Semi-urban Areas Research Articles

Association between cancer stigma and cervical cancer screening uptake among women of Dhulikhel and Banepa, Nepal.

Cervical cancer ranks as the most common cancer among Nepalese women with a high incidence and mortality. Despite evidence that effective screening programs reduce disease burden, screening services are under-utilized. Cancer stigma can be a major barrier to cervical cancer screening uptake among Nepalese women. This study assessed the association between cancer stigma and cervical cancer screening uptake among women residing in semi-urban areas of Kavrepalanchok district (Dhulikhel and Banepa), Nepal. We conducted a cross-sectional study among 426 women aged 30-60 years using telephone interview method from 15th June to 15th October 2021. A validated Cancer Stigma Scale (CASS) was used to measure cancer stigma and categorized women as presence of cancer stigma if the mean total score was greater than three. We obtained information on cervical cancer screening uptake through self-reported responses. Univariable and multivariable logistic regression were performed to assess the association between cancer stigma and cervical cancer screening uptake. We adjusted socio-demographic: age, ethnicity, occupation, religion and education, and reproductive health variables: parity, family planning user, age of menarche and age at first sexual intercourse during multivariable logistic regression. Twenty-three percent of women had cancer stigma and 27 percent reported that they had ever been screened for cervical cancer. The odds of being screened was 0.23 times lower among women who had stigma compared to those who had no stigma (95% CI: 0.11-0.49) after adjusting for confounders: age, ethnicity, occupation, religion, education, parity, contraceptive use, age of menarche and age at first sexual intercourse. Women residing in semi-urban areas of Nepal and had cancer stigma were less likely to have been screened for cervical cancer. De-stigmatizing interventions may alleviate cancer stigma and contribute to higher uptake of cervical cancer screening.

Investigation of the determinants of the consumption of biofuels by Greek consumers

The purpose of this study was to investigate the determining factors that contribute to the increase in the use of biofuels among Greek consumers. The research tool is a fully structured questionnaire (260 consumers; random sampling) consisting of closed-ended questions with answers on a 5-point Likert scale. Greek consumers do not use biofuels frequently and their knowledge about biofuels is unsatisfactory. The non-demographic factors that exert a statistically significant influence on the levels of use of biofuels are the lower cost of ownership , lower operating costs , better cost–performance ratio compared to other fuels, fewer installation intervention requirements, less environmental impact, easier handling and the consumers’ knowledge about the biofuels. The influence of demographic factors on the use of biofuels by Greek consumers was also examined. The consumer demographics that showed a statistically significant correlation with and influence on the use of biofuels were gender, age, education, and place of permanent residence. Women, older consumers, and those with a higher level of education end up being more positive about using biofuels in their daily lives. Similarly, the state of rural and island areas ends up being more positive, compared to the residents of urban and semi-urban areas.

Trends in the Consumption of Antidepressant Drugs before and during the COVID-19 Pandemic in the Canary Islands, Spain: The Case of the Province of Las Palmas.

The use of antidepressants (ADs) has increased significantly as a result of COVID-19 and its consequences. However, there are some notable differences in the relative levels of use between geographical areas and population groups. The aim of this work is to assess the impact of COVID-19 on the consumption of ADs in the Canary Islands, focusing on the islands of Gran Canaria, Fuerteventura and Lanzarote, by analyzing the trends in prescriptions of ADs during the pandemic period (2020) compared to the pre-pandemic period (2016-2020). Data were extracted from the community pharmacy wholesaler at a population level. Consumption patterns are expressed as the number of defined daily doses per 1000 inhabitant/day. The overall consumption of DIDs was higher in Gran Canaria, mainly in urban areas and the capital. It was similar in both Lanzarote and Fuerteventura, but particularly localized in the capital, which are considered semi-urban areas. Lanzarote and Fuerteventura present the same pattern of prescription ADs use, whereas Gran Canaria is notably different. This finding was also observed in the more consumed active pharmaceutical ingredients, although small inter-island variations in the ranking and percentages were observed. Sertraline and escitalopram are two of the most prescribed N06AB ADs, whereas the most recent N06AX ADs such as venlafaxine, mirtazapine and desvenlafaxine are more commonly prescribed. These differences in prescription ADs can be explained by demographical characteristics, population size, the fact of living in an urban area and general medical practice. In this context, the COVID-19 pandemic did not have an impact on the overall trend of the use of ADs between 2016 and 2020 in the islands under study.

