Search results for: south korea

Authors: Nwafia Ifeyinwa Nkeiruka, Nwafia Walter Chukwuma

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Since the early 1980’s fungi have emerged as major causes of human diseases, especially among immunocompromised. The most commonly isolated yeast is Candida albicans and constitutes the 4th most common nosocomial BSI in humans. It is progressive and cumulative and become more complex over time.It can even lead to leaky gut syndrome that causes food and environmental allergies. It is worthy of note that all the available data on oral Candida risk factors in humans were documented essentially using data from studies conducted in other areas, hence there is need for comparative and complementary information from the South eastern part of Nigeria. Method: 200 subjects of all age groups of both sexes were randomly examined,by swabbing their palatine mucosa and dorsal tongue with sterile cotton wool,then cultured into Sabouraud dextrose agar plates supplemented with antibiotics and incubated aerobically at 37 degree for 48 hrs. Identification of Candida albicans was done by germ tubes tests, chlamydospores production on cornmeal agar supplemented with 1% Tween 80.Sugar and nitrogen assimilation test using API 20C Auxanogram and potassium nitrate agar. Results: Out of 30 samples that were positive for candida, 15 (50%) were candida albicans. Using the anova test (P < 0.05) this variation is significant (P = 0016). followed by C. dublinensis 3 (13%), C. tropicalis 3 (10%), C. pseudotropicalis 3 (10%), C, glabrata 2 (7%), C. parapsilosis 2 (7%) and lastly C. krusei 1 (3%).However, 53% of the patients were female while 47% were male. Among the HIV positive isolates.67% were HIV isolates not on drugs while 33% positives isolates were on drugs and the percentages of candida species in these patients were as follows C. albicans were 45% followed by C. glabrata and C.tropicalis which were 17% each, C.parapsilosis, C.dubliensis and C.pseudotropicalis were all 8% each. Conclusion: Oral Candidiasis is a marker of systemic diseases and in some cases, it may be the first clinical presentation. There is need for more intensive clinical and laboratory monitoring and possible early intervention to prevent the reoccurrence and resistance to treatment.

Keywords: oral cavity, Candida species, oral Candidiasis, risk factors

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Authors: Tafadzwa Makonese, Harold Annegarn, Patricia Forbes

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Residential coal combustion is one of the largest sources of carbonaceous aerosols in the Highveld region of South Africa, significantly affecting the local and regional climate. In this study, we investigated single coal burning particles emitted when using different fire-ignition techniques (top-lit up-draft vs bottom-lit up-draft) and air ventilation rates (defined by the number of air holes above and below the fire grate) in selected informal braziers. Aerosol samples were collected on nucleopore filters at the SeTAR Centre Laboratory, University of Johannesburg. Individual particles (~700) were investigated using a scanning electron microscope equipped with an energy-dispersive X-ray spectroscopy (EDS). Two distinct forms of spherical organic particles (SOPs) were identified, one less oxidized than the other. The particles were further classified into "electronically" dark and bright, according to China et al. [2014]. EDS analysis showed that 70% of the dark spherical organic particles balls had higher (~60%) relative oxygen content than in the bright SOPs. We quantify the morphology of spherical organic particles and classify them into four categories: ~50% are bare single particles; ~35% particles are aggregated and form diffusion accretion chains; 10% have inclusions; and 5% are deformed due to impaction on filter material during sampling. We conclude that there are two distinct kinds of coal burning spherical organic particles and that dark SOPs are less volatile than bright SOPs. We also show that these spherical organic particles are similar in nature and characteristics to tar balls observed in biomass combustion, and that they have the potential to absorb sunlight thereby affecting the earth’s radiative budget and climate. This study provides insights on the mixing states, morphology, and possible formation mechanisms of these organic particles from residential coal combustion in informal stoves.

Keywords: spherical organic particles, residential coal combustion, fixed-bed, aerosols, morphology, stoves

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Authors: Sonto Maputle

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Background: Support during labour increase women's chances of having positive childbirth experiences as well as childbirth outcomes. The purpose of this study was to determine the support provided by midwives to women during labour at the public hospital in Limpopo Province. The study was conducted at the Tertiary hospital in Limpopo Province. Methods: A qualitative, participant observation approach was used. Population consisted of all women that were admitted to deliver their babies and the midwives who provided midwifery care in the obstetric unit of one tertiary public hospital in Limpopo Province. Non-probability, purposive and convenience sampling were used to sample 24 women and 12 midwives. Data were collected through participant observations which included unstructured conversations with the use of observational guide, field notes of events and conversations that occurred when women interact with midwives were recorded verbatim and a Visual Analog Scale to complement the observations. Data was analysed qualitatively but were presented in the tables and bar graphs. Results: Five themes emerged as support provided by midwives during labour, namely; communication between women and midwives, informational support, emotional support activities, interpretation of the experienced labour pain and supportive care activities during labour. Conclusion: The communication was occurring when the midwife was rendering midwifery care and very limited for empowering. The information sharing focused on the assistive actions rather than on the activities that would promote mothers’ participation. The emotional support activities indicated lack of respect and disregard cultural preferences and this contributed to inability to exercise choices in decision-making. The study recommended the implementation of Batho Pele principles in order to provide woman-centred care during labour.

Keywords: communication between women and midwives, labour pains, informational and emotional support, physical comforting measures

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Authors: Benhammadi Hocine, Fehdi Chemseddine, Chaffai Hicham

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The study site is the plateau Cheria, a city in south eastern Algeria (Tebessa) thanks to its structure perched syncline is the region of Tebessa a real water tower. Special rates provided by some boreholes and wells around the city Cheria have long been led to believe that the reserves were virtually limitless. The investigations carried out in this region have located karstified limestone areas at depth of 100 meters of the carbonate formation. During the last two decades a rainfall deficit has increased the effect of drought has caused an increase in flow from this aquifer. The effect on water resources is a significant and progressive reduction of the static level of the karst aquifer. The qualitative aspect has also been marked by degradation. This climate variability marked by the decade of drought (1990/2000) has had the effect on the local population, a forced change of their activity primarily agricultural. Abandoning agro pastoral mode due to prolonged drought, populations chose agriculture maraichère consumer a lot of water, this increasing the depletion of water resources. This change in activity was accompanied by a rural exodus to urban areas. The result has led to an increase in population in the urban areas, this has resulted in an increase in water demand and an increase in emissions (waste water). Uncontrolled discharges contribute to pollute a little more groundwater. The second consequence is type Geotechnical, it is the appearance of sinkholes, results of the alternating periods of drought and violent floods. Sinkholes are a real concern for the management and urban development. An interdisciplinary contribution (geology, hydrology, climatology and management) is essential to reduce or avoid impacts in different sectors.

