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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 June 06, 2025

Food security, dietary diversity, and age as determinants of nutritional status among adolescent girls in coastal Bangladesh

Abstract Background: Adolescent girls living in disaster-prone coastal regions of Bangladesh face heightened nutritional vulnerability due to limited food access, poor dietary diversity, and environmental stressors. Despite growing concerns about adolescent malnutrition, few studies have examined the combined influence of food security, dietary diversity, and age on nutritional outcomes in these [...] Read more.
Background: Adolescent girls living in disaster-prone coastal regions of Bangladesh face heightened nutritional vulnerability due to limited food access, poor dietary diversity, and environmental stressors. Despite growing concerns about adolescent malnutrition, few studies have examined the combined influence of food security, dietary diversity, and age on nutritional outcomes in these settings. Objectives: This study aimed to assess the association between dietary diversity, food security, and age with the nutritional status of adolescent girls in coastal Bangladesh. Methods: A cross-sectional survey was conducted among 345 adolescent girls aged 10–19 in Chattogram and Cox’s Bazar. Data on dietary intake were collected using a 24-hour dietary recall and a food frequency questionnaire. Household food security was assessed using a validated scale. Nutritional status was determined using BMI-for-age classifications. Bivariate and multivariate analyses explored associations between dietary diversity, food security, age, and nutritional status. Results: Among participants, 10.14% were underweight, and 29.85% were either overweight or obese. While 17.39% demonstrated high dietary diversity (≥7 food groups), the majority had moderate diversity (5 or 6 food groups) (59.42%). Food-insecure households were significantly more likely to have overweight or obese adolescents (p < 0.05). Although dietary diversity was associated with BMI in bivariate analysis, it was not a significant predictor in the multivariate model. Age showed a significant relationship with both dietary diversity and nutritional status. Conclusion: The findings emphasize the importance of addressing household food security and age-related nutritional vulnerabilities in coastal areas. Interventions should prioritize age-sensitive, culturally appropriate strategies to improve dietary quality and prevent the double burden of malnutrition among adolescent girls.
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Open Access April 22, 2025

A Multimodal Critical Discourse Analysis of the Online Brand Identity Construction of National Museums

Abstract The national museum of a country, as a cultural symbol of the nation, plays an important role in cultural communication at home and abroad. This study explores the online brand identity construction of two national museums—the British Museum and the National Museum of China—to inform cultural brands of the discursive strategies to distinguish themselves from others and communicate with their [...] Read more.
The national museum of a country, as a cultural symbol of the nation, plays an important role in cultural communication at home and abroad. This study explores the online brand identity construction of two national museums—the British Museum and the National Museum of China—to inform cultural brands of the discursive strategies to distinguish themselves from others and communicate with their audiences effectively. Informed by multimodal critical discourse analysis, this paper analyzes the websites of the two museums and their social media posts, depicts their brand identity prisms, and evaluates the effectiveness of their online communication. The results show that both museums use multimodal and hypertextual resources to create unique and congruent brand images in website design and social media interaction with their target audiences, fulfilling the institutional functions of museums as the symbol of national culture or world civilization. They express differential personalities and cultural values to reinforce their brand identities in different sociocultural and political contexts. The findings may provide insight into the use of multimodality in online communication for cultural institutions to enhance their brand images and promote cultural exchanges.
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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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Article
Open Access February 04, 2025

The Use of Differentiated Instruction to Achieve Culturally Responsive Teaching

Abstract With an increasing diversity of learners in today’s educational set-ups, there is an insurmountable need to cater for individual differences including the cultural variations among learners. It is therefore necessary for educators to develop culturally responsive teaching that enhances intercultural competencies of learners. As educators strive to provide inclusive learning environments in which [...] Read more.
With an increasing diversity of learners in today’s educational set-ups, there is an insurmountable need to cater for individual differences including the cultural variations among learners. It is therefore necessary for educators to develop culturally responsive teaching that enhances intercultural competencies of learners. As educators strive to provide inclusive learning environments in which learners from diverse cultural backgrounds learn equitably, differentiated instruction becomes a practical tool. This paper explores how differentiated instruction can support and enhance culturally responsive teaching by examining how tailored instructional approaches can bridge cultural gaps and enhance educational outcomes. The aim is to provide a comprehensive understanding of how educators can effectively integrate differentiated instructional methodologies to achieve the goals of Culturally Responsive Teaching. The study used a descriptive survey design to determine the use of differentiated instruction by junior school teachers in Kenya and a systematic review of literature, practical examples, and studies on teachers’ practices in culturally responsive teaching. The study outcomes indicated that teachers used various differentiated instructional strategies with flexible grouping being the most commonly used strategy. However, there arises a concern, that teachers were not very familiar with cultural variations of learners in their classrooms even as they developed their differentiated instructional strategies. Literature provided the principles and practices of culturally responsive teaching. The combination of these results were used to formulate a conceptual framework for Culturally Responsive Differentiated Instruction (CRDI) that provides insights for practitioners to develop and implement culturally responsive differentiated instructional strategies. The study recommends that a framework to support teachers in the implementation of inclusive and equitable curriculum through CRDI be developed, CRDI be integrated into the teaching processes and the teachers be trained on providing for learner differences through CRDI.
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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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Systematic Review
Open Access April 25, 2024

Green spaces more adapted and resilient to the current and future climatic conditions in the south of Portugal (Algarve): Xerophytic gardens using xeromorphic succulents

Abstract Considering the current climate conjuncture, it is a consensus that green spaces in large contemporary urban areas should be increasingly more numerous and simultaneously more sustainable, being adapted to the edaphoclimatic conditions of the site, and with reduced maintenance costs. In the case of Algarve, where this research is focused, the current and future water availability, assumes a [...] Read more.
Considering the current climate conjuncture, it is a consensus that green spaces in large contemporary urban areas should be increasingly more numerous and simultaneously more sustainable, being adapted to the edaphoclimatic conditions of the site, and with reduced maintenance costs. In the case of Algarve, where this research is focused, the current and future water availability, assumes a preponderant role in the design of green spaces, where the demands mentioned above can only be achieved if we deviate from conventional landscape practices and develop holistic strategies of management and design of green spaces that integrate different areas of knowledge and not merely aesthetic issues. In this context, this work aims to develop more adapted and resilient landscaping practices to the current and future climatic conditions of the Algarve, thus reinventing the concept of landscaping in the south of Portugal. Thus, it will be of paramount importance to develop more sustainable, resilient and tolerant projects to worsening ecological conditions, particularly limitations associated with water availability. The xeromorphic succulents are a group of plants with mechanisms of tolerance to water stress and with very specific characteristics, being succulence one of the most relevant. Studies on these mechanisms are increasingly frequent, which may prove to be very advantageous in our adaptation to future climatic challenges. In addition, their ornamental potential is enormous, since their bold forms and colours are a veritable sensory explosion, which, combined with their morphological and physiological characteristics, make them the species of choice in the reconversion or creation of xerophytic gardens.
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Article
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 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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Article
Open Access December 12, 2023

Threatened Wildlife for an Instructional Approach about Biodiversity Conservation

Abstract Biodiversity is related to a global problem: its destruction, a fact supported by scientific authorities. It is not trivial that educational dimension has been contemplated as one of the strategies for its conservation. Since 1992 global initiatives such as the Convention on Biological Diversity postulates concepts that linked education and nature conservation. The main objective of this research work is to test the level of assimilation of extracurricular scientific knowledge by primary school pupils. The method chosen for the content was, on the one hand, a master class intervention with an interactive presentation on a digital whiteboard. Third cases were chosen. Each case consisted of a presentation of the current status of a species of fauna present in Spain. On the second part, students were asked to write an essay and to illustrate the experience during the presentation. Regarding the essays, students showed that they were more attracted to the first species that was presented (Iberian lynx) in a proportion of over 45% of cases. The “Endangered species” concept appeared in more than 77% of the texts reviewed. In terms of drawings, almost 55% of the responses seem to devote more attention to the second species described (Testudo graeca [...] Read more.
Biodiversity is related to a global problem: its destruction, a fact supported by scientific authorities. It is not trivial that educational dimension has been contemplated as one of the strategies for its conservation. Since 1992 global initiatives such as the Convention on Biological Diversity postulates concepts that linked education and nature conservation. The main objective of this research work is to test the level of assimilation of extracurricular scientific knowledge by primary school pupils. The method chosen for the content was, on the one hand, a master class intervention with an interactive presentation on a digital whiteboard. Third cases were chosen. Each case consisted of a presentation of the current status of a species of fauna present in Spain. On the second part, students were asked to write an essay and to illustrate the experience during the presentation. Regarding the essays, students showed that they were more attracted to the first species that was presented (Iberian lynx) in a proportion of over 45% of cases. The “Endangered species” concept appeared in more than 77% of the texts reviewed. In terms of drawings, almost 55% of the responses seem to devote more attention to the second species described (Testudo graeca). An attempt was made to offer rigorous, structured information related to different aspects of natural reality in order to contemplate the broadest possible vision. The example of an instructional intervention presented here aims to be an alternative to other transmissive teaching models. Likewise, the linking of abstract concepts with socio-cultural reality proved to be a successful strategy to reinforce knowledge about natural biodiversity, endangered species or threat factors.
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Article
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 May 10, 2023

Knowledge of Obstetric Warning Signs and Associated Risks among Saudi Pregnant Women

Abstract Women must be aware of the risk factors of pregnancy complications and the negative maternal and fetal health consequences to take preventative measures and management strategies that will result in a successful pregnancy. This study aimed to assess the Level of Knowledge about obstetric warning signs and the associated factors among pregnant Saudi women attending antenatal care in a tertiary care [...] Read more.
Women must be aware of the risk factors of pregnancy complications and the negative maternal and fetal health consequences to take preventative measures and management strategies that will result in a successful pregnancy. This study aimed to assess the Level of Knowledge about obstetric warning signs and the associated factors among pregnant Saudi women attending antenatal care in a tertiary care maternity set-up in Riyadh City. Data for this cross-sectional study were obtained using a structured questionnaire from eligible pregnant women admitted to King Saud Medical City (KSMC) between August 2020 and March 2021. Data were analyzed using descriptive and inferential statistics. Out of a minimum estimated sample size of 170, researchers recruited 362 participants. As observed, only 92 people, or 25.4%, had enough knowledge about various educational levels. The majority (91.2%) lived in villages, had no history of chronic disease (74.0%), and said that it took them at least 30 minutes to commute from their home to the hospital (69.3%). Two hundred two (55.7%) lacked appropriate knowledge, although most women (76.2%) had one to four pregnancies. Poor psychological health resulted from 37 people's (10.2%) inadequate Awareness. Even though 139 (38.4%) had spent more than 15 minutes receiving education from medical staff and 200 (61.5%) had attended the prenatal care clinic more than four times, most lacked adequate knowledge. The variables education level (P=0.000), working status (P=0.022), and place of residence (P=0.044) showed a statistically significant association with the knowledge level, also only education level statistically significantly affected the likelihood of knowledge gaps. In conclusion, early identification of obstetric warning signs and associated risk factors of pregnancy complications is integral to prevention.
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Article
Open Access October 26, 2022

Notes about Winning Strategies for Some Combinatorial Games

Abstract We study the theory of combinatorial games and find winning strategies for players. The algorithmic implementation of the winning strategies for the game TacTix is presented and the software implementation for this game in Python programming language is implemented. The program has a console interface and allows one to check the winning strategies in practice.
We study the theory of combinatorial games and find winning strategies for players. The algorithmic implementation of the winning strategies for the game TacTix is presented and the software implementation for this game in Python programming language is implemented. The program has a console interface and allows one to check the winning strategies in practice.
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Article
Open Access December 15, 2021

Dissemination and Exploitation of Regional Meteo-Hydrological Datasets through Web-based Interactive Applications: The SOL System Case Study

Abstract The effects of climate change are already being felt in several parts of the World. Variability of changing rainfall intensity, drought and weather patterns contribute to determining the vulnerability of many human activities such as agriculture. In the next future, climate change considerations will depend on having appropriate strategies such as strengthen implementation agencies working in a [...] Read more.
The effects of climate change are already being felt in several parts of the World. Variability of changing rainfall intensity, drought and weather patterns contribute to determining the vulnerability of many human activities such as agriculture. In the next future, climate change considerations will depend on having appropriate strategies such as strengthen implementation agencies working in a coordinated manner and with a data-driven approach in order to ensure monitoring, reporting and data verification. In this context, national and regional meteorological Services are facing with high demand for timely and quality information, services and products. A web-based interactive application with the aim of disseminating meteo-hydrological information at regional scale is described in this paper. The web application is built on a relational database and client-side programming has been used for implementing the user interface and controlling the web page behavior. The combination of PHP (Hypertext Preprocessor, a general-purpose scripting language, especially suited to server-side web development) and JavaScript (high-level object-oriented scripting language, nowadays the dominant client-side scripting language of the Web) has been chosen for this reason, since such software is free to use for everyone. The SOL system, developed on behalf of Marche region, Italy, was chosen as a case study, due to its multi-source data framework and because of the processing and public dissemination of several ad-hoc data elaborations.
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Case Study
Open Access October 22, 2021

PTEN May Involve in Regulation of PD-L1 Expression in Triple Negative Breast Carcinoma

Abstract Triple negative breast carcinoma (TNBC) is a rapid progressive tumor and has a poor overall survival. Therefore, it is crucial to find out effective molecular targets and develop optimal therapeutic strategies for TNBC. In this study, immunohistochemical staining was used to detect expressions of programmed death-ligand 1 (PD-L1) and phosphatase and tensin homolog (PTEN) in 136 breast carcinomas including 50 TNBC. The effect of PTEN on regulation of PD-L1 expression was assessed in vitro in the PTEN knockdown TNBC cells. We found that PD-L1(SP142) positive rate in TNBC (48.0%) was significantly higher than non-TNBC (23.3%). PTEN negative rate was 42% in TNBC. The inverse correlation between PTEN and PD-L1(SP142) expression in TNBC was statistically significant (P [...] Read more.
Triple negative breast carcinoma (TNBC) is a rapid progressive tumor and has a poor overall survival. Therefore, it is crucial to find out effective molecular targets and develop optimal therapeutic strategies for TNBC. In this study, immunohistochemical staining was used to detect expressions of programmed death-ligand 1 (PD-L1) and phosphatase and tensin homolog (PTEN) in 136 breast carcinomas including 50 TNBC. The effect of PTEN on regulation of PD-L1 expression was assessed in vitro in the PTEN knockdown TNBC cells. We found that PD-L1(SP142) positive rate in TNBC (48.0%) was significantly higher than non-TNBC (23.3%). PTEN negative rate was 42% in TNBC. The inverse correlation between PTEN and PD-L1(SP142) expression in TNBC was statistically significant (P<0.05). After PTEN knockdown, PD-L1 expression in TNBC cells increased significantly, and the expression level of AKT increased simultaneously. PTEN knockdown promoted cell proliferation, viability and G1/S switch of TNBC cells. These results suggested that PTEN may involve in regulation of PD-L1 expression, because PTEN loss can upregulate PD-L1 expression in TNBC. Antitumor immunity of PD-L1 could be enhanced in TNBC when targeting PTEN at the same time.
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Communication
Open Access March 05, 2026

For My Family, I Take It’: A Phenomenological Study of Antihypertensive Medication Use Among Filipino Adults

