Search results for: public health management

Authors: Sachi Matsuoka

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This study aimed at implicating a current community health in South India focusing on a Vaidya, a non-codified traditional doctor, based on long-term field works. As the prevalence of colonic diseases is increasing in all over the world, it is needed to know the potential of non-codified medicines and how they can effectively take in a part in community health. Describing the people’s treatment seeking behaviours in a suburban village which is susceptible to modernization can give us a new insight for studying Indian medicines, that is included not only non-codified but also codified traditional ones, affected by global, national and local communities. Both qualitative and quantitative data were gathered via participatory fieldworks and open-ended interviews to a Vaidya and his 97 patients and 31 individuals who lived in a community near the Vaidya’s station. It was found that the community members seldom consulted the Vaidya while a number of patients outside the village (mainly from urban nearby area) daily visited the Vaidya. Thus, the role of the Vaidya as the community’ s primary health care provider had nearly disappeared. Nonetheless, the Vaidya was deeply respected as one of the community’ s leaders by its members because of the spiritual and financial support he provided to them. The reasons for choosing the Vaidya for the patients from urban area are characterized by several social factors of the patients such as their religious belief, seriousness, occupation and medical history. Meanwhile, not only the Vaidya but also other codified traditional medicines, e.g., Ayurveda, were less popular among the community members. It sounds paradoxical given that the traditional Indian medical system has been becoming popular as an alternative medicine in societies outside of India, such as in Europe. The community members who are less educated and engaged in religious activities in daily life preferred to allopathy, the biomedicine in Indian context. It is thus concluded that roles of non-codified medicine has changed depending on its cultural and social contexts, even though its medical system is not authorized by the government. Nowadays, traditional medical effectiveness is recognized as evidenced by scientific survey and the codified medical doctors treats diseases rather than people. However, this study implicated that people’s treatment seeking behaviors are likely based on the social context in which people live their lives even though evidenced based codified medicine is provided in their community.

Keywords: medical pluralism, non-codified medicine, south india, treatment-seeking behaviours

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Authors: Aukse Miskinyte, Audrius Dedele

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The impact of urban air pollution on human health effects has been revealed in epidemiological studies, which have assessed the associations between various types of gases and particles and negative health outcomes. The percentage of population living in urban areas is increasing, and the assessment of air pollution in certain zones in the city (like street canyons) that have higher level of air pollution and specific dispersion conditions is essential as these places tend to contain a lot of people. Street canyon is defined as a street surrounded by tall buildings on both sides that trapes traffic emissions and prevents pollution dispersion. The aim of this study was to determine the pollution of nitrogen dioxide in street canyons in Kaunas city during cold and warm seasons. The measurements were conducted using passive sampling technique during two-week period in two street canyon sites, whose axes are approximately north-south and north-northeast‒south-southwest. Both of these streets are two-lane roads of 7 meters width, one is in the central part of the city, and other is in the Old Town. The results of two-week measurements showed that the concentration of nitrogen dioxide was higher in summer season than in winter in both street canyon sites. The difference between the level of NO2 in winter and summer seasons was 5.1 and 19.4 µg/m3 in the first and in the second street canyon sites, respectively. The higher concentration of NO2 was determined in the second street canyon site than in the first, although there was calculated lower traffic intensity. These results could be related to the certain street canyon characteristics.

Keywords: air pollution, nitrogen dioxide, passive sampler, street canyon

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Authors: Sanjiv Kumar Soni, Chetna Janveja

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The approach of utilizing zero cost kitchen waste residues for growing suitable strains of fungi for the induction of a cocktail of hydrolytic enzymes and ethanol generation has been validated in the present study with the objective of developing an indigenous biorefinery for low cost bioethanol production with the generation of zero waste. Solid state fermentation has been carried out to evaluate the potential of various steam pretreated kitchen waste residues as substrates for the co-production of multiple carbohydrases including cellulases, hemicellulases, pectinase and amylases by a locally isolated strain of Aspergillus niger C-5. Of all the residues, potato peels induced the maximum yields of all the enzyme components corresponding to 64.0±1.92 IU of CMCase, 17.0±0.54 IU of FPase , 42.8±1.28 IU of β-glucosidase, 990.0±28.90 IU of xylanase, 53.2±2.12 IU of mannanase, 126.0±3.72 IU of pectinase, 31500.0±375.78 IU of α-amylase and 488.8±9.82 IU of glucoamylase/g dry substrate respectively. Saccharification of various kitchen refuse residues using inhouse produced crude enzyme cocktail resulted in the release of 610±10.56, 570±8.89, 435±6.54, 475±4.56, 445±4.27, 385±4.49, 370±6.89, 490±10.45 mg of total reducing sugars/g of dried potato peels, orange peels, pineapple peels, mausami peels, onion peels, banana stalks, pea pods and composite mixture respectively revealing carbohydrate conversion efficiencies in the range of 97.0-99.4%. After fermentation of released hexoses by Saccharomyces cerevisae, ethanol yields ranging from 80-262 mL/ kg of dry residues were obtained. The study has successfully evaluated the valorization of kitchen garbage, a highly biodegradable component in Municipal Solid Waste by using it as a substrate for the in-house co-production of multiple carbohydrases and employing the steam treated residues as a feed stock for bioethanol production. Such valorization of kitchen garbage may reduce the level of Municipal Solid Waste going into land-fills thus lowering the emissions of greenhouse gases. Moreover, the solid residue left after the bioconversion may be used as a biofertilizer for improving the fertility of the soils.

Keywords: kitchen waste, bioethanol, solid waste, bioconversion, waste management

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Authors: Pphakamani Irvine Dlamini

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The impact of supervisory gossip on subordinate work performance was investigated in this paper. The paper postulated that supervisory gossip, both bad and positive, has an impact on employee job engagement, which in turn has an impact on employee job performance. Data was collected from 238 employees and supervisors from the Mpumalanga Government Municipality in South Africa using a dyadic study approach. Employees responded to questions on supervisor gossip and job engagement, while supervisors responded to questions about employee work performance. Three waves of data gathering were carried out. Favourable superior gossip had a positive and substantial effect on employee job engagement, which increased employee job performance, according to the study, but negative superior gossip had a positive but insignificant effect on employee job engagement. The multicultural aspect of the municipality, as well as causation concerns and frequent method biases connected with research design, hampered the study. After successfully disentangling the supervisor-subordinate reciprocal communication web using Social Exchange Theory (SET), the study suggests that managers should instil effective ways for using both positive and negative gossip in the workplace to achieve favourable employee outcomes. Positive gossip creates workplace rivalry and competition, but negative gossip creates tension, stress, and mistrust among employees. This study attempted to assess the implication of supervisor gossip on employee job engagement and performance in the public service sector, whose employees are characterised by high job security as compared to their peers in the private sector.