Keywords: aquifer, carbonate formation, drought, exodus, resources, chéria, Algéria

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Authors: Pius Borona, Cheikh Mbow, Issa Ouedraogo

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In the Sahel, climate variability has been associated with a complex web of direct and indirect impacts. This natural phenomenon has been an impediment to agro-pastoral communities who experience uncertainty while involving in farming activities which is also their key source of livelihood. In this scenario, the role of climate variability in influencing the performance, quantity and quality of staple cereals yields, vital for food and nutrition security has been a topic of importance. This response of crops and subsequent yield variability is also a subject of immense debate due to the complexity of crop development at different stages. This complexity is further compounded by influence of slowly changing non-climatic factors. With these challenges in mind, the present paper initially explores the occurrence of climate variability at an inter annual and inter decadal level in South Burkina Faso. This is evidenced by variation of the total annual rainfall and the number of rainy days among other climatic descriptors. Further, it is shown how district-scale cereal yields in the study area including maize, sorghum and millet casually associate variably to the inter-annual variation of selected climate variables. Statistical models show that the three cereals widely depict sensitivity to the length of the growing period and total dry days in the growing season. Maize yields on the other hand relate strongly to the rainfall amount variation (R2=51.8%) showing high moisture dependence during critical growth stages. Our conclusions emphasize on adoption of efficient water utilization platforms especially those that have evidently increased yields and strengthening of forecasts dissemination.

Keywords: climate variability, cereal yields, seasonality, rain fed farming, Burkina Faso, rainfall

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Authors: Nissim Avissar

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This paper aims to question the practice of bringing together people belonging to groups in conflict with the aim of bridging differences through universal empathy and interpersonal connections. It is argued that in cases where one group has the power, and the other is in a struggle to change the balance assuming universal equality between the groups and encouraging emphatic understanding is a non-emphatic practice. Accordingly, a new concept is posited–justice-sensitive empathy, conditioning empathy in such situations on the acknowledgement of an imbalance of power/injustice. With this reframing in mind, educational practices promoting social justice are discussed. In order to create conditions for justice-seeking or politically sensitive empathy, we need to go beyond the conventional definitions of empathy and offer other means and possibilities. Three possibilities are discussed. The first focuses on intra-group (as opposed to inter-group) processes within each group. It means temporary and tactical separation that may allow each group to focus on its own needs and values and perhaps to return to the dialogue more confidently. The second option emphasizes the notion of "constructive conflict," which means that each side still aspires to promote his own interests but without demolishing the other side (which is a rival but also an unwanted and forced partner). Here, alongside the "obligation to resist" and to act to promote justice as we view and understand it, we have to take into account the other side. The third and last option relates to the practice of Restorative Justice. This practice originated in the Truth and Reconciliation committees in South Africa, but it is now widely used in other contexts. Those committees had the authority to punish (or pardon) people; however, their main purpose was to seek truth and, from there, nourish reconciliation. This is the main idea of restorative justice; it seeks justice for the sake of restoring relationships. All the above options involve action and are aware of power relations (i.e., politics). They all seek justice. They may create conditions for the more conventional empathic practice to evolve, but no less than that, they are examples of justice-seeking and politically sensitive empathetic practice.

Keywords: education, empathy, justice, reconciliation

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Authors: Massimo Mozzon, Nadia Raffaelli

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Proteases from herbs, woody plants, and trees are exploited for cheesemaking in several countries, especially in South Europe and West Africa. Particularly, “thistles” belonging to several genera within the Asteraceae family (Cynara, Silybum, Centaurea, Carlina, Cirsium, Onopordum) are traditionally used in Mediterranean countries for clotting raw ewe’s and goat’s milk. For the first time, the clotting performance of an aqueous extract from flowers of Onopordum tauricum Willd. (Taurian thistle, bull cottonthistle) were tested in milk of different origin (cow, goat, ewe). The vegetable material was collected in the Central Apennines range, between the Marche and Umbria regions. A response surface methodology (RSM) approach was used to study the effect of the curdling variables (temperature, pH, amount of enzymatic extract) on the technological performance of the thistle extract. A three-step procedure for the purification of the enzyme (ammonium sulphate precipitation, gel filtration and ion-exchange chromatography) was also carried out. The milk clotting activity (MCA) of O. tauricum crude extracts was strongly affected by temperature, pH and by the interaction between these two variables, according to a second-order response surface model, while the milk/coagulant ratio did not affect in a significant way the clotting properties. Experimental data showed that the addition of 10 mM CaCl2 reduced the clotting time of ewe’s, goat’s, and cow’s milk by about 3-fold, 8-fold, and 14-fold, respectively, at 35°C and pH 6.7-6.8. After purification, an enzymatic preparation very close to homogeneity was obtained, which showed a major band at about 30 kDa when analyzed by SDS-PAGE. The identity of the enzyme as an aspartic protease was confirmed by inhibition studies. Cheese-making trials were carried out to check the scale-up (1 to 5 L of milk; 37 °C; 10 mM CaCl2 fortification) and set the recipe: 35-45% of curd yields were recorded, according to curd cutting and pressing.

Keywords: milk clotting activity, Onopordum tauricum, plant proteases, vegetable rennet

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Authors: Hosia T. Pule, Julius T. Tjelele, Michelle J. Tedder, Dawood Hattas

