Face Interviews Research Articles

Prevalence and Factors Associated with Major Depression Disorder among Rohingya Refugees in Bangladesh

Background: Rohingya refugees are a persecuted minority and one of Myanmar's largest populations of stateless people. Mental health problems, particularly depression, have been identified as a major public health issue for those living in refugee camps in Southeast Bangladesh. The prime objective is to assess the prevalence and factors associated with depression among Rohingya refuges. Materials and methods: A camp-based cross-sectional study with 384 adult refugees was conducted in January to June 2019 at Modhurchora, Kutupalong refugee camp in Cox’s Bazar. Data were collected by face to face interviews through using a semi-structured questionnaire, level of exposure to trauma by Harvard Trauma Questionnaire and depression symptoms by using SIGECAP Questionnaire. Results: The mean age of the Rohingya refugees was 31.9±11.8 years and twothirds of them (66.4%) were from the age group 18-34 years. The mean scores of depression among Rohingya refugees were 6.9±1.2 and 38.3±6.0 by SIGECAPQ and HTQ respectively. Levels of depression by SIGECAPQ scores, about three out of four refugees were suffering from severe depression and by HTQ scores, the majority of the refugees (96.9%) were suffering from severe depression. Conclusion: The study revealed high levels of depression among Rohingya refugees. Addressing these risk factors could be imperative for improving mental health outcomes in this vulnerable population.The study emphasised the significance of providing psychosocial support services in this camp. Chatt Maa Shi Hosp Med Coll J; Vol.23 (2); July 2024; Page 60-64

Common Presenting Health Problems of Adult in Slum Dwellers of Chattogram City

Background: The rapid growth of urbanization in Bangladesh has created some adverse effects on the overall urban environmental health of the cities. Among all, mass poverty, expansion of poor neighborhood, inadequate supply of urban services such as water, sanitation, waste disposal etc. are mostly responsible for health risks of urban people particularly in low socio-economic condition. A host of environmental and social problems beset the port city of Chattogram due to overcrowding of slums, which is largely blamed on unplanned urbanization. More than four hundred slums accommodating about 1 million of people are scattered across the city. Majority of these slums are situated on the Ice Factory road, along the railway tracks under Dewanhat Bridge, Sholosohor, Pahartali, Chittagong Railway Station, and Lalkhan Bazar MotiJhornaarea. The purpose of the study was to assess the pattern of common health problems of the adult members of the slum dwellers of Chattogram city. Materials and methods: A descriptive type of cross-sectional study was conducted from September to October 2022, using a sample of 321 respondents living in urban slums. Data was collected by face to face interview using a pretested mixed type of questionnaire. After collection, data was analyzed and resultswere presented as tables and figures. Results: Out of a total of 1492 family members of 321 families, there were 744 male and 748 female individuals. The most common presenting health problems among the adult respondents were Back pain and Generalized body-ache (24%), followed by Hypertension (16%), Headache (14%), Generalized Weakness (10%), Diabetes (8%), Asthma (8%), Cough (6%), Fever (5%), Chest Pain (4%), Anaemia (4%). Conclusion: The study concludes that physical structure of the neighborhood, and the physical and mental sufferings of its inhabitants are interdependent. To reduce the sufferings of inhabitants, their health hazards can be reduced with the combined efforts of the Government and the NGOs and the local people as well. Most of the slum dwellers are dependent on the pharmacy for their health problems. They are reluctant to take government health care facilities. Measures should be taken to make these facilities easily available to them. Chatt Maa Shi Hosp Med Coll J; Vol.23 (2); July 2024; Page 3-5

Investigation of veterinary service delivery and service providers on dairy cattle farms in central Ethiopia

