Search results for: health tourism

Authors: Akinwale Adeyinka

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Critical natural resources such as clean ground water, fertile topsoil, and biodiversity are diminishing at an exponential rate, orders of magnitude above that at which they can be regenerated. Based on news on world population record, over 6 billion people on earth, and almost a quarter million added each day, the scale of human activity and environmental impact is unprecedented. Soaring human population growth over the past century has created a visible challenge to earth’s life support systems. In addition, the world faces an onslaught of other environmental threats including degenerated global climate change, global warming, intensified acid rain, stratospheric ozone depletion and health threatening pollution. Overpopulation and the use of deleterious technologies combine to increase the scale of human activities to a level that underlies these entire problems. These intensifying trends cannot continue indefinitely, hopefully, through increased understanding and valuation of ecosystems and their services, earth’s basic life-support system will be protected for the future.To say the fact, human civilization is now the dominant cause of change in the global environment. Now that our relationship to the earth has change so utterly, we have to see that change and understand its implication. These are actually 2 aspects to the challenges which we should believe. The first is to realize that our power to harm the earth can indeed have global and even permanent effects. Second is to realize that the only way to understand our new role as a co-architect of nature is to see ourselves as part of a complex system that does operate according to the same simple rules of cause and effect we are used to. So understanding the physical/biological dimension of earth system is an important precondition for making sensible policy to protect our environment. Because we believe Sustainable Development Is a matter of reconciling respect for the environment, social equity and economic profitability. Also, we strongly believe that environmental protection is naturally about reducing air and water pollution, but it also includes the improvement of the environmental performance of existing process. That is why we should always have it at the heart of our business that the environmental problem is not our effect on the environment so much as our relationship with the environment. We should always think of being environmental friendly in our operation.

Keywords: Stratospheric ozone depletion ion , Climate Change, global warming, social equity and economic profitability

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Authors: Henok Yebyo Henok, Araya Abrha Araya, Alemayehu Bayray Alemayehu, Gelila Goba Gelila

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Background: Every year, an estimated 19–20 million unsafe abortions take place, almost all in developing countries, leading to 68,000 deaths and millions more injured many permanently. Many women throughout the world, experience more than one abortion in their lifetimes. Repeat abortion is an indicator of the larger problem of unintended pregnancy. This study aimed to identify determinants of repeat abortion in Tigray Region, Ethiopia. Methods: Unmatched case-control study was conducted in hospitals in Tigray Region, Northern Ethiopia, from November 2014 to June 2015. The sample included 105 cases and 204 controls, recruited from among women seeking abortion care at public hospitals. Clients having two or more abortions (“repeat abortion”) were taken as cases, and those who had a total of one abortion were taken as controls (“single abortion”). Cases were selected consecutive based on proportional to size allocation while systematic sampling was employed for controls. Data were analyzed using SPSS version 20.0. Binary and multiple variable logistic regression analyses were calculated with 95% CI. Results: Mean age of cases was 24 years (±6.85) and 22 years (±6.25) for controls. 79.0% of cases had their sexual debut in less than 18 years of age compared to 57% of controls. 42.2% of controls and 23.8% of cases cited rape as the reason for having an abortion. Study participants who did not understand their fertility cycle and when they were most likely to conceive after menstruation (adjusted odds ratio [AOR]=2.0, 95% confidence interval [CI]: 1.1-3.7), having a previous abortion using medication(AOR=3.3, CI: 1.83, 6.11), having multiple sexual partners in the preceding 12 months (AOR=4.4, CI: 2.39,8.45), perceiving that the abortion procedure is not painful (AOR=2.3, CI: 1.31,4.26), initiating sexual intercourse before the age of 18 years (AOR=2.7, CI: 1.49, 5.23) and disclosure to a third-party about terminating the pregnancy (AOR=2.1, CI: 1.2,3.83) were independent predictors of repeat abortion. Conclusion: This study identified several factors correlated with women having repeat abortions. It may be helpful for the Government of Ethiopia to encourage women to delay sexual debut and decrease their number of sexual partners, including by promoting discussion within families about sexuality, to decrease the occurrence of repeated abortion.

Keywords: abortion, Ethiopia, repeated abortion, single abortion

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Authors: Suboohi Nasrin, MHD. Shahid, Abduraheem K.

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India is a tropical country, and it is estimated that biological and abiological agents are the major factors in the destruction and deterioration of archival materials like herbarium, paper, cellulose, bookbinding, etc. Silverfish, German Cockroaches, Termites, Booklice, Tobacco beetle and Carpet beetles are the common insect's pests in the museum, which causes deterioration to collections of museum specimens. Among them, silverfish is one of the most notorious pests and primarily responsible for the deterioration of Archival materials. So far, the investigation has been carried to overcome this existing problem as different management strategies such as chemical insecticides, fungicides, herbicides, nematicides, etc., have been applied. Moreover, Synthetic molecules lead to affect the ecological balance, have a detrimental effects on human health, reduce the beneficial microbial flora and fauna, etc. With a view, numbers of chemicals have been banned and advised not to be used due to their long-lasting persistency in soil ecosystem, water and carcinogenic. That’s why the authors used natural products with biocidal activity, cost-effective and eco-friendly approaches. In this study, various concentrations (30, 60 and 90 ml/L) of clove and lemongrass essential oil at different treatment duration (30, 60, 90 and 120-minutes) were investigated to test its properties as a silverfish repellent and insecticidal effect. The result of two ways ANOVA revealed that the mortality was significantly influenced by oil concentration, treatment duration and interaction between two independent factors was also found significant. The mortality rate increased with increasing the oil concentration in clove oil, and 100 % mortality was recorded in 0.9 ml at 120-minute. It was also observed that the treatment duration has the highest effect on the mortality rate of silverfish. The clove oil had the greatest effect on the silverfish in comparison to lemongrass. While in the case of percentage, repellency of adult silverfish was oil concentration and treatment duration-dependent, i.e., increase in concentration and treatment duration resulted in higher repellency percentage. The clove oil was found more effective, showing maximum repellency of 80.00% at 0.9ml/cm2 (highest) concentration, and in lemongrass highest repellency was observed at 33.4% at 0.9 ml/cm2 concentration in the treated area.

Keywords: adult silverfish, oils, oil concentration, treatment duration, mortality (%) and repellency

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Authors: Brian Fleischli, Shani Robins

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In recent years, the implementation of wisdom skills, including emotional intelligence, mindfulness, empathy, compassion, gratitude, realism (Cognitive-Behavioral Therapy), and humility, within K-12 educational settings has demonstrated significant benefits in reducing stress, anxiety, anger, and conflict among students. This study summarizes the findings of research conducted over several years, showcasing the positive outcomes associated with teaching these skills to elementary and high school students. Additionally, this overview includes an updated synthesis of current literature concerning the application and effectiveness of training these skill sets in K-12 schools. The research outcomes highlight substantial improvements in student well-being and behavior. Demonstrated with treatment group students exhibiting notable reductions in anger, anxiety, depression, and disruptive behaviors compared to control groups. For instance, fourth-grade students showed enhanced empathy, responsibility, and attention, particularly benefiting those with lower initial scores on these measures. Specific interaction effects suggest that older students and males particularly benefit from these interventions, showcasing the nuanced impact of wisdom skill training across different demographics. Furthermore, this presentation emphasizes the critical role of Social and Emotional Learning (SEL) programs in addressing the multifaceted challenges faced by children and adolescents, including mental health issues, academic performance, and social behaviors. The integration of wisdom skills into school curricula not only fosters individual growth and emotional regulation but also enhances overall school climate and academic achievement. In conclusion, the findings contribute to the growing body of empirical evidence supporting the efficacy of teaching wisdom skills in educational settings. The success of these interventions underscores the potential for widespread implementation of evidence-based programs to promote emotional well-being and academic success among students nationwide.

