Search results for: public disorder
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 6827

Search results for: public disorder

4277 Characterization of the Intestinal Microbiota: A Signature in Fecal Samples from Patients with Irritable Bowel Syndrome

Authors: Mina Hojat Ansari, Kamran Bagheri Lankarani, Mohammad Reza Fattahi, Ali Reza Safarpour

Abstract:

Irritable bowel syndrome (IBS) is a common bowel disorder which is usually diagnosed through the abdominal pain, fecal irregularities and bloating. Alteration in the intestinal microbial composition is implicating to inflammatory and functional bowel disorders which is recently also noted as an IBS feature. Owing to the potential importance of microbiota implication in both efficiencies of the treatment and prevention of the diseases, we examined the association between the intestinal microbiota and different bowel patterns in a cohort of subjects with IBS and healthy controls. Fresh fecal samples were collected from a total of 50 subjects, 30 of whom met the Rome IV criteria for IBS and 20 Healthy control. Total DNA was extracted and library preparation was conducted following the standard protocol for small whole genome sequencing. The pooled libraries sequenced on an Illumina Nextseq platform with a 2 × 150 paired-end read length and obtained sequences were analyzed using several bioinformatics programs. The majority of sequences obtained in the current study assigned to bacteria. However, our finding highlighted the significant microbial taxa variation among the studied groups. The result, therefore, suggests a significant association of the microbiota with symptoms and bowel characteristics in patients with IBS. These alterations in fecal microbiota could be exploited as a biomarker for IBS or its subtypes and suggest the modification of the microbiota might be integrated into prevention and treatment strategies for IBS.

Keywords: irritable bowel syndrome, intestinal microbiota, small whole genome sequencing, fecal samples, Illumina

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4276 Prenatal Lead Exposure and Postpartum Depression: An Exploratory Study of Women in Mexico

Authors: Nia McRae, Robert Wright, Ghalib Bello

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Introduction: Postpartum depression is a prevalent mood disorder that is detrimental to the mental and physical health of mothers and their newborns. Lead (Pb) is a toxic metal that is associated with hormonal imbalance and mental impairments. The hormone changes that accompany pregnancy and childbirth may be exacerbated by Pb and increase new mothers’ susceptibility to postpartum depression. To the best of the author’s knowledge, this is the only study that investigates the association between prenatal Pb exposure and postpartum depression. Identifying risk factors can contribute to improved prevention and treatment strategies for postpartum depression. Methods: Data was derived from the Programming Research in Obesity, Growth, Environment and Social Stress (PROGRESS) study which is an ongoing longitudinal birth cohort. Postpartum depression was identified by a score of 13 or above on the 10-Item Edinburg Postnatal Depression Scale (EPDS) 6-months and 12-months postpartum. Pb was measured in the blood (BPb) in the second and third trimester and in the tibia and patella 1-month postpartum. Quantile regression models were used to assess the relationship between BPb and postpartum depression. Results: BPb in the second trimester was negatively associated with the 80th percentile of depression 6-months postpartum (β: -0.26; 95% CI: -0.51, -0.01). No significant association was found between BPb in the third trimester and depression 6-months postpartum. BPb in the third trimester exhibited an inverse relationship with the 60th percentile (β: -0.23; 95% CI: -0.41, -0.06), 70th percentile (β: -0.31; 95% CI: -0.52, -0.10), and 90th percentile of depression 12-months postpartum (β: -0.36; 95% CI: -0.69, -0.03). There was no significant association between BPb in the second trimester and depression 12-months postpartum. Bone Pb concentrations were not significantly associated with postpartum depression. Conclusion: The negative association between BPb and postpartum depression may support research which demonstrates lead is a nontherapeutic stimulant. Further research is needed to verify these results and identify effect modifiers.

Keywords: depression, lead, postpartum, prenatal

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4275 Pattern and Clinical Profile of Children and Adolescent Visiting Psychiatry Out Patient Department of Tertiary Health Center Amidst COVID Pandemic- a Cross Sectional Study

Authors: Poornima Khadanga, Gaurav Pawar, Madhavi Rairikar

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Background: The COVID 19 pandemic, with its unparalleled mental health repercussions, has impacted people globally and has catalyzed a Mental Health pandemic among the youth. The detrimental effects on mental health needs to be pondered at the earliest. Aims: To study the behavioral problems among children and adolescents visiting Psychiatry Outpatient Department Tertiary Health Care during COVID pandemic and its correlation with socio-demographic profiles. Methods: A cross sectional study was conducted by interviewing 120 participants between 4 to 17 years of age and their parents, visiting Psychiatry OPD. Behavioral problems were assessed using the Strength and Difficulties Questionnaire and diagnosed by DSM-5. Statistical analysis was done by SPSS-21. Results: Male participants showed significant association with conduct (t=2.36, p=0.02) and hyperactive problems (t=5.07, p<0.05). Increase in screen time showed a positive correlation with conduct problems (r=0.22. p=0.02). Attention Deficit Hyperkinetic Disorder (18.3%) was the most commonly diagnosed psychiatric illness. Total difficulty score was significantly associated with difficult temperament (F=68.69, p<0.05). Conclusion: The study brings to light the pattern of behavioral problems that emerged during recent times of uncertainties among the young ones, including those with special needs. The increase in disruptive behaviors with increase screen time needs to be addressed at the earliest.

Keywords: behavioral problems, pandemic, screen time, temperament

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4274 Local and Global Sustainability: the Case-Study of Beja Municipality Local Agenda 21 Operationalization Challenges

Authors: Maria Inês Faria, João Miguel Simão

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Frequently, the Sustainable Development paradigm is considered the contemporary societies flag and is has been assuming different nuances on local and global dialogues. This reveals the ambivalent character associated to its implementation due, namely, to the kind of synergies that political institutions, social organizations and citizenry can actually create. The Sustainable Development concept needs further discussion so that it can be useful in decision-making processes. In fact, the polysemic nature of this concept has consistently undermined its credibility leading, among other factors, to the talk and action gap, as well as to misappropriations of this notion. The present study focuses on the importance in questioning the sustainable development operationalization, "To walk the talk", and intends, in a broad sense, identify prospects and the elements of sustainability that are included in strategic plans (global, national and local) and, in the strict sense, confront discourse and practice in the context of local public policies for sustainable development, in particular with regard to the implementation of Local Agenda 21 in the municipality of Beja (Portugal) in order to analyze at what extent the strategies adopted and implemented are aligned with the paradigm of sustainable development. The method is based on critical analysis of literature and official documentation, using three complementary approaches: a) exploratory review of literature in order to identify publications on sustainability and sustainable development; b) this second approach complements the first, focused on the official documentation for the adoption and implementation of sustainable development, which is produced in the global plan, regional, national and local levels; c) and the approach which is focused on official documentation that expresses the policy options, the strategic lines and actions for sustainable development implementation Beja´s Municipality. The main results of this study highlight the type of alignment of the Beja´s Municipality sustainable policies, concerning the officially stipulated for the promotion of sustainable development on the international agenda, stressing the potentialities, constraints and challenges of Agenda 21 Local implementation.

