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53 articles
Agronomy Research Open Access

RETRACTED: Development of Biorational Management Package of Root Knot Nematode Disease of Country Bean

Feb 2022 DOI 10.14302/issn.2639-3166.jar-21-4019

This article has been retracted on 10 November 2022. VIEW THE RETRACTION NOTICE (https://doi.org/10.14302/issn.2639-3166.jar-25-5841) A field experiment was conducted with a view to test the efficacy of Tricho-composts and integration of Tricho-composts, poultry refuse (PR), neem oilcake (NOC), saw dust burning (SDB) with chemical nematicide Furadan 5G (Carbofuran) for controlling root knot nematode of country bean through which growers will be benefited. The root-knot nematode infested soils were treated with Tricho-compost-1 @ 2 kg/pit, Tricho-compost-2 @ 2 kg/pit, Tricho-compost-1 @ 2 kg/pit + Furadan 5 G @ 20 g/pit, Tricho-compost-2 @ 2 kg/pit + Furadan 5 G @ 20 g/pit, poultry refuse @ 5-6 kg/pit + Furadan 5 G @20 g/pit , neem oil cake @ 500 g/pit + Furadan 5 G @ 20 g/pit and saw dust burning + Furadan 5 G @ 20 g/pit. It was revealed that all the treatments performed well in reducing root-knot nematode infestation and increasing plant growth and yield country bean compared to farmers’ practices. Among the treatments, integration of poultry refuse with Furadan 5G or Trichoderma based bio-fungicides Tricho-composts with Furadan 5G or neem oil cake with Furadan 5G are the best treatments in reducing root-knot nematode infestation and increasing plant growth as well as yield of country bean. Soil treatment with only Tricho-composts or integration of saw dust burning with Furadan 5G also performed better in reduction of root knot nematode disease and increasing plant growth as well as yield of country bean.

A Predictive Tobacco Control Mass Media Programming Model to Achieve Best Buys in Low –and Middle-Income Country Settings

Dec 2020 DOI 10.14302/issn.2641-4538.jphi-20-3641

Background Evidence based message design and efficient dissemination of messages are critical to the success of tobacco control mass media campaigns. Although evidence to measure effectiveness of messages is emerging within low -and middle-income country (LMIC) settings, evidence-based approaches for mass media message dissemination is currently lacking due to challenges in accurate assessment of gross rating points (GRPs) for efficient delivery of campaign messages. Approaches to more accurately predict optimal campaign impact are required to achieve best-buys in resource constrained settings Method A case study approach compared findings from two national tobacco control mass media campaigns implemented in Bangladesh. Stage one reviewed protocols to assess the efficacy of message designs. Second stage analysis involved a review of the mass media campaign recall findings from cross-sectional, post-intervention surveys. Last, a post assessment of GRPs for both campaigns was conducted to support the development of an algorithm to better predict campaign impact at the greatest cost-efficiencies. Results Message mean pre-test scores identified that the Baby Alive campaign scored approximately 20% lower than mean pre-test scores of messages for the Graphic Health Warning campaign. Media dissemination for the Baby Alive campaign was also relatively low at 165GRPs achieving 16.8% prompted recall while the Graphic Health Warning campaign delivered 292GRPs to achieve 47.0% prompted recall. The analytic-predictive model identified that for messages with high pre-test scores an increase of only 1.5GRPs was required to the existing media plan to potentially achieve an additional percentage point of recall. Discussion Given the weaknesses in GRP calculations in LMIC settings, analysis of multiple metrics should be considered to achieve best buys for tobacco control mass media campaigns. Based on optimal message mean pre-test scores of 90%+ and delivery of 292GRPs, which achieved 47% campaign recall, optimal recall of 70% could be predicted with a media plan delivering 342GRPs. More analytical-predictive mass media programming models need to be developed in other LMIC settings examining multiple campaign findings to confirm if this algorithm can provide better returns on investment with efforts directed toward delivering interventions that are supported by a strong evidence base.

Respiratory Diseases Open Access

Diaphragmatic Pacing as an Alternative to Mechanical Ventilation: Early Experience from a Developing Country

Mar 2019 DOI 10.14302/issn.2642-9241.jrd-19-2689

Background The aim of this study is to evaluate the outcomes of patients submitted to diaphragmatic pacing, and the impact on quality of life of patients who chronically depend on mechanical ventilation, as well as the effectiveness of phrenic stimulation to eliminate the need for mechanical ventilation. Methods From 2010- 2014, 10 patients completely dependent on mechanical ventilation were operated upon, with the implantation of phrenic pacing device. The diagnoses were quadriplegia and congenital central hypoventilation syndrome (CCHS). All patients underwent bilateral approach to the phrenic nerves, by video-assisted thoracic surgery or mini-thoracotomy. Results All patientsstarted pacing 30-40 days post-operatively. The mean age of patients was 12.1 years (2-27 years range) with a median of ten years. Six patients (54.5%) were as old as ten years, and three (27.2%) were older than 20 years. Younger patients had CCHS and older ones were quadriplegic. All patients with CCHS (n = 4) were nine years old or younger while only two quadriplegic patients were in this age group. Conclusions Diaphragmatic pacing can provide improvement in the quality of life of patients who depend on mechanical ventilation, allowing freedom to conduct daily activities, lower respiratory infections, and tracheostomy decannulation.

Toxicology and Drug Safety Issues: A Review Article

Dec 2025

Background Research and drug development industries have multiphase drug screening procedures, which can be debated. As a result, harmful products may still reach for public health service delivery due to vulnerabilities in the process. Main body A wide range of test compounds have delayed manifestation of undesired effect on the study subject, with the time to undesired effects after acute exposure being weeks and months. Acute toxicology in a preclinical trial also has limited clinical value as its lethal dose is the endpoint for a conclusion, and death sometimes occurs after a scheduled period of acute toxicology. Countless resources are wasted, and numerous new drugs are introduced into the pharmaceutical market with assumed safety analysis every year due to vulnerable multi-procedures in preclinical trials. The principal use of collected data from a preclinical trial is to support regulatory categorization and harmful labelling decisions. However, the data can also be used to derive safe use threshold levels, which may lead to the use of unsafe material. The criteria for classification and labelling also differ among countries, sometimes among authorities within the same country. The fundamental concept of toxicology states that ‘all chemical substances are potential poisons depending on the amount and duration of exposure. However, the toxic property of a test compound cannot be created or eliminated by simply the amount administered to study animals. Conclusion All xenobiotics are poisons at any amount with different severity that can be calculated using biological parameters.

Diagnostic Performance of Smear Microscopy and Xpert MTB/RIF Versus MGIT Culture in Republic of Congo

Nov 2025 DOI 10.14302/issn.2690-4721.ijcm-25-5786

In the Republic of the Congo, tuberculosis (TB) remains a major public health concern. Although the GeneXpert MTB/RIF assay is the WHO-recommended first-line diagnostic test, smear microscopy is still used for treatment monitoring and in facilities where molecular testing is limited. Evaluating the diagnostic accuracy of smear microscopy compared to GeneXpert and MGIT culture is essential to guide diagnostic strategies and strengthen TB control in the country. A cross-sectional study was conducted among 92 presumptive pulmonary TB patients at Makelekele Hospital. Sputum samples were analyzed by smear microscopy, GeneXpert MTB/RIF, and MGIT culture. Sensitivity, specificity, positive and negative predictive value were calculated for smear microscopy and GeneXpert, using culture as the reference standard. Culture detected more Mycobacterium tuberculosis than microscopy (49% vs. 32%, P<0.001). Smear microscopy showed a sensitivity of 58% (95% CI: 43–71%) and specificity of 92% (95% CI: 80–97%). GeneXpert detected more MTB (62% vs. 49%, P<0.001) with a sensitivity of 98% (95% CI: 89–100%) and specificity of 72% (95% CI: 58–83%). GeneXpert showed superior sensitivity for TB detection, while microscopy remained specific. Expanding GeneXpert testing across the Republic of the Congo will improve TB management.

The Impact of Public Financing, Economic Growth, and Corruption on Immunization Performance: Evidence from 37 Sub-Saharan African Countries

Oct 2025 DOI 10.14302/issn.2693-1176.ijgh-25-5729

Background In sub-Saharan Africa, where many countries continue to experience high burdens of vaccine-preventable diseases, increasing immunization access have been a priority for the governments and international organizations such as Gavi, the Vaccine Alliance. Over 40 Gavi-supported African countries have been impacted, with 364 million children reached and over US$5.7 billion disbursed, averting over 8.9 million child deaths. Despite this progress, the African region has struggled with immunization coverage due to various factors. Nevertheless, some African countries are transitioning out of Gavi support due to economic growth. However, many require strong political will to increase their expenditure on immunization. This study therefore aims to understand the factors influencing immunization performance and its relationship to public expenditure. Methods Data on 37 Gavi-eligible sub-Saharan African countries between 2006 and 2019 was obtained from the World Bank’s World Development Indicators, the WHO and UNICEF Joint Reporting Form and the Transparency International’s Corruption Perception Index. Descriptive immunization and health expenditure were analyzed using a panel regression of variables. DPT3 was used as an indicator of immunization uptake. The indicator for public expenditure on immunization per child was based on government spending on immunization divided by the number of children in the birth cohort. Results The average gross national income increased from US$639 to US$1,192 per capita, while government spending on immunization increased from US$1.7 to about US$4.5 per child. The findings show that there is a correlation between improved immunization financing, increased gross national income, reduced corruption, and improved immunization coverage. However, performance declines beyond a certain threshold when gross national income per capita increases. In addition, an English-speaking country effect was observed. Conclusions While improved immunization financing increases immunization coverage and constitutes an advocacy talking point, there is a need to understand why an increase in gross national income per capita does not translate into an improved immunization coverage. Key highlights Increasing national spending on immunization drives up the uptake of childhood vaccines. There is a threshold beyond which immunization coverage falls despite increased GNI. Controlling corruption increases immunization coverage tendency. French- and English-speaking countries’ immunization coverage differs. Immunization and health system financing have separate outcomes.

