Search results for: pulmonary involvement

Authors: Emmanuel Olasope Bamigboye, Ismail Oladeji Oladosu

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Local people of south-western Nigeria like in other climes, continue to be confronted with the vagaries of changing environments. Through the modification of existing practice and shifting resource base, their strategies for coping with change have enabled them to successfully negotiate the shifts in climate change and the environment. This article analyses indigenous adaptation strategies for climate change with a view to enhancing sustainable crop farming in south –western Nigeria. Multi-stage sampling procedure was used to select 340 respondents from the two major ecological zones (Forest and Derived Savannah) for good geographical spread. The article draws on mixed methods of qualitative research, literature review, field observations, informal interview and multinomial logit regression to capture choice probabilities across the various options of climate change adaptation options among arable crop farmers. The study revealed that most 85.0% of the arable crop farmers were males. It also showed that the use of local climate change adaptation strategies had no relationship with the educational level of the respondents as 77.3% had educational experiences at varying levels. Furthermore, the findings showed that seven local adaptation strategies were commonly utilized by arable crop farmers. Nonetheless, crop diversification, consultation with rainmakers and involvement in non-agricultural ventures were prioritized in the order of 1-3, respectively. Also, multinomial logit analysis result showed that at p ≤ 0.05 level of significance, household size (P<0.08), sex (p<0.06), access to loan(p<0.16), age(p<0.07), educational level (P<0.17) and functional extension contact (P<0.28) were all important in explaining the indigenous climate change adaptation utilized by the arable crops farmers in south-western Nigeria. The study concluded that all the identified local adaptation strategies need to be integrated into the development process for sustainable climate change adaptation.

Keywords: crop diversification, climate change, adaptation option, sustainable, small farmers

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Authors: Ezat Vahidian, Babak Eshrati

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Introduction: Elder abuse, a very complex issue with diverse definitions and names, has been very slow to capture the public eye and public policy since it is manifested at many levels. It requires the involvement of different types of professionals. While elder abuse is not a new phenomenon, the speed of population ageing world-wide is likely to lead to an increase in its incidence and prevalence. Elder abuse has devastating consequences for older persons such as poor quality of life, psychological distress, and loss of property and security. It is also associated with increased mortality and morbidity. Elder abuse is a problem that manifests itself in both rich and poor countries and at all levels of society. Purpose: The purpose of this study is to determine the prevalence of elder abuse and effects of social factor on it in Markazi Province. Materials and methods: The society of the study was all of the elders in Markazi Province that were available by geographical address in the table of rural and urban household societies. The study was cross sectional and multi phases in sampling the first one was classification according rural and urban area and the second one was cluster sampling with equal cluster. Estimation of samples were 472 persons and increased by design effect to 1110 persons. Collection data was done by questionnaire and analyzed by SPSS and chi 2 exam. Results: This study showed 70 persons were abused (42/8% male and 57/2% female) mean of ages was 74/7 years. 64% were marred and 31% were widows. There were not any significant meaningful association between elder abuse and area of living (pv=0.299),occupation (p.v=0.104), education (pv=0.358) and age (P.value=0.104) there were significant meaningful association between physical impairment (pv=0.08), and movement impairment (P.value=0.008). Conclusion: Results verify that maltreatment occurred in the aged persons. Analysis of data indicated that elder abuse exist in every socioeconomic group with any context of education in urban area and rural area and in men and women. Prevalence of elder abuse was 6.3% (70 persons) that verify the data of developed countries with limited sample.

Keywords: elder abuse, education, occupation, area of living

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Authors: Ralene Sim, Stefan Mueller, N. Gopalakrishna Iyer, Ngian Chye Tan, Khee Chee Soo, R. Shetty Mahalakshmi, Hiang Khoon Tan

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Background: Regional failure in nasopharyngeal carcinoma (NPC) is managed by salvage treatment in the form of neck dissection. Radical neck dissection (RND) is preferred over modified radical neck dissection (MRND) since it is traditionally believed to offer better long-term disease control. However, with the advent of more advanced imaging modalities like high-resolution Magnetic Resonance Imaging, Computed Tomography, and Positron Emission Tomography-CT scans, earlier detection is achieved. Additionally, concurrent chemotherapy also contributes to reduced tumour burden. Hence, there may be a lesser need for an RND and a greater role for MRND. With this retrospective study, the primary aim is to ascertain whether MRND, as opposed to RND, has similar outcomes and hence, whether there would be more grounds to offer a less aggressive procedure to achieve lower patient morbidity. Methods: This is a retrospective study of 66 NPC patients treated at Singapore General Hospital between 1994 to 2016 for histologically proven regional recurrence, of which 41 patients underwent RND and 25 who underwent MRND, based on surgeon preference. The type of ND performed, primary treatment mode, adjuvant treatment, and pattern of recurrence were reviewed. Overall survival (OS) was calculated using Kaplan-Meier estimate and compared. Results: Overall, the disease parameters such as nodal involvement and extranodal extension were comparable between the two groups. Comparing MRND and RND, the median (IQR) OS is 1.76 (0.58 to 3.49) and 2.41 (0.78 to 4.11) respectively. However, the p-value found is 0.5301 and hence not statistically significant. Conclusion: RND is more aggressive and has been associated with greater morbidity. Hence, with similar outcomes, MRND could be an alternative salvage procedure for regional failure in selected NPC patients, allowing similar salvage rates with lesser mortality and morbidity.

Keywords: nasopharyngeal carcinoma, neck dissection, modified neck dissection, radical neck dissection

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Authors: Sabika Khalid, Endale Fantahun Tadesse

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Unlike other professional sectors, a great deal of studies has addressed the overwhelming gender disparity phenomena in the early childhood education (ECE) workforce, which is acknowledged for the dominance of women over men teachers. The irony of ECE being a gendered working environment is not only observed in societies that are ruled by gender roles but also in Western countries that claim to margin the gender gap in several professions. The participation of male teachers in ECE across most countries ranged from 1% to 3% of the total preschool or kindergarten teachers. When it comes to a dynamic Chinese society tempered with a deep-rooted tradition and cultural ideology, the ECE has no less place for males, and males have a low place for ECE. According to the Ministry of Education of China (2020), there are over 5 million kindergarten teachers and staff members, while only 2.3% are accounted for male teachers. The traditional gender-based discourse asserts that giving care and guidance for young children related to nurturing ‘mothering’ labels the profession in ECE as women’s work derived from originated from their ‘naturality.’ Although a large volume of evidence sheds light on the cause for low male teachers, the perception of parents, female teachers working with male teachers, and the experience of male teachers working in ECE, less is known and understood before being a teacher. Hence, this study argues that the promotion of the involvement of male teachers in light of their masculinity identity asset in the children's learning environment is comprehended to understand the construction of male student teachers' (preservice) professional identity during early childhood teacher training that allows obtaining substantial evidence that provides a feasible and robust implication in the preparation of competent and professional male preschool teachers that understand, cherish, and bring harmony in Chinese ECE through professionalism socialization with the stakeholders. This study intended to reveal male ECE preservice teachers’ knowledge of their professional identity, i.e., how they perceive themselves as a teacher and what factors agents these perceptions towards their professional identity.