Keywords: worlplace gossip, supervisor, employee engagement, LMX

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Authors: Arben Murtezani, Shefqet Mrasori, Vančo Spirov, Bukurije Rama, Oliver Dimitrovski, Visar Bunjaku

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Overview: Temporomandibular disorders (TMDs) are chronic musculoskeletal pain conditions. Clinical indicators of discomfort are related to the use of the joint stiffness during first motions after extended rest and restricted joint range of motion can cause substantial pain and disability. There is little evidence that physical therapy methods of management cause long-lasting reduction in signs and symptoms. Exercise programs premeditated to improve physical fitness have beneficial effects on chronic pain and disability of the musculoskeletal system. Objective: The aim of this study was to assess the effectiveness of physical therapy interventions in the management of temporomandibular disorders. Materials and Methods: A prospective comparative study with a 2-month follow-up period was conducted between April 2016 and June 2016 at the Physical Medicine and Rehabilitation Clinic in Prishtina. Forty six patients with TMDs, (more than three months duration of symptoms) were randomized into two groups: the TENS therapy group (n=24) and combination of active exercise and manual therapy group (n=22). The TENS therapy group patients were treated with twelve sessions of TENS. The treatment period of both groups was 3 weeks at an outpatient clinic. Following main outcome measures were evaluated: (1) pain at rest (2) pain at stress (3) impairment (4) mouth opening at base-line, before and after treatment and at 3 month follow-up. Results: Significant reduction in pain was observed in both treatment groups. In the TENS group 73% (16/22) achieved at least 80% improvement from baseline in TMJ pain at 2 months compared with 54% (13/24) in the exercise group (difference of 19%; 95% confidence interval 220 to 30%). Active and passive maximum mouth opening has been greater in the TENS group (p < 0.05). Conclusion: Exercise therapy in combination with TENS seems to be useful in the treatment of temporomandibular disorders.

Keywords: temporomandibular joint disorders, TENS, manual therapy, exercise

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Authors: Shiva Mardani, Mehdi Nasr-Esfahani, Majid Olia, Hamid Molahosseini, Hamed Hassanzadeh Khankahdani

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Plant-parasitic nematodes cause serious diseases on plants and effectively reduce food production in quality and quantity worldwide, with at least 17 nematode species in the three important and major genera, including Meloidogyne, Heterodera, and Pratylenchus. Root-knot nematodes (RKN), Meloidogyne spp. with the dominant species, Meloidogynejavanica, are considered as the important plant pathogens of agricultural products globally. The hosts range can be vegetables, bedding plants, grasses, shrubs, numerous weeds, and trees, including forests. In this study, chemical management was carried out on RKN, M. javanica, to investigate the efficacy of Iranian Abamectin insecticide product [acaricide Abamectin (Vermectin® 2% EC, Gyah Corp., Iran)] verses imported normal Abamectin available in the Iran markets [acaricide Abamectin (Vermectin® 1.8% EC, Cropstar Chemical Industry Co., Ltd.)] each of which at the rate of 8 L./ha, on Tomatoes, Solanumlycopersicum L., (No. 29-41, Dutch company Siemens) as a test plant, and the controls (infested to RKN and without any chemical pesticides treatments); and (sterile soil without any RKN and chemical pesticides treatments) at the greenhouse in Isfahan, Iran. The trails were repeated thrice. The results indicated a highly significant reduction in RKN population and an increase in biomass parameters at 1% level of significance, respectively. Relatively similar results were obtained in all the three experiments conducted on tomato root-knot nematodes. The treatments of Gyah-Abamectin (51.6%) and external Abamectin (40.4%) had the highest to least effect on reducing the number of larvae in the soil compared to the infected controls, respectively. Gyah-Abamectin by 44.1% and then external one by 31.9% had the highest effect on reducing the number of larvae and eggs in the root and 31.4% and 24.1% reduction in the number of galls compared to the infected controls, respectively. Based on priority, Gyah-Abamectin (47.4 % ) and external Abamectin (31.1 %) treatments had the highest effect on reducing the number of egg- masses in the root compared to the infected controls, with no significant difference between Gyah-Abamectin and external Abamectin. The highest reproduction of larvae and egg in the root was observed in the infected controls (75.5%) and the lowest in the healthy controls (0.0%). The highest reduction in the larval and egg reproduction in the roots compared to the infected controls was observed in Gyah-Abamectin and the lowest in the external one. Based on preference, Gyah-Abamectin (37.6%) and external Abamectin (26.9%) had the highest effect on the reduction of the larvae and egg reproduction in the root compared to the infected controls, respectively. Regarding growth parameters factors, the lowest stem length was observed in external Abamectin (51.9 cm), with nosignificantly different from Gyah-Abamectin and healthy controls. The highest root fresh weight was recorded in the infected controls (19.81 gr.) and the lowest in the healthy ones (9.81 gr.); the highest root length in the healthy controls (22.4 cm), and the lowest in the infected controls and external Abamectin (12.6 and 11.9 cm), respectively. Conclusively, the results of these three tests on tomato plants revealed that Gyah-Abamectin 2% compared to external Abamectin 1.8% is competitive in the chemical management of the root nematodes of these types of products and is a suitable alternative in this regard.

Keywords: solanum lycopersicum, vermectin, biomass, tomato

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Authors: Johnnie Hay

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New Zealand is well known for its natural beauty, diversity of people but also for its strong focus on mental health through the provision of a vast network of psycho-social support services. South African-trained psychologists often make New Zealand their new home when emigrating - as it is relatively simple to slot into the well-established mental health system. South Africa is bigger in size, population, GDP and probably people diversity than New Zealand but struggles to provide adequate educational and psychological support services to schools. This is mainly due to budgetary pressures brought about by the imperative to first ensure that the approximately 13 million learners all have a teacher in front of their classes and at an average ratio of not more than 40 learners per class. In this paper, perspectives on educational and psychological support in New Zealand and South African schools will be shared. Through basic qualitative research encompassing semi-structured interviews with two South African educational psychologists who returned from New Zealand, supplemented by document analysis, the New Zealand situation will be scrutinized. South African perspectives will be obtained through a number of semi-structured interviews and questionnaires administered by education support services specialists working in district-based support teams in three provinces of the country. This research is in process, but preliminary findings indicate large disparities between the two countries' emphasis, funding, post provisioning and structure regarding educational and psychological support services.