Weather Changes Open Access

Impact of Climate Change on Public Health in Rwanda

Sep 2024 DOI 10.14302/issn.3070-3379.jwc-24-5199

Rwanda is a small Central African country. A land with thousands of hills and mountains. It is a low-income country and one of Africa's fastest-growing economies. It is home to a variety of ecosystems, such as mountainous rainforests, gallery forests, savanna woodlands, wetlands, aquatic forests, and agroecosystems. From rising temperatures to changing rainfall patterns, the hidden dangers of climate change are unmasking themselves in the form of various health risks. Every year, many deaths, bodily injuries, and house collapses, among other repercussions, are documented as detrimental effects of climate change events on public health. This article delves into the intricate relationship between climate change and public health in Rwanda, exploring the adverse effects it has on vulnerable communities. By shedding light on this pressing issue, we can better understand the urgency of taking action to mitigate the impact of climate change on public health as well as potential solutions to the current predicament. The authors researched several literatures to develop their perspectives on the subject and explored potential solutions to protect the well-being of Rwandans in the face of this global crisis.

Precision Agriculture Open Access

Sesame (Sesamum indicum L.) seeds and di ammonium phosphate (dap) potential for controlling Striga seed germination, sorghum growth and grain yield

Apr 2024 DOI 10.14302/issn.2998-1506.jpa-22-4349

Sorghum is important staple food for feeding humans and animals in sub-Saharan African country. Nowadays, with the advent of climate change couple to the population growth, the crop is faced to new challenges wish are gradually affecting the productivity. In Niger, a dry land country where farmers are growing sorghum at a small scale for family subsistence, the crop is confronted to biotic and abioticonstraints including nutrient deficiency in the soil. Among those constraint, Striga is the one that causes huge damage to sorghum cultivation through yield reduction. In addition, nutrient depletion in the soil are causing weed progresses in farmer’s field at a large scale. In fact, to overcome Striga problem several control methods have been successfully tested, but some of them are efficient but not accessible to farmers. It is important to control the weed by using effective and accessible way for smallholder farme in Niger. The main objective of this study was to assess the effectiveness of different doses of sesame (0, 0.5 and 1.5 g) and DAP (0, 2 and 5 g) on Striga impact and sorghum grain yield. Two (2) grammes micro dosing utilization of DAP shows good result in Striga plant emergency and distribution along sorghum field. Concerning the three doses of sesame seed involve in this experiment, the micro dosing two (1.5 g) positively affect Striga effect. The combination sesame seed and DAP can significantly reduce Striga impact on sorghum cultivation and increased sorghum grain yield.

Family Medicine Open Access

Antibiotic Prescribing Practices for Upper Respiratory Tract Infection Among Clinical Officers at Kiambu County

Mar 2024 DOI 10.14302/issn.2640-690X.jfm-24-5016

Background Antibiotics are the most prescribed medications worldwide. Global consumption rose by 65% in 76 low and middle-income countries between the years 2000 and 2015. According to the World Health Organization, improper administration of antibiotics occurs in over 60% of people with upper respiratory tract infections. Inadvertent antibiotic use has been identified as a contributor to antimicrobial resistance. Outpatient antibiotic use accounts for around 80-90% of all antibiotic use in patients. Clinical officers are non-physician healthcare workers who have received less training, have a more restricted scope of practice than physicians. Clinical officers are key service providers in this country especially at the primary healthcare level. Objective The study assessed the factors that influence antibiotic prescribing for upper respiratory tract infections by clinical officers. Method A prospective study was carried out at 20 public hospitals in Kiambu County, on 36 clinical officers and 600 patient prescriptions. The parameters measured were patient factors, prescriber factors, institutional factors and how they affected the antibiotic prescribing practices by either being rational or irrational. Rational prescribing was identified as prescribing the right drug, at the right frequency, in the right duration, right dose for the right indication. Prescriptions were considered irrational if they did not satisfy any of the rational indices. Data was collected via a questionnaire from the clinical officers while WHO prescription checklist was used to collect data from patient encounters. Data was analyzed using Statistical Package for Social Sciences version 22.0 (SPSS v22.0) with P-value, Confidence Interval and Odds Ratio. Results A total of 600 patient encounters were recorded and 79.8% of the 479 encounters had an antibiotic prescription for URTI, 91% of the antibiotics prescribed were the right dose, 98% had the right frequency, 75% had the right duration, and only 23% had the right indication. Patients above 65 years were more likely to receive an antibiotic prescription OR 3.98 CI 0.91,17.41 P=0.17 compared to children under 12 years old. Males were more likely to receive an antibiotic, but this was not significant OR 1.06 CI 0.70, 1.59 P=0.79. A total of 28 (4.6%) patients had fever, and all received antibiotics. A total of 36 clinical officers were sampled and only 5 (13.8%) were found to have rational prescriptions (P=0.63), prescriber age (P=0.92), prescriber level of education (P=0.99) and prescriber work experience (P=0.22) were not associated with antibiotic prescription. As per institutional factors, availability of antibiotics (P=0.026) and availability of prescription guidelines (P=0.012) were associated with rational prescription of antibiotics. Conclusion The study indicated that there was a high antibiotic prescription rate deviating from the WHO standard. It demonstrated that most antibiotic prescriptions were irrational.

Determinants of Exclusive Breastfeeding Among Mothers of Infants Less Than Six Months of Age in Mogadishu: A Facility-Based Cross-Sectional Study

Jan 2024 DOI 10.14302/issn.2691-5014.jphn-23-4865

Background Breastfeeding is a vital practice for infant health and well-being, with exclusive breastfeeding (EBF) during the first six months being particularly crucial. Despite its benefits, EBF is sub-optimally practiced in many low-to-middle income countries. This study focuses on Somalia, a country with historical political instability and poor health indicators, aiming to identify the prevalence and determinants of exclusive breastfeeding among women with infants under six months attending SOS Mother and Child Hospital in Mogadishu. Methods A hospital-based cross-sectional design was used, and data were collected through a structured questionnaire. The study sample consisted of 345 mothers, selected using a systematic sampling technique. Descriptive, bivariate, and multivariate analyses were conducted to assess breastfeeding practices and determine factors influencing exclusive breastfeeding prevalence. Result The study found that the prevalence of exclusive breastfeeding among the study population in Somalia was 44%, influenced by factors such as maternal education, employment, and utilization of antenatal and postnatal care services. Male infants and younger infants had higher odds of being exclusively breastfed. Conclusion and recommendations The study emphasizes the importance of promoting exclusive breastfeeding as the optimal feeding practice for infants in Somalia, highlighting the need for comprehensive health education during antenatal care visits and postnatal counseling. It recommends the development of supportive policies, such as maternity leave and workplace accommodations, along with community-based initiatives and support groups to facilitate and encourage exclusive breastfeeding practices.

Prevention and Safety Training to Improve Community Health

Mar 2023 DOI 10.14302/issn.2690-0904.ijoe-21-3884

Background and Purpose Public health problems are caused by the emergence of environmental pollution and infectious diseases, which have caused concern around the world. The public health threat affects the relationship between people. Population growth and associated pressures increase difficulties associated with effective means of maintaining public health. The diseases transmitted from human and livestock communication, water pollution, air pollution, and environmental pollutants urge us to find new solutions to address these problems. Understanding the environmental and environmental health is a prerequisite for protecting public health. In Iran, like other countries in the world, the issue of environmental protection and its compliance with the first program of economic, social and cultural development of the Islamic Republic has begun and expanded in the future. In this regard, new perspectives are being introduced that will bring about dramatic changes at various levels of planning, processes and specialized sectors such as civil, industrial and educational sectors. The training of engineers in this regard can play a very important role in refining the attitudes of young engineers and using these bases in their specialized activities. One of the important tasks of universities is to provide a suitable platform for such training. In this regard, it is essential that the major industrial universities of the country develop various programs in this field. Materials and Methods The present study is a review of the type of validity that is performed through search of authoritative scientific databases such as PubMed and Scopus, Google scholar, PubMed using the key words of building safety and health, HSE, and prevention methods are the latest information. Results Implementing the principles of HSE in various construction, industrial and other projects requires time, because any change that is considered in the system requires a change of attitude, which in turn requires time to adapt and adapt to the new conditions. The conditions for the projects in this research are their current conditions, and the next research, after a while, can determine the percentage of project progress in terms of HSE. Conclusion In order to comply with the principle of HSE cases, there is a need for training. These trainings should be executed at different levels and levels of contracting and monitoring so that the level of awareness of the risks involved in the development of civil operations between the personnel reaches a common frontier.

Agronomy Research Open Access

Screening Sorghum Genotypes for Striga Resistance

Mar 2023 DOI 10.14302/issn.2639-3166.jar-22-4356

In Niger, sorghum (Sorghum bicolor) is one of the most important staple crop for food and money. Despite the importance of the crop and its easiest adaptative capacity to dry, the crop is confronted to striga (Striga hermonthica), a plant parasite, which drastically hinder the productivity and causing yield loss between 20% to 80%. The best and easiest way to control and improve sorghum productivity is through the development of novel Striga resistance sorghum genotypes. The purpose of this study was to assess 20 sorghum genotypes from diverse country for striga resistance and grain yield capacity. Varieties with high yield average, medium size and resistance to Striga were found.

Diseases Open Access

Prevalence of Typhoid and Paratyphoid fever in a tertiary care hospital of Kathmandu valley

Feb 2023 DOI 10.14302/issn.2997-1977.jd-22-4378

Typhoid or enteric fever is caused by Salmonella serotype typhi and paratyphi. It is one of the major public health problem in developing countries including Nepal. In recent years, increased urbanization and growing population within Kathmandu valley, attributed mainly to improper sanitary condition and fecal contamination of drinking water. These all factors contributes to a very high prevalence of typhoid fever through out the country. Methods This study was laboratory based study carried out six month period from march 2017 to August 2017 at microbiology lab in Nepal Medical college. Results and conclusion In the present study, the prevalence of enteric fever is mainly caused by Salmonella. Typhi than Salmonella Paratyphi A was observed.

