Search results for: ministry programs

Authors: Sonda Jallouli, Sameh Ghroubi, Salma Sakka, Abdelmoneem Yahia, Mohamed Habib Elleuch, Imen Ben Dhia, Chokri Mhiri, Omar Hammouda

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The pathophysiology, prevalence, and progression of MS are gender dependent. Indeed, the inflammation is more pronounced in women, but the neurodegeneration is more important in men. In addition, women have more sleep disorders while men suffer more from cognitive decline. These non-physical disorders can negatively affect postural balance and fall risk. However, no study has examined the difference between men and women in those physical parameters in MS. Our objective was to determine the effect gender difference on postural balance and fall risk in MS persons. Methods: Eight men and twelve women with relapsing remitting-MS participated in this study. The assessment includes a posturographic examination to assess static (with eyes opened (EO) and eyes closed (EC)) and dynamic (with EO) postural balance. Unipedal balance and fall risk were assessed by a clinical unipedal balance test and the Four Square Step Test, respectively. Sleep quality was assessed using Spiegel's questionnaire, and cognitive assessment was performed using the Montreal Cognitive Assessment (MoCA) and the Simple Reaction Time Test. Results: Compared to men, women showed an increase in CdPVm in static bipedal condition with EC (p=0.037; d=0.71) and a decrease in MoCA scores (p=0.028; d=1.06). No gender differences were found in the other tests. Discussion: Static postural balance was more impaired in women compared to men. This result could be explained by the more pronounced cognitive decline observed in women compared to men. Indeed, cognitive disorders have been shown to be predictive factors of postural balance impairment. Conclusion: women were less stable than men in the static condition, possibly due to their lower cognitive performance. This gender difference could be taken into account by therapists in training programs.

Keywords: multiple sclerosis, bipedal postural balance, fall risk, sleep disturbance, cognitive deficiency

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Authors: Ana Maria Girotti Sperandio, Jussara Conceição Guarnieri, Lauro Luiz Francisco Filho, Ana Claudia Martins Alves, Adriana Aparecida Carneiro Rosa

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The urban planning of a city should contemplate the construction of healthy spaces to provide quality of life for people. In a Brazilian municipality located 180 km from the capital of São Paulo with around 27,000 thousand inhabitants, the federal government made possible a program that allows the improvement of the quality of life of the inhabitants through the practice of physical activity. To describe health promotion strategies in the city that collaborate in the reduction of chronic non-communicable diseases (CDNT) and the improvement the quality of its residents. Considering the CDNT as a fundamental public health concern in different countries, the methodology of this work considered the different actions of health promotion that occurred in the city for the implementation of the Polo Health Academy with the objective of increasing the population's access to places that could develop targeted physical activities. As an instrument, it used records of participants of this academy such as: assessment sheets, evolution, photos, filming and daily reports of physical activities. Results: The implantation and implementation process of the Polo Health Academy in the city of Conchal / SP / Brazil was in accordance with the principles and values of the National Health Promotion Policy (PNaPS) in Brazil and with the city statute, that provides improvement in the quality of life of the Brazilian population. An increase was observed in the number of participants in different hours practicing physical activities in the territory linked to one of the five Health Units, showing the program provides that happiness and well-being to the students. The Brazilian health promotion policy, combined with the city’s development policy, provides the population with access to programs that stimulate the reduction of CDNTs, confirming the urban planning of a healthy city.

Keywords: health city, health promotion, physical activity, urban planning

Procedia PDF Downloads 188

Authors: C. Vázquez, L. M. Gigirey, C. P. del Oro, S. Seoane

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Early detection of visual problems plays a key role in the aging process. However, although vision problems are common among older people, the percentage of aging people who perform regular optometric exams is low. In fact, uncorrected refractive errors are one of the main causes of visual impairment in this group of the population. Purpose: To evaluate functional vision of older residents in order to show the urgent need of visual screening programs in Galician nursing homes. Methodology: We examined 364 older adults aged 65 years and over. To measure vision of the daily living, we tested distance and near presenting visual acuity (binocular visual acuity with habitual correction if warn, directional E-Snellen) Presenting near vision was tested at the usual working distance. We defined visual impairment (distance and near) as a presenting visual acuity less than 0.3. Exclusion criteria included immobilized residents unable to reach the USC Dual Sensory Loss Unit for visual screening. Association between categorical variables was performed using chi-square tests. We used Pearson and Spearman correlation tests and the variance analysis to determine differences between groups of interest. Results: 23,1% of participants have visual impairment for distance vision and 16,4% for near vision. The percentage of residents with far and near visual impairment reaches 8,2%. As expected, prevalence of visual impairment increases with age. No differences exist with regard to the level of functional vision between gender. Differences exist between age group respect to distance vision, but not in case of near vision. Conclusion: prevalence of visual impairment is high among the older people tested in this pilot study. This means a high percentage of older people with limitations in their daily life activities. It is necessary to develop an effective vision screening program for early detection of vision problems in Galician nursing homes.

Keywords: functional vision, elders, aging, nursing homes

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Authors: Nino Paresashvili, Nino Abesadze

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The modern world faces huge challenges. Globalization changed the socio-economic conditions of many countries. The current processes in the global environment have a different impact on countries with different cultures. However, an alleviation of poverty and improvement of living conditions is still the basic challenge for the majority of countries, because much of the population still lives under the official threshold of poverty. It is very important to stimulate youth employment. In order to prepare young people for the labour market, it is essential to provide them with the appropriate professional skills and knowledge. It is necessary to plan efficient activities for decreasing an unemployment rate and for developing the perfect mechanisms for regulation of a labour market. Such planning requires thorough study and analysis of existing reality, as well as development of corresponding mechanisms. Statistical analysis of unemployment is one of the main platforms for regulation of the labour market key mechanisms. The corresponding statistical methods should be used in the study process. Such methods are observation, gathering, grouping, and calculation of the generalized indicators. Unemployment is one of the most severe socioeconomic problems in Georgia. According to the past as well as the current statistics, unemployment rates always have been the most problematic issue to resolve for policy makers. Analytical works towards to the above-mentioned problem will be the basis for the next sustainable steps to solve the main problem. The results of the study showed that the choice of young people is not often due to their inclinations, their interests and the labour market demand. That is why the wrong professional orientation of young people in most cases leads to their unemployment. At the same time, it was shown that there are a number of professions in the labour market with a high demand because of the deficit the appropriate specialties. To achieve healthy competitiveness in youth employment, it is necessary to formulate regional employment programs with taking into account the regional infrastructure specifications.