Keywords: educational psychological support services, support for learners experiencing special needs, education support services, diverse learner population

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Authors: S. N. Susenburger, D. Boecker

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In the age of Volatility, Uncertainty, Complexity, and Ambiguity (VUCA), where digital transformation is challenging long standing traditional hardware and manufacturing companies, innovation needs a different methodology, strategy, mindset, and culture. What used to be a mindset of scaling per quantity is now shifting to orchestrating ecosystems, platform business models and service bundles. While large corporations are trying to mimic the nimbleness and versatile mindset of startups in the core of their digital strategies, they’re at the frontier of facing one of the largest organizational and cultural changes in history. This paper elaborates on how a manufacturing giant transformed its Corporate Information Technology (IT) to enable digital and Internet of Things (IoT) business while establishing the mindset and the approaches of the Innovation Inside-Out/Outside-In Strategy. It gives insights into the core elements of an innovation culture and the tactics and methodologies leveraged to support the cultural shift and transformation into an IoT company. This paper also outlines the core elements for an innovation culture and how the persona 'Connected Engineer' thrives in the digital innovation environment. Further, it explores how tapping domain-focused ecosystems in vibrant innovative cities can be used as a part of the strategy to facilitate partner co-innovation. Therefore, findings from several use cases, observations and surveys led to conclusion for the strategy tandem of Innovation Inside-Out/Outside-In. The findings indicate that it's crucial in which phases and maturity level the Innovation Inside-Out/Outside-In Strategy is activated: cultural aspects of the business and the regional ecosystem need to be considered, as well as cultural readiness from management and active contributors. The 'not invented here syndrome' is a barrier of large corporations that need to be addressed and managed to successfully drive partnerships, as well as embracing co-innovation and a mindset shifting away from physical products toward new business models, services, and IoT platforms. This paper elaborates on various methodologies and approaches tested in different countries and cultures, including the U.S., Brazil, Mexico, and Germany.

Keywords: innovation management, innovation culture, innovation methodologies, digital transformation

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Authors: Özgür Emi̇nağaoğlu, Hayal Akyildirim Beğen, Şevval Sali̇oğlu

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In this study, the plant used for purification and aromatic purposes by the public in Adagül, Akpınar, Alaca, Ambarlı, Arkaköy, Avcılar, Balcı, Civan, Demirciler, Düzköy, İbrikli, Kale, Kaynarca and Taraklı villages in Borcka (Artvin) district between 2020-2022. The purpose of the study, determining the surgical common and local names, regions, botanical features, used parts of plants, purpose of use, local usage intensive, and giving literature data. The research area is located on the A8 square according to Davis's grid system; its phytogeographic extensions are in the Holarctic regions, and the Euro-Siberian flora settlement is in the Colchic subsection of the Euxine region. In the research area, 71 personal questionnaires were applied. As a result of the surveys, it was determined that 93 plant species belonging to 44 families were used by the local people for purification and aromatic purposes. The families that contain the most taxa in the research area are, respectively, Rosaceae (15 taxa), Astericaeae (9 taxa), Lamiaceae (7 taxa), Crassulaceae (4 taxa). As a result of the survey studies, Plantago major L. is known by almost all participants. The most used plants were Allium scorodoprasum, Helichrysum arenarium, Alnus glutinosa subsp. barbata, Juglans regia, Tilia rubra subsp. caucasica, Picea orientalis, Urtica dioica. These plants are used in the treatment of many diseases. Some of these plants that grow in Borçka are used in different countries for the treatment of the same diseases.

Keywords: artvin, borçka, medicinal, aromatic, plant

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Authors: Akinbo Razak Yinka, Adesanya Kehinde Kazeem, Oladokun Oluwagbenga Peter

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Time series data are sequences of observations collected over a period of time. Such data can be used to predict health outcomes, such as disease progression, mortality, hospitalization, etc. The Statistical approach is based on mathematical models that capture the patterns and trends of the data, such as autocorrelation, seasonality, and noise, while Neural methods are based on artificial neural networks, which are computational models that mimic the structure and function of biological neurons. This paper compared both parametric and non-parametric time series models of patients treated for malaria in Maternal and Child Health Centres in Lagos State, Nigeria. The forecast methods considered linear regression, Integrated Moving Average, ARIMA and SARIMA Modeling for the parametric approach, while Multilayer Perceptron (MLP) and Long Short-Term Memory (LSTM) Network were used for the non-parametric model. The performance of each method is evaluated using the Mean Absolute Error (MAE), R-squared (R2) and Root Mean Square Error (RMSE) as criteria to determine the accuracy of each model. The study revealed that the best performance in terms of error was found in MLP, followed by the LSTM and ARIMA models. In addition, the Bootstrap Aggregating technique was used to make robust forecasts when there are uncertainties in the data.

Keywords: ARIMA, bootstrap aggregation, MLP, LSTM, SARIMA, time-series analysis

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Authors: Sunday Sedodo Nupo, Clara Berstien Oguntona, Babatunde Oguntona, Oluseyi Akinloye, P. A. Olunusi Adeboye

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Cardiovascular diseases are now becoming dominant sources of morbidity and mortality worldwide. This study investigated the lipid profile of civil servants. A cross-sectional study was carried out among randomly selected 202 male and 298 female civil servants in Abeokuta Ogun state. A pretested structured questionnaire was used to elicit information on history of non-communicable diseases and physical activity pattern of the respondents. The blood pressures of the subjects were measured and classified using World Health Organization criteria. The total cholesterol (TC), triglycerides (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL). Ethical approval was obtained from Ogun State Ministry of Health. Data collected were analysed using Statistical package for social science version 17.1. Results showed that majority (76%) of the subjects were within the age range of 20 - 40 years, 75% earned between N58,500 - N98,000 monthly and 68% were sedentary. The mean energy intake of men and women were 3942±38 kcal and 2791±3 kcal respectively, while the protein intake for men was 65±49 g/day and 54.28±40 g/day for women. Desirable TC level (<200 mg/dl) was found in 80% of the selected subjects while the normal TG (<150 mg/dl) and LDL (<129 mg/dl) was found in 95% and 90% subjects respectively. The mean TC was 78.91±11 mg/dl and 62.69±9 mg/dl in men and women respectively. The study showed that most of the subjects had normal lipid in terms of serum triglycerides, total cholesterol, HDL cholesterol and LDL cholesterol.