Keywords: male teachers, Early Childhood Education (ECE), self-identity, perception of stakeholders

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Authors: Ali Bayram, Remzi Yiğiter

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Objective: Alzheimer's disease (AD), the most common cause of dementia, is a progressive neurodegenerative disease. At present, diagnosis of AD is rather late in the disease. Therefore, we attempted to find peripheral biomarkers for the early diagnosis of AD. Herein, we conducted a study to investigate the unc-51 like autophagy activating kinase-1 (ULK1) mRNA expression levels in human peripheral blood mononuclear cells from patients with Alzheimer's disease. Method: To determine whether ULK1 gene expression are altered in AD patients, we measured their gene expression in human peripheral blood cell in 50 patients with AD and 50 age and gender matched healthy controls by quantitative real-time PCR technique. Results: We found that both ULK1 gene expression in peripheral blood cell were significantly decreased in patients with AD as compared with controls (p <0.05). Lower levels of ULK1 gene expression were significantly associated with the increased risk for AD. Conclusions: Serine/threonine-protein kinase involved in autophagy in response to starvation. Acts upstream of phosphatidylinositol 3-kinase PIK3C3 to regulate the formation of autophagophores, the precursors of autophagosomes. Part of regulatory feedback loops in autophagy: acts both as a downstream effector and negative regulator of mammalian target of rapamycin complex 1 (mTORC1) via interaction with RPTOR. Activated via phosphorylation by AMPK and also acts as a regulator of AMPK by mediating phosphorylation of AMPK subunits PRKAA1, PRKAB2, and PRKAG1, leading to negatively regulate AMPK activity. May phosphorylate ATG13/KIAA0652 and RPTOR; however such data need additional evidences. Plays a role early in neuronal differentiation and is required for granule cell axon formation. Alzheimer is the most common neurodegenerative disease. Our results provide useful information that the ULK1 gene expression is decreased in the neurodegeneration and AD patients with, indicating their possible systemic involvement in AD.

Keywords: Alzheimer’s sisease, ULK1, mRNA expression, RT-PCR

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Authors: Madhulika Pathak, Polani Seshagiri, Vani Venkatappa

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Blastocyst hatching is an indispensable process for successful implantation. One of the major reasons for implantation failure in IVF clinic is poor quality of embryo, which are not development/hatching-competent. Therefore, attempts are required to develop or enhance the culture system with a molecule recapitulating the autocrine/paracrine factors containing the environment of in-vivo endometrial milieu. We have tried to explore the functional molecules involved in the hamster hatching phenomenon. Blastocyst hatching is governed by several molecules that are entwined and regulate this process, among which cytokines are known to be expressed and are still least explored. Two of such cytokines we have used for our study are IL-1β and its natural antagonist IL-1ra to understand the functional dynamics of cytokines involved in the hatching process. Using hamster, an intriguing experimental model for hatching behavior, we have shown the mRNA (qPCR) and protein (ICC) expression of IL-1β, IL-1ra and IL-1 receptor type 1 throughout all the stages of morula, blastocyst and hatched blastocyst. Post-asserting the expression, the functional role is shown by supplementation studies, where IL-1β supplementation showed enhancement in hatching level (IL-1β treated: 84.1 ± 4.2% vs control: 63.7 ± 3.1 %, N=11), further confirmed by the diminishing effect of IL-1ra on hatching rate (IL-1ra treated: 27.5 ± 11.1% vs control: 67.9 ± 3.1%). The exogenous supplementation of IL-1ra decreased the survival rate of embryos and affected the viability in dose-dependent manner, establishing the importance of IL-1β in blastocyst cell survival. Previously, the cathepsin L and B were established as the proteases that were involved in the hamster hatching process. The inducing effect of IL-1β was correlated with enhanced mRNA level, as analyzed by qPCR, for both CAT L (by 1.9 ± 0.5 fold) and CAT B (by 3.5 ± 0.1) fold which was diminished in presence of IL-1ra (Cat L by 88 percent and Cat B by 94 percent. Moreover, using a specific fluorescent substrate-based assay kit, the enzymatic activity of these proteases was found to be increased in presence of IL-1β (Cat L by 2.1 ± 0.1 fold and CAT B by 2.3 ± 0.7 fold) and was curtailed in presence of IL-1ra. These observations provide functional insights with respect to the involvement of cytokines in the hatching process. This has implications in understanding the hatching biology and improving the embryo development quality in IVF clinics.

Keywords: Blastocyst, Cytokines, Hatching, Interleukin

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Authors: Zarish Jawad, Nikita Chugh, Karina Dadar

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Introduction: This paper aims to identify barriers indigenous women face in accessing prenatal care in Canada. It explores the differences in prenatal care received between indigenous and non-indigenous women. The objective is to look at changes or programs in Canada's healthcare system to reduce barriers to accessing safe prenatal care for indigenous women. Methods: A literature search of 12 papers was conducted using the following databases: PubMed, Medline, OVID, Google Scholar, and ScienceDirect. The studies included were written in English only, including indigenous females between the age of 19-35, and review articles were excluded. Participants in the studies examined did not have any severe underlying medical conditions for the duration of the study, and study designs included in the review are prospective cohort, cross-sectional, case report, and case-control studies. Results: Among all the barriers Indigenous women face in accessing prenatal care, the three most significant barriers Indigenous women face include a lack of culturally safe prenatal care, lack of services in the Indigenous community, proximity of prenatal facilities to Indigenous communities and costs of transportation. Discussion: The study found three significant barriers indigenous women face in accessing prenatal care in Canada; the geographical distribution of healthcare facilities, distrust between patients and healthcare professionals, and cultural sensitivity. Some of the suggested solutions include building more birthing and prenatal care facilities in rural areas for indigenous women, educating healthcare professionals on culturally sensitive healthcare, and involving indigenous people in the decision-making process to reduce distrust and power imbalances. Conclusion: The involvement of indigenous women and community leaders is important in making decisions regarding the implementation of effective healthcare and prenatal programs for indigenous women. However, further research is required to understand the effectiveness of the solutions and the barriers that make prenatal care less accessible for indigenous women in Canada.

Keywords: indigenous, maternal health, prenatal care, barriers

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Authors: Ekaterina Sánchez Romero, Emily Gabriela Aguirre Herrera, Sandra Luz Espinoza Esquerra, Jorge García Campos

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Female, 7 months old, daughter of a mother with anemia during pregnancy, with no history of atopy in the family, since birth she presents with recurrent dermatological and gastrointestinal infections, chronically treated for recurrent diaper dermatitis. At 6 months of age, she begins with generalized pallor, hyperpigmentation in hands and feet, smooth tongue, psychomotor retardation with lack of head support, sedation, and hypoactivity. She was referred to our hospital for a fever of 38°C, severe diaper rash, and pancytopenia with HB 9.3, platelets 38000, neutrophils 0.39 MCV: 86.80 high for her age. The approach was initiated to rule out myeloproliferative syndrome, with negative immunohistochemical results of bone marrow aspirate; during her stay, she presented neurological regression, lack of sucking, and focal seizures. CT scan showed cortical atrophy. The patient was diagnosed with primary immunodeficiency due to history; gamma globulin was administered without improvement with normal results of immunoglobulins and metabolic screening. When dermatological and neurological diagnoses were ruled out as the primary cause, a nutritional factor was evaluated, and a therapeutic trial was started with the administration of vitamin B12 and zinc, presenting clinical neurological improvement and resolution of pancytopenia in 2 months. It was decided to continue outpatient management. Discussion: We present a patient with neurological, dermatological involvement, and pancytopenia, so the most common differential diagnoses in this population were ruled out. Vitamin B12 deficiency is an uncommon entity. Due to maternal and clinical history, a therapeutic trial was started resulting in an improvement. Conclusion: VitaminB12 deficiency should be considered one of the differential diagnoses in the approach to pancytopenia with megaloblastic anemia associated with dermatologic and neurologic manifestations. Early treatment can reduce irreversible damage in these patients.