Keywords: unemployment, analysis, methods, tendencies, regulation mechanisms

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Authors: Birendra Kumar Jha, Mingma L. Sherpa, Binod Kumar Dahal

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Background: The metabolic syndrome is emerging as a major public health concern in the world. Urbanization, surplus energy uptake, compounded by decreased physical activities, and increasing obesity are the major factors contributing to the epidemic of metabolic syndrome worldwide. However, prevalence of metabolic syndrome and its risk factors are little studied in Terai region of Nepal. The objectives of this research were to estimate the prevalence and to identify the risk factors of metabolic syndrome among adults in Terai region of Nepal. Method: We used a community based cross sectional study design. A total of 225 adults (age: 18 to 80 years) were selected from three district of Terai region of Nepal using cluster sampling by camp approach. IDF criteria (central obesity with any two of following four factors: triglycerides ≥ 150 mg/dl or specific treatment for lipid abnormality, reduced HDL, raised blood pressure and raised fasting plasma glucose or previously diagnosed type 2 diabetes) were used to assess metabolic syndrome. Interview, physical and clinical examination, measurement of fasting blood glucose and lipid profile were conducted for all participants. Chi-square test and multivariable logistic regression were employed to explore the risk factors of metabolic syndrome. Result: The overall prevalence of metabolic syndrome was 70.7%. Hypertension, increased fasting blood sugar, increased triglycerides and decreased HDL were observed in 50.7%, 32.4%, 41.8% and 79.1% of the subjects respectively. Socio-economic and behavioral risk factors significantly associated with metabolic syndrome were gender male (OR=2.56, 955 CI: 1.42-4.63; p=0.002), in service or retired from service (OR=3.72, 95% CI: 1.72-8.03; p=0.001) and smoking (OR= 4.10, 95% CI: 1.19-14.07; p=0.016). Conclusion: Higher prevalence of Metabolic syndrome along with presence of behavioral risk factors in Terai region of Nepal likely suggest lack of awareness and health promotion activities for metabolic syndrome and indicate the need to promote public health programs in this region to maintain quality of life.

Keywords: metabolic syndrome, Nepal, prevalence, risk factors, Terai

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Authors: Lidia Kowalska, Edward Arseniuk

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Glume and leaf blotch is a disease of wheat caused by necrotrophic fungus Parastagonospora nodorum. It is a serious pathogen in many wheat-growing areas throughout the world. Use of resistant cultivars is the most effective and economical means to control the above-mentioned disease. Plant breeders and pathologists have worked intensively to incorporate resistance to the pathogen in new cultivars. Conventional methods of breeding for resistance can be supported by using the biotechnological ones, i.e., somatic embryogenesis and androgenesis. Therefore, an effort was undertaken to compare genetic variation in P. nodorum resistance among winter wheat somaclones, dihaploids and conventional varieties. For the purpose, a population of 16 somaclonal and 4 dihaploid wheat lines from six crosses were used to assess their resistance to P. nodorum under field conditions. Lines were grown in disease-free (fungicide protected) and inoculated micro plots in 2 replications of a split-plot design in a single environment. The plant leaves were inoculated with a mixture of P. nodorum isolates three times. Spore concentrations were adjusted to 4 x 10⁶ of viable spores per one milliliter. The disease severity was rated on a scale, where > 90% – susceptible, < 10% - resistant. Disease ratings of plant leaves showed statistically significant differences among all lines tested. Higher resistance to P. nodorum was observed more often on leaves of somaclonal lines than on dihaploid ones. On average, disease, severity reached 15% on leaves of somaclones and 30% on leaves of dihaploids. Some of the genotypes were showing low leaf infection, e.g. dihaploid D-33 (disease severity 4%) and a somaclone S-1 (disease severity 2%). The results from this study prove that dihaploid and somaclonal variation might be successfully used as an additional source of wheat resistance to the pathogen and it could be recommended to use in commercial breeding programs. The reported results prove that biotechnological methods may effectively be used in breeding for disease resistance of wheat to fungal necrotrophic pathogens.

Keywords: glume and leaf blotch, somaclonal, androgenic variation, wheat, resistance breeding

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Authors: Vassilis Argyropoulos, Magda Nikolaraizi, Maria Papazafiri

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This study describes a series of learning workshops, which took place within CUIDAR project. The workshops aimed to empower children to share their experiences and views in relation to natural hazards and disasters. The participants in the workshops were ten primary school students who had severe visual impairments or multiple disabilities and visual impairments (MDVI). The main objectives of the workshops were: a) to promote access of the children through the use of appropriate educational material such as texts in braille, enlarged text, tactile maps and the implementation of differentiated instruction, b) to make children aware regarding their rights to have access to information and to participate in planning and decision-making especially in relation to disaster education programs, and c) to encourage children to have an active role during the workshops through child-led and experiential learning activities. The children expressed their views regarding the meaning of hazards and disasters. Following, they discussed their experiences and emotions regarding natural hazards and disasters, and they chose to place the emphasis on a hazard, which was more pertinent to them, their community and their region, namely fires. Therefore, they recalled fires that have caused major disasters, and they discussed about the impact that these fires had on their community or on their country. Furthermore, they were encouraged to become aware regarding their own role and responsibility to prevent a fire or get prepared and know how to behave if a fire occurs. They realized that prevention and preparation are a matter of personal responsibility. They also felt the responsibility to inform their own families. Finally, they met important people involved in fire protection such as rescuers and firefighters and had the opportunity to carry dialogues. In conclusion, through child led workshops, experiential and accessible activities, the students had the opportunity to share their own experiences, to express their views and their questions, to broaden their knowledge and to realize their personal responsibility in disaster risk reduction, specifically in relation to fires.

Keywords: accessibility, children, disasters, visual impairment

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Authors: Kofi Nkonkonya Mpuangnan, Samantha Govender, Hlengiwe Romualda Mhlongo

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Educational leaders are skilled architects crafting a vibrant environment where growth, creativity, and adaptability can flourish within schools. Their journey is one of transformation, urging them to explore administrative strategies that align seamlessly with evolving educational models and cater to the specific needs of students, educators, and stakeholders. Through this committed effort to innovate, they seek to enhance the effectiveness and influence of educational systems, paving the way for a more inclusive and forward-thinking educational environment. In this context, the authors explored the concept of transforming educational leadership with administrative strategies in alignment with the following research objectives. To find the strategies that can be adopted by transformation leaders to promote effective administrative practices in an educational setting and to explore the roles of educational leaders in promoting collaboration in education. To find answers to these questions, a systematic literature review underpinned by the transformational leadership model was adopted. Therefore, concepts integrated from a variety of outlets, including academic journals, conference proceedings, and reports found within SCOPUS, WoS, and IBSS databases. A search was aided using specific themes like innovative administrative practices, the roles of educational leaders, and interdisciplinary approaches to administrative practices. The process of conducting the search adhered to the five-step framework, which was subjected to inclusion and exclusion of studies. It was found that transformational leadership, agile methodologies, employee wellbeing, seminars and workshops could foster a culture of innovation and creativity among teachers and staff to transform administrative practices in education settings. It was recommended that professional development programs be organized periodically for educational leaders in educational institutions to help them revitalize their knowledge and skills in educational administration.

Keywords: educational leadership, innovative strategies, administrative practices, professional development, stakeholder engaement, student outcome

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Authors: Amber Zahid, Fatima Naseer, Maham Atta, Fareeha Zafar

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Corporate social authority (CSR) talk, scholarly scrutinize, open arrangement and media editorials, which have thrived in the previous not many decades according to the craving to characterize the nexus between business and social order had a tendency to center primarily on expansive corporate associations which are required to act mindfully. The enormous organizations have for a long time pulled in huge volume of expositive expression on CSR. Almost no expositive expression is presently accessible to upgrade our comprehension about the engagement of little and medium-measured endeavors (SMEs) in CSR. The SMEs, regularly characterized differently regarding turnover terrible stake quality, proprietorship structure and the amount of workers, is a noteworthy part worldwide as far as monetary ecological and the social effect they make. This paper endeavoured to extend this obvious research bay, characterized the way of SMEs the total commitments of the area to economies of both advanced and advancing countries and their part engagement in CSR. The study embraced qualitative literary works review strategy. An audit of the negligible expositive expression furnished knowledge and characterized the course of examination in this significant and underexplored region of study. SMEs were discovered to perform parts connected with group improvement, representative activities, consumerism, natural movements, and production network necessities. To defeat the imperatives going up against SMEs engagement in CSR activities the paper prescribed expanded assets, preparing programs advancement of SMEs arranged instruments and guidelines to guide appropriation and execution and government mediation systems to make the fundamental motivating forces and underpin administrations for adequate engagement.

