Search results for: family friendly policy

Authors: Mulligan T., Barker-Collo S., Gobson K., Jones K.

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There is a relatively scarce body of literature regarding adolescent experiences of traumatic brain injury (TBI). This qualitative study explored how sustaining a TBI at this unique stage of development might impact a young person as they navigate the challenges of adolescence and transition to adulthood, and what might support recovery. Thirteen young adults who sustained a mild-moderate TBI as an adolescent (aged 13 – 17 years), approximately 7.7 years (range = 6.7 – 8.0 years) prior, participated in the research. Semi-structured individual interviews were conducted to explore participants’ experiences surrounding and following their TBIs. Thematic analysis of interview data produced five key categories of findings: (1) Following their TBIs, many participants experienced problems with cognitive (e.g., forgetfulness, concentration difficulties), physical (e.g., migraines, fatigue) and emotional (e.g., depression, anxiety) functioning, which were often endured into adulthood. (2) TBI-related problems often adversely affected important areas of life for the participant, including school, work and friendships. (3) Changes following TBI commonly impacted identity formation. (4) Recovery processes evolved over time as the participants coped initially by just ‘getting on with it’, before learning to accept new limitations and, ultimately, growing from their TBI experiences. (5) While the presence of friends and family assisted recovery, struggles were often exacerbated by a lack of emotional support from others, in addition to the absence of any assistance or information-provision from professionals regarding what to expect following TBI. The findings suggest that even mild TBI sustained during adolescence can have consequences for an individual’s functioning, engagement in life and identity development, whilst also giving rise to post-traumatic growth. Recovery following adolescent TBI might be maximised by facilitating greater understanding of the injury and acknowledging its impacts on important areas of life, as well as the provision of emotional support and facilitating self-reflection and meaning-making.

Keywords: adolescent, brain Injury, qualitative, post-traumatic growth

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Authors: Elena Maria Scalisi

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Currently, photodegradation by nanoparticles (NPs) is a common solution for wastewater treatment. Nanoparticles are efficient for removing organic and inorganic pollutants, heavy metals from wastewater and killing microorganisms through environmentally friendly. In this context, the major representative of photocatalytic technology for industrial wastewater treatment are TiO₂ nanoparticles (TiO₂-NPs). TiO₂-NPs have a strong catalytic activity that depends to their physicochemical properties. Thanks to their small size (between 1-100 nm), nanoparticles occupy less volume, then their surface area increases. The increase in the surface-to-volume ratio results in the increase of the particle surface energy, which improve their reactivity potential. However, these unique properties represent risks to the ecosystems and organisms when unintentionally TiO₂-NPs are release into the environment and absorbed by living organisms. Several studies confirm that there is a high level of interest concerning the safety of TiO₂-NPs in the aquatic environment, furthermore, ecotoxicological tools are useful to correctly evaluate their toxicity. In the current study, we aimed to characterize potential toxic effects of TiO₂-NP suspension to zebrafish during embryo-larval stages to evaluate parameters such as survival rates, malformation, hatching, the overall length of the larvae heartbeat, and biochemical biomarkers that reflect the acute toxicity and sublethal effects of TiO₂-NPs. Zebrafish embryos were exposed to titanium dioxide nanoparticles (TiO₂-NPs at 1mg/L, 2mg/L, and 4mg/L) from fertilization to the free swimming stage (144hpf). Every day, we recorded the toxicological endpoints, moreover, immunohistochemical analysis has been performed at the end of the exposure. In particular, we have evaluate the expression of the following biomarkers: Heat Shock Protein 70 (HSP70), Poly ADP-Ribose Polymerase-1 (PARP-1), Metallothioneins (MTs). Our results have shown that hatch ability, survival, and malformation rate were not affected by TiO₂ NPs at these exposure levels. However, TiO₂-NPs caused an increase of heartbeat and reduction of body length; at the same time, TiO₂-NPs have inducted the production of ROS and the expression of oxidative stress biomarkers HSP70 and PARP-1. Hight positivity for PARP-1 at all concentration tested was observed. As regards MT, positivity was found in the expression of this biomarker in the whole body of the embryo, with the exception of the end of the tail. Metallothioneins (MT) are biomarkers widely used in environmental monitoring programs for aquatic creatures. At the light of our results i.e. no death until the end of the experiment (144hpf), no malformation and expression of the biomarkers mentioned, it is evident that zebrafish larvae with their natural detoxification pathways are able to resist the presence of toxic substances and then they can tolerate the presence of metal concentrations. However, an excessive oxidative state can compromise cell function, therefore the uncontrolled release of nanoparticles into the environment is severe and must be constantly monitored.

Keywords: nanoparticles, embryo zebrafish, HSP70, PARP-1

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Authors: M. J. Eichner, Y. S. Sarhan

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Overall study purpose has been the evaluation of ‘Vertical Villages’ as a new sustainable building typology, reducing significantly negative impacts of rapid urbanization processes in third world capital cities. Commonly in fast-growing cities, housing and job supply, educational and recreational opportunities, as well as public transportation infrastructure, are not accommodating rapid population growth, exposing people to high noise and emission polluted living environments with low-quality neighborhoods and a lack of recreational areas. Like many others, Egypt’s capital city Cairo, according to the UN facing annual population growth rates of up to 428.000 people, is struggling to address the general deterioration of urban living conditions. New settlements typologies and urban reconstruction approach hardly follow sustainable urbanization principles or socio-ecologic urbanization models with severe effects not only for inhabitants but also for the local environment and global climate. The authors prove that ‘Vertical Village’ buildings can offer a sustainable solution for increasing urban density with at the same time improving the living quality and urban environment significantly. Inserting them within high-density urban fabrics the ecologic and socio-cultural conditions of low-quality neighborhoods can be transformed towards districts, considering all needs of sustainable and social urban life. This study analyzes existing building typologies in Cairo’s «low quality - high density» districts Ard el Lewa, Dokki and Mohandesen according to benchmarks for sustainable residential buildings, identifying major problems and deficits. In 3 case study design projects, the sustainable transformation potential through ‘Vertical Village’ buildings are laid out and comparative studies show the improvement of the urban microclimate, safety, social diversity, sense of community, aesthetics, privacy, efficiency, healthiness and accessibility. The main result of the paper is that the disadvantages of density and overpopulation in developing countries can be converted with ‘Vertical Village’ buildings into advantages, achieving attractive and environmentally friendly living environments with multiple synergies. The paper is documenting based on scientific criteria that mixed-use vertical building structures, designed according to sustainable principles of low rise housing, can serve as an alternative to convert «low quality - high density» districts in megacities, opening a pathway for governments to achieve sustainable urban transformation goals. Neglected informal urban districts, home to millions of the poorer population groups, can be converted into healthier living and working environments.