BackgroundLivestock diseases are major constraints affecting the productivity, health and welfare of animals in dairy sectors in Ethiopia. The prevalence of animal diseases and inadequate animal health services are key barriers to improving animal productivity and health. Studies assessing animal health delivery in Ethiopia are limited.MethodsA survey was conducted to assess veterinary service delivery on dairy farms, the level of service provision, and the major service providers in the area. A total of 381 dairy farms were recruited from different towns in central Ethiopia for the survey. Data were collected using a structured questionnaire developed via an online platform (https://www.kobotoolbox.org/) and administered via face‒to-face interviews. The generated data were analyzed and descriptively summarized as frequency distributions and percentages.ResultsThe results of the present study revealed that a wide range of animal diseases have occurred and adversely affected the dairy farms in the study area. Several government and private veterinary service providers have been engaged in providing animal health care to dairy farms. Private veterinary services cover most of the veterinary services of dairy farms at selected sites in central Ethiopia. For veterinary services related to the treatment and control of external and internal parasites, the purchase of drugs, artificial insemination, assisted delivery and pregnancy diagnosis of animals, dairy farmers prefer private veterinary services. The government veterinary sector, on the other hand, was preferred the ability to vaccinate animals against major dairy animal diseases (36.3%) and provide health-related training services (21.8%). In this survey, 61.05% and 45.53% of the respondents were dissatisfied with high service charges and insufficient medicine for the treatment of major diseases, respectively. However, 76.3% and 75% of them were highly satisfied with the good skills of the veterinary professionals and with the recovery of their animals after treatment, respectively.ConclusionThe assessment of veterinary service delivery in dairy cattle management systems in central Ethiopia revealed that private veterinary service providers are the most dominant and that the comparative preference for private service, apart from its high comparative cost, may be related to its availability or accessibility. The overall users’ satisfaction was reported to be low. It is advised that public veterinary services maintain professional freedom and acquire adequate physical and financial resources to carry out their tasks. Finally, privatization or the promotion of public‒private partnerships should be supported to foster a competitive atmosphere for high-quality veterinary services.

Awareness on Cervical Cancer, Its Screening and HPV Vaccination Among Women of Reproductive Age Group (15-49 Years) in Manipur

Background: Cervical cancer is the second most common cause of cancer among females in India. Proper knowledge, regular screening and timely vaccination can prevent occurrence of cervical cancer. Aims/Objectives: To assess awareness of cervical cancer and its screening and vaccination among women of reproductive age group in Manipur.Also to determine the association between awareness of cervical cancer and some socio-demographic variables. Methodology: A community-based cross-sectional study was conducted among women of reproductive age group (15-49 years) residing in Manipur. Two urban and two rural areas were selected using purposive sampling. Face to face interview method was done using pretested, validated, semi-structured questionnaire. Descriptive statistics, univariate and multivariate logistic regression analysis were used to test for association taking all variables with p <0.1 for model building of the adjusted analysis. P-value of less than 0.05 was considered statistically significant. Results: Total number of respondents were 409. More than half (57%) were aware about cervical cancer. None of the respondents got HPV vaccination. Seven respondents had a history of cervical cancer in the family. Majority of them did not know any risk factors (33%) or signs and symptoms (38%) of cervical cancer. Maximum of them (94%) had not undergone screening test. Increasing age of the respondents (AOR: 0.932, 95% C.I. 0.902-0.964) shows a lesser awareness of cervical cancer but being a Christian was found to have increased awareness of cervical cancer (AOR: 4.639, 95%C.I. 2.001-10.753). Conclusions: Awareness of cervical cancer was found to be poor. Intensified health education and health promotion strategies at the community level about prevention and control of cervical cancer is the need of the hour.

Experiences of postnatal mothers regarding the implementation of maternal and neonatal referral system guidelines in Mopani District in the Limpopo Province, South Africa.

South Africa experiences challenges of maternal mortality, caused by pregnancy related conditions. Limpopo Province as one of the provinces in South Africa, is also affected. There are challenges facing obstetric emergency referrals, despite the availability of maternal/neonatal referral system guidelines. Therefore, this study explored the experiences of postnatal mothers aiming at facilitation of prompt referral of obstetric emergencies. Descriptive phenomenological research methods were used. The study was conducted in two selected sites, a maternity unit of a district hospital and a primary healthcare facility (fixed clinic), which is a feeder clinic to the district hospital in a selected sub-district of the Mopani district. Population were eleven (11) postnatal mothers. Purposive sampling was used. Data were collected using in- depth individual face -to- face interviews. Data was analysed using Colaizzi's seven procedural steps. Four essential meanings and their constituents were revealed: postnatal mothers' positive experiences, challenging experiences, consequences of challenges and post-natal mothers' recommendations. Health care facilities to be equipped with adequate, functional, safe, reliable, well equipped obstetrical equipment, material and human resources to facilitate prompt referral of obstetric emergencies.

