Search results for: rural hospitals

Authors: Muhammad Adil

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Women in different parts of the world confront several barriers to accomplishing their legal rights, particularly political rights. One of the common barriers in this respect is the indigenous culture of the locality. In the same way, women in Khyber Pakhtunkhwa are facing difficulties in accomplishing their political rights. The most significant obstacle in this context is Pakhtunwali, the traditional code of conduct in Pakhtun society, which is perceived as a substantial impediment for Pakhtun women in practicing their political rights as guaranteed by the Constitution of Pakistan and international legal instruments. Several codes of Pakhtunwali, like peghor (slander or abuse), tor (blame or disgraced), sharam (shame and dishonor), purdah (gender segregation), and ghayrat (honor) have a prominent role in this regard. The research approach employed a combination of both qualitative and quantitative methods to ensure a thorough exploration of the subject. Not only different documents have been analyzed but also a questionnaire has been developed to get accurate findings. Simultaneously, both primary and secondary data have been utilized. The finding shows that the Pakhtun culture is a formidable hurdle in accomplishing women’s political rights in Pakhtun society, particularly in rural areas. Observation reveals that a prevailing societal perception is that having women as their representatives would be viewed as a challenge to the honor of Pakhtun men. Consequently, women candidates who participated in the general elections in Khyber Pakhtunkhwa received only 1 percent or less than 1 percent of the votes compared to their male counterparts. It is recommended that certain codes of Pakhtunwali should be redefined and made compatible with international legal instruments.

Keywords: constitution, fundamental rights, honor, pakhtunwali.

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Authors: Akinsola Oluwatosin, Udofia Samuel, Odofin Mayowa

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The study is aimed at assessing the Geographic Information System (GIS)-based spatial analysis of Survival Pattern and Treatment Outcomes of Multi-Drug Resistant Tuberculosis (MDR-TB) cases for Lagos, Nigeria, with an objective to inform priority areas for public health planning and resource allocation. Multi-drug resistant tuberculosis (MDR-TB) develops due to problems such as irregular drug supply, poor drug quality, inappropriate prescription, and poor adherence to treatment. The shapefile(s) for this study were already georeferenced to Minna datum. The patient’s information was acquired on MS Excel and later converted to . CSV file for easy processing to ArcMap from various hospitals. To superimpose the patient’s information the spatial data, the addresses was geocoded to generate the longitude and latitude of the patients. The database was used for the SQL query to the various pattern of the treatment. To show the pattern of disease spread, spatial autocorrelation analysis was used. The result was displayed in a graphical format showing the areas of dispersing, random and clustered of patients in the study area. Hot and cold spot analysis was analyzed to show high-density areas. The distance between these patients and the closest health facility was examined using the buffer analysis. The result shows that 22% of the points were successfully matched, while 15% were tied. However, the result table shows that a greater percentage of it was unmatched; this is evident in the fact that most of the streets within the State are unnamed, and then again, most of the patients are likely to supply the wrong addresses. MDR-TB patients of all age groups are concentrated within Lagos-Mainland, Shomolu, Mushin, Surulere, Oshodi-Isolo, and Ifelodun LGAs. MDR-TB patients between the age group of 30-47 years had the highest number and were identified to be about 184 in number. The outcome of patients on ART treatment revealed that a high number of patients (300) were not ART treatment while a paltry 45 patients were on ART treatment. The result shows the Z-score of the distribution is greater than 1 (>2.58), which means that the distribution is highly clustered at a significance level of 0.01.

Keywords: tuberculosis, patients, treatment, GIS, MDR-TB

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Authors: Thuy Hang Le

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Traditional agroforestry systems are land-use practices still widespread in tropical and subtropical countries, while in Europe have significantly decreased due to land-use intensification, land abandonment, and urbanization. Nevertheless, scientific evidence reveals that traditional agroforestry systems significantly support biodiversity and ecosystem services and may positively contribute to socioeconomic rural regional development. We worked out a review that follows the PRISMA approach and compiled comprehensive information on traditional agroforestry systems in Europe. Based on the differentiation of different land-use systems, also considering the agricultural as well as forestry components, we compiled information regarding current distribution, management (agrodiversity), biodiversity and agrobiodiversity, ecosystem and landscape services, threats, and restoration initiatives. From a total of 3,304 studies that dealt with agroforestry systems in Europe, both “modern” (e.g., buffer strip) and “traditional” (e.g., meadow orchards), we filtered out 158 studies from 35 European countries which represent the basis for in-depth investigation. We found, for example, that the traditional pastoral agroforestry system in the Mediterranean region, the so-called Dehesa, can harbor up to 300 plant species as well as 238 bird species, of which 134 are breeding birds. With regard to carbon storage, the traditional orchard agroforestry system in Germany stocks ranged between 6.5 and 9.8 Mg C ha−1, showing significantly higher values compared to an intensively used grassland with around 3.4 to 6.7 Mg C ha−1. With the remarkably high benefit for biodiversity and ecosystem services provided, the important role and multifunctionality of traditional agroforestry systems in Europe should be acknowledged and promoted.

Keywords: biodiversity, ecosystem services, landscape services, traditional agroforestry systems

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Authors: Ilirian Laçi, Alketa Spahiu