Keywords: sustainable, architecture, urbanization, urban transformation, vertical village

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Authors: Gaya Bin Noon, Thoko Hanjahanja-Phiri, Laura Xavier Fadrique, Plinio Pelegrini Morita, Hélène Vaillancourt, Jennifer Teague, Tania Donovska

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Active Assisted Living (AAL) refers to systems designed to improve the quality of life, aid in independence, and create healthier lifestyles for care recipients. As the population ages, there is a pressing need for non-intrusive, continuous, adaptable, and reliable health monitoring tools to support aging in place. AAL has great potential to support these efforts with the wide variety of solutions currently available, but insufficient efforts have been made to address concerns arising from the integration of AAL into care. The purpose of this research was to (1) explore the integration of AAL technologies and data into the clinical pathway, and (2) map data access and governance for AAL technology in order to develop standards for use by policy-makers, technology manufacturers, and developers of smart communities for seniors. This was done through four successive research phases: (1) literature search to explore existing work in this area and identify lessons learned; (2) modeling of the continuum of care; (3) adapting a framework for data governance into the AAL context; and (4) interviews with stakeholders to explore the applicability of previous work. Opportunities for standards found in these research phases included a need for greater consistency in language and technology requirements, better role definition regarding who can access and who is responsible for taking action based on the gathered data, and understanding of the privacy-utility tradeoff inherent in using AAL technologies in care settings.

Keywords: active assisted living, aging in place, internet of things, standards

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Authors: Libia Jiménez Chávez

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This is a study of freedom riders and their courageous journey for civil rights, but the year was not 1961. It was 2003. This paper chronicles the emergence of a new civil rights movement for immigrant rights through an oral history of the 2003 U.S. Immigrant Workers Freedom Ride (IWFR). During the height of the post-9/11 immigrant repression, a bloc of organizations inspired by the Civil Rights Movement of the 1960s mobilized 900 multinational immigrants and their allies in the fight for legal status, labor protections, family reunification, and civil rights. The activists visited over 100 U.S. cities, met with Congressional leaders in the nation’s capital, and led a rally of over 50,000 people in New York City. This unified effort set the groundwork for the national May Day immigration protests of 2006. Movements can be characterized in two distinct ways: physical movement and social movements. In the past, historians have considered immigrants both as people and as participants in social movements. In contrast, studies of recent migrants tend to say little about their involvement in immigrant political mobilizations. The dominant literature on immigration portrays immigrants as objects of exclusion, border enforcement, detention, and deportation instead of strategic political actors. This paper aims to change this perception. It considers the Freedom Riders both as immigrants who were literally on the move and as participants in a social movement. Through interviews with participants and archival video footage housed at the University of California Los Angeles, it is possible to study this mobile protest as a movement. This contemporary immigrant struggle is an opportunity to explore the makeup and development of a heterogenous immigrant coalition and consider the relationship between population movements and social justice. In addition to oral histories and archival research, the study will utilize social movement literature, U.S. immigration and labor history, and Undocumented Critical Theory to expand the historiography of immigrant social movements in America.

Keywords: civil rights, immigrant social movements, undocumented communities, undocumented critical theory

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Authors: Stanis Koko Nyalongomo, Benjamin Mputela Bankanza, Moise Kisempa Mahungudi

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Several areas in the Democratic Republic of Congo (DRC) experience serious problems of streaming and soil erosion. Erosion leads to degradation of soil health, and the three main causative factors of similar importance are deforestation, overgrazing, and land agricultural mismanagement. Degradation of soil health leads to a decrease in agricultural productivity and carbon dioxide (CO₂), and other greenhouse gas emissions. Agricultural productivity low, and sanitation-related diseases are a concern of a majority of DRC rural people -whose main livelihoods are conventional smallholder agriculture- due to degradation of agricultural soil health and prevalence of inappropriate sanitation in rural areas. Land management practices that increase soil carbon stocks on agricultural lands with practices including conservation agriculture and agroforestry do not only limit CO₂ emissions but also help prevent erosion while enhancing soil health and productivity. Promotion to adopt sustainable land management practices, especially conversion to well-managed agroforestry practices, is a necessity. This needs to be accompanied by incentives. Methods that incite smallholders to adopt practices that increase carbon stocks in agricultural lands and enhance soil health and productivity for social, economic, and environmental benefits, and give them the ability to get and use household dry toilets -included activities to inform and raise smallholder households awareness on the conversion of croplands to well-managed agroforestry systems through planting at least 20 fruit trees and/or acacias, soil carbon and practices that sequester it in soil and ecological sanitation; and offer smallholders technique and material supports and incentives under the form of dry toilets constructed for free for well-managed agroforestry implementation- were carried out to address problems of soil erosion as well as agricultural productivity and sanitation-related diseases. In 2018 and 2019, 19 of 23 targeted smallholder households expressed their satisfaction and converted their croplands to agroforestry through planting 374 trees, and each gotten 1 dry toilet constructed for free. Their neighbors expressed a willingness to participate in the project. Conversion to well-managed agroforestry practices offers many advantages to both farmers and the environment. The strategy of offering smallholders incentives for soil-friendly agricultural practices, especially well-managed agroforestry, is one of the solutions to prevent soil erosion. DRC rural people whose majority are smallholder households, need to be able to get and use dry toilets. So, dry toilets could be offered like incentives for well-managed agroforestry practices. Given the many advantages agroforestry and dry toilet can offer, recommendations are made for funding organizations to support such projects that promote the adoption of soil health practices.

Keywords: agroforestry, croplands, soil carbon, soil health

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Authors: Papai Barman, Harihar Sahoo

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With increasing life expectancy, urbanization, and adult out migration, elder people live without adult child and most of time responsible for grandchild caring while the care is needed for them. On this line, the current study examined the association between grandchild caring (GCC) with different household structures and depression among elderly (60+) grandparents (GP) living in India using Longitudinal Aging Study in India (LASI), 2017-18. HH structure was defined as the skipped-generation household (SGH) where GP and GC lived together without middle generation and the multi-generation household (MGH) where more than two generations lived together. GCC was defined by two categories, compulsive and non-compulsive caring. CES-D depression scale was utilized to measure GP’s mental health. Socio-economic characteristics, chronic diseases, and health behavior were controlled to get the effect of HH structure and GCC considered key explanatory variables. Bivariate analyses showed that the prevalence of elderly lived in SGH in India (2.5%). Prevalence of compulsive caring was found 16.3% in MGH and 51.1% in SGH. Prevalence of depressions was found nearly 37.1 and 49.5% among the GPs responsible for GCC in MGH and SGH, respectively. Using Biprobit and margins results, GPs lived in SGH were 0.40 times (dy/dx=0.40, p<0.001) more likely to report depression than GPs lived in MGH, given the condition on compulsive caring. Ensuring SDG goal-3, health aging, and giving more social security to the elder people responsible for caring while they are needed care at later life, the current study may improve the existing knowledge and help policy makers to make an intervention on this most vulnerable people, especially for the elderly people living in SGH and responsible for caring.