Chronic pain management for older adults in ambulatory care : Results of arandomized pragmatic trial in Berlin, Germany.

Chronic pain is amajor health challenge in older populations and approaches to improve ambulatory care are urgently needed. We conducted apragmatic trial to test whether staff-directed interventions can improve chronic pain management in older community-dwelling adults and thereby improve their pain situation. Participants of 22ambulatory nursing services (clusters) were allocated to 3 study arms: I1 (individual intervention with recommendations for each participant's physician and anewly trained pain nurse), I2 (digital training offered for participants' physicians and nursing staff) and CG (control group). Survey-based face to face interviews were held at the participants' homes. Descriptive statistics, ANOVA, and χ2-tests were utilized for data analysis. At baseline, 190 and at follow-up 144 participants were analyzed (24% dropout). Overall, the interventions were only implemented by asmall proportion of involved staff. We found significant changes in documented nursing care in I1 but improvements regarding pain medication appropriateness or pain situations of participants could not be achieved. Structural challenges like time and staff shortages as well as the lack of billing options in ambulatory care were identified as major obstacles to substantially improve pain care. Policy makers need to enable appropriate compensation models for chronic pain care at home to enable aging in place for agrowing population of older adults.

Infrastructure Development and Economic Growth in South Sudan

Purpose: The purpose of this study was to examine the infrastructure development and its contribution to the economic growth of South Sudan with emphasis on transport, communication and electricity. The dependent variable was economic growth, measured by the growth rate of gross domestic product, and the independent variables to measure infrastructure were road transportation, communication, and electricity. Methodology: Qualitative methodology was used through face to face interviews using an interview guide and focused group discussions from a sample of 200 respondents comprising of the directors from the Ministry of Infrastructure, Ministry of Finance, Members of parliament and local government as the representative of the common citizens selected using stratified sampling technique. The data collected was analyzed descriptively into themes and interpreted. Findings: The findings revealed that infrastructure played a significant role in the economic growth of the country. Road Transportation, communication, and electricity had a positive impact in development of the country. However the absence of economic resilience and the inability need to fill the technology gap and insufficient production of basic needs contributed to inequality and states’ disparities. Unique Contribution to theory, Practice and Policy: The study findings were aligned to the theory of infrastructure-led development, which states that public capital, in which infrastructure is included as necessary input in the production process, contributes to economic growth. The study recommended that South Sudan should adopt strategies and policies that will increase the quantity and quality of infrastructure development, as well as a capital formation strategy accompanied by human capital development and high institutional quality.

District Mental Health Programme Link Clinic: Experience from an Academic Neuropsychiatric Institute of India

Abstract Background: Routine follow up appointments for psychiatric diseases don’t need to take place in tertiary care facilities because doing so not only causes patients’ inconvenience and travel related costs but also results in the improper use of resources. In September 2019, the Tele Medicine Centre of NIMHANS, Bengaluru launched the District Mental Health Program (DMHP) link clinic (DLC) at OPD with the aim of integrating eligible patients to their individual DMHPs for routine follow up care. We used a mixed method study approach. Materials and Methods: Self designed referral farms and data record sheets were the tools used for the data entry. For data collection, face to face and telephonic interview methods were used. We carried out both descriptive and thematic analyses to understand the following outcomes of DLC. Results: Out of 343 referred patients, males were 164 (47.8%) and females were 179 (52.2%). 32.6% of integration was possible. The referral service was reported to be cost effective. Among those who visited DMHPs (n = 207), 102 (49.2%) patients reported being very satisfied, and 81 (39%) patients reported being satisfied. Alteration of current medication, knowledge about DMHP services, economic benefits, availability of DMHP staff, and satisfaction with services are the main themes found in qualitative analysis. Conclusion: A preliminary report suggests that integrating routine follow ups from tertiary care psychiatric centers into community mental healthcare centers could significantly reduce out of pocket expenditure and time spent.