A descriptive study to assess the experiences of mothers of infants (42 days-6 months of age) on respectful maternity care residing in Dadu Majra Colony, UT, Chandigarh (2021-2022)

Respectful Maternity Care (RMC) is right to receive dignified and respectful care by health care worker and right to freedom from harm. “The relationship between the lack of quality care and adverse maternal outcome has been highlighted globally. RMC include respect for women autonomy, dignity, feelings, privacy choices and freedom from ill-treatment, coercion, consideration for personal preference include option for companionship during maternity care.” To assess the experiences of mothers of infants (42 days- 6 months of age) regarding RMC residing in Dadu Majra colony UT. Chandigarh. This descriptive study was conducted on 133 mother of infants (42 days-6 month of age) residing in one semi urban area of Chandigarh, by using total enumeration sampling technique. The ethical clearance was given by the Ethics committee of NINE, PGIMER, Chandigarh. Tool used for data collection was interview schedule comprised of three parts : 1) Socio demographic profile of participants 2) Obstetrical profile of participants 3) Interview schedule to assess RMC, in the form of Likert scale in which 43 items scored into 5 categories i.e All the times (5). Sometimes (4). Often (3), Rarely (2) and Never (1). Data was collected by interviewing the participants as per interview schedule after taking informed written consent. Data was analysed by SPSS 20 version.Majority of the participants (90.2%) received very good RMC, other 7.3% received RMC and 2.3% received fair RMC. Most of the mothers received very good care in domain of dignified care (91.7%), equitable care (100.0%), highest attainable level of care (78.9%). freedom from harm (89.5%) and informed consent (88%) while the domain of privacy and confidential care 52.6% mothers received good respectful maternity care.Majority of the participant received the very good RMC, only few of the participants reported abusive cares such as yelling by the HCW and the security guards, slapped on the thighs etc.

Heavy metals in agricultural cultivated products irrigated with wastewater in India: a review

Abstract Indiscriminate industrialization and urbanization have negatively impacted our environment. One of the common environmental problems in semi-urban areas in India is the discharge of inefficiently treated municipal, industrial and domestic wastewater into the environment, resulting in the degradation of soil and water qualities. Depleting freshwater resources have led Indian farmers to look for easily available, cheaper, and nutrient-rich sources of irrigation water in the form of wastewater; however, this also led to increased pollutant transfer to the soils. Known as persistent pollutants, heavy metals such as cadmium (Cd), copper (Cu), chromium (Cr), lead (Pb), mercury (Hg), and a few others are potentially hazardous due to their non-biodegradable nature, extended biological half-lives, and biological interactions. These heavy metals can bind to soil surfaces and then be absorbed by plant tissues. Vegetables supply micronutrients, antioxidants, vitamins, and other nutrients essential for human growth. Therefore, the consumption of vegetables/crops grown in wastewater-irrigated land poses a potential threat to humans. Since wastewater irrigation cannot be eliminated in the Indian (semi-)urban areas because of the ever-increasing demand for irrigation water, it is important to assess the impact of wastewater irrigation. This review article congregates the findings of studies from India wherein heavy metal contaminations in vegetables have been reported. An attempt was made to estimate the risk to human health because of the long-term consumption of vegetables cultivated in wastewater-irrigated lands from the Indian sites.

Cohort profile: Bangladesh Cook Stove Pregnancy Cohort Study (CSPCS)

PurposeThe Cook Stove Pregnancy Cohort Study (CSPCS) was designed to assess the effects of biomass fuel use on household air pollution (HAP) as well as the effects of HAP (fine...

