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Open Access June 26, 2025

Mathematical modelling of the impact of HIV prevention strategies among female sex workers on public health in Burkina Faso

Abstract This article presents a mathematical model designed to simulate the impact of targeted interventions aimed at preventing HIV transmission among female sex workers (FSWs) and their clients, while also analyzing their effects on the health of the general population. The compartmental model distinguishes between high-risk populations (FSWs and their clients) and low-risk populations (sexually active [...] Read more.
This article presents a mathematical model designed to simulate the impact of targeted interventions aimed at preventing HIV transmission among female sex workers (FSWs) and their clients, while also analyzing their effects on the health of the general population. The compartmental model distinguishes between high-risk populations (FSWs and their clients) and low-risk populations (sexually active men and women in the general population), and links prevention efforts in high-risk groups to the evolution of the epidemic in the low-risk population. The fundamental properties of the model, such as the positivity of solutions and the boundedness of the system, have been verified, and the basic reproduction number R0 has been calculated. Finally, the stability of the model was studied using Varga’s theorem and the Lyapunov method. Simulation results show that targeted prevention among FSWs and their clients reduces HIV incidence in the general population. This framework provides a valuable tool for guiding policymakers in the design of effective strategies to combat the epidemic, especially relevant in the context of suspension of USAID funding.
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Open Access April 10, 2025

Impact of Vaccination on Severe Outcomes in COVID-19 Reinfections and Breakthrough Infections

Abstract COVID-19 vaccines have demonstrated efficacy in reducing the prevalence of serious illnesses. The relative risk of hospitalization and mortality for patients who get breakthrough infections after immunization versus those who develop reinfections after a prior spontaneous infection is examined in this correspondence. Based on a study on U.S. Veterans who were not vaccinated and experienced [...] Read more.
COVID-19 vaccines have demonstrated efficacy in reducing the prevalence of serious illnesses. The relative risk of hospitalization and mortality for patients who get breakthrough infections after immunization versus those who develop reinfections after a prior spontaneous infection is examined in this correspondence. Based on a study on U.S. Veterans who were not vaccinated and experienced reinfections had a much higher risk of experiencing severe illness outcomes compared to those who had received immunizations and experienced breakthrough infections, even if the rates of reinfection and breakthrough infection were similar. Our findings highlight the value of immunization in reducing severe COVID-19 outcomes, even in the presence of reinfections.
Correspondence
Open Access April 10, 2025

Assessment of the Knowledge, Attitude, and Practice of Sokoine University Students Regarding Endocrine Disruptors Coming from Plastic Chemicals

Abstract Objective: The knowledge, attitudes, and practices of SUA students about the use of plastics containing endocrine disruptors were investigated in this study. Methodology: A study with 150 participants was conducted to assess individuals' knowledge about endocrine disruptors, attitudes, and plastic use practices. Results: The findings indicate that the participants possessed an [...] Read more.
Objective: The knowledge, attitudes, and practices of SUA students about the use of plastics containing endocrine disruptors were investigated in this study. Methodology: A study with 150 participants was conducted to assess individuals' knowledge about endocrine disruptors, attitudes, and plastic use practices. Results: The findings indicate that the participants possessed an average degree of knowledge 50.2 ± 3.85 with the main emphasis of awareness being generic concepts rather than specific substances. Regarding the potential health impacts of endocrine-disrupting chemicals present in plastics, respondents' attitudes ranged from fair to positive, with a mean score of 3.5 ±0.09 indicating a fair attitude overall. Conclusion: It is important to practice polite behavior and increase public awareness of safe plastic disposal methods. Surprising only 38.0% of the participants mentioned that they refrain from heating their food in plastic containers to reduce their exposure to plastics. Students' practices revealed a notable dependence on plastic products despite their awareness of the concerns surrounding endocrine disruptors, as most of them reported using plastic water bottles, plastic cups, and plastic bags almost always. Additionally, only 20.7% of the respondents consistently implemented strategies to prevent exposure to endocrine-disrupting chemicals. Recommendation: The study recommended increasing the use of cleaner plastic substitutes and improving educational programs to convert information into practical actions. Policies that encourage environmentally friendly behavior and raise public awareness of safe plastic disposal techniques should be put into practice.
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Open Access March 29, 2025

The Role of Type 3 Diabetes in Alzheimer’s Disease: A Review of Current Evidence

Abstract Background: Type 2 Diabetes Mellitus (T2DM) and Alzheimer’s Disease (AD) are increasingly linked through shared pathophysiological mechanisms, giving rise to the concept of Type 3 Diabetes Mellitus (T3DM). Brain insulin resistance, oxidative stress, and neuroinflammation are central to both conditions, contributing to cognitive decline and AD progression. Aim: This review aims to [...] Read more.
Background: Type 2 Diabetes Mellitus (T2DM) and Alzheimer’s Disease (AD) are increasingly linked through shared pathophysiological mechanisms, giving rise to the concept of Type 3 Diabetes Mellitus (T3DM). Brain insulin resistance, oxidative stress, and neuroinflammation are central to both conditions, contributing to cognitive decline and AD progression. Aim: This review aims to explore this emerging relationship and its implications for prevention and management. Methods: Using an integrative review, 21 studies were systematically analyzed. The review focused on identifying demographic, genetic, and lifestyle factors contributing to T2DM and AD and examined shared molecular pathways such as insulin dysregulation and amyloid-beta accumulation. Results: The findings reveal that T3DM shares key features with T2DM and AD, including insulin resistance and chronic inflammation. Lifestyle interventions, such as diet and exercise, alongside routine cognitive and metabolic screenings, are critical in mitigating progression. Conclusions: Further research into diagnostic biomarkers and targeted therapies is essential to manage T3DM and its impact on AD. The role of nursing professionals in early detection, education, and holistic management is emphasized as vital in addressing this dual disease burden. This review offers actionable insights into integrated strategies for addressing these interconnected conditions.
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Review Article
Open Access March 06, 2025

Impact of Food Security on Dietary Diversity and Nutritional Intake Among Pregnant Women in Low-Resource Settings

Abstract Background: Food security and dietary diversity are essential determinants of maternal health, particularly among pregnant women in refugee populations who face heightened vulnerabilities due to displacement and inadequate living conditions. This study examines the impact of food security on dietary diversity and nutritional intake among pregnant Rohingya women residing in the makeshift [...] Read more.
Background: Food security and dietary diversity are essential determinants of maternal health, particularly among pregnant women in refugee populations who face heightened vulnerabilities due to displacement and inadequate living conditions. This study examines the impact of food security on dietary diversity and nutritional intake among pregnant Rohingya women residing in the makeshift camps of Ukhiya, Cox’s Bazar. Methods: A descriptive cross-sectional study was conducted among 96 pregnant Rohingya women from June to September 2022. Data were collected using structured questionnaires assessing socio-demographic characteristics, food security, and dietary diversity. Food security was evaluated using the Household Food Insecurity Access Scale (HFIAS), while dietary diversity was assessed through a 24-hour dietary recall and a 7-day food frequency questionnaire. Data were analyzed using SPSS (Version 26) and Stata (Version 13), employing descriptive statistics and chi-square tests to examine associations. Results: Most participants (57.3%) were food secure, and 85.4% demonstrated high dietary diversity, consuming seven or more food groups. However, 21.9% of households experienced severe food insecurity, highlighting ongoing challenges in food access. The highest consumption was observed for starch, flesh foods, dark green leafy vegetables, and vitamin A-rich fruits and vegetables (99.0%), while dairy products (69.8%) and organ meat (34.4%) were consumed less frequently. Despite high dietary diversity, severe food insecurity persists, indicating gaps in food assistance programs. Conclusions: While food support programs appear to contribute to high dietary diversity among pregnant Rohingya women, severe food insecurity remains a significant concern. Strengthening food security interventions, improving access to diverse nutrient-rich foods, and integrating sustainable food assistance models are essential to addressing these challenges. Future research should explore long-term strategies to enhance food security and assess the impact of targeted nutritional interventions on maternal health outcomes in refugee settings.
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Open Access February 21, 2025

Diminished Returns of Educational Attainment on Unpaid and Paid Maternity Leave of Mothers Giving Birth in Poverty

Abstract Background: Maternity leave, whether paid or unpaid, is a critical resource that can significantly impact maternal well-being and newborn outcomes. However, its availability and utilization among mothers living in poverty remain understudied. Education is widely recognized as a key factor that increases access to both paid and unpaid leave. However, the theory of Minorities’ [...] Read more.
Background: Maternity leave, whether paid or unpaid, is a critical resource that can significantly impact maternal well-being and newborn outcomes. However, its availability and utilization among mothers living in poverty remain understudied. Education is widely recognized as a key factor that increases access to both paid and unpaid leave. However, the theory of Minorities’ Diminished Returns (MDRs) posits that structural racism, segregation, and labor market discrimination limit the benefits of socioeconomic resources, such as education, for Black and Latino individuals. This suggests that the effects of education on maternity leave may not be uniform across racial and ethnic groups. Objective: This study aimed to examine the MDRs of education on access to unpaid and paid maternity leave among Black and Latino mothers compared to White mothers giving birth while living in poverty. Methods: We utilized baseline data from the Baby’s First Years Study (BFY), a longitudinal investigation of the effects of poverty on child development. The sample consisted of 1,050 mothers living in poverty who had recently given birth. Maternity leave (paid and unpaid) was assessed via self-report, and educational attainment was measured in years of schooling. Structural equation modeling (SEM) and interaction terms were employed to analyze racial and ethnic differences in the relationship between education and access to maternity leave. Results: Educational attainment was positively associated with access to unpaid maternity leave for the overall sample of mothers giving birth in poverty, but this association was weaker for Black and Latino mothers compared to non-Latino White mothers. Education did not significantly increase the likelihood of paid maternity leave, and there were no group differences for this association. Conclusion: This study highlights the urgent needs to address structural racism, labor market discrimination, and residential segregation that diminish the impact of education on living conditions for Black and Latino mothers, compared to non-Latino White mothers, even for those living under poverty. Policymakers and practitioners should develop targeted interventions to reduce racial and ethnic disparities in access to paid and unpaid maternity leave and other critical resources, particularly for new mothers living in poverty. Addressing these inequities is essential for improving maternal and newborn health outcomes and promoting social justice.
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Open Access January 11, 2025

Exploring LiDAR Applications for Urban Feature Detection: Leveraging AI for Enhanced Feature Extraction from LiDAR Data

Abstract The integration of LiDAR and Artificial Intelligence (AI) has revolutionized feature detection in urban environments. LiDAR systems, which utilize pulsed laser emissions and reflection measurements, produce detailed 3D maps of urban landscapes. When combined with AI, this data enables accurate identification of urban features such as buildings, green spaces, and infrastructure. This synergy is [...] Read more.
The integration of LiDAR and Artificial Intelligence (AI) has revolutionized feature detection in urban environments. LiDAR systems, which utilize pulsed laser emissions and reflection measurements, produce detailed 3D maps of urban landscapes. When combined with AI, this data enables accurate identification of urban features such as buildings, green spaces, and infrastructure. This synergy is crucial for enhancing urban development, environmental monitoring, and advancing smart city governance. LiDAR, known for its high-resolution 3D data capture capabilities, paired with AI, particularly deep learning algorithms, facilitates advanced analysis and interpretation of urban areas. This combination supports precise mapping, real-time monitoring, and predictive modeling of urban growth and infrastructure. For instance, AI can process LiDAR data to identify patterns and anomalies, aiding in traffic management, environmental oversight, and infrastructure maintenance. These advancements not only improve urban living conditions but also contribute to sustainable development by optimizing resource use and reducing environmental impacts. Furthermore, AI-enhanced LiDAR is pivotal in advancing autonomous navigation and sophisticated spatial analysis, marking a significant step forward in urban management and evaluation. The reviewed paper highlights the geometric properties of LiDAR data, derived from spatial point positioning, and underscores the effectiveness of machine learning algorithms in object extraction from point clouds. The study also covers concepts related to LiDAR imaging, feature selection methods, and the identification of outliers in LiDAR point clouds. Findings demonstrate that AI algorithms, especially deep learning models, excel in analyzing high-resolution 3D LiDAR data for accurate urban feature identification and classification. These models leverage extensive datasets to detect patterns and anomalies, improving the detection of buildings, roads, vegetation, and other elements. Automating feature extraction with AI minimizes the need for manual analysis, thereby enhancing urban planning and management efficiency. Additionally, AI methods continually improve with more data, leading to increasingly precise feature detection. The results indicate that the pulse emitted by continuous wave LiDAR sensors changes when encountering obstacles, causing discrepancies in measured physical parameters.
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Open Access December 10, 2024

Psychological Corollaries, Self-Care and Coping Behaviors of Healthcare Workers During COVID-19 Pandemic: An Integrative Review

Abstract Background: The COVID-19 pandemic posed significant psychological challenges to frontline healthcare workers (HCWs), including anxiety, stress, and emotional strain. Aim: This study investigates the psychological impact on HCWs during the pandemic and explores coping strategies employed to manage distress. Methods: An integrative review was conducted using 24 studies published [...] Read more.
Background: The COVID-19 pandemic posed significant psychological challenges to frontline healthcare workers (HCWs), including anxiety, stress, and emotional strain. Aim: This study investigates the psychological impact on HCWs during the pandemic and explores coping strategies employed to manage distress. Methods: An integrative review was conducted using 24 studies published between January and December 2020. These studies were analyzed to identify common psychological outcomes and coping mechanisms among HCWs. Results: Healthcare workers experienced significant psychological distress during the COVID-19 pandemic, including anxiety, stress, insomnia, and depression. Anxiety was the most commonly reported issue, particularly among women, younger healthcare workers, and frontline staff. Stress levels were heightened by high workloads, exposure to COVID-19 patients, and inadequate protective measures. Coping strategies and self-care behaviors, such as seeking social support and utilizing institutional resources, varied in effectiveness across populations. Conclusion: The findings highlight the urgent need for targeted mental health support and resilience programs for HCWs, ensuring they are better equipped to face future health crises.
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Integrative Review
Open Access December 03, 2024

Diabetes Nursing Education Its Implication Towards an Improved Quality of Life of Persons with Diabetes: A Systematic Review

Abstract Background: Diabetes is a chronic global health issue that requires effective management to improve patient outcomes and quality of life. Nursing education plays a critical role in empowering diabetic patients with self-management skills. Aim This systematic review evaluates the impact of diabetes-focused nursing education on patient outcomes and quality of life. Methods: This study [...] Read more.
Background: Diabetes is a chronic global health issue that requires effective management to improve patient outcomes and quality of life. Nursing education plays a critical role in empowering diabetic patients with self-management skills. Aim This systematic review evaluates the impact of diabetes-focused nursing education on patient outcomes and quality of life. Methods: This study uses PRISMA guidelines and a systematic approach to identify and evaluate relevant literature. Results and Discussion: Among the 14 studies reviewed, eight emphasized self-management education, while four incorporated multidisciplinary approaches. Findings consistently demonstrated that structured nursing education programs significantly improved self-management behaviors, glycemic control, and patient knowledge. For instance, nurse-led self-management programs resulted in substantial enhancements in self-care skills and diabetes-related knowledge. Moreover, interventions that combined health education with psychological support were particularly effective, leading to better blood glucose control and increased adherence to treatment. Studies that examined quality of life reported reductions in anxiety, improved lifestyle habits, and better overall self-management. These findings highlight the multifaceted benefits of nursing education, suggesting that structured, supportive programs positively impact both clinical and psychological aspects of diabetes care. Conclusion: The review emphasizes the value of comprehensive nursing education that integrates both clinical guidance and psychological support for holistic diabetes management. Implications: Ongoing professional development and culturally sensitive education programs are recommended to address the diverse needs of diabetic patients. Future research should investigate the long-term effects of nursing education and explore innovative strategies to enhance diabetes management outcomes.
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Open Access November 26, 2024

Impact of Classroom from the Primary Level of the Acquisition of English as a Second Language in Bangladesh

Abstract This paper examines the impact of primary level classroom environments on the acquisition of English as a second language (L2) in Bangladesh, comparing English-medium and Bangla-medium schools. The study investigates how different instructional approaches and early exposure to English influence language proficiency among students. Through a mixed-methods approach, including surveys, interviews, [...] Read more.
This paper examines the impact of primary level classroom environments on the acquisition of English as a second language (L2) in Bangladesh, comparing English-medium and Bangla-medium schools. The study investigates how different instructional approaches and early exposure to English influence language proficiency among students. Through a mixed-methods approach, including surveys, interviews, and proficiency tests, the research reveals significant differences in language acquisition outcomes between the two educational settings. Findings indicate that students in English-medium schools, who are exposed to Natural approach methods of language learning and immersive English-speaking environments, demonstrate higher proficiency in speaking and listening skills compared to their Bangla-medium counterparts, who primarily receive grammar-focused instruction. The study highlights the critical role of early exposure to English, with students who begin learning the language at a younger age showing better phonological and syntactic development. Additionally, the integration of technology in language teaching emerges as a valuable tool for enhancing language learning, particularly in contexts with limited classroom exposure. The research suggests that Bangla-medium schools could benefit from adopting more interactive, student-centered teaching methods and integrating digital tools to support practical language use. The study's findings have significant implications for educational policy, advocating for a shift towards more immersive and communicative teaching practices to improve English language acquisition in Bangladesh. This research contributes to the broader understanding of SLA and offers practical recommendations for enhancing language education in similar contexts.
Article
Open Access October 19, 2024

The Impact of Extracurricular Activities on Learner's Achievement in EFL: A Study at Daffodil International University

Abstract Extracurricular activities and academic performance are connected in every aspect of the education system. Daffodil International University is one of the top universities in Bangladesh that focuses on student improvement through extracurricular activities. Extracurricular activities help students improve skills like leadership, teamwork, and analytical abilities. Do extracurricular activities [...] Read more.
Extracurricular activities and academic performance are connected in every aspect of the education system. Daffodil International University is one of the top universities in Bangladesh that focuses on student improvement through extracurricular activities. Extracurricular activities help students improve skills like leadership, teamwork, and analytical abilities. Do extracurricular activities help English as a Foreign Language (EFL) students improve their academic performance? This evaluation aims to find out this question among Daffodil International University students. The study focused on both qualitative and quantitative data. Therefore, the data analysis followed a mixed method. The quantitative data focused on the students' participation in extracurricular activities. Respectively, the comparison between their participation and EFL course improvement. On the other hand, the qualitative data focused on the interviewee's experience. However, it's been proven that though extracurricular activities help students improve their other soft skills, they actually don't have as much impact on improving their EFL course curriculum performance.
Article
Open Access April 29, 2024

Floristic composition of vascular epiphytes in a disturbed forest of the Douala- Edea National Park (Cameroon)

Abstract The Douala-Edea National Park is a coastal protected area that opens to the Atlantic Ocean, and contains an abundant wildlife which finds a privilege habitat there, and certain taxa such as epiphytes, which are of particular interest for conservation. In many tropical forests, vascular epiphytes are one of the richest taxa, with major impacts on the nutrient and hydrological cycles. The aim of this research was to study the effect of the disturbance of habitat on the floristic composition of vascular epiphytes in the Douala-Edea National Park. This study was carried out between January - April 2021 in three types of disturbed habitats at the northern part of the park. Three plots of 100 m × 100 m dimensions were laid out across three ecosystems along the Sanaga river. The sampling method consisted in the direct observation of five adjacent transects of 100 m x 20 m dimensions inside each plot. Epiphytes species were evaluated on all trees of DBH ≥10 cm. Epiphytes' life-forms and the position on the host trees occupied by the epiphytes were also recorded. A total of 18 species belonging to 16 genera and 13 families were identified. Culcasia sp. was the most common species with a relative frequency of 30.27%. Biological indicators were represented by Ferns, with four species, and Orchidaceae, with one species. [...] Read more.
The Douala-Edea National Park is a coastal protected area that opens to the Atlantic Ocean, and contains an abundant wildlife which finds a privilege habitat there, and certain taxa such as epiphytes, which are of particular interest for conservation. In many tropical forests, vascular epiphytes are one of the richest taxa, with major impacts on the nutrient and hydrological cycles. The aim of this research was to study the effect of the disturbance of habitat on the floristic composition of vascular epiphytes in the Douala-Edea National Park. This study was carried out between January - April 2021 in three types of disturbed habitats at the northern part of the park. Three plots of 100 m × 100 m dimensions were laid out across three ecosystems along the Sanaga river. The sampling method consisted in the direct observation of five adjacent transects of 100 m x 20 m dimensions inside each plot. Epiphytes species were evaluated on all trees of DBH ≥10 cm. Epiphytes' life-forms and the position on the host trees occupied by the epiphytes were also recorded. A total of 18 species belonging to 16 genera and 13 families were identified. Culcasia sp. was the most common species with a relative frequency of 30.27%. Biological indicators were represented by Ferns, with four species, and Orchidaceae, with one species. The epiphytes species richness was highest in the low disturbed habitat (13 species), and lowest in the highly disturbed habitat (8 species). Strict epiphytes were highly recorded in the low disturbed habitat (6 species), and were absent in the highly disturbed habitat. Hemi-epiphytes were the commonest life-form (12 species) in the highly disturbed habitat, and have been defined as indicators of the perturbation of the habitat. Canopy was mostly sollicitated by epiphytes in the low disturbed habitat (66.25%) than the moderate disturbed habitat (49.85%), and highly disturbed habitat (30.66%). It has been found that the different forest sites have an influence on the typology of epiphytic species, and therefore, epiphytic flora should be managed for the conservation of the biodiversity in tropical forests.
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Open Access March 08, 2024

Analysis of Toxic Contaminants in Agriculture: Educational Strategies to Avoid Their Influence on Food