Keywords: wisdom skills, CBT, cognitive behavioral training, mindfulness, empathy, anxiety

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Authors: Li Shihao, Dieter Trau

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Bilirubin is a yellow substance that is made when the body breaks down old red blood cells. High levels of bilirubin can cause jaundice, a condition that makes the newborn's skin and the white part of the eyes look yellow. Jaundice is a serial-killer in developing countries in Southeast Asia such as Myanmar and most parts of Africa where jaundice screening is largely unavailable. Worldwide, 60% of newborns experience infant jaundice. One in ten will require therapy to prevent serious complications and lifelong neurologic sequelae. Limitations of current solutions: - Blood test: Blood tests are painful may largely unavailable in poor areas of developing countries, and also can be costly and unsafe due to the insufficient investment and lack of access to health care systems. - Transcutaneous jaundice-meter: 1) can only provide reliable results to caucasian newborns, due to skin pigmentations since current technologies measure bilirubin by the color of the skin. Basically, the darker the skin is, the harder to measure, 2) current jaundice meters are not affordable for most underdeveloped areas in Africa like Kenya and Togo, 3) fat tissue under the skin also influences the accuracy, which will give overestimated results, 4) current jaundice meters are not reliable after treatment (phototherapy) because bilirubin levels underneath the skin will be reduced first, while overall levels may be quite high. Thus, there is an urgent need for a low-cost non-invasive device, which can be effective not only for caucasian babies but also Asian and African newborns, to save lives at the most vulnerable time and prevent any complications like brain damage. Instead of measuring bilirubin on skin, we proposed a new method to do the measurement on the sclera, which can avoid the difference of skin pigmentations and ethnicities, due to the necessity for the sclera to be white regardless of racial background. This is a novel approach for measuring bilirubin by an optical method of light reflection off the white part of the eye. Moreover, the device is connected to a smart device, which can provide a user-friendly interface and the ability to record the clinical data continuously A disposable eye cap will be provided avoiding contamination and fixing the distance to the eye.

Keywords: Jaundice, bilirubin, non-invasive, sclera

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Authors: Jiazhen Chen, Yue Sun, Joanne Yip, Kit-Lun Yick

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The design of sports bras poses a considerable challenge due to the difficulty in accurately predicting the wearing result after computer-aided design (CAD). It needs repeated physical try-on or virtual try-on to obtain a comfortable pressure range during motion. Specifically, in the context of running, the exact support area and force exerted on the breasts remain unclear. Consequently, obtaining an effective method to design the sports bra pads shape becomes particularly challenging. This predicament hinders the successful creation and production of sports bras that cater to women's health needs. The purpose of this study is to propose an effective method to obtain the 3D shape of sports bra pads and to understand the relationship between the supporting force and the 3D shape parameters of the pads. Firstly, the static 3D shape of the sports bra pad and human motion data (Running) are obtained by using the 3D scanner and advanced 4D scanning technology. The 3D shape of the sports bra pad is parameterised and simplified by Free-form Deformation (FFD). Then the sub-models of sports bra and human body are constructed by segmenting and meshing them with MSC Apex software. The material coefficient of sports bras is obtained by material testing. The Marc software is then utilised to establish a dynamic contact model between the human breast and the sports bra pad. To realise the reverse design of the sports bra pad, this contact model serves as a forward model for calculating the inverse problem. Based on the forward contact model, the inverse problem of the 3D shape parameters of the sports bra pad with the target bra-wearing pressure range as the boundary condition is solved. Finally, the credibility and accuracy of the simulation are validated by comparing the experimental results with the simulations by the FE model on the pressure distribution. On the one hand, this research allows for a more accurate understanding of the support area and force distribution on the breasts during running. On the other hand, this study can contribute to the customization of sports bra pads for different individuals. It can help to obtain sports bra pads with comfortable dynamic pressure.

Keywords: sports bra design, breast motion, running, inverse problem, finite element dynamic model

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Authors: Brid Dinnee, Jessica Taylor, Joseph Hartland, Michael Natarajan

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Background:The third stage of labour (TSL) can be complicated by Post-Partum Haemorrhage (PPH), which can have a significant impact on maternal mortality and morbidity. In Africa, 33.9% of maternal deaths are attributable to PPH1. In order to minimise this figure, current recommendations for the developing world are that all women have active management of the third stage of labour (AMTSL). The aim of this project was to examine TSL practice in a rural Ugandan Hospital, highlight any deviation from best practice and identify barriers to change in resource limited settings as part of a 4th year medical student External Student Selected Component field trip. Method: Five key elements from the current World Health Organisation (WHO) guidelines on AMTSL were used to develop an audit tool. All daytime vaginal deliveries over a two week period in July 2016 were audited. In addition to this, a retrospective comparison of PPH rates, between 2006 (when ubiquitous use of intramuscular oxytocin for management of TSL was introduced) and 2015 was performed. Results: Eight vaginal deliveries were observed; at all of which intramuscular oxytocin was administered and controlled cord traction used. Against WHO recommendation, all umbilical cords were clamped within one minute, and no infants received early skin-to-skin contact. In only one case was uterine massage performed after placental delivery. A retrospective comparison of data rates identified a 40% reduction in total number of PPHs from November 2006 to November 2015. Maternal deaths per delivery reduced from 2% to 0.5%. Discussion: Maternal mortality and PPH are still major issues in developing countries. Maternal mortality due to PPH can be reduced by good practices regarding TSL, but not all of these are used in low-resource settings. There is a notable difference in outcomes between the developed and developing world. At Kitovu Hospital, there has been a reduction in maternal mortality and number of PPHs following introduction of IM Oxytocin administration. In order to further improve these rates, staff education and further government funding is key.

Keywords: post-partum haemorrhage, PPH, third stage labour, Uganda

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Authors: Bandana Bhattacharya

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‘Buddhism’, as such signifies the ‘ism’ that is based on Buddha’s life and teachings or that is concerned with the gospel of Buddha as recorded in the literature available in Pali, Sanskrit, Buddhist Sanskrit, Prakrit and even in the other non-Indian languages wherein it has been described a very abstruse, complex and lofty philosophy of life or ‘the way of life’ preached by Him (Buddha). It has another side too, i.e., the applicability of the tenets of Buddha according to the needs of the present society, where human life and outlook has been totally changed. Applied Buddhism signifies the applicability of the Buddha’s noble tenets. Along with the theological exposition and textual criticism of the Buddha’s discourses, it has now become almost obligatory for the Buddhist scholars to re-interpret Buddhism from modern perspectives. Basically Applied Buddhism defined a ‘way of life’ which may transform the higher quality of life or essence of life due to changed circumstances, places and time. Nowadays, if we observe the present situation of the world, we will find the current problems such as health, economic, politic, global warming, population explosion, pollution of all types including cultural scarcity essential commodities and indiscriminate use of human, natural and water resources are becoming more and more pronounced day by day, under such a backdrop of world situation. Applied Buddhism rather Buddhism may be the only instrument left now for mankind to address all such human achievements, lapses, and problems. Buddha’s doctrine is itself called ‘akālika, timeless’. On the eve of the Mahāparinibbāṇa at Kusinara, the Blessed One allows His disciples to change, modify and alter His minor teachings according to the needs of the future, although He has made some utterances, which would eternally remain fresh. Hence Buddhism has been able to occupy a prominent place in modern life, because of its timeless applicability, emanating from a set of eternal values. The logical and scientific outlook of Buddha may be traced in His very first sermon named the Dhammacakkapavattana-Sutta where He suggested to avoid the two extremes, namely, constantly attachment to sensual pleasures (Kāmasukhallikānuyoga) and devotion to self-mortification that is painful as well as unprofitable and asked to adopt Majjhimapaṭipadā, ‘Middle path’, which is very much applicable even today in every spheres of human life; and the absence of which is the root cause of all problems event at present. This paper will be a humble attempt to highlight the relevance of Buddhism in the present society.