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Acceptability of plant material to herbivores is influenced by, among other factors; nutrients, plant secondary metabolites and growth stage of the plants. However, the effect of these factors on Seriphium plumosum L. acceptability to livestock is still not clearly understood, despite its importance in managing its encroachment in grassland communities. The study used 2 x 2 x 2 factorial analysis of variance to investigate the effect of season (wet and dry), fire, slope position (top and bottom) and their interaction on Seriphium plumosum chemistry. We tested the hypothesis that S. plumosum chemistry varies temporally, spatially and pre- and post-fire treatment. Seriphium plumosum edible material was collected during the wet and dry season from burned and unburned areas on both top and bottom slopes before being analysed for protein (CP) content, neutral detergent fibre (NDF), total phenolics (TP) and condensed tannins (CT). Season had a significant effect on S. plumosum protein content, neutral detergent fibre, total phenolics and condensed tannins. Fire had a significant effect on CP. Interaction of season x fire had a significant effect on NDF and CP (p < 0.05). Seriphium plumosum in the wet season (6.69% ± 0.20 (SE)) had significantly higher CP than in the dry season (5.22% ± 0.13). NDF was significantly higher (58.01% ± 0.41) in the dry season than in the wet season (53.17% ± 0.34), while TP were significantly higher in the dry season (14.44 mg/gDw ± 1.03) than in the wet season (11.08 mg/gDw ± 1.07). CT in the wet season were significantly higher (1.56 mg/gDw ± 0.13) than in the dry season (1 mg/gDw ± 0.03). CP was significantly higher in burned (6. 31 % ± 0.22) than in unburned S. plumosum edible material (5.60 % ± 0.15). Seriphium plumosum CP was significantly higher in wet season x burned (7.34 % ± 0.31) than wet season x unburned (6.08 % ± 0.20) material and dry season x burned (5.34 % ± 0.18) and unburned (5.09 % ± 0.18) material were similar. NDF was similar in dry season x burned (58.31% ± 0.54) and dry season x unburned (57.69 % ± 0.62) material and significantly higher than similar wet season x burned (52.43% ± 0.45) and wet season x post-unburned (53.88% ± 0.47) material. This study suggests integrating fire, browsers, and supplements as encroacher S. plumosum control agents, especially in the wet season, following fire due to high S. plumosum CP content.

Keywords: acceptability, chemistry, edible material, encroachment, phenolics, tannins

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Authors: Abdela Bulbula

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Background: Marek’s disease virus is a devastating infection, causing high morbidity and mortality in chickens in Ethiopia. Methods: The current study was conducted from March to November, 2021 with the general objective of performing antemortem and postmortem, isolation, and molecular detection of Marek’s disease virus from outbreak cases in southwestern Ethiopia. Accordingly, based on outbreak information reported from the study sites namely, Bedelle, Yayo, and Bonga towns in southwestern Ethiopia, 50 sick chickens were sampled. The backyard and intensive farming systems of chickens were included in the sampling and priorities were given for chickens that showed clinical signs that are characteristics of Marek’s disease. Results: By clinical examinations, paralysis of legs and wings, gray eye, loss of weight, difficulty in breathing, and depression were recorded on all chickens sampled for this study and death of diseased chickens was observed. In addition, enlargement of the spleen and gross lesions of the liver and heart were recorded during postmortem examination. The death of infected chickens was observed in both vaccinated and non-vaccinated flocks. Out of 50 pooled feather follicle samples, Marek’s disease virus was isolated from 14/50 (28%) by cell culture method and out of six tissue samples, the virus was isolated from 5/6(83.30%). By Real time polymerization chain reaction technique, which was targeted to detect the Meq gene, Marek’s disease virus was detected from 18/50 feather follicles which accounts for 36% of sampled chickens. Conclusion: In general, the current study showed that the circulating Marek’s disease virus in southwestern Ethiopia was caused by the oncogenic Gallid herpesvirus-2 (Serotype-1). Further research on molecular characterization of revolving virus in current and other regions is recommended for effective control of the disease through vaccination.

Keywords: Ethioi, Marek's disease, isolation, molecular

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Authors: Alexandra Von Guionneau, William Sloper, Charlotte Burford

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The benefits of exercise for the prevention and management of chronic disease are well established and the importance of primary care practitioners in promoting exercise is becoming increasingly recognized. However, those with severe manifestations of the chronic disease are managed in a secondary care setting. Secondary care practitioners, therefore, have a role to play in promoting physical activity. Methods: In order to assess secondary care doctors’ knowledge of the Chief Medical Officer’s guidelines for physical activity, a 12-question survey was administered to staff working in a district general hospital in South England during team and unit meetings. Questions related to knowledge of the current guidelines for both 19 - 64 year olds and older adults (65 years and above), barriers to exercise discussion or prescription and doctors’ own exercise habits. Responses were collected anonymously and analyzed using SPSS Version 24.0. Results: 96 responses were collected. Doctors taking part in the survey ranged from foundation years (26%) to consultants (40%). 17.7% of participants knew the guidelines for moderate intensity activity for 19 - 64 year olds. Only one participant knew all of the guidance for both 19 - 64 year olds and older adults. While 71.6% of doctors felt they were adequately informed about how to exercise, only 45.6% met the minimum recommended guidance for moderate intensity activity. Conclusion: More work is needed to promote the physical activity guidelines and exercise prescription to doctors working within a secondary care setting. In addition, doctors require more support to personally meet the recommended minimum level of physical activity.

Keywords: exercise is medicine, exercise prescription, physical activity guidelines, exercise habits

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Authors: Ahmed Bux Jamali

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The purpose of this study is to examine and evaluate the overall counterterrorism cooperation during Obama Administration towards Pakistan. It aims and focuses on the performances and measures taken by United States of America during President Obama in office in order to eradicate terrorism from Pakistan. Being a grave national security threat, terrorism played a disastrous role in the domestic peace and stability of both countries. For the sake of curbing this menace in South Asia in general and Pakistan in particular, the role of Obama Administration is viable and results-oriented despite major ups and downs in Pakistan U.S Relations during that period of time. Obama administration formulated policies when he comes to office in 2009 by looking at the already efforts done by Bush Administration to counterterrorism from Pakistan. Obama’s foreign policy was revolving around defense and diplomacy when it comes to dealing with Pakistan. The concept of smart power was indeed a core principle of Obama’s administration to gain the strategic objectives in Pakistan. Obama’s strategies in terms of providing military aid packages and various assistance programs, working on institutional building and strengthening the economy helped Pakistan in strengthening the military capabilities to go for militant operation in the safe havens area in the tribal areas of Pakistan. It further helped building institutional mechanism in the governmental policies to counter terrorism and militancy. The training of combat forces, artillery, and equipment provided by US proved fatal for the militant terrorist organizations seeking hideouts in the tribal areas of Pakistan. Resultantly, many top leaders of al Qaeda and many affiliated militant groups were captured and given to US as well. Despite many ups and downs in the bilateral relations on various domestic and international issues, both countries didn’t compromise the elimination of terrorist phenomena from Pakistan which was indeed a great success of the Obama administration’s counterterrorism and counterinsurgency strategies in the long run.