Keywords: high density lipoprotein, morbidity, mortality, triglycerides

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Authors: Sibnath Sarkar

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Developing countries are facing many Social problems. In India, too there are several such problems. The problem of street children is one of them. No country or city anywhere in the world today is without the presence of street children, but the problem is most acute in developing countries. Thousands of street children can be seen in our populous cities like Mumbai, Kolkata, Delhi, and Chennai. Most of them are in the age group of 5-15 years. The number of street children is increasing gradually. Poverty, unemployment, rapid urbanization, rural-urban migrations are the root causes of street children. Being deprive from many of their, they have escaped to the street as a safe place for living. Street children always related with the urban spaces in the developing world and it represents a sad outcome of the rapid urbanization process. After coming to the streets, these children have to cope with the new situation every day. They also adopt or develop many complex survival strategies and a variety of different informal or even illegal activities in public space and form supportive social networks in order to survive in street life. Street children use the different suitable urban spaces as their earning, living, entertaining spot. Therefore, the livelihoods of young people on the street should analyze in relation to the spaces they use, as well as their age and length of stay on the streets. This paper tries to explore the livelihood strategies and copping situation of street children in Sealdah station area. One hundred seventy-five street living children are included in the study living in and around the railway station.

Keywords: strategies, street children, survive, urban-space

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Authors: Tae-Uk Yun, Pullip Chung, Kee-Young Kwahk, Hyunchul Ahn

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Fake news is defined as the news articles that are intentionally and verifiably false, and could mislead readers. Spread of fake news may provoke anxiety, chaos, fear, or irrational decisions of the public. Thus, detecting fake news and preventing its spread has become very important issue in our society. However, due to the huge amount of fake news produced every day, it is almost impossible to identify it by a human. Under this context, researchers have tried to develop automated fake news detection using machine learning techniques over the past years. But, there have been no prior studies proposed an automated fake news detection method for Korean news to our best knowledge. In this study, we aim to detect Korean fake news using text mining and machine learning techniques. Our proposed method consists of two steps. In the first step, the news contents to be analyzed is convert to quantified values using various text mining techniques (topic modeling, TF-IDF, and so on). After that, in step 2, classifiers are trained using the values produced in step 1. As the classifiers, machine learning techniques such as logistic regression, backpropagation network, support vector machine, and deep neural network can be applied. To validate the effectiveness of the proposed method, we collected about 200 short Korean news from Seoul National University’s FactCheck. which provides with detailed analysis reports from 20 media outlets and links to source documents for each case. Using this dataset, we will identify which text features are important as well as which classifiers are effective in detecting Korean fake news.

Keywords: fake news detection, Korean news, machine learning, text mining

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Authors: Innocent C. Abazie, Odukoya A. Olatunde, Ochuko Orakpoghenor, Bamidele J. Kolawole, Hannah L. Kolawole

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This study was carried out to obtain five-year retrospective data on dog bite cases and antirabies vaccination of dogs in relation to rabies control in Aba, Abia state, Nigeria. Data for retrospective studies (2016 - 2020) was collected from both government and private veterinary clinics in Aba. A total of 66 dog bite cases were reported between January 2016 and December 2020 with a majority of victims being adults (51.5%) within the ages of 18 – 50 years. On the prevalence of dog bite cases according to the gender of victims, males (75.8%) were mostly involved compared to female victims (24.2%). Anatomically, the majority of bite wounds (65.2%) were on the legs. The monthly distribution of bites indicates a higher frequency in the months of January and March (dry season). Local 28 (43.8%) and exotic breeds 30(46.8%) of dogs were mostly involved in the dog bite cases. The majority of the dogs (92.2%) involved in the bite cases were known dogs whose owners could be contacted, while a very few proportion (7.8%) were stray dogs. Results of this study indicated that only 16 (25%) of the offending dogs had a current antirabies vaccination record, 8 (12.5%) had an unknown vaccination record, while the largest proportion, 40 (62.5%) of the offending dogs had no current vaccination record. Public awareness of the danger of dog bites in relation to rabies and increased antirabies vaccination of dogs as a means of controlling the disease is recommended.

Keywords: Aba, dog bite, rabies, vaccination profile

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Authors: Mehdi Mirzaei Alavijeh, Farzad Jalilian

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Background: Marijuana is the most widely used illicit drug worldwide, especially among adolescents and young adults, which can cause numerous complications. The aim of this study was to determine the pattern, motivation use, and factors related to marijuana use among Iranian youths based on the integrative model of behavioral prediction Methods: A cross-sectional study was conducted among 174 youths marijuana user in Kermanshah County and Isfahan County, during summer 2014 which was selected with the convenience sampling for participation in this study. A self-reporting questionnaire was applied for collecting data. Data were analyzed by SPSS version 21 using bivariate correlations and linear regression statistical tests. Results: The mean marijuana use of respondents was 4.60 times at during week [95% CI: 4.06, 5.15]. Linear regression statistical showed, the structures of integrative model of behavioral prediction accounted for 36% of the variation in the outcome measure of the marijuana use at during week (R2 = 36% & P < 0.001); and among them attitude, marijuana refuse, and subjective norms were a stronger predictors. Conclusion: Comprehensive health education and prevention programs need to emphasize on cognitive factors that predict youth’s health-related behaviors. Based on our findings it seems, designing educational and behavioral intervention for reducing positive belief about marijuana, marijuana self-efficacy refuse promotion and reduce subjective norms encourage marijuana use has an effective potential to protect youths marijuana use.

