Search results for: socio-economic status

Authors: Shu-Ching Chen, Li-Yun Lee

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The purpose of the study was to identify the factors associated with head and neck cancer-related lymphoedema (HNCRL)-related symptoms, body image, and HNCRL-related functional outcomes among patients with resected advanced head and neck cancer. A cross-sectional correlational design was conducted to examine the predictors of HNCRL-related functional outcomes in patients with resected advanced head and neck cancer. Eligible patients were recruited from a single medical center in northern Taiwan. Consecutive patients were approached and recruited from the Radiation Head and Neck Outpatient Department of this medical center. Eligible subjects were assessed for the Symptom Distress Scale–Modified for Head and Neck Cancer (SDS-mhnc), Brief International Classification of Functioning, Disability and Health (ICF) Core Set for Head and Neck Cancer (BCSQ-H&N), Body Image Scale–Modified (BIS-m), The MD Anderson Head and Neck Lymphedema Rating Scale (MDAHNLRS), The Foldi’s Stages of Lymphedema (Foldi’s Scale), Patterson’s Scale, UCLA Shoulder Rating Scale (UCLA SRS), and Karnofsky’s Performance Status Index (KPS). The results showed that the worst problems with body HNCRL functional outcomes. Patients’ HNCRL symptom distress and performance status are robust predictors across over for overall HNCRL functional outcomes, problems with body HNCRL functional outcomes, and activity and social functioning HNCRL functional outcomes. Based on the results of this period research program, we will develop a Cancer Rehabilitation and Lymphedema Care Program (CRLCP) to use in the care of patients with resected advanced head and neck cancer.

Keywords: head and neck cancer, resected, lymphedema, symptom, body image, functional outcome

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Authors: Parmeet Kaur, Nighat Yaseen Sofi, Shakti Kumar Gupta, Veena Pandey, Rajvaedhan Azad

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Nutritional status and prevailing blood glucose level trends amongst hospitalized patients has been linked to clinical outcome. Therefore, the present study was undertaken to assess hospitalized Diabetic Eye Disease (DED) patients' anthropometric and dietary intake trends. DED patients with type 1 or 2 diabetes > 20 years were enrolled. Actual food intake was determined by weighed food record method. Mifflin St Joer predictive equation multiplied by a combined stress and activity factor of 1.3 was applied to estimate caloric needs. A questionnaire was further administered to obtain reasons of inadequate dietary intake. Results indicated validity of joint analyses of body mass index in combination with waist circumference for clinical risk prediction. Dietary data showed a significant difference (p < 0.0005) between average daily caloric and carbohydrate intake and actual daily caloric and carbohydrate needs. Mean fasting and post-prandial plasma glucose levels were 150.71 ± 72.200 mg/dL and 219.76 ± 97.365 mg/dL, respectively. Improvement in food delivery systems and nutrition educations were indicated for reducing plate waste and to enable better understanding of dietary aspects of diabetes management. A team approach of nurses, physicians and other health care providers is required besides the expertise of dietetics professional. To conclude, findings of the present study will be useful in planning nutritional care process (NCP) for optimizing glucose control as a component of quality medical nutrition therapy (MNT) in hospitalized DED patients.

Keywords: nutritional status, diabetic eye disease, nutrition care process, medical nutrition therapy

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Authors: Jureerat Kilsomporn, Chularat Howharn

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The aim of this qualitative study was to describe the meaning of leisure and the role of leisure among elderly people aged more than 80. Participants were purposive selected. Inclusion criteria were age more than 80 year, has no disease, and independent for daily life activities. Data were collected by in-depth interview. Each participant was interviewed two times and 45-60 minutes in each time of interview. Content analyses were conducted to describe the findings. The findings were as followed. Ten active aging participated in this study. All of them are Buddhist with age between 83-89 years old. Most of them completed the primary school. All of them were active members of community club such as elderly club, women club, and funeral association. Active aging described leisure as activities that connected them with their communities. Leisure could be categorized into three groups which were religious activities, entertainment activities, and hobbies. Examples of religious activities were ordination, house-blessing ceremony, and wedding ceremony. Examples of entertainment activities were Thai dance, beat a drum, and sang local songs. Participants described more that they joined and did in leisure for a sake of pleasure. These leisure played significant roles; significantly affect were their minds and their spiritual. Religious activities play a significant role in spiritual well-being while entertainment activities play a significant role in maintaining good status of mental health. Effect of hobby activities which most of these were payable activities were increased their self-valued. Although it was not high incomes but they can use their own money as they designed. Moreover, participants describe that they have a feeling of use their time wisely since they can earn the money, they can have an exercise, and they can share the time with their neighborhood with these activities. Suggestions from this study were that authorized personnel should promote leisure for aging regularly and continuously. Any facilities that meet with their need and their desired should be promoted since these can facilitate aging to maintain their good health status.

Keywords: active aging, activities, elderly, leisure

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Authors: Endah Tri Lestari, Mustafa Mahmud Amin, Elmeida Effendy

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Background: Vitamin D levels with schizophrenia is lower than the control due to lifestyle and physical health factors such as smoking, increases of body mass index, inactivity, and social withdrawal including decreases of sunlight exposure. Asia has the lowest average of vitamin D serum levels and Europe with lighter colored skin has higher serum levels of vitamin D. Indonesia is a tropical region in the area of the equator, and has only two seasons: the rainy season and summer. The Indonesian people are known as a nation that has a diversity of ethnic groups that exist in many areas. Each tribe has differences in living habits. Ethnic diversity, culture, religion, customs, geographical location, this is reflected in our daily lives that will affect the levels of vitamin D in patients with schizophrenic. Individuals with darker skin tend to be deficient in vitamin D and increases the chance of schizophrenia than the general population. Aims: To determine the difference of vitamin D serum by ethnicity between Bataknese and Malayan schizophrenic patient. Methods: This study was an analytical study to recruited 60 subjects of schizophrenic male patient (30 Bataknese and 30 Malayan), aged between 15 to 55 years old, period at May - November 2016, the acute phase with no agitation. Statistical analysis was using T- independent test. Blood sample for vitamin D serum was using ELFA method. Results: The vitamin D serum levels were lower in Bataknese ethnic group schizophrenic patients in highland than Malayan ethnic group in lowland, reaching statistically (22.9±3.33 ng/ml) vs (27.9±4.19 ng/ml) p < 0,001. Conclusion: There are significant differences of vitamin D serum Status by Ethnicity between Bataknese in the Highland and Malayan in the Lowland on Schizophrenic Patient in North Sumatera.