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Big strums of thyroid glandule observed by a simple viewing can be witnessed in everyday life. Medical cabinets evidence patients withpalpablenodes of thyroid glandule, mainly nodes of the size of 10 millimeters. Further, more cases which have resulted in negative under palpation have resulted in positive at ultrasound examination. Therefore, the use of ultrasound for diagnosing has increased the number of patients with nodes of thyroid glandule in the last couple of decades in all countries, Albania included. Thus, there has been evidence of an increased number of patients affected by this pathology, where female patients dominate. Demographically, the capital shows high numbers due to the high population, but of interest is the high incidence of those areas distanced from the sea. While regarding related pathologies, no significant link was evidenced, an element of ancestry was evident in the nodes of the thyroid glandule. When we talk of nodes of the thyroid glandule, we should consider hyperplasia, neoplasia, and inflammatory diseases that cause nodes of the thyroid glandule. This increase parallels the world’s increase of the incidence of thyroid glandule, with malign cases, which are at about 5% and are not depended on size. Given the numbers, with most thyroid glandule nodes being benign, the main objective of the examination of the nodes was the determination of benign and malign cases to avoid undue surgery. Subject of this study were 212 patients that underwent fine-needle aspiration (FNA) under ultrasound guidance at the Medical University Center of Tirana. All the patients came to the Mother Teresa University Hospital from public and private hospitals and other polyclinics. These patients had an ultrasound examination before visiting the Center of Nuclear Medicine for a scintigraph of thyroid glandule in the period September 2016 and September 2017. To correlate, all patients had been examined via ultrasound of the thyroid glandule prior to the scintigraph. The ultrasound included evaluation of the number of nodes, their size, their solid, cystic, or solid-cystic structure, echogenicity according to the gray scale, the presence of calcification, the presence of lymph nodes, the presence of adenopathy, and the correlation of the cytology results from the Laboratory of Pathological Anatomy of Medical University Center of Tirana.

Keywords: thyroid nodes, fine needle aspiration, ultrasound, scintigraphy

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Authors: Yoseph Gela Ali

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Inadequate quality and quantity diet is one of the major reasons for high levels of malnutrition in pregnant women. Across-sectional survey was conducted in Shashemene District, Southern Oromia Region. A two-stage cluster sampling technique was used to select a representative sample of 15190 pregnant women aged 20-50 years from four rural villages Energy and nutrient intakes from foods were calculated from one-day weighed food records on a sub-sample (n = 83). The result of the study showed that the intakes of most nutrients were lower than the recommended intake. The energy intake of the study participants both in 2nd and 3rd trimesters of pregnancy were 2,308 kcal and 1,420.5 kcal compared to the recommended 2,340 kcal and 2,452 kcal, respectively. Except iron, almost all micronutrient intakes were lower than the recommended intake. Vitamin A intake was 3 µg compared with the recommended 800 µg, while protein intake of the study respondents in 2nd and 3rd trimester of pregnancy was 45.9 g and 31.5 g, respectively, compared with the recommended 71 g. Risk factors for under nutrition were multiple pregnancy and no consumption of cereal-based foods. This study revealed that the energy and nutrient intake of the pregnant women in the study area was below the recommended intakes. Furthermore, the situation might be aggravated by the high phytate content food consumption reported. Nutritional status of pregnant women in the study area was not adequate to support the increased energy and nutrient requirement of the participants.

Keywords: nutrition, pregnancy, protein, vitamin, energy

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Authors: Stefano Barone

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Seismic retrofit of buildings through base isolation represents a consolidated protection strategy against earthquakes. It consists in decoupling the ground motion from that of the structure and introducing anti-seismic devices at the base of the building, characterized by high horizontal flexibility and medium/high dissipative capacity. This allows to protect structural elements and to limit damages to non-structural ones. For these reasons, full functionality is guaranteed after an earthquake event. Base isolation is applied extensively to both new and existing buildings. For the latter, it usually does not require any interruption of the structure use and occupants evacuation, a special advantage for strategic buildings such as schools, hospitals, and military buildings. This paper describes the application of seismic isolation to three existing masonry buildings in Italy: Villa “La Maddalena” in Macerata (Marche region), “Giacomo Matteotti” and “Plinio Il Giovane” school buildings in Perugia (Umbria region). The seismic hazard of the sites is characterized by a Peak Ground Acceleration (PGA) of 0.213g-0.287g for the Life Safety Limit State and between 0.271g-0.359g for the Collapse Limit State. All the buildings are isolated with a combination of free sliders type TETRON® CD with confined elastomeric disk and anti-seismic rubber isolators type ISOSISM® HDRB to reduce the eccentricity between the center of mass and stiffness, thus limiting torsional effects during a seismic event. The isolation systems are designed to lengthen the original period of vibration (i.e., without isolators) by at least three times and to guarantee medium/high levels of energy dissipation capacity (equivalent viscous damping between 12.5% and 16%). This allows the structures to resist 100% of the seismic design action. This article shows the performances of the supplied anti-seismic devices with particular attention to the experimental dynamic response. Finally, a special focus is given to the main site activities required to isolate a masonry building.

Keywords: retrofit, masonry buildings, seismic isolation, energy dissipation, anti-seismic devices

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Authors: Indrajeet Kumar, Jayanta Bhattacharya

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This study was evaluated for the potential use of nanosilver (nAg) as a disinfectant and antimicrobial growth promoter supplement for the poultry. The experiments were conducted in the Kangsabati river basin region, in West Medinipur district, West Bengal, India for six months. Two poultry farms were adopted for the experiment. The rural economy of this region from Jhargram to Barkola is heavily dependent on contract poultry farming. The water samples were collected from the water source of poultry farm which has been used for poultry drinking purpose. The bacteriological analysis of water sample revealed that the total bacterial count (total coliform and E. coli) were higher than the acceptable standards. The bacterial loads badly affected the growth performance and health of the poultry. For disinfection, a number of chemical compounds (like formaldehyde, calcium hypochloride, sodium hypochloride, and sodium bicarbonate) have been used in typical commercial formulations. However, the effects of all these chemical compounds have not been significant over time. As a part of our research-to-market initiative, we used nanosilver (nAg) formulation as a disinfectant. The nAg formulation was synthesized by hydrothermal technique and characterized by UV-visible, TEM, SEM, and EDX. The obtained results revealed that the mortality rate of poultry was reduced due to nAg formulation compared to the mortality rate of the negative control. Moreover, the income of the farmer family was increased by 10-20% due to less mortality and better health of the poultry.