Keywords: corporate social responsibility, small and medium-sized enterprises, responsible practices, corporate citizenship

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Authors: Gihan Thilakarathna, Fernando Ishara, Rathnayake Yasith, Bandara A. M. R. Y.

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E-learning is a crucial component of intelligent education. Even in the midst of a pandemic, E-learning is becoming increasingly important in the educational system. Several e-learning programs are accessible for students. Here, we decided to create an e-learning framework for children. We've found a few issues that teachers are having with their online classes. When there are numerous students in an online classroom, how does a teacher recognize a student's focus on academics and below-the-surface behaviors? Some kids are not paying attention in class, and others are napping. The teacher is unable to keep track of each and every student. Key challenge in e-learning is online exams. Because students can cheat easily during online exams. Hence there is need of exam proctoring is occurred. In here we propose an automated online exam cheating detection method using a web camera. The purpose of this project is to present an E-learning platform for math education and include games for kids as an alternative teaching method for math students. The game will be accessible via a web browser. The imagery in the game is drawn in a cartoonish style. This will help students learn math through games. Everything in this day and age is moving towards automation. However, automatic answer evaluation is only available for MCQ-based questions. As a result, the checker has a difficult time evaluating the theory solution. The current system requires more manpower and takes a long time to evaluate responses. It's also possible to mark two identical responses differently and receive two different grades. As a result, this application employs machine learning techniques to provide an automatic evaluation of subjective responses based on the keyword provided to the computer as student input, resulting in a fair distribution of marks. In addition, it will save time and manpower. We used deep learning, machine learning, image processing and natural language technologies to develop these research components.

Keywords: math, education games, e-learning platform, artificial intelligence

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Authors: Gülcan Taşkıran, Ayla Bayık Temel

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Background: Florence Nightingale, the modern founder of the nursing, is most famous for her role as a nurse. But not so much known about her contributions as a mathematician and statistician. Aim: In this conceptual article it is aimed to examine Florence Nightingale's statistics education, how she used her passion for statistics and applied statistical data in nursing care and her scientific contributions to statistical science. Design: Literature review method was used in the study. The databases of Istanbul University Library Search Engine, Turkish Medical Directory, Thesis Scanning Center of Higher Education Council, PubMed, Google Scholar, EBSCO Host, Web of Science were scanned to reach the studies. The keywords 'statistics' and 'Florence Nightingale' have been used in Turkish and English while being screened. As a result of the screening, totally 41 studies were examined from the national and international literature. Results: Florence Nightingale has interested in mathematics and statistics at her early ages and has received various training in these subjects. Lessons learned by Nightingale in a cultured family environment, her talent in mathematics and numbers, and her religious beliefs played a crucial role in the direction of the statistics. She was influenced by Quetelet's ideas in the formation of the statistical philosophy and received support from William Farr in her statistical studies. During the Crimean War, she applied statistical knowledge to nursing care, developed many statistical methods and graphics, so that she made revolutionary reforms in the health field. Conclusions: Nightingale's interest in statistics, her broad vision, the statistical ideas fused with religious beliefs, the innovative graphics she has developed and the extraordinary statistical projects that she carried out has been influential on the basis of her professional achievements. Florence Nightingale has also become a model for women in statistics. Today, using and teaching of statistics and research in nursing care practices and education programs continues with the light she gave.

Keywords: Crimean war, Florence Nightingale, nursing, statistics

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Authors: Md. Rasel Mia, Ashik Billah

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The empowerment of girls and youth in Bangladesh is a demanding issue in today's digital age, where online learning and education have become integral to personal and societal development. This abstract explores the critical importance of creating a secure online environment for girls and youth in Bangladesh, emphasizing the transformative impact it can have on their access to education and knowledge. Bangladesh, like many developing nations, faces gender inequalities in education and access to digital resources. The creation of a safe digital space not only mitigates the gender digital divide but also fosters an environment where girls and youth can thrive academically and professionally. This manuscript draws attention to the efforts through a mixed-method study to assess the current digital landscape in Bangladesh, revealing disparities in phone and internet access, online practices, and awareness of cyber security among diverse demographic groups. Moreover, the study unveils the varying levels of familial support and barriers encountered by girls and youth in their quest for digital literacy. It emphasizes the need for tailored training programs that address specific learning needs while also advocating for enhanced internet accessibility, safe online practices, and inclusive online platforms. The manuscript culminates in a call for collaborative efforts among stakeholders, including NGOs, government agencies, and telecommunications companies, to implement targeted interventions that bridge the gender digital divide and pave the way for a brighter, more equitable future for girls and youth in Bangladesh. In conclusion, this research highlights the undeniable significance of creating a safe digital space as a catalyst for the empowerment of girls and youth in Bangladesh, ensuring that they not only access but excel in the online space, thereby contributing to their personal growth and the advancement of society as a whole.

Keywords: collaboration, cyber security, digital literacy, digital resources, inclusiveness

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Authors: Geremew Geidare Kailo, Igor Gáspár, András Koris, Ivana Pajčin, Flóra Vitális, Vanja Vlajkov

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Three-dimension (3D) printing, a very popular additive manufacturing technology, has recently undergone rapid growth and replaced the use of conventional technology from prototyping to producing end-user parts and products. The 3D Printing technology involves a digital manufacturing machine that produces three-dimensional objects according to designs created by the user via 3D modeling or computer-aided design/manufacturing (CAD/CAM) software. The most popular 3D printing system is Fused Deposition Modeling (FDM) or also called Fused Filament Fabrication (FFF). A 3D-printed object is considered food safe if it can have direct contact with the food without any toxic effects, even after cleaning, storing, and reusing the object. This work analyzes the processing timeline of the filament (material for 3D printing) from unboxing to the extrusion through the nozzle. It is an important task to analyze the growth of bacteria on the 3D printed surface and in gaps between the layers. By default, the 3D-printed object is not food safe after longer usage and direct contact with food (even though they use food-safe filaments), but there are solutions for this problem. The aim of this work was to evaluate the 3D-printed object from different perspectives of food safety. Firstly, testing antimicrobial 3D printing filaments from a food safety aspect since the 3D Printed object in the food industry may have direct contact with the food. Therefore, the main purpose of the work is to reduce the microbial load on the surface of a 3D-printed part. Coating with epoxy resin was investigated, too, to see its effect on mechanical strength, thermal resistance, surface smoothness and food safety (cleanability). Another aim of this study was to test new temperature-resistant filaments and the effect of high temperature on 3D printed materials to see if they can be cleaned with boiling or similar hi-temp treatment. This work proved that all three mentioned methods could improve the food safety of the 3D printed object, but the size of this effect variates. The best result we got was with coating with epoxy resin, and the object was cleanable like any other injection molded plastic object with a smooth surface. Very good results we got by boiling the objects, and it is good to see that nowadays, more and more special filaments have a food-safe certificate and can withstand boiling temperatures too. Using antibacterial filaments reduced bacterial colonies to 1/5, but the biggest advantage of this method is that it doesn’t require any post-processing. The object is ready out of the 3D printer. Acknowledgements: The research was supported by the Hungarian and Serbian bilateral scientific and technological cooperation project funded by the Hungarian National Office for Research, Development and Innovation (NKFI, 2019-2.1.11-TÉT-2020-00249) and the Ministry of Education, Science and Technological Development of the Republic of Serbia. The authors acknowledge the Hungarian University of Agriculture and Life Sciences’s Doctoral School of Food Science for the support in this study