Who are the vulnerable, and how do we reach them? Perspectives of health system actors and community leaders in Kerala, India

BackgroundAmong the core principles of the 2030 agenda of Sustainable Development Goals (SDGs) is the call to Leave no One behind (LNOB), a principle that gained resonance as the world contended with the COVID-19 pandemic. The south Indian state of Kerala received acclaim globally for its efforts in managing COVID-19 pandemic. Less attention has been paid, however, to how inclusive this management was, as well as if and how those “left behind” in testing, care, treatment, and vaccination efforts were identified and catered to. Filling this gap was the aim of our study.MethodsWe conducted In-depth interviews with 80 participants from four districts of Kerala from July to October 2021. Participants included elected local self-government members, medical and public health staff, as well as community leaders. Following written informed consent procedures, each interviewee was asked questions about whom they considered the most “vulnerable” in their areas. They were also asked if there were any special programmes/schemes to support the access of “vulnerable” groups to general and COVID related health services, as well as other needs. Recordings were transliterated into English and analysed thematically by a team of researchers using ATLAS.ti 9.1 software.ResultsThe age range of participants was between 35 and 60 years. Vulnerability was described differentially by geography and economic context; for e.g., fisherfolk were identified in coastal areas while migrant labourers were considered as vulnerable in semi-urban areas. In the context of COVID-19, some participants reflected that everyone was vulnerable. In most cases, vulnerable groups were already beneficiaries of various government schemes within and beyond the health sector. During COVID, the government prioritized access to COVID-19 testing and vaccination among marginalized population groups like palliative care patients, the elderly, migrant labourers, as well as Scheduled Caste and Scheduled Tribes communities. Livelihood support like food kits, community kitchen, and patient transportation were provided by the LSGs to support these groups. This involved coordination between health and other departments, which may be formalised, streamlined and optimised in the future.ConclusionHealth system actors and local self-government members were aware of vulnerable populations prioritized under various schemes but did not describe vulnerable groups beyond this. Emphasis was placed on the broad range of services made available to these “left behind” groups through interdepartmental and multi-stakeholder collaboration. Further study (currently underway) may offer insights into how these communities – identified as vulnerable – perceive themselves, and whether/how they receive, and experience schemes designed for them. At the program level, inclusive and innovative identification and recruitment mechanisms need to be devised to identify populations who are currently left behind but may still be invisible to system actors and leaders.

The Usage of Contraceptive among Adolescent School Girls in a Semi-Urban Settlement, Cameroon

Background : Adolescent sexual activity, unwanted pregnancy, unsafe abortion and high number of HIV/AIDS infection have become the main reason of concern in urban and semi-urban areas Douala, Cameroon. More so, teenage pregnancy is a risk factor for poverty, unemployment, poorer educational achievements and poor mental health. The aim of this study was to assess the knowledge, attitude and practices on the usage of contraceptive among adolescent school girls in Mbanga, Littoral region-Douala. Methods : A cross sectional study was conducted in Mbanga, Littoral region-Douala during the month of February to march 2023 among 201 adolescent school girls to evaluate the knowledge, attitude and practices of contraception. Data was collected with the used of structured questionnaires and inputted in Microsoft excel and analyzed using SPSS version 23. With a 5% confidential interval. Results : 95.5% (192/201) of adolescent school girls had knowledge of contraceptives. Most of them (41.8%) got the information from health workers in hospitals. With respect to attitude, they had a negative attitudes towards contraceptives use; 43.3% declared that after using contraceptives it is difficult to get pregnant, 42.8% said pills and contraceptive injections affects female health, 37.3% said sex with condoms reduces pleasure. 56.7% of the participants were sexually active and 38.8% had used a contraceptive method. 16.4% and 15.9% of the participants used condom and calendar methods respectively. Conclusion : Adolescent school girls in Mbanga, littoral region-Douala had good knowledge of contraceptives usage. The attitude and practices on the usage of contraceptive was low among the study population. This study recommends that more sensitization on the attitude and practices on the usage of contraceptive should be carried out by local government and school authorities. Keywords: Contraceptive, Adolescent, school girls, Knowledge, Attitude, Practices DOI: 10.7176/JHMN/107-04 Publication date: April 30 th 2023