Abstract Hypertension remains a leading cause of cardiovascular morbidity and mortality. Although effective antihypertensive therapies are available, sustained blood pressure control remains suboptimal due to inconsistent medication use. Most adherence research is quantitative and offers limited understanding of how individuals interpret lifelong treatment within daily life, particularly in culturally [...] Read more.
Hypertension remains a leading cause of cardiovascular morbidity and mortality. Although effective antihypertensive therapies are available, sustained blood pressure control remains suboptimal due to inconsistent medication use. Most adherence research is quantitative and offers limited understanding of how individuals interpret lifelong treatment within daily life, particularly in culturally grounded contexts. To explore the lived experiences of Filipino adults taking antihypertensive medication. A qualitative study grounded in Heideggerian interpretive phenomenology was conducted. Ten Filipino adults diagnosed with hypertension were purposively recruited from outpatient clinics in Manila, Philippines. In-depth semi-structured interviews were transcribed verbatim and analyzed using the six-step IPA framework. Analysis revealed six interconnected themes describing how participants interpreted and sustained medication use: (1) Diagnosis as Disruption; (2) Medication as Protection and Responsibility; (3) The Paradox of the Silent Illness; (4) Everyday Barriers to Sustained Treatment; (5) Constructing Routine and Adaptive Self-Management; and (6) Family as Anchor within Cultural Contexts. These themes reflected emotional adjustment, symptom-driven adherence, financial and work-related barriers, adaptive coping strategies, and strong family-centered motivation. Medication-taking was experienced as an ongoing negotiation shaped by bodily cues, daily demands, and relational obligations. Conclusion: Antihypertensive medication use is shaped by relational, cultural, and socioeconomic contexts, underscoring the need for family-inclusive and culturally responsive hypertension care.
Article
Open Access February 16, 2026

Tuberculosis among elderly patients: diagnostic and therapeutic challenges (2020-2024)

Abstract Background: Tuberculosis (TB) in the elderly poses significant diagnostic and therapeutic challenges due to immunosenescence, comorbidities, and atypical clinical presentation. This study evaluates the epidemiological and clinical characteristics of TB in patients aged ≥65 years. Methods: A retrospective descriptive study was conducted including all TB cases reported between 2020 and [...] Read more.
Background: Tuberculosis (TB) in the elderly poses significant diagnostic and therapeutic challenges due to immunosenescence, comorbidities, and atypical clinical presentation. This study evaluates the epidemiological and clinical characteristics of TB in patients aged ≥65 years. Methods: A retrospective descriptive study was conducted including all TB cases reported between 2020 and 2024. Data from the National Tuberculosis Program were analyzed for demographic characteristics, clinical form, bacteriological confirmation, comorbidities, and treatment outcomes. Results: Of 1,335 TB cases, 352 (26.4%) occurred in individuals aged ≥65 years. Pulmonary TB accounted for 80.7% of cases. Men represented 63.4% of patients, and 56.8% lived in urban areas. Bacteriological confirmation was achieved in 82% of pulmonary cases, and treatment success exceeded 85%. Diabetes mellitus (26.5%) and arterial hypertension (31%) were the most common comorbidities. An increase in TB cases was observed in the post-COVID-19 period. A significant association was found between age and clinical form of TB (p < 0.001). Conclusions: Elderly individuals constitute a substantial proportion of TB cases and frequently present with chronic comorbidities. Despite diagnostic challenges, favorable treatment outcomes were achieved, highlighting the need for integrated and early management strategies in this population.
Brief Report
Open Access January 16, 2026

Evaluating the Effectiveness of Occupational Health and Safety Management Practices in Improving Workplace Safety in Nigerian Construction Sites

Abstract The construction industry remains one of the most hazardous sectors globally, with Nigeria experiencing a high incidence of workplace accidents despite the adoption of Occupational Health and Safety Management (OHSM) frameworks. This study evaluated the effectiveness of OHSM practices in improving workplace safety across construction companies in Nigeria’s coastal cities. A cross-sectional design [...] Read more.
The construction industry remains one of the most hazardous sectors globally, with Nigeria experiencing a high incidence of workplace accidents despite the adoption of Occupational Health and Safety Management (OHSM) frameworks. This study evaluated the effectiveness of OHSM practices in improving workplace safety across construction companies in Nigeria’s coastal cities. A cross-sectional design was employed, combining quantitative surveys of construction workers (n = 1,400) with qualitative interviews of 35 managers and supervisors. Quantitative data were analyzed using SPSS version 28, while thematic analysis was applied to qualitative responses. Findings revealed a generally positive perception of OHSM, with 54.4% of workers rating OHS policy effectiveness as “Good” and 52.0% rating health outcomes as “Good.” However, accident frequency remained a concern, with 46.4% reporting accidents occurred “Occasionally” and 31.9% acknowledging them as “Frequent” or “Very Frequent.” Comparative analysis showed indigenous firms were rated higher in policy effectiveness and health outcomes but also reported slightly higher accident frequencies than international firms. Thematic analysis identified five key monitoring and evaluation strategies including routine inspections, regular training, audits, behavioural reinforcement, and access control, Also, five measures of OHSM effectiveness, including compliance observation, incident tracking, KPIs, employee feedback, and benchmarking. OHSM was found to positively influence project outcomes by reducing compensation costs, enhancing reputation, and improving supervision and quality of work. OHSM practices in Nigeria’s construction sector are perceived as effective in policy and health outcomes, yet accident rates remain a critical challenge. The study underscores the importance of continuous training, stricter enforcement, behavioural reinforcement, and systematic performance evaluation.
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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 December 22, 2025

Reimagining Mathematical Modeling for a Responsive and Integrated Future in Infectious Disease Epidemiology

Abstract Mathematical modeling plays a central role in infectious disease epidemiology, shaping outbreak response strategies and informing public health policy. The COVID-19 pandemic demonstrated the value of these models but also exposed persistent limitations related to data fragility, lack of transparency, limited stakeholder engagement, and insufficient consideration of social and political contexts. [...] Read more.
Mathematical modeling plays a central role in infectious disease epidemiology, shaping outbreak response strategies and informing public health policy. The COVID-19 pandemic demonstrated the value of these models but also exposed persistent limitations related to data fragility, lack of transparency, limited stakeholder engagement, and insufficient consideration of social and political contexts. Rather than critiquing modeling as a discipline, this perspective argues for a reorientation of infectious disease modeling toward a more responsive, equity-centered, and participatory paradigm. We propose a conceptual framework built on three interrelated principles: adaptability through real-time data integration, transparency via open-source and reproducible practices, and relevance through interdisciplinary and co-produced model design. Drawing on illustrative examples from COVID-19 and dengue control efforts, we highlight how integrating behavioral dynamics, local knowledge, and policy feedback can improve model usefulness and public trust. Reconceptualizing models as dynamic systems of inquiry rather than static forecasting tools can enhance decision-making and promote more equitable and effective responses to future public health emergencies.
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Brief Review
Open Access November 12, 2025

Effect of Sleep Deprivation on Executive Functioning Among Young Adults: Meta-Analysis

Abstract Background: Sleep deprivation is increasingly prevalent among young adults due to academic, occupational, and social demands, making them susceptible to circadian disruption. Executive functioning—encompassing working memory, inhibitory control, and cognitive flexibility is essential for academic and professional success. This meta-analysis quantifies the effect of sleep deprivation on [...] Read more.
Background: Sleep deprivation is increasingly prevalent among young adults due to academic, occupational, and social demands, making them susceptible to circadian disruption. Executive functioning—encompassing working memory, inhibitory control, and cognitive flexibility is essential for academic and professional success. This meta-analysis quantifies the effect of sleep deprivation on executive functioning in healthy young adults. Practical Implications: These findings highlight the need for evidence-based interventions such as university-level sleep education programs, flexible academic scheduling, and workplace policies promoting adequate sleep to optimize cognitive performance and productivity among young adults. Methods: Following PRISMA 2020 guidelines, PubMed, Scopus, PsycINFO, and Web of Science were searched (January 2000–March 2024) for studies assessing acute (<6 hours sleep or ≥24 hours total deprivation) or chronic (<6 hours/night over multiple days) sleep deprivation in young adults. Outcomes included validated executive function tests (e.g., Stroop, N-Back). Random-effects meta-analysis (Hedges’ g) was conducted using R (version 4.3.2) with metafor/meta packages. Heterogeneity (I², Q-test), sensitivity (leave-one-out), and publication bias (funnel plot, Egger’s test) were evaluated. Results: Out of 2,478 screened studies, 39 met inclusion criteria (n=4,578). Sleep deprivation had a moderate-to-large detrimental effect on executive functioning (Hedges’ g = -0.62, 95% CI [-0.78, -0.45], p<0.001). Subdomain analysis revealed greatest impairment in working memory (g = -0.71), followed by inhibitory control (g = -0.59) and cognitive flexibility (g = -0.49) (all p<0.001). Moderate heterogeneity was present (I² = 58%), with results robust to sensitivity analysis. Egger’s test indicated no significant publication bias (p=0.22). Interpretation: Sleep deprivation significantly impairs executive functioning in young adults, especially working memory. Interventions improve sleep may enhance cognitive performance and should be integrated into public health strategies and educational policies. Future research should assess chronic restriction and individual vulnerability factors.
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Meta-Analysis
Open Access September 14, 2025

Lifecycle Management as a Roadmap to the Tobacco Endgame

Abstract Background: Tobacco endgame, defined as elimination of commercial tobacco sales The U.S. tobacco control landscape is a complex, adaptive system shaped by diverse stakeholders, evolving products and regulations, shifting social norms, and the strategic countermeasures of a powerful industry. Managing such complexity requires more than isolated interventions—it demands a coordinated, [...] Read more.
Background: Tobacco endgame, defined as elimination of commercial tobacco sales The U.S. tobacco control landscape is a complex, adaptive system shaped by diverse stakeholders, evolving products and regulations, shifting social norms, and the strategic countermeasures of a powerful industry. Managing such complexity requires more than isolated interventions—it demands a coordinated, enterprise-wide approach that accounts for dynamic interactions, feedback loops, and emergent risks. Objective: Drawing on complex systems thinking, Zachman enterprise architecture model, and public health best practices, we conceptualize tobacco control as an evolving enterprise progressing through six interconnected phases: (1) Conception & Initiation, (2) Policy & System Design, (3) Implementation & Operation, (4) Evaluation & Adaptation, (5) Consolidation & Endgame Transition, and (6) Sustainment or Sunset. Each phase incorporates governance structures, performance benchmarks, and transition criteria designed to manage interdependence and reduce systemic vulnerabilities. Results: The lifecycle framing emphasizes how tobacco control in the U.S. can evolve as a complex, adaptive enterprise—integrating public health objectives with legal, operational, and cultural change processes. This model supports strategic sequencing, cross-sector alignment, and risk mitigation against emergent industry tactics, enabling a resilient and measurable pathway to the endgame. Conclusions: Seeing tobacco control as a complex enterprise that operates under a lifecycle model may offer a roadmap for achieving and sustaining the tobacco endgame. Using this approach may enhance policy coherence, resource efficiency, and adaptability, ensuring tobacco endgame is achieved.
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Article
Open Access September 04, 2025

Evidence-Based Protocols for the Prevention and Treatment of Prosthetic Joint Infection in Total Hip Arthroplasty: A Systematic Review

Abstract Objective: This systematic review aimed to identify, synthesize, and critically analyze the available evidence on clinical protocols used for the prevention and treatment of prosthetic joint infection (PJI) in total hip arthroplasty (THA), based on studies published between 2000 and 2025. Methods: The review was conducted according to PRISMA guidelines. Electronic searches were performed in PubMed (MEDLINE), Scopus, Web of Science, and Embase between January and April 2025. Eligible studies included clinical trials, cohort studies, case-control studies, systematic reviews, and meta-analyses published in English that addressed either preventive or therapeutic strategies for PJI in THA. Study selection, data extraction, and quality assessment were carried out independently by two reviewers. Due to the heterogeneity of the included studies, a qualitative synthesis was performed. Results: A total of 32 studies were included. Preventive measures identified in the literature comprised combined antibiotic prophylaxis (cefazolin and gentamicin), multimodal perioperative protocols such as ACERTO, nasal decolonization for Staphylococcus aureus [...] Read more.
Objective: This systematic review aimed to identify, synthesize, and critically analyze the available evidence on clinical protocols used for the prevention and treatment of prosthetic joint infection (PJI) in total hip arthroplasty (THA), based on studies published between 2000 and 2025. Methods: The review was conducted according to PRISMA guidelines. Electronic searches were performed in PubMed (MEDLINE), Scopus, Web of Science, and Embase between January and April 2025. Eligible studies included clinical trials, cohort studies, case-control studies, systematic reviews, and meta-analyses published in English that addressed either preventive or therapeutic strategies for PJI in THA. Study selection, data extraction, and quality assessment were carried out independently by two reviewers. Due to the heterogeneity of the included studies, a qualitative synthesis was performed. Results: A total of 32 studies were included. Preventive measures identified in the literature comprised combined antibiotic prophylaxis (cefazolin and gentamicin), multimodal perioperative protocols such as ACERTO, nasal decolonization for Staphylococcus aureus, silver-impregnated dressings, and structured post-discharge surveillance. Treatment strategies included DAIR (Debridement, Antibiotics, and Implant Retention), the DAPRI technique, one-stage and two-stage revision surgeries, muscle flap reconstructions, and protocols without spacers. These interventions were associated with significantly reduced infection rates and improved clinical outcomes when applied appropriately and in accordance with patient-specific factors. Conclusion: Effective prevention and treatment of PJI in total hip arthroplasty require a systematic and evidence-based approach. Integrated protocols—spanning preoperative optimization, meticulous intraoperative techniques, and rigorous postoperative monitoring—have proven effective in reducing infection incidence. In cases of established infection, surgical management must be tailored to the timing of infection, microbial profile, and host conditions. Two-stage revision remains the gold standard for complex infections, while one-stage revision and emerging techniques like DAPRI offer promising results in selected cases. This review contributes to the standardization of clinical practice and supports improved patient outcomes.
Systematic 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 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 June 03, 2025

Complexity Leadership Theory Integration into Nursing Leadership and Development in Addressing COVID-19 and Future Pandemics

Abstract Complexity Leadership Theory (CLT) is a new and revolutionary concept in addressing healthcare crises worldwide. Its relevance and applications were tested during the COVID-19 pandemic. However, no definite and encompassing research was done to apply it to nursing leadership. Thus, this study examines CLT integration into nursing leadership to address the challenges posed by the pandemic. Through [...] Read more.
Complexity Leadership Theory (CLT) is a new and revolutionary concept in addressing healthcare crises worldwide. Its relevance and applications were tested during the COVID-19 pandemic. However, no definite and encompassing research was done to apply it to nursing leadership. Thus, this study examines CLT integration into nursing leadership to address the challenges posed by the pandemic. Through a systematic review of literature from PubMed, Scopus, and Web of Science, relevant studies were analyzed to determine how complexity leadership theory was defined, conceptualized, and operationalized within nursing leadership context. The findings reveal that traditional hierarchical leadership models are insufficient in a dynamic crisis environment like the pandemic. Instead, CLT’s framework which encompasses adaptive, administrative, and enabling leadership facilitates innovation, resilience, and effective interprofessional collaboration. Nurse leaders employing these strategies are better positioned to manage resources limitation, foster shared decision-making, and implement technological advancements in rapidly changing healthcare settings. Overall, this study underscores the potential of complexity leadership theory to transform nursing leadership practices by promoting continuous learning and empowerment, thereby enhancing crisis response and preparedness for future pandemics.
Systematic Review
Open Access May 20, 2025

Periprosthetic Joint Infections in Total Hip Arthroplasty: Diagnostic Advances, Treatment Algorithms, and Technological Innovations — A Comprehensive Review

Abstract Objective: This integrative review aims to critically examine the clinical management of periprosthetic joint infections (PJI) in total hip arthroplasty (THA), emphasizing decision-making strategies, diagnostic advancements, and therapeutic innovations. The study focuses on the complexity of infection control, microbial resistance, and individualized treatment planning. Methods: [...] Read more.
Objective: This integrative review aims to critically examine the clinical management of periprosthetic joint infections (PJI) in total hip arthroplasty (THA), emphasizing decision-making strategies, diagnostic advancements, and therapeutic innovations. The study focuses on the complexity of infection control, microbial resistance, and individualized treatment planning. Methods: A systematic review of the literature was conducted using PubMed, Scopus, Web of Science, and Google Scholar, targeting studies published between 2015 and 2025. Articles were selected based on their contribution to understanding the clinical, microbiological, and surgical aspects of PJI in THA. Fifty-five studies met the inclusion criteria and were analyzed descriptively. Results: PJI in THA is influenced by multifactorial risk profiles, including obesity, diabetes, and immunosuppression. Staphylococcus aureus, particularly MRSA, remains the most frequently isolated pathogen, followed by Gram-negative organisms and fungal species. Diagnostic innovations such as next-generation sequencing have enhanced pathogen detection, while two-stage revision remains the gold standard for chronic infections. Emerging strategies—such as antimicrobial coatings, tailored antibiotic protocols, and multidisciplinary care models—demonstrate promise in improving clinical outcomes. Conclusion: Managing PJI in THA necessitates a comprehensive and individualized approach, integrating early and accurate diagnosis, pathogen-specific treatment, and advanced preventive measures. The integration of emerging technologies and personalized care pathways is critical to optimizing outcomes and reducing the clinical and economic burden of PJI.
Review Article
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

