Search results for: science education

Authors: Tadewos Awugchew Wudineh

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Health and safety issues have always been a major problem and concern in the building construction industry. The health and safety regulations are stated to eliminate the potential hazards and to reduce the consequential risks. However, the importance of the regulations seems to be overlooked in building construction sites of Hawassa City. Accordingly, many companies don’t follow the regulations as construction workers are more likely to be injured and killed by construction accident than any other type of employment. This paper aimed to identify factors that affect the implementation of construction health and safety regulations, their effects and mitigation measures in building construction project sites of Hawassa City. To reach this objective, a review of literature as well as the Ethiopian construction health and safety regulations have been undertaken. Mainly a five-point Likert scale questionnaire was distributed, and statistical analysis was used to summarize, interpret the data, and to find the significances of the responses. In addition, interviews were carried out. Accordingly, the findings indicate that the top factors which affect the implementation of CHS regulations are, availability and development of a clear health and safety policy, health and safety inspections by top management, conducting health and safety training and orientation, provision of healthy and safe working environment and employment of trained safety officers. The study revealed that implementation or non-implementation of CHS regulations have effects on the worker’s productivity, job satisfaction, rate of accidents, and cost greatly. Thus, the suggestion to minimize the impact on worker’s job performance are, developing of a clear health and safety policy, management commitment towards implementation of health and safety regulations, health and safety education and training and conducting regular health and safety inspections. It was concluded from the study that good implementation of health and safety regulations are the results from administrative and management commitment which calls for more attention to be paid to improve the implementation of CHS regulations in building construction sites of Hawassa City.

Keywords: construction health and safety regulations, effects, factors, mitigation

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Authors: Pirjo Kaakinen, Helvi Kyngäs, Danica Železnik

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People live longer than earlier and healthy lifestyle is one of the important issue to prevent functional inability and chronic disease. Aim of this study was describe the lifestyle changes of Carintia region’s people. The study was cross-sectional study. Data were collected by questionnaire in two period, first May 2013 (N=63) and on March 2014 (N=77) at the University of College of ‘Health Sciences Slovenj Gradec’. The study was part of project ‘Choose a healthy lifestyle - an investment for the future’. The questionnaire included self-estimated questions about physical activity, nutrition, grocery habit, smoking habit and alcohol use. Participants were measured clinical parameters such as blood pressure, blood glucose, BMI. Most of participants were women (61%) and they were over 60 years old (64%). Participants have a high BMI (75%) and elevated blood pressure (64%). However, almost all participants (89%) had normal blood glucose level. Slightly more than half of participants (54%) have normal cholesterol level. Participants (83%) eat breakfast in the morning and most of them have three or four daily meals. Fruit and vegetable consumption decrease during this study. Half of participants (51%) drank a litre of water per day and popular beverage was coffee or tea. To drink carbonate beverages was not so popular over 60 year’s old participants than younger one. There was less smokers in 2014 than 2013. Intensity of daily physical activity increased during healthy lifestyle project. The most popular form of physical activity was hiking. This study showed that the project can be effective in the Carintia region’s people lifestyle changes even it was short time. People did changes in their daily life and there were a positive influence physical activity, meal frequency, fruit, vegetable and alcohol consumption. In the future is needed the follow up study to get out longitudinal lifestyle changes.

Keywords: adults, healthy lifestyle, health education, quality of life

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Authors: Paula Paulino, Alzira Matias, Ana Margarida Veiga Simão

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Self-regulated learning (SRL) directs students in analyzing proposed tasks, setting goals and designing plans to achieve those goals. The literature has suggested a metacognitive strategy for goal attainment known as Mental Contrasting with Implementation Intentions (MCII). This strategy involves Mental Contrasting (MC), in which a significant goal and an obstacle are identified, and Implementation Intentions (II), in which an "if... then…" plan is conceived and operationalized to overcome that obstacle. The present study proposes to assess the MCII process and whether it promotes students’ commitment towards learning goals during school tasks in sciences subjects. In this investigation, we intended to study the MCII strategy in a systemic context of the classroom. Fifty-six students from middle school and secondary education attending a public school in Lisbon (Portugal) participated in the study. The MCII strategy was explicitly taught in a procedure that included metacognitive modeling, guided practice and autonomous practice of strategy. A mental contrast between a goal they wanted to achieve and a possible obstacle to achieving that desire was instructed, and then the formulation of plans in order to overcome the obstacle identified previously. The preliminary results suggest that the MCII metacognitive strategy, applied to the school context, leads to more sophisticated reflections, the promotion of learning goals and the elaboration of more complex and specific self-regulated plans. Further, students achieve better results on school tests and worksheets after strategy practice. This study presents important implications since the MCII has been related to improved outcomes and increased attendance. Additionally, MCII seems to be an innovative process that captures students’ efforts to learn and enhances self-efficacy beliefs during learning tasks.

Keywords: implementation intentions, learning goals, mental contrasting, metacognitive strategy, self-regulated learning

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Authors: Shorena Sadzaglishvili, Teona Gotsiridze, Ketevan Lekishvili, Darejan Javakhishvili, Alida Bouris

