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1 An Assessment of the Knowledge and Practices of Mothers on Home Management of Diarrhoea in the under Five Children at the Medicalised Health Center Nkwen, North West-Cameroon , Christina Asoh  
Diarrhoea has been and is still one of the highest threats to the lives of children below five years. According to millennium development goal, the fourth goal aims at reducing child mortality and morbidity to 2/3 from 1990 to 2015. Diarrhea remains the second leading cause of death among children under five years globally [Adimoraet al (2011)]. Nearly one in five child deaths, about 1.5 million each year, are due to diarrhea [Ansari et al (2011)]. Northern Cameroon estimated approximately 18500 diarrhoea episodes and 3696 RVA-associated child mortality occurred in Cameroon annually (Parasharet al, 2003). Many children under five who come to that hospital suffer from diarrhea they have been a steady rise ain the prevalence of diarrhoea among children under five in Cameroon and word (WHO 2004). Therefore, this study aims at assessing the knowledge and practices of mothers on home management of diarrhea in under five. The descriptive cross-sectional study design was used to assess the knowledge, and practices of the mother in the home management of diarrhea. Targets were mothers in home management of diarrhea in children (0-5 years) who came in IWC, ANC units at the Nkwen Medicalised Health Center within the period of study. The instrument of data collection was a structured questionnaire, Microsoft Excel 2010 was used for analysis and data presented on tables, pie charts, histograms and Bar charts. The current study revealed that mothers have inadequate knowledge on home management of diarrhoea 90(60%). They had negative practices towards the home management of diarrhoea and the use of ORS/zinc tablets as recommended by WHO was very low (29%) as compared to the use of drugs and traditional medicine. According to USAID and Experts worldwide (2002), success in the reduction of deaths and illnesses due to diarrhoea in childhood depends on the acceptance of the scientific basis and benefits of ORT by governments and medical communities. There is need to educate mothers on home management of diarrhea using scientific bases to reduce infant mortality from diarrhea. Keywords: knowledge and practices, diarrhea, under five children.  
2 Knowledge, Behaviour and Perceptions Affecting Control of HPV / HIV Co-Infection and Cervical Neoplasma Screening Among Patients with Cervical Cancer in Kenya , Philip Kasawa Naluande, Praveen Thaggikuppe Krishnamurthy, Margaret Nyanchoki Keraka
The main objective of this study was to assess how Knowledge, behavior and perceptions affect Cervical Cancer screening and the control of HIV/ HPV Co-infection among patients with cervical cancer in Kenya. The following specific objectives guided the study; to weigh the knowledge, behavior, and perceptions on the understanding of the absorption of Cervical Cancer Screening and prevention strategies among women in Kenya. This was a cross-sectional, descriptive and quantitative comparative study of cervical neoplasia screening and control strategies among women attending Kenyatta National Hospital and Coast Provincial General Hospitals in Kenya. The study was conducted at the Coastal region of Kenya particularly Mombasa County and all parts of Nairobi County over a twelve-month period at the Coast Provincial General Hospital (CPGH) and Kenyatta National Hospital respectively. The target population for this work involved all female respondents who had tested positive for HIV and Cervical Cancer and have the results or they need further screening. Convenience sampling technique was used because of time constraints. Random sampling was used to identify participants. The study concludes that knowledge, behavior, and perceptions on absorption of Cervical Cancer Screening and prevention by women depend on initiatives that have been put in place to motivate and educate women on issues related to cancer screening. The study recommends that the need for community understanding of cervical cancer and the causal relationship between HPV and cervical cancer is usually poor, giving priority to continuing education on the significance of HPV prevention and periodic cervical Cancer screening.  
3 Factors Influencing the Practice of Exclusive Breastfeeding among Lactating Mothers Attending the IWC in District Hospital Mbengwi in the North West Region of Cameroon , Christina Asoh  
Breastfeeding is an unequalled way of providing ideal nutrition for the healthy growth and development of infants. The global public health recommendation is that infants should be exclusively breastfed for the first six months of life to achieve optimal growth, development and health (WHO, 2003). Exclusive breastfeeding in the first six months of life stimulates babies’ immune systems and protects them from diarrhea and acute respiratory infections, two of the major causes of infant mortality in the developing world and improves their responses to vaccination (UNICEF, 2006). Approximately 1.5 million young infants die each year as a result of lack of knowledge about exclusive breastfeeding benefits and improper infant and young child feeding practices (Nguyen, 2009). The World Health Organization (WHO), United Nations Children’s Fund (UNICEF) and other organizations promote exclusive breastfeeding as one of the key effective low-cost interventions to enhance child survival. It is therefore for these reasons that we sort to find out the factors influencing the practice of exclusive breastfeeding among lactating mothers attending infant welfare clinic (IWC) at the Mbengwi District Hospital. A cross-sectional survey was used where the convenient sampling technique was used. Data collection tool was a structured questionnaire with open and closed ended questions to give a snapshot of the factors influencing the practice of breast feeding among lactating mothers attending IWC. Data analysis was done using Microsoft Excel tables and figures. The rate of exclusive breastfeeding among lactating mothers attending IWC in district hospital Mbengwi was found to be 26.6% which is relatively higher compared to those reported in other studies 13.3%, 16%, in Tanzania, Kenya, respectively (Maru et al, 2009). This observed difference may be due to the strengthened MCH services. Despite the improvement in the percentage as compared to other African countries, there is still a need for strengthened MCH services to improve the percentage of mothers adhering to exclusive breastfeeding. Keywords: exclusive breast feeding, lactating mother, infant welfare clinic, Mbengwi District hospital  
4 Comparative Study of Haematological Parameters in Male-Female Diabetics and Non-Diabetics in Abuja, Nigeria , Lawrence Chinaemelu , Abiodun Olaiya Paul, Sanni Olaniyi Felix, Charity Nkem Umeji, Abiodun Abiola Folake, Okeke Ndubisi Chrisitian, Nicholas Innocent Eigege, Chisara Sylvestina Okolo
Diabetes mellitus (DM) is a disease caused by a deficiency or diminished effectiveness of endogenous insulin. The complicationsof diabetes mellitus are known to be very severe, unbearable, incapacitating, fatal, and has high health and economic burdens. This study was conducted to compare hematological parameters in diabetic males and females compared with non-diabetic individuals. This study was done at the Defense Reference Laboratory, Asokoro, Abuja, Nigeria. Venipuncture was performed on all participants; Complete Blood Count was carried out with 2ML-EDTA blood tubes using the Sysmex platform while Fasting blood sugar was done using 2ML-Fluoride Oxalate blood tube. This assay was done using an automated Chemistry analyzer (Selectra Pro-S). The data were analyzed using SPSS for Windows version 25.0. A total of 200 participants including 40 diabetic males, 60 diabetic females, 48 non-diabetic males, and 52 non-diabetic females were recruited for the study. The values of FBS and MCHC were significantly higher in the diabetic male and female group. The mean values of PCV and MCV were significantly higher in both male and female non-diabetic group. The values of HB, RBC, and PLT-CT were also significantly lower in diabetic male but not significantly in females. There were 48% cases of anaemia among diabetic females 27% among non-diabetic females whereas only 13% anaemia was seen for diabetic males. Hematological parameters should be evaluated and treated periodically in both male and female diabetic patients to reduce the burden of DM and ocular morbidity due to retinopathy.  
5 Big Data Phenomenon in Banking , Bernard Aliu  
The banking industry has significantly thrived with the rapid advancement of human civilization and the associated growth in information technology. Earlier to this digital era, all the transactions and the business intelligence thereof had excessive human involvement. The digital world, while making the transactions clear and transparent, generated large amount of digital data. Digital data has snowballed, with the proliferation of network services, mobile devices, and online users on the Internet the banking sector has witnessed a rise of interest in big data. A recent study showed that the global population produces a total of 2.5 quintillion bytes of data daily and this continue to rise. The global financial service sector continues to rapidly embrace digitization aided by the advent of new technologies and greater government push. This trend has been further stimulated by the emergence of Financial Technology (FinTech) players, who are playing a significant role in the banking value chain. The availability of Big Data in this domain has opened up new avenues for innovation and has offered huge opportunities for growth and sustainability. Simultaneously, it has presented a number of new challenges that must be surmounted in order to maximize its value. Since today’s customers expect more personalized banking services and to remain competitive while complying with bigger regulatory surveillance, the banking services sector is hugely pressurized to utilize the depth and breadth of the available data in the best possible way. This study will examine big data and its analytics while looking at the impact and applications of Big Data in the banking domain. It will also consider the important Big Data challenges that remain to be addressed in the banking sector. Keywords: Big Data, Big Data Analytics, Financial institution, Banking.  
6 Examining the Use of Digital Media and Technologies in teachers’ teaching: A Case of Selected Schools in Luampa District, Zambia , Nawa Maseli  
The purpose of this study was to investigate and examine teachers’ use of technology and digital media in their lesson delivery. This study also explored how teachers equip their learners with 21st century skills that are taking place in the education sectors. Respondents under this study were primary and secondary school teachers. The primary school runs from early childhood to grade 9, while the secondary sector covers grades 8 to 12. A questionnaire was formulated and used to collect data from two institutions used as study areas. Results revealed that the most worrying concern is lack of knowledge of many teachers on the use of digital media and emerging technologies on teaching. The other challenge observed was on the lack of the required technological tools to use at the secondary sector and lack of technological skills. There was need to train teachers on technology skills so that they can provide our learners with solid foundation of ICT and Computer Studies. Keywords: digital media; emerging technologies; creativity; ICT; primary and secondary school.  
7 The Challenges in Analyzing Project Management Principles in Service Delivery in the Issuance of Driver’s License (A Case Study the Driver’s and Vehicle Licensing Authority (DVLA) of Ghana.) , Daniel Quansah  
Project management is the discipline of planning, organizing, securing, managing, leading and controlling resources to achieve specific goals (kshama, 2018). Driver and Vehicle Licensing Authority is a semi-autonomous public sector organization that promote good driving standards and establish methods for the training and testing of driving instructors and drivers of motor vehicle and riders of motor cycles in Ghana. Of recent, there have been a lot of road accidents as a result of poor driving practices. This study is to address some of the contributing factors by analyzing the project management principles in the service organization by focusing on the process of issuing driver’s license by DVLA. Several literatures assess the concept of driving license. 300 respondents made up of employee and customers of the firm were sampled for the study. The mix method was employed in collection of data whilst the purposive sampling and simple random sampling techniques were used. The findings of the study indicate that an applicant is eligible for a driver’s license if he/she is 18 years and above and must have attended an accredited driving school. The study found that, there are delays in the operations of DVLA due to the manual process they employ, the trend been currently used to register applicant and book them for exam and driving test as well as the time wasted in the printing and issuance of driver’s license. Customers are very dissatisfied with the manure of operation especially customer service and accessibility to information in the company. keywords: Applicants, Driver and Vehicle licensing Authority, Probationary, Satisfaction, Semi-autonomous.  
8 Discouraging Ageism in Workplace: Key to Global Organizational Efficiency , Sam Bodunrin
According to Dictionary.com, it define human aging as “discrimination against persons of a certain age group.” Within the above contest, one can begin to ask a rhetorical question that who will not get old? Why older persons are discriminated or age restrictions to some of the vital things we do in the society? The science of gerontology is vast and could only be treated positively when its impact is well understood. The impact of age discrimination is retrogressively demeaning to the victims especially the baby boomers who were veterans and had sacrificed for the so called freedom we enjoyed today. In establishing the impact of gerontology and ageism, I dedicated my study to carry out a research that on age discrimination and was able to establish some facts about ageism and its effect in our society. The purpose of this study is to identify the impact of age discrimination on the aged emotions and capability. In ascertain this study, we deployed questionnaires to the aged old in Lagos Nigeria (sample population) where we got feedback from veterans and other retired fellows staying in old people’s home. About 95% of our sample population confirmed that they felt cheated and undignified after they were discriminated at in various aspects of their lives, even after retirement, while 3.8% disagreed not to have experienced age discrimination and 1% prefer not to comment on it. Details of the survey shall be given in the body of this article. In this article, the first and second paragraph introduced the timing and age bracket that falls victims of ageism -especially the aged ones. When it is likely to start experiencing age discrimination which sometimes is not limited to aged but also the under-aged who are rated as incompetent to carry out or participate in an aged rated activities. The third paragraph underscored how ageism affect the baby boomers and Gen x irrespective of their fitness and how millennial also face age discrimination in recruitment and political eligibility. Further to this, work of Robert Butler – the first researcher on ageism was mentioned with our team research at Regina Mundi Ages Home in Lagos and other field survey that were carried out in paragraph seven and eight. The article pointed out different countries acts that protect age discrimination in paragraph nine while the general effect of ageism in our society with our recommendation on how to stop ageism were cited in paragraph ten and eleven respectively.  
9 A Comparative Assessment of Near Point of Convergence between Goldsmiths and Normal Population , JayaRajini Vasanth, Jeevitha.J
The process of jewelry making involves minute visual tasks at closer working distance for goldsmiths, which demands high visual ability that eventually might result with receded near point of convergence (NPC). Hence the aim of our study is to compare the near point of convergence between goldsmiths and normal population. One group of 72 male experienced goldsmiths and other group of 72 male normal populations were evaluated. Binocularly the near point of convergence was tested with sharpened tip of pencil. The patient age ranges between 30 to 60 years with best corrected visual acuity of 6/6, N6 monocularly without any ocular pathology were included in both the groups. The other near occupational work was excluded for normal population. The p-value for subjective comparison of NPC is 0.008 and for the objective comparison of NPC is 0.0005 which showed a highly statistical significant changes between goldsmiths and normal population for both subjective and objective comparison. Hence this test can be used as a clue to suspect whether the goldsmiths having convergence insufficiency and to decide on referring the patient for further binocular vision assessment and treatment accordingly. Keywords: Goldsmiths, near point of convergence, sharpened pencil tip.  
10 Effect of Health Workers Strikes on Quality of Care in Health Institution in Cross River State, Nigeria , Samson Olusegun , Robert J. Chiegil, Amosu Ademola, Felix Sanni, Musa Orenyi, Abiodun Olaiya Paul, Opeyemi Joseph, Margaret Dakwat
The focus of this study is to examine the effect of labour strikes on patient’s quality of care in health facilities. However, the objective can be achieved by answering the research question which is “does labour strike affects quality of care in health institutions? The study is a cross-sectional descriptive study of 508 respondents from the outpatient, laboratory and pharmacy departments, Ante-Natal, Post-Natal and ART clinics of the 7 secondary health institutions spread across 3 senatorial districts in the state between January and February 2018 using multistage method. Data were collected using a semi structured closed- and open-ended questionnaire divided into different sections. Raw data were entered EpiData™ and exported for analysis using the SPSS software version 20. The data were cleaned and validated for use. Frequency tables were produced and associations between categorical variables were determined using chi squared test at a significance level of P<0.05. The negative effects of strikes are highly felt generally among all patients with no statistical significant difference whether employed, unemployed or retired (P>0.05). However, the significant effect of health workers’ strike on quality of care is that strikes increases death rates. The result showed that regardless of patient’s education level, patients are fully aware that one of the effects of health worker strikes is increase in death rate with P value >0.05. Labour strike also increases misuse of drugs, expiry and wastages of drugs and laboratory reagents. In conclusion, the higher the level of education, the higher the awareness that labour strikes affect the duty of health workers and have effect on patient’s attendance, poor healthcare indicators and cause patients’ dissatisfaction. Keywords: Health Workers Strikes, Quality of Care, Patient Satisfaction and Secondary Health Institutions.  
11 Investigating the Areas of Student Difficulty in Chemistry Curriculum: A Case Study in Qatar , Caleb moyo  
The exploratory study focused on the identification of difficult topics in Chemistry in the International General Certificate of Secondary Education (IGCSE) curriculum. A structured questionnaire was used to obtain data from thirty students by simple random sampling technique. Interviews and focus group discussions were carried out to seek clarifications on some of the responses to the questionnaire questions and to elicit detailed explanations of the causes of the perceived difficulties. A multiple-choice test was also administered for the purpose of triangulation. Frequencies and means were used to answer the research question. The findings indicate that the causes of poor performance could be categorised into five groups i.e.: nature of concepts, prior knowledge, access to the language of instruction, teaching processes and mathematical efficacy. The study recommends a more structured form of curriculum mapping of all topics and sequencing of topics over the two-year period of study of IGCSE Chemistry and suggests further research on misconceptions and their origins in the subject matter. Keywords: chemistry, difficulty, concepts, abstract, igcse, sub-micro.  
12 Uptake of Artemisinin-based Combination Therapy for Treatment of Acute Malaria at Federal Capital Territory Abuja, Nigeria: A Rretrospective Hospital Based Study , Ibrahim S. A, Ukaga C. N
Malaria remains a major public health challenge in Abuja. Considerable efforts have been made to reduce the prevalence of the disease; however, the last decade of malaria control has witnessed increased support by government and its partners in the areas of mass distribution of long-lasting insecticidal nets (LLINs) and a massive scale up in malaria case management. Consequently, it has become necessary to provide evidence-based data on the status of progress towards malaria control. A retrospective hospital based study on the uptake of Artemisinin-based Combination Therapy drug for treatment of acute malaria was carried out using a five years hospital records from Wuse District Hospital Abuja. All the records of patients diagnosed with malaria confirmed by Giemsa stained thick and thin peripheral blood films were considered. Data was entered and analyzed using SPSS Chicago version 25. Appropriate tables and mean numbers were displayed. A chi square test was performed to determine the level of significance using 95% confidence interval and p- value. Findings revealed a total of 22,934 patients were diagnosed with acute malaria based on hospital records. Only 48.4% of the patients received Artemisinin Combination Therapy (ACT) drugs. 32.1% of the patients were given non-ACT drugs, 9.3% of patients received Sulfadoxine – Pyrimethamine, 7.59% were given Chloroquine. The study concluded that, The use of Artemisin base Combination Therapy (ACT) as recommended by WHO has a significant influence on malaria treatment outcome. Keywords: Artemisinin-based Combination Therapy, Malaria, Uptake, Malaria.  
13 The Integration of ICT in Students Information Database Management System , Wilson  
After relying on ICT for individual tasks, learning institutions realized that integration of ICT in student information database management systems is more effective. The study identifies the various benefits and challenges of integration as well as the role of ICT and Database Management Systems. Also, different departments have been discussed with respect to adoption of ICT in their DBMS. In a global context, developing countries are at the peak of technical advancement while developed nations have begun to include sophisticated innovations as the next phase of ICT. The research mentions how ICT integration influences school’s operations and its impacts on students. Keywords: students, Database management system (DBMS), web-portal, academic records, departments.  
14 Diagnosing Dry Eyes in Post-Menopausal Women using Schirmer’s Test in Open and Closed Eyes without Anesthesia , JayaRajini Vasanth, Divyalakshmi
Objectives: To compare the wettability and wetting time between open and closed eyes of post menopausal women using Schirmer’s test without anaesthesia (ST) and to assess the number of dry eyes in open (STO) and closed (STC) schirmer test. Methods: One-Hundred and Twenty eyes of 60 normal Post-Menopausal women were recruited from Sri Ramachandra University. Schirmer test (ST) was performed in a closed environment with the absence of air flow. This procedure was performed with the subjects both eyes open and closed with an interval of 1 hour and were conducted in 5 minutes. If wetting values are 35 mm before 5 minutes, wetting time should be recorded. Results: In this study 120 eyes of 60 Post-menopausal women were included. Measurements of STI performed with open eyes (27.0 ± 9.5) were higher statistical different from those performed with closed eyes (17.5 ± 11.0) in right eye of the patients. Measurements of STI performed with open eyes (27.5 ± 9.9) were higher statistical different from those performed with closed eyes (19.0 ± 11.4) in left eye of the patients. Wetting time of STI performed with open eyes (4.1 ± 1.2) were lower statistical different from those performed with closed eyes (4.7 ± 0.8) in right eye of the patients. Wetting time of STI performed with open eyes (4.1 ± 1.2) were lower statistical different from those performed with closed eyes (4.6 ± 0.8) in left eye of the patients. The p value from measurements of STI for right and left eye was 0.0005 and the p value from wetting time for right and left eye was 0.0005, so, there was a significant change between open and closed eyes. Conclusion: ST performed with open and closed eyes can have an important influence in the diagnosis of dry eyes in post-menopausal women. Keywords: Dry eyes, Post-menopausal women, Opened schirmer’s test, closed schirmer’s test.  
15 Organizational Integrity of Administrators of Divine Word Colleges in Region I, Philippines and Employees’ Job Satisfaction As Perceived by the Employees , Fr. Damianus Abun, Alfie P.Racoma
The study was to determine the level of integrity of administrators of Divine Word Colleges in Northern Province, Philippine, and determine the effect of organizational integrity and job satisfaction of employees. It was found that overall, the integrity of administrators were at the moderate or good level. It was also established that the level of integrity of administrators influence employees’ job satisfaction. Such relationship concludes that employees’ job satisfaction is not just caused by monetary reward but how the administrators carry out their duties and responsibilities in an ethical manner. Keywords: Integrity, job satisfaction, self-integration, maintenance of identity, standing up for something, moral purpose.  
16 Increasing Human Security to Disaster Risk Targeting Vulnerable Communities in the North of Haiti , Pierre Edwidge Moise  
Human Security was never a concept used in Haiti in the past. As disaster in this country remain a critical factor, the concept become more important than ever. Human Security can respond to the complexity of emerging security threats in an integrated manner. Human security protect the vital core of all human lives. It is important to use processes that build on people’s strengths and aspirations. It means creating, social, environmental, economic and cultural systems that together give people the building blocks of survival, livelihood and dignity. This project work respond to those needs. It is all about empowerment and protection. With this concept, institutions are reinforce with a focus on capacity development of keys partners locally and regionally. The North department was a key focus to build that capacity targeting vulnerable communities. By addressing the full range of insecurities faced by the targeted communities in the North, the project promotes responses that are community-driven, preventive and sustainable in the long run.  
17 Evaluating the Current Usage and Integration of ICTs in Education: A Review of Teachers’ Usage and Barriers to Integration , Caleb Moyo  
This study examined current usage of information and communication technologies (ICTs) in a group of private secondary schools in Qatar and explored the barriers to effective integration of technology in Maths and Science lessons. The data was obtained from a total of 40 (18 female and 22 male) high school teachers. Results indicate that most teachers do not use ICTs as part of their pedagogical repertoire, instead, teachers reported using ICTs mostly for administrative work: - tracking attendance, preparing power point presentations, handouts and assessments. The article also reviews personal, institutional and technological factors that hinder teachers’ use of computer technology in teaching and learning processes: - teacher-level, school-level and system-level. These barriers include lack of teacher ICT skills; lack of teacher confidence; lack of pedagogical professional development and a streamlined and effective school policy on ICT; lack of suitable and adequate educational software; limited access to ICT infrastructure and a restrictive curricula, amongst other factors. Teachers also made insightful suggestions on how to ameliorate the current situation. Implications of this study will help the group management and administration in planning, implementation and evaluation of effective integration of ICTs in teaching and learning within the group of schools, efficient use of limited technology infrastructure and resources, and improvement of access to learning for the students. Keywords: ICT adoption; integration; barriers; teaching and learning.  
18 Contractor Information Management System (CIMS) – Import Module , Wais Meeran
X-organization is looking for a solution to enables the X-client to identify which contractors are being used in Afghanistan and for what purpose (contracts). The contractor should be defined as business / enterprise / organization / or individual that will commission or employ to perform a specific job for a specific period through a contract with the X-Organization. Furthermore, the application should provide details on where the contracts are as well as the value, and to indicate the performance of the contract / contractor per different clients. Based on strong research, the Application has been developed in Drupal. After some time, the organization decided to add more features in the application to satisfy their clients for example bulk import, grouping specific fields and a map showing geographical information. Previously X-organization clients were adding each contractor separately which was quite time consuming, but recently they installed a new module called “Feeds Import” to facilitate their client’s data import process. This new module allows clients to import, a list of their contractor/contracts information just by importing from a CSV file. By implementing the above features the X-organization faced another challenge. Each CSV file had to be imported several times to accomplish the bulk import process and we later explain in more details in the next sections of this paper why the clients had to import the same file several times? Now, the organization is looking for a solution to eliminate the need for importing one content type multiple times. So, the purpose of this document is to design and develop a module through which the import process is made dynamic, flexible and user friendly. Keywords: Drupal, import module, Contractor Information Management System, Feeds Import, Field collection, bulk import.