Keywords: applied Buddhism, ecology, self-awareness, value

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Authors: Lebeza Alemu Tenaw, Fei Wan Ngai

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Background: Postpartum depression is the most common mental health disorder that occurs after childbirth, and it is more prevalent among teenage mothers compared to adults. Although there is emerging evidence suggesting psychosocial interventions can decrease postpartum depression, there are no consistent findings regarding the effectiveness of these interventions, especially for teenage mothers. The current review aimed to investigate the effectiveness of psychosocial interventions in preventing postpartum depression among teenage mothers. Methods: The Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) manual was implemented to select articles from online databases. The articles were searched using the Population, Intervention, Control, and Outcome (PICO) model. The quality of the articles was assessed using the Cochrane Collaboration Risk of Bias assessment tool. The statistical analyses were performed using Stata 17, and the effect size was estimated using the standard mean difference score of depression between the intervention and control groups. Heterogeneity between the studies was assessed through the I2 statistic and Q statistic, while the publication bias was evaluated using the asymmetry of the funnel plot and Egger's test. Results: In this systematic review, a total of nine articles were included. While psychosocial interventions demonstrated in reducing the risk of postpartum depression compared to usual maternal care, it is important to note that the mean difference score of depression was significant in only three of the included studies. The overall meta-analysis finding revealed that psychosocial interventions were effective in preventing postpartum depression, with a pooled effect size of -0.5 (95% CI: -0.95, -0.06) during the final time postpartum depression assessment. The heterogeneity level was found to be substantial, with an I2 value of 82.3%. However, no publication bias was observed. Conclusion: The review findings suggest that psychosocial interventions initiated during the late antenatal and early postnatal periods effectively prevent postpartum depression. The interventions were found to be more beneficial during the first three months of the postpartum period. However, this review also highlighted that there is a scarcity of interventional studies conducted in low-income countries, indicating the need for further studies in diverse communities.

Keywords: teenage pregnancy, postpartum depression, review

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Authors: Aneia Rajiel Busmente, Renato Gunio Jr., Jazin Mautante, Denise Joy Mendoza, Raymond Benedict Tagorio, Gabriel Uy, Natalie Quinn Valenzuela, Ma. Elayza Villa, Francine Yezha Vizcarra, Sofia Madelle Yapan, Eugene Kurt Yboa

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COVID-19’s rapid spread caused a dramatic change in the nation, especially the educational system. The Department of Education was forced to adopt a practical learning platform without neglecting health, a printed modular distance learning. The Philippines' K–12 curriculum includes Statistics and Probability as one of the key courses as it offers students the knowledge to evaluate and comprehend data. Due to student’s difficulty and lack of understanding of the concepts of Statistics and Probability in Normal Distribution. The Self-Learning Module in Statistics and Probability about the Normal Distribution created by the Department of Education has several problems, including many activities, unclear illustrations, and insufficient examples of concepts which enables learners to have a difficulty accomplishing the module. The purpose of this study is to determine the effectiveness of self-learning module on the academic performance of students in the subject Statistics and Probability, it will also explore students’ perception towards the quality of created Self-Learning Module in Statistics and Probability. Despite the availability of Self-Learning Modules in Statistics and Probability in the Philippines, there are still few literatures that discuss its effectiveness in improving the performance of Senior High School students in Statistics and Probability. In this study, a Self-Learning Module on Normal Distribution is evaluated using a quasi-experimental design. STEM students in Grade 11 from National University's Nazareth School will be the study's participants, chosen by purposive sampling. Google Forms will be utilized to find at least 100 STEM students in Grade 11. The research instrument consists of 20-item pre- and post-test to assess participants' knowledge and performance regarding Normal Distribution, and a Likert scale survey to evaluate how the students perceived the self-learning module. Pre-test, post-test, and Likert scale surveys will be utilized to gather data, with Jeffreys' Amazing Statistics Program (JASP) software being used for analysis.

Keywords: self-learning module, academic performance, statistics and probability, normal distribution

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Authors: S. Alemayehu, F. A. Abera, K. M. Ayimut, R. Mahroof, J. Harvey, B. Subramanyam

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The occurrence of mycotoxins in sesame seeds poses a significant threat to food safety and the economy in Ethiopia. This study aimed to determine the levels and occurrence of mycotoxins in on-farm stored sesame seeds in major-growing districts of Ethiopia. A total of 470 sesame seed samples were collected from randomly selected farmers' storage structures in five major-growing districts using purposive sampling techniques. An enzyme-linked immunosorbent assay (ELISA) was used to analyze the collected samples for the presence of four mycotoxins: total aflatoxins (AFT), ochratoxin A (OTA), total fumonisins (FUM), and deoxynivalenol (DON). The study found that all samples contained varying levels of mycotoxins, with AFT and DON being the most prevalent. AFT concentrations in detected samples ranged from 2.5 to 27.8 parts per billion (ppb), with a mean concentration of 13.8 ppb. OTA levels ranged from 5.0 ppb to 9.7 ppb, with a mean level of 7.1 ppb. Total fumonisin concentrations ranged from 300 to 1300 ppb in all samples, with a mean of 800 ppb. DON concentrations ranged from 560 to 700 ppb in the analyzed samples. The majority (96.8%) of the samples were safe from AFT, FUM, and DON mean levels when compared to the Federal Drug Administration maximum limit. AFT-OTA, DON-OTA, AFT-FUM, FUM-DON, and FUM-OTA, respectively, had co-occurrence rates of 44.0, 38.3, 33.8, 30.2, 29.8 and 26.0% for mycotoxins. On average, 37.2% of the sesame samples had fungal infection, and seed germination rates ranged from 66.8% to 91.1%. The Limmu district had higher levels of total aflatoxins, kernel infection, and lower germination rates than other districts. The Wollega variety of sesame had higher kernel infection, total aflatoxins concentration, and lower germination rates than other varieties. Grain age had a statistically significant (p<0.05) effect on both kernel infection and germination. The storage methods used for sesame in major-growing districts of Ethiopia favor mycotoxin-producing fungi. As the levels of mycotoxins in sesame are of public health significance, stakeholders should come together to identify secure and suitable storage technologies to maintain the quantity and quality of sesame at the level of smallholder farmers. This study suggests the need for suitable storage technologies to maintain the quality of sesame and reduce the risk of mycotoxin contamination.