Keywords: schizophrenia, serum vitamin D, ethnicity

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Authors: Danute Jablonskyte-Rasce, Laura Masilionyte

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The field experiments of different farming systems were conducted at Joniškėlis Experimental Station of the Lithuanian Research Centre for Agriculture and Forestry in 2006–2016. The soil of the experimental site was Endocalcari-Endohypogleyic Cambisol (CMg-n-w-can). The research was designed to identify the effects of dry matter and nitrogen accumulated in the above-ground biomass of various catch crops grown after winter wheat on soil mineral nitrogen variation during the autumn and spring period in the presence of intensive leaching complex. Research was done in the soil differing in humus status in the organic and sustainable cropping systems by growing various plant mixtures as catch crops: narrow-leafed lupine (Lupinus angustifolius L.) and oil radish (Raphanus sativus var. Oleifera L.), white mustard (Sinapis alba L.) and buckwheat (Fagopyrum exculentum Moench.) and white mustard as a sole crop. All crop and soil management practices have shown optimal efficiency in late autumn – stubble breaking, catch crops and straw used during the post-harvest period of the main crops, reduced Nmin migration into deeper (40–80 cm) soil layer. The greatest Nmin reduction in the 0–40 cm soil layer during the period from late autumn to early spring was identified in the sustainable cropping system having applied N30 for the promotion of straw mineralization and with no catch crops cultivation. The sustainable cropping system, having applied N30 for straw mineralization and growing white mustard in combination with buckwheat as catch crops, Nmin difference in the spring compared with its status in the autumn in the soil low and moderate in humus was lower by 70.1% and 34.2%, respectively.

Keywords: soil nitrogen, catch crops, ecological and sustainable farming systems, Cambisol

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Authors: Sabina Garayeva

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To determine the significant risk factors for intrauterine growth restriction (IUGR), we carried out a thorough study of the social status of the parents of children with IUGR. We observed 315 mothers who gave birth to children with (IUGR), of which 172 mothers with asymmetric type and 143 mothers with symmetric type of IUGR. Through a detailed survey was gathered detailed information about education of parents. The results show that the majority of mothers with IUGR had secondary education (44,8 ± 2,8%), and fathers - higher education (35,2 ± 2,7%). Whereas in the control group, the largest number of parents had higher education (mother 35,3 ± 4,4%, fathers 42,9 ± 4,5%). Number of mothers with secondary education with IUGR was significantly (p1 <0,01; χ2 = 22,67) differs from the number of mothers with physiological pregnancy with the same level of education. Meanwhile, in the group with a symmetrical embodiment of IUGR mothers with secondary formation of significantly greater 53,1 ± 4,2%, than the asymmetric embodiment IUGR 37,8 ± 3,7% (p2 <0,05; χ2 = 8 06). Among fathers with secondary education significant difference was noted in the symmetric version of IUGR 37,8 ± 4,1% more than in the control group (p1 <0,05), and among parents of children with asymmetric IUGR option prevailed fathers with higher education - 37 2 ± 3,7%. Thus, our results revealed a low educational level of the mother as a risk factor for IUGR, which further help to develop preventive and therapeutic measures to eliminate the severity of its consequences. As seen from the data presented, mothers of children with asymmetric IUGR had a school education and fathers - higher education, while in the symmetric type of both parents had secondary education. It is found that frequency of children, born with IUGR, of mothers - housewives and fathers, engage in physical labor, was high. Thus, the analysis conducted by the social status of the parents with IUGR revealed a low level of education and unemployed mothers as risk factors for this disease, which in the future will help to develop preventive and therapeutic measures to eliminate the severity of its.

Keywords: intrauterine growth restriction, education of mothers, education influence, IUGR

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Authors: H. Z. M. Chong, M. E. Y. Leong, G. L. Khor, S. C. Loke

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Vitamin D insufficiency is reported to be prevalent among women living in different altitudes including the equator where sunshine is available throughout the year. Multiple factors for vitamin D insufficiency include poor intake of vitamin D rich food and inadequate sun exposure, especially among women working indoor with a sedentary lifestyle. Furthermore, Muslim women in Malaysia whose attire covers the entire body are likely to receive poor sun exposure. This research determined serum vitamin D status, vitamin D intake and sun exposure of women aged 20-45 years of different ethnicity in Kuala Lumpur, Malaysia. Blood samples were collected from 106 women for determination of serum 25(OH)D levels. Information about vitamin D intake and sun exposure were obtained by interviewing the subjects using pre-tested questionnaires. The overall mean serum 25(OH)D was found to be 29.9 ± 14 nmol/L. Vitamin D deficiency and insufficiency was prevalent and highest among the Malay women. Less than ten percent of the subjects in this study met the sufficient vitamin D level recommendation of ≥50 nmol/L. Intake of vitamin D rich food such as oily fishes was poor across the different ethnicity. Other dietary sources of vitamin D in the diet were fortified bread and skim milk. On the other hand, the median sunlight exposure of the subjects was 3.9 hours per week. The Malay women reported to have the highest duration being exposed to the sun. Nevertheless, due to cultural clothing practices, these women had the least body surface area exposed to sunlight, resulting in the lowest calculated sun index score compared to the Chinese and the Indians. Low intake of vitamin D rich foods and sun exposure were negatively correlated with serum 25(OH)D level. In conclusion, intake of food sources rich in vitamin D and adequate body surface area exposed to the sun are essential to ensure healthy vitamin D level. Supplementation of vitamin D may be recommended to women whom unable to meet these recommendations.

