Search results for: nutrition intervention

Authors: Tulsi Ram Bhusal

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Global climate change is known to have a huge impact on agriculture due to changing in rainfall pattern and elevated air temperature that lead to drought and/or flooding. This systematic study has focused on agriculture in Nepal. The study has shown that the trend of current climatic change is affecting rice production, while the farmers with technological access have tried to adapt to the changing conditions at their level. There is insufficient intervention from the government side in terms of policies and schemes. The lack of sufficient funds is one of the significant reasons in terms of governance. The climatic trends and the way it is affecting the annual riceyieldinNepal has been discussed in this study thoroughly. This study has reviewed published studies and ferred important points regarding the Nepal’s status on rice production. Mainly due to the increasing graph of average temperature and other physical conditions needed for the proper cultivation of ricearechanging due to which there is significant dropofannual rice production. Although from corners of the country, many farmers have attempted to adapt the methods of cultivation to the changing climatic conditions, lack of access to technologies, and fund allocation from the governmental level, it is difficult for the mtobringchanges in rice production by the crown without any institutional help. This systematic study effectively presents the magnitude of the impact on rice cultivation due to climatic changes inrecenttimesinNepal. This review aims to bring the current scenarioofNepal’sricefarming, and it impacts due to changing climate, which can subsequently contribute in devising plans for proper governance, formulating policies, and allocation of funds for the betterment.

Keywords: rice, climate change, rice production, nepal, agriculture

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Authors: Yuki Irie, Shota Ogawa, Hitomi Kosugi, Hiromitsu Shinozaki

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Background: Dropout from higher educational institutions is a major problem both for students and institutions, and poor mental health is one of the risk factors. Medical college students are at higher risk of poor mental health than general students because of their hard academic schedules. On the other hand, food insecurity has negative impacts on mental health. The healthcare college of the project site is located heavily snowy area. The students without own vehicles may be at higher risk of food insecurity, especially in the winter season. Therefore, they have many risks to mental health. The aim of the study is to clarify the relationship between mental health and its risk factors to promote students’ mental well-being. Method: A cross-sectional design was used to investigate the relationship between mental health status and lifestyle, including diet and food security among the students (n=421, 147 male, 274 females; 20.7 ± 2.8 years old). Participants were required to answer 3 questionnaires which consisted of diet, lifestyle, food security, and mental health. The survey was conducted during the snowy season from Dec. 2022 to Jan. 2023. Results: Mean mental score was 6.7±4.6 (max. score 27, a higher score means worse mental health). Significant risk factors in mental health were breakfast habit (p=0.02), subjective dietary habit (p=0.00), subjective health (p=0.00), exercise habit (p=0.02), food insecurity in the winter season (p=0.01), and vitamin A intakes (p=0.03). Conclusions: Nutrients intakes are not associated with mental health except vitamin A; however, some other lifestyle factors are significantly associated with mental health. Nutrition doesn’t lead to poor mental health directly; however, the promotion of a healthy lifestyle and improved food security in winter may be effective in better mental health.

Keywords: mental health, winter, lifestyle, students

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Authors: Sara D. Garduno-Diaz, Philippe Y. Garduno-Diaz

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To date, one of the few comprehensive indicators for the measurement of food security is the Global Food Security Index. This index is a dynamic quantitative and qualitative bench marking model, constructed from 28 unique indicators, that measures drivers of food security across both developing and developed countries. Whereas the Global Food Security Index has been calculated across a set of 109 countries, in this paper we aim to present and compare, for the Middle East and North Africa (MENA), 1) the Food Security Index scores achieved and 2) the data available on affordability, availability, and quality of food. The data for this work was taken from the latest (2014) report published by the creators of the GFSI, which in turn used information from national and international statistical sources. According to the 2014 Global Food Security Index, MENA countries rank from place 17/109 (Israel, although with resent political turmoil this is likely to have changed) to place 91/109 (Yemen) with household expenditure spent in food ranging from 15.5% (Israel) to 60% (Egypt). Lower spending on food as a share of household consumption in most countries and better food safety net programs in the MENA have contributed to a notable increase in food affordability. The region has also however experienced a decline in food availability, owing to more limited food supplies and higher volatility of agricultural production. In terms of food quality and safety the MENA has the top ranking country (Israel). The most frequent challenges faced by the countries of the MENA include public expenditure on agricultural research and development as well as volatility of agricultural production. Food security is a complex phenomenon that interacts with many other indicators of a country’s well-being; in the MENA it is slowly but markedly improving.

Keywords: diet, food insecurity, global food security index, nutrition, sustainability

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Authors: Eli Maria Forti-Pazzianotto, Carolina Moraes Da Costa, Daniela Faleiros Berteli Merino, Maura Rigoldi Simões Da Rocha, Irineu Rasera-Junior

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There is no conclusive evidence to support the use of one type or brand of incentive espirometry over others. The decision as to which equipment is best, have being based on empirical assessment of patient acceptance, ease of use, and cost. The aim was to evaluate the effects of use of two methodologies of breathing exercises, performed by flow-oriented incentive spirometry, in the reversal of diaphragmatic dysfunction in postoperative bariatric surgery. 38 morbid obese women were selected. Respiratory muscle strength was evaluated through the nasal inspiratory pressure (NIP), and the respiratory muscles endurance, through incremental test by measurement of sustained maximal inspiratory pressure (SMIP). They were randomized in 2 groups: 1- Respiron® Classic (RC) the inspirations were slow, deep and sustained for as long as possible (5 sec). 2- Respiron® Athletic1 (RA1) - the inspirations were explosive, quick and intense, raising balls by the explosive way. 6 sets of 15 repetitions with intervals of 30 to 60 seconds were performed in groups. At the end of the intervention program (second PO), the volunteers were reevaluated. The groups were homogeneous with regard to initial assessment. However on reevaluating there was a significant decline of the variable PIN (p= < 0.0001) and SMIP (p=0.0004) in RC. In the RA1 group there was a maintenance of SMIP (p=0.5076) after surgery. The use of the Respiron Athletic 1, as well as the methodology of application used, can contribute positively to preserve the inspiratory muscle endurance and improve the diaphragmatic dysfunction in postoperative period.