Abstract A diagnosis of the current state of the crops is made regarding the control of weeds, use of pesticides, fungicides; with an assessment of the state of the plant covers in the crop, and its control by different types of herbicides, and we detected a high loss of biological diversity; and some of these compounds are mentioned due to their high toxicity. Similarly, the use of pesticides and [...] Read more.
A diagnosis of the current state of the crops is made regarding the control of weeds, use of pesticides, fungicides; with an assessment of the state of the plant covers in the crop, and its control by different types of herbicides, and we detected a high loss of biological diversity; and some of these compounds are mentioned due to their high toxicity. Similarly, the use of pesticides and fungicides is discussed due to their repercussions on health. In order to avoid the unhealthiness caused by the applications of these products, phytosanitary and educational control strategies are proposed; promoting the inspection of fruit and vegetable markets, and modifying the contents in higher professional and university education. To this end, we propose an active teaching methodology, through which the student acquires skills and responsibility for the use of chemical agents in agriculture, which serves to prevent the entry of these contaminants into the food chain. Of the different polluting chemical agents, in the case of herbicides we highlight Oxyfluorfen and Glyphosate with high toxicity and whose consumption is very high. In the case of pesticides and fungicides, among others are Organochlorine compounds, which have been detected in blood, and Carbon Tetrachloride and Chloroform, considered potent hepatotoxic and neurotoxic. The basic objective of this study is the awareness and acquisition of knowledge by future teachers about polluting agents, which will subsequently have an impact on society.
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Open Access March 05, 2024

Culture Shock in Nursing: A Concept Analysis

Abstract 1) Background: Culture shock is a common experience by internationally educated nurses (IENs) working in foreign countries, characterized by disorientation and discomfort due to distinct norms, values, and rituals. 2) Aim: this study explores culture shock in IENs and explores mitigation techniques to enhance understanding of challenges faced in foreign cultural contexts. [...] Read more.
1) Background: Culture shock is a common experience by internationally educated nurses (IENs) working in foreign countries, characterized by disorientation and discomfort due to distinct norms, values, and rituals. 2) Aim: this study explores culture shock in IENs and explores mitigation techniques to enhance understanding of challenges faced in foreign cultural contexts. 3) Method: Using Concept Analysis by Walker and Avant (2019). 4) Results: A total of 20 articles were reviewed. Four major attributes were identified: psychological and emotional impact, communication barriers, acculturation and quality of life, and organizational challenges. 5) Conclusion: This paper explores the challenges faced by nurses from foreign countries due to cultural adjustment and proposes solutions to minimize its effects. It is beneficial for nurses, healthcare organizations, and policymakers, aiming to improve patient care and health outcomes. 6) Implication for Practice: Addressing culture shock can promote a smooth transition, enhance nurses' experience, and improve their cultural competence. Providing tailored orientation and mentorship programs can help IENs feel supported and empowered, leading to increased job satisfaction, retention rates, and better patient outcomes.
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Open Access December 25, 2023

An Appraisal of International Students Retention and Graduation at Northern Arizona University

Abstract The Internationalization of higher education has plummeted since the 2010 tightening of migration policies. This study aims to examine the retention and graduation rates of international students at Northern Arizona University (NAU). Using a quantitative analysis approach, the study utilized secondary data from the Center for International Admission and Recruitment Office at NAU to examine the [...] Read more.
The Internationalization of higher education has plummeted since the 2010 tightening of migration policies. This study aims to examine the retention and graduation rates of international students at Northern Arizona University (NAU). Using a quantitative analysis approach, the study utilized secondary data from the Center for International Admission and Recruitment Office at NAU to examine the university’s recruitment, graduation, and retention strategies. The aim was to evaluate the impact of internationalization strategies on application and enrolment numbers. The study sample consisted over 2000 international students from fourteen countries, including China, India, Vietnam, Kuwait, Nepal, Ghana, Nigeria, United Kingdom, Spain, Germany, Canada, Mexico, France, and Iran in four cultural groups (Asia, Europe, Africa, and North America). A random sampling technique was used to select these countries partly because of their highest applications, enrolment numbers, as well as their adoption of recruitment strategies like those used by higher education institutions in the United States. A descriptive graphic representation, focusing on full-time undergraduate students during fall semesters, specifically freshmen international students, is illustrated. To facilitate a cross-country comparison of international students, this study presents an analysis of retention and graduation data across different countries spanning the past five years, from 2016 to 2020.
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Open Access November 10, 2023

New records for the alien vascular flora of Calabria (S-Italy)

Abstract While alien organisms, vascular plants included, are progressively increasing their worldwide impact on habitats, the present research confirms a similar dangerous trend for Calabria, the southernmost and floristically richest region of Italian Peninsula. The set of additional alien taxa here recorded for the vascular flora of Calabria includes: Acacia melanoxylon, Bidens subalternans, Buddleja davidii, Cucurbita moschata, Cyclospermum leptophyllum, Erigeron annuus subsp. annuus, Hesperocyparis glabra, Ligustrum ovalifolium, Mahonia aquifolium, Morus indica, Oenothera speciosa, Prunus serotina, Pyracantha fortuneana, Rudbeckia laciniata, Solanum nitidibaccatum, Sparaxis bulbifera, Tradescantia cerinthoides, [...] Read more.
While alien organisms, vascular plants included, are progressively increasing their worldwide impact on habitats, the present research confirms a similar dangerous trend for Calabria, the southernmost and floristically richest region of Italian Peninsula. The set of additional alien taxa here recorded for the vascular flora of Calabria includes: Acacia melanoxylon, Bidens subalternans, Buddleja davidii, Cucurbita moschata, Cyclospermum leptophyllum, Erigeron annuus subsp. annuus, Hesperocyparis glabra, Ligustrum ovalifolium, Mahonia aquifolium, Morus indica, Oenothera speciosa, Prunus serotina, Pyracantha fortuneana, Rudbeckia laciniata, Solanum nitidibaccatum, Sparaxis bulbifera, Tradescantia cerinthoides, Ulmus pumila. These additional 18 taxa bring the total number of alien species from 382 to 400. The most represented biological forms are scapose therophyte and scapose phanerophyte with 5 species (27.8% of the total). The most frequent biogeographic origins of the surveyed species are North America (6 species; 33.3%), followed by Asia and South America both with 4 species (22.2%). The most common habitats hosting the recorded alien taxa are roadsides (8 species; 44.4%), although all surveyed plants have been found in deeply anthropized environments. The altitude of occurrence, extending 3 to 1,286 m a.s.l., together with other ecological data provided, demonstrate the ability of aliens to potentially colonize a wide range of environments in the region.
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Open Access November 03, 2023

Mathematical Modeling of the Price Volatility of Maize and Sorghum between 1960 and 2022

Abstract The price of grains like maize and sorghum is subject to significant fluctuations, which can have a significant impact on a country's economy and food security. The aim of the study is to model sorghum and maize price volatility in Nigeria. The data utilized in the study was extracted from World Bank Commodity Price Data (WBCPD), 2022. The data consists of monthly prices in nominal US dollars for [...] Read more.
The price of grains like maize and sorghum is subject to significant fluctuations, which can have a significant impact on a country's economy and food security. The aim of the study is to model sorghum and maize price volatility in Nigeria. The data utilized in the study was extracted from World Bank Commodity Price Data (WBCPD), 2022. The data consists of monthly prices in nominal US dollars for maize and sorghum from January 1960 – August 2022. The Autoregressive Conditional Heteroskedasticity (ARCH) and Generalized Autoregressive Conditional Heteroskedasticity (GARCH) models were utilized for capturing the two-grain price volatility. Two types of conditional heteroscedastic models exist, the first group uses exact functions to control the evolution of , while the second group describes with stochastic equations. It is inferred from the result that inherent uncertainties and fluctuations existed in the prices of maize and sorghum in Nigeria which implies that the price volatility is positive and statistically significant suggesting that historical information and past shocks play a crucial role in determining the volatility observed in the grains. It is recommended that the ARCH, GARCH, EGARCH, TGARCH, PARCH, CGARCH, and IGARCH models should be employed for modeling and managing the volatility of maize and sorghum prices in Nigeria. These models have shown effectiveness in capturing different aspects of volatility, including the impact of past shocks, conditional volatility, asymmetry, and other relevant factors.
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Open Access November 03, 2023

Quality of Communication between Healthcare Providers and Pregnant Women: Impact on Maternal Satisfaction, Health Outcomes, and Shared Decision-Making

Abstract The quality of communication between healthcare providers and pregnant women is a topic of paramount importance within the realm of maternal healthcare. It is not merely an aspect of medical interaction; rather, it is the prerequisite that influences various critical dimensions of maternal care, including maternal satisfaction, health outcomes, and shared decision-making. Effective communication [...] Read more.
The quality of communication between healthcare providers and pregnant women is a topic of paramount importance within the realm of maternal healthcare. It is not merely an aspect of medical interaction; rather, it is the prerequisite that influences various critical dimensions of maternal care, including maternal satisfaction, health outcomes, and shared decision-making. Effective communication between healthcare providers and pregnant women is essential for optimal maternal care during pregnancy and childbirth. Maternal satisfaction is a fundamental metric of patient-centered care, and improved communication, characterized by empathy, information sharing, and active listening, cultivates trust and enhances women's contentment with their care experiences. Positive provider-patient interactions are associated with improved emotional well-being, reduced stress levels, and increased adherence to prenatal recommendations, contributing to positive health outcomes for both mother and fetus. Shared decision-making is impacted by open and transparent dialogue between healthcare providers and pregnant women. Inclusive discussions about available interventions, risks, and benefits empower women to make informed choices aligned with their preferences and values. This shared decision-making promotes autonomy, self-efficacy, and a collaborative care partnership, potentially influencing the birthing experience and postpartum adaptation. However, challenges persist in communication quality, such as variability in healthcare provider communication styles, cultural considerations, and system-level factors. Addressing these challenges through targeted interventions, training, and policy implementation can further enhance the overall maternal care experience. Further research is needed to explore innovative strategies that optimize communication and promote positive outcomes throughout the continuum of maternal care.
Review Article
Open Access November 02, 2023

Off-Label Use of Esketamine

Abstract Major depressive disorder (MDD) is a significant psychiatric condition, with many affected individuals not gaining remission from conventional treatments, leading to classification as treatment-resistant depression (TRD). This study aimed to investigate the potential of intravenous (IV) ketamine, particularly the S-enantiomer esketamine in nasal spray form, for treating patients with TRD and [...] Read more.
Major depressive disorder (MDD) is a significant psychiatric condition, with many affected individuals not gaining remission from conventional treatments, leading to classification as treatment-resistant depression (TRD). This study aimed to investigate the potential of intravenous (IV) ketamine, particularly the S-enantiomer esketamine in nasal spray form, for treating patients with TRD and associated comorbidities. We report three cases of patients with diverse psychiatric and medical backgrounds whom all reported significant symptomatic relief from depressive episodes and suicidal ideation (SI) following esketamine administration. Additionally, esketamine seemed to proffer benefits beyond the primary depressive symptoms, positively impacting other comorbid conditions, such as agitation, self-injurious behavior (SIB), and chronic pain. The goal of this paper is to highlight that while esketamine's primary utility is in addressing TRD, its therapeutic potential may extend to a variety of associated conditions. However, it is crucial to underscore the heterogeneity of MDD, emphasizing the necessity for individualized therapeutic approaches and further research into esketamine's broader applications.
Case Series
Open Access October 11, 2023

Quality of Life Assessment of Health Record Professionals Working in a Tertiary Health Facility, during the COVID 19 Pandemic in South Western Nigeria

Abstract Background: There is paucity of data on health-related quality of life (HRQoL) among Health Information Managers/Health Record Officers (HROs) in the Nigeria health system. Hence, this study investigated the impact of the COVID-19 pandemic on health-related quality of life (QoL) among HROs in Obafemi Awolowo University Teaching Hospital Complex (OAUTHC), Ile-Ife, Nigeria. Methods: A [...] Read more.
Background: There is paucity of data on health-related quality of life (HRQoL) among Health Information Managers/Health Record Officers (HROs) in the Nigeria health system. Hence, this study investigated the impact of the COVID-19 pandemic on health-related quality of life (QoL) among HROs in Obafemi Awolowo University Teaching Hospital Complex (OAUTHC), Ile-Ife, Nigeria. Methods: A cross-sectional study was conducted in the University Hospital, where a total of 52 health record officers were purposively sampled. Relevant data were collected using the Short Form survey (SF-36v2) questionnaire. One-way ANOVA was used to determine mean group differences across the nine and the two QoL (physical and mental) summary domains based on respondents’ socio-demographics, while level of significance was set at 0.05. Results: All the QoL sections of the instrument used yielded an α-Cronbach’s score of > 0.70. Analysis of some QoL physical component dimensions showed that; Bodily pain (BP) was found to be significantly (P=0.032) associated with marital status, Physical functioning (PF) with gender (P=0.023), and general health (GH) with age group (P=00.025) and highest level of education (P=0.023). On the other hand, mental health component analysis revealed that Social Functioning (SF) was associated with age group (P=014), Role limitation (RE) with marital status (P=0.048), highest level of education (P=0.048) and years of service (P=0.015) etc. Conclusion: The QoL among HROs studied was generally above average, and demographic characteristics such as age, gender and marital status significantly influence QoL. Health managers and stakeholders should consider some of the factors identified in managing HROs.
Article
Open Access October 07, 2023

A Systematic Review of Observational Studies Focusing on Impact of Telehealth Consultation in Osteoporosis Management during the Pandemic

Abstract Background: The COVID-19 pandemic disrupted routine osteoporosis care due to clinic closures and limited in-person consultations. Telehealth emerged as an alternative model enabling remote care delivery and monitoring. However, previous reviews on telehealth either did not include the pandemic period or had a limited focus in scope. Evidence synthesized specifically for osteoporosis care [...] Read more.
Background: The COVID-19 pandemic disrupted routine osteoporosis care due to clinic closures and limited in-person consultations. Telehealth emerged as an alternative model enabling remote care delivery and monitoring. However, previous reviews on telehealth either did not include the pandemic period or had a limited focus in scope. Evidence synthesized specifically for osteoporosis care during the pandemic is needed but lacking. Methods: We systematically searched PubMed, MEDLINE, EMBASE, PsycINFO, Web of Science, and CINAHL for studies on telehealth for osteoporosis published between January 2021 and March 2023. Five studies met the inclusion criteria of: osteoporosis population, telehealth intervention, and COVID-19 pandemic timeframe. Data was extracted on study characteristics, COVID-19 outcomes, osteoporosis status, telehealth purpose, patient satisfaction, and clinical outcomes. Result: The five studies showed telehealth was used for monitoring data, delivering test results, adjusting medications, and assessments. Osteoporosis prevalence among telehealth users ranged 30-100%. High patient satisfaction was reported with telehealth versus in-person care. No major differences occurred in medication delays or fractures between telehealth and in-person groups. Conclusion: This review found telehealth enables effective osteoporosis care and monitoring during the pandemic, with high patient and provider satisfaction. However, more robust randomized controlled trials are needed to establish stronger evidence around telehealth's impacts on clinical osteoporosis outcomes. Implications: Though promising, further high-quality studies will help clarify telehealth's role in improving osteoporosis care and outcomes. Findings inform guidelines on integrating telehealth into routine management. Evidence on user perspectives optimizes telehealth implementation policies.
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Systematic Review
Open Access October 03, 2023

Pharmaceutical Drug Serialization: A Comprehensive Review

Abstract A persistent problem in the pharmaceutical industry that has existed for centuries is the prevalence of counterfeit drugs, and the World Health Organization (WHO) estimates that millions of people are affected by this issue each year. In particular, 4 out of 10 drugs in poor or underdeveloped countries may be adulterated, which can lead to severe adverse events. To address this problem, many [...] Read more.
A persistent problem in the pharmaceutical industry that has existed for centuries is the prevalence of counterfeit drugs, and the World Health Organization (WHO) estimates that millions of people are affected by this issue each year. In particular, 4 out of 10 drugs in poor or underdeveloped countries may be adulterated, which can lead to severe adverse events. To address this problem, many countries have implemented regulatory compliance measures such as pharmaceutical drug serialization, which requires the unique identification of every drug package manufactured. This enables tracking and tracing of individual packages throughout the supply chain and helps to prevent counterfeit drugs from entering the market. In this paper, we conduct a systematic review of the serialization process evaluation and its impact on the pharmaceutical industry. We discuss the benefits of pharmaceutical drug serialization, including its ability to improve drug security and reduce adverse events and investigations. We also examine the challenges associated with implementing serialization processes and the regulatory requirements necessary for compliance. Finally, we explore the various tracking and tracing technologies used in serialization processes and their effectiveness in preventing the distribution of counterfeit drugs. Overall, this paper highlights the importance of pharmaceutical drug serialization in ensuring the safety and efficacy of drugs in the healthcare industry, particularly in poor or underdeveloped countries where the problem of adulterated drugs is especially prevalent.
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Review Article
Open Access September 19, 2023

Lonely No More: Investigating the Connection between Family Health, Social Support, and Well-being in Chinese “Empty Nest Youth”

Abstract Background: The phenomenon of "empty nest youth" is becoming increasingly ubiquitous, capturing the attention of society at large. However, few studies have been conducted in recent years on this group, especially focusing on their family and mental health. As such, this study investigates the correlation between family health and well-being among "empty nest youth," as well as the function of social support and loneliness in this relationship. Methods: A cross-sectional survey was conducted from June to August 2022 across 32 provinces, municipalities, and autonomous regions in China, utilizing a multi-stage sampling technique. And we screened individuals who were unmarried, living alone, and between 22-44 years old, resulting in a valid sample size of 908 cases; multiple regression analysis, mediation effect testing, and moderation effect testing are used to examine research hypotheses. Results: The regression analysis results show that family health not only has a direct impact on well-being (β = 0.36, p < 0.001) but also indirectly affects well-being through social support [β = 0.23, 95% CI: 0.19 0.28]. Additionally, the loneliness moderates the predictive impact of not only family health on social support (β = -0.13, p < 0.001) but also social support on well-being (β = -0.06, p [...] Read more.
Background: The phenomenon of "empty nest youth" is becoming increasingly ubiquitous, capturing the attention of society at large. However, few studies have been conducted in recent years on this group, especially focusing on their family and mental health. As such, this study investigates the correlation between family health and well-being among "empty nest youth," as well as the function of social support and loneliness in this relationship. Methods: A cross-sectional survey was conducted from June to August 2022 across 32 provinces, municipalities, and autonomous regions in China, utilizing a multi-stage sampling technique. And we screened individuals who were unmarried, living alone, and between 22-44 years old, resulting in a valid sample size of 908 cases; multiple regression analysis, mediation effect testing, and moderation effect testing are used to examine research hypotheses. Results: The regression analysis results show that family health not only has a direct impact on well-being (β = 0.36, p < 0.001) but also indirectly affects well-being through social support [β = 0.23, 95% CI: 0.19 0.28]. Additionally, the loneliness moderates the predictive impact of not only family health on social support (β = -0.13, p < 0.001) but also social support on well-being (β = -0.06, p < 0.001). Conclusions: These findings underscore the significance of directing policymakers and healthcare professionals towards the "empty nest youth's" familial and social support systems. It underscores the need for the development of policies aimed at addressing their emotional and material requirements by leveraging these familial and social networks. This approach ultimately contributes to the enhancement of their overall psychological well-being, promoting a more coherent and logical pathway for intervention and support.
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Open Access May 06, 2023

Socioeconomic Drivers of Conservation Commitment: Residents’ Willingness to Pay for Ecosystem Services Provided by Beaches in Lagos State, Nigeria

Abstract Beaches are known for their ability to provide people with several services – these are generally referred to as ‘ecosystem services’ and they have been identified as one of the ways through which nature relates to humans. However, beaches in Nigeria are challenged by mismanagement caused by anthropogenic factors. It is expected that people will demonstrate a certain amount of dedication to [...] Read more.
Beaches are known for their ability to provide people with several services – these are generally referred to as ‘ecosystem services’ and they have been identified as one of the ways through which nature relates to humans. However, beaches in Nigeria are challenged by mismanagement caused by anthropogenic factors. It is expected that people will demonstrate a certain amount of dedication to protecting this ecosystem to address this issue. Sometimes, a person's commitment to conservation is based on the advantages they anticipate or are currently experiencing from the ecosystem, which are a result of their socioeconomic traits. Against this backdrop, this study captured individuals’ commitment as their Willingness to Pay (WTP) for these ecosystem services, assessed their level of awareness of the various ecosystem services provided by beaches and investigated the impact of socioeconomic factors on participants’ willingness to pay. Data were collected using a structured questionnaire and a total of 221 responses were analyzed using descriptive statistics, logistic regression and content analysis. The results revealed that the cultural service provided by beaches was the most common ecosystem service identified by the participants. Furthermore, most of the participants were willing to pay less than $3 for beach maintenance while the major determinants of WTP were age, household size and education. This study recommended that the government should work with other stakeholders to set up programs that would boost people’s awareness of ecosystem services provided by beaches as well as reiterate the need to maintain this ecosystem to ensure continued enjoyment of the services provided.
Article
Open Access April 27, 2023

Evaluation of the Critical risk factors in PPP - procured Mass Housing Projects in Abuja Nigeria - A fuzzy synthetic evaluation (FSE) approach

Abstract The study accessed the critical risk factors in public-private partnership (PPP)-procured mass housing project (MHP) delivery in Nigeria. The research design adopts a quantitative approach, using well-structured questionnaires distributed to stakeholders involved in PPP-MHPs i.e. consultants, in-house professionals, contractors, and the organized private sector (OPS) registered with PPP [...] Read more.
The study accessed the critical risk factors in public-private partnership (PPP)-procured mass housing project (MHP) delivery in Nigeria. The research design adopts a quantitative approach, using well-structured questionnaires distributed to stakeholders involved in PPP-MHPs i.e. consultants, in-house professionals, contractors, and the organized private sector (OPS) registered with PPP departments in the Federal Capital Territory Development Authority (FCDA) Abuja, Nigeria. The instrument relates to the background information of respondents and the risk peculiar to PPP-MHP. Sixty-three (63) risk factors were submitted for the respondents to rank using Mean Item score (MIS) for risk occurrence and its severity, while risk significance index (RI) was used to determine the risk impact. Fuzzy Synthetic Evaluation (FSE) method was subsequently applied to determine the risk criticality groups and the overall risk level in the sector. The fuzzy set theory deals with ambiguous, subjective and imprecise judgments peculiar to decision making in construction project risk assessment. It aims to provide a synthetic evaluation of an object relative to a fuzzy decision environment with multiple criteria that requires qualitative linguistic terms. The findings show that thirty-one (31) risk factors were critical in the sector while financial and micro-economic risk group is contributing most significantly to the overall risk level in PPP-MHPs in Nigeria. The top 10 risk factors in the sector include availability of finance, high finance cost, the unstable value of the local currency, lack of creditworthiness, influential economic events (boom/recession), high bidding cost, poor financial market, financial attraction to project investors, interest rate volatility, inflation rate volatility, corruption and lack of respect for the law, non-involvement of the host community and poor execution of housing policies. The implication for practice is that having known the risk group contributing most significantly to the overall risk level in PPP-MHPs, adequate financial and budgetary allocation should be made available before embarking on such venture so as to sustain the scheme in the country. The study is one of the recent researches conducted on housing, since the procurement option is novel in the sector. The study is of immense value to PPP actors in providing necessary information required to formulate risk response methods in minimize the identified risk impact sector.
Article
Open Access February 04, 2023