Keywords: serum 25-OH, sun exposure, vitamin D food frequency, vitamin D deficiency

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Authors: Marlon P. Perez

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The study intended to determine the level of occupational stress that was experienced by faculty members of private and public business schools in Batangas City with the end in view of proposing organizational development interventions in managing occupational stressors. Stressors such as factors intrinsic to the job, role in the organization, relationships at work, career development and organizational structure and climate were used as determinants of occupational stress level. Descriptive method of research was used as its research design. There were only 64 full-time faculty members coming from private and public business schools in Batangas City – University of Batangas, Lyceum of the Philippines University-Batangas, Golden Gate Colleges, Batangas State University and Colegio ng Lungsod ng Batangas. Survey questionnaire was used as data gathering instrument. It was found out that all occupational stressors were assessed stressful when grouped according to its classification of tertiary schools while response of subject respondents differs on their assessment of occupational stressors. Age variable has become significantly related to respondents’ assessments on factors intrinsic to the job and career development; however, it was not significantly related to role in the organization, relationships at work and organizational structure and climate. On the other hand, gender, marital status, highest educational attainment, employment status, length of service, area of specialization and classification of tertiary school were revealed to be not significantly related to all occupational stressors. Various organizational development interventions have been proposed to manage the occupational stressors that are experienced by business faculty members in the institution.

Keywords: occupational stress, business school, organizational development, intervention, stressors, faculty members, assessment, manage

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Authors: O. Hakim, K. Hart, P. McCabe, J. Berry, L. E. Rhodes, N. Spyrou, A. Alfuraih, S. Lanham-New

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It is known that skin pigmentation reduces the penetration of ultraviolet radiation (UVR) and thus photosynthesis of 25(OH)D. However, the ethnic differences in 25(OH)D production remain to be fully elucidated. This study aimed to investigate the differences in vitamin D production between Asian and Caucasian postmenopausal women, in response to a defined, controlled UVB exposure. Seventeen women; nine white Caucasian (skin phototype II and III), eight South Asian women (skin phototype IV and V) participated in the study, acting as their controls. Three blood samples were taken for measurement of 25(OH)D during the run-in period (nine days, no sunbed exposure) after which all subjects underwent an identical UVR exposure protocol irrespective of skin colour (nine days, three sunbed sessions: 6, 8 and 8 minutes respectively with approximately 80% of body surface exposed). Skin tone was measured four times during the study. Both groups showed a gradual increase in 25(OH)D with final levels significantly higher than baseline (p<0.01). 25(OH)D concentration mean from a baseline of 43.58±19.65 to 57.80±17.11 nmol/l among Caucasian and from 27.03±23.92 to 44.73±17.74 nmol/l among Asian women. The baseline status of vitamin D was classified as deficient among the Asian women and insufficient among the Caucasian women. The percentage increase in vitamin D3 among Caucasians was 39.86% (21.02) and 207.78% (286.02) in Asian subjects respectively. This greater response to UVR exposure reflects the lower baseline levels of the Asian subjects. The mixed linear model analysis identified a significant effect of duration of UVR exposure on the production of 25(OH)D. However, the model shows no significant effect of ethnicity and skin tone on the production of 25(OH)D. These novel findings indicate that people of Asian ethnicity have the full capability to produce a similar amount of vitamin D compared to the Caucasian group; initial vitamin D concentration influences the amount of UVB needed to reach equal serum concentrations.

Keywords: ethnicity, Caucasian, South Asian, vitamin D, ultraviolet radiation, UVR

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Authors: S. Abdolvahab Samavi, Kobra Hajializadeh, S. Abdolhadi Samavi

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Nursing is a critical work that that can effect on the health of the society. A parenting style is a psychological construct demonstrating standard policies that parents use in their child rearing. The quality of parenting is more critical than the quantity spend with the child. Also, marital Conflict resolution is conceptualized as the methods and processes involved in facilitating the peaceful ending of conflict between couples. Both of these variables were affected by job status in nurses. Aim of this study was to compare the Marital Conflict Resolution and Parenting Styles between Nurses with fixed and rotating shifts in public hospitals of Bandar Abbas, Iran. Statistical population includes all married Nurses in hospitals of Bandar Abbas (900 Persons). For sample size estimation, the Morgan table was used, 270 people were selected by random sampling method. Conflict solution styles and Baumrind parenting styles questionnaire were used for collecting data about study variables. For analysis of data, descriptive and inferential statistics were used. Results showed there was significant difference between both groups in conflict solution styles. According to study results, nurses with fixed shifts had an effective conflict solution styles. Also, there was significant difference between both groups in Parenting Styles. According to study results, nurses with fixed shifts had an effective parenting style. Totally, results of this study showed that job status of nurses affected on Marital Conflict Resolution and Parenting Styles of nurses. Managers of health system should be consider these issues about work of nurses and if possible, married nurses employed at fixed day (vs. rotating) shift.

Keywords: marital conflict resolution procedures, parenting styles, nurses with fixed and rotating shifts, public hospitals

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Authors: Nuzhat Fatima

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This is very misleading conception that Islam is the religion of terrorists or terrorism. It is also another misconception that women are not given due important in Islamic. And women are forced to use veil. But if we closely look at the other two religions they also have the same commandments about the veil. Then comes education, women are given the equal right of education in Islam. But there are certain people creating the bad image of Islam and not giving permission to their females to get education. This paper will present the brief description of education and status of women in all three religions.

