Search results for: child involvement

Authors: Emma Avoyan

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The safety standards for flood protection in the Netherlands have been revised recently. It is expected that all major flood-protection structures will have to be reinforced to meet the new standards. The Dutch Flood Protection Programme aims at accomplishing this task through innovative integrated projects such as construction of multi-functional flood defenses. In these projects, flood safety purposes will be combined with spatial planning, nature development, emergency management or other sectoral objectives. Therefore, implementation of dike reinforcement projects requires early involvement and collaboration between public and private sectors, different governmental actors and agencies. The development and implementation of such integrated projects has been an issue in Dutch flood risk management since long. Therefore, this article analyses how cross-sector collaboration within flood risk governance in the Netherlands has evolved over time, and how this development can be explained. The integrative framework for collaborative governance is applied as an analytical tool to map external factors framing possibilities as well as constraints for cross-sector collaboration in Dutch flood risk domain. Supported by an extensive document and literature analysis, the paper offers insights on how the system context and different drivers changing over time either promoted or hindered cross-sector collaboration between flood protection sector, urban development, nature conservation or any other sector involved in flood risk governance. The system context refers to the multi-layered and interrelated suite of conditions that influence the formation and performance of complex governance systems, such as collaborative governance regimes, whereas the drivers initiate and enable the overall process of collaboration. In addition, by applying a method of process tracing we identify a causal and chronological chain of events shaping cross-sectoral interaction in Dutch flood risk management. Our results indicate that in order to evaluate the performance of complex governance systems, it is important to firstly study the system context that shapes it. Clear understanding of the system conditions and drivers for collaboration gives insight into the possibilities of and constraints for effective performance of complex governance systems. The performance of the governance system is affected by the system conditions, while at the same time the governance system can also change the system conditions. Our results show that the sequence of changes within the system conditions and drivers over time affect how cross-sector interaction in Dutch flood risk governance system happens now. Moreover, we have traced the potential of this governance system to shape and change the system context.

Keywords: collaborative governance, cross-sector interaction, flood risk management, the Netherlands

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Authors: Eszter J. Tóth, Alexandra Hoffmann, Csaba Vágvölgyi, Tamás Papp

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Members of the genera Curvularia and Bipolaris are closely related melanin producing filamentous fungi; both of them have the teleomorph states in genus Cochliobolus. While Bipolaris species infect only plants and may cause serious agriculture damages, some Curvularia species was recovered from opportunistic human infections. The human pathogenic species typically cause phaeohyphomycoses, i.e. mould infections caused by melanised fungi, which can manifest as invasive mycoses with frequent involvement of the central nervous system in immunocompromised patients or as local infections (e.g. keratitis, sinusitis, and cutaneous lesions) in immunocompetent people. Although their plant-fungal interactions have been intensively studied, there is only little information available about the human pathogenic feature of these fungi. The aim of this study was to investigate the neutrophil granulocytes’ response to hyphal forms of Curvularia and Bipolaris in comparison with the response to Aspergillus. In the present study Curvularia lunata SZMC 23759 and Aspergillus fumigatus SZMC 23245 both isolated from human eye infection, and Bipolaris zeicola BRIP 19582b isolated from plant leaf were examined. Neutrophils were isolated from heparinised venous blood of healthy donors with dextran sedimentation followed by centrifugation over Ficoll and hypotonic lysis of erythrocytes. Viability and purity of the cells were checked with trypan blue and Wright staining, respectively. Infection of neutrophils was carried out with germinated conidia in a ratio of 5:1. Production of hydrogen peroxide, superoxide anion, and nitrogen monoxide was measured both intracellularly and extracellularly in response to the germinated spores with or without the supernatant and after serum treatment. ROS and NOS production of neutrophils in interaction with the three fungi were compared. It is already known that Aspergillus species induce ROS production of neutrophils only after serum treatment. Although, in case of C. lunata, serum opsonisation also induced an intensive production of reactive species, lower level of production was measured in the lack of serum as well. After interaction with the plant pathogenic B. zeicola, amount of reactive species found to be similar with and without serum treatment. The presence of germination supernatant decreased the reactive species production in case of each fungus. Interaction with Curvularia, Bipolaris and Aspergillus species induced different response of neutrophils. It seems that recognition of C. lunata and B. zeicola is independent of serum opsonisation, albeit it increases the level of the produced reactive species in response for C. lunata. The study was supported by the grant LP2016-8/2016.

Keywords: Curvularia, neutrophils, NOS, ROS, serum opsonisation

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Authors: Erica Cochran Hameen, Bobuchi Ken-Opurum, Shalini Priyadarshini, Berangere Lartigue, Sadhana Anath-Pisipati

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School districts throughout the United States are constantly seeking measures to improve test scores, reduce school absenteeism and improve indoor environmental quality. It is imperative to identify key building investments which will provide the largest benefits to schools in terms of improving the aforementioned factors. This study uses Analysis of Variance (ANOVA) tests to statistically evaluate the impact of a school building’s mechanical and plumbing characteristics on a child’s educational performance. The educational performance is measured via three indicators, i.e. test scores, suspensions, and absenteeism. The study investigated 125 New York City school facilities to determine the potential correlations between 50 mechanical and plumbing variables and the performance indicators. Key findings from the tests revealed that elementary schools with pneumatic systems in “good” condition have 48.8% lower percentages of students scoring at the minimum English Language Arts (ELA) competency level compared with those with no pneumatic system. Additionally, elementary schools with “unit heaters/cabinet heaters” in “good to fair” conditions have 1.1% higher attendance rates compared to schools with no “unit heaters/cabinet heaters” or those in inferior condition. Furthermore, elementary schools with air conditioning have 0.6% higher attendance rates compared to schools with no air conditioning, and those with interior floor drains in “good” condition have 1.8% higher attendance rates compared to schools with interior drains in inferior condition.

Keywords: academic attendance and performance, mechanical and plumbing systems, schools, student health

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Authors: Liang-Jen Wang, Sung-Chou Li, Yuan-Ming Yeh, Sheng-Yu Lee, Ho-Chang Kuo, Chia-Yu Yang

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Background: Dysbiosis in the gut microbial community might be involved in the pathophysiology of attention deficit/hyperactivity disorder (ADHD). The fungal component of the gut microbiome, namely the mycobiota, is a hyperdiverse group of multicellular eukaryotes that can influence host intestinal permeability. This study therefore aimed to investigate the impact of fungal mycobiome dysbiosis and intestinal permeability on ADHD. Methods: Faecal samples were collected from 35 children with ADHD and from 35 healthy controls. Total DNA was extracted from the faecal samples, and the internal transcribed spacer (ITS) regions were sequenced using high-throughput next-generation sequencing (NGS). The fungal taxonomic classification was analysed using bioinformatics tools, and the differentially expressed fungal species between the ADHD and healthy control groups were identified. An in vitro permeability assay (Caco-2 cell layer) was used to evaluate the biological effects of fungal dysbiosis on intestinal epithelial barrier function. Results: The β-diversity (the species diversity between two communities), but not α-diversity (the species diversity within a community), reflected the differences in fungal community composition between ADHD and control groups. At the phylum level, the ADHD group displayed a significantly higher abundance of Ascomycota and significantly lower abundance of Basidiomycota than the healthy control group. At the genus level, the abundance of Candida (especially Candida albicans) was significantly increased in ADHD patients compared to the healthy controls. In addition, the in vitro cell assay revealed that C. albicans secretions significantly enhanced the permeability of Caco-2 cells. Conclusions: The current study is the first to explore altered gut mycobiome dysbiosis using the NGS platform in ADHD. The findings from this study indicated that dysbiosis of the fungal mycobiome and intestinal permeability might be associated with susceptibility to ADHD.

