct dynamic life table for Guwahati for the year 2011 based on the rates of change of probabilities of death over the previous 10 and 25 years (i.e.,2001 and 1986) and to compute corresponding dynamic cause specific death ratio and probabilities of death due to CVD. Methodology and Data: The study uses the method proposed by Denton and Spencer (2011) to construct dynamic life table for Guwahati. So, the data from the Office of the Birth and Death, Guwahati Municipal Corporation for the years 1986, 2001 and 2011 are taken. The population based data are taken from 2001 and 2011 census (India). However, the population data for 1986 has been estimated. Also, the cause of death ratio and probabilities of death due to CVD are computed for the aforementioned years and then extended to dynamic set up for the year 2011 by considering the rates of change of those probabilities over the previous 10 and 25 years. Findings: The dynamic life expectancy at birth (LEB) for Guwahati is found to be higher than the corresponding values in the period table by 3.28 (5.65) years for males and 8.30 (6.37) years for females during the period of 10 (25) years. The life expectancies under dynamic consideration in all the other age groups are also seen higher than the usual life expectancies, which may be possible due to gradual decline in probabilities of death since 1986-2011. Further, a continuous decline has also been observed in death ratio due to CVD along with cause specific probabilities of death for both sexes. As a consequence, dynamic cause of death probability due to CVD is found to be less in comparison to usual procedure. Conclusion: Since incorporation of changing mortality rates in period life table for Guwahati resulted in higher life expectancies and lower probabilities of death due to CVD, this would possibly bring out the real situation of deaths prevailing in the city.

Keywords: cause specific death ratio, cause specific probabilities of death, dynamic, life expectancy

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Authors: Oladele V. Adeniyi, B. Longo-Mbenza, Daniel T. Goon

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Background: Lipids are often low or in the normal ranges and controversial in the atherogenesis among Black Africans. The effect of the severity of obesity on some traditional and novel cardiovascular disease risk factors is unclear before and after a diet and exercise maintenance programme among obese black South Africans with type 2 diabetes mellitus (T2DM). Therefore, this study aimed to identify the risk factors to discriminate obesity classes among patients with T2DM before and after a diet and exercise programme. Methods: This interventional cohort of Black South Africans with T2DM was followed by a very – low calorie diet and exercise programme in Mthatha, between August and November 2013. Gender, age, and the levels of body mass index (BMI), blood pressure, monthly income, daily frequency of meals, blood random plasma glucose (RPG), serum creatinine, total cholesterol (TC), triglycerides (TG), LDL –C, HDL – C, Non-HDL, ratios of TC/HDL, TG/HDL, and LDL/HDL were recorded. Univariate analysis (ANOVA) and multivariate discriminant analysis were performed to separate obesity classes: normal weight (BMI = 18.5 – 24.9 kg/m2), overweight (BMI = 25 – 29.9 kg/m2), obesity Class 1 (BMI = 30 – 34.9 kg/m2), obesity Class 2 (BMI = 35 – 39.9 kg/m2), and obesity Class 3 (BMI ≥ 40 kg/m2). Results: At the baseline (1st Month September), all 327 patients were overweight/obese: 19.6% overweight, 42.8% obese class 1, 22.3% obese class 2, and 15.3% obese class 3. In discriminant analysis, only systolic blood pressure (SBP with positive association) and LDL/HDL ratio (negative association) significantly separated increasing obesity classes. At the post – evaluation (3rd Month November), out of all 327 patients, 19.9%, 19.3%, 37.6%, 15%, and 8.3% had normal weight, overweight, obesity class 1, obesity class 2, and obesity class 3, respectively. There was a significant negative association between serum creatinine and increase in BMI. In discriminant analysis, only age (positive association), SBP (U – shaped relationship), monthly income (inverted U – shaped association), daily frequency of meals (positive association), and LDL/HDL ratio (positive association) classified significantly increasing obesity classes. Conclusion: There is an epidemic of diabesity (Obesity + T2DM) in this Black South Africans with some weight loss. Further studies are needed to understand positive or negative linear correlations and paradoxical curvilinear correlations between these markers and increase in BMI among black South African T2DM patients.

Keywords: atherogenic dyslipidaemia, dietary interventions, obesity, south africans

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