Keywords: Islam, women, education, christianity, Judaism

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Authors: Eman Hegazy, Stefan Anderberg, Joakim Krook

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Urban water infrastructure is crucial for efficient and reliable water supply in growing cities. With the growth of cities, the need for maintenance and renewal of these systems increases but often goes unfulfilled due to a variety of reasons, such as limited funding, political priorities, or lack of public awareness. Neglecting the renewal needs of these systems can lead to frequent malfunctions and reduced quality and reliability of water supply, as well as increased costs and health and environmental hazards. It is important for cities to prioritize investment in water infrastructure and develop long-term plans to address renewal needs. Drawing general conclusions about the rate of renewal of urban water infrastructure systems at an international or national level can be challenging due to the influence of local management decisions. In many countries, the responsibility for water infrastructure management lies with the municipal authorities, who are responsible for making decisions about the allocation of resources for repair, maintenance, and renewal. These decisions can vary widely based on factors such as local finances, political priorities, and public perception of the importance of water infrastructure. As a result, it is difficult to make generalizations about the rate of renewal across different countries or regions. In Sweden, the situation is not different, and the information from Svenskt Vatten indicates that the rate of renewal varies across municipalities and can be insufficient, leading to a buildup of maintenance and renewal needs. This study aims to examine the adequacy of the rate of renewal of urban water infrastructure in Linköping case city in Sweden. Using a case study framework, the study will assess the current status of the urban water system and the need for renewal. The study will also consider the role of factors such as proper identification processes, limited funding, competing for political priorities, and local management decisions in contributing to insufficient renewal. The study investigates the following questions: (1) What is the current status of water and sewerage networks in terms of length, age distribution, and material composition, estimated total water leakage in the network per year, damages, leaks, and outages occur per year, both overall and by district? (2) What are the main causes of these damages, leaks, and interruptions, and how are they related to lack of maintenance and renewal? (3) What is the current status of renewal work for the water and sewerage networks, including the renewal rate and changes over time, recent renewal material composition, and the budget allocation for renewal and emergency repairs? (4) What factors influence the need for renewal and what conditions should be considered in the assessment? The findings of the study provide insights into the challenges facing urban water infrastructure and identify strategies for improving the rate of renewal to ensure a reliable and sustainable water supply.

Keywords: case study, infrastructure, management, renewal need, Sweden

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Authors: Ratu Khabiba, Qisha Quarina

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This study aims to analyse the effect of married couples’ assortative educational attainments on the division of economic activities among themselves in the household. This study contributes to the literature on women’s participation in employment, especially among married women, to see whether the traditional values about gender roles in the household still continue to shape the employment participation among married women in Indonesia, despite increasing women’s human capital through education. This study utilizes the Indonesian National Socioeconomic Survey (SUSENAS) 2016 and estimates the results using the multinomial logit model. Our results show that compared to high-educated educational homogamy couples, educational heterogamy couples, especially hypergamy, have a higher probability of being a single-worker type. Moreover, the high-educated educational homogamy couples have the highest probability of being a dual-worker type. Thus, we found evidence that the traditional values of gender role segregation seem to still play a significant role in married women’s employment decision in Indonesia, particularly for couples’ with educational heterogamy and low-educated educational homogamy couples.

Keywords: assortative education, dual-worker, hypergamy, homogamy, traditional values, women labor participation

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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: Phannarithisen Ong

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Children's independent mobility for school trips promotes physical and mental well-being, reduces parental chauffeuring and traffic congestion, and boosts children's public confidence. However, in Thailand, despite a decade of rail mass transit development in Bangkok City, cars still queue to drop students at schools near transit stations. This worsens congestion, urging better independent mobility among children in mass transit regions. The high reliance on the private vehicle will influence the private mode in the children's adulthood. This research emphasizes mass transit use among high school students near transit systems. Through a questionnaire survey, quantitative and qualitative methods reveal key factors impacting school trip mode choice. Preliminary findings highlight children's independence as crucial. The socioeconomic, demographic, trip, and transportation traits explain private car use, even schools near mass transit stations. The outcomes of this study will shed light on urban strategic policies for improvement, advocacy, and encouragement of students using mass transit for school trips, which will help normalize the use of mass transit for such trips.

Keywords: children's independence mobility, mode choice, school trips, TOD, extraneous variable, children's independency

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Authors: Yibeltal T. Bayou, Yohana S. Mashalla, Gloria Thupayagale-Tshweneagae

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Background: Maternal mortality has been shown to be lower in urban areas than in rural areas. However, disparities for the fast-growing population of urban poor who struggle as much their rural counterparts to access quality healthcare are masked by the urban averages. The aim of this paper is to report on the findings of antenatal adequacy among slum residents in Addis Ababa, Ethiopia. Methods and Materials: A quantitative and cross-sectional community-based study design was employed. A stratified two-stage cluster sampling technique was used to determine the sample and data was collected using structured questionnaire administered to 837 women aged 15-49 years. Binary logistic regression models were employed to identify predictors of adequacy of antenatal care. Results: The majority of slum residents did not have adequate antenatal care services i.e., only 50.7%, 19.3% and 10.2% of the slum resident women initiated early antenatal care, received adequate antenatal care service contents and had overall adequate antenatal care services. Pregnancy intention, educational status and place of ANC visits were important determinant factors for adequacy of ANC in the study area. Women with secondary and above educational status were 2.9 times more likely to have overall adequate care compared to those with no formal education. Similarly, women whose last pregnancy was intended and clients of private healthcare facilities were 1.8 and 2.8 times more likely to have overall adequate antenatal care compared to those whose last pregnancy was unintended and clients of public healthcare facilities respectively. Conclusion: In order to improve ANC adequacy in the study area, the policymaking, planning, and implementation processes should focus on the poor adequacy of ANC among the disadvantaged groups in particular and the slum residents in general.

Keywords: Addis Ababa, adequacy of antenatal care, slum residents, maternal mortality

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Authors: J. K. Pis-An

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Objective: The purpose of the study was to examine the vulnerability of farmers to the effects of climate change, specifically the El Niño phenomenon was felt in the Philippines in 2009-2010. Methods: KAP Survey determines behavioral response to vulnerability to the effects of El Niño. Body Mass Index: Dietary Assessment using 24-hour food recall. Results: 75% of the respondents claimed that crop significantly decreased during drought. Indications that households of farmers are large where 51.6% are composed of 6-10 family members with 68% annual incomes below Php 100,00. Anthropometric assessment showed that the prevalence of Chronic Energy Deficiency Grade 1 among females 17% and 28.57% for low normal. While male body mass index result for chronic energy deficiency grade 1 10%, low normal 18.33% and and obese grade 1, 31.67%. Dietary assessment of macronutrient intake of carbohydrates, protein, and fat 31.6 % among respondents are below recommended amounts. Micronutrient deficiency of calcium, iron, vit. A, thiamine, riboflavin, niacin, and Vit. C. Conclusion: Majority of the rural populations are engaged into farming livelihood that makes up the backbone of their economic growth. Placing the current nutritional status of the farmers in the context of food security, there are reasons to believe that the status will go for worse if the extreme climatic conditions will once again prevail in the region. Farmers rely primarily on home grown crops for their food supply, a reduction in farm production during drought is expected to adversely affect dietary intake. The local government therefore institute programs to increase food resiliency and to prioritize health of the population as the moving force for productivity and development.