Wildlife Open Access

Distribution of protected area and large-sized mammals order in Ethiopia

Feb 2023 DOI 10.14302/issn.2997-2248.jwl-23-4439

Ethiopia is one of the countries found in the eastern horn of Africa, which is endowed with beautiful landscape and topography from which diverse habitats and fauna composition. The objective of this paper is to review relevant documents on distribution of protected area and large-sized mammals order in Ethiopia. The Method of the data were by compiling related information from different sources like published articles grey literature and other office reports from concerned institutions. Altitudinal and geographical variations made the Ethiopia to be among the biodiversity-rich nations in the world. Mammal fauna in Ethiopia consists of 326 species, among 144 genera, 43 families and 14 orders; out of which 32 mammals of the country categories under critically threated group. Among the mammals in Ethiopia eight of them are endemic. Among mammals’ antelopes are flagships (charismatic). The large mammals are mainly concentrated in the south and southwest border.

Examining the Effects of Mobile Telephone Communication on the Utilization of Antenatal Care Services Among Expectant Mothers in Kyotera And Rakai Districts, Uganda

Oct 2022 DOI 10.14302/issn.2641-4538.jphi-22-4281

Uganda still grapples with a high maternal mortality rates of 336 deaths per 100,000. Expectant mothers across the country lack awareness about the availability of antenatal care services; yet attendance of antenatal care services during pregnancy is crucial in protecting the health of women and unborn children. This article describes a protocol for investigating the effectiveness of mobile telephone communication interventions on the utilization of antenatal care services among expectant mothers in the districts of Kyotera and Rakai Districts in Uganda. Under the protocol, 28 health facilities in the districts of Kyotera and Rakai will be selected using simple random sampling and allocated into the intervention and control arms at a ratio of 1:1. A total of 2224 expectant mothers receiving antenatal care from the sampled health facilities will be recruited using systematic sampling. Expectant mothers receiving antenatal care from facilities allocated into the intervention arm will receive mobile telephone voice and text messages reminders for scheduled ANC visits. The mobile telephone messages will further provide maternal health information and availability of ANC services on a fortnightly basis. On the other hand, expectant mothers receiving antenatal care from facilities allocated into the control group will not get any reminders for scheduled ANC visit and maternal health information through the mobile telephone communication platform. Expectant mothers in the control arm will receive standard maternal health care without reminders. Expectant mothers in both groups will provide baseline data, midterm data will be obtained from the ANC registers at 6 moths while end of term data will be collected after an intervention period of 12months. The data collected will include the number of antenatal care visits attended, antenatal care services obtained from the health facilities, sociodemographic factors and mobile telephone usage, ownership and knowledge. The anticipated outcomes are; increased awareness and utilization of ANC services.

Water Open Access

Scrutinizing Famine Disaster Based On Rainfall Trend Investigation (A Case Study of Khorasan Razavi Province)

May 2022 DOI 10.14302/issn.2769-2264.jw-22-4086

Rainfall is one of the most important components of the hydrological cycle. The importance of rainfall in arid and semi-arid regions is more apparent. Due to the important role of rainfall trend assessment in the proper management of water resources, in the present study, Khorasan Razavi province, the second-most populous province of Iran located in the northeast of the country, for this purpose was studied. Currently, this region is facing water shortage problems. In this study, the non-parametric Mann-Kendall method was used to evaluate the annual rainfall trend over a thirty-year period from 1989 to 2019. On the other hand, Sen's slope estimator method was used to determine the magnitude of the rainfall trend in the studied synoptic and rain gauge stations. The results showed that the root of water shortage problems is not due to drastic changes in rainfall. Therefore, water shortage problems in Khorasan Razavi province are mainly due to a lack of proper management (i.e., mismanagement). The present study, by examining the rainfall trend using an appropriate framework, tried to take an effective step towards improving the management of water resources in the northeast of Iran.

Analysis of Risk of Death due to COVID-19 in Cameroon

Mar 2022 DOI 10.14302/issn.2692-1537.ijcv-22-4115

Background Cameroon is battling against the novel coronavirus (COVID-19) pandemic. Although several control measures have been implemented, the epidemic continues to progress. This paper analyses the evolution of the pandemic in Cameroon and attempts to provide insight on the evolution of COVID-19 within the country’s population. Methods A susceptible-infected-recovered-dead (SIRD)-like model coupled with a discrete time-dependent Markov chain was applied to predict COVID-19 distribution and assess the risk of death. Two main assumptions were examined in a 10-state and 3-state Markov chain: i) a recovered person can get infected again; ii) the person will remain recovered. The COVID-19 data collected in Cameroon during the period of March 6 to July 30, 2020 were used in the analysis. Results COVID-19 epidemic showed several peaks. The reproductive number was 3.08 between May 18 and May 31; 2.75 between June 1 and June 25, and 2.84 between June 16 and June 24. The number of infected individuals ranged from 17632 to 26424 (June 1 to June 15), and 28100 to 36628 (June 16 to June 24). The month of January 2021 was estimated as the last epidemic peak. Under the assumption that a recovered person will get infected again with probability 0.15, 50000 iterations of the Markov chain (10 and 3- state) demonstrated that the death state was the most probable state. The estimated lethality rate was 0.44, 95%CI=0.10%-0.79%. Mean lethality rate assuming ii) was 0.10. Computation of transition probabilities from reported data revealed a significant increase in the number of active cases throughout July and August, 2020, with a mean lethality rate of 3% by September 2020. Conclusion Multiple approaches to data analysis is a fundamental step for managing and controlling COVID-19 in Cameroon. The rate of transmission of COVID-19 is growing fast because of insufficient implementation of public health measures. While the epidemic is spreading, assessment of major factors that contribute to COVID-19-associated mortality may provide the country’s public health system with strategies to reduce the burden of the disease. The model outputs present the threatening nature of the disease and its consequences. Considering the model outputs and taking concrete actions may enhance the implementation of current public health intervention strategies in Cameroon. Strict application of preventive measures, such as wearing masks and social distancing, could be reinforced before and after the opening of learning institutions (schools and universities) in the 2020/2021 calendar year and next.

Adolescent Girls in Guatemala: Can an Empowerment Program Change Perceptions of Gender Equity, Aspirations, and Communication?

Aug 2021 DOI 10.14302/issn.2641-4538.jphi-21-3927

While Guatemala has made great strides towards gender equality, it remains a country with vast disparities. Gender sensitization and empowerment programs during adolescence when gender attitudes are formed have the potential to diminish gender inequities. The Girl Rising Pilot Program (GR) is a 24-week curriculum designed for adolescent girls living in the Sololá region where 95% of the total population is indigenous and Mayan. The present pilot study evaluated outcomes of the GR Guatemala pilot program. Specifically, the evaluation examined whether there were differences between baseline and follow-up on perceptions of gender equity, aspirations, and communication for adolescent girls who participated in the GR program. A quasi-experimental study design with a one group pre- and post-test was implemented. The pilot evaluation study included all 265 participants at baseline who participated in the GR program. after controlling for significant variables, it was found that the gender equitable attitudes score and communications scale still significantly increased between baseline and follow-up. The results of this evaluation prove that gender sensitization programs play a key role in forming and changing gender attitudes during adolescence, and have the potential to alter their short and long-term attitudes and beliefs.

Fertility Biomarkers Open Access

Is Freezing the Future? Investigating Interest of Elective Oocyte Freezing Amongst Singaporean Women

Jun 2021 DOI 10.14302/issn.2576-2818.jfb-21-3849

A novel technological innovation called Elective Oocyte Freezing (EOF) has emerged as a solution for women who wish to preserve their fertility to delay childbearing for non-medical reasons. This technology has grown in popularity as women have undertaken a greater role in the workforce and faced the dilemma of balancing work and family. In spite of the rising trend of Singaporean women postponing childbearing to advance their careers, EOF is currently prohibited in Singapore. Many Singaporean individuals have declared this policy to be both outdated and a threat to women’s reproductive rights. However, prior to this survey, no research, to my knowledge, has analyzed Singaporean female professionals' interests in EOF, if made available. Through this quantitative, cross-sectional, 4-part survey, I conclude that if EOF was permitted, encouraged, and subsidised by the Singaporean government, Singaporean women possess a strong interest in freezing their eggs for social purposes This paper further demonstrates an existing positive relationship between 48 Singaporean female professionals’ interest in EOF prior to and following reading an information leaflet. Specifically, after being informed of the social benefits presented by EOF, participants were significantly more inclined to freeze their eggs if such practice was permitted in Singapore. This conclusion suggests that the Singaporean government should re-evaluate their position on EOF in order to facilitate childbearing dilemmas faced by the increasing number of women entering the country’s workforce each year. Additionally, as this policy is currently a subject of debate in Singapore, the implications of this research, revealing Singaporean female professionals’ interest in EOF, create a foundation for both future research and the possible evaluation of this policy. If this conclusion is corroborated with subsequent research, further evidence may substantiate my findings regarding the desires of Singaporean women and possibly result in a change of legislation.