Keywords: farm water, nanosilver, field application, and poultry performance

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Authors: Festus Epetimehin

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Agriculture remains the dominant sector in the rural areas where over 70% of Nigerian reside and it’s still the backbone of our economy. The observed poor performance of farmers in agricultural productivity is due to the nature of risks and uncertainties in agriculture.Agricultural insurance is one of the mechanisms by which farmers can stabilize farm income and investment. The study examined the relationship between agricultural insurance scheme (AIS) and performance of agribusiness in Nigeria. The study adopted exploratory research design which is an ex-ante research approach. One hundred copies of structured questionnaire were administered for the purpose of the study. Correlation analysis and regression analysis were employed for the study. The correlation analysis of the finding revealed that the independent variable; agricultural insurance scheme (AIS) is positively and significantly correlated with the set of dependent variables; where turnover (ABT)=0.582**, profitability (ABP)=0.321**, solvency (ABS)=0.418**and cost of production (ABC)=0.23** respectively. The regression analysis result also revealed the degree of relationship between the independent variable (AIS) and set of dependent variables where one(1%) percent increase in independent variable will lead to 33.9% (ABT), 9.7% (ABP), 17.5%(ABS) and 1.5%(ABC).The study recommended that the Federal Government in collaboration with the participating Agricultural insurers embark on awareness campaign through to the length and breadth of Nigeria on government support and insurance scheme for farmers. Government should also ensure that the loan and insurance scheme should extend beyond the mechanized farmers and include the intensive subsistence farmers in view of the fact that they are the dominants in most of the farm produce markets.

Keywords: agribusiness, agricultural insurance, performance, turnover, solvency, agricultural risks

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Authors: A. Vinod Kumar, G. Sunny Deol, Rakesh Kumar, B. Chandra

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Application of fiber reinforcement in road construction is gaining some interest in enhancing soil strength. In this paper, the natural Geotextile material obtained from gunny bags was used due to vast local availability material. Construction of flexible pavement on weaker soil such as clay soils are a significant problem in construction as well as in design due to its expansive characteristics. Jute Geotextile (JGT) was used on a foundation layer of flexible pavement on rural roads. This problem will be conquered by increasing the subgrade strength by decreasing sub-base layer thickness by improving their overall pavement strength characteristics which ultimately reduces the cost of construction and leads to economically design. The California Bearing Ratio (CBR), unconfined compressive strength (UCS) and triaxial laboratory tests were conducted on two different soil samples CI and MI. Weaker soil is reinforced with JGT, JGT+Bitumen; JGT+polythene sheet was varied with heights while performing the laboratory tests. Subgrade strength evaluation was investigated by conducting soak CBR test in the laboratory for clayey and silt soils. Laboratory results reveal that reinforced soak CBR value of clayey soil (CI) observed was 10.35%, and silty soil (MI) was 15.6%. This study intends to develop new technique for reinforcing weaker soil with JGT varying parameters for the need of low volume flexible pavements. It was observed that the performance of JGT is inferior when used with bitumen and polyethylene sheets.

Keywords: CBR, Jute geotextile, low volume road, weaker soil

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Authors: Kashyap L. Mokariya, Varsha A. Shah, Makarand M. Lokhande

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As the current status and growth of Indian automobile industry is remarkable, transportation sectors are the main concern in terms of Energy security and climate change. Rising demand of fuel and its dependency on other countries affects the GDP of nation. So in this context if the 10 percent of vehicle got operated in Electrical mode how much saving in terms of Rs and in terms of liters is achieved has been analyzed which is also a part of Nations Electric mobility mission plan. Analysis is also done for converting unit consumption of Electricity of Electric vehicle into equivalent fuel consumption in liters which shows that at present tariff rate Electrical operated vehicles are far more beneficial. It also gives benchmark to the authorities to set the tariff rate for Electrical vehicles. Current situation of Indian grid is shown and how the Gap between Generation and Demand can be reduced is analyzed in terms of increasing generation capacity and Energy Conservation measures. As the certain regions of country is facing serious deficit than how to take energy conservation measures in Industry and especially in rural areas where generally Energy Auditing is not carried out that is analyzed in context of Electric vehicle penetration in near future. Author was a part of Vishvakarma yojna where in 255 villages of Gujarat Energy losses were measured and solutions were given to mitigate them and corresponding report to the authorities of villages was delivered.

Keywords: vehiclepenetration, feasibility, Energyconservation, future grid, Energy security, pf controller

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Authors: Ayushi Mishra

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Migrant construction workers or construction labors are one of the majority of the working population in our urban and rural areas. Even after being the majority, their involvement in the upbringing of the economy is hardly ever documented or recognized. Non-permanent or migrant workers face loads of exploitations and susceptibilities than other informal sector workers in India which in turn has affected the productivity of the labors. The relation of their employment and migration and the links of these dynamics to their housing and other basic needs in the city are mostly unstated. Even the urban planning and housing policies do not make thoughtful provision for them, they forcing them to live in extremely wretched conditions. And even if the policies are made, it frequently happens that they are not implemented. As the issue is very much prevalent in today’s time in India with so many large-scale and labor extensive projects going on, this study focuses on the assessment of the gap between the existing government policies and the current scenario of the construction workers in ongoing projects of Vijayawada, Andhra Pradesh. A few of the policies for construction workers conditions a lot of things, out of which only a few are functional which makes this study to assess the reason behind the unorganized living condition and poor physical, the social and mental health of construction workers of Vijayawada. In present, the dignity of construction labors is compromised every day on construction sites, in terms of work and basic rights which leads to many other problems in future. So to work for the betterment of this community, knowledge on the differences is very much required and hence this study is a little effort to replenish the difference and compare the policies with the existing conditions of construction labors in Vijayawada.