Keywords: sustainable development, Local Agenda 21, sustainable local public policies, Beja

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4273 Refutation of Imre Hermann's Allegation: János Bolyai Was Not Insane

Authors: Oláh Gál Róbert, Veress Bágyi Ibolya

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The scientific public has relatively little knowledge about the Hungarian János Bolyai, one of the greatest thinkers of all times. Few people know that apart from being the founder of the non-Euclidean geometry he was also interested in sociology, philosophy, epistemology and linguistics. According to the renowned Hungarian psychoanalytic Imre Hermann, who lives in France, János Bolyai was mentally deranged. However, this is incorrect. The present article intends to prove that he was completely sane until the moment of his death.

Keywords: Imre Hermann, insane, János Bolyai, mathematics, non-Euclidean geometry, psyphoanalytic

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4272 Post-Experts in Polish Mainstream Media: Quantitative and Qualitative Analysis of Selected Information Programs

Authors: Aldona Guzik

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Experts have always played a special role in society. Drawing on their opinions was and most certainly is one of the most important strategies that direct people when they make decisions; something often used with the aim of exerting influence and ensuring social conformism. Many factors decide on who becomes an expert. The most important of these have hitherto been: the possession of extensive knowledge, charisma, authority as well as experience. Increasingly, however, these factors are insufficient and may even be deemed unnecessary. This state of affairs has been brought about (among other things) by the development of the media and the media’s influence on our lives. The inspiration to write the present article has its grounding in the book by Tom Nichols The Death of Expertise. The Campaign Against Established Knowledge and Why it Matters, in which the author claims that in our present-day open society experts and their expertise count for increasingly less for everyone who has unlimited access to the Internet and education. This has, in turn, resulted in the creation of so-called ‘collective wisdom,’ which is placed higher than any of the specialist knowledge proclaimed by experts. However, this is an incomplete picture, because admittedly, access to knowledge is nowadays unlimited, but on the other hand, the ubiquitous risk causes that the expert is someone who allows them to minimize it. Therefore, a modern society so readily refers to their opinion; from the smallest matters, eg home appliance, to important political issues. Hence, many information services include numerous experts (scientists, journalists, specialists, celebrities), whose task is to explain to the viewers in a simple way the presented reality. However, more and more often their role is also to give credence to what they explain. Hence the questions arise: who are the experts, what is their typology and what roles they play in Polish information services? To answer them, quantitative and qualitative research was used, such as analysis of lists of 100 most influential experts, analysis of expert profiles and their statements in three differentiated information services (TVN - commercial, TVP1 - public, TV Trwam - non-commercial/religious). They will be the basis for answering the above-mentioned questions and, above all, determining their role in information services in Poland.

Keywords: experts, media, public discours, symbolic elites

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4271 Barriers to Yoga and Yoga-Based Therapy for Black and Brown Individuals in the United States: Implications for Social Work Practice

Authors: Jessica Gladden

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Yoga has been accepted in the majority of communities in the United States as a method of assisting individuals with improving their physical health. Both community yoga classes and yoga-based therapy have been shown to be highly useful for individual’s mental health. Yoga-based therapy has been supported by research to be an evidence-based practice for individuals experiencing anxiety, depression, and disordered eating and for those experiencing post traumatic stress disorder in the wake of trauma. Many individuals who have experienced trauma, as well as other mental health diagnoses, are either very disconnected from their physical bodies or feel unsafe in their bodies. Yoga can be a method of creating safety and control in the body. This is recommended by some of the leading researchers in trauma therapy as a beginning step towards finding safety in the body in order to begin to work on the additional mental health challenges before addressing other long-term challenges. Unfortunately, yoga for physical and mental health is underutilized in black and brown communities despite the research regarding the benefits. Very few studies have examined the barriers to access to yoga for black, brown, and indigenous individuals. This study interviewed 15 yoga practitioners who identified as black or brown and explored the barriers they see in their communities related to accessing yoga and yoga-based services. Several of the themes reported include not feeling welcome, cost of services, time, and cultural/ religious components. Methods for reducing barriers will also be discussed.

Keywords: yoga, sport, barrier, black

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4270 Effectiveness of Office-Based Occupational Therapy for Office Workers with Low Back Pain: A Public Health Approach

Authors: Dina Jalalvand, Joshua A. Cleland

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This double-blind, randomized control trial with parallel groups aimed to examine the effectiveness of office-based occupational therapy for office workers with low back pain on the intensity of pain and range of motion. Seventy-two male office workers (age: 20-50 years) with chronic low back pain (more than three months with at least two symptoms of chronic low back pain) satisfied eligibility criteria and agreed to participate in this study. The absence of joint burst following magnetic resonance imagining (MRI) was considered as an important inclusion criterion as well. Subjects were randomly assigned to a control or experimental group. The experimental group received the modified package of exercise-based occupational therapy, which included 11 simple exercise movements (derived from Williams and McKenzie), and the control group just received the conventional therapy, which included their routine physiotherapy sessions. The subjects completed the exercises three times a week for a duration of six weeks. Each exercise session was 10-15 minutes. Pain intensity and range of motion were the primary outcomes and were measured at baseline, 6 weeks, and 12 weeks after the end of the intervention using the numerical rating scale (NRS) and goniometer accordingly. Repeated measure ANOVA was used for analyzing data. The results of this study showed that significant decreases in pain intensity (p ≤ 0.05) and an increase in range of motion (p ≤ 0.001) in the experimental group in comparison with the control group after 6 and 12 weeks of intervention (between-group comparisons). In addition, there was a significant decrease in intensity of the pain (p ≤ 0.05) and an increase (p ≤ 0.001) in range of motion in the intervention group in comparison with baseline after 6 and 12 weeks (within-group comparison). This showed a positive effect of exercise-based occupational therapy that could potentially be used with low cost among office workers who suffer from low back pain. In addition, it should be noted that the introduced package of exercise training is easy to do, and there is not a need for a specific introduction.