Keywords: household structure, grandchild caring, skipped-generation household, multi-generation household, depression, mental health, India

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Authors: Nada Mohammad Eljeshi

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In the United Arab Emirates (UAE), preschoolers can enroll in kindergarten after completing four years old by August 31 of their admission year. This study aims to better understand how Sharjah-based parents’ engagement with preschoolers contributes to their phonological awareness, literacy development, and print knowledge before their kindergarten admission considering cognitive development is addressed in the UAE national child care standards. More specifically, it will discuss the importance of cognitive development activities to preschoolers, the rationale behind defining the admission age to kindergarten and compare and benchmark the policy to other countries. To achieve this study's objectives, an online survey was conducted and distributed. Respondents were asked 13 dichotomous questions related to activities that promote the preschooler’s linguistics literacy and cognitive development. The results suggested parents’ emphasis on phonological awareness, followed by developing their print knowledge. However, the majority of the surveyed parents did not engage in literacy development with their preschoolers. On this basis, it is clear parents’ awareness should occur by introducing various activities such as book reading, that there is a need to introduce and encourage parents to various activities such as reading a printed book and drawings to keep up with their children's cognitive development. The survey results suggested an emphasis on phonological awareness, followed by developing their print knowledge. However, the majority of the surveyed parents did not engage in literacy development with their preschoolers. On this basis, parental awareness of the importance of preschoolers' cognitive development should be developed and engage the parents in understanding their preschooler’s cognitive development before entering kindergarten.

Keywords: preschoolers, cognitive development, parental engagement, Sharjah-based case study

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Authors: Kumudini Apsara Munasinghe, Devin Gregory Lissau, Ryan Thomas Wade

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Fresh fruits and vegetables are rich in vitamins, minerals, and fibers and help maintain a healthy weight over high-calorie food. Eating fruits and vegetables protects us from free radicals produced by metabolic reactions and safeguards us from cardiovascular disease and cancer. However, there has been an increased concern about foodborne diseases tied to contaminated farmers’ market produce. In addition, very little information is available about the contribution of eating raw fruits and vegetables to human exposure to antibiotic-resistant bacteria. This research aims to identify bacteria isolated from farmers’ market fruits and vegetables and understand their antibiotic resistance. Vegetables and fruits were collected from farmers’ markets around Frostburg and Cumberland areas in Maryland and transported to the microbiology lab at Frostburg State University for the isolation of bacteria. Bacteria were extracted from tomatoes, cucumber, strawberry, and lettuce using Tryptic soy broth overnight at 37°C, and Tryptic Soy agar was used for the streak plate technique to isolate bacteria. Pure cultures were used to identify bacteria using biochemical reactions after conducting Gram staining technique. The research used many biochemical reactions, including Mannitol Salt agar, MacConkey agar, and Eosin Methylene blue agar, for identification. Antibiotic sensitivity was tested for many different types of antibiotics, including amoxicillin, penicillin, tetracycline, ampicillin, and erythromycin. Most prevalent bacteria in the isolates were Staphylococcus, Bacillus, Micrococcus, Enterococcus, Enterobacter, Citrobacter, and other bacteria from the family Enterobacteriaceae. The data obtained from this research will be useful to educate and train farmers and individuals involved in post-harvest processes such as transportation and selling in farmers’ markets. Further results for bacterial antibiotic resistance will be obtained, and unculturable bacteria will be identified by next-generation DNA sequencing.

Keywords: antibiotic resistance, farmers markets, fruits, bacteria, vegetables

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Authors: C. Chaillou

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The dominant theoretical approaches in Criminology are interested in the phenomenon of delinquency from the question of the management of the risks incurred by the population. Thus, this research advocate prevention of this phenomenon by a tracking of early disorders in children. Treatments offered to rely on medical research (genetics and biology are cited as a reference) and assuming a high naturalization of delinquent behaviour. Programs that are offered also reduce to a recovery of the deviant behaviour, and rely readily on behavioral guidelines, with an educational grant. Public policy then rely on these programs to prevent unwanted behaviour within a given population and to reduce the risk for the company. This is the case in France, with national institutes making (juvenile) violence a public health problem. We consider that other approaches, issues of sociology, are more relevant to the treatment of offenders. These approaches are moving, not on its prevention, but from its inputs and its outputs. Several modalities of entries and exits of delinquency can find and analyze in terms of process. We assume that there is a dynamic inherent in the individual and it is important to take into account the environment of the offender. These different types of processes can illuminate from the derived work of the Psychoanalytical psychopathology and lead to more effective treatment of delinquent acts. Psychoanalytic concepts have enabled us to offer a new look means to treat delinquency, placing several types of relationship with the other and relating to the clinical structure and the uniqueness of the case, we have been able to enter subjective and unconscious logics at work in delinquent acts. This research has facilitated the reduction of these types of subjective responses and proposed others, opening to a reintegration of offenders in a social link them being more favourable and in a longer term.

Keywords: delinquency, insertion, social link, unconscious

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Authors: S. Ben-Shabat, T. Turgeman, O. Leubinski, N. Roth-Bejerano, V. Kagan-Zur, Y. Sitrit

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The ectomycorrhizal (ECM) desert truffle Terfezia boudieri produces edible fruit bodies and forms symbiosis with its host plant Helianthemum sessiliflorum (Cistaceae) in the Negev desert of Israel. The symbiosis is vital for both partners' survival under desert conditions. Under desert habitat conditions, ECMs must form symbiosis before entering the dry season. To secure a successful encounter, in the course of evolution, both partners have responded by evolving special signals exchange that facilitates recognition. Members of the Cistaceae family serve as host plants for many important truffles. Conceivably, during evolution a common molecule present in Cistaceae plants was recruited to facilitate successful encounter with ectomycorrhizas. Arbuscular vesicular fungi (AM) are promiscuous in host preferences, in contrast, ECM fungi show specificity to host plants. Accordingly, we hypothesize that H. sessiliflorum secretes a chemotrophic-signaling, which is common to plants hosting ECM fungi belonging to the Pezizales. However, thus far no signaling molecules have been identified in ECM fungi. We developed a bioassay for chemotrophic activity. Fractionation of root exudates revealed a substance with chemotrophic activity and molecular mass of 534. Following the above concept, screening the transcriptome of Terfezia, grown under chemoattraction, discovered genes showing high homology to G proteins-coupled receptors of plant pathogens involved in positive chemotaxis and chemotaxis suppression. This study aimed to identify the active molecule using analytical methods (LC-MS, NMR etc.). This should contribute to our understanding of how ECM fungi communicate with their hosts in the rhizosphere. In line with the ability of Terfezia to form also endomycorrhizal symbiosis like AM fungi, analysis of the mechanisms may likewise be applicable to AM fungi. Developing methods to manipulate fungal growth by the chemoattractant can open new ways to improve inoculation of plants.