A framework for evaluation of improvement opportunities for environmental impacts on construction works using life cycle assessment and value stream mapping concepts: offsite and onsite building construction

Abstract There have been various concerns about the environmental impact of construction works. This generates a need to take a more proactive approach in evaluating the environmental impacts of construction operations and further explore ways to reduce the environmental impacts. Enormous opportunities exist within the building industry to achieve a reduction in greenhouse gas emissions. The aim of the [...] Read more.
There have been various concerns about the environmental impact of construction works. This generates a need to take a more proactive approach in evaluating the environmental impacts of construction operations and further explore ways to reduce the environmental impacts. Enormous opportunities exist within the building industry to achieve a reduction in greenhouse gas emissions. The aim of the study is to develop a framework for the evaluation of improvement opportunities for environmental impact for onsite and offsite building construction works using life cycle assessment (LCA) and value-stream-mapping concepts. Various tools for LCA exist; however, there is a need for the development of an LCA framework and improvement opportunities that can be localized to various communities to evaluate improvement opportunities for building construction. This study conducts a review of methods to evaluate the LCA of buildings on local construction sites. A procedure for establishing improvement opportunities is also developed. Based on the author’s knowledge and experience, including site visits, using value stream mapping (VSM) techniques, a conceptual framework of the present state map and future state map of residential construction works was developed. The study presents a procedure for the evaluation of improvement opportunities for the environmental impacts of construction operations.
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Open Access January 28, 2023

A framework for the evaluation of the decision between onsite and offsite construction using life cycle analysis (LCA) concepts and system dynamics modeling

Abstract The decision to choose between onsite and offsite construction is important in the effort toward sustainable construction. Offsite construction is often promoted as an environmentally friendly approach to construction operations. However, previous studies have shown that there is a lack of clarity on the environmental trade-offs between onsite and offsite construction. Factors that can affect the [...] Read more.
The decision to choose between onsite and offsite construction is important in the effort toward sustainable construction. Offsite construction is often promoted as an environmentally friendly approach to construction operations. However, previous studies have shown that there is a lack of clarity on the environmental trade-offs between onsite and offsite construction. Factors that can affect the decision to build onsite or offsite include the availability of a local offsite manufacturing facility, the distance of the offsite factory to the final place of use, the proximity of the site to the local supply of material and labor, etc. This study provides a framework to apply the system dynamic modeling technique to evaluate how various factors can affect the environmental impact of the building construction phase (for onsite or offsite construction methods). The system dynamic model (using Vensim software) that was developed provides a platform that allows users to input variables such as the distance that is expected for transportation of labor, material, and equipment to both the onsite facility and the offsite construction location, factors associated with the use of equipment for construction, the distance needed for transportation of building panels or modules from the offsite facility to the final site, etc. Among other things, the model showed that an increase in the distance from the offsite yard to the final construction site increases the total impacts of transportation of completed modules. An increase in the number of trips for the transportation of material to the onsite construction location increases the total impact of onsite construction. In terms of the environmental impact of construction, none of the two methods of construction gives an absolute superiority over the other. The environmental performance of offsite and onsite depends on various associated factors. It is recommended that building practitioners review various factors that are peculiar to their projects to make an informed decision on the best construction methods.
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Open Access January 14, 2023

Searching for What You Can’t See - Evaluation of Pesticide Residues in Grain Sold at Selected Markets of Southwest Nigeria

Abstract Studies on the use of pesticides in southwest Nigeria have revealed a substantial rise in a variety of pesticide-related illnesses, including mental impairment and reproductive problems. Those who work in agriculture and are regularly exposed to pesticides are the most impacted. The World Health Organization (WHO) predicts that three million severe pesticide poisoning episodes occur globally each [...] Read more.
Studies on the use of pesticides in southwest Nigeria have revealed a substantial rise in a variety of pesticide-related illnesses, including mental impairment and reproductive problems. Those who work in agriculture and are regularly exposed to pesticides are the most impacted. The World Health Organization (WHO) predicts that three million severe pesticide poisoning episodes occur globally each year, with at least 300.000 deaths and 99% of cases occurring in low- and middle-income nations. The effects of longer-term exposure to pesticides on health are not yet precisely estimated. Objectives: To this end, the objective of this study is to assess the knowledge of pesticide residues and common pesticides in grain-based food (brown and white beans, yellow and white maize, brown millet and rice) about pesticide use in selected markets of Southwest Nigeria. Methods: A total of 240 respondents were selected from four states (Ado-Ekiti, Ibadan, Osun and Ondo) with the aid of structured questionnaire and interview guide using purposive sampling technique. The markets were Oja-titun (market) Ile-Ife, Osun; Alesinloye Market Ibadan, Oyo; Oja Oba, Ado-Ekiti, Ekiti; and Oja Oba, Akure Ondo State. The identification and quantification of pesticide residues was done using a Varian 3800/4000 gas chromatograph mass spectrometer while 60 structured questionnaires were administered to respondents including food merchants, buyers/consumers as well as food vendors. Data were analysed using descriptive statistics. Results: The experiment was conducted from November 2020 to November 2021. Up to 50.4% never read instructions on pesticide application while a shared 24.8% read them always and occasionally. The number of respondents who never read the instructions were particularly high in Ekiti and Ondo, up to 52.5% of the respondents in Ekiti do not know whether or not they are exposed to pesticides during application. Also, majority of the respondents never attended any professional training on pesticide application, this amounted to 79.3%. Most people were not aware that unsafe pesticide application is harmful to human health. Similarly, a wide variety of symptoms were reported by respondents following pesticide application or consumption of grains, these included headaches and dizziness, itching and redness of the eyes, skin allergy, diarrhea, and stomach disorder, vomiting and loss of appetite, weakness of the body, asthma, permanent skin patches, shortness of breath, excessive sweating. Millet recorded the highest number of OCP residues while maize had the lowest. On the contrary, maize had the highest number of OPP and carbamate residues while millet had the lowest number of OPP residues. Meanwhile, maize, rice and beans had only one carbamate pesticide residue. Conclusions: According to the study's conclusions, farmers who can only get information from agricultural extension officials should receive urgent and immediate attention for raising awareness. Additionally, extensive IPM training programs must be created with the intention of disseminating precautions for protecting human health and a healthy agro-ecosystem. In order to find more effective pest management methods that utilize less pesticides, it is crucial to reevaluate the pesticide residues and common pesticides found in grains in the targeted markets. To reduce farmers' exposure to pesticides, it is also required to establish personal protective measures, special educational initiatives, and legislation promoting the use of safer pesticides. Significance and novelty: This study gives policymakers a comprehensive understanding of the ways that may be utilized to close the significant knowledge gap on pesticide residues in grains and provides an insight into the knowledge of pesticide residues and common pesticides in grains.
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Open Access January 06, 2023

False Beliefs about Contracting Avian (Bird) Flu from Processed Poultry Products

Abstract Avian influenza (bird flu) occurs sporadically in American poultry flocks, decimating these flocks and causing substantial economic losses. Avian influenza also impacts the beliefs of food handlers and preparers in the home (home cooks). Although those who properly handle and prepare processed poultry products cannot succumb to avian influenza, there is a widespread belief that one can contract [...] Read more.
Avian influenza (bird flu) occurs sporadically in American poultry flocks, decimating these flocks and causing substantial economic losses. Avian influenza also impacts the beliefs of food handlers and preparers in the home (home cooks). Although those who properly handle and prepare processed poultry products cannot succumb to avian influenza, there is a widespread belief that one can contract the bird flu from these foods. Beliefs about getting avian influenza from poultry products and intentions to avoid consuming poultry products are the focus of this study of 285 home cooks. False beliefs about getting avian influenza from handling, preparing, and consuming poultry products are apparent in this sample. Correlational analysis also shows that those holding the false beliefs intend to act upon those beliefs by planning not to consume poultry products. Moreover, the false beliefs about contracting avian influenza from poultry products are correlated with a bias to see oneself as less likely to produce food that contains foodborne diseases. These findings are consistent with, and contribute to, the research literatures on belief formation and change, behavioral intentions, and with research showing how guilt by association thought processes underlie false beliefs related to food safety. This research has important implications for poultry and other food processing industries, and for campaigns to persuade the public about real and imaginary risks associated with particular food products.
Article
Open Access December 02, 2022

Effect of Industrial Effluent on Irrigation Water Quality of Choba River in the Niger Delta Region of Nigeria

Abstract Poor irrigation water quality due to oil spillage on surface water can result in food insecurity, health and economic challenges. This paper investigated the effect of total petroleum hydrocarbon (TPHC) and lead (Pb) on irrigation water quality in the oil spill prone area of the Niger Delta region of Nigeria. Water samples were taken from five different sections labelled A, B, C, D, and E along [...] Read more.
Poor irrigation water quality due to oil spillage on surface water can result in food insecurity, health and economic challenges. This paper investigated the effect of total petroleum hydrocarbon (TPHC) and lead (Pb) on irrigation water quality in the oil spill prone area of the Niger Delta region of Nigeria. Water samples were taken from five different sections labelled A, B, C, D, and E along the Choba River, in Rivers State, Nigeria. Sections B, C, D and E were direct industrial effluent discharge points while section A was without direct industrial effluent discharge. Standard methods were employed in the water sampling and analysis. Suitability of Choba river water for irrigation was assessed by comprehensive pollution index (CPI) that incorporated salinity, sodicity, and permeability hazard potentials as well as the specific toxicity hazard potentials of TPHC and Pb. Results showed that all primary water parameters except pH were within the Food and Agriculture Organization (FAO) guidelines. The pH was low, ranging between 4.48 and 5.6. TPHC values for four out of the five samples were greater than the 10mg/l guideline as recommended by the Directorate of Petroleum Resources for surface water. TPHC for the four samples ranged between 14.52 and 174.32mg/l. The parameters with the most impact on CPI include EC, PI and TPHC with TPHC having the most impact. Water samples from sections A, B and E with CPI values 0.14, 0.37, and 0.8 respectively were classified in the clean, sub clean and slightly polluted categories respectively, while water samples from sections C and D with CPI values greater than 1 range from moderately to heavily polluted and not suitable for agricultural irrigation. Only water sample A was found suitable for irrigation.
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Open Access November 29, 2022

The Application of Machine Learning in the Corona Era, With an Emphasis on Economic Concepts and Sustainable Development Goals

Abstract The aim of this article is to examine the impacts of Coronavirus Disease -19 (Covid-19) vaccines on economic condition and sustainable development goals. In other words, we are going to study the economic condition during Covid19. We have studied the economic costs of pandemic, benefits in terms of gross domestic product (GDP), public finances and employment, investment on vaccines around the [...] Read more.
The aim of this article is to examine the impacts of Coronavirus Disease -19 (Covid-19) vaccines on economic condition and sustainable development goals. In other words, we are going to study the economic condition during Covid19. We have studied the economic costs of pandemic, benefits in terms of gross domestic product (GDP), public finances and employment, investment on vaccines around the world, progress and totally the economic impacts of vaccines and the impacts of emerging markets (EM) on achieving sustainable development goals (SDGs), including no poverty, good health and well-being, zero hunger, reduced inequality etc. The importance of emerging economies in reducing the harmful effects of the Corona has also been noted. We have tried to do experimental results and forecast daily new death cases from Feb-2020 to Aug-2021 in Iran using Artificial Neural Network (ANN) and Beetle Antennae Search (BAS) algorithm as a case study with econometric models and regression analysis. The findings show that Covid19 has had devastating economic and health effects on the world, and the vaccine can be very helpful in eliminating these effects specially in long-term. We observed that there is inequality in the distribution of Corona vaccines in rich countries compared to poor which EM can decrease the gap between them. The results show that both models (i.e., Artificial intelligence (AI) and econometric models) almost have the same results but AI optimization models can robust the model and prediction. The main contribution of this article is that we have surveyed the impacts of vaccination from socio-economic viewpoint not just report some facts and truth. We have surveyed the impacts of vaccines on sustainable development goals and the role of EM in achieving SDGs. In addition to using the theoretical framework, we have also used quantitative and empirical results that have rarely been seen in other articles.
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Open Access November 14, 2022

A Comparison of Life Cycle Impact of Mass Timber and Concrete in Building Construction

Abstract Life cycle assessment, LCA is one of the tools that is used to measure the environmental impacts of a process or an operation. Various studies have mentioned the benefits of mass timber in building construction. This study presents an evaluation of the LCA of certain mass timber in relation to concrete-based materials. Using Athena impact estimator for buildings, the study compared the results of [...] Read more.
Life cycle assessment, LCA is one of the tools that is used to measure the environmental impacts of a process or an operation. Various studies have mentioned the benefits of mass timber in building construction. This study presents an evaluation of the LCA of certain mass timber in relation to concrete-based materials. Using Athena impact estimator for buildings, the study compared the results of an LCA study for a house that is designed with concrete beams, concrete columns, and concrete walls with brick in the envelope category (Material group 1) with those that are made with glulam beams, glulam columns, CLT walls with spruce wood bevel siding (Material group 2), and another building with LVL columns, LVL beams, CLT walls with spruce wood bevel siding (Material group 3). The results are in line with those that were reported by the majority of previous researchers. For the location that is being reviewed (Calgary, Alberta), the designs showed that construction with wood materials having mass timber components will have a better environmental performance than that for a building design with more concrete-based materials. The building design with more concrete-based material (group 1) showed 242% and 60% higher global warming and acidification potential respectively than the building with glulam beams and columns (material group 2). Except for ozone depletion potential, material group 2 (with glulam beams and columns) has a lower impact than material group 3 (with LVL/PSL beams and columns). The differences in impacts are more pronounced when the comparison is with design with more concrete-based products. This report further shows that LCA can be helpful during the preliminary design to evaluate the expected environmental impacts of the choice of different materials. This study recommends that material manufacturers and building contractors pay attention to LCA results to evaluate areas for continuous improvement.
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Open Access September 01, 2022

Public Perspective on the Negative Impacts of Substance Use-Related Social Media Content on Adolescents: A Survey

Abstract Despite the pervasive nature of internet use among adolescents and young adults, there is not enough knowledge about whether and how involvement in social media influences substance use patterns and the risk of drug use-related problems. This study was conducted to examine the complex relationship between substance use-related social media engagement (viewing, liking, commenting, and posting the [...] Read more.
Despite the pervasive nature of internet use among adolescents and young adults, there is not enough knowledge about whether and how involvement in social media influences substance use patterns and the risk of drug use-related problems. This study was conducted to examine the complex relationship between substance use-related social media engagement (viewing, liking, commenting, and posting the substance use-related social media content) and the drug use-related problem in adolescents from public perception. We surveyed to determine the perception of social media users regarding the association between substance use-related social media content and substance/drug abuse problems. An anonymous online questionnaire was conducted to collect the response from each participant. The response was generated after collecting the data from 126 users of mixed ages. The data was stringently analyzed, and the response was displayed in the form of bar charts. The primary findings indicated a significant relationship between drug/alcohol-related social media engagement and drug/alcohol-related problems. From public perception, a positive correlation was found between the engagement in the drug use-related content and drug use associated problems. However, further research is needed to determine the right direction of these associations that can provide substantiative solutions for numerous interventions aiming to prevent drug use-related adverse consequences.
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Open Access June 30, 2022

Weekly Quizzes Reinforce Student Learning Outcomes and Performance in Biomedical Sciences in-course Assessments

Abstract Studies have highlighted the benefits of frequent quizzing in class. Frequent quizzing can promote more student attendance, engagement, practice and review, and achievement. Conversely, the opponents of frequent quizzing suggest that too frequent testing might hinder learning by frustrating anxious students and inhibiting larger units of instructional material. Notably, most studies have used [...] Read more.
Studies have highlighted the benefits of frequent quizzing in class. Frequent quizzing can promote more student attendance, engagement, practice and review, and achievement. Conversely, the opponents of frequent quizzing suggest that too frequent testing might hinder learning by frustrating anxious students and inhibiting larger units of instructional material. Notably, most studies have used degree examinations to evaluate the impact of quizzes on student learning and performance, yet little is known about whether quizzes can reinforce student performance in the in-course assessments (ICAs) despite ICA importance in student learning. The present study aimed to test the hypothesis that administration of weekly MCQ quizzes can enhance the leaning outcomes and performance of biomedical science students in assessment methods such as essay and oral presentation that can directly measure and provide information about student learning. It was therefore limited to in-course assessments. We found that the performance of the weekly quiz student group is remarkably better than that of the control student group in both the essay and oral presentation ICAs, which are two measures and indicators of student learning, suggesting improved student learning outcomes and performance after administrating weekly MCQ quizzes that also promoted student attendance in classrooms. The findings of this research study have implications for students, teachers, and curriculum designers in higher education.
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Open Access August 21, 2021

Global Analysis of Potential COVID 19 Transmission and Enabling Factors

Abstract Background: Coronavirus disease has caused global turmoil especially causing huge impact on human life all over the world. Current reports states more than 3 million people have lost life and more than 160 million people are known to be suspected with the SARS-CoV-2. Transmission and disease incidence rates are indicators to assess the seriousness of COVID-19 pandemic and studies to understand the factors that aid in this direction are very vital to curb the disease. Methods: The study intends to discover the relationship by performing statistical analysis using correlation and multiple linear regression analysis between the variable’s population density, temperature, relative humidity, and active time of virus and find out the parameters that predict the cases reported per million population in 83 countries. Results: Analysis indicates active time of virus in days is very positively associated with the COVID -19 cases in all the countries r = .604, p < .01. Active time of virus shows strong negative correlation with temperature r = -.930, p [...] Read more.
Background: Coronavirus disease has caused global turmoil especially causing huge impact on human life all over the world. Current reports states more than 3 million people have lost life and more than 160 million people are known to be suspected with the SARS-CoV-2. Transmission and disease incidence rates are indicators to assess the seriousness of COVID-19 pandemic and studies to understand the factors that aid in this direction are very vital to curb the disease. Methods: The study intends to discover the relationship by performing statistical analysis using correlation and multiple linear regression analysis between the variable’s population density, temperature, relative humidity, and active time of virus and find out the parameters that predict the cases reported per million population in 83 countries. Results: Analysis indicates active time of virus in days is very positively associated with the COVID -19 cases in all the countries r = .604, p < .01. Active time of virus shows strong negative correlation with temperature r = -.930, p < .01 revealing that rise in temperature will reduce the virus activity in the population. Together, these variables will account for 36.2% variance in the cases per million population with no significant prediction estimated from any factor. Conclusion: The study outcomes clearly state that population density alone is insufficient to estimate the extent of influence on COVID -19 cases as the number of persons living per sq. km of land is a dynamic quantity tend to fluctuate over time and space due to migration of population. In conjunction to the previous studies reported on the environmental and climatic factors influencing the cases reported, population dynamics does not show much significance on the disease spread and incidence. Contribution: The rise in confirmed cases and the high incidence rate reported in countries can be attributed to the active time of virus life expectancy as there is a positive correlation observed between the COVID-19 cases reported and the virus active time in the examined countries. Also, environment and climatic factors play a role in modulating the infection and transmission rate with less significant influence of population density on the COVID-19.
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Open Access June 16, 2021

Impact of Pandemic Covid-19 on Higher Education-Indian Context

Abstract Education stratum of India as well as world are worst-hit by Covid-19 and has imposed lockdown originating deleterious effect on academic life. A sheer number of learners ceased moving educational institutions and all pedagogies halted in India. Catastrophe has behaved as a stimulant for the educational institutions to cultivate and choose for platforms with technologies which were previously [...] Read more.
Education stratum of India as well as world are worst-hit by Covid-19 and has imposed lockdown originating deleterious effect on academic life. A sheer number of learners ceased moving educational institutions and all pedagogies halted in India. Catastrophe has behaved as a stimulant for the educational institutions to cultivate and choose for platforms with technologies which were previously noviced. Education sector has been challenging to weather the crux with alternative strategy and digitizing the challenges to hoover the menaces of the pandemic. Hypothesis of digital study has prognosis to impact the ventures of higher education for eon. Findings evince that despite digital learning is a nice adventure for little skills, varying illiberalities partake. Learners are crunched and academy also exclusively in unstable job. It has yet to be established the scope whereupon digital study would climactically cover for conventional study. Covid-19 conundrum has divulged prefacing dilemma and disparities clamoring synergetic attempt to contemplate even so pandemic’s approach. This deliberate paper illuminates sparse impeccable education in India and has discussed the positive and negative impacts of Covid-19. The paper also contributes a methodical substantiation of the experience and lessons digested from the impact of the pandemic on the transitional education panorama, and the dissemination and acceptance of e-learning in education. To end, few suggestions along with policy recommendations have been made to meet didactics during the pandemic contingency.
Article
Open Access May 21, 2021

Modeling of Target Audience'S Intellectual Behavior

Abstract The article considers the problems of theoretical substantiation of negative informational and psychological impact evaluation principles, and conducting of relevant researches in this field. At the same time, due to imperfections of theory and practice of negative informational and psychological impact evaluation, previous researches were conducted mainly by “mirroring” the ways of information [...] Read more.
The article considers the problems of theoretical substantiation of negative informational and psychological impact evaluation principles, and conducting of relevant researches in this field. At the same time, due to imperfections of theory and practice of negative informational and psychological impact evaluation, previous researches were conducted mainly by “mirroring” the ways of information counteraction, both for our own measures of information and psychological influence, and for the adversary. The rationale for the methodological approaches used in the organization of information and psychological influence is due to inability to access the adversary's target audiences freely and gather the necessary information, as well as the inadequacy of assessing the degree of change in their behaviour. Characteristics mentioned in article classify target audiences according to defined indicators of remote information control of social and individual behaviour of possible objects of influence. Using the formulated conditions and relying on the psychological and psychophysiological characteristics of individuals, a database of target audience behaviour vulnerabilities is forming, that reflects the dependence of indicators of social behaviour perception changes on the intensity of external negative informational and psychological influences. The algorithm of target audience’s information perception is developed based on the model of planned behaviour, in which the subject’s overestimation of small values of probabilities are compared in dynamic with decrease of big ones. The proposed algorithm of evaluation of information-psychological impact allows to receive initial data based on which the model of target audience behaviour will be designed in any environmental conditions.
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Article
Open Access December 30, 2025