Keywords: construction, labours, policy, productivity

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Authors: Kai Zhang

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Transformation under the reconfiguration of urban-rural relation in Liuzhou city has never been as radical and visible as it has been since the tremendous turn of the last century in China. Huanjiang village is located in Linhuashan Scenic Area in the middle east of Liuzhou city, with spectacular landscape and traditional features. Nowadays Huanjiang village has become a so-called "village in city", which is considered full of great potential for development because of the economic value of regional advantages during the urban sprawl. Communities of village found it difficult to acclimatize with the dramatic changes, which later led to numerous problems including ecological damage, unemployment of landless farmers and loss of traditional culture. Government has started up a series of renewal planings to resolve the problems, which are based on advanced technology and conform to sustainable and integrated strategies of city planning considering the original context and historical culture, superseding the traditional arrangements based on the guide of extensive economic growth. This paper aims to elaborate the context of Liuzhou city and Huanjiang village offered to both the traditional and sustainable planning approaches, in order to understand challenges and solutions of the rebuilding process. Through the analysis of the place relevant to architecture, society and culture, it will establish the corresponding systematic strategies. Considering the local features, it concludes with a comprehensive perspective on organic renewal in the case of Huanjiang village.

Keywords: China, Liuzhou, sustainable strategy, urban renewal, village in city

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Authors: M. Yaqoob, C. S. O’Neill, S. Faraj, C. L. O’Neill

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This paper presents the preliminary findings from a study exploring nurse’s contributions to end of life decisions and to the care of dying patients in ICU units in the Kingdom of Bahrain. The process of dying is complex as medical clinicians are frequently unable to say with certainty when death will occur. It is generally accepted that end of life care begins when it is possible to know that death is imminent. Nurses do not make medical treatment decisions when caring for a dying patient. There are, however, many other types of decisions made when a patient is approaching the end of life and nurses are either formally or informally part of these decision making processes. This study explored nurses care practices at the end of life, in two ICU units in large hospitals in the Kingdom of Bahrain. The research design was a grounded theory approach. Ten nurses participated, six of whom were Bahraini nationals and four were Indian. A core category death avoidance talk was supported by three major subcategories, degrees of involvement in decision making; signalling and creating an awareness of death; care shifting from dying patients to family. Despite nurses asserting that they carried out the orders of doctors and had no role in decision making processes at end of life this study showed that there were degrees of nurse involvement. Doctors frequently discussed the patient’s clinical condition with nurses and also sought information regarding the family. Information about the family was of particular relevance if the doctor was considering a DNR order, which the nurses equated with dying. Families were not always informed when a DNR decision was made. When families were not informed the nurses engaged in sophisticated rituals signalling and creating awareness to family members that the death of their loved one was near. This process also involved a subtle shifting of care from the dying patient to the family. This seminar paper will focus particularly on how nurses signal and create an awareness of death in an ICU setting. The findings suggest that despite the avoidance of death talk in the ICU nurses indirectly convey and create an awareness that death is near to family members.

Keywords: decision making, dying patients, end of life, intensive care unit

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Authors: Nadia Naseem, Farwa Batool, Nasir Mehmood, AbdulHannan Nagi

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Background: The incidence and mortality of breast cancer vary significantly in geographically distinct populations. In Pakistan, breast cancer has shown an increase in incidence in young females and is characterized by more aggressive behavior. The tumor suppressor TP53 gene is a crucial genetic factor that plays a significant role in breast carcinogenesis. This study investigated the TP53 mutations in molecular subtypes of both nodes negative and positive breast cancer in young Pakistani patients. Material and Methods: p53, Estrogen Receptor (ER), Progesterone Receptor (PR), Her-2 neu and Ki 67 expressions were analyzed immunohistochemically in a series of 75 node negative (A) and 75 node positive (B) young (aged: 19-40 years) breast cancer patients diagnosed between 2014 to 2017 at two leading hospitals of Punjab, Pakistan. Tumor tissue specimens and peripheral blood samples were examined for TP53 mutations by direct sequencing of the gene (exons 4-9). The relation of TP53 mutations to these markers and clinicopathological data was investigated. Results: Mean age of the patients was 32.4 + 9.1 SD. Invasive breast carcinoma was the most frequent histological variant (A=92%, B=94.6%). Grade 3 carcinoma was the commonest grade (A=72%, B=81.3%). Triple negative cases (ER-, PR-, Her-2) formed most of the molecular subtypes (A=44%, B=50.6%). A total of 17.2% (A: 6.6%, B: 10.6%) patients showed TP53 mutations. Mutations were significantly more frequent in triple negative cases (A: 74.8%, B: 62.2%) compared to HER2-positive patients (P < 0.0001). In the multivariate analysis of the whole patient group, the independent prognosticator were triple negative cases (P=0.021), TP53 overexpression by IHC (P=0.001) and advanced-stage disease (P=0.007). No statistically significant correlation between TP53 mutations and clinicopathological parameters was found (P < 0.05). Conclusions: It is concluded that TP53 mutations are infrequently present in breast carcinoma of young Pakistani population and there was no significant correlation between p53 mutation and early onset disease. Immunohistochemically detected TP53 expression in our resource-constrained to set up can be beneficial in predicting mutations at the younger age in our population.

Keywords: immunohistochemistry (IHC), invasive breast carcinoma (IBC), Pakistan, TP53

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Authors: Ilana Margalith, Adaya Meirowitz, Sigalit Cohavi