Keywords: food safety, 3D printing, filaments, microbial, temperature

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Authors: Purevdolgor Luvsantseren, Ajnai Luvsan-Ish, Oyuntsetseg Sandag, Javzmaa Tsend, Akhit Tileubai, Baasandorj Chilhaasuren, Jargalbat Puntsagdash, Galbadrakh Chuluunbaatar

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One of the indicators of the quality of university services is student satisfaction. Aim: We aimed to study the level of satisfaction of students in the first year of premedical courses in the course of Medical Physics using the cluster method. Materials and Methods: In the framework of this goal, a questionnaire was collected from a total of 324 students who studied the medical physics course of the 1st course of the premedical course at the Mongolian National University of Medical Sciences. When determining the level of satisfaction, the answers were obtained on five levels of satisfaction: "excellent", "good", "medium", "bad" and "very bad". A total of 39 questionnaires were collected from students: 8 for course evaluation, 19 for teacher evaluation, and 12 for student evaluation. From the research, a database with 39 fields and 324 records was created. Results: In this database, cluster analysis was performed in MATLAB and R programs using the k-means method of data mining. Calculated the Hopkins statistic in the created database, the values are 0.88, 0.87, and 0.97. This shows that cluster analysis methods can be used. The course evaluation sub-fund is divided into three clusters. Among them, cluster I has 150 objects with a "good" rating of 46.2%, cluster II has 119 objects with a "medium" rating of 36.7%, and Cluster III has 54 objects with a "good" rating of 16.6%. The teacher evaluation sub-base into three clusters, there are 179 objects with a "good" rating of 55.2% in cluster II, 108 objects with an "average" rating of 33.3% in cluster III, and 36 objects with an "excellent" rating in cluster I of 11.1%. The sub-base of student evaluations is divided into two clusters: cluster II has 215 objects with an "excellent" rating of 66.3%, and cluster I has 108 objects with an "excellent" rating of 33.3%. Evaluating the resulting clusters with the Silhouette coefficient, 0.32 for the course evaluation cluster, 0.31 for the teacher evaluation cluster, and 0.30 for student evaluation show statistical significance. Conclusion: Finally, to conclude, cluster analysis in the model of the medical physics lesson “good” - 46.2%, “middle” - 36.7%, “bad” - 16.6%; 55.2% - “good”, 33.3% - “middle”, 11.1% - “bad” in the teacher evaluation model; 66.3% - “good” and 33.3% of “bad” in the student evaluation model.

Keywords: questionnaire, data mining, k-means method, silhouette coefficient

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Authors: Rashed Shah, Jeanne Koepsell, Dixmer Rivera, Eric Swedberg, David Marsh

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Success of primary health care goals of health promotion and disease prevention may well be determined by community based health workers’ overall job satisfaction. It is also important to understand the ways community health workers perceive their jobs and the importance they give to the various factors influencing their job satisfaction, which is critical before making a decision for task-shifting and for expanding their scope of work. Although brigadistas are unpaid volunteers, they are formally recognized and receive support and supervision from the Ministry of Health in Nicaragua. Brigadistas are responsible for classifying and diagnosing illnesses, administering treatment, counseling mothers and care givers within the community, encouraging referral in case of serious illness and making follow-up visits at home. Some brigadistas provide more technically advanced services, including treatment for pneumonia, diarrhea, malaria and tuberculosis and/or distribution of contraceptives. Expanding brigadistas’ duties could threaten their heretofore ‘job satisfaction’. This study primarily aims to report on job satisfaction of brigadistas in Nicaragua before expanding the scope of their work by adding more responsibilities. The study was guided by the following research questions: 1) What aspects of their job made the brigadistas satisfied or dissatisfied? 2) What is the job satisfaction level of brigadistas in Nicaragua? This cross-sectional study was conducted during March – July 2014, to assess brigadistas’ job satisfaction, prior to deciding on inclusion of care for sick newborns and young infants (<2 months of age) to brigadistas’ existing service package of community case management for children of 2-59 months of age. Following stratified random sampling strategy, 15 brigadistas were randomly selected from each of the following four strata: [(1) females under 25 years of age, (2) females over 30 years of age, (3) males under 25 years of age, and (4) males over 30 years of age. Out of 45 completed in-person interview with eligible and available brigadistas, 20 (44.4%) were with female and 25 (55.6%) were with male respondents; the mean age (±sd) was found as 32.0 (±3.2) years. About 53% (24/45) brigadista mentioned “Training” as the most helpful for performing their job. Another 31% (14/45) mentioned that “feeling of doing good, supporting community, women and children” was helpful to perform their job well. When asked about difficulty, about 35.5% (16/45) brigadistas mentioned about “Lack of time” due to their responsibilities in family, farm, other work places, study and such time constraint made their job performance difficult. Measured on a 0-5 scale, estimated average job satisfaction was 4.2. Current trends in task-shifting and integrated program delivery require community health workers (like the brigadistas) to deliver several essential services, including maternal, newborn and child health, and family planning, and thereby increasing their responsibilities. Given the reported level of job satisfaction among brigadistas (4.2 out of 5), and the mentioned difficulty in performing their current job (as ‘Lack of Time’) in this study results, the policy makers and program managers in MOH should be cautious enough before making a decision to expand current scope of work for brigadistas in Nicaragua.

Keywords: Brigadisata, job satisfaction, Nicaragua, task-shifting

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Authors: Harini Aiyer, Kalyani Premkumar

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Health professionals are the key players who can help achieve the goals of population health equity. Social accountability (SA) of health professionals emphasizes their role in addressing issues of equity in the population they serve. Therefore, health professional education must focus on instilling SA in health professionals. There is limited literature offering a longitudinal perspective of how students sustain the practice of SA in later life. This project aims to identify the drivers of social accountability among physicians. This study employed an exploratory mixed methods design (QUAL-> Quant) to explore alumni perceptions and experiences. The qualitative data, collected via 20 in-depth, semi-structured interviews, provided an understanding of the perceptions of the alumni regarding the influence of their undergraduate learning environment on their SA. This was followed by a quantitative portion -a questionnaire designed from the themes identified from the qualitative data. Emerging themes from the study highlighted community-centered education and a focus on social and preventative medicine in both curricular and non-curricular facilitators of SA among physicians. Curricular components included opportunities to engage with the community, such as roadside clinics, community-orientation programs, and postings at a secondary hospital. Other facilitators that emerged were the faculty leading by example, a subsidized fee structure, and a system that prepared students for practice in rural and remote areas. The study offers a fresh perspective and dimension on how SA is addressed by medical schools. The findings may be adapted by medical schools to understand how their own SA initiatives have been sustained among physicians over the long run.