Keywords: ADHD, fungus, gut–brain axis, biomarker, child psychiatry

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Authors: Kushal Patel, Manasa Dittakavi, Cyrus Falsafi, Gretchen Lovett

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Rural America has seen a surge in opioid addiction rates and overdose deaths in recent years, becoming a significant public health crisis. This may be due to a variety of factors, such as lack of access to healthcare or other economic and social factors that can contribute to addiction such as poverty, unemployment, and social isolation. As the opioid epidemic has disproportionately affected rural communities, pregnant women in these areas may be highly susceptible and face additional difficulties in facing the appropriate care they need. Opioid use disorder has many negative effects on prenatal infants. These include changes in their microbiome, mental health, neurodevelopment and cognition. These can affect how the child performs in various activities in life and how they interact with others. It has been demonstrated that using cognitive behavioral therapy improves not just pain-related results but also mobility, quality of life, disability, and mood outcomes. This indicates that cognitive behavioral therapy (CBT) may be a useful therapeutic strategy for enhancing general health and wellbeing in people with opioid use problems. In terms of treating psychiatric diseases, CBT carries fewer dangers than opioids. One study that illustrates the potential for CBT to promote a reduction in opioid use disorder used self-reported drug use patterns 6 months prior to and during their pregnancy. At the beginning of the study, participants reported an average of 3.78 drug or alcohol use days in the previous 28 days, which decreased to 1.63 days after treatment. The study also found a decrease in depression scores, as measured by IDS scores, from 23.9 to 17.1 at the end of treatment. These and other results show that CBT can have meaningful impacts on pregnant women in Rural America who struggle with an opioid use disorder. This project has been approved by the West Virginia School of Osteopathic Medicine- Office of Research and Sponsored Programs and deemed non-research scholarly work.

Keywords: appalachia, CBT, opiods, pregnancy

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Authors: Nneka Evelyn Udeh

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Women’s economic participation and empowerment are fundamental to strengthening women’s rights and enabling women to have control over their lives and exert influence in the society. The economic empowerment of women is a prerequisite for sustainable development, pro-poor growth and the achievement of all the millennium development Goals (MDGs). For women to be in development they need to be empowered morally, socially, economically, and financially and this is why women in Udi Local Government Area of Nigeria meet every August, the eighth month of the year to discuss matters relating to the pursuit of women empowerment, community welfare, and national development. This exploratory study depicts how annual august meetings serve as a stimulator for female empowerment with a case study Udi Local Government area of Enugu state, Nigeria. The paper finds that ‘August Meeting’ is a regular annual occurrence in Udi Local Government Area, Enugu State, Nigeria particularly for married women and is designed to better the lot of women, the child, family, the church, and the Community. Through this forum, with its seminars and workshops, women have the opportunity to learn everything about womanhood and how to chart new courses of action and sources of empowerment. The gathering gives women the opportunity to be integrated into their community development projects, and having women as stakeholders and not mere observers helps guarantee a speedy and steady community and overall national development progress. Funds are raised for community development projects through annual dues, levies, donations, fines, sales, income from money-yielding ventures, endowment and investiture. Annual August meeting also known as ‘Mothers Summit’ is indeed a powerful stimulator for female empowerment. Support and invigoration of this women initiative is essential for sustainable emancipation of female gender, not just in Udi Local Government Area of Nigeria but globally.

Keywords: women empowerment, annual august meeting, Udi Lga, mothers' summit, stimulator, emancipation, sustainability, community welfare, national development, millennium development goal

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Authors: Suegnet Smit

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Prior to 1994, special education in South Africa was marginalized and fragmented. Moving away from a Medical model approach to special education, the Government, after 1994, promoted an Inclusive approach, as a means to transform education in general, and special education in particular. This transformation, however, is moving at too a slow pace for learners with barriers to learning and development to benefit fully from their education. The goal of the Department of Basic Education is to minimize, remove, and prevent barriers to learning and development in the educational setting, by attending to the unique needs of the individual learner. However, the implementation of Inclusive education is problematic, and general education remains poor. This paper highlights the historical development of special education in South Africa, underpinned by a bio-ecological perspective. Problematic areas within the systemic levels of the education system are highlighted in order to indicate how the interactive processes within the systemic levels affect special needs learners on the personal dimension of the bio-ecological approach. As part of the methodology, thorough document analysis was conducted on information collected from a large body of research literature, which included academic articles, reports, policies, and policy reviews. Through a qualitative analysis, data were grouped and categorized according to the bio-ecological model systems, which revealed various successes and challenges within the education system. The challenges inhibit change, growth, and development for the child, who experience barriers to learning. From these findings, it is established that special education in South Africa has been, and still is, on a bumpy road. Sadly, the transformation process of change, envisaged by implementing Inclusive education, is still yet a dream, not fully realized. Special education seems to be stuck at what is, and the education system has not moved forward significantly enough to reach what special education should and could be. The gap that exists between a vision of Inclusive quality education for all, and the current reality, is still too wide. Problems encountered in all the education system levels, causes a funnel-effect downward to learners with special educational needs, with negative effects for the development of these learners.

Keywords: bio-ecological perspective, education systems, inclusive education, special education

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Authors: Wajeeha Zahid, Shafquat Rozi, Farhan Raza, Masood Kadir

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Background: Dental caries affects the overall health and well-being of children. Findings from various international studies regarding the association of dental caries with asthma are inconsistent. With the increasing burden of caries and childhood asthma, it becomes imperative for an underdeveloped country like Pakistan where resources are limited to identify whether there is a relationship between the two. This study aims to identify an association between dental caries and asthma. Methods: A cross-sectional study was conducted on 544 children aged 12-15 years recruited from five private schools in Karachi. Information on asthma was collected through the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. The questionnaire addressed questions regarding child’s demographics, physician diagnoses of asthma, type of medication administered, family history of asthma and allergies, dietary habits and oral hygiene behavior. Dental caries was assessed using DMFT Index (Decayed, Missing, Filled teeth) index The data was analyzed using Cox proportional Hazard algorithm and crude and adjusted prevalence ratios with 95% CI were reported. Results: This study comprises of 306 (56.3%) boys and 238 (43.8%) girls. The mean age of children was 13.2 ± (0.05) years. The total number of children with carious teeth (DMFT > 0) were 166/544 (30.5%), and the decayed component contributed largely (22.8%) to the DMFT score. The prevalence of physician’s diagnosed asthma was 13%. This study identified almost 7% asthmatic children using the internationally validated International Study of Asthma and Allergies in Childhood (ISAAC) tool and 8 children with childhood asthma were identified by parent interviews. Overall prevalence of asthma was 109/544 (20%). The prevalence of caries in asthmatic children was 28.4% as compared to 31% among non-asthmatic children. The adjusted prevalence ratio of dental caries in asthmatic children was 0.8 (95% CI 0.59-1.29). After adjusting for carious food intake, age, oral hygiene index and dentist visit, the association between asthma and dental caries turned out to be non-significant. Conclusion: There was no association between asthma and dental caries among children who participated in this study.