Keywords: public health, office workers, low back pain, occupational therapy

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4269 A Development of Community Participation in Developing Healthy Religion Places in Narathiwat Province, Thailand

Authors: Waepa Wanhussen

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The Ministry of Public Health has established policies accelerating health promotion to prevent public health problems in five border provinces of Thailand. One of these policies employs the religion to guide the community development and solve health issues consistent with the lifestyle and culture of those people. This policy is an important strategy to solve the problems due to the unrest and conflicts in the southern border provinces. This participatory action research aimed to develop mosques as healthy religion places in Narathiwat Province. In the development, the participatory action, consisting of 5 stages, was conducted from October 2012 - May 2013. Stage I: Conducting a survey for problems and needs for developing healthy religion places by employing community participation. Stage II: Analyzing problems and situations at a workshop containing informal interviews and group conversations with 200 participants (health providers at district level, Imams (the Muslim leaders), and community leaders). Stage III: Planning for developing healthy religion places by health providers, Imams, community leaders. Stage IV: Implementing the plan according to the conditions of problems and needs of the community in order to develop healthy religion places. Stage V: Evaluating the implementation by using the instrument, a criteria of being healthy religion place, for collecting data. Data were analyzed by using percentage. It was found that out of 630 mosques 575 (90.12%) passed the criteria of being a healthy religion place. Among these mosques, 190 mosques (30.15%) were in good and very good level, in which, after the implementation, the number of being good and very good healthy mosques increased by 22.58%. The researcher suggested that the developing sustainably healthy religion places require the participation of residences in the community and agencies such as local government, the Islamic Council of Narathiwat Province, and Council of Culture of Narathiwat Province. The healthy religion places can be used to strengthen and sustain health promotion and disease prevention in the community as health learning centers.

Keywords: healthy religion places, development of community participation, nursing informatics, health

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4268 Elderly Health Care Process by Community Participation: A Sub-District in the Lower Northern Region of Thailand

Authors: Amaraporn Puraya, Roongtiva Boonpracom, Somsak Thojampa, Sirikanok Klankhajhon, Kittisak Kumpeera

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The objective of this qualitative research was to study the elderly health care process by community participation. Data were collected by quality research methods, including secondary data study, observation, in-depth interviews, and focus group discussions and analyzed by content analysis, reflection and review of information. The research results pointed out that the important elderly health care process by community participation consisted of 2 parts, namely the community participation development process in elderly health care and the outcomes from the participation development process. The community participation development process consisted of 4 steps as follows: 1) Building the leadership team, an important social capital of the community, which started from searching for both formal and informal leaders by giving the opportunity for public participation and creating clear agreements defining roles, duties and responsibilities; 2) investigating the problems and the needs of the community, 3) designing the elderly health care activities under the concept of self-care potential development of the elderly through participation in community forums and meetings to exchange knowledge with common goals, plans and operation and 4) the development process of sustainable health care agreement at the local level, starting from opening communication channels to create awareness and participation in various activities at both individual and group levels as well as pushing activities/projects into the community development plan consistent with the local administration policy. The outcomes from the participation development process were as follows. 1) There was the integration of the elderly for doing the elderly health care activities/projects in the community managed by the elderly themselves. 2) The service system was changed from the passive to the proactive one, focusing on health promotion rather than treating diseases or illnesses. 3) The registered nurses / the public health officers can provide care for the elderly with chronic illnesses through the implementation of activities/projects of elderly health care so that the elderly can access the services more. 4) The local government organization became the main mechanism in driving the elderly health care process by community participation.

Keywords: elderly health care process, community participation, elderly, Thailand

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4267 Challenges in E-Government: Conceptual Views and Solutions

Authors: Rasim Alguliev, Farhad Yusifov

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Considering the international experience, conceptual and architectural principles of forming of electron government are researched and some suggestions were made. The assessment of monitoring of forming processes of electron government, intellectual analysis of web-resources, provision of information security, electron democracy problems were researched, conceptual approaches were suggested. By taking into consideration main principles of electron government theory, important research directions were specified.

Keywords: electron government, public administration, information security, web-analytics, social networks, data mining

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4266 Dynamic Modelling and Assessment for Urban Growth and Transport in Riyadh City, Saudi Arabia

Authors: Majid Aldalbahi

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In 2009, over 3.4 billion people in the world resided in urban areas as a result of rapid urban growth. This figure is estimated to increase to 6.5 billion by 2050. This urban growth phenomenon has raised challenges for many countries in both the developing and developed worlds. Urban growth is a complicated process involving the spatiotemporal changes of all socio-economic and physical components at different scales. The socio-economic components of urban growth are related to urban population growth and economic growth, while physical components of urban growth and economic growth are related to spatial expansion, land cover change and land use change which are the focus of this research. The interactions between these components are complex and no-linear. Several factors and forces cause these complex interactions including transportation and communication, internal and international migrations, public policies, high natural growth rates of urban populations and public policies. Urban growth has positive and negative consequences. The positive effects relates to planned and orderly urban growth, while negative effects relate to unplanned and scattered growth, which is called sprawl. Although urban growth is considered as necessary for sustainable urbanization, uncontrolled and rapid growth cause various problems including consumption of precious rural land resources at urban fringe, landscape alteration, traffic congestion, infrastructure pressure, and neighborhood conflicts. Traditional urban planning approaches in fast growing cities cannot accommodate the negative consequences of rapid urban growth. Microsimulation programme, and modelling techniques are effective means to provide new urban development, management and planning methods and approaches. This paper aims to use these techniques to understand and analyse the complex interactions for the case study of Riyadh city, a fast growing city in Saudi Arabia.

Keywords: policy implications, urban planning, traffic congestion, urban growth, Suadi Arabia, Riyadh

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4265 Assessment of Very Low Birth Weight Neonatal Tracking and a High-Risk Approach to Minimize Neonatal Mortality in Bihar, India