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Violence against health professionals by patients and their families have recently become a disturbing phenomenon worldwide, exacting psychological as well as economic tolls. Health workplaces in Israel (e.g. hospitals and H.M.O clinics) provide workshops for their employees, supplying them with coping strategies. However, these workshops do not focus on nursing students, who are also subjected to this violence. Their learning environment is no longer as protective as it used to be. Furthermore, coping with violence was not part of the curriculum for Israeli nursing students. Thus, based on human aggression theories which depict the pivotal role of the professional's correct response in preventing the onset of an aggressive response or the escalation of violence, a workshop was developed for undergraduate nursing students at the Clalit Nursing Academy, Rabin Campus (Dina), Israel. The workshop aimed at reducing students' anxiety vis a vis the aggressive patient or family in addition to strengthening their ability to cope with such situations. The students practiced interpersonal skills, especially relevant to early detection of potential violence, as well as ‘a correct response’ reaction to the violence, thus developing the necessary steps to be implemented when encountering violence in the workplace. In order to assess the efficiency of the workshop, the participants filled out a questionnaire comprising knowledge and self-efficacy scales. Moreover, the replies of the 23 participants in this workshop were compared with those of 24 students who attended a standard course on interpersonal communication. Students' self-efficacy and knowledge were measured in both groups before and after the course. A statistically significant interaction was found between group (workshop/standard course) and time (before/after) as to the influence on students' self-efficacy (p=0.004) and knowledge (p=0.007). Nursing students, who participated in this ‘coping with workplace violence’ workshop, gained knowledge, confidence and a sense of self-efficacy with regard to workplace violence. Early detection of signs of imminent violence amongst patients or families and the prevention of its escalation, as well as the ability to manage the threatening situation when occurring, are acquired skills. Encouraging nursing students to learn and practice these skills may enhance their ability to cope with these unfortunate occurrences.

Keywords: early detection of violence, nursing students, patient aggression, self-efficacy, workplace violence

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Authors: R. Chedid, R. Ghajar

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Lebanon electricity crisis continues to escalate. Rationing hours still apply across the country but with different rates. The capital Beirut is subjected to 3 hours cut while other cities, town and villages may endure 9 to 14 hours of power shortage. To mitigate this situation, private diesel generators distributed illegally all over the country are being used to bridge the gap in power supply. Almost each building in large cities has its own generator and individual villages may have more than one generator supplying their loads. These generators together with their private networks form incomplete and ill-designed and managed microgrids (MG) but can be further developed to become renewable energy-based MG operating in island- or grid-connected modes. This paper will analyze the potential of introducing MG to help resolve the energy crisis in Lebanon. It will investigate the usefulness of developing MG under the prevailing situation of existing private power supply service providers and in light of the developed national energy policy that supports renewable energy development. A case study on a distribution feeder in a rural area will be analyzed using HOMER software to demonstrate the usefulness of introducing photovoltaic (PV) arrays along the existing diesel generators for all the stakeholders; namely, the developers, the customers, the utility and the community at large. Policy recommendations regarding MG development in Lebanon will be presented on the basis of the accumulated experience in private generation and the privatization and public-private partnership laws.

Keywords: decentralized systems, distributed generation, microgrids, renewable energy

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Authors: Rajeshwari Biradar

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Background: The anecdotal evidences indicate that utilization of HIV services especially in Government facilities is affected by stigma and discrimination among HIV positive female sex workers (FSWs) in Karnataka. To our knowledge, there is no quantitative study on this issue. In this study an attempt is made to examine these aspects among positive FSWs exposed to prevention programs. Methods: This is a cross‐ sectional quantitative survey of HIV positive FSWs in the 3 districts of northern Karnataka using a structured questionnaire. The list of HIV Positive FSWs was organized by stratification, and 607 positive FSWs were selected using a systematic random selection. The data were analyzed using both bivariate and multivariate statistical techniques. Results: Half of the sex workers (52%) are traditional (devadasi, dedicated to the temple), 22% are widowed and the mean age is 33 years. The FSWs practice sex work on an average 13 days a month with 2.3 clients per day and was in sex work for about 13 years. Almost all of them (97%) used condom with the clients they had on the last day of sex work. About 74% were ever registered in the ART center and 47% of them reported being ever on ART, of which 6% dropped out. Multivariate results support the hypothesis that the interventions addressing stigma and discrimination enabled accessing health services in the government facilities (AOR=1.37; p=0.17). Conclusions: Based on the results of the study, programs addressing stigma, discrimination and positive prevention can be implemented in places where government health services are not utilized by HIV positive FSWs. However, the study may be limited by the fact that majority of the FSWs entered into sex work through the traditional devadasi system, which may not be the case in other parts of India.

Keywords: sex work, HIV/AIDS, female sex workers, health

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Authors: Marzieh Amiri, Zahra Iranpour Mobarakeh, Fatemeh Mehrbakhsh, Mehran Amiri

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Introduction: Early diagnosis and intervention of congenital hearing loss is necessary to minimize the adverse effects of hearing loss. The aim of the present study was to report the results of newborn hearing screening in a centerin the south part of Iran, Fasa. Material and methods: In this study, the data related to 6,144 newbornsduring September 2018 up to September2021, was analyzed. Hearing screening was performed using transient evoked otoacoustic emissions (TEOAEs) and automated auditory brainstem response (AABR) tests. Results: From all 6144 newborns,3752 and 2392referred to the center from urban and rural part of Fasa, respectively. There were 2958 female and 3186 male in this study. Of 6144 newborns, 6098 ones passed the screening tests, and 46 neonates were referred to a diagnostic audiology clinic. Finally, nine neonates were diagnosed with congenital hearing loss (seven with sensorineural hearing loss and two with conductive hearing loss). The severity of all the hearing impaired neonates was moderate and above. The most important risk factors were family history of hearing loss, low gestational age, NICU hospitalization, and hyperbilirubinemia. Conclusion: Our results showed that the prevalence of hearing loss was 1.46 per 1000 infants. Boosting public knowledge by providing families with proper education appears to be helpful in preventing the negative effects of delayed implementation of health screening programs.