Keywords: bariatric surgery, incentive spirometry, respiratory muscle, physiotherapy

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Authors: Belaynesh Tsegay, Teklay Gebrecherkos, Atsebaha Gebrekidan Kahsay, Mahmud Abdulkader

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Background: Hepatitis B and C viruses are important health and socioeconomic problem across the globe, with a remarkable number of diseases and deaths in sub-Saharan African countries. The burden of hepatitis is unknown in the prison settings of Tigray. Therefore, we aimed to describe the seroprevalence and associated factors of hepatitis B and C viruses among prisoners in Tigray, Ethiopia. Methods: A cross-sectional study was carried out from February 2020 to May 2020 at the prison facilities of Tigray. Demographics and associated factors were collected from 315 prisoners prospectively. Five milliliters of blood were collected and tested using rapid tests kits of HBsAg (Zhejiang orient Gene Biotech Co., Ltd., China) and HCV antibodies (Volkan Kozmetik Sanayi Ve Ticaret Ltd. STI, Turkey). Positive samples were confirmed using ELISA (Beijing Wantai Biological Pharmacy Enterprise Co. Ltd). Data were analyzed using the SPSS version 20, and p<0.05 was considered statistically significant. Results: The overall seroprevalence of HBV and HCV were 25 (7.9%) and 1 (0.3%), respectively. The majority of hepatitis B viral infections were identified from the age groups of 18–25 years (10.7%) and unmarried prisoners (11.8%). Prisoners greater than 100 per cell (AOR=3.95, 95% CI=1.15–13.6, p=0.029) and with a history of alcohol consumption (AOR=3.01, 95% CI=1.17–7.74, p=0.022) were significantly associated with HBV infections. Conclusion: The seroprevalence of HBV among prisoners was nearly high or borderline, with a very low HCV prevalence. HBV was most prevalent among young adults, those housed with a large number of prisoners per cell, and those who had a history of alcohol consumption. This study recommends that there should be prison-focused intervention, including regular health education, with the emphasis on the mode of transmission and introducing HBV screening policy for prisoners, especially when they enter the prison.

Keywords: seroprevalence, HBV, HCV, prisoners, tigray

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Authors: A. E. Buyken, D. J. Mela, P. Dussort, I. T. Johnson, I. A. Macdonald, A. Piekarz, J. D. Stowell, F. Brouns

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Recently a number of renewed dietary guidelines have been published by various health authorities. The aim of the present work was 1) to review the processes (systematic approach/review, inclusion of public consultation) and methodological approaches used to identify and select the underpinning evidence base for the established recommendations for total carbohydrate (CHO), fiber and sugar consumption, and 2) examine how differences in the methods and processes applied may have influenced the final recommendations. A search of WHO, US, Canada, Australia and European sources identified 13 authoritative dietary guidelines with the desired detailed information. Each of these guidelines was evaluated for its scientific basis (types and grading of the evidence) and the processes by which the guidelines were developed Based on the data retrieved the following conclusions can be drawn: 1) Generally, a relatively high total CHO and fiber intake and limited intake of sugars (added or free) is recommended. 2) Even where recommendations are quite similar, the specific, justifications for quantitative/qualitative recommendations differ across authorities. 3) Differences appear to be due to inconsistencies in underlying definitions of CHO exposure and in the concurrent appraisal of CHO-providing foods and nutrients as well the choice and number of health outcomes selected for the evidence appraisal. 4) Differences in the selected articles, time frames or data aggregation method appeared to be of rather minor influence. From this assessment, the main recommendations are for: 1) more explicit quantitative justifications for numerical guidelines and communication of uncertainty; and 2) greater international harmonization, particularly with regard to underlying definitions of exposures and range of relevant nutrition-related outcomes.

Keywords: carbohydrates, dietary fibres, dietary guidelines, recommendations, sugars

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Authors: Faiz Bakhsh, Tahira Yasmeen

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The Afghan refugee children in Pakistan are considered as the most vulnerable persons in danger of being abused and treated badly as compared to the minimum criteria of the protection of refugee children under 1951 refugee convention. This paper explores the impact of the 1951 refugee convention on the protection of refugee children, affected by the armed conflict in Afghanistan, residing in refugee camps in Pakistan. Despite, protection available under Refugee Convention, there exist millions of refugees in the world, including a huge portion of women and children, that remain unprotected, and their protection remains a challenging task for the world community. This study investigates the status and number of refugees in Pakistan, especially children; protection and assistance of refugees under Refugee Convention; protection of the rights of refugee children in Pakistan; and implementation of the rules of Refugee Convention relating refugee children in Pakistan and measures for the protection of refugee children in Pakistan. This socio-legal study utilizes a qualitative research approach and applies mixed methods of data collection. The primary data is collected through the interpretation of the legal framework available for the protection of refugees as well as domestic laws of Pakistan. The secondary data is collected through previous studies available on the same topic. The result of this study indicates that lack of proper implementation of the rules, of the Refugee Convention, relating protection of refugee children cause sufferings to refugee children including the provision of basic health, nutrition, family life, education and protection from child abuse. Pakistan needs a comprehensive domestic legal framework for the protection of refugees, especially refugee children. Moreover, the government of Pakistan with the help of the United Nations High Commissioner for Refugees (UNHCR) must prioritize the protection of Afghan refugee children as per standard criteria provided by the refugee convention 1951.