The degradation of spring water resources in Nepal: some policy gaps

Abstract In this study, first, we conducted a case study to understand the spring status in a semi-urban area, then synthesized the knowledge acquired so far, of nationwide springs status to highlight the current state and future policy and action implications of spring conservation in Nepal. We found that in 72% of the springs of semi-urban areas, the discharge rate has been decreasing over the past decade. In addition, the springs of such areas were exposed to higher contamination of biological pollutants compared with the rural areas. Synthesis of spring research in Nepal shows that springs of Nepal are degrading at an alarming rate where 16% had already dried up and about 60% have declining discharge, mainly due to declining rainfall, haphazard infrastructure development, and excessive spring resource exploitation. In response to the degrading springs and water crisis, several initiatives have been made, yet they are scattered, focused on limited springs, and not adequate to curb the current rate of spring degradation. We argue that the existing policies that are intended to operate in a top-down approach at the basin and watershed level are not effective in addressing local water issues at the springshed level.

GIS based Approach for Suitability Analysis of Residential Land Use

Developing countries in particular are experiencing a tremendous rise in urbanization. Population growth and internal migration generated rapid urbanization and uncontrolled infrastructure construction in urban and semi urban area in Nepal. In general, local needs for infrastructure development, and construction of housing and apartments are typically used to select the most suitable site for residential use. Identification of the criterion is crucial to a suitability analysis based on local needs. Site suitability analysis is used for identification of the best location or site for residential area using geographic information system (GIS) based on multi-criteria evaluation (MCE). Majority of research work, spatial analytical hierarchy process (AHP) is a suitable tool and used in suitability analysis purpose. The criteria were determined through prior work and customized in the local situation interaction with land use planner as expert perspective and focus group discussions, and utilized in land suitability analysis. In this study, GIS-MCE-AHP models is applied as an effective approach of spatial decision making process and play efficient vital role for identifying the potential areas for residential use. In the suitability residential index map, suitable level of residential area is covered only 5% and 38% land covered with the moderate suitable for residential area in Sambhunath municipality. The suitable for residential area is mainly occurred along the major road network and surrounding to the existing settlement area. GIS conjunction with MCE and AHP is useful for conducting land suitability analysis and serving as planning tool for suitable residential site.

Modeling of crashworthy foam mounted braced unreinforced brick masonry wall and prediction of anti-blast performance

Explosions are continually occurring in many parts of the world endangering human lives and seriously affecting the health of infrastructures and facilities. Low-rise buildings having a height of fewer than 13 m are load-bearing structures generally made of unreinforced masonry (URM), particularly in semi-urban areas, villages, and war-prone border areas. Many structures of importance including buildings constructed in the pre- and post-independence era of courts, monuments, etc., are masonry load-bearing structures. URM is also used as non–load-bearing partition walls and compound/boundary walls. Such walls are susceptible to out-of-plane blast loading. Under such loadings, these walls fail to survive and thus either get severely damaged or collapsed, jeopardizing the stability of the entire structure. Resistance of masonry walls against blast loading is vital for the safety of the building and its users as injuries sustained and casualties are generally not caused due to explosion, but by the brittle dynamic fracture and fragments of masonry walls, window glass panes shattering, and other secondary objects propelled as missiles by the blasts. In general, buildings are not designed for blast loading. For the safety of the building users, it is imperative that the walls must withstand such short-duration high-magnitude extreme loadings without not only undergoing catastrophic collapse but also not producing deadly fragments which could cause grievous injuries to the users. To protect URM walls from high-intensity blast waves, an out-of-box wall protecting technique using foams of polymer (e.g., polyurethane) and metals namely; aluminum and titanium, is considered on the face of the wall exposed to the blast pressure. This study describes a numerical technique implemented in ABAQUS/Explicit software to predict the overall anti-blast performance of URM wall strengthened externally with the above three different crashworthy foams. For this purpose, a braced URM wall made of clay bricks, with two transverse bracing walls one at each end on the same side, tested experimentally by Badshah et al. in the year 2021 under the chemical explosive loads of 4.34 kg and 7.39 kg-TNT, respectively, at scaled distances 2.19 m/kg1/3 and 1.83 m/kg1/3 is considered as the reference model and is validated against the test observations. Explosion load is modeled with ABAQUS built-in ConWep simulation program to simulate the wall-explosion wave interactions in the free field. Material nonlinearities of the brickwork have been attributed to bricks, joint-mortar, and brick-mortar interfaces through constitutive laws considering strain-rate effects. The foams are modeled using ABAQUS’s inbuilt Crushable Foam Plasticity Hardening model considering foam hardening and rate-dependent schemes. Results show that the higher Young’s modulus and inelastic stiffness of the foams contribute to dissipating more explosion energy and improve the resistance of the walls from savage explosions.