Keywords: world health organization, united nation framework convention on climate change, anthropometric, macronutrient, micronutrient

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Authors: Binod Duwadi

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This article examines the language and literacy practices of English Code-mixing in Nepalese Classroom. Situating the study within an ecological framework, a systematic functional linguistic (SFL) approach was used to analyze students writing in two Neplease schools. Data collection included interviews with teachers, classroom observations, instructional materials, and focal students’ writing samples. Data analyses revealed vastly different language ecologies between the schools owing to sharp socioeconomic stratification, the structural organization of schools, and the pervasiveness of standard language ideology, with stigmatizes English code mixing (ECM) and privileges Standard English in schools. Functional analysis of students’ writing showed that the nature of the writing tasks at the schools created different affordances for exploiting lexicogrammatically choices for meaning making-enhancing them in the case of one school but severely restricting them in the case of another- perpetuating the academic disadvantage for code mixing speakers. Recommendations for structural and attitudinal changes through teacher training and implementation of approaches that engage students’ bidialectal competence for learning are made as important first steps towards addressing educational inequities in Nepalese schools.

Keywords: code-mixing, ecological perspective, systematic functional approach, language and identity

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Authors: Akhtar Malik Muhammad, Agha Mirwais

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Dams are considered to recharge aquifers by raising the water table, especially the ones near wells. The present study investigates the impact of dams on groundwater recharge in Jilga, Pakistan. The comparative analysis of changes in the groundwater table of the year 2012 and 2019 was carried out using ArcGIS 10.5 through the kriging method and remote sensing techniques to evaluate the mini dam's impact on the upstream area. Arc Info Spatial Analyze extension was used to find static water level maps of the years. The water table was observed minimum 67.08 feet and maximum 130.09 feet in 2012 whereas in 2019 the minimum water table level 49.89 feet and maximum 115.85 feet. Groundwater recharge with different ratio was noted, but the most significant was at Rabbani dam with 26ft due to supported lithology conditions and the lowest recharge was found at Garang dam14ft. The overall positive trend indicates the rehabilitation of dead karez and agriculture activities by increasing 36% the vegetation area in 2019. An over 6% increase in human settlement indicates socioeconomic development. Thus, it highlights the need for preferential focus on the construction of the dam so that the water level could be sustained to cater to the agricultural and domestic needs of the local population around the year

Keywords: water table, GIS, land cover, mini dams, agriculture

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Authors: E Tambo, O. O. Olalubi, E. C. Ugwu, J. Y. Ngogang

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Despite the World Health Organization (WHO) declaration of international health emergency concern, the status quo of responses and efforts to stem the worst-recorded Ebola epidemic Ebola outbreak is still precariously inadequate in most of the affected in West. Mining natural resources have been shown to play a key role in both motivating and fuelling ethnic, civil and armed conflicts that have plagued a number of African countries over the last decade. Revenues from the exploitation of natural resources are not only used in sustaining the national economy but also armies, personal enrichment and building political support. Little is documented on the mining and ecological impact on the emergence and geographical distribution of Ebola in Africa over time and space. We aimed to provide a better understanding of the interconnectedness among issues of mining natural, resource management, mining conflict and post-conflict on Ebola outbreak and how wealth generated from abundant natural resources could be better managed in promoting research and development towards strengthening environmental, socioeconomic and health systems sustainability on Ebola outbreak and other emerging diseases surveillance and responses systems prevention and control, early warning alert, durable peace and sustainable development rather than to fuel conflicts, resurgence and emerging diseases epidemics in the perspective of community and national/regional approach. Our results showed the first assessment of systematic impact of all major minerals conflict events diffusion over space and time and mining activities on nine Ebola genesis and geo-distribution in affected countries across Africa. We demonstrate how, where and when mining activities in Africa increase ecological degradation, conflicts at the local level and then spreads violence across territory and time by enhancing the financial capacities of fighting groups/ethnics and diseases onset. In addition, led process of developing minimum standards for natural resource governance; improving governmental and civil society capacity for natural resource management, including the strengthening of monitoring and enforcement mechanisms; understanding the post-mining and conflicts community or national reconstruction and rehabilitation programmes in strengthening or developing community health systems and regulatory mechanisms. In addition the quest for the control over these resources and illegal mining across the landscape forest incursion provided increase environmental and ecological instability and displacement and disequilibrium, therefore affecting the intensity and duration of mining and conflict/wars and episode of Ebola outbreaks over time and space. We highlight the key findings and lessons learnt in promoting country or community-led process in transforming natural resource wealth from a peace liability to a peace asset. The imperative necessity for advocacy and through facilitating intergovernmental deliberations on critical issues and challenges affecting Africa community transforming exploitation of natural resources from a peace liability to outbreak prevention and control. The vital role of mining in increasing government revenues and expenditures, equitable distribution of wealth and health to all stakeholders, in particular local communities requires coordination, cooperative leadership and partnership in fostering sustainable developmental initiatives from mining context to outbreak and other infectious diseases surveillance responses systems in prevention and control, and judicious resource management.