Keywords: refugee children, refugee convention, armed conflict, Pakistan

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Authors: Diego Carrasco, Catarina Freitas, Hugo Rio Tinto, Ricardo Rio Tinto, Nuno Couto, Joaquim Gago, Carlos Carvalho

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Introduction: Endoscopic ultrasound-guided choledochoduodenostomy (EUS-CD) to drain the gallbladder can be a palliative care procedure for non-surgical oncologic patients with cholelithiasis and cholangitis process. Case description: A 59-years old Caucasian male diagnosed with extrahepatic cholangiocarcinoma with multiple liver, lung and peritoneum metastasis, unresponsive to treatment with gemcitabine/cisplatin, presented in the institution with fever, hypotension, and severe upper right abdominal pain secondary to cholelithiasis and cholangitis process. The patient was admitted and started on large spectrum antibiotics plus fluid-challenge. Afterward, a percutaneous transhepatic biliary drainage (PTBD) was performed to drain the gallbladder. This procedure temporarily stabilized the patient. However, the definitive solution required gallbladder removal. Since the patient exhibited an advanced oncologic disease and poor response to the chemotherapy, he was not a candidate for surgical intervention. Diagnostic Pathways: A self-expanding metal stent was placed from the duodenum into the bile duct by endoscopic ultrasound-guided. The stent allowed efficient drainage of the contrast from the gallbladder at the end of the endoscopic procedure. Conclusion and Discussion: The stent allowed efficient drainage of the contrast from the gallbladder at the end of the endoscopic procedure and successfully reversed the cholangitis process. EUS-CD is an effective and safe technique and can be used as a palliative care procedure for non-surgical oncologic patients.

Keywords: palliative care, cholangiocarcinoma, choledochoduodenostomy, endoscopic ultrasound-guided

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Authors: Julia Wong, Hua Beng Lim, Cheryl Ho, Gin Jen Gwee, Rachel Tay

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In Singapore, a few hospitals and non-governmental social service agencies have been utilising animal-assisted therapy (AAT) in their practice in recent years, although the animals used (e.g., dogs, cats, and horses) and program modality may differ due to the different practice settings, client profiles, and intervention goals. This pilot study explores dog owners’ perceptions of AAT with a focus on examining the enablers and barriers towards volunteering with their dogs in AAT programs in Singapore. A qualitative, thematic analysis study was conducted using in-depth, semi-structured interviews with 16 dog owners. 3 of the dog owners had previous experience volunteering with their dogs serving elderly patients in a community hospital, while the rest of the dog owners had no previous experience volunteering with their dogs. The former group was recruited with the help of the hospital, while the latter group was recruited via word-of-mouth. Dog owners who had volunteering experiences in AAT program versus those who had none differed in their perceptions towards AAT. Dog owners who had volunteered with their dogs in an AAT program in a hospital felt that their volunteering experience were meaningful to patients and to themselves, as they were intrinsically motivated by the desire to serve the community. Those who had not volunteered were hesitant to volunteer with their dogs as they were not comfortable with strangers touching their dogs. They also felt that it would be a huge commitment in terms of time and money; most of them do not own a car as it is uneconomical, and pets are not allowed on Singapore’s public transport systems. This study is limited by its small sample size, and its findings are not generalisable. However, given that volunteers are an invaluable resource in healthcare settings, future studies can examine more stakeholders’ perceptions towards AAT.

Keywords: animal-assisted therapy, dog-assisted therapy, volunteers, complementary therapy

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Authors: Mangala M. Pai, B. V. Murlimanju, Latha V. Prabhu, P. J. Jiji , Vandana Blossom

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Background:To study the morphological parameters of the axis vertebra in anatomical specimens. Methods: The present study was designed to obtain the morphometric data of axis vertebra. The superior and inferior articular facets of the axis were macroscopically observed for their shapes and the different parameters were measured using the digital Vernier caliper. It included 20 dried axis bones, which were obtained from the anatomy laboratory. Results: The morphometric data obtained in the present study are represented in the tables. The side wise comparison of the length and width of the articular facets of the axis vertebra were done. The present study observed that, there is no statistically significant difference observed among the parameters of right and left side articular facets (p>0.05). The superior and inferior articular facets were observed to have variable shapes. The frequencies of different shapes of superior and inferior articular facets are represented in figures. All the shapes of the inferior and superior articular facets were symmetrical over the right and left sides. Among the superior articular facets, the constrictions were absent in 13 cases (65%), 2 (10%) exhibited a single constriction, 3 (15%) had 2 constrictions and 2 (10%) were having 3 constrictions. The constrictions were absent in 11 (55%) of the inferior articular facets, 3 (15%) of them had 1 constriction, 3 (15%) were having 2 constrictions, 2 (10%) exhibited 3 constrictions and 1 (5%) of them had 4 constrictions. The constrictions of the inferior and superior articular facets were symmetrical over the right and left sides. Conclusion: We believe that the present study has provided additional information on the morphometric data of the axis vertebra. The data are important to the neurosurgeons, orthopedic surgeons and radiologists. The preoperative assessment of the axis vertebra may prevent dangerous complications like spinal cord and nerve root compression during the surgical intervention.

Keywords: axis, articular facet, morphology, morphometry

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Authors: Suleiman Hassan Otuoze, Dexter Vernon Lloyd Hunt, Ian Jefferson

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Urbanization has continued to widen the gap between demand and resources available to provide resilient and sustainable transport services in many fast-growing developing countries' cities. Transport demand management is a decision-based optimization concept for both benchmarking and ensuring efficient use of transport resources. This study assesses the service quality of infrastructure and mobility services in the Nigerian cities of Kano and Lagos through five dimensions of quality (i.e., Tangibility, Reliability, Responsibility, Safety Assurance and Empathy). The methodology adopts a hybrid AHP-SERVQUAL model applied on questionnaire surveys to gauge the quality of satisfaction and the views of experts in the field. The AHP results prioritize tangibility, which defines the state of transportation infrastructure and services in terms of satisfaction qualities and intervention decision weights in the two cities. The results recorded ‘unsatisfactory’ indices of quality of performance and satisfaction rating values of 48% and 49% for Kano and Lagos, respectively. The satisfaction indices are identified as indicators of low performances of transportation demand management (TDM) measures and the necessity to re-order priorities and take proactive steps towards infrastructure. The findings pilot a framework for comparative assessment of recognizable standards in transport services, best ethics of management and a necessity of quality infrastructure to guarantee both resilient and sustainable urban mobility.