“Happy Village” Concept Helping Villages to Face COVID-19

Jun 2021 DOI 10.14302/issn.2692-1537.ijcv-21-3758

“Health Promoting Village” concept named as “Happy Villages” started in 2007 in Badulla District in Uva Province was a community mobilization process through which village communities have been empowered to look after their community health. The areas included were Early Childhood Care and Development (ECCD), Non-Communicable Diseases (NCD) prevention , Alcohol and drug abuse. Gender Based Violence. The programmed used many interactive tools as “Mood Chart” or “Happiness Calendar” which was giving a visualizing effect. Continuous assessments done from 2009 to 2013 showed that the Health promotion strategies used in the Happy Village concept in the Uva Province can effectively and efficiently be utilized for improvement of nutrition and achievement of milestones in children. From 2017 a National program is launched named “Happy Villages”. During the Covid 19 outbreak health promotion approaches were initiated to change in lay communities successfully. Villagers had actively engaged, collectively acted in responsible manner, and identified measures to prevent COVID-19 transmission in their households, neighbourhood and community. The use of village empowerment had become a fruitful source to face the Covid pandemic in Sri Lanka. Almost 300 “Happy Villages” around the country have made facing the Covid epidemic their chief task. Many innovative ideas and practices in facing Covid 19 pandemic at village level including a visualizing calendar to identify the risk behaviours of the family members as well as the Happiness calendar to identify the family stress levels are among them. Health promotion concept is getting rooted around the country with active participation of the villages with a multisectoral support. Continuous monitoring and evaluation and sharing best practices will show the world the effectiveness of Health Promotion and the ability of empowered people in facing pandemic situations

Impact of COVID-19 on Supply Chains in Zimbabwe

May 2021 DOI 10.14302/issn.2641-4538.jphi-21-3824

Zimbabwe like many other sub-Saharan African states has been struggling to provide a quality health service delivery system. Nations with rampant corruption and ineffective bureaucracy made worse, the response towards the fight against COVID-19, Coronavirus Disease 2019. Despite the Zimbabwean government setting out protocols with international agencies such as WHO, World Health Organization to mount an effective response against COVID-19, the health system has been overstretched with lack of personal protective equipment, shortage of drugs and essential equipment and wanton corruption practices coupled with shortage of staff. Timely delivery of orders is still a challenge due to strict bureaucratic measures when transporting goods and the existing competition between countries. Manufacturers and donors are shifting their focus to their countries leaving the Zimbabwean health service underfunded and under-resourced. However, among the challenges experienced the country has been given a chance to revisit its priorities and strategize how best the government and organizations can move essential medical goods, utilize current trade agreements such as ACFTA, African Continental Free Trade Area and local drug manufacturers to produce essential medicines. Launching an efficient mechanism to end corrupt practices in procurement and supply as well as improve interagency cooperation and communication may help improve efforts to end COVID-19 in Zimbabwe.  

The Multi Sectorial Approach to COVID-19 Pandemic in Limited-Resource Settings: Discussing Rwandan Experience

Apr 2021 DOI 10.14302/issn.2641-4538.jphi-21-3776

COVID-19 has unprecedentedly shaken the health systems across the globe. Rwanda, a low-income country in East Africa, has succeeded to contain the first wave but is struggling to curb the second wave in the wait for a massive vaccination program. The national committee composed of different ministries and a COVID-19 Joint Task Force was established as a Multi-sectoral approach in the early days of the pandemic. The approach together with transparent communication to the population has been effective. However, much more tailored and cost-effective measures against the drivers of cluster outbreaks are needed to save both the economy and more lives. It is challenging to produce evidence about behaviors attributable to the surge of infections, and their hardship, and how to allow the population to live their lives with less risk. With important research, policymakers will be able to think locally and provide easy and inexpensive recommended behaviors while awaiting the vaccine.

Uptake of Breast Screening Among Female Staff at A Tertiary Health Institution in South-West Nigeria

Mar 2021 DOI 10.14302/issn.2474-3585.jpmc-20-3557

Background Breast cancer is one of the most common types of cancer affecting women globally. It has shown increasing morbidity and mortality rates over the past years. Several screening methods ranging from simple breast self-examination to a highly sensitive test procedures for early detection and treatment are available, but uptake is a challenge. Lack of a national screening programme in the country makes available regional screening programme unsuccessful. This study aims to assess the factors affecting the uptake of breast cancer screening programme among female staff in a tertiary hospital, Southwest Nigeria. Method This descriptive cross-sectional study involves 375 participants selected by a stratified random sampling technique, with proportional allocation to population size and the use of a semi-structured questionnaire. Respondents were questioned on their basic knowledge of breast cancer symptoms, risk factors and treatment, over a score of 50 and above, were set as the cut-off mark to determine good knowledge of breast cancer. Patients attitudes towards breast cancer screening as well as factors affecting uptake were also measured. Descriptive statistical analysis was done using SPSS-20 while the predictors of the uptake of screening were determined using logistic regression at p ≤ 0.05. Results There were 360 respondents, comprising of 13.3% clinical and 86.7% non-clinical female staff within the age bracket of 20 to 58 years (38.2±0.42 years). Out of the respondents, 97.8% have heard about breast cancer but only 52.3% had been screened while 65.5% had “Good knowledge” of breast cancer. Positive attitude to breast cancer screening was displayed in 52.5% while over 90% claimed to be practicing breast self-examination. Only 36.1% of respondents above 40 years old have had mammography done. Most frequent barriers to screening uptake include cost, poor accessibility to screening facilities, shyness (unfamiliar screener), unavailability of female doctors, careless attitude, fear of cancer and other more pressing family problems. Using logistic Regression at p ≤ 0.05, females with a negative attitude, young unmarried (less than 30years) and lack of easy accessibility to screening facilities were significant factors affecting uptake of breast cancer screening services. Conclusion Due to knowledge-uptake gap of breast cancer screening revealed in this study. It is therefore obvious from these findings that a concerted effort is needed to actively remove these barriers by repeated education, training and re-training strategies among health workers and to improve their uptake and level of advocacy and campaign for breast cancer screening among their patients and clients.

Models and data Analysis of the Outbreak Risk of COVID-19

Jan 2021 DOI 10.14302/issn.2692-1537.ijcv-20-3383

With the spread of the new coronavirus around the world, governments of various countries have begun to use the mathematical modeling method to construct some virus transmission models assessing the risks of spatial spread of the new coronavirus COVID-19, while carrying out epidemic prevention work, and then calculate the inflection point for better prevention and control of epidemic transmission. This work analyzes the spread of the new coronavirus in China, Italy, Germany, Spain, and France, and explores the quantitative relationship between the growth rate of the number of new coronavirus infections and time. In investigating the dynamics of a disease such as COVID-19, its mathematical representation can be constructed at many levels of details, guided by the questions the model tries to help answer. Mathematical sophistication may have to yield to a more pragmatic approach closer to the ability to make predictions that inform public health policies. Background In December 2019 , the first Chinese patients with pneumonia of unknown cause is China admitted to hospital in Wuhan, Hubei Jinyintan , since then, COVID-19 in the rapid expansion of China Wuhan, Hubei, in a few months time, COVID-19 is Soon it spread to a total of 34 provincial-level administrative regions in China and neighboring countries, and Hubei Province immediately became the hardest hit by the new coronavirus. In an emergency situation, we strive to establish an accurate infectious disease retardation growth model to predict the development and propagation of COVID-19, and on this basis, make some short-term effective predictions. The construction of this model has Relevant departments are helpful for the prevention and monitoring of the new coronavirus, and also strive for more time for the clinical trials of Chinese researchers and the research on vaccines against the virus to eliminate the new corona virus as soon as possible. Methods According to the original data change law, Establish a Logistic growth model, we collect and compare and integrate the spread of COVID-19 in China, Italy, France, Spain and Germany, record the virus transmission trend among people in each country and the protest measures of relevant government departments. Findings Based on the analysis results of the Logistic model model, the Logistic model has a good fitting effect on the actual cumulative number of confirmed cases, which can bring a better effect to the prediction of the epidemic situation and the prevention and control of the epidemic situation. Interpretation In the early stage of the epidemic, due to inadequate anti-epidemic measures in various countries, the epidemic situation in various countries spread rapidly. However, with the gradual understanding of COVI D -19, the epidemic situation began to be gradually controlled, thereby retarding growth

Agronomy Research Open Access

The Impact of Migration and Remittances on Employment in Agriculture in the Gambia

Dec 2020 DOI 10.14302/issn.2639-3166.jar-20-3318

For economic growth and development in any WE African country the GDP progress is depending on the key push-pull factors as migration, personal remittances received, bilateral aids and, absolutely, employment in agriculture which is about 1/3 of the population and not a predominant and protected minority as happens in the industrialized EU and North America. In order to represent the framework of the reciprocal dependencies the present study used the statistics of Gambia from WDI covering the periods from 1960 to 2017 by applying linear regression models. The results confirmed that migration and remittances have significant positive impact on employment in agriculture because new investment in agriculture created new skilled and unskilled employment.  The results also found out that employment in agriculture has negative and significant impacts on foreign aids: 10% increase in migration, increases foreign aid by 50.3%. Increasing 10% of remittance, increase economic growth by 0.14% but 10% increases in employment in agriculture, decrease economic growth by 0.04%. To face globalization the economy of the Gambia should use the foreign aid to improve agriculture production and productivity thereby increase economic growth through human capital theory of migration, skilled migration, export and food security, the study recommends.

Dynamics of Infections and Number of Vaccines Needed to Avoid Covid-19 in Europe

Oct 2020 DOI 10.14302/issn.2692-1537.ijcv-20-3587

The work analyzes the dynamics of transmission of infections by the new coronavirus in twelve European countries, including France, Germany, Italy, Spain, UK, Austria, Croatia, Denmark, Greece, Romania, Czech Republic, and Portugal, whose data from contagion were obtained by Johns Hopkins University until September 24, 2020. The study confirmed that this new coronavirus (SARS-CoV-2) surprised all the countries of the world that had to improve their public health policies to confront this disease according to the results obtained from the calculation of the mantissa. Although the countries were able to improve their policies after the first wave of contagion, Spain and France have the highest proportion of cases that stand out significantly with the rest of the countries in the second wave of infections that the world faces again. Likewise, the beginning of the epidemic outbreak was determined, which could help to track the spread of the disease through European countries (not the first case registered in each country), from which it can be inferred that the outbreak begins in Italy and later the rebound begins in Germany, France, and Spain. Within days, it significantly affects Greece and Austria, reaching Denmark, the Czech Republic, Romania, and Croatia. Finally, the number of people who must be vaccinated to counteract the advance of Covid-19 in these European countries was determined based on the calculation of the Effective Reproductive Number, Rt. The number of people that would have to be vaccinated in all these countries to counteract this disease sums up to 206.830.361.