Adoption and profitability of Binadhan-16 in some selected areas of Bangladesh

The study was conducted in three Binadhan-16 growing areas of Bangladesh, namely Mymensingh, Netrokona and Rangpur districts. The objectives of the study were to find out the determinants of adoption of Binadhan-16 rice variety at the farm level and to estimate the costs and return of Binadhan-16 cultivation in the study areas. Moreover, some problems of the Binadhan-16 cultivation were also investigated in this study. This study was based on primary data which were collected from 180 farmers, 60 from each district where 30 was adopter and 30 was non-adopter of Binadhan-16 growers. Data were collected through face to face interview with the help of a pre-designed interview schedule from three upazillas i e. Valuka (Mymensingh), Purbadhala (Netrokona) and Sadar (Rangpur). Descriptive statistics and logit regression model were used to fulfill the objectives. The result of logit regression model shows that farm size, yield, seed, training and extension contact have positive and significant effect on Binadhan-16 adoption. Education and cultivation duration were found as negatively significant variables in explaining the variation in Binadhan-16 adoption. The study also found that total variable cost of Binadhan-16 cultivation was Tk. 44346 per hectare which was 66.78% of total cost of production. The highest cost item was human labour which accounted for 46.44 % of the total cost. Cost of land preparation was 17.84% and land use cost accounted for 14.63% of total cost and ranked as second and third cost items, respectively. On an average, the total cost of production was Tk. 66404 per hectare where 33.22% was fixed costs and 66.78% was variable cost. It was found that Binadhan-16 production is profitable. The highest yield was found at Rangpur (5546 kg ha-1) followed by Mymensingh (5379 kg ha-1) and Netrokona (5297 kg ha-1). The average selling price of Binadhan-16 was Tk. 24.88 kg-1 where cost of production was Tk. 12.28 kg-1. The average gross margin was found Tk. 98756 on variable cost basis. The average net return per hectare was Tk. 76698. The average Benefit Cost Ratio (BCR) was 2.16. Regarding major problems of the variety cultivation, 15% mentioned about high labour cost which ranked top followed by quality seed in timely manner (14%), infestation of disease (11%), scarcity of labour (9%), low price of paddy and high transportation cost (8%). As the variety yield higher profit more emphasis should be given on farm size, seed, yield, and training programme for the expansion of the variety. Bangladesh J. Nuclear Agric, 38(2): 125-135, 2024

Public Awareness and Perceptions of Medicolegal Autopsies in Kerala

BACKGROUND:Death is often met with fear, rooted in the unknown, and many cultures maintain beliefs in lifeafter death, souls, and ghosts. These beliefs shape rituals to honor the departed. However,unnatural deaths requiring autopsies can intensify challenges, especially in superstition-heavysocieties. Even in Kerala, with its 100% literacy rate, such beliefs persist. This study examinespublic awareness, perceptions, and attitudes toward medicolegal autopsies, exploring howeducation, superstition, and medical practices intersect in shaping societal responses.AIM:To study the general public’s awareness in Kerala regarding various aspects of medicolegalautopsies, including the purpose, process, legal implications, and societal perceptions of suchinvestigations.MATERIALS AND METHODS: A cross-sectional study was conducted using face to face interviews and questionnaire thatwas carefully prepared and distributed randomly among the general public across differentregions of Kerala. The responses from study population, were collected for analysis. Theresponses were thoroughly examined, and conclusions were drawn based on the data gathered,providing insights into the public's awareness and perceptions of medicolegal autopsies in thestate.RESULTS:The study conducted in Kerala revealed that most laypeople were aware of medicolegalautopsies, with 92% demonstrating a good understanding. However, 6% partially accepted theprocedure’s feasibility, 1.25% opposed it due to personal or cultural beliefs, and 0.75% wereunfamiliar with the concept. Among those opposing autopsies, 27% cited religious reasons, 18%feared disfigurement, and 3% considered it ethically wrong. While basic awareness exists,comprehensive knowledge about the purpose, legal implications, procedures, and significance ofmedicolegal autopsies is limited. Misconceptions or incomplete information about when andwhy autopsies are conducted were common. The findings highlight the need for educationalinitiatives to enhance public understanding of the vital role of medicolegal autopsies in forensicand legal contexts.CONCLUSION: The study highlights strong support for autopsies but reveals significant publicknowledge gaps. Addressing misconceptions through education and collaboration can improveunderstanding and acceptance, promoting informed consent for medical and legal purposes.