19 Challenges and Issues of Medical and Nursing Education: An Outcome qualitative Research at various Medical/Nursing Institutes of Pakistan , Sumera noshin  
Objectives: To evaluate the consequences of individualized education and systematic social contract education through exploring education systems of various training institutes. Materials & Methods: Qualitative design was applied and data were collected through using interview guide/topic guide. Data was collected on emails, telephone, and face to face interviews, till saturation. Data was collected in the months of January and February 2017 with different types of participants. Participants were selected using purposive and networking sampling from various medical/nursing colleges. Finally, 4 patients, 4 students 4 faculty members 6 academic key informants, were selected for interview. Results: After analyzing and data interpretation, the challenges and issues are categorized in four main themes, including 1. Deficient Multidisciplinary /multi-setting teaching methodology, 2. Curriculum paradigm shift, 3. Curriculum misalignment and 4. Need for Professionalism. Each of these main themes comprises several subthemes and accordingly each subtheme encompasses several issues. Each issue is presented in form of verbatim. Recommendations: Curriculum revisions and retreat can help in facing the challenges and fixing up the issues. Research and program evaluation is mandatory for the curriculum paradigm shift. Keywords: Multidisciplinary teaching, Multi-setting teaching methodology, Curriculum paradigm shift, Curriculum alignment, Curriculum misalignment.  
20 Uganda DHIS2 Case Based Surveillance System: Would Have Detected the 2016 Yellow Fever Outbreak in Uganda , Prosper Behumbiize  
Majority of developing countries have relayed on aggregate weekly epidemiological data to detect, investigate and respond to outbreak, however as revealed by the West Africa Ebola Outbreak in 2015, these systems were not able to detect the outbreak in time. This has driven countries to building effective case based surveillance systems aimed to link cases to laboratories. Uganda’s journey to a web-based electronic case-based surveillance started in 2013 with the United States Government (USG) Uganda Global Health Security (GHS) demo project. On 24th March 2016, an alert of a suspected Viral Haemorrhagic Fever (VHF) outbreak was received by the Ministry of Health through the Public Health Emergency Operations Centre (PHEOC) and the case was confirmed on 8 April 2016 for Yellow Fever. A total of 60 suspected YF cases were reported between April and June, with 7 cases testing positive. Building on the successful GHS Specimen Tracking System, we embarked on rebuilding the DHIS2 tracker expanding the scope and coverage to the now eIDSR. Different disease specific Case notification forms were reviewed and common key notification elements harmonized into a general minimum data case DHIS2 tracker registry for immediate reporting. The system underwent vigorous testing and fine tuning using the yellow fever outbreak cases. The systems demonstrated that it’s possible to build an effective case notification and lab confirmation system using DHIS2 tracker with automated SMS and email notification. With the success above it recommended to countrywide rollout and adoption. Keywords: Disease Surveillance, Outbreak, Notifications, Yellow fever, DHIS2, Tracker.  
21 The Role of Education on Small-scale Mining for Sustainable Development- A case of Banda/Nkwanta Community in the Bole District-Ghana   , Nestor Naabulee Nasage  
The activities of small scale miners in Ghana have had negative effects on the environment and this has hampered security within the environment. The study seeks to assess the role of education on small-scale mining for sustainable development in the Banda/Nkwanta community in the Bole District, the Northern part of Ghana. Small scale mining operations have been a major cause of most of the negative environmental impacts in most parts of Ghana. This activity has now found its way to the Northern part of Ghana which is a serious canker for sustainable development. The environmental effects of these activities are higher because most of the activities are not coordinated and monitored by authorities especially in the Northern part of Ghana. The methods of mining applied by operators determine the severity of threat to environmental security. The chemical method of processing gold is a severe health hazard, especially the amalgamation with mercury. Small scale mining activities have a lot of negative impacts on agricultural activities, the major occupation and source of livelihood for the people. It is recommended that Government and its agencies should encourage the illegal small-scale operators to formalize their operations in order to be accessible for supervision. The issuance of licenses and permit for surface mining should be reduced and most of these companies should be encouraged to explore the underground mining method with appropriate techniques and skills that meet international best practices. The Bole District Assembly should enforce environmentally friendly bye-laws, education and comprehensive environmental protection measures. Keywords: Education, small-scale Mining, Sustainable development.  
22 A Model to Assess Technological Innovations at Institutions of Higher Learning in Kenya , Rajab Philip Muchiri  
Objective: The aim was to develop an innovation assessment model to analyse the impact of broadband in spurring innovations in Kenya by studying the role of broadband diffusion, the impact of broadband collaborations, the influence of electronic research and the role of online broadband products usability. Background: Many countries in Africa invest in broadband infrastructure because they have realized that broadband encourages innovation leading to economic development and prosperity. Understanding the relationship between universities, business enterprises and government enabled by broadband is critical in assessing a country's innovative capacity. Methodology: This study applied descriptive survey research design. It used a logistic regression model as an inferential analysis tool in the quantitative aspects of the research. The target population for this study was institutions of higher learning (IHL) operating in Kenya by 31st December, 2015 which included both private and public accredited universities in Kenya. Results: The response rate from the sampled population was at 75% Reliability measures were above the recommended level of 0.70 as an indicator for adequate internal consistency. The overall model evaluation, goodness-of-fit statistics, statistical tests of individual predictors and validations of predicted probabilities. Showed that the data fitted the model and the model performed well. Conclusion: Institutions of higher learning in Kenya have a positive but low capacity in technological innovation implementation. Broadband diffusion is inhibited by poor infrastructural development attributed to high costs of connections and bandwidth acquisition and a high demand for broadband among the students and staff. Keywords: Broadband, Innovation, Internet, Education, model.  
23 Adolescents’ Antisocial Behavior in Schools: Examining the Influence of Poverty on Adolescents from Low Socio- Economic Families and Schools , Memoir Chimwamurombe  
The phenomenon of adolescents’ antisocial behavior in schools has become a globally discussed issue. Even though there are various factors leading to antisocial behavior in adolescents in schools, poverty has been identified as one of the contributing factors. Adolescents from low socio-economic status families are confronted by environmental pressures that lead to aggressive behaviors. This does not only lead to high failure rate, but also hinders the country’s progress in terms of nurturing future human resource pool and the nation’s productivity. The aim of this study was to examine the influence of poverty on adolescent misbehavior in Windhoek High Schools. A quantitative methodological technique was used to conduct the study. The adolescents for this investigation were from the age of 13 to 17 years who were in public secondary (high) schools in Windhoek, Namibia. The sample consisted of 300 participants who were chosen using stratified sampling throughout Windhoek from under privileged settings. A questionnaire was used to collect data. Ethical considerations were cautiously adhered to before and during the research process. Consent forms were given to parents and the purpose of the study was clearly explained to both parents and participants during data collection. The instrument’s reliability was tested by means of a pilot study. Statistical Package for Social Sciences (SPSS) was used to analyze the data. The results were in the context of the influence of poverty on adolescents’ behavior. Lastly, suitable recommendations were highlighted to fit the observed trends. Keywords: Antisocial behavior, economic status, environment, school, Poverty and teenagers.  
24 Intricacies of Secured Multi-Biometric System , Emmanuel Chinweuba Nwani
The Multi-biometrics system is designed as a measure for security purposes to recognize individuals using all available features. It is a thrilling research domain carried out to boost the security level of a country or of an organization. The integration of muti-modal biometrics in real time application resolves the limitations of the uni-modal applications. Although, the design and assessment of the multi-biometrics systems raises much issues, this paper tends to unravel the clumsiness and trade-offs in its applications, the benefits of fusion level, integration strategies and check to spoofing. In conclusion, a thorough reviewing of multi-modal secured biometrics techniques and approaches was carried out to ensure data identification integrity. Some points were suggested for consideration as subjects of interest for future research. Keywords: Multi-Biometrics; Multimodal application; Unimodal application; Secured Biometrics; fusion levels Spoofing.  
25 The Legal Aspect of Insidious Diseases in the Workplace: A Case Study of Jwaneng Diamond Mine in Botswana , Comfort Matthew Tanko  
The purpose of this study is to examine the legal aspect of insidious diseases in Botswana mining sector. Sixty respondents from Jwaneng mine will take part in this study involving top management and the rest of the staff members. And they will be served with questionnaires as a primary source of data collection. The approach gives opportunity to collate, process, present and analyse data from courts and authors. In so doing the study will identify the gap and inability of workers in Jwaneng mine to file a claim for compensation when faced with insidious diseases. Early in the life of a Motswana miner, the legal aspect of insidious diseases wasn’t necessary; because insidious diseases take a long time to manifest and most miners are not aware of their rights to compensation and so it becomes very difficult and complicated to file for a claim. Although Jwaneng mine has a good safety management record, there are instances when accidents still happen and therefore requiring some form of compensation and one way this can be done is by having it clearly stated in a contract of employment agreement. Employees may also be sensitized on their rights so they know the channels to take in seeking redress. This is aimed at ensuring there is harmony between the top management and workers in their respective endeavours. Keywords: Botswana, Compensation, Debswana Diamond Mine, Jwaneng, legal aspect, Insidious diseases.  
26 Assessing Domestic Violence in Nigeria , Kehinde Oluseyi Macaulay  
Domestic violence is form of violation of person’s human rights or abuse of anyone in a way that causes pain, distress or injury. It refers to any abusive treatment of one person by another, thus violating the law of basic human rights. It includes battering of intimate partners and others, sexual abuse of children by parents or relative, such as marital rape and traditional practices that are harmful and inhuman to a person, men or women. In this paper we will discuss the prevalent rate of domestic violence in Nigeria, the situation of domestic violence, cause, types, effect and managements of domestic violence in Nigeria. Lastly preventive and remedial is proffered as a panacea for the ugly phenomenon. Keywords: Domestic, Violence, Abuse, Nigeria, Counselling, Patriarchal.  
27 Evaluation on Awareness and Application of Statistical Process Control (SPC) among Health Practitioners of Rural Tanzania Health Facilities , Crescent Daniel Ombay,  Theodotha John Malisa
Background: Statistical process control (SPC) is a collection of tools that when used together can result in process stability and variance reduction in production and services. For effective and efficiency of quality performance, health practitioners must be fully aware of general concept of SPC, its components and how to apply it in their daily work. Health practitioners are the once who will shape the nature of quality of those components to fit the needs and demands of health seekers (customers) through proficient application of SPC in their daily practices. However, different studies reported that, general concept of SPC is unclear to many practitioners and its application does not gratify the needs and demands of those health seekers. The study was aimed at evaluating awareness and application of SPC among rural Tanzania health practitioner. Method: This article was aimed at evaluating awareness and application of SPC among health practitioners of Rural Tanzania Health Facilities in their daily practices. Non-interventional of cross-sectional explorative method in nature where both quantitative and qualitative data was collected. Thirty five (35) health professionals were conveniently interviewed. Self-administered questionnaires were administered and data was systematically analyzed by excel programs in computer. Result: The result revealed that, of 35 health parishioners interviewed, (47%) do not completely know the general concept of SPC. On other hand, all (100%) of health practitioners interviewed, had never applied at all SPC in their daily practices. About the tools of SPC, of the 280 required responses, only 22 (8%) indicated that they are aware with check sheet. Few respondents were poorly responded to other recommended tools of SPC. However, there are other forms of SPC tools used in the hospital for quality control. When practitioners were asked on their opinions to apply SPC as way forward to improve their practice in future, a great number (29, 83%) recommended the SPC to be incorporated in clinical practice to improve quality of work. Conclusion: If properly considered, the result from this mini study will improve efficiencies and effectiveness of performance among health practitioners. The result will also be useful for health facility managers as they will use as a guide for decision making about where improvement and efforts of action to be focused in the first place. However, this study may not sufficiently reflect the real situation of Rural Tanzania Health Facilities as it took place in only one health facility with a very small sample size. For this reason, this study may be a good platform for further study with adequate sample size. Keyword: Awareness of SPC, standard SPC tools, application of SPC  
28 Neuro-V: An all in One Natural Supplement to Improve Nerve Regeneration, Increase Cognitive and Physical Performance and Effects on Neuroprotection , Nicole C. Hank  
Worldwide, nutritional supplements have been utilized prophylactically, as well as to assist and improve specific diseases and illnesses for decades. Since the U.S. Food and Drug Administration (FDA) does not regulate dietary supplements in the same way that it regulates medicine, dietary supplements can be sold without FDA approval. Neuro-V, a product that was originally developed to improve nerve regeneration in people who suffer from Neuropathy, has a myriad of health benefits that can also protect against oxidative stress as well as improve energy production. The antioxidants and amino acids that were meticulously chosen in Neuro-V (Acetyl L-Carnitine, Alpha Lipoic Acid, N-Acetyl L-Cysteine, Cyanocobalamin (B-12), Pyridoxine HCL (B-6), Folic Acid (B-9) and Grape Seed Extract) have individually been reported and studied to reduce neuropathic pain as well as prevent mitochondrial damage. Although, there are a variety of treatments that essentially provide symptomatic relief for patients who suffer from neuropathy, including non pharmacological, pharmacological and interventional therapies, there is yet to be a supplement that can provide a multitude of benefits and is available worldwide. This paper will discuss the important ingredients of Neuro-V and research that went into specific, efficacious, safe, non- toxic doses that can not only improve nerve regeneration, and increase cognitive and physical performance, but can also be utilized as a supplement for neuroprotection. Keywords: Neuroprotection, neuropathy, nerve regeneration, Neuro-V, natural supplement, mitochondrial damage  
29 Enhanced Simplified Symmetric Key Encryption Algorithm , Mahendra Kumar Shrivas, Antwi Baffour Boasiako, Sangeetha Krishanan, Thomas Yeboah
Data has become very important not only for individuals but for organizations as well. Data security is the biggest challenge that we care facing currently. Recent successful hacks and data breaches have certainly played an important role in the development of data security related technologies. Cryptography is a well adopted method to ensure that data is secure and confidentiality of user data is maintained. The content owner encrypts the actual data using an encryption key which converts the data into cipher text. The cipher text is an intermediate data which is unreadable form which can be shared amount other users and can be stored in the various storage media. The cipher text can be converted into the actual data using the same encryption key in case of symmetric key encryption or using different key in case of asymmetric key encryption. Currently, the Encryption/Decryption algorithms that exist depend on complex mathematical manipulations. The length of the encryption keys are growing and growing to get more secure and more stronger encryption thus processing throughput and memory consumption requirement is also growing. In this work researchers are focusing on various symmetric key encryption throughput and memory consumption with proposed high speed new algorithm which can be useful for the devices with low memory and processing capabilities. The work sought the possibility to trim down the complicated throughput of symmetric cryptography and ensuring maximum security at the same time. Keywords: Cryptography, Algorithms, Authentication, Cipher text, Complex Mathematical Manipulations, Encryption, Decryption, Symmetric Key.  
30 Harmonization of Thyroid Stimulating Hormone; an Alternative Approach , Izza Abdulhafedh  
Introduction: Comparison of TSH values by analysis of retrospective data obtained from daily internal quality control (IQC) runs performed concurrently on Architect i2000 and cobas e601; the two platforms used to run TSH test for patient samples at The Nairobi Hospital, Kenya. Method: Data analysis was carried out using R project version 3.2.3. Data was analyzed both in combination (N=590) and segregated as Level 2 (N= 297) and level 3 (N=293).           Results: Shapiro-Wilk normality test returned normal distribution for level 2, abnormal distribution for level 3 and combined data on both platforms. Paired T-test for level 2 and Mann–Whitney U -Wilcoxon signed rank test for level 3 and combined data, indicated that the alternative hypothesis: true location shift is not equal to 0. Deming and Passing-Bablok regression analysis for level 2 and 3 showed a significant deviation in values between the two methods by a constant. Concordance correlation of the individual levels 2 and 3 is poor. Discussion: The data demonstrates that there is a constant systematic error between the two methods, with cobas values reading higher each time, and that this difference is significant at both levels. Conclusion: Regression analysis shows transferability of results from one method to another, however, the difference in means and the poor concordance correlation obliges a consideration of the TSH value results given by the lab especially so in the subclinical range (5 – 10) mIU/ml. Keywords: Thyroid Stimulating Hormone, TSH, Architect i2000SR, Cobas e601  
31 Disclosure and Non-Disclosure of HIV Positive Status to Partners among Pregnant Women at a Regional Hospital in Swaziland , Roger Maziya, Cynthia Z. Vilakati
Individuals diagnosed with HIV often have difficulty disclosing their status to others, yet hiding the diagnosis can have serious implications. Disclosure of HIV status involves a process of decision-making, based upon numerous factors. This study was done to explore the reasons why some women disclose and some do not disclose their HIV status. The study was conducted in a regional hospital in Manzini. The researcher employed the qualitative descriptive phenomenological methodology. Convenience and purposive sampling were utilized, and the data collection methods were in-depth Interviewing methods. A total of 15 pregnant women attending antenatal care were interviewed. Most prominent reasons for disclosure of the HIV status by pregnant women attended to for the PMTCT program were that of the need to practice safer sex. Some felt the need to disclose because it would make their sexual partners to protect the unborn babies and to reduce the chances of re-infection. Most women who disclosed stated that they were so hurt by finding themselves HIV positive yet, they knew that they were faithful to their sexual partners. Some stated that they needed somebody to share the pain with. Some women stated that they did not disclose their HIV statuses out of fear of lack of support and probably domestic violence. Keywords: Disclosure, HIV, PMTCT, domestic violence, SWAGAA, antenatal care.  
32 Anticolitis Activity of Myrobalan Powder via Regulating Colonic Enterochromaffin Cells and Serotonin , Shirish Sharma, Sanjay Vaze, Harish Kumar Lalan  
Objective: To investigate whether Myrobalan powder has an anti-inflammatory effect on colonic inflammation and to explore the mechanism involved. Materials and Methods: Myrobalan powder was orally administrated to trinitrobenzene sulfonic acid (TNBS)-induced colitis mice at the dose of 3, 6, and 12 g/kg/d for 7 consecutive days. Body weight, stool consistency, histopathological score, and myeloperoxidase (MPO) activity were tested to evaluate the effect of Myrobalan powder on colonic inflammation while colonic enterochromaffin (EC) cell density and serotonin 5-hydroxytryptamine (5-HT) content were investigated to identify the effect of Myrobalan powder on colonic 5-HT availability. Results: The results showed that the body weight of colitis mice was markedly decreased by 10, 12, 14, and 17% at 1, 3, 5, and 7 days (P< 0.05), whereas stool consistency score (3.6 vs. 0.4, P< 0.05), histopathological score (3.6 vs. 0.3, P< 0.05), and MPO activity (2.7 vs. 0.1,P< 0.05) in colitis mice were significantly increased compared to that of the normal mice; Myrobalan powder treatment dose-dependently increased the body weight (7–13% increase) and decreased the stool consistency score (0.4–1.4 decrease), histopathological score (0.2–0.7 decrease), and MPO activity (0.1–0.9 decrease) in colitis mice. Colonic EC cell density (70% increase) and 5-HT content (40% increase) were markedly increased in colitis mice (P< 0.05), Myrobalan powder treatment dose-dependently reduced EC cell density (20–50% decrease), and 5-HT content (5–27% decrease) in colitis mice. Conclusion: The findings demonstrate that the anti-inflammatory effect of Myrobalan powder on TNBS - induced colitis may be mediated via reducing EC cell hyperplasia and 5-HT content. The important role of Myrobalan powder in regulating colonic EC cell number and 5-HT content may provide an alternative therapy for colonic inflammation. Keywords: Colonic inflammation, enterochromaffin cell, serotonin, ulcerative colitis  
33 The Potency of Information Technology in addressing Learning Anxiety Disorder (LAD) using the E-learning Education Framework , Ikechukwu F. Ezeugo  
The evolution of Information Technology (IT) has undoubtedly catalysed the growth and advancement of higher education through its e-learning (online) education systems. Whereas there are many valuable research works on the dynamics of the tangible and some aspects of the intangible means by which IT has played its famous roles in advancing the e-learning education system, the same cannot also be said about empirical studies that focus on identifying and evaluating solutions to certain psychological issues that critically affect many adult learners. While the IT tangible attributes include systems, tools and platforms, the intangibles are the nonphysical factors that influence designs and delivery strategies, policies within the sector, and service consumer’s preferences. Beyond the physicals, the intangible elements have significantly influenced the evolution of the e-learning education system of the information age in very critical ways, howbeit unnoticeably. Further to the popular E-learning systems’ attributes of cost-effectiveness, flexibility, availability and accessibility considered as major attractions for its rapid grow, there are the silent but salient attributes of Dynamic Personal Learning Environment whose right application is capable of offering very potent solutions to the subsisting but largely ignored challenges of Learning Anxiety Disorder (LAD). The concept of LAD is derived from Social Anxiety Disorder (SAD); and, it is construed to be a product of unwarranted self-consciousness, misappropriated Ego, severe Shyness, and Phobia resulting into learning inhibitions, disenchantment for socially-involved learning and possible diminution of cognitive abilities. Therefore, this project is set to examine the notion of Learning Anxiety Disorder (LAD), evaluate the potency of Information Technology in addressing its challenges to the adult learner; and assess available mitigation strategies through the e-learning Dynamic Personal Learning Environments features. The objective shall be to find how these can be harnessed for innovative policies and practices aimed at making the e-learning system and its products much more viable in comparison. Keywords: E-Learning, Online Studies, Open and Distance Education, socially-involved learning, Severe Shyness, Phobia, Ego, Learning Anxiety Disorder (LAD), Social Anxiety Disorder (SAD), Personal Learning Environment, Information Technology Intangible elements.  
34 Special Issues in Clinical Research: Conflict of Interest, Post Trial Drug Access and Use of Placebo in Clinical Trials   , Maduri Patel, Kannan Sridharan, Jayesh Patel, Shraddha Ghai
The aim of this study is to identify ethical issues and challenges in clinical research in India. This study provides clear picture of special ethical issues in clinical research such as conflict of interest, post trial access to investigational product and use of placebo. We examined clinical research professional perceptions on those issues. Individuals (N=385) working in field of clinical research in India have participated in the study. This study involves self administered survey research for collection of data and information from participants through their responses. The survey questionnaire was validated by colleagues and guides and experts in the field. The survey elicited responses based on general experience and opinions of clinical research professionals. Participants were given the option to complete the survey on the internet. Surveys completed via the internet were stored in Microsoft excel. For data analysis SPSS software have been used and descriptive analysis have been conducted. A total of 389 surveys were received, of which 385 were considered complete and used for this analysis. The respondents were from India, currently working in clinical research field. Demographic information pertaining to respondents such as education, type of organization age, experience etc have been collected, whether they had ethics training ever, and if yes which type of training they had. The data shows that majority have responded that they are not favouring post trial access to investigational product or it is not ethical. Further to that, participants were asked to select reasons for their opinion on post trial access to investigational product. If participant believes that post trial access to investigational drug is ethical, they have selected applicable reasons for their opinion. Majority of respondents favour use of placebo in clinical trials in general. If participant is favouring the use of placebo, further they have provided their opinion on possible steps to be taken care of in placebo controlled trial. Participants has been asked to rate the factors which can promote or causes conflict of interests in clinical trials. As per data, financial gain is the most affecting factor causing conflict of interests. Comparing responses employer wise, CROs, ECs and Study sites are rating “recruitment target” more than sponsors. The data shows that industry influence, patent or other commercial benefits are not highly affecting. KEY WORDS Placebo, Conflict of interest, post trial access, ethics  
35 Knowledge Attitude and Practice Towards Pre-M aritial/Prenatal Genetic Testing among Young People (15-45) Years of Age in Sapele Local Government Area, Delta State. Nigeria   , Iweriebor Onoiribholo Bridget
This study investigated knowledge, attitude and practice toward premarital/prenatal genetic testing among young people of 15-45years of age in Sapele Local Government Area in Delta State Nigeria. Descriptive survey research design was used. The population of the study consisted of the members of four major communities (Amukpe, Amuogoddo, Okirighwe and Uguanja). The respondents were selected by simple random sampling method. The research instrument was a self-constructed questionnaire. A total of 50 respondents were selected. A total 50 questionnaire were distributed and same retrieved. The objectives of the study were to determine level of knowledge of premarital/prenatal genetic testing among young people, to assess the level of practice and to identify factors influencing their attitude towards premarital/prenatal genetic testing. The rational is to enhance young people’s knowledge about premarital/prenatal genetic testing, encourage premarital/prenatal genetic screening and also reduces some of the factors influencing attitudes of young people towards premarital/prenatal genetic testing. Data collected were analyzed using frequency and percentages and were presented using tables and graphs. The study shows that 30% of the respondent level of knowledge of premarital/premarital genetic testing is of high level, 70% of the respondents have low level of knowledge and the source of information was through media (20%), health personnel (40%), friends (6%) etc. The study also showed that the level of practice is low as 80% of the respondent does not practice premarital/prenatal genetic testing, only 20% practiced it. it also shows that there are some factors influencing their attitudes towards premarital/prenatal genetic testing which include lack of knowledge (66%), non affordability (20%), non Accessibility (55) and also as a result of non availabilities of centers (15%) where premarital/prenatal genetic testing should be carried out. In conclusion, lack of basic knowledge, negative attitude and practice has a negative impact on the young people, their family, their community and the society as a whole. It is therefore recommended that effort should be made by government, parents, and health personnel to improve knowledge, attitude and practice towards premarital/prenatal genetic testing thereby reducing the incidence rate of having children with genetic defect.  