Keywords: marijuana, youth, integrative model of behavioral prediction, Iran

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Authors: S. Haque, M. Kanapathy, E. Bollen, I. Younis, A. Mosahebi

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Background: Implant loss due to infection is the most devastating complication of implant-based breast reconstruction. The use of negative pressure wound therapy with instillation (NPWTi) for salvage of infected implant-based breast reconstructions has shown promising results to allow early reinsertion of a new implant as an alternative to current management of delayed reinsertion. This study compares the cost implication of NPWTi against current management of delayed reinsertion of infected breast implants. Methods: 20 cases of an infected breast implant treated with NPWTi (V.A.C. VERAFLO™ Therapy) followed by early re-insertion of a new implant were compared with 20 cases who had delayed reinsertion (non-NPWTi). Average cost per person was calculated using total operative expenses, cost of inpatient stay, cost of investigations, cost of antibiotics, and cost of outpatient visits. Results: Treatment with NPWTi allowed for earlier re-insertion of a new implant (NPWTi: 9.04 ± 2.92 days vs. non-NPWTi: 236.25 ± 123.89 days). The average cost per patient for NPWTi and non-NPWTi was £14,343.13 ± £2,786.70 and £8,920.31 ± £3,005.73 respectively. All patients treated with NPWTi had one admission and spent 11.9 ± 4.1days as an inpatient while non-NPWTi patients had 2.1 ± 0.3 admissions with total length of inpatient stay of 7.1 ± 5.8days. Patients treated with NPWTi had more surgeries (NPWTi: 3.35 ± 0.81 vs. non-NPWTi: 2.2 ± 0.41), however 3 non-NPWTi cases required flap reconstruction. Patients treated with NPWTi had fewer total outpatient visits (NPWTi: 12 ± 6 vs. non-NPWTi: 14.2 ± 6.3). Conclusion: Patients treated with NPWTi incurred higher average cost per patient, longer inpatient stay, and more procedures; however, had early re-insertion of new implants and fewer admissions and outpatient visits. A further study on patient-reported outcome is essential to compare cost against patient benefit.

Keywords: breast reconstruction, cost evaluation, infection, negative pressure wound therapy

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Authors: Ana Ferraz, Martim Santos, M. Graça Pereira

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Distress among parents of children with acute lymphoblastic leukemia (ALL) is common during treatment and can persist several years post-diagnosis, impacting the adjustment of children and parents themselves. Current evidence is needed to examine the scope and nature of parental distress in childhood ALL. This review focused on associated variables, predictors, and outcomes of parental distress following their ALL diagnosis of their child. PubMed, Web of Science, and PsycINFO databases were searched for English and Spanish papers published from 1983 to 2021. PRISMA statement was followed, and papers were evaluated through a standardized methodological quality assessment tool (NHLBI). Of the 28 papers included, 16 were evaluated as fair, eight as good, and four as poor. Regarding results, 11 papers reported subgroup differences, and 15 found potential predictors of parental distress, including sociodemographic, psychosocial, psychological, family, health, and ALL-specific variables. Significant correlations were found between parental distress, social support, illness cognitions, and resilience, as well as contradictory results regarding the impact of sociodemographic variables on parental distress. Family cohesion and caregiver burden were associated with distress, and the use of healthy coping strategies was associated with less anxiety. Caregiver strain contributed to distress, and the overall impact of illness positively predicted anxiety in mothers and somatization in fathers. Differences in parental distress were found regarding group risk, time since diagnosis, and treatment phases. Thirteen papers explored the outcomes of parental distress on psychological, family, health, and social/education outcomes. Parental distress was the most important predictor of family strain. Significant correlations were found between parental distress at diagnosis and further psychological adjustment of parents themselves and their children. Most papers reported correlations between parental distress on children’s adjustment and quality of life, although few studies reported no association. Correlations between maternal depression and child participation in education and social life were also found. Longitudinal studies are needed to better understand parental distress and its consequences on health outcomes, in particular. Future interventions should focus mainly on parents on distress reduction and psychological adjustment, both in parents and children over time.

Keywords: childhood acute lymphoblastic leukemia, family, parental distress, psychological adjustment, quality of life

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Authors: Rosanna M. Rooney, Sharinaz Hassan, Maryanne McDevitt, Jacob D. Peckover, Robert T. Kane

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Anxiety and depression are the most common mental health problems experienced by Australian children and adolescents. Research into youth mental health points to the importance of considering emotional competence, parental influence on the child’s emotional development, and the fact that cognitions are still developing in childhood when designing and implementing positive psychology interventions. Additionally, research into such interventions has suggested the inclusion of a coaching component aimed at supporting those implementing the intervention enhances the effects of the intervention itself. In light of these findings and given the burden of anxiety and depression in the longer term, it is necessary to enhance the Aussie Optimism Positive Thinking Skills program and evaluate its efficacy in terms of children’s mental health outcomes. It was expected that the enhancement of the emotional and cognitive aspects of the Aussie Optimism Positive Thinking Skills program, the addition of coaching, and the inclusion of a parent manual would lead to significant prevention effects in internalizing problems at post-test, 6- and 18-months after the completion of the intervention. 502 students (9-11 years old) were randomly assigned to the intervention group (n = 347) or control group (n = 155). At each time point (baseline, post-test, 6-month follow-up, and 18-month follow-up), students completed a battery of self-report measures. The ten intervention sessions making up the enhanced Aussie Optimism Positive Thinking Skills program were run weekly. At post-test and 6-month follow-up, the intervention group reported significantly lower depression than the control group, with no group differences at the 18-month follow-up. The intervention group reported significantly lower anxiety than the control group only at the 6-month follow-up, with no group differences in the post-test or at the 18-month follow-up. Results suggest that the enhanced Aussie Optimism Positive Thinking Skills program can reduce depressive and anxious symptoms in the short term and highlight the importance of universally implemented positive psychology interventions.

Keywords: positive psychology, emotional competence, internalizing symptoms, universal implementation

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Authors: Wanhyun Cho, Soonja Kang, Sangkyoon Kim, Soonyoung Park

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In this paper, we propose a novel inference algorithm for the multi-class Gaussian process classification model that can be used in the field of human behavior recognition. This algorithm can drive simultaneously both a posterior distribution of a latent function and estimators of hyper-parameters in a Gaussian process classification model with multi-class. Our algorithm is based on the Laplace approximation (LA) technique and variational EM framework. This is performed in two steps: called expectation and maximization steps. First, in the expectation step, using the Bayesian formula and LA technique, we derive approximately the posterior distribution of the latent function indicating the possibility that each observation belongs to a certain class in the Gaussian process classification model. Second, in the maximization step, using a derived posterior distribution of latent function, we compute the maximum likelihood estimator for hyper-parameters of a covariance matrix necessary to define prior distribution for latent function. These two steps iteratively repeat until a convergence condition satisfies. Moreover, we apply the proposed algorithm with human action classification problem using a public database, namely, the KTH human action data set. Experimental results reveal that the proposed algorithm shows good performance on this data set.