Dance harnesses humanity in exercise: perceptions of dance following an adapted dance program for people with chronic stroke

ABSTRACT Introduction Perceptions of exercise are important in ensuring physical activity is translated into daily life. If dance is perceived as enjoyable exercise, promoting it may increase exercise engagement in people with stroke. Objective To examine perceptions of dance as exercise in people with chronic stroke after participating in an adapted dance program. Materials and Methods Qualitative interpretive description approach utilizing semi-structured face to face interviews with 18 people post-stroke who completed a 10-week adapted dance program. Results Three themes were identified: (1) Dance is Exercise; (2) Dance Moves Beyond Exercise; and (3) Dance Harnesses Humanity in Exercise. Discussion According to participants in this study, dance offers elements of traditional physical rehabilitation (i.e. improved balance) and creates a humanistic space where more intangible elements (i.e. liberation, personal growth) are accessed organically. These findings illuminate dance as a holistic approach to rehabilitation, as it addresses both the physical and psychosocial impacts of stroke.

Adaptation of the Shirom–Melamed Burnout Measure in Parents of Turkish Pediatric Oncology Patients

Adaptation of the Shirom–Melamed Burnout Measure in Parents of Turkish Pediatric Oncology Patients

Social interventions for children in street situations in South Africa: socio-legal protection by the South African Department of Social Development

The protection of children in street situations is a key policy issue that is mostly spearheaded by governments, the non-profit sector, private sector and religious organisations. Children in street situations are a vulnerable population. In South Africa, projects and programs to protect children in need of care and protection emanate from the Department of Social Development (DSD) which is one of the leading government agencies with responsibilities over children in need of care and protection in the country. Though problems experienced by children in street situations have been widely studied, there exists limited research which explores how these children as juridical subjects are targets of specific public policies and social programmes designed purposely for them. This paper situates and analyses the socio-legal and policy contexts for the social protection of children in street situations in South Africa and the role played by the Department of Social Development as the main government entity responsible for vulnerable children. The study adopted a qualitative approach where data was collected through face to face and telephone interviews with social workers who work with children in street situations in Pretoria. Data was analysed using thematic analysis. The study findings reveal that children in street situations in South Africa fall under a broad category of children in need of care and protection. The children are not viewed as a distinct group, hence, there are no targeted interventions specifically for them as existing interventions are universal for all vulnerable children in South Africa. Thus, social policy for children in need of care and protection should be implemented to target specific groups of children within the broader category of children in need of care and protection in the country.

Barriers of achieving and maintaining glycemic target among patients with type 2 diabetes mellitus on insulin therapy

Background: Many obstacles exist that lead to failure of achievement of glycemic target in persons with diabetes mellitus (DM) prescribed with insulin. However, there is an inadequate amount of data to address these barriers and to make effective intervention. The aim of this study was to identify barriers of achieving and maintaining glycemic target among type 2 diabetic patients on insulin therapy. Methods: This cross-sectional study was carried out in the Department of Endocrinology, BIRDEM General Hospital from March 2020 to August 2022. Total 384 patients with type 2 DM on insulin therapy were recruited by convenient sampling. Face to face interview was taken from the patient by following the inclusion and exclusion criteria. Patients were examined for his/her injection site, injection technique; insulin vial and syringe were also checked for any mismatch. Biochemical reports were collected from patient records. Data analysis was done by SPSS version 25 considering level of significance at 0.05. Results: The mean age of the participants was 56 ± 10, (m±SD) years. Majority (73.9%) were obese. Hypertension (70.6%) was common among the patients. Few (10.7%) patients maintained physical exercise regularly. The mean duration of DM was 12.15± 5.39 years and they were taking insulin for a mean of 4.40± 2.64 years. Most of the patients took premixed insulin (38.3%) followed by split mixed (29.7%) and basal-bolus (21.1%) regimen. Most common cause of poor glycemic control was insulin omission (46.4%). Obesity, using premixed insulin, irregular physical exercise, irregular self-monitoring of blood glucose (SMBG), not following the diet chart, no education on target glucose and insulin dose adjustment were associated with HbA1c >10%, which indicates poor glycemic control. Conclusion: Overall, lack of knowledge about glycemic control and insulin dose adjustment, insulin omission, non-adherence to the diet, irregular physical exercise act as barriers to achieve optimum glycemic control. BIRDEM Med J 2025; 15(1): 34-38

