Semi-urban Areas Research Articles

Out Of Pocket Expenditure Of End Stage Renal Disease Patients For Maintenance Haemodialysis.

Background: End stage renal disease (ESRD) is a major and growing public health problem in Bangladesh. It is linked to higher hospitalization rates, lost productivity, illness, and early death, and it is a major cost on people, health care systems, and societies. Haemodialysis as a life saving measure can save patients but out-of-pocket expenditure of Haemodialysis in Bangladesh is high in comparison to their monthly family income. Therefore, it places a significant financial strain on the families of the disease victims. The aim of this study was to find out the out-of-pocket expenditure of ESRD patients for maintenance haemodialysis. Methods: This descriptive cross sectional study was carried out among 160 ESRD patients getting haemodialysis at Dialysis centre of a selected tertiary government hospital in Dhaka during the period of January to December 2022. Simple random sampling technique was followed. Data were collected by face to face interview with a semi-structured questionnaire and by check list reviewing medical documents. Results: The mean (±SD) age of the respondents was 49.28 ±12.706 years. Majority (60.6%) were male and 39.4% were female. Majority (29.4%) had secondary followed by 21.9% who had higher secondary level of education. About three fourths (71.9%) were from urban, 18.8% from rural, 8.1% from semi-urban areas and 1.3% were slum dwellers. The median of monthly family income was Tk. 20000 (interquartile range 15750). The median (IQR) total direct cost was Tk. 15983 (7203). The mean (±SD) total indirect cost was Tk. 5431.25±1128.17. The mean (±SD) total haemodialysis cost was Tk. 24205.59 ±17164.580. Conclusion: Out-of-pocket expenditure of Haemodialysis in Bangladesh is high in comparison to monthly family income and it poses huge financial burden to the families of the victims of end stage renal disease. The study recommended cost effective measures like subsidized or free of cost treatment of ESRD and free of cost haemodialysis of patients to reduce the financial burden of the families. Bangladesh Armed Forces Med J Vol 56 No (1) June 2023, pp 28-34

Geophysical and physicochemical assessment of groundwater and the implication on the public health in rural and semi-urban areas of Northern Nigeria

Groundwater resource plays a central role in every sector of life globally. Unfortunately, the roles of groundwater are often unappreciated in many parts of the world, especially in developing nations. The paper applied a combined geo-electrical method and hydrochemical analysis alongside physical surveys to investigate aquifer promising zones, the quality and the source of water supply in the selected regions. The geo-electric resistivity data were used to select the most aquifer-promising zone for groundwater development with a key interest in groundwater potential and aquifer overburden protective capacity overlying the water-bearing unit. Seventeen (17) vertical electrical sounding (VES) acquired in four regions reveals that the regional weathered/fractured unit which constitutes the aquifer unity extends from 13.4 m to 41.3 m in depth with the subsurface resistivity value varying between 53 Ωm–1013 Ωm in terms of resistivity values. The overburdened thickness (protective soil layers) stretches from 2.5 m to 13 m with a resistive layer of resistivity values ranging from 111 Ωm to 2877 Ωm, which could provide high aquifer protective cover for the regional groundwater systems. The computed aquifer transmissivity and hydraulic conductivity range from 0.54 m2/h\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$${m}^{2}/h$$\\end{document}–15.85 m2/h\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$${m}^{2}/h$$\\end{document}, and 0.95 m/day–9.19 m/day, respectively. The estimated average longitudinal conductance (0.2 moh) reveals that the regional groundwater systems are moderately protective against surface contaminants. In addition, the physicochemical water analysis was examined, which exposes the level of heavy metals (HMs) compositions in the regional groundwater systems and the possible public health risks compared to WHO permissible drinking water limits. The sample water from the Rivers had the highest concentration of HMs (0.089 mg/I–2.012 mg/l), followed by the hand-dug wells (HWDs) (0.033 mg/l–1.555 mg/l) and the lowest in the borehole (0.011 mg/l–0.511 mg/l). In contrast, the borehole water sample shows a moderation where the HMs presence falls within the WHO standard for drinking water. The outcomes of the study show that 63% of the investigated region consumed water with a high concentration of HMs above the WHO permissible standard allowance for drinking water, while only 37% took water that falls within the WHO permissible standard. In conclusion, the study showed significant impacts of anthropogenic activities on the regional water quality, which provides vital information about the regional groundwater systems and the quality of water supply for adequate groundwater development and sustainability.