Keywords: bayesian rule, gaussian process classification model with multiclass, gaussian process prior, human action classification, laplace approximation, variational EM algorithm

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Authors: Nélio Veiga, Paula Ferreira, Tiago Correia, Maria J. Correia, Carlos Pereira, Odete Amaral, Ilídio J. Correia

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Introduction: The application of fissure sealants is considered to be an important primary prevention method used in dental medicine. However, the formation of microleakage gaps between tooth enamel and the fissure sealant applied is one of the most common reasons of dental caries development in teeth with fissure sealants. The association between various dental biomaterials may limit the major disadvantages and limitations of biomaterials functioning in a complementary manner. The present study consists in the incorporation of a cariostatic agent – silver diamine fluoride (SDF) – in a resin-based fissure sealant followed by the study of release kinetics by spectrophotometry analysis of the association between both biomaterials and assessment of the inhibitory effect on the growth of the reference bacterial strain Streptococcus mutans (S. mutans) in an in vitro study. Materials and Methods: An experimental in vitro study was designed consisting in the entrapment of SDF (Cariestop^® 12% and 30%) into a commercially available fissure sealant (Fissurit^®), by photopolymerization and photocrosslinking. The same sealant, without SDF was used as a negative control. The effect of the sealants on the growth of S. mutans was determined by the presence of bacterial inhibitory halos in the cultures at the end of the incubation period. In order to confirm the absence of bacteria in the surface of the materials, Scanning Electron Microscopy (SEM) characterization was performed. Also, to analyze the release profile of SDF along time, spectrophotometry technique was applied. Results: The obtained results indicate that the association of SDF to a resin-based fissure sealant may be able to increase the inhibition of S. mutans growth. However, no SDF release was noticed during the in vitro release studies and no statistical significant difference was verified when comparing the inhibitory halo sizes obtained for test and control group.  Conclusions: In this study, the entrapment of SDF in the resin-based fissure sealant did not potentiate the antibacterial effect of the fissure sealant or avoid the immediate development of dental caries. The development of more laboratorial research and, afterwards, long-term clinical data are necessary in order to verify if this association between these biomaterials is effective and can be considered for being used in oral health management. Also, other methodologies for associating cariostatic agents and sealant should be addressed.

Keywords: biomaterial, fissure sealant, primary prevention, silver diamine fluoride

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Authors: Alex Hughes

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Patients with advanced heart failure develop specific palliative care needs due to the progressive symptom burden and unpredictable disease trajectory. NICE guidance advises that palliative care should be provided to patients with both cancer and non-cancer conditions as and when required. However, there is some way to go before this guidance is consistently and effectively implemented nationwide in conditions such as heart failure. The Ambitions for Palliative and End of Life Care: A national framework for local action in England provides a set of foundations and ambitions which outline a vision for what high-quality palliative and end-of-life care look like in England. This poster aims to critically consider how to improve access to palliative care for heart failure patients in England by analysing the foundations taken from this framework to generate specific recommendations using Soft Systems Methodology (SSM). The eight foundations analysed are: ‘Personalised care planning’, ‘Shared records’, ‘Evidence and information’, ‘Involving, supporting and caring for those important to the dying Person’, ‘Education and training’, ‘24/7 access’, ‘Co-design’ and ‘Leadership.’ A number of specific recommendations have been generated which highlight a need to close the evidence-policy gap and implement policy with sufficient evidence. These recommendations, alongside the creation of an evidence-based national strategy for palliative care and heart failure, should improve access to palliative care for heart failure patients in England. Once implemented, it will be necessary to evaluate the effect of these proposals to understand if access to palliative care for heart failure patients actually improves.

Keywords: access, health systems, heart failure, palliative care

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

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Objectives: Atopic diseases are increasingly prevalent among children and adolescents, both locally and internationally. One of the possible contributing factors could be the hypercholesterolemia which leads to cholesterol accumulation in macrophages and other immune cells that would eventually promote inflammatory responses, including augmentation of toll-like receptor (TLR). Meanwhile, physical activity is well known for its beneficial effects against the condition of hypercholesterolemia and incidence of atopic diseases. This study, therefore, explored whether atopic diseases were associated with increased cholesterol levels and whether physical activity habit influenced this association. Methods: This is a sub-study derived from the longitudinal cohort study which recruited a group of children at five years of age in Kindergarten 3 (K3) to investigate the long-term impact of family socioeconomic status on child development. In 2018/19, adolescents (average age: 13 years old) were asked to report their physical activity habit and history of any atopic diseases. During health assessment, peripheral blood samples were collected from the adolescents to study their lipid profile [total cholesterol, high-density lipoprotein (HDL)-cholesterol, and low-density lipoprotein (LDL)-cholesterol]. Regression analyses were performed to test the relationships between variables of interest. Results: Among the 315 adolescents, 99 (31.4%) reported to have allergic rhinitis. There were 45 (14.3%) with eczema, 17 (5.4%) with a food allergy, and 12 (3.8%) with asthma. Regression analyses showed that adolescents with a history of any type of atopic diseases had significantly higher total cholesterol (B=13.3, p < 0.01) and LDL cholesterol (B=7.9, p < 0.05) levels. Further subgroup analyses were conducted to examine the effect of physical activity level on the association between atopic diseases and cholesterol levels. We found stronger associations among those who did not meet the World Health Organization recommendation of at least 60 minutes of moderate-to-vigorous activities each day (total cholesterol: B=15.5, p < 0.01; LDL cholesterol: B=10.4, p < 0.05). For those who met this recommendation, the associations between atopic diseases and cholesterol levels became insignificant. Conclusion: Our study results support the current research evidence on the relationship between an elevated level of cholesterol and atopic diseases. More importantly, our results provide preliminary support for the protective effect of regular exercises against elevated cholesterol level due to atopic diseases. The findings highlight the importance of a healthy lifestyle for keeping cholesterol levels in the normal range, which can bring benefits to both physical and mental health.