Keywords: districts, seed germination, kernel infection, moisture content, relative humidity, temperature

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Authors: Nafiseh Mirabdolhosseini, Jerry Zhou, Vincent Ho

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The dramatic global rise in acid reflux has also led to oesophageal adenocarcinoma (OAC) becoming the fastest-growing cancer in developed countries. While gastroscopy with biopsy is used to diagnose OAC patients, this labour-intensive and expensive process is not suitable for population screening. This study aims to design, develop, and implement a minimally invasive system to capture optical data of the distal oesophagus for rapid screening of potential abnormalities. To develop the system and understand user requirements, a user-centric approach was employed by utilising co-design strategies. Target users’ segments were identified, and 38 patients and 14 health providers were interviewed. Next, the technical requirements were developed based on consultations with the industry. A minimally invasive optical system was designed and developed considering patient comfort. This system consists of the sensing catheter, controller unit, and analysis program. Its procedure only takes 10 minutes to perform and does not require cleaning afterward since it has a single-use catheter. A prototype system was evaluated for safety and efficacy for both laboratory and clinical performance. This prototype performed successfully when submerged in simulated gastric fluid without showing evidence of erosion after 24 hours. The system effectively recorded a video of the mid-distal oesophagus of a healthy volunteer (34-year-old male). The recorded images were used to develop an automated program to identify abnormalities in the distal oesophagus. Further data from a larger clinical study will be used to train the automated program. This system allows for quick visual assessment of the lower oesophagus in primary care settings and can serve as a screening tool for oesophageal adenocarcinoma. In addition, this system is able to be coupled with 24hr ambulatory pH monitoring to better correlate oesophageal physiological changes with reflux symptoms. It also can provide additional information on lower oesophageal sphincter functions such as opening times and bolus retention.

Keywords: endoscopy, MedTech, oesophageal adenocarcinoma, optical system, screening tool

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Authors: Jovana Nikolov, Natasa Todorovic, Ivana Stojkovic

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Monitoring of 222Rn in drinking or surface waters, as well as in groundwater has been performed in connection with geological, hydrogeological and hydrological surveys and health hazard studies. Liquid scintillation counting (LSC) is often preferred analytical method for 222Rn measurements in waters because it allows multiple-sample automatic analysis. LSC method implies mixing of water samples with organic scintillation cocktail, which triggers radon diffusion from the aqueous into organic phase for which it has a much greater affinity, eliminating possibility of radon emanation in that manner. Two direct LSC methods that assume different sample composition have been presented, optimized and evaluated in this study. One-phase method assumed direct mixing of 10 ml sample with 10 ml of emulsifying cocktail (Ultima Gold AB scintillation cocktail is used). Two-phase method involved usage of water-immiscible cocktails (in this study High Efficiency Mineral Oil Scintillator, Opti-Fluor O and Ultima Gold F are used). Calibration samples were prepared with aqueous 226Ra standard in glass 20 ml vials and counted on ultra-low background spectrometer Quantulus 1220TM equipped with PSA (Pulse Shape Analysis) circuit which discriminates alpha/beta spectra. Since calibration procedure is carried out with 226Ra standard, which has both alpha and beta progenies, it is clear that PSA discriminator has vital importance in order to provide reliable and precise spectra separation. Consequentially, calibration procedure was done through investigation of PSA discriminator level influence on 222Rn efficiency detection, using 226Ra calibration standard in wide range of activity concentrations. Evaluation of presented methods was based on obtained efficiency detections and achieved Minimal Detectable Activity (MDA). Comparison of presented methods, accuracy and precision as well as different scintillation cocktail’s performance was considered from results of measurements of 226Ra spiked water samples with known activity and environmental samples.

Keywords: 222Rn in water, Quantulus1220TM, scintillation cocktail, PSA parameter

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Authors: Habib Noorbhai

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History of Cricket: Cricket has a known history spanning from the 16th century till present, with international matches having been played since 1844. The game of cricket arrived in Australia as soon as colonization began in 1788. Cricketers started playing on turf wickets in the late 1800’s and dimensions for both the boundary and pitch later became assimilated. As the years evolved, cricket bats and balls, protective equipment, playing surfaces and the three formats of the game adapted to the playing conditions and laws of cricket. Business of Cricket: During the late 1900's, the shorter version of the game (T20) was introduced in order to attract the crowds to stadiums and television viewers for broadcasting rights. One could argue if this was merely a business venture or a platform for enhancing the performance of cricketers. Between the 16th and 20th century, cricket was a common sport played for passion and pure enjoyment. Industries saw a potential in diversified business ventures in the game (as well as other sports played globally) and cricket subsequently became a career for players, administrators and coaches, the media, health professionals, managers and the corporate world. Pros and Cons of Cricket Developments: At present, the game has significantly gained from the use of technology, sports sciences and varied mechanisms to optimize the performances and forecast frameworks for injury prevention in cricket players. Unfortunately, these had not been utilized in the earlier times of cricket and it would prove interesting to observe how the greats of the game would have benefited with such developments. Cricketers in the 21st century are faced with many overwhelming commitments. One of these is playing cricket for 11 months in a year, making it more than 250 days away from home and their families. As the demand of player contracts increase, the supply of commitment and performances from players increase. Way Forward and Future Implications: The questions are: Are such disadvantages contributing to the overload and injury risks of players? How far have we really come in the cricketing world or has everything since the game’s inception become institutionalized with a business model? These are the fundamental questions which need to be addressed and legislation, policies and ethical considerations need to be drafted and implemented. These will ensure that there is equilibrium of effective transitions and management of not only the players, but also the credibility of the wonderful game.

Keywords: enterprising business of cricket, technology, legislation, credibility

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Authors: Abimbola Akintounde

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Supporting the social and emotional needs of young adolescents has become an emergent concern for schools around the world. Yet educators remain in a dilemma regarding the optimum approach for integrating social and emotional learning (SEL) into their content area instruction. The purpose of this study was to explore the perception of secondary students regarding their schoolwide SEL interventions. Twenty-four International Baccalaureate students in a final year mathematics course at an American Public Secondary School near Washington D. C. were randomly selected for participation in this study via an online electronic survey. The participants in this study used Likert-scale items to rate the effectiveness of the socio-emotional and character development programs being implemented at their schools. Respondents also ranked their preferred mode of delivery of social and emotional support programs. About 71% of the teenagers surveyed preferred SEL support rendered via interactive team-building activities and games, 42% of the high school students in the study ranked focus group discussions as their preferred format for SEL interventions, while only 13% of the respondents in the study regarded lectures and presentations as their preferred mode of SEL delivery. About one-fourth of the study participants agreed that explicit instruction was critical to enhancing students’ wellness, 79% agreed that SEL programs should foster less teacher talk, while 88% of the students indicated that student engagement was critical to their mental health. Eighty percent of the teenagers surveyed decried that the focus of their school-wide social and emotional programs was poorly prioritized. About two-thirds of the students agreed that social justice and equity issues should be embedded in their schools’ advisory programs. More than half of the respondents agitated for strategies for managing stress and their school workload. About 54% of the respondents also clamored for SEL programs that reinforce emotion regulation and coping strategies for anxiety. Based on the findings of this study, recommendations were proffered for best practices in the design and implementation of effective learner-friendly social and emotional development interventions.