Keywords: community-based work, global health, health education, medical education, providing health in remote areas, social accountability

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Authors: Vladimir Klepikov

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To develop the programs to supply crude oil to North European refineries, it is necessary to take into account the refineries’ location, crude refining capacity, and the transport infrastructure capacity. Among the countries of the region, we include those having a marine boundary along the Northern Sea and the Baltic Sea (from France in the west to Finland in the east). The paper envisages the geographic allocation of the refineries and contains the evaluation of the refineries’ capacities for the region under review. The sustainable operations of refineries in the region are determined by the transportation system capacity to supply crude oil to them. The assessment of capacity of crude oil transportation to the refineries is conducted. The research is performed for the period of 2005/2015, using the quantitative analysis method. The countries are classified by the refineries’ aggregate capacities and the crude oil output on their territory. The crude oil output capacities in the region in the period under review are determined. The capacities of the region’s transportation system to supply crude oil produced in the region to the refineries are revealed. The analysis suggested that imported raw materials are the main source of oil for the refineries in the region. The main sources of crude oil supplies to North European refineries are reviewed. The change in the refineries’ capacities in the group of countries and each particular country, as well as the utilization of the refineries' capacities in the region in the period under review, was studied. The input suggests that the bulk of crude oil is supplied by marine and pipeline transport. The paper contains the assessment of the crude oil transportation by pipeline transport in the overall crude oil cargo flow. The refineries’ production rate for the groups of countries under the review and for each particular country was the subject of study. Our study yielded the trend towards the increase in the crude oil refining at the refineries of the region and reduction in the crude oil output. If this trend persists in the near future, the cargo flow of imported crude oil and the utilization of the North European logistics infrastructure may increase. According to the study, the existing transport infrastructure in the region is able to handle the increasing imported crude oil flow.

Keywords: European region, infrastructure, oil terminal capacity, pipeline capacity, tanker draft

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Authors: G. H. B. Dilhari, A. A. D. T. Saparamadu

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The coir is one of the by-products of the coconut and the coir industry can be identified as one of the traditional industries in Sri Lanka. Sri Lanka is one of the prominent countries for the coir production. Due to the labour insensitiveness, the labourers are the significant factor in the coir production process. The study has analyzed the determinants and its impact on income of the household level coir yarn labourers. The study was conducted in the Kumarakanda Grama Niladhari division, Galle, Sri Lanka. Simple random sampling was used to generate the sample of 100 household level coir yarn labourers and structured questionnaire, personal interviews and discussion were performed to gather the required data. The obtained data were statistically analyzed by using Statistical Package for Social Science (SPSS) software. Mann-Whitney U and Kruskal-Wallis test were carried out. The findings revealed that the household level coir yarn industry is dominated by the female workers and fewer amounts of workers have engaged this industry as the main occupation. In addition to that, elderly participation of the industry is greater than younger participation and most of them engaged as an extra income source. Level of education, the methods of engagement, satisfaction, labour’s children employment in the coir industry, support from the government, method of government support, working hours per day, employed as a main job, no of completed units per day, suffering any job related diseases and type of the diseases were related with income level of household level coir yarn labourers. The recommendations were formulated in respect to these problems including technological transformation for coir yarn production, strengthening of the raw material base and regulating the raw material supply, introduction of new technologies, markets and training programs, the establishment of the labourers association, the initiation of micro credit schemes, better consideration about the job oriented diseases.

Keywords: coir, coir yarn labourers, income, Galle

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Authors: Julian Dario Castro Cifuentes

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In Colombia, the armed conflict has lasted for more than sixty years bringing poverty, internal displacement of people, deaths from both government and insurgent forces and other violence-related problems that has damaged its social fabric. In 2016, the peace process between the Colombian government and the FARC rebels brought the possibility of ending this war and a new set of challenges to Colombian society in order to achieve pacific coexistence and reconciliation. In this scenario, there have been different efforts from diverse social actors in order to build peace and reconciliation mainly within the victims of the armed conflict. In the case of music, there have been multiple programs for social transformation through music and pedagogical experiences. Nevertheless, the need to strengthen this initiative by giving ‘peace building oriented’ pedagogical tools to the musicians that lead this experiences and understanding which aspects make this practices ‘musically meaningful’, has been recognized. For this reason, the purpose of this study is to discuss the convergences and divergences of music, and educational experiences applied to peacebuilding in the context of Colombia’s post-conflict. In this research, the hermeneutic phenomenology paradigm is applied in a case study of a peace building music education experience in the department of Nariño, Colombia articulated with the program ‘Manos a la Paz’. Two particular experiences, one on musical practice and another on music education are taken as a unit of analysis to understand its essence and structure in order to find ways to articulate efforts in peace building actions from music. This study shows how the existent gap between music experience and its subjacent pedagogical knowledge, can be reduced through deconstruction of the music and pedagogical experience. The ‘Manos a la Paz’ program showed how a peace building approach to music education can make major contributions to Pacific Coexistence and Reconciliation in Colombia’s Post-Conflict.

Keywords: music education, music for peace, music pedagogy, peace building, social fabric

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Authors: Andréanne Gagné, Jo Anni Joncas, Éric Tendon

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Teaching in vocational training requires an excellent mastery of the trade being taught, but also solid professional skills in pedagogy. Teachers are typically recruited on the basis of their trade expertise, and they do not necessarily have training or experience in pedagogy. In order to counter this lack, the Ministry of Education (Québec, Canada) requires them to complete a 120-credit university program to obtain their teaching certificate. They must complete this training in addition to their teaching duties. This training was rarely planned in the teacher’s life course, and each teacher approaches it differently: some are enthusiastic, but many feel reluctant discouragement and even frustration at the idea of committing to a training program lasting an average of 10 years to completion. However, Quebec is experiencing an unprecedented shortage of teachers, and the perseverance of vocational teachers in their careers requires special attention because of the conditions of their specific integration conditions. Our research examines the perceptions that vocational teachers in training have of their academic experience in pre-service teaching. It differs from previous research in that it focuses on the influence of the academic experience on the teaching employment experience. The goal is that by better understanding the university experience of teachers in vocational education, we can identify support strategies to support their school experience and their teaching. To do this, the research is based on the theoretical framework of the sociology of experience, which allows us to study the way in which these “teachers-students” give meaning to their university program in articulation with their jobs according to three logics of action. The logic of integration is based on the process of socialization, where the action is preceded by the internalization of values, norms, and cultural models associated with the training context. The logic of strategy refers to the usefulness of this experience where the individual constructs a form of rationality according to his objectives, resources, social position, and situational constraints. The logic of subjectivation refers to reflexivity activities aimed at solving problems and making choices. These logics served as a framework for the development of an online questionnaire. Three hundred respondents, newly enrolled in an undergraduate teaching program (bachelor's degree in vocational education), expressed themselves about their academic experience. This paper relates qualitative data (open-ended questions) subjected to an interpretive repertory analysis approach to descriptive data (closed-ended questions) that emerged. The results shed light on how the respondents perceive themselves as teachers and students, their perceptions of university training and the support offered, and the place that training occupies in their professional path. Indeed, their professional and academic paths are inextricably linked, and it seems essential to take them into account simultaneously to better meet their needs and foster the development of their expertise in pedagogy. The discussion focuses on the strengths and limitations of university training from the perspective of the logic of action. The results also suggest support strategies that can be implemented to better support the integration and retention of student teachers in professional education.