Keywords: mining, mining conflicts, mines, ecological, Ebola, outbreak, mining companies, miners, impact

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Authors: Nwadioha Samuel Iheanacho, Abah Paul, Odimayo Simidele Michael

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Background: The World Health Assembly through the Global Health Sector Strategy on viral hepatitis calls for the elimination of viral hepatitis as a public health threat by 2030. All hands are on deck to actualize this goal through an effective and active vaccination and monitoring tool. Aim: To combine the Epidemiologic with Laboratory Hepatitis B Virus vaccination monitoring tools. Method: Laboratory results analysis of subjects recruited during the World Hepatitis week from July 2020 to July 2021 was done after obtaining their epidemiologic data on Hepatitis B virus risk factors, in the Medical Microbiology Laboratory of Benue State University Teaching Hospital, Nigeria. Result: A total of 500 subjects comprising males 60.0%(n=300/500) and females 40.0%(n=200/500) were recruited. A fifty-three percent majority was of the age range of 26 to 36 years. Serologic profiles were as follows, 15.0%(n=75/500) HBsAg; 7.0% (n=35/500) HBeAg; 8.0% (n=40/500) Anti-Hbe; 20.0% (n=100/500) Anti-HBc and 38.0% (n=190/500) Anti-HBs. Immune responses to vaccination were as follows, 47.0%(n=235/500) Immune naïve {no serologic marker + normal ALT}; 33%(n=165/500) Immunity by vaccination {Anti-HBs + normal ALT}; 5%(n=25/500) Immunity to previous infection {Anti-HBs, Anti-HBc, +/- Anti-HBe + normal ALT}; 8%(n=40/500) Carriers {HBsAg, Anti-HBc, Anti-HBe +normal ALT} and 7% (35/500) Anti-HBe serum- negative infections {HBsAg, HBeAg, Anti-HBc +elevated ALT}. Conclusion: The present 33.0% immunity by vaccination coverage in Central Nigeria was much lower than the 41.0% national peak in 2013, and a far cry from the global expectation of attainment of a Global Health Sector Strategy on the elimination of viral hepatitis as a public health threat by 2030. Therefore, more creative ideas and collective effort are needed to attain this goal of the World Health Assembly.

Keywords: Hepatitis B, vaccination status, laboratory tools, resource-limited settings

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Authors: Agnes Simone

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A 52-year-old male with unknown psychiatric and medical history was brought to the Psychiatric Emergency Room by ambulance directly from jail. He had been detained for three weeks for possession of a firearm while intoxicated. On initial evaluation, the patient was unable to provide a reliable history. He presented with odd jerking movements of his extremities and catatonic features, including mutism and stupor. His vital signs were stable. Patient was transferred to the medical emergency department for work-up of altered mental status. Due to suspicion for opioid overdose, the patient was given naloxone (Narcan) with no improvement. Laboratory work-up included complete blood count, comprehensive metabolic panel, thyroid stimulating hormone, vitamin B12, folate, magnesium, rapid plasma reagin, HIV, blood alcohol level, aspirin, and Tylenol blood levels, urine drug screen, and urinalysis, which were all negative. CT head and chest X-Ray were also negative. With this negative work-up, the medical team concluded there was no organic etiology and requested inpatient psychiatric admission. Upon re-evaluation by psychiatry, it was evident that the patient continued to have an altered mental status. Of note, the medical team did not include substance withdrawal in the differential diagnosis due to stable vital signs and a negative urine drug screen. The psychiatry team decided to check California's prescription drug monitoring program (CURES) and discovered that the patient was prescribed benzodiazepine alprazolam (Xanax) 2mg BID, a sedative-hypnotic, and hydrocodone/acetaminophen 10mg/325mg (Norco) QID, an opioid. After a thorough chart review, his daughter's contact information was found, and she confirmed his benzodiazepine and opioid use, with recent escalation and misuse. It was determined that the patient was experiencing alprazolam withdrawal, given this collateral information, his current symptoms, negative urine drug screen, and recent abrupt discontinuation of medications while incarcerated. After admission to the medical unit and two doses of alprazolam 2mg, the patient's mental status, alertness, and orientation improved, but he had no memory of the events that led to his hospitalization. He was discharged with a limited supply of alprazolam and a close follow-up to arrange a taper. Accompanying this case report, a qualitative review of presentations with alprazolam withdrawal was completed. This case and the review highlights: (1) Alprazolam withdrawal can occur at low doses and within just one week of use. (2) Alprazolam withdrawal can present without any vital sign instability. (3) Alprazolam withdrawal does not respond to short-acting benzodiazepines but does respond to certain long-acting benzodiazepines due to its unique chemical structure. (4) Alprazolam withdrawal is distinct from and more severe than other benzodiazepine withdrawals. This case highlights (1) the importance of physician utilization of drug-monitoring programs. This case, in particular, relied on California's drug monitoring program. (2) The importance of obtaining collateral information, especially in cases in which the patient is unable to provide a reliable history. (3) The importance of including substance intoxication and withdrawal in the differential diagnosis even when there is a negative urine drug screen. Toxidrome of withdrawal can be delayed. (4) The importance of discussing addiction and withdrawal risks of medications with patients.

Keywords: addiction risk of benzodiazepines, alprazolam withdrawal, altered mental status, benzodiazepines, drug monitoring programs, sedative-hypnotics, substance use disorder

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Authors: Oluwatobi Emmanuel Olaniyi, Babafemi George Ogunjemite

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The high rate of infrastructural development in Ikogosi warm spring towards harnessing her great ecotourism potentials calls for a serious concern, as more forest areas are been opened up for public access and the landscape is modified. On this note, we investigated the implication of ecotourism development on the floristic composition and forest structure in Ikogosi. The study aimed at identifying the past and present status of infrastructural development, assessing and comparing the floristic composition and structure of the built- up/ recreational areas and undisturbed forested areas, to infer on the impact of ecotourism development on the study site. We conducted stakeholder interview and field observation to identify the past and present status of infrastructural development respectively. A total of ten quadrants were employed in the vegetation assessment to characterize the woody tree species composition, diameter at breast height and height, to obtain mean indices characterizing each part of the site. These indices were compared using T – test analysis. A total of 49 different woody tree species distributed in 21 families were identified in the built-in/ recreational areas while 67 different woody tree species belonging to 25 families were recorded in the undeveloped forested areas. Although, the latter has a higher mean diameter at breast height of woody trees, it was not significantly different from the former (T-test = -0.74, p = 0.46). On the contrary, the built-up area had a higher mean trees height than the undeveloped areas, but the difference was not statistically significant (T-test= 1.04, p = 0.30). Despite these, the slight reduction in richness and diversity of the woody tree species in the built- up/ recreational areas implies mitigating the negative effects of infrastructural development on the warm spring's vegetation.