Wrist Wearable Health Band for COVID-19 Testing

Sep 2020 DOI 10.14302/issn.2641-5526.jmid-20-3505

Testing people for COVID-19 in a country like India with a huge population is a near impossible task therefore the government is using body temperature as a testing parameter to cover the whole population. Infrared thermometers are used to find the temperature because it is a cheaper and faster way. This testing rate can be done even faster, without the need of manpower and with far more accuracy using smart watches and bands. These wrist-wearables are mostly used for fitness purposes which have more measuring equipment that is used for preliminary testing done for COVID. This equipment’s are in the form of electric sensors which are small enough to be used in wearables. So we can get even more insight and accuracy compared to the standard method. In this study an application is created to use an array of sensors (Pulse sensor, Pulse oximeter, Accelerometer and temperature sensor) are being used in these wearables to find the chance, that a person is affected due to COVID-19 and the information can be seen real time in mobile phone through the application. All the information can be sent to the health organization’s if required.

Mental Health Scenario of Climate Migrant Women among Slum Dwellers in Dhaka City

Aug 2020 DOI 10.14302/issn.2574-612X.ijpr-20-3491

Climate change is a global challenge which is likely to affect the mankind in substantial ways. Not only climate change is expected to affect physical health, it is also likely to affect mental health. Increased frequency of disasters with climate change can lead to posttraumatic stress disorder, adjustment disorder, and depression. Changes in climate may require population to migrate, which can lead to acculturation stress. It can also lead to increased rates of physical illnesses, which secondarily would be associated with psychological distress. Using a qualitative approach, this research explores the mental health status of migrant women in two urban slum areas in Dhaka city. The purpose of this study is to perform a review of existing secondary data and present mental health scenario of climate migrant women among slum dwellers and amplified gaps in knowledge regarding psychological health care system in Bangladesh. It is found that there is a lack of mental health preparedness and response in majority parts in the country specially the city slum, where aid cannot be reached to the sufferers. The paper concludes with a discussion of what can and should be done to tackle the expected mental health issues consequent to climate change and migration.

A New Graph to Display the Epidemic Outbreaks of Covid-19 in the World

Aug 2020 DOI 10.14302/issn.2692-1537.ijcv-20-3498

The paper proposes a new visualization scheme for the registry of Covid-19 cases by calculating the mantissa of the registered ones, so there is no need of performing complicated mathematical calculations. As an example, six countries are randomly selected: Australia, Brazil, China, Colombia, Portugal and Venezuela. The results show that China is the only country that keeps the epidemic under control, while Australia begins a new outbreak after having previously controlled the epidemic. Colombia and Portugal show a very similar behavior of registered cases and, finally, we can see that Venezuela, Brazil, Portugal, and Colombia present a growth of cases that may trigger new outbreaks in the future. Results are obtained from data registered at Johns Hopkins University until July 18th, 2020.

A quick Look at the Registered Cases of Covid-19 Throughout the World

Jul 2020 DOI 10.14302/issn.2692-1537.ijcv-20-3453

The present work analyzes the registered cases of Covid-19 throughout the world according the data registered at Johns Hopkins University. We selected 15 countries to analyze their data. In alphabetical order the countries are: Argentina, Australia, Brazil, Chile, China, Colombia, Germany, India, Italy, Mexico, Peru, Portugal, Spain, United States and Venezuela. With this information, three different studies were carried out. First, the data was validated using Benford's Law which is based on forensic techniques that allow us to guarantee the integrity of the information. Later, we calculated the value of the basic reproduction number (R0), ie., the number of secondary host infections caused by one primary host infection that helps us to determine if a country has an outbreak of Covid-19. Finally, we show that the best representation for the change in the number of cases in the time is to calculate the mantissa value, ie., the floating number obtained from the logarithm of the data.

Energy Conservation Open Access

Energy Conservation Measures in Heavy Trucks Freight Transport

Jul 2020 DOI 10.14302/issn.2642-3146.jec-20-3389

Since the independence of South Sudan, Sudan lost 75% of its oil reserves, this led to major fuel shortages country wide, the fuel shortage raised the fuel prices and the overall transport prices. Scarcity led to black market trade of fuel specially in states away from the Capital City (Khartoum). Managing the available stock comes first before increasing the supply amount in order to solve the problem, one of the major fuel consumers to be managed is the transport sector specially the long haulage freight transport. Moving freight in Sudan is constrained by inadequate infrastructure and high costs. This paper covers specifically the long haulage freight transport between Khartoum State and Western side of the country (Darfur Region), Contributing to manage fuel consumption for trucks, taking into account trucks types used, roads, environmental impacts and mitigation measures applicable to save fuel . The results showed that the primary reason for the excessive fuel consumption is the usage of the rigid trucks (lorries) for transport specially the Hino700 series, this truck type, overload and absence of weight stations and control policies contributed significantly to deterioration of roads and transport efficiency decreasing. First step towards the solution would be in upgrading roads infrastructure assuring high quality along with enforced weight regulations and weight stations to protect roads from damages. High quality roads shall ease the usage of different truck types with different configurations. Then stablish a policy to force replacement of the low efficiency lorry truck types with high quality tractor semi-trailer combinations.

How Valid are the Reported Cases of People Infected with Covid-19 in the World?

May 2020 DOI 10.14302/issn.2692-1537.ijcv-20-3376

The goal of this paper is to analyze the registered cases of people who have been infected with Covid-19 registered from throughout the world, using a digital forensic analysis technique that is based on Benford's Law. Twenty-three countries were randomly chosen for this analysis: China, India, Germany, Brazil, Venezuela, Netherlands, Italy, Colombia, Russia, Norway, South Africa, Portugal, Singapore, United Kingdom, Chile, Ecuador, Egypt, Denmark, Ireland, France, Belgium, Australia and Croatia.. We calculate on the p-values based on Pearson χ2 and Mantissa Arc Test according to the results obtained with the first digit. If any country fails these two tests, a third proof will be carried out based on the Freedman-Watson test. The results indicated that results from Italy, Portugal, Netherlands, United Kingdom, Denmark, Belgium and Chile are suspicions of data manipulation because the numbers fail the Benford’s Law according to the results obtained until April 30, 2020. However, it is necessary to carry out further studies in these countries in order to ensure that they countries manipulate or altered the information. 

Agronomy Research Open Access

Proposed Spray System for Family Agriculture with A Remote-Controlled UAV (Small Drone or Helicopter) and An Economical Sprinkler

Apr 2020 DOI 10.14302/issn.2639-3166.jar-20-3283

In the country, food production is more compromised every day, despite zero efforts and government, agricultural and livestock sector, causing poverty, migration, marginalization among other social disorders in addition to food insecurity. In Mexico 34% of the population is engaged in agricultural tasks, with very small land areas. The fact that 85% of do not have more than 5 ha of arable land, and that among them, 90% do not reach 3 ha clearly indicates their great need for light machinery .The solution to these problems family farmers are provided with affordable technologies to increase their productivity. One of the most common problems in agriculture is the application of agrochemicals, which is tedious and dangerous when farmers are exposed to these highly toxic products, therefore a system is proposed is through the help of a drone or remote control helicopter, both of economic type connected by a hose to the sprinkler and a tank. Due to the danger of applying agrochemicals for family farmers who rarely follow the precautions to apply these products, the proposed alternative is attractive for small agricultural properties, although it is not free of cost, the drone and the optimal sprayer should be investigated.  

Using Human Development Indices to Identify Indicators to Monitor the Corona Virus Pandemic

Apr 2020 DOI 10.14302/issn.2691-8862.jvat-20-3306

Introduction The Corona virus (CoVID-19) pandemic has hit the most developed countries and has thence spread to inflict other countries around the world. It is the first pandemic that appears in countries not linked to poverty and poor hygiene. Aim To study the relationship between human development and the pattern of the pandemic caused by the CoVID-19 and to identify development indicators that can be useful in monitoring the pandemic. Methods Data collected included confirmed cases of CoVID-19 by country, number of cases that recovered and cases that died and population density per million in this particular country. The data for this information was obtained from the online data on the daily reports on CoVID-19 from the different countries. Data for the Human Development index (HDI) and the ranking for each country were obtained from the most recent United Nations Development of Populations (UNDP) report for 2019. We analyzed data for 166 countries for which the HDI was available for the date of cases reported online on 27th March, 2020 at midnight. Findings There were significant differences by ANOVA for the confirmed cases of CoVID19 cases and total cases per one million population between the countries in the 4 tier group of Human Development. HDI was significantly correlated with confirmed cases, case density and cases that died from CoVID-19 (P<0.01) for all countries but the significance decreased by tier group. Country ranking was inversely correlated with confirmed cases of CoVID-19 (r-0.25 at P=0.001), CoVID-19 cases per million (r-0.4 at P=0.000) and cases that died from CoVID-19 (r-0.2 at P=0.03). Recovery was not inked to HDI or country ranking. The upper HDI tier groups (very high, high and medium) showed significant correlations with total cases per one million population P<0.05, but no correlation was found with confirmed cases or cases that died or recovered from CoVID-19 P>0.05. Conclusions Total cases of CoVID-19 per one million population seems to be a better indicator of the pandemic. The pattern of spread is closely linked to industry.

Parasite Research Open Access

Incidence of Gastrointestinal Parasites in Zebu and N’dama Breeds from Cattle Ranches in Jos Plateau, Nigeria

Mar 2020 DOI 10.14302/issn.2690-6759.jpar-20-3285

The incidence of gastrointestinal parasites in Zebu and N’dama breeds known to be trypanotolerant cattle from some ranches in Jos Plateau was investigated at the peak of the raining season, August to October, 2018. A total of 150 cattle from some Ranches in Jos Plateau were randomly selected for faecal sampling out of which 85 were Zebu (Bos indicus) and 65 were N’dama (Bos taurus) breeds respectively. The samples were analyzed for ova of gastrointestinal parasites using the simple flotation and sedimentation techniques and the results were interesting. The strongyloids, Oesophagostomumradiatum had the highest incidence of 4.7% followed by the Trichostrongylus species with 4%. Fasciolagigantica and Haemonchusplacei both were 3.3%. Then Paramphistomumcervi 2%; bovine hook worm, Bunostomumphlebotomum 1.3%, Taenia saginata1.3%, Schistosoma bovis 1.3% and Nematodirusspathiger 0.7%. The incidence of nematodes, cestodes and trematodes in this study in the raining season was significant (p<0.05) and could pose production and economic threat to institutional farms and ranches in the development of livestock and dairy industries in Nigeria. There should be a strong policy on the control of gastrointestinal parasites in the country for farmers to benefit from their contribution in ensuring food security.