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Globally, adolescents and young people experience high levels of HIV vulnerability and risk. Estimates suggest that AIDS-related deaths among young people are increasing, suggesting poor prioritization of adolescents in national plans for HIV testing and treatment services. HIV/AIDS is currently the sixth leading cause of death in people aged 10-24 years. Among young people, street connected youth are clearly distinguished as being among the most at risk for HIV infection. The present study recognizes the urgent need to scale up effective HIV responses that are tailored to the unique needs of street connected youth for the global HIV agenda and especially, the former Soviet country - Georgia, where 'street kids' are a new phenomenon and estimated to be about 2,500. During two months trained interviewers conducted individual semi-structured qualitative interviews with 22 key informants from the local governmental and nongovernmental service organizations, including psychologists, social workers, peer educators, mobile health workers, and managers. Informants discussed social network characteristics influencing street connected youth’s sexual risk behaviors. Data were analyzed using Dedoose. It was revealed that there are three types of homogeneous networks of street-connected youth aged 10-19 based on ethnical background: (1) Georgians; (2) migrant kids of Azeri-Kurdish origin, and (3) local Roma-Moldavian kids. These networks are distinguished with various HIV risk through both risky sexual and drug-related behaviors. In addition, there are several cases of HIV infection identified through reactive social services. Street connected youth do not have basic information about the HIV related sexual, alcohol and drug behaviors nor there are any systematic programs providing HIV testing and consultation for reducing the vulnerability of HIV infection. There is a need to systematically examine street-connected youth risk-taking behaviors by applying an integrated, multilevel framework to a population at great risk of HIV. Acknowledgment: This work was supported by Shota Rustaveli National Science Foundation of Georgia (SRNSFG) [#FR 17_31], Ilia State University.

Keywords: street connected youth, social networks, HIV/AIDS, HIV testing

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Authors: Fatima Taqi, Abrar Alanzi

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Objectives: The objective of this study is to determine and assess the level of knowledge and attitudes of dental patients attending Kuwait University Dental Clinics (KUDC) regarding the infection control protocols practiced in the clinic. The results would highlight the importance of conducting awareness campaigns in the community to promote good oral healthcare in Kuwait. Materials and Methods: A cross-sectional descriptive survey was carried out among dental patients attending KUDC. A structured questionnaire, in both Arabic and English languages, was used for data collection about the socio-demographic characteristics, knowledge about the dental cross-infection, and attitudes and self-reported practices regarding infection transmission and control in dentistry. Results: A response rate of 80% (202/250) was reported. 47% of respondents had poor knowledge about dental infection transmission, and only 19.8% had satisfactory knowledge. Female participants obtained a higher satisfactory score (14.3%) compared to males (5.5%). Patients with a university degree or higher education had a better level of knowledge compared to patients with a lower educational level (p < 0.05). The majority of participants agreed that the dentist should wear gloves (95.5%), masks (89.6%), safety glasses (70.3%), and gowns (84.7%). Many patients believed that the protection measures are mainly to stop the infection transmission from patient to patient via the dentist. Half of the participants would ask if the instruments are sterilized and might accept treatment from non-vaccinated dentists. Conclusions: Many dental patients attending KUDC have obtained poor knowledge scores regarding infection transmission in the dental clinic. The educational level was significantly associated with their level of knowledge. An overall positive attitude was reported regarding the infection control protocols practiced in the dental clinic. Raising awareness among dental patients about dental infection transmission and protective measures is of utmost importance.

Keywords: dental infection, knowledge, dental patients, infection control

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Authors: Svetlana Bialkova, Marnix van Gisbergen

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Advanced Virtual Reality (VR) technologies offer compelling multisensory and interactive experiences applicable in various fields from education to entertainment. However, serious VR applications within the financial sector are scarce, and managing ‘real’ business services with(in) VR is a challenge inviting further investigation. The current research addresses this challenge, by exploring the key parameters influencing the VR business power and the development of appropriate VR applications in real financial business. We conducted profound investigation of both B2B and B2C needs, and how these could be met. In three studies, we have approached experts from leading international banks (finance to computer specialists), and their (potential) customers. Study 1 included focus group discussions with experts. First, participants could experience different VR devices such as Samsung Gear VR, then a structured discussion was held. The outcomes are analyzed and summarized in a portfolio. Study 2 further used the portfolio analyzer to profile the management of real business services with(in) VR. Again experts participated, where first being introduced with Samsung Gear, then experiencing it and being interviewed. Based on the outcomes, a survey was developed to interview (potential) customers and test ideas created (Study 3). The results suggest that developing proper system architectures to connect people and to connect devices is crucial for building up powerful business with(in) VR. From one side, connecting devices, e.g., pairing mobile Head Mounted Displays for VR with smart-phones and/or wearable technologies would be appropriate way “to have” customers anywhere, anytime with a brand and/or business. Developing VR Apps, providing detailed real time visualization of performance and infrastructure types could enable 3D VR navigation, 3D contents viewing, but also being opportunity for connecting people in collaborative platforms. The outcomes of the current research are summarized in a model which could be applied to unlock the real business power of VR.

Keywords: business power, B2B, B2C, VR applications

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Authors: Maulita Sari Hani, Abraham B. Sianipar, Jamaluddin Jompa, Natsir Nessa, Alan T. White

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Manta ray is an icon for tourism in Raja Ampat. The tourist volume has been increased for the past ten years which up to approximately 23,000 tourists in 2017. Since 2013, Conservation International Indonesia deployed satellite and acoustic tags on manta ray in Dampier strait to track the species and identify the aggregation areas. These findings encourage the government and the local community to boost conservation through the management of marine protected areas for tourism purposes. Community in Dampier strait including the village of Arborek, Kurkapa, Kapisawar, and Sawingray involved in variety of small scale tourism business including homestay, dive shop, tour operator, and crafts. Working groups of related local businesses were established to support the local community and to ensure the sustainability of the economic viability and environmental sustainability. In order to analyze the economic benefits of manta ray tourism, this study was conducted to identify the number of local business in Dampier Strait and the economic impacts in terms of local finance security, social, humanity, individual, and physical assets. The results of this study identify 30 homestays, 2 dive shops, 10 tour operators, 30 women involved in crafts, and about 50 villagers worked for dive resorts. In addition to community assets, we confirmed the welfare of community has been improved in terms of food security, households, education for children, savings, and health insurance.