Comparative evaluation of spectrum occupancy of the broadcasting bands in urban, sub-urban and rural environments

Wireless services are at high demand all over the world, leading to increased bandwidth requirement and exhausted spectrum. In response, efforts are on-going to find ways to allow secondary access to spectrum without causing unacceptable interference issues to the Primary Users. In the fore-front of these efforts is the attempt to allow for secondary access on the TV spectrum, hence this analysis on spectrum usage measured outdoors in three locations namely Calabar in Cross River State representing an urban environment, Eket and Asong in Akwa Ibom State representing semi-urban and rural communities in Nigeria respectively. The UHF band percentage utilizations for the three locations were 98%, 76% and 33% with available cumulative bandwidths of 8MHz, 96MHz, and 264MHz respectively. Further validation of urban spectrum condition was done at Uyo in Akwa Ibom State. Findings showed that the spectrums are relatively busy in the urban and semi-urban areas whereas the economically challenging rural areas have free spectrum that can be deployed to enhance cellular broadband services at affordable rates to uplift the living standard of the dwellers.

Monitoring the Air Quality and Microclimate in a Semi-urban Area Using a Smartphone

In most developing countries, the air quality index is a relevant issue since it directly impacts human health and mobility. Commercial devices have already been used to describe the relationship between the air quality index and associated risks. But these results are not readily accessible to the general public, especially in semi-urban areas where threats of air pollution lurk with rapid urbanisation. The main idea is to use open-source wireless technologies for real-time monitoring of outdoor pollutants where free access to data on air pollution is not available. The result of the study shows the mean concentration of nitrous oxide ranges from 1.50 μg/m3 to 3.83 μg/m3 with the maximum being 6 μg/m3 and the minimum being 0 μg/m3. The average daily concentration of P.M10 ranges from 20.58 μg/m3 to 38.43 μg/m3 with a maximum 46 μg/m3 and the minimum 13 μg/m3. The average concentration of particulate matter P.M2.5 ranges from 30.04 μg/m3 to 53.39 μg/m3 with the maximum concentration being 59 μg/m3 and the minimum concentration being 2 μg/m3 in the study period. Similarly, the daily mean concentration of ozone varied between 19.87 μg/m3 and 34.75 μg/m3 with a maximum 52 μg/m3 and the minimum 5 μg/m3. The mean AQI value ranges from 34.54 to 54.30 with a maximum value of 91 and a minimum being 24. PM2.5 and PM10 showed a positive correlation (r2 = 0.998) with each other, indicating they came from the same source. Both PM2.5 and PM10 were negatively and weakly correlated with temperature and humidity. In the study, it is shown that PM10 acts as a single variable that affects the air quality index as a result of the combined effects of multiple factors.