Keywords: asthma, caries, children, school-based

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Authors: Arshad Hussain

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Background: Sukh Initiative is a multi-donor funded, family planning and reproductive health project, primed by Aman Healthcare Services; implemented through a consortium of local and international organizations, in a selected one million underserved peri-urban population of Karachi, Sindh; which aims at increasing modern contraceptive prevalence rate by 15 percentage point. Objective: To empower women to access contraception by increasing knowledge, improving quality of services and expanding the basket of choices; contributing to the goals of FP2020. Methods: A five years project has a multi-pronged approach with door to door services by LHWs and CHWs in an LHWs covered population and provision of quality FP/RH services both at public and private health care facilities. The project engages youth (12-16 years) both with community and at secondary schools to mentor them for responsible adulthood with life skilled base initiative. A 24/7 availability of youth and FP helpline service provides counselling, referrals in addition with a follow-up mechanism. Results: 131,810 MWRAs were reached by 191 community health workers through 29,693 of community support group meetings and 166,775 house hold visits. These MWRAs were counselled on FP related myths and misconception and referred to 216 providers trained for quality family planning services and maintaining average 64% quality scores in 43 public health and 35 private facilities in the project area. Of those referred 26% MWRAs opted modern contraception with 17.56% in LARCs and 41% PPFP as compared to baseline. Aman TeleHealth is linked with 24/7 counselling, referrals and post services follow-ups to clients, showing 14% proportion of FP call volume. Sukh has a unique role in engaging all partners on youth SRHR issues through family life education sessions, 30 higher sec. schools in Sukh area have been provided LSBE to 16,000 students (aged 15-17), and in community approximately 10, 496 girls and boys have received SRHR information. Conclusion: Through individual counselling, access to quality family planning services and involvement of stakeholders, Suk created an enabling environment to rapid increase in family planning in the project intervention area.

Keywords: family planning and reproductive health, married women with reproductive age, urban squatter, Pakistan

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Authors: Jonathan Turner, Julie Doyle, Laura O’Philbin, Dympna O’Sullivan

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People living with dementia should be at the centre of decision-making regarding goals for daily living. These goals include basic activities (dressing, hygiene, and mobility), advanced activities (finances, transportation, and shopping), and meaningful activities that promote well-being (pastimes and intellectual pursuits). However, there is limited involvement of people living with dementia in the design of technology to support their goals. A project is described that is co-designing intelligent computer-based support for, and with, people affected by dementia and their carers. The technology will support self-management, empower participation in shared decision-making with carers and help people living with dementia remain healthy and independent in their homes for longer. It includes information from the patient’s care plan, which documents medications, contacts, and the patient's wishes on end-of-life care. Importantly for this work, the plan can outline activities that should be maintained or worked towards, such as exercise or social contact. The authors discuss how to integrate care goal information from such a care plan with data collected from passive sensors in the patient’s home in order to deliver individualized planning and interventions for persons with dementia. A number of scientific challenges are addressed: First, to co-design with dementia patients and their carers computerized support for shared decision-making about their care while allowing the patient to share the care plan. Second, to develop a new and open monitoring framework with which to configure sensor technologies to collect data about whether goals and actions specified for a person in their care plan are being achieved. This is developed top-down by associating care quality types and metrics elicited from the co-design activities with types of data that can be collected within the home, from passive and active sensors, and from the patient’s feedback collected through a simple co-designed interface. These activities and data will be mapped to appropriate sensors and technological infrastructure with which to collect the data. Third, the application of machine learning models to analyze data collected via the sensing devices in order to investigate whether and to what extent activities outlined via the care plan are being achieved. The models will capture longitudinal data to track disease progression over time; as the disease progresses and captured data show that activities outlined in the care plan are not being achieved, the care plan may recommend alternative activities. Disease progression may also require care changes, and a data-driven approach can capture changes in a condition more quickly and allow care plans to evolve and be updated.

Keywords: care goals, decision-making, dementia, self-care, sensors

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Authors: Alyona Cerfontyne, Levita D'Souza, Lefteris Patlamazoglou

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Unlike adoption and donor-assisted reproduction, misattributed paternity occurring within the context of spontaneous conception and outside of formally recognised practices of having a child remains largely an understudied phenomenon. In adulthood, to discover misattributed paternity, i.e., that the man you call your father is not related to you genetically, can have profound implications for everyone affected. Until the advent of direct-to-consumer DNA testing 20 years ago, such discoveries were relatively rare. Despite the growing number of individuals uncovering their biogenetic paternity through genetic testing, there is very limited research on misattributed paternity from the perspective of adult children affected by it. No research exists on how to support these individuals through counselling post-discovery. Framed as insider action research, this study aimed to explore the perceived psychosocial consequences of misattributed paternity discoveries and coping strategies used by individuals who discover their misattributed paternity status in adulthood. In total, 12 individuals with misattributed paternity participated in semi-structured interviews in July-August 2022. The collected data was analysed using reflexive thematic analysis. The study’s results indicate that discovering misattributed paternity in adulthood can be likened to a watershed moment forever changing the trajectory of one’s life. Psychological experiences consistent with trauma, as well as grief and loss, re-evaluation of close family relationships, reestablishment of one’s identity, as well as experiencing a profound need to belong are the key themes emerging from the analysis of psychosocial experiences. Post-discovery, individuals with misattributed paternity employ a wide range of emotional and problem-focused coping strategies, amongst which seeking connection with those who understand, searching for information on the new biogenetic family and finding new meanings to life are most prominent. The study contributes both to the academic and practical knowledge of experiences of misattributed paternity and highlights the importance of further research on the topic.

Keywords: discovery of misattributed paternity, misattributed paternity, paternal discrepancy, psychosocial consequences, coping

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Authors: Saima Murtaza

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Ethics and aesthetics have invariably remained the two closely integrated artistic appurtenances for the production of any work of art. These artistic devices configure themselves into a complex synthesis in our contemporary literature. The labyrinthine integration of ethics and aesthetics, operating in the lives of human characters, to the extent of transcending all limits has resulted in an artistic puzzle for the readers. Art, no doubt, is an extrinsic expression of the intrinsic life of man. The use of aesthetics in literature pertaining to human existence; aesthetic solipsism, has resulted in the artistic objectification of these characters. The practice of the like aestheticism deprives the characters of their souls, rendering them as mere objects of aesthetic gaze at the hands of their artists-creators. Artists orchestrate their lives founding it on a plot which deviates from normal social and ethical standards. Their perverse attitude can be seen in dealing with characters, their feelings and the incidents of their lives. Morality is made to appear not as a religious construct but as an individual’s private affair. Furthermore, the idea of beauty incarnated, in other words hedonistic aesthetic does not placate a true aesthete. Ethics and aesthetics are the two most recurring motifs of our contemporary literature, especially of Nabokov’s world. The purpose of this study is to peruse these aforementioned motifs in Nabokov’s most enigmatic novel Lolita, a story of pedophilia, which is in fact reflective of our complex individual psychic and societal patterns. The narrative subverts all the traditional and hitherto known notions of aesthetics and ethics. When applied to literature, aesthetic does not simply mean ‘beautiful’ in the text. It refers to an intricate relationship between feelings and perception and also incorporates within its range wide-ranging emotional reactions to text. The term aesthetics in literature is connected with the readers whose critical responses to the text determine the merit of any work to be really a piece of art. Aestheticism is the child of ethics. Morality sets the grounds for the production of any work and the idea of aesthetics gives it transcendence.