Keywords: counterterrorism cooperation, national security strategy, Obama administration, Pakistan-US relations

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Authors: Sunday Nathaniel Obasi, Chiamak Chinasa Obasi

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Soil characterization and classification provide the basic information necessary to create a functional evaluation and soil classification schemes. Fertility capability classification (FCC) on the other hand is a technical system that groups the soils according to kinds of problems they present for management of soil physical and chemical properties. This research was carried out in Ebonyi state, southeastern Nigeria, which is an agrarian state and a leading rice producing part of southeastern Nigeria. In order to maximize the soil and enhance the productivity of rice in Ebonyi soils, soil classification, and fertility classification information need to be supplied. The state was grouped into three locations according to their agricultural zones namely; Ebonyi north, Ebonyi central and Ebonyi south representing Abakaliki, Ikwo and Ivo locations respectively. Major rice growing areas of the soils were located and two profile pits were sunk in each of the studied zones from which soils were characterized, classified and fertility capability classification (FCC) developed. Soil classification was done using United State Department of Agriculture (USDA) Soil Taxonomy and correlated with World Reference Base for soil resources. Results obtained classified Abakaliki 1 and Abakaliki 2 as Typic Fluvaquents (Ochric Fluvisols). Ikwo 1 was classified as Vertic Eutrudepts (Eutric Vertisols) while Ikwo 2 was classified as Typic Eutrudepts (Eutric Cambisols). Ivo 1 and Ivo 2 were both classified as Aquic Eutrudepts (Gleyic Leptosols). Fertility capability classification (FCC) revealed that all studied soils had mostly loamy topsoils and subsoils except Ikwo 1 with clayey topsoil. Limitations encountered in the studied soils include; dryness (d), low ECEC (e), low nutrient capital reserve (k) and water logging/ anaerobic condition (gley). Thus, FCC classifications were Ldek for Abakaliki 1 and 2, Ckv for Ikwo 1, LCk for Ikwo 2 while Ivo 1 and 2 were Legk and Lgk respectively.

Keywords: soil classification, soil fertility, limitations, modifiers, Southeastern Nigeria

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Authors: Hermalina Sinay, Estri L. Arumingtyas

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The research objective was to determine the expression level of dehydration responsive element binding/DREB gene of local corn cultivars from Kisar Island Maluku. The study design was a randomized block design with single factor consist of six local corn cultivars obtained from farmers in Kisar Island and one reference varieties wich has been released by the government as a drought-tolerant varieties and obtained from Cereal Crops Research Institute (ICERI) Maros South Sulawesi. Leaf samples were taken is the second leaf after the flag leaf at the 65 days after planting. Isolation of total RNA from leaf samples was carried out according to the protocols of the R & A-BlueTM Total RNA Extraction Kit and was used as a template for cDNA synthesis. The making of cDNA from total RNA was carried out according to the protocol of One-Step Reverse Transcriptase PCR Premix Kit. Real Time-PCR was performed on cDNA from reverse transcription followed the procedures of Real MODTM Green Real-Time PCR Master Mix Kit. Data obtained from the real time-PCR results were analyzed using relative quantification method based on the critical point / Cycle Threshold (CP / CT). The results of gene expression analysis of DREB gene showed that the expression level of the gene was highest obtained at Deep Yellow local corn cultivar, and the lowest one was obtained at the Rubby Brown Cob cultivar. It can be concluded that the expression level of DREB gene of Deep Yellow local corn cultivar was highest than other local corn cultivars and Srikandi variety as a reference variety.

Keywords: expression, level, DREB gene, local corn cultivars, Kisar Island, Maluku

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Authors: S. M. Rashed Ul Islam, Shahina Tabassum, Afsana Anwar Miti

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Objective: HIV testing and counseling center (HTC) is an important component of the HIV/AIDS detection, prevention and control interventions. The service was first initiated at the Department of Virology, Bangabandhu Sheikh Mujib Medical University (BSMMU) since the first case detection in 1989. The present study aimed to describe the demographic profile among the attendees tested HIV positive. Methods: The present study was carried out among 219 HIV positive cases detected through screening at the Department of Virology of BSMMU during the year of 2012-2016. Data were collected through pre-structured written questionnaire during the counseling session. Data were expressed as frequency and percentages and analyzed using SPSS v20.0 program. Results: Out of 219 HIV cases detected, 77.6% were males, and 22.4% were females with a mean age (mean±SD) of 35.46±9.46 years. Among them, 70.7% belonged to the 26-45 age groups representing the sexually active age. The majority of the cases were married (86.3%) and 49.8% had primary level of education whereas, 8.7% were illiterate. Nearly 42% of cases were referred from Chittagong division (south-east part of the country) followed by Dhaka division (35.6%). The bulk of study population admitted to involvement in high-risk behaviour (90%) in the past and 42% of them had worked overseas. The Pearson Chi-square (χ2) analysis revealed significant relationship of gender with marital (χ2=7.88 at 2% level) and occupation status (χ2=120.48 at 6% level); however, no association was observed with risk behaviour and educational status. Recommendations: HIV risk behavior was found to be a prime source for HIV infection among the study population. So, there is need for health education and awareness program to bring about behavioral changes to halt the yearly increase of new cases in the country with special attention to our overseas workers on HIV/AIDS risk and safety.

Keywords: Bangladesh, health education, HIV testing and counseling (HTC), HIV/AIDS, risk behavior

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Authors: Dong Yinan, Zhou Zijie

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Urban fringe belt is an important part of urban morphology research. Different from the relatively fixed central district of city, the position of fringe belt is changing. In the process of urban expansion, the original fringe belt is likely to be merged by the new-built city, even become new city public center. During the change, we are facing the dialectic between restoring the organicity of old urban form and creating new urban image. There are lots of relevant research in urban scale, but when we focus on building scale, rare design method can be proposed, thus some new individual building cannot match the overall urban planning intent. The expansion project of the second middle school in Xuancheng is facing this situation. The existing campus is located in the south fringe belt of Xuancheng, Anhui province, China, adjacent to farmland and ponds. While based on the Xucheng urban planning, the farmland and ponds will be transformed into a big lake, around which new public center will be built; the expansion of the school becomes an important part of the boundary of the new public center. Therefore, the expansion project faces challenges from both urban and building scale. In urban scale, we analyze and summarize the fringe belt characters through the reading of existing and future urban organism, in order to determine the form of the expansion project. Meanwhile, in building scale, we study on different types of school buildings and select appropriate type which can satisfy to both urban form and school function. This research attempts to investigate design methods based on an under construction project in Xuancheng, a historic city in southeast China. It also aims to bridge the gap from urban design to individual building design through the typo-morphological research.