Elimination of HIV Transmission Risks through Viral Suppression: Undetectable=Untransmittable and its Impact among People Living with HIV

Abstract The principle of Undetectable = Untransmittable (U=U) posits that people living with the human immunodeficiency virus (HIV) who are able to achieve and maintain a viral load of <200 copies/mL by regularly taking antiretroviral drugs (ARVs) are considered virally suppressed and cannot transmit the HIV virus to other individuals through sex. This groundbreaking message has emerged as a key HIV [...] Read more.
The principle of Undetectable = Untransmittable (U=U) posits that people living with the human immunodeficiency virus (HIV) who are able to achieve and maintain a viral load of <200 copies/mL by regularly taking antiretroviral drugs (ARVs) are considered virally suppressed and cannot transmit the HIV virus to other individuals through sex. This groundbreaking message has emerged as a key HIV prevention strategy for eliminating transmission risks and enhancing the quality of life of people living with HIV. This narrative review explores the clinical foundation of U=U, the level of awareness and acceptance of the message globally, and the psychosocial impact on people living with HIV. It has been discovered that this message minimizes stigma, improves mental health, promote treatment adherence and good disclosure behaviors among people living with HIV. Evidence has shown that despite the U=U revolution for HIV prevention, there are significant differences in awareness and acceptance of the message among different population groups. The challenges noted were poor communication by healthcare providers, limitations in the health system, and stigma issues. Nevertheless, the inclusion of U=U in mainstream HIV services has proven to increase awareness and enhance its adoption. The urgent need in the present review is to advocate for strategies to increase the equitable distribution of U=U to harness its full potential in public health.
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Review Article
Open Access October 09, 2025

Simulation-Based Learning in Nursing Education: Perspectives of Student Nurses in the Philippines

Abstract Simulation-based learning (SBL) is widely recognized as an effective educational approach that bridges theory and practice in nursing education. Despite its global adoption, limited research has examined the experiences of Filipino nursing students with SBL, particularly in resource-constrained settings. This study explored the perspectives of Bachelor of Science in Nursing students from a [...] Read more.
Simulation-based learning (SBL) is widely recognized as an effective educational approach that bridges theory and practice in nursing education. Despite its global adoption, limited research has examined the experiences of Filipino nursing students with SBL, particularly in resource-constrained settings. This study explored the perspectives of Bachelor of Science in Nursing students from a university in Metro Manila, Philippines, on the impact of SBL on their skills, emotional responses, and challenges encountered. A descriptive qualitative design was employed using purposive sampling of ten students who had participated in at least one SBL activity. Data were collected through semi-structured interviews and short written reflections and analyzed thematically following Braun and Clarke’s framework to capture nuanced experiences. Three major themes emerged from the analysis. First, students reported initial anxiety, nervousness, and stress during their early SBL experiences, which gradually transformed into confidence, adaptability, and resilience as they gained familiarity and competence. Second, SBL enhanced technical and cognitive skills such as clinical judgment, decision-making, teamwork, and patient-centered care, supporting students’ readiness for real-world practice. Third, students identified resource limitations, insufficient equipment, and time constraints as significant barriers to optimal learning, though these challenges also fostered creativity and perseverance. The findings demonstrate that SBL fosters technical competence, critical thinking, and professional growth but requires institutional support to address resource constraints and faculty development needs. This study underscores the importance of expanding SBL in Philippine nursing curricula to align with international best practices and to contribute to Sustainable Development Goals 3 (good health and well-being), 4 (quality education), and 5 (gender equality).
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Article
Open Access September 19, 2025

Effectiveness of Subglottal Suctioning Could Prevent the Develop of VAP in the Patient on Mechanic Ventilator

Abstract VAP, or Ventilator Associated Pneumonia, is a type of pneumonia that arises in patients receiving mechanical ventilation. This condition is a serious complication and can lead to the patient's decline while on a mechanical ventilator, posing a significant risk for secondary complications if not addressed promptly. In particular, VAP is a prevalent issue in intensive care units, where the [...] Read more.
VAP, or Ventilator Associated Pneumonia, is a type of pneumonia that arises in patients receiving mechanical ventilation. This condition is a serious complication and can lead to the patient's decline while on a mechanical ventilator, posing a significant risk for secondary complications if not addressed promptly. In particular, VAP is a prevalent issue in intensive care units, where the healthcare team works to prevent further deterioration of the patient. VAP is associated with a notably high mortality rate, particularly in individuals with weakened immune systems, as well as in younger and older populations. Extended intubation and prolonged sedation can contribute to the onset of VAP. The previous study had found that incidence of VAP accounts for 9 % to 27 % endotracheal intubated patients, whereas VAP has a mortality rate ranging from 25 % to 50 % [1-3]. VAP increased ICU and hospital length of stay, antibiotic consumption, and healthcare cost (Zhi Mao et al, 2016) [4]. While using the subglottic suctioning could prevent and help the intubated patient to decreased the development of VAP. The study shown by Smith et al (2021) [5] SSD is a technique employed to reduce micro aspiration of oropharyngeal secretions in patients with cuffed endotracheal airways. Aspiration of oropharyngeal secretions is the accepted cause of the majority of ventilator-associated pneumonia (VAP), a complication of invasive ventilation with high associated mortality. Another study by Rahul Gujadhur et al (2005) [6], subglottic suction has also been shown to delay the onset of VAP but no benefits in terms of ventilation time, hospital stay or mortality benefit have ever been shown. This investigation into subglottic suctioning may assist the healthcare team, particularly in the intensive care unit, in preventing the development of VAP and shortening the duration of ventilation for patients. The advantages of subglottic suctioning are often debated, particularly regarding its impact on the duration of intubation. However, recent research indicates that implementing subglottic suctioning within a time frame of fewer than three days could help reduce intubation duration and lead to improved patient recovery.
Abstract
Open Access September 02, 2025

Listening at the End: A Review of Communication and Compassion in Palliative Settings (2025)

Abstract This review explores the role of listening as a foundational component of communication and compassionate care in palliative settings. Drawing from ten scholarly articles published in 2025, the study examines how listening affects the experiences of patients, families, and healthcare providers. The findings emphasize that listening is not only a professional skill but a human act that reduces [...] Read more.
This review explores the role of listening as a foundational component of communication and compassionate care in palliative settings. Drawing from ten scholarly articles published in 2025, the study examines how listening affects the experiences of patients, families, and healthcare providers. The findings emphasize that listening is not only a professional skill but a human act that reduces suffering, promotes dignity, and strengthens trust, especially where resources or standardized protocols are lacking. The review is organized into four main areas: the importance of listening in clinical decision making; its role in emotional support and team communication; its contribution to preserving patient dignity and comfort; and its impact on family involvement and closure. The study calls for future research to develop standardized tools for measuring listening in palliative care and to explore how cultural, economic, and technological contexts shape listening practices. Ultimately, the review concludes that listening must be at the heart of ethical, patient-centered care during the final stages of life.
Brief Review
Open Access August 22, 2025

Status Epilepticus in Sub-Saharan Africa: A Literature Review on Epidemiological Challenges, Socio-Cultural Barriers, and Public Health Impact

Abstract This literature review delves deeply into the epidemiology, structural and cultural challenges, and management strategies of status epilepticus (SE) in sub-Saharan Africa (SSA). Incidence rates of SE vary significantly between countries, with notable disparities associated with socio-economic contexts, healthcare infrastructures, and cultural perceptions of epilepsy. The management of SE in this [...] Read more.
This literature review delves deeply into the epidemiology, structural and cultural challenges, and management strategies of status epilepticus (SE) in sub-Saharan Africa (SSA). Incidence rates of SE vary significantly between countries, with notable disparities associated with socio-economic contexts, healthcare infrastructures, and cultural perceptions of epilepsy. The management of SE in this region is often hindered by constraints in medical infrastructure, inadequate access to specialist diagnostics such as electroencephalogram, and limited availability of essential anti-epileptic drugs, which are frequently out of reach for rural populations. These challenges are further exacerbated by the social stigma and cultural beliefs surrounding epilepsy, impeding access to care and widening inequalities. Moreover, the scarcity of qualified medical personnel undermines the efficient and prompt management of this neurological emergency. The review underscores the pressing need to enhance healthcare infrastructures, boost the capabilities of healthcare professionals, and conduct community awareness initiatives to destigmatize epilepsy and lessen prejudice. Additionally, practical recommendations are put forward for enhancing local capacity, fostering equity in care access, and mitigating regional health disparities in SSA.
Literature Review
Open Access August 02, 2025

Portraying the Familiar: An Artistic Inquiry into the Dynamics of Enduring Friendship

Abstract This work explores the intimate process of creating an acrylic portrait of a long-time friend, guided by photographs. Through a detailed examination of the technical and emotional aspects of portrait painting, this narrative reflects on the deep bond and shared history between the artist and subject. Emphasising the role of mutual understanding, trust, and empathy in the creative process, the [...] Read more.
This work explores the intimate process of creating an acrylic portrait of a long-time friend, guided by photographs. Through a detailed examination of the technical and emotional aspects of portrait painting, this narrative reflects on the deep bond and shared history between the artist and subject. Emphasising the role of mutual understanding, trust, and empathy in the creative process, the paper illustrates how personal experiences and memories shape artistic expression. Drawing on art therapy, narrative identity, and the psychological impact of art, this study offers insights into how portrait painting can facilitate personal reflection, retrospection, and meaningful connection.
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Creative
Open Access June 26, 2025

The Intersection of Climate Change Adaptation and Smallholder Farmer Food Security: A Review of Strategies and Barriers

Abstract Smallholder farmers play a pivotal role in global food security; however, they remain exceptionally vulnerable to the impacts of climate change due to their reliance on natural resources and limited adaptive capacities. This narrative review synthesizes a wide range of global sources to explore the intersection of smallholder agriculture and climate adaptation strategies. The review examines [...] Read more.
Smallholder farmers play a pivotal role in global food security; however, they remain exceptionally vulnerable to the impacts of climate change due to their reliance on natural resources and limited adaptive capacities. This narrative review synthesizes a wide range of global sources to explore the intersection of smallholder agriculture and climate adaptation strategies. The review examines adaptation practices, agroecological methods, and the adoption of climate-resilient crop varieties. It reveals that the implementation of these strategies is frequently hindered by systemic barriers such as financial constraints, limited technological access, and institutional inefficiencies. Recognizing that previous studies have addressed isolated aspects of adaptation or relied on secondary data, this review highlights research gaps and offers a comprehensive synthesis of relevant literature. This review uses a narrative synthesis model suitable for integrating evidence from agronomy, economics, and social science to capture the complex challenges faced by smallholder farmers. The review emphasizes the importance of policy frameworks and participatory approaches that empower smallholder communities. This review synthesizes current evidence to inform potential directions for targeted interventions and future field-based studies, while recognizing the limitations of relying on secondary data. These recommendations aim to facilitate integrated policy reforms and drive research initiatives, ultimately strengthening the resilience and adaptability of smallholder agriculture in the face of ongoing climate change.
Review Article
Open Access May 24, 2025

Exploring Smartphone Use and Learning Behaviors among Senior High School Students: Insights from a Developing Region in Indonesia

Abstract Smartphone use among adolescents has surged globally, reshaping communication and learning patterns, especially in developing countries. However, the implications of such digital habits on students in rural or under-resourced areas remain underexplored. This study aims to examine the patterns of smartphone usage and its effects on learning among high school students in Tarutung, a developing [...] Read more.
Smartphone use among adolescents has surged globally, reshaping communication and learning patterns, especially in developing countries. However, the implications of such digital habits on students in rural or under-resourced areas remain underexplored. This study aims to examine the patterns of smartphone usage and its effects on learning among high school students in Tarutung, a developing region of North Sumatra, Indonesia. Utilizing a quantitative descriptive approach, data were collected from 358 students using structured questionnaires. The results show that 96.05% of students own personal smartphones regardless of socioeconomic background, with an average daily usage of 4 hours and 45 minutes. While 91.81% believe smartphones support their learning, 25.99% report declining academic performance. Alarmingly, 20.62% of students admitted involvement in cyberbullying activities, highlighting a critical digital risk impacting the school environment and student well-being. The study concludes that although smartphones offer educational benefits, their misuse can lead to negative academic, social, and psychological outcomes. This study recommends digital literacy curricula and structured cooperation between parents and educators to prevent risks while optimizing educational opportunities in smartphone use.
Article
Open Access May 05, 2025

Persistent Social Welfare Needs Among Educated Caribbean Black Individuals: Evidence of Minorities' Diminished Returns

Abstract Background: Educational attainment is strongly linked to increased employment opportunities, higher income, and greater financial security, making its inverse relationship with reliance on social welfare programs well-documented. However, consistent with the Minorities' Diminished Returns (MDRs) theory, the protective effects of education may be weaker for racial and ethnic minority [...] Read more.
Background: Educational attainment is strongly linked to increased employment opportunities, higher income, and greater financial security, making its inverse relationship with reliance on social welfare programs well-documented. However, consistent with the Minorities' Diminished Returns (MDRs) theory, the protective effects of education may be weaker for racial and ethnic minority groups compared to non-Latino Whites. This study examines whether the impact of educational attainment (measured as years of schooling) on social welfare use differs between Caribbean Black and White adults in the United States, focusing on outcomes since age 18 and in the past year. Objective: To investigate the relationship between years of schooling and the likelihood of using social welfare programs, while exploring whether this association varies between Caribbean Black and White adults, in alignment with the MDRs framework. Methods: Data were derived from the National Survey of American Life (NSAL), a nationally representative dataset with a robust sample of Black and White adults in the United States. The study focused on Caribbean Black and White participants aged 18 and older. Structural equation modeling (SEM) was employed to examine the relationship between years of schooling and social welfare use, adjusting for covariates including age, gender, employment status, and marital status. Interaction terms were used to assess potential differences in the returns of education across racial groups. Results: Higher educational attainment was associated with reduced likelihood of using social welfare programs overall. However, consistent with the MDRs framework, the protective effect of education was weaker for Caribbean Black individuals compared to their White counterparts. Caribbean Blacks with similar levels of education as Whites were more likely to report using social welfare programs since age 18 and in the past year, highlighting diminished returns on education for this population. Conclusion: This study extends the MDRs framework to Caribbean Black populations, a group rarely studied in the U.S., revealing significant disparities in the economic benefits of education. The findings underscore the need for policies that address systemic barriers limiting the economic returns of education for racial and ethnic minorities, including Caribbean Blacks, to promote greater equity in social and economic outcomes.
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Open Access May 05, 2025

Educated Yet Unhealthy? Diminished Returns of Education for Immigrants in the USA

Abstract Background: Minorities’ Diminished Returns (MDRs) theory posits that the health benefits of socioeconomic resources, such as education, are smaller for marginalized and minoritized populations, including immigrants. While MDRs have been extensively documented for racial and ethnic minorities, less is known about whether these diminished returns extend to immigrant populations. This study [...] Read more.
Background: Minorities’ Diminished Returns (MDRs) theory posits that the health benefits of socioeconomic resources, such as education, are smaller for marginalized and minoritized populations, including immigrants. While MDRs have been extensively documented for racial and ethnic minorities, less is known about whether these diminished returns extend to immigrant populations. This study tested MDRs of education on various health and cognitive outcomes, including self-rated health (SRH), cognitive function, numeracy, number of chronic medical conditions, and limitations in activities of daily living (ADLs) among immigrants compared to non-immigrants in the United States. Objective. To examine whether educational attainment confers weaker protective effects on SRH, cognitive function, numeracy, chronic medical conditions, and ADLs in immigrants compared to non-immigrants, confirming the presence of MDRs across these domains. Methods: We used data from the Understanding America Study (UAS), a nationally representative survey of U.S. adults. We tested the association between educational attainment and five outcomes—SRH, cognitive function, numeracy, number of chronic medical conditions, and limitations in ADLs—across immigrant and non-immigrant groups. Multivariate regression models were employed, adjusting for key sociodemographic covariates. Results: The protective effects of education on a range of health outcomes were significantly weaker for immigrants compared to non-immigrants. Education level showed weaker associations with SRH, cognitive function, numeracy, number of chronic conditions, and ADLs among immigrants. These findings suggest that even at higher levels of educational attainment, immigrants experience poorer health and cognitive functioning than their U.S.-born counterparts. Conclusion: This study offers strong evidence for the MDRs of education on multiple health outcomes among U.S. immigrants. One possible explanation is that, despite achieving higher levels of education, immigrants often face structural barriers—such as discrimination, limited access to resources, and economic inequities—that constrain the health-related benefits typically associated with educational attainment. Additionally, a portion of immigrant education may be acquired outside the United States, where credentials may not be fully recognized or rewarded within the U.S. labor market. These findings highlight the importance of policies aimed at addressing systemic inequities and improving access to healthcare, employment opportunities, and social support for immigrant communities. Future research should further explore the mechanisms underlying these diminished returns and identify policy solutions to reduce their impact. Keywords: Educational Attainment, Immigrants, Nativity, Self-Rated Health, Chronic Disease, Activities of Daily Living (ADL), Cognitive Function
Original Article
Open Access May 01, 2025

The Importance of Job Satisfaction, Work Engagement, and Sufficient Staffing in the Nursing Practice

Abstract The commentary paper reviewed the above research study conducted by Wang et al. (2025), and the investigators examined the association between nurse staffing, job satisfaction, and work engagement, and how these variables impact the quality of care provision provided among the Chinese hospitals. Despite knowing that low staffing within the healthcare facilities is a global issue, Wang and [...] Read more.
The commentary paper reviewed the above research study conducted by Wang et al. (2025), and the investigators examined the association between nurse staffing, job satisfaction, and work engagement, and how these variables impact the quality of care provision provided among the Chinese hospitals. Despite knowing that low staffing within the healthcare facilities is a global issue, Wang and colleagues believed that low staffing is negatively and significantly associated with nurse’s welfare and patient care outcome. This issue causes an increase in burnout and decreased retention of healthcare providers within the clinical setting. It is important to consider and focus on improving and fostering job satisfaction and work engagement among nurses to provide better quality care even within a low staffing environment. According to Wang and colleagues, low staffing outcomes could be mitigated by encouraging workplaces to create healthy and supportive environments for the engaged and satisfied nurses. These would result in better out among patients and increase job fulfilment and welfare among nurses.
Commentary
Open Access April 10, 2025

Advancements in Pharmaceutical IT: Transforming the Industry with ERP Systems

Abstract The pharmaceutical industry is undergoing a profound transformation driven by advancements in Information Technology (IT), with Enterprise Resource Planning (ERP) systems playing a pivotal role in reshaping operations. These systems offer integrated solutions that streamline key business processes, such as production, inventory management, supply chain optimization, regulatory compliance, and data [...] Read more.
The pharmaceutical industry is undergoing a profound transformation driven by advancements in Information Technology (IT), with Enterprise Resource Planning (ERP) systems playing a pivotal role in reshaping operations. These systems offer integrated solutions that streamline key business processes, such as production, inventory management, supply chain optimization, regulatory compliance, and data integration, contributing significantly to operational efficiency and organizational agility. This paper explores the evolution and impact of ERP systems within the pharmaceutical sector, highlighting their contributions to overcoming the industry’s inherent challenges, including complex regulatory requirements, the need for accurate and real-time data, and the demand for supply chain resilience. The integration of cloud-based ERP solutions, the incorporation of emerging technologies like Artificial Intelligence (AI), Machine Learning (ML), and the Internet of Things (IoT), and enhanced data analytics capabilities have revolutionized pharmaceutical IT. These advancements not only reduce operational costs, improve forecasting accuracy, and enhance collaboration but also ensure compliance with stringent global regulations, such as Good Manufacturing Practices (GMP) and FDA guidelines. Moreover, ERP systems have been instrumental in managing the pharmaceutical supply chain, ensuring product traceability, and improving inventory control and order fulfillment processes. This manuscript examines how ERP systems enable pharmaceutical companies to maintain high standards of product quality, improve decision-making, and ensure the safety and efficacy of drugs through robust tracking and auditing mechanisms. A case study of a pharmaceutical company that implemented an ERP system demonstrates the tangible benefits, including increased operational efficiency, improved compliance rates, and enhanced customer satisfaction. However, despite the clear advantages, challenges such as customization complexities, data integration issues, and resistance to change remain. As the pharmaceutical industry continues to evolve, ERP systems will remain a cornerstone of digital transformation, facilitating smarter decision-making, better resource management, and enhanced collaboration across global operations. This paper also identifies future trends, including the potential of AI and blockchain technologies in further strengthening ERP systems and transforming the pharmaceutical landscape.
Review Article
Open Access March 29, 2025

How Stigma Affects Patients Seeking Help for Drug Addiction

Abstract Stigma surrounding drug addiction remains a critical barrier to effective treatment, significantly influencing healthcare access, patient engagement, and recovery outcomes. This study explores the multifaceted impact of stigma on individuals seeking help for substance use disorders (SUDs), with a focus on healthcare-related discrimination, internalized stigma, and structural barriers. Research [...] Read more.
Stigma surrounding drug addiction remains a critical barrier to effective treatment, significantly influencing healthcare access, patient engagement, and recovery outcomes. This study explores the multifaceted impact of stigma on individuals seeking help for substance use disorders (SUDs), with a focus on healthcare-related discrimination, internalized stigma, and structural barriers. Research indicates that negative perceptions among healthcare providers contribute to delayed treatment-seeking behaviors, reduced adherence to medication-assisted treatment (MAT), and increased relapse rates. Additionally, patients internalizing these societal judgments experience heightened psychological distress, social isolation, and decreased self-efficacy, further hindering their recovery process. To address these challenges, evidence-based strategies such as addiction medicine education, trauma-informed care, harm reduction approaches, and peer support models have been shown to effectively reduce stigma and improve treatment outcomes. Hospital administrators and nursing leaders play a critical role in fostering a culture of empathy, advocating for the reframing of addiction as a neuro-psycho-biological disease rather than a moral failing. Future research should explore digital mental health interventions, motivational interviewing techniques, and interdisciplinary collaboration to further dismantle stigma and enhance the effectiveness of addiction treatment programs. This study highlights the urgent need for systemic policy changes, targeted educational programs, and a shift in clinical attitudes to create a more inclusive and stigma-free healthcare environment. Through implementing these approaches, healthcare providers can ensure equitable access to treatment and improve long-term health outcomes for individuals with opioid use disorder (OUD) and other substance-related conditions.
Essay
Open Access February 26, 2025