36 Innovative Nursing Approaches in Managing Lower Back Pain (LBP) Among the Elderly Persons. A Case Study in Maridi County, Western Equatorial State, South Sudan   , Bakoko Joyce Matua
The elderly generation, coexists with the rest of the population of the world (Jared T. Scott 2010).They suffer a great deal of several kinds of pain including lower back pain. In most cases this condition in the elderly is not managed by use of nursing interventions rather managed with other medical remedies, and yet the client spend most of their times with nurses, than, other health workers. This case study addressed the gap that could be filled by nurses by using innovative means in nursing to relieve pain of lower back in the elderly by ideal assessment then given specified nursing interventions to a specific individual, so as to avoid disabilities. Sackett et al (2000). Conclusion: Disabilities in elderly related conditions can be assessed and managed by nursing intervention hence preventing disabilities in the geriatric patients. Recommendations: Nurses needs to be trained with more contemporary skills in assessing LBP, suggesting that the knowledge of nurse with higher qualification is paramount to meet the fourth coming challenges in the management of the elderly with LBP.  
37 Donor Driven Health Systems: Reflections on the Implications for Healthcare Delivery in Nigeria   , Oyibo Patrick Gold, Ejughemre
Efforts geared towards strengthening health systems and improving health outcomes necessitated the co-operation between developed and developing countries for long term international developmental assistance for the latter. These efforts climaxed with the signing of the United Nations millennium development goals which created a platform for the ‘injection’ of billions of dollars of donor funds, technical assistance, inter alia, into countries with great need. Accordingly, there are reflections of marked achievements towards achieving the envisaged objective(s) in recipient countries such as Nigeria. In fact, the impact of donor support for health system strengthening in Nigeria has being remarkable with funding to combat major health problems reaching unprecedented levels in recent times with improvements on certain fronts. Of such include, decrease in the prevalence of HIV/AIDS, Tuberculosis and the eradication of guinea worm, as well as capacity development and health facility infrastructural upgrades. Nevertheless, these obvious gains have not being without issues of concern hitherto. Cardinal amongst these is that not all the developmental support is reaching communities with the greatest of needs or being delivered in a manner that is proving effective. More so, are the issues of corruption, abdication of co-operate social responsibilities by the government in certain instances to donor partners, as well as the rising ‘ineptitude’ in many of the recipient communities that has fast created a climate were self-reliance is being ebbed into a place called the past. The argument therefore is that the merits and demerits of donor support for health system strengthening in Nigeria has created debates, needing further reflections thereof.  
38 Awareness of Ebola Virus Disease Among Non-Doctor Hospital Staff in Bassa Local Government Area of Kogi State   , Okebugwu Andrew Nwachimere-eze
The objective of this study was to assess the level of awareness amongst non doctor hospital staff in Bassa L.G.A of Kogi state on the subject of Ebola Virus Disease. Methodology: A descriptive cross sectional study design was used. A well structured self-administered questionnaire was given to 278 consenting health staff in Bassa L.G.A selected by a multistage sampling technique comprising of clustering and simple random sampling. The results were collated and analyzed manually. Results: A total of 278 health staff drawn from different departments completed the questionnaire. 58.2% of respondents respectively, were between the ages of 21 and 30 years and first degree holders. All the respondents have heard of Ebola Virus Disease. 83.5% heard of it from electronic media such as radio and television. 74.8% respectively knew that  it is caused by Ebola virus, can occur both in the rural and urban areas, putting on protective wears each time one visits an Ebola patient or during routine clinical work can protect one from the virus and that Ebola has no cure. 66.5% knew that everyone is at risk of contracting the disease and that confirmation is by laboratory assays. 91.7% knew that the incubation period is between 2 and 21 days, the same number knew that high fever is an early symptom. 50% of the respondents knew vomiting and bloody diarrhea as late symptoms. None of the respondents knew the location of the laboratories in Nigeria. Conclusions: the result shows a below average awareness about Ebola virus Disease among these health workers. However, more awareness is needed in certain areas. KEYWORDS Ebola virus disease, Awareness.  
39 Patients’ Satisfaction in Public and Private Hospital of Morang District Nepal: A Comparative Cross-Sectional Study   , Anil Sigdel
Patient satisfaction is a multidimensional aspect, represents a vital key marker for the quality of health care. The objective of the study was to compare the level of patients’ satisfaction among public and private hospital. A cross sectional comparative was conducted in two hospitals of Morang District i.e. one public and one private hospital selected purposively. Patients discharged from different wards were selected by consecutive sampling method and exit interview was performed. The sample of study was 220. The written consent was taken before the interview. 5 points Likert scale was used for measuring patients’ satisfaction. Discharged slip was checked for the maintaining validity and Chronbach’s Alfa was calculated for ensuring reliability of tools. Coding, entry and analysis was done in SPSS version 16. A median score of 148 was used as the cutoff point for defining the level of patients’ satisfaction. Patients in public hospital were more satisfied (61.8%) than those of private hospital (37.27%) and the difference in level of satisfaction and type of hospital found to be statistically significant (p<0.001).Moreover, the patients in public hospital were more satisfied with overall cost of health services (OR=30.83, CI 95%:13.014-73.05), laboratory and registration facilities (OR=2.805, CI 95%:1.628-4.833) and other facilities of hospital (OR=8.35, CI 95%:4.31-16.196) compared to private hospitals. Patients in public hospital were more likely to be good satisfied compared to public hospital and the important reasons for this was found to be high cost of health services in private hospitals and lack of health insurance provision. KEY WORDS Patients Satisfaction, Comparative, Public, Private, Hospital  
40 Assessing Botswana’s Preparedness in Dealing with Natural Disasters   , Tinashe Ashley Sibanda Mutize
Natural Disaster - Any event or force of nature that has catastrophic consequences (1) Disaster – Any event that would disrupt the normal pattern of activities in a given area as a result of interaction between hazard and human population. This results in loss of life, injury, economic and social hardships. Disaster risk – The potential disaster losses in lives, health status, livelihoods, assets and services which could happen in a specified community Disaster management – An integrated series of activities and strategies (prevention, mitigation, preparedness, response and recovery) implemented within the context of national development Disaster mitigation – refers to the plans, strategies and actions taken to reduce the vulnerability of a population to a future disaster threat Disaster preparedness – refers to the plans and actions taken to ensure an effective response to a disaster that may occur in the future Emergency response – refers to the actual operations and actions that are taken s soon as a disaster strikes. These are aimed at providing assistance and support to the affeceted population and area. Recovery – refers to all the actions that are taken to return the affected population to normal life and to phase in mitigation measures to help with better protection in the futureNatural Disaster - Any event or force of nature that has catastrophic consequences (1) Disaster – Any event that would disrupt the normal pattern of activities in a given area as a result of interaction between hazard and human population. This results in loss of life, injury, economic and social hardships. Disaster risk – The potential disaster losses in lives, health status, livelihoods, assets and services which could happen in a specified community Disaster management – An integrated series of activities and strategies (prevention, mitigation, preparedness, response and recovery) implemented within the context of national development Disaster mitigation – refers to the plans, strategies and actions taken to reduce the vulnerability of a population to a future disaster threat Disaster preparedness – refers to the plans and actions taken to ensure an effective response to a disaster that may occur in the future Emergency response – refers to the actual operations and actions that are taken s soon as a disaster strikes. These are aimed at providing assistance and support to the affeceted population and area. Recovery – refers to all the actions that are taken to return the affected population to normal life and to phase in mitigation measures to help with better protection in the future
41 Dietary Diversity and Its Effect on Anaemia Prevalence Amongst Tea Tribe Adolescent Girls in Dibrugarh District of Assam, India   , Tulika Goswami Mahanta, Bhupendra Narayan Mahanta, Pronab Gogoi, Jenita Baruah
OBJECTIVE Effect of Dietary diversity and other intervention in prevalence and determinants of anaemia amongst tea tribe adolescent girls. DESIGN A community based before after intervention study was conducted covering 16 tea estates of Dibrugarh District, Assam. PROCEDURE Variables includes socio-demographic, environmental, anthropometry, history of present and past illness, clinical examination and laboratory investigation including haemoglobin, serum ferritin, haemoglobin typing and routine stool examination and dietary survey using 24 hour recall method and food frequency questionnaire. Interventions given were dietary diversification, health promotion by monthly NHED, cooking demonstration, cooking competition and kitchen garden promotion and counselling to improve IFA compliance and remove barriers and directly observed weekly IFA supplementation. SPSS and EpiInfo software, used to calculate of rates, ratios, chi-square test, Fisher Exact test and multiple logistic regression analysis. RESULTS Enrolments were 802, with mean age, 14.8 years. Anaemia prevalence was 96.3% with median serum ferritin, 22.9 ng/ml. Prevalence of Sickle cell anaemia was,12% and helminthiasis 84.20%, night blindness (5.6%), weakness (62.1%), loss of appetite (37.5%), gum bleeding (23.6%), loose motion (13%), loss of weight (9.9%), menstrual problem (19.3%) was common. Following intervention mean haemoglobin difference was 1.48 gm/dl with 13.5% difference in prevalence. Significant association found with worm infestation, lower serum ferritin, insanitary water-sanitation facility and extra salt use, indicating infection, infestation and iron deficiency as major cause of anaemia. Dietary diversification found effective. CONCLUSIONS High anaemia prevalence requires urgent attention. Implementation of different intervention in an integrated manner was found effective. KEYWORDS Dietary diversification, Anaemia, tea tribe, adolescent girls, Iron folic acid supplementation (IFA), Assam.  
42 Hygiene and Sanitation Practices in the Collection, Treatment and Preservation of Potable Water in Santa Town, North West Cameroon. , Bodzewan Emmanuel Fonyuy  
Access to safe drinkable water has improved over the last decades in almost every part of the world, but approximately one billion people in Africa still lack access to safe water and over 2.5 billion lack access to adequate sanitation. In large parts of the world, humans have inadequate access to potable water and use sources contaminated with disease vectors, pathogens or unacceptable levels of toxins or suspended solids. Drinking or using such water in food preparation leads to widespread acute or chronic illnesses and it is a major cause of death and misery in many countries. As such prevention of water borne diseases is a major health goal in developing countries (Fawell J & Chipman K, 2010). The health burden of poor water quality is enormous with an estimated 37.7million individuals affected by water-borne diseases; annually 1.5 million children are estimated to die from diarrheal-related diseases each year (WHO, 2012). The developing countries in the world still face the problem of water scarcity with Africa having the largest number of countries encountering these problems. Due to water scarcity, many families tend to store water in their home for long term use. Most families have inadequate knowledge or are ignorant on the duration of the storage and the type of container or vessel used in the collection and storage of drinkable water. Inhabitants in Santa town in North West region of Cameroon experience inherent episodes of water shortages all round the year prompting household to fetch, store and consume water from doubtful sources. A study was carried out to assess the knowledge and practices of the inhabitants of Santa town in the collection and preservation of potable water in order to avert the occurrence of water-borne diseases. Primary data was collected with the use of a structured questionnaire with open and close-ended questions, administered by the researcher and co-researchers to the study population in the randomly selected quarters using cluster sampling. A sample size of 110 households was recruited for the study. Results show that 68 (58.18%) of respondents defined drinkable water as water safe enough to be consumed with low risk of harm, 24 (21.8%) defined it as water which originates from pipe borne water while 16 (14.5%) said that it is water from any natural source. On the criteria used in the identification of unsafe water, 68 (58.18%) said they identified water which is not safe for drinking from its color, taste and odor; on the issue of water protection and preservation from contaminants, 58(52.7%) of the responses were that they lacked containers for their drinking water, 32(29.5%) said they lacked chemicals and filters to treat their water, while 14(12.9%) did not have knowledge in the protection and preservation of potable water while 06 (5.5%) said that the problem they encountered was the presence of children playing around drinkable water sources and water storage containers. From the data collected, and analysis made it be can be concluded that there exist inadequate knowledge on the protection and preservation of potable water. Their understanding of the notions of hygiene and sanitation, the knowledge and practices on the collection and preservation of potable water are not based on the level of education but on how much public health information they got about drinking water collection, treatment and preservation. So, an up-to-date, knowledge and practices on the collection, treatment and preservation of potable water is necessary for the wellbeing of the Santa community. The Council’s hygiene and sanitation service should take it as duty function to organize regular public health education lectures in social institutions in order to enlighten the community.  
43 Attitudes and Practices of Health Care Workers Towards HIV Positive Patients at the Federal Medical Centre Owo Ondo State Nigeria , Ebenezer Obi Daniel  
PROBLEM: Nigeria has an estimated 3.6 million people with HIV/AIDS and is home to one out of every11 people with HIV/AIDS worldwide. In Nigeria, as elsewhere, AIDS is perceived as a disease of “others” – of people living on the margins of society, whose lifestyles are considered “perverted” and “sinful.” Discrimination, stigmatization, and denial are the expected outcomes of such values, affecting life in families, communities, workplaces, schools, and health care settings. OBJECTIVE: The study was designed to determine the attitude and practices of health care workers towards HIV positive patients at the Federal Medical Centre Owo , Ondo State, Nigeria. METHODS: The study was carried out at Federal Medical Centre Owo in Ondo State, Nigeria. A descriptive cross sectional survey of all seven categories of health-care workers in the centre was conducted. Each category of health care workers; Doctors, Nurses, Pharmacists, Physiotherapists, Medical Laboratory Scientists, Health Information Managers and Medical Imaging Scientists was taken as a sample unit. Sample size proportional to the size of each unit was selected using simple random sampling in order to make the calculated overall sample size. Data was obtained through the use of structured, self-administered questionnaire. Summated scores were used to assess respondents’ attitudes and practices towards HIV positive patients. Data analysis was done using the Statistical package for Social Science (SPSS) version 17. Data were presented using descriptive statistics of frequencies, percentages, pie and bar charts. Inferential statistics of Chi-square was used to test for associations between various factors and the attitude and practices of health care workers towards care for patients with HIV. Statistical level of significance was set at P-value <0.05. An approval to conduct the study was obtained from Research Ethics Committee of Federal Medical Centre, Owo. Participants were allowed to give their consent in writing before participating in the study. OUTCOME: A considerable percentage (31.8%) of 252 respondents has varying degrees of poor attitude, while almost half (48.8%) have poor practices towards HIV positive patients. Exposure to blood and other body fluids or injury as a result of work in the last one year, was found to be significantly associated with the attitude of health care workers towards HIV positive patients (P<0.05). It was also revealed in this study that, there is a statistically significant association between sex, professional status of health care workers and practices towards HIV positive patients (P<0.05). This study also showed that 37.7% gave varying degrees of poor responses to the preventive measures towards discrimination against HIV positive patients. This study recommended the inclusion of HIV/AIDS education in the training curriculum of schools attended by all health care workers, continuous education/counsel of health care workers on HIV/AIDS, creation of HIV/AIDS policies in all hospitals, further research on the study, and that all health care workers should serve as examples in the crusade against discrimination of HIV positive patients.  
44 An Assessment of Medical Waste Management in Bawku Presbyterian Hospital of the Upper East Region of Ghana. , Francis Abugri Akum  
Background Medical waste unlike other ordinary waste poses serious health risk to the handlers, health staff, patients and the community. The area of medical waste management is neglected in most health care facilities in Ghana. The main objective of the study was to assess the Medical Waste management practices in Bawku Presbyterian Hospital of the Upper East Region of Ghana. Methods The study used structured questionnaires, observation checklist and key informant interview guide to collect data from management staff and waste workers. Results It was observed that there was low knowledge about medical waste among waste workers. Medical waste is not segregated, waste containers not coded/labelled, no secured storage area for waste, no budget specifically for medical waste management and no waste management manual in the hospital. Conclusion This study has shown that, waste management in the hospital is poor and has health implications to the handlers, staff, patients and visitors. Keywords: medical waste, Bawku Presbyterian Hospital, waste segregation, waste storage.  
45 A comparison of knowledge of diabetes mellitus between patients with diabetes and healthy adults: A survey from north Malaysia , Sophonie Ndahayo  
The purpose of this study was to assess and compare the knowledge of diabetes mellitus possessed by patients with diabetes and healthy adult volunteers in Penang, Malaysia. A cross-sectional study was conducted in. A 240 sample randomly selected (120 patients with diabetes mellitus and 120 healthy adults at a shopping complex participated in the survey. Data collection was done through face-to-face interviews. A30 items questionnaire facilitated data collection about diabetes mellitus. The results showed that patients with diabetes mellitus were significantly more knowledgeable than the healthy group on the following aspects: risk factors, symptoms, chronic complications, treatment and self-management, and monitoring parameters. Educational level was the best predictive factor for diabetes mellitus and public awareness. In conclusion, knowledge about diabetes mellitus should be improved among the general population. The study has key practice implications as it served as a baseline for the design of educational programmes for diabetics and a health promotion programme for the healthy population in general, and especially for those at high risk.  
46 A study to determine the factors affecting the effective management of third stage of labour in some selected health facilities in Adamawa State Nigeria , Ukwo Joy Michael  
Most maternal deaths are avoidable through the use of known interventions. However, those interventions are often inaccessible to many of those in need. As with most African communities, Hemorrhage (of which postpartum hemorrhage is most common) is the leading cause of maternal mortality in Adamawa State. Postpartum hemorrhage is mainly caused by complications arising during the third stage of labor. Effective management of the third stage of labor has the potential of significantly reducing maternal mortality. The process, component and the effects of services offered in the management of third stage of labour in Adamawa state has been under-investigated.  Understanding the process and effects of management of third stage of labour and factors associated with poor outcomes is key to designing effective policies and programme to reduce maternal deaths and improve maternal health status[i]. The aim of this research is therefore to fill the gap in present understanding of factors associated with maternal deaths that occur as a result of the management of the third stage of labour in Adamawa State in order to make evidence-based recommendation for improved programmatic intervention.  
47 Knowledge, Attitude and Practices of Breastfeeding of Mothers in Rural and Urban Settings in the Federal Capital Territory, Nigeria , Ogundana Adejoke Esther Aderonke  
Breastfeeding is a very important way of providing the needed food and nourishment for the healthy growth and development of babies or infants. It is also relevant in the reproductive health of mothers. Breastfeeding is an attitude inherited from generations in Nigeria. There are so many cultural beliefs attributed to breast feeding in communities in Nigeria which may have affected breast feeding practices. It was a culture in our society for a woman to breast feed her baby for 3years before weaning the baby but now most nursing mothers breastfeed their babies for 1 year while some breastfeed for less than a year. WHO gave the recommendation that mothers worldwide are to breastfeed their infants exclusively for the first six months to achieve optimal growth, development and health, after which complementary foods that are nutritious could be given to the baby and to continue breastfeeding until two years or beyond. In 2009, a review of the evidence on exclusive breastfeeding was conducted by WHO and UNICEF with the findings advocating that exclusively breastfeeding infants with only breast milk and no other foods for six months has several advantages which includes; lower risk of gastrointestinal infection for the baby, rapid maternal weight loss after birth, and delayed return of menstrual periods in the mother.  
48 The Impact of Social and Cultural Factors on Population Health , Floris Rosalyn Gordon  
Background – Chronic disease has now become a major contributor to mortality, the increase in risk factors has had serious impact on health. Much attention has been paid to healthy lifestyle and the need for behavior change. Behavior is transitioning in many developing countries due to urbanization, improved income and access to technological advances. This has resulted in increase in risk factors such excessive alcohol consumption, smoking and inactivity. More persons are seeking processed and prepackaged meals and consuming more food leading to obesity. Objective – The objective of the project is to provide a critical look at the social and cultural factors and how they impact health. To explore how health promotion and there interventions impact on the prevalence of these risk factors. Method – This study will explore at least 10 published articles on this topic the impact of risk factors on health and strategies used to reduce the occurrence of these factors. This review will provide information required to provide recommendations to address prevention of risk factor development. Results – Results across different studies show that lifestyle behavior influences the development of risk factors. Unhealthy behavior like smoking, excessive alcohol consumption and inactivity is associated with obesity, elevated blood pressures and ultimately the development of chronic illnesses like cardiovascular disease and cancer. Conclusion – Risk factors such as smoking, alcohol consumption and inactivity influence the occurrence of chronic illnesses. Surveillance for risk factors must be done and health education must be used as an intervention strategy to prevent the development of risk factors to reduce mortality.  
49 Attitude and Behaviour of Users of Motorcycle Towards the Use of Crash Helmet in Ado-Ekiti, Nigeria. , Pius Izundu Okpoko  
Introduction: There is a major and growing public health concern in preventing serious injuries and deaths from motorcycle crashes. The judicious use of motorcycle crash helmet is a proactive approach to preventing head injury among motorcycle users. The objective of this study is to determine the attitude and behaviour of users of motorcycle towards the use of crash helmet in Ado-Ekiti, Nigeria. Method: This is a cross-sectional study design that made use of quantitative survey method involving data collection and analysis. There were 283 voluntary adults who were randomly recruited within Ado-Ekiti metropolis. A semi-structured questionnaire was administered to participants who also consented to the survey. Results: There were 283 returned and analyzable questionnaires out of 321. The modal age group was 21-30 years (42%). There were more males, 209 (73.9%). Majority of the respondents were single (55.1%). There were more Students, 92(32.5%), in the study. Two hundred and forty respondents (84.8%) believed that it is necessary to use crash helmet. The frequency of self-reported helmet use was 171(60.4%). Seventy percent of respondents believed that helmet use should be made compulsory. Various reasons for non use of helmet include too heavy 99(35.0%), fear of contracting disease 93(32.9%) and not protective 24(8.5%). Conclusions: This study highlighted that a far greater number of respondents believed that the use of crash helmet is necessary for safety and should be made compulsory. Nevertheless, the discomfort which is associated with wearing a crash helmet and perceived risk of contracting infection from helmet use were the main negative factors militating against helmet use. Key words: Attitude, Behaviour, Crash helmet, Head injuries, Motorcycle, Users.  
50 The health status of maternal and children under five in Gozarah district belonging to Herat province west part of Afghanistan by Catchment Area Annual Census (CAAC) survey in 2013. , Ehsan Ahmad
Afghanistan's health status was one of the worst in the world before 2002 ( UNICEF 2002) Fortunately after that there are many change during the recent years with some positive intervention and revised Basic Package of Health Services ( BPHS) by ministry of public health of Afghanistan and decreased maternal and children mortality rate, The under-5 mortality rate for Afghanistan excluding the South zone for the 2-6 years prior to the survey is 97 deaths per 1,000 births, and the infant mortality rate is 77 deaths per 1,000 births(Afghanistan Mortality Survey( AMS 2010).  