DIGITAL LITERACY TRAINING FOR WOMEN ENTREPRENEURS IN THE DIRECTION OF ATMANIRBHARTA- A CASE OF KAROLIA VILLAGE

The impact of any global crisis is rarely ever gender neutral, and Covid-19 is not an exception. Countless women across diverse geographies have experienced an increase in their domestic workload, alongside the shrinking or complete loss of their livelihoods. While the entire world is facing unprecedented challenges, women are largely bearing the brunt of the economic and social fallout of Covid-19. Women from marginalized communities, employed in the informal sector in semi-urban and rural areas, are especially susceptible to loss of avenues of income, and added hours of unpaid labour with day-care and schools shutting down. The scenario in India is no different. Here, the struggle for women employed in the informal sector, or in running small business enterprises is even more pronounced. According to the Centre for Monitoring Indian Economy, unemployment levels in the country have moved into double digits. In fact, recent study under the UdyamStree campaign had 57 percent of women entrepreneurs cite a deterioration in their business enterprises during the pandemic owing to factors like diminishing customer base, loss of supply chains and avenues of funding shutting down. In the face of such adversity, the key to survival lies in the quick adoption of new business models that cater to what has now become the ‘new normal’. Business models that were primarily dependent on offline production or delivery models, experienced a far greater decline than those reliant on digital channels. Digital technology can act as the game changer for women entrepreneurs, particularly in rural areas. It can make a greater impact in the lives of women who run different kinds of micro small and medium businesses in rural and semi-urban areas. The penetration of mobile phones in rural areas could be leveraged wisely to bring these women closer to the stakeholders in their business ecosystems. The women in Karolia are skilled and have initiated their business several times but the initiative is not sustainable due their inability to get finance registrar their business and get business digitally. Thus, a project was to train women entrepreneur on digital literacy. 15 rural women undergone the training. They have learnt all the key principles of online platforms. Women were able to share their experiences and were amazed to realise their constant practices after their session. The evaluation was done by questionnaire method in which it covered all the content from start. The group at the end has been digitally active to do their business and has started managing their business digitally.

Multimorbidity and Sleep Patterns among Adults in a Peruvian Semi-Urban Area.

Objective To assess if the duration and quality of sleep vary due to the presence of multimorbidity. Materials and Methods We performed a secondary analysis using data from a population-based study involving adult subjects aged between 30 and 69 years residing in a semi-urban area of Tumbes, Peru. The duration (normal, short or prolonged) and quality (good or poor) of sleep were our outcome variables, whereas the exposure was multimorbidity (two or more chronic conditions). Crude and adjusted Poisson regression models were built to assess the association of interest, and prevalence ratios (PRs) and 95% confidence intervals (95%CIs) were reported. Results We analyzed data from 1,607 subjects with a mean age of 48.2 (standard deviation [SD]: ± 10.6) years, 809 (50.3%) of whom were women. Multimorbidity was present in 634 (39.5%; 95%CI: 37.1-41.9%) subjects, and 193 (12.1%; 95%CI: 10.5-13.7%) were short sleepers, 131 (8.2%; 95%CI: 6.9-9.6%) were long sleepers, and 312 (19.5%; 95%CI: 17.5-21.5%) had poor sleep quality. In the multivariable model, multimorbidity was associated with prolonged sleep duration (PR = 1.45; 95%CI: 1.03-2.04) and poor sleep quality (PR = 2.04; 95%CI: 1.65-2.52). Conclusions Multimorbidity was associated with prolonged, but not short, sleep duration, as well as with poor sleep quality. Our results suggest the need of assessing sleep patterns among adults with multimorbidity.

Urban Drainage: The Challenges and Failure Assessment Using AHP, Addis Ababa, Ethiopia

Urban drainage infrastructures are facing critical challenges due to a lack of integrated asset management, periodic maintenance, improper design, and construction methodologies. The objective of this study is to understand the urban drainage challenges and assess the failure causes and their impacts to recommend possible mitigation measures. Drainage failure causes and impacts are analyzed using the analytical hierarchy process (AHP) qualitative multicriteria decision model after conducting technical group discussions, interviews, and technical field surveys. The assessment was performed by taking representative samples from both cross- and longitudinal drainage infrastructures. The AHP analysis results showed that approximately 35.5% and 28.6% of failure causes are debris and various solid wastes for cross- and longitudinal drainage structures with correlation coefficients of 0.93 and 0.95, respectively. The result showed that design and construction defects are the second major failure causes. The research results showed that urbanization has a direct relationship with major drainage failure causes, resulting from man-made debris and solid waste clogging. On the other hand, drainage failure caused by siltation, drifts, and vegetation is higher in newly developing semi-urban and agricultural areas. The number of barrels in cross-drainage structures also contribute significantly to cross-drainage failure by creating a flow barrier due to the intermediate columns. The drainage failure impact assessment result showed that both cross- and longitudinal drainage failures primarily impact road pavement following transport disruption and traffic accidents, accounting for 38.5%, 18%, and 16%, respectively. Our research recommended that the mitigation measures for drainage failure are proper asset management and maintenance, appropriate construction supervision, and awareness creation, with weights of 36.3%, 15.5%, and 15.3%, respectively. As a drainage problem mitigation measure, the longitudinal drainage analysis results showed that the provision of a combination of cross-fall slopes, gutter slopes, and local depressions at the inlets can contribute to an increase in the trapping efficiency of the drainage system by 50%, which can reduce surface flooding substantially.