Innovations and Challenges in Pharmaceutical Supply Chain, Serialization and Regulatory Landscape

Abstract The pharmaceutical supply chain has become increasingly complex and vulnerable to various risks, including counterfeit drugs, diversion, and fraud. As these challenges threaten patient safety and the integrity of global healthcare systems, serialization has emerged as a pivotal innovation in pharmaceutical logistics and regulatory compliance. Serialization involves assigning unique identifiers to [...] Read more.
The pharmaceutical supply chain has become increasingly complex and vulnerable to various risks, including counterfeit drugs, diversion, and fraud. As these challenges threaten patient safety and the integrity of global healthcare systems, serialization has emerged as a pivotal innovation in pharmaceutical logistics and regulatory compliance. Serialization involves assigning unique identifiers to individual drug packages, enabling precise tracking and authentication at every stage of the supply chain. This process provides unprecedented transparency, enhances product security, and facilitates real-time monitoring of pharmaceutical products as they move from manufacturers to end consumers. Despite its potential to revolutionize pharmaceutical traceability, the integration of serialization technologies faces numerous obstacles. These include high implementation costs, regulatory inconsistencies across regions, and the technological challenges of managing vast amounts of data. Moreover, the complex, multi-tiered nature of the global supply chain introduces additional risks related to data integrity, cybersecurity, and interoperability between systems. As pharmaceutical companies seek to navigate these challenges, innovations in serialization technology—such as blockchain, artificial intelligence (AI), the Internet of Things (IoT), and radio frequency identification (RFID)—are providing promising solutions to enhance efficiency, reduce fraud, and increase visibility. This manuscript explores both the innovative advancements and the key challenges associated with the integration of serialization in the pharmaceutical supply chain. It delves into the evolving regulatory landscape, highlighting the need for global harmonization of serialization standards, and examines the impact of serialization on securing pharmaceutical distribution networks. Additionally, the paper emphasizes the importance of collaboration among manufacturers, technology providers, and regulatory bodies in overcoming implementation barriers and realizing the full potential of serialization. As the pharmaceutical industry moves towards a more interconnected and data-driven future, serialization promises to play a central role in shaping the next generation of drug safety and supply chain management. By addressing the hurdles to adoption and leveraging emerging technologies, the pharmaceutical sector can create a more secure, transparent, and efficient supply chain that better serves public health and fosters greater trust among consumers and healthcare professionals alike.
Review Article
Open Access February 16, 2025

Uneven Impact of Maternal Education at Birth on High School Grades of Black and White Students

Abstract Background: The Minorities' Diminished Returns (MDRs) theory posits that social determinants of health, such as parental education, exert weaker protective effects on health and educational outcomes in racialized and minoritized populations compared to White populations. Aim: This study examines whether higher maternal education is associated with better high school GPA in Black [...] Read more.
Background: The Minorities' Diminished Returns (MDRs) theory posits that social determinants of health, such as parental education, exert weaker protective effects on health and educational outcomes in racialized and minoritized populations compared to White populations. Aim: This study examines whether higher maternal education is associated with better high school GPA in Black youth and whether this association aligns with the MDRs framework. Methods: Data were drawn from the Future of Families and Child Wellbeing Study also known as Fragile Families and Child Wellbeing Study (FFCWS) baseline and 22nd year follow-up (1990-2022). This study included 1873 Black or White participants who were followed from birth to age 22. Linear regression models were used to assess the association between maternal education and high school GPA, adjusting for sociodemographic covariates. Analyses focused on the differential effects of maternal education across racial groups, particularly among Black youth. Results: While maternal education was positively associated with high school GPA, this effect was weaker for Black students compared to their White counterparts. Specifically, each additional year of maternal education corresponded to a lower GPA increase in Black students, consistent with the MDRs hypothesis. Conclusion: Findings support the MDRs theory, indicating that maternal education has a reduced protective effect on high school GPA among Black youth. These results underscore the need for policies that address structural factors beyond education to promote equitable academic achievement.
Article
Open Access January 10, 2025

Extreme Heat Exposure is Associated with Lower Learning, General Cognitive Ability, and Memory among US Children

Abstract Background: The increasing frequency and intensity of extreme heat exposure is a significant consequence of climate change, with broad public health implications. While many health risks associated with heat exposure are well-documented, less research has focused on its impact on children’s cognitive function. Objectives: This study examines the [...] Read more.
Background: The increasing frequency and intensity of extreme heat exposure is a significant consequence of climate change, with broad public health implications. While many health risks associated with heat exposure are well-documented, less research has focused on its impact on children’s cognitive function. Objectives: This study examines the relationship between extreme heat exposure and various domains of cognitive function in children. Methods: Data were drawn from the Adolescent Brain Cognitive Development (ABCD) study. Key variables included race/ethnicity, age, gender, family socioeconomic status (SES), heatwave exposure, and multiple cognitive domains: total composite score, fluid composite score, crystallized intelligence, reading ability, picture vocabulary, pattern recognition, card sorting, and list recall. Structural equation modeling (SEM) was used for data analysis. Results: A total of 11,878 children were included in the analysis. Findings revealed significant associations between extreme heat exposure and lower cognitive performance across multiple domains. The strongest adjusted effects were observed in pattern recognition (B = −0.064, p < 0.001) and reading ability (B = −0.050, p < 0.001), both within the learning domain, as well as total composite cognitive ability (B = −0.067, p < 0.001), fluid composite (B = −0.053, p < 0.001), and crystallized intelligence (B = −0.061, p < 0.001), all within general cognitive ability. Weaker but still significant associations were found for list recall (B = −0.025, p = 0.006) and card sorting (B = −0.043, p < 0.001) within the memory domain, as well as picture vocabulary (B = −0.025, p = 0.008) within general cognitive ability. These associations remained significant after controlling for demographic factors, race/ethnicity, family SES, and neighborhood SES. Conclusions: This study underscores the impact of climate change on cognitive function disparities, particularly in learning and general cognitive ability among children exposed to extreme heat. Findings highlight the need for targeted interventions to mitigate the cognitive risks associated with heat exposure in vulnerable populations.
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Open Access February 10, 2025

Higher-than Expected Social Security Reliance Among Educated Black Americans: Minorities' Diminished Returns in National Health Interview Survey (NHIS) 2023

Abstract Background: While educational attainment is generally associated with reduced reliance on Social Security and disability benefits, Minorities' Diminished Returns (MDRs) theory suggests that the socioeconomic benefits of educational attainment are not equally distributed across racial groups and are weaker for minoritized populations. This study explores the association between educational [...] Read more.
Background: While educational attainment is generally associated with reduced reliance on Social Security and disability benefits, Minorities' Diminished Returns (MDRs) theory suggests that the socioeconomic benefits of educational attainment are not equally distributed across racial groups and are weaker for minoritized populations. This study explores the association between educational attainment and reliance on Social Security and disability benefits among Black and White adults in the United States. Objective: Building on the MDRs framework, we analyzed data from the National Health Interview Survey (NHIS) 2023 to examine how educational attainment impacts reliance on Social Security disability income, disability benefits, and public assistance for Black and White adults. Methods: We used a nationally representative sample of Black and White adults from the NHIS 2023 dataset. The outcomes assessed were reliance on three income sources: (1) Social Security disability income, (2) disability benefit income, and (3) public assistance disability income. Educational attainment was classified into three levels: less than high school (reference), high school diploma to some college, and college graduate or more. Logistic regression models assessed the relationship between educational attainment and reliance on each income source, with separate analyses for Black and White adults to evaluate differential effects. Results: Higher levels of educational attainment (high school diploma to some college and college graduate or more) were associated with lower odds of relying on Social Security disability, disability benefits, and public assistance. However, the protective effects of educational attainment were notably stronger for White adults than for Black adults. Among Black adults, even high educational attainment showed limited effectiveness in reducing reliance on these income sources, underscoring the Minorities' Diminished Returns (MDRs) phenomenon. Conclusions: Although educational attainment reduces reliance on Social Security and disability-related income sources, these protective effects are less pronounced for Black adults compared to White adults. The findings reveal persistent racial disparities in the economic returns of education, suggesting that structural factors may undermine the socioeconomic and health benefits of educational achievement for Black Americans. Targeted policy interventions may be needed to improve economic stability for Black adults, including those with higher educational credentials.
Article
Open Access February 10, 2025

Diminished Returns of Educational Attainment on Welfare Receipt of American Indian/Alaska Native People: National Health Interview Survey (NHIS) 2023

Abstract Background: Educational attainment is generally associated with reduced reliance on Social Security and disability benefits; however, the Minorities' Diminished Returns (MDRs) theory suggests that the socioeconomic benefits of education are weaker for minoritized populations. This study investigates the relationship between educational attainment and welfare receipt among American [...] Read more.
Background: Educational attainment is generally associated with reduced reliance on Social Security and disability benefits; however, the Minorities' Diminished Returns (MDRs) theory suggests that the socioeconomic benefits of education are weaker for minoritized populations. This study investigates the relationship between educational attainment and welfare receipt among American Indian/Alaska Native (AIAN) and White adults in the United States. Objective: Using the MDRs framework, we analyzed data from the National Health Interview Survey (NHIS) 2023 to examine how educational attainment impacts welfare receipt among AIAN and White adults. Methods: We analyzed a nationally representative sample of AIAN and White adults from the NHIS 2023 dataset. Welfare receipt was assessed as the receipt of any public assistance or welfare payments from state or local welfare offices. Educational attainment was categorized into three levels: less than high school (reference), high school diploma to some college, and college degree or higher. Logistic regression models were used to assess the relationship between educational attainment and welfare receipt, with separate analyses for AIAN and White adults to evaluate differential effects. Results: Higher educational attainment (high school diploma to some college and college degree or higher) was associated with lower odds of welfare receipt across both groups. However, the protective effect of a college degree was significantly weaker for AIAN adults compared to White adults. Consequently, AIAN adults remain at a higher risk of welfare reliance even with higher education, consistent with the Minorities' Diminished Returns (MDRs) framework. Conclusions: Although educational attainment generally reduces welfare reliance, this protection is less pronounced for AIAN adults than for White adults. This discrepancy suggests that structural factors, segregation, and social stratification may undermine the economic and health benefits of education for racialized groups in the U.S. Addressing these disparities requires policy interventions that extend beyond education, emphasizing quality job opportunities, healthcare access, and reduced labor market discrimination for individuals with advanced educational credentials, regardless of race.
Article
Open Access February 07, 2025

CEASE Tobacco Cessation Program: Validation of Self-Rated Quit with Fagerstrom Test for Nicotine Dependence

Abstract Background: Despite advancements in smoking cessation interventions, few programs have demonstrated sustained effectiveness among low-income, underserved populations. The Communities Engaged and Advocating for a Smoke-free Environment (CEASE) program was developed to address this gap and support tobacco cessation in these communities. However, it remains unclear whether self-reported [...] Read more.
Background: Despite advancements in smoking cessation interventions, few programs have demonstrated sustained effectiveness among low-income, underserved populations. The Communities Engaged and Advocating for a Smoke-free Environment (CEASE) program was developed to address this gap and support tobacco cessation in these communities. However, it remains unclear whether self-reported outcome measures in this context are in line with more objective outcome measures. Aims: This study aimed to validate self-reported quit rates using the Fagerström Test for Nicotine Dependence (FTND) as a gold standard outcome measure for evaluation of the effectiveness of the CEASE smoking cessation intervention compared to a self-help approach among low-income, underserved adult smokers. Methods: A quasi-experimental design was employed to evaluate this community-based intervention. Although participants were initially assigned to three groups, this report focuses on two arms that show the major difference in the efficacy of the program: (1) the self-help group (reference; Arm 1) and (2) the in-person CEASE group (Arm 2). Outcomes included successful quitting, assessed through self-reports, and changes in FTND scores. To examine the concordance between these measures, we tested whether changes in FTND scores fully explained the relationship between the intervention and self-reported quitting. Potential confounders included demographic, socioeconomic, and health-related variables. Data were analyzed using regression and structural equation modeling (SEM). Results: The majority of participants were Black Americans, followed by White individuals and those of other racial backgrounds. The CEASE intervention (Arm 2) demonstrated effectiveness in reducing nicotine dependence (measured by FTND) and increasing self-reported quit rates compared to the self-help group. Importantly, changes in FTND scores fully explained the effect of the CEASE intervention on self-reported quitting, highlighting the program’s impact on addiction severity. Conclusion: Successful quitting measured using self-report is in line with the decline in nicotine addiction severity among low-income racial minority populations. CEASE holds promise as a scalable solution to address smoking disparities in underserved communities.
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Open Access January 24, 2025

Pallidum Functional Hypoconnectivity and Inhibitory Control as Partial Mediators of Environmental Influences on Tobacco and Marijuana Initiation

Abstract Background: Low socioeconomic status (SES) has been linked to higher rates of tobacco and marijuana use initiation; however, the contributions of environmental and neurocognitive factors remain underexplored. This study investigates a potential pathway connecting low SES, fine particulate matter (PM2.5) exposure, brain functional connectivity, and inhibitory control to increased [...] Read more.
Background: Low socioeconomic status (SES) has been linked to higher rates of tobacco and marijuana use initiation; however, the contributions of environmental and neurocognitive factors remain underexplored. This study investigates a potential pathway connecting low SES, fine particulate matter (PM2.5) exposure, brain functional connectivity, and inhibitory control to increased tobacco and marijuana use initiation among adolescents. Objectives: To examine the mediating roles of PM2.5 exposure, resting-state functional connectivity between the right pallidum and the ventral attention network (P-VAN rsFC), and inhibitory control in the relationship between low SES and tobacco and marijuana use initiation. Methods: Data were drawn from the Adolescent Brain Cognitive Development (ABCD) study to assess associations between baseline SES, baseline PM2.5 exposure (based on zip code), baseline P-VAN rsFC, baseline inhibitory control, and subsequent tobacco and marijuana use initiation. Mediation models were used to determine whether PM2.5 exposure and changes in P-VAN rsFC act as pathways linking low SES to diminished inhibitory control and subsequent substance use initiation. Results: Low SES was associated with higher PM2.5 exposure, which, in turn, was linked to alterations in P-VAN rsFC. These alterations were correlated with lower inhibitory control, which significantly predicted tobacco and marijuana use initiation over time. Inhibitory control partially mediated the relationship between low SES and substance use initiation, indicating a complex pathway influenced by environmental and neurocognitive factors. Conclusions: This study identifies a potential mechanism linking low SES to tobacco and marijuana use initiation through environmental and neurobiological pathways. Understanding how PM2.5 exposure and neurofunctional connectivity impact inhibitory control can provide valuable insights for developing targeted interventions to reduce substance use among adolescents in low SES environments.
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Open Access January 21, 2025

A Disaster Management Contingency and Training Plan for Nursing Service Personnel

Abstract Background: Disasters such as typhoons, floods, and earthquakes frequently impact the Philippines, placing nurses at the forefront of response and care. Given these recurring threats, ensuring that nurses possess adequate awareness, knowledge, and skills is crucial to mitigate risks, enhance preparedness, and promote effective disaster management. Aim/Objectives: This study sought to [...] Read more.
Background: Disasters such as typhoons, floods, and earthquakes frequently impact the Philippines, placing nurses at the forefront of response and care. Given these recurring threats, ensuring that nurses possess adequate awareness, knowledge, and skills is crucial to mitigate risks, enhance preparedness, and promote effective disaster management. Aim/Objectives: This study sought to (1) assess the current levels of awareness, knowledge, skills, and involvement of private hospital nurses in Rizal Province across four phases of disaster management—mitigation and prevention, preparedness, response, and rehabilitation and recovery; and (2) propose a contingency and training plan based on identified gaps. Methods: A descriptive correlational design was employed. A total of 350 nurses from Level 1, 2, and 3 hospitals participated by completing a validated questionnaire. Data were analyzed using descriptive statistics, analysis of variance, and correlation tests to identify differences and relationships among variables. Results: Overall, the nurses reported very high levels of awareness and skills, coupled with a high level of knowledge and significant involvement in disaster-related activities. Nurses in larger (Level 3) hospitals exhibited higher practical readiness and engagement, while those in Level 1 and 2 facilities had comparatively lower scores. Positive correlations emerged between higher levels of awareness, knowledge, and skills and increased engagement in disaster initiatives. Conclusion: Building on these findings, a targeted contingency and training plan was designed using Pucel’s Performance-based Instructional Design, emphasizing hands-on simulations, structured policy briefings, and collaborative efforts with local disaster risk reduction offices. Addressing these specific gaps can bolster hospital preparedness, strengthen community resilience, and ensure more effective disaster response and patient care.
Article
Open Access January 16, 2025

Extreme Heat Exposure and Adolescent Cognitive Function

Abstract Background: Extreme heat exposure is an increasing public health concern, particularly in the context of climate change. Limited research has explored its impact on children's cognitive outcomes. This study investigates the association between extreme heat exposure and cognitive function in 9–10-year-old children, using data from the Adolescent Brain Cognitive Development (ABCD) study. [...] Read more.
Background: Extreme heat exposure is an increasing public health concern, particularly in the context of climate change. Limited research has explored its impact on children's cognitive outcomes. This study investigates the association between extreme heat exposure and cognitive function in 9–10-year-old children, using data from the Adolescent Brain Cognitive Development (ABCD) study. Additionally, we assess whether this effect is independent of socio-demographic factors such as race, family socioeconomic status (SES), and neighborhood SES. Methods: Data were drawn from the ABCD study, comprising over 10,000 children aged 9–10 years. Cognitive function was assessed through standardized cognitive tests, while extreme heat exposure was estimated using geographic and climate data. Structural equation modeling (SEM) was employed to examine the direct effects of heat exposure on cognitive outcomes and to account for potential confounding variables, including race, family SES, and neighborhood SES. Results: Black families, low SES households, and children from low SES neighborhoods were disproportionately exposed to extreme heat. Extreme heat exposure was significantly associated with lower cognitive function in children, and this association remained robust even after adjusting for socio-demographic factors. Conclusions: Extreme heat exposure is linked to diminished cognitive function in children, particularly among socio-economically disadvantaged and marginalized populations. Given the increasing frequency of extreme heat events due to climate change, future research should further explore these implications for children’s cognitive outcomes. Policy interventions that improve access to cooling infrastructure, expand green spaces, and prioritize at-risk populations are critical to mitigating the adverse cognitive effects of extreme heat in low SES communities.
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Open Access January 16, 2025

Heat Exposure Predicts Earlier Childhood Pubertal Initiation, Behavioral Problems, and Tobacco Use

Abstract Background: Climate change has raised significant concerns about its impact on health, particularly for vulnerable populations such as children and adolescents. While extensive research has examined physical health effects, limited attention has been given to the influence of extreme heat on developmental and behavioral outcomes. Objectives: This study investigates the association [...] Read more.
Background: Climate change has raised significant concerns about its impact on health, particularly for vulnerable populations such as children and adolescents. While extensive research has examined physical health effects, limited attention has been given to the influence of extreme heat on developmental and behavioral outcomes. Objectives: This study investigates the association between extreme heat exposure and early puberty initiation (ages 9-10), using data from the Adolescent Brain Cognitive Development (ABCD) study. It further explores how early puberty correlates with behavioral problems and tobacco use initiation. Methods: Data from 11,878 participants in the ABCD study were analyzed to examine the relationship between extreme heat exposure (independent variable) and puberty initiation (outcome). Behavioral problems and tobacco use initiation were evaluated as downstream outcomes of early puberty. Covariates included age, sex, and race/ethnicity, and behavioral problems were assessed using the Child Behavior Checklist (CBCL). Structural equation modeling (SEM) was employed for analysis. Results: Extreme heat exposure was significantly associated with earlier puberty initiation at ages 9-10. Early puberty, in turn, correlated with higher levels of behavioral problems and an increased likelihood of tobacco use initiation. Conclusions: These findings underscore the importance of addressing environmental factors such as extreme heat to reduce risks associated with early maturation, including behavioral and substance use challenges. Targeted interventions and policies are needed to mitigate the impact of extreme heat on child development, and longitudinal studies are essential to confirm these results and inform effective prevention strategies.
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Open Access January 16, 2025

Puberty Onset and Positive Urgency Explain Diminished Returns of Family Income on Tobacco and Marijuana Use

Abstract Background: Puberty is a crucial developmental milestone that involves significant physiological, emotional, and behavioral changes. Early puberty onset, influenced by both biological and social factors, is associated with an increased risk of engaging in substance use, such as tobacco and marijuana. While high family income is generally linked to delayed puberty onset and lower behavioral [...] Read more.
Background: Puberty is a crucial developmental milestone that involves significant physiological, emotional, and behavioral changes. Early puberty onset, influenced by both biological and social factors, is associated with an increased risk of engaging in substance use, such as tobacco and marijuana. While high family income is generally linked to delayed puberty onset and lower behavioral risks, these benefits may not be equally protective for Black youth due to the phenomenon of Minorities' Diminished Returns (MDRs). MDRs suggest that higher family income does not offer the same protective effects for Black youth as it does for White youth, potentially leading to earlier puberty and increased substance use among high-income Black adolescents. Objective: This study aimed to investigate whether early puberty onset and associated positive urgency (impulsivity) mediate the relationship between family income and the initiation of tobacco and marijuana use over a six-year follow-up period among adolescents. Additionally, the study examined whether the effects of family income on early puberty onset differ by race, testing the hypothesis that high-income Black youth would experience earlier puberty onset compared to their high-income White peers. Methods: Data were sourced from the Adolescent Brain Cognitive Development (ABCD) Study. Participants were 9-10-year-old adolescents at baseline, followed over a period of six years. Structural equation modeling (SEM) was used to assess whether early puberty onset mediated the effects of family income on substance use behaviors. Interaction terms between race and family income were included to test whether the impact of family income varies by race. Results: Early puberty onset and associated positive urgency partially explained the relationship between family income and the initiation of tobacco and marijuana use. High-income Black youth showed earlier puberty onset compared to their White counterparts. Earlier puberty onset then predicted higher positive urgency. These factors, in turn, were linked to higher rates of tobacco and marijuana initiation. Conclusions: This study provides additional evidence that the benefits of high family income do not extend equally to Black adolescents, particularly regarding delaying puberty onset and its consequences for substance use.
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Open Access January 15, 2025