51 The relevance of Financial Statements and Its Impact on Organizational Performance: A case study of Atwima Mponua Rural Bank , Eric Kwame Buah  
This paper investigates the relevance of financial statements on Rural and Community Bank performance. Rural banks are the main source of financial service in rural sub- Saharan Africa and their services are mostly patronized by persons with little or no level of education. The study is therefore examining their level of knowledge on financial performance of the rural bank in which they are investing. The data was collected from a sample of one hundred and eighty respondents using questionnaires and face to face interviews conducted with management staff of the bank and used for analysis. The statistical tools employed in assessing the relevance of financial statements on the performance of Atwima Mponua Rural Bank were Mean distribution, coefficient of variation and regression analysis. The results indicate that the bank has been giving account statement quarterly or yearly to its customers. Findings of the study indicate that the bank post its annual financial statement to customers or post it on the bank’s notice board. Then, it is found that the bank organized annual general meetings to explain its financial statement to its customers. It is therefore concluded that there is no evidence to ascertain that knowledge on financial statement is relevant to organizational performance. It is recommended that this study will be extended to other rural banks in the country to help assess the findings of this study. Keywords: Financial Statements, Performance, Atwima Mponua Rural Bank, Case study  
52 Crime Propensity Indices of the Urban Dwellers in Dapitan and Dipolog Cities , Clarita D. Bidad, Leonardo D. Cainta
This study aimed to determine the crimes of urban offenders in the Cities of Dipolog and Dapitan that may be attributed to poverty during the year 2005-2010. The subjects of this study were two hundred eighty nine inmates in Dipolog City Rehabilitation Center and one hundred twenty three inmates in Dapitan City Rehabilitation Center.Results of the study revealed that the most common crimes committed which were related to poverty were: violation of RA 9165, sec.5,11, and 12 (drugs related), robbery, murder/frustrated murder, theft, violation of RA 6539 (anti-carnapping), estafa, and homicide/frustrated homicide in the order of decreasing propensity. It was further revealed that crimes were committed to make life better, sustain family needs and support drug habits. KEYWORDS: Crime propensity index, Poverty, Urban poor
53 Agriculture –Based Alternative Livelihood for the Depressed Communities in Zamboanga Del Norte   , Wilson C. Nabua, Edwin Templado
Depressed communities in Zamboanga del Norte namely; La Libertad, Siayan and Godod, are agricultural communities. The study identified low productivity as the main reason for the low income of the families in the communities. Low productivity in turn was linked to the farming practices, general topography of the farming communities and marketing practices. The paper proceeds to evaluate alternative agricultural production system as well as livelihood that hinge on agricultural food processing towards enhancing the economic productivity of these communities. KEYWORDS: Agricultural production system, poverty, food processing
54 Disparate Policies in Social Education Practices Damage Social Peace   , Dr Jakir Hossain
Educational policies and practices in Bangladesh are dominating issue in terms of managing educational establishments. Disparate policies and practices in educational profession are prone to damaging social peace has become apparent in the writing and study. Education is the destiny for a nation and a core field that helps the nation develop all sections of activities and make fit her citizens as a rich nation. The study has got several issues of importance and found that worthy citizens who boys and girls must be educated well and bring peace or prosperity if they are well equipped with factors like supports and facilities which beget merits, talents, skills and expertise and on the contrary, abuses of law, quota systems for employments and education, discriminatory treatments in legal issues towards boys who could not contribute more and more to building the nation but have very less scopes for success due to readymade obstacles. The crimes and corruptions, injustice, aggressive feminism policies, political undue scopes, illiteracy and ignorance, poverty of boys and later as men grow in alarming rates as a result of depriving them of their rights and opportunities at early stages as citizens of the country. All supports and facilities such as free education up to graduation levels, stipends, food for education programs and legal supports only for girls students who easily achieve the opportunities in education and employments have been issues of controversial behaviors. KEY WORDS Discrimination, Free education, Stipend, Quota, Ignorance, Talent, Crimes, Feminism
55 The Effects of Motivation on Workers Performance (a Case Study of Panas Pharmaceuticals Pvt. Ltd., Ganapur, Banke)   , Subarna Budhathoki,
The main focus of this research is to find out the effects of motivation on workers performance in Panas Pharmaceutical Pvt. Ltd. An effort have been made to evaluate the existing workers motivational policies in Panas Pharmaceutical with a view to examine the effects of motivation on worker productivity increase and also to identity the variable that are directly or indirectly responsible for workers performance, while assess how motivation come into play in Panas Pharmaceutical Pvt. Ltd. The researchers however, observed that most of the motivation Policies in the company were not adequately function and the little policies that are function were inconsistent and irrelevant for workers needs and desired in Panas Pharmaceutical. In making these findings possible, thirty (30) respondents were presented with questionnaires, out of sixty (60) work force of the company and translated their responses into tables using simple distribution and percentages. Therefore, it has been proved that motivating workers sufficiently with relevance incentives as the only alternative towards workers performance to achieve goal and objectives of the organization. On the basis of these findings, implications of the findings for future study were highlighted. KEYWORDS Effects, Motivation, Workers, Performance
56 The Relationship among Work System, Workplace Hazards and Employee’s Behaviour: A Study of Selected Staff of Nigeria Eagle Flourmill, Ibadan   , Oludele, M. Solaja
The study examined the relationship between work system, workplace hazards and employees behaviour. It aimed at addressing the issue of how work can be structured in order to reduce workplace hazards and produce affirmative employee‟s work behavior. The study uses survey research method. Participants in the study were 120 staffs of Nigerian Eagle Flourmill, Ibadan who were selected through stratified and simple random sampling techniques. Data were collected via responses elicited using the questionnaire instrument. Results show that there is a significant relationship between work system, workplace hazards and employees behaviour. The findings were discussed with reference to relevant empirical literatures, and with recommendations for management of organizations both for practice and future research highlighted. KEYWORDS Work system, workplace hazard, employees, behaviour, organization
57 Discrimination and Abuses: The impact on the Mental and General Health Conditions of Gay, Lesbian, Bisexual, and Transgender Populations in Ghana , Nathaniel Acolatse
Despite the growing acceptance of lesbian, gay, bisexual, and transgender (LGBT) in the world, homosexuality in Ghana is illegal. LGBTs in Ghana are subjected to myriads of discrimination and abuses. The purpose of this study was to examine the impact discrimination and abuses faced by the LGBTs have on their mental and general health conditions. A total of 494 self-identified LGBTs, recruited via non-probability sampling technique of snow-ball participated in the study. The survey included four categories of survey items: demographic information, forms of discrimination and abuses, general health, and mental health. The findings of the study indicated that the major forms of discrimination and abuses faced by the LGBTs are of legal, social and employment forms. The findings of the study revealed that LGBT individuals in Ghana experience somatization, depression, and anxiety several days. On the contrary, a significant proportion 218(48.3%) of the LGBTs considered themselves to be in good general health condition. A simple linear regression analysis performed to examine the impact the discrimination and abuses faced by the LGBTs have on their mental and general health conditions revealed that the legal, employment, and family discrimination and abuses faced by the LGBTs have a detrimental effect on the psychological distress of anxiety, somatization, and depression of the LGBTs. It is recommended that policies and laws against LGBTs in Ghana be changed to allow for their acceptance, otherwise LGBTs in Ghana will continue to experience discriminations and abuses which will have negative effects on their mental and general health.
58 An Assessment of the Knowledge, Attitudes and Care Practices of Health Workers on Mental Health Persons Living with HIV/AIDS , Edna Chirwa Simwinga
Evidence has shown that socioeconomic inequalities are an important topic in politics, social sciences and public health research. The common trend is that individuals from low socioeconomic backgrounds are often deprived of essential commodities, in the form of service, that are critical to their wellbeing. Nonetheless, little but surely, these deprivations result in affecting the psychological health of the victims and ultimately may end up causing mental dysfunction. It is against such hypothesis that many scholars have established the link of SES as being a powerful risk factor of mental illness. In light of the above, this study aimed at exploring the association of SES, home environment, HIV/AIDS and mental illness. A more specific approach was to assess the knowledge, attitudes and care practices of health workers on mental Health Persons Living with HIV/AIDS (PLWHA). A mixed method approach was used to carry out this investigation, however, much embedded on the qualitative approached. The study collected primary data study participants through the use of a semi-structured interview guide. The study participants included Nurses and Clinical Officers in Health Centres in Lusaka urban and rural, as well as relatives of the mental health patients. Consent was sought from the ministry of health to conduct the study and all study participants were consented before participating in the study. The study revealed that health workers had adequate knowledge on HIV/AIDS; however, there was evidence on negligence in provision of health care towards mental persons living with HIV/AIDS. Despite a lot of health care reporting to have had training on care for HIV/AID persons (90%), the findings revealed that some of them had a negative attitude towards caring for persons living with HIV/AIDS and this affects the quality of care. This study provides strong evidence that SES impacts the development of mental illness directly, as well as indirectly through its association with adverse economic stressful conditions among lower income groups.
59 Modern Movement and the Debates of Tradition and Modernity in Iran , Hamid Aghaei Rad
This article considers and analyses the historical events of 200 years (i.e., 1779–1978) and two dynasties: the Qajar and the Pahlavi in Iran. Arguments proceed chronologically. The main intentions of the leaders of the modern movement, social modifications and related criticisms are analysed. From a historical point of view, this article explores the history of the modern movement and the debates around modernity in Iran. From an analytical point of view, this article considers the background of Iranian criticism against Westernisation and analysed the situation that led to raising the debate on modernity. Criticisms against modernity are considered in this essay. In addition to eco-social changes, it explores criticisms about modernity in different fields such as philosophy and literature. This essay also highlights that from a philosophical point of view Gnosticism became important as an alternative to Westernism. In this respect, the perspective of Nasr, an avant-garde scholar, is outlined. Keywords: Modern movement; westernism; Gnosticism; history of Iranian modernisation; Social modifications and its impact on Iranian architecture.  
60 The COVID-19 Pandemic and Mental Health: A Systemic Review , Irin Hossain, Ashekur Rahman Mullick, Ayesha Haidar, M M Aktaruzzaman
This review study aims at discussing about the mental health condition during COVID-19 occurrence among health-care professionals, patients and mass population. The COVID-19 pandemic has been rapidly spread in China, USA, Italy, France, Spain and other Asian and European counterparts. This COVID-19 pandemic has aroused increasing attention nationwide. Patients, health-care professionals, and the mass population are under unmeasurable mental pressure which may lead to different types of mental health problems, such as anxiety, fear, depression, and insomnia. According to the World Health Organization (WHO), mental health includes "subjective well-being, perceived self-efficacy, autonomy, competence, inter-generational dependence, and self-actualization of one's intellectual and emotional potential, among others”. The WHO further states that the well-being of an individual is encompassed in the realization of their abilities, coping with normal stresses of life, productive work, and contribution to their community. It was a systemic review study regarding mental health problems due to COVID-19. We gather total 29 articles related to COVID-19 and mental health using different search portal like PubMed, Google Scholar, Nature, Lancet. After proper literature review only 8 literatures which were related to this study were taken for this systemic review purpose. Public health and mental health specialist have reached a decision about the severe mental illness during the COVID-19 outbreak among health-care professionals, patients and mass population. But, the rapid spread of the COVID-19 has emerged a serious challenge to the mental health service in COVID-19 affected countries.
61 Knowledge, Attitudes and Practices of Postoperative Pain Assessment and Management among Health Care Practitioners in Cape Coast Metropolis, Ghana , Richard Sarfo-Walters
Postoperative patients experience moderates to severe pain within first 48 hours and this minimizes comfort. This study aims to establish level of nurses’ knowledge, attitudes and practices of postoperative pain assessment and management in Cape Coast. A descriptive quantitative, cross- sectional research design was used. A purposive sampling technique was used to select a sample of 200 nurse anaesthetists and registered nurses from Cape Coast Teaching Hospital and Cape Coast Metropolitan Hospital, Central Region, Ghana. The respondents’ knowledge, attitudes and practices of postoperative pain management were evaluated using opened and closed-ended questionnaires. The findings of the study revealed, more than half of the respondents stated that postoperative pain is best told by the patients themselves but significant number 34% stated health care practitioners can best tell patient pain intensity. Less than half of the respondents observed the effect of pain medication on patients. Almost half of the respondents agreed patients would be addicted when they are given opioids analgesics. It was concluded that there were adequate knowledge of postoperative pain assessment and management among respondents but there is knowledge gap with regards to who best tell if patient experiences pain or not. Knowledge and practices of postoperative pain assessment and management were statistically significantly related and there is a strong relationship between knowledge and practice of postoperative pain assessment management. It was recommended that pain assessment and management should be done before and after administration of analgesia. Pain medications such as opioids should be given as and when necessary.  
62 Factors Influencing Student Nurses’ Clinical Learning during their Clinical Practice at Rusangu University, Monze campus, Zambia , Benius Kaliyangile, Catherine M Ngoma
63 The Impact of Different Learning Methods on Nursing Students Learning Styles at the University of Lahore, Pakistan , Muhammad Afzal, Tazeen Saeed Ali, Syed Amir Gilani
Blended learning (BL) is positive development in education. This method provokes the learner’s critical thinking and given different ways for implementation of their knowledge in real life. The objective of the study is to determine the difference of blended learning teaching strategy and lecture-based teaching strategy on the learning outcome of the undergraduate nursing students in Lahore, Pakistan. Quasi experimental study design was used by utilizing control and experimental groups for comprising two methods of students learning. 197 participants were recruited in control group and experimental groups. The study sample was determined through the convenient sampling method. In this study the establishing reliability and construct validity of the tool was 0.7 and 0.75 respectively. In addition to this internal consistency Cronbach's coefficient alpha was computed 0.70. Generally, the reliability and validity were considered acceptable and satisfactory above 0.70. The results findings revealed that blended learning has significant relationship with awareness (p= < 0.02) learning strategies (p= < 0.07) learning activities (p=< 0.06), evaluation (p=0.04) among the experimental groups. In the conclusion, blended learning significantly improves the learning of the students and provides the space for better skills in the clinical setting simultaneously. Thereafter, institutions, policy makers and regulatory bodies should incorporate this strategy in the nursing curriculum in Pakistan.  
64 The Perception of Instructors and Learners' in Expertise Building in Vocational Courses in Ghana , Mustapha Bin Danquah
The main objective of the study was to ascertain the perception of instructors and learners regarding the role of supervision on expertise building in building construction course in vocational institutes in Ghana. The study adopted a descriptive survey research design and it was carried out at Cape Coast Technical Institute. Utilizing a simple random sampling technique, 90 students were selected while purposive sampling was adopted in the selection of the 10 teachers for the study. This means, in all, 100 participants were selected for the study. A questionnaire was the major instruction for data collection for the study. The result of the study shows that the teachers and several students strongly believe and were convinced that supervision of instruction can be instrumental to the development of expertise in building construction. It facilitates students understanding of valuable aspects of building construction; develop the right attitude and requisite skills. Given the above findings, it is recommended that instructors should be abreast the latest pedagogical approach in building construction to acquaint teachers with a practical yet simple way of imparting requisite skills in building construction students. Also, teachers of building construction should be cooperative with supervisors, be open and willing to adopt the constructive recommendation of supervisors and refrain from teaching student in an autocratic manner. It is also important for building construction teachers to be abreast with the latest information on building construction to build students' expertise valuable for the labour market.  
65 Features of Problem Based Learning Lesson Plan That Fits into the Realities in the Teaching and Learning of Mathematics for Pre-service Teachers in Ghana , Eric Sefa Boye
The traditional method of teaching Mathematics has been criticised by researchers as learner passive paving the way for Problem Based Learning (PBL) strategy into the teacher education curriculum in Ghana. This development has aroused concerns about the effectiveness of lesson plans designed for teaching using the traditional method. Consequently, the introduction of a PBL lesson plan that is learner-centred, interactive, and involves the cooperation of learners in small group activities has become indispensable. The study seeks to determine the features of the PBL lesson plan that fits into the realities in the teaching and learning of Mathematics for pre-service teachers at the colleges of education in Ghana. The methodology employed in this study involved a literature review of a traditional lesson plan for pre-service teachers in Ghana alongside a proposed PBL lesson plan for pre-service teachers through a qualitative analysis before the enactment of the instructional process. The result and discussions of the two lesson plans placed the PBL lesson plan as a more constructive and a deeper reflection of the three domains of learning (cognitive, affective, and psychomotor) which are crucial in stating instructional objectives and for teaching Mathematics. The paper recommended that the PBL strategy should be integrated into the teacher education curriculum in Ghana since its features better fit into the realities in Mathematics education in Ghana.  
66 Mobile Learning Support in Delivering Distance Education: Perception of Students of University of Cape Coast, Ghana , Douglas Yeboah, Paul Nyagorme, Kwaku Barfi
This paper explored the perception of University of Cape Coast distance education students on the use of mobile technologies to facilitate interactions among students and tutors as a learning-support system. The paper aimed at establishing whether distance education students would accept to be taught using a blend of mobile technologies and biweekly direct face-to-face tutorials on weekends. A questionnaire was used to collect data from a sample of 300 students pursuing various Diploma, Bachelor’s and Master’s degrees by distance at University of Cape Coast using systematic sampling technique. The data was analysed using descriptive statistics. It was found that scheduled face-to-face tutorial sessions of distance education in University of Cape Coast were not supportive enough to address students’ learning needs. Also, all the respondents possessed mobile devices and perceived blending of mobile learning in distance education as an avenue to enhance collaborative learning with faculty and colleagues. It was recommended that curriculum and instructional designers of distance education courses must consider incorporating mobile learning pedagogies in the distance courses and learning experiences to address students’ learning needs using mobile technologies.  
67 An Investigation into Engagement Processes between Antenatal Providers and Users in Lundazi District – Zambia , Patricia Mambwe, Catherine. M. Ngoma
Background: Strategies to engage pregnant women in their prenatal care, educating them and encourage hospital deliveries are important elements to consider in efforts aimed to improve quality Antenatal Care (ANC). Methods: A facility based cross-sectional study employing both qualitative and quantitative methods was conducted in Lundazi District, Zambia. Engagement processes between ANC providers and pregnant mothers during the provision of antenatal care were explored. Data was collected from sixty pregnant women who attended ANC clinic in five public health facilities. It was also collected from seventy-five ANC providers. Data were collected through focus group discussion with ANC users, observation during consultation and self-administered questionnaire from ANC providers. Results: This study observed that one to one individualized health education was not reinforced despite the health and gestational age of clients. Only thirty-seven percent of ANC providers explained their findings to the clients during physical examination. Clients were not counselled on blurred vision, severe headache, convulsions, fever and difficulties in breathing. This study further found that ANC providers could not explain the reason for referral submitting that Antenatal mothers would still not understand even if staff took the entire year explaining. However, eighty percent of the ANC users were encouraged to deliver from the health facility. Conclusion: Lack of engagement with ANC users indicates missed opportunities for delivering quality ANC Care. Reforcement of this component would improve the quality of care and improve maternal and fetal wellbeing.  
68 A Human Rights-Based Approach: Analysis of Administrative Instruments used in the Fight Against COVID 19 in Zimbabwe and Botswana , Feddious Mutenheri
Subsequent to the appearance of the COVID-19 contagion, governments around the world were confronted with the challenge of combating its spread. It has been established that the infection is predominantly human to human and this reality informed the approaches used to counter it. Governments, particularly those perceived to have impeccable democratic credentials, had the difficult decision to deploy martial laws against laissez faire tactics in order to save lives. Most countries resorted to martial law, which gave leaders of governments unfettered state power to make decisions “to save lives”. Whereas most Western countries took a wait-and-see approach in implementing State of Emergencies, China and most countries in the developing world were quick to declare them. Developing countries’ records on human rights are generally poor. There has been a worldwide human rights confrontation between governments and citizens on the extent of the instruments used to fight COVID 19. Have these instruments been effective? Have they been the only necessary and key instruments to fight the pandemic? To what extent did they impinge on the human rights imperatives of the citizen? This paper interrogates the necessity of using these instruments to combat COVID-19 and their consequences on people’s rights. The paper presents the instruments used in Zimbabwe and Botswana and uses the Human Rights-Based Approach (HRBA) to compare their consequences on people’s freedoms in these countries. This research uses mixed methods in interrogating the impact of the administrative instruments that were used to combat COVID 19. Where necessary, descriptive and ethnographic approaches are employed to deepen the understanding of the impact of these instruments on human rights.
69 Social Media as a form of Digital Tool(s) and Academic Performance of University Students in Nigeria , Aderinsola Eunice Kayode, Bolaji Asegun Olaoluwa, Oluseyi Emmanuel Oladele, Folasade Janet Agunbiade  
The purpose of this article is to access the use of social media as a form of digital tools on the academic performance of undergraduate students of the University of Ibadan, Nigeria. The paper reviews the actual impact of the use of social media with student’s classroom learning. The descriptive research design was utilized. Two hundred (200) undergraduate students purposively selected from eight faculties. The paper reveals that a great number of students are addicted to the use of social media and frequency use of social networks in digitalization tool becomes an integral part of the students’ development which has resulted in improving students’ academic performance. In conclusion, the paper reveals that the use of social media is part of digital tools that shaping and influencing how students lean and interact with their studies and also, with e-communication with peers this help a student to collaborate and discuss issues related to their academic studies. Social media have a dual impact on student achievement, and it is necessary to approach adolescents' use of social networks with ultimate positive responsibility. With the outcome of the findings, this paper recommends that the government and educational planners should improve the leisure, information exchange among learners, therefore, academic performance can be maintained. The researcher recommends that social media should be used for educational purposes as well, Social Networking Sites should be expanded and new pages should be created to enhance academic activities and avoid setbacks in the students’ academic performance.  
70 Digital Integration into the Nigerian Educational System: Challenges and Prospects , Abigail Olubukola Irele
In the last ten years, there have been conscious attempts by every nation to integrate digital tools into their educational system especially at the tertiary level. Nigeria is no exception. The policymakers in Nigeria at the federal and state levels have felt the need to integrate Information Communication Technology (ICT) in their educational policies. It is felt that in this globalized world the country must embrace digital technology to enhance support teaching and learning environment. It is the belief that in the present globalized world every nation should embrace digital technology to be competitive and also have knowledge-based society as well as information society or as Castells, (1996) has put it “Network Society” and also Perevozchikova, et.al. (2020). The COVID-19 pandemic has also made it imperative that countries should advance towards e-learning. The future of education is therefore intertwined with Information Communication Technologies (ICTs). The Nigerian government has realized that the new normal or post-COVID-19 pandemic environment has made the traditional method of teaching and learning outmoded. It is therefore in this regard that most policymakers in Nigeria are advocating an advance towards ICT hence there is what we can call paradigm-shift in terms of teaching and learning in Nigeria now. This paper discusses the Nigerian guidelines on digital education highlighting the challenges and the prospects of digital education. It concludes that digital education must be embraced because the post-COVID-19 pandemic has made it impossible to continue with the traditional mode of teaching/learning.
71 Virtual Teaching and Learning: The Sustainable Tools in Digitalization of Education , Olutayo T. Omole
Virtual teaching and learning have been part of the integration of the use of technological tools in this digital age and new normal. The formation of a knowledge society and the digital storage of development of modern civilization culture still remain a continuous process in the era of virtual teaching and learning within the education system especially during this global pandemic lockdown. This article reviews the use of virtual teaching and learning as techniques to improve digitalization in the use of new e-tools in teaching and learning in Nigeria. To achieve this, the concept of virtual teaching and learning is reviewed with the intention of looking at its features in digital education. The benefits of virtual teaching and learning are many which include opportunity for timely and distance education, better interactions, easily accessible to learners; the lesson can be easily tracked and recorded. It was concluded that virtual teaching and learning had great significant impacts on digital education and proved to be a vital and sustainable tool in digitalization of education. This paper recommends that the government of Nigeria should improve on adequate provision of infrastructures which will aid the use of virtual teaching and learning at all levels of education system.