Investigating the Views of Directors of Secondary Education Units About the Burnout Syndrome During the Three-Year Term (2017-2020)

Background and aim: Τhe phenomenon of professional burnout has begun to be studied systematically in the field of education, particularly in those who serve in a managerial role in order to determine how the multilevel role affects the effectiveness and self-perception of individuals. This study was conducted with the aim of recording/investigating the symptoms of the phenomenon of burnout in the directors of school units serving in the Secondary Education of the Regional Units of Evros and Rodopi in Greece. Methodology: Literature review documented by sources of theoretical content guided the acquisition of empirical findings through quantitative research, a sample of which was responding 50 directors from 78 schools in urban, semi-urban and rural areas of the above regional units. Statistical data analysis was done using the google drive form and the possibilities provided by the excel program. Results: Data were analyzed according to variables of sex, type of residential area, number of students and years of experience. Discussion: Results indicated that secondary school directors do not experience burnout to a significant degree. Greater difficulty is reported in managing the time they spend due to their duties and bureaucracy Further research is required to shed light on the aspects of the phenomenon and explore the psychological consequences and its management.

Discriminatory practices and poor job performance: A study of person-related hostility among nursing staff

This study highlights the organisational-level factors that become the reason for propagating hostile behaviours among female nurses. Freire’s theory of oppression has been used as an underpinning theory for developing the conceptual framework. This study empirically verifies the conceptual framework of the study that gender discrimination and lack of administrative support are the antecedents of person-related hostility, which is the reason for poor job performance in the healthcare sector. We applied a quantitative research approach, using questionnaires to collect data. Total of 707 survey forms were collected from female nurses working in public sector hospitals in four main cities of Pakistan. The software SPSS 20 and SmartPLS 3 were used for the final data analysis. All hypotheses regarding the direct and indirect relationship of variables were accepted. Gender discrimination and lack of administrative support were positively associated with person-related hostility. Moreover, person-related hostility also mediated the relationship between independent variables (gender discrimination, lack of administrative support) and dependent variable (poor job performance). Future research is directed to study person-related hostility among nursing staff of semi-urban areas and small towns with low literacy rates, considering other dependent variables like burnout, mental well-being, and mental health. HR strategies and policies for fair performance evaluation and timely promotions of nursing professionals are proposed in the study for building an overall healthy environment.

A Retrospective Study on Profile of Patients with Faciomaxilary Fractures in a Tertiary Care Center.