Too Much Heat May Make You Smoke

Abstract Background: The rising concerns surrounding climate change have drawn attention to its potential impact on health, particularly among vulnerable groups such as children and older adults. Despite extensive research on health consequences, limited studies have explored the connection between extreme heat exposure and tobacco use initiation among adolescents in the United States. [...] Read more.
Background: The rising concerns surrounding climate change have drawn attention to its potential impact on health, particularly among vulnerable groups such as children and older adults. Despite extensive research on health consequences, limited studies have explored the connection between extreme heat exposure and tobacco use initiation among adolescents in the United States. Objectives: This study examines the relationship between extreme heat exposure and the initiation of tobacco use in adolescents, using data from the Adolescent Brain Cognitive Development (ABCD) study. It also evaluates the mediating roles of major depressive disorder (MDD) and childhood behavioral problems. Methods: Data from 11,878 participants in the ABCD study were analyzed to explore the link between extreme heat exposure (independent variable) and tobacco use initiation (dependent variable). Covariates included age, sex, and race/ethnicity, while MDD and behavioral problems (measured using the Child Behavior Checklist, CBCL) were assessed as potential mediators. Structural equation modeling (SEM) was applied for analysis. Results: The findings indicated a significant association between extreme heat exposure and an increased likelihood of tobacco use initiation in adolescents aged 9 to 15. MDD and behavioral problems partially mediated this relationship. Conclusions: These results underscore the importance of targeted interventions aimed at mitigating the impact of extreme heat on adolescent health, including its influence on tobacco use initiation. Addressing mental health and behavioral challenges could help reduce these risks. Future longitudinal research is needed to confirm these findings and evaluate the efficacy of strategies to protect vulnerable youth populations.
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Open Access November 21, 2024

Financial Strain Partially Explains Diminished Returns of Parental Education in the ABCD Study

Abstract Background: Previous research shows that socioeconomic status (SES) positively impacts children's development, yet the benefits are not equally distributed across racial groups. According to the Minorities’ Diminished Returns (MDRs) framework, Black children tend to experience smaller gains from parental education compared to White children. Objective: Building on the MDRs framework, [...] Read more.
Background: Previous research shows that socioeconomic status (SES) positively impacts children's development, yet the benefits are not equally distributed across racial groups. According to the Minorities’ Diminished Returns (MDRs) framework, Black children tend to experience smaller gains from parental education compared to White children. Objective: Building on the MDRs framework, this study examines whether high financial strain contributes to the diminished returns of parental education for Black children, using data from the Adolescent Brain Cognitive Development (ABCD) Study. We hypothesized that: (1) there would be a positive effect of parental education on total cortical volume, (2) this effect would be weaker for Black than White children, and (3) higher household financial strain in Black families would mediate the diminished returns of parental education on total cortical volume for Black children. Methods: Data were drawn from the baseline ABCD Study, focusing on 7,936 9- and 10-year-old children identified as either Black (n = 1,775) or White (n = 6,161). Parental education was the key independent variable, covariates included age, sex, household income, and marital status, race was the moderator, financial strain was the mediator, and total cortical volume was the outcome. Structural Equation Models (SEMs) were employed to examine the associations between parental education and cortical volume, with financial strain as a mediator and race as a moderator. Results: Higher parental education was associated with greater cortical volume in the pooled sample. However, this effect was significantly weaker for Black children. Financial strain partially mediated the observed diminished returns of parental education. Conclusion: High financial strain experienced by middle-class Black families partially explains why the association between parental education and child development is weaker in Black than White families. Interventions aimed at enhancing educational quality, increasing employability, expanding access to higher-paying jobs, and reducing labor market discrimination against Black individuals may help address racial inequities in child development in the U.S. Efforts to reduce financial strain should extend beyond low-income populations to also support higher-educated minority families.
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Open Access November 07, 2024

Optimizing Pharmaceutical Supply Chain: Key Challenges and Strategic Solutions

Abstract Pharmaceutical supply chains are critical to ensuring the availability of safe and effective medications, yet they face numerous challenges that can jeopardize public health. This article provides a comprehensive analysis of the key issues impacting pharmaceutical supply chains, including regulatory compliance, demand forecasting, supply chain visibility, quality assurance, and geopolitical risks. [...] Read more.
Pharmaceutical supply chains are critical to ensuring the availability of safe and effective medications, yet they face numerous challenges that can jeopardize public health. This article provides a comprehensive analysis of the key issues impacting pharmaceutical supply chains, including regulatory compliance, demand forecasting, supply chain visibility, quality assurance, and geopolitical risks. Regulatory compliance remains a significant concern due to the stringent guidelines imposed by authorities such as the FDA and EMA, which can lead to increased operational costs and time delays. Additionally, traditional demand forecasting methods often fail to accurately predict fluctuations in drug demand, resulting in stockouts or excess inventory. Limited supply chain visibility further complicates these challenges, hindering timely decision-making and operational efficiency. Quality assurance is paramount, as maintaining the integrity of pharmaceutical products throughout the supply chain is crucial to preventing costly recalls and ensuring patient safety. Moreover, the globalization of supply chains introduces vulnerabilities to geopolitical risks, trade disputes, and natural disasters. In response to these issues, this article outlines strategic recommendations for optimizing pharmaceutical supply chains. These include leveraging advanced analytics and IoT technologies to enhance demand forecasting and visibility, strengthening compliance through automated systems and training, fostering collaboration among stakeholders, implementing robust risk management frameworks, and investing in quality management systems. By adopting these strategies, pharmaceutical companies can enhance the efficiency and resilience of their supply chains, ultimately ensuring the continuous availability of essential medications for patients worldwide. This analysis serves as a critical resource for industry professionals seeking to navigate the complexities of pharmaceutical supply chains in an increasingly dynamic global environment.
Review Article
Open Access November 05, 2024

Diminished Returns of Educational Attainment on Numeracy Score of Latino Populations: Insights from UAS Data

Abstract Background: Educational attainment is a well-established social determinant of various domains of cognitive function across the lifespan. However, the theory of Minorities' Diminished Returns (MDRs) suggests that the health benefits of educational attainment tend to be weaker for ethnic minorities compared to non-Latino Whites. This phenomenon may reflect the impact of structural [...] Read more.
Background: Educational attainment is a well-established social determinant of various domains of cognitive function across the lifespan. However, the theory of Minorities' Diminished Returns (MDRs) suggests that the health benefits of educational attainment tend to be weaker for ethnic minorities compared to non-Latino Whites. This phenomenon may reflect the impact of structural inequalities, social stratification, and historical disadvantage. Objective: This study examines whether the association between educational attainment and numeracy score, one domain of cognitive function, is weaker in Latino individuals compared to non-Latino individuals, as predicted by the MDRs framework. Methods: Data were drawn from the 2014 wave of the Understanding America Study (UAS), a national internet-based panel. Numeracy score, a domain of the cognitive function was measured using an 8-item measure. Linear regression models were used to analyze the association between educational attainment and numeracy score, with an interaction term for ethnicity x educational attainment to explore differences between Latino and non-Latino participants. Models were adjusted for age, gender, marital status, immigration, and employment, and results were presented as beta coefficients, p-values, and 95% confidence intervals (CIs). Results: Overall, 5,659 participants entered our analysis. Higher educational attainment was positively associated with higher numeracy score for both Latino and non-Latino participants (p < 0.001). However, the interaction between education and ethnicity was significant (p < 0.05), indicating that Latino individuals experienced smaller numeracy benefits from education compared to non-Latino individuals. These results support the MDRs framework, suggesting that structural barriers may reduce the numeracy returns of education for Latino individuals. Conclusion: This study provides evidence of diminished returns of educational attainment in terms of numeracy scores among Latino individuals. While education is a key determinant of cognitive abilities such as numeracy, its benefits are not equitably distributed across ethnic groups. Structural inequalities particularly in educational opportunities likely contribute to this disparity. Addressing these underlying factors through targeted policy interventions is necessary to promote cognitive equity for Latino populations.
Article
Open Access November 03, 2024

Students' Perceptions of the Usefulness of Formative Feedback in Mathematics Lessons

Abstract This study aimed to examine students' perceptions of the usefulness of formative feedback in mathematics lessons at Sagnerigu Municipality in the Northern Region of Ghana. Quantitatively, this study employed a descriptive non-experimental survey design. The population comprises all pupils of public Junior High Schools in the Sagnerigu Municipality. A purposive sampling technique was used to [...] Read more.
This study aimed to examine students' perceptions of the usefulness of formative feedback in mathematics lessons at Sagnerigu Municipality in the Northern Region of Ghana. Quantitatively, this study employed a descriptive non-experimental survey design. The population comprises all pupils of public Junior High Schools in the Sagnerigu Municipality. A purposive sampling technique was used to select the Junior High School students for the study. The criterion purposive sampling technique was used to select 518 final-year students for the 2022 Basic education certificate examination from 14 schools in Sagnerigu Municipality. The chosen schools comprised 291 students from high-performing schools and 227 students from low-performing schools. The primary tool for the study was the Student Feedback Perception Questionnaire (SFPQ), administered to the student participants. The Descriptive statistical tool was used to analyse the mean and standard deviation of the data. The study's examination of students' perceptions of feedback revealed a moderate level of perceived usefulness. This emphasises the importance of feedback as a tool for student growth and development. However, the findings also suggest the need for further support and guidance to optimise the impact of feedback on student learning outcomes. The findings also suggest that students value feedback that helps them improve their skills and strategies in Mathematics and keeps them on track to succeed. It also highlights the importance of providing different types of feedback to cater to the diverse learning needs of students. Educators can create a conducive environment that promotes student engagement and achievement by equipping teachers with effective feedback techniques, emphasising constructive comments and avoiding grades.
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Open Access November 01, 2024

Impacts of Drug Shortages in the Pharmaceutical Supply Chain

Abstract Drug shortages represent a significant and growing challenge within the pharmaceutical supply chain, with profound implications for patient care, public health, and healthcare costs. This manuscript provides a comprehensive examination of the causes and impacts of drug shortages, highlighting the multifaceted nature of this issue. Key factors contributing to shortages include manufacturing [...] Read more.
Drug shortages represent a significant and growing challenge within the pharmaceutical supply chain, with profound implications for patient care, public health, and healthcare costs. This manuscript provides a comprehensive examination of the causes and impacts of drug shortages, highlighting the multifaceted nature of this issue. Key factors contributing to shortages include manufacturing complications, limited availability of active pharmaceutical ingredients (APIs), market dynamics that discourage the production of less profitable medications, and regulatory challenges that slow down the approval process for new manufacturing capacities. The consequences of these shortages are far-reaching. Patients often face treatment delays, which can lead to adverse health outcomes, increased hospitalization rates, and even mortality. Healthcare providers experience heightened operational costs as they seek alternative therapies and manage complications resulting from inadequate treatment. Furthermore, the frequent occurrence of drug shortages erodes public trust in both the healthcare system and the pharmaceutical industry, leading to decreased patient adherence to prescribed therapies. To mitigate the impacts of drug shortages, this manuscript proposes several strategic solutions, including enhanced communication among stakeholders, diversification of supply sources, increased regulatory flexibility, and collaborative approaches between public and private sectors. Additionally, raising awareness among healthcare providers and patients regarding the causes and potential alternatives can empower stakeholders to navigate shortages effectively. Ultimately, addressing drug shortages necessitates a proactive and coordinated effort from all participants in the pharmaceutical supply chain. By implementing these strategies, stakeholders can enhance the resilience of the supply chain, ensuring that essential medications remain accessible and that patient care is not compromised. The findings of this manuscript underscore the urgent need for ongoing vigilance and collaborative action to tackle the challenges posed by drug shortages, safeguarding public health and improving healthcare outcomes globally.
Review Article
Open Access October 31, 2024

The Long Shadow of Early Poverty: Poverty at Birth, Epigenetic Changes at Age 15, And Youth Outcomes at Age 22

Abstract Background: Early life socioeconomic conditions and race/ethnicity are critical determinants of long-term health and behavioral outcomes. Epigenetic changes, particularly those measured by the GrimAge biomarker, may mediate the impact of these early adversities on later life outcomes. This study investigates the relationships between race/ethnicity, poverty at birth, epigenetic aging at age [...] Read more.
Background: Early life socioeconomic conditions and race/ethnicity are critical determinants of long-term health and behavioral outcomes. Epigenetic changes, particularly those measured by the GrimAge biomarker, may mediate the impact of these early adversities on later life outcomes. This study investigates the relationships between race/ethnicity, poverty at birth, epigenetic aging at age 15, and subsequent self-rated health, school discipline, depression, and school dropout at age 22. We explored sex differences in these paths. Methods: Data were drawn from the Fragile Families and Child Wellbeing Study (FFCWS), which included 733 youth with comprehensive follow-up data up to age 22. Structural Equation Modeling (SEM) was employed to assess the pathways from race/ethnicity and poverty at birth to epigenetic aging (GrimAge) at age 15, and subsequently to self-rated health and school discipline at age 22. The model controlled for potential confounders including sex, family structure, and parental education. Results: Race/ethnicity and poverty at birth were significantly associated with higher GrimAge scores at age 15 (p < 0.05). Higher GrimAge scores were predictive of poorer self-rated health (β = -0.08, p < 0.05) and increased instances of school discipline (β = 0.13, p < 0.01) at age 22. The indirect effects of race/ethnicity and poverty at birth on self-rated health and school discipline through GrimAge were also significant (p < 0.05), suggesting that epigenetic aging partially mediates these relationships. Sex differences were also observed. Poverty at birth predicted faster epigenetic aging at age 15 for males not females. We also observed that faster epigenetic aging at age 15 was predictive of school discipline of male not female participants at age 22. In contrast, faster epigenetic aging at age 15 was predictive of self-rated health (SRH) of female not male participants at age 22. Conclusions: This study provides evidence that with some sex differences, race/ethnicity and poverty at birth contribute to accelerated epigenetic aging (GrimAge) by age 15, which in turn predicts poorer self-rated health and increased school discipline issues by age 22. These findings emphasize the importance of early interventions targeting social determinants to mitigate long-term health and behavioral disparities. Addressing these early life conditions is crucial for improving health equity and outcomes in young adulthood.
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Open Access October 30, 2024

Social Determinants of Successful Smoking Cessation: An Eight-Year Analysis of Population Assessment of Tobacco and Health (PATH) Data

Abstract Background: Smoking cessation is a crucial public health goal due to its substantial impact on reducing the morbidity and mortality associated with tobacco use. However, significant disparities in smoking cessation success persist across socioeconomic groups in the United States. Objectives: This study aimed to examine differences in smoking cessation rates among daily smokers [...] Read more.
Background: Smoking cessation is a crucial public health goal due to its substantial impact on reducing the morbidity and mortality associated with tobacco use. However, significant disparities in smoking cessation success persist across socioeconomic groups in the United States. Objectives: This study aimed to examine differences in smoking cessation rates among daily smokers based on race, ethnicity, and socioeconomic status (SES) using data from the Population Assessment of Tobacco and Health (PATH) study, spanning waves 1 to 6 (eight years). Methods: Longitudinal data from PATH were analyzed, focusing on baseline daily cigarette smokers followed over an eight-year period to assess cessation outcomes. SES was measured by education and poverty status. Successful smoking cessation was defined as sustained abstinence from cigarettes for 12 months or more at the final wave. Logistic regression models identified predictors of successful cessation, adjusting for potential confounders, including age, nicotine dependence, and access to cessation resources. Results: The analysis revealed significant disparities in cessation success across racial, ethnic, and SES groups. Smokers living in poverty and those with lower educational attainment were less likely to achieve cessation success than their counterparts. Race (Black) and ethnicity (Latino) were also significantly associated with lower cessation success. Conclusions: This study highlights the social determinants of smoking cessation success among U.S. adult smokers, with lower success rates observed among those in poverty and with less educational attainment. These findings emphasize the need for targeted interventions that address the unique barriers to cessation faced by low-SES groups. Public health strategies should prioritize equitable access to cessation resources and culturally tailored interventions to reduce these disparities and improve cessation outcomes among all smokers.
Article
Open Access October 26, 2024

Exploring the Relationship between Teacher Training and Challenges in Delivering Effective Sex Education

Abstract This study aimed to explore the relationship between teacher training and challenges in delivering effective sex education in the Sagnarigu district in the Northern region of Ghana. The Social-cultural theory underpins the study. A descriptive survey research design was adopted for the study. The population of this study comprises teachers, head teachers and a School Improvement Support Officer [...] Read more.
This study aimed to explore the relationship between teacher training and challenges in delivering effective sex education in the Sagnarigu district in the Northern region of Ghana. The Social-cultural theory underpins the study. A descriptive survey research design was adopted for the study. The population of this study comprises teachers, head teachers and a School Improvement Support Officer (SiSo) in basic schools in the Gumani/Nyanshegu circuit in the Sagnarigu district of the Northern Region. This study adopted multi-sampling methods to select respondents. Random and purposive sampling techniques were used to select the study's 10 basic schools and 83 respondents. The main tools used for the data collection were the questionnaire and interview. The data was analysed using Statistical Package for Social Scientists (SPSS) software version 23 tools. Descriptive Statistical tools such as frequencies were used to gauge the number of occurrences of the studied variables. The qualitative data was also further analysed in line with the research questions to establish patterns of similarities and variations. These were then validated with the quantitative data for any possible contradictions in the findings. The study concludes that people's socio-cultural and religious beliefs and practices affect the teaching of sex education in school. It was observed that sex education could be misconstrued as an encouragement to young people to engage in early sexual promiscuity. Finally, the study concludes that there cannot be effective sex education without the appropriate logistics such as T.L.M.s, syllabus and time allocation for the subject. The study also acknowledges that the availability of these materials must go along with appropriate capacity building for teachers to be well-positioned to teach the subject. It is recommended that Sexuality education should be included in the curricular and academic calendar of basic schools, along with the provision of adequate T.L.M.s and the proper collaboration with appropriate agencies for the effective teaching of the subject. Sex education needs to be given maximum attention, just as any of the life skills subjects, with adequate investment and motivation to both teachers and pupils to ensure a meaningful impact. There should be regular monitoring, supervision, and assessment of the training of teachers and its influence on the teaching of the subject, as well as ensuring that ethical considerations regarding cultural and religious sensitivities and individual privacy issues are upheld.
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Open Access October 19, 2024

Quantitative Intersectionality Scoring System (QISS): Opportunities for Enhancing Predictive Modeling, Comparative Analysis, Health Needs Assessment, and Policy Evaluation

Abstract Intersectionality has significantly enhanced our understanding of how overlapping social identities—such as race, ethnicity, gender, sex, class, and sexual orientation—interact to shape individual experiences. However, despite its theoretical importance, much of the existing literature has relied on qualitative approaches to define and study intersectionality, limiting its application in [...] Read more.
Intersectionality has significantly enhanced our understanding of how overlapping social identities—such as race, ethnicity, gender, sex, class, and sexual orientation—interact to shape individual experiences. However, despite its theoretical importance, much of the existing literature has relied on qualitative approaches to define and study intersectionality, limiting its application in predictive modeling, comparative analysis, and policy development. This paper introduces the concept of Quantitative Intersectionality Scoring System (QISS), a novel approach that assigns numerical scores to intersecting identities, thereby enabling a more systematic and data-driven analysis of intersectional effects. We argue that QISS can substantially enhance the utility and predictive validity of quantitative models by capturing the complexities of multiple, overlapping social determinants. By presenting concrete examples, such as the varying impacts of socioeconomic mobility on life expectancy among different intersectional groups, we demonstrate how QISS can yield more precise and reliable forecasts. Such a shift would allow policymakers and service providers to dynamically assess economic and health needs, as well as the uncertainties around them, as individuals move through different social and economic contexts. QISS-based models could be more responsive to the complexities of intersecting identities, allowing for a more quantified and nuanced evaluation of policy interventions. We conclude by discussing the challenges of implementing QISS and emphasizing the need for further research to validate these quantifications using robust quantitative methods. Ultimately, adopting QISS has the potential to improve the accuracy of predictive models and the effectiveness of policies aimed at promoting social justice and health equity.
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Perspective
Open Access September 27, 2024

The Relationship between Physical Education Activity Programs and Academic Achievement

Abstract The benefits of physical activity are immense and indisputable; however, the inclusion of Physical Education Activity Programs (PEAP) within the college setting, specifically the University Undergraduate Core Curriculum, is largely disregarded and viewed as unnecessary. Increased physical activity has shown to have a positive relationship throughout the human development process. Health promotion [...] Read more.
The benefits of physical activity are immense and indisputable; however, the inclusion of Physical Education Activity Programs (PEAP) within the college setting, specifically the University Undergraduate Core Curriculum, is largely disregarded and viewed as unnecessary. Increased physical activity has shown to have a positive relationship throughout the human development process. Health promotion programs should target people of all ages, since the risk of chronic disease starts in childhood and increases with age. In addition to the physical activity benefits associated with human development, decrease disease rate, and extended lifespan, physical activity has also been thoroughly researched and documented to have positive effects on academic achievement. Despite the evidence identified through the results of the research, PEAP at the college level are consistently being ignored and removed from university undergraduate core curriculum. The purpose for university exclusion of PEAP is unknown; however, addressing the gap within the literature may provide justification for re-installment; research has not yet identified the impact of PEAP on the academic achievement of undergraduate students. A positive outcome could be gained by increasing the curricular value of compulsory PK-12 health and physical education requirements.
Commentary
Open Access September 27, 2024

Psychological Impact of Poverty on Children’s Mental Health and Wellbeing in Adentan Municipality, Ghana

Abstract This study examined the psychological impact of poverty on the mental health and wellbeing of children in Adentan Municipality, Ghana. The study adopted a phenomenological qualitative approach. A sample of 15 children from poor homes were selected using purposive and snowball sampling for the study. Data were collected using a semi-structured interview guide and analysed using thematic analysis. [...] Read more.
This study examined the psychological impact of poverty on the mental health and wellbeing of children in Adentan Municipality, Ghana. The study adopted a phenomenological qualitative approach. A sample of 15 children from poor homes were selected using purposive and snowball sampling for the study. Data were collected using a semi-structured interview guide and analysed using thematic analysis. The study found that the main experiences of the children raised in poor homes were that they had unmet basic needs and limited income. Also, it was found that the psychological impact of poverty on children included stigma and inferiority, distress and hopelessness. From the results, it was concluded that poverty can have a psychological impact on the mental health and wellbeing of children. it was recommended that Social Welfare liaise with community leaders to identify children from poor homes and provide support for these children in terms of their basic needs like food and clothing.
Article
Open Access September 12, 2024

Assessment of Coping Strategies Among Nursing Students: Basis for Psychological First Aid

Abstract Background: Telomere length is a critical biomarker of cellular aging and overall health. While childhood socioeconomic status (SES) indicators such as education and poverty can have long-lasting effects on biological aging, research has shown contradictory results regarding the impact of adulthood SES on future telomere length, particularly in racially and ethnically diverse individuals. [...] Read more.
Background: Telomere length is a critical biomarker of cellular aging and overall health. While childhood socioeconomic status (SES) indicators such as education and poverty can have long-lasting effects on biological aging, research has shown contradictory results regarding the impact of adulthood SES on future telomere length, particularly in racially and ethnically diverse individuals. This study investigates the effects of baseline adulthood SES indicators such as education and poverty on telomere length nine years later in women, using data from the Future of Families and Child Wellbeing Study (FFCWS). Methods: We analyzed data from the FFCWS, a longitudinal cohort study. The sample included baseline adulthood SES and follow-up telomere length measure of women (n = 2,421) with varying socioeconomic conditions. Telomere length was measured from saliva samples nine years after the baseline measure of adulthood SES. Education, poverty, and marital status at baseline were assessed. Multivariate linear regression models were used to examine the association between adulthood SES indicators at baseline and future telomere length, controlling for potential confounders. Results: From the total 2,421 women, 675 were Latino White, 1,158 were non-Latino Black, and 588 were non-Latino White. Our findings indicate that for non-Latino White women poverty at certain level, and childbirth weight, and for non-Latino Black maternal age were predictors of telomere lengths nine years later. Conclusion: Poverty at a specific level, maternal age and childbirth weight serve as predictors of telomere lengths nine years later in some women. These findings underscore the importance of socioeconomic factors and early-life influences in understanding telomere dynamics and aging processes among women from varied racial and ethnic backgrounds.
Article
Open Access September 10, 2024

Does Adulthood Socioeconomic Status Predict Subsequent Telomere Length in Racially and Ethnically Diverse Women?