Comprehensive Review of Conservative and Surgical Treatment Strategies for Knee Osteoarthritis: Efficacy, Safety, and Emerging Therapies

Abstract Knee osteoarthritis (KOA) is a chronic degenerative joint disorder that significantly impairs mobility and quality of life. While surgical interventions such as total knee arthroplasty (TKA) are effective in severe cases, conservative treatments are critical for early and intermediate disease management. This review evaluates the efficacy, safety, and clinical applications of both conservative and [...] Read more.
Knee osteoarthritis (KOA) is a chronic degenerative joint disorder that significantly impairs mobility and quality of life. While surgical interventions such as total knee arthroplasty (TKA) are effective in severe cases, conservative treatments are critical for early and intermediate disease management. This review evaluates the efficacy, safety, and clinical applications of both conservative and surgical treatment approaches, including lifestyle modifications, physical therapy, pharmacological interventions, regenerative medicine, and surgical procedures. The integration of a multidisciplinary approach is emphasized as a key strategy for optimizing clinical outcomes and tailoring interventions to disease severity.
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 March 11, 2025

Why High Income Fails to Reduce E-Cigarette Use: The Knowledge-Attitude Paradox in the SMOKES Study

Abstract Background: Electronic cigarette (e-cigarette) use and vaping tobacco have increased rapidly worldwide, raising concerns about their health effects, social acceptability, and regulatory challenges. In many countries, e-cigarettes are more commonly used by individuals from higher socioeconomic status (SES) backgrounds, who, in theory, should have greater knowledge about e-cigarettes and [...] Read more.
Background: Electronic cigarette (e-cigarette) use and vaping tobacco have increased rapidly worldwide, raising concerns about their health effects, social acceptability, and regulatory challenges. In many countries, e-cigarettes are more commonly used by individuals from higher socioeconomic status (SES) backgrounds, who, in theory, should have greater knowledge about e-cigarettes and their associated risks. However, it remains unclear why a group with more knowledge about e-cigarette risks would also hold more positive attitudes toward vaping and exhibit higher usage rates — a phenomenon that may represent a knowledge-behavior paradox. Understanding this paradox, along with the complex relationships between e-cigarette knowledge, attitudes, and behaviors, is critical for informing effective public health interventions, campaigns, social media messaging, and regulatory policies. Objectives: This study aimed to evaluate the complex relationship between SES, e-cigarette knowledge, pro-vaping attitudes, and e-cigarette use. Methods: The SMOKES Study (Study of Measurement of Knowledge and Examination of Support for Tobacco Control Policies) used a multi-center, cross-sectional design, collecting data from 2,403 college and university students across 15 provinces in Iran (covering nearly half of the country's provinces). The survey measured family income, age, sex, ethnicity, e-cigarette use, knowledge, and attitudes. Structural Equation Modeling (SEM) was employed to examine the interrelations between SES, knowledge, attitudes, and behavior, while adjusting for age, sex, and ethnic minority status. Results: SEM analysis confirmed the hypothesized paradox. Although greater knowledge about e-cigarettes was linked to less favorable attitudes toward vaping and lower use, pro-vaping attitudes emerged as the strongest predictor of vaping behavior, while knowledge played a weaker protective role. Notably, individuals with higher SES simultaneously showed higher knowledge and, paradoxically, more pro-e-cigarette attitudes and greater usage. Female students and ethnic minority students reported higher correct knowledge and lower pro-vaping attitudes and use. Although age and higher family income were associated with more favorable attitudes, they did not directly predict vaping behavior. These results suggest that for higher SES individuals, poor knowledge is not the main driver of e-cigarette use; rather, their pro-e-cigarette attitudes, which seem to outweigh the influence of knowledge, play a key role. Conclusions: Although individuals from higher SES backgrounds report greater correct knowledge about e-cigarettes, this knowledge does not necessarily translate into reduced positive attitudes or lower usage. This study highlights the complexity of these paradoxical effects and suggests that public health strategies need to go beyond simple education and knowledge-based interventions. Targeted approaches should address industry messaging, challenge misconceptions, and strengthen regulatory efforts to reduce e-cigarette use among young adults, including those from higher SES backgrounds.
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Original Article
Open Access March 09, 2025

Gender Differences in Quit Rates in a Tobacco Cessation Program: In Search of Demographic, Socioeconomic, Health, or Behavioral Explanatory Mechanisms

Abstract Background: Women have consistently shown lower quit rates in tobacco cessation programs compared to men. This gender disparity persists despite comprehensive interventions and access to cessation resources. While prior studies suggest that factors such as social support, chronic disease burden, and socioeconomic status may contribute to these differences, there is limited empirical [...] Read more.
Background: Women have consistently shown lower quit rates in tobacco cessation programs compared to men. This gender disparity persists despite comprehensive interventions and access to cessation resources. While prior studies suggest that factors such as social support, chronic disease burden, and socioeconomic status may contribute to these differences, there is limited empirical evidence to confirm these mechanisms. Aims: This study aimed to investigate potential mechanisms underlying gender differences in quit rates in a tobacco cessation program, testing whether demographic, socioeconomic, health, or behavioral factors explain the observed disparities. Methods: Participants were assigned to one of three smoking cessation interventions: an in-person program (CEASE), a self-help approach, or an online/hybrid program. The main outcome measured was smoking abstinence, evaluated three months after the intervention. Secondary analyses explored whether demographic, socioeconomic, health, or tobacco use-related factors mediated the association between gender and quit rates. Results: Women had significantly lower quit rates than men (p < 0.01). This association remained significant after adjusting for demographic, socioeconomic, health, and addiction-related factors. While women reported higher social support and a higher prevalence of chronic cardiometabolic conditions, these factors did not explain the gender disparity in quit rates. Conclusions: Gender differences in quit rates persist despite controlling for known factors that could influence cessation success. Although women had higher social support, they had lower quit rate. Future research should explore unmeasured variables, such as psychological, biological, and structural influences, to develop more effective cessation strategies tailored for women.
Article
Open Access March 06, 2025

Tobacco-control policy support and tobacco use: SMOKES study

Abstract Background: Tobacco control policies are implemented globally to reduce tobacco-related morbidity and mortality. Emerging evidence suggests that individual tobacco use may influence the level of support for these policies. However, the extent to which personal use affects policy endorsement remains underexplored, particularly among young adults in academic settings. Aims: This study [...] Read more.
Background: Tobacco control policies are implemented globally to reduce tobacco-related morbidity and mortality. Emerging evidence suggests that individual tobacco use may influence the level of support for these policies. However, the extent to which personal use affects policy endorsement remains underexplored, particularly among young adults in academic settings. Aims: This study aimed to examine whether college students who use tobacco exhibit lower support for tobacco control policies compared to their non-user counterparts. Methods: We conducted a multi-center, cross-sectional study involving 2403 college students from various provinces in Iran. Tobacco use was ascertained based on self-reported consumption of cigarettes, electronic cigarettes, and hookah. Attitudes toward tobacco control policies were evaluated using a structured survey instrument, and comparative analyses were performed to assess differences in policy support between tobacco users and non-users. Results: The analysis revealed that tobacco users demonstrated significantly lower support for tobacco control policies compared to non-users. This association was consistently observed across users of cigarettes, electronic cigarettes, and hookah, suggesting a systematic pattern irrespective of the type of tobacco product used. Conclusion: These findings indicated a clear association between tobacco use and reduced endorsement of tobacco control policies among Iranian college students. These results have potential implications for public health policy, emphasizing the importance of addressing individual tobacco use behaviors in the development and implementation of tobacco control strategies. Further research is needed to elucidate the underlying mechanisms of this relationship.
Article
Open Access March 04, 2025

SMOKES: Study of Measurement of Knowledge and Examination of Support for tobacco control policies

Abstract Background: Tobacco use remains a major global health concern, and understanding the factors that influence tobacco-related knowledge and support for tobacco control policies is critical for effective development of tobacco control policies that are accepted by the public. Objectives: This study introduces the rationale, design, methodology, and participants of the SMOKES Study [...] Read more.
Background: Tobacco use remains a major global health concern, and understanding the factors that influence tobacco-related knowledge and support for tobacco control policies is critical for effective development of tobacco control policies that are accepted by the public. Objectives: This study introduces the rationale, design, methodology, and participants of the SMOKES Study (Study of Measurement of Knowledge and Examination of Support for tobacco control policies), which is conducted to evaluate tobacco use, tobacco-related knowledge and attitude, as well as support for tobacco control policies among college and university students. Methods: The SMOKES Study was designed to address significant gaps in literature by focusing on college and university students in a non-Western context. A multi-center, cross-sectional design was employed to collect data from a diverse sample of college and university students across different geographical provinces in Iran. The survey instrument incorporated a range of measures covering socio-demographic characteristics, university-related variables, family tobacco use status, personal tobacco consumption behaviors (including detailed assessments of cigarette, hookah, and electronic cigarette use), and attitudinal as well as knowledge-based assessments related to vaping. Support for tobacco control policies is also measured. Data were collected using an online survey that included self-administered questionnaires, enabling access to a large diverse sample. This study may be used to determine the prevalence of ever and current use of cigarettes, electronic cigarettes, and hookah, as well as examining the correlates of single, dual, and poly-tobacco use. The study also aims to assess the role of social determinants, attitudes, and ethnic/geographic differences in shaping these outcomes. Results: The study sample consisted of 2403 college and university students, including undergraduates enrolled in different academic programs from all faculties and disciplines. Participants were drawn from universities across 15 provinces, and 11 ethnic groups, ensuring a heterogeneous sample with respect to socio-demographic background, ethnicity, and institutional affiliation. This diversity enhances the generalizability of the findings and allows for the exploration of subgroup differences in tobacco use patterns and policy support. Conclusions: The SMOKES Study offers a framework for examining tobacco-related knowledge and the acceptability of tobacco control policies among a key part of the population, being college and university students. By providing detailed insights into the prevalence and correlates of tobacco knowledge, attitude, use, as well as the tobacco control policy support, the study lays the groundwork for tailored public health interventions and more effective tobacco regulation strategies particularly for college campuses in a non-Western setting.
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Article
Open Access February 26, 2025

Lower Successful Quit Rate of Menthol Tobacco Users in a Tobacco Cessation Program: An Explanatory Analysis in Search of Potential Mechanisms

Abstract Background: Menthol-flavored tobacco products are disproportionately used in low-income African American communities, a result of decades of targeted marketing and systemic inequities. Menthol use has been associated with lower quit rates, often compounded by factors such as lower trust in healthcare systems, reduced access to cessation programs, and other structural barriers. [...] Read more.
Background: Menthol-flavored tobacco products are disproportionately used in low-income African American communities, a result of decades of targeted marketing and systemic inequities. Menthol use has been associated with lower quit rates, often compounded by factors such as lower trust in healthcare systems, reduced access to cessation programs, and other structural barriers. Despite this, few studies have systematically examined the explanatory mechanisms that might clarify why menthol-flavored tobacco is linked to poorer cessation outcomes among participants in tobacco cessation programs. Aims: This study aimed to investigate the potential mechanisms by which menthol tobacco use is associated with lower quit rates across three types of smoking cessation interventions. Methods: Participants were randomized into one of three smoking cessation interventions: in-person (CEASE), self-help, or online/hybrid programs. Smoking abstinence was assessed three months post-intervention as the primary outcome. Secondary analyses explored whether demographic, socioeconomic, or behavioral factors mediated the association between menthol use and quit rates across the intervention arms. Results: Menthol tobacco use was significantly associated with lower quit rates (p < 0.01). This association was not explained by demographic, socioeconomic, health, or addiction-related factors. While menthol use was associated with lower education and employment levels, demographic characteristics, physical or mental health, or addiction did not explain the effect of menthol on tobacco cessation. These findings suggest that the lower quit rates observed among menthol users cannot be attributed to any third factors assessed in this study. Conclusions: Menthol tobacco use independently predicts lower quit rates, and the mechanisms behind this disparity remain unclear. The consistent findings across different intervention types highlight the need for further research to uncover the underlying pathways and to design targeted strategies to improve cessation outcomes for menthol users.
Article
Open Access February 19, 2025

The CEASE Tobacco Cessation Controlled Trial for Low-Income Racial and Ethnic Minority Participants: Key Predictors of Success

Abstract Background: Tobacco use remains disproportionately high among low-income and racial-ethnic minority populations. The CEASE program, with its self-help, hybrid/online, and in-person modalities, has demonstrated efficacy in promoting tobacco cessation. However, predictors of successful cessation among participants in these groups remain unclear. Objective: To identify baseline predictors of successful tobacco cessation among low-income and racial-ethnic minority participants in the CEASE program, with a focus on demographic, socioeconomic, behavioral, and psychosocial factors. Methods: Participants were allocated into three intervention arms: self-help, CEASE hybrid/online, and CEASE in-person. Baseline characteristics, including demographics (e.g., age, gender), socioeconomic status (e.g., education, employment), substance use profiles (e.g., cigarette packs per week, use of other tobacco products, menthol tobacco use), physical health (e.g., general health, number of cardiometabolic risk conditions), mental health (e.g., depressive symptoms, perceived stress), perceived social support, and nicotine dependence, were analyzed as potential predictors of cessation success. Multivariable logistic regression models were used to identify factors associated with successful quitting, controlling for the study arm. Results: In addition to the study arm, gender, baseline depression, cardiometabolic conditions, tobacco flavor, and the use of other tobacco products were significant predictors of quit success. Individuals receiving in-person interventions had significantly higher odds of quitting (AOR = 3.79, p < 0.05). Women were significantly less likely to quit compared to men (AOR = 0.24, p < 0.01). Participants with a greater number of cardiometabolic risk conditions were more likely to quit (AOR = 1.93, p < 0.05), while those with higher levels of depression had lower odds of quitting (AOR = 0.61, p < 0.05). Menthol tobacco users were also less likely to quit (AOR = 0.10, p < 0.05). Interestingly, individuals who used other forms of tobacco in addition to cigarettes had increased odds of quitting (AOR = 2.86, p [...] Read more.
Background: Tobacco use remains disproportionately high among low-income and racial-ethnic minority populations. The CEASE program, with its self-help, hybrid/online, and in-person modalities, has demonstrated efficacy in promoting tobacco cessation. However, predictors of successful cessation among participants in these groups remain unclear. Objective: To identify baseline predictors of successful tobacco cessation among low-income and racial-ethnic minority participants in the CEASE program, with a focus on demographic, socioeconomic, behavioral, and psychosocial factors. Methods: Participants were allocated into three intervention arms: self-help, CEASE hybrid/online, and CEASE in-person. Baseline characteristics, including demographics (e.g., age, gender), socioeconomic status (e.g., education, employment), substance use profiles (e.g., cigarette packs per week, use of other tobacco products, menthol tobacco use), physical health (e.g., general health, number of cardiometabolic risk conditions), mental health (e.g., depressive symptoms, perceived stress), perceived social support, and nicotine dependence, were analyzed as potential predictors of cessation success. Multivariable logistic regression models were used to identify factors associated with successful quitting, controlling for the study arm. Results: In addition to the study arm, gender, baseline depression, cardiometabolic conditions, tobacco flavor, and the use of other tobacco products were significant predictors of quit success. Individuals receiving in-person interventions had significantly higher odds of quitting (AOR = 3.79, p < 0.05). Women were significantly less likely to quit compared to men (AOR = 0.24, p < 0.01). Participants with a greater number of cardiometabolic risk conditions were more likely to quit (AOR = 1.93, p < 0.05), while those with higher levels of depression had lower odds of quitting (AOR = 0.61, p < 0.05). Menthol tobacco users were also less likely to quit (AOR = 0.10, p < 0.05). Interestingly, individuals who used other forms of tobacco in addition to cigarettes had increased odds of quitting (AOR = 2.86, p < 0.05). No other factors, including demographic variables (e.g., age), socioeconomic status (e.g., education, marital status), substance use profiles (e.g., cigarette packs per week, NRT use), or nicotine dependence, were significant predictors of cessation success. Conclusion: Baseline self-reported anxiety/depression and depressive symptoms play a critical role in reducing the likelihood of successful tobacco cessation among low-income and racial-ethnic minority participants in the CEASE program. These findings underscore the importance of addressing mental health challenges as part of tobacco cessation interventions to enhance their efficacy. Future research should explore targeted strategies for integrating mental health support into cessation programs to improve outcomes for underserved populations.
Article
Open Access February 17, 2025