Keywords: marine wildlife tourism, elasmobranch, conservation, ecotourism, co-management, economic viability, environmental sustainability

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Authors: Ying Liang, Na Li

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Lipo-alkaloid is a kind of C19-norditerpenoid alkaloids existed in Aconitum species, which usually contains an aconitane skeleton and one or two fatty acid residues. The structures are very similar to that of diester-type alkaloids, which are considered as the main bioactive components in Aconitum carmichaelii. They have anti-inflammatory, anti-nociceptive, and anti-proliferative activities. So far, more than 200 lipo-alkaloids were reported from plants, semisynthesis, and biotransformations. In our research, by the combination of ultra-high performance liquid chromatography-quadruple-time of flight mass spectrometry (UHPLC-Q-TOF-MS) and an in-house database, 148 lipo-alkaloids were identified from A. carmichaelii, including 93 potential new compounds and 38 compounds with oxygenated fatty acid moieties. To our knowledge, this is the first time of the reporting of the oxygenated fatty acids as the side chains in naturally-occurring lipo-alkaloids. Considering the fatty acid residues in lipo-alkaloids should come from the free acids in the plant, the fatty acids and their relationship with lipo-alkaloids were further investigated by GC-MS and LC-MS. Among 17 fatty acids identified by GC-MS, 12 were detected as the side chains of lipo-alkaloids, which accounted for about 1/3 of total lipo-alkaloids, while these fatty acid residues were less than 1/4 of total fatty acid residues. And, total of 37 fatty acids were determined by UHPCL-Q-TOF-MS, including 18 oxidized fatty acids firstly identified from A. carmichaelii. These fatty acids were observed as the side chains of lipo-alkaloids. In addition, although over 140 lipo-alkaloids were identified, six lipo-alkaloids, 8-O-linoleoyl-14-benzoylmesaconine (1), 8-O-linoleoyl-14-benzoylaconine (2), 8-O-palmitoyl-14-benzoylmesaconine (3), 8-O-oleoyl-14-benzoylmesaconine (4), 8-O-pal-benzoylaconine (5), and 8-O-ole-Benzoylaconine (6), were found to be the main components, which accounted for over 90% content of total lipo-alkaloids. Therefore, using these six components as standards, a UHPLC-Triple Quadrupole-MS (UHPLC-QQQ-MS) approach was established to investigate the influence of processing on the contents of lipo-alkaloids. Although it was commonly supposed that the contents of lipo-alkaloids increased after processing, our research showed that no significant change was observed before and after processing. Using the same methods, the lipo-alkaloids in the lateral roots of A. carmichaelii and the roots of A. kusnezoffii were determined and quantified. The contents of lipo-alkaloids in A. kusnezoffii were close to that of the parent roots of A. carmichaelii, while the lateral roots had less lipo-alkaloids than the parent roots. This work was supported by Macao Science and Technology Development Fund (086/2013/A3 and 003/2016/A1).

Keywords: Aconitum carmichaelii, fatty acids, GC-MS, LC-MS, lipo-alkaloids

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Authors: Abdelrhman Elagez, Rolla Monib

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This empirical study investigates the observed risks associated with adopting Artificial Intelligence (AI) technologies in the construction industry and proposes potential mitigation strategies. While AI has transformed several industries, the construction industry is slowly adopting advanced technologies like AI, introducing new risks that lack critical analysis in the current literature. A comprehensive literature review identified a research gap, highlighting the lack of critical analysis of risks and the need for a framework to measure and mitigate the risks of AI implementation in the construction industry. Consequently, an online survey was conducted with 24 project managers and construction professionals, possessing experience ranging from 1 to 30 years (with an average of 6.38 years), to gather industry perspectives and concerns relating to AI integration. The survey results yielded several significant findings. Firstly, respondents exhibited a moderate level of familiarity (66.67%) with AI technologies, while the industry's readiness for AI deployment and current usage rates remained low at 2.72 out of 5. Secondly, the top-ranked barriers to AI adoption were identified as lack of awareness, insufficient knowledge and skills, data quality concerns, high implementation costs, absence of prior case studies, and the uncertainty of outcomes. Thirdly, the most significant risks associated with AI use in construction were perceived to be a lack of human control (decision-making), accountability, algorithm bias, data security/privacy, and lack of legislation and regulations. Additionally, the participants acknowledged the value of factors such as education, training, organizational support, and communication in facilitating AI integration within the industry. These findings emphasize the necessity for tailored risk assessment frameworks, guidelines, and governance principles to address the identified risks and promote the responsible adoption of AI technologies in the construction sector.

Keywords: risk management, construction, artificial intelligence, technology

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Authors: Amy Yee Kai Wan

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The arrival of a new baby to first-time parents is an exciting and joyous occasion, yet, the daunting task of raising the baby and the uncertainty of how it will affect the lives of the couple present a great challenge to them. This study examines the causes of conflicts and needs of the new parents through a qualitative research of five pairs of new parents in Hong Kong. Semi-structured in-depth qualitative interviews were conducted to explore the changes babies brought to their marriages, sources of support they received and found important and assistance they felt would help with their transition to parenthood. Thematic analysis was used to analyze the commonalities and differences between the five couples’ subjective experiences. Narrative analysis was used to compare the experiences of two parents who are the under-functioning parent of the couple, to study the different strategies they employed in response to the over-functioning parent and to analyze how the marital relationships were affected. Four main themes emerged from the study: 1) Change and adjustment in marital relationship, 2) parents’ level of involvement, 3) support in childcaring, and 4) challenges faced by the parents. Results from the study indicated that father involvement in childcaring is an important element in mother’s marital satisfaction Father’s marital satisfaction is dependent upon the mother – her satisfaction with father involvement, which affects the mother’s marital satisfaction. Marital convergence and co-parenting alliance acted as moderators for marital satisfaction. Implications from the study include: i) offering programmes that improve couple relationship and enhance parenting efficacy in tandem to improve overall marital satisfaction, and ii) offering prenatal counselling services or provide education to new parents from prenatal to postnatal period that can help couples reduce discrepancies between expectations and realities of their marital relationship and parenting responsibilities after their baby is born.