Keywords: ethics, aesthetics and hedonistic aesthetic, nymphet syndrome, pedophilia

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Authors: Mesfin Abebe Molla

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This research aims to examine the practices of inclusion of the hard of hearing and deaf students in regular schools. It also focuses on exploring strategies for optimal benefits of students with Hard of Hearing and Deaf (HH-D) from inclusion. Concurrent mixed methods research design was used to collect quantitative and qualitative data. The instruments used to gather data for this study were questionnaire, semi- structured interview, and observations. A total of 102 HH-D students and 42 primary and High School teachers were selected using simple random sampling technique and used as participants to collect quantitative data. Non-probability sampling technique was also employed to select 14 participants (4-school principals, 6-teachers and 4-parents of HH-D students) and they were interviewed to collect qualitative data. Descriptive and inferential statistical techniques (independent sample t-test, one way ANOVA and Multiple regressions) were employed to analyze quantitative data. Qualitative data were also analyzed qualitatively by theme analysis. The findings reported that there were individual principals’, teachers’ and parents’ strong commitment and efforts for practicing inclusion of HH-D students effectively; however, most of the core values of inclusion were missing in both schools. Most of the teachers (78.6 %) and HH-D students (75.5%) had negative attitude and considerable reservations about the feasibility of inclusion of HH-D students in both schools. Furthermore, there was a statistically significant difference of attitude toward to inclusion between the two school’s teachers and the teachers’ who had taken and had not taken additional training on IE and sign language. The study also indicated that there was a statistically significant difference of attitude toward to inclusion between hard of hearing and deaf students. However, the overall contribution of the demographic variables of teachers and HH-D students on their attitude toward inclusion is not statistically significant. The finding also showed that HH-D students did not have access to modified curriculum which would maximize their abilities and help them to learn together with their hearing peers. In addition, there is no clear and adequate direction for the medium of instruction. Poor school organization and management, lack of commitment, financial resources, collaboration and teachers’ inadequate training on Inclusive Education (IE) and sign language, large class size, inappropriate assessment procedure, lack of trained deaf adult personnel who can serve as role model for HH-D students and lack of parents and community members’ involvement were some of the major factors that affect the practicing inclusion of students HH-D. Finally, recommendations are made to improve the practices of inclusion of HH-D students and to make inclusion of HH-D students an integrated part of Ethiopian education based on the findings of the study.

Keywords: deaf, hard of hearing, inclusion, regular schools

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Authors: Neha Bharti, Martin Sénéchal, Danielle R. Bouchard

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Mostly attributed to lack of time, only 15% of adults currently reach the International Physical Activity Guidelines, which state that every adult should achieve minimum of 150 minutes of aerobic exercise per week at moderate to vigorous intensity in minimum bouts of 10 minutes each, in addition to two days of resistance training. Recent studies have suggested that any bout of aerobic exercise reaching moderate intensity has potential to improve health. If one could reach moderate intensity while doing resistance training, this could reduce the total weekly time involvement to reach the International Physical Activity Guidelines. Objectives: 1) To determine whether overweight and older adults can reach a minimum of moderate intensity while doing resistance training compared with young non-overweight adults, 2) To identify if the proportion of time spent at moderate to vigorous intensity is different in overweight adults and older adults when compared with young non-overweight adults when lifting 70% or 80% of maximal load, 3) To determine variables associated with proportion of time spent at moderate to vigorous intensity while doing resistance training. Methods: Sixty participants already doing resistance training were recruited (20 young non-overweight adults, 20 overweight adults, and 20 older adults). Participants visited fitness facility three times, separated by at least 48 hours, and performed eight resistance exercises each time. First visit was to collect baseline measurements and to measure maximal load for each of the eight exercises. Second and third visits were performed wearing a heart rate monitor to record heart rate and to measure exercise intensity. The two exercise sessions were performed at 70% and 80% of maximal capacity. Moderate intensity was defined as 40% of heart rate reserve. Results: The proportion of time spent at moderate to vigorous intensity ranged from 51% to 93% among the three groups. No difference was observed between the young group and the overweight adults group in the proportion of time spent at moderate to vigorous intensity, 82.6% (69.2-94.6) vs 92.5% (73.3-99.1). However, older adults spent lower proportion of time at moderate to vigorous intensity for both sessions 51.5% (22.0-86.6); P < .01. When doing resistance training at 70% and 80% of maximal capacity, the proportion of time spent at moderate to vigorous intensity was 82.3% (56.1-94.7) and 82.0% (59.2-98.0) with no significant difference (P=.83). Conclusion: This study suggests that overweight adults and older adults can reach moderate intensity for at least 51% of the time spent doing resistance training. However, time spent at moderate to vigorous intensity was lower for older adults compared to young non-overweight adults. For adults aged 60 or less, three resistance training sessions of 60 minutes weekly could be enough to reach both aerobic and resistance training components of the International Physical Activity Guidelines. Further research is needed to test if resistance training at moderate to vigorous intensity can have the same health benefits compared with adults completing the International Physical Activity Guidelines as currently suggested.

Keywords: aerobic exercise, international physical activity guidelines, moderate to vigorous intensity, resistance training

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Authors: Tamunotonye Mayowa Braide, Isaac Oluwatayo

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This study investigates multidimensional poverty, and its correlates among rural households in Sekhukhune and Capricorn District municipalities (SDM & CDM) in Limpopo Province, South Africa. Primary data were collected from 407 rural households selected through purposive and simple random sampling techniques. Analytical techniques employed include descriptive statistics, principal component analysis (PCA), and the Alkire Foster (A-F) methodology. The results of the descriptive statistics showed there are more females (66%) than males (34%) in rural areas of Limpopo Province, with about 45% of them having secondary school education as the highest educational level attained and only about 3% do not have formal education. In the analysis of deprivation, eight dimensions of deprivation, constructed from 21 variables, were identified using the PCA. These dimensions include type and condition of dwelling water and sanitation, educational attainment and income, type of fuel for cooking and heating, access to clothing and cell phone, assets and fuel for light, health condition, crowding, and child health. In identifying the poor with poverty cut-off (0.13) of all indicators, about 75.9% of the rural households are deprived in 25% of the total dimensions, with the adjusted headcount ratio (M0) being 0.19. Multidimensional poverty estimates showed higher estimates of poor rural households with 71%, compared to 29%, which fall below the income poverty line. The study conducted poverty decomposition, using sub-groups within the area by examining regions and household characteristics. In SDM, there are more multidimensionally poor households than in CDM. The water and sanitation dimension is the largest contributor to the multidimensional poverty index (MPI) in rural areas of Limpopo Province. The findings can, therefore, assist in better design of welfare policy and target poverty alleviation programs and as well help in efficient resource allocation at the provincial and local municipality levels.