Keywords: ecosystem services, forest structure, vegetation assessment, warm-spring

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Authors: Donna L. Roberts

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Heroin has appeared on the drug scene before. Yet the current opioid crisis differs in significant ways. In order to address the grave challenges, this epidemic poses, the unique precipitating and sustaining conditions must be thoroughly examined. This research explored the various aspects of the political, economic, and social conditions that created a 'perfect storm' for the evolution and maintenance of the current opioid crisis. Specifically, the epidemiology, demographics, and progression of addiction inherent in the current crisis were compared to the patterns of past opioid use. Additionally, the role of pharmaceutical companies and prescribing physicians, the nature and pharmaceutical properties of the available substances and the changing socioeconomic climate were considered. Results indicated that the current crisis differs significantly with respect to its evolution, magnitude, prevalence, and widespread societal effects. Precipitated by a proliferation of prescription medication and sustained by the availability of cheaper, more potent street drugs, including new versions of synthetic opioids, the current crisis presents unprecedented challenges affecting a wider and more diverse segment of society. The unique aspects of this epidemic demand unique approaches to addressing the problem. Understanding these differences is a key step in working toward a practical and enduring solution.

Keywords: addiction, drug abuse, opioids, opioid crisis

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Authors: David Xiaoqian Sun, Khairunnisa Binti Haji Sibah, Jr., Lejak Anak Ambol

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The purpose of the study was to examine the relationships between objectively measured physical activity levels (PALs), enjoyment of physical activity (EPA), and body mass index (BMI) among adolescents. A total of 188 12-14-year-old Bruneian secondary school adolescents (88 boys and 100 girls) voluntarily took part in this study. Subjects wore the RT3 accelerometer for seven consecutive days in order to measure their PALs. Times of students’ engagement in total (TPA), light (LPA), moderate (MPV), and vigorous PA (VPA) were obtained from the accelerometer. Their BMIs were calculated from their body height and weight. Physical Activity Enjoyment Scale (PACES) was administrated to obtain their EPA levels. Four key enjoyment factors including fun factors, positive perceptions, unexciting in doing activities, and negative perceptions were identified. Subjects’ social economic status (SES) was provided by school administration. Results show that all the adolescents did not meet the recommended PA guidelines even though boys were engaged in more MVPA than girls. No relationships were found between BMI and all PALs in both boys and girls. BMI was significantly related to the PACES scores (r = -.22, p = 0.01), fun factors (r = -.20, p = 0.05) and positive perceptions (r =-.21, p < 0.05). The PACES scores were significantly related to LPA (r = .18, p = 0.01) but not related to MVPA (r = .04, p > 0.05). After controlling for age and SES, BMI was only significantly related to the PACES scores in girls (r = -.27, p < .01) but boys (r = -.06, p > 0.05). Fun factors were significantly related to LPA and MVPA (p < .01) in girls while negative perceptions were significantly related to LPA and MVPA (p < .01) in boys. This study provides evidence that enjoyment may be a trigger of LPA but MVPA and may be influenced by their BMI status particularly in girls. Based on these findings, physical and health educators are suggested to not only make PA more enjoyable, but also consider gender differences in promoting adolescents' participation in MVPA.

Keywords: accelerometer, body mass index, enjoyment of physical activity, moderate to vigorous physical activity

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Authors: S. M. Rashed Ul Islam, Shahina Tabassum, Afsana Anwar Miti

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Objective: HIV testing and counseling center (HTC) is an important component of the HIV/AIDS detection, prevention and control interventions. The service was first initiated at the Department of Virology, Bangabandhu Sheikh Mujib Medical University (BSMMU) since the first case detection in 1989. The present study aimed to describe the demographic profile among the attendees tested HIV positive. Methods: The present study was carried out among 219 HIV positive cases detected through screening at the Department of Virology of BSMMU during the year of 2012-2016. Data were collected through pre-structured written questionnaire during the counseling session. Data were expressed as frequency and percentages and analyzed using SPSS v20.0 program. Results: Out of 219 HIV cases detected, 77.6% were males, and 22.4% were females with a mean age (mean±SD) of 35.46±9.46 years. Among them, 70.7% belonged to the 26-45 age groups representing the sexually active age. The majority of the cases were married (86.3%) and 49.8% had primary level of education whereas, 8.7% were illiterate. Nearly 42% of cases were referred from Chittagong division (south-east part of the country) followed by Dhaka division (35.6%). The bulk of study population admitted to involvement in high-risk behaviour (90%) in the past and 42% of them had worked overseas. The Pearson Chi-square (χ2) analysis revealed significant relationship of gender with marital (χ2=7.88 at 2% level) and occupation status (χ2=120.48 at 6% level); however, no association was observed with risk behaviour and educational status. Recommendations: HIV risk behavior was found to be a prime source for HIV infection among the study population. So, there is need for health education and awareness program to bring about behavioral changes to halt the yearly increase of new cases in the country with special attention to our overseas workers on HIV/AIDS risk and safety.