Keywords: co-parenting alliance, father involvement, marital convergence, maternal gatekeeping, new parents, transition to parenthood

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Authors: Barry Majeed, Eka Febriana, Seto Julianto

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Kepulauan Seribu National Parks is a marine preservation region in Indonesia. It is located in 5°23' - 5°40' LS, 106°25' - 106°37' BT North of Jakarta City. Covered with area 107,489 ha, Kepulauan Seribu has a lot of tourism spots such as cluster islands, fringing reef and many more. Kepulauan Seribu is also nominated as Strategic Tourism Region In Indonesia (KSPN). So, these islands have a lot of potential sides more than preservation function as a national park, hence the development of sustainable geotourism. The aim of this study is for enhancing the development of eco-geotourism in Kepulauan Seribu. This study concern for three main aspect of eco-geotourism such as tourism, form and process. Study for the tourism aspect includes attractions, accommodations, tours, activities, interpretation, and planning & management in Kepulauan Seribu. Study for the form aspect focused on the carbonate platform situated between two islands. Primarily in carbonate reef such as head coral, branchy coral, platy coral that created the carbonate sequence in Kepulauan Seribu. Study for the process aspect primarily discussed the process of forming of carbonate from carbonate factory later becomes Kepulauan Seribu. Study for the regional geology of Kepulauan Seribu has been conducted and suggested that Kepulauan Seribu lithologies are mainly quarternary limestone. In this study, primary data was taken from an observation of quarternary carbonate platform between two islands from Hati Island, Macan Island, Bulat Island, Ubi Island and Kelapa Island. From this observation, the best routes for tourist have been made from Island to Island. Qualitative methods such as depth interview to the local people in purposive sampling also have been made. Finally, this study also giving education about geological site – carbonate sequence - in Kepulauan Seribu for the local wisdom so that this study can support the development of sustainable eco-geotourism in Kepulauan Seribu.

Keywords: carbonate factory, carbonate platform, geotourism, Kepulauan Seribu

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Authors: Manar Al-Ateeq

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The building construction industry plays a major role in the economy of the word and the state of Kuwait. This paper evaluates existing new civil site engineers, describes a new system for improvement and insures the importance of prequalifying and developing for new engineers. In order to have a strong base in engineering, educational institutes and workplaces should be responsible to continuously train engineers and update them with new methods and techniques in engineering. As to achieve that, school of engineering should constantly update computational resources to be used in the professions. A survey was prepared for graduated Engineers based on stated objectives to understand the status of graduate engineers in both the public and private sector. Interviews were made with different sectors in Kuwait, and several visits were made to different training centers within different workplaces in Kuwait to evaluate training process and try to improve it. Virtual Reality (VR) technology could be applied as a complement to three-dimensional (3D) modeling, leading to better communication whether in job training, in education or in professional practice. Techniques of 3D modeling and VR can be applied to develop the models related to the construction process. The 3D models can support rehabilitation design as it can be considered as a great tool for monitoring failure and defaults in structures; also it can support decisions based on the visual analyses of alternative solutions. Therefore, teaching computer-aided design (CAD) and VR techniques in school will help engineering students in order to prepare them to site work and also will assist them to consider these technologies as important supports in their later professional practice. This teaching technique will show how the construction works developed, allow the visual simulation of progression of each type of work and help them to know more about the necessary equipment needed for tasks and how it works on site.

Keywords: three dimensional modeling (3DM), civil engineers (CE), professional practice (PP), virtual reality (VR)

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Authors: Shanmugasundaram Selvadurai, Amal Chandran

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Small satellites have become an alternative low-cost solution for several missions to accomplish specific missions such as Earth imaging, Technology demonstration, Education, and other commercial purposes. Small satellite missions focusing on Infrared imaging applications require lower temperature for scientific instruments and such low temperature can be achieved only using external cryocoolers but the disadvantage is that they generate a large amount of waste heat. Existing passive thermal control techniques are not capable to handle such large thermal loads and hence one of the traditional active Thermal Control System (TCS) is studied for a small satellite configuration. This work aims to downscale the existing Mechanically Pumped Fluid Loop (MPFL) TCS to a 27U CubeSat platform for an imaginary scientific instrument. The temperature-sensitive detector in the instrument considered to be maintained between 130K and 150K to reduce dark current noise and increase the data quality. A Single-Phase fluid based MPFL is chosen for this system-level study and this TCS consists of a microfluid pump, a micro-cryocooler, a fluid accumulator, external heaters, flow regulators, and sensors. This work also explains the thermal control system architecture with a conceptual design, arrangement of all the components, and thermal analysis for different low orbit conditions. Sizing and extensive trade studies for the components are conducted and the results have shown that the Single-phase MPFL system is able to handle the given thermal loads and maintain the satellite’s interface temperature within the desired limit.