Keywords: Alkire-Foster methodology, Limpopo province, multidimensional poverty, principal component analysis, South Africa

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Authors: Khanday Pervaiz Ahmad

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It was in 19th century when the Indian educated class started to reform their socio-religious set up as an imperative to respond to the challenges put forward by the colonial empire. The colonial discourse on India from the very beginning was gendered, as the colonized society was feminized and its ‘effeminate’ character, as opposed to ‘colonial masculinity’ was held to be a justification for its loss of independence. The ‘women health figure’ is prominently in these gender discourses. The women’s health received a much place in the colonial discourse. Lack of health consciousness, illiteracy, and belief in myths, rituals and superstitions were deemed the main factors taken as an indicator of miserable condition of Indian women’s health. As the low position of women caused shame to the natives, reforming the condition of women, its health occupied a major place in their intellectual as well as activist engagements. Magazines (journals) for women began to appear in various Indian languages in the mid to late 19th century with Bengal leading the front. These sources (Magazines) like Harm, Tehzib un Niswan, Saheli, Khatoon etc. are essential for the study of the emergence of an ideology of respectable domesticity in Indian Muslim upper middle class. Similarly for the study of development of Women’s health consciousness, women’s magazines are very essential. These earliest women Urdu magazines were first started by men, and then followed by the women’s own magazines. Various health issues, like pregnancy, child-rearing, menstruation, midwives training, Pardah, and health etc. were discussed at a time when it was impossible to discuss them in public sphere. These women magazines were brave pioneers, expanding the frontiers of women’s roles, and consciousness at a time when those frontiers were severely limited. This paper will try to focus on how women responded to the question of colonial discourse about their bodies. How health consciousness developed among Indian Muslim women and in what way it contributed in the development of feminist consciousness in South Asian Muslim Women community.

Keywords: Ashraf class, khatoon, haram women, feminism

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Authors: Geraldine Landon, Enora Clero, Jean-Rene Jourdain

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In 2005, the Institut de Radioprotection et de Sûreté Nucléaire (IRSN, France) launched a research program named EPICE (acronym for 'Evaluation of Pathologies potentially Induced by CaEsium') to collect scientific information on non-cancer effects possibly induced by chronic exposures to low doses of ionizing radiation with the view of addressing a question raised by several French NGOs related to health consequences of the Chernobyl nuclear accident in children. The implementation of the program was preceded by a pilot phase to ensure that the project would be feasible and determine the conditions for implementing an epidemiological study on a population of several thousand children. The EPICE program focused on childhood cardiac arrhythmias started in May 2009 for 4 years, in partnership with the Russian Bryansk Diagnostic Center. The purpose of this cross-sectional study was to determine the prevalence of cardiac arrhythmias in the Bryansk oblast (depending on the contamination of the territory and the caesium-137 whole-body burden) and to assess whether caesium-137 was or not a factor associated with the onset of cardiac arrhythmias. To address these questions, a study bringing together 18 152 children aged 2 to 18 years was initiated; each child received three medical examinations (ECG, echocardiography, and caesium-137 whole-body activity measurement) and some of them were given with a 24-hour Holter monitoring and blood tests. The findings of the study, currently submitted to an international journal justifying that no results can be given at this step, allow us to answer clearly to the issue of radiation-induced childhood arrhythmia, a subject that has been debated for many years. Our results will be certainly helpful for health professionals responsible for the monitoring of population exposed to the releases from the Fukushima Dai-ichi nuclear power plant and also useful for future comparative study in children exposed to ionizing radiation in other contexts, such as cancer radiation therapies.

Keywords: Caesium-137, cardiac arrhythmia, Chernobyl, children

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Authors: E. Gopi, E. Devaindran

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Objective: Non-operative management of blunt splenic trauma have started to overtake the traditional splenectomy in recent years across the grade of splenic injury. The two main non-operative methods are observation and angioembolisation. However, the post management convalescence in these groups are still being investigated. The study attempts to quantify the clinical indicators among the two in particular complications, mortalities, conversions to operative management and duration of inpatient stay. Methodology: A systematic search was done via PUBMED, MEDLINE, and EMBASE. A total of 639 articles identified and subsequently 68 articles were identified post duplicates, full text, and inclusion and exclusion criteria. Main exclusions were non-English articles without English translation, pure observational or angioembolisation articles of which no comparison data could be identified and articles looking into pure hemodynamically unstable patients. Results: 24 non randomized controlled trial, 5 clinical control trial and 39 retrospective studies analyzing a total of 23700 patients with blunt splenic trauma. Discrepancies in data were noted in the group who had observational management versus angioembolisation in particular as data was compared among the classes of splenic rupture, the protocol of management in different centers, availability of angiogram suite, and the study design. Further variability was also noted in the angioembolisation arm as the preference for treatment differs between distal versus proximal splenic artery involvement. Overall the cumulative mortality in both observational and angioembolisation group were similar, 2.78% and 5.97% respectively. The cause of death however is not directly attributed to the management itself but rather patient comorbidities, other associated injuries and conversions to splenectomy leading to post splenectomy complications. The cumulative morbidity among each group appears to be same approximately 12% in observational versus 15% in angioembolisation. However, the type of complications varies with the observational group having higher rates of inpatient stay and intrabdominal hematoma infection and angioembolisation group developing more splenic infarcts and bleeds. There were significant disparity in reporting the actual data on duration of inpatient stay and complications to allow a statistically significant quantitative analysis to be done, 15 articles however are currently being considered. Conclusions: Observational management appears to be much effective in managing lower grade splenic trauma (grade 1 and 2) where else angioembolisation appears to play a bigger role in intermediate grades (grade 3-4) in ensuring splenic function preservation. Care has to be taken however in the angioembolisation group in view of distal splenic infarct group compromising splenic function. The cumulated data of 15 articles are now being considered for a meta-analysis.