Keywords: chemotrophic signal, Helianthemum sessiliflorum, Terfezia boudieri, ECM

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Authors: S. Zev Kalifon

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The question of polygamy for Moslem minorities in Western nations has often been raised in the political and social discourse. Can polygamy be tolerated as a religious or human right in the West. For example, before the 2015 election in Israel, changes were made in the electoral system, which encouraged three small Arab parties to merge into one list. This “Unity List” included the socially liberal Communist list and a socially conservative Islamist list. Two members of the Islamist list were polygamists. Some rival politicians called for the election board to disqualify these men (and even the whole list) from the election process. This request was denied by the courts, and the men were elected to the parliament. Their subsequent seating in the parliament was questioned by many on both the liberal and conservative sides of the political spectrum. Some political commentators went so far as to describe polygamy as a “mark of disgrace” (a term usually reserved for people convicted on corruption charges). There are also problems in other areas of society; these include the rights of these families for welfare and social services (public policy issues) and residence in Israel. Using qualitative methods (primarily historical and archival data), this paper will analyze at the historic and cultural processes which created the intense opposition to polygamy in Judaism (for Israel) and Christianity (for the Western world). It will look at the debate over the "religious right" of polygamy for Moslem citizens in Israel and other Western cultures. Finally, it will examine the political, cultural, and demographic pressures which encourage polygamy in these minorities. This paper will demonstrate that the debate over polygamy is more than a question of religious freedom or human rights or multi-culturalism. It is a central symbol of modernity and the Western worldview.

Keywords: human rights, Judaism, multi-culturalism, polygamy, western values

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Authors: Chomba Kalunga

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Many developing countries have a rich endowment of natural resources. Yet, amidst that wealth, living standards remain poor. At the same time, international markets have been surged with an increase in copper prices in the last twenty years. This is a presentation of the findings on the causal economic impact of Zambia’s copper mines, a country located in sub-Saharan Africa endowed with vast copper deposits on living standards using household data from 1996 to 2010, exploiting an episode where the copper prices on the international market were rising. Using an Instrumental Variable approach and controlling for constituency-level and microeconomic factors, the results show a significant impact of copper production on living standards. After splitting the constituencies close to and far away from the nearest mine, the results document that constituencies close to the mines benefited significantly from the increase in copper production, compared to their counterparts through increased levels of employment. Finally, the results are not consistent with the natural resource curse hypothesis; findings show a positive causal relationship between the presence of natural resources and socioeconomic outcomes in less developed countries, particularly for constituencies close to the mines in Zambia. Some key policy implications follow from the findings. The finding that increased copper production led to an increase in employment suggests that, in Zambias’ context, policies that promote local employment may be more beneficial to residents. Meaning that it is government policies that can help improve the living standards were government needs to work towards making this impact more substantial.

Keywords: copper prices, local development, mining, natural resources

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Authors: M. D. Antoine

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Despite the widespread use of complementary and alternative medicine (CAM) for autistic children, little is known about the communication flow between the different parties involved in autism care (e.g., parents/caregivers, conventional providers, alternative practitioners). This study aimed to describe how communication occurs through the first year following an autism spectrum disorder (ASD) diagnosis to identify challenges and potential barriers to communication within the healthcare system in Ottawa, Canada. From an ecological perspective, we collected qualitative data through 12 semi-structured interviews with six parents/caregivers, three conventional providers (e.g., family doctor, neurodevelopmental pediatrician, psychologist), and three alternative practitioners (e.g., naturopath, occupational therapist, speech and language pathologist) operating in Ottawa. We interpreted the data using thematic analysis. Findings revealed communication challenges between the parents/caregivers and conventional providers while they experience better communication flow with fewer challenges in alternative care settings. However, parents/caregivers are the only links between the health professionals of both streams. From the five contexts examined: organizational, interpersonal, media, cultural, and political-legal, we found four themes (provider knowledge, care integration, flexible care, and time constraints) underlining specific barriers to communication flow between the parties involved in the care of autistic children. The increasing interest in alternative medicine is forcing changes in the healthcare system. Communications occur outside the norms making openings for better communication and information-sharing increasingly essential. Within the identified themes in the current study, the necessity for better communication between all parties involved in the care of autistic children is evident. More ASD and CAM-related training for providers would support effective parent/caregiver-provider communication. The findings of the current study contribute to a better understanding of the role of communication in the care management of autism, which has implications for effective autism care.

Keywords: alternative medicine, autism care management, autism spectrum disorder, conventional medicine, parent-provider communication

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Authors: Andi Setiawan, Annisa Ulfah Pristya

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Indonesian rubber plant area reached 2.9 million hectares with productivity reached 1.38 million. High rubber productivity is directly proportional to the amount of waste produced rubber processing industry. Rubber industry would produce a negative impact on the rubber industry in the form of environmental pollution caused by waste that has not been treated optimally. Rubber industrial wastewater containing high-nitrogen compounds (nitrate and ammonia) and phosphate compounds which cause water pollution and odor problems due to the high ammonia content. On the other hand, demand for NPK fertilizers in Indonesia continues to increase from year to year and in need of ammonia and phosphate as raw material. Based on domestic demand, it takes a year to 400,000 tons of ammonia and Indonesia imports 200,000 tons of ammonia per year valued at IDR 4.2 trillion. As well, the lack of phosphoric acid to be imported from Jordan, Morocco, South Africa, the Philippines, and India as many as 225 thousand tons per year. During this time, the process of wastewater treatment is generally done with a rubber on the tank to contain the waste and then precipitated, filtered and the rest released into the environment. However, this method is inefficient and thus require high energy costs because through many stages before producing clean water that can be discharged into the river. On the other hand, Indonesia has the potential of pineapple fruit can be harvested throughout the year in all of Indonesia. In 2010, production reached 1,406,445 tons of pineapple in Indonesia or about 9.36 percent of the total fruit production in Indonesia. Increased productivity is directly proportional to the amount of pineapple waste pineapple leaves are kept continuous and usually just dumped in the ground or disposed of with other waste at the final disposal. Through Eco-Nanofiltration Membrane-Based Fiber Pineapple leaves Waste so that environmental problems can be solved efficiently. Nanofiltration is a process that uses pressure as a driving force that can be either convection or diffusion of each molecule. Nanofiltration membranes that can split water to nano size so as to separate the waste processed residual economic value that N and P were higher as a raw material for the manufacture of NPK fertilizer to overcome the crisis in Indonesia. The raw materials were used to manufacture Eco-Nanofiltration Membrane is cellulose from pineapple fiber which processed into cellulose acetate which is biodegradable and only requires a change of the membrane every 6 months. Expected output target is Green eco-technology so with nanofiltration membranes not only treat waste rubber industry in an effective, efficient and environmentally friendly but also lowers the cost of waste treatment compared to conventional methods.