P-1717. Perception and Practice of Physicians' Antibiotic Use at Tertiary Military Hospitals in Bangladesh

Abstract Background Inappropriate use of antibiotics, which contributes to increased antimicrobial resistance (AMR), is common in healthcare settings across the globe, especially in low-resources settings. Antibiotics are widely and inappropriately used without adherence to international guidelines in Bangladesh, which may contribute significantly to the development AMR. Military hospitals are known for better compliance of health care system. We sought to investigate the perceptions of Physicians of Tertiary military hospitals in Bangladesh regarding appropriate antibiotic use and prescribing approach. Physicians' AMR perception Methods We conducted a cross-sectional survey using a semi-structured questionnaire and data collected through face to face interview from 84 Military doctors of two major tertiary military hospitals of Bangladesh – Combined Military hospital (CMH) Dhaka (1650 bedded) and Jashore (500 bedded) between September 2020 and January 2021. Descriptive statistics were performed to analyze the data and for interpretation Approach of physician to prescribing antibiotic Results Out of 84 respondents, 70% of the physicians considered AMR is a significant concern worldwide, but only 26.7% Physician of Dhaka CMH and 11% of Jashore CMH considered it as a problem in their hospital. Two-third respondent (66%) considered that inappropriate use of antibiotic is the main cause of rising AMR, followed by Over prescription of broad-spectrum antibiotics by 62.2%, and Easy access to antibiotics without a prescription by 58.8%. Around 36.2% opined that poor IPC practices by health professionals are also important factor. Total 72.6% respondent ensure that they routinely step down I/V antibiotics to oral antibiotics as earliest, 13.4% physicians considered cost affordability of the patient affects their choice of antibiotics. Over half of the physicians (51.2%) use prophylactic antibiotic for 3 to 7 days after any surgical procedure of a clean-contaminated case without signs of infection, where only 7.3% doctor use single dose antibiotic prophylaxis. Use of antibiotic prophylaxis in surgical procedure Conclusion Physicians' perception on AMR and rational antibiotic prescription were found fall of short of the standard. Strict compliance of antibiotic use and trade guideline, Introduction of formal antibiotic stewardship program in Bangladesh may be a useful intervention Disclosures All Authors: No reported disclosures

Outcome of Unintended Pregnancy and Associated Factors Among Rural Women of Reproductive Age

Background: Unintended pregnancy is well recognized reproductive health problem in developing countries like Bangladesh. It is more problematic in rural Bangladesh where illiteracy, poverty and empowerment crisis of women are common scenarios. Methods: This cross-sectional study was conducted at Shahdaulatpur village in Mainamati union of Comilla District during the period from July 2017 to June 2018. The study enrolled 317 rural women selected by systematic random sampling technique. Mixed method approach was introduced for data collection to find out the determinants and outcomes of unintended pregnancy among rural women. Focus group discussions and in-depth interviews were arranged for qualitative data and quantitative data were collected through face to face interview by pretested questionnaire. Ethical issues were considered in all aspect of the study. Results: Mean age of the rural women was 22.1 years with standard deviation of (SD) ± 3.6 years. The average monthly income of the family was 10732 ± 3228 Taka. Among the respondent more than half (55.2%) used contraceptive methods. Oral contraceptive pill (OCP) was their first choice (40.9%) and injections (19.8%) were common among the users of invasive family planning methods. Male participation in contraceptive use was only 8.8%. More than one-third (35.6%) had history of unintended pregnancy and among them majority (70.8%) had mistimed pregnancy and rest of them (29.2%) had unwanted pregnancy. The outcomes of the unintended pregnancy were mostly unplanned birth (93.4%) with (2.6%) miscarriages and termination of pregnancy by (4.4%) menstrual regulation (MR) or abortion. Age and educational status and monthly family income of rural women showed very high significant association with unintended pregnancy (p<0.001). Conclusion: As the quality of future human resource depends on healthy mother and safe motherhood, improvement of family planning knowledge should be given top priority. Hence, care should be taken to improve the status of knowledge and awareness about family planning. JOPSOM 2023; 42(2): 29-35