Keywords: newborn hearing screening, hearing loss, risk factor, prevalence

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Authors: Emmanuel Ukpe, S. M. F. D. Syed Mustapha

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Trust in an organization has been perceived as one of the key factors behind knowledge sharing, mainly in an unstructured work environment. In an informal working environment, to instill trust among individuals is a challenge and even more in the virtual environment. The study has contributed in developing the framework for building trust in an unstructured organization in performing knowledge sharing in a virtual environment. The artifact called KAPE (Knowledge Acquisition, Processing, and Exchange) was developed for knowledge sharing for the informal organization where the framework was incorporated. It applies to Cassava farmers to facilitate knowledge sharing using web-based platform. A survey was conducted; data were collected from 382 farmers from 21 farm communities. Multiple regression technique, Cronbach’s Alpha reliability test; Tukey’s Honestly significant difference (HSD) analysis; one way Analysis of Variance (ANOVA), and all trust acceptable measures (TAM) were used to test the hypothesis and to determine noteworthy relationships. The results show a significant difference when there is a trust in knowledge sharing between farmers, the ones who have high in trust acceptable factors found in the model (M = 3.66 SD = .93) and the ones who have low on trust acceptable factors (M = 2.08 SD = .28), (t (48) = 5.69, p = .00). Furthermore, when applying Cognitive Expectancy Theory, the farmers with cognitive-consonance show higher level of trust and satisfaction with knowledge and information from KAPE, as compared with a low level of cognitive-dissonance. These results imply that the adopted trust model KAPE positively improved knowledge sharing activities in an informal environment amongst rural farmers.

Keywords: trust, knowledge, sharing, knowledge acquisition, processing and exchange, KAPE

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Authors: Kerdsiri Hongthai, Darunee Jongudomkarn, Rutja Phuphaibul

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In Thailand, many adults in rural areas migrate to seek employ¬ment resulting in skipped-generation family where grandparents care for grandchildren with no other adults present. This is a preliminary study using qualitative case study methods, aimed to explore the situations of older adult grandparents' experiences in skipped-generation family in North-East of Thailand. Data were collected by in-depth inter¬views with 6 grandparents living in skipped-generation families; 5 females and 1 males grandparents, aged 62-75, some of them have diabetes mellitus, hypertension, during November to December, 2017. The finding themes are: ‘Caught up in the middle’: the older adults were pleased to have grandchildren but, at the same time, acknowledge the burden that this placed on them, especially when the migrant children failed to send enough money back to support the family. ‘Getting bad health’: they reported to be fatigued and stressed due to burden of caring for their grandchildren without support. This situation can aggravate problems of poor health status and be worsening economic status of the grandparents. In some cases of deprivation, the grandparents feel that having to be the sole care providers of their grandchildren can negative adversely affect their mental status. It is important to find out in other sectors similar to Thailand and lead to more in-depth research to answer the research questions about policy and social support in skipped-generation family in the future.

Keywords: older adult grandparents, experiences, principle care giver, skipped-generation family

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Authors: D. A. Dakul, T. M. Akindigh, B. J. Dogonyaro, O. J. Abba, K. T. Tangtur, N. Sambo, J. A. E. Okopi, J. A. Yohanna, G. E. Imade, G. S. Mwansat, S. Oguche

Abstract:

Malaria and urinary Schistosomaisis are both endemic in Nigeria and pose a serious health challenge in rural areas where co-infections are common. This descriptive cross sectional study was carried out to determine the prevalence of co-infection and the impact of concurrent infection on haemoglobin concentration, Eosinophil and CD4+ T-lymphocyte counts. Plasmodium falciparum and Schistosoma haematobium infection were determined by Malaria Rapid Diagnostic Test (MRDT) kits and the presence of visible haematuria respectively and confirmed by conventional Polymerase Chain Reaction (cPCR). P values < 0.05 were considered statistically significant. Of the 110 children examined, 13 (11.8%) had concurrent infection with Schistosoma haematobium falciparum, 46(41.8%) had Plasmodium falciparum infection while 16(14.5%) had Schistosoma haematobium infection. A strong association between co-infection and the ages of 10-15 years with a 36.4% prevalence of anaemia was observed. Malaria was significantly associated with anaemia than with concurrent infections or schistomiasis alone. Co-infection with both pathogens and a high prevalence of anaemia was observed in Jinduut community. Although the causes of anaemia are multi-factorial, further investigation into the extent to which malaria and urinary schistosomiasis contribute to anaemia is needed. Also, integrated control efforts must be strengthened to mitigate the impact of concurrent infection in this group of vulnerable members in the community. The results can be applied to other communities during control.

Keywords: co-Infection, plasmodium falciparum and scistosoma haematobium, Jinduut, Nigeria

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Authors: Sudarshan Chalise, Athula Naranpanawa

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This paper attempts to investigate the viability of cropland re-allocation as an adaptation strategy to minimise the economy-wide costs of climate change on agriculture. Nepal makes an interesting case study as it is one of the most vulnerable agricultural economies within South Asia. This paper develops a comparative static multi-household Computable General Equilibrium (CGE) model for Nepal with a nested set of Constant Elasticity of Transformation (CET) functional forms to model the allocation of land within different agricultural sectors. Land transformation elasticities in these CET functions are allowed to reflect the ease of switching from one crop to another based on their agronomic characteristics. The results suggest that, in the long run, farmers in Nepal tend to allocate land to crops that are comparatively less impacted by climate change, such as paddy, thereby minimizing the economy-wide impacts of climate change. Furthermore, the results reveal that land re-allocation tends to reduce the income disparity among different household groups by significantly moderating the income losses of rural marginal farmers. Therefore, it is suggested that policy makers in Nepal should prioritise schemes such as providing climate-smart paddy varieties (i.e., those that are resistant to heat, drought and floods) to farmers, subsidising fertilizers, improving agronomic practices, and educating farmers to switch from crops that are highly impacted by climate change to those that are not, such as paddy.

Keywords: climate change, general equilibrium, land re-allocation, nepalese agriculture

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Authors: I. Wayan Wiwin

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Poverty is one of the big problems faced by big cities in the world. Urbanization one cause, many rural communities trying to earn a living to the city in the hope that they can improve the level of economy, but not equipped with adequate skills so that it becomes an urban demographic problem. Denpasar as the capital of the province of Bali one of them, in the city area of Denpasar there are many slum dwellings inhabited by the poor, whereas Bali is known as one of the best tourist destinations in the world. This condition is very inversely proportional to the progress of tourism in Bali. For that it is necessary to attempt to overcome poverty in the city of Denpasar, one with the development of city tours in the form of charity walking tours, where tourists are invited to take a walk to see directly the state of the poor in the city of Denpasar and provide assistance to them in the form of home assistance, educational scholarships, health assistance, as well as skill and business capital assistance. This research is explorative-qualitative, that is exploring the potential of charity walking tour to overcome poverty in Denpasar City, which is written qualitatively. In the end based on potential data and information, then analyzed into a decision whether it is possible to develop. Therefore, this study only requires respondents or informants who are able to provide answers or qualitative information about matters related to the potential development of charity walking tour. Thus, informants in this study are tourism stakeholders, such as Municipal government officials, businessmen, community leaders and tourism actors, who are considered to be providing information relating to the development of urban tourism.