Keywords: SEL, math anxiety, student support, emotion regulation, social awareness, self awareness, self management, relationship building

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Authors: Katarzyna Pasternak

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Experiencing the meaning of life is widely recognised as a vital element of well-being and central human motivation. Studies have shown that a higher meaning of life is associated, among other things, with a higher quality of life, higher levels of happiness and better declared health. The subject of the study is the meaning in life measured with The Meaning in Life Questionnaire and the presence of such emotions as nostalgia, awe and hope, and the content of imaginations measured after temporal mental simulations in Americans and Poles. The respondents had to imagine themselves in future, in 40 years and describe two events that would take place at that time. Next, participants assessed the importance of the events described by them, recognised whether during their journey through time they felt awe, hope and nostalgia, and answered the questionnaire examining the meaning in life. 204 (102 from Poland 102 from the USA ) people aged 21 to 60 participated in the study. The study checked whether there were differences in the content of the imaginations of the respondents from Poland and USA, and whether there were statistically significant difference between the declared sense of meaning in life among participants from both countries. The result of the study hane shown that there were no differences in the overall result obtained by the participants in The Meaning in Life Questionnaire , while there were statistically significant differences among the subscales of the questionnaire. It turned out that Americans have a higher presence of meaning in life than Poles, but they obtained lower results in searching of meaning in life. Studies have also shown that there was a statistically significant difference between Poles and Americans in feeling awe after a mental simulation. Poles felt higher level of awe. Images about the future differed between Poles and Americans. Poles judged that the events they described were very important to them. Interestingly, the content of American participants’ imaginations was dominated by topics related to the future of the world, ecology and world peace. There were also ideas about nice moments spent with friends and family. Among Poles, ideas related to professional career and development as well as family events dominated. Research shows that despite the lack of differences in the general meaning in life, Poles are more focused on searching for meaning in life than Americans. The study shows interesting differences between the two cultures.

Keywords: meaning in life, mental simulations, imaginations, temporal mental simulations, future, cultural differences

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Authors: Charles Bijjah Nkhata, Memory Nekati Mvula, Milton Masautso Kalongonda, Martha Masamba, Isaac Thom Shawa

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Viral Hepatitis is a serious public health concern globally with deaths estimated at 1.4 million annually due to liver fibrosis, cirrhosis, and hepatocellular carcinoma. Hepatitis B and C are the most common viruses that cause liver damage. However, the majority of infected individuals are unaware of their serostatus. Viral Hepatitis has contributed to maternal and neonatal morbidity and mortality. There is no updated data on the Epidemiology of hepatitis B and C among pregnant mothers in Malawi. To assess the epidemiology of Hepatitis B and C viruses among pregnant women at Queen Elizabeth Central Hospital. Specific Objectives • To determine sero-prevalence of HBsAg and Anti-HCV in pregnant women at QECH. • To investigate risk factors associated with HBV and HCV infection in pregnant women. • To determine the distribution of HBsAg and Anti-HCV infection among pregnant women of different age group. A descriptive cross-sectional study was conducted among pregnant women at QECH in last quarter of 2021. Of the 114 pregnant women, 96 participants were consented and enrolled using a convenient sampling technique. 12 participants were dropped due to various reasons; therefore 84 completed the study. A semi-structured questionnaire was used to collect socio-demographic and behavior characteristics to assess the risk of exposure. Serum was processed from venous blood samples and tested for HBsAg and Anti-HCV markers utilizing Rapid screening assays for screening and Enzyme Linked Immunosorbent Assay for confirmatory. A total of 84 pregnant consenting pregnant women participated in the study, with 1.2% (n=1/84) testing positive for HBsAg and nobody had detectable anti-HCV antibodies. There was no significant link between HBV and HCV in any of the socio-demographic data or putative risk variables. The findings indicate a viral hepatitis prevalence lower than the set range by the WHO. This suggests that HBV and HCV are rare in pregnant women at QECH. Nevertheless, accessible screening for all pregnant women should be provided. The prevention of MTCT is key for reduction and prevention of the global burden of chronic viral Hepatitis.

Keywords: viral hepatitis, hepatitis B, hepatitis C, pregnancy, malawi, liver disease, mother to child transmission

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Authors: Arun Kumar Yadav

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Coal contributes a significant role in India’s developmental mission. But, ironically, on the other side it causes large scale population displacement and significant changes in indigenous people’s livelihood mechanism. Dhanbad which is regarded as one of the oldest and large mining area, as well as a “Coal Capital of India”. Here, mining exploration work started nearly a century ago. But with the passage of time, mining brings a lot of changes in the life of local people. In this context, study tries to do comparative situational analysis of the changes in the living condition of dwellers living in mines affected and non-mines affected villages based on livelihood approach. Since, this place has long history of mining so it is very difficult to conduct before and after comparison between mines and non-mines affected areas. Consequently, the present study is based on relative comparison approach to elucidate the actual scenario. By using primary survey data which was collected by the author during the month of September 2014 to March 2015 at Dhanbad, Jharkhand. The data were collected from eight villages, these were categorised broadly into mines and non-mines affected villages. Further at micro level, mines affected villages has been categorised into open cast and underground mines. This categorization will help us to capture the deeper understanding about the issues of mine affected villages group. Total of 400 household were surveyed. Result depicts that in every sphere mining affected villages are more vulnerable. Regarding financial capital, although mine affected villages are engaged in mining work and get higher mean income. But in contrast, non-mine affected villages are more occupationally diversified. They have an opportunity to earn money from diversified extents like agricultural land, working in mining area, selling coal informally as well as receiving remittances. Non-mines affected villages are in better physical capital which comprises of basic infrastructure to support livelihood. They have an access to secured shelter, adequate water supply & sanitation, and affordable information and transport. Mining affected villages are more prone to health risks. Regarding social capital, it shows that in comparison to last five years, law and order has been improved in mine affected villages.

Keywords: displacement, indigenous, livelihood, mining

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Authors: Matt S. Van Deren, Michael Papenfus

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Seattle is one of the hundreds of cities in the United States that relies on a combined sewer system to collect and convey municipal wastewater. By design, these systems convey all wastewater, including industrial and commercial wastewater, human sewage, and stormwater runoff, through a single network of pipes. Serious problems arise for combined sewer systems during heavy precipitation events when treatment plants and storage facilities are unable to accommodate the influx of wastewater needing treatment, causing the sewer system to overflow into local waterways through sewer outfalls. CSOs (Combined Sewer Overflows) pose a serious threat to human and environmental health. Principal pollutants found in CSO discharge include microbial pathogens, comprising of bacteria, viruses, parasites, oxygen-depleting substances, suspended solids, chemicals or chemical mixtures, and excess nutrients, primarily nitrogen and phosphorus. While concentrations of these pollutants can vary between overflow events, CSOs have the potential to spread disease and waterborne illnesses, contaminate drinking water supplies, disrupt aquatic life, and effect a waterbody’s designated use. This paper estimates the economic impact of CSOs on residential property values. Using residential property sales data from Seattle, Washington, this paper employs a hedonic valuation model that controls for housing and neighborhood characteristics, as well as spatial and temporal effects, to predict a consumer’s willingness to pay for improved water quality near their homes. Initial results indicate that a 100,000-gallon decrease in the average annual overflow discharged from a sewer outfall within 300 meters of a home is associated with a 0.053% increase in the property’s sale price. For the average home in the sample, the price increase is estimated to be $18,860.23. These findings reveal some of the important economic benefits of improving water quality by reducing the frequency and severity of combined sewer overflows.