Keywords: biodegradable, cellulose diacetate, fertilizers, pineapple, rubber

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Authors: Odufu Ifakachukwu Clifford

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Developing country governments are struggling to meet the basic needs and demands of citizens, especially so for the rural poor. With tightly constrained budgets, these governments have followed the lead of developed countries that have sought to restructure public service delivery through privatization, contracting out, public-private partnerships, and similar reforms. Such reforms in service delivery are generally welcomed when it is believed that private sector partners are better equipped to provide certain services than are governments. With respect to basic and essential services, however, a higher degree of uncertainty and apprehension exists as the focus shifts from simply minimizing the costs of delivering services to broadening access to all citizens. The constitution stipulates that everyone has the right to have access to sufficient food and water. Affordable and/or subsidized water, then, is not a privilege but a basic right of all citizens. Citizens elect political representatives to serve in office, with their sole mandate being to provide for the needs of the citizenry. As governments pass on some amount of responsibility for service delivery to private businesses, these governments must be able to exercise control in order to account to the people for the work done by private partners. This paper examines the legislative and policy frameworks as well as the environment within which PPPs take place in South Africa and the extent to which accountability can be strengthened in this environment. Within the aforementioned backdrop of PPPs and accountability, the constricted focus area of the paper aims to assess the extent to which the provision of clean and safe consumable water in South Africa is sustainable, cost-effective in terms of provision, and affordable to all.

Keywords: privatisation, accountability, essential services, government

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Authors: Engida Yisma, Berhanu Dessalegn, Ayalew Astatkie, Nebreed Fesseha

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Background: The use of the partograph is a well-known best practice for quality monitoring of labour and subsequent prevention of obstructed and prolonged labour. However, a number of cases of obstructed labour do happen in health facilities due to poor quality of intrapartum care. Methods: A cross-sectional quantitative study assessed knowledge and utilization of partograph among obstetric care givers in public health institutions of Addis Ababa, Ethiopia using a structured interviewer administered questionnaire. The collected data was analyzed using SPSS version 16.0. Logistic regression analysis was used to identify factors associated with knowledge and use of partograph among obstetric care givers. Results: Knowledge about the partograph was fair: 189 (96.6%) of all the respondents correctly mentioned at least one component of the partograph, 104 (53.3%) correctly explained the function of alert line and 161 (82.6%) correctly explained the function of action line. The study showed that 112 (57.3%) of the obstetric care givers at public health institutions reportedly utilized partograph to monitor mothers in labour. The utilization of the partograph was significantly higher among obstetric care givers working in health centres (67.9%) compared to those working in hospitals (34.4%) [Adjusted OR = 3.63(95%CI: 1.81, 7.28)]. Conclusions: A significant percentage of obstetric care givers had fair knowledge of the partograph and why it is necessary to use it in the management of labour and over half of obstetric care givers reported use of the partograph to monitor mothers in labour. Pre-service and on-job training of obstetric care givers on the use of the partograph should be given emphasis. Mandatory health facility policy is also recommended to ensure safety of women in labour in public health facilities in Addis Ababa, Ethiopia.

Keywords: partograph, knowledge, utilization, obstetric care givers, public health institutions

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Authors: Youssef El Makhrout, Aude Pommeret, Tunç Durmaz

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This paper analyses the consequences of a heat pump on the optimal behavior of a prosumer. A theoretical microeconomic model is developed for household heating and electricity consumption to analyze the profitability of installing a solar PV system with a heat pump, battery storage, and grid use. The aim is to present the optimal scenario of investment in renewable energy equipment to cover domestic and heating needs. Simulation data of a French house of 170m² in Chambery are used in this paper. The house is divided into 5 zones with 3 heated zones of 89.4 m² occupied by two people. The analysis is based on hourly data for one year, from 00:00 01/01/2021 to 23:00 31/12/2021. Results indicate that without taking the cost of materials and no financial aid, the most profitable scenario for a household is when he owns solar panels, a heat pump, and battery storage. However, with the costs and financial aid of the French government for energy renovation, the net economic surplus change and the profitability during 20 years are important when the household decides to add a heat pump to existing solar panels. In this scenario, the household can realize 35.84% as a surplus change improvement, but this cannot cover all installation costs. The household can get benefits and cover all installation costs after exploiting financial support in the case of adopting a heat pump. The investment in a battery is still not profitable because of its high cost and the lack of financial aid. Some public policy recommendations are proposed, especially for solar panels and battery storage.

Keywords: household’s heating, prosumer, electricity consumption, renewable energy, welfare gain, comfort, solar PV, heat pumps, storage

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Authors: Wassie Molla, Klaas Frankena, Mart De Jong

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Lumpy skin disease (LSD) is a severe viral disease of cattle, which often occurs in epidemic form. It is caused by lumpy skin disease virus of the genus capripoxvirus of family poxviridae. Mathematical models play important role in the study of infectious diseases epidemiology. They help to explain the dynamics and understand the transmission of an infectious disease within a population. Understanding the transmission dynamics of lumpy skin disease between animals is important for the implementation of effective prevention and control measures against the disease. This study was carried out in central and north-western part of Ethiopia with the objectives to understand LSD outbreak dynamics, quantify the transmission between animals and herds, and estimate the disease reproduction ratio in dominantly crop-livestock mixed and commercial herd types. Field observation and follow-up study were undertaken, and the transmission parameters were estimated based on a SIR epidemic model in which individuals are susceptible (S), infected and infectious (I), and recovered and immune or dead (R) using the final size and generalized linear model methods. The result showed that a higher morbidity was recorded in infected crop-livestock (24.1%) mixed production system herds than infected commercial production (17.5%) system herds whereas mortality was higher in intensive (4.0%) than crop-livestock (1.5%) system and the differences were statistically significant. The transmission rate among animals and between herds were 0.75 and 0.68 per week, respectively in dominantly crop-livestock production system. The transmission study undertaken in dominantly crop-livestock production system highlighted the presence of statistically significant seasonal difference in LSD transmission among animals. The reproduction numbers of LSD in dominantly crop-livestock production system were 1.06 among animals and 1.28 between herds whereas it varies from 1.03 to 1.31 among animals in commercial production system. Though the R estimated for LSD in different production systems at different localities is greater than 1, its magnitude is low implying that the disease can be easily controlled by implementing the appropriate control measures.