Keywords: teacher, vocational training, pre-service training, academic experience

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Authors: Flex Anim

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The financial system is a decentralized studies system that was put into place in Ghana as a grassroots financial studies approach. Its main goal is to give people the precise knowledge, abilities, and training required for a given trade, business, profession, or occupation. In this essay, the question of how the financial studies system's devolution to local businesses results in responsible and responsive representation as well as long-term company learning is raised. It centers on two case studies, Asekwa Municipal and Oforikrom. The next question posed by the study is how senior high school students are rebuilding their livelihoods and socioeconomic well-being by creating new curriculum and social practices related to the finance and business studies system. The paper here concentrates on Kumasi District and makes inferences for the other two examples. The paper demonstrates how the financial studies system's establishment of representative groups creates the democratic space required for the successful representation of community goals. Nonetheless, the interests of a privileged few are advanced as a result of elite capture. The state's financial and business training programs do not adhere to the financial studies system's established policy procedures and do not transfer pertinent and discretionary resources to local educators. As a result, local educators are unable to encourage representation that is accountable and responsive. The financial studies system continues to pique the interest of rural areas, but this desire is skewed toward getting access to financial or business training institutions for higher education. Since the locals are not actively involved in financial education, the financial studies system serves just to advance the interests of specific populations. This article explains how rhetoric and personal benefits can be supported by the public even in the case of "failed" interventions.

Keywords: financial studies system, financial studies' devolution, local government, senior high schools and financial education, as well as community goals and representation

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Authors: Antonio Marco Miotti, Antonella Ruffatto, Giampaola Basso, Antonio Madia, Giulia Zavatta, Emanuela Salvatico, Emanuela Zilli

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A National Action Plan to fight antimicrobial resistance was launched in Italy in 2017. In order to reduce inappropriate exposure to antibiotics and infections from multi-drug resistant bacteria, it is essential to set up a structured system of surveillance and monitoring of the implementation of National Action Plan standards, including antimicrobial consumption, with a special focus on quinolones, third generation cephalosporins and carbapenems. A quantitative estimate of antibiotic consumption (defined daily dose - DDD - consumption per 100 days of hospitalization) has been provided by the Pharmaceutical Service to the Hospital of Cittadella, ULSS 6 Euganea – Health Trust (District of Padua) for the years 2019 (before the pandemic), 2020 and 2021 for all classes of antibiotics. Multidisciplinary meetings have been organized monthly by the local Antimicrobial Stewardship Group. Between 2019 and 2021, an increase in the consumption of carbapenems in the Intensive Care Unit (from 12.2 to 18.2 DDD, + 49.2%) and a decrease in Medical wards (from 5.3 to 2.6 DDD, - 50.9%) was reported; a decrease in the consumption of quinolones in Intensive Care Unit (from 17.2 to 10.8 DDD, - 37.2%), Medical wards (from 10.5 to 6.6 DDD, - 37.1%) and Surgical wards (from 10.2 to 9.3 DDD, - 8.8%) was highlighted; an increase in the consumption of third generation cephalosporins in Medical wards (from 18.1 to 22.6 DDD, + 24,1%) was reported. Finally, after an increase in the consumption of macrolides between 2020 and 2019, in 2021, a decrease was reported in the Intensive Care Unit (DDD: 8.0 in 2019, 18.0 in 2020, 6.4 in 2021) and Medical wards (DDD: 9.0 in 2019, 13.7 in 2020, 10.9 in 2021). Constant monitoring of antimicrobial consumption and timely identifying of warning situations that may need a specific intervention are the cornerstone of Antimicrobial Stewardship programs, together with analysing data on bacterial resistance rates and infections from multi-drug resistant bacteria.

Keywords: carbapenems, quinolones, antimicrobial, stewardship

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Authors: Sandra Cardoso, Gaspar Pais, Judite Neves, Sandra Cavaca, Fernando Araújo

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In 2021, Portugal has 63 emergency department (ED) visits per 100 people annually, the highest numbers in Europe. While EDs provide a critical service, high use is indicative of inappropriate and inefficient healthcare. In Portugal, all ED have the Manchester Triage System (MTS), a clinical risk management tool to enable that patients are seen in order of clinical priority. In 2023, more than 40% of the ED visits were of non-urgent conditions (blue and green), that could be better managed in primary health care (PHC), meaning wrong use of resources and lack of health literacy. From 2017, the country has a phone line, SNS24 (Contact Centre of the National Health Service), for triage, counseling, and referral service, 24 hours/7 days a week. The pilot project ‘Call before, save lives’ was implemented in the municipalities of Póvoa de Varzim and Vila do Conde (around 150.000 residents), in May 2023, by the executive board of the Portuguese Health Service, with the support of the Shared Services of the Ministry of Health, and local authorities. This geographical area has short travel times, 99% of the population a family doctor and the region is organized in a health local unit (HLU), integrating PHC and the local hospital. The purposes of this project included to increase awareness to contact SNS 24, before going to an ED, and non-urgent conditions oriented to a family doctor, reducing ED visits. The implementation of the project involved two phases, beginning with: i) development of campaigns using local influencers (fishmonger, model, fireman) through local institutions and media; ii) provision of telephone installed on site to contact SNS24; iii) establishment of open consultation in PHC; iv) promotion of the use of SNS24; v) creation of acute consultations at the hospital for complex chronic patients; and vi) direct referral for home hospitalization by PHC. The results of this project showed an excellent level of access to SNS24, an increase in the number of users referred to ED, with great satisfaction of users and professionals. The second phase, initiated in January 2024, for access to the ED, the need for prior referral was established as an admission rule, except for certain situations, as trauma patients. If the patient refuses, their registration in the ED and subsequent screening in accordance with the MTS must be ensured. When the patient is non-urgent, shall not be observed in the ED, provided that, according to his clinical condition, is guaranteed to be referred to PHC or to consultation/day hospital, through effective scheduling of an appointment for the same or the following day. In terms of results, 8 weeks after beginning of phase 2, we assist of a decrease in self-reported patients to ED from 59% to 15%, and a reduction of around 7% of ED visits. The key for this success was an effective public campaign that increases the knowledge of the right use of the health system, and capable of changing behaviors.

Keywords: contact centre of the national health service, emergency department visits, public campaign, health literacy, SNS24

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Authors: Kushaal Selvarajah, Geetha Annavi, Mohd Noor Hisham Mohd Nadzir

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Sambar deer (Rusa unicolor) was uplisted from Least Concern to Vulnerable by the International Union for Conservation of Nature Red list in 2015 due to drastic population decline in the wild throughout its geographical range. Sambar deer is a valued prey for the highly endangered species such as the Malayan tiger. Ex-situ conservation efforts, i.e., captive breeding, initiated by local government to boost sambar deer numbers in captivity and to reintroduce into the wild to support a higher number of tigers, consistent with the goal of our National Tiger Conservation Action Plan. The reproductive success of sambar deer and their welfare management practices in captivity are important components for effective captive breeding programs. However, there is a lack of study carried out on sambar deer in recent years and their behavior in captivity. Three captive sites (Zoo Negara, Zoo Taiping, and Sungkai Conservation Centre) were selected and observed for an average of 40 days each site (6 hours/day). A Generalized Linear Model (GLM) was used to determine the correlation between social behavior and extrinsic parameters. A comparison between all three captive sites showed the strongest correlation in behavioral variability, followed by a time of observation. This proves that there is a difference between in behavioral consistency and frequency between herds across captive sites rising to the possibility of external factors that are influential. Time of day of observation also had significant influence on certain extrinsic parameters being skewed to morning observations and this could be due to an adaptive behavior to the feeding time in the captive sites being in the morning which caused the deer to be resting towards the afternoon. Extensive study need to be done on sambar deer to pinpoint the specifics and better understanding of these possible influential factors in their behavior.