Perspectives of Health Care Providers Working with HIV Positive Clients on Nutritional Challenges Among People Living with HIV/AIDS in Kigali, Rwanda

Mar 2020 DOI 10.14302/issn.2641-4538.jphi-20-3261

Efforts to control the Human Immunodeficiency Virus epidemic in Rwanda have seen remarkable success over the years. Effective antiretroviral therapy has played great role in improving longevity among people living with HIV/AIDS (PLWH). While this is the case, there are various nutritional challenges, which are often faced, among PLWH. Guided by the Rwanda country guidelines for nutritional management for PLWH and WHO recommendations, this study aimed to explore the perspectives of health care providers (HCPs) working with PLWH on nutritional challenges faced by their clients in Kigali, Rwanda. We conducted a qualitative study using in-depth interviews to collect data. A non-probability purposive sampling was employed to recruit HCPs. Data analysis was based on the naturalistic paradigm. We followed the hybrid approach in conducting thematic analysis. Three themes were identified. First, HCPs had good knowledge on nutritional requirements for PLWH. They demonstrated good communication skills and adequate counseling skills that were necessary for addressing concerns on nutrition from their clients. Secondly, it emerged that HCPs perceived a lack of resources to be the major challenge faced in nutritional management of their clients. From theme three, it emerged that, from HCPs experiences, food insecurity and lack of feeding supplements were the main causes of malnutrition among PLWH in Kigali, Rwanda. From the HCPs perspective, there is a need to improve healthcare institutions capacity to manage nutritional challenges faced by PLWH. To achieve this, policy makers need to channel adequate resources for this cause.

D Allele and DD Genotype of I /D Polymorphism in The ACE Gene in Patients with Hypertension, Stroke And Cancer Prostate In Libreville: A Concern Given The High Frequencies of these Signatures in Gabonese Population

Dec 2019 DOI 10.14302/issn.2326-0793.jpgr-19-3114

Background During the last two decades, the polymorphism of Angiotensin-Converting Enzyme (ACE) gene has been extensively studied among different human populations. In humans, several studies have shown the relationship between this polymorphism and the risk of many serious diseases with a heavy burden of health in developing countries. After analyzing the polymorphism in the population, the present study was also concerned with the investigation of an eventual association between hypertension, stroke, cancer prostate and I/D polymorphism of the ACE gene. Materials and Methods Our study population included 163 Baka (pygmy) and 158 Fang (Bantu) from Gabon to evaluate the polymorphism in the country. Concerning the diseases, we included 105 patients and 120 controls for hypertension, 37 patients stroke matched with 50 controls and 97 patients with prostate cancer were recruited. All participants in the study were genotyped for the ACE I/D polymorphism obtained by polymerase chain reaction amplification on genomic DNA. Results Our analysis showed that the ACE D allele DD genotype frequencies were highest of all the data so far in human populations. We obtained a frequency of 0.138 for I allele and 0.862 for D allele among pygmy and the frequencies of 0.313 and 0.687 respectively for the I and D alleles. This difference was significant (p<0.05). In patients, we revealed the predominance of D allele and DD genotype for hypertension (0.27 for I allele and 0.73 for D allele), for stroke (0.15 for I allele and 0.85 for D allele) and 83% of individuals with cancer prostate carry the D allele. D allele and DD genotype are associated with risk to hypertension whereas allele I seem protective at the occurrence of stroke (p<0.05 between healthy and controls). Conclusion We show that the D allele and DD genotype were higher in this population. Also theses two signatures may be associated at genetic risk of hypertension, stroke and prostate cancer in this country deprived of human resources for quality care of many patients.

Adolescents’ Perceptions of Gender Discrimination in India: Do Perceptions Differ for Boys and Girls?

Sep 2019 DOI 10.14302/issn.2641-4538.jphi-19-2995

Despite the gains India has made in recent decades, it remains a country with vast gender inequities. Gender sensitization and empowerment programs aimed at young people, precisely at the time when they are forming their gender attitudes, has the potential to diminish gender inequity in the long-term. This study represents data from 36 qualitative in-depth interviews conducted amongst adolescent boys and girls enrolled in grade 7 in northern India, in schools that serve under-resourced communities. The interviews asked questions related to positive youth development, gender roles, violence, and locus of control. The results of the qualitative analysis provide insights into how adolescents perceive gender discrimination in their families and communnites. The majority of expectations for boys revolved around physical labor, while, for girls, gender roles were primarily focused on stopping education early to get married and take care of the household and children. Many of the responses from both boys and girls on privileges/restrictions were related to daughters not being fully educated while sons often were. Furthermore, when comparing between boys and girls (attributes) and understanding superiority, many participants noted there is a clear preference of boys compared to girls. Girls also had higher proportion of violence codes compared to boys, perhaps because many girls felt they were hit more frequently than boys. The results of this qualitative analysis provide direction for both future research as well as the development of gender sensitization interventions specifically designed for adolescents.

Agronomy Research Open Access

The Future Perspectives of Agricultural Graduates and Sustainable Agriculture in Sudan

Apr 2019 DOI 10.14302/issn.2639-3166.jar-19-2732

The objectives of this study were to assess the Quality of Agricultural Graduates, employers’ perceptions of the employability and skills. A descriptive, analytical statistics, multistage random sampling method was adopted. Where two types of questionnaires were distributed to the Graduates and institutions associated with Sustainable agriculture (SA). The collected data was analyzed by Statistical Packages for Social Sciences (SPSS). The results revealed some respondents began higher education in Arabic (66.7%), while others in English (33.3%). The respondents faced with difficulties in understanding the courses due to teaching methods (36.7%), language (33.3%), and curriculum (30%). The result indicated some respondents (56.7%) do not have back ground about (SA). The respondents in the Ministries of Agriculture assessed the Graduates in regard to agricultural skills, and confidence to perform duties as fair (10%), and good (23.3%), but, for reliability, managerial skills, tactic and ability to participate in forums as fair (6.7%). Good (27.7%), fair (3.3%), and good (30%) respectively. Assessment of the Graduates at Research Centers, were assessed in relation to Research methodology, statistical analysis, and writing scientific papers as good (40 %,).While for Software skills as excellent (100%), and for Agricultural Technology Transfer as very good (80%). While; the respondents from Faculties of Agriculture, assessed the Graduated for practical skills, teaching ability, skills of writing scientific papers, participation in workshops and seminars as good (93.3%), very good (6.7%), fair (6.7) and very good (33.3%), respectively. The Graduates’ quality is below the expectations. Based on the above findings, the study recommends the review of the whole educational system, Faculties of Agriculture to include the concepts of sustainable agriculture in their curriculum and give high consideration to practical part. In the same context, further study is recommended including the whole Country.

Parasite Research Open Access

Bancroftian Filariasis Still Endemic in Some Foci in Sohag Governorate, Upper Egypt

Jan 2019 DOI 10.14302/issn.2690-6759.jpar-18-2510

Bancroftian filariasis (BF) is a debilitating disease that has plagued Egypt since the time of the pharaohs. Egypt is the first large endemic country in the world to reach the five-year mark in its national campaign. Now that the mass treatments are completed, a follow-up epidemiological assessment will reveal whether this large-scale, pioneering campaign has been successful in finally eliminating the disease. Hence the aim of the present work was to detect the prevalence of bancoftian filariasis in Tema, El-Maragha, Akhmeem and Girga districts in Sohag Governorate, Upper Egypt. Finger prick thick blood films were randomly collected from 500 clinically suspected individuals representing different sexes and ages suffering from lower limb non-pitting edema and/or inguinal lymphadenitis from May 2015 to February 2017. Three patients (0.6%) were infected with microfilariae of Wuchereria bancrofti while one chronic case was detected with severe chronic elephantiasis that was amicrofilaraemic but was confirmed serologically. Results were discussed in regards of age, gender, occupation, locality and residence. It was concluded that bancroftian filariasis is still endemic in three districts (Tema, El- maragha and Girga). Although in sporadic few cases, the problem should be taken seriously as one microfilaramic patient could be a patent reservoir for spreading of the disease through infecting the prevailing Culex pipiense mosquito intermediate host.

A Multilevel Hazards Model for Child Mortality In Nigeria

Jan 2019 DOI 10.14302/issn.2643-6655.jcap-18-2541

Many researchers have devoted considerable attention to the impact of individual-level factors on child mortality, but little is known about how family and community characteristics affect health of children. Trend in child mortality as well as its determinants, has long been the subject of academic and policy debates. In spite of this, the problem of child mortality remains as daunting as ever. In fact, advancement in medical sciences and the upsurge in information and telecommunication technology equipment have not significantly reduced child mortality in the country, unlike in the West. The Multilevel proportional hazards model for data that are hierarchically clustered at three levels was applied to the study of covariates of child mortality in Nigeria. This study merges two parallel developments of statistical tools for data analysis: statistical methods known as hazard models that are used for analyzing event-duration data and statistical methods for analyzing hierarchically clustered data known as multilevel models. These developments have rarely been integrated in research practice and the formalization and estimation of models for hierarchically clustered survival data remain largely uncharted. The model was estimated using the Newton-Raphsons numerical search approach. The model accounts for hierarchical clustering with three random effects or frailty effects. We assume that the random effects are independent and follow the Exponential and Weibull distribution. The results indicate that bio-demographic factors are more important in infancy while socioeconomic factors and household and environmental conditions have a greater effect in childhood. Furthermore, there is significant variation in child mortality risks even after controlling for measured determinants of mortality. Also, factors that fall under family and community level are more significant indicating that child survival is most controlled or determined by family and community factors and variables at the child level is not weighty. This suggests that there may exits unobserved or unobservable factors related to mortality.