Keywords: benefits, hedonic, Seattle, sewer

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Authors: Oluwafunmibi Omotayo Fasanya, Augustine Kena Adjei

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Limited research has examined the variations in dietary quality among U.S. adults diagnosed with chronic conditions like diabetes mellitus (DM), osteoarthritis (OA), and rheumatoid arthritis (RA), particularly across different age groups. Understanding how diet differs in relation to these conditions is crucial to developing targeted nutritional interventions. This cross-sectional study analyzed data from adult participants in the National Health and Nutrition Examination Survey (NHANES) between 2011 and 2021. Dietary quality was measured using the Healthy Eating Index (HEI)-2015 scores, encompassing both total and component scores for different dietary factors. Self-reported disease statuses for DM, OA, and RA were obtained, with age groups stratified into younger adults (20–59 years, n = 10,050) and older adults (60 years and older, n = 5,200). Logistic regression models, adjusted for demographic factors like sex, race/ethnicity, education, income, weight status, physical activity, and smoking, were used to examine the relationship between disease status and dietary quality, accounting for NHANES' complex survey design. Among younger adults, 8% had DM, 10% had OA, and 4% had RA. Among older adults, 22% had DM, 35% had OA, and 7% had RA. The results showed a consistent association between excess added sugar intake and DM in both age groups. In younger adults, excess sodium intake was also linked to DM, while low seafood and plant protein intake was associated with a higher prevalence of RA. Among older adults, a poor overall dietary pattern was strongly associated with RA, while OA showed varying associations depending on the intake of specific nutrients like fiber and saturated fats. The dietary quality of U.S. adults with DM, OA, and RA varies significantly by age group and disease type. Younger adults with these conditions demonstrated more specific dietary inadequacies, such as high sodium and low protein intake, while older adults exhibited a broader pattern of poor dietary quality, particularly in relation to RA. These findings suggest that personalized nutritional strategies are needed to address the unique dietary challenges faced by individuals with chronic conditions in different age groups.

Keywords: dietary, diabetes, osteoarthritis, rheumatoid arthritis, logistic regression

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Authors: Syed Imran Hussain Shah

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Air pollution rapidly impacts the Earth's climate and environmental quality, causing public health nuisances and cardio-pulmonary illnesses. Air pollution is a global issue, and all population groups in all the regions in the developed and developing parts of the world were affected by it. The promise of a reduction in deaths and diseases as per SDG No. 3 is an international commitment towards sustainable development. In that context, assessing and evaluating the ambient air quality is paramount. This article estimates the air pollution released by the vehicles on roads of Lahore, a mega city having 13.98 million populations. A survey was conducted on different fuel stations to determine the estimated fuel pumped to different types of vehicles from different fuel stations. The number of fuel stations in Lahore is around 350. Another survey was also conducted to interview the drivers to know the per-litre fuel consumption of other vehicles. Therefore, a survey was conducted on 189 fuel stations and 400 drivers using a combination of random sampling and convenience sampling methods. The sampling was done in a manner to cover all areas of the city including central commercial hubs, modern housing societies, industrial zones, main highways, old traditional population centres, etc. Mathematical equations were also used to estimate the emissions from different modes of vehicles. Due to the increase in population, the number of vehicles is increasing, and consequently, traffic emissions were rising at a higher level. Motorcycles, auto rickshaws, motor cars, and vans were the main contributors to Carbon dioxide and vehicular emissions in the air. It has been observed that vehicles that use petrol fuel produce more Carbon dioxide emissions in the air. Buses and trucks were the main contributors to NOx in the air due to the use of diesel fuel. Whereas vans, buses, and trucks produce the maximum amount of SO2. PM10 and PM2.5 were mainly produced by motorcycles and motorcycle two-stroke rickshaws. Auto rickshaws and motor cars mainly produce benzene emissions. This study may act as a major tool for traffic and vehicle policy decisions to promote better fuel quality and more fuel-efficient vehicles to reduce emissions.

Keywords: particulate matter, nitrogen dioxide, climate change, pollution control

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Authors: Nilima Barman, M. Atiqul Haque, Debabrata Ghosh

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Background: Zinc, one of the vital micronutrients, has an incredible role in the immune system. Hypozincemia affects host defense by reducing the number of circulating T cells and phagocytosis activity of other cells which ultimately impair cell-mediated immunity 1, 2. The immune system is detrimentally suppressed in multidrug-resistant tuberculosis (MDR-TB) 3, 4, a major threat of TB control worldwide5. As zinc deficiency causes immune suppression, we assume that it might have a role in the development of MDR-TB. Objectives: To estimate the serum zinc level in newly diagnosed multidrug resistant tuberculosis (MDR-TB) in comparison with that of newly diagnosed pulmonary TB (NdPTB) and healthy individuals. Materials and Methods: This study was carried out in the department of Public Health and Informatics, Bangabandhu Sheikh Mujib Medical University, Dhaka in collaboration with National Institute of Diseases of the Chest Hospital (NIDCH), Bangladesh from March’ 2012 to February 2013. A total of 337 respondents, of them 107 were MDR TB patients enrolled from NIDCH, 69 were NdPTB and 161 were healthy adults. All NdPTB patients and healthy adults were randomly selected from Sirajdikhan subdistrict of Munshiganj District. It is a rural community 22 kilometer south from capital city Dhaka. Serum zinc level was estimated by atomic absorption spectrophotometry method from early morning fasting blood sample. The evaluation of serum zinc level was done according to normal range from 70 to120 µgm/dL6. Results: Males were predominant in study groups (p>0.05). Mean (sd) serum zinc levels in MDR-TB, NdPTB and healthy adult group were 65.14 (12.52), 75.22(15.89), and 87.98 (21.80) μgm/dL respectively and differences were statistically significant (F=52.08, P value<0.001). After multiple comparison test (Bonferroni test) significantly lower level of serum zinc was found in MDRTB group than NdPTB and healthy adults (p<.001). Point biserial correlation showed a negative association of having MDR TB and serum zinc level (r= -.578; p value <0.001). Conclusion: The significant low level of serum zinc in MDR-TB patients suggested impaired immune status. We recommended for further exploration of low level of serum zinc as risk factor of MDR TB.

Keywords: Bangladesh, immune status, multidrug-resistant tuberculosis, serum zinc

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Authors: Luke Sniewski, Pante Farvid, Phil Carter, Rita Csako

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Background and Aims: Self-Perceived Problematic Porn Use (SPPPU) refers to individuals who identify as or perceive themselves to be addicted to porn. These individuals feel they are unable to regulate their porn consumption and experience adverse consequences as a result of their use in everyday life. To the author’s best knowledge, this research represents the first study to intervene with pornography use with mindfulness meditation, and aims to investigate the experiences and challenges of men with SPPPU as they engage in a mindfulness meditation intervention. As meditation is commonly characterized by sitting and observing one’s internal experience with non-reaction and acceptance, the study’s principal hypothesis was that consistent practice of meditation would develop the participant’s capacity to respond to cravings, urges, and unwanted thoughts in less reactive, more productive ways. Method: This 12-mixed method research utilised Single Case Experimental Design (SCED) methodology, with a standard AB design. Each participant was randomly assigned to an initial baseline time period between 2 to 5 weeks before learning the meditation technique and practicing it for the remainder of the 12-week study. The pilot study included 3 participants, while the intervention study included 12. The meditation technique used for the study involved a 15-minute guided breathing exercise in the morning, along with a 15-minute guided concentration meditation in the evening. Results: At the time of submission, only pilot study results were available. Results from the pilot study indicate an improved capacity for self-awareness of the uncomfortable mental and emotional states that drove their participants’ pornography use. Statistically significant reductions were also observed in daily porn use, total weekly time spent viewing porn, as well as lowered Pornography Craving Questionnaire (PCQ) and Problematic Pornography Use Scale (PPUS) scores. Conclusion: Pilot study results suggest that meditation could serve as a complementary tool for health professionals to provide clients in conjunction with therapeutic interventions. Study limitations, directions for future research, and clinical implications to be discussed as well.