Keywords: Bangladesh, health education, HIV testing and counseling (HTC), HIV/AIDS, risk behavior

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Authors: Alyaa Farouk Ibrahim, Gehan ElSayed, Ola Mamdouh, Nazek AbdelGhany

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Background: Primary health care (PHC) can be considered the first contact between the patient and the health care system. It includes all the basic health care services to be provided to the community. Patient's satisfaction regarding health care has often improved the provision of care, also considered as one of the most important measures for evaluating the health care. Objective: This study aims to identify patient’s satisfaction with services provided at the primary health care settings in Alexandria. Setting: Seven primary health care settings representing the seven zones of Alexandria governorate were selected randomly and included in the study. Subjects: The study comprised 386 patients attended the previously selected settings at least twice before the time of the study. Tools: Two tools were utilized for data collection; sociodemographic characteristics and health status structured interview schedule and patient satisfaction scale. Reliability test for the scale was done using Cronbach's Alpha test, the result of the test ranged between 0.717 and 0.967. The overall satisfaction was computed and divided into high, medium, and low satisfaction. Results: Age of the studied sample ranged between 19 and 62 years, more than half (54.2%) of them aged 40 to less than 60 years. More than half (52.8%) of the patients included in the study were diabetics, 39.1% of them were hypertensive, 19.2% had cardiovascular diseases, the rest of the sample had tumor, liver diseases, and orthopedic/neurological disorders (6.5%, 5.2% & 3.2%, respectively). The vast majority of the study group mentioned high satisfaction with overall service cost, environmental conditions, medical staff attitude and health education given at the PHC settings (87.8%, 90.7%, 86.3% & 90.9%, respectively), however, medium satisfaction was mostly reported concerning medical checkup procedures, follow-up data and referral system (41.2%, 28.5% & 28.9%, respectively). Score level of patient satisfaction with health services provided at the assessed Primary health care settings proved to be significantly associated with patients’ social status (P=0.003, X²=14.2), occupation (P=0.011, X²=11.2), and monthly income (P=0.039, X²=6.50). In addition, a significant association was observed between score level of satisfaction and type of illness (P=0.007, X²=9.366), type of medication (P=0.014, X²=9.033), prior knowledge about the health center (P=0.050, X²=3.346), and highly significant with the administrative zone (P=0.001, X²=55.294). Conclusion: The current study revealed that overall service cost, environmental conditions, staff attitude and health education at the assessed primary health care settings gained high patient satisfaction level, while, medical checkup procedures, follow-up, and referral system caused a medium level of satisfaction among assessed patients. Nevertheless, social status, occupation, monthly income, type of illness, type of medication and administrative zones are all factors influencing patient satisfaction with services provided at the health facilities.

Keywords: patient satisfaction, chronic illness, quality of health service, quality of service indicators

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Authors: S. Umar, B. F. Umar

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This study was conducted at Giron Masa village, located 30 km from Yauri town. The study determines the socio-economic factors influencing the use of coping strategies among farmers and herders during post-conflict situation. Simple random sampling was employed to select one hundred respondents (50 farmers and 50 herders) from the study area. Logistic regression analysis (LR) was used to ascertain the socioeconomic variables that influenced the use of the coping strategies. The results of the study shows that age, income, family size and farming experience were individually significant and thus influenced the use of POCS by farmers. Annual income and production system influenced the use of POCS by herders. Age, farm size and farming experience were found to be individually significant in influencing the use of EOCS among farmers. Specifically, years of occupation experience among the herders increased the use of emotion oriented coping strategies among herders. The use of SSCS among farmers was influenced by educational level; farm size and farming experience, while the variables are not collectively significant in influencing the use of SSCS among the herders. The research recommends a need to adopt the strategy of community coping to cope with stress.

Keywords: farmers, herders, conflict, coping strategies

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Authors: Mark Joseph Quinto, Roan Beronilla, Guiller Damian, Eliza Camaso, Ronaldo Alberto

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Forest inventories are essential to assess the composition, structure and distribution of forest vegetation that can be used as baseline information for management decisions. Classical forest inventory is labor intensive and time-consuming and sometimes even dangerous. The use of Light Detection and Ranging (LiDAR) in forest inventory would improve and overcome these restrictions. This study was conducted to determine the possibility of using LiDAR derived data in extracting high accuracy forest biophysical parameters and as a non-destructive method for forest status analysis of San Manual, Pangasinan. Forest resources extraction was carried out using LAS tools, GIS, Envi and .bat scripts with the available LiDAR data. The process includes the generation of derivatives such as Digital Terrain Model (DTM), Canopy Height Model (CHM) and Canopy Cover Model (CCM) in .bat scripts followed by the generation of 17 composite bands to be used in the extraction of forest classification covers using ENVI 4.8 and GIS software. The Diameter in Breast Height (DBH), Above Ground Biomass (AGB) and Carbon Stock (CS) were estimated for each classified forest cover and Tree Count Extraction was carried out using GIS. Subsequently, field validation was conducted for accuracy assessment. Results showed that the forest of San Manuel has 73% Forest Cover, which is relatively much higher as compared to the 10% canopy cover requirement. On the extracted canopy height, 80% of the tree’s height ranges from 12 m to 17 m. CS of the three forest covers based on the AGB were: 20819.59 kg/20x20 m for closed broadleaf, 8609.82 kg/20x20 m for broadleaf plantation and 15545.57 kg/20x20m for open broadleaf. Average tree counts for the tree forest plantation was 413 trees/ha. As such, the forest of San Manuel has high percent forest cover and high CS.

Keywords: carbon stock, forest inventory, LiDAR, tree count

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Authors: Lameck Zetu Khonje, Mulala Danny Simatele

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Malawi’s economy is agriculture based. Recently the government earmarked the tourism sector as an important economic sector which could support the agriculture sector to bring about sustainable economic development and help socioeconomic wellbeing of the local people. Greening of the hotel industry is one of the proven ideal ways of creating a sustainable tourism industry which brings about sustainable economic development in a country like Malawi. This study uses qualitative methodology to examine the efficacy of the governance and policing tools that Malawi uses to guide the development and general practices of the hotel sector to ascertain whether these tools are for greening or not. Grounded Theory method is used whereby semi-structured interviews and field visits were conducted to collect data for the study. The results of the study show that there are loopholes in the governance system in Malawi. The results also reveal gaps within the policing tools such that the hotel industry is not properly guided on green issues. Furthermore, the results show that there is a lack of collaboration for the enforcement of the green practices in the hotel industry. It is also revealed that there is a lack of knowledge of green issues within the governance structures. Awareness campaigns and capacity building would improve greening of the hotel industry in Malawi.

Keywords: governance, greening, Grounded Theory, Malawi

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