Keywords: active thermal control system, satellite thermal, mechanically pumped fluid loop system, cryogenics, cryocooler

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Authors: Rebecca K. Blais, Lindsey Monteith, Hallie Tannahill

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Military sexual trauma (MST) includes sexual harassment or assault that occurred during military service. Studies conducted to date on the association of MST with mental health and suicide outcomes are generally circumscribed to either active duty or veteran samples, precluding a thorough analysis of developmental trajectories of distress following MST within the context of ongoing (vs. discharged from) military service. The Military Social Science Laboratory has collected data on mixed service samples of men and women service members, addressing this important literature gap. The purpose of this study was to examine the association of MST, suicide risk, PTSD, depression, alcohol use, and posttraumatic cognitions using two separate samples, which collectively allow for a comprehensive examination of the development of distress following MST. The first sample consisted of 1389 men and women service members and veterans with varying levels of MST severity, including no MST, harassment-only MST, and assault MST. The second sample consisted of 400 men and women service members, all reporting the highest severity of MST, assault MST. In both samples, roughly half reported being discharged from service. Participants completed self-report measures of MST exposure severity, suicide ideation, suicide risk, PTSD, depression, alcohol misuse, and posttraumatic cognitions, as well as perceptions of how the military responded to their MST. Relative to those still serving in the US military, veterans were more likely to endorse suicidal ideation, higher PTSD symptoms, and higher depression symptoms if they felt the military mishandled their experience of MST (referred to as perceived institutional betrayal). However, among those reporting the most severe MST, veterans reported lower alcohol misuse and more adaptive posttraumatic cognitions. These findings suggest that those separated from the military experience different posttraumatic aftermath following MST relative to those who are currently serving in the military. Such findings suggest critical differences in the developmental trajectory of distress, necessitating different interventions to successfully reduce distress and dysfunction. Additional analyses will explore the impact of gender on these associations and explore full mechanistic models of distress grouped by discharged status.

Keywords: military sexual trauma, PTSD, suicide, developmental trajectories, depression

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Authors: E. Mattio

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The aim of this project is to study the Chinese presence in Ethiopia, following the path of the last salt caravans from Danakil to Tigray region. Official estimates of the number of Chinese in Africa vary widely; on the continent, there are increasingly diverse groups of Chinese migrants in terms of language, dialect, class, education, and employment. Based on this and on a very general state of the art, it was decided to increase the studies on this phenomenon, documenting the extraction of salt and following the sellers in the north of the country. The project is unique and allows you to admire a landscape that will soon change, due to the construction of infrastructure that is changing the dynamics of movement and sales. To carry out this study, interdisciplinary investigation methods were integrated, such as landscape archeology, historiographic research, participatory anthropology, geopolitics, and cultural anthropology and ethnology. There are two main objectives of the research. The first was an analysis of risk perceptions to predict what will happen to these populations and how the territory will be modified, trying to monitor the growth of infrastructure in the country and the effects it will have on the population. Thanks to the use of GIS, some roads created by Chinese companies that worked in the area have been georeferenced. The second point was to document the life and rituals of Ethiopian populations, in order not to lose the aspects of uniqueness that risk being lost. The local interviews have garnered impressions and criticisms from the local population to understand whether the Chinese presence is perceived as a threat or a solution. Among the most exclusive interviews, there are those made to Afar leaders in the Logya area and some Coptic representatives in the Wukro area. To make this project even more unique, the Coptic rituals of Gennà and Timkat have been documented, unique expressions of a millennial tradition. The aim was to understand whether the Maoist presence began to influence the religious rites and forms of belief present in the country.

Keywords: China, Ethiopia, GIS, risk perceptions

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

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

Keywords: health literacy, Peru, tuberculosis, tuberculosis knowledge

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Authors: Neslihan Sahin Celik, Ali Eraslan

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Mathematical model and modeling are one of the topics that have been intensively discussed in recent years. In line with the results of the PISA studies, researchers in many countries have begun to question how much students in school-education system are prepared to solve the real-world problems they encounter in their future professional lives. As a result, many mathematics educators have begun to emphasize the importance of new skills and understanding such as constructing, Hypothesizing, Describing, manipulating, predicting, working together for complex and multifaceted problems for success in beyond the school. When students increasingly face this kind of situations in their daily life, it is important to make sure that students have enough experience to work together and interpret mathematical situations that enable them to think in different ways and share their ideas with their peers. Thus, model eliciting activities are one of main tools that help students to gain experiences and the new skills required. This research study was carried on the town center of a big city located in the Black Sea region in Turkey. The participants were eighth-grade students in a middle school. After a six-week preliminary study, three students in an eighth-grade classroom were selected using criterion sampling technique and placed in a focus group. The focus group of three students was videotaped as they worked on a model eliciting activity, the Summer Job Problem. The conversation of the group was transcribed, examined with students’ written work and then qualitatively analyzed through the lens of Blum’s (1996) modeling processing cycle. The study results showed that eighth grade students can successfully work with the model eliciting, develop a model based on the two parameters and review the whole process. On the other hand, they had difficulties to relate parameters to each other and take all parameters into account to establish the model.

Keywords: middle school, modeling, mathematical modeling, summer job problem

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Authors: Jerome E. Abiemo, Takeshi Mizunoya

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The Aveyime community in the Volta region of Ghana is one of the major hubs for rice production. In the past, rice farmers applied organic pesticides to control pests, and compost as a soil amendment to improve fertility and productivity. However, the introduction of chemical pesticides and fertilizers have led many farmers to convert to inorganic system of rice production, without considering the social costs (e.g. groundwater contamination and health costs) related to the use of pesticides. The study estimates and compares the private and social BCRs of organic and inorganic systems of rice production. Both stratified and simple random sampling techniques were employed to select 300 organic and inorganic rice farmers and 50 pesticide applicators. The respondents were interviewed with pre-tested questionnaires. The Contingent Valuation Method (CVM) which elucidates organic farmers` Willingness-to-Pay (WTP) was employed to estimate the cost of groundwater contamination. The Cost of Illness (COI) analysis was used to estimate the health cost of pesticide-induced poisoning of applicators. The data collated, was analyzed with the aid of Microsoft excel. The study found that high private benefit (e.g. increase in farm yield and income) was the most influential factor for the rapid adoption of pesticides among rice farmers. The study also shows that the social costs of inorganic rice production were high. As such the social BCR of inorganic farming (0.2) was low as compared to organic farming (0.7). Based on the results, it was recommended that government should impose pesticide environmental tax, review current agricultural policies to favour organic farming and promote extension education to farmers on pesticide risk, to ensure agricultural and environmental sustainability.