Keywords: tourism, city tours, charity walking tours, poverty

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Authors: Sitti Rahmawati

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Payment system of cataract surgery implemented by professional attendant of doctor and nurse has been increasing, through health insurance program and this has become one of the factors that affects a lot of government in the budget establishment. This system has been implemented in purpose of quality and expenditure control, i.e., controlling health overpayment to obtain benefit (moral hazard) by the user of insurance or health service provider. The increasing health cost becomes the main issue that hampers the society to receive required health service in cash payment-system. One of the efforts that should be taken by the government in health payment is by securing health insurance through society's health insurance. The objective of the study is to learn the capability of a patient to pay cataract eye operation for the elders. Method of study sample population in this study was patients who obtain health insurance board card for the society that was started in the first of tri-semester (January-March) 2015 and claimed in Indonesian software-Case Based Group as a purposive sampling of 40 patients. Results of the study show that total unit cost analysis of surgery service unit was obtained $75 for unit cost without AFC and salary of nurse and doctor. The operation tariff that has been implemented today at Anutapura hospitals in eye department is tariff without AFC and the salary of the employee is $80. The operation tariff of the unit cost calculation with double distribution model at $65. Conclusion, the calculation result of actual unit cost that is much greater causes incentive distribution system provided to an ophthalmologist at $37 and nurse at $20 for one operation. The surgery service tariff is still low; consequently, the hospital receives low revenue and the quality of health insurance in eye operation department is relatively low. In purpose of increasing the service quality, it requires adequately high cost to equip medical equipment and increase the number of professional health attendant in serving patients in cataract eye operation at hospital.

Keywords: economic evaluation, cataract operation, health attendant, health insurance system

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Authors: Veenapani Rajeev Verma

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Context: Assessing facility readiness is paramount as it can indicate capacity of facilities to provide essential care for resilience to health challenges. In the context of decentralization, estimation of supply side readiness indices at sub national level is imperative for effective evidence based policy but remains a colossal challenge due to lack of dependable and representative data sources. Setting: District Poonch of Jammu and Kashmir was selected for this study. It is remote, rural district with unprecedented topographical barriers and is identified as high priority by government. It is also a fragile area as is bounded by Line of Control with Pakistan bearing the brunt of cease fire violations, military skirmishes and sporadic militant attacks. Hilly geographical terrain, rudimentary/absence of road network and impoverishment are quintessential to this area. Objectives: Objective of the study is to a) Evaluate the service readiness of health facilities and create a concise index subsuming plethora of discrete indicators and b) Ascertain supply side barriers in service provisioning via stakeholder’s analysis. Study also strives to expand analytical domain unravelling context and area specific intricacies associated with service delivery. Methodology: Mixed method approach was employed to triangulate quantitative analysis with qualitative nuances. Facility survey encompassing 90 Subcentres, 44 Primary health centres, 3 Community health centres and 1 District hospital was conducted to gauge general service availability and service specific availability (depth of coverage). Compendium of checklist was designed using Indian Public Health Standards (IPHS) in form of standard core questionnaire and scorecard generated for each facility. Information was collected across dimensions of amenities, equipment, medicines, laboratory and infection control protocols as proposed in WHO’s Service Availability and Readiness Assesment (SARA). Two stage polychoric principal component analysis employed to generate a parsimonious index by coalescing an array of tracer indicators. OLS regression method used to determine factors explaining composite index generated from PCA. Stakeholder analysis was conducted to discern qualitative information. Myriad of techniques like observations, key informant interviews and focus group discussions using semi structured questionnaires on both leaders and laggards were administered for critical stakeholder’s analysis. Results: General readiness score of health facilities was found to be 0.48. Results indicated poorest readiness for subcentres and PHC’s (first point of contact) with composite score of 0.47 and 0.41 respectively. For primary care facilities; principal component was characterized by basic newborn care as well as preparedness for delivery. Results revealed availability of equipment and surgical preparedness having lowest score (0.46 and 0.47) for facilities providing secondary care. Presence of contractual staff, more than 1 hr walk to facility, facilities in zone A (most vulnerable) to cross border shelling and facilities inaccessible due to snowfall and thick jungles was negatively associated with readiness index. Nonchalant staff attitude, unavailability of staff quarters, leakages and constraint in supply chain of drugs and consumables were other impediments identified. Conclusions/Policy Implications: It is pertinent to first strengthen primary care facilities in this setting. Complex dimensions such as geographic barriers, user and provider behavior is not under precinct of this methodology.

Keywords: effective coverage, principal component analysis, readiness index, universal health coverage

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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: G. Salavwa, P. Erhijakpor Jr., H. Ukwu

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This study will explore child labour issues in Nigeria because it is capable of affecting the physical and general well-being of children who perform hazardous work. This feat will be achieved through qualitative research methodology. Data collection shall be elicited by oral interviews and documental content analysis to delve on the application of the Convention on the Rights of the Child (CRC), International Labour Organization ILO and Geneva Convention relating to child labour practices in Nigeria. This will include the relevance of present domestic laws relating to child labour as implemented in Nigeria, together with factors that contribute to the practice of child labour in the country. The oral interview data analysis will be performed by breaking the interview data into significant statements and themes. This shall be done by comparing and determining the commonalities that are prevalent in the participants’ views regarding child labour menace in Nigeria. Presumably, findings from this study shall unveil that a poor educational policy, a widespread poverty level which is mostly prevalent amongst families in the rural areas of the country, a lack of employment for adults, have led to the ineffectiveness of the local child labour laws in Nigeria. These has in turn culminated into a somewhat non-implementation of the international laws of the CRC, ILO and Geneva Declaration on child labour to which the Nigerian government is a signatory. Based on the finding, this study will calls on the government of Nigeria to extend its free educational policy from the elementary, secondary to tertiary educations. The government also has to ensure that offenders of children’s rights should face a severe punishment.