Authors: Aritra Das, Tanmay Mahapatra, Prabir Maharana, Sridhar Srikantiah

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In the absence of adequate well-equipped neonatal-care facilities serving rural Bihar, India, the practice of essential home-based newborn-care remains critically important for reduction of neonatal and infant mortality, especially among pre-term and small-for-gestational-age (Low-birth-weight) newborns. To improve the child health parameters in Bihar, ‘Very-Low-Birth-Weight (vLBW) Tracking’ intervention is being conducted by CARE India, since 2015, targeting public facility-delivered newborns weighing ≤2000g at birth, to improve their identification and provision of immediate post-natal care. To assess the effectiveness of the intervention, 200 public health facilities were randomly selected from all functional public-sector delivery points in Bihar and various outcomes were tracked among the neonates born there. Thus far, one pre-intervention (Feb-Apr’2015-born neonates) and three post-intervention (for Sep-Oct’2015, Sep-Oct’2016 and Sep-Oct’2017-born children) follow-up studies were conducted. In each round, interviews were conducted with the mothers/caregivers of successfully-tracked children to understand outcome, service-coverage and care-seeking during the neonatal period. Data from 171 matched facilities common across all rounds were analyzed using SAS-9.4. Identification of neonates with birth-weight ≤ 2000g improved from 2% at baseline to 3.3%-4% during post-intervention. All indicators pertaining to post-natal home-visits by frontline-workers (FLWs) improved. Significant improvements between baseline and post-intervention rounds were also noted regarding mothers being informed about ‘weak’ child – at the facility (R1 = 25 to R4 = 50%) and at home by FLW (R1 = 19%, to R4 = 30%). Practice of ‘Kangaroo-Mother-Care (KMC)’– an important component of essential newborn care – showed significant improvement in postintervention period compared to baseline in both facility (R1 = 15% to R4 = 31%) and home (R1 = 10% to R4=29%). Increasing trend was noted regarding detection and birth weight-recording of the extremely low-birth-weight newborns (< 1500 g) showed an increasing trend. Moreover, there was a downward trend in mortality across rounds, in each birth-weight strata (< 1500g, 1500-1799g and >= 1800g). After adjustment for the differential distribution of birth-weights, mortality was found to decline significantly from R1 (22.11%) to R4 (11.87%). Significantly declining trend was also observed for both early and late neonatal mortality and morbidities. Multiple regression analysis identified - birth during immediate post-intervention phase as well as that during the maintenance phase, birth weight > 1500g, children of low-parity mothers, receiving visit from FLW in the first week and/or receiving advice on extra care from FLW as predictors of survival during neonatal period among vLBW newborns. vLBW tracking was found to be a successful and sustainable intervention and has already been handed over to the Government.

Keywords: weak newborn tracking, very low birth weight babies, newborn care, community response

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4264 Haemoglobin Variants and Their Frequency Distribution in Human Population of Niger State, Nigeria

Authors: Akeem Akinboro, Bala Alhaj Kegun

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Haemoglobinopathy is a genetic disorder that has the potentiality to cause death of individuals in whom both the alpha (α) and beta (β) globin chains of the haemoglobin molecule are defective due to mutations in their genes. The haemoglobin genotype variants among some residents of Niger state, Nigeria, were determined using the secondary data available at Bida, Minna and Kotangora general hospitals of the state. A total of 1,639 data, representing 434, 655 and 550, collected from the outside patients who visited the medical laboratory units of the three general hospitals, respectively, over five years period (2015-2020) were analyzed into gene frequency, sex and age to determine their haemoglobin genotypes status. More males (51.6 – 58.7%) than females (41.3 – 48.4%) visited the three hospitals during the period covered and most of the patients were between 11 - 20 years old. The frequency of HbA allele in the human population was 0.72, 0.65, 0.68 for Bida, Minna and Kotangora, respectively, while it was 0.25, 0.29 and 0.28 for HbS allele. The HbC allele was prevalent at 0.03, 0.06 and 0.05 among the human population in Bida, Minna and Kotangora cities of Niger state. In overall, the prevalence of HbA, HbS and HbC alleles in Niger state of Nigeria was 0.68, 0.28 and 0.05. Minna being the capital city of Niger state and the most populous among the three cities in the state seems to have influx of more people who are carriers of abnormal haemoglobin genotypes which has resulted to higher frequency of HbS and HbC than those of the other two cities in this study. These results show that the pattern of haemoglobin genotypes frequency of Kontagora could be a prediction for the whole of Niger state. It is therefore necessary and important to take screening of blood for haemoglobin genotype serious among intending couples to prevent and reduce the possibility of having increase in the number of people with abnormal haemoglobin genotypes in the state.

Keywords: haemoglobin, genotype, niger state, gene frequency, general hospitals

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4263 The Disease That 'Has a Woman Face': Feminization of HIV/AIDS in Nagaland, North-East India

Authors: Kitoholi V. Zhimo

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Unlike the cases of cases of homosexuals, haemophilic and or drug users in USA, France, Africa and other countries, in India the first case of HIV/AIDS was detected in heterosexual female sex workers (FSW) in Chennai in 1986. This image played an important role in understanding HIV/AIDS scenario in the country. Similar to popular and dominant metaphors on HIV/AIDS such as ‘gay plague’, ‘new cancer’, ‘lethal disease’, ‘slim disease’, ‘foreign disease’, ‘junkie disease’, etc. around the world, the social construction of the virus was largely attributed to women in India. It was established that women particularly sex workers are ‘carrier’ and ‘transmitter’ of virus and were categorised as High Risk Groups (HRG’s) alongside homosexuals, transgenders and injecting drug users. Recent literature reveals growing rate of HIV infection among housewives since 1997 which revolutionised public health scenario in India. This means shift from high risk group to general public through ‘bridge population’ encompassing long distance truckers and migrant labours who at the expense of their nature of work and mobility comes in contact with HRG’s and transmit the virus to the general public especially women who are confined to the domestic space. As HIV epidemic expands, married women in monogamous relationship/marriage stand highly susceptible to infection with limited control, right and access over their sexual and reproductive health and planning. In context of Nagaland, a small state in North-eastern part of India HIV/AIDS transmission through injecting drug use dominated the early scene of the epidemic. However, paradigm shift occurred with declining trend of HIV prevalence among injecting drug users (IDU’s) over the past years with the introduction of Opioid Substitution Therapy (OST) and easy access/availability of syringes and injecting needles. Reflection on statistical data reveals that out of 36 states and union territories in India, the position of Nagaland in HIV prevalence among IDU’s has significantly dropped down from 6th position in 2003 to 16th position in 2017. The present face of virus in Nagaland is defined by (hetero) sexual mode of transmission which accounts for about 91% of as reported by Nagaland state AIDS control society (NSACS) in 2016 wherein young and married woman were found to be most affected leading to feminization of HIV/AIDS epidemic in the state. Thus, not only is HIV epidemic feminised but emerged victim to domestic violence which is more often accepted as normal part of heterosexual relationship. In the backdrop of these understanding, the present paper based on ethnographic fieldwork explores the plight, lived experiences and images of HIV+ve women with regard to sexual and reproductive rights against the backdrop of patriarchal system in Nagaland.