72 Reinventing New Learning Model through Cultural Values and Transformational Education in a Digital Age , Maria Ekpenyong
For some decades now, Nigeria’s socio-economic and educational crisis has deepened in every sphere of life, a predisposition attributable to unprecedented challenges from new for technologies and interconnectivity. In existence now is a system of education that is no longer relevant globally, which translates to a paradigm shift in ways students want to learn and how teachers want to instruct. This has resulted in uncertainties of knowledge dissemination, transfer and sustainability. This paper holds the believe strongly that revisiting cultural and values-based education and adjustment to the digitalization process will lead to inclusive learning without boundary, development and transformation in human values. The main thrust of the paper is to re-design, using the qualitative approach, the curricular and courses to reflect activities for the mind, character, and technical skills formation, on a conceptualised tripartite of the three ‘’H’’: Head, Heart and Hands for online education for positive changes. It is, therefore, expedient to state that the outcome of new models, education for positive change is attainable by using a digitalized formula that synthesizes the head, the hands and the heart. The paper concludes that an induced change in mind-set and borderless education for all will liberate the world from digital uncertainties. Thus, the paper recommends youth-centred real-life application project-based learning and education in human values for the transformation of society. This will help reduce the rigidity of the formal method and a wide range of resource requirements, thereby making it more effective and affordable.  
73 Strengthening School’s Management Capacity for Better Education Outcomes in Eswatini: Calling for a Paradigm Shift , Sbongile Patricia Khumalo-Zwane
This paper provides a critical analysis of the various competencies necessary for the development and training of effective principals in the light of the current school administrative and management practice in Eswatini. In order to provide a cadre of effective school administrators, it is important that administrators get equipped with a range of the essential administrative and management skills. The Eswatini education school system allows for ascendency into management and administrative positions without the requisite knowledge and experience. Promoted officers invariably tend to get presented with the learning-on-the-job kind of experiential management engagement. Yet the Principals and their Deputies are disproportionately critical in the facilitation and implementation of the current education reform processes. Furthermore, there seems to be rare if at all any occasions where they are assisted to deal with the “culture shock” in their new roles as Managers of schools —they are left to swim or sink on their own. This paper presents findings drawn from observations, experiential practice and interaction with some principals in the Manzini Region. It further suggests pathways for addressing the critical administrative and management gaps in the school education system. These include constructive utilization of pre-deployment capacity building forums, on the job training, supportive supervision, monitoring and evaluation for optimal educational outcomes.  
74 Triggers of Acute Asthma in Patients Attending Emergency Centre in a Peri-urban District Hospital, Johannesburg, South Africa , JMM Musonda, Kabundji DM, MA Eyassu
Introduction: Many avoidable triggers lead to acute asthma attack and subsequent visit to the emergency centre. The aim of the study was to determine triggers of acute asthma in order to target prevention efforts in patients attending emergency centre in a district hospital, Johannesburg, South Africa. Objectives were to describe acute asthma patients, identify triggers and severity at presentation. Methods involved a prospective descriptive cross-sectional study conducted from April to August 2015, in consenting adult participants. A researcher or trained assistant completed the semi-structured questionnaire in English. Results: Overall, 239 patients enrolled (139 males, 100 females with the median age 31 years). Majority presented with moderate acute asthma (52.72%). Active cigarette smoking (p-value<0.001) and/or passive cigarette smoking (p-value=0.004) were identified potential triggers for acute asthma attack. Chi-square or Fisher Exact test analysis were used for associations between variables and severity. Bivariate logistic regression was used to ascertain triggers associated with acute asthma attack. P-value < 0.05 was statistically significant. Confidence interval was 95%. There were no significant associations between the severity of acute asthma attack and acute respiratory infection (p-value=0.818), use of medication-related asthma triggers (p-value=0.942) and knowledge of asthma allergens (p-value =0.086). Conclusion: The majority patients presented in moderate acute asthma attack which was most probably triggered by active and/ or passive cigarette smoking. Hence, frequent visits to hospital in acute asthma attack could be minimized by removing avoidable triggers from households.  
75 Colonization, Virulence Factors, and Antimicrobial Susceptibility Patterns of Staphylococcus Aureus Isolated from the Anterior Nares of Medical and Paramedical Students , Venkataramana Kandi, Vidyadhari, Harshini
Background: Hospital environment and healthcare personnel form an integral part of healthcare system. Patients visit the hospital for various reasons. Some patients require hospitalization and others require medical and surgical interventions. Microbes present in the hospital environment and those colonized in the anterior nares, and on the skin of healthcare personnel could pose an increased threat of hospital acquired infections. Staphylococcus aureus (S. aureus) is one among many microbial species with potential to cause mild to severe infections that could be present colonized in the healthcare personnel. This study is aimed to evaluate the colonization of S. aureus in the anterior nares of medical and paramedical students. Methods: Nasal swabs were collected from a total of 100 medical, and paramedical students. The swabs were cultured on blood agar, and the staphylococcal isolates were identified to the species level by using standard and conventional microbiological techniques. The colonies were counted on isolation (<10 colonies-scanty growth; <25 colonies-moderate growth; <50 colonies-moderate to heavy growth; and > 50 colonies; heavy growth). The virulence determinants including hemolysis, pigment production was assessed. The antimicrobial susceptibility testing was performed using Kirby-Bauer disk diffusion method. Results: Microbes had grown in 97% of the nasal swabs. Most frequent bacterial isolates were Coagulase negative Staphylococcus (CONS), and diphtheroid bacteria (bacterial resembling Corynebacterium diphtheriae. S. aureus was isolated in 13% of the study participants. Conclusion: The isolation rates of S. aureus were noted to be 13%.  Increased resistance was noted against vancomycin, and commonly used antimicrobial agents. Most isolates demonstrated hemolysis on blood agar.
76 Mosquito-Avoidance Practices among Caregivers of Children Under Five in Somolu Local Government Area, Lagos State, Nigeria , Ojo OreOluwa, Ajayi IkeOluwapo, Adeneye Adeniyi, Tola Monday, Awolola Sam  
Malaria control efforts currently lay emphasis on reducing transmission by limiting human-vector contact. Meanwhile, Mosquito-Avoidance Practices (MAPs) have been shown to be sub-optimal in urban areas, especially among under-five children (U-5C), resulting in high child morbidity and mortality. This study was therefore designed to investigate MAPs among caregivers of U-5C living in Somolu; an urban Local Government Area (LGA) in Lagos State, Nigeria. A cross-sectional survey was conducted involving 394 female caregivers of U-5C. The LGA was stratified into three layers based on the level of planning and drainage using a geographic information system (GIS). Data were collected using a semi-structured, interviewer-administered questionnaire and were analysed using descriptive statistics and Chi-square test at p=0.05. Mean age of respondents was 33.6±7.7 years. The proportion who mentioned mosquito nets as a MAP by strata were: S1-59.3%, S2-80.7% and S3-64.3%. Other MAPs reported included: spraying insecticide: S1-20.5%, S2-26.3% and S3-17.1%, shutting door after sunset: S1-9.6%, S2-10.5% and S3-11.4%, and clearing surroundings: S1-2.9%, S2-5.3% and S3-2.9%. Ownership of bed nets was: S1-76.0%, S2-75.4% and S3-68.6%, and out of these, S1-73.1%, S2-70.7% and S3-72.4% reported that their child slept under the net the night before the survey. The most common mosquito-avoidance practice among caregivers of under-five children was the use of bed nets, and this did not differ by level of planning and drainage of the study site. Therefore, strategies to improve and sustain the use of bed nets and to promote the use of other effective mosquito-avoidance practices should be encouraged.
77 Mosquito-Avoidance Practices among Caregivers of Children Under Five in Somolu Local Government Area, Lagos State, Nigeria , Ojo OreOluwa, Ajayi IkeOluwapo, Adeneye Adeniyi, Tola Monday, Awolola Sam  
Malaria control efforts currently lay emphasis on reducing transmission by limiting human-vector contact. Meanwhile, Mosquito-Avoidance Practices (MAPs) have been shown to be sub-optimal in urban areas, especially among under-five children (U-5C), resulting in high child morbidity and mortality. This study was therefore designed to investigate MAPs among caregivers of U-5C living in Somolu; an urban Local Government Area (LGA) in Lagos State, Nigeria. A cross-sectional survey was conducted involving 394 female caregivers of U-5C. The LGA was stratified into three layers based on the level of planning and drainage using a geographic information system (GIS). Data were collected using a semi-structured, interviewer-administered questionnaire and were analysed using descriptive statistics and Chi-square test at p=0.05. Mean age of respondents was 33.6±7.7 years. The proportion who mentioned mosquito nets as a MAP by strata were: S1-59.3%, S2-80.7% and S3-64.3%. Other MAPs reported included: spraying insecticide: S1-20.5%, S2-26.3% and S3-17.1%, shutting door after sunset: S1-9.6%, S2-10.5% and S3-11.4%, and clearing surroundings: S1-2.9%, S2-5.3% and S3-2.9%. Ownership of bed nets was: S1-76.0%, S2-75.4% and S3-68.6%, and out of these, S1-73.1%, S2-70.7% and S3-72.4% reported that their child slept under the net the night before the survey. The most common mosquito-avoidance practice among caregivers of under-five children was the use of bed nets, and this did not differ by level of planning and drainage of the study site. Therefore, strategies to improve and sustain the use of bed nets and to promote the use of other effective mosquito-avoidance practices should be encouraged.
78 Factors Influencing Marital Satisfaction Among Couples in Lartebiokoshie, Accra, Chana , Asuquo Udofia
The study examined the interaction of three variables, intimacy, self-esteem, and locus of control, and their effect on marital satisfaction in Lartebiokoshie a suburb under the Ablekuma South Constituency in the Greater Accra Region, Ghana. Across sectional survey method was adopted to study the variables of interest. Standardized questionnaires were used to assess all variables of interest. Enrich Marital Satisfaction Scale (EMS), Rosenberg Self-Esteem Scale (RSE) and Locus of Control of Behavior scale (LCB) were utilized. Data entry, validation and analysis was done using the Statistical package for Social Science software (SPSS version 25). A total of 720 purposively selected participants took part in the research. The sample was predominantly female, 430 (60%) and Christian, 675 (94%). The modal age group for respondents and spouses was 31-45 years 387(54%) and 400 (56%) respectively. Study participants who were married by ordinance comprised 400 (56%). One hundred and fifty study participants (21%) had the same ethnicity with their spouses and the mean years of marriage was 13.1510.70. The result of the study revealed a significant positive correlation between intimacy and marital satisfaction [r(718) = .460, p< .000], a no significant correlation between locus of control and marital satisfaction [r(718) = .041, p>.05], a negative correlation between self-esteem and marital satisfaction variables [r(718) = -.027, p> .05]. Partner intimacy for to-be-wed couples should be promoted within appropriate and approved settings due to the significant influence demonstrated in this research.  
79 The Impact of Funding on Quality of Early Childhood Education Service Provision in Zambia from 2015-2018 , Tashar Simasiku
High-quality Early Childhood and Education (ECE) is critical to positive child development and generates high economic returns. On the contrary, Access to quality ECE in Zambia remains low particularly for the vulnerable. The situations are compounded by inadequate funding to the ECE subsector. This study evaluated the effect of funding on the quality of ECE in Zambia for the period 2015 to 2018. It assessed the effect of funding on the provision of ECE services by analysing the funding patterns to the Ministry of General Education through to Directorate of Early Childhood Education (DECE), Provincial Education Office (PEO), District Education Board Office (DEBO) and finally the 10 identified schools /ECE centres. To assess effect on quality, the study analysed the effect of funding on the eight identified early learning quality elements as espoused by the Ministry of General Education. These are, Infrastructure, Water and sanitation, Playgrounds, Furniture, Equipment and materials, Staffing, Support Staff and Enrolment. The methodology employed in this study included desk review of the funding reports at the identified fund management levels as well as Key Informant Interviews (KII) at each identified level. The results from the desk review and KII indicated that, funding to ECE for the period 2015 to 2018 was inadequate. At school level, much of the funding went toward equipment and materials while Water and Sanitation Infrastructure, Playgrounds, Furniture Equipment and materials were inadequately funded. This negatively affected the quality of ECE services provided in Zambia between 2015 to 2018.  
80 Open Defecation Free Zone and Practice in Jorayal Gaunpalika , Mukunda Raj Pokhrel
The study is based on Open Defecation Free Zone and Their Practice in Jorayal Gaunpalika -4, Doti District. The main objective of the study is to analyze the practice of open defecation free zone. Out of 310 total households, only 150 households were selected for the study. The cluster sampling method was applied to collect necessary information. The study area was divided into 6 clusters and from each cluster 25 households were selected randomly. According to the study, hand wash practice is very high that is 85.3 percent wash their hands with soap and water and 14.7 percent use soil and water. The high majority of the respondents (88.7 percent) said that they maintained the garden and the toilet, 7.3 percent said that they kept the courtyard of the house plain. Most of the respondents (82.7 percent) cleaned the toilet every day. Most of the respondents (70.7) expressed that they defecated in the field, and 28.7 percent respondents said that they defecated along the riverside and remaining others used the road. In this study, the researcher gives suggestions to the concerned department and to possible future researchers. The government and non-government sectors should support such open defecation free zone area ensuring adequate environmental sanitation. The municipality should be made aware of the importance of a good environmental hygiene. Furthermore, such studies should be conducted at the national level.  
81 Teachers’ and Students’ Experiences of Mandatory Online Teaching in Qatar: the case of a Covid-19 Crisis , Caleb Moyo, Selaelo Sylvia Maifala
The nature of schooling was forced to evolve during the Covid-19 pandemic as schools around the world were compelled to make a paradigm shift to teaching and learning through virtual learning environments (VLE). This inquiry sought to explore teachers’ and students’ experiences of mandatory online instruction and the role of instructional leadership in supporting the transition. Using a qualitative case study, three data generation techniques were used; one on one interview with teachers, focus group discussions with students and document analysis of e-mail correspondence from the school management to teachers in providing direction during the transition period. Responses were coded using word processing and the findings revealed lack of prior-training and preparedness for teachers which led to various challenges in navigating the online platforms. These challenges, some experienced by both teachers and students include; technical, heavy workload, lack of interaction, effective feedback and classroom management. Further, it was found that the instructional leadership practices of the school were focused more on giving directives than guidelines and support in navigating the ‘new normal’. The implications point towards, amongst other requisites, a need for social, cognitive and teaching presence in VLE and a more dynamic instructional leadership approach.  
82 Environmental and Sustainability Literacy among Students at a Selected Institution of Higher Learning in Zimbabwe , Taremba Chirigo, Joe Phaeton Mukaro, F. Ruparanganda
The study was carried to assess students’ environmental and sustainability literacy at a selected institution of higher learning in Zimbabwe. A descriptive cross-sectional design was used. The questionnaire used was validated, and the Cronbach’s alpha was used to determine reliability (α = 0.767). Purposive, stratified and simple random sampling techniques were used to select 70 respondents for the study from a population of 1352. The study revealed that the level of knowledge was mediocre, and one-way ANOVA showed no statistically significant difference in the level of knowledge among the groups (F (3,66) =2.376, p=0.078). Results also showed a positive attitude towards environment and sustainability issues; and identified the need to train every student about environment and sustainability (83%), with government support (93%) to achieve an environmentally sustainable world (96%). It was concluded that although the attitude among students was positive, the current syllabi are not explicit about environmental and sustainability issues which bear negatively on their environmental knowledge. The study recommends the introduction of a compulsory environmental education course in Higher and Tertiary Education in order to raise the environmental and sustainability literacy. Keywords: Environmental education, Environmental literacy, Higher and tertiary education, Sustainability literacy, Sustainable development.
83 The Impact of Employee Engagement on Organization’s Productivity on United Methods on Relief Services , Ayot Irene
Employee engagement has arisen as a widespread organizational perception in current years. It is the level of strength of mental and emotional connection employees feel toward their workplaces and its values and beliefs. When employees are engaged and aware of the business framework and work as a team to improve performance within the job for the advantage of the organization. Employee engagement resourcefulness has a straight effect on the organization's level of production. Every company/ organization requires their workers to be engaged in their respective work. Employee engagement is linked to customer satisfaction which is connected to an organization's financial success. Engagement arises when adequate individuals give attention to performing good work and care concerned about what the company is thriving to attain and in what way it is an accomplishment. This helpful mentality and behavior only arise once people get satisfied with their jobs they do and are convinced that the organization supports them, with an effective HR manager. This paper covers a literature review from several study findings and practices employed by the use of an expressive research method. It schemes the effect of worker’s engagement on the productivity of the organization. It also showcased the factors affecting the worker’s assignation and organizational results. Keywords: Employee Engagement, Organization, outcome, Productivity, Retention.
84 Use of Topical Finasteride Vs Systemic Finasteride in Male Pattern Baldness , R V Kumar, M S Abirami
In this study we have analyzed the use of finasteride which is a type P-selective 5a-reductase inhibitor. By decreasing dihydroxytestestrone (DHT) level, it is found to be effective in the treatment of male androgenic alopecia. In this study, we compared the effect of topical vs. systemic finasteride in the treatment of androgenic alopecia.  Our study is a randomized clinical trial study having 30 male patients. They have come for alopecia treatment at Nesam hospital, Coimbatore, India. We have selected male patients with androgenic alopecia and divided them into two groups (A, B), randomly having 15 patients in each group. For group A, Topical finasteride (0.1%) with minoxidil (5%) solution was given. Group B patients received topical minoxidil with oral finasteride (1mg) tablets. All patients were regularly followed up till the end of 6 months. A Patient had a first review in the first week followed by monthly follow up. Following parameters were taken into account: size of bald area, total hair count, and terminal hair. Data was analyzed by Chi-square statistical test. Each month the terminal hair, size of bald area and hair count between the two groups were compared. In the initial few months group, A showed good improvement. But Serial measurements indicated that a significant increase in hair counts and terminal hair counts is seen in both groups.  This study showed that on long term follow-up of more than 3 months, both topical and systemic finasteride groups had similar results. Keywords: Androgenetic alopecia, Finasteride, Terminal hair.
85 Microbial Assessment of Dried Fish Sold in Streets and Supermarkets in Harare Central Business District: Zimbabwe , Joe Phaeton , F. Ruparanganda, Primrose Katsande
The study focused on the microbiological quality of dried fish sold in the streets and supermarkets in Harare Central Business District. The analysis was based on determining the microbiological load of dried fish samples. Samples were systematically collected from three different streets and three different supermarkets each week. The study period was from January 2020 to April 2020.The samples were analyzed for Salmonella spp., Staphylococcus aureus, Escherichia coli, Aspergillus spp and Penicillium spp. The methods used were pour plate, streaking and microscopy. Results obtained from this study showed that street sold fish microbial levels were within unacceptable levels food safety standards. Supermarket sold dried fish microbial levels were also within the unacceptable levels. In comparing the levels of indicator microorganisms between streets and supermarkets, the results showed that the contamination of level was similar for all the microorganisms except Salmonella. Purchasing dried fish in supermarkets does not guarantee food safety. It was concluded that street and supermarket sold dried fish pose high food safety concerns and can be a potential source of foodborne illnesses. Keywords: Food borne illnesses, food contamination, Microorganisms, Microbial load.
86 Reliability of Rapid Diagnostic Tests in the Diagnosis of Malaria amongst Children attending the Outpatient Department of the Tetteh Quarshie Memorial Hospital in the Akuapem North District of the Eastern Region of Ghana , Aquel Rene Lopez
Treatment of malaria, with the appropriate diagnostic tool, helps to reduce morbidity and mortality in children. The absence of resources and inadequate labor in emerging countries like Ghana make malaria microscopy difficult. The Rapid Diagnostic Test kit (RDT) remains unpopular despite its availability and ease of use because of limited research on its effectiveness leading to over­ prescription of antimalarial drugs. This study shows how reliable the malaria diagnostic test is. Out of 132 children were recruited in all into the study with more females (59.1%) than males (40.9%). 35 (26.5%) of children who were recruited tested positive for Plasmodium falciparum with the Malaria rapid diagnostic test cassette while 97 (73.5%) children tested negative for Plasmodium falciparum with the malaria diagnostic test cassette. In Malaria Microscopy, 35 (26.5%) children tested positive while 97 (73.5%) tested negative for malaria parasites. Out of the 35 children who tested positive, RDT picked 33 as positive and 2 as negative (sensitivity = 94.3%). While out of the 97 that tested negative for microscopy, RDT picked 94 as negative and 3 as positive (specificity= 96.9%). The positive predictive value and negative predictive values are 91.7% and 97.9%, respectively.This clearly shows the Rapid Diagnostic Test (RDT) is an effective diagnostic tool for the testing of malaria in children in the Akuapem North District in the Eastern Region of Ghana. Keywords: Histidine-rich protein 2 (HRP2), Malaria, Out Patient Department (OPD), Rapid Diagnostic Test (RDT).
87 How do Nigerian Gynaecologist in a Tertiary Health Facility Manage Infertile Patients for Sexual Dysfunction? , Orji Ernest O, Ogunjuyigbe Peter O, Orji Victoria O
This study was conducted to evaluate the approaches gynaecologists in Osun East Senatorial district; South west Nigeria uses to screen and manage their infertile women for sexual dysfunction. Forty gynaecologists and their resident doctors managing infertile women at Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria, were interviewed (June -December 2020) using an in-depth-interview guide and semi-structured questionnaires. All the forty doctors assessed the sexual functioning of infertile patients. The Assessment was usually done at the first time of seeing the patient and at other times when patients start a discussion about it or when a patient’s complaints are directly related to it. Ways of eliciting sexual concerns were by asking on the frequency of sexual intercourse per week, about ejaculatory intercourse, sexual satisfaction, and dyspareunia. None of them used any standardized assessment tools to screen infertile women. Most are not aware of any standardized tools for sexual functions assessment because they had no training in sexual dysfunction in both undergraduate and postgraduate training as it was not in their curricula. While they welcome the introduction of the tools in training and in the case file of patients, they believed that routine screening using these tools would increase the waiting time and would be an added burden on the doctors. This study showed that gynaecologists and residents are poorly equipped to address sexual problems and sexual dysfunction among infertile women. It is imperative that the curricula of medical training be updated to include assessing sexual functioning tools for better care. Keywords: Female sexual dysfunction, Nigerian gynaecologist, Management.  
88 Atherosclerotic Cardiovascular Disease Risk Among Patients with Type 2 Diabetes in Uganda , William Lumu, Ronald Mutebi, Emmanuel Ssendikwanawa, Davis Kibirige, Ronald Wesonga, Silver Bahendeka
While atherosclerotic cardiovascular disease risk is increased in patients with type 2 diabetes, the magnitude and socio-demographic determinants of this risk are not known in Uganda. We aimed to establish the magnitude of the predicted 10-year atherosclerotic cardiovascular risk and describe its socio-demographic determinants among patients with type 2 diabetes in Uganda. This was a cross-sectional study conducted in eight (8) diabetes clinics from November 2020 to February 2021. We enrolled 500 patients with type 2 diabetes aged between 40 to 79 years. Patients were interviewed on their socio-demographic characteristics. Anthropometric and laboratory measurements were performed. The predicted 10-year atherosclerotic cardiovascular risk was categorized using the Pooled Cohorts Risks Equations. Bivariate and multivariate logistic regression was conducted to establish associated socio-demographic factors. The majority of participants were females (78%), with a mean age of 55.14years (SD±8.96). Of the patients studied, 20% were at low risk (score <5%), 14.2% borderline risk (score 5-≤7.5%), 45.2% intermediate risk (score7.5-<20) and 20.6% high risk (score ≥20%). Elevated risk of score ≥7.5% was found in 65.8%. The male gender (AOR= 5.456, 95% CI 2.998-9.932, p=0.001), at least 50 years of age (AOR=7.841 95% CI 4.863-12.642, p=0.001), part-time employment (AOR=1.726, 95% CI 1.221-2.441, p=0.002) and being widowed (AOR=2.4, 95% CI 1.192-4.833, p=0.002) were significantly associated with cardiovascular disease risk. The cardiovascular disease risk among patients with type 2 diabetes is high. The male gender, age of at least 50years, part-time employment, and being widowed are socio-demographic factors that should be prioritized at primary level management of cardiovascular disease. Keywords: Atherosclerotic cardiovascular risk, Diabetes mellitus, Uganda.