Evaluation of Serum Vitamin D Levels in Foster's Children Care Center

Jan 2019 DOI 10.14302/issn.2691-5014.jphn-18-2456

Vitamin D, the sunshine vitamin, is now recognized not only for its importance in promoting bone health in children and adults, but also for its other health benefits, including reducing the risk of chronic diseases such as autoimmune diseases, common cancer, and cardiovascular diseases. Ultraviolet radiation of the sun with wavelengths of 290-310 nm penetrates into the skin and converts 7-dehydrocholesterol to previtamin D3, which quickly transforms to vitamin D3. Vitamin D (D represents either D2 or D3) made in the skin or ingested through diet is biologically inert and requires two successive hydroxylations first in the liver on carbon 25 to form 25-hydroxyvitamin D 25(OH)D and then in the kidney for a hydroxylation on carbon 1 to form the biologically active form of vitamin D, 1,25-dihydroxyvitamin D (1,25(OH)2D) 121419. The concentration of the produced 25-hydroxy vitamin D in blood circulation is 1,000 times more than 1,25-dihydroxy vitamin D 4, and it is regarded as a standard indicator of vitamin D status in humans 3. 25-hydroxy vitamin D half-life is about 2-3 weeks and it is regulated by calcium (Ca), phosphorus (P), and serum parathyroid hormone (PTH) to some extent. 25-hydroxy vitamin D content also reflects the amount of vitamin D produced in the skin after exposure to sunlight or received through food intake 56. Guidelines for vitamin D insufficiency/deficiency defined by serum 25(OH)D concentrations have been published from many countries and regions all over the world 7891011. Vitamin D deficiency is a pandemic problem. According to global estimations, more than one billion people around the world suffer from vitamin D deficiency. Among Iranian population, the incidence of vitamin D deficiency varies from 2.5 to 98.5% based on geographic area 1213. Various factors may give rise to vitamin D deficiency, including skin pigments, low levels of vitamin D in diet (insufficient fish oil and egg yolk intake), malnutrition, genetic factors, exclusive breast feeding, vitamin D deficiency of mother during pregnancy, prematurity, chronic use of drugs (e.g., anticonvulsants, aluminum-containing anti-acids, rifampcin, isoniazid, antifungal drugs, antiviral drugs, and glucocorticoids), winter and obesity 113. Cultural habits, the need for full body coverage during outdoor activities and the lack of sunlight programs are the risk factors for low vitamin D levels in women 151617. Children enter foster care due to early childhood adverse experiences such as poor prenatal and infant health care, food insecurity, chronic stress, and the effects of abuse and neglect. As a result, they are at higher risk for poor physical, psychological, neuroendocrine and neurocognitive outcomes compared to others. Foster children are at risk for growth and nutritional deficiencies due to their poor nutritional environment prior to placement in foster care. Insufficient caloric intake results in growth deficiencies. Evidence showed that the risk of stunting and underweight is high in this population 18. The risk of developing hypovitaminosis D was significantly higher in children living in foster homes. One reason is that they are at higher risk of child abuse, emotional deprivation and physical neglect than children living with their families. Moreover, these children most likely do not spend much time outdoors and they lack adequate sun exposure. Another reason is that as children grow up in institutional care, they shift from a diet of vitamin D–fortified formula milk to cooked food, which may not be fortified with vitamin D 1. Iranian government has made some efforts to apply efficient interventions to reduce the prevalence of vitamin D deficiency, and the country’s healthcare system should be managed through accurate planning. Yet, in this country, studies on vitamin D deficiency in children living in foster homes are very limited, and given that timely diagnosis and treatment of this deficiency is vital, this research is conducted in Ali Asghar foster home in Mashhad, Iran.

Knowledge, Attitude and Practice of Healthcare Workers Towards Availability of Antiretroviral Pre-Exposure Prohylaxis in Nigeria

Dec 2018 DOI 10.14302/issn.2324-7339.jcrhap-18-2333

Introduction: The introduction of preexposure prophylaxis (PrEP) against incident HIV infection has changed the epidemiology of disease as continuous treatment with tenofovir and emtricitabine among high risk groups can reduce the relative risk for incident HIV infection by over 90%.However,despite the approved use of TDF+FTC, as a fixed dose combination of emtricitabine 200 mg and tenofovir disoproxil fumarate 300 mg, for oral PrEP since 2012 , it does not appear to have become widely accepted and in use among healthcare workers especially those in low income countries. Researches are therefore needed to consider the awareness and practice of health workers towards the availability of PrEP services in this part of the world. Healthcare workers are expected to be promoters of the use of PrEP services. Method: A cross sectional questionnaire-based study conducted in southern Nigerian over a 6 months period. Data were collected from 250 healthcare workers using interviewer-administered questionnaires. The data analysis was done using statistical package for the social sciences (SPSS) for windows version 20.0 software (SPSS Inc; Chicago, IL, USA). Frequency counts were generated for all variables and statistical test of significance was performed with chi-square test. Significance was fixed at P < 0.05 and highly significance if P < 0.01. Results: A high proportion of the respondents(>60%) were highly educated healthcare workers(majorly Nurses and medical doctors) and about half (55%) having at least 10yrs working experience in the health sector with most especially on the HIV program(>90%), majority (94%) of the health workers were aware about ARV pre-exposure prophylaxis but very few ( 6% )could give the standard definition for PrEP as the use of ARV drugs by HIV negative persons to prevent the acquisition of HIV.Most(67%) of them gave wrong definition for PrEP and worse still about one fifth (20%) had no idea what PrEP was all about. Most (70%) could not correctly identify all the ARV drugs in a standard PrEP regimen while about 35% had no idea at all of the approved ARVs used for PrEP. Though PrEP services was not available at any of the facilities where the respondents were working ,the approved drugs(TDF+FTC) for PrEP were available at about 40% of the health facilities(public and private) and 15% community pharmacies in the vicinity of the respondents . Only 60% of the respondents were willing to access PrEP service for themselves if indicated while 35% would not use such services even if it is indicated for reasons which include concern about adverse effects and safety.Awareness of PrEP was significantly associated with the ability of the healthcare workers to identify the correct ARV regimen, ARV dosages and also correct indication for PrEP. Awareness was also associated with the knowledge of the correct proven efficacy for PrEP(>95%) and high likelihood of seeing a patient placed on PrEP and willingness to use PrEP based on personal indication Conclusion: The level of awareness of PrEP among healthcare workers was very high at about 90% yet many(60%) could not give correct standard definitions of PrEP, PrEP ARV regimen, dosages and level of efficacy of PrEP. Also none of the respondent had PrEP services available either at their center or any known referral centers. This is unacceptable in a country with second highest HIV burden in the world and has adopted PrEP in her national HIV guideline with ongoing PrEP demonstration studies. The few healthcare workers who were able to mentioned this information were more likely to have seen a patient placed on PrEP and were more willing to use PrEP based on personal indication. Recommendations: There is need to deepen the and knowledge of PrEP among healthcare workers especially those in poor resource settings by engaging them through update courses outreach, educational resources, campaigns/seminars and workshops and various job aids. All healthcare service providers should be very comfortable to carry out HIV risk assessment of their clients and provide PrEP to those indicated directly or indirectly through referral

The Health of Older People in Switzerland

Oct 2018 DOI 10.14302/issn.2641-4538.jphi-18-2426

Over the past century, the proportion of Swiss residents aged 65 or older rose from 5.8% to 17.8%; during the same period, the proportion aged over 80 rose from 0.5% to 5.0%. Although the majority of older people in Switzerland enjoy good health, disease prevalence rises with age. Almost half (49%) of people over 65 living at home report at least one chronic illness. Among the 65- to 79-year-olds living at home, 25.2% suffer from several chronic diseases; among people in the 80s, this figure reaches 41.3%. People aged over 80 are also particularly at risk for falls (30%). In addition, between 15% and 25% of the elderly suffer from at least one mental illness. Close to 30% of healthcare costs are attributable to people over the age of 75, who make up only 8% of the total population. Given the public health importance of the issue a health promotion project targeting the elderly – the VIA Project -, based on successful local programs, is being implemented throughout the country. The overall goal of the VIA project is to promote the health of older people and to strengthen their self-determination and independence.

The Birth of Endowiki, An Italian Online Platform for Continuous Medical Education In Endocrinology

Jan 2018 DOI 10.14302/issn.2641-5526.jmid-17-1891

Background Conventional tools for medical education are burdened by many drawbacks. Textbooks become rapidly outdated, meeting attendance is expensive, and results reported in journals are not easily suitable for clinical practice. Uptodate and Endotext are excellent online tools, but they have been developed for a clinical context far different from that of our country. Methodology Italian Association of Clinical Endocrinologists (AME) charged a task force aiming to develop an educational tool specifically tailored for Italian clinical endocrinologists. Required characteristics were clinical approach, modularity, continuous updating, full online availability (even by mobile devices), open sections and sections for registered members only, opportunity for individualization, indexing and search engine to facilitate browsing. Starting from an open-source platform, Joomla, several changes were implemented. Results Three editors, 2 central editorial secretaries, 30 section coordinators and over 350 authors have been involved in the writing of 21 different sections covering all fields of endocrine and metabolic diseases. The access to Endowiki is free for AME members and is fully open in sections for patients. All readers are requested to serve as referee, pointing to mistakes and need for revision. The system is attended daily by a mean of 250 individuals. Conclusions Endowiki stands alone as an opportunity for medical education in Italy. The big challenges will be the continuous updating and the link to the national certified system for CME.