Abstract Background: Telomere length is a critical biomarker of cellular aging and overall health. While childhood socioeconomic status (SES) indicators such as education and poverty can have long-lasting effects on biological aging, research has shown contradictory results regarding the impact of adulthood SES on future telomere length, particularly in racially and ethnically diverse individuals. [...] Read more.
Background: Telomere length is a critical biomarker of cellular aging and overall health. While childhood socioeconomic status (SES) indicators such as education and poverty can have long-lasting effects on biological aging, research has shown contradictory results regarding the impact of adulthood SES on future telomere length, particularly in racially and ethnically diverse individuals. This study investigates the effects of baseline adulthood SES indicators such as education and poverty on telomere length nine years later in women, using data from the Future of Families and Child Wellbeing Study (FFCWS). Methods: We analyzed data from the FFCWS, a longitudinal cohort study. The sample included baseline adulthood SES and follow-up telomere length measure of women (n = 2,421) with varying socioeconomic conditions. Telomere length was measured from saliva samples nine years after the baseline measure of adulthood SES. Education, poverty, and marital status at baseline were assessed. Multivariate linear regression models were used to examine the association between adulthood SES indicators at baseline and future telomere length, controlling for potential confounders. Results: From the total 2,421 women, 675 were Latino White, 1,158 were non-Latino Black, and 588 were non-Latino White. Our findings indicate that for women in our study, no adulthood SES indicators such as poverty status, education, or marital status at baseline were predictive of telomere lengths nine years later. Conclusion: Our observations challenge that expected longitudinal association between adulthood SES indicators and subsequent telomere length almost a decade later in racially and ethnically diverse group of women. These findings underscore the need for additional research on the validity of TL as a mediator of the effects of adulthood SES on future rate of biological aging.
Article
Open Access September 05, 2024

Caste-based Diminished Returns of Educational Attainment on Wealth Accumulation in India

Abstract Background: Education is widely recognized as a key driver of wealth generation, providing individuals with the opportunity to enhance their socioeconomic status. However, the effectiveness of education in generating wealth varies significantly across different social groups. In the United States, research has shown that Black individuals experience weaker economic returns on education [...] Read more.
Background: Education is widely recognized as a key driver of wealth generation, providing individuals with the opportunity to enhance their socioeconomic status. However, the effectiveness of education in generating wealth varies significantly across different social groups. In the United States, research has shown that Black individuals experience weaker economic returns on education compared to their White counterparts, a phenomenon explained by the theory of Minorities' Diminished Returns (MDRs). Although MDRs have been documented in various countries, their relevance to caste-based disparities in India remains unexplored. Objective: This study aims to investigate the caste-based diminished returns of education on wealth in India. We hypothesize that the returns on educational attainment, in terms of wealth generation, will be weaker for individuals from Scheduled Castes (SCs) compared to those from higher castes, using data from the India Demographic and Health Surveys (DHS). Methods: This study was a cross-sectional analysis of DHS -2019/2021 data from India, examining the relationship between educational attainment and wealth across different caste groups (scheduled castes and non-scheduled castes). Multivariate regression models will be employed to assess the interaction between caste and education in predicting wealth outcomes, controlling for relevant covariates such as age, gender, and region. Results: The study is expected to find that the returns on education, in terms of wealth, are significantly weaker for individuals from Scheduled Castes compared to those from higher castes. This would indicate that caste-based discrimination continues to hinder the economic progress of Scheduled Castes, even when they achieve similar levels of education as their upper-caste counterparts. Conclusion: The findings of this study will extend the MDR framework to the Indian context, demonstrating that caste-based disparities result in diminished returns on education for wealth generation. This study underscores the need for targeted policies that address the specific barriers faced by Scheduled Castes in translating educational attainment into economic success and highlights the ongoing impact of caste-based discrimination in India.
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Open Access September 04, 2024

Social Epidemiology of Early Initiation of Electronic and Conventional Cigarette Use in Early to Middle Adolescents

Abstract Background: Early initiation of tobacco use among adolescents is a significant public health concern. While there is extensive research on overall tobacco use, much of it focuses on initiation in late adolescence, uses cross-sectional designs, and lacks specific exploration of electronic versus conventional cigarette use. This study aims to investigate social determinants influencing the [...] Read more.
Background: Early initiation of tobacco use among adolescents is a significant public health concern. While there is extensive research on overall tobacco use, much of it focuses on initiation in late adolescence, uses cross-sectional designs, and lacks specific exploration of electronic versus conventional cigarette use. This study aims to investigate social determinants influencing the early initiation of electronic and conventional cigarette use among U.S. adolescents. Methods: We utilized data from the Adolescent Brain Cognitive Development (ABCD) study, which follows a cohort of tobacco-naïve children from age nine through age 16. The social determinants examined included household income, parental education, financial difficulties, racial/ethnic minority status, family structure, neighborhood income, and gender minority status. Structural equation models were employed to assess associations between these determinants and early initiation of electronic and conventional cigarette use. Results: Male gender was associated with a higher likelihood of conventional cigarette use, while the risk of early initiation of electronic cigarette use was similar across genders. White adolescents were at a higher risk of conventional cigarette use; however, the risk for electronic cigarette use was comparable across White and non-White groups. Financial difficulties were linked to an increased likelihood of early initiation of conventional cigarette use but not electronic cigarette use. Higher household income was associated with a reduced risk of initiating conventional cigarettes but did not significantly impact electronic cigarette use. Adolescents from married families were less likely to initiate electronic cigarette use. No significant effects were found for parental education or neighborhood income on the initiation of either type of cigarette use. Age did not significantly affect the initiation of either cigarette type, and gender minority status was marginally associated with early initiation of conventional cigarette use. Conclusions: The social patterning of electronic cigarette use differs from that of conventional cigarette use, suggesting that distinct tobacco products do not pose a uniform risk across all adolescents. This study underscores the importance of tailored prevention efforts that address the unique challenges associated with early initiation of electronic and conventional cigarette use among adolescents. The differential risk factors identified suggest targeted prevention strategies for conventional cigarette use, focusing on financial difficulties, household income, and gender-specific interventions. In contrast, prevention efforts for electronic cigarette use may require broader, more inclusive approaches that address all adolescents, regardless of their background. Comprehensive universal screening for electronic cigarette use and targeted screening for conventional cigarette use among adolescents are recommended.
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Open Access August 18, 2024

Extreme Heat Exposure Is Associated with Higher Socioeconomic Disadvantage and Elevated Youth Delinquency

Abstract Background: Climate change has led to an increase in the frequency and intensity of extreme heat events, a trend expected to continue. This poses significant health risks, particularly for vulnerable populations like children. While previous research has largely concentrated on the physical health impacts of extreme heat, less attention has been given to behavioral outcomes, such as [...] Read more.
Background: Climate change has led to an increase in the frequency and intensity of extreme heat events, a trend expected to continue. This poses significant health risks, particularly for vulnerable populations like children. While previous research has largely concentrated on the physical health impacts of extreme heat, less attention has been given to behavioral outcomes, such as delinquency. Objectives: This study investigates the association between extreme heat exposure and delinquency among children, utilizing data from the Adolescent Brain Cognitive Development (ABCD) study. It also explores the potential mediating roles of neighborhood socioeconomic status (SES; measured by median home value), puberty, peer deviance, and financial difficulties. Methods: Data from the national ABCD study were analyzed to assess the relationship between extreme heat exposure (exposure) and delinquency (outcome). Covariates included race/ethnicity, sex, and age. Mediators examined were neighborhood SES, puberty, peer deviance, and financial difficulties. Structural equation modeling (SEM) was employed for data analysis. Results: Overall, 11,878 children entered our analysis. The analysis revealed a significant association between extreme heat exposure and higher levels of delinquency among children. Children more exposed to extreme heat were more likely to be Black, reside in lower SES neighborhoods, experience greater financial difficulties, and have more advanced puberty status. The group facing the highest heat exposure was also economically disadvantaged. Conclusions: The findings suggest that children already disadvantaged by socio-economic factors are disproportionately affected by extreme heat, leading to increased delinquency. This highlights the need for targeted interventions to protect these vulnerable populations and address the mediators of extreme heat exposure. Future research should focus on longitudinal studies and evaluate the effectiveness of various mitigation strategies to address these disparities.
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Open Access August 14, 2024

Handing Money to the Poor Is Never Enough: The Impact of Marginalization-Related Diminished Returns

Abstract Recent US studies such as Baby’s First Years have again demonstrated that unconditional cash transfers and guaranteed income do not lead to significant improvements in the health, economic status, and well-being of individuals living in poverty. In this perspective article we review the emerging literature on this topic and offer explanations for the observed outcomes. We then apply the theory and [...] Read more.
Recent US studies such as Baby’s First Years have again demonstrated that unconditional cash transfers and guaranteed income do not lead to significant improvements in the health, economic status, and well-being of individuals living in poverty. In this perspective article we review the emerging literature on this topic and offer explanations for the observed outcomes. We then apply the theory and empirical evidence on marginalization-related diminished returns (MDRs) also called minorities diminished returns (MDRs) to elucidate the weak or null effects of cash transfers in the lives of marginalized populations. According to the MDR theory, marginalization not only reduces access to resources but also reduces their utility. Individuals who experience long-term poverty and marginalization exhibit smaller than expected benefits from new resources, such as cash, in adulthood. This is due to the deeply entrenched structural barriers and systemic discrimination that persist throughout their lives. The existing literature suggests that socioeconomic changes in adulthood have limited impact on the health and well-being of populations that have been raised in poverty. This is because the advantages of increased socioeconomic status (SES) are often undermined by ongoing marginalization and limited access to supportive resources and opportunities. As a result, simply providing cash transfers is insufficient to create substantial and lasting improvements in the lives of those living in poverty. To address these challenges, we recommend a multifaceted approach that includes childhood poverty prevention, interventions aimed at reducing marginalization, and comprehensive multi-sector strategies. By focusing on early intervention and addressing the root causes of poverty and marginalization, we can create more effective and sustainable solutions to improve health and well-being among disadvantaged populations. This holistic approach recognizes the complexity of poverty and the necessity of addressing both immediate needs and long-term structural barriers to achieve meaningful change.
Perspective
Open Access August 12, 2024

Handling Practices of Folded Vermicelli by Small-scale Processors in Tanga City, Tanzania

Abstract This study assessed the handling and processing practices of 30 small-scale folded vermicelli processors in Tanga, specifically in urban areas of Tanga City, Tanzania. However, the micro- and small-scale processors were producing in unhygienic way because they are lacking facilities and equipment to process and handle the product hygienically. Multistage sampling design was adopted for this study [...] Read more.
This study assessed the handling and processing practices of 30 small-scale folded vermicelli processors in Tanga, specifically in urban areas of Tanga City, Tanzania. However, the micro- and small-scale processors were producing in unhygienic way because they are lacking facilities and equipment to process and handle the product hygienically. Multistage sampling design was adopted for this study and face-to-face interviews were conducted to collect data from all processing units through nine streets using semi-structured questionnaires and observation checklists. Data were analyzed using Statistical Package for Social Sciences, where the statistics aspect was determined from the results obtained. The processors found across various streets (ranging from 3.3% in Kwaminchi Street to 23.3% in Mabawa Street), exhibited diverse demographics, with 53.3% being owner-operators and 40% and 6.7% in labourer and supervisor roles, respectively. A significant portion (53.3%) had 1-3 years of experience, and a small portion (10%) attended formal training in pasta processing. Despite 73.3% possessing food manufacturing licenses, many were unfamiliar with legal requirements, lacking documentation and standardized processes, raising concerns about food safety. Raw materials were sourced locally, but 56.7% lacked storage facilities. Hygienic practices varied, with 43.3% undergoing periodic medical check-ups, 70% using protective gear, and 60% had hand washing facilities. Sun drying was the sole method employed, with 86.7% placed drying trays on rooftops. Packaging practices raised concerns, as 93.3% reused woven polypropylene bags, potentially impacting product quality. Awareness of aflatoxin and its health implications was lacking in 90% of the processors. Overall, the study highlighted gaps in awareness, training, and adherence to standards among processors, posing potential risks to food safety and quality. Encourage them to adhere with Tanzania Bureau of Standards requirements and formalize their quality control practices.
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Open Access July 31, 2024

Black-White Differences in The Effects of Parental Education on College Students’ Beliefs about Racial Discrimination

Abstract Background: Racial discrimination remains a significant issue in the United States, particularly affecting Black individuals. Understanding how beliefs about the persistence of racial discrimination are shaped by race and parental education among college students is crucial for developing strategies to address these inequities. Objectives: This study aims to examine the [...] Read more.
Background: Racial discrimination remains a significant issue in the United States, particularly affecting Black individuals. Understanding how beliefs about the persistence of racial discrimination are shaped by race and parental education among college students is crucial for developing strategies to address these inequities. Objectives: This study aims to examine the multiplicative effects of race and parental education on beliefs about the persistence of racial discrimination among Black and White college students. We hypothesize that Black students, particularly those with highly educated parents, will exhibit stronger beliefs in the persistence of racial discrimination as a significant issue compared to their White peers. Methods: Data were drawn from the Higher Education Research Institute (HERI) study, which includes a national sample of Black and White young adults on college campuses across the United States. We conducted statistical analyses to explore the influence of race and parental education on students' beliefs about racial discrimination. Results: Black students demonstrated stronger beliefs in the persistence of racial discrimination compared to White students. Additionally, students with higher parental education levels were more likely to recognize racial discrimination as a significant issue than those with lower parental education. The impact of parental education on these beliefs was more pronounced for Black students compared to White students. Discussion: Black college students, especially those from higher SES backgrounds, exhibit a heightened awareness of racial discrimination due to their lived experiences and educational exposure. High SES Black individuals often face increased visibility and prejudice in predominantly White environments, further reinforcing their beliefs about the persistence of discrimination. These findings highlight the need for targeted interventions to support Black students in higher education and promote awareness of racial discrimination. Policy solutions should include comprehensive anti-discrimination policies, increased diversity and inclusion efforts, and educational curricula that address systemic racism and social justice. The cross-sectional nature of the data limits causality inference, and self-reported measures may be subject to bias. Despite these limitations, the study's large and diverse sample enhances the generalizability of the findings. Race and parental education have multiplicative effects on college students' beliefs about the persistence of racial discrimination. Black students, particularly those from high SES backgrounds, are more likely to perceive racial discrimination as a continuing problem. Addressing these disparities through targeted policies and interventions is essential for creating equitable and inclusive educational environments.
Article
Open Access July 24, 2024

Race by Sex Intersectional Differences in the Association between Allostatic Load and Depression in US Adults: 2005-2018

Abstract Objective: Previous research has underscored the link between allostatic load—a comprehensive indicator of the cumulative physiological burden of chronic stress—and depression. However, there remains a significant gap in understanding how this relationship may differ across race and sex intersectional groups. This study aimed to investigate variations in the association between elevated [...] Read more.
Objective: Previous research has underscored the link between allostatic load—a comprehensive indicator of the cumulative physiological burden of chronic stress—and depression. However, there remains a significant gap in understanding how this relationship may differ across race and sex intersectional groups. This study aimed to investigate variations in the association between elevated allostatic load (AL>4) and depression among different race-sex intersectional groups within the general population. Methods: This cross-sectional secondary analysis utilized data from the National Health and Nutrition Examination Survey (NHANES) spanning 2005-2018. The analysis included variables such as race, sex, age, socioeconomic status, depression (measured via the Patient Health Questionnaire - PHQ), and allostatic load. Linear regression analyses were conducted to examine the interactions between race and sex with allostatic load, focusing on the likelihood of high depression as the outcome. Results: Across the pooled sample, an allostatic load greater than 4 was significantly associated with increased depression. Notably, an interaction effect was observed between race and AL>4 on depression among women, indicating that non-Hispanic Black women with a high allostatic load exhibited more pronounced depressive symptoms (Beta: 1.09, CI: 0.02-2.61). Conversely, among men, allostatic load greater than 4 neither correlated with nor interacted with race to influence depression levels. Conclusion: The study highlights the critical need to consider allostatic load as a key target for interventions that aim to reduce depression among Black women. These findings underscore the necessity for customized intervention strategies that address the nuanced race-sex disparities in the impact of allostatic load on mental health across populations.
Article
Open Access July 21, 2024

From Designed Object to Designed Context: Changes in Environmental Discourse in the First Twenty Years of the International Design Conference in Aspen

Abstract Through an in-depth discussion of the International Design Conference in Aspen from 1951 to 1970, this paper explores how environmental discourse underwent a shift in its connotations in the field of design during the conference. Of particular importance in this process of discursive transformation was the 1970 conference. This year's conference erupted into a conflict over the connotations of [...] Read more.
Through an in-depth discussion of the International Design Conference in Aspen from 1951 to 1970, this paper explores how environmental discourse underwent a shift in its connotations in the field of design during the conference. Of particular importance in this process of discursive transformation was the 1970 conference. This year's conference erupted into a conflict over the connotations of environmental discourse as environmental discourse outside of design impacted on and transformed the environmental discourse within design. This article examines the different concepts of the term 'environment', as presented by speakers and participants at the International Design Conferences in Aspen from 1951 to 1970, and especially focuses on the debates surrounding 'environment' at the 1970 conference. The article concludes by exploring the implications of this event and summarises the role of the 1970 International Design Conference in Aspen at this crucial turning point in environmental discourse. The aim is to explain and strengthen the significance of discourse a design conferences in the history of design, and to explore a new direction of design history research.
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Open Access July 18, 2024

Household Income and Offspring Education Explain Blacks’ Diminished Returns of Parental Education

Abstract Background: High parental education promotes various aspects of offspring well-being including reducing their risk of depression/anxiety, criminal justice involvement, and welfare reliance. However, according to minorities’ diminished returns, these benefits are not equal across racial groups, with Black families experiencing diminished returns of parental education compared to White [...] Read more.
Background: High parental education promotes various aspects of offspring well-being including reducing their risk of depression/anxiety, criminal justice involvement, and welfare reliance. However, according to minorities’ diminished returns, these benefits are not equal across racial groups, with Black families experiencing diminished returns of parental education compared to White families. This study explores the role of household income and offspring educational attainment as potential serial pathways that operate as mechanisms underlying diminished returns of parental education on offspring outcomes in Black families. Gender differences in these effects were also explored. Methods: Utilizing data from the Future of Families and Child Wellbeing Study (FFCWS) over a 22-year follow-up period (seven waves), we examined the serial mediation by household income and offspring educational attainment in explaining the relationship between parental education and offspring outcomes namely depression, anxiety, criminal justice involvement, and welfare reliance [Temporary Assistance for Needy Families (TANF) and Supplemental Nutrition Assistance Program (SNAP)]. We used structural equation modeling (SEM) with household income as the first mediator and young adult education as the second mediator. Multi-group models were used to explore gender differences in these paths. Results: The study confirmed the role of our proposed serial mediators for Blacks’ weaker effects of parental education on offspring outcomes. We observed weaker effects of first affects household income, with this effect being for Black families compared to White families, which then impacted educational attainment of the offspring. The findings indicate that household income plays a crucial mediating role, but its effect is weaker in Black families. Additionally, the educational attainment of offspring from highly educated Black parents is less effective in improving outcomes compared to their White peers, further contributing to diminished returns. Some gender differences were observed for the effects of educational attainment on economic and health outcomes of young adults. Conclusions: The study underscores the need to reconsider traditional assumptions about the comparability of family conditions and outcomes across racial groups with similar levels of parental education. The findings highlight the importance of targeted policies and interventions aimed at enhancing the economic stability and educational outcomes of Black families to address these disparities. Policies should focus on promoting the economic well-being of highly educated Black parents and improving the educational outcomes of their children.
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Open Access July 15, 2024