Keywords: atopic diseases, Chinese adolescents, cholesterol level, physical activity

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Authors: Maria Luz Macasinag

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This study aims to determine and to examine critically successful family-owned higher educational institutions towards identifying the attributes and practices that may likely have led to their success. This research is confined to private, non-sectarian, family-owned higher institutions of learning that have been operating for more than fifty years, had only one founder and had at least two transitions in terms of generation. The criteria for selecting family-owned universities to be part of the cases under investigation include institutions (1) with increasing enrollment over the past five years, with level III accreditation status, (3) with good performance in the Board examinations in most of its programs and (4) with high employability of graduates. The study uses the multiple case study method. A model based on the cross-case analysis of the attributes and practices of all the case studies of successful family- owned higher institutions of learning is the output. The paper provides insights to current and future school owners and administrators in the management of their institutions for competitiveness, sustainability and advancement. This research encourages the evaluation of how the ideas that may lead to the success of schools owned by families in developing a sense of community, a reciprocal relationship among colleagues, the students and other stakeholders will result to the attainment of the vision and mission of the school. The study is beneficial to entrepreneurs and to business students whose know-how may provide insights that would be helpful in guiding prospective school owners. The commission on higher education and the Department of Education stand to benefit from this academic paper for the guidance that they provide to family-owned educational institutions. Banks and other financial institutions may find valuable ideas from this academic paper for the purpose of providing financial assistance to colleges and universities that are family-owned. Researchers in the field of educational management and administration may be able to extract from this study related topics for future research.

Keywords: administration practices, attributes, family-owned schools, success factors

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Authors: Wahhaj Ahmed Farooqi, Bilal Ahmad, Sandra Maritza Zambrano Bernal

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In view of structural engineering, monitoring of structural responses over time is of great importance with respect to recent developments of construction technologies. Recently, developments of advanced computing tools have enabled researcher’s better execution of structural health monitoring (SHM) and control systems. In the last decade, building information modeling (BIM) has substantially enhanced the workflow of planning and operating engineering structures. Typically, building information can be stored and exchanged via model files that are based on the Industry Foundation Classes (IFC) standard. In this study a modeling approach for semantic modeling of SHM and control systems is integrated into the BIM methodology using the IFC standard. For validation of the modeling approach, a laboratory test structure, a four-story shear frame structure, is modeled using a conventional BIM software tool. An IFC schema extension is applied to describe information related to monitoring and control of a prototype SHM and control system installed on the laboratory test structure. The SHM and control system is described by a semantic model applying Unified Modeling Language (UML). Subsequently, the semantic model is mapped into the IFC schema. The test structure is composed of four aluminum slabs and plate-to-column connections are fully fixed. In the center of the top story, semi-active tuned liquid column damper (TLCD) is installed. The TLCD is used to reduce effects of structural responses in context of dynamic vibration and displacement. The wireless prototype SHM and control system is composed of wireless sensor nodes. For testing the SHM and control system, acceleration response is automatically recorded by the sensor nodes equipped with accelerometers and analyzed using embedded computing. As a result, SHM and control systems can be described within open BIM, dynamic responses and information of damages can be stored, documented, and exchanged on the formal basis of the IFC standard.

Keywords: structural health monitoring, open building information modeling, industry foundation classes, unified modeling language, semi-active tuned liquid column damper, nondestructive testing

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Authors: Ilona Buchem, Carolin Gellner

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The call for the support of senior learners in the development of digital literacy has become prevalent in recent years, especially in view of the aging societies paired with advances in digitalization in all spheres of life, including e-health. The goal has been to create opportunities for learning that incorporate the use of context in a reflective and dialogical way. Contextual learning has focused on developing skills through the application of authentic problems. While major research efforts in supporting senior learners in developing digital literacy have been invested so far in e-learning, focusing on knowledge acquisition and cognitive tasks, little research exists in reflective mentoring and coaching with the help of pedagogical agents and addressing the contextual dimensions of learning. This paper describes an approach to creating opportunities for senior learners to improve their digital literacy in the authentic context of the electronic health record (EHR) with the support of an intelligent virtual learning coach. The paper focuses on the design of the virtual coach as part of an e-learning system, which was developed in the EPA-Coach project founded by the German Ministry of Education and Research. The paper starts with the theoretical underpinnings of contextual learning and the related design considerations for a virtual learning coach based on previous studies. Since previous research in the area was mostly designed to cater to the needs of younger audiences, the results had to be adapted to the specific needs of senior learners. Next, the paper outlines the stages in the design of the virtual coach, which included the adaptation of the design requirements, the iterative development of the prototypes, the results of the two evaluation studies and how these results were used to improve the design of the virtual coach. The paper then presents the four prototypes of a senior-friendly virtual learning coach, which were designed to represent different preferences related to the visual appearance, the communication and social interaction styles, and the pedagogical roles. The first evaluation of the virtual coach design was an exploratory, qualitative study, which was carried out in October 2020 with eight seniors aged 64 to 78 and included a range of questions about the preferences of senior learners related to the visual design, gender, age, communication and role. Based on the results of the first evaluation, the design was adapted to the preferences of the senior learners and the new versions of prototypes were created to represent two male and two female options of the virtual coach. The second evaluation followed a quantitative approach with an online questionnaire and was conducted in May 2021 with 41 seniors aged 66 to 93 years. Following three research questions, the survey asked about (1) the intention to use, (2) the perceived characteristics, and (3) the preferred communication/interaction style of the virtual coach, i. e. task-oriented, relationship-oriented, or a mix. This paper follows with the discussion of the results of the design process and ends with conclusions and next steps in the development of the virtual coach including recommendations for further research.

Keywords: virtual learning coach, virtual mentor, pedagogical agent, senior learners, digital literacy, electronic health records

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Authors: Lilik Sudiajeng, Wiraga Wayan, Lanang Parwita I Gusti

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This is the ongoing research started in 2013 with the final aim is to design the recharge wells both for housing and industry for ground water conservation in Bali - Indonesia. The research started in Denpasar Regency, one of the strategic areas in Bali. The research showed that there is some critical area of ground water resources, especially in north and west part of Denpasar Regency. It driven by the rapid increase of the tourism industry which is followed by the high rate of population, change of land use that leads to the decreasing of rain water catchment areas, and less awareness on preserve natural resources, including ground water. Focus Group Discussion concluded that in order to solve the problem of groundwater crisis, requires the contribution of all parties, started from making simple recharge well for housing. Because of the availability of land is limited and expensive, it is necessary to present an ergonomic shallow recharge well in accordance with the ability of the family or community. The ergonomics shallow recharge well is designed based on the data of hydrology and the characteristics of soil. The design is very flexible depending on the availability of land, environmentally friendly, energy efficient, culture-based, and affordable. To meet the recommended standard of ground water quality, then it equipped with a filtration and sedimentation ponds. Before design recharge wells is disseminated to the public, it is necessary to analyze the effectiveness of the wells to harvest and absorb rainwater into the ground.