Keywords: benefit-cost-ratio (BCR), inorganic farming, pesticides, social cost

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Authors: E. Xavier, B. Nandita

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

Keywords: embodiment, liminal, refugee, Rohingya

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Authors: Shiran Bord, Assaf Oshri, Matthew W. Carlson, Sihong Liu

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Background: Alcohol-impaired driving (AID) and binge drinking are major health concerns among college students. Although the link between binge drinking and AID is well established, knowledge regarding binge drinking patterns, the factors influencing binge drinking, and the associations between consumption patterns and alcohol-related risk behaviors is lacking. Aims: To examine heterogeneous trajectories of binge drinking during college and tests factors that might predict class membership as well as class membership outcomes. Methods: Data were obtained from a sample of 1,265 college students (Mage = 18.5, SD = .66) as part of the Longitudinal Study of Violence Against Women (N = 1,265; 59.3% female; 69.2% white). Analyses were completed in three stages. First, a growth curve analysis was conducted to identify trajectories of binge drinking over time. Second, growth curve mixture modeling analyses were pursued to assess unobserved growth trajectories of binge drinking without predictors. Lastly, parental drinking variables were added to the model as predictors of class membership, and AID and being a passenger of a drunk driver were added to the model as outcomes. Results: Three binge drinking trajectories were identified: high-convex, medium concave and low-increasing. Parental drinking was associated with being in high-convex and medium-concave classes. Compared to the low-increasing class, the high convex and medium concave classes reported more AID and being a passenger of a drunk driver more frequently. Conclusions: Parental drinking may affect children’s later engagement in AID. Efforts should focus on parents' education regarding the consequences of parental modeling of alcohol consumption.

Keywords: alcohol impaired driving, alcohol consumption, binge drinking, college students, parental modeling

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Authors: Lenore Van Den Berg

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Vocabulary development is positively associated with reading development, reading comprehension, and academic achievement. It is frequently stated that South Africa is in the midst of a literacy crisis. The past 24 years since the first democratically elected government have not revolutionised the education system; rather, after various curriculum changes and continued struggles to incorporate all 11 official languages as languages of instruction, research shows that 78 per cent of South African Grade 4 learners are functionally illiterate. The study sets out to find solutions to this problem and to add to the research base on vocabulary acquisition by assessing the effect of integrating the principles of explicit, interactive vocabulary instruction, within the context of storybook reading, on Grade 1 vocabulary acquisition. Participants comprised of 69 Grade 1 English second language learners from three classes in two government primary schools. The two schools differ in socio-economic status (SES), with School A having a lower SES than School B. One Grade 1 class was randomly assigned to be the Experimental Group, while two other classes served as control groups. The intervention took place for a period of 18 weeks and consisted of 30-minute storybook reading sessions, accompanied by interactive vocabulary instruction, twice a week. The Peabody Picture Vocabulary Test IV (PPVT-IV) was the diagnostic test administered to all learners before the intervention, as a pre-test, and after the interventions as a post-test. Data regarding excising vocabulary instruction practices and approaches were also collected through classroom observations and individual, semi-structured interviews with the Experimental Group’s teacher. Findings suggest that second language storybook reading, accompanied by explicit, interactive vocabulary instruction, have a positive impact on Grade 1 vocabulary acquisition but that vocabulary teaching practices and socio-economic status also play a key role in vocabulary acquisition.

Keywords: interactive vocabulary instruction, second language vocabulary, storybook reading, vocabulary acquisition, reading development, PPVT

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Authors: Nditsheni Ramakuela, Sonto Maputle, Base Khoza, Augustine Tugli

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Inadequate health literacy can cause difficulties in understanding and compliance to treatment plan. With diabetic condition, self-care activities include behaviours of following a diet plan, avoiding high fat foods, increased exercise, self-glucose monitoring, and foot care. Patients with poor health literacy have difficulty interpreting medication warning labels, following directions on a prescription label and identifying their medications. Difficulties in understanding and performing self-care and health-related activities may ultimately lead to poor health outcomes. The study explored and described factors affecting health literacy and self-care to diabetic regimen by female patients at selected hospital in Limpopo Province of South Africa. Qualitative and explorative research design was used. Female patients who were admitted and diagnosed with diabetes in female medical ward constituted the study population. Non-probability, purposive sampling was used to select 20 female patients diagnosed with diabetes, who were above 18 years and admitted during April–November 2014. An in-depth face-to-face, unstructured interview was used to collect data. Data were analysed using open coding method. Measures to ensure trustworthiness and ethical considerations were adhered to. Findings revealed factors affecting health literacy for diabetic self-care activities amongst patients were; patient, family, disease and facility related. Proposed recommendations were; to strengthen diabetes education and patient-provider partnership. This is important and must be transferred to strengthen self-care activities to fully benefit the patient.

Keywords: compliance, diabetes mellitus, diabetic regimen, health literacy, self activities

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Authors: Sankalpa Satapathy

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

Keywords: disability, gender, marriage, relationships

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Authors: Osman Zorbaz, Selen Demirtas-Zorbaz, Ozlem Ulas

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The factors that cause adolescents to drop out school were several. One of the frameworks about school dropout focuses on the contextual factors around the adolescents whereas the other one focuses on individual factors. It can be said that both factors are important equally. In this study, both adolescent’s individual factors (anti-social behaviors, academic success) and contextual factors (parent academic involvement, parent academic support, number of siblings, living with parent) were examined in the term of school dropout. The study sample consisted of 346 high school students in the public schools in Ankara who continued their education in 2015-2016 academic year. One hundred eighty-five the students (53.5%) were girls and 161 (46.5%) were boys. In addition to this 118 of them were in ninth grade, 122 of them in tenth grade and 106 of them were in eleventh grade. Multiple regression and one-way ANOVA statistical methods were used. First, it was examined if the data meet the assumptions and conditions that are required for regression analysis. After controlling the assumptions, regression analysis was conducted. Parent academic involvement, parent academic support, number of siblings, anti-social behaviors, academic success variables were taken into the regression model and it was seen that parent academic involvement (t=-3.023, p < .01), anti-social behaviors (t=7.038, p < .001), and academic success (t=-3.718, p < .001) predicted school dropout whereas parent academic support (t=-1.403, p > .05) and number of siblings (t=-1.908, p > .05) didn’t. The model explained 30% of the variance (R=.557, R2=.300, F5,345=30.626, p < .001). In addition to this the variance, results showed there was no significant difference on high school students school dropout levels according to living with parents or not (F2;345=1.183, p > .05). Results discussed in the light of the literature and suggestion were made. As a result, academic involvement, academic success and anti-social behaviors will be considered as an important factors for preventing school drop-out.