Keywords: meditation, behavioural change, pornography, mindfulness

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Authors: Temesgen Minase Woldegebriel

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This study undertakes a comparative analysis of two distinct staples from diverse culinary heritages: Polish traditional bread and Teff Injera. Despite originating from disparate cultural contexts, both these foods hold significant roles in their respective societies, serving as dietary staples rich in cultural symbolism and nutritional value. Our investigation delves into the historical, cultural, and nutritional dimensions of Polish bread and Teff Injera, shedding light on their ingredients, preparation methods, and consumption patterns. Firstly, we explore the rich history and cultural significance embedded within Polish traditional bread, tracing its evolution through centuries of tradition and craftsmanship. From the ubiquitous Polish Rye bread to the intricate regional variations, we unravel the socio-cultural narratives intertwined with each loaf, reflecting Polish identity and culinary heritage. In contrast, our analysis extends to Teff Injera, a staple of Ethiopian and Eritrean cuisine known for its spongy texture and tangy flavor. We delve into the ancient origins of Teff cultivation, highlighting its pivotal role in Ethiopian culture and its symbolic significance in communal dining practices, such as the traditional Ethiopian coffee ceremony. Furthermore, we undertake a comparative examination of the nutritional profiles of Polish bread and Teff Injera, assessing their respective contributions to dietary health and well-being. Through comprehensive nutritional analysis, we elucidate the unique attributes of each staple, considering factors such as gluten content, fiber composition, and micronutrient density. Moreover, our study investigates the contemporary relevance of these traditional staples in the context of shifting dietary preferences and global culinary trends. We analyze consumer perceptions and market dynamics surrounding Polish bread and Teff Injera, discerning patterns of consumption and avenues for innovation in a rapidly evolving food landscape. In conclusion, our comparative analysis illuminates the multifaceted dimensions of Polish traditional bread and Teff Injera, transcending mere culinary discourse to encompass broader themes of cultural heritage, nutrition, and gastronomic diversity.

Keywords: bread, culinary, injera, teff

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Authors: Zakir Hossain, Arzu Pervin, Halima Jahan, Rabeya Akter, Abdel Omri

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Replacement of fish meal with soybean meal is an effective way to relieve the pressure on fish meal as the supply of this feed ingredient is dwindling and certainly is not sustainable in long term at present levels in commercial feeds. This study was designed to determine the effect of fishmeal (FM) replacement with soybean meal (SBM) in diet on growth, digestive enzyme activity, antioxidation and gut histomorphology of tilapia (Oreochromis niloticus). Five diets were formulated where SBM0 contained 100% FM, FM substituted with graded levels of a mix of SBM to replace 25% (SBM25), 50% (SBM50), 75% (SBM75) and 100% (SBM100) of FM. Juvenile tilapia having weight and length of 6.60±0.13 g and 5.42±0.17 cm were randomly divided into five treatment groups having 40 individual each group and fed to visual satiation for 90 days. Diet with SBM was increased significant in body weight gain and specific growth rate in fish compared to the fish fed with SBM100. Fish having the similar weight (74.34±5.41 g) fed the diets SBM50, SBM75 and SBM100 containing higher level of SBM showed significantly longer intestine compared to SBM0. Villus height of stomach and intestine were significantly greater in the fish fed with the diets SBM0, SBM25 and SBM50 compared to SBM100. Muscular thickness was inversely changed with the increasing villus height. Protease activity was increased significantly in stomach, anterior and posterior intestine of fish fed with SBM0 and SBM25 compared to SBM100. In anterior and posterior segment of intestine, significantly higher lipase activity was observed in fish fed with the diets SBM0 and SBM25 compared to diet SBM100. In stomach, amylase activity was also significantly greater in SBM0 compared to SBM100. The antioxidant enzymes including catalase and superoxide dismutase of liver were significantly (P < 0.05) higher in the O. niloticus fed SBM100 compared to the ones fed SBM0. These results suggest that the replacement of FM upto 75% with SBM could be possible considering the growth performances, gut health and activities digestive enzymes and antioxidant enzymes in O. niloticus.

Keywords: soybean meal, fish meal, digestive enzymes, anti-oxidant enzymes

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Authors: Joshua Chima Chizoba, Wisdom Izuchukwu Uzoma, Elizabeth Ifeyiwa Okoyeh

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Water cannot be optimally used and sustained unless the quality is periodically assessed. The study area Umunneochi and environs are located in south eastern part of Nigeria. It stretches geographically from latitudes 50501N to 60000N and longitudes 70201E to 70301. The major geologic formations in the area include the Asu River group, Nkporo Shale, and Ajali Sandstone. The aim of this study is to evaluate the hydrochemical characteristics of surface and ground water sources in parts of Umunneochi and environs in order to establish portability of the water sources for drinking, domestic and irrigation purposes. A total of 15 samples were collected randomly from streams, springs and wells. The samples were analyzed for physicochemical parameters and heavy metals using handheld digital kits, photometer, titration method and Atomic Absorption Spectrophotometer (AAS) following acceptable standards. The obtained analytical data were interpreted, and results were compared with World Health Organization (WHO) standard. The concentration of pH, SO42-and Cl- range from 5.81 mg/l – 6.07 mg/l, 41.93 mg/l – 142.95 mg/l and 20.00 mg/l – 111 mg/l respectively, while Pb and Zn revealed a relative low mean concentration of 0.14 mg/l and 0.40 mg/l, which are all within (WHO) permissible limits except pH. About 27% of the samples are moderately hard. This is attributed to the mining activities in the areas. The abundance of cations and anions in the area are in the order of K+>Na+>Mg2+>Ca2+ and SO4->Cl->HCO3->NO3-, respectively. Chloride, bicarbonate, and nitrate are all within the permissible limits. 13.33% of the total samples contain Sulphate above the standard permissible limits. The values of calculated Water Quality Index (WQI) are less than 50 indicating excellent water. The predominant water-type in the study area is Na-Cl water type and mixed Ca-Mg-Cl water type based on the sample plots on the Piper diagram. The Sodium Absorption Ratio (SAR) calculations showed excellent water for consumption and also good water for irrigation purpose with low sodium and alkalinity ratio respectively. Government water projects are recommended in the area for sustainable domestic and agricultural water supply to ease the stress of water supply problems.