Keywords: HIV/AIDS, monogamy, Nagaland, sex worker disease, women

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4262 Analyzing the Street Pattern Characteristics on Young People’s Choice to Walk or Not: A Study Based on Accelerometer and Global Positioning Systems Data

Authors: Ebru Cubukcu, Gozde Eksioglu Cetintahra, Burcin Hepguzel Hatip, Mert Cubukcu

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Obesity and overweight cause serious health problems. Public and private organizations aim to encourage walking in various ways in order to cope with the problem of obesity and overweight. This study aims to understand how the spatial characteristics of urban street pattern, connectivity and complexity influence young people’s choice to walk or not. 185 public university students in Izmir, the third largest city in Turkey, participated in the study. Each participant had worn an accelerometer and a global positioning (GPS) device for a week. The accelerometer device records data on the intensity of the participant’s activity at a specified time interval, and the GPS device on the activities’ locations. Combining the two datasets, activity maps are derived. These maps are then used to differentiate the participants’ walk trips and motor vehicle trips. Given that, the frequency of walk and motor vehicle trips are calculated at the street segment level, and the street segments are then categorized into two as ‘preferred by pedestrians’ and ‘preferred by motor vehicles’. Graph Theory-based accessibility indices are calculated to quantify the spatial characteristics of the streets in the sample. Six different indices are used: (I) edge density, (II) edge sinuosity, (III) eta index, (IV) node density, (V) order of a node, and (VI) beta index. T-tests show that the index values for the ‘preferred by pedestrians’ and ‘preferred by motor vehicles’ are significantly different. The findings indicate that the spatial characteristics of the street network have a measurable effect on young people’s choice to walk or not. Policy implications are discussed. This study is funded by the Scientific and Technological Research Council of Turkey, Project No: 116K358.

Keywords: graph theory, walkability, accessibility, street network

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4261 Scenarios of Digitalization and Energy Efficiency in the Building Sector in Brazil: 2050 Horizon

Authors: Maria Fatima Almeida, Rodrigo Calili, George Soares, João Krause, Myrthes Marcele Dos Santos, Anna Carolina Suzano E. Silva, Marcos Alexandre Da

Abstract:

In Brazil, the building sector accounts for 1/6 of energy consumption and 50% of electricity consumption. A complex sector with several driving actors plays an essential role in the country's economy. Currently, the digitalization readiness in this sector is still low, mainly due to the high investment costs and the difficulty of estimating the benefits of digital technologies in buildings. Nevertheless, the potential contribution of digitalization for increasing energy efficiency in the building sector in Brazil has been pointed out as relevant in the political and sectoral contexts, both in the medium and long-term horizons. To contribute to the debate on the possible evolving trajectories of digitalization in the building sector in Brazil and to subsidize the formulation or revision of current public policies and managerial decisions, three future scenarios were created to anticipate the potential energy efficiency in the building sector in Brazil due to digitalization by 2050. This work aims to present these scenarios as a basis to foresight the potential energy efficiency in this sector, according to different digitalization paces - slow, moderate, or fast in the 2050 horizon. A methodological approach was proposed to create alternative prospective scenarios, combining the Global Business Network (GBN) and the Laboratory for Investigation in Prospective Strategy and Organisation (LIPSOR) methods. This approach consists of seven steps: (i) definition of the question to be foresighted and time horizon to be considered (2050); (ii) definition and classification of a set of key variables, using the prospective structural analysis; (iii) identification of the main actors with an active role in the digital and energy spheres; (iv) characterization of the current situation (2021) and identification of main uncertainties that were considered critical in the development of alternative future scenarios; (v) scanning possible futures using morphological analysis; (vi) selection and description of the most likely scenarios; (vii) foresighting the potential energy efficiency in each of the three scenarios, namely slow digitalization; moderate digitalization, and fast digitalization. Each scenario begins with a core logic and then encompasses potentially related elements, including potential energy efficiency. Then, the first scenario refers to digitalization at a slow pace, with induction by the government limited to public buildings. In the second scenario, digitalization is implemented at a moderate pace, induced by the government in public, commercial, and service buildings, through regulation integrating digitalization and energy efficiency mechanisms. Finally, in the third scenario, digitalization in the building sector is implemented at a fast pace in the country and is strongly induced by the government, but with broad participation of private investments and accelerated adoption of digital technologies. As a result of the slow pace of digitalization in the sector, the potential for energy efficiency stands at levels below 10% of the total of 161TWh by 2050. In the moderate digitalization scenario, the potential reaches 20 to 30% of the total 161TWh by 2050. Furthermore, in the rapid digitalization scenario, it will reach 30 to 40% of the total 161TWh by 2050.

Keywords: building digitalization, energy efficiency, scenario building, prospective structural analysis, morphological analysis

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4260 Narrative Review Evaluating Systematic Reviews Assessing the Effect of Probiotic Interventions on Depressive Symptoms

Authors: Ibrahim Nadeem, Mohammed Rahman, Yasser Ad-Dab’Bagh, Mahmood Akhtar

Abstract:

Depression is one of the most prevalent mental illnesses and is often associated with various other medical disorders. In this review, we aim to evaluate existing systematic reviews that investigate the use of probiotics as a treatment for depressive symptoms. Five online databases were searched for relevant studies up to December 2017. Systematic reviews that included randomized controlled trials assessing the efficacy of probiotics in the treatment of depressive symptoms were included. Seven systematic reviews met the inclusion criteria. Three of these reviews conducted meta-analyses, out of which, two found probiotics to significantly improve depressive symptoms in the sample population. Two meta-analyses conducted subgroup analysis based on health status, and both found probiotics to significantly decrease depressive symptoms in patients with major depressive disorder, but only one review found it to significantly decrease in healthy patients. Another subgroup analysis was conducted based on age, and found probiotics to produce significant effects on subjects under the age of 60, but close to no effect on patients over the age of 65. Out of the four reviews that conducted qualitative analysis, three reviews concluded that probiotics have the potential to be used as a treatment. Due to the differences in clinical trials, a definitive effect of probiotics on depressive symptoms cannot be concluded. Nonetheless, probiotics seem to produce a significant therapeutic effect for subjects with pre-existing depressive symptoms. Further studies are warranted for definitive conclusions.

Keywords: depression, gut-brain axis, gut microbiota, probiotic, psychobiotic

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4259 Evaluation of the Benefit of Anti-Endomysial IgA and Anti-Tissue Transglutaminase IgA Antibodies for the Diagnosis of Coeliac Disease in a University Hospital, 2010-2016

Authors: Recep Keşli, Onur Türkyılmaz, Hayriye Tokay, Kasım Demir

Abstract:

Objective: Coeliac disease (CD) is a primary small intestine disorder caused by high sensitivity to gluten which is present in the crops, characterized by inflammation in the small intestine mucosa. The goal of this study was to determine and to compare the sensitivity and specificity values of anti-endomysial IgA (EMA IgA) (IFA) and anti-tissue transglutaminase IgA (anti-tTG IgA) (ELISA) antibodies in the diagnosis of patients suspected with the CD. Methods: One thousand two hundred seventy three patients, who have applied to gastroenterology and pediatric disease polyclinics of Afyon Kocatepe University ANS Research and Practice Hospital were included into the study between 23.09.2010 and 30.05.2016. Sera samples were investigated by immunofluorescence method for EMA positiveness (Euroimmun, Luebeck, Germany). In order to determine quantitative value of Anti-tTG IgA (EIA) (Orgentec Mainz, Germany) fully automated ELISA device (Alisei, Seac, Firenze, Italy) were used. Results: Out of 1273 patients, 160 were diagnosed with coeliac disease according to ESPGHAN 2012 diagnosis criteria. Out of 160 CD patients, 120 were female, 40 were male. The EMA specificity and sensitivity were calculated as 98% and 80% respectively. Specificity and sensitivity of Anti-tTG IgA were determined as 99% and 96% respectively. Conclusion: The specificity of EMA for CD was excellent because all EMA-positive patients (n = 144) were diagnosed with CD. The presence of human anti-tTG IgA was found as a reliable marker for diagnosis and follow-up the CD. Diagnosis of CD should be established on both the clinical and serologic profiles together.