Keywords: behaviour ecology, captivity, ex-situ conservation, husbandry

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Authors: Ahmed R. Z. Baghdadi,  Mona H. Gamal Eldein

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Background: With the perceived pain and poor function experienced following knee arthroplasty, patients usually feel unsatisfied. Yet, a controversy still persists on the appropriate operative technique that doesn’t affect proprioception much. Purpose: This study compared the effects of Cruciate Retaining (CR) and Posterior Stabilized (PS) total knee arthroplasty (TKA on dynamic balance, pain and functional performance following rehabilitation. Methods: Thirty patients with CRTKA (group I), thirty with PSTKA (group II) and fifteen indicated for arthroplasty but weren’t operated on yet (group III) participated in the study. The mean age was 54.53±3.44, 55.13±3.48 and 55.33±2.32 years and BMI 35.7±3.03, 35.7±1.99 and 35.73±1.03 kg/m2 for group I, II, and III respectively. The Berg Balance Scale (BBS), WOMAC pain subscale and Timed-Up-and-Go (TUG) and Stair-Climbing (SC) tests were used for assessment. Assessments were conducted four weeks pre- and post-operatively, three, six and twelve months post-operatively with the control group being assessed at the same time intervals. The post-operative rehabilitation involved hospitalization (1st week), home-based (2nd-4th weeks), and outpatient clinic (5th-12th weeks) programs, follow-up to all groups for twelve months. Results: The Mixed design MANOVA revealed that group I had significantly lower pain scores and SC time compared with group II three, six and twelve months post-operatively. Moreover, the BBS scores increased significantly and the pain scores and TUG and SC time decreased significantly six months post-operatively compared with four weeks pre- and post-operatively and three months post-operatively in group I and II with the opposite being true four weeks post-operatively. But no significant differences in BBS scores, pain scores and TUG and SC time between six and twelve months post-operatively in group I and II. Interpretation/Conclusion: CRTKA is preferable to PSTKA, possibly due to the preserved human proprioceptors in the un-excised PCL.

Keywords: dynamic balance, functional performance, knee arthroplasty, long-term

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Authors: Vagisha Rawal, Anupam V. Sharma, Tarun Kumar Vats, Ashok Kumar Singh

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The antifeedant activity of methanol and hexane extract of leaves and seeds of Datura innoxia (Mill.) (Solanaceae) was evaluated against the 5th instar Spodoptera litura (F.) (Lepidoptera: Noctuidae) larvae in choice and no-choice leaf disc bioassays under laboratory conditions. These larvae when given a choice between the ‘control’ and ‘treated’ leaf discs in choice bioassays, consumed significantly (p ˂ 0.05) greater area of the ‘control’ leaf discs compared to those treated with the crude extracts of leaves and seeds of D. innoxia. The Antifeedant Index (AFI) for 5% concentration of the hexane extract of Datura seeds (DSHE) was 43.3% and 38.5% for methanol extract of Datura seeds (DSME). On the other hand, these values were 34.1% for the hexane extract of Datura leaves (DLHE), and 31.0% for the methanol extract of Datura leaves (DLME), respectively. In no-choice bioassays also, there was a significant (p˂0.05) reduction in the larval consumption of ‘treated’ leaf discs compared to the ‘control’ leaf discs. Maximum AFI was recorded at 5% concentration of the extracts of both the leaves and seeds with 47.7% for DSHE against 40.0% (DSME) and 39.4% for DLHE compared with 38.4% (DLME). Moreover, DSHE was found to have the maximum antifeedant effect irrespective of its concentration in comparison to the other crude extracts of leaves or seeds of D. innoxia. It is evident from these results that the crude methanol and hexane extracts of leaves and seeds of D. innoxia exhibited potent antifeedant activity against the 5th instar S. litura larvae. Also, the use of the bioactive compound(s) present in these extracts can prove to be an effective, eco-friendly, viable and sustainable component that can be integrated in IPM programs for the management of this economically important polyphagous insect pest in the Indian subcontinent.

Keywords: antifeedant activity, antifeedant index, datura innoxia, spodoptera litura

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Authors: Sukhvinder Kaur, Ashok Agarwal

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Background: For the first time in 2009, India was able to generate estimates of HIV incidence (the number of new HIV infections per year). Analysis of epidemic projections helped in revealing that the number of new annual HIV infections in India had declined by more than 50% during the last decade (GOI Ministry of Health and Family Welfare, 2010). Then, National AIDS Control Organisation (NACO) planned to scale up its efforts in generating projections through epidemiological analysis and modelling by taking recent available sources of evidence such as HIV Sentinel Surveillance (HSS), India Census data and other critical data sets. Recently, NACO generated current round of HIV estimates-2012 through globally recommended tool “Spectrum Software” and came out with the estimates for adult HIV prevalence, annual new infections, number of people living with HIV, AIDS-related deaths and treatment needs. State level prevalence and incidence projections produced were used to project consequences of the epidemic in spectrum. In presence of HIV estimates generated at state level in India by NACO, USIAD funded PIPPSE project under the leadership of NACO undertook the estimations and projections to district level using same Spectrum software. In 2011, adult HIV prevalence in one of the high prevalent States, Maharashtra was 0.42% ahead of the national average of 0.27%. Considering the heterogeneity of HIV epidemic between districts, two districts of Maharashtra – Thane and Mumbai were selected to estimate and project the number of People-Living-with-HIV/AIDS (PLHIV), HIV-prevalence among adults and annual new HIV infections till 2017. Methodology: Inputs in spectrum included demographic data from Census of India since 1980 and sample registration system, programmatic data on ‘Alive and on ART (adult and children)’,‘Mother-Baby pairs under PPTCT’ and ‘High Risk Group (HRG)-size mapping estimates’, surveillance data from various rounds of HSS, National Family Health Survey–III, Integrated Biological and Behavioural Assessment and Behavioural Sentinel Surveillance. Major Findings: Assuming current programmatic interventions in these districts, an estimated decrease of 12% points in Thane and 31% points in Mumbai among new infections in HRGs and migrants is observed from 2011 by 2017. Conclusions: Project also validated decrease in HIV new infection among one of the high risk groups-FSWs using program cohort data since 2012 to 2016. Though there is a decrease in HIV prevalence and new infections in Thane and Mumbai, further decrease is possible if appropriate programme response, strategies and interventions are envisaged for specific target groups based on this evidence. Moreover, evidence need to be validated by other estimation/modelling techniques; and evidence can be generated for other districts of the state, where HIV prevalence is high and reliable data sources are available, to understand the epidemic within the local context.