Gender Differences in the Association Between Socioeconomic Status and Cardiometabolic Health: National Health and Nutrition Examination Survey

Abstract Background: Socioeconomic status (SES) is a well-established determinant of health, often associated with lower risk of cardiometabolic diseases (CMD). However, the extent to which SES influences CMD may vary by gender due to differences in social roles, health behaviors, and biological susceptibilities. This study examined the relationship between SES, measured by the [...] Read more.
Background: Socioeconomic status (SES) is a well-established determinant of health, often associated with lower risk of cardiometabolic diseases (CMD). However, the extent to which SES influences CMD may vary by gender due to differences in social roles, health behaviors, and biological susceptibilities. This study examined the relationship between SES, measured by the poverty-to-income ratio (PIR), and CMD indicators—including obesity, diabetes, and cardiovascular disease (CVD)—among men and women using data from the National Health and Nutrition Examination Survey (NHANES). Methods: This cross-sectional study utilized NHANES data (1999-2018), adjusting for race/ethnicity and age. SES was operationalized using PIR, with CMD outcomes (obesity, diabetes, and CVD) as dependent variables. Generalized linear models (GLM) were employed to evaluate the main effects of SES on CMD, with gender included as a moderator. Results: Higher SES was associated with lower overall CMD risk. However, the protective effects of SES were more pronounced in women than in men for all outcomes. These findings suggest that gender-specific pathways may mediate the relationship between SES and CMD. Women may derive greater health benefits from higher SES due to factors such as reduced stress exposure, healthier behaviors, and increased healthcare utilization. Conversely, the weaker association observed in men may reflect differences in social hierarchy sensitivity, responses to unemployment, or other contextual factors. Conclusion: The findings highlight the importance of gender-specific considerations when addressing SES-related disparities in CMD outcomes. Policies and interventions aimed at reducing CMD burden should account for these gender differences to promote equitable improvements in cardiometabolic health. Further research is needed to unravel the mechanisms driving these differences and to inform targeted strategies.
Article
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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Article
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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Article
Open Access November 19, 2024

Social Epidemiology of Dual Use of Electronic and Combustible Cigarettes Among U.S. Adults: Insights from the Population Assessment of Tobacco and Health (PATH) Study

Abstract Background: The dual use of e-cigarettes and combustible cigarettes poses significant public health concerns due to the compounded risks associated with the use of both products. Understanding the predictors of dual use can inform targeted interventions and tobacco control strategies aimed at reducing nicotine dependence and health risks among adults. Objective: This study [...] Read more.
Background: The dual use of e-cigarettes and combustible cigarettes poses significant public health concerns due to the compounded risks associated with the use of both products. Understanding the predictors of dual use can inform targeted interventions and tobacco control strategies aimed at reducing nicotine dependence and health risks among adults. Objective: This study aims to identify the sociodemographic predictors of dual use of e-cigarettes and combustible cigarettes among U.S. adults using baseline data from the Population Assessment of Tobacco and Health (PATH) Study. Methods: We analyzed baseline data from the PATH Study, focusing on adult participants who reported the use of both e-cigarettes and combustible cigarettes. Logistic regression models were used to identify the associations between dual use and key sociodemographic variables, including age, gender, race/ethnicity, and education level. Results: The analysis revealed that dual use of e-cigarettes and combustible cigarettes was predominantly observed among young, female, non-Latino, White, and highly educated adults. Younger adults were more likely to engage in dual use compared to older age groups. Females showed higher rates of dual use compared to males. Non-Latino White individuals were more likely to be dual users than individuals from other racial/ethnic backgrounds. Additionally, higher educational attainment was associated with increased dual use, contrary to traditional smoking patterns. Conclusion: The findings highlight specific demographic groups that are at higher risk of dual use of e-cigarettes and combustible cigarettes, particularly younger, highly educated, non-Latino White females. These insights suggest the need for tailored public health interventions that address the unique needs and behaviors of these populations. Future research should explore the underlying motivations and contextual factors contributing to dual use to enhance the effectiveness of tobacco control policies and cessation programs.
Article
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 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 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 21, 2024

Sexual Harassment in Ghanaian Tertiary Institutions: Reality or Perception

Abstract This article assesses the realities of sexual harassment (SH) in selected tertiary educational institutions in Ghana. Using multiple data collection techniques, three areas that are related to SH were assessed. These are knowledge of what constitutes SH, the nature and incidence of SH, and strategies/procedures for handling issues of SH in tertiary educational institutions. The findings from the [...] Read more.
This article assesses the realities of sexual harassment (SH) in selected tertiary educational institutions in Ghana. Using multiple data collection techniques, three areas that are related to SH were assessed. These are knowledge of what constitutes SH, the nature and incidence of SH, and strategies/procedures for handling issues of SH in tertiary educational institutions. The findings from the perspective of teaching and non-teaching staff strongly suggest that knowledge of SH was high among teaching staff but low among non-teaching staff. Staff could not relate very well to the reporting systems and procedures of SH in their institutions. Issues of SH were left in the hands of only a few staff while newly recruited staff showed little understanding of the reporting systems and procedures. From the perspective of students, knowledge of what constitutes SH was high. Students were able to indicate the various SH reporting systems/procedures in the tertiary educational institutions and further indicated that the institutions have provided a safe environment and appointed designated people to handle sexual harassment complaints. Surprisingly, the incidence of sexual harassment was low, and this affected sexual harassment reporting.
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Open Access September 18, 2024

Effect of Multicultural Teaching Competency on the Culturally Responsive Teaching of Religious and Moral Education Teachers

Abstract The study aimed to establish the effect of Multicultural Teaching Competency (MTC) on the Culturally Responsive Teaching (CRT) of RME teachers in Cape Coast. The cross-sectional survey design was used. All 150 RME teachers in the 54 schools in Cape Coast were involved in the study through the census method and a 33-item close-ended structured questionnaire was used for the data collection exercise. Data were analysed using descriptive and inferential (Factorial ANOVA and PLS-SEM) statistics. Results revealed that RME teachers have a high level of MTC and CRT even though the students seem not to show interest in the subject leading to them failing in their final examinations. There was a statistically significant effect of RME teachers’ sex, academic qualification, teaching experience, and professional qualification on their MTC F (30, 4) = 7.142, p = .000, partial ƞ2 =.643 and CRT, F (30, 4) = 3.874, p = .000*, partial ƞ2 = .494 [...] Read more.
The study aimed to establish the effect of Multicultural Teaching Competency (MTC) on the Culturally Responsive Teaching (CRT) of RME teachers in Cape Coast. The cross-sectional survey design was used. All 150 RME teachers in the 54 schools in Cape Coast were involved in the study through the census method and a 33-item close-ended structured questionnaire was used for the data collection exercise. Data were analysed using descriptive and inferential (Factorial ANOVA and PLS-SEM) statistics. Results revealed that RME teachers have a high level of MTC and CRT even though the students seem not to show interest in the subject leading to them failing in their final examinations. There was a statistically significant effect of RME teachers’ sex, academic qualification, teaching experience, and professional qualification on their MTC F (30, 4) = 7.142, p = .000, partial ƞ2 =.643 and CRT, F (30, 4) = 3.874, p = .000*, partial ƞ2 = .494. The result showed that RME teachers' MTC substantially explained 61.2% of the variation in their CRT. It was recommended that GES and the Metropolitan Education office should provide ongoing professional development opportunities specifically focused on translating MTC principles into actionable strategies.
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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 04, 2024

Cognitive and Psychological Mediators of the Social Gradient in Tobacco Use Initiation Among Adolescents: Evidence from the ABCD Study

Abstract Background: Tobacco use among adolescents is a significant public health concern, with early initiation leading to long-term health risks. Understanding the factors that contribute to the initiation of tobacco use is crucial for developing effective prevention strategies. This study investigates the roles of substance use harm knowledge and tobacco susceptibility in mediating the [...] Read more.
Background: Tobacco use among adolescents is a significant public health concern, with early initiation leading to long-term health risks. Understanding the factors that contribute to the initiation of tobacco use is crucial for developing effective prevention strategies. This study investigates the roles of substance use harm knowledge and tobacco susceptibility in mediating the relationship between social gradients (race, ethnicity, and socioeconomic status) and tobacco use initiation among adolescents. Methods: Data from the Adolescent Brain Cognitive Development (ABCD) study, comprising a racially, ethnically, and economically diverse sample of tobacco-naive adolescents aged 9 to 16, were analyzed. Structural equation modeling (SEM) was used to test whether substance use harm knowledge and tobacco susceptibility mediate the effects of socioeconomic status (SES) on the initiation of tobacco use. Results: Findings indicated that both substance use harm knowledge and tobacco susceptibility partially mediate the relationship between SES and tobacco use initiation. Adolescents from lower SES backgrounds exhibited lower levels of harm knowledge and higher levels of tobacco susceptibility, which increased their likelihood of initiating tobacco use. Conclusion: This study highlights the complex interplay between social determinants and individual cognitive and psychological factors in influencing tobacco use initiation among adolescents. Public health interventions that enhance harm knowledge and reduce susceptibility to tobacco use are crucial for preventing initiation, particularly among racially, ethnically, and economically diverse adolescents. These efforts can help reduce health disparities and promote health equity.
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Original Research
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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Article
Open Access August 27, 2024

Role of Impulsivity in Explaining Social Gradient in Youth Tobacco Use Initiation: Does Race Matter?

Abstract Background: Socioeconomic status (SES) is traditionally viewed as a protective factor against impulsivity and subsequent tobacco use in youth. The prevailing model suggests that higher SES is associated with lower impulsivity, which in turn reduces the likelihood of future tobacco use. However, this pathway may not hold uniformly across racial groups due to differences in impulsivity and [...] Read more.
Background: Socioeconomic status (SES) is traditionally viewed as a protective factor against impulsivity and subsequent tobacco use in youth. The prevailing model suggests that higher SES is associated with lower impulsivity, which in turn reduces the likelihood of future tobacco use. However, this pathway may not hold uniformly across racial groups due to differences in impulsivity and the phenomenon of Minorities' Diminished Returns (MDRs), where the protective effects of SES, such as educational attainment, tend to be weaker or even reversed for Black youth compared to their White counterparts. Objectives: This study aims to examine the racial heterogeneity in the pathway from childhood SES to impulsivity and subsequent tobacco use initiation during adolescence, focusing on differences between Black and White youth. Methods: Data were drawn from the Adolescent Brain Cognitive Development (ABCD) Study, which includes a diverse sample of youth aged 9 to 16 years. The analysis examined the relationship between baseline family SES (age 9), impulsivity (age 9), and subsequent tobacco use (ages 9 to 16). Impulsivity was measured using the Urgency, Premeditation (lack of), Perseverance (lack of), Sensation Seeking, and Positive Urgency Impulsive Behavior Scale (UPPS-P). Structural equation modeling (SEM) was employed, with analyses stratified by race to explore potential differences in these associations. Results: Overall, 6,161 non-Latino White and 1,775 non-Latino Black adolescents entered our analysis. In the full sample, higher family SES was linked to lower childhood impulsivity and, consequently, less tobacco uses in adolescence. However, racial differences emerged upon stratification. Among White youth, higher SES was associated with lower impulsivity, leading to reduced tobacco use, consistent with the expected model. In contrast, among Black youth, higher SES was not associated with lower impulsivity, thereby disrupting the protective effect of SES on tobacco use through this pathway. These findings suggest that racial heterogeneity exists in the SES-impulsivity-tobacco use pathway, aligning with the MDRs framework, which highlights how structural factors may weaken the protective effects of high SES among Black youth. Conclusions: These findings underscore the importance of considering racial heterogeneity in the relationships between SES, impulsivity, and tobacco use. The observed disparities suggest a need for targeted interventions that address the unique challenges faced by Black youth, who may not experience the same protective benefits of high SES as their White peers. These results carry significant implications for public health strategies aimed at reducing tobacco use in racially diverse populations.
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Article
Open Access August 24, 2024

Higher Neighborhood Crime Rates Don't Always Predict Early Initiation of Tobacco, Marijuana, and Alcohol

Abstract Background: The initiation of substance use during adolescence is a significant public health concern with long-term implications. Structural and environmental factors, such as community-level crime statistics related to drug offenses, are often assumed to influence the likelihood of substance use among youth. However, the relationship between these environmental crime indicators and [...] Read more.
Background: The initiation of substance use during adolescence is a significant public health concern with long-term implications. Structural and environmental factors, such as community-level crime statistics related to drug offenses, are often assumed to influence the likelihood of substance use among youth. However, the relationship between these environmental crime indicators and early substance use initiation in adolescents is not well understood. Objective: This study aims to examine the association between environmental drug-related crime statistics—derived from Uniform Crime Reports, including drug abuse violations, drug sales, marijuana sales, drug possession, and driving under the influence (DUI)—and the use of tobacco, marijuana, and alcohol among adolescents aged 9-16 in the United States. Methods: Data from the Adolescent Brain Cognitive Development (ABCD) study, which follows a cohort of adolescents from ages 9-10 to 16, were analyzed. 11,878 participants entered our analysis. The primary environmental measures included total drug abuse violations, drug sale offenses, marijuana sale offenses, drug possession offenses, and DUI reports. Substance use outcomes of interest were the frequency and prevalence of tobacco, marijuana, and alcohol use across the observed age range. Results: Contrary to expectations, higher levels of drug-related crime in a community were not associated with increased use of tobacco, marijuana, or alcohol among adolescents. In fact, the study found a significant inverse relationship between the total number of drug-related crimes and tobacco use, suggesting lower tobacco use in areas with higher reported drug abuse violations, drug sales, marijuana sales, drug possession, and DUI incidents. No significant associations were observed between these crime indicators and the use of marijuana or alcohol. Conclusions: These findings challenge the prevailing assumption that higher environmental drug-related crime statistics necessarily predict greater substance use among adolescents. The observed inverse relationship between drug-related crime and tobacco use warrants further investigation to understand the underlying mechanisms and to inform targeted intervention strategies. Future research should explore the complex interplay between structural environmental factors and youth substance use to better inform public health policies.
Article
Open Access March 30, 2024

Essence Control of Active Pharmaceutical Ingredients

Abstract Active Pharmaceutical Ingredients (APIs) form the backbone of pharmaceutical formulations, influencing their efficacy, safety, and stability. Essence control of APIs involves stringent regulation and optimization of their chemical, physical, and biological properties to ensure consistent quality and therapeutic outcomes. This manuscript explores the critical aspects of essence control in APIs, [...] Read more.
Active Pharmaceutical Ingredients (APIs) form the backbone of pharmaceutical formulations, influencing their efficacy, safety, and stability. Essence control of APIs involves stringent regulation and optimization of their chemical, physical, and biological properties to ensure consistent quality and therapeutic outcomes. This manuscript explores the critical aspects of essence control in APIs, including synthesis, characterization, quality assessment, and regulatory considerations. The synthesis of Active Pharmaceutical Ingredients is a pivotal stage in pharmaceutical manufacturing, where precise control over chemical reactions and process conditions is paramount to achieving high-quality, safe, and effective medicines. Advances in synthetic methodologies, optimization strategies, sustainability practices, and the implementation of PAT technologies continue to drive innovation in API synthesis, supporting the development of novel therapeutic agents and enhancing pharmaceutical manufacturing efficiency.
Review Article
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 17, 2024