Keywords: vitamin B12 deficiency, pediatrics, pancytopenia, diaper dermatitis

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Authors: Muhammad Saleem

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Background: Inattentive food choices and engagement in excessive physical activities by male athletes can potentially lead to adverse health consequences. Objective: The aim was to ascertain the occurrence of risk factors associated with the Male Athlete Triad among young elite athletes in Pakistan. Methodology: In 2018, a cross-sectional study based on questionnaires was conducted at the Pakistan Sports Board. The study aimed to explore the risk factors related to the Male Athlete Triad in young elite athletes who were part of national training camps in major metropolitan areas. The study included proficient male elite athletes aged 18 to 25 years, capable of understanding the English questionnaire. The athletes completed a survey encompassing aspects like demographic information, educational background, Body Mass Index (BMI), sports involvement, and hours of participation. Additionally, they filled out the Eating Attitude Test-26 (EAT-26) and questionnaires assessing risks of amenorrhea and low bone mineral density. The prevalence of risk factors for each of the three components was individually evaluated. The collected data underwent analysis using SPSS-20, with descriptive statistics being applied. Results: The study comprised a sample of 90 elite athletes (mean age: 23.57 ± 2.37 years, mean BMI: 21.97 ± 1.90) engaged in various sports. The EAT-26 results indicated that 50% of athletes were at risk of developing an eating disorder. Moreover, 83.3% exhibited disordered eating behaviors that necessitated referral. Risks for amenorrhea were observed in 15% of the participants, and regarding low bone mineral density, notable risks were absent except for the consumption of caffeinated beverages, which was noted in 51.7% of participants. Conclusion: The study identified a significant prevalence of disordered eating risk among male elite athletes in Pakistan. However, the risks associated with amenorrhea and low bone mineral density were not a major concern in this particular group.

Keywords: Pakistan, osteoporosis, female athlete triad, bone mineral density, athlete, amenorrhea, eating disorders

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Authors: Angelis P. Barlampas

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Introduction: The term phantom lung mass describes the ovoid collection of fluid within the interlobular fissure, which initially creates the impression of a mass. The problem of correct differential diagnosis is great, especially in plain radiography. A case is presented with three nodular pulmonary foci, the shape, location, and density of which, as well as the presence of chronic loculated pleural effusions, suggest the presence of multiple phantom tumors of the lung. Purpose: The aim of this paper is to draw the attention of non-experienced and non-specialized physicians to the existence of benign findings that mimic pathological conditions and vice versa. The careful study of a radiological examination and the comparison with previous exams or further control protect against quick wrong conclusions. Methods: A hospitalized patient underwent a non-contrast CT scan of the chest as part of the general control of her situation. Results: Computed tomography revealed pleural effusions, some of them loculated, increased cardiothoracic index, as well as the presence of three nodular foci, one in the left lung and two in the right with a maximum density of up to 18 Hounsfield units and a mean diameter of approximately five centimeters. Two of them are located in the characteristical anatomical position of the major interlobular fissure. The third one is located in the area of the right lower lobe’s posterior basal part, and it presents the same characteristics as the previous ones and is likely to be a loculated fluid collection, within an auxiliary interlobular fissure or a cyst, in the context of the patient's more general pleural entrapments and loculations. The differential diagnosis of nodular foci based on their imaging characteristics includes the following: a) rare metastatic foci with low density (liposarcoma, mucous tumors of the digestive or genital system, necrotic metastatic foci, metastatic renal cancer, etc.), b) necrotic multiple primary lung tumor locations (squamous epithelial cancer, etc. ), c) hamartomas of the lung, d) fibrotic tumors of the interlobular fissures, e) lipoid pneumonia, f) fluid concentrations within the interlobular fissures, g) lipoma of the lung, h) myelolipomas of the lung. Conclusions: The collection of fluid within the interlobular fissure of the lung can give the false impression of a lung mass, particularly on plain chest radiography. In the case of computed tomography, the ability to measure the density of a lesion, combined with the provided high anatomical details of the location and characteristics of the lesion, can lead relatively easily to the correct diagnosis. In cases of doubt or image artifacts, comparison with previous or subsequent examinations can resolve any disagreements, while in rare cases, intravenous contrast may be necessary.

Keywords: phantom mass, chest CT, pleural effusion, cancer

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Authors: Nadine Ponnusamy

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Reducing risks to food security resulting from climate change is recognized as one of the major challenges of the 21st century. The risks to food security have intensified, primarily due to globalization, a growing population, rapid urbanization, and the constantly evolving urban environment. One of the key challenges facing cities is the need to supply sufficient food to households amid increasing demand, which necessitates a continuous effort to enhance food production. Given the severity of climate change, it is imperative to adopt solutions to address food insecurity. Communities and individuals must explore sustainable livelihood options that do not harm the environment. Urban agriculture represents one of the many strategies that can be employed to improve household food security. The objective of this research is to establish the extent to which community gardens can enhance urban food security, focusing on the Thulubukele Community Farm in Newlands West, Durban. The researcher utilized a qualitative case study approach to gain insight into urban agriculture and food security within this context, while also examining the long-term impacts on food security and community development. The sampling method utilized for selecting participants and gathering information included purposive sampling. Since the study centers on urban agriculture, key stakeholders were specifically targeted. Participants were selected for interviews based on their involvement in the food garden. In-depth interviews were conducted to collect and analyze data. Secondary data from the literature facilitated a comparative analysis of similar case studies through precedent studies. This study demonstrates that growing food not only improves the nutritional value of the produce but also enhances household food security, enables individuals to generate disposable income, and facilitates significant contributions to the local community and other organizations in need.

Keywords: community gardens, food security, South Africa, urban agriculture

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Authors: Karolina Siejka, Monika Piekarska, Monika Zbroja, Weronika Cyranka, Maryla Kuczynska, Magdalena Grzegorczyk, Malgorzata Nowakowska, Agnieszka Brodzisz, Magdalena Maria Wozniak

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Crohn’s disease is one of chronic inflammatory bowel diseases. It is increasing in prevalence worldwide, especially with young people. The disease usually occurs in the second to the fourth decade of life. Traditionally is diagnosed by clinical indicates, endoscopic, and histological findings. Magnetic Resonance Enterography (MRE) can demonstrate mural and extramural inflammatory signs and complications, which make it a valuable diagnostic modality. The study included 76 adults and 36 children diagnosed with Crohn’s disease. Each patient underwent MRE with intravenous administration of a contrast agent. All the studies were performed using Siemens Aera 1.5T scanner according to a local study protocol. Whenever applicable, MR Enterography findings were verified with endoscopy. Forty adults and all 36 children had an active phase of Crohn’s disease; five adults had a chronic phase of the disease; one adult had both chronic and active inflammatory features. Thirty adults have no sings of pathology. In both adult and pediatric groups the most commonly observed manifestation of active disease was thickened edematous ileum wall (26 adults and 36 children). Adults had Bauhin’s valve edema in 58% cases (n=23) and mesenteric changes in 34% cases (n=9). To compare, 32 children had Bauhin’s valve edema (89%) and, in 23 cases, was found inflammatory infiltration of the peri-intestinal fat (64%). The involvement of the large intestine was more common among children (100%). Complications of Crohn’s disease were found commonly in adults (40% of adults, 22% of children). There were observed 18 fistulas (14 adults, four children) and six abscesses (2 adults, four children). MRE is a reliable method in the evaluation of Crohn’s disease activity, especially of its complications. The lack of radiations makes MRE well-tolerated modality, which can be often repeated, particularly in young patients. The disease had different medical sings depending on age – children often had a more active inflammatory process, but there were more complications in the adult group.