89 The Role of Top Management in Developing Security and Safety Culture in the Organization (A Case of Enterprise Group) , Alexander D. K. Acquaye, Nestor Naabulee Nasage
The study investigated the role top management play in developing security and safety culture in the organization. Specifically, a case study exploration was used to evaluate one primary area of interest: 1. the role top management plays in developing organization’s security and safety culture. The strategy used for this work was exploratory, with both qualitative and quantitative approaches since the data collected would be converted into numerical value for better interpretation. The target population was the staff of Enterprise Group in the Greater Accra Region of Ghana, and the sample was composed of 30 management and staff members, using convenience sampling. Primary and secondary sources of data were used in this study. A survey questionnaire was used to acquire information from the target management and staff of Enterprise Group Ltd. The data gathered was analyzed quantitatively by using descriptive statistical tables and percentages where the Chi-Square test was considered. Statistical package for social sciences (SPSS) version 25 software was also used in the analysis. The study concluded that top management plays a role in developing security and safety culture in organizations through Security and Safety Supervision Committee, by building enabling security and safety working environment in organizations, ensuring there are policies and procedures guidelines in place in organizations. When there is Daily Reporting and available systems to address non-compliance issues in the organization to develop security and safety culture among employees. it is recommended that the Government and regulatory bodies of organizations should emphasize the establishment of security and safety policies in organizations. Keywords: Culture, Developing, Security and Safety, Top Management.
90 Anti-inflammatory Effect of Salvia Miltiorrhiza is Mediated via IL-6, JAK, and STAT Pathway in a Dysfunctional Vascular Endothelial Cell , Emmanuel Adikwu Orgah, Ifeoluwa Margaret Idowu, Mbaoji camilus
The vascular complication of diabetes mellitus is a problem for the patient, and the ability to cope with the disease and the associated inflammation is a critical aspect of diabetes. Cytokines-induced inflammation in vascular endothelial cells (VECs) plays an active role in chronic diseases such as atherosclerosis, diabetes mellitus, kidney injury, and stroke. We investigated the role of total salvianolic acids (TSA), total tanshinones (TTSN), and their combination (TSA/TTSN) on the activated vascular endothelial cell and its inhibitory effect on signal transduction and cytokines regulation. In the extracellular medium of the injury model of human umbilical vein endothelial cells (HUVECs) induced by thrombin, the human IL-6, VCAM-1, and ICAM-1 were significantly elevated (p Ë‚ 0.05). However, suppression in the TSA, TTSN, and TSA/TTSN (100 µg/L)-treated groups (p > 0.05) were notable. TSA alone but not TTSN and TSA/TTSN combination, inhibited the expression of P-selectin (p < 0.05) and E-selectin (p < 0.01) respectively, in VECs. Western blot analysis showed JAK and STAT expression in VECs however, the protein expression was modest in the Salvia miltiorrhiza-treated groups, indicating the potential of TSA/TTSN in the inflammatory pathways of IL-6, JAK, and STAT signal transduction in endothelial cells (ECs). This study has made novel observations regarding the components of Salvia miltiorrhiza regulatory effect on cytokines in Vascular Biology.
91 Knowledge, Attitudes, and Behaviours of Adults (15-49 Years) towards HIV/AIDS in Ghana , Justice Thomas Sevugu, Justice Ofori-Amoah, Emmanuel K Nakua
The adult population (15-49 years) are the most productive and yet the most vulnerable to HIV infections in Ghana. A phenomenon that threatens the socio-economic growth of the country and the survival of its people. Poor knowledge, ill-informed attitudes, and risky lifestyles are the key factors that hinder the prevention of HIV spread among adults. The study’s aim was to explore knowledge, attitudes, and risky behaviours among adults which hinder the prevention of HIV/AIDS in Ghana. A case-control study of 362 adults was conducted in the Ahafo and Northern regions of Ghana in 2020. Descriptive and inferential statistics were significant at 1% and 5%. Results indicated that the majority of adults in Ghana are sexually active with limited education but high knowledge of HIV/AIDS. The study revealed significant levels of association between HIV infections and age, sex, marital status, sex with multiple partners, use of the condom, sex for money, sexually transmitted infections, alcohol or drug abuse, personal income, access to places where sex is traded, and migration. The study concludes that both cases and controls generally had good knowledge regarding HIV/AIDS but show poor attitudes towards PLHIV and also engaged in risky behaviours that might predispose others to HIV infections. Findings also highlight the need for culturally adaptive and age-specific HIV education for adults across all regions. Identified misconceptions on HIV/AIDS, poor attitudes of adults towards PLHIV, and risky behaviours of adults regarding HIV/AIDS need specific and targeted education towards behavioural change.  
92 Prevalence of PFHRP2 and PFHRP3 Gene Deletions in Plasmodium Falciparum Isolates and their Performance of HRP2 Based Malaria Rapid Diagnostic Tests in Three Districts of Ghana , Aquel Rene Lopez, Charles Brown, Edith Bortier
Malaria rapid diagnostic tests (MRDTs) are important for malaria disease management. However, the performance of the RDTs is affected when the targeted antigens in the parasite have a variation or are altogether absent. The most common parasite target antigen in RDTs, Plasmodium falciparum histidine-rich protein 2 (HRP2), has been reported to be absent in some P. falciparum parasites. 371 patient samples, from Akuapem North (58.5%), Atiwa East (21.3%), and from New Juaben (20.2%), were used in the study. PCR provided the highest number, 14.8% (55/371), of positive detections for falciparum infections. Microscopy detected parasites in 20/261 (7.7%) samples, and the minimum parasite density by microscopy was 430 parasites/µL. Out of the 371 samples, 27 (7.3%) were positive by RDT. The highest RDT positivity rate, 13.3% (10/75), was observed at New Juaben. False-negative RDT results were obtained in 43/55 (78.2%) of the negative branded RDT kits. Only two microscopies positive sample were RDT positive. Using 18SrDNA PCR, 55 (14.8%) samples were positive for P. falciparum. In Akuapem North, 79.2 % (19/24) of the PCR positive samples had P. falciparum parasites that lacked exon 2 of PFHRP2. An overall RDT positivity rate of 7.3% (27/371) and false-negative rate of 78.2% (43/55) were observed for the study sites. Plasmodium falciparum parasite populations with deletions of the PFHRP2 and PFHRP3 genes are present in Ghana. There is an urgent need to investigate the prevalence and geographic distribution of these parasites.  
93 Rural-Urban Disparities in the Acceptance and Adoption of Family Planning among Couples in Oyo State, Nigeria , Stella Akinso, Femi Rufus Tinuola, Amitabye Luximon-Ramma, Folajinmi Oluwasina
Modern contraceptive use can enhance the living standard and reduce mortality among people living in rural and urban areas. However, contraceptive use tends to be low in the rural than the urban populace. A descriptive, cross-sectional study of systematic sampling technique was used to select 570 persons of reproductive age in the rural and urban communities of Oyo State. A semi-structured questionnaire on socio-demographic characteristics, knowledge, attitude and factors influencing uptake of modern contraceptives was administered to respondents. of the 570 respondents, the mean age was 34.3 ±8.4 years. The majority (63.3%) were female compared to 36.7% male respondents. Most (97.0%) of respondents had heard of family planning in the past. The result shows significant differences in location, gender, marital status, occupation, ethnicity, and a number of children (P<0.001). The majority (33.3%) of the respondents sourced family planning information from health care providers, while 31.3% sourced theirs from mass media – Radio, TV, or newspapers. Respondents in urban areas were currently using family planning methods than respondents in rural areas (61.8% vs. 38.2%). People in the urban area are 2.344 times the odds of utilizing any family planning compared to people in rural area (95% CI 1.495, 3.676). Urban and rural disposition to modern contraception services is influenced by economic, socio-cultural, environmental factors, location, age, educational, traditional beliefs, religion, family type, and level of knowledge. Although some signs of progress have been made in family planning at the communities, more work needs to be done. Men need to be actively involved, and other fears about family planning addressed.  
94 Influence of the Registration Process and Requirements on Cooperative Performance in Zambia , Sikalumbi Arona Dewin, Surya Prabhu, Muchemwa Victor  
Having the registration process and requirements that are easy and affordable is one thing, and having the entire process that supports cooperative performance is yet another. This study intended to establish the influence of the registration process and requirements on the performance of the cooperative societies. The study adopted a descriptive research design using a mix method paradigm.12.6% of the total cooperatives in the Central province of Zambia were sampled from 16% of the total districts in the province. A total of 210 respondents were arrived at through purposive and systematic random sampling techniques. The desk review, semi-structured questionnaires with a reliability test of Cronbach's Alpha of 0.890, and interview schedules were the instruments used to collect data. The data were analyzed qualitatively using themes and quantitatively using descriptive statistics using SPSS Version 22. The study reveals that cooperative registration requirements are affordable, and the process is easy but hardly supports the cooperative growth and performance. The study, therefore, recommends the revision of the registration process being used so as to enhance cooperative performance and eventually bring about social and economic development in rural Zambia.  
95 Socio-Demographic, Behavioural and Biomedical Factors Contributing to HIV Spread among Adults in Ghana - A Case-Control Study , Justice Thomas Sevugu, Justice Ofori-Amoah, Emmanuel K Nakua
HIV/AIDS prevalence remains a major global public health and development challenge despite key interventions to curb its spread. Ghana, in particular, for a decade now, has experienced a persistent increase in the number of HIV new infections among adults, with the new infection rates varying across the administrative regions. The study examines socio-demographic, health, social, behavioural, and biomedical factors contributing to the spread of HIV among adults in Ghana and how these factors vary across administrative regions. A case-control study was carried on involving 362 respondents made of 181 HIV cases and controls, each from the Ahafo and Northern regions of Ghana. Structured questionnaires were administered. Socio-demographic characteristics of respondents, their health status, social behavioural, and biomedical factors that have potential influence on the spread of HIV was collected. A logistic regression model was used to estimate the degree to which each of the risk factors collected were associated with the spread of HIV in Ghana and across regions. Out of 21 risk factors identified, 13 accounted for the spread of HIV in the Ahafo region compared to only 6 in the Northern region. The study concludes that factors for HIV spread in Ghana are many but vary across administrative regions in the country. It, therefore, suggests the need to create job opportunities, have HIV awareness campaign programmes, regulate the sale of alcoholic and other related drugs, discourage sex trade, promote condom use throughout the country for those who cannot abstain, and tailored to regions.  
96 Self-injected Depot–Medroxyprogesterone Acetate Subcutaneous (DMPA-SC) Uptake in Nigeria: A Paradigm Shift   , Kehinde Osinowo, Oluwaseun Ojomo, Segun Ibitoye, Philip Oluwayemi, Femi Rufus Tinuola  
Self-injection of DMPA-SC method is one of the Government of Nigeria’s (GON) national family planning goals to address the unmet need for contraception. Some studies on DMPA-SC/SI have demonstrated its feasibility to improve modern contraceptive uptake. However, there is a gap in the predictors of method uptake and continuation across self-injecting and provider-administered in Nigeria. This study explored the uptake of self-injection DMPA-SC contraceptives among women in two geopolitical zones of Nigeria. The study employed 20 focused group discussions (FGDs) and 40 In-depth interviews (IDIs). Self-structured pretested questionnaire to elicit information from 844 women registered for Family Planning in selected health facilities. Descriptive statistics were calculated and multivariate logistic regression was used to model determinants of DMPA-SC/SI family planning uptake. Six months of Secondary Data from the Health Management Information system (HMIS) was used to triangulate the trends in uptake. About 97.6% reported ever heard DMPA-SC/SI family planning method; 78.4% reported its uptake; while 88.5% reported ever heard of self-injection as an option of family planning method. Data for each State showed a remarkable increase in uptake of DMPA-SC/SI. The motivations to use DMPA-SC/Self Injection were ease of accessibility, convenience, and self-administer/care. Factors that encourage the uptake of DMPA-SC/SI were; health benefits, the prevailing economic situation and its effectiveness. Findings from the study showed that interventions that deploy health education, awareness, social mobilization, advocacy, policy implementation, and public sensitization, making contraceptive services available for free, will increase the uptake of DMPA-SC/SI in the study areas.  
97 Effects of Big Data Management on Industrial Growth: A Case for the Organization of Economic Cooperation and Development Countries   , Bulus Pikitda
Industrial growth is an essential condition for sustainable economic development. However, data management also plays an important role in ensuring effective planning and result-oriented decision-making in an organization. Although big data management is essential in this regard, its usage in most countries seems to be a new field. The aim of this study was to examine the effect of big data management on industrial growth in the Organization of Economic Cooperation and Development (OECD) countries. The study used expost-facto design approach and time-series or secondary data covering 2018 to 2020. A sample of 43 countries were used for the study. The Ordinary Least Square (OLS) regression technique was used as a technique for data analysis. The results from the descriptive analysis revealed that ICT access and usage had a higher mean value than internet access which signifies that ICT access and usage contributed more to industrial growth in OECD than internet access (INA). The findings from the analysis of the hypotheses also found that ICT access and usage and internet access have a significant effect on industrial growth in OECD countries. The study, therefore, concluded that big data management had positive effects on industrial growth in OECD countries and recommended that governments of OECD countries should invest more on internet access so as to promote efficiency in big data management and that they should also provide ICT infrastructure that are necessary for effective management of big data and industrial growth.
98 Effect of Duffy Antigen Receptor for Chemokines on Severity in Sickle Cell Disease , Aquel Rene Lopez, Charles Brown, Eli Dzandu, Clement Amedor, Richard Adom-Akessah, Isaac Asare, Julia Karikari
Sickle-cell disease is among the commonest severe monogenic global disorders. At the centre of sickle cell disease physiopathology is the polymerisation haemoglobin, resulting in erythrocytes become rigid and vascular occlusion. It has been hypothesized that the Duffy glycoprotein (Fy) on erythrocytes may enhance clearance of inflammatory cytokines. This may have an impact on the initiation and development of vascular occlusion in Sickle cell disease. The aim of this study was to determine whether or not the Duffy genotype is in any way linked with the severity of clinical disease in Sickle cell disease patients. Those who were hospitalized >4 times in the previous year because of Vaso-occlusive crisis were classified as having a severe phenotype. Duffy genotypes were determined by polymerase chain reaction (PCR), then Sty1 restriction endonuclease enzyme analysis. A total of 193 participants (133 cases and 60 controls) were recruited for the study. Vaso-occlusive crises were absent in more than half (58.5%) of the cases. Vaso-occlusive crisis per year occurred three times and four times at 5.2% and 1.65%, respectively. The number of vascular occlusions per year was highest in the 18-28 years and 29-39 years age groups. All the participants were genotyped as homozygotes for Duffy null genotype (FY*B-33/FY*B-33) and categorised as Fy(a-b-). No associations between Duffy genotype and number of VOCs per year was obtained. All the samples analysed were genotyped as Duffy negative homozygous [Fy(a-b-)]. No association between Duffy genotype and number of was vascular occlusion found. Keywords: Chemokine, Duffy antigen, Sickle cell, Vascular occlusion.
99 A Systematic Review to Observe the Impact of Risk-Based Monitoring as Compared to Conventional On-Site Monitoring in Randomised Clinical Trials and Quality Management in Large Cohort Studies , Shubhra Bansal, Neha Chawla
International Council for Harmonisation, Good Clinical Practice R2 (ICH GCP R2) focuses on quality management as per risk-based methodology, and there has been a lot of focus on monitoring strategy, which is a mixed method of on-site and centralised monitoring. This systematic review was planned to search for the articles providing the evidence for the impact of risk-based monitoring methodology and monitoring standards for cohort studies. A literature search was performed on MEDLINE, COCHRANE, and WEB OF SCIENCE were as per the keyword’s searches. All the publications were reviewed for the data that provides evidence risk-based monitoring for randomised clinical trials and its impact to ensure that data integrity, patient safety, and results obtained were reliable. The search resulted in four articles that were qualified that discussed about the comparison between monitoring techniques and the risk-based monitoring methodology in randomised control trials and other interventional trials. Two publications suggested that the SDV% can be <8% and range from 20-50%, respectively, depending on the assessed factors and risks. Although there is research being conducted to generate the evidence for risk-based monitoring and reduced SDV linked to data errors, further empirical quantitative research should happen to show the impact of risk-based methodology for clinical trials. There is a lack of systematic and empirical data for monitoring as part of quality management in cohort studies. Keywords: Cohort, monitoring, Quality management, Risk-based monitoring, Source data verification.
100 Impact of Cultural Diversity on Overall Organizational Performance: A Moderating Role Education , Laar David Diam
This study focused on the impact of cultural diversity on organizational performance as moderated by employees’ educational attainment. The study measured cultural diversity as language, religious and value system diversity. Organizational performance was measured as team building, communication, and employee productivity. The study collected primary data from 353 employees from ten different manufacturing companies in the Ashanti and Greater Accra Regions of Ghana. The study employed mean and standard deviation for descriptive analysis. The study employed a structural equation model for the estimation. Cultural diversity was found to be prevalence in the sampled companies. However, team building, and communication were effective, and employee productivity was high. The educational attainment of employees significantly reduced the negative impact of language, religious, and value system diversity on each organizational performance indicator. Stakeholders in Ghana’s manufacturing industry should encourage continued human resource development through the pursuance of higher education, internal and external training, and seminars. Keywords: Cultural Diversity, Educational attainment, Organizational Performance.
101 Resettlement of Internally Displaced Persons in the North Central Geopolitical Zone of Nigeria , Askederin, F. M, Omole, D. K, Shonibare. D. O
This paper investigated the Humanitarian Crisis in the North Central zone of Nigeria and the resettlement challenges faced by Internally Displaced Persons (IDPs). It was designed to find out the types and causes of Displacement in the zone and determine the readiness of IDPs to return to their original communities before Displacement. The Research was carried out in three states of the North Central Geopolitical Zone, which are Nasarawa, Niger, and the Federal Capital Territory using a total of nine IDP camps. It was conducted using a combination of research designs by applying quantitative and qualitative research methods. Data was collected using three data collection tools which are questionnaires, observation schedule, and focus group discussions schedule. Results revealed that the internally displaced persons found in the North Central geopolitical zone in the states of Nasarawa and the FCT come mostly from the Northeastern states of Borno, Adamawa, and Yobe, and were displaced due to the Boko Haram insurgency. Those living in Niger State come from within Niger and were displaced due to Banditry. Results also revealed that the majority of IDPs live in deplorable conditions within the North Central Geopolitical zone with limited access to food, education, health services, water, sanitation, and hygiene facilities. The Research further revealed that most IDPs are willing to return to their original homes, and their first deciding factor to return is the restoration of security back in their communities, the second factor is their family ties, third is funding to support their return, and then fourth is government legislation that may compel relocation of displaced persons. Keywords: Humanitarian, Insurgency, Internally Displaced Persons, Refugees, Resettlement.
102 Integration of Mind and Skin; Psychological Co-morbidity in Dermatology and Skin Signs in Psychiatry , Bushra Khan, Fawwaz A. Khan
Being the largest organ of the body, the skin is known to respond to both exogenous and endogenous stimuli. Whereas it is known that having a dermatological ailment can have a negative effect on one’s body image, in addition to one’s mental state, it should also be noted that the opposite is also true. That is to say that possessing psychological issues can subsequently lead to dermatological ailments. Considering this, the study aimed to analyze the co-integration of the skin and mind, analyzing the comorbidity of psychiatric disorders and dermatological issues. 30 dermatological patients, 25 psychiatry patients, and 10 control patients were enrolled into the study. Patients were tasked to complete a 21-item Depression, Anxiety and Stress Scale (21-DASS) questionnaire and a 10-item Dermatology Life Quality Index. Each patient was then assessed by a dermatologist and a psychologist. It was found that when compared to the control group, the psychological out-patients were more likely to experience dermatological ailments (p<0.001). In addition, it was found that when compared to the control group, the dermatological patients experienced an overall lower quality of life and a higher 21-DASS test result. Ultimately, it can be seen that one’s mental state does in fact, have the potential to affect one’s dermatological condition. With that in mind, it has been proposed to utilize stress reduction techniques and psychological intervention as adjuvant treatments for dermatological ailments. Keywords: Comorbidity, Dermatological, Mind, Mental, Psychological, Skin.
103 Basic Academic Research Structure and Format Guiding Principles for Students , Aquila Hakim M. Jongroor
The main purpose of the guideline is to develop a basic academic research structure and format guiding principles for students with two specific objectives; to develop a coherent research structure and academic research format for the public universities in South Sudan. One hundred and seventeen dissertations were reviewed, and a total of 88 teaching staff were interviewed, giving 91% response rate. The dissertations were selected randomly, and teaching staff were selected purposively by virtue of their positions and availability. The validity and reliability of the instruments was ensured through pretesting, CVI, and triangulations. SPSS v22 was used to analyze data, both descriptive and thematic analysis were used. Permissions were sought from university administrations and one of the respondents before data collection. There is some significant variation on academic structure and format across the five universities in the republic of South Sudan. The research structural variations and inconsistencies were found in their contents and order of titles and subtitles of dissertations reviewed. In conclusion, this basic academic research guide is developed to set some standards and directions for students and their supervisors to complete the dissertation on time with less stress as it provides where to begin and the end. It will also enhance the objective grading of dissertations and evaluation levels of the university. The guideline will contribute to the development of consensus on academic research structure and format standards for students that will encourage young researchers to have an interest in research as a career. Keywords: Basic academic research structure, Format guide.
104 An Assessment of Covid-19 Factors which Influence Non-Compliance of Payments in Respect of Social Security Contributions in Ghana , Samuel Nii Attoh Abbey
COVID-19 has been wreaking havoc on the business world for nearly two years, with most industries experiencing a significant decline in revenue. The major statutory agency in charge of regulating employee pension schemes in Ghana, the Social Security National Insurance Trust (SSNIT) Ghana, has also seen a drop in monthly contributions. As a result, the goal of the study was to see how the COVID-19 epidemic is affecting non-compliance with Ghana’s Social Security Monthly Contribution Payments. The study used a random sampling methodology to select 6 out of 19 decentralized governance structures in Accra, after which a purposive selection method was used to select 50 small and medium business enterprises for their perspectives on the study’s goals. The major research tool was the questionnaire, and the Statistical Package for Social Science (SPSS) was used to analyze the data collected in the field. COVID-19 appears to be taking a toll on the finances of small and medium-sized businesses that have made deals with SSNIT authorities to reschedule obligations related to default contributions, according to the findings. Although new projects have been placed on hold due to diminishing inflows, SSNIT’s commitment to employees and payment of pensions to elderly residents remains unaffected. In light of the a fore mentioned challenges posed by the pandemic, the study suggested that the Government of Ghana should seek concessionary loans from world-class lenders such as the World Bank to strengthen its local stabilization fund and inject a significant amount of funds to assist struggling SMEs in resuming operations. Keywords: Accra Metropolis, Business Operations, COVID-19, Pandemic, Social Security, Virus.
105 Government Expenditure on Economic Growth: Empirical Evidence from Ghana , Charlotte Adamkie Atteh, Joshua Akanyonge, Alfred Asapeo
The role of the government in a market economy cannot be underestimated. In reality, the public sector plays significant role in an economy. Markets do fail sometimes, and for that reason, government intervention is needed to provide public goods or handle externalities and enforce competition in an economy. In the quest of government playing its role in an economy, it faces the challenge of an appropriate level of government size (government final consumption % of GDP) that can ensure sustained economic growth. Data on government fiscal behavior in Ghana over the last two decades generally shows a rising trend in government expenditure, yet the economic growth rate has not risen commensurately. The study set out to provide additional empirical evidence on the linkage between government size and economic growth in Ghana by a time series data analysis and to test the optimal threshold level of which government final consumption could lead to rapid growth in Ghana. The study concluded that total government expenditure has a direct positive impact on economic growth. As a result of that, the study recommended that government expenditure should not exceed the optimum threshold level of 0.114% to maximize economic growth. The study, therefore, advocates for fiscal discipline and control to keep government spending at the optimal level so as to trigger a positive ripple effect to other sectors of the economy and avoid a crowding out effect in the Ghanaian economy. Keywords: Economic growth, Expenditure, Fiscal discipline, Government Size.