Keywords: adolescents, anti-social behavior, parent academic involvement, parent academic support, school dropout

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Authors: Kyngäs Helvi, Patala-Pudas, Kaakinen Pirjo

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It has been reported that COPD -patients may experience much emotional distress, which can compromise positive health outcomes. The aim of this study was to explore disease-related uncertainty as reported by Chronic Obstructive Pulmonary Disease (COPD) patients. Uncertainty was defined as a lack of confidence; negative feelings; a sense of confidence; and awareness of the sources of uncertainty. Research design was a non-experimental cross-sectional survey. The data (n=141) was collected by validated questionnaire during COPD -patients’ visits or admissions to a tertiary hospital. The response rate was 62%. The data was analyzed by statistical methods. Around 70% of the participants were male with COPD diagnosed many years ago. Fifty-four percent were under 65 years and used an electronic respiratory aid apparatus (52%) (oxygen concentrator, ventilator or electronic inhalation device). Forty-one percent of the participants smoked. Disease-related uncertainty was widely reported. Seventy-three percent of the participants had uncertainty about their knowledge of the disease, the pulmonary medication and nutrition. One-quarter (25%) did not feel sure about managing COPD exacerbation. About forty percent (43%) reported that they did not have a written exacerbation decision aid indicating how to act in relation to COPD symptoms. Over half of the respondents were uncertain about self-management behavior related to health habits such as exercise and nutrition. Over a third of the participants (37%) felt uncertain about self-management skills related to giving up smoking. Support from the care providers was correlated significantly with the patients’ sense of confidence. COPD -patients who felt no confidence stated that they received significantly less support in care. Disease-related uncertainty should be considered more closely and broadly in the patient care context, and those strategies within patient education that enhance adherence should be strengthened and incorporated into standard practice.

Keywords: adherence, COPD, disease-management, uncertainty

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Authors: Shree Kumar Maharjan

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Climate change has varied impacts on diverse livelihood sectors, which is more prominent at the community level. The stakeholders and local institutions have been supporting the communities either by building adaptive capacities and resilience or minimizing the impacts of different adaptation interventions. Some of these interventions are effective, whereas others need further dynamisms and exertions considering the complexity of the risks and vulnerabilities. Hence, consolidated efforts of concerned stakeholders are required to minimize and adapt the present and future impacts. This study digs out and analyses the perceptions of local stakeholders in climate change adaptation in Madi and Deukhuri valleys of Nepal through a questionnaire survey. The study has categorized the local stakeholders into 5 groups in the study sites – Farmers groups and cooperatives, Government, I/NGOs, Development banks and education and other organizations. The local stakeholders revealed flood, drought, cold wave and riverbank erosion as the major climatic risks and hazards found in the sites eventually impacting on the loss of agricultural production, loss of agricultural land and properties, loss of livestock, the emergence of diseases and pest. The stakeholders believed that most of the farmers dealing with these impacts based on their traditional knowledge and practices, followed by with the support of NGOs and with the help of neighbors and community. The major supports of the stakeholders to deal with these impacts were on training and awareness, risk analysis and minimization, livelihood improvement, financial support, coordination and networking and facilitation in policy formulation. The stakeholders emphasized primarily on capacity building, appropriate technologies, community-based planning and monitoring, prioritization to the poor and the marginalized and establishment of community fund respectively for building adaptive capacities.

Keywords: climate change adaptation, local stakeholders, Madi, Deukhuri, Nepal

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Authors: Abdallah Al-ZoubI, Mamoun Dmour

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The spectrum of IoT devices is becoming widely diversified, entering almost all possible fields and finding applications in industry, health, finance, logistics, education, to name a few. The IoT active endpoint sensors and devices exceeded the 12 billion mark in 2021 and are expected to reach 27 billion in 2025, with over $34 billion in total market value. This sheer rise in numbers and use of IoT devices bring with it considerable concerns regarding data storage, analysis, manipulation and protection. IoT Blockchain-based systems have recently been proposed as a decentralized solution for large-scale data storage and protection. COVID-19 has actually accelerated the desire to utilize IoT devices as it impacted both demand and supply and significantly affected several regions due to logistic reasons such as supply chain interruptions, shortage of shipping containers and port congestion. An IoT-blockchain system is proposed to handle big data generated by a distributed network of sensors and controllers in an interactive manner. The system is designed using the Ethereum platform, which utilizes smart contracts, programmed in solidity to execute and manage data generated by IoT sensors and devices. such as Raspberry Pi 4, Rasbpian, and add-on hardware security modules. The proposed system will run a number of applications hosted by a local machine used to validate transactions. It then sends data to the rest of the network through InterPlanetary File System (IPFS) and Ethereum Swarm, forming a closed IoT ecosystem run by blockchain where a number of distributed IoT devices can communicate and interact, thus forming a closed, controlled environment. A prototype has been deployed with three IoT handling units distributed over a wide geographical space in order to examine its feasibility, performance and costs. Initial results indicated that big IoT data retrieval and storage is feasible and interactivity is possible, provided that certain conditions of cost, speed and thorough put are met.