Health-care-seeking behaviour in patients with hypertension: experience from a dedicated hypertension centre in Bangladesh

Objective: The study aimed to assess health-seeking behaviour (HSB) and associated factors among hypertensive patients in Bangladesh.Methods: This cross-sectional study was conducted in the Hypertension & Research Centre, Rangpur, Bangladesh, between January 2022 and June 2022. A total of 497 hypertensive adults were recruited consecutively. A pre-tested structured questionnaire was deployed by the research team for data collection. Multivariable logistic regression analysis was used to explore the predictors of HSB.Results: The mean age of the hypertensive patients was 52 ± 11 (SD) years. Most of them were aged between 51 and 60 years (33%), female (55%), came from rural areas (57%), and belonged to middle socioeconomic class (68%). One-fourth of the patients (27%) had chosen informal healthcare providers for their first consultation. Fear of stroke (244, 45%), headache (170, 36%), and neck pain (81, 17%) were the three most common compelling causes of their visit to the hypertension centre. Age (aOR 0.78, 95% CI 0.68 − 0.89), male sex (aOR: 1.79, 95% CI 1.05 − 3.10), living in semi-urban (aOR 4.68, 95% CI 1.45 − 15.10) and rural area (aOR 1.68, 95% CI 1.01 − 2.80), farmers as occupation (aOR: 3.24, 95%CI: 1.31 − 8.06) and belonging to lower social economic class (aOR 4.24, 95% CI 1.68 − 10.69) were predictors of visiting informal providers of hypertensive patient. One-fourth of the hypertensive patients received consultation from informal healthcare providers.Conclusions: Raising awareness among patients and proper referral to specialised hypertension centres could promulgate the patients towards appropriate behaviour.

Plant use knowledge and quantitative analysis of some medicinal plants from Ondo State, Southwestern Nigeria

This study was conducted to investigate the plants used medicinally in rural and semi-urban areas of Ondo State, Nigeria with a view to generating a comprehensive list of therapeutic plants and evaluating their importance quantitatively. Surveys were conducted in some communities in Ondo State between November 2021 and November 2022 with focus on different uses of plants. Structured questionnaires were administered to plant collectors and users. Data were analyzed based on some ethnobotanical indices. In total, 179 medicinal plants belonging to 66 plant families were recorded. The family Fabaceae had the highest (16.20%) representative species while shrubs formed the most used plant form (32%). The highest Frequency of Citation (FC, 49) was obtained for Azadirachta indica. The most valuable plant was A. indica (0.17) based on the Relative Frequency of Citation (RFC) and highest (1.67) Use Value (UV). The Consensus Index and Fidelity Level (FL) were also found to be highest with A. indica (50% and 83.33% respectively) while Fabaceae had the highest Family Importance Value (FIV, 10.98%). The ethnomedicinal use of A. indica, V. amygdalina etc. in the treatment of malaria/fever has been further confirmed in this study. The family Fabaceae has been shown to contain plant species that are important to the informants. The use of quantitative techniques in ethnomedicinal studies allows the identification of commonly used plants and their recommendation for pharmacological research to confirm traditional claims. There is need to properly educate plant users in the communities on the sustainable use of plant resources.

Early childhood caries among pre-school children in rural areas

Background: Early childhood caries can occur and exist among children in slums areas, rural areas and under-served communities. Africa has countries with rural areas inhabited by diverse ethnic populations of pre-school children, with their parents and family members. Method: An electronic literature search in Science direct and PubMed was done in January, 2024 using the Population, Concept and Context framework. Search terms and keywords were combined by Boolean operators. Two independent investigators screened titles and abstracts of publications on early childhood caries among pre-school children in rural areas. The inclusion criteria was original (primary) research articles with accessible full text, related to early childhood caries among pre-school children in rural areas, carried out in Africa, published in English and in electronic databases. Original research articles related to early childhood caries among pre-school children in urban, semi-urban or sub-urban areas, hospital based studies, studies with participants selected from rural and urban or rural and semi-urban communities, review articles, systematic reviews, thesis or dissertations were excluded during screening. Results: Three articles with accessible full texts were included as it was assessed to meet the aim of the review. The study designs of the included studies were cross-sectional study, randomized, controlled field trial and a case-control study respectively. The studies were carried out in rural areas of Uganda and Egypt respectively. Conclusion: Early childhood caries has multifactorial aetiology. More studies from diverse ethnic population in Africa countries will fill the gaps in knowledge and add to the existing literature.

CORRELATION ANALYSIS OF NORMAL AND JAUNDICE-RELATED BIRTHS: A COMPARATIVE STUDY IN GENERAL HOSPITAL AGBOR (SEMI-URBAN) AND FEDERAL MEDICAL CENTER ASABA (URBAN), 2013-2022

CORRELATION ANALYSIS OF NORMAL AND JAUNDICE-RELATED BIRTHS: A COMPARATIVE STUDY IN GENERAL HOSPITAL AGBOR (SEMI-URBAN) AND FEDERAL MEDICAL CENTER ASABA (URBAN), 2013-2022

Revealing the microbiome diversity and biocontrol potential of field Aedes ssp.: Implications for disease vector management.