Keywords: transportation demand management, multi-criteria decision support, transport infrastructure, service quality, sustainable transport

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Authors: Zena Ebrahim, Susan Woodhouse

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Previous research shows that mothers’ experiences of trauma are linked to their child’s later socioemotional functioning. However, the mechanisms involved are not well understood. One potential mediator is maternal insensitive responses to child distress. This study examined the link between maternal trauma, mothers’ responses to toddler distress, and toddlers’ socioemotional outcomes among a socioeconomically diverse sample of 110 mothers and their 12- to 35-month-old toddlers. It was hypothesized that a mother’s difficulty in responding sensitively to her child’s distress would mediate the relations between maternal trauma and child internalizing and externalizing behaviors. Two mediational models were tested to examine non-supportive responses to distress as a potential mediator of the relation between maternal trauma and toddler mental health outcomes; one model focused on predicting child internalizing symptoms and the other focused on predicting child externalizing symptoms. Measures included assessment of maternal trauma (Life Stressor Checklist-Revised), mothers’ responses to child distress (Coping with Toddlers’ Negative Emotions Scale), and toddler socioemotional functioning (Infant-Toddler Social and Emotional Assessment). Results revealed that the relations between maternal trauma and toddler symptoms (internalizing and externalizing symptoms) were mediated by maternal non-supportive response to child distress for both internalizing and externalizing domains of child mental health. Findings suggest the importance of early intervention for trauma-exposed mothers and target areas for parenting interventions.

Keywords: trauma, parenting, child mental health, transgenerational effects of trauma

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Authors: Didem Kepir Savoly, Selen Demirtas Zorbaz

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University students are at such a developmental stage that they are in between adolescence and adulthood, which is called emerging adulthood. And this developmental stage can be stressful due to its own nature. The potential stressor can be related to their academic life, career thoughts or beliefs, and the quality of their relationships with their peers, friends, and partners. University life is also a time that they explore and navigate their career goals and relationships. These life events may contribute to their wellbeing and mental health positively or negatively. Also, relationship status can have an impact on individuals’ mental health, whether they feel satisfied or not, and can play a role in university students’ wellbeing. The relationships between career, relationship, and wellbeing can be multifaceted and complex, and more research is required in this area. Therefore, this study aims to fill this gap in the literature by exploring the influence of career optimism and relationship status on university students’ wellbeing. According to the purpose of the research, the following hypotheses are established: 1. University students with higher career optimism will exhibit a higher level of wellbeing. 2. University students in relationships will report a higher level of wellbeing. This research is based on a quantitative method. The scale implementation, correlational, and group comparison analysis were utilized to analyze data. The data was collected from university students in Turkiye by utilizing the Career Optimism Scale and a questionnaire to identify participants’ relationship status and demographic variables. The findings and their implications may inspire researchers and practitioners, especially practitioners at counseling centers and career services of universities, in order to tailor psychoeducational and intervention programs to promote university students’ mental health.

Keywords: career optimism, relationship status, university students, wellbeing

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Authors: Jiayan Gou, Kexin He, Xin Zhang, Fei Wang, Liuni Zou

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Background: Homocysteine is a high-risk factor for cognitive decline, and folic acid supplementation can lower homocysteine levels. However, current clinical research results are inconsistent, and the effects of folic acid on homocysteine levels and cognitive function in older people are inconsistent. Objective: The objective of this study is to systematically evaluate the effects of folic acid alone or in combination with other nutrients on homocysteine levels and cognitive function in older adults. Methods: Systematic searches were conducted in five databases, including PubMed, Embase, the Cochrane Library, Web of Science, and CINAHL, from inception to June 1, 2023. Randomized controlled trials were included investigating the effects of folic acid alone or in combination with other nutrients on cognitive function in older people. Results: 17 articles were included, with six focusing on the effects of folic acid alone and 11 examining folic acid in combination with other nutrients. The study included 3,100 individuals aged 60 to 83.2 years, with a relatively equal gender distribution (approximately 51.82% male). Conclusion: Folic acid alone or combined with other nutrients can effectively lower homocysteine level and improve cognitive function in patients with mild cognitive impairment. But for patients with Alzheimer's disease and dementia, the intervention only can reduce the homocysteine level, but the improvement in cognitive function is not significant. In healthy older people, high baseline homocysteine levels (>11.3 μmol/L) and good ω-3 fatty acid status (>590 μmol/L) can enhance the improvement effect of folic acid on cognitive function. This trial has been registered on PROSPERO as CRD42023433096.

Keywords: B-complex vitamins, cognitive function, folic acid, homocysteine

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Authors: Beatrix Faragó, Zsolt Szakály, Ágnes Kovácsné Tóth, Csaba Konczos, Norbert Kovács, Zsófia Pápai, Tamás Kertész

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The future of the nation is the embodiment of a healthy society. A key segment of government policy is the development of health and a health-oriented environment. As a result, sport as an activator of health is an important area for development. In Hungary, sport is a strategic sector with the aim of developing a sports nation. The function of sport in the global society is multifaceted, which is manifested in both social and economic terms. The economic importance of sport is gaining ground in the world, with implications for Central and Eastern Europe. Smaller states, such as Hungary, cannot ignore the economic effects of exploiting the effects of sport. The relationship between physical activity and health is driven by the health economy towards the nation's economic factor. In our research, we analyzed sport as a national strategy sector and its impact on age groups. By presenting the current state of health behavior, we get an idea of the directions where development opportunities require even more intervention. The foundation of the health of a nation is the young age group, whose shaping of health will shape the future generation. Our research was attended by university students from the Faculty of Health and Sports Sciences who will be experts in the field of health in the future. The other group is the elderly, who are a growing social group due to demographic change and are a key segment of the labor market and consumer society. Our study presents the health behavior of the two age groups, their differences, and similarities. The survey also identifies gaps in the development of a health management strategy that national strategies should take into account.