Maxillofacial injuries in general occur quite commonly following trauma and these injuries if not properly managed can negatively influence both the psychosocial and functional activities of the patient. This is as a result of the centrality of the facial region as a key factor in human identity, aesthetics, and general well-being. Fractures involving the facial skeleton may be isolated or complex. High velocity trauma is usually seen in urban and semi-urban areas while low velocity trauma is the common setting in rural areas. The pattern of faciomaxillary fractures vary with geographical area, socioeconomic condition, enforcements of law and order of a country. Trauma to the faciomaxillary region mandates special attention as important sensory systems are contained within the face (e.g. vision, auditory, somatic sensation, gustatory, olfaction and vestibular), also, vital structures in the head and neck region are intimately associated (airway, blood vessels, nerves and gastrointestinal tracts. It should be noted that the treatment outcome of maxillofacial fractures is mainly dependent among other things on the degree of injury, type of fracture, the expertise of the surgeon, and available technology. The aim of this study is to find out the incidence of faciomaxillary injuries resulting from various etiological factor Classification of facial bone fractures; Diagnosis and different treatment modalities. This is a prospective cross sectional study comprising of 75 patients who were having different faciomaxillary fractures and visited to L.G. hospital from December 2020 to April 2022. Patients were evaluated thoroughly by history taking, proper examination and routine investigations. In general examination consciousness, orientation to time, place and person, neck movements, and general mobility of the patients were checked. In local examination- facial oedema, facial asymmetry, skin lacerations, deep cuts, decreased mouth opening, improper teeth occlusion, teeth loss, nasal bleeding, black eye, eyeball movements and redness of eyes were checked. In specialized radiological investigations x- rays, 2D & 3D Computed Tomography (CT) of Facial bones were done in all cases. CT Brain and CT Cervical spine were done in patients if needed. From our study, it seems reasonable to assume that road traffic accident remains the leading cause of faciomaxillary fractures and is closely followed by fall especially among men in their productive years. It is necessary to diagnose faciomaxillary fracture at the earliest to prevent the complications of fractures such as infection and malocclusion, for that thorough clinical examination and radiological investigations are very important. 3D CT face is the gold standard investigation in case of different faciomaxillary fractures. In isolated fractures nasal bone fractures remains the most affected bone of the facial skeleton followed by mandible. Among the different sites of mandibular fractures body of the mandible is the most common site for mandibular fractures.

Detection of the Omicron BA.1 Variant of SARS-CoV-2 in Wastewater From a Las Vegas Tourist Area

Interpretation of wastewater surveillance data is potentially confounded in communities with mobile populations, so it is important to account for this issue when conducting wastewater-based epidemiology (WBE). To leverage spatial and temporal differences in wastewater whole-genome sequencing (WGS) data to quantify relative SARS-CoV-2 contributions from visitors to southern Nevada. This cross-sectional wastewater surveillance study was performed during the COVID-19 pandemic (March 2020 to February 2022) and included weekly influent wastewater samples that were analyzed by reverse transcription-quantitative polymerase chain reaction to quantify SARS-CoV-2 RNA and WGS for identification of variants of concern. This study was conducted in the Las Vegas, Nevada, metropolitan area, which is a semi-urban area with approximately 2.3 million residents and nearly 1 million weekly visitors. Samples were collected from 7 wastewater treatment plant (WWTP) locations that collectively serve the vast majority of southern Nevada (excluding the small number of septic systems) and 1 manhole serving the southern portion of the Las Vegas Strip. With Las Vegas tourism returning to prepandemic levels in 2021, it was hypothesized that visitors were contributing a disproportionate fraction of SARS-CoV-2 RNA to the largest WWTP in southern Nevada, potentially confounding efforts to estimate COVID-19 incidence in the local community through WBE. Relative SARS-CoV-2 load and variants from visitors vs the local population. The Omicron BA.1 VOC was detected in the Las Vegas Strip manhole approximately 1 week before its detection at the WWTP locations (December 13, 2021) and by clinical testing (December 14, 2021). On December 13, Omicron-specific mutations represented a mean (SD) of 48.0% (4.2%) of all genomes from the Las Vegas Strip manhole and 4.1% (1.4%) of all genomes at facilities 2 and 3; by December 20, Omicron-specific mutations represented means (SD) of 82.0% (3.0%) of all genomes at the Las Vegas Strip manhole and 48.0% (2.8%) of all genomes at facilities 2 and 3, respectively. During this time, it was estimated that visitors contributed more than 60% of the SARS-CoV-2 load to the sewershed serving the Las Vegas Strip and that Omicron prevalence among visitors was 40% to 60% on December 13 and 80% to 100% on December 20th. Wastewater surveillance is a valuable complement to clinical tools and can provide time-sensitive data for decision-makers and policy makers. This study represents a novel approach for quantifying the confounding effects of mobile populations on wastewater surveillance data, thereby allowing for modification of an existing WBE framework for estimating COVID-19 incidence in southern Nevada.