Keywords: anti-endomysial antibody, anti-tTG IgA, coeliac disease, immunofluorescence assay (IFA)

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4258 Prevalence and Pattern of Drug Usage among Youth in Ogbomoso, Nigeria

Authors: Samson F. Agberotimi, Rachel B. Asagba, Choja Oduaran

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Disturbing rate of use of different substances such as cannabis, alcohol, as well as pharmaceutical drugs among Nigerian youth in recent times has been affirmed in the literature. There is, however, a paucity of literature addressing the pattern of usage of such drugs, especially for clinical relevance and intervention planning. The present study investigated the prevalence and pattern of drug usage among youth in Ogbomoso, Nigeria. A cross-sectional survey involving 92 purposively selected participants comprising of 82 males and 10 females aged between 15 and 24 years was conducted. A measure of drug involvement and demographic characteristics was administered to the participants. Descriptive analysis was done using the SPSS v.21. Cannabis (79.4%), alcohol (77.2%), codeine (70.7%), tobacco (65.2%) and tramadol (47.8%) are the five most frequently used substances. However, the majority of the users of tobacco (68.3%) and alcohol (62.0%) are casual users indicating a mild level of use of the substances among the participants. On the other hand, 49.2% of the codeine users, 27.3% of the tramadol users, and 21.9% of the cannabis users reported harmful/intensive levels of use. Furthermore, the results revealed individuals at the pathological level of use as 28.8% for cannabis, 25.0% for tramadol, and 21.6% for codeine, and thus require clinical/therapeutic intervention. In conclusion, cannabis remains the most frequently used substance among youths. However, there appears to be a shift from the use of conventional psychoactive substances to pharmaceutical/prescription drugs such as codeine and tramadol. The findings of this study raised the need for both preventive and therapeutic interventions addressing the problem of substance use disorder among youth in contemporary society.

Keywords: Ogbomoso, pattern of drug use, prevalence of drug use, youth

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4257 The Attitude of Parents and Teachers towards Multilingual Medium of Instruction in Lower Primary School Classrooms: The Case of Kapiri District Schools of Zambia

Authors: E. Machinyise

Abstract:

The main purpose of this study was to investigate the attitudes of parents and teachers towards multilingual medium of instruction in lower primary schools of Zambia. In 2013, the Government of Zambia formulated a language policy which stipulates that regional familiar languages should be used as the medium of instruction (MOI) from grade one to four in all public primary schools, while English is introduced as a subject in the second grade. This study investigated the views of parents and teachers on the use of multilingual medium of instruction in lower primary schools in order to accommodate learners who are not native speakers of regional familiar languages as well as the second languages which are official languages used in class. The study revealed that most parents suggested that teachers who teach lower primary school classes should be conversant with at least the four major local languages of Zambia (Bemba, Nyanja, Tonga and Lozi). In the same vain other parents felt that teachers teaching lower grades should not only be familiar with the regional official language but should be able to speak other dialects found in the region. Teachers teaching in lower primary grade felt that although it is difficult to speak all languages of learners in class, it is important for a teacher of lower grade class to try to accommodate children who are not speakers of the familiar languages by addressing them in the language they understand. Both teachers and parents highlighted a number of advantages of teaching children in their mother tongues. Both qualitative and quantitative methods were used for the collection of data for this study. 30 teachers from selected public primary schools and 20 parents of Kapiri district and five lecturers of teacher training colleges in Central province were selected for this study. The researcher also observed class lessons in lower primary schools of Kapiri district. This study revealed that both parents and teachers are of the views that teachers teaching lower primary classes should use multilingual medium of instruction in lower primary classes so as to accommodated children of different linguistic backgrounds.

Keywords: familiar languages, medium of instruction, multilingual medium of instruction, native speakers

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4256 Approaches to Estimating the Radiation and Socio-Economic Consequences of the Fukushima Daiichi Nuclear Power Plant Accident Using the Data Available in the Public Domain

Authors: Dmitry Aron

Abstract:

Major radiation accidents carry not only the potential risks of negative consequences for public health due to exposure but also because of large-scale emergency measures were taken by authorities to protect the population, which can lead to unreasonable social and economic damage. It is technically difficult, as a rule, to assess the possible costs and damages from decisions on evacuation or resettlement of residents in the shortest possible time, since it requires specially prepared information systems containing relevant information on demographic, economic parameters and incoming data on radiation conditions. Foreign observers also face the difficulties in assessing the consequences of an accident in a foreign territory, since they usually do not have official and detailed statistical data on the territory of foreign state beforehand. Also, they can suppose the application of unofficial data from open Internet sources is an unreliable and overly labor-consuming procedure. This paper describes an approach to prompt creation of relational database that contains detailed actual data on economics, demographics and radiation situation at the Fukushima Prefecture during the Fukushima Daiichi NPP accident, received by the author from open Internet sources. This database was developed and used to assess the number of evacuated population, radiation doses, expected financial losses and other parameters of the affected areas. The costs for the areas with temporarily evacuated and long-term resettled population were investigated, and the radiological and economic effectiveness of the measures taken to protect the population was estimated. Some of the results are presented in the article. The study showed that such a tool for analyzing the consequences of radiation accidents can be prepared in a short space of time for the entire territory of Japan, and it can serve for the modeling of social and economic consequences for hypothetical accidents for any nuclear power plant in its territory.

Keywords: Fukushima, radiation accident, emergency measures, database

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4255 A Novel Approach of Secret Communication Using Douglas-Peucker Algorithm

Authors: R. Kiruthika, A. Kannan

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Steganography is the problem of hiding secret messages in 'innocent – looking' public communication so that the presence of the secret message cannot be detected. This paper introduces a steganographic security in terms of computational in-distinguishability from a channel of probability distributions on cover messages. This method first splits the cover image into two separate blocks using Douglas – Peucker algorithm. The text message and the image will be hided in the Least Significant Bit (LSB) of the cover image.