Keywords: competitiveness, health behavior, health economy, health management, sports nation

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Authors: J. Mano Ranjini

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Each and every child is special, born with a unique talent to explore this world. The word Dyslexia is derived from the Greek language in which “dys” meaning poor or inadequate and “lexis” meaning words or language. Dyslexia describes about a different kind of mind, which is often gifted and productive, that learns the concept differently. The main aim of the study is to bring the positive outcome of the reading level by examining the effectiveness of Visual Auditory Kinesthetic Tactile technique on Reading Level among Dyslexic Children at Helikx Open School and Learning Centre. A Quasi experimental one group pretest post test design was adopted for this study. The Reading Level was assessed by using the Schonell Graded Word Reading Test. Thirty subjects were drawn by using purposive sampling technique and the intervention Visual Auditory Kinesthetic Tactile technique was implemented to the Dyslexic Children for 30 consecutive days followed by the post Reading Level assessment revealed the improvement in the mean score value of reading level by 12%. Multi-sensory (VAKT) teaching uses all learning pathways in the brain (visual, auditory, kinesthetic-tactile) in order to enhance memory and learning and the ability in uplifting emotional, physical and societal dimensions. VAKT is an effective method to improve the reading skill of the Dyslexic Children that ensures the enormous significance of learning thereby influencing the wholesome of the child’s life.

Keywords: visual auditory kinesthetic tactile technique, reading level, dyslexic children, Helikx Open School

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Authors: R. Santos Alimi

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Using time-series techniques, this study empirically tested the validity of existing theory which stipulates there is a nonlinear relationship between government size and economic growth; such that government spending is growth-enhancing at low levels but growth-retarding at high levels, with the optimal size occurring somewhere in between. This study employed three estimation equations. First, for the size of government, two measures are considered as follows: (i) share of total expenditures to gross domestic product, (ii) share of recurrent expenditures to gross domestic product. Second, the study adopted real GDP (without government expenditure component), as a variant measure of economic growth other than the real total GDP, in estimating the optimal level of government expenditure. The study is based on annual Nigeria country-level data for the period 1970 to 2012. Estimation results show that the inverted U-shaped curve exists for the two measures of government size and the estimated optimum shares are 19.81% and 10.98%, respectively. Finally, with the adoption of real GDP (without government expenditure component), the optimum government size was found to be 12.58% of GDP. Our analysis shows that the actual share of government spending on average (2000 - 2012) is about 13.4%.This study adds to the literature confirming that the optimal government size exists not only for developed economies but also for developing economy like Nigeria. Thus, a public intervention threshold level that fosters economic growth is a reality; beyond this point economic growth should be left in the hands of the private sector. This finding has a significant implication for the appraisal of government spending and budgetary policy design.

Keywords: public expenditure, economic growth, optimum level, fully modified OLS

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Authors: Jiashu Shen

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With the increase in the prevalence of divorce, the impact of divorce on children’s sexual and reproductive health has received wide attention, while few studies have investigated parent marital relationship. This study aims to study the relation of both parent divorce and perceived parental marital relationship with children’s sexual behaviors among Chinese university or vocational college students. The study used data from “National College Student Survey on Sexual and Reproductive Health 2019”, an internet-based survey conducted from November 2019 to February 2020, in 241 universities or vocational colleges in China. Statistical analyses were conducted to assess the relationship of perceived parental marital relationship and parents’ divorce of distinct occurrence time with sexual intercourse, risky sexual behaviors, unintended health outcomes and sexual abuse. Among 51,124 university or vocational college students, those whose parents had divorced accounted for 10.72%. Better perceived parental relationship was associated with a lower likelihood to have sexual intercourse (male: OR: 0.83, 95%CI: 0.80-0.86; female: OR: 0.73, 95%CI: 0.70-0.75), sexual abuse, risky sexual behaviors and unintended health outcomes. Divorce was also found to be associated with higher risk of sexual abuse, risky sexual behaviors and unintended health outcomes. The findings highlight the importance of parental marital relationship and divorce in risky sexual behavior among young adults. The findings may provide implications on intervention programs targeting at children with divorced parents from an early stage.

Keywords: college students, divorce, family relationship, sexual behavior

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Authors: Hsien Hua Kuo, Wen Chun Lin, Chia Chi Hsu, Hsien Wen Kuo

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Objective: Despite the high prevalence of musculoskeletal disorders (MSDs) among nurses, which has been consistently observed in the studies of Western countries, very little information regarding intensity of workload and work-related quality of life (WRQOL) related to MSDs among nurses is available in Taiwan. The objective of this study is to investigate the factors affecting musculoskeletal disorders in nurses from a hospital. Methods: 550 nurses from a hospital in Taoyuan were interviewed using a modified standardized Nordic Musculoskeletal (NMQ) questionnaire which contained the demographic information, workplace condition and musculoskeletal disorders. Results: Response rate of nurses were 92.5% from a teaching hospital. Based on medical diagnosis by physician, neck of musculoskeletal disorders had the highest percentage in nine body portions. The higher percentage of musculoskeletal disorders in nurses found from wards of internal and surgery. Severity and symptoms of musculoskeletal disorders diagnosed by self-reported questionnaire significantly correlated with WRQOL, job satisfaction and intensity of workload among nurses based on the logistic regression model. Conclusion: The severity and symptoms of musculoskeletal disorders among nurses showed a dose-dependent with WRQOL and workload. When work characteristics in hospital were modified, the severity of musculoskeletal disorders among nurses will be decreased and alleviated. Comment: Multifaceted ergonomic intervention programme to reduce the prevalence of MSDs among nurses was by encouraging nurses to do more physical activity which will make them more flexible and increase their strength. Therefore, the head nurse should encourage nurses to regularly physical activity and to modify unfitting ergonomic environment in order to reduce the prevalence of MSDs.