Keywords: HIV sentinel surveillance, high risk groups, projections, new infections

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Authors: Moses Obenade, Henry U. Okeke, Francis I. Okpiliya, Eugene J. Aniah

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Population growth in Eleme has been rapid over the past 75 years with its attendant pressure on the natural resources of the area. Between 1937 and 2006 the population of Eleme grew from 2,528 to 190,194 and is projected to be above 265,707 in 2016 based on an annual growth rate of 3.4%. Using the combined technologies of Geographic Information Systems (GIS), remote sensing (RS) and Demography techniques as its methodology, this paper examines the environmental implications of rapid population growth on land use dynamics in Eleme between 1986 and 2015. The study reveals that between 1986 and 2006, Built-up area and Farmland increased by 72.67 and 12.77% respectively, while light and thick vegetation recorded a decrease of -6.92 and -61.64% respectively. Water body remains fairly constant with minimal changes. Also, between 2006 and 2015 covering a period of 9 years, Built-up area further increased by 53% with an annual growth rate of 2.32 km2 gaining more land area on the detriment of other land uses. Built-up area has an annual growth rate of 2.32km2 and is expected to increase from 18.67km2 in 2006 to 41.87km2 in 2016.The observed Land used/Land cover dynamics is derived by the demographic characteristics of the Study area. Eleme has a total area of 138km2 out of which the Federal Government of Nigeria compulsorily acquired an estimated area of 59.34km2 for industrial purposes excluding acquisitions by the Rivers State Government. It is evident from the findings of this study that the carrying capacity of Eleme ecosystem is under threat due to the current population growth and land consumption rates. Therefore, measures such as use of appropriate technologies in farming techniques, waste management; investment in family planning and female empowerment, maternal health and education, afforestation programs; and amendment of Land Use Act of 1978 are recommended.

Keywords: population growth, Eleme, land use, GIS and remote sensing

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Authors: Jelena Filipovic, Marija Bodroza-Solarov, Milenko Kosutic, Nebojsa Novkovic, Vladimir Filipovic, Vesna Vucurovic

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Spelt wheat is suitable raw material for extruded products such as pasta, special types of bread and other products of altered nutritional characteristics compared to conventional wheat products. During the process of extrusion, spelt is exposed to high temperature and high pressure, during which raw material is also mechanically treated by shear forces. Spelt wheat is growing without the use of pesticides in harsh ecological conditions and in marginal areas of cultivation. So it can be used for organic and health safe food. Pasta is the most popular foodstuff; its consumption has been observed to rise. Pasta quality depends mainly on the properties of flour raw materials, especially protein content and its quality but starch properties are of a lesser importance. Pasta is characterized by significant amounts of complex carbohydrates, low sodium, total fat fiber, minerals, and essential fatty acids and its nutritional value can be improved with additional functional component. Over the past few decades, wheat pasta has been successfully formulated using different ingredients in pasta to cater health-conscious consumers who prefer having a product rich in protein, healthy lipids and other health benefits. Flaxseed flour is used in the production of bakery and pasta products that have properties of functional foods. However, it should be taken into account that food products retain the technological and sensory quality despite the added flax seed. Flaxseed contains important substances in its composition such as vitamins and minerals elements, and it is also an excellent source of fiber and one of the best sources of ω-3 fatty acids and lignin. In this paper, the quality and identification of spelt extruded product with the addition of flax seed, which is positively contributing to the nutritive and technology changes of the product, is investigated. ω-3 fatty acids are polyunsaturated essential fatty acids, and they must be taken with food to satisfy the recommended daily intake. Flaxseed flour is added in the quantity of 10/100 g of sample and 20/100 g of sample on farina. It is shown that the presence of ω-3 fatty acids in pasta can be clearly distinguished from other fatty acids by gas chromatography with mass spectrometry. Addition of flax seed flour influence chemical content of pasta. The addition of flax seed flour in spelt pasta in the quantities of 20g/100 g significantly increases the share of ω-3 fatty acids, which results in improved ratio of ω-6/ω-3 1:2.4 and completely satisfies minimum daily needs of ω-3 essential fatty acids (3.8 g/100 g) recommended by FDA. Flex flour influenced the pasta quality by increasing of hardness (2377.8 ± 13.3; 2874.5 ± 7.4; 3076.3 ± 5.9) and work of shear (102.6 ± 11.4; 150.8 ± 11.3; 165.0 ± 18.9) and increasing of adhesiveness (11.8 ± 20.6; 9.,98 ± 0.12; 7.1 ± 12.5) of the final product. Presented data point at good indicators of technological quality of spelt pasta with flax seed and that GC-MS analysis can be used in the quality control for flax seed identification. Acknowledgment: The research was financed by the Ministry of Education and Science of the Republic of Serbia (Project No. III 46005).

Keywords: GC-MS analysis, ω-3 fatty acids, flex seed, spelt wheat, daily needs

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Authors: Tamrat Girma Biru

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Multidrug-resistant tuberculosis (MDR-TB) is defined as resistant to at least Refampicin and Isoniazed: the most two power full TB drugs. It is a leading cause of high rates of morbidity and mortality, and increasing psychosocial challenges to patients, especially when co-infected with Human Immunodeficiency Virus (HIV). Ethiopia faces the highest rates of MDR-TB infection in the world. Objectives: The main objective of this study was to identify the psychosocial challenges of MDR-TB patients, to investigate the extent of the psychosocial challenges on (self-esteem, depression, and stigma) that MDR-TB patients encounter, to examine whether there is a sex difference in experiencing psychosocial challenges and assess the counseling needs of MDR-TB patients. Methodology: A cross-sectional study was conducted at St. Peter TB Specialized Hospital, Addis Ababa on 40 patients (25 males and 15 females) who are hospitalized for treatment. The patients were identified by using purposive sampling and made fill a questionnaire measuring their level of self-esteem, depression and stigma. Besides, data were collected from 16 participants, 28 care providers and 8 guardians, using semi-structured interview. The obtained data were analyzed using SPSS statistical program, descriptive statistics, independent t-test, and qualitative description. Results and Discussion: The results of the study showed that the majority (80%) of the respondents had suffered psychological challenges and social discriminations. Thus, the significance of MDR-TB and its association with HIV/AIDS problems is considered. Besides the psychosocial challenges, various aggravating factors such as length of treatment, drug burden and insecurity in economy together highly challenges the life of patients. In addition, 60% of participants showed low level of self-esteem. The patients also reported that they experienced high self-stigma and stigma by other members of the society. The majority of the participants (75%) showed moderate and severe level of depression. In terms of sex there is no difference between the mean scores of males and females in the level of depression and stigmatization by others and by themselves. But females showed lower level of self-esteem than males. The analysis of the t-test also shows that there were no statistically significant sex difference on the level of depression and stigma. Based on the qualitative data MDR-TB patients face various challenges in their life sphere such as: Psychological (depression, low self value, lowliness, anxiety), social (stigma, isolation from social relations, self-stigmatization,) and medical (drug side effect, drug toxicity, drug burden, treatment length, hospital stays). Recommendations: Based on the findings of this study possible recommendations were forwarded: develop and extend MDR-TB disease awareness creation through by media (printing and electronic), school net TB clubs, and door to door community education. Strengthen psychological wellbeing and social relationship of MDR-TB patients using proper and consistent psychosocial support and counseling. Responsible bodies like Ministry of Health (MOH) and its stakeholders and Non Governmental Organizations (NGOs) need to assess the challenges of patients and take measures on this pressing issue.

Keywords: psychosocial challenges, counseling, multi-drug resistant tuberculosis (MDR-TB), tuberculosis therapy

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