Keywords: commercial, crop-livestock, Ethiopia, LSD, reproduction number, transmission

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Authors: S. Reshma Reghu, Shiburaj Sugathan, T. G. Nandu, K. B. Ramesh Kumar, Mathew Dan

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Bacterial diseases are considered to be one of the most prevalent health hazards in the developing world and many bacteria are becoming resistant to existing antibiotics making the treatment ineffective. Thus, it is necessary to find novel targets and develop new antibacterial drugs with a novel mechanism of action. The process of bacterial cell division is a novel and attractive target for new antibacterial drug discovery. FtsZ, a homolog of eukaryotic tubulin, is the major protein of the bacterial cell division machinery and is considered as an important antibacterial drug target. Zingiberaceae, the Ginger family consists of aromatic herbs with creeping rhizomes. Many of these plants have antimicrobial properties.This study aimed to determine the anti-bacterial activity of selected Zingiberaceous plants by targeting bacterial cell division protein, FtsZ. Essential oils and methanol extracts of Amomum ghaticum, Alpinia galanga, Kaempferia galanga, K. rotunda, and Zingiber officinale were tested to find its antibacterial efficiency using disc diffusion method against authentic bacterial strains obtained from MTCC (India). Essential oil isolated from A.galanga and Z.officinale were further assayed for FtsZ inhibition assay following non-radioactive malachite green-phosphomolybdate assay using E. coli FtsZ protein obtained from Cytoskelton Inc., USA. Z.officinale essential oil possess FtsZ inhibitory property. A molecular docking study was conducted with the known bioactive compounds of Z. officinale as ligands with the E. coli FtsZ protein homology model. Some of the major constituents of this plant like catechin, epicatechin, and gingerol possess agreeable docking scores. The results of this study revealed that several chemical constituents in Ginger plants can be utilised as potential source of antibacterial activity and it can warrant further investigation through drug discovery studies.

Keywords: antibacterial, FtsZ, zingiberaceae, docking

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Authors: Katarzyna Zięba, Hajnalka Szentgyörgyi, Paweł Miśkowiec, Agnieszka Moos-Matysik

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Bees are effective pollinators of plants using by humans. However, there is a concern about the fate different species due to their recently decline. Pollution of the environment is described in the literature as one of the causes of this phenomenon. Due to human activities, heavy metals and aromatic hydrocarbons can occur in bee organisms in high concentrations. The presented study aims to provide information on how pollution affects bee quality, taking into account, also the biological differences between various groups of bees. Understanding the consequences of environmental pollution on bees can help to create and promote bee friendly habitats and actions. The analyses were carried out using two contamination gradients with 5 sites on each. The first, mainly heavy metal polluted gradient is stretching approx. 30km from the Bukowno Zinc smelter near Olkusz in the Lesser Poland Voivodship, to the north. The second cuts through the agglomeration of Kraków up to the southern borders of the Ojców National Park. The gradient near Olkusz is a well-described pollution gradient contaminated mainly by zinc, lead, and cadmium. The second gradient cut through the agglomeration of Kraków and end below the Ojców National Park. On each gradient, two bee species were installed: red mason bees (Osmia bicornis) and honey bees (Apis mellifera). Red mason bee is a polylectic, solitary bee species, widely distributed in Poland. Honey bees are a highly social species of bees, with clearly defined casts and roles in the colony. Before installing the bees in the field, samples of imagos of red mason bees and samples of pollen and imagos from each honey bee colony were analysed for zinc, lead cadmium, polycyclic and monocyclic hydrocarbons levels. After collecting the bees from the field, samples of bees and pollen samples for each site were prepared for heavy metal, monocyclic hydrocarbon, and polycyclic hydrocarbon analysis. Analyses of aromatic hydrocarbons were performed with gas chromatography coupled with a headspace sampler (HP 7694E) and mass spectrometer (MS) as detector. Monocyclic compounds were injected into column with headspace sampler while polycyclic ones with manual injector (after solid-liquid extraction with hexane). The heavy metal content (zinc, lead and cadmium) was assessed with flame atomic absorption spectroscopy (FAAS AAnalyst 300 Perkin Elmer spectrometer) according to the methods for honey and bee products described in the literature. Pollution levels found in bee bodies and imago body masses in both species, and proportion of sex in case of red mason bees were correlated with pollution levels found in pollen for each site and colony or trap nest. An attempt to pinpoint the most important form of contamination regarding bee health was also be undertaken based on the achieved results.

Keywords: heavy metals, aromatic hydrocarbons, bees, pollution

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Authors: Jing-Jing Wang, Yang Gao, Heather H. M. Kwok, Wendy Y. J. Huang

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Objectives: Intellectual disability (ID) ranks among the top 20 most costly disorders. A child with ID creates a wide set of challenges to the individual, family, and society, and overweight and obesity aggravate those challenges. People with ID have the right to attain optimal health like the rest of the population. They should be given priority to eliminate existing health inequities. Childhood obesity epidemic and associated factors among children, in general, has been well documented, while knowledge about overweight and obesity in children with ID is scarce. Methods: A cross-sectional study was conducted among 524 Chinese children with ID (males: 68.9%, mean age: 12.2 years) in Hong Kong in 2015. Children’s height and weight were measured at school. Parents, in the presence of their children, completed a self-administered questionnaire at home about the children’s physical activity (PA), eating habits, and sleep duration in a typical week as well as parenting practices regarding children’s eating and PA, and their socio-demographic characteristics. Multivariate logistic regression estimated the potential risk factors for children being overweight. Results: The prevalence of overweight and obesity in children with ID was 31.3%, which was higher than their general counterparts (18.7%-19.9%). Multivariate analyses revealed that the risk factors of overweight and obese in children with ID included: comorbidity with autism, the maternal side being overweight or obese, parenting practices with less pressure to eat more, children having shorter sleep duration, longer periods of sedentary behavior, and higher intake frequencies of sweetened food, fried food, and meats, fish, and eggs. Children born in other places, having snacks more frequently, and having irregular meals were also more likely to be overweight or obese, with marginal significance. Conclusions: Children with ID are more vulnerable to being overweight or obese than their typically developing counterparts. Identified risk factors in this study highlight a multifaceted approach to the involvement of parents as well as the modification of some children’s questionable behaviors to help them achieve a healthy weight.