Keywords: design methods, urban fringe belt, typo-morphological research, middle school

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Authors: Zinhle Cindi, Collet Dandara, Mpiko Ntsekhe, Edson Makambwa, Miguel Larceda

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Background: Warfarin is the most commonly used drug in the management of thromboembolic disease. However, there is a huge variability in the time, number of doses or starting doses for patients to achieve the required international normalised ratio (INR) which is compounded by a narrow therapeutic index. Many genetic-association studies have reported on European and Asian populations which have led to the designing of specific algorithms that are now being used to assist in warfarin dosing. However, very few or no studies have looked at the pharmacogenetics of warfarin in African populations, yet, huge differences in dosage requirements to reach the same INR have been observed. Objective: We set out to investigate the distribution of 3 SNPs CYP4F2 c.1347C > T, VKORC1 g.-1639G > A and VKORC1 c.1173C > T among South African Mixed Ancestry (MA) and Black African patients. Methods: DNA was extracted from 383 participants and subsequently genotyped using PCR/RFLP for the CYP4F2 c.1347 (V433M) (rs2108622), VKORC1 g.-1639 (rs9923231) and VKORC1 c.1173 (rs9934438) SNPs. Results: Comparing the Black and MA groups, significant differences were observed in the distribution of the following genotypes; CYP4F2 c.1347C/T (23% vs. 39% p=0.03). All VKORC1 g.-1639G > A genotypes (p < 0.006) and all VKORC1 c.1173C > T genotypes (p < 0.007). Conclusion: CYP4F2 c.1347T (V433M) reduces CYP4F2 protein levels and therefore expected to affect the amount of warfarin needed to block vitamin k recycling. The VKORC1 g-1639A variant alters transcriptional regulation therefore affecting the function of vitamin k epoxide reductase in vitamin k production. The VKORC1 c.1173T variant reduces the enzyme activity of VKORC1 consequently enhancing the effectiveness of warfarin. These are preliminary results; more genetic characterization is required to understand all the genetic determinants affecting how patients respond to warfarin.

Keywords: algorithms, pharmacogenetics, thromboembolic disease, warfarin

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Authors: Babawale Akin Adeyemi, Esan Temitayo, Adeyemi Olabisi Omowumi

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The paper analyzed waste disposal system in Akure, Ondo State using GIS techniques. Specifically, the study identified the spatial distribution of collection points and existing dumpsite; evaluated the accessibility of waste collection points and their proximity to each other with the view of enhancing better performance of the waste disposal system. Data for the study were obtained from both primary and secondary sources. Primary data were obtained through the administration of questionnaire. From field survey, 35 collection points were identified in the study area. 10 questionnaires were administered around each collection point making a total of 350 questionnaires for the study. Also, co-ordinates of each collection point were captured using a hand-held Global Positioning System (GPS) receiver which was used to analyze the spatial distribution of collection points. Secondary data used include administrative map collected from Akure South Local Government Secretariat. Data collected was analyzed using the GIS analytical tools which is neighborhood function. The result revealed that collection points were found in all parts of Akure with the highest concentration around the central business district. The study also showed that 80% of the collection points enjoyed efficient waste service while the remaining 20% does not. The study further revealed that most collection points in the core of the city were in close proximity to each other. In conclusion, the paper revealed the capability of Geographic Information System (GIS) as a technique in management of waste collection and disposal technique. The application of Geographic Information System (GIS) in the evaluation of the solid waste management in Akure is highly invaluable for the state waste management board which could also be beneficial to other states in developing a modern day solid waste management system. Further study on solid waste management is also recommended especially for updating of information on both spatial and non-spatial data.

Keywords: assessment, geospatial, system, waste disposal

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Authors: Tumelo Jaquiline Ntsopi

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This study explored the academic writing challenges of first-year students who use English as an Additional Language (EAL) registered in the EAW101 module at an ODeL institution. Research shows that academic writing is a challenge for EAL teaching and learning contexts across the globe in higher education institutions (HEIs). Academic writing is an important aspect of academic literacy in any institution of higher learning, more so in an ODeL institution. This has probed research that shows that academic writing is and continues to pose challenges for EAL teaching and learning contexts in higher education institutions. This study stems from the researcher’s experience in teaching academic writing to first-year students in the EAW101 module. The motivation for this study emerged from the fact that EAW101 is a writing module that has a high number of students in the Department of English Studies with an average of between 50-80 percent pass rate. These statistics elaborate on the argument that most students registered in this module struggle with academic writing, and they need intervention to assist and support them in achieving competence in the module. This study is underpinned by Community of Inquiry (CoI) framework and Transactional distance theory. This study adopted a qualitative research methodology and utilised a case study approach as a research design. Furthermore, the study gathered data from first year students and the EAW101 module’s student support initiatives. To collect data, focus group discussions, structured open-ended evaluation questions, and an observation schedule were used to gather data. The study is vital towards exploring academic writing challenges that first-year students in EAW101 encounter so that lecturers in the module may consider re-evaluating their methods of teaching to improve EAL students’ academic writing skills. This study may help lecturers towards enhancing academic writing in a ODeL context by assisting first year students through using student support interventions.

Keywords: academic writing, academic writing challenge, ODeL, EAL

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Authors: Eyad H. R. Fadda, Jawaher K. Al Rashdieah, Aysha H. Al Rashdieh

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Urban Sprawl is a phenomenon that many regions in the Sultanate of Oman suffer from in general and in Welayat Barka in particular. It is considered a human phenomenon that causes many negative effects as it has increased in the last time clearly, and this study aims to diagnose the current status of urban growth taking place in Walayat Barka. The objective of this study is to monitor and follow up on the most prominent changes and developments taking place in Barka in the period from 2002 to 2019 and provide suggestions to the decision-makers to reduce the negative effects of the phenomenon. The study methodology depends on the descriptive and analytical approach to describe the phenomenon and its analysis and knowledge of the factors that helped in urban expansion in the Barka, using a number of studies and interviews with the specialists, both in governmental and private institutions, as well as with individuals who own land, real estate, and others. Geographic Information Systems (GIS) and Remote Sensing (ERDAS software) have been used to analyze the satellite images that helped in obtaining results that reflect the changes Barka, in addition to knowing the natural and human determinants that stand on Urban Sprawl Expansion. The study concluded that the geographical location of Barka has a significant role in its urban expansion, as it is the closest state to the capital Muscat, as this expansion continues toward the southern and south-western directions, as this expansion has significant negative effects represented in the low number of agricultural lands due to the continuous change in land use. In addition, it was found that there are two types of natural determinants of urban expansion in Barka, which are consumed land from the Sea of Oman and from the western sands.