Socioeconomic Status Partially Mediates the Effects of Structural Racism on Youth Tobacco Use Initiation

Abstract Background: Recent research has identified structural racism—systemic policies and practices that perpetuate racial inequalities—as a significant social determinant of population health. Studies utilizing data from the Adolescent Brain Cognitive Development (ABCD) study have shown an association between higher levels of state-level structural racism and increased tobacco use among youth in [...] Read more.
Background: Recent research has identified structural racism—systemic policies and practices that perpetuate racial inequalities—as a significant social determinant of population health. Studies utilizing data from the Adolescent Brain Cognitive Development (ABCD) study have shown an association between higher levels of state-level structural racism and increased tobacco use among youth in the United States. However, there has been limited exploration of the psychosocial mediators of this relationship, particularly in the context of youth aged 10-16 years. Objective: This study aimed to assess the roles of socioeconomic status (SES), tobacco susceptibility, and perceived discrimination as potential mediators in the relationship between state-level structural racism and youth tobacco initiation rates. Methods: We analyzed data from the ABCD study, a nationally representative longitudinal survey of 11,698 youth followed from ages 9/10 to 15/16. These data were combined with state-level indicators of structural racism. We employed structural equation modeling (SEM) to investigate the mediators of the association between structural racism and self-reported initiation of tobacco use, while controlling for individual and state-level covariates. Results: Our findings indicate that higher levels of structural racism were associated with increased rates of tobacco initiation among youth. This relationship was partially mediated by lower SES, but not by perceived discrimination or tobacco susceptibility. Conclusion: The association between structural racism and youth tobacco initiation appears to be influenced in part by the lower SES prevalent in states with higher levels of racism. These results highlight the need for addressing both racism and SES inequalities as key strategies for reducing tobacco disparities among youth.
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Article
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 08, 2024

Challenges and Strategies: Usage of Multimedia Resources in Teaching Social Studies Concepts in the Junior High Schools of Ghana

Abstract Access to and the availability of digital infrastructure remains the most significant issue influencing teachers' use of multimedia technology in teaching and learning processes. Qualitatively, the study focused on a case study research design. The study population consisted of five (5) Social Studies teachers at Presbyterian University College of Education Demonstration Junior High School in the [...] Read more.
Access to and the availability of digital infrastructure remains the most significant issue influencing teachers' use of multimedia technology in teaching and learning processes. Qualitatively, the study focused on a case study research design. The study population consisted of five (5) Social Studies teachers at Presbyterian University College of Education Demonstration Junior High School in the Akuapem North Municipality of the Eastern Region of Ghana. A purposive sampling technique was used to select all the Social Studies teachers for the study. The main instruments for data collection were an interview guide and observation protocols. The data was analysed using the interpretative method based on the themes arrived at during the data collection. The themes were related to the research question and interpreted on the number of issues raised by participants. The study indicated that more resources are needed to use multimedia resources effectively in social studies instruction. Limited access to computers and the internet, unreliable power supply, time constraints for teachers, and a lack of necessary competencies all contribute to this challenge. Although multimedia has become crucial to education, teachers often need more training to utilise these resources fully. The government must collaborate with other organisations to procure ICT resources to address these challenges rather than shouldering the sole responsibility for financing education. Establishing a school-based ICT policy framework to guide technology implementation in teaching and learning is essential.
Review Article
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 27, 2024

Paradoxical Effects of Income and Income Inequality on Racial Health Disparities

Abstract The intersection of race and place in shaping health disparities presents complex dynamics, as evidenced by studies in cities like Detroit, Baltimore, and Philadelphia, where predominantly Black and economically disadvantaged populations experience high overall rates of health problems. Surprisingly, these cities do not exhibit the most pronounced racial disparities. In contrast, areas with a [...] Read more.
The intersection of race and place in shaping health disparities presents complex dynamics, as evidenced by studies in cities like Detroit, Baltimore, and Philadelphia, where predominantly Black and economically disadvantaged populations experience high overall rates of health problems. Surprisingly, these cities do not exhibit the most pronounced racial disparities. In contrast, areas with a higher percentage of White residents, indicative of greater income inequality, show stark differences in health outcomes between Black and White populations. This disparity underscores how conditions diverge more sharply between Black and White individuals in wealthier urban areas. This phenomenon suggests a complex and sometimes counterintuitive relationship among race, place, income, and income inequality in shaping racial health disparities. These dynamics have significant policy implications. Addressing health disparities requires nuanced strategies that recognize the multiplicative effects of race and income inequality on health outcomes. Policies focusing on areas with a high disease burden, such as Detroit, Philadelphia, and Baltimore can effectively mitigate disparities both locally and more broadly. Conversely, interventions targeting regions with lower disease prevalence, but higher racial disparities must be approached carefully to avoid exacerbating inequalities. In conclusion, understanding and addressing the complex drivers of health disparities demand comprehensive approaches that acknowledge the intertwined influences of race, income, and place. By prioritizing interventions that address economic disparities alongside health initiatives, policymakers can foster more equitable health outcomes across diverse communities.
Perspective
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 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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Review Article
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 17, 2024

Knowledge Level of Teachers on Inclusive Education in Tamale Metropolis in the Northern Region of Ghana

Abstract The study examined teachers' perception of inclusive education in the three educational circuits in Tamale Metropolis in the Northern Region of Ghana. Research paradigms underpinning the study are Positivism, Interpretivism, and Pragmatism. The study adopted a cross-sectional survey research design. The study population comprised 81 teachers from the Gumbihini Educational Circuit, 100 from the [...] Read more.
The study examined teachers' perception of inclusive education in the three educational circuits in Tamale Metropolis in the Northern Region of Ghana. Research paradigms underpinning the study are Positivism, Interpretivism, and Pragmatism. The study adopted a cross-sectional survey research design. The study population comprised 81 teachers from the Gumbihini Educational Circuit, 100 from the Hospital Educational Circuit, and 72 from the Salaga Road Educational Circuit. The study population was from a pool of two hundred and fifty-three (253) teachers. The census method was used as a sampling technique for three (3) educational circuits and two hundred and fifty-three (253) teachers. The main instrument for data collection was a questionnaire. The data were analysed with descriptive statistics to determine the frequencies, percentages, mean and standard deviation scores for the response from the questionnaire and hypothesis. On the level of knowledge teachers in Tamale Metropolis have about inclusive education, Even though the study revealed that teachers know how to meet the needs of learners with learning disabilities and use varied learning activities to engage a diverse range of learners, knowledge in meeting the needs of learners who are gifted most teachers do not know to meet the needs of learners with speech and language, or communication disorder. Again, the findings revealed that teachers need to learn about meeting the needs of learners who are seen as having behavioural difficulties. Teachers were also found to not know about meeting the needs of learners who are blind or have low vision. Furthermore, the study revealed that teachers do not know how to assess, test, or evaluate the learning of children with disabilities. In the statistical analysis, special educators were found to possess a higher level of knowledge among primary school teachers who were studied than their general/regular educators' counterparts, even though the difference was not statistically significant. On the level of knowledge teachers in Tamale Metropolis have about inclusive education, regular in-service education and refresher courses will help improve and reorient teachers' knowledge towards performing their duties in inclusive education. The study, therefore, recommends that the Tamale Metropolis Directorate of Ghana Education Service collaborate with bare school heads in assisting teachers through the implementation of professional development/training programmes to employ adaptive instructional strategies to help children with disabilities.
Article
Open Access May 14, 2024

A review of reliability techniques for the evaluation of Programmable logic controller

Abstract PLCs, or programmable logic controllers, are essential parts of contemporary industrial automation systems and are responsible for managing and keeping an eye on a variety of operations. PLC reliability is critical to maintaining industrial systems' continuous and secure operation. A wide range of reliability strategies were used to improve the reliability of Programmable Logic Controllers, and [...] Read more.
PLCs, or programmable logic controllers, are essential parts of contemporary industrial automation systems and are responsible for managing and keeping an eye on a variety of operations. PLC reliability is critical to maintaining industrial systems' continuous and secure operation. A wide range of reliability strategies were used to improve the reliability of Programmable Logic Controllers, and this article methodically looks at them all. The evaluation classified PLC reliability techniques into Root Cause Analysis (RCA), Reliability Centered Maintenance (RCM), Hazard analysis (HA), Reliability block diagram (RBD), Fault tree analysis (FTA), Physics of failure (PoF) and FMEA/FMECA, after thoroughly reviewing the body of literature. The proportion of reviewed papers using either RCA, RCM, FMEA/FMECA, FTA, RBD, RCM, PoF, or Hazard analysis to increase the reliability of PLCs showed that RCA, which makes up 20% of the publications reviewed, has been used the most to increase the reliability of the PLC, followed by HA, RCM, RBD, FTA, and PoF, which account for 17%, 16%, 16%,13%, 10%, and 8% of the articles reviewed, respectively. The paper discusses new developments and trends in PLC reliability, such as the application of machine learning (ML) and artificial intelligence (AI) to fault detection and predictive maintenance.
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Review Article
Open Access May 03, 2024

Congruence Between Intended and Observed Transactions in the Implementation of the Senior High School (SHS) Social Studies Curriculum in Ghana

Abstract This study aimed to evaluate the Social Studies Curriculum for Senior High Schools in Ghana to determine whether the subject has attained its goal(s) or not, using Stake’s Countenance Evaluation Model. The study took place in the Asante Akim North District. The population for study were all Social Studies teachers and students in the district. The multi-stage sampling technique was adopted for the [...] Read more.
This study aimed to evaluate the Social Studies Curriculum for Senior High Schools in Ghana to determine whether the subject has attained its goal(s) or not, using Stake’s Countenance Evaluation Model. The study took place in the Asante Akim North District. The population for study were all Social Studies teachers and students in the district. The multi-stage sampling technique was adopted for the study and the sample size was 120, made up of 100 students and 20 teachers. The concurrent mixed method approach was adopted. The main instruments used for collecting data were questionnaires, interviews (focus group and unstructured interview), observation and documentary analysis. Quantitative data were tabulated, organised, analysed and interpreted to draw sound conclusions and generalisations. The data were presented in the form of tables and percentages. Words were used to interpret the tables and percentages for easy understanding. The qualitative data responses were described and explained in the form of themes. Sometimes responses were quoted verbatim to authenticate claims made. The study looked at the congruence between what was intended to occur and what was observed before and during the implementation of the curriculum in the Asante Akim North District. On the transactions, it was revealed that teachers in the district communicate the problem the topic seeks to address and the specific objectives to the learners during instruction. Also, teachers varied their teaching methods, techniques and strategies. However, teachers failed to take students out on field trips. Also, they failed to use video documentaries to deliver their lessons inhibiting students’ creativity as they are denied the opportunity to explore and get first-hand information to build up knowledge and develop the needed attitudes and values. From the findings, it is therefore recommended that the National Council for Curriculum and Assessment should increase the time allotted to the teaching of Social Studies at the SHS level from 3-periods of 40 minutes a week to 5-periods of 40 minutes a week to give teachers and learners ample time to discuss, debate, digest and solve problems during instructional hours to enable the goal of the subject attained.
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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 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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Review Article
Open Access August 23, 2023

Investigating Ghanaian Pre-Tertiary Teachers' Adaption of Differentiated Instructional Strategies

Abstract The emphasis on adapting learner-centric education and inclusive pedagogies to promote learning effectiveness is part of the paradigm shift in teaching. By maximizing variability, differentiated education methodologies ensure individualized instruction and equal academic success for all students. Based on this justification, this study sought to investigate Ghanaian pre-tertiary teachers' adaption [...] Read more.
The emphasis on adapting learner-centric education and inclusive pedagogies to promote learning effectiveness is part of the paradigm shift in teaching. By maximizing variability, differentiated education methodologies ensure individualized instruction and equal academic success for all students. Based on this justification, this study sought to investigate Ghanaian pre-tertiary teachers' adaption of differentiated instruction strategies during the teaching and learning processes. Pre-tertiary teachers within the Kwahu Ridge of the Eastern Region of Ghana were sampled to respond to the close-ended questionnaire. A multi-pronged approach was employed in the data analysis. Respondents possessed knowledge of the differentiated instruction strategies, however, there were some disparities between first and second-cycle teachers. Significant factors influenced the range of diversity in the classroom and knowledge and experience, with the latter showing an unexpected negative influence, possibly due to experienced teachers' preference for traditional methods of teaching. Notwithstanding, a perfect alignment of instructional techniques, activities and assessment practices to accommodate the heterogeneity of students stimulate active participation, interest and readiness to learn. It is recommended that educational stakeholders should recognize the dynamic nature of the learning environment and better provide pre-tertiary teachers with the tools and support needed to employ differentiated instruction techniques successfully to ensure inclusive, individualized and intensive instruction in the classroom.
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Open Access July 29, 2023

Critical Success Factors of Adopting an Enterprise System for Pharmaceutical Drug Traceability

Abstract For conducting advanced analytics initiatives to acquire in-depth data into usage habits, regional access, sales, and promotional success, etc., unique identification of packaged pharmaceuticals will be a fantastic enabler. The main objective of this study is to prevent and reduce the production of erroneous and counterfeit drugs using the enterprise system, which has become a serious threat [...] Read more.
For conducting advanced analytics initiatives to acquire in-depth data into usage habits, regional access, sales, and promotional success, etc., unique identification of packaged pharmaceuticals will be a fantastic enabler. The main objective of this study is to prevent and reduce the production of erroneous and counterfeit drugs using the enterprise system, which has become a serious threat because it damages the reputation of legitimate drug manufacturers by trying to produce and market placebo medications that are identical to the real thing. Due to federal government procedures and priorities that frequently change over time, the majority of implementation takes time. To achieve compliance with numerous federal regulatory authorities, including drug traceability for patient safety, the pharmaceutical industry must implement a systematic procedure in an ERP environment. The goals would be to guarantee medical drug traceability and provide real-time warnings to supply chain stakeholders and regulatory bodies to maximize the benefit of integrating a drug traceability system into an ERP environment. Additionally, manufacturers are compelled to maintain product costs on the higher side due to a heavy burden of unchecked manufacturing cost spikes. As a result, innovative marketing schemes must be introduced in order to increase the reach to consumers by putting into practice successful strategies.
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Review Article
Open Access July 28, 2023

An Assessment of Coping Strategies on Work-family Conflict and Job Performance in Ghana