Keywords: ergonomics, ground water resources, recharge well, sustainable

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Authors: Othman M. Hakami, Abdul Jabbar Al-Rajab

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Occurrence of heavy metals in water resources increased in the recent years albeit at low concentrations. Lead (PbII) is among the most important inorganic pollutants in ground and surface water. However, removal of this toxic metal efficiently from water is of public and scientific concern. In this study, we developed a rapid and efficient removal method of lead from water using chitosan/magnetite nanoparticles. A simple and effective process has been used to prepare chitosan/magnetite nanoparticles (NPs) (CS/Mag NPs) with effect on saturation magnetization value; the particles were strongly responsive to an external magnetic field making separation from solution possible in less than 2 minutes using a permanent magnet and the total Fe in solution was below the detection limit of ICP-OES (<0.19 mg L-1). The hydrodynamic particle size distribution increased from an average diameter of ~60 nm for Fe3O4 NPs to ~75 nm after chitosan coating. The feasibility of the prepared NPs for the adsorption and desorption of Pb(II) from water were evaluated using Chitosan/Magnetite NPs which showed a high removal efficiency for Pb(II) uptake, with 90% of Pb(II) removed during the first 5 minutes and equilibrium in less than 10 minutes. Maximum adsorption capacities for Pb(II) occurred at pH 6.0 and under room temperature were as high as 85.5 mg g-1, according to Langmuir isotherm model. Desorption of adsorbed Pb on CS/Mag NPs was evaluated using deionized water at different pH values ranged from 1 to 7 which was an effective eluent and did not result the destruction of NPs, then, they could subsequently be reused without any loss of their activity in further adsorption tests. Overall, our results showed the high efficiency of chitosan/magnetite nanoparticles (NPs) in lead removal from water in controlled conditions, and further studies should be realized in real field conditions.

Keywords: chitosan, magnetite, water, treatment

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Authors: Cristian Matti, Valerie Fowles, Eva Enyedi, Piotr Pogorzelski

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The system mapping process can be defined as a knowledge service where a team of facilitators, experts and practitioners facilitate a guided conversation, enable the exchange of information and support an iterative curation process. System mapping processes rely on science-based tools to introduce and simplify a variety of components and concepts of socio-technical systems through metaphors while facilitating an interactive dialogue process to enable the design of co-created maps. System maps work then as “artifacts” to provide information and focus the conversation into specific areas around the defined challenge and related decision-making process. Knowledge management facilitates the curation of that data gathered during the system mapping sessions through practices of documentation and subsequent knowledge co-production for which common practices from data science are applied to identify new patterns, hidden insights, recurrent loops and unexpected elements. This study presents empirical evidence on the application of these techniques to explore mechanisms by which visual tools provide guiding principles to portray system components, key variables and types of data through the lens of climate change. In addition, data science facilitates the structuring of elements that allow the analysis of layers of information through affinity and clustering analysis and, therefore, develop simple indicators for supporting the decision-making process. This paper addresses methodological and empirical elements on the horizontal learning process that integrate system mapping through visual tools, interpretation, cognitive transformation and analysis. The process is designed to introduce practitioners to simple iterative and inclusive processes that create actionable knowledge and enable a shared understanding of the system in which they are embedded.

Keywords: indicators, knowledge management, system mapping, visual tools

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Authors: Georgitta Joseph Valiyamattam

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Autism spectrum disorders (ASD) are a growing phenomenon in India with over 10 million cases being recorded. Children with various levels and forms of ASD can be a major challenge both within the context of regular or special schooling. According to statistics by the Centers for Disease Control and Prevention (CDC), one in every 88 children today is born with autism spectrum disorder (ASD) against a ratio of one in 110 few years back. The growing number of children with autism spectrum disorders places greater demands on health services and necessitates the roping in of non-traditional modes of treatment to complement or even substitute traditional health care methods when possible. Research evidence, particularly from Western countries, as also some parts of Asia, suggests that animal-assisted therapy, or zootherapy, may be used as an effective individual or complementary therapeutic tool for increasing overall wellbeing and quality of life among children with Autism spectrum disorders. The paper through a case-study format seeks to evaluate the efficacy (initial stage) of animal assisted therapy (canine-therapy with visiting dog: breed-Golden retriever), as a non-conventional treatment modality for improving cognitive functioning and managing the behavioral and psychological symptoms of Autism Spectrum Disorders. As a pilot study forming the basis for subsequent larger application of AAT, it analyses areas of efficacy as also the challenges faced, both with regard to the mode of therapy, as also particular to the Indian setting.

Keywords: animal assisted therapy, autism, canine therapy, analyzing initial efficacy

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Authors: Veliswa Nonfundo Hoho, Jabulani Gilford Kheswa

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This paper reports on teenage motherhood and its adverse outcomes on the academic performance, emotional well-being and sexual relationships that adolescent females encounter. Drawing from Ryff’s six dimensions of psychological well-being and Bronfenbrenner’s ecological model which underpinned this study, teenage motherhood has been found to link with multiple factors such as poverty, negative self-esteem, substance abuse, cohabitation, intimate partner violence and ill-health. Furthermore, research indicates that in schools where educators fail to perform their duties as loco-parentis to motivate adolescent females learners who are mothers, absenteeism, poor academic performance and learned helplessness, are likely. The aim of this research was two-fold, namely; (i) to determine the impact of teenage motherhood on the psychological well-being of the teenage mothers and (ii) to investigate the policies which protect the human rights of teenage mothers attending secondary schools. In a qualitative study conducted in one secondary school, Fort Beaufort, Eastern Cape, South Africa, fifteen Xhosa-speaking teenage mothers, aged 15-18 years old, were interviewed. The sample was recruited by means of snow-ball sampling. To safeguard the human dignity of the respondents, informed consent, confidentiality, anonymity and privacy of the respondents were assured. For trustworthiness, this research ensured that credibility, neutrality, and transferability, are met. Following an axial and open coding of responses, five themes were identified; Health issues of teenage mothers, lack of support, violation of human rights, impaired sense of purpose in life and intimate partner-violence. From these findings, it is clear that teenage mothers lack resilience and are susceptible to contract sexually transmitted infections and HIV/AIDS because they are submissive and hopeless. Furthermore, owing to stigma that the teenage mothers' experience from family members, they resort to alcohol and drug abuse, and feel demotivated to bond with their babies. In conclusion, the recommendations are that the Health and Social Development departments collaborate to empower the psychological well-being of teenage mothers. Furthermore, school policies on discrimination should be enacted and consistently implemented.

Keywords: depression, discrimination, self-esteem, teenage mothers

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