The Role of Dignity and Respect in Maternity Care: An Integrative Literature Review

Abstract This integrative literature review aims to explore the pivotal role of dignity and respect in maternity care, focusing on their profound impact on the experiences of pregnant individuals. Emphasis is placed on cultural competence as a crucial factor in fostering understanding and respect for diverse backgrounds, promoting inclusive approaches to maternal care. The overarching goal is to underscore [...] Read more.
This integrative literature review aims to explore the pivotal role of dignity and respect in maternity care, focusing on their profound impact on the experiences of pregnant individuals. Emphasis is placed on cultural competence as a crucial factor in fostering understanding and respect for diverse backgrounds, promoting inclusive approaches to maternal care. The overarching goal is to underscore the significance of dignified and respectful care in enhancing maternal satisfaction, postpartum outcomes, and overall well-being. Methods: The review synthesizes existing literature (n=22) on maternity care, dignity, and respect, drawing insights from diverse sources to comprehensively analyze the multifaceted nature of this critical healthcare aspect. Cultural competence is explored as a key theme in understanding and appreciating the varied backgrounds of pregnant individuals. The analysis encompasses factors such as effective communication, healthcare provider attitudes, cultural competence, informed consent, and systemic considerations, shedding light on their collective influence on dignity and respect in maternity care. Principal Findings: The literature review reveals that providing dignified and respectful care significantly contributes to improving maternal satisfaction and postpartum outcomes. Cultural competence emerges as a crucial element, ensuring that care approaches are inclusive and tailored to diverse cultural backgrounds. Effective communication, positive healthcare provider attitudes, and considerations for systemic factors are identified as key determinants of the dignity and respect experienced by pregnant individuals. The findings underscore the interconnectedness of these factors in shaping the overall quality of maternity care. Practical Applications: Recommendations stemming from the literature review include interventions aimed at enhancing healthcare providers' communication skills, cultural competence training, and the promotion of patient-centered care models. Acknowledging the systemic factors influencing maternity care, the review calls for collaborative efforts among healthcare providers, policymakers, and researchers to create an environment that upholds pregnant individuals' autonomy and values. The practical applications emphasize the need for comprehensive and culturally sensitive approaches to ensure that all pregnant individuals receive dignified and respectful care. In summary, this integrative literature review provides a comprehensive understanding of the critical role of dignity and respect in maternity care, offering insights into effective strategies for improvement and emphasizing the importance of cultural competence and collaborative efforts in shaping the future of maternal healthcare.
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Open Access July 12, 2024

Race, Poverty Status at Birth, and DNA Methylation of Youth at Age 15

Abstract Epigenetic studies, which can reflect biological aging, have shown that measuring DNA methylation (DNAm) levels provides new insights into the biological effects of social environment and socioeconomic position (SEP). This study explores how race, family structure, and SEP (income to poverty ratio) at birth influence youth epigenetic aging at age 15. Data were obtained from the Future [...] Read more.
Epigenetic studies, which can reflect biological aging, have shown that measuring DNA methylation (DNAm) levels provides new insights into the biological effects of social environment and socioeconomic position (SEP). This study explores how race, family structure, and SEP (income to poverty ratio) at birth influence youth epigenetic aging at age 15. Data were obtained from the Future of Families and Child Wellbeing Study (FFCWS) cohort, with GrimAge used as a measure of DNAm levels and epigenetic aging. Our analysis included 854 racially and ethnically diverse participants followed from birth to age 15. Structural equation modeling (SEM) examined the relationships among race, SEP at birth, and epigenetic aging at age 15, controlling for sex, ethnicity, and family structure at birth. Findings indicate that race was associated with lower SEP at birth and faster epigenetic aging. Specifically, income to poverty ratio at birth partially mediated the effects of race on accelerated aging by age 15. The effect of income to poverty ratio at birth on DNAm was observed in male but not female youth at age 15. Thus, SEP partially mediated the effect of race on epigenetic aging in male but not female youth. These results suggest that income to poverty ratio at birth partially mediates the effects of race on biological aging into adolescence. These findings highlight the long-term biological impact of early-life poverty in explaining racial disparities in epigenetic aging and underscore the importance of addressing economic inequalities to mitigate these disparities. Policymakers should focus on poverty prevention in Black communities to prevent accelerated biological aging and associated health risks later in life. Interventions aimed at eliminating poverty and addressing racial inequities could have significant long-term benefits for public health. Future research should explore additional factors contributing to epigenetic aging and investigate potential interventions to slow down the aging process. Further studies are needed to understand the mechanisms underlying these associations and to identify effective strategies for mitigating the impact of SEP and racial disparities on biological aging.
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Open Access January 30, 2024

Unveiling Vulnerabilities in the Active Pharmaceutical Ingredient Supply Chain Amid Disruptions

Abstract The operational performance of Active Pharmaceutical Ingredients (API) supply chains often suffers from significant disruptions attributed to inherent vulnerabilities. Despite theoretical discussions, empirical evidence validating these vulnerabilities remains sparse. This study endeavours to empirically substantiate the vulnerabilities arising from dynamic disruptions within the pharmaceutical [...] Read more.
The operational performance of Active Pharmaceutical Ingredients (API) supply chains often suffers from significant disruptions attributed to inherent vulnerabilities. Despite theoretical discussions, empirical evidence validating these vulnerabilities remains sparse. This study endeavours to empirically substantiate the vulnerabilities arising from dynamic disruptions within the pharmaceutical supply chain. Its primary goal is to discern actionable insights that can inform the development of robust resilience strategies capable of effectively mitigating such disruptions. This study investigates vulnerabilities within the active pharmaceutical ingredient (API) supply chain in response to disruptions. Despite theoretical insights, empirical evidence validating these vulnerabilities remains limited. Through empirical analysis, this research aims to identify and elucidate the specific vulnerabilities exacerbated by dynamic disruptions in the API supply chain. The findings are intended to inform the development of resilient strategies capable of mitigating the impact of disruptions on pharmaceutical supply chains.
Review Article
Open Access June 18, 2024

Concord Errors in Academic Writing: A Study of First-Year Students at Offinso College of Education and Strategies for Improvement

Abstract This study examines concord errors in academic writing among first-year students at Offinso College of Education in Ghana, aiming to identify common errors and propose remedial strategies for improvement. The population sample consists of first-year students at the college, reflecting a gender-sensitive distribution. The study adopts a mixed-methods research design, combining qualitative and [...] Read more.
This study examines concord errors in academic writing among first-year students at Offinso College of Education in Ghana, aiming to identify common errors and propose remedial strategies for improvement. The population sample consists of first-year students at the college, reflecting a gender-sensitive distribution. The study adopts a mixed-methods research design, combining qualitative and quantitative analyses to explore the effects of concord errors on academic writing. Sampling techniques include purposive, quota sampling, and simple random sampling methods. Research instruments include questionnaires, interviews, and writing assessments to evaluate students' language skills. Data analysis involves identifying concord errors in students' writing and assessing the impact on their academic performance. The study concludes by recommending strategies to mitigate concord errors, such as targeted language practice, timely feedback, and awareness of grammatical conventions, to enhance students' writing proficiency and academic success.
Article
Open Access June 01, 2024

An Assessment of Off-Season Vegetable Farming on Farmers in Savelugu Municipality in the Northern Region

Abstract The study aimed to assess the impact of off-season vegetable farming on farmers in the Savelugu Municipality in the Northern Region. The study population consisted of all respondents to off-season vegetable farming in the Savelugu Municipality in the five selected communities in the Northern Region. A purposive sampling technique was used for a sample size of fifty (50) off-season farmers in the [...] Read more.
The study aimed to assess the impact of off-season vegetable farming on farmers in the Savelugu Municipality in the Northern Region. The study population consisted of all respondents to off-season vegetable farming in the Savelugu Municipality in the five selected communities in the Northern Region. A purposive sampling technique was used for a sample size of fifty (50) off-season farmers in the selected communities. An interview guide and questionnaire were used to solicit data to conclude the findings. The data derived from the questionnaire were analysed in a step-by-step thematic analysis that included reading the transcriptions several times, coding, generating codes, and reviewing and naming themes. Afterwards, the questionnaire and interview guide responses were transferred into Microsoft Excel under assigned variable names. Descriptive statistics, namely frequency, means, and percentages, were used to analyse the data. Off-season vegetable production technology can be gained by using different agro-climatic regions, maintaining or adjusting planting time, selecting varieties, and creating artificial and controlled environments through tunnels, polytene houses, glass houses, hotbeds, etc. Moreover, Off-Season vegetables helped earn income and ranked highest with an overall mean score of 1. Nearly all the trained farmers said their primary constraint was the high incidence of pests and diseases. It is evident that off-season cultivation is profitable and significantly impacts the farmers' consumption expenditure and food security status. Therefore, providing improved and modern agricultural inputs to off-season farmers is essential for rural agricultural development.
Review Article
Open Access May 30, 2024

Assessing the Socio-Economic Implications of Free Senior High School (SHS) Policy on Tertiary Institutions in Ghana: A Case Study of the Western Region

Abstract Ghana's Free Senior High School (SHS) policy has been touted as one of the most significant educational reforms in recent years, fueling the nation's achievement of Goal 4 [...] Read more.
Ghana's Free Senior High School (SHS) policy has been touted as one of the most significant educational reforms in recent years, fueling the nation's achievement of Goal 4 of the United Nations Sustainable Development Goals (SDGs). While many studies have been conducted on the policy’s impact on beneficiaries, little is known about its impact on tertiary institutions. The purpose of this study is to evaluate the socioeconomic effects of the Free SHS policy on tertiary institutions in Ghana's Western Region. We also provide suggestions on how to improve the policy's efficacy and lessen any obstacles to its incorporation into higher education. Methodologically, 103 employees of Takoradi Technical University and the University of Mines and Technology were sampled using a purposive sampling technique. According to the report, despite the lack of adequate facilities such as lecture halls, dorms, and residence halls on campus, the Free SHS policy has increased enrollment at the postsecondary level. This has resulted in a high student-to-lecturer ratio, increased utility bills, a high cost of living on campus, and a rise in the opening of businesses on campus. To address some of these socioeconomic impacts, respondents proposed that the government should improve infrastructure in the country's higher institutions, hire more lecturers, boost incentives for lecturers, and foster partnerships with private institutions to support infrastructure development.
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Open Access May 18, 2024

Systematic Research Survey on the Impact of Software Quality Measurement Scales on User Satisfaction

Abstract A user is considered to be someone who would be actually using the system. The definition of a user is contextual and for any specific software project it depends on the software development methodology being developed. Satisfaction is the fulfillment of one’s wishes, expectations, needs or the pleasure that is derived from using a software product therefore “user satisfaction “is a reflection of [...] Read more.
A user is considered to be someone who would be actually using the system. The definition of a user is contextual and for any specific software project it depends on the software development methodology being developed. Satisfaction is the fulfillment of one’s wishes, expectations, needs or the pleasure that is derived from using a software product therefore “user satisfaction “is a reflection of quality from different perspective than measuring defects or code structure. Measurement in software engineering makes comparison possible and when you compare you have a choice and quality is quantified in terms of values. Therefore, this paper aims to explore the impact of software measurement scales on user satisfaction.
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Review Article
Open Access May 12, 2024

Socio-Demographic Factors Influencing Work-Family Conflict Among Hotel Managers

Abstract This study examines the influence of socio-demographic factors on work-family conflict among management staff in star-rated hotels in the Accra Metropolis. The research aims to explore how variables such as gender, age, marital status, and educational background impact the experiences of work-family conflict among hotel managers. A quantitative research design was employed, and data were collected [...] Read more.
This study examines the influence of socio-demographic factors on work-family conflict among management staff in star-rated hotels in the Accra Metropolis. The research aims to explore how variables such as gender, age, marital status, and educational background impact the experiences of work-family conflict among hotel managers. A quantitative research design was employed, and data were collected through structured questionnaires distributed to a purposive sample of hotel managers. The findings reveal significant associations between socio-demographic characteristics and work-family conflict, highlighting the complexities of balancing work responsibilities with family obligations in the hospitality industry. The implications of the study underscore the importance of tailored interventions to support the well-being of hotel managers, while the recommendations emphasise the implementation of work-life balance programs, support for family obligations, promotion of diversity and inclusion, and continuous training and development. It is recommended that hotel organisations create a supportive work environment that enhances the job satisfaction and productivity of their management staff. This study contributes valuable insights to the existing literature on work-family conflict in the hospitality sector and provides a foundation for future research endeavours in this area.
Article
Open Access April 24, 2024

Optimization of Delirium Care in Adult Patients with Cancer: A Comprehensive and Integrative Review of Efficacy and Patient Outcomes

Abstract Delirium is a major complication most commonly observed in patients with advanced cancer. However, despite its prevalence, the early diagnosis, management, and prevention of this condition have not seen significant progress. Aim of this research is to provide insights into the prevalence of delirium, the optimization of interventions for managing delirium symptoms, their effectiveness and the [...] Read more.
Delirium is a major complication most commonly observed in patients with advanced cancer. However, despite its prevalence, the early diagnosis, management, and prevention of this condition have not seen significant progress. Aim of this research is to provide insights into the prevalence of delirium, the optimization of interventions for managing delirium symptoms, their effectiveness and the impact of underlying factors on the reversibility of delirium in advanced cancer patients receiving palliative care. The review involved systematic searches of relevant databases including MEDLINE, CINAHL, ProQuest Nursing and Allied Health, and PsychInfo using refined search terms. Eight publications out of 614 studies originally searched were selected and critically reviewed. Their quality was assessed using Joanna Briggs Institute's Critical Appraisal Tool for Case Series. Data abstraction and content analysis were performed to synthesize the findings. Delirium is prevalent among advanced cancer patients in palliative care, with rates ranging from 10.3% to 24.1%. Pharmacotherapy and non-pharmacological interventions showed effectiveness in reducing delirium symptoms. Delirium was found to be reversible through palliative care interventions, antipsychotic medications, and exercise therapy. Effective delirium management is crucial in improving the quality of life of cancer patients. This review emphasizes the importance of subtype-specific treatments, standardized guidelines, and long-term follow-up studies. Implementing evidence-based individualized approaches to delirium management can optimize treatment efficacy and clinical outcomes in patients as well as improve the quality of care. Tailored interventions, standardized protocols, and further research are hereby recommended.
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Review Article
Open Access April 16, 2024

Impact of Covid-19 on the Active Pharmaceutical Ingredient Supply Chain

Abstract An increasing number of adverse events are raising concern in the pharmaceutical supply chain due to contaminated active pharmaceutical ingredients (APIs). Most of the active pharmaceutical ingredients are not currently under the scope of environmental regulations, despite their negative impact on human health and the environment. API's life cycle plays a significant role in identifying potential [...] Read more.
An increasing number of adverse events are raising concern in the pharmaceutical supply chain due to contaminated active pharmaceutical ingredients (APIs). Most of the active pharmaceutical ingredients are not currently under the scope of environmental regulations, despite their negative impact on human health and the environment. API's life cycle plays a significant role in identifying potential supply chain sources and determining their impact on the environment. The Covid-19 pandemic's intermittent manufacturing interruptions and the increase in the frequency of drug shortages over the past ten years have sparked worries about how resilient the world's drug supply chains are. Many clinical trials were conducted on patients with COVID-19 during the SARS-CoV-2 pandemic and resulted in millions of deaths globally by 2022.
Review Article
Open Access March 16, 2024

Metaverse in Nursing: A Concept Analysis

Abstract Background: Over the past decade, there has been a rapid advancement in technology and virtual reality applications, leading to the emergence of the metaverse - a virtual universe where users interact with each other and their surroundings through immersive experiences. In the nursing profession, the metaverse presents unique opportunities to enhance patient care, education, and collaboration. [...] Read more.
Background: Over the past decade, there has been a rapid advancement in technology and virtual reality applications, leading to the emergence of the metaverse - a virtual universe where users interact with each other and their surroundings through immersive experiences. In the nursing profession, the metaverse presents unique opportunities to enhance patient care, education, and collaboration. Aim: To analyze and identify the attributes of metaverse in nursing, exploring its dimensions, benefits, challenges, and implications. By examining relevant literature, this study will contribute to a better understanding of the metaverse in nursing. Method/Design: Concept analysis by Walker and Avant (2019). Results: Metaverse in nursing involves three defining attributes: use of advanced technologies, better access to education and healthcare, and collaboration and community building. Antecedents of metaverse in nursing require technological advancements, increased digital literacy, demand for innovative education, globalization of healthcare education Conclusion: Metaverse in Nursing suggests that it is a promising technology that has the potential to enhance nursing practice and improve patient outcomes, but further research is needed to fully explore the impact of its integration.
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Open Access March 13, 2024

Current Risk in the Supply Chain for the Active Pharmaceutical Ingredients Business

Abstract The active pharmaceutical ingredients (API) are very critical substances for generic drugs. Any issue in the global supply chain for sourcing APIs heavily impacts generic drugs demands in the market. It is imperative to keep a close eye on the API supply in order to spot possible priorities for domestic manufacturing as well as bottlenecks in the US pharmaceutical supply chain. Most of the API's [...] Read more.
The active pharmaceutical ingredients (API) are very critical substances for generic drugs. Any issue in the global supply chain for sourcing APIs heavily impacts generic drugs demands in the market. It is imperative to keep a close eye on the API supply in order to spot possible priorities for domestic manufacturing as well as bottlenecks in the US pharmaceutical supply chain. Most of the API's are manufactured in countries like India and China, and any issue in the manufacturing or supply of the API's may critically impact generic drug production globally. The Government and regulatory agencies must take initiatives to mitigate the risk of supply chain interruptions in the API business.
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Review Article
Open Access February 19, 2024

The use of contemporary Enterprise Resource Planning (ERP) technologies for digital transformation

Abstract Our lives are becoming more and more digital, and this has an impact on how we work, study, communicate, and interact. Businesses are currently digitally altering their information systems, procedures, culture, and strategy. Existing businesses and economies are severely disrupted by the digital revolution. The Internet of Things, microservices, and mobile services are examples of IT systems with [...] Read more.
Our lives are becoming more and more digital, and this has an impact on how we work, study, communicate, and interact. Businesses are currently digitally altering their information systems, procedures, culture, and strategy. Existing businesses and economies are severely disrupted by the digital revolution. The Internet of Things, microservices, and mobile services are examples of IT systems with numerous, dispersed, and very small structures that are made possible by digitization. Utilizing the possibilities of cloud computing, mobile systems, big data and analytics, services computing, Internet of Things, collaborative networks, and decision support, numerous new business prospects have emerged throughout the years. The logical basis for robust and self-optimizing run-time environments for intelligent business services and adaptable distributed information systems with service-oriented enterprise architectures comes from biological metaphors of living, dynamic ecosystems. This has a significant effect on how digital services and products are designed from a value- and service-oriented perspective. The evolution of enterprise architectures and the shift from a closed-world modeling environment to a more flexible open-world composition establish the dynamic framework for highly distributed and adaptive systems, which are crucial for enabling the digital transformation. This study examines how enterprise architecture has changed over time, taking into account newly established, value-based relationships between digital business models, digital strategies, and enhanced enterprise architecture.
Review Article
Open Access February 19, 2024

The COVID-19 Pandemic & College Students’ Perceptions of Access to Mental Health Services

Abstract The COVID-19 pandemic has had a significant impact on individuals worldwide, affecting not only their educational futures but also their mental health. This paper aims to explore college students' perceived barriers to accessing mental health services during the pandemic. The study finds that there is a significant difference between stigma-related and non-stigma-related barriers, with non-stigma [...] Read more.
The COVID-19 pandemic has had a significant impact on individuals worldwide, affecting not only their educational futures but also their mental health. This paper aims to explore college students' perceived barriers to accessing mental health services during the pandemic. The study finds that there is a significant difference between stigma-related and non-stigma-related barriers, with non-stigma items being rated higher on average. The most commonly reported non-stigma barriers include wanting to solve the problem independently, financial constraints, and the belief that the issue will resolve itself. Stigma-related barriers include feeling embarrassed or ashamed, concern about having a mental health problem on medical records, and fear of being seen as crazy or weak. This research sheds light on the challenges students face in seeking mental health care during the pandemic and highlights the need to address these barriers.
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Open Access January 24, 2024

Influence of social media on the stock market: Part 1. A brief analysis

Abstract The world of the stock market is an intricately complex financial ecosystem that demands years of dedicated study to comprehend fully. It relies on risk mitigation practices and fundamental theoretical techniques to engage in speculation regarding stock and cryptocurrency fluctuations. However, this realm is progressively becoming more inclusive, with accessibility expanding beyond traditional [...] Read more.
The world of the stock market is an intricately complex financial ecosystem that demands years of dedicated study to comprehend fully. It relies on risk mitigation practices and fundamental theoretical techniques to engage in speculation regarding stock and cryptocurrency fluctuations. However, this realm is progressively becoming more inclusive, with accessibility expanding beyond traditional educational barriers. Technological advancements, coupled with the ease of entry into this domain and the information-disseminating power of social networks, contribute to a rising number of individuals participating in this financial movement. What makes this evolution disruptive is that the same tools facilitating accessibility also exert influence on the way market trends unfold. This paper delves into the escalating impact of social media within the financial sphere, emphasizing the heightened accessibility to information and market involvement facilitated by platforms like Twitter and Reddit. It sheds light on how social media plays a pivotal role in market manipulation, as evidenced by phenomena such as the r/wallstreetbets subreddit, where meme-based strategies were employed to inflate the prices of stocks like GameStop. The study explores the utilization of social media by influential figures, exemplified by Elon Musk, who leverage their platforms to sway market movements. Additionally, this paper addresses instances of misinformation, such as the confusion surrounding Virgin Galactic's shares following a SpaceX failure and the introduction of "AGUA" in the Mexican stock market, leading to widespread misunderstandings. The paper extends its examination to the effects of social media on cryptocurrencies, highlighting how comments from public figures can significantly impact the prices of Bitcoin and Dogecoin. Overall, it underscores the imperative need for adaptation to these changes in the digital financial paradigm.
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