Keywords: commonalities, tertiary, constitution, qualitative

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Authors: Akachi Odoemene

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Climate change and land grabbing are tightly interconnected in ways that are both diverse and complex. They have impacted each other in significant ways too. Both phenomena are not only a political reality, but have diverse dire implications, especially for food and livelihood security of vulnerable populations in developing economies. The critical nexus and interactions of climate change and land grabbing remain one of the challenges of sustainable development in modern times. The nuanced understanding of the nexus, importance and implications of climate change and land grabbing are the primary focus of this chapter. It begins with conceptual clarifications, particularly arguing that the absence of some important principles of engagement underline and define a land grab. It also analyses and notes a good number of contemporary land deals as 'one-sided', in which wealthy entities connive with local elites to exploit and disposes rural poor populations. The paper not only examines both global and local factors that drive land grabbing and, in some cases, their connections with the incidence of climate change, but also explores their crucial links with such sector as agriculture. It is argued and exhibited in the paper why certain societies are susceptible to the incidence of climate change and land grabbing, while the overall consequences of these phenomena on the affected societies are further interrogated. The paper concludes that the lack of political will by global political leaders to effectively combat and resolve critical issues associated with both climate change and land grabbing remains a daunting challenge. It notes that these phenomena – climate change and land grabbing – if not abated, will certainly become another set of global tragic episodes to be regretted in the future.

Keywords: climate change, land grabbing, global governance, developing economies

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Authors: Yassir Adam Shuaib, Stefan Niemann, Eltahir Awad Khalil, Ulrich Schaible, Lothar Heinz Wieler, Mohammed Ahmed Bakhiet, Abbashar Osman Mohammed, Mohamed Abdelsalam Abdalla, Elvira Richter

Abstract:

Tuberculosis (TB) is a chronic bacterial disease of humans and animals and it is characterized by the progressive development of specific granulomatous tubercle lesions in affected tissues. In a six-month study, from June to November 2014, a total of 2,304 carcasses of cattle, camel, sheep, and goats slaughtered at East and West Gaash slaughterhouses, Kassala, were investigated during postmortem, in parallel, 101 sputum samples from TB suspected patients at Kassala and El-Gadarif Teaching Hospitals were collected in order to investigate tuberculosis in animals and humans. Only 0.1% carcasses were found with suspected TB lesions in the liver and lung and peritoneal cavity of two sheep and no tuberculous lesions were found in the carcasses of cattle, goats or camels. All samples, tissue lesions and sputum, were decontaminated by the NALC-NaOH method and cultured for mycobacterial growth at the NRZ for Mycobacteria, Research Center Borstel, Germany. Genotyping and molecular characterization of the grown strains were done by line probe assay (GenoType CM and MTBC) and 16S rDNA, rpoB gene, and ITS sequencing, spoligotyping, MIRU-VNTR typing and next generation sequencing (NGS). Culture of the specimens revealed growth of organisms from 81.6% of all samples. Mycobacterium tuberculosis (76.2%), M. intracellulare (14.2%), mixed infection with M. tuberculosis and M. intracellulare (6.0%) and mixed infection with M. tuberculosis and M. fortuitum and with M. intracellulare and unknown species (1.2%) were detected in the sputum samples and unknown species (1.2%) were detected in the samples of one of the animals tissues. From the 69 M. tuberculosis strains, 25 (36.2%) were showing either mono-drug-resistant or multi-drug-resistant or poly-drug-resistant but none was extensively drug-resistant. In conclusion, the prevalence of TB in animals was very low while in humans M. tuberculosis-Delhi/CAS lineage was responsible for most cases and there was an evidence of MDR transmission and acquisition.

Keywords: animal, human, slaughterhouse, Sudan, tuberculosis

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Authors: S. Shalaweh, P. Bouic, F. Weitz, R. Henkel

Abstract:

More than 3000 plants of notable phyto-therapeutic value grow in South Africa; these include Cissampelos capensis, commonly known in Afrikaans as dawidjie or dawidjiewortel. C. capensis is the most significant and popular medicinal plant used by the Khoisan as well as other rural groups in the Western region of South Africa. Its rhizomes are traditionally used to treat male fertility problems. Yet, no studies have investigated the effects of this plant or its extracts on human spermatozoa. Therefore, this study aimed at investigating the effects of C. capensis rhizome extract (CRE) fractions on ejaculated human spermatozoa in vitro. Spermatozoa from a total of 77 semen samples were washed with human tubular fluid medium supplemented with bovine serum albumin (HTF-BSA) and incubated for 2 hourswith 20 µg/ml progesterone (P4) followed by incubation with different concentrations (0, 0.05, 0.5, 5, 50, 200 µg/ml) of fractionated CRE (F1=0% MeOH, F2=30% MeOH, F3=60% MeOH and F4=100% MeOH) for 1.5 hours at 37°C. A sample without addition of CRE fractions served as control. Samples were analyzed for sperm motility, reactive oxygen species (ROS), DNA-fragmentation, acrosome reaction and capacitation. Results showed that F1 resulted in significantly higher values for ROS, capacitation and hyper-activation compared to F2, F3, and F4 with P4-stimulated samples generally having higher values. No significant effect was found for the other parameters. In conclusion, alkaloids present in F1 of CRE appear to have triggered sperm intrinsic ROS production leading to sperm capacitation and acrosome reaction induced by P4.

Keywords: capacitaion, acrosome reaction, DNA fragmentation, ROS

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