Learners’ Perception of Physical Geography as a Barrier to Choice of Geography in Secondary Schools in Kiminini Sub-County, Kenya

The number of students studying Geography in secondary schools in Kenya has significantly declined in recent years. It was against this background that the study sought to determine how learners’ perception of physical geography hindered them from selecting the subject in secondary schools in Kiminini Sub-county in Kenya. The study was based on Lev Vygotsky’s social constructivist theory which explains how a learner’s cognitive development and learning ability guides and mediates their learning hence their choices. The study was carried out among selected secondary schools in Kiminini Sub- County, which is one of the sub counties in Trans-Nzoia County. Three main groups were selected as participants of the study. These were the form III learners who had dropped geography after Form II, the geography teachers and Heads of Departments for geography. The research used stratification to categorize secondary schools into National, Extra County, County and Sub- County, selecting 2 national schools, 2 extra county schools and 2 county and two sub-county schools for the study. This yielded a total of eight schools, 2 in every category. Furthermore, random purposive sampling technique was used to select ten students from each of the selected schools. There was therefore a total of 80 students who participated in the study. These were Form III students who were not taking geography. Geography teachers who had taught a Form II class were selected from each of the sampled schools whereas the heads of department were purposively sampled. The study adopted a qualitative approach in which data was collected using unstructured questionnaire, face to face interview and focus group discussion. A thematic analysis was adopted for the study which saw the study findings represented through thematic narratives. The study revealed that most learners who had dropped geography had negative attitude towards physical geography which they considered abstract and uninteresting. Geography teachers on the other hand were well trained and experienced but strictly ensured learners took part in all learning activities which often led to learners leaving the subject and dropping out. The syllabus content for physical geography was considered wide with complex concepts that made the field difficult for learners. This paper should be able to provide useful information to players involved in teaching geography and aid in expanding knowledge on geography instruction.

Unpacking the Chemistry of Urban Land Governance in Africa: In search of land governance

The purpose of the study was to interrogate the chemistry (best mix practices) and challenges (dilemmas) of urban land governance in Africa. We note that there is an increase in demand for good urban governance by city residents all over Africa. This paper briefly traces the current issues in the region in response to the growing quest for “good governance” in urban land affairs. The paper argues that the paradox of land management and distribution can no longer be taken for granted, given a series of land conflicts being handled every day. This study seeks to interrogate the urban land governance systems in Africa as is experienced in African countries and it then proposes the construction of an urban land governance framework that addresses African urban leadership and infrastructural challenges. An intensive desk review research was conducted by ploughing through various literature and empirical evidence from selected African countries. To complement literature findings (evidence) from secondary data, grey data and personal experiences in urban land governance, we conducted empirical studies in six countries namely Botswana, Namibia, Zimbabwe, Ghana, Tanzania, Ethiopia and South Africa-part of the study triangulation efforts to validate already existing findings. Data were collected from 15 office holders in 8 Urban Councils and Land board chairpersons through questionnaires and face to face interviews. Besides, interviews were conducted with purposefully selected officeholders. The results of the data analysis were presented using mean, standard deviation, Pearson correlation, and logistic regression to see the relationship between the independent variables and the dependent variable. The major findings showed that the elements of good urban governance (participation, responsiveness, accountability, transparency, equity, and efficiency and effectiveness) are not practiced appropriately. The major challenges in good urban land governance included lack of resources, corruption, political interference and leadership incompetence.