106 Impact of Human Resources Budgeting on Human Resource Management Accountability in Metropolitan, Municipal, and District Assemblies in the Ashanti Region , Laar David Diam
The Metropolitan, Municipal, and District Assemblies in Ghana have adopted, have been practicing Human Resource Budgeting for effective accounting of human resources. However, little is done to determine its impact on Human Resource Management Accountability. This study, therefore, focused on the impact of Human Resource Budgeting on Human Resource Management Accountability in Metropolitan, Municipal, and District Assemblies (MMDAs) in the Ashanti Region of Ghana. The study purposively sampled Heads of Departments since they have the responsibility of supervising, directing, coordinating the activities of other employees within the MMDAs. The study collected primary data from 387 Heads of Departments in 43 MMDAs in the region. The study employed mean and standard deviation for descriptive analysis. The study employed a structural equation model for the estimation of the impact of Human Resource Budgeting on Human Resource Management Accountability. The sex, educational level, and years of experience of the respondents were controlled for in the model estimation. Human Resource Budgeting in the MMDAs was occasionally done. Human Resource Budgeting had a significant positive impact on Human Resource Management Accountability in the MMDAs. Ministry of Local Government and Rural Development should see Human Resource Budgeting as a strategic tool for enhancing Human Resource Management Accountability in MMDAs. For this reason, Human Resource budgeting practices should be enforced to the latter. Keywords: Human Resource Budgeting, Human Resource Management Accountability, Metropolitan, Municipal and District Assemblies.
107 Tales of Early Childhood Education Teachers in Government Schools in Chipata, Zambia , Daniel L. Mpolomoka, Moono, Muvombo, Mutinta N. Matimba, Tuke Chulu, Joseph Mate, Mubita Situmbeko
This article houses findings of a study that uncovered the provision of early childhood education (ECE) in government schools with a bias towards learners with special education needs. It focused on challenges faced by teachers in providing educational services to children with special education needs at the early childhood education level in the targeted government schools. The rationale of the study was to solicit trends-in-practice among ECE teachers through their stories, thus partly help other teachers who shall read findings of this study tap into their engagements with ECE learners; and partly nurture children’s development in a right way in early years. Qualitative methodology was used because it allowed for in-depth realities faced in 5 schools in Chipata. The study employed a descriptive research method for two years from 2016 to 2017, comprising five primary schools in Chipata District, Zambia, were conveniently sampled for the study. Interviews, focus group discussions, and questionnaires were used to collect data, which was analysed qualitatively. The study revealed challenges that are quite universal for teaching early childhood education learners. Teachers in this study expressed the need for reduced class sizes, adequate learning and teaching materials, teacher extrinsic motivation, additional support services from the government, and an accommodative curriculum. The study further revealed that early childhood education centres in government schools in Zambia at large have poor learning environments specially to support the learners with special education needs. The study showed that collaboration between early childhood education teachers and parents is necessary for the wellbeing of their children. The study recommends that the government should invest in infrastructure development for ECE centres; and that schools should purchase appropriate learning and teaching materials and stock ECE centres. Keywords: Early Childhood, Learner, Schools, Special Education Needs, Teacher.
108 The Role Professional Accountant Firms play within the Liberian Market in Terms of Strategic Implementation of Financial Statement Audit , Jerome M. Kesselly
The study has evaluated the role Professional Accountant Firms play in the Liberian market and to understand the strategic tools used in implementing financial statement Audits [1]. A deductive approach was adopted, and information was collected from thirty respondents via Unstructured face-to-face interviews. Purposive sampling was engaged as this technique aided the cognizant arrangement of targeted respondents (Audit Associates, Staff Auditors, Semi Senior Auditors, Senior Auditors, Asst. Audit managers, Audit Managers, and Audit Partners). The findings show that Professional Accountant Firms in Liberia play a positive and significant role in the Liberian market. Professional Accountant Firms make great contributions in keeping Liberian businesses at full compliant with international financial reporting standards, legal and regulatory requirements, and their own policies and procedures. It is recommended that to be more efficient, Liberian businesses should embrace the role Professional Accountant Firms play within the Liberian market. It is concluded that the Liberia Institute of certified Public Accountants (LICPA) should strengthen, trained, and Licensed all Professional Accountant Firms to meet the growing need of the Professional Accounting industry in the Country. Keywords: Professional Accounting Industry, Financial Statement, Reporting Standards, Liberian Businesses.
109 4Dimensional X Strain and 2Dimensional Speckle Tracking Echocardiographic Study: Normative Values of Strain Parameters of Left Ventricle and Tissue Doppler Imaging of Ascending Aorta in Healthy Adults –A Single Centre Indian Study , Akhil Mehrotra, Ajay Sharma, Mohammad Shadab, Mukesh Srivastava, Naveen Chandra, Alok Kumar Singh
Global longitudinal strain (GLS) is a sensitive measure of LV dysfunction and is better than EF at predicting CVD events and deaths. Recently 3D/4D/4D X strain speckle tracking echocardiography (STE) is used to analyse complex LV mechanics. Interestingly, HFpEF is related to both GLS and increased Aortic stiffness. TDI of ascending Aorta is an effective technique to assess Aortic stiffness. The aim of the present study is to establish normal values of TDI of AA by 2DE and 4D X-strain volumetric and strain parameters of LV of healthy adults. 102 subjects were enrolled, 72 assessed by 2DE-GROUP-A, and 30 were analysed by 4D X-strain echocardiography-GROUP-B. Important TDI parameters of Aortic stiffness were 3.90 ±3.79& 5.23 ± 10.55, (p = NS), in males & females respectively and Aortic strain were 10.55 ± 7.67% and 9.49 ± 5.56%, (p = NS), in males & females respectively. Volumetric data of EF were 64 ± 7.0 % & 65 ± 6.0 %, (p = NS), in males & females respectively and CO were 5.6 ± 1.5 l/min & 4.91±1.53l/min, (p = NS), in males & females respectively. Moreover, 4D X-strain STE indices of GLS being -17.29 ± 2.71 & -19.00 ± 3.51, (p = NS), in males & females, respectively GCS being -15.46 ± 7.1 & -14.12 ± 6.15, (p =NS), in males & females respectively and GRS being -24.53 ± 9.8 & -21.93 ± -8.81, (p= NS), in males & females respectively. No previous data is available, making the research a singular experience. Keywords: 2Dimensional Speckle Tracking, 4Dimensional X Strain echocardiography, Echocardiography, LV segmental strain, 4D volumetric data.
110 Making FIFA World Cup Qatar 2022 Truly Healthy and Safe: Strategies and Legacy for Present and Future Sporting Events , Abiodun Bamidele Adelowo
Aside from the FIFA men’s World cup, fewer other global sporting events have the potential to attract the undivided attention of global leaders and citizens. It is arguable the most influential global sporting event. Thus, the FIFA World Cup Qatar 2022 has been themed “Healthy 2022 World Cup - Creating Legacy for Sport and Health”, and the goal is to make the event the most successful, healthiest, and safest sporting event in recent human history. The event is meant to rekindle the global conversation around the double disease pandemic that is presently ravaging the world. The fast and furious Covid-19 and the subtle and steadily progressing non-communicable diseases (NCDs). The event organizers also intend to use the platform to provide and implement health promotional strategies that will successfully prevent and control the spread and progression of these diseases and influence most global football enthusiasts to cultivate healthy and sustainable lifestyle changes. A successful event may likely be a model and legacy for future sporting or social events. However, for the FIFA World cup Qatar 2022 to be effective in changing unhealthy behaviours and in promoting safe and healthy lifestyles, it should have some vital components. The planning and execution of such a project need to be systematic, comprehensive, and evidence-based. This review briefly discussed the global impacts of Covid-19 and NCDs, the importance of combating these diseases through the FIFA World cup Qatar 2022, and finally suggested strategies that will likely ensure the event achieves its set goals and objectives.
111  Epidemics and Vaccination Dilemma in Complex Networks: A Case Study of Kosefe and Shomolu Local Government Area Lagos Nigeria , Odis Adaora Isabella, Okpoko Pius, Ganu Daniel, Ogbenna Ann
Vaccination is undoubtedly one of the foremost important preventive measures of modern times; epidemics are feared as one of the most damaging phenomena in human societies. Aim: The thesis unveiled how the interplay between the probability of infection, vaccine effectiveness, and cost gives rise to non–linear responses in vaccine uptake. The study design was a cross-sectional descriptive study that used pretested closed-ended questionnaire that was distributed to the respondents. The sample size of 375 was adopted, which was calculated from the target population using the Cochrane formula for sample size calculation. Parents/guardians that strongly believe politicians should be role models that encourage vaccination were 61.87%, while 50.67% of mothers/caregivers were not sure if there is still a link between MMR vaccination and autism. The majority of parents/guardians (55.47% + 29.87%) strongly agree plus agree that media reports on vaccination programmes encourage them to vaccinate their children. 32.80% strongly agree, and 22.40% agree that the media exaggerates reports about disease outbreaks. Conclusion: The level of education plays an important role in the level of knowledge and attitude towards epidemics and vaccination. Income and Cost of vaccines affect vaccination uptake because of the present economic situation in Nigeria. Media plays a key role in vaccination campaigns, awareness, and intervention and should be promoted more to achieve the goal of ensuring all children are vaccinated properly. Doctors and Public Health Nurses have a major role to play in terms of influencing parents/guardian’s vaccination uptake.
112 Predictors of Family Size Among Men in Urban Slums of Enugu, Southeast Nigeria: A Cross Sectional Study , Enebe NO, Osi-Okeke UC, Oputa SC, Ozoemena CL, Ozoemena OF, Enebe JT, Ndu AC
A rapidly increasing population is a threat to national development, family stability and social security. This study aimed at assessing family size preferences and its predictors among married men in urban slums in Enugu, Nigeria. A descriptive cross-sectional study that involved household survey of 381 married men living in urban slums of Enugu, Nigeria was carried out. Data was collected using pre-tested, interviewer-administered questionnaires. Data aanalysis was done with IBM Statistical Package for the Social Sciences (SPSS). The average actual family size was 6 people, with an average of 4 children. 62.5% had their children mixed, 27% had all males, while 10.5% had all girls. However, over 50% of respondents desired to have a family size of 8 or more, with 52.8% of them preferring to have at least 3 sons and 3 daughters. The predictors of family size were: age of respondent (AOR 2.951; CI=1.343-3.314), sex distribution (AOR 2.905; CI= 1.960-4.306), number of twins (AOR 4.720 CI= 1.821-12.231), desired number of children (AOR 7.566; CI=2.334-24.522), desire to continue childbirth (AOR 0.202; CI=0.084-0.482) and desire to have more children if income is increased (AOR 0.403; CI= 0.176-0.919). Actual and desired family size, as well as male sex preference, were high among married men in Enugu urban slums. Family size was predicted by the age of respondent, sex distribution, number of twins, the desired number of children and desire to have more children. Health education programs on population control should target urban slum dwellers to enhance human and economic development.
113 Knowledge, Attitude and Practices of Infant and Young Child Feeding Practices Among Caregivers in Ekiti State (A South-Western State) in Nigeria , Raymond Ade Adesanmi
The knowledge of caregivers is an important factor when it comes to the maintenance of both the nutritional status of children and protection of their nutritional needs to ensure a sound foundation and secure future of any healthy society. This research thus aimed at investigating the trends in Infant and Young Child Feeding practices for children aged 0 to 23 months to evaluate how the nutrition education and counselling received during contact with health workers have contributed to the Knowledge, Attitudes and Practices of the caregivers regarding appropriate nutrition in Ekiti State. The assessment was done using a cross-sectional survey method, and FAO’s guideline for assessing nutrition related KAP5 was adopted and used. Cochran’s equation was used to calculate the sample size, and three households were randomly picked in each political ward. Data was collected and analysed using EPI Info 7. 94.3% of the respondents breastfeed their children on demand, and 47.2% of the mothers had skin contact with their babies after delivery. 78.2% believed that exclusive breastfeeding is very good. 68.2% believed that their children could get diarrhoea from the use of a feeding bottle. 88.3% are aware that 5-9 months are the appropriate age for the introduction of semi-solid and solid food. There is a high level of knowledge, attitude and practice among the caregivers and an improvement was observed in most of the infant and young child feeding practices in Ekiti State.
114 Investigating the Effectiveness of Case Management among Orphans and Vulnerable Children at Household Level in Enugu State, Nigeria , Prince O. Ezekiel
In sub-Saharan Africa, a large proportion of children lack basic necessity and support for optimum development. In Nigeria, the estimated number of children who are orphans and vulnerable and in need of essential care is 17.5 million as of 2008. Major causes of orphaning and vulnerability include poverty, conflicts, HIV/AIDS, road accidents, communicable and non-communicable diseases, and harmful cultural practices. Hence, the Case management approach has been adopted as a community service delivery strategy for addressing the needs of orphans and vulnerable children at the household level. This study investigated vulnerable households in Enugu State who have been ever enrolled into Orphans and Vulnerable Children (OVC) donor-funded programs and received services that are geared toward enhancing their socio-economic stability. The standard OVC custom indicators were used in measuring the results and outcomes of services provided to OVC and their caregivers. The results show significant effect and impact of the case management approach in OVC program service delivery as over 50,000 beneficiaries from over 14,000 households were served from four domains of Healthy, Safe, Schooled and Stable. Households received these services after enrolment and were moved from a state of vulnerability to self-resiliency. Also, results show strong collaboration between OVC implementing NGOs and government stakeholders in terms of capacity building and systems strengthening in addressing the need of OVC and their caregivers. Conversely, results indicated a week synergy between local and state government OVC officials – hampering on their oversight capabilities of OVC programs. This can be improved with increased funding and coordination.
115 Knowledge of Community Based Health Insurance among Residence of Katsina State, Nigeria; A Comparative Cross-Sectional Study , Yahaya Shamsuddeen Suleiman, Mustapha Mukhtar, Lawal Nasir, Runka Jamilu Yahaya
Enrollment into any form of insurance is very low in Katsina State, with the majority of people paying out of pocket for health care. Knowledge of Community Health Insurance (CHI) has been found to influence enrolment into the scheme. To compare differences in Knowledge between community-based health insurance member households and non-member households and to identify factors associated with the knowledge. A comparative cross-sectional descriptive study was conducted among household heads in Katsina State, Nigeria. A sample size of 300 was determined, and respondents were selected using the multistage sampling technique, data was analyzed using SPSS. The mean age of respondents was 46.82±13 and 44±12.5 years for ensured and non-ensured groups, respectively. Heads of the households were predominantly males and currently married, with 97.3% and 93.3% for CBHI members compared to 82.7% and 99.3% in non-member households, respectively. A greater proportion of the sampled households had Quran education only. The majority of respondents in both groups have heard about CHI, and the source of information was from community leaders. There was no statistically significant difference in the level of knowledge of CBHI between insured (56. %7) and uninsured (47.3%) households (t Stat =4.642, p= 0.07). Knowledge of CHI is higher in an insured group than non-insured but there is still a knowledge gap in both groups. To ensure that health care is accessible to all, CHI should be promoted, and more people should be encouraged to join.
116 An Analysis of Factors that Affect Food Choices of University of Zambia Students , Rabecca Kayumba, Samuel Adebayo Awoniyi, Lloyd Makamure, Margret Mulenga Pansho, Annie Musonda-Mubanga
The purpose of the study was to analyse factors that affect food choices of accommodated female students at the university of Zambia. The sample for the study was 249 female students selected using the proportional stratified simple random sampling technique. A questionnaire was used in collecting data. The data collected were analysed using descriptive statistics, t- test and factor analysis. The factor analysis showed that food choices could be grouped into six groups accounting for 58.765% of the variance. The average mean of 2.0180 indicated that respondents have limited Nutrition Knowledge. It was also noted that; there was no difference in Nutrition Knowledge between the young ones and the older ones. The non-vegetarians ate more food groups than the vegetarians. The vegetarians spent more time on exercise and drank more water per day. Respondents also differed in their food choices and cooking methods according to their socio-economic status. The main recommendation that emerged from the study was that Food Science and Nutrition should be added to one of the first-year core courses at the University of Zambia. In addition, outsourcing experts such as dieticians and nutritionists to address students on importance of safe clean water and good food hygiene practices would be invaluable in ensuring healthy lifestyles and enhanced academic productivity. 
117 Characteristics of the Low Vision Population in South-East Nigeria , Samuel Ononuju Ndukuba,, Okechi Ulunma Amaechi, Precious Chidozie Azubuike
The increasing attention on the indices around low vision and blindness globally is worth noting. With strategic interventions aimed at preventing avoidable blindness and reducing the burden of low vision, research is being carried out to reveal the magnitude, characteristics, and available interventions for low vision. This study was aimed at characterizing low vision among populations in the South-East geopolitical zone of Nigeria. A total of 1473 persons were screened in outreaches across the zone. Clinical assessments, including external examination, refraction and ophthalmoscopy, were carried out, and 239 persons (16.2%) were identified with vision impairment with the various categories established. Data were analyzed using the IBM Statistical Package for the Social Sciences (version 24.0) and presented using frequencies, percentages, and tables. Statistical significance was based on p<0.05. The prevalence of moderate and severe vision impairment was 8.6% and 3.7%, respectively, while blindness was 3.9%. Cataracts (32.6%) and glaucoma (22.2%) were the most common causes of vision impairment and blindness. There was no positive relationship between age, sex and occupation of individuals and level of vision impairment with P values of 0.52, 0.21 and 0.11, respectively. Living in a rural area was not significantly associated with a higher degree of visual impairment than living in an urban area with P=0.81.
118 The Effect of Cultural Beliefs on Effective Utilization of Immunization on Childhood Killer Diseases in Kuje , Bassey, G. M
This article evaluates the effect of cultural beliefs on the effective utilization of immunization on childhood killer diseases among parents living in some remote areas in Kuje Area Council in FCT. Relevant cultural factors hindering effective utilization of immunization were discovered; likewise, Universal immunization of children against six preventable diseases (tuberculosis, diphtheria, pertussis, tetanus, polio, and measles) is crucial to diminish childhood mortality and morbidity across the world. Improving access to and utilization of routine immunization services are the best option for the prevention and control of vaccine-preventable diseases (VPD). The expanded program on immunization (EPI) was launched in 1994 as a global program for controlling and reducing death from vaccine-preventable diseases. A recent report from the world health organisation (WHO) revealed that the number of children under one year of age who did not receive the diphtheria-tetanus-pertussis vaccine (DTP3) worldwide was estimated to be 21.8 million in 2013 compared to 22.8 million in 2012. Three hundred and eighty-four (384) questionnaires were administered to parents using the house to house strategy in the Kuje community. Of those surveyed, (30.2%) had basic education, and the level of illiteracy could have contributed greatly to noncompliance. (80.2%) believed that only immunization can protect children against childhood killer diseases, while (19.8%) disagreed. (32.0%) believed that immunization could lead to HIV infection, (30.5%) of the respondents assumed that immunization causes a child to be sterile and (20.6%) agreed that immunization is forbidden by God, while (16.9%) believed that it causes some mental, spiritual, and physical deformity in children.
119 Higher Readability Levels and Suboptimal Design of Medicine Information Leaflets in Artemisinin-based Combination Therapy Antimalarial Packages: A Consequence for Over-the-Counter-Medicines Use , Rachel Obonose Titus, Margaret Olubunmi Afolab, Omoniyi Joseph Ola-Olorun
The study aimed to determine the readability level and assess the design layout of medicine information leaflets in packages of Artemisinin-based Combination (ACT) antimalarials used as over-the-counter medicines in Nigeria where malaria is endemic with higher adverse events in under-five children and pregnant women. A cross-sectional study design was adopted to evaluate thirty-two medicine information leaflets of ACTs obtained from community pharmacies. Texts in selected passages of the leaflets were subjected to the Flesch-Kincaid (F-K) formula to determine the F-K score and the corresponding reading-grade level. The Baker Able Leaflet Design (BALD) assessment tool was employed to assess the medicine information leaflets design layout. The mean Flesch-Kincaid score for the MILs was 14.22 ±5.06. A proportion of 15.63% of the MILs were readable at the postgraduate level, 28.13% at the undergraduate level, 37.5% at the senior secondary school level and 18.76% at the junior secondary school level. This represented the total proportion of leaflets readable at the junior secondary school level which is the average level of education in Nigeria. On the BALD tool, 46.28% of the MILs were rated ‘above standard’ and 53.72% were ‘poor’ in design. The dimension of the longest MIL was 80cm by 36cm. A large proportion of the MILs were written above the reading level of average Nigerians and were poorly designed. Most Nigerians are not likely to be able to read these leaflets for reference purposes and to serve as reminder for instructions obtained during medication counselling.
120 Outcome of Community-Initiated Treatment of Drug-Resistant Tuberculosis Patients in Akwa Ibom State, Nigeria , Asuquo, E.A.
Drug-resistant Tuberculosis (DRTB) occurs when the drugs used to treat TB are misused or mismanaged by, WHO 2018 Examples of misuse or mismanagement include People who do not complete a full course of TB treatment, Health care providers prescribing the wrong treatment (the wrong dose or length of time), Drugs for proper treatment are not available, and poor quality of drugs. The study aimed at determining the treatment outcome of Community-Initiated Drug-Resistant Tuberculosis Patients registered between January 2017 and December 2020.in Akwa Ibom State, Nigeria. The study design was a retrospective cohort study; a total sampling technique was employed to review patients that were diagnosed and registered during the period of study. The demographic and clinical data of each patient were retrieved from the DR-TB patient treatment cards, DR-TB patient treatment progress notes from directly observed treatment short-course (DOTS) providers in the community, the state DR-TB central register, and treatment card. Data were analyzed using Statistical Package for Social Sciences (SPSS) Software (Version 23; SPSS, Chicago, IL, USA). The median age of clients that participated in the study was 34 years [27- 49.5]. Most of the participants were male (56.2%), and a greater proportion of the enrollees were all new cases (76.3%). The study determined some of the sociodemographic characteristics of patients that received treatment for drug-resistant tuberculosis using the Community-Initiated model, their health outcomes, and assessed the predictors of some of the health outcomes.
121 The Benefits of Technological Developments on Businesses: A Survey Conducted among SMEs in Beni, Democratic Republic of Congo , Rodrigue Kalumendo
New technologies are considerably influencing companies for information system implementation every year. This trend has led many people, including business managers and researchers, to question the benefits of technology to business. While Small Medium Enterprises (SMEs) in developing countries, particularly those in the Democratic Republic of Congo (DRC), are gradually digitalizing their information systems, To our knowledge, very few studies to analyze the benefits of technologies on DRC SMEs have been conducted. This study, therefore, sought to place itself in the Congolese context to find out about the benefits of digitalized information system. 119 SMEs that have been using information system technologies for at least two years were selected for data collection. Descriptive statistics and Pearson’s correlation were used for the data analysis. The findings from the study show that SMEs derive certain benefits from the use of technology and have improved organizational system performance that including an increase in profit, optimized time management, reduced paperwork, improved information quality, and improved financial reporting quality. The results also reveal that the more a company invests in technology, the more benefits it receives.
122 Cloud Computing in Healthcare Industry , Ravindra Patel
The advent of technology has become inevitable in today’s world, and every industry is on the frontline of incorporating the technology. The healthcare industry has not been an exception, as it has also integrated the essential components of technology into its functioning. Patient records are no longer stored manually but are instead stored electronically, and this has benefited the industry by increasing the productivity of patient care. It has also assisted healthcare in having easy accessibility and usage. The current technological innovation that has occurred in the health care industry is the innovation of cloud computing. However, there are many fears and various security measures that have come up in the health industry concerning patient records being stored remotely. Therefore, a person needs to understand what benefits are attached to the application of cloud computing in the health industry and the fears associated with the same. Besides, one also needs to be aware of both the merits and the disadvantages that are come in because of the newly invented technology. After a lot of advancements and developments, the usage of cloud computing has been increasing steadily. Therefore, cloud computing is the right time to explore the use of this technology to improve on the healthcare industry’s services to the public. Lastly, the main purpose of the paper is to evaluate the various factors that healthcare organizations should consider when implementing cloud computing technology.