Keywords: prevalence, risk factors, obesity, children with disability

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Authors: Axel Mancebo, Ana M. Bada, Angel Casacó, Bárbara González, Avelina León, María E. Arteaga, Consuelo González, Belinda Sánchez, Adriana Carr, Nuris Ledón, Arianna Iglesias

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Despite the many preventive and therapeutic modalities aimed at curing cancer, it remains as a serious world health problem. Promising recent developments suggest that cancer immunotherapy may be the next great hope for cancer treatment. EGFRs are receptor tyrosine kinases and it is considered an important therapeutic target related with tumor progression, and several types of molecular therapies, including monoclonal antibodies, small molecules, and vaccines, have been developed to target the HER family of receptors. On the other hand, gangliosides are membrane glycosphingolipids that contain two variants of sialic acid, the N-acetylated (NeuAc) and the N-glycolylated (NeuGc) variant. The high expression of this antigen-specific molecule has been associated with malignant tumor progression and immunosuppressive mechanisms, so ganglioside could be considered as the target for cancer immunotherapy. We have been working for several years in the safety evaluation of cancer vaccines targeting these two systems, the EGF receptor and ganglioside. We presented in this work results of repeated dose toxicity studies performed in Sprague Dawley rats and Cynomolgus monkeys, including clinical observations, body weight and rectal temperature measuring, clinical pathology analysis, gross necropsy and histological examination in rodent studies, and immunological evaluation. Immunizations were capable of inducing mainly inflammatory effects at the injection site, with findings largely attributable to the adjuvants used and probably enhanced by the immunological properties of the antigens. In general, these vaccines were shown to be well tolerated, and these studies in relevant species allow treating cancer patients with tumors during long periods with relative weight safety margin.

Keywords: cancer vaccines, safety, toxicology, rats, non human primates

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Authors: Amita Rana

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From the ancient to modern times, the nature of fitness activities has varied. We can choose any form of exercise that is suitable for our particular need. Watchers of fitness trends say that the road to better health is paved with new possibilities along with some old ones that are poised to make a comeback. Educated, certified and experienced fitness professionals; strength training; fitness programmes for older adults; exercise and weight loss; children and obesity; personal training; core training; group personal training; Zumba and other dance workouts; functional fitness; yoga; comprehensive health promotion programmes at worksite; boot-camp; outdoor activities; reaching new markets; spinning; sport-specific training; worker incentive programmes; wellness coaching; and physician referrals are among the fitness trends included in worldwide surveys. However, trends related to fitness in India could be the same or different. Hence, the present paper makes an attempt to analyze the latest fitness trends in India. A total of eighteen (18) surveys were shortlisted on the basis of their relevance to the present topic of study and were arranged in descending order of their chronology. Content analysis was done after the preliminary set of data collection, which formed the basis of a group of data. Further, frequency and percentage were used to statistically represent the data. It can be concluded from the analysis of data regarding recent fitness trends in India that yoga dominates the fitness activity list, followed by numerous other activities including running, Zumba and sh’bam, boot camp, boxing, kickboxing, cycling, swimming, TRX, ass-pocalypse, ballet, biking, bokwa fitness, dance-iso-bic, masala bhangra, outdoor activities, pilates, planks, push-ups, sofa workouts, stairs Workouts, tabata training, and twerking. The body weight/ gym-specified/ strength training as well as high intensity interval training dominate the preferred workouts; followed by mixed work-outs, cross training work-outs, express work-outs, functional fitness, natural body movements, personalized training, and stay-at-home workouts. General areas that featured in the latest fitness trends in India demonstrates that the fitness is making an impact on all sections of the society be it children, women, older adults, senior citizens, worksite fitness. Fitness is becoming the lifestyle of the masses. People are doing exercise for weight-loss, combining diet with exercising; prefer sweating, making groups participate in fitness activities and wellness programmes. Technology is another area which has a high impact on the lives of people. They are using wearable technology for workout tracking and following numerous mobile friendly apps.

Keywords: fitness, India, survey, trend

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Authors: A. Nurgiartiningsih, G. Ciptadi, S. B. Siswijono

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This research was done to identify the performance and breeding potency of Local Buffalo in Kangean Island, Sumenep, East Java, Indonesia. Materials used were buffalo and farmer in Kangean Island. Method used was survey with purposive sampling method. Qualitative trait and existing breeding system including the type of production system were directly observed. Quantitative trait consisted of chest girth, body weight and wither height were measured and recorded. Data were analyzed using analysis of variance applying software GENSTAT 14. Results showed the purposes of buffalo breeding in Kangean Island were for production of calves, saving, religion tradition, and buffalo racing. The combination between grazing and cut and carry system were applied in Kangean Island. Forage, grass and agricultural waste product were available abundantly especially, during the wet season. Buffalo in Kangean Island was categorized as swamp buffalo with 48 chromosomes. Observation on qualitative trait indicated that there were three skin color types: gray (81.25%), red (10.42%) and white/albino (8.33%). Analysis on quantitative trait showed that there was no significant difference between male and female buffalo. The performance of male buffalo was 132.56 cm, 119.33 cm and 174.11 cm, for the mean of body length, whither height and chest girth, respectively. The performance of female buffalo were 129.8 cm, 114.0 cm and 166.2 cm, for mean of body length, wither height and chest girth (CG), respectively. The performance of local buffalo in Kangean Island was categorized well. Kangean Island could be promoted as center of buffalo breeding and conservation. For optimal improvement of population number and its genetics value, government policy in buffalo breeding program should be implemented.

Keywords: chromosome, qualitative trait, quantitative trait, swamp buffalo

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Authors: Shittu Bisi Agnes

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Studies on households’ willingness to pay for environmental and general health safety in the advent of Ebola virus Diseases in Nigeria was carried out. This is aimed at revealing the means by which the virus was eventually eradicated in Nigeria as widely claimed in the media. This study therefore attempted to determine the environmental and general health condition in the State Of Osun, how socio-economic characteristics of the people affected willingness to pay. And also provide platform for the reduction of environmental and general health problems. Data were collected with the aid of well-structured questionnaire and administer 150 randomly selected people of study area, and oral interview was also utilized. Data collected were analyzed using both descriptive tools and inferential statistics vis-a-viz regression analysis. Findings showed 92.5% of respondents was aware of ebola virus diseases outbreak in Nigeria, 8.5% was unaware of any disease outbreak. And 65.7% of respondents was strongly willing to pay for environmental and general health safety 27.1% was fairly willing, 5.7% was indifferent and 1.7% was unwilling to pay. 5% rated the level of environmental and general health condition in the area has been good, 53.6% rated theirs has been fair, 33.6% as been poor. The average willingness to pay per household per month were #500.00, #250.00, #150.00 and #100.00 respectively for the four categories. It was recommended that policy instruments to increase peoples' income will accelerate eradication of environmental and general health problems, environmental health education in form of talk shop, workshop, lectures and seminars could be organized at the political ward levels, churches, mosque, and at schools. Environmental and general health safety related information could be disseminated through mass media, market women, and functional unions.