Keywords: blunt splenic trauma, conservative, non-operative, angioembolisation

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Authors: M. Sulieman, H. Arabiyat, H. Ali, K. Potiszil, I. Abbas, R. English, P. King, I. Brown, P. Drew

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Introduction: The incidence of breast ductal Carcinoma in Situ (DCIS) has been increasing; it currently represents up 20-25% of all breast carcinomas. Some aspects of DCIS management are still controversial, mainly due to the heterogeneity of its clinical presentation and of its biological and pathological characteristics. In DCIS, histological diagnosis obtained preoperatively, carries the risk of sampling error if the presence of invasive cancer is subsequently diagnosed. The mammographic extent over than 4–5 cm and the presence of architectural distortion, focal asymmetric density or mass on mammography are proven important risk factors of preoperative histological under staging. Intracystic papillary cancer (IPC) is a rare form of breast carcinoma. Despite being previously compared to DCIS it has been shown to present histologically with invasion of the basement membrane and even metastasis. SLNB – Carries the risk of associated comorbidity that should be considered when planning surgery for DCIS and IPC. Objectives: The aim of this Audit was to better define a ‘high risk’ group of patients with pre-op diagnosis of non-invasive cancer undergoing breast conserving surgery, who would benefit from sentinel node biopsy. Method: Retrospective data collection of all patients with ductal carcinoma in situ over 5 years. 636 patients identified, and after exclusion criteria applied: 394 patients were included. High risk defined as: Extensive micro-calcification >40mm OR any mass forming DCIS. IPC: Winpath search from for the term ‘papillary carcinoma’ in any breast specimen for 5 years duration;.29 patients were included in this group. Results: DCIS: 188 deemed high risk due to >40mm calcification or a mass forming (radiological or palpable) 61% of those had a mastectomy and 32% BCS. Overall, in that high-risk group - the number with invasive disease was 38%. Of those high-risk DCIS pts 85% had a SLN - 80% at the time of surgery and 5% at a second operation. For the BCS patients - 42% had SLN at time of surgery and 13% (8 patients) at a second operation. 15 (7.9%) pts in the high-risk group had a positive SLNB, 11 having a mastectomy and 4 having BCS. IPC: The provisional diagnosis of encysted papillary carcinoma is upgraded to an invasive carcinoma on final histology in around a third of cases. This has may have implications when deciding whether to offer sentinel node removal at the time of therapeutic surgery. Conclusions: We have defined a ‘high risk’ group of pts with pre-op diagnosis of non-invasive cancer undergoing BCS, who would benefit from SLNB at the time of the surgery. In patients with high-risk features; the risk of invasive disease is up to 40% but the risk of nodal involvement is approximately 8%. The risk of morbidity from SLN is up to about 5% especially the risk of lymphedema.

Keywords: breast ductal carcinoma in Situ (DCIS), intracystic papillary carcinoma (IPC), sentinel node biopsy (SLNB), high-risk, non-invasive, cancer disease

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Authors: Anum Obaid, Bushra Noor, Zoshia Zainab

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In South Asian countries, Pakistan faces significant public health challenges regarding maternal and neonatal health (MNH). Despite global efforts to improve maternal, newborn, child, and health (MNCH) outcomes through initiatives like the Millennium Development Goals (MDGs) and Sustainable Development Goals (SDGs), high maternal and neonatal mortality rates persist. In patriarchal societies, cultural norms, family dynamics, and gender roles heavily influence healthcare accessibility and decision-making processes, often leading to delayed and inadequate maternal care. Addressing these socio-cultural barriers and enhancing healthcare resources is crucial to improving maternal health outcomes in areas like Faisalabad. A qualitative study was conducted involving two groups of informants: gynecologists practicing in private clinics and first-time pregnant women receiving care in government hospitals. Data collection included obtaining institutional permission, conducting semi-structured in-depth interviews, and using non-probability sampling techniques. A proactive strategy to overcome maternal health challenges involves using aversion therapy and disseminating knowledge among family members. This approach aims to foster a deep understanding within the family unit regarding the importance of maternal well-being, thereby creating a supportive environment and facilitating informed decision-making related to healthcare access and lifestyle choices. The findings indicate that maternal health is compromised both physiologically and psychologically, with significant implications for the baby's health. Mental well-being, in particular, is profoundly affected, largely due to familial behavior and entrenched cultural taboos.

Keywords: maternal health, neonatal health, socio-cultural norms, primigravida women, gynecologist, familial conduct, cultural taboos

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Authors: Anum Obaid, Bushra Noor, Zoshia Zainab

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In South Asian countries, Pakistan faces significant public health challenges regarding maternal and neonatal health (MNH). Despite global efforts to improve maternal, newborn, child, and health (MNCH) outcomes through initiatives like the Millennium Development Goals (MDGs) and Sustainable Development Goals (SDGs), high maternal and neonatal mortality rates persist. In patriarchal societies, cultural norms, family dynamics, and gender roles heavily influence healthcare accessibility and decision-making processes, often leading to delayed and inadequate maternal care. Addressing these socio-cultural barriers and enhancing healthcare resources is crucial to improving maternal health outcomes in areas like Faisalabad. A qualitative study was conducted involving two groups of informants: gynecologists practicing in private clinics and first-time pregnant women receiving care in government hospitals. Data collection included obtaining institutional permission, conducting semi-structured in-depth interviews, and using non-probability sampling techniques. A proactive strategy to overcome maternal health challenges involves using aversion therapy and disseminating knowledge among family members. This approach aims to foster a deep understanding within the family unit regarding the importance of maternal well-being, thereby creating a supportive environment and facilitating informed decision-making related to healthcare access and lifestyle choices. The findings indicate that maternal health is compromised both physiologically and psychologically, with significant implications for the baby's health. Mental well-being, in particular, is profoundly affected, largely due to familial behavior and entrenched cultural taboos.

Keywords: maternal health, neonatal health, socio-cultural norms, primigravida women, gynecologist, familial conduct, cultural taboos.

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Authors: Mesfin Nigussie Ibido

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The study is designed to explore the effects of land certification in securing women’s land rights of two rural villages in Robe district at Arsi Zone of Oromia regional state. The land is very critical assets for human life survival and the backbone for rural women livelihood. Equal access and control power to the land have given a chance for rural women to participate in different economic activities and improve their bargaining ability for decision making on their rights. Unfortunately, women were discriminated and marginalized from access and control of land for centuries through customary practices. However, in many countries, legal reform is used as a powerful tool for eliminating discriminatory provisions in property rights. Among other equity and efficiency concerns, the land certification program in Ethiopia attempts to address gender bias concerns of the current land-tenure system. The existed rural land policy was recognizing a women land rights and benefited by strengthened wives awareness of their land rights and contribute to the strong involvement of wives in decision making. However, harmful practices and policy implementation problems still against women do not fully exercise a provision of land rights in a different area of the country. Thus, this study is carried out to examine the effect of land certification in securing women’s land rights by eliminating the discriminatory nature of cultural abuses of study areas. Probability and non-probability sampling types were used, and the sample size was determined by using the sampling distribution of the proportion method. Systematic random sampling method was applied by taking the nth element of the sample frame. Both quantitative and qualitative research methods were applied, and survey respondents of 192 households were conducted and administering questionnaires in the quantitative method. The qualitative method was applied by interviews with focus group discussions with rural women, case stories, Village, and relevant district offices. Triangulation method was applied in data collection, data presentation and in the analysis of findings. Study finding revealed that the existence of land certification is affected by rural women positively by advancing their land rights, but still, some women are challenged by unsolved problems in the study areas. The study forwards recommendation on the existed problems or gaps to ensure women’s equal access to and control over land in the study areas.