Keywords: GIS applications, remote sensing, urbanization, urban sprawl expansion trends

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Authors: J. Van der Walt, N. A. Plastow, M. Unger

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Gross and fine motor skill difficulties among children affect their ability to learn and progress in school. Research indicates that children in low socio-economic areas are at a higher risk of motor skill difficulties, while therapy resources are limited. The Hopscotch motor skill programme is a well-researched accessible in-school intervention developed by occupational and physiotherapists through complex intervention development. The development stage of the complex intervention development model firstly included a prevalence study in a low-resourced area in the West Coast of South Africa, indicating a high prevalence with significant motor skill difficulties among pre-school children at 14.5% with fine motor skill difficulties at 24.6%. A scoping review identifies motor skill interventions for pre-school children and a proposed a framework of fundamental concepts to consider when developing a motor skill intervention. a Delphi-study considered the framework and encouraged collaboration between therapists and educators to make the programme accessible, resource and cost effective, specifically geared towards a rural, low resourced area. The results from the Delphi study, together with the proposed framework from the scoping review was used to develop the Hopscotch programme, adopting a task-shifting approach. The eight-week small-group programme is facilitated by teachers with the support of therapists. The programme aims to improve the motor skills of pre-school aged children with motor skill difficulties to promote academic readiness through obstacle courses, ball skill games and fine motor games and crafts. A randomised controlled trial is planned as a next stage to determine the preliminary effect of the programme on the motor and early academic skills of pre-school children.

Keywords: accesible learning, motor skill intervention, school readiness, task shifting

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Authors: Barbara Janari

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This paper focuses on temporality in J.M. Coetzee’s first novel, Dusklands, to argue that the novel’s fractured, disjointed temporality is intricately linked to the representations of the war in Vietnam and the colonial project in South Africa. The disrupted temporalities in the novel eschew chronological plots and linear time in favour of narratives that subvert the notion of historical progress to suggest instead the coextensive, multivalent ways in which the past and present interpenetrate one another. The disruption of temporal flow in the novel is evident in its form – the novel comprises two novellas that are juxtaposed, with the first part (‘The Vietnam War’) set centuries before the second part (‘The Narrative of Jacobus Coetzee’). The juxtaposition of the two novellas suggests history’s sometimes overlapping and lateral, rather than linear, movement. The novel’s form is extended in its montage narrative structure, which works to extend its temporal range. The temporal disjunction is reinforced, firstly, by Coetzee’s textual strategies, which include the subversion and critique of realism, parody, repetition, and the narrative technique of montage, and secondly, by the novel’s thematic concerns, which focus on the ways in which American domination can be linked to the colonial quest from earlier times. The complex structure of various strands and levels of authorship slows down the narrative’s temporal flow, requiring the reader to spend a fair amount of time unraveling the various parts of the narrative and relating them to each other. The structure epitomizes reflexive referencing, in which the reader can only make sense of the narrative by going back and forth and connecting various parts of it. The narrative structure also emphasizes the underlying similarities in the brutality that marked these two distinct historical events, epitomized by the drive towards subjection and domination by the novel’s two protagonists, Eugene Dawn and Jacobus Coetzee. The links and overlapping strands between the two novellas emphasize the ways in which the historical truth of colonial discourse becomes as much a myth as the propaganda program in Vietnam.

Keywords: disjunction, juxtaposition, montage, temporality

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Authors: F. V. Matta, C. M. Donnelly, M. B. Jaafar, N. I. Ward

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‘Yerba Mate’ (Ilex paraguariensis) is a native plant from South America with the main producers being Argentina and Brazil. ‘Mate’ is widely consumed in Argentina, Brazil, Uruguay and Paraguay. The most popular format is as an infusion made from dried leaves of a traditional cup, roasted material in tea bags or iced tea infusions. There are many alleged health benefits resulted from mate consumption, even though there is a lack of conclusive research published in the international literature. The main objective of this study was to develop and evaluate the sample preparation and instrumental analysis stages involved in the determination of trace elements in yerba mate using inductively coupled plasma mass spectrometry (ICP-MS). Specific details on the methods of sample digestion, validation of the ICP-MS analysis especially for polyatomic ion correction and matrix effects associated with the complex medium of mate will be presented. More importantly, mate produced in Brazil and Argentina, is subject to different soil conditions, methods of cultivation and production, especially for loose leaves and tea bags. The highest concentrations for loose mate leaf were for (mg/kg, dry weight): aluminium (253.6 – 506.9 for Brazil (Bra), 230.0 – 541.8 for Argentina (Arg), respectively), manganese (378.3 – 762.6 Bra; 440.8 – 879.9 Arg), iron (32.5 – 85.7 Bra; 28.2 – 132.9 Arg), zinc (28.2 – 91.1 Bra; 39.1 – 92.3 Arg), nickel (2.2 – 4.3 Bra; 2.9 – 10.8 Arg) and copper (4.8 – 9.1 Bra; 4.3 – 9.2 Arg), with lower levels of chromium, cobalt, selenium, molybdenum, cadmium, lead and arsenic. Elemental levels of mate leaf consumed in tea bags were found to be higher, mainly due to only using leaf material (as opposed to leaf and twig for loose packed product). Further implications of the way of consuming yerba mate will be presented, including different infusion methods in Brazil and Argentina. This research provides for the first time an extensive evaluation of mate products from both countries and the possible implications of specific trace elements, especially Mn, Fe, Se, Cu and Zn and the various health claims of consuming yerba mate.