Keywords: steganography, lsb, embedding, Douglas-Peucker algorithm

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4254 Economic Valuation of Emissions from Mobile Sources in the Urban Environment of Bogotá

Authors: Dayron Camilo Bermudez Mendoza

Abstract:

Road transportation is a significant source of externalities, notably in terms of environmental degradation and the emission of pollutants. These emissions adversely affect public health, attributable to criteria pollutants like particulate matter (PM2.5 and PM10) and carbon monoxide (CO), and also contribute to climate change through the release of greenhouse gases, such as carbon dioxide (CO2). It is, therefore, crucial to quantify the emissions from mobile sources and develop a methodological framework for their economic valuation, aiding in the assessment of associated costs and informing policy decisions. The forthcoming congress will shed light on the externalities of transportation in Bogotá, showcasing methodologies and findings from the construction of emission inventories and their spatial analysis within the city. This research focuses on the economic valuation of emissions from mobile sources in Bogotá, employing methods like hedonic pricing and contingent valuation. Conducted within the urban confines of Bogotá, the study leverages demographic, transportation, and emission data sourced from the Mobility Survey, official emission inventories, and tailored estimates and measurements. The use of hedonic pricing and contingent valuation methodologies facilitates the estimation of the influence of transportation emissions on real estate values and gauges the willingness of Bogotá's residents to invest in reducing these emissions. The findings are anticipated to be instrumental in the formulation and execution of public policies aimed at emission reduction and air quality enhancement. In compiling the emission inventory, innovative data sources were identified to determine activity factors, including information from automotive diagnostic centers and used vehicle sales websites. The COPERT model was utilized to ascertain emission factors, requiring diverse inputs such as data from the national transit registry (RUNT), OpenStreetMap road network details, climatological data from the IDEAM portal, and Google API for speed analysis. Spatial disaggregation employed GIS tools and publicly available official spatial data. The development of the valuation methodology involved an exhaustive systematic review, utilizing platforms like the EVRI (Environmental Valuation Reference Inventory) portal and other relevant sources. The contingent valuation method was implemented via surveys in various public settings across the city, using a referendum-style approach for a sample of 400 residents. For the hedonic price valuation, an extensive database was developed, integrating data from several official sources and basing analyses on the per-square meter property values in each city block. The upcoming conference anticipates the presentation and publication of these results, embodying a multidisciplinary knowledge integration and culminating in a master's thesis.

Keywords: economic valuation, transport economics, pollutant emissions, urban transportation, sustainable mobility

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4253 Challenges for a WPT 4 Waiting Lane Concept - Laboratory and Practical Experience

Authors: Julia Langen

Abstract:

This article describes the challenges of a wireless charging system for a cab waiting lane in a public space and presents a concept for solving them. In this concept, multiple cabs can be charged simultaneously and during stopping and rolling. Particular technical challenges are a coil topology that meets the EMF requirements and an intelligent control concept that allows the individual coil segments to be switched on and off. The charging concept explained here is currently being implemented as a pilot project, so that initial results on the operation can be presented.

Keywords: charge lane, inductive charging solution, smart city, wireless power transfer

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4252 Teacher Education in a Bilingual Perspective: Brazilian Sign Language and Portuguese

Authors: Neuma Chaveiro, Juliana Guimarães Faria

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Introduction: The thematic that guides this study is teacher training for the teaching of sign language in a perspective of bilingual education – specifically aimed at Brazilian public schools that offer inclusive education, and that have, among its students, deaf children who use Brazilian Sign Language as a means of communication and expression. In the Teacher Training Course for Letters/Libras at the Universidade Federal de Goiás/UFG, we developed a bilingual education project for the deaf, linked to PIBID (Institutional Scholarship for Teaching Initiation Program), funded by the Brazilian Federal Government through CAPES (Coordination for the Improvement of Higher Education Personnel). Goals: to provide the education of higher education teachers to work in public schools in basic education and to insert students from the UFG’s Letters/Libras course in the school’s daily life, giving them the opportunity for the creation and participation in methodological experiences and of teaching practices in order to overcome the problems identified in the teaching-learning process of deaf students, in a bilingual perspective, associating Libras (Brazilian Sign Language) and Portuguese. Methodology: qualitative approach and research-action, prioritizing action – reflection – action of the people involved. The Letters-Libras PIBID of the College of Letters/UFG, in this qualitative context, is guided by the assumptions of investigation-action to contribute to the education of the Libras teacher. Results: production of studies and researches in the area of education, professionalization and teaching practice for the degree holder in Letters: Libras; b) studies, research and training in bilingual education; c) clarification and discussion of the myths that permeate the reality of users of sign languages; d) involving students in the development of didactic materials for bilingual education. Conclusion: the PIBID Project Letters/Libras allows, both to the basic education school and to the teachers in training for the teaching of Libras, an integrated and collective work partnership, with discussions and changes in relation to bilingual education for the deaf and the teaching of Libras.

Keywords: deaf, sign language, teacher training, educacion

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4251 Cognitive Functioning and Cortisol Suppression in Major Depression in a Long-Term Perspective

Authors: Pia Berner Hansson, Robert Murison Anders Lund, Hammar Åsa

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Major Depressive Disorder (MDD) is often associated with high levels of stress and disturbances in the Hypothalamic Pituitary Adrenal (HPA) system, yielding high levels of cortisol, in addition to cognitive dysfunction. Previous studies in this patient group have shown a relationship between cortisol profile and cognitive functioning in the acute phase of MDD and that the patients had significantly less suppression after dexamethasone administration. However, few studies have investigated this relationship over time and in phases of symptom reduction. The aim of the present study was to examine the relationships between cortisol levels after the Dexamethasone Suppression Test (DST) and cognitive function in a long term perspective in MDD patients. Patients meeting the DSM-IV criteria for a MDD were included in the study and tested in symptom reduction. A control group was included. Cortisol was measured in saliva collected with Salivette sampling devices. Saliva samples were collected 4 times during a 24 hours period over two consecutive days: at awakening, after 45 minutes, after 7 hours and at 11 pm. Dexamethasone (1.0 mg) was given on Day 1 at 11 pm. The neuropsychological test battery consisted of standardized tests measuring memory and Executive Functioning (EF). Cortisol levels did not differ significantly between patients and controls on Day 1 or Day 2. Both groups showed significant suppression after Dexamethasone. There were no correlations between cortisol levels or suppression after Dexamethasone and cognitive measures. The results indicate that the HPA-axis functioning normalizes in phases of symptom reduction in MDD patients and that there no relation between cortisol profile and cognitive functioning in memory or EF.