Abstract The purpose of this study was to examine coping strategies for managing the effects of work-family conflict on the management staff of hotels in the Accra metropolis of Ghana. The study adopted a Convergent parallel mixed methods research technique. The population of the study is all-star-rated management staff of star-rated hotels in the Accra metropolis. multi-stage sampling. The estimation of [...] Read more.
The purpose of this study was to examine coping strategies for managing the effects of work-family conflict on the management staff of hotels in the Accra metropolis of Ghana. The study adopted a Convergent parallel mixed methods research technique. The population of the study is all-star-rated management staff of star-rated hotels in the Accra metropolis. multi-stage sampling. The estimation of the sample size for the hotel managers was based on Krejcie and Morgan’s table for the determination of the sample size for a given population. The population of 100 managers were stratified and randomly sampled out of the 182 managers. The main instruments for data collection were questionnaires and an interview. Statistical Package for Social Sciences (SPSS) version 22.0 was used to determine simple percentages and frequencies of responses. Pearson product-moment Correlation and structural equation model were used to determine the consequences of work-family conflict as well as coping strategies adopted by managers. Amos PLS was used to determine the moderating effect of coping strategies on work-family conflict and job performance. Hotel managers in the Accra metropolis combine the strategies of structural role redefinition, personal role redefinition, cognitive restructuring and reactive role redefinition to curb work-family conflict. The study demonstrated a positive relationship between coping strategies and job performance. Coping strategies had a moderating effect on the relationship between work-family conflict and the job performance of hotel managers. Thus, to improve the job performance of hotel managers, there should be the application of coping interventions to help them perform on the job. The study also determined that work-family conflict had a significant positive relationship with job performance. Similarly, the study established that coping strategies significantly moderate the relationship between work-family conflict and job performance among hotel managers in the Accra metropolis. Although coping strategies were employed by hotel managers in the Accra metropolis, it is recommended that training sessions on the use of coping strategies and stress management techniques should be considered by management to address psychological and emotional work environment stressors since they have been proven to reduce stress and WFC. It is also recommended that there should be an inter-hotel collaboration to offer smaller hotels which do not have the resources some leverage the impact of work-family conflict. This platform can be provided by the Ghana hotels association to impact knowledge of coping strategies in smaller hotels. The government must be encouraged to liaise with the Ghana hotels association to enforce the mandatory eight-hour work per day to avoid overworking of hotel managers.
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Open Access June 30, 2023

An Investigation into Strategies for Using Chopped Onion and Grated Fresh Cassava in Reducing Cooking Time of Dry Beans

Abstract This study was conducted with beans to determine a protocol that will help reduce the cooking time of beans. It was carried out in the Foods laboratory at the University for Development Studies, Department of Family and Consumer Sciences. A quasi-experimental design was the design tool employed for this study to establish a cause-and-effect relationship between an independent and dependent [...] Read more.
This study was conducted with beans to determine a protocol that will help reduce the cooking time of beans. It was carried out in the Foods laboratory at the University for Development Studies, Department of Family and Consumer Sciences. A quasi-experimental design was the design tool employed for this study to establish a cause-and-effect relationship between an independent and dependent variable where the independent variable is cooking time and dependent variable is softness of the beans. An experiment was carried out to text the effect of 2 different treatments given to beans during cooking to ascertain which treatment is best for reducing the cooking time for bean. The treatments meted out were addition of blended onion, crushed cassava and no additives. Addition of blended onion had a very significant effect in reducing cooking time with cooking time of 43minutes. Cooking beans with crushed cassava also saw some reduction in the cooking time for beans with 46 minutes. Cooking dry beans with no additive having the highest cooking time (47minutes). With quantity of water, the dry beans sample with crushed cassava used more quantity of water (3.4 liters). Cooking with blended onion and with no treatment both used 2.9 litres per 100grams beans each. The study therefore recommends that crushed onions are added to help reduce the cooking time of dry beans.
Article
Open Access May 15, 2023

Social Studies Teachers' Authentic Assessment Practices, Tools and Challenges in Assessing Students' Learning Outcomes

Abstract Assessment is a vital aspect of curriculum practice. The study adopted explanatory mixed-method approach and sequential research design. The population for the study comprised all Social Studies teachers in Junior High Schools in the Ayensuano District. Convenient sampling techniques and census method were used to select the district, and all the one hundred and twenty-seven (127) teachers who [...] Read more.
Assessment is a vital aspect of curriculum practice. The study adopted explanatory mixed-method approach and sequential research design. The population for the study comprised all Social Studies teachers in Junior High Schools in the Ayensuano District. Convenient sampling techniques and census method were used to select the district, and all the one hundred and twenty-seven (127) teachers who teach Social Studies in the junior high schools in the district. The main instruments used for data collection and analysis were questionnaire and interview guide. The quantitative data was analysed both descriptive and inferential statistical tools. The qualitative data was transliterated and coded based on themes. Pre-set themes were used to generate the transcript (text) data based upon the research questions and discussed. The study concluded that authentic assessment practices by Social Studies teachers included the occasional guidance they give to their students about how to interpret topics and situations into relevant tasks with a clearly defined goal, and how to relate their knowledge in practical challenges. The study also revealed that refined essays, oral presentations, interviews, case study discussions, and live performances as authentic assessment strategies or tools Social Studies teachers used in assessing their students' learning outcomes in lessons. The study indicated that large class size, traditional assessment (examination) system, insufficient logistics and infrastructure, a paucity of funds to begin various activities and programs, a lack of motivation from school administrators, time constraints and difficulty in developing some authentic assessment tasks coupled with assessing some lessons using authentic assessment method are some of the criteria that influence the effectiveness of authentic assessment execution in teaching Social Studies courses. It is recommended that educational leaders should provide the resources to motivate Social Studies teachers to use authentic assessments for students’ learning in the classroom situation. It is also recommended that, Colleges of Education, Universities and National Teaching Council should organise professional development workshops and seminars to build the capacity of trained Social Studies teachers on the effective uses of authentic assessment practices.
Article
Open Access February 14, 2023

The Advertising Narrative for the Alpha Generation: The Role of YouTube Channels in the Dissemination of Toys and Electronic Games

Abstract This article seeks to relate the narrative strategies used by video channels on YouTube with the advertising of toys and electronic games intended for the Alpha generation. Based on the principle that we live in a society composed of different age groups, the main theoretical references that make it possible to understand generation as a local and global phenomenon will be exposed. After such [...] Read more.
This article seeks to relate the narrative strategies used by video channels on YouTube with the advertising of toys and electronic games intended for the Alpha generation. Based on the principle that we live in a society composed of different age groups, the main theoretical references that make it possible to understand generation as a local and global phenomenon will be exposed. After such concepts, the rise of the image and its importance for the new generations will be approached, to support the selection of the audiovisual platform YouTube and its growing fascination by the public. Finally, concepts from semiotics will be applied to verify the narrative and discursive power of video channels for contemporary children, also known as the Alpha generation.
Communication
Open Access December 28, 2022

It’s time for reimagining the future of food security in sub–Saharan Africa: Gender-Smallholder Agriculture-Climate Change nexus

Abstract There is an ongoing debate regarding how to feed Sub-Saharan Africa's fast rising population in the long run, as well as the implications for food security. To maintain food security, various strategies have been recommended, including a focus on the significance of diversifying and improving people's diets. Proposals have been tabled elsewhere with a primary focus on enhancing agricultural inputs [...] Read more.
There is an ongoing debate regarding how to feed Sub-Saharan Africa's fast rising population in the long run, as well as the implications for food security. To maintain food security, various strategies have been recommended, including a focus on the significance of diversifying and improving people's diets. Proposals have been tabled elsewhere with a primary focus on enhancing agricultural inputs and technology adoption in order to increase agricultural production and productivity, hence strengthening food security. The current opinion piece attempts to contribute to this debate by examining smallholder agriculture and its role to African food security. This discussion proposes a future paradigm shift toward a gendered climate-smart smallholder agriculture and food production and security conceptual framework based on the promotion and development of smallholder agriculture and food production and security. Therefore, it's predicated that the micro-livestock-centered approach can remodel smallholder agrarian households and communities toward a gender-inclusive global climate change adaptive smallholder agriculture to strengthen production, supply, and food security in Sub-Saharan Africa. For Africa, today’s predicament is to ensure food security for the anticipated rapid population expansion, while on the other hand handling an overall net adverse effect of worldwide global climate change, and increased socio-economic ills associated with gender inequality in smallholder agriculture and ensuring long-term agriculture sustainable development. The failure to address gender inequality in smallholder agriculture and food production and pontificate of global climate change effect has thrown Sub-Saharan Africa into a state of perpetual food scarcity and insecurity because of low agricultural productivity and food supply, and by force of circumstances exposing the agricultural communities and its people to extreme poverty and nutrition and food insecurity. Therefore, it's predicated that the micro-livestock-centered approach can remodel smallholder agrarian households and communities toward a gender-inclusive global climate change adaptive smallholder agriculture to strengthen production, supply, and food security in Sub-Saharan Africa. For this purpose, this discussion proposes a future paradigm shift towards a gendered climate-smart smallholder agriculture and food production and security conceptual framework hinged on the promotion and development of the micro-livestock and/or unconventional animal species sub-sector to strengthen food security on the continent. Overall, the discussion emphasizes the importance of taking immediate action to alleviate the negative effects of climate change and address gender inequality through promotion of micro livestock to assist in the development of long-term adaptation measures to maintain smallholder agricultural productivity.
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Review Article
Open Access November 29, 2022

An Evaluation of Gender Mainstreaming Efforts in a Public University in Ghana: A Case Study of University of Education, Winneba (UEW)

Abstract This paper brings to light efforts of male institutional leaders in the University of Education, Winneba in promoting the gender equality agenda and effects of their efforts in bridging the gender gaps in staff and students’ levels. It sheds further light on involving men in the gender mainstreaming efforts. Both primary and secondary data on gender equality and equity measures were used in this [...] Read more.
This paper brings to light efforts of male institutional leaders in the University of Education, Winneba in promoting the gender equality agenda and effects of their efforts in bridging the gender gaps in staff and students’ levels. It sheds further light on involving men in the gender mainstreaming efforts. Both primary and secondary data on gender equality and equity measures were used in this study. The study found that male Vice-Chancellors have over the years been devoted to promoting gender equality agenda in the University. The effects of their efforts are largely seen in the increase in the number of females that have benefited from the institutional mentorship and scholarship programmes, which has impacted positively on addressing the gender gaps in the University. It is recommended that new strategies be adopted in promoting gender equality agenda. These strategies include revision in gender policies to involve men as agents of change in gender mainstreaming activities; gender training for male staff and students of all levels and categories for effective gender work, offering specific trainings and interactive discussions on gender issues for men as volunteers for gender mainstreaming. The study further suggests among other things, the need to engage the university community in entertaining activities like cycling for the equality agenda to be made more real to men and court their interest to promote men’s involvement in gender work.
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Open Access October 30, 2022

Prevalence of Oral Health Problems and Distribution According to Socio-demographic Variables and Blood Groups among Patients in the Tripoli Region

Abstract Background: Oral health plays an important role in maintaining life functions and quality of life. Periodontal disease can vary with respect to bacterial etiology, host response, and clinical disease progression. A key role of genetic effects has suggested distribution of lesions and severity of destruction in each individual. Many diseases, particularly digestive disorders, cancer, and infection, show preferences among the ABO blood types. Knowledge of blood groups and their association with oral diseases is very important, as it may help in early diagnosis and treatment strategies‏. Objectives: The study aimed to investigate the distribution of patients with oral and dental health problems according to age, regions, Socio-demographic Variables, and blood groups in the Tripoli region. Material and Methods: The present study was conducted on 200 patients with oral and dental health problems attending six medical centers in Tripoli region from the 01st March 2022 to the 01st June 2022. Also, 100 healthy individuals without any oral and dental health problems or any other diseases were recruited as a control group. This study was approved by the Research and Ethical Committee of the medical centers and Libyan Academy of graduate studies. One ml of venous blood was withdrawn from each participant in the study for determination of blood groups. The data were compared using Chi-Square using SPSS Statistics for Windows, Version 25. Results: The results showed that the mean age of the patients was 43.03±13.82 years. The higher distribution of patients was 58 patients (29%) in the age group (26-35) years while the lower distribution was 10 patients (5%) in the age group (66-75) years. The distribution of patients according to the region were 81.5%, 13%, 4%, and 1.5% in Tripoli, South Tripoli, West Tripoli, and East Tripoli, respectively. The Distribution of patients according to occupation were 4.5% Students, 30% Housewives, 10.5% Employers, 12.5% Teachers, 14% Nurses, 7.5% Doctors, 12.5% Laboratory Technicians and 8.5% Freelance workers. The distribution of patients according to levels of education were 23.5% Pre-Secondary, 19% Secondary, 46% Bachelor's or equivalent, and 11.5% Master's or equivalent. The distribution of patients according to marital status were 26% single and 74% married. The distribution of patients according to oral and dental problems were 5% with bridge, 8% with missing teeth, 86% with dental caries, 63.5% with bleeding of gum, and 25.5% with swelling of gum. The degrees of gingival erythema among patients were 36.5% mild, 38% moderate, and 25.5% severe. The degrees of gingival inflammation among patients were 36% mild, 38.5% moderate, and 25.5% severe. The distribution of A, B, AB, and O blood groups showed a significant (P=0.000) difference between healthy individuals and oral and dental health problems among patients that, were 54%, 12%, 4%& 30%, and 21.5%, 9%, 3.5% & 66%, respectively. Also, the distribution of A+, A-, B+, B-, AB+, O+, and O- blood groups showed a significant (P=0.000) difference between healthy individuals and patients with oral and dental health problems that, were 49%, 5%, 10%, 2%, 4%, 25%, & 5%, and 18%, 3.5%, 8%, 1%, 3.5%, 60%& 6%, respectively. But, the distribution of Rh+ and Rh- blood groups showed a non-significant (P=0.695 [...] Read more.
Background: Oral health plays an important role in maintaining life functions and quality of life. Periodontal disease can vary with respect to bacterial etiology, host response, and clinical disease progression. A key role of genetic effects has suggested distribution of lesions and severity of destruction in each individual. Many diseases, particularly digestive disorders, cancer, and infection, show preferences among the ABO blood types. Knowledge of blood groups and their association with oral diseases is very important, as it may help in early diagnosis and treatment strategies‏. Objectives: The study aimed to investigate the distribution of patients with oral and dental health problems according to age, regions, Socio-demographic Variables, and blood groups in the Tripoli region. Material and Methods: The present study was conducted on 200 patients with oral and dental health problems attending six medical centers in Tripoli region from the 01st March 2022 to the 01st June 2022. Also, 100 healthy individuals without any oral and dental health problems or any other diseases were recruited as a control group. This study was approved by the Research and Ethical Committee of the medical centers and Libyan Academy of graduate studies. One ml of venous blood was withdrawn from each participant in the study for determination of blood groups. The data were compared using Chi-Square using SPSS Statistics for Windows, Version 25. Results: The results showed that the mean age of the patients was 43.03±13.82 years. The higher distribution of patients was 58 patients (29%) in the age group (26-35) years while the lower distribution was 10 patients (5%) in the age group (66-75) years. The distribution of patients according to the region were 81.5%, 13%, 4%, and 1.5% in Tripoli, South Tripoli, West Tripoli, and East Tripoli, respectively. The Distribution of patients according to occupation were 4.5% Students, 30% Housewives, 10.5% Employers, 12.5% Teachers, 14% Nurses, 7.5% Doctors, 12.5% Laboratory Technicians and 8.5% Freelance workers. The distribution of patients according to levels of education were 23.5% Pre-Secondary, 19% Secondary, 46% Bachelor's or equivalent, and 11.5% Master's or equivalent. The distribution of patients according to marital status were 26% single and 74% married. The distribution of patients according to oral and dental problems were 5% with bridge, 8% with missing teeth, 86% with dental caries, 63.5% with bleeding of gum, and 25.5% with swelling of gum. The degrees of gingival erythema among patients were 36.5% mild, 38% moderate, and 25.5% severe. The degrees of gingival inflammation among patients were 36% mild, 38.5% moderate, and 25.5% severe. The distribution of A, B, AB, and O blood groups showed a significant (P=0.000) difference between healthy individuals and oral and dental health problems among patients that, were 54%, 12%, 4%& 30%, and 21.5%, 9%, 3.5% & 66%, respectively. Also, the distribution of A+, A-, B+, B-, AB+, O+, and O- blood groups showed a significant (P=0.000) difference between healthy individuals and patients with oral and dental health problems that, were 49%, 5%, 10%, 2%, 4%, 25%, & 5%, and 18%, 3.5%, 8%, 1%, 3.5%, 60%& 6%, respectively. But, the distribution of Rh+ and Rh- blood groups showed a non-significant (P=0.695) difference between healthy individuals and patients that, were 88% & 12%, and 89.5%& 10.5%, respectively. Conclusion: It can be concluded that the mean age of the patients with oral and dental health problems was 43.03 years and the higher distribution of patients was in the age group (26-35) years. The higher distribution of ABO blood groups was O blood group among patients especially O+ blood groups. The distribution of Rh+ and Rh- blood groups were showed a non-significant difference between healthy individuals and patients with oral and dental health problems. Further studies are needed to confirm these results.
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Article
Open Access July 25, 2022