Keywords: Crohn's disease, diagnostics, inflammatory bowel disease, magnetic resonance enterography, MRE

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Authors: Nagendra P. Luitel, Mark J. D. Jordans

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Globally, there is a significant gap between the number of individuals in need of mental health care and those who actually receive treatment. The evidence is accumulating that mental health services can be delivered effectively by primary health care workers through community-based programs and task-sharing approaches. Changing the role of specialist mental health workers from service delivery to building clinical capacity of the primary health care (PHC) workers could help in reducing treatment gap in low and middle-income countries (LMICs). We developed a comprehensive mental health care plan in 2012 and evaluated its feasibility and effectiveness over the past three years. Initially, a mixed method formative study was conducted for the development of mental health care plan (MHCP). Routine monitoring and evaluation data, including client flow and reports of satisfaction, were obtained from beneficiaries (n=135) during the pilot-testing phase. Repeated community survey (N=2040); facility detection survey (N=4704) and the cohort study (N=576) were conducted for evaluation of the MHCP. The resulting MHCP consists of twelve packages divided over the community, health facility, and healthcare organization platforms. Detection of mental health problems increased significantly after introducing MHCP. Service implementation data support the real-life applicability of the MHCP, with reasonable treatment uptake. Currently, MHCP has been implemented in the entire Chitwan district where over 1400 people (438 people with depression, 406 people with psychosis, 181 people with epilepsy, 360 people with alcohol use disorder and 51 others) have received mental health services from trained health workers. Key barriers were identified and addressed, namely dissatisfaction with privacy, perceived burden among health workers, high drop-out rates and continue the supply of medicines. The results indicated that involvement of PHC workers in detection and management of mental health problems is an effective strategy to minimize treatment gap on mental health care in Nepal.

Keywords: mental health, Nepal, primary care, treatment gap

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Authors: Libia Jiménez Chávez

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This is a study of freedom riders and their courageous journey for civil rights, but the year was not 1961. It was 2003. This paper chronicles the emergence of a new civil rights movement for immigrant rights through an oral history of the 2003 U.S. Immigrant Workers Freedom Ride (IWFR). During the height of the post-9/11 immigrant repression, a bloc of organizations inspired by the Civil Rights Movement of the 1960s mobilized 900 multinational immigrants and their allies in the fight for legal status, labor protections, family reunification, and civil rights. The activists visited over 100 U.S. cities, met with Congressional leaders in the nation’s capital, and led a rally of over 50,000 people in New York City. This unified effort set the groundwork for the national May Day immigration protests of 2006. Movements can be characterized in two distinct ways: physical movement and social movements. In the past, historians have considered immigrants both as people and as participants in social movements. In contrast, studies of recent migrants tend to say little about their involvement in immigrant political mobilizations. The dominant literature on immigration portrays immigrants as objects of exclusion, border enforcement, detention, and deportation instead of strategic political actors. This paper aims to change this perception. It considers the Freedom Riders both as immigrants who were literally on the move and as participants in a social movement. Through interviews with participants and archival video footage housed at the University of California Los Angeles, it is possible to study this mobile protest as a movement. This contemporary immigrant struggle is an opportunity to explore the makeup and development of a heterogenous immigrant coalition and consider the relationship between population movements and social justice. In addition to oral histories and archival research, the study will utilize social movement literature, U.S. immigration and labor history, and Undocumented Critical Theory to expand the historiography of immigrant social movements in America.

Keywords: civil rights, immigrant social movements, undocumented communities, undocumented critical theory

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Authors: Vaibhav Singh Parihar

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Incidents of serious offenses being committed by children are increasing day by day thereby becoming a matter of great concern. The involvement of a 17-year-old boy in the incident that took place on 16th December 2012 (most commonly known as ‘Nirbhaya Case’)wherein a 23-year-old girl was brutally gang-raped and thrown out of the moving bus, took the entire nation by shock. Previously, the legislation dealing with juvenile delinquency in India considered a child to be juvenile if he/she was below the age of 18 years. As a consequence, the accused who was just six months short of attaining the age of 18 years was convicted for only three years. The primary objective of the study is to understand the gravity as to why the need for distinguishing a child and juvenile arose in this time and to what extent legislations are successful in this regard. It initially explains the history and evolution of juvenile legislation in India and the provisions contained in the Indian Constitution. It then goes on to explain the causes of juvenile delinquency in India. Further, the study focuses on the latest trends that have developed in juvenile delinquency, explaining how the Nirbhaya Case led to the amendments made to the Juvenile Justice Act, 2010. Also, it focuses on the Child Rights and Child Protection and the stand taken by the National Human Rights Commission and the international community. An attempt has been made to settle the debate as to whether the juvenile justice system in India is reformative or punitive. The need for amendment in the Juvenile Justice Act is also highlighted. The outcome of the study suggests that the legislation relating to juvenile delinquency have not been able to achieve the desired results. The age determination method in our system has been given paramount importance. The maximum punishment prescribed, even for heinous crimes, is only three years. Also, the reformative style of punishment is not adequate and more emphasis should be laid on penalization. Finally, the author concludes that the legislation has failed at creating a deterrent effect. It is suggested to strengthen the role of government authorities and to sensitize people in this regard to increase community participation. A non-doctrinal and analytical approach has been adopted and secondary sources of data have been relied upon by the author for conducting the research for the study.