Keywords: musculoskeletal disorders, nurse, WRQOL, job satisfaction

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Authors: Matthew Heidman, Susan Dallabrida, Analice Costa

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For infant caregivers, choosing an infant formula for their child can be a difficult task in an already stressful environment of caring for a newborn. There exist several channels that influence purchasing decision of infant formula such as, friends and family and their experiences, health care professionals, social media influencers, as well as standard media marketing. This study sought to identify the key channels by which caregivers obtain information regarding infant formula and help them make their purchasing decision. A digital survey was issued for 90 days in the US (n=121) and 30 days in Mexico (n=88) targeting respondents with children ≤4 years of age. Respondents were asked two key questions regarding the influences on their purchasing decisions: 1) “When choosing a formula brand, what do you do to help you make your decision?”, and 2) “When choosing a formula brand, what is most important to you?”. A list of potential answers was provided for each question and respondents were asked to select all that apply to them. Lastly, respondents were provided a 5-point Likert scale and asked to respond to the statement 3) “I am more likely to buy a particular formula brand if my pediatrician recommends it to me”. For question 1, in the US and Mexico, 76% and 95% of respondents respectively, selected “I ask my pediatrician” which represented the top selection. For question 2, 52% and 45% of respondents respectively, selected “On package “Pediatrician Recommended” claim…” which also represented the top selection. For statement 3, 82% and 89% of respondents respectively, stated that they either “somewhat agree” or “strongly agree” with the statement. For infant caregivers, the pediatrician is a very important channel of influence when it comes to purchasing decision of infant formula. Caregivers clearly see the pediatrician as the arbiter of their child’s nutrition and seek their recommendations for infant formula use. For infant formula manufacturers, it is important that they see the pediatrician as the gatekeeper to this market, and they put resources into medical marketing communication to this health care professional group to ensure success.

Keywords: infant formula, pediatrician, purchasing driver, caregiver

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Authors: Beng Zhen Yeow

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In most work that involves children, the voice of the children is often not heard. This is ironic since a lot of discussions might involve their welfare and safety. It might seem natural that the professionals should hear from them about what they wish for instead of deciding what is best for them. However, this, unfortunately, might be more the exception than the norm in most case and hence in many instances, children are merely 'subjects' in conversations about safety instead of active participants in the construction or creation of safety in the family. There might be many reasons why it does not happen in our work. Firstly, professionals have learnt how to 'socialise' into their professional roles and hence in the process become 'un-childlike'. Secondly, there is also a lack of professional training with regards to how to talk with children. Finally, there might be also a lack of concrete tools and techniques that are developed to facilitate the process. In this paper, the case study method is used to show how the idea of safety could be concretised and discussed with children and their family members, and hence making them active participants and co-creators of their own safety. Specific skills and techniques are highlighted through the case study. In this case, there was improvement in outcomes like no repeated offence or abuse. In addition, children were also able to advocate for their own safety after six months of intervention and how the family members were able to explicitly say what they can do to improve safety. The professionals in the safety network reported significant improvements. On top of that, the abused child who was removed due to child protection concerns, had verbalized observations of change in mother’s parenting abilities, and has requested for home leave to begin due to ownership of safety planning and having confidence to co-create safety for her siblings and herself together with the professionals in the safety network. Children becoming active participants in the co-creation of safety not only serve the purpose in allowing them to own a 'voice' but at the same time, give them greater confidence to protect themselves at home and in other contexts outside of home.

Keywords: partnering for safety, collaborative social work, family and systemic psychotherapy, child protection

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Authors: A. A. Sadia, A. Emdad, E. Hossain

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The increasing importance of mushrooms as a source of nutrition, health benefits, and even potential cancer treatment has raised awareness of the impact of climate-sensitive variables on their cultivation. Factors like temperature, relative humidity, air quality, and substrate composition play pivotal roles in shaping mushroom growth, especially in Bangladesh. Oyster mushrooms, a commonly cultivated variety in this region, are particularly vulnerable to climate fluctuations. This research explores the climatic dynamics affecting oyster mushroom cultivation and, presents an approach to address these challenges and provides tangible solutions to fortify the agro-economy, ensure food security, and promote the sustainability of this crucial food source. Using climate and production data, this study evaluates the performance of three clustering algorithms -KMeans, OPTICS, and BIRCH- based on various quality metrics. While each algorithm demonstrates specific strengths, the findings provide insights into their effectiveness for this specific dataset. The results yield essential information, pinpointing the optimal temperature range of 13°C-22°C, the unfavorable temperature threshold of 28°C and above, and the ideal relative humidity range of 75-85% with the suitable production regions in three different seasons: Kharif-1, 2, and Robi. Additionally, a user-friendly web application is developed to support mushroom farmers in making well-informed decisions about their cultivation practices. This platform offers valuable insights into the most advantageous periods for oyster mushroom farming, with the overarching goal of enhancing the efficiency and profitability of mushroom farming.

Keywords: climate variability, mushroom cultivation, clustering techniques, food security, sustainability, web-application

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Authors: Ghadah Abusalim, Suliman Alharbi, Hesham Khalil, Milton Wainwright, Mohammad A. Khiyami

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The use of implantable foreign devices in medicine has recently increased dramatically. Intravascular cannulae and catheters are used to administer fluids, medications, parenteral nutrition, and blood products in order to monitor hemodynamic status and also to provide hemodialysis. The early and late failure of inserted or implanted devices is largely the result of bacterial infection and may lead to the disruption of integration between the device and the tissues which surround it. Staphylococcus aureus and Staphylococcus epidermidis are widely considered to be the most common organisms causing device-related infection. Our study showed that S. aureus and S. epidermidis adhered to intravascular cannulae made up of PTFE, SPTFE and vialon. Adhesion of S. epidermidis and S. aureus to intravascular cannulae varied significantly depending upon the type of material used and the presence of coating materials. Both bacteria adhered less to PTFE followed by Vialon and SPTFE and the adhesion capacity of S. aureus and S. epidermidis increased over time. Coating intravascular cannulae with human serum albumin inhibited the adhesion of S. aureus and S. epidermidis to these cannulae, and pretreatment of cannulae with fibronectin inhibited the adhesion of S. epidermidis but increased the adhesion of S. aureus to all types of cannulae. Pretreatment of cannulae surface with potassium chloride or calcium chloride increased the adhesion of S. aureus and S. epidermidis to cannulae, suggesting a role for electrostatic forces in the mechanism of such adhesion. This study will hopefully clarify the mechanism of adhesion and provide possible means of preventing such adhesion either by the use of better material coatings or by interfering with the process of adhesion by targeting bacterial structures responsible for it. Currently we recommend the use of PTFE cannulae as they exhibit a lower bacterial adhesion capacity compared to the other tested cannulae.