Dental caries and related factors in the elderly of the Azar cohort population: A cross-sectional study.

Oral health is often overlooked among the elderly due to the numerous comorbidities prevalent in this population. However, oral health significantly influences quality of life by affecting both general health and psychological well-being. The present study aimed to assess dental caries in elderly individuals using the DMFT index (decayed, missing, and filled teeth) and to explore its relationship with various factors based on data from the Azar cohort study in Iran. In this cross-sectional study, data from the initial phase of the Azar cohort study, which involved 2629 elderly individuals (aged 60 years and older), were statistically analyzed. The Azar cohort study evaluated demographic factors, the history of chronic diseases, and behavioral habits using a well-designed questionnaire administered through face- to -face interviews. The DMFT index was evaluated through oral examination. A negative binomial regression analysis with a log link function was employed to investigate the relationship between the DMFT and related variables, including gender, age, marital status, level of education, socioeconomic status, chronic diseases, smoking, alcohol consumption, and body mass index. The mean (SD) age of elderly individuals was 64.15±2.91 years. The mean (SD) DMFT was 28.42±6, and the mean (SD) number of missing teeth was 26.58±8.36. Approximately 70.8% of elderly individuals were edentulous. Women exhibited a higher mean DMFT score and a greater number of missing teeth compared to men. The mean DMFT score and its components significantly differed based on the level of education and socioeconomic status. However, no significant relationship was found between the DMFT index and the variables in the multiple regression analysis. The high prevalence of edentulism and the elevated DMFT scores in the elderly population of the Azar cohort indicate a poor oral health status among older individuals. Providing the dental services within the primary health care system for the adults, can be beneficial in improving oral health in old age.

Prevalence and contributors to anaemia among children aged 6 to 59 months in Kyangwali Refugee settlement, Western Uganda: a cross-sectional study

BackgroundAnaemia is a major cause of morbidity among children under five years in Uganda. However, its magnitude among refugee populations is marginally documented. In this study, the prevalence and contributors to anaemia among children 6 to 59 months in Kyangwali refugee settlement in Western Uganda was determined.MethodsThis was a cross-sectional study that was carried out among 415 mother- child dyads at Kwangwali refugee settlement. Anaemia was determined by measuring haemoglobin concentration using the HaemoCue method, while nutritional status was examined using standard World Health Organisation (WHO) nutritional indices. Data abstraction forms, pretested questionnaires and face to face interviews were used to collect patient data. Associations between the independent variables and anaemia were examined using modified Poisson regression with robust standard errors. In all statistical tests, a P- value of < 0.05 was considered as significant.ResultsThe proportion of children with anaemia was 49.2% (95% CI: 44.4–53.9). Anaemia was 1.4 times (95% CI = 1.13–1.82; p = 0.003) more prevalent among wasted children than the normal children. The prevalence of anaemia was also higher among underweight children than those with normal weight (aPR = 1.37, 95% CI = 1.11–1.70; p = 0.004). Additionally, the prevalence of anaemia was higher among children of birth order of 6 or above (aPR = 2.00, 95% CI = 1.22–3.29; p = 0.006), while anaemia prevalence was lower among children whose mothers’ had attained secondary level of education (aPR = 0.19, CI = 0.04–0.98; p = 0.048) and those who fed on fish (aPR = 0.75, 95% CI = 0.57–0.99; p = 0.039) and meals prepared with oils and fats (aPR = 0.70, 95% CI = 0.51–0.97; p = 0.029). There was no significant relationship between anaemia occurrence and the household dietary diversity score.ConclusionsAbout half of the study children were found to be anaemic. The most significant contributors to anaemia in the study population were malnutrition, maternal education, feeding practices and birth order. The study findings suggest need of screening of children for anaemia at all nutritional clinics, promotion of education, addressing barriers to sustainable food supply and accessibility of nutrient-dense foods, treating anaemia in children alongside other micronutrient deficiencies and addressing the nutritional needs of multiparous mothers in refugee communities.