Keywords: child, delinquency, juvenile, Nirbhaya case

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Authors: Daniela N. Correa-Llantén, Sebastián A. Muñoz-Ibacache, Mathilde Maire, Jenny M. Blamey

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The biosynthesis of nanoparticles by microorganisms, on the contrary to chemical synthesis, is an environmentally-friendly process which has low energy requirements. In this investigation, we used the microorganism Geobacillus wiegelii, strain GWE1, an aerobic thermophile belonging to genus Geobacillus, isolated from a drying oven. This microorganism has the ability to reduce selenite evidenced by the change of color from colorless to red in the culture. Elemental analysis and composition of the particles were verified using transmission electron microscopy and energy-dispersive X-ray analysis. The nanoparticles have a defined spherical shape and a selenium elemental state. Previous experiments showed that the presence of the whole microorganism for the reduction of selenite was not necessary. The results strongly suggested that an intracellular NADPH/NADH-dependent reductase mediates selenium nanoparticles synthesis under aerobic conditions. The enzyme was purified and identified by mass spectroscopy MALDI-TOF TOF technique. The enzyme is a 1-pyrroline-5-carboxylate dehydrogenase. Histograms of nanoparticles sizes were obtained. Size distribution ranged from 40-160 nm, where 70% of nanoparticles have less than 100 nm in size. Spectroscopic analysis showed that the nanoparticles are composed of elemental selenium. To analyse the effect of pH in size and morphology of nanoparticles, the synthesis of them was carried out at different pHs (4.0, 5.0, 6.0, 7.0, 8.0). For thermostability studies samples were incubated at different temperatures (60, 80 and 100 ºC) for 1 h and 3 h. The size of all nanoparticles was less than 100 nm at pH 4.0; over 50% of nanoparticles have less than 100 nm at pH 5.0; at pH 6.0 and 8.0 over 90% of nanoparticles have less than 100 nm in size. At neutral pH (7.0) nanoparticles reach a size around 120 nm and only 20% of them were less than 100 nm. When looking at temperature effect, nanoparticles did not show a significant difference in size when they were incubated between 0 and 3 h at 60 ºC. Meanwhile at 80 °C the nanoparticles suspension lost its homogeneity. A change in size was observed from 0 h of incubation at 80ºC, observing a size range between 40-160 nm, with 20% of them over 100 nm. Meanwhile after 3 h of incubation at size range changed to 60-180 nm with 50% of them over 100 nm. At 100 °C the nanoparticles aggregate forming nanorod structures. In conclusion, these results indicate that is possible to modulate size and shape of biologically synthesized nanoparticles by modulating pH and temperature.

Keywords: genus Geobacillus, NADPH/NADH-dependent reductase, selenium nanoparticles, biosynthesis

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Authors: M. B. Ricardo De Oliveira, A. Borghi-Silva, E. Paravizo, F. Lizarelli, L. Di Thomazzo, D. Braatz

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Prototypes are a critical feature in the product development process, as they help the project team visualize early concept flaws, communicate ideas and introduce an initial product testing. Involving stakeholders, such as consumers and users, in prototype tests allows the gathering of valuable feedback, contributing for a better product and making the design process more participatory. Even though recent studies have shown that user evaluation of prototypes is valuable, few articles provide a method or protocol on how designers should conduct it. This multidisciplinary study (involving the areas of physiotherapy, engineering and computer science) aims to develop an evaluation protocol, using an ergometric step prototype as the product prototype to be assessed. The protocol consisted of performing two tests (the 2 Minute Step Test and the Portability Test) to allow users (patients) and consumers (physiotherapists) to have an experience with the prototype. Furthermore, the protocol contained four Likert-Scale questionnaires (one for users and three for consumers), that inquired participants about how they perceived the design characteristics of the product (performance, safety, materials, maintenance, portability, usability and ergonomics), in their use of the prototype. Additionally, the protocol indicated the need to conduct interviews with the product designers, in order to link their feedback to the ones from the consumers and users. Both tests and interviews were recorded for further analysis. The participation criteria for the study was gender and age for patients, gender and experience with 2 Minute Step Test for physiotherapists and involvement level in the product development project for designers. The questionnaire's reliability was validated using Cronbach's Alpha and the quantitative data of the questionnaires were analyzed using non-parametric hypothesis tests with a significance level of 0.05 (p <0.05) and descriptive statistics. As a result, this study provides a concise evaluation protocol which can assist designers in their development process, collecting quantitative feedback from consumer and users, and qualitative feedback from designers.

Keywords: Product Design, Product Evaluation, Prototypes, Step

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Authors: Fiorenza Misale

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The painful phenomenon of so-called white deaths and accidents at work, unfortunately, is always current. The key is to act on the culture of security through effective measures of attitudes and behaviors that go far beyond the knowledge and the know-how. It is necessary that there is an ‘introjection’ of safety culture through the conscious involvement of all workers. The legislation on work safety identifies the main tool to promote the culture of safety at work and prevention within the workplace. In law the term education is used to distinguish itself from the information with which they will simply theoretically transmit, and from the training with which they will provide the practical skills. The new decree fact fills several gaps in previous legislation and stresses the importance of training in the workplace, that is, the main activity through which it is possible to achieve the active participation of all workers in the company’s prevention system. This system is built only through the dissemination of risk information, the circulation of information, comparison and dialogue between all actors involved that are the necessary elements for a correct transmission of the culture of worker safety. Training activity should put the focus on work experience in order to bring out all the knowledge needed to identify and assess the risks in the work place, and especially the action to eliminate or control them, integrating, when necessary, the missing knowledge. In addition to traditional training and information systems can be utilized for the purpose of training that are able to affect both one emotionally and aesthetically, team-theatre is one of them. Among the methods of company theater that can be used in work safety we have: Lesson show, theater workshop, improvised theater, forum theater, theater playback. The theater can represent a complementary approach to traditional training and give information on safety measures, demonstrating that there are more engaging outreach tools. Team-theatre allows identification with the characters, a transmission of emotions and moods and it is through the staging of a story that the individual processes new information. It’ also s a means of experiential training that allows you to work with your mind, body, emotions.The aim of one work is the use of corporate theater on the personnel working in the health sector. Through a questionnaire we are able to analyze the knowledge of occupational safety and current risks; in particular in health care which is to be administered before and after the play.

Keywords: theater, training, occupational health, safety

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Authors: Jing-Jing Wang, Yang Gao, Heather H. M. Kwok, Wendy Y. J. Huang

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Objectives: Intellectual disability (ID) ranks among the top 20 most costly disorders. A child with ID creates a wide set of challenges to the individual, family, and society, and overweight and obesity aggravate those challenges. People with ID have the right to attain optimal health like the rest of the population. They should be given priority to eliminate existing health inequities. Childhood obesity epidemic and associated factors among children, in general, has been well documented, while knowledge about overweight and obesity in children with ID is scarce. Methods: A cross-sectional study was conducted among 524 Chinese children with ID (males: 68.9%, mean age: 12.2 years) in Hong Kong in 2015. Children’s height and weight were measured at school. Parents, in the presence of their children, completed a self-administered questionnaire at home about the children’s physical activity (PA), eating habits, and sleep duration in a typical week as well as parenting practices regarding children’s eating and PA, and their socio-demographic characteristics. Multivariate logistic regression estimated the potential risk factors for children being overweight. Results: The prevalence of overweight and obesity in children with ID was 31.3%, which was higher than their general counterparts (18.7%-19.9%). Multivariate analyses revealed that the risk factors of overweight and obese in children with ID included: comorbidity with autism, the maternal side being overweight or obese, parenting practices with less pressure to eat more, children having shorter sleep duration, longer periods of sedentary behavior, and higher intake frequencies of sweetened food, fried food, and meats, fish, and eggs. Children born in other places, having snacks more frequently, and having irregular meals were also more likely to be overweight or obese, with marginal significance. Conclusions: Children with ID are more vulnerable to being overweight or obese than their typically developing counterparts. Identified risk factors in this study highlight a multifaceted approach to the involvement of parents as well as the modification of some children’s questionable behaviors to help them achieve a healthy weight.