Keywords: Staphylococcus epidermidis, Staphylococcus aureus, adhesion, cannulae, PTFE, Vialon

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Authors: Jinan Fiaidhi, Hashmath Shaik

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Breaking the barrier for practicing evidence-based medicine relies on effective methods for rapidly identifying relevant evidence from the body of biomedical literature. An important challenge confronted by medical practitioners is the long time needed to browse, filter, summarize and compile information from different medical resources. Deep learning can help in solving this based on automatic question answering (Q&A) and transformers. However, Q&A and transformer technologies are not trained to answer clinical queries that can be used for evidence-based practice, nor can they respond to structured clinical questioning protocols like PICO (Patient/Problem, Intervention, Comparison and Outcome). This article describes the use of deep learning techniques for Q&A that are based on transformer models like BERT and GPT to answer PICO clinical questions that can be used for evidence-based practice extracted from sound medical research resources like PubMed. We are reporting acceptable clinical answers that are supported by findings from PubMed. Our transformer methods are reaching an acceptable state-of-the-art performance based on two staged bootstrapping processes involving filtering relevant articles followed by identifying articles that support the requested outcome expressed by the PICO question. Moreover, we are also reporting experimentations to empower our bootstrapping techniques with patch attention to the most important keywords in the clinical case and the PICO questions. Our bootstrapped patched with attention is showing relevancy of the evidence collected based on entropy metrics.

Keywords: automatic question answering, PICO questions, evidence-based medicine, generative models, LLM transformers

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Authors: Samir Kumar Pal

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Background: Targeted rapid degradation of bilirubin has the potential to thwart incipient bilirubin encephalopathy. Uncontrolled hyperbilirubinemia is a potential problem in developing countries, including India, because of the lack of reliable healthcare institutes for conventional phototherapy. In India, most of the rural subjects duel in the exchange limit during transport, leading to a risk of kernicterus when they arrive at the treatment centre. Thus, an alternative pharmaceutical agent is needed for the hours. Objective: Exploration of a distinct therapeutic strategy for the control of neonatal hyperbilirubinemia compared to conventional phototherapy in a clinical setting. Method: We synthesized, characterized and investigated a spinel-structured Manganese citrate nanocomplex (C-Mn₃O₄ NC, the nanodrug) along with conventional phototherapy in neonatal subjects. We have also observed BIND scores in order to assess neurological dysfunctions. Results: Our observational study clearly reveals that the rate of declination of bilirubin in neonatal subjects with nanodrug oral administration and phototherapy is faster compared to that in the case of phototherapy only. The associated neural dysfunctions were also found to be significantly lower in the case of combined therapy. Conclusion: This study demonstrates that combined therapy works better than conventional phototherapy only for the control of hyperbilirubinemia. We have observed that a significant portion of neonatal subjects requiring blood exchange has been prevented with the combined therapeutic strategy. Further compilation of a drug-safety-dossier is warranted to translate this novel therapeutic chemo preventive approach to clinical settings.

Keywords: nanodrug, nanoparticle, Neonatal hyperbilirubinemia, alternative to phototherapy, redox modulation, redox medicine

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Authors: Levent Dumenci, Laura A. Siminoff

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Health literacy has been shown to predict a variety of health outcomes. Reliable identification of persons with limited cancer health literacy (LCHL) has been proved questionable with existing instruments using an arbitrary cut point along a continuum. The CHLT-6, however, uses a latent mixture modeling approach to identify persons with LCHL. The purpose of this study was to estimate two-week and six-month stability of identifying persons with LCHL using the CHLT-6 with a discrete latent variable approach as the underlying measurement structure. Using a test-retest design, the CHLT-6 was administered to cancer patients with two-week (N=98) and six-month (N=51) intervals. The two-week and six-month latent test-retest agreements were 89% and 88%, respectively. The chance-corrected latent agreements estimated from Dumenci’s latent kappa were 0.62 (95% CI: 0.41 – 0.82) and .47 (95% CI: 0.14 – 0.80) for the two-week and six-month intervals, respectively. High levels of latent test-retest agreement between limited and adequate categories of cancer health literacy construct, coupled with moderate to good levels of change-corrected latent agreements indicated that the CHLT-6 classification of limited versus adequate cancer health literacy is relatively stable over time. In conclusion, the measurement structure underlying the instrument allows for estimating classification errors circumventing limitations due to arbitrary approaches adopted by all other instruments. The CHLT-6 can be used to identify persons with LCHL in oncology clinics and intervention studies to accurately estimate treatment effectiveness.