Keywords: IoT devices, blockchain, Ethereum, big data

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Authors: Nemanja D. Kidzin

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The field of personality change has recently garnered increased attention, while the psychology of acting has remained relatively understudied. This research tried to contribute to the both research field by investigating whether the process of acting can lead to personality changes in acting students and, if so, in what manner. It was hypothesized that significant differences would be observed in self-reported personality traits of acting students between the beginning and end of their role preparation. The study also examined potential moderator variables, including the reported personality traits of the roles portrayed by the students, empathy, disintegration, and years of formal acting education. The sample comprised 47 students of acting from the Faculty of Dramatic Arts (first to fourth-year) and the Faculty of Modern Arts (first-year students only). The research involved two waves of testing, conducted at the beginning (T1) and end (T2) of the semester. Personality traits (measured using the HEXACO-60 self-report version), empathy (measured using the Questionnaire of Cognitive and Affective Empathy, QCAE), and disintegration (measured using the DELTA9, 10-item version) were assessed at both T1 and T2, while the personality of the role (measured using the HEXACO-60 observer version) was assessed at T2. Repeated-measures t-tests revealed significant differences in emotionality and conscientiousness between T1 and T2. Additionally, an index of absolute personality change was significantly different from 0 for all traits, indicating personality change. The average test-retest correlation for HEXACO traits was 0.57, lower than that proposed in similar research. However, the personality of the role, empathy, and disintegration did not explain the changes in students' personality traits as moderator variables. The magnitude of personality change was highest among fourth-year students, with no significant differences observed among the remaining three years of study. Overall, the findings suggest the presence of personality changes or trait variability in acting students. However, these changes cannot be conclusively attributed to the process of role preparation. Further research with more stringent methodologies is needed to better understand the role of acting in personality change.

Keywords: personality change, psychology of acting, empathy, disintegraton

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Authors: Najith Duminda Galmangoda Guruge, Nadeeka Rathnayake, Vinodani Wimalasena, Dinesha Wijesooriya

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Investing in Early Learning can improve children’ interests for education and makes them ready for school. Children in economically disadvantaged communities may have reduced readiness for schools. Health Promotion approach enables communities including disadvantaged to control over their health. Mothers of children under the age five in ‘Alapathwewa’ community (n=40) were selected as the sample with the aim to promote early learning of children to improve their school readiness. Mothers in ‘Morakeewa’ community (n=40) were the control. Interventions were for a period of 2 years and children of these mothers were followed up to school entry. Importance of early learning and possibility of providing quality learning environments for children at a low cost was discussed with mothers in an experimental setting by facilitators. Mothers were enabled to make age-appropriate baby rooms which provide learning opportunities. Collective community playhouses and play areas were developed by mothers to provide opportunities for children to interact and learn with each other. Mothers started discussing with each other and sharing experiences. The progress was monitored by mothers at regular intervals. Data regarding school competencies of children were obtained from school teachers. School teachers measured thirteen competencies of children on a scale of ‘very good, good, moderate and weak’. All children in the experimental group were in ‘very good’ level in two competencies, ‘communicate friendly with others’ and ‘express ideas well’. Children in the experimental group reported a significantly higher achievement of all thirteen competencies (p < .05) than children in control. Providing quality early learning environments for children even in economically disadvantaged settings makes them ready for schools. Through a Health Promotion approach, early learning experiences for children can be provided at a low cost.

Keywords: disadvantaged, early learning, economically, health promotion

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Authors: Teklay Gebrecherkos, Dawit Wolday, Muhamud Abdulkader

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Background: COVID-19 symptomatology in Africa appears significantly less serious than in the industrialized world. Our hypothesis for this phenomenon, being a different, more activated immune system due to parasite infections contributes to reduced COVID-19 outcome. We investigated this hypothesis in an endemic area in sub sub-saharan Africa. Methods: Ethiopian COVID-19 patients were enrolled and screened for intestinal parasites, between July 2020 and March 2021. The primary outcome was the proportion of patients with severe COVID-19. SARS-CoV-2 infection was confirmed by RT-PCR on samples obtained from nasopharyngeal swabs, while direct microscopic examination, modified Ritchie concentration, and Kato-Katz methods were used to identify parasites and ova from a fresh stool sample. Ordinal logistic regression models were used to estimate the association between parasite infection and COVID-19 severity. Models were adjusted for sex, age, residence, education level, occupation, body mass index, and comorbidities. Data were analyzed using STATA version 14. P-value <0.05 was considered statistically significant. Results: A total of 751 SARS-CoV-2 infected patients were enrolled, of whom 284 (37•8%) had an intestinal parasitic infection. Only 27/255 (10•6%) severe COVID-19 patients were co-infected with intestinal parasites, while 257/496 (51•8%) non-severe COVID-19 patients appeared parasite positive (p<0.0001). Patients co-infected with parasites had lower odds of developing severe COVID-19, with an adjusted odds ratio (AOR) of 0•14 (95% CI 0•09–0•24; p<0•0001) for all parasites, AOR 0•20 ([95% CI 0•11–0•38]; p<0•0001) for protozoa, and AOR 0•13 ([95% CI 0•07–0•26]; p<0•0001) for helminths. When stratified by species, co-infection with Entamoeba spp., Hymenolopis nana, and Schistosoma mansoni implied a lower probability of developing severe COVID-19. There were 11 deaths (1•5%), and all were among patients without parasites (p=0•009). Conclusions: Parasite co-infection is associated with a reduced risk of severe COVID-19 in African patients. Parasite-driven immunomodulatory responses may mute hyper-inflammation associated with severe COVID-19.

Keywords: COVID-19, SARS-COV-2, intestinal parasite, RT-PCR, co-infection

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