Keywords: groundwater, hydrochemical, physichochemical, water-type, sodium adsorption ratio

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Authors: Fatemeh Jannesarvatan, Ghazaal Parastooei, Jimmy frerejan, Saedeh Mokhtari, Peter Van Rosmalen

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Medical and dental education increasingly emphasizes the acquisition, integration, and coordination of complex knowledge, skills, and attitudes that can be applied in practical situations. Instructional design approaches have focused on using real-life tasks in order to facilitate complex learning in both real and simulated environments. The Four component instructional design (4C/ID) model has become a useful guideline for designing instructional materials that improve learning transfer, especially in health profession education. The objective of this study was to apply the 4C/ID model in the creation of virtual patients (VPs) that dental students can use to practice their clinical management and clinical reasoning skills. The study first explored the context and concept of complication factors and common errors for novices and how they can affect the design of a virtual patient program. The study then selected key dental information and considered the content needs of dental students. The design of virtual patients was based on the 4C/ID model's fundamental principles, which included: Designing learning tasks that reflect real patient scenarios and applying different levels of task complexity to challenge students to apply their knowledge and skills in different contexts. Creating varied learning materials that support students during the VP program and are closely integrated with the learning tasks and students' curricula. Cognitive feedback was provided at different levels of the program. Providing procedural information where students followed a step-by-step process from history taking to writing a comprehensive treatment plan. Four virtual patients were designed using the 4C/ID model's principles, and an experimental design was used to test the effectiveness of the principles in achieving the intended educational outcomes. The 4C/ID model provides an effective framework for designing engaging and successful virtual patients that support the transfer of knowledge and skills for dental students. However, there are some challenges and pitfalls that instructional designers should take into account when developing these educational tools.

Keywords: 4C/ID model, virtual patients, education, dental, instructional design

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Authors: Vivek Saxena, Shreshtha Saxena

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Background: Gestational diabetes mellitus (GDM) is defined as impaired glucose tolerance first recognized during pregnancy. Uncontrolled or untreated GDM is associated with various adverse outcomes to the maternal and fetal health. Overt diabetes mellitus may also develop in such patients. It is universally accepted fact that first and foremost management to treat GDM is dietary control and lifestyle modification even before starting any oral hypoglycemic agent (OHA) or insulin. So, proper dietary management and little changes in the patient’s lifestyle are very effective for reducing her plasma glucose level. Objectives: Proper counselling of the patients and flexibility in their lifestyle and diet can effectively control the plasma glucose level in GDM patients. Methods: Total 60 GDM patients of age > 18 years were taken. We had three counselling sessions with the patient and other members of the family like husband, parents, and in-laws at different intervals, discussed their lifestyle and diet pattern, helped them to eliminate the factors those had an adverse effect on plasma glucose level and promoted them to acquire a healthy lifestyle. We have counselled the patient and her family member separately and then together also. They have explained how increased plasma glucose level can be effectively controlled with the little modification in their diet and routine activities. They were also taught to remain stress-free during their rest of antenatal period. We have excluded the patients from our study who were diabetic before pregnancy and patients with other comorbid illnesses like hypothyroidism and valvular heart disease. Results and conclusions: Results were very rewarding as patients could acquire a lifestyle of their choice. They were happy because extra pill burden was not there. All the 60 patients were normoglycemic in remaining antenatal period, 48 patients were delivered normally and 12 patients underwent cesarean section due to various reasons.Regular counselling of the patients regarding their disease and little alterations in diet and lifestyle controlled the plasma glucose level much effectively. The things were more easier and effective when we included other family members during our counselling session because they play a major role in patient’s day to day activity and influence her life.

Keywords: dietary management, gestational diabetes mellitus, impaired glucose tolerance, oral hypoglycemic agent, pregnancy

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Authors: Recep Kesli, Gulşah Asik, Cengiz Demir, Onur Turkyilmaz

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Objective: Acinetobacter baumannii (A. baumannii) can cause health-care associated infections, such as bacteremia, urinary tract and wound infections, endocarditis, meningitis, and pneumonia, particularly in intensive care unit patients. In this study, we aimed to evaluate A. baumannii production in sputum and bronchoalveolar lavage and susceptibilities for antibiotics in a 24 months period. Methods: Between October 2013 and September 2015, Acinetobacter baumannii isolated from respiratory tract speciments were evaluated retrospectively. The strains were isolated from the different intensive care units patients. A. baumannii strains were identified by both the conventional methods and aoutomated identification system -VITEK 2 (bio-Merieux, Marcy l’etoile, France). Antibiotic resistance testing was performed by Kirby-Bauer disc diffusion method according to CLSI criteria. Results: All the ninety isolates included in the study were from respiratory tract specimens. While of all the isolated 90 Acinetobacter baumannii strains were found to be resistant (100%), against ceftriaxone, ceftazidime, ciprofloxacin and piperacillin/ tazobactam, resistance rates against other tested antibiotics found as follows; meropenem 77, 86%, imipenem 75, 83%, trimethoprim-sulfamethoxazole (TMP-STX) 69, 76,6%, gentamicin 51, 56,6% and amikacin 48, 53,3%. Colistin was found as the most effective antibiotic against Acinetobacter baumannii, and there were not found any resistant (0%) strain against colistin. Conclusion: This study demonstrated that the no resistance was found in Acinetobacter baumannii against to colistin. High rates of resistance to carbapenems (imipenem and meropenem) and other tested antibiotics (ceftiaxone, ceftazidime, ciprofloxacine, piperacilline-tazobactam, TMP-STX gentamicin and amikacin) also have remarkable resistance rates. There was a significant relationship between demographic features of patients such as age, undergoing mechanical ventilation, length of hospital stay with resistance rates. High resistance rates against antibiotics require implementation of the infection control program and rational use of antibiotics. In the present study, while there were not found colistin resistance, panresistance were found against to ceftriaxone, ceftazidime, ciprofloxacin and piperacillin/ tazobactam.

Keywords: acinetobacter baumannii, antibiotic resistance, multi drug resistance, intensive care unit

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Authors: Vilma Zydziunaite, Ausra Rutkiene

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In modern society, problems related to the teacher's personality, mental and physical health, teacher's emotions and competencies are becoming more and more relevant. In Lithuania, compared to other European countries, teachers experience specific difficulties at work: they have to work in conditions of constant reforms and changes and face growing competition due to the decrease in students and schools. Professional burnout, teacher’s self-efficacy and perceived stress are interrelated personally and/or organisationally. So, the relationship between teachers' professional burnout, self-efficacy, and perceived stress in the school environment seems to be a relatively underresearched area in Lithuania. The research aim was to reveal and characterize teacher burnout, self-efficacy, and perceived stress in the Lithuanian school context. The quantitative research design with a questioning survey was chosen for the study. The sample size consisted of 427 Lithuanian teachers. Research results revealed the highest scores for exhaustion and the lowest for cynicism; at a time when the teacher experiences professional burnout, cynicism is observed as the weakest characteristic; no significant differences were found according to educational level work experience; significant differences were identified according to age for exhaustion and overall burnout level among teachers; the most of teachers in Lithuanian sample perceive the moderate stress level in school environment; overall burnout has a significant correlation with self-efficacy and stress among Lithuanian teachers. This study has empirical and practical implications: it is relevant to study the problems of teacher's professional burnout, stress, and self-efficacy in connection with contextual qualitative variables and specify the interrelationships between variables in order to be able to identify specific problems and provide empirical evidence to practically solve them. From a practical point of view, the results show that the socio-emotional state of teachers should not be dismissed as an insignificant aspect. Therefore, the school administration must make efforts to develop a positive school climate that supports the socio-emotional state of the teacher. At the same time, school administration must pay great attention to the development of teachers' socio-emotional competencies without ignoring their importance in the teacher's professional life.

Keywords: Lithuania, perceived stress, professional burnout, self-efficacy, teacher

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