Techniques and Strategies Use in Assessing Social Studies Concepts

Abstract The purpose of the study was to examine techniques and strategies use in assessing Social Studies concepts in the three senior high schools in Sefwi Wiawso Municipality in the Western North Region of Ghana. Qualitatively, the research design for this study was a Case study. The population for this study consisted of all ten (10) Social Studies teachers in three public Senior High Schools (Wiawso [...] Read more.
The purpose of the study was to examine techniques and strategies use in assessing Social Studies concepts in the three senior high schools in Sefwi Wiawso Municipality in the Western North Region of Ghana. Qualitatively, the research design for this study was a Case study. The population for this study consisted of all ten (10) Social Studies teachers in three public Senior High Schools (Wiawso Senior High School, Wiawso Senior/Technical school, and Asawinso senior high school) in Sefwi Wiawso municipality in the Western North Region of Ghana. Purposive and convenient sampling techniques were used to select municipalities, schools, and Social Studies teachers for the study. The main instrument used for data collection was interview. The data were edited before being analyzed in themes and pattern. Being a case study design in qualitative research, the researcher read through the data several times so as to familiarize with the data, making notes, referring back to the research question, making decisions whether to focus on individual responses or on topics. The interview data were interpreted to articulate meaning, making decisions on whether to use direct quotes or the summary of respondents’ responses and reporting the data considering the interest of various audiences. The study revealed that teachers used various teaching techniques such as brainstorming, simulation, discovery-learning, role-play discussion, dramatization, problem-solving, and building a community implies that they believed in child-centered method of the teaching and learning of Social Studies. The study also concluded that Social Studies teachers use techniques and strategies like concept attainment, field trips, and debate co-operative learning in motivating and providing learners with the opportunity to interact with their own community or environment. It is recommended that Social Studies teachers should make effort either to go on field trips or make use of available experts that are in their communities by inviting them into the Social Studies classrooms to tap into their rich knowledge to enhance concept learning. It is also recommended that frequent seminars and periodic or regular in-service training should be organised by the Ghana Education Service to help Social Studies teachers to acquaint themselves with the modern teaching techniques and strategies that promote the teaching and learning of Social Studies concepts.
Article
Open Access July 05, 2022

Teaching and Learning Strategies in Double Indicator Titration: An appraisal of Chemistry Teachers

Abstract The purpose of this study was to examine chemistry teachers' teaching and learning strategies in double indicator titration in Senior High Schools in Ghana. Action research design using a quantitative approach was used for the study. Purposive and simple random sampling procedures were employed to select one hundred and seventy-five (175) participants (teachers and students) for the study. The [...] Read more.
The purpose of this study was to examine chemistry teachers' teaching and learning strategies in double indicator titration in Senior High Schools in Ghana. Action research design using a quantitative approach was used for the study. Purposive and simple random sampling procedures were employed to select one hundred and seventy-five (175) participants (teachers and students) for the study. The classroom observational checklist and questionnaire were the instruments used to collect data in the study. Descriptive statistics tools (frequency, percentage, mean and standard deviation) were used to analyse the quantitative data. The study revealed that Chemistry teachers in the Kwaebibirim and Denkyembuo Districts of the Eastern Region used the lecture method in teaching double indicator titration lessons instead of practical activities and this had negative effects on their academic performance. The study also indicated that the effective model that can be used to improve teaching and learning of double indicator titration is the developed practical teaching model (DEPTEM) as compared to the teachers’ method. It is recommended that in-service training should be organized for chemistry teachers who were already in the field of work to use more of the developed practical model (DEPTEM) in relation to the lecture method. It is also recommended that chemistry teachers should use teaching methods that would allow chemistry students to participate and manipulate equipment/materials using their five senses and other skills instead of teaching in abstract or allowing them to remain less active in their class.
Article
Open Access June 22, 2022

Adapting examination and student evaluation at Biomedical Science Institute in the time of COVID-19

Abstract As COVID-19 pandemic spreads worldwide, universities and academic institutions were forced to shift their face-to-face education to online learning since spring 2020. This shift was termed “emergency remote education or learning”, caused many distractions to students, and posed many challenges for both assessment and examination systems and practices at our Zhejiang University-University of [...] Read more.
As COVID-19 pandemic spreads worldwide, universities and academic institutions were forced to shift their face-to-face education to online learning since spring 2020. This shift was termed “emergency remote education or learning”, caused many distractions to students, and posed many challenges for both assessment and examination systems and practices at our Zhejiang University-University of Edinburgh (ZJU-UoE) Biomedical Science Institute, like other educational institutions worldwide. This necessitated the development of alternative and effective approaches and procedures to teach students, and several changes and adaptions of assessments and examinations at ZJU-UoE institute. In this article, we described the implications of the COVID-19 pandemic for student assessment systems and practices at ZJU-UoE Institute. The article is particularly reflecting on alternative approaches and strategies that we have developed at ZJU-UoE institute to change and adapt student assessments and examinations during COVID-19 pandemic. These changes involved developing general examination strategies and settings, including online (MCQ-type) test exam settings and online written exam settings, and developing effective procedure and policy to safeguard academic integrity during the COVID-19 pandemic that can help with facing various education and learning challenges in a time of crisis worldwide.
Short Reflection and Observation Report
Open Access June 16, 2022

Graph Coloring Solutions to Queen Graphs

Abstract Graph coloring, an NP-complete problem is used in many real-world applications. The minimum color, that is, the chromatic number of a connected graph is determined using different soft computing strategies. This article gives some of the solutions obtained for queen graphs using evolutionary methods.
Graph coloring, an NP-complete problem is used in many real-world applications. The minimum color, that is, the chromatic number of a connected graph is determined using different soft computing strategies. This article gives some of the solutions obtained for queen graphs using evolutionary methods.
Mini Review
Open Access April 28, 2022

Analysis of Network Modeling for Real-world Recommender Systems

Abstract Nowadays, recommendation systems are existing everywhere in the internet world, online people are presented with the required needs not just for actual physical products, but also for several other things such as songs, places, books, friends, movies, and many more requirements. Most of the systems are developed with the basic collaborative and hybrid filtering, where the people or users are [...] Read more.
Nowadays, recommendation systems are existing everywhere in the internet world, online people are presented with the required needs not just for actual physical products, but also for several other things such as songs, places, books, friends, movies, and many more requirements. Most of the systems are developed with the basic collaborative and hybrid filtering, where the people or users are recommended items that the choices are based on the right preferences of other people by applying the machine intelligence strategies. In this research, the importance of network modeling is analyzed in solving real-world problems.
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Article
Open Access April 08, 2022

The Use of Language and Thematic Concerns: A case of Five Selected African Poems

Abstract This study is a critical analysis of the language and themes used by the under listed five African poets: The Cathedral by Kofi Awoonor, Troubadour by Dennis Brutus, Telephone Conversation by Wole Soyinka, I Will Pronounce Your Name by Leopard Seder Senghor, and If You Should Know Me by Oswald Mbuyiseni Mtshali. Its main thrust is, therefore, the isolation and discussion of the elements of [...] Read more.
This study is a critical analysis of the language and themes used by the under listed five African poets: The Cathedral by Kofi Awoonor, Troubadour by Dennis Brutus, Telephone Conversation by Wole Soyinka, I Will Pronounce Your Name by Leopard Seder Senghor, and If You Should Know Me by Oswald Mbuyiseni Mtshali. Its main thrust is, therefore, the isolation and discussion of the elements of language and the themes that make up the artistic framework upon which their individual poems are based. The writers employ Critical Race Theory as the framework for this work. It looks at how individually and collectively they tackle the theme of racism as well as their choices of language in expressing their contempt to this social canker. The study narrows down to a discussion of the artistic positions of the authors within these two basic narrative variables. An examination of the various artistic strategies employed to create a multi¬plicity of poetic fronts and their attendant scenes as well as backgrounds are what these divisions of the study target. It is this primacy of the artistic theme that this study dwells upon. The study intends to condemn this social injustice that brings separation rather than cohesion to human race. It is recommended that the Ministry of Education and Ghana Education Service should organise essay competition on these African Poets' books to bring social cohesion among students in Ghana and Africa as a whole.
Article
Open Access March 15, 2022

Diagnostic Assessment of Health Promotion Strategies for Increasing Access to Maternal Health Care Services

Abstract Background: Everywhere in the world, Pregnancy and birth possess a risk to the life and health of women and newborns, regardless of whether a pregnancy was intended or unintended. The level of risk depends on a woman’s health before she is pregnant, her living conditions and the care she receives during delivery which is aggravated by lack of access to maternal health care services, leading [...] Read more.
Background: Everywhere in the world, Pregnancy and birth possess a risk to the life and health of women and newborns, regardless of whether a pregnancy was intended or unintended. The level of risk depends on a woman’s health before she is pregnant, her living conditions and the care she receives during delivery which is aggravated by lack of access to maternal health care services, leading to increase in the magnitude of death from preventable health problems. This paper therefore diagnostically assessed health promotion strategies for increasing access to maternal healthcare services in some remote districts in Anambra state. Methods: The study is a cross-sectional study and utilized a structured instrument which was validated by three experts in measurement and evaluation and health education and pilot tested on 20 pregnant women using test-retest in Ugwunagbor Abia state. The reliability yielded 0.84. Percentage, mean and standard deviation were used to answer the research questions. The population was 620 confirmed pregnant women from 4 to 9 months in the area of study in health centers in the state. A sample of 60 participants was selected using simple random sampling technique. Results: Findings show that antepartum, Intra-natal care, puerperium and family planning cares were prevalent in the local governments under study and that access to skilled delivery was associated with age, educational background, number of children and income level of the mother among other findings. Recommendations and conclusion: The researchers therefore recommended that there is urgent need to build healthy public policy, create supportive environments amongst others which can add to the effective measures of reducing maternal mortality in the longer term.
Article
Open Access February 25, 2022

Prevalence and Determinants of Acute Respiratory Infections among Children under Five Years in Rural Settings of The Gambia: Evidence from a National Survey

Abstract Background: Acute respiratory infections (ARIs) generally describe a group of infections caused by a range of organisms whose site of action includes the nostrils, through the pharynx to the alveoli. ARIs are reportedly key contributing factors to childhood morbidities and deaths, with a higher impact on children less than the age of five years. This paper aimed at exploring the prevalence [...] Read more.
Background: Acute respiratory infections (ARIs) generally describe a group of infections caused by a range of organisms whose site of action includes the nostrils, through the pharynx to the alveoli. ARIs are reportedly key contributing factors to childhood morbidities and deaths, with a higher impact on children less than the age of five years. This paper aimed at exploring the prevalence of ARIs and their contextual determinants among children less than 60 months of age in the rural settings of the Gambia. Method: The Gambia Demographic and Health Survey (GDHS) in 2019-20 was used for this study. Data were obtained from 1364 rural women aged 15-49 with children less than 60 months through a stratified two-stage cluster sampling approach. Percentages and chi-square tests were used and variables with p-value <0.15 were included in the model. A multivariable logistic regression model was used to assess the predictors of acute respiratory infection at 95% confidence interval (CIs) with computed adjusted odds ratios (aORs). All the study data were analyzed using Stata version 17. Results: The weighted prevalence of ARIs among children under 60 months of age in the rural Gambia was 37.1% with 95% CI (34.5% - 39.6%). The magnitude of ARI was higher among children 25-60 months age group (38.6%), male children (38.9%) unvaccinated children (42.9%), and those whose fathers and mothers were not working at 60.5% and 38.7%, respectively. In the adjusted model, children whose mother had primary education (aOR=0.65, 95% CI= 0.46-0.91), currently non-breastfed children (aOR=1.40, 95% CI= 1.09-1.79) and those whose father were not working (aOR=2.65, 95% CI= 1.47-4.17) were found to be associated with ARIs among children less than 60 months in The Gambia. Conclusion: The prevalence of ARI was moderately high across children under 5 years of age in rural Gambia, low mother’s educational levels, and unemployed fathers. The program must consider improvements in the quality of care provided to children in both primary, secondary and tertiary healthcare levels in rural settings. Partner support and adapting community-based supporting systems on child health strategies should be strengthened especially in rural settings.
Article
Open Access February 25, 2022

How to Increase Customer Satisfaction by Beautifying Sports Facilities? What is the Key Role of Service Quality?

Abstract The purpose of this study was to investigate the key role of service quality and beauty of sports facilities in increasing customer satisfaction. The research method is descriptive and correlational research. The statistical population of the study was 154188 organized athletes covered by sports insurance (103890 men, 50298 women) who were working in sports halls of Mazandaran province and [...] Read more.
The purpose of this study was to investigate the key role of service quality and beauty of sports facilities in increasing customer satisfaction. The research method is descriptive and correlational research. The statistical population of the study was 154188 organized athletes covered by sports insurance (103890 men, 50298 women) who were working in sports halls of Mazandaran province and according to Morgan table, 384 athletes were randomly selected by cluster Were. Aesthetic questionnaire, service quality and customer satisfaction were used to collect information. Data analysis was performed using Pearson test and structural equation modeling by SPSS24 and Amos structure analysis software. According to the research results, the indirect effect of aesthetics of sports venues on increasing customer satisfaction through service quality is significant. Managers can take effective steps to increase their presence and increase the income of gyms by using quality improvement strategies and customer satisfaction.
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Article
Open Access November 29, 2021

Mucormycosis and Candida Infections in Patients of COVID-19 Pneumonia: A Systematic Review

Abstract Introduction: The city of Wuhan in China reported the first case of coronavirus, termed as SARS-CoV-2, in December 2019. To date, 187,827,660 cases have been reported to the WHO (3). With current research focusing on potential therapeutic agents for the coronavirus disease and vaccines, there remain major gaps in our understanding of the pathophysiology and clinical course of this viral [...] Read more.
Introduction: The city of Wuhan in China reported the first case of coronavirus, termed as SARS-CoV-2, in December 2019. To date, 187,827,660 cases have been reported to the WHO (3). With current research focusing on potential therapeutic agents for the coronavirus disease and vaccines, there remain major gaps in our understanding of the pathophysiology and clinical course of this viral pneumonia. Secondary infections are one of them. In this systematic review, we analyze the outcomes of two fungal infections in patients of COVID-19, viz. Mucormycosis and candida. Methodology: A systematic review has been done on secondary infections with mucor and candida fungi in patients of COVID-19. Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were used. Twenty-three studies were included in the final analysis. Our review included studies from various countries across the globe. The risk of bias was analyzed using the NIH Quality Assessment Tool for Case Series Studies. This study did not require ethical approval as data was obtained from already available databases, and patients were not directly involved. Results: A total of 23 articles were included in the final review and the total number of patients included was 79 Male: female ratio was calculated to be 1.6 and the average age of patients was 52 years (ranging from 24-86 years). Various types of comorbidities were seen in the included patients, the most common being diabetes mellitus. Among the 18 patients in the cohort of mucormycosis, 7 patients died and four studies did not report patient outcomes. Among the 61 patients, 13 patients died and one patient was still ventilated at the time of publication. Conclusion: Secondary infections after COVID-19 are a cause of major concerns. Further studies and case reports are needed to better understand the various other types of secondary infections and also to formulate strategies to prevent these.
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Systematic Review
Open Access November 22, 2021