Keywords: depression, MDD, cortisol, suppression, cognitive functioning

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4250 Timing of Ileostomy Closure Following Rectal Cancer Surgery at an Australian Regional Hospital

Authors: Tedman Cheuk-Yiu Chau, Xavier Harvey, Hung Nguyen

Abstract:

Defunctioning ileostomies are frequently used as an adjunct to low anterior resection in the surgical treatment of rectal cancer. Despite reducing the rate of clinically relevant anastomotic leak, the burden of defunctioning ileostomy is significant, with up to two-thirds of patients reporting stoma-related morbidity. International data have demonstrated an increased risk of bowel dysfunction and lower quality of life in patients with delayed closure (greater than six months post-surgery). While timely reversal is safe and cost-effective, the time to the reversal in Australian and New Zealand public hospitals is not described in the published literature. Thus, it is important to assess the current timeliness of ileostomy closure in the Australian regional context and examine the reasons for the delay. A retrospective analysis of ileostomy closure in Launceston General Hospital (LGH) patients treated with low/ultra low anterior resection for rectal cancer between 2012 and 2019 was undertaken. 94 cases of rectal adenocarcinoma undergoing ultralow anterior resection were examined over the years between 2012-2019. Amongst these, 21 cases (22.3%) were not reversed due to disease progress, death prior to reversal, or surgical complication. Demographics, disease status, surgical technique, and hospital inpatient events of these cases were examined. An average waiting time of 213.2 days was noted. Reasons for the delay include non-specified/prolonged hospital waiting time (54%), delayed or complicated chemotherapy course (13%), surgical complication (11%), advanced age, and frailty(5%). Complication of a delayed ileostomy reversal includes post-operation ileus and the development of an incisional hernia. We conclude that a delayed reversal of ileostomy can contribute to a higher incidence of stoma-related co-morbidities and contribute to a longer hospital stay and therefore use of public hospital resources.

Keywords: anterior resection, colorectal surgery, ileostomy reversal, rectal cancer

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4249 Women's Challenges in Access to Urban Spaces and Infrastructures: A Comparative Study of the Urban Infrastructures Conforming to Women's Needs in Tehran and Istanbul

Authors: Parastoo Kazemiyan

Abstract:

Over the past 80 years, in compliance with the advent of modernity in Iran and Turkey, the presence of women in economic and social arenas has creates serious challenges in the capacity of urban spaces to respond to their presence and transport because urban spaces up until then were based on masculine criteria and therefore, women could use such spaces in the company of their fathers or husbands. However, as modernity expanded by Reza Shah and Ataturk, women found the opportunity to work and be present in urban spaces alongside men and their presence in economic and social domains resulted in their presence in these spaces in the early and late hours of the day. Therefore, the city had to be transformed in structural, social, and environmental terms to accommodate women's activities and presence in various urban arenas, which was a huge step in transition from a masculine man-based culture to an all-inclusive human-based culture in these two countries. However, the optimization of urban space was subject to political changes in the two countries, leading to significant differences in designing urban spaces in Tehran and Istanbul. What shows the importance and novelty of the present study lie in the differences in urban planning and optimization in the two capital cities, which gave rise to different outcomes in desirability and quality of living in these two capital cities. Due to the importance of the topic, one of the most significant factors in desirability and acceptability of urban space for women was examined using a descriptive-analytic method based on qualitative methodology in Tehran and Istanbul. The results showed that the infrastructural factors in Istanbul, including safety of access, variety, and number of public transport modes, transparency, and supervision over public spaces have provided women with a safer and more constant presence compared to Tehran. It seems that challenges involved in providing access to urban spaces in Tehran in terms of infrastructure and function have made Tehran unable to respond to the most basic needs of its female citizens.

Keywords: gender differences, urban space security, access to transportation systems, women's challenges

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4248 Characterization of Antibiotic Resistance in Cultivable Enterobacteriaceae Isolates from Different Ecological Niches in the Eastern Cape, South Africa

Authors: Martins A. Adefisoye, Mpaka Lindelwa, Fadare Folake, Anthony I. Okoh

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Evolution and rapid dissemination of antibiotic resistance from one ecosystem to another has been responsible for wide-scale epidemic and endemic spreads of multi-drug resistance pathogens. This study assessed the prevalence of Enterobacteriaceae in different environmental samples, including river water, hospital effluents, abattoir wastewater, animal rectal swabs and faecal droppings, soil, and vegetables, using standard microbiological procedure. The identity of the isolates were confirmed using matrix-assisted laser desorption ionization-time of flight mass spectrophotometry (MALDI-TOF) while the isolates were profiled for resistance against a panel of 16 antibiotics using disc diffusion (DD) test, and the occurrence of resistance genes (ARG) was determined by polymerase chain reactions (PCR). Enterobacteriaceae counts in the samples range as follows: river water 4.0 × 101 – 2.0 × 104 cfu/100 ml, hospital effluents 1.5 × 103 – 3.0 × 107 cfu/100 ml, municipal wastewater 2.3 × 103 – 9.2 × 104 cfu/100 ml, faecal droppings 3.0 × 105 – 9.5 × 106 cfu/g, animal rectal swabs 3.0 × 102 – 2.9 × 107 cfu/ml, soil 0 – 1.2 × 105 cfu/g and vegetables 0 – 2.2 × 107 cfu/g. Of the 700 randomly selected presumptive isolates subjected to MALDI-TOF analysis, 129 (18.4%), 68 (9.7%), 67 (9.5%), 41 (5.9%) were E. coli, Klebsiella spp., Enterobacter spp., and Citrobacter spp. respectively while the remaining isolates belong to other genera not targeted in the study. The DD test shows resistance ranging between 91.6% (175/191) for cefuroxime and (15.2%, 29/191) for imipenem The predominant multiple antibiotic resistance phenotypes (MARP), (GM-AUG-AP-CTX-CXM-CIP-NOR-NI-C-NA-TS-T-DXT) occurred in 9 Klebsiella isolates. The multiple antibiotic resistance indices (MARI) the isolates (range 0.17–1.0) generally showed >95% had MARI above the 0.2 thresholds, suggesting that most of the isolates originate from high-risk environments with high antibiotic use and high selective pressure for the emergence of resistance. The associated ARG in the isolates include: bla TEM 61.9 (65), bla SHV 1.9 (2), bla OXA 8.6 (9), CTX-M-2 8.6 (9), CTX-M-9 6.7 (7), sul 2 26.7 (28), tet A 16.2 (17), tet M 17.1 (18), aadA 59.1 (62), strA 34.3 (36), aac(3)A 19.1 (20), (aa2)A 7.6 (8), and aph(3)-1A 10.5 (11). The results underscore the need for preventative measures to curb the proliferation of antibiotic-resistant bacteria including Enterobacteriaceae to protect public health.

Keywords: enterobacteriaceae, antibiotic-resistance, MALDI-TOF, resistance genes, MARP, MARI, public health

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