Keywords: decision making, effects, land certification, land right, tenure security

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Authors: Dina Mohamed Ayman, Rafieu Akin

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In an attempt to increase the female total entrepreneurial activities (TEA) within Egypt and Nigeria, this paper aims to investigate the challenges facing female entrepreneurs operating in Egypt, in relative to Nigeria. In this regard, both researchers undertook a qualitative approach due to the scarcity of the literature reviewed on the topic; in those particular countries, and as an in-depth comparative mode. Therefore, ten Egyptian entrepreneurs in relative to ten Nigerian entrepreneurs were in-depth investigated. The research findings prove that female entrepreneurs face complex problems for being both gender and country-specific. Regarding the gender-specific obstacles, the work/life imbalance due to the scarcity of child-care nurseries and the prevalence of the gender-role division while performing the house chores rather than the concept of co-operation, acted as a main source of cultural challenge because women are considered mostly as 'housewives'. However, interestingly, this specific gender-discrimination challenge is proven to have no grounded effect in terms of the business-establishment and daily dealings neither in Egypt nor Nigeria, as one of the sample exclaimed 'as long as you pay, then no gender difference is set on the table'. Other country-specific challenges facing female entrepreneurs, lied in, the aggregate weak entrepreneurial framework governing both countries, also, women faced the difficulty of access to financial institutions with collateral requirements that are usually "hardly to be met", besides, the absence of the "micro-credit-Grameen-banks" concept. As well, the scarcity of incubators and business training centers providing network, consultancy and well-trained workforce to female entrepreneurs constitute a major hurdle for women entrepreneurs operating in both countries. Finally, this paper will conclude the research by offering a set of public-policy recommendations to pave the way for females to choose self-employment as a career path.

Keywords: entrepreneurship, female entrepreneurship, obstacles, framework conditions, culture, micro-credit

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Authors: Luciano Tarantino, Emanuele Balzano, Aurelio Nasto

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S.R. 53 years. January 2009: HCV-related cirrhosis, Child-Pugh A5 class, EGDS no aesophageal Varices. No important comorbidities. Treated with PEG-IFN+Ribavirin (march-november 2009) with subsequent sustained virologic response. HCVRNA absent overtime. October 2016 :CT detected small HCC nodule in the VIII segment (diam.=12 mm). Treated with US guided RF-ablation. November 2016 CT: complete necrosis. Unfortunately, the patient dropped out US and CT follow-up controls.September 2018: asthenia and weight loss. CT showed a large tumor infiltrating V-VII-VI segments and complete PVTT of right portal vein and its branches . Surgical Consultation excluded indication to Liver resection and OLT . 23 october 2018: ECT of a large peri-hilar area of the tumor including the PVTT. 1 and 3 months post-treatment CT showed complete necrosis and retraction of the thrombus and residual viable tumor in the peripheral portion of the right lobe . Therefor, the patient was reevaluated for OLT and considered eligible in waiting list . March 2019: CT showed no perihilar or portal vein recurrence and distant progression in the right lobe . March 2019 : Trans-arterial-Radio-therapy (TARE) of the right lobe. Post-treatment CT demonstrated no perihilar or portal vein recurrence and extensive necrosis of the residual tumor . December 2019: CT demonstrated several recurrences of HCC infiltrating the VI and VII segment . Howewer no recurrence was observed at hepatic hilum and in portal vessels . Therefore, on February 2020 the patient received OLT. At 44 months follow-up, no complication or recurrence or liver disfunction have been observed.

Keywords: hepatocellular carcinoma, portal vein tumor thrombosis, interventional ultrasound, liver tumor ablation, liver transplantation

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Authors: Remya Radhakrishnan, Hema Perinbanathan, Anukriti Rath, Reshmi Ramachandran, Rohith Thazhathuvetil Sasindrababu, Maria Karizhenskaia

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Childhood adversities have lasting effects on health and well-being. This abstract explores the connection between adverse childhood experiences (ACEs) and health consequences, including substance abuse and obesity. Understanding the impact of childhood trauma and emphasizing the importance of culturally sensitive treatments and focused interventions help to mitigate these effects. Research consistently shows a strong link between ACEs and poor health outcomes. Our team conducted a comprehensive literature review of depression and anxiety in Canadian children and youth, exploring diverse treatment methods, including medical, psychotherapy, and alternative therapies like art and music therapy. We searched Medline, Google Scholar, and St. Lawrence College Library. Only original research papers, published between 2012 and 2023, peer-reviewed, and reporting on childhood adversities on health and its treatment methods in children and youth in Canada were considered. We focused on their significance in treating depression and anxiety. According to the study's findings, the prevalence of adverse childhood experiences (ACEs) is still a significant concern. In Canada, 40% of people report having had multiple ACEs, and 78% report having had at least one ACE, highlighting the persistence of childhood adversity and indicating that the issue is unlikely to fade off in the near future. Likewise, findings revealed that individuals who experienced abuse, neglect, or violence during childhood are likelier to engage in harmful behaviors like polydrug use, suicidal ideation, and victimization and suffer from mental health problems such as depression and post-traumatic stress disorder (PTSD).

Keywords: adverse childhood experiences (ACEs), obesity, post-traumatic stress disorder (PTSD), resilience, substance abuse, trauma-informed care

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Authors: Obaidul Fattah Tanvir, Zinat Ara Afroze

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Community living adjacent to forests and Protected Areas, especially in South Asian countries, have a common practice in extracting resources for their living and livelihoods. This extraction of resources, because the way it is done, destroys the biophysical features of the area. Deforestation, wildlife poaching, illegal logging, unauthorized hill cutting etc. are some of the serious issues of concern for the sustainability of the natural resources that has a direct impact on environment and climate as a whole. To ensure community involvement in conservation initiatives of the state, community based forest management, commonly known as Comanagement, has been in practice in 6 South Asian countries. These are -India, Nepal, Sri Lanka, Pakistan, Bhutan and Bangladesh. Involving community in forestry management was initiated first in Bangladesh in 1979 and reached as an effective co-management approach through a several paradigm shifts. This idea of Comanagement has been institutionalized through a Government Order (GO) by the Ministry of Environment and Forests, Government of Bangladesh on November 23, 2009. This GO clearly defines the structure and functions of Co-management and its different bodies. Bangladesh Forest Department has been working in association with community to conserve and manage the Forests and Protected areas of Bangladesh following this legal document. Demographically young people constitute the largest segment of population in Bangladesh. This group, if properly sensitized, can produce valuable impacts on the conservation initiatives, both by community and government. This study traced the major factors that motivate community youths to work effectively with different tiers of comanagement organizations in conservation of forests and Protected Areas of Bangladesh. For the purpose of this study, 3 FGDs were conducted with 30 youths from the community living around the Protected Areas of Cox’s bazar, South East corner of Bangladesh, who are actively involved in Co-management organizations. KII were conducted with 5 key officials of Forest Department stationed at Cox’s Bazar. 2 FGDs were conducted with the representatives of 7 Co-management organizations working in Cox’s Bazar region and approaches of different community outreach activities conducted for forest conservation by 3 private organizations and Projects have been reviewed. Also secondary literatures were reviewed for the history and evolution of Co-management in Bangladesh and six South Asian countries. This study found that innovative community outreach activities that are financed by public and private sectors involving youths and community as a whole have played a pivotal role in conservation of forests and Protected Areas of the region. This approach can be replicated in other regions of Bangladesh as well as other countries of South Asia where Co-Management exists in practice.