Keywords: ebola virus diseases (EVD), socio-economic, safety, pay, Osun

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Authors: Christopher Meyer, Laima Gerlitz

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European Ports are about to take an important step towards their future economic development. Existing legislatives such as the European Green Deal are changing the perspective on ports as individual logistic institutions and demand a more holistic view on ports in their characteristic as ecosystem involving several different actors in an interdisciplinary and multilevel approach. A special role is taken by small and medium-sized ports facing the same political restriction and future goals - such as reducing environmental impacts with 2030 and 2050 as targets - while suffering from low financing capacity, outdated infrastructure, low innovation measures and missing political support. In contrast, they are playing a key role in regional economic development and cross-border logistics as well as facilitator for the regional hinterland. Also, in comparison to their big counterparts, small and medium-sized ports are often located within or close to city areas. This does not only bear more challenges especially when it comes to the environmental performance, but can also carry out growth potentials by putting the city as a key actor into the port ecosystem. For city development, the Smart City concept is one of the key strategies currently applied mostly on demonstration level in selected cities. Hence, the basic idea behind is par to the Smart Port concept. Thus, this paper is analysing potential synergetic effects resulting from the application of Smart City and Smart Port concepts for small and medium-sized ports' ecosystems closely located to cities with focus on innovation application, greening measurements and economic performances as well as strategic positioning of the ports in Smart City initiatives.

Keywords: port-city ecosystems, regional development, sustainability transition, innovation policy

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Authors: Travis Morris

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The purpose of this study is to measure the intersection of environmental security entities in terrorist propaganda. To the best of author’s knowledge, this is the first study of its kind to examine this intersection within terrorist propaganda. Rosoka, natural language processing software and frame analysis are used to advance our understanding of how environmental frames function as emotive triggers. Violent jihadi demagogues use frames to suggest violent and non-violent solutions to their grievances. Emotive triggers are framed in a way to leverage individual and collective attitudes in psychological warfare. A comparative research design is used because of the differences and similarities that exist between two variants of violent jihadi propaganda that target western audiences. Analysis is based on salience and network text analysis, which generates violent jihadi semantic networks. Findings indicate that environmental frames are used as emotive triggers across both data sets, but also as tactical and information data points. A significant finding is that certain core environmental emotive triggers like “water,” “soil,” and “trees” are significantly salient at the aggregate level across both data sets. All environmental entities can be classified into two categories, symbolic and literal. Importantly, this research illustrates how demagogues use environmental emotive triggers in cyber space from a subcultural perspective to mobilize target audiences to their ideology and praxis. Understanding the anatomy of propaganda construction is necessary in order to generate effective counter narratives in information operations. This research advances an additional method to inform practitioners and policy makers of how environmental security and propaganda intersect.

Keywords: propaganda analysis, emotive triggers environmental security, frames

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Authors: Kamen Kirov

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In the late 19th and early 20th centuries, Britain dominated global trade and finance in large part due to its maritime superiority. Germany, a land power, sought to undermine Britain’s position as the primary hegemon but ultimately could not challenge Britain’s maritime position or capabilities. This drove Germany to seek alternative strategies to weaken Britain’s position. Notably, it pushed Germany to create a reliable overland link through the Balkans to the Middle East via railroad. This article will seek to draw parallels between the German-British hegemonic conflict of the early 20th century and the Chinese-American hegemonic conflict taking place today using both secondary historical sources and current scholarly discussions of the changing international sphere. In doing so, it will provide useful insights into how China might attempt to outflank American power. The article will demonstrate that in many ways, the strategic positions and approaches of the early-20th century Germany and modern China are similar. Both countries were faced with a vastly superior foe with respect to maritime and economic power, and in both cases, their response was to undermine their rival hegemon by creating new overland infrastructure. Furthermore, in both cases, a major goal of creating new overland links was to gain further access to and control over Middle Eastern energy markets. It seems that in the modern day, China is conducting such a policy on a much grander scale than Germany did in the early 20th century—which may result in negative consequences for the US strategic position.

Keywords: belt and road Initiative, hegemonic conflict, maritime power, realism

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Authors: Visa I. Tyakaray, M. Abdulaziz, O. Badmus, N. Karaye, M. Dalhat, A. Shehu, I. Bello, T. Hussaini, S. Akar, G. Effah, P. Nguku

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Introduction: Nigeria has recorded outbreaks of meningitis in the past, being in the meningitis belt. A multi-state outbreak of Cerebrospinal Meningitis (CSM) from Neisseria meningitides occurred in 2017 involving 24 states, and Kano State reported its first two confirmed CSM cases on 22nd March, 2017. We conducted the outbreak investigation to characterize the outbreak, determine its associated risk factors and institute appropriate control measures. Method: We conducted an unmatched Case-control study with ratio 1:2. A case was defined as any person with sudden onset of fever (>38.5˚C rectal or 38.0˚C axillary) and one of the following: neck stiffness, altered consciousness or bulging fontanelle in toddlers while a control was defined as any person who resides around the case such as family members, caregivers, neighbors, and healthcare personnel. We reviewed and validated line list and conducted active case search in health facilities and neighboring communities. Descriptive, bivariate, stratified and multivariate analysis were performed. Laboratory confirmation was by Latex agglutination and/or Culture. Results: We recruited 48 cases with median age of 11 years (1 month – 65 years), attack rate was 2.4/100,000 population with case fatality rate of 8%; 34 of 44 local government areas were affected.On stratification, age was found to be a confounder. Independent factors associated with the outbreak were age (Adjusted Odds Ratio, AOR =6.58; 95% Confidence Interval (CI) =2.85-15.180, history of Vaccination (AOR=0.37; 95% CI=0.13-0.99) and history of travel (AOR=10.16; (1.99-51.85). Laboratory results showed 22 positive cases for Neisseria meningitides types C and A/Y. Conclusion: Major risk factors associated with this outbreak were age (>14years), not being vaccinated and history of travel. We sensitized communities and strengthened case management. We recommended immediate reactive vaccination and enhanced surveillance in bordering communities.

Keywords: cerebrospinal, factors, Kano-Nigeria, meningitis, risk

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