Keywords: beverage analysis, ICP-MS, trace elements, yerba mate

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Authors: Pradip Baishya, D. K. Mahanta

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Rapid and unplanned urbanisation in most cities of India has progressively increased the problem of managing municipal waste in the past few years. With insufficient infrastructure and funds, Municipalities in most cities are struggling to cope with the pace of waste generated. Open dumping is widely in practice as a cheaper option. Scientific disposal of waste in such a large scale with the elements of segregation, recycling, landfill, and incineration involves sophisticated and expensive plants. In an effort to finding affordable and simple solutions to address this burning issue of waste disposal, a semi-mechanized plant has been designed underlying the concept of a zero waste community. The fabrication work of the waste management unit is carried out by local skills from locally available materials. A resident colony in the city of Guwahati has been chosen, which is seen as a typical representative of most cities in India in terms of size and key issues surrounding waste management. Scientific management and disposal of waste on site is carried out on the principle of reduce, reuse and recycle from segregation to compositing. It is a local community participatory model, which involves all stakeholders in the process namely rag pickers, residents, municipality and local industry. Studies were conducted to testify the plant as revenue earning self-sustaining model in the long term. Current working efficiency of plant for segregation was found to be 1kg per minute. Identifying bottlenecks in the success of the model, data on efficiency of the plant, economics of its fabrication were part of the study. Similar satellite waste management plants could potentially be a solution to supplement the waste management system of municipalities of similar sized cities in India or South East Asia with similar issues surrounding waste disposal.

Keywords: affordable, rag pickers, recycle, reduce, reuse, segregation, zero waste

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Authors: Andrew Kanzunguze, Sopani Sichinga, Paston Simkoko, George Nxumayo, Cosmas, V. B. Dambo

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Early detection of plant invasions is a necessary prerequisite for effective invasive plant management in protected areas. This study was conducted to determine the distribution and abundance of alien invasive trees in Nyika National Park (NNP). Data on species' presence and abundance were collected from belt transects (n=31) in a 100 square kilometer area on the central plateau. The data were tested for normality using the Shapiro-Wilk test; Mann-Whitney test was carried out to compare frequencies and abundances between the species, and geographical information systems were used for spatial analyses. Results revealed that Black Wattle (Acacia mearnsii), Mexican Pine (Pinus patula) and Himalayan Raspberry (Rubus ellipticus) were the main alien invasive trees on the plateau. A. mearnsii was localized in the areas where it was first introduced, whereas P. patula and R. ellipticus were spread out beyond original points of introduction. R. ellipticus occurred as dense, extensive (up to 50 meters) thickets on the margins of forest patches and pine stands, whilst P. patula trees were frequent in the valleys, occurring most densely (up to 39 stems per 100 square meters) south-west of Chelinda camp on the central plateau with high variation in tree heights. Additionally, there were no significant differences in abundance between R. ellipticus (48) and P. patula (48) in the study area (p > 0.05) It was concluded that R. ellipticus and P. patula require more attention as compared to A. mearnsii. Howbeit, further studies into the invasion ecology of both P. patula and R. ellipticus on the Nyika plateau are highly recommended so as to assess the threat posed by the species on biodiversity, and recommend appropriate conservation measures in the national park.

Keywords: alien-invasive trees, Himalayan raspberry, Nyika National Park, Mexican pine

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Authors: Talar Agopian

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Teaching English as a Second Language (ESL) is a common practice in many Lebanese schools. However, ESL teaching is done in traditional ways. Methods such as constructivism are seldom used, especially in villages. Here lies the significance of this research which joins constructivism and Piaget’s theory of cognitive development in ESL classes in Lebanese villages. The purpose of the present study is to explore the effects of applying constructivist student-centered strategies in teaching grammar, reading comprehension, and poetry on students in elementary ESL classes in two villages in Lebanon, Zefta in South Lebanon and Boqaata in Mount Lebanon. 20 English teachers participated in a training titled “Teaching English with Fun”, which focused on strategies that create a student-centered class where active learning takes place and there is increased learner engagement and autonomy. The training covered three main areas in teaching English: grammar, reading comprehension, and poetry. After participating in the training, the teachers applied the new strategies and methods in their ESL classes. The methodology comprised two phases: in phase one, practice-based research was conducted as the teachers attended the training and applied the constructivist strategies in their respective ESL classes. Phase two included the reflections of the teachers on the effects of the application of constructivist strategies. The results revealed the educational benefits of constructivist student-centered strategies; the students of teachers who applied these strategies showed improved engagement, positive attitudes towards poetry, increased motivation, and a better sense of autonomy. Future research is required in applying constructivist methods in the areas of writing, spelling, and vocabulary in ESL classrooms of Lebanese villages.

Keywords: active learning, constructivism, learner engagement, student-centered strategies

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Authors: Alonge Isaac Olusola

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Taking a cue from countries such as China and Japan, there is no doubt that the teaching and learning of Mother Tongue ( MT) or Language of Immediate Environment (LIE) is a potential source of development in every country. The engine of economic, scientific, technological and political advancement would be more functional when the language of instruction for teaching and learning in schools is in the child’s mother tongue. The purpose of this paper therefore, is to delve into the genesis of the official recognition given to the teaching and learning of Nigerian languages at national level with special focus on Yoruba language. Yoruba language and other Nigerian languages were placed on a national pedestal by a Nigerian Educational Minister, Late Professor Babatunde Fafunwa, who served under the government of General Ibrahim Babangida (1985 – 1993). Through his laudable effort, the teaching and learning of Nigerian languages in schools all over the nation was incorporated officially in the national policy of education. Among all the Nigerian languages, Hausa, Igbo and Yoruba were given foremost priorities because of the large population of their speakers. Since the Fafunwa era, Yoruba language has become a national subject taught in primary, secondary and tertiary institutions in Nigeria. However, like every new policy, its implementation has suffered several forms of criticisms and impediments from governments, policy makers, curriculum developers, school administrators, teachers and learners. This paper has been able to arrive at certain findings through oral interviews, questionnaires and evaluation of pupils/students enrolment and performances in Yoruba language with special focus on the South-west and North central regions of Nigeria. From the research carried out, some factors have been found to be responsible for the successful implementation or otherwise of Yoruba language instruction policy in some schools, colleges and higher institutions in Nigeria. In conclusion, the paper made recommendations on how the National Policy of Education would be implemented to enhance the teaching and learning of Yoruba language in all Nigerian schools.