Keywords: prevalence, risk factors, obesity, children with disability

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Authors: Ren Boyuan

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This study focuses on how the Character and Citizenship Education textbook in Singapore primary schools deliver preferred and desired qualities to students and therefore reveals how discourse in textbooks can facilitate and perpetuate certain social practices. In this way, this study also serves to encourage the critical thinking of textbook writers and school educators by unveiling the nuanced message through language use that facilitates the perpetuation of social practices in a society. In Singapore, Character and Citizenship Education is a compulsory subject for primary school students. Under the framework of 21st Century Competencies, Character and Citizenship Education in Singapore aims to help students thrive in this fast-changing world. The Singapore government is involved in the development of CCE curriculum in schools from primary schools to pre-university. Inevitably, the CCE curriculum is not free from ideological influences. This qualitative study utilizes Fairclough’s three-dimensional theory and his framework of three assumptions to analyze the Character and Citizenship Education textbook for Primary 1 and to reveal ideologies in this textbook. Data for the analysis in this study are the textual parts of the whole textbook for Primary 1 students as this book is used at the beginning of citizenship education in primary schools. It is significant because it promotes messages about CCE to the foundation years of a child's education. The findings of this study show that the four revealed ideologies, namely pragmatism, communitarianism, nationalism, and multiculturalism, are not only dated back in the national history but also updated and explained by the current demands for Singapore’s thriving and prosperity in a sustainable term. This study ends with a discussion of the implications of this study. By pointing out the ideologies in this textbook and how they are embedded in the discourse, this study may help teachers and textbook writers realize the possible political involvement in the book and therefore develop their recognition of the implicit influence of lexical choice on their teaching and writing. In addition, by exploring the ideologies in this book and comparing them with ideologies in past textbooks, this study helps researchers in this area on how language influences readers and reflects certain social demands.

Keywords: citizenship education, critical discourse analysis, sociolinguistics, textbook analysis

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Authors: Christina Zourna, Ioanna Papavassiliou-Alexiou

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Drama in Education (DiE) is a dynamic experiential method that can be used in many interdisciplinary contexts. In the Educational and Social Policy Department, University of Macedonia, Thessaloniki, Greece, DiE is being used as a core method for developing professional competences in pre- and postgraduate courses as well as adult education training programs. In this presentation, an innovative DiE application will be described concerning the development of educational leaders’ skills necessary to meet unprecedented, unexpected challenges in the 21st century schools. In a non-threatening risk-taking no-penalty environment, future educational leaders live-in-role problems, challenges, and dilemmas before having to face similar ones in their profession. Through personal involvement, emotional engagement, and reflection, via individual and group activities, they experience the behaviour, dilemmas, decision-making processes, and informed choices of a recognized leader and are able to make connections with their own life. As pretext serves the life of Alexander the Great, the Macedonian King who defeated the vast Persian empire in the 4th century BC and, by uniting all Greeks, conquered the up-to-date known eastern world thanks to his authentic leadership skills and exceptional personality traits. Since the early years of his education mastered by the famous Greek philosopher Aristotle, Alexander proved his unique qualities by providing the world with the example of an undeniably genuine, inspirational, effective, and most recognizable authentic leader. Through questionnaires and individual interviews, participants in these workshops revealed how they developed active listening, empathy, creativity, imagination, critical strategic and out-of-the-box thinking, cooperation and own vision communicating, crisis management skills, self-efficacy, self-awareness, self-exposure, information management, negotiation and inspiration skills, enhanced sense of responsibility and commitment, and decision-making skills.

Keywords: drama in education method, educational leadership, professional competences, skills’ development

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Authors: Yusuf E. Mustapha, Inioluwa A Akindoyeni, Oluwatoyin G. Ezekiel, Ifeoluwa O. Awogbindin, Ebenezer O. Farombi

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Background: Parkinson's disease (PD) is the most prevalent motor disorder. Available therapies are palliative with no effect on disease progression. Kolaviron (KV), a natural anti-inflammatory and antioxidant agent, has been reported to possess neuroprotective effects in Parkinsonian flies and rats. Objective: The present study investigates the neuroprotective effect of KV, focusing on the DJ1/Nrf2 signaling pathway. Methodology: All-trans retinoic acid (ATRA, 10 mg/kg, i.p.) was used to inhibit Nrf2. Murine model of PD was established with four doses of MPTP (20 mg/kg i.p.) at 2 hours interval. MPTP mice were pre-treated with either KV (200 mg/kg/day p.o), ATRA, or both conditions for seven days before PD induction. Motor behaviour was evaluated, and markers of oxidative stress/damage and its regulators were assessed with immunofluorescence and ELISA techniques. Results: MPTP-treated mice covered less distance with reduced numbers of anticlockwise rotations, heightened freezing, and prolonged immobility when compared to control. However, KV significantly attenuated these deficits. Pretreatment of MPTP mice with KV upregulated Nrf2 expression beyond MPTP level with a remarkable reduction in Keap1 expression and marked elevation of DJ-1 level, whereas co-administration with ATRA abrogated these effects. KV treatment restored MPTP-mediated depletion of endogenous antioxidant, striatal oxidative stress, oxidative damage, and inhibition of acetylcholinesterase activity. However, ATRA treatment potentiated acetylcholinesterase inhibition and attenuated the protective effect of KV on the level of nitric oxide and activities of catalase and superoxide dismutase. Conclusion: Kolaviron protects Parkinsonian mice by stabilizing and activating the Nrf2 signaling pathway. Thus, kolaviron can be explored as a pharmacological lead in PD management.

Keywords: Garcinia kola, Kolaviron, Parkinson Disease, Nrf2, behavioral incompetence, neurodegeneration

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Authors: Jeanne Leblond, Warren Viricel, Amira Mbarek

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Although several products have reached the market, gene therapeutics are still in their first stages and require optimization. It is possible to improve their lacking efficiency by the use of carefully engineered vectors, able to carry the genetic material through each of the biological barriers they need to cross. In particular, getting inside the cell is a major challenge, because these hydrophilic nucleic acids have to cross the lipid-rich plasmatic and/or endosomal membrane, before being degraded into lysosomes. It takes less than one hour for newly endocytosed liposomes to reach highly acidic lysosomes, meaning that the degradation of the carried gene occurs rapidly, thus limiting the transfection efficiency. We propose to use a new pH-sensitive lipid able to change its conformation upon protonation at endosomal pH values, leading to the disruption of the lipidic bilayer and thus to the fast release of the nucleic acids into the cytosol. It is expected that this new pH-sensitive mechanism promote endosomal escape of the gene, thereby its transfection efficiency. The main challenge of this work was to design a preparation presenting fast-responding lipidic bilayer destabilization properties at endosomal pH 5 while remaining stable at blood pH value and during storage. A series of pH-sensitive lipids able to perform a conformational switch upon acidification were designed and synthesized. Liposomes containing these switchable lipids, as well as co-lipids were prepared and characterized. The liposomes were stable at 4°C and pH 7.4 for several months. Incubation with siRNA led to the full entrapment of nucleic acids as soon as the positive/negative charge ratio was superior to 2. The best liposomal formulation demonstrated a silencing efficiency up to 10% on HeLa cells, very similar to a commercial agent, with a lowest toxicity than the commercial agent. Using flow cytometry and microscopy assays, we demonstrated that drop of pH was required for the transfection efficiency, since bafilomycin blocked the transfection efficiency. Additional evidence was brought by the synthesis of a negative control lipid, which was unable to switch its conformation, and consequently exhibited no transfection ability. Mechanistic studies revealed that the uptake was mediated through endocytosis, by clathrin and caveolae pathways, as reported for previous lipid nanoparticle systems. This potent system was used for the treatment of hypercholesterolemia. The switchable lipids were able to knockdown PCSK9 expression on human hepatocytes (Huh-7). Its efficiency is currently evaluated on in vivo mice model of PCSK9 KO mice. In summary, we designed and optimized a new cationic pH-sensitive lipid for gene delivery. Its transfection efficiency is similar to the best available commercial agent, without the usually associated toxicity. The promising results lead to its use for the treatment of hypercholesterolemia on a mice model. Anticancer applications and pulmonary chronic disease are also currently investigated.