123 Private General Practitioners’ Agreement on Skills and Competencies for Universal Health Coverage in Urban South Africa - A Descriptive Cross-Sectional Survey , John Mukuka Musonda, Shabir Moosa
Globally, Sustainable Development Goals (SDGs) and Universal Health Coverage (UHC) are designed to ensure equity and quality health care. In South Africa, National Health Insurance (NHI) is the vehicle for it. Strategic purchasing and contracting private general practitioners (GPs) are key strategies. Skills training will prepare GPs for NHI. However, it is not clear as to which GP skills and competencies are currently implemented in practice. The study assessed GPs’ agreement on skills and competencies in urban South Africa. A descriptive cross-sectional design and the online semi-structured survey was undertaken between 30 September to 14 October 2020. We targeted 5,212 private GPs registered on Medpages in Gauteng Province. Respondents who answered all questions were conveniently sampled. Data analysis was performed using SAS institute software, version 9.4. A four-point Likert scale was categorized as agree or disagree. A Wald Chi-square test evaluated associations between variables. Findings revealed that most had no government contract (84.3%, n=97) and were solo (53%, n=61). The majority were agreeable to the eye, ear, nose, and throat skills (93.3%, n=207). The least agreeable was the abdominal skill (32.7%, n=72). Logistic regression showed qualifications, work experience and type of practice were significant predictors. The GP contracts affected the skills range. Surveyed GPs did not agree on many listed skills. Significant predictors of an agreement to skills in the current practice were identified. The findings highlight the need to fast-track GP skills training in South Africa.
124 Patient Satisfaction with Non-Pharmacological Pain Management during Labour at a Midwife Obstetric Unit in a Peri-Urban South Africa - A Descriptive Cross-Sectional Study , John Mukuka Musonda, Makafane Cyril Mabathoana
Patient’s satisfaction with pain management is vital for quality care. Therefore, pharmacological and non-pharmacological interventions do contribute significantly to pain control. The aim was to determine patients’ satisfaction with non-pharmacological pain management in labour. A descriptive, cross-sectional design was conducted from June 2017 to March 2019. Participants were conveniently sampled to include 311 women three days after normal delivery. The research tools were Pain Satisfaction and American Pain Society Outcome Questionnaires were used to collect data. Univariate logistic regression was used to test for associations between variables. Findings of the study revealed a mean age of the women was 26.9 years, and 90.4% were Black, IsiZulu speakers, having two children and had secondary education. Moderate pain was experienced in 49.2%, and herbs or prayer were used by 55.3%. To relieve pain, participants reported deep breathing (26.2%), walking (22%), massage (21%) and prayer (14%). Effective pain relief was in 53.1%, while satisfaction was by 56.3%. The only statistically significant predictor of dissatisfaction was the number of live births (p=0.003). One live birth compared to four live births was more likely to be dissatisfied (OR=11.5; 95% CI 1.4-97.2). Findings suggest that non-pharmacological interventions are effective. The moderate pain experienced by a significant proportion may signify the need for pharmacological treatments. The association between low parity and dissatisfaction warrants further research.
125 Combating the Terrorism of Boko Haram in Nigeria: Political and Military Approach , Amos Ojo Adedeji
In the history of the human race, power has more often been wielded through terror and inciting fear. The use of terror began at the very birth of organized society as a means of discretion or punishment. Terrorism has become a song to be sung in Nigeria with the emergence of dreaded Boko Haram terrorising old and young, male and female, rich and poor, spearing nobody in the area of their operation, most especially in Northern Nigeria; hence collateral killing is their watchword. The study examines the efficacy of the political and military approach in combatting the menace. It employs a mixed approach, which mostly relies on both primary and secondary data collection to elicit information. To meet the security challenges posed by this dreaded sect, the researcher advocates the use of intelligence-led policing, counter-insurgency and trust-building strategies between the government and citizenry.
126 Changing Cultural Values and Grassroots Transformation in Nigeria , Maria Ekpenyong
The issue of changing cultural values and grassroots transformation is the concern of every Nigerian, and as such, grassroots communities should embrace change. Some people refuse to embrace change for so many reasons. This could be due to the complexity of values and beliefs which are prevailing in a society. This forms the basis for justifying people’s actions which are termed ideologies. Ideology is a crucial device for the sustenance of the community as it has the capacity to shape how community people perceive and interact with society about grassroots transformation. Hence a society without a clear-cut development ideology or agenda risks stagnation. It is on this assumption that this article suggests that Nigeria should embrace cultural change for transformation at the grassroots for national and global benefits. Against this background, the article examines the cultural value and the transformation of people at the grassroots with a view to understanding how changes in cultural values will affect transformation at the grassroots in Nigerian communities. Based on this, the article believes that there is a connection between changing cultural values and grassroots transformation capable of avoiding stagnation and enhancing innovation; increasing understanding, improve productivity, community services and socio-economic activities. The article recommends the provision of acculturation to keep up with emerging global demands and survive future uncertainties. We need to change what is termed “normal and acceptable” and educate people to master our environments and acquire new skills from other societies for innovation to enhance a higher standard of living and growth at the grassroots.
127 Innovation on Social Media Platform as a Tool for Students’ Learning in Selected Public Institutions in Oyo State, Nigeria , Kayode Aderinsola Eunice,  Kareem Rafiyat Motunrayo, George-Kayode Blessing
Innovation in the educational sector brings something new to enhance pedagogy using technological tools in teaching and learning globally. This study explored the actual impact of daily use of social media platforms in learning among students in selected institutions in Nigeria. A descriptive research design was utilized to gain an accurate profile of situations. Six hundred (600) University of Ibadan and Emmanuel Alayande College of Education students actively using social media are the respondents of the study. The research respondents cut across 6 faculties in the University of Ibadan and 3 Schools in Emmanuel Alayande College of Education. Summing up, social networks became an integral part of the students’ full life and took up most of their free time. Undoubtedly, in social networks, there are also things useful for the development of the students. Social media is the most preferred online learning platform for students across Nigerian institutions. In addition, Students in Nigerian institutions during learning have limited access to free data. Thus, it can be concluded that social media have a dual impact on student achievement, and it is necessary to approach adolescents’ use of social networks with ultimate responsibility. The findings of this research can be used to propose effective plans for improving students’ learning in such a way that a balance in leisure, information exchange, and students’ learning can be maintained. To this end, the researchers recommended that social media be used for educational purposes and Social Networking. Cite should be expanded, and new pages should be created to enhance academic activities and avoid students’ learning setbacks.
128   Protective Masks: A Semiotic Discourse in Times of Pandemic , Kundlata Mishra, Shweta Rangnekar
Face masks have been an essential part of Personal Protective Equipment (PPE). Protective masks are pieces of kit or equipment worn on the head and face to afford protection to the wearer. They are usually worn for providing a supply of air or filtering the outside air (respirators and dust masks). In the past two years while coping with the pandemic, one of the most significant changes that have been part of our wardrobes is a face mask. The Covid-19 pandemic disrupted our normal to give rise to a post-pandemic new normal where the focus has shifted to multi-functional clothing that provides a multidimensional experience to the wearer. Safety, functionality, comfort and aesthetics are at the core of this fashion. However, what continues through the pandemic as well is the ability to communicate visually. Thus, making fashion as a major contributor towards the perception and interpretation of identities. With this as the base, the authors studied the semiotic discourse in perceiving a community’s identity in the times of pandemic with respect to performance clothing. The authors conducted an in-depth qualitative analysis of workers using a questionnaire based on a Likert scale and open-ended questions from process industries and Original Equipment Manufacturers (n=50) of Northern and Western India to explore creating mask designs to communicate their work identities. The face masks were designed, which not only help protect against covid-19 and the work hazards but also projected the area and potential hazards of the job profile for better compliance in the workers.
129 Strengths and Challenges to the Integration of Mental Health Services into the Primary Health Care System in Developing Countries: A Systematic Review , Roxanne Stowe-Maloney
The existence of a treatment gap for persons with mental disorders has led the WHO to implore leaders around the world to integrate mental health services into the community or primary health care system. Whilst there are strengths, there are great challenges to the integration process that are hindering the implementation of this initiative in developing countries. The aim of this paper is to synthesize evidence from various researchers regarding the strengths and challenges to the integration of mental health services into the primary or community health care system in developing countries. The sources of information included Pubmed, Medline, Google Scholar, Ebsco Host, and the WHO website. Seventeen (17) studies met the inclusion criteria out of the search results of 2,200. The challenges most reported were inadequate support and supervision structures; lack of key resources, limited Knowledge, inadequate training, and lack of experience of healthcare providers in mental health; time constraints for the primary healthcare workers; lack of regulatory measures to encourage the integration. The strengths most reported were health care workers’ acceptance of responsibility to provide mental health services in the community setting. This paper has proven a number of strengths and challenges regarding the integration of mental health services into the primary or community health care system. It is hoped that this paper will assist stakeholders and policymakers in overcoming the majority of the challenges identified in the integration of mental health services in the primary health care system. Keywords: Challenges, Developing countries, Integration, Mental health services, Primary health care, Strengths.
130 The Effect of Acupuncture Using Specific Acupoints and Non-Acupoints in Non-Traumatic, Chronic Shoulder Pain: A Case Study , Murukesu M Margapandu
Chronic shoulder pain is one of the most common presentations of musculoskeletal pain in our community, which usually complicates or interferes with a person’s daily activities, social events, and overall quality of life. It is the leading cause of disability among middle-aged working individuals. It has been reported that until the present day, none of the conventional treatments has proved effective for chronic shoulder pain in the long term. Furthermore, there are considerable side effects, to varying degrees of these treatments. Acupuncture, as part of Traditional Chinese Medicine, has shown effective results in treating shoulder pain by minimizing the pain and improving range of motion and mobility. The present case involves four patients diagnosed with non-traumatic chronic shoulder pain. All the patients were given three acupuncture treatments per week, lasting 40 minutes for the duration of two weeks. Needling was inserted at six specific acupoints and five specific non-acupoints. Pain and mobility assessments were done before and twenty minutes after each treatment. The result shows positive effects of acupuncture using specific acupoints and specific non-acupoints in alleviating non-traumatic chronic shoulder pain. At the end of this study, their shoulder pain was greatly minimized, and their shoulder functionality improved remarkably. Although larger clinical intervention studies on the effect of acupuncture treatment on chronic shoulder pain due to non-traumatic injury are needed, the result of this case study indicates that acupuncture treatment using specific acupoints and specific non-acupoints can be an effective alternative therapy or treatment tool for patients with non-traumatic chronic shoulder pain. Keywords: Acupuncture, Acupuncture points, Chronic shoulder pain, Conventional treatment, non-acupuncture points, non-traumatic shoulder pain, pain scale, range of motion and mobility.
131 The Relationship between Adverse Life Experiences in Childhood and Unhealthy Eating Behaviour in Adulthood: A Literature Review , Marina, Nagy Sabry Samy
The manuscript is simply discussing several forms of adverse childhood experiences (ACE) and their negative impact on children. ACE may contribute to the development of eating disorders (ED) that mostly appear during adolescence, and if untreated earlier, children will suffer ED chronically. Undoubtedly, we are humans that make mistakes, and such mistakes may be stressful to others. Also, life is not so easy; it involves difficulties as well as enjoyment. Thus, in this study, the author analyzed the stressful conditions that occur in childhood and their negative impact on human behaviour that can be developed into many disorders such as eating disorders, obsessive-compulsive disorders, and others. The author used the methodology of searching articles published between 1990 and till present. The authors investigated the factors that play a role in the appearance of such disorders such as culture, media, genetics, upbringing, environment, peers, school, and others. The severity of disorders depends on the intensity, harshness, and frequency of ACE. Moreover, the relative relationship between the child and the one who harmed him plays a significant role in the severity of disorders. Studies proved that treatment of disorders is not impossible, and relief can occur. Keywords: Adverse childhood experiences, Abnormal eating behaviours, Childhood psychological problems, Eating disorders, and treatment of eating disorders.
132 Does Gender Matter in the Adoption of Emails in the Namibian Enterprises? , Adalbertus Kamanzi
The paper examines if gender matters in the use of emails in the enterprises of Namibia. The paper is based on the usefulness of emails in business organizations, using the Namibia Enterprise Survey data collected from 580 enterprises by the World Bank in 2014/2015 in order to test a null hypothesis that there is no association in the use of emails between women and men top-managed enterprises in Namibia. The paper finds out that there is an association with men in top-managed enterprises using more emails than women’s top-managed organizations. This finding signifies the institutionalized gender digital divide in enterprises, signalling the marginal benefit of advantages accruing from emails in the enterprises that are top managed by women. Hence, gender matters. Keywords: Emails; Enterprises; Enterprise data; Adoption; World Bank.
133 Exploring Nigeria Annual Budgets and Health Sector Budget Provisions towards Attainment of Universal Health Coverage Amid the Covid-19 Pandemic Preparedness , Gloria Nonyelum Eneh
The Covid-19 outbreak is currently having a significant impact on the health and economic growth of the World. This study explored the trend in Nigeria’s annual budget from 2016 to 2020, the assumptions for these annual budgets, the budget allocations to the Health Sector and the policy measures in place for health emergencies. The mixed-method approach was used and involved key informant interviews of 30 employees and 30 top management officials across the Federal Ministries of Health and Finance using a structured interview guide. There were also desk reviews of documents in public domains and government published financial and budget data at global and national levels. The findings reveal that Nigeria has continued to increase her annual budget without much improvement in her revenue position. The key assumptions on which the various annual budgets were based were distinct, and none envisaged the Covid-19 pandemic and its aftermath. On health sector allocation, the Federal Government of Nigeria lays little emphasis on efforts towards the attainment of UHC and emergency health events. The government ensured that health care financing policies and provisions are in place. However, the adequacy of those policies and provisions needs to be improved upon. The past spending pattern between 2016 and 2020 shows that these policies are not directed at closing the scary gap that makes ordinary Nigerians suffer from the overwhelming cost of healthcare. This includes a lack of attention to the basic health fund and funds for emergencies, probably due to inadequate political will and commitment to health. Keywords: Budget allocation, Covid-19 pandemic, Emergency preparedness, Health budget, Health expenditure, Universal health coverage.
134 New E-Technologies and Practices Adoption Framework (Ne-TPAF) Dealing with the Crucial Times , Judith Namabira, Berine Rhobi Magaria, Tafuteni Nicholaus Chusi
The study investigates into the factors influencing the adoption of e-HRM technologies in order to propose a framework for the adoption of new e-technologies and practices during critical times of disruption, uncertainty, complexity, and ambiguity, as is with the case of the Covid-19 pandemic. Through the identification of the factors that influence the adoption of e-HRM technologies in one of the biggest commercial banks in Tanzania, the paper proposes a new e-Technologies and Practices Adoption Framework (Ne-TPAF) in order to promote the adoption of new e-technologies and practices during and after the abnormal times. Keywords: Adoption, Critical times, e-HRM, e-technologies, Influential factors, Ne-TPAF.
135 An Investigation into Project Management Best Practices in Nigeria’s Telecommunication Industry , Olanrewaju Modupe-Samuel
The purpose of the study was to investigate project management best practices in Nigeria’s telecommunication industry. Data was collected across 379 telecommunication firms and analyzed using the descriptive method. The study found that telecommunication firms in Nigeria adopt the best project management practices. Best project management practices are widespread in the telecommunication industry in Nigeria. The project management practices adopted by telecommunication firms include holding initial meetings of all the project stakeholders, the development of project scope management, keeping all related parties updated throughout the project’s lifecycle, the creating of resource plan, the creation of a response risk team, transparency in the implementation of projects, setting realistic project milestone and review of project performance. Keywords: Best Practices, Project, Project Management, Telecommunication Industry.
136 Perception Regarding Health Care Financing System and Its Advancement towards Universal Health Coverage in Nigeria among Residents of Awka, Anambra State , Gloria Nonyelum Eneh
The purpose of this study was to explore the perception regarding the health care financing system and its advancement towards health coverage in Nigeria among residents of Awka, Anambra state. An exploratory survey approach was used; and entailed the collection of both qualitative and quantitative data from 360 participants using one set of structured questionnaires, which was also used as an interview guide to collect data from the non-literate respondents. The findings reveal that majority of the respondents do not have knowledge of what the health care financing system involves, whether, on generation, allocation, or utilization of funds for health care, and thus do not agree with whatever the objectives of health care financing system is in Nigeria. Out-of-pocket expenditure has been reported as the mechanism commonly used for implementing a health financing system in Nigeria. There is little or no knowledge regarding the objective of pooling resources for health and no knowledge of how the government secures health services for the populace. Nigeria should develop and implement health financing policies that ensure contributions from relevant stakeholders aimed at investing in individuals, families, and communities, ensuring capacity development that will enable their active and meaningful engagement in health issues. This will thus optimize their knowledge as advocates for healthy policies, active co-developers of health and social services, and implementers of these services. Keywords: Health care financing, Health financing system, Pooling of funds, Universal health coverage.
137 Normal Value Ranges of LV Deformation, Rotation and Twist Parameters in Healthy Adults by 4Dimensional XStrain Speckle Tracking Echocardiography , Akhil Mehrotra, Shubham Kacker, Mohammad Shadab, NaveenChandra, Alok Kumar Singh
XStrain 4D Speckle tracking echocardiography is a novel approach to address both the strain deformation and rotational mechanics of LV. The aim was to comprehensively present the normal value ranges of LV strain and rotational parameters of healthy Indian adults after assessment with this innovative technique. The study population comprising of 80 adults (58 males, 22 females; Group A < 30 years, Group B > 31 years) is revealing the values of Global longitudinal strain (GLS), Global longitudinal strain rate (GLSR), Transverse strain (TS), Transverse strain rate (TSR), Shear and Shear rate are greater in men than in women (p<0.01) and moreover in Group A, Global Circumferential strain (GCS), Global Circumferential strain rate (GCSR), Global Radial strain and Global Radial strain rate (GRSR) were similarly higher in men. Peak apical rotation, peak twist, twist rate and untwist rate values were again greater in men (p<0.01) and increased with advancing age. This is the first study to present a candid and comprehensive analysis of extensive parameters of LV strain and rotational mechanics in healthy Indian adults. Keywords: 4Dimensional XStrain echocardiography, LV rotational mechanics, LV twist and torsion, Speckle tracking echocardiography.
138 Factors Associated with Viral Load Suppression amongst People Living with HIV on Highly Active Anti-retroviral Therapy [Haart] at Kaloko, Chipulukusu and Kantolomba Art Health Facilities of Ndola District , Nandipha Hanene
It is important to monitor HIV clients in ART treatment using viral load testing in an effort to meet the third 95 strategy of UNAIDS 95-95-95, which is viral load suppression. The target “95-95-95” strategy is expected to be achieved by 2030. Unfortunately, there is insufficient regional data, especially in the third “95”. Screening for viral load in low- and middle-income countries allows VLS monitoring of individual categories and demographics, necessary to achieve global epidemic control. The aim of this study was to find progress in the three [3] rural health centers in Ndola District on the achievement of VLS among HIV-positive patients on ART and related factors affecting the program. Sociodemography data, including age, gender, drug type and duration of treatment and laboratory variability [current viral load results], were extracted from client records using the SmartCare system. VL suppression and failure are determined using WHO definitions [viral pressure such as viral load <1000 copies/ml and virologic failure ≥1000 copies/ml]. Regular clinic [used as a proxy for adherence to medication and medication] will be defined as monthly clinical access to HAART treatment and other clinical management over the past 12 months. Keywords: ART, HIV, Suppression, SmartCare, Viral load.
139 Assessment of Knowledge and Acceptance of Covid-19 Vaccinations among Healthcare Workers in Kano State, Nigeria , Abdullahi Abduljaleel, Ibrahim Yar Zever, Lawal Kayode Olatunji, Zarau Bello Ibrahim
Coronavirus is an ongoing global viral disease firstly identified in Wuhan, China in December 2019, hence its name Covid-19. The World Health Organization (WHO) declared Covid-19 as a pandemic with Public Health Emergency of International Concern (PHEIC). People get infected when they inhale small airborne particles or droplets exhaled by a Covid-19 infected person. Some of the recommended preventive measures include social or physical distancing, covering the mouth when sneezing or coughing, wearing of face masks and regular hand wash. A multi-stage sampling method was used to select the study locations, hospitals, healthcare departments and survey groups. A quantitative method - using structured questionnaires was used. Statistical analysis was conducted using Statistical Package for Social Science (SPSS) version 26. Out of the 1004 participants that were surveyed, 864 responses were retrieved. The bulk of the respondents (59%) were male. Knowledge of Covid–19 was poor, 24.3%, while acceptance of Covid-19 vaccination was high (74.2%). Important predictors of Covid-19 vaccination are the number of years in service, marital status, designated work, and type of medical facility. Knowledge of Covid-19 is low, but acceptance of its vaccination was high among the study population. This could be due to fear of contacting the disease early plus the associated high mortality among the study population. There is a need for an enlightenment campaign to increase knowledge and further improve acceptance of the Covid-19 vaccination. Keywords: Acceptance, Covid –19, Knowledge, Vaccination.
140 Assessing the Social and Economic Impact of Logistics Management on the Liberian Economy (The National Transit Authority 2015-2018) , Jeremiah Momo Gbellay
Under the able leadership of Her Excellency Madam Sirleaf, the government envisioned that to address the many unemployment in Liberia, it was prudent to decentralize governance and all government services appertaining transportation from the transport ministry to the national transit authority (NTA) to alleviate huge unemployment deficiency with employment. Therefore, affordable public transportation for Liberians was identified as one of the areas for strategic intervention. Significantly, the remodeling of the Monrovia Transit Authority (MTA) into the National Transit Authority (NTA) tries to pursue decentralization to provide affordable, convenient, and reliable mass transit services to citizens throughout the breadth of the country for all citizenries. After over a decade of post-conflict growth and relative peace and stability since the end of the 1989-2003 conflict, Liberia’s transport infrastructure and logistics sector have the potential for enormous growth and development. Over the past period, there has been an increasing emphasis on supply chain and logistics management as a medium for firms to achieve competitive advantage in markets (Collins, 2003. P. 8). A large number of examples in the 1990s show how countries have made significant investments to streamline the supply chain to improve customer satisfaction and increase the internal productivity of their economy. In conclusion, this paper fully explores both the framework for and an analysis of such reflections of the civil unrest conflicts in Liberia and assessing the social and economic impact of logistics management of the Liberian economy. Keywords: Social, Economic, Impact, Logistic management, The Liberian economy.
141 Information Overload and the Role of Librarians in Information Dissemination in Tertiary Institutions in Cross River State, Nigeria , Ebaye, A.S, Osim, T.A
The advancement in “technology” has brought with it an information explosion causing excessive information everywhere. Hence, there is a huge amount of information resulting in information overload. Information overload is being experienced everywhere, in public and private organizations, institutions, government officers, information users, individuals and so on. This study, therefore, attempts to examine the causes of information overload and the role of librarians in information dissemination in tertiary institutions in Cross River State, Nigeria. Seventy-two (72) librarians from tertiary institutions in the state were used as the population for the study. A structured questionnaire was developed by the researchers for data collection. Data collected was analyzed using mean and standard deviation. The result revealed that receiving repetitive massages, an explosion in the volume of information sources, and the advent of technological innovation, among others, are the major causes of information overload. The study also revealed that SDI, e-SDI, referral services, and CAS are the major ways through which librarians can disseminate information promptly to users. The study further revealed that information filtering, and information withdrawal, among others, are the major strategies used by librarians in Cross River state to improve and remedy information overload. Based on the findings, it was recommended, among others, that librarians and information professionals should provide effective and innovative ways/strategies for tackling the problem of information overload. Keywords: Academic libraries, Information dissemination, Information overload, Information, Role of librarians.
142 Performance Appraisal System and its Implication on Employee Performance: A Study of Zambia Revenue Authority , Kausa Josephine Kasongo
Performance appraisal systems used by a multitude of organisations globally should pose a major concern to all who use this employee evaluation process. This is mainly because performance appraisals do have an effect on employees. Whether this effect is for good or bad is the primary goal of this paper. Using data from a named organisation, the study will strive to determine whether the performance appraisal methods of that organisation have indeed had intrinsic effects on the performance of individual employees and whether this has indeed trickled down to the entire organisation as a whole. Both quantitative and qualitative research approaches were chosen as a primary and secondary data source. Questionnaires and interviews were used for primary data collection. Secondary data were collected from different articles, books, and online sources as well as the organisation under consideration. The results showed that, indeed, inherent in a performance appraisal system may be factors that need special attention if it is to work out for the benefit of the organisation. Whereas the procedures of the system may in themselves be very beneficial, the implementation thereof may be lacking and expose holes that may need to be filled from top management, middle management, and supervisees alike in order for the organisation as a whole to realise the full benefit of the performance appraisal system. The researcher recommended that the organisation take these factors into consideration if they are to achieve organisational objectives and goals. Keywords: Appraisal, Employee, Management, Organisations, Performance.