Keywords: language of immediate environment, mother tongue, national policy of education, yoruba language

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Authors: J. Chakwizira, P. Bikam, T. A. Adeboyejo

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This paper seeks to illustrate the impact of rapid urbanization (in terms of both increase in people and vehicles) in the Gauteng region (which includes Johannesburg, Pretoria and Ekurhuleni). The impact that existing transport systems and options place on the capacity of residents from low income areas to travel and conduct various socio-economic activities is discussed. The findings are drawn from a 2013 analysis of a random transport household survey of 1550 households carried out in Gauteng province. 91.4% of the study respondents had access to public transport, while 8.6% had no access to public transport. Of the 91.4% who used public transport, the main reason used to explain this state of affairs was that it was affordable (54.3%), convenient (15.9%), Accessible (11.9%), lack of alternatives (6.4%) and reliable at 4.1%. Recommendations advanced revolve around the need to reverse land use and transportation effects of apartheid planning, growing and developing a sustainable critical mass of public transport interventions supported by appropriate transport systems that are environmentally sustainable through proper governance. 38.5% of the respondents indicated that developing compact, smart and integrated urban land spaces was key to reducing travel challenges in the study area. 23.4% indicated that the introduction and upgrading of BRT buses to cover all areas in the study area was a step in the right direction because it has great potential in shifting travel patterns to favor public modes of transport. 15.1% indicated that all open spaces should be developed so that fragmentation of land uses can be addressed. This would help to fight disconnected and fragmented space and trip making challenges in Gauteng. 13.4% indicated that improving the metro rail services was critical since this is a mass mover of commuters. 9.6% of the respondents highlighted that the bus subsidy policy has to be retained in the short to medium term since the spatial mismatches and challenges created by apartheid are yet to be fully reversed.

Keywords: urbanisation, population, public, transport systems, Gauteng

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Authors: Ofri Earon

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This article is about a growing focus in the city of Copenhagen – the edge zone between the private space inside the residential building and the public space out at the residential street. A slow transition between the private living room and the public urban space creates a mutual benefit. The urban space benefits from an insertion of a homey atmosphere by the extended performance of living rooms to the exterior. The dwelling benefits from belonging to a liveable neighborliness, which means an extension of the private home to a collective home (= the neighborhood). Grounded by this reciprocal value of the edge zone, through the article, it is argued that a wide generosity of the edge zones is of interest among both planners and residents. The article introduces the idea of the edge zone and its possible implications in the development of the liveable residential city. Three examples of ongoing projects at Arkitema Architects are bought to illustrate the challenges and potentials of a generous edge zone. Every example represents a specific dwelling typology in a particular urban context: (1) multi-family residential building in a previous industrial area in the city (2) new courtyard building in the city’s outskirt (3) low and dense residential area out in the suburbia. Throughout these examples, the article seeks to discuss the significance of the edge zone in forthcoming residential areas in Denmark. The analysis of the Danish examples raises the question of why a social behavior that happens spontaneously in the south of Europe has to be carefully implemented in the architecture of north of Europe. In this light, the article ends with a discussion on how to create edge zones that are not designed for a particular usage, but rather as an architectural invitation for varied social behaviors that spontaneously occur in different moments of time by different people. Finally, the article ends with a list of recommendations for the development of the generous edge zone as an open invitation for diverse usage over time.

Keywords: dwelling, edge zone, generosity, livability, urban space

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Authors: Sandeep Vasaikar, Lary Obi

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Rapid and discriminative genotyping methods are useful for determining the clonality of the isolates in nosocomial or household outbreaks. Multilocus sequence typing (MLST) is a nucleotide sequence-based approach for characterising bacterial isolates. The genetic diversity and the clinical relevance of the drug-resistant Klebsiella isolates from Mthatha are largely unknown. For this reason, prospective, experimental study of the molecular epidemiology of Klebsiella isolates from patients being treated in Mthatha over a three-year period was analysed. Methodology: PCR amplification and sequencing of the drug-resistance-associated genes, and multilocus sequence typing (MLST) using 7 housekeeping genes mdh, pgi, infB, FusAR, phoE, gapA and rpoB were conducted. A total of 32 isolates were analysed. Results: The percentages of multidrug-resistant (MDR), extensively drug-resistance (XDR) and pandrug-resistant (PDR) isolates were; MDR 65.6 % (21) and XDR and PDR with 0 % each. In this study, K. pneumoniae was 19/32 (59.4 %). MLST results showed 22 sequence types (STs) were identified, which were further separated by Maximum Parsimony into 10 clonal complexes and 12 singletons. The most dominant group was Klebsiella pneumoniae with 23/32 (71.8 %) isolates, Klebsiella oxytoca as a second group with 2/32 (6.25 %) isolates, and a single (3.1 %) K. varricola as a third group while 6 isolates were of unknown sequences. Conclusions/significance: A phylogenetic analysis of the concatenated sequences of the 7 housekeeping genes showed that strains of K. pneumoniae form a distinct lineage within the genus Klebsiella, with K. oxytoca and K. varricola its nearest phylogenetic neighbours. With the analysis of 7 genes were determined 1 K. variicola, which was mistakenly identified as K. pneumoniae by phenotypic methods. Two misidentifications of K. oxytoca were found when phenotypic methods were used. No significant differences were observed between ESBL blaCTX-M, blaTEM and blaSHV groups in the distribution of Sequence types (STs) or Clonal complexes (CCs).

Keywords: phylogenetic analysis, phylogeny, klebsiella phylogenetic, klebsiella

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Authors: Qirat Naz

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The aim of this research study is to explore the perspectives of migrants and interpreters from diverse backgrounds on language barriers, their English language proficiency and access to health care facilities. A qualitative research methodology was used including in-depth interviews and focus group discussions. Data was collected from 20 migrants who have difficulty conversing in the English language and 12 interpreters including family members and friends who provide translation services as part of accessing health care. The findings seek to address three key research questions: how language is a barrier for non-national language speakers to access the health care facilities, what is the impact of various socio-cultural and linguistic backgrounds on health compliance, and what is the role of interpreters in providing access to, usage of, and satisfaction with health-care facilities. The most crucial component of providing care was found to be effective communication between patient and health care professionals. Language barrier was the major concern for healthcare professionals in providing and for migrants in accessing sufficient, suitable, and productive health care facilities. Language and sociocultural background play a significant role in health compliance as this research reported; respondents believe that patients who interact with the doctors who have same sociocultural and linguistic background benefit from receiving better medical care than those who do not. Language limitations and the socio-cultural gap make it difficult for patients and medical staff to communicate clearly with one another, which has a negative effect on quality of care and patient satisfaction. The use of qualified interpreters was found to be beneficial but there were also drawbacks such as accessibility and availability of them in a timely manner for patient needs. The findings of this research can help health care workers and policy makers working to improve health care delivery system and to create appropriate strategies to overcome this challenge.

Keywords: migration, migrants, language barrier, healthcare access

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