Keywords: limited cancer health literacy, the CHLT-6, discrete latent variable modeling, latent agreement

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Authors: Raya Harkouss, Bilal Hamad

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Self-Consolidating Concrete (SCC) is considered as a relatively new technology created as an effective solution to problems associated with low quality consolidation. A SCC mix is defined as successful if it flows freely and cohesively without the intervention of mechanical compaction. The construction industry is showing high tendency to use SCC in many contemporary projects to benefit from the various advantages offered by this technology. At this point, a main question is raised regarding the effect of enhanced fluidity of SCC on the structural behavior of high strength self-consolidating reinforced concrete. A three phase research program was conducted at the American University of Beirut (AUB) to address this concern. The first two phases consisted of comparative studies conducted on concrete and mortar mixes prepared with second generation Sulphonated Naphtalene-based superplasticizer (SNF) or third generation Polycarboxylate Ethers-based superplasticizer (PCE). The third phase of the research program investigates and compares the structural performance of high strength reinforced concrete beam specimens prepared with two different generations of superplasticizers that formed the unique variable between the concrete mixes. The beams were designed to test and exhibit flexure, shear, or bond splitting failure. The outcomes of the experimental work revealed comparable resistance of beam specimens cast using self-compacting concrete and conventional vibrated concrete. The dissimilarities in the experimental values between the SCC and the control VC beams were minimal, leading to a conclusion, that the high consistency of SCC has little effect on the flexural, shear and bond strengths of concrete members.

Keywords: self-consolidating concrete (SCC), high-strength concrete, concrete admixtures, mechanical properties of hardened SCC, structural behavior of reinforced concrete beams

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Authors: Sanjay Sinha, Mohd Umair Khan

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The level of income inequality in India has been worrisome as the World Inequality Report termed it as a “poor and unequal country, with an affluent elite”. As important as income is to understand inequality and deprivation, it is just one dimension. But the historical roots and current realities of inequality and deprivation in India lies in many of the non-income dimensions such as housing, nutrition, education, agency, sense of inclusion etc. which are often ignored, especially in solution-oriented research. The level of inequality and deprivation among the tribal is one such case. There is a corpus of literature establishing that the tribal communities in India are disadvantageous on various grounds. Given their rural geography, issues of access and quality of basic facilities such as education and healthcare are often unaddressed. COVID-19 has further exacerbated this challenge and climate change will make it even more worrying. With this background, a succinct measurement tool at the village level is necessary to design short to medium-term actions with reference to risk mitigation for tribal communities. This research paper examines the level of inequality and deprivation among the tribal communities in the rural areas of Andhra Pradesh state of India using a Multidimensional Inequality and Deprivation Index based on the Alkire-Foster methodology. The methodology is theoretically grounded in the capability approach propounded by Amartya Sen, emphasizing on achieving the “beings and doings” (functionings) an individual reason to value. In the index, the authors have five domains, including Livelihood, Food Security, Education, Health and Housing and these domains are divided into sixteen indicators. This assessment is followed by domain-wise short-term and long-term solutions.

Keywords: Andhra Pradesh, Alkire-Foster methodology, deprivation, inequality, multidimensionality, poverty, tribal

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Authors: Meza-Quintero Myriam, Lobo Torrado Katty Andrea, Sanchez Picon Yesenia, Hurtado-Lugo Naudin

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The objective of the study was to evaluate the internal and external quality of the egg in the three production housing systems: floor, cage, and grazing of laying birds of the Isa Brown line, in the laying period between weeks 35 to 41; 135 hens distributed in 3 treatments of 45 birds per repetition were used (the replicas were the seven weeks of the trial). The feeding treatment supplied in the floor and cage systems contained 114 g/bird/day; for the grazing system, 14 grams less concentrate was provided. Nine eggs were collected to be studied and analyzed in the animal nutrition laboratory (3 eggs per housing system). The random statistical model was implemented: for the statistical analysis of the data, the statistical software of IBM® Statistical Products and Services Solution (SPSS) version 2.3 was used. The evaluation and follow-up instruments were the vernier caliper for the measurement in millimeters, a YolkFan™16 from Roche DSM for the evaluation of the egg yolk pigmentation, a digital scale for the measurement in grams, a micrometer for the measurement in millimeters and evaluation in the laboratory using dry matter, ashes, and ethereal extract. The results suggested that equivalent to the size of the egg (0.04 ± 3.55) and the thickness of the shell (0.46 ± 3.55), where P-Value> 0.05 was obtained, weight albumen (0.18 ± 3.55), albumen height (0.38 ± 3.55), yolk weight (0.64 ± 3.55), yolk height (0.54 ± 3.55) and for yolk pigmentation (1.23 ± 3.55). It was concluded that the hens in the three production systems, floor, cage, and grazing, did not show significant statistical differences in the internal and external quality of the chicken in the parameters studied egg for the production system.

Keywords: biological, territories, genetic resource, egg

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Authors: Cornelia-Eugenia Munteanu

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From a psychological perspective, psychopathology is the area of clinical psychology that has at its core psychological assessment and psychotherapy. In day-to-day clinical practice, psychodiagnosis and psychotherapy are used independently, according to their intended purpose and their specific methods of application. The paper explores how the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and Mini Mental State Examination-2 (MMSE-2) psychological tools contribute to enhancing the effectiveness of cognitive behavioral psychotherapy (CBT). This combined approach, psychotherapy in conjunction with assessment of personality and cognitive functions, is illustrated by two cases, a severe depressive episode with psychotic symptoms and a mixed anxiety-depressive disorder. The order in which CBT, MMPI-2, and MMSE-2 were used in the diagnostic and therapeutic process was determined by the particularities of each case. In the first case, the sequence started with psychotherapy, followed by the administration of blue form MMSE-2, MMPI-2, and red form MMSE-2. In the second case, the cognitive screening with blue form MMSE-2 led to a personality assessment using MMPI-2, followed by red form MMSE-2; reapplication of the MMPI-2 due to the invalidation of the first profile, and finally, psychotherapy. The MMPI-2 protocols gathered useful information that directed the steps of therapeutic intervention: a detailed symptom picture of potentially self-destructive thoughts and behaviors otherwise undetected during the interview. The memory loss and poor concentration were confirmed by MMSE-2 cognitive screening. This combined approach, psychotherapy with psychological assessment, aligns with the trend of adaptation of the psychological services to the everyday life of contemporary man and paves the way for deepening and developing the field.

Keywords: assessment, cognitive behavioral psychotherapy, MMPI-2, MMSE-2, psychopathology

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