Association of Non Epileptic Seizures and Epilepsy:2 Cases Reports of Masturbation Seizures

Dec 2017 DOI 10.14302/issn.2470-5020.jnrt-17-1803

Introduction: Non epileptic seizures (NES) are little reported in our country. Case report: We report 2 observations of 4 years old girls, with normal psychomotor development, and frequent paroxystic seizures, characterized by stereotyped movements of the members, occurring during sleep onset or deep sleep. Electroencephalogram Sleep records showed brief discharges of spikes and spikes-waves. Magnetic Resonance Imaging was normal. Suspicion of NES associated with epilepsy was based on the following arguments: mild regression of the seizures frequency after using antiepileptic drug video records of the seizures strongly suggestive of masturbation seizures, masturbation seizures are triggered by the girls and stopped on order, best regression of the seizures frequency after adjunction of trihexiphenidyl. Moreover, the authors make a review of literature on the NES. Conclusion: The early diagnosis of the NES allows to avoid the inadequate treatments and an improvement of the prognosis.

Placenta Previa with History of Previous Caesarean Delivery – an Obstetrician's Nightmare

Oct 2017 DOI 10.14302/issn.2381-862X.jwrh-17-1758

Background: The nature of placenta previa can be unpredictable and harsh on the mother and baby. These complications are often unpredictable, unpreventable and often leave the labour ward team in a dilemma. This Obstetricians' nightmare is fortunately a rare complication. The frequency of placenta previa at the time of delivery average 1/200 births i.e. 0.5%. Placenta previa is still an important cause of maternal and fetal death in our country. The risk factors are Advanced Maternal age, Multi parity, Previous Cesarean Section, Multiple gestation, Previous Abortions, Previous intrauterine surgery, placenta previa in previous pregnancy, Smoking. Objective: Identification of risk factors, the feto-maternal outcome and complications of patients having placenta previa with previous caesarean section. Methodology: This cross sectional study was conducted from July 2012 to June 2015 in Obstetrics and Gynaecology department, Dhaka Medical College hospital. 100 patients of placenta previa were included in this study. Non-probability purposive sampling method was used for selection of patients. Results: In this study, Socio-demographic profiles, Identification of risk factors, the feto-maternal outcome and complications of patients having placenta previa were assessed. The frequency of placenta previa associated with previous cesarean section was 61%. In demographic profiles of the patients in this study - with a history of previous caesarean section, 78.7% patients were in the age group 26-35. Multiparity was predominant on scarred uterus group (63.9%). Here, demonstrated that > 2 previous history of caesarean section was associated with 80.3% of placenta previa. Regarding maternal outcome, complications like massive haemorrhage, ureteral injury, bladder injury, wound infection, DIC, maternal and perinatal mortality were more in the scarred patients than in the unscarred patients. In our study, 29.5% of morbid adhesion of placenta observed in scarred uterus. Conclusions: There is significant association of placenta previa with previous cesarean delivery. So, Careful monitoring of high risk pregnancies is of utmost importance. Avoidance of unnecessary caesarean sections and early week’s pregnancy terminations can minimize the Obstetricians' nightmare.

Facilitators and Barriers to Health Care Access among the Elderly in Tanzania: A Health System Perspective from Managers and Service Providers.

Jun 2017 DOI 10.14302/issn.2474-7785.jarh-16-1354

Tanzania is among the developing countries experiencing rapid growth of an ageing population, which has an implication in healthcare expenditure especially in resource poor settings where majority of elderly people cannot afford to pay for the cost of accessing health services. The country has developed the Tanzania National Health Policy (2007) and National Ageing Policy (2003), which, among other things, recognize the importance of having a healthcare system that provides free basic services to the vulnerable elderly population. This study aimed at exploring health service providers’ and managers’ perspectives on the factors facilitating or prohibiting access to health services among elderly people in Tanzania. The study adopted a qualitative approach and data were collected using semi-structured interviews. A total of 24 in-depth interviews were conducted with district healthcare managers, heads of public healthcare facilities, and health service providers. The data generated were analysed for themes and patterns. The results show that Tanzania’s healthcare system has made some efforts to implement the national exemption policy to ensure better access to health services for the elderly. Some of these efforts include: having in place a system to identify and exempt elderly people from paying for health services and giving them special priority during treatment. However, there are some barriers hindering elderly people’s access to health services. Among others include: lack of specific consultation rooms and doctors for serving the elderly, and lack of sufficient drugs and other medical equipment in most government-owned healthcare facilities. In summary, the healthcare system has created a good environment for the implementation of exemption policy aiming at enhancing accessibility of health services among the elderly population in the country. However, such environment cannot function effectively without addressing the identified barriers. It is recommended that the government should allocate adequate human and non-human resources to the healthcare system to enable it to function effectively, including the provision of health services to the elderly.

Optimization of drying temperature and time in gesho “Rhamuns Prinoide” leaf powder processing as hop substitute in commercial beer brewing industries

Jun 2017 DOI 10.14302/issn.2835-2165.jfsh-17-1556

Beer is typically brewed from four basic ingredients (water, a starch source, brewer’s yeast and flavoring agent such as hops). In Ethiopian case hops are coasty ingredient of beer which is imported with hard currency of the country. But this flavoring agent (hops) in beer production can also be substituted by locally available flavouring agent called gesho “Rhamuns Prinoide” leaf. In this study the effect of drying temperature and time on brewing components of gesho “Rhamuns Prinoide” leaf was examined using oven dryer. Brewing components of gesho “Rhamuns Prinoide” leaf were compared by taking the commercial hop brewing component as a standard. Drying temperature and time have a significant effect (P< 0.05) on major beer brewing components (Resin, Hop oil, Polyphenol, Mineral and Protein) of gesho leaf. Not only drying temperature and time but also the interaction effect has significant effect on these major brewing components of the leaf. The optimal drying temperature and time of gesho leaf was also determined to commercialize the gesho leaf powder or pellet as hop substitute in commercial beer brewers as flavouring

Breastfeeding Biology Open Access

Raising Awareness About Breast Milk Composition Among Women in Latvia

Nov 2016 DOI 10.14302/issn.2644-0105.jbfb-16-1257

Background: Breast milk is the ideal food source that contains all components an infant needs. Infants are at risk of receiving possible pollutants and high levels of trans fatty acids through breast milk that may affect their cardiovascular health and cognitive development. Statistics indicate that the proportion of children who are breastfed up to one year of age shows an annual increase in Latvia. Objectives: 1. To review studies conducted among the Latvian population regarding breast milk composition. 2.  To evaluate the necessary future studies emphasizing the importance of the trans fatty acid content in a mother’s diet and correspondingly in breast milk and taking into consideration the new changes in Latvian legislation setting the maximum trans fat content in foodstuffs. Conclusions: There is very little research done about the human milk composition in Latvia that could be referable to a general population. It is known that the exposure of breast milk to persistent organic pollutants in Latvia corresponds to the lowest levels detected in the European countries and is not a cause of health disorders. Taking into consideration the adverse effect trans fatty acids have on human’s health regardless of the age, consumption should be as low as possible. Latvia has become the latest European Union country to set the maximum amount of trans fats in foodstuffs, yet there is no information about trans fatty acids content in human milk among women in Latvia. This problem needs to be addressed and set in motion. Therefore, it would be a novel idea to study if the TFA content also declines in milk among Latvian women after the introduction of the new legislation.

Improving Confidence in Obstetric Skills with Basic and Advanced Life Support in Obstetrics® Training in Ethiopia: A Pre/post Study

Jun 2015 DOI 10.14302/issn.2381-862X.jwrh-14-622

Basic Life Support in Obstetrics (BLSO®) is a novel, simulation-based, emergency obstetrics training program for health care workers who perform deliveries infrequently, such as paramedics and nurses. Advanced Life Support in Obstetrics (ALSO®) is intended for regular maternity care providers such as physicians and certified nurse midwives. This paper describes a pre/post study of 111 learners in two ALSO and two BLSO courses taught in Addis Ababa, Bonga, and Jimma, Ethiopia in October, 2012. The study objective was to assess the effectiveness of ALSO and BLSO training programs to improve Ethiopian health care workers’ confidence in managing common obstetrical problems. A previously-validated survey tool was given immediately pre- and post-course and six months post-course. The survey tool included demographic questions and Likert scales to self-assess comfort managing 13 common obstetric emergencies including postpartum hemorrhage, maternal resuscitation, and preeclampsia. Ninety-seven ALSO and BLSO learners completed pre- and immediate post-training questionnaires. Nineteen ALSO learners completed the 6 month post-training questionnaire. Immediately post-course, participants in ALSO and BLSO courses reported increased comfort in all 13 areas assessed. ALSO participants had increased comfort at 6 months in all areas except breech delivery. Participation in a novel emergency obstetrics training program increases Ethiopian health workers’ self-assessed confidence in addressing common obstetrical emergencies. This increase in confidence persists in most topic areas for at least six months. This paper describes the first formal evaluation of BLSO and contributes to the growing body of evidence regarding the value of ALSO training in a low- and middle-income country.

Culturally Tailored Nutrition and Lifestyle Intervention can Effectively Reduce the Cardio-Metabolic Risk Factors in Korean Migrants Living in Australia

Jan 2015 DOI 10.14302/issn.2379-7835.ijn-14-536

The risk levels of chronic diseases are increasing among Asian migrants in Western countries compared to their origin-country counterparts. This study evaluates the impact of an 8-week nutrition and lifestyle intervention on cardio-metabolic risk factors in Korean migrants living in Melbourne, Australia. Thirty participants aged 32-62 years completed the program. Self-reported food intake and physical activity, anthropometric and blood pressure measurements, and biomarkers of cardio-metabolic risk were assessed. An initial training session and four consequent nutrition advice sessions were provided for all participants. There was a significant reduction in the waist and hip circumferences. Positive changes were also observed in plasma lipid profiles, calcium intake and frequency of physical activities. These findings demonstrate that a culturally appropriate nutrition and lifestyle intervention can be successfully delivered to reduce the cardio-metabolic risk factors and improve the health and wellbeing of Korean adult migrants.

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