Keywords: liposomes, siRNA, pH-sensitive, molecular switch

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Authors: Saira Maqbool, Qaisara Parveen, Muhammad Arshad Dahar

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Improving females' involvement in management and enterprises in Pakistan requires the development of female entrepreneurs as leaders. Entrepreneurial education aims for providing students the knowledge, aptitudes and motivation to energize innovative accomplishment in various settings. Assortments of venture instruction are advertised at all stages of mentoring, from fundamental or discretionary institutes through graduate institutional platforms. The business enterprise will be considered the procedure by which a looming business visionary or business person pursues after openings without respect to the resources they directly regulate. This entails the ability of the business visionary to join every single other generation. This study explores the relationship between developing Women's Leadership skills and Entrepreneurship Education The essential reason for this consider was to analyze the role of Entrepreneurship Edification (EE) towards women's Leadership and develop entrepreneurial intentions among students. The major goal of this study was to foster entrepreneurial attitudes among PMAS Arid Agriculture University undergraduate students concerning their choice to work for themselves. This study focuses on the motivation and interest of female students in the social sciences to build entrepreneurial leadership skills. The quantitative analysis used a true-experimental, pretest-posttest control group research design. Female undergraduate students from PMAS Arid Agriculture University made up the study population. For entrepreneurial activity, a training module has been created. The students underwent a three-week training program at PMAS Arid Agriculture University, where they learned about entrepreneurial leadership abilities. The quantitative data were analyzed using descriptive statistics and T-tests. The findings indicated that students acquired entrepreneurial leadership skills and intentions after training. They have decided to launch their businesses as leaders. It is advised that other PMAS Arid Agriculture University departments use the training module and course outline because the research's usage of them has important results.

Keywords: business, entrepreneurial, intentions, leadership, women

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Authors: Zeynep Yazicioglu

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Project development is a complex process where many stakeholders work together. Employers and main contractors are the base stakeholders, whereas designers, engineers, sub-contractors, suppliers, supervisors, and consultants are other stakeholders. A combination of the complexity of the building process with a large number of stakeholders often leads to time and cost overruns and irregular resource utilization. Failure to comply with the work schedule and inefficient use of resources in the construction processes indicate that it is necessary to accelerate production and increase productivity. The development of computer software called Building Information Modeling, abbreviated as BIM, is a major technological breakthrough in this area. The use of BIM enables architectural, structural, mechanical, and electrical projects to be drawn in coordination. BIM is a tool that should be considered by every stakeholder with the opportunities it offers, such as minimizing construction errors, reducing construction time, forecasting, and determination of the final construction cost. It is a process spreading over the years, enabling all stakeholders associated with the project and construction to use it. The main goal of this paper is to explore the problems associated with the adoption of BIM in multi-stakeholder projects. The paper is a conceptual study, summarizing the author’s practical experience with design offices and construction firms working with BIM. In the transition period to BIM, three of the challenges will be examined in this paper: 1. The compatibility of supplier companies with BIM, 2. The need for two-dimensional drawings, 3. Contractual issues related to BIM. The paper reviews the literature on BIM usage and reviews the challenges in the transition stage to BIM. Even on an international scale, the supplier that can work in harmony with BIM is not very common, which means that BIM's transition is continuing. In parallel, employers, local approval authorities, and material suppliers still need a 2-D drawing. In the BIM environment, different stakeholders can work on the same project simultaneously, giving rise to design ownership issues. Practical applications and problems encountered are also discussed, providing a number of suggestions for the future.

Keywords: BIM opportunities, collaboration, contract issues about BIM, stakeholders of project

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Authors: Endalew Jibat, Feyera Senbeta, Tesfaye Zeleke, Fitsum Hagos

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Water governance considers multi-sector participation beyond the state; and for sustainable use of water resources, appropriate laws, policies, regulations, and institutions needs to be developed and put in place. Water policy, a critical and integral instrument of water governance, guided water use schemes and ensures equitable water distribution among users. The Ethiopian Central Rift Valley (CRV) is wealthy of water resources, but these water resources are currently under severe strain owing to an imbalance in human-water interactions. The main aim of the study was to examine the state of water resources governance in the CRV of Ethiopia, and the impact of the Ethiopian Water Resources Management Policy on water governance. Key informant interviews (KII), focused group discussions, and document reviews were used to gather data for the study. The NVivo 11 program was used to organize, code, and analyze the data. The results revealed that water resources governance practices such as water allocation and apportionment, comprehensive and integrated water management plans, water resources protection, and conservation activities were rarely implemented. Water resources management policy mechanisms were not fully put in place. Lack of coherence in water policy implementation, absence of clear roles and responsibilities of stakeholders, absence of transparency and accountability in irrigation water service delivery, and lack of meaningful participation of key actors in water governance decision-making were the primary shortcomings observed. Factors such as over-abstraction, deterioration of buffer zone, and chemical erosion from surrounding farming have contributed to the reduction in water volume and quality in the CRV. These challenges have influenced aquatic ecosystem services and threaten the livelihoods of the surrounding communities. Hence, reforms relating to policy coherence and enforcement, stakeholder involvement, water distribution strategies, and the application of water governance principles must be given more emphasis.

Keywords: water resources, irrigation, governance, water allocation, governance principles, stakeholders engagement, central rift valley

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Authors: A. Kourou, M. Panoutsopoulou

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Nowadays, disaster risk reduction requires innovative ways of working collaboratively, monitoring tools, management methods, risk communication, and knowledge, as key factors for decision-making actors. Experience has shown that the assessment of seismic risk and its effective management is still an important challenge. In Greece, Ionian Islands region is characterized as the most seismic area of the country and one of the most active worldwide. It is well known that in case of a disastrous earthquake the local authorities need to assess the situation in the affected area and coordinate the disaster response. In particular, the main outcomes of 'Telemachus' project are the development of an innovative operational system that hosts the needed data of seismic risk management in the Ionian Islands and the implementation of educational actions for the involved target groups. This project is funded in the Priority Axis 'Environmental Protection and Sustainable Development' of Operational Plan 'Ionian Islands 2014-2020'. EPPO is one of the partners of the project and it is responsible, among others, for the development of proper training material. This paper presents the training material of 'Telemachus' and its usage as a helpful, managerial tool in case of earthquake emergency. This material is addressed to different target groups, such as civil protection staff, people that involved with the tourism industry, educators of disabled people, etc. Very positive aspect of the project is the involvement of end-users that should evaluate the training products; test standards; clarify the personnel’s roles and responsibilities; improve interagency coordination; identify gaps in resources; improve individual performance; and identify opportunities for improvement. It is worth mentioning that even though the abovementioned material developed is useful for the training of specific target groups on emergency management issues within Ionian Islands Region, it could be used throughout Greece and other countries too.