Keywords: community, co-management, conservation, forests, protected areas, youth

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Authors: Kathryn Rooney, Kaitlyn Eddy, Evan Landers, Weihui Li

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The international mortality rate for neonates and infants has been declining at a disproportionally low rate when compared to the overall decline in child mortality in recent decades. A significant portion of infant deaths could be prevented with the implementation of low-cost and easy to use physiological monitoring devices, by enabling early identification of symptoms before they progress into life-threatening illnesses. The oral diagnostic device discussed in this paper serves to continuously monitor the key vital signs of body temperature, respiratory rate, heart rate, and oxygen saturation. The device mimics an infant pacifier, designed to be easily tolerated by infants as well as orthodontically inert. The fundamental measurements are gathered via thermistors and a pulse oximeter, each encapsulated in medical-grade silicone and wired internally to a microcontroller chip. The chip then translates the raw measurements into physiological values via an internal algorithm, before outputting the data to a liquid crystal display screen and an Android application. Additionally, a biological sample collection chamber is incorporated into the internal portion of the device. The movement within the oral chamber created by sucking on the pacifier-like device pushes saliva through a small check valve in the distal end, where it is accumulated and stored. The collection chamber can be easily removed, making the sample readily available to be tested for various diseases and analytes. With the vital sign monitoring and sample collection offered by this device, abnormal fluctuations in physiological parameters can be identified and appropriate medical care can be sought. This device enables preventative diagnosis for infants who may otherwise have gone undiagnosed, due to the inaccessibility of healthcare that plagues vast numbers of underprivileged populations.

Keywords: neonate mortality, infant mortality, low-cost diagnostics, vital signs, saliva testing, preventative care

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Authors: Chirine Dannaoui, Maya Antoun

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This paper explores the intricate dynamics of play-based early childhood education (ECE) and the impact of professional development on teachers implementing play-based pedagogy, particularly in the context of vulnerable Syrian refugee children in Lebanon. By utilizing qualitative methodologies, including classroom observations and in-depth interviews with five early childhood educators and a field manager, this study delves into the challenges and transformations experienced by teachers in adopting play-based learning strategies. The research unveils the critical role of continuous and context-specific professional development in empowering teachers to implement play-based pedagogies effectively. When appropriately supported, it emphasizes how such educational approaches significantly enhance children's cognitive, social, and emotional development in crisis-affected environments. Key findings indicate that despite diverse educational backgrounds, teachers show considerable growth in their pedagogical skills through targeted professional development. This growth is vital for fostering a learning environment where vulnerable children can thrive, particularly in humanitarian settings. The paper also addresses educators' challenges, including adapting to play-based methodologies, resource limitations, and balancing curricular requirements with the need for holistic child development. This study contributes to the discourse on early childhood education in crisis contexts, emphasizing the need for sustainable, well-structured professional development programs. It underscores the potential of play-based learning to bridge educational gaps and contribute to the healing process of children facing calamity. The study highlights significant implications for policymakers, educators, schools, and not-for-profit organizations engaged in early childhood education in humanitarian contexts, stressing the importance of investing in teacher capacity and curriculum reform to enhance the quality of education for children in general and vulnerable ones in particular.

Keywords: play-based learning, professional development, vulnerable children, early childhood education

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Authors: Matteo Mazzucato, Elena Faccio, Antonio Iudici

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Prison is a social reality constructed by everyday interactions between an inmate, other social actors (cellmates, prison officers, educationalists and psychologists or other detainees) and the external world which participates in this complex construction through the social discourses on prison reality and its problems. Being a detainee means performing a self dealing with processes of stereotypization, attribution of a social role and prejudices assigned by various interlocutors and depending on what kind of crime one has been convicted of. Among all inmates, sex offenders are the ones who risk more to be socially condemned beyond a legal sentence since they have committed one of the most hated and disapproved crime. Regarding this, prison has to be considered as a critical context in which all community expectations and beliefs are converged: for common sense, rapists and child molesters are dangerous people who have to be stigmatized, punished and isolated. Furthermore, other detainees share a code of conduct by which the ‘sex offender’ is collocated at the lowest level of the social hierarchy of the prison. The penitentiary administration too defines this kind of detainee as a ‘vulnerable person to protect’ while prison staff considers him as a particular inmate who has to be treated and definitely changed. Considering all the complexities connected with being imprisoned as a sex offender, our research aimed at exploring how people convicted of sex crimes are called upon to manage all these hetero-narrations about their selves. Set this goal, textual data retrieved from this qualitative research show that sex offenders tend to not face the stigma assigned to them. They are rather used to minimize the story telling about their selves and costruct alternative biographies to be shared with other inmates. Managing narrations about their selves in this way permits to distance them from all the threats perceived living together with other detainees but it blocks sex offenders’ ri-signification of their offences during prison treatment. Given these results, prison administration should develop activities in order to create fields of interaction between detainees where experiencing new versions of their selves spendable even in external social situations. Regarding this it’s important to re-consider prison as part of the community and the sex offenders as a member of it.

Keywords: interactions, qualitative research, prison reality, sex offender

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Authors: Rupali Chaudhary

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Shakespeare has been widely revisited by dramatists, critics, filmmakers and scholars around the globe. Shakespeare's kaleidoscopic work has been borrowed and redesigned into resonant patterns by artists, thus weaving myriad manifestations to pick from. Along with adaptation into wholly verbal medium (e.g., translations) the practice of indigenization through performing arts has played a great role in amplifying the reach of plays. The proliferation of Shakespeare's oeuvre commenced with the spread of colonialism itself. The plays illustrating the core values of Western tradition were introduced in the colonies. Therefore, the colonial domination extended to cultural domination. The plays were translated and adapted by the locals at times as it is and sometimes intermingled with the altered landscape and culture. The present paper discusses the global dimensions of Shakespearean cinema along with the historical cinematic shift from silent era to spoken dialogue in multiple languages. The methodology followed is descriptive in nature, and related information is availed from related literature, i.e., books, research articles and films. America and Europe dominated the silent era Shakespearean film production, thereby giving the term 'global' a less broad meaning. Five nations that dominated silent Shakespearean cinema were the United States, England, Italy, France, and Germany. Gradually the work of the exemplary figure with artistic and literary greatness surpassed the boundaries of the colonies and became a global legacy. Presently apart from English speaking nations Shakespearean films have been shot or produced in many of non-Anglophone locales. The findings indicate that when discussing about global dimensions of Shakespearean cinema various factors can be considered: involvement of actors and directors of foreign origin, transportability and universal comprehensibility of visual imagery across geographical borders, commodification of art or West's use of it as a tool of cultural hegemony or promotion of international amity, propagation of interculturalism through individual director's cultural translations and localization of Western art. Understanding of Shakespeare as a global export also depends on how an individual Shakespearean film works. Shakespeare's global appeal for cinema does not reside alone in his exquisite writings, distinctive characters, the setting, the story and the plots that have nurtured cinema since the medium's formative years. Shakespeare's global cinematic appeal is present in the spirit of cinema itself, i.e., the moving images capturing human behaviour and emotions that the plays invoke in audiences.

Keywords: adaptation, global dimensions, Shakespeare, Shakespearean cinema

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