COVID-19 and Legionella Co-Infection

Abstract Introduction: Concurrent infections or co-infections in patients diagnosed with Coronavirus Disease-19 (COVID-19) are not uncommon and predict a pejorative prognosis. A co-infection accounts for 1 out of every 5 cases of COVID-19 and increases the likelihood of adverse health outcomes such as mechanical ventilations, ICU admissions, and death. Specifically, Legionella spp. [...] Read more.
Introduction: Concurrent infections or co-infections in patients diagnosed with Coronavirus Disease-19 (COVID-19) are not uncommon and predict a pejorative prognosis. A co-infection accounts for 1 out of every 5 cases of COVID-19 and increases the likelihood of adverse health outcomes such as mechanical ventilations, ICU admissions, and death. Specifically, Legionella spp. co-infection presents additional challenges in COVID-19 patients because of its rarity, similar clinical presentation to SARS-CoV-2, and poorer outcomes without prompt treatment. Cases Presentation: Case 1. A 62-year-old female presented with a 3-day history of subjective fever and worsening shortness of breath. Room air saturation (saO2) was 70% and improved to 100% on noninvasive positive- pressure ventilation (NIPPV). Lung auscultation revealed rales BL. Chest X –Ray (CXR) showed patchy airspace opacities bilaterally (BL), SARS-CoV-2 PCR and urine legionella antigen tests were positive. The diagnosis of hypoxic respiratory failure secondary to COVID-19 and Legionella pneumonia was made. Patient was admitted to intensive care unit (ICU) and managed with decadron, remdesivir, one unit of convalescent plasma for COVID-19 and Azithromycin for Legionella. Patient subsequently developed acute respiratory distress syndrome (ARDS). ARDS protocol was initiated. 13 days after, the patient was compassionately extubated. Case 2. A 41-year-old male presented with 5-day history of fever, worsening shortness of breath, cough and diarrhea. Patient admitted history of ethanol abuse. SaO2 was 88% and improved on oxygen canula. Lung auscultation revealed rhonchi BL. CXR showed extensive left lung consolidation. Urine test for legionella antigen was positive. COVID-19 PCR was negative, but SARS-CoV-2 IgG was reactive. The diagnosis of Legionnaire disease was made. Despite initial treatment with Azithromycin, patient's hypoxia continued to worsen requiring NIPPV, and subsequently mechanical ventilation in the ICU. The adjunction of empiric treatment for COVID-19 with convalescent plasma, remdesivir and steroids improved both clinicals and laboratory findings. Discussion: The cases illustrated the practical challenges of managing COVID-19 and legionella co- infection. Legionella spp and SARS-CoV-2 overlapping incubation periods and similar clinical presentations and complications. In the absence of diagnosis and treatment, legionella pneumonia has an intrinsic mortality rate of up to 80%. As some COVID-19 mitigation strategies, such as the closure of businesses, have enhanced the conditions for Legionella spp proliferation, the incidence of Co-infection with COVID-19 may increase. We recommend clinicians to have high-indexed suspicion of COVID-19 and Legionella co-infection in order to obtain complete work up at patient’s initial presentation.
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Case Report
Open Access October 24, 2021

The Developmental Factors of Identity Strategies Variation among Schooled Central African Adolescent Refugees in the East-Region of Cameroon

Abstract The present study poses the problem of the variations observed in the construction of identity strategies among schooled adolescent refugees. It starts from the observation that the latter express serious difficulties to be integrated into their host socio-cultural environments. Yet proximity to their original culture should guarantee continuity in the emergence of developmental skills initiated [...] Read more.
The present study poses the problem of the variations observed in the construction of identity strategies among schooled adolescent refugees. It starts from the observation that the latter express serious difficulties to be integrated into their host socio-cultural environments. Yet proximity to their original culture should guarantee continuity in the emergence of developmental skills initiated in their basic anthropomorphic universe. Paradoxically, they become dysfunctional in face of the demands of the host environment, and require the construction of identity strategies to adapt. Data collected from one hundred and eighty-four (184) central African refugee adolescents in the Lom-and-Djérem Division (Cameroon’s East-Region), show that in a situation of socio-emotional adaptation, age and sex are among the main factors of variation in the construction of these identity strategies.
Article
Open Access September 23, 2021

Green Economy: A Necessary Decision to be Taken

Abstract The concept of the green economy is one of the global strategies to face contemporary societies' economic and environmental crises. Methodologically, the conceptualization, objectives, implementation, and criticism of various sectors of society to this new economic paradigm are addressed. It was found that authors and civil organizations have great expectations in the face of the challenges and [...] Read more.
The concept of the green economy is one of the global strategies to face contemporary societies' economic and environmental crises. Methodologically, the conceptualization, objectives, implementation, and criticism of various sectors of society to this new economic paradigm are addressed. It was found that authors and civil organizations have great expectations in the face of the challenges and challenges of this global strategy that has within its objectives sustainability, the eradication of poverty, and the inclusion of vulnerable social sectors. It is concluded that the green economy can contribute to maintaining a healthy environment and the proper use of ecosystem services, both for the present generation and for future generations.
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Open Access September 23, 2021

Assessing Clinical Skills of Nursing Students: A Triangulation Study to Explore Faculty Experiences and Feedback in Objective Structured Clinical Examination (OSCE)

Abstract Background and aim: Developing clinical skills and its assessment is one of the most important components in nursing education which prepares the student for the reality of practice. Objective structured clinical examination (OSCE) is extensively used and widely accepted by nurse educators across the globe to assess the competency skills of nursing students. The present study aimed at [...] Read more.
Background and aim: Developing clinical skills and its assessment is one of the most important components in nursing education which prepares the student for the reality of practice. Objective structured clinical examination (OSCE) is extensively used and widely accepted by nurse educators across the globe to assess the competency skills of nursing students. The present study aimed at identifying the attitude and perceptions of faculty, and exploring their feedback and experience in conducting OSCE as an assessment tool. Methods: A triangulation research approach was used with convenience sampling. Data collection was carried out using questionnaires and semi-structured interviews. Participants were ten faculty members who were involved in conducting OSCE for students. Results and conclusion: Most of the faculty felt that OSCE reflected the skills of delivery of safe patient care, and the structure reflected mastery of knowledge and skills, which are related to course objectives. OSCE was regarded by the faculty as a consistent, reliable, valid, and objective measure to assess students’ performance and to improve students’ confidence in clinical skills. Concerns were raised about a high level of stress in students, the time required for the proper performance of tasks, OSCE scenarios lacking real-life situations in assessment, and the need for repeated practice and intensive mock training sessions. The applicability of OSCE in terms of limitations in human and material resources with a large number of students would necessitate rethinking in developing other assessment strategies to improve the overall process.
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Article
Open Access August 21, 2021

Decision Makers for Online Purchases of Fashion Products on Reebonz Online Shopping Sites

Abstract The level of business competition in several online shopping sites for fashion products is currently experiencing quite crucial dynamics. Competitive match will indirectly affect consumer purchasing decisions. This research explores what factors are dominantly influencing the level of product purchase decisions on online shopping sites in terms of product variety, price, brand image and promotion [...] Read more.
The level of business competition in several online shopping sites for fashion products is currently experiencing quite crucial dynamics. Competitive match will indirectly affect consumer purchasing decisions. This research explores what factors are dominantly influencing the level of product purchase decisions on online shopping sites in terms of product variety, price, brand image and promotion aspects. This research design uses a quantitative research design. Determination of the sample in this study using the convenience sampling method with a total of 110 respondents. Data collection uses a questionnaire distributed online during the period from May to June 2021. This study concludes that product variations and brand image have a positive and significant influence on purchasing decisions. Then for the effect of price and promotion on purchasing decisions obtained a positive but not significant impact. This study confirms the importance of paying attention to aspects of pricing and product promotion strategies on the Reebonz online shopping site.
Article
Open Access August 16, 2021

When Water Turns Deadly: Investigating Source Identification and Quality of Drinking Water in Piwoyi Community of Federal Capital Territory, Abuja Nigeria.

Abstract Essentiality of water sustain life, and a satisfactory supply must be readily available to promote health, prolong life expectancy and prevent diseases. This study assesses the sources and quality of drinking water in Piwoyi community of Federal Capital Territory, Abuja, Nigeria. Thirty-five (35) Boreholes and Two (2) Sachet water were identified sources of drinking water in Piwoyi Community. Six [...] Read more.
Essentiality of water sustain life, and a satisfactory supply must be readily available to promote health, prolong life expectancy and prevent diseases. This study assesses the sources and quality of drinking water in Piwoyi community of Federal Capital Territory, Abuja, Nigeria. Thirty-five (35) Boreholes and Two (2) Sachet water were identified sources of drinking water in Piwoyi Community. Six Samples (5 Boreholes and 1Sachet water) were selected at random and analyzed in the laboratory. The Physicochemical parameters examined include electrical conductivity (EC), pH, temperature, turbidity, dissolve oxygen (DO), chloride, total hardness, alkalinity, nitrate, calcium, magnesium, phosphate, phosphorous, sulphate, sodium, potassium, fluoride, bicarbonate, nitrate-nitrogen, nitrite, copper, iron and zinc; and Microbiological parameters include Coliforms, E-coli and Faecal Strep. The results of analysis shows significant concentration of physicochemical and microbiological parameters in the samples of water analyzed according to Nigerian Standard for Drinking Water Quality thereby makes the water unsafe for drinking. Drinking from these sources of water will pose serious health risk to the people of Piwoyi Community. Therefore, the study helps to identify the contaminated locations as well as assist to follow emerging remedial measures toward controlling the contamination source in the community. It also recommends continuous monitoring and enforcement of environmental violations, aggressive sensitization on water sanitation and hygiene; adequate purification of water at domestic level; and government support on potable water supply and establish reasonable management strategies for sustainable water quality protection toward protecting public health.
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Article
Open Access August 12, 2021

Responding to the Call through Translating Science into Impact: Building an Evidence-Based Approaches to Effectively Curb Public Health Emergencies [Covid-19 Crisis]

Abstract COVID-19 demonstrated a global catastrophe that touched everybody, including the scientific community. As we respond and recover rapidly from this pandemic, there is an opportunity to guarantee that the fabric of our society includes sustainability, fairness, and care. However, approaches to environmental health attempt to decrease the populations burden of COVID-19, toward saving patients from [...] Read more.
COVID-19 demonstrated a global catastrophe that touched everybody, including the scientific community. As we respond and recover rapidly from this pandemic, there is an opportunity to guarantee that the fabric of our society includes sustainability, fairness, and care. However, approaches to environmental health attempt to decrease the populations burden of COVID-19, toward saving patients from becoming ill along with preserving the allocation of clinical resources and public safety standards. This paper explores environmental and public health evidence-based practices toward responding to Covid-19. A literature review tried to do a deep dive through the use of various search engines such as Mendeley, Research Gate, CAB Abstract, Google Scholar, Summon, PubMed, Scopus, Hinari, Dimension, OARE Abstract, SSRN, Academia search strategy toward retrieving research publications, “grey literature” as well as reports from expert working groups. To achieve enhanced population health, it is recommended to adopt widespread evidence-based strategies, particularly in this uncertain time. As only together can evidence-informed decision-making (EIDM) can become a reality which include effective policies and practices, transparency and accountability of decisions, and equity outcomes; these are all more relevant in resource-constrained contexts, such as Nigeria. Effective and ethical EIDM though requires the production as well as use of high-quality evidence that are timely, appropriate and structured. One way to do so is through co-production. Co-production (or co-creation or co-design) of environmental/public health evidence considered as a key tool for addressing complex global crises such as the high risk of severe COVID-19 in different nations. A significant evidence-based component of environmental/public health (EBEPH) consist of decisions making based on best accessible, evidence that is peer-reviewed; using data as well as systematic information systems; community engagement in policy making; conducting sound evaluation; do a thorough program-planning frameworks; as well as disseminating what is being learned. As researchers, scientists, statisticians, journal editors, practitioners, as well as decision makers strive to improve population health, having a natural tendency toward scrutinizing the scientific literature aimed at novel research findings serving as the foundation for intervention as well as prevention programs. The main inspiration behind conducting research ought to be toward stimulating and collaborating appropriately on public/environmental health action. Hence, there is need for a “Plan B” of effective behavioural, environmental, social as well as systems interventions (BESSI) toward reducing transmission.
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Review Article
Open Access December 27, 2021

Leveraging AI in Urban Traffic Management: Addressing Congestion and Traffic Flow with Intelligent Systems

Abstract Traffic congestion across the globe is a multimodal problem, intertwining vehicular, pedestrian, and bicycle traffic. The relationship between the multimodal traffic flow is a key factor in understanding urban traffic dynamics. The impact of excessive congestion extends to the excessive cost spent on traffic maintenance, as well as the inherent transportation inefficiency and delayed travel times. [...] Read more.
Traffic congestion across the globe is a multimodal problem, intertwining vehicular, pedestrian, and bicycle traffic. The relationship between the multimodal traffic flow is a key factor in understanding urban traffic dynamics. The impact of excessive congestion extends to the excessive cost spent on traffic maintenance, as well as the inherent transportation inefficiency and delayed travel times. From an urban transportation standpoint, an immediate consideration on one hand is monitoring traffic conditions and demand cycles, while on the other hand inducing flow modifications that benefit the traffic network and mitigate congestion. Embedded and centralized control systems that characterize modern traffic management systems extract traffic conditions specific to their regions but lack communication between networks. Moreover, innovative methods are required to provide more accurate up-to-date traffic forecasts that characterize real-world traffic dynamics and facilitate optimal traffic management decisions. In this chapter, we briefly outline the main difficulties and complexities in modeling, managing, and forecasting traffic dynamics. We also compare various conventional and modern Intelligent Transportation Strategies in terms of accuracy and applicability, their performance, and potential opportunities for optimization of multimodal traffic flow and congestion reduction. This chapter introduces various proposed data-driven models and tools employed for traffic flow prediction and management, investigating specific strategies' strengths, weaknesses, and benefits in addressing various real-world traffic management problems. We describe that the design phase of dependable Intelligent Transportation Systems bears unique requirements in terms of the robustness, safety, and response times of their components and the encompassing system model. Furthermore, this architectural blueprint shares similarities with distributed coordinate searching and collective adaptive systems. Town size-independent models induce systemic performance improvements through reconfigurable embedded functionality. These AI techniques feature elaborate anytime planner-engagers ensuring near-optimal performances in an unbiased behavior when the model complexity is varied. Sustainable models minimize congestion during peaks, flooding, and emergency occurrences as they adhere to area-specific regulations. Security-aware and fail-safe traffic management systems relinquish reasonable assurances of persistent operation under various environmental settings, to acknowledge metropolis and complex traffic junctions. The chapter concludes by outlining challenges, research questions, and future research paths in the field of transportation management.
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Review Article
Open Access December 27, 2020

Enhancing Pharmaceutical Supply Chain Efficiency with Deep Learning-Driven Insights

Abstract The growing complexity of the operating environment urges pharmaceutical innovation. This essay addresses the need for the integration of advanced technologies in the pharmaceutical supply chain. It justifies the value proposition and presents a concrete use case for the integration of deep learning insights to make data-driven decisions. The supply chain has always been a priority for the [...] Read more.
The growing complexity of the operating environment urges pharmaceutical innovation. This essay addresses the need for the integration of advanced technologies in the pharmaceutical supply chain. It justifies the value proposition and presents a concrete use case for the integration of deep learning insights to make data-driven decisions. The supply chain has always been a priority for the pharmaceutical industry; research and development recognizes companies' increasing investment in big data strategies, with plans for a CAGR in big data tool adoption. The work presented herein has a preliminary explorative character to recuperate and integrate evidence from partly overlooked practical experience and know-how. The practical relevance of the essay is directed toward practitioners in pharmaceutical production, supply chain management, logistics, and regulatory agencies. The literature has shown a long-term concern for enhanced performance in the pharmaceutical supply chain network. This essay demonstrates the application of deep learning-driven insights to reveal non-evident flow dependencies. The main aim is to present a comprehensive insight into deep learning-driven decision support. The supply chain is portrayed in a holistic manner, seeking end-to-end visibility. Implications for public policy are discussed, such as data equity: many countries are protecting their populations and economic growth by building resilience and efficiency to ensure the capacity to move goods across supply chains. The implementation strategy is covered. The combined reduction of variability, efficiency as matured richness, reliability (on stochastic flows and their understanding through deep learning and data), and system noise (increased dampening through the inclusiveness of all stakeholders) results in increased responsiveness of supply chains for pharmaceutical products. Future work involves the integration of external data, closing the loop between planning and its application in reality.
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Review Article

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