Keywords: education of civil protection staff, Ionian Islands Region of Greece, seismic risk, training material

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Authors: Q. B. Maria de la Luz Ortega Juárez, Saúl Rojas Hernández, Itzel Berenice Rodríguez Mera, María Maricela Carrasco Yépez, Mara Gutierrez Sánchez

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Naegleria fowleri is a free-living amoeba found mainly in temperate freshwater and is the etiologic agent of primary amebic meningoencephalitis (PAM), a fatal acute disease with a mortality rate greater than 95%. At present, there are no treatments available for MAP, and the development of effective vaccines that generate long-term immunological memory allowing protection against MAP would be of great importance. The objective of this work was to analyze the effector and memory immune response in BALB/c mice immunized with total extract of N. fowleri co-administered with cholera toxin. In this study, BALB/c mice were immunized four times intranasally with ET of N. fowleri adjuvanted with CT with or without booster at three months and were challenged or not with the lethal dose of N. fowleri, determining survival, the humoral, effector and memory response, by ELISA and flow cytometry techniques. The results obtained showed that the survival of mice immunized with booster had 60% protection compared to the group without booster, which obtained 20% protection. Evaluating the humoral response, it was found that both IgG and IgA levels were higher in sera than in nasal washes in both treatments. In the cellular response, the increase in the percentage of positive cells was found for effector T and B lymphocytes in the nasal passages (NP) in the group with boost and nasopharynx-associated lymphoid tissue (NALT) in the group without boost and lymphocytes only. B in both treatments, as well as in memory cells treatment with boost T lymphocytes in PN and NALT and without boost in cervical lymph nodes (CG) with respect to B lymphocytes, in PN, GC and NALT in treatment with boost and NALT in treatment without booster. Therefore, the involvement of the effector immune response and memory play a fundamental role for protection against N. fowleri and for the development of vaccine candidates.

Keywords: immune response, immunological memory, naegleria fowleri, primary amebic meningoencephalitis

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Authors: Gift Chidi-Onwuta, Iwe Nkem Nkechinyere, Chikamadu Christabelle Chinyere

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The teaching of English is a resource-driven activity that requires rich resource-classroom settings for the delivery of effective lessons and the acquisition of interpersonal skills for integration in a target-language environment. However, throughout the world, English is often taught in low-resource classrooms. This paper is aimed to reveal the common problems associated with teaching English in low-resource environments and the prospects for teachers who found themselves in such undefined teaching settings. Self-structured and validated questionnaire in a closed-ended format, open question format and scaling format was administered to teachers across five countries: Nigeria, Cameroun, Iraq, Turkey, and Sudan. The study adopts situational language teaching theory (SLTT), which emphasizes a performance improvement imperative. This study inclines to this model because it maintains that learning must be fun and enjoyable like playing a favorite sport, just as in real life. Since teaching resources make learning engaging, we found this model apt for the current study. The perceptions of teachers about accessibility and functionality of teaching material resources, the nature of teaching outcomes in resource-less environments, their levels of involvement in improvisation and the prospects associated with resource limitations were sourced. Data were analysed using percentages and presented in frequency tables. Results: showed that a greater number of teachers across these nations do not have access to sufficient productive resource materials that can aid effective English language teaching. Teaching outcomes, from the findings, are affected by low material resources; however, results show certain advantages to teaching English with limited resources: flexibility and autonomy with students and creativity and innovation amongst teachers. Results further revealed group work, story, critical thinking strategy, flex, cardboards and flashcards, dictation and dramatization as common teaching strategies, as well as materials adopted by teachers to overcome low resource-related challenges in classrooms.

Keywords: teaching materials, low-resource environments, English language teaching, situational language theory

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Authors: Sarika Gupta, Harshika Khanna, Ajay K Verma, Surya Kant

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Background: Drug-resistant tuberculosis (DR-TB) is a growing health challenge to global TB control efforts. Pediatric DR-TB is one of the neglected infectious diseases. In our previously published report, we have notified an increased prevalence of DR-TB in the pediatric population at a tertiary health care centre in North India which was estimated as 17.4%, 15.1%, 18.4%, and 20.3% in (%) in the year 2018, 2019, 2020, and 2021. Limited evidence exists about a pattern of drug resistance, side effect profile and programmatic outcomes of Paediatric DR-TB treatment. Therefore, this study was done to find out the pattern of resistance, side effect profile and treatment outcome. Methodology: This was a prospective cohort study conducted at the nodal drug-resistant tuberculosis centre of a tertiary care hospital in North India from January 2021 to December 2022. Subjects included children aged between 0-18 years of age with a diagnosis of DR-TB, on the basis of GeneXpert (rifampicin [RIF] resistance detected), line probe assay and drug sensitivity testing (DST) of M. tuberculosis (MTB) grown on a culture of body fluids. Children were classified as monoresistant TB, polyresistant TB (resistance to more than 1 first-line anti-TB drug, other than both INH and RIF), MDR-TB, pre-XDR-TB and XDR-TB, as per the WHO classification. All the patients were prescribed DR TB treatment as per the standard guidelines, either shorter oral DR-TB regimen or a longer all-oral MDR/XDR-TB regimen (age below five years needed modification). All the patients were followed up for side effects of treatment once per month. The patient outcomes were categorized as good outcomes if they had completed treatment and cured or were improving during the course of treatment, while bad outcomes included death or not improving during the course of treatment. Results: Of the 50 pediatric patients included in the study, 34 were females (66.7%) and 16 were male (31.4%). Around 33 patients (64.7%) were suffering from pulmonary TB, while 17 (33.3%) were suffering from extrapulmonary TB. The proportions of monoresistant TB, polyresistant TB, MDR-TB, pre-XDR-TB and XDR-TB were 2.0%, 0%, 50.0%, 30.0% and 18.0%, respectively. Good outcome was reported in 40 patients (80.0%). The 10 bad outcomes were 7 deaths (14%) and 3 (6.0%) children who were not improving. Adverse events (single or multiple) were reported in all the patients, most of which were mild in nature. The most common adverse events were metallic taste 16(31.4%), rash and allergic reaction 15(29.4%), nausea and vomiting 13(26.0%), arthralgia 11 (21.6%) and alopecia 11 (21.6%). Serious adverse event of QTc prolongation was reported in 4 cases (7.8%), but neither arrhythmias nor symptomatic cardiac side effects occurred. Vestibular toxicity was reported in 2(3.9%), and psychotic symptoms in 4(7.8%). Hepatotoxicity, hypothyroidism, peripheral neuropathy, gynaecomastia, and amenorrhea were reported in 2 (4.0%), 4 (7.8%), 2 (3.9%), 1(2.0%), and 2 (3.9%) respectively. None of the drugs needed to be withdrawn due to uncontrolled adverse events. Conclusion: Paediatric DR TB treatment achieved favorable outcomes in a large proportion of children. DR TB treatment regimen drugs were overall well tolerated in this cohort.

Keywords: pediatric, drug-resistant, tuberculosis, adverse events, treatment

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