The mosquito Aedes spp. holds important relevance for human and animal health, as it serves as a vector for transmitting multiple diseases, including dengue and Zika virus. The microbiome's impact on its host's health and fitness is well known. However, most studies on mosquito microbiomes have been conducted in laboratory settings. We explored the mixed microbial communities within Aedes spp., utilizing the 16S rRNA gene for diversity analysis and shotgun metagenomics for functional genomics. Our samples, which included Ae. aegypti and Ae. albopictus, spanned various developmental stages-eggs, larvae, and adults-gathered from five semiurban areas in Mexico. Our findings revealed a substantial diversity of 8,346 operational taxonomic units (OTUs), representing 967 bacterial genera and 126,366 annotated proteins. The host developmental stage was identified as the primary factor associated with variations in the microbiome composition. Subsequently, we searched for genes and species involved in mosquito biocontrol. Wolbachia accounted for 9.6% of the 16S gene sequences. We observed a high diversity (203 OTUs) of Wolbachia strains commonly associated with mosquitoes, such as wAlb, with a noticeable increase in abundance during the adult stages. Notably, we detected the presence of the cifA and cifB genes, which are associated with Wolbachia's cytoplasmic incompatibility, a biocontrol mechanism. Additionally, we identified 221 OTUs related to Bacillus, including strains linked to B. thuringiensis. Furthermore, we discovered multiple genes encoding insecticidal toxins, such as Cry, Mcf, Vip, and Vpp. Overall, our study contributes to the understanding of mosquito microbiome biodiversity and metabolic capabilities, which are essential for developing effective biocontrol strategies against this disease vector.

Comparative Study of Life Satisfaction, Adversity Quotient and Self-concept in Working and Non-working Women

This ex-post facto study examines the relationship between employment status and psychological variables - life satisfaction, adversity quotient, and self-concept - among married women aged 35-45 in semi-urban and urban areas of India. Utilizing purposive sampling with the snowball method, data were collected from 76 working women and 76 non-working women who met specific inclusion criteria. Assessment tools included the Satisfaction with Life Scale (SWLS) for life satisfaction, the Adversity Response Profile (ARP) for adversity quotient, and the Mohsin Self-Concept Inventory (MSCI) for self-concept. Analysis involved one-way analysis of variance (ANOVA). Results revealed significant differences in both life satisfaction and self-concept between working and non-working women, with employed individuals reporting higher levels of satisfaction and self-concept. However, no significant difference was observed in adversity quotient between the two groups. These findings suggest that employment status may influence various aspects of psychological well-being differently among women in India. Implications for policy and intervention strategies aimed at enhancing women's overall well-being are discussed.

Reconstruction of the Subsurface of Al-Hassa Oasis Using Gravity Geophysical Data

Al-Hassa city, located in Eastern Saudi Arabia, boasts the world’s largest oasis and the most expansive naturally irrigated lands. Historically, a total of 280 natural springs facilitated significant groundwater discharge and irrigation of agricultural land. Furthermore, the water in certain springs formerly had a high temperature. The spatial variability of the water quality was evident. At the same time, Al-Hassa Oasis is situated on the northeastern side of the Ghawar field, which is the largest conventional onshore oil field in the world in terms of both reserves and daily output (approximately 3.8 mmb/d). The aforementioned traits suggest an intricate subsurface that has not yet been publicly and thoroughly characterized. Due to the presence of significant cultural noise caused by agricultural and nearby industrial activities, a robust, easy-to-use, and accurate geophysical method (gravity) was used to cover an area of 350 km2, producing the 3D subsurface model of the study area. A total of 571 gravity stations were collected, covering the whole Al-Hassa Oasis and parts of the nearby semi-urban areas. The gravity data were corrected and processed, and a 3D inversion was applied. The resulting 3D geophysical subsurface modeling unveiled an intricate subterranean configuration and revealed lateral variations in density, indicating the presence of a potential salt dome structure, as well as fracture zones that serve as conduits or obstacles to the flow of the subsurface fluids. This comprehensive modeling approach offers valuable insights into the subsurface dynamics of the broader study area, enhancing our understanding of its qualitative tectonic and hydraulic features and their impacts on the area’s natural resources, such as groundwater and hydrocarbons.

Integrating traditional and allopathic child health: A healthcare transformation opportunity.

Numerous forums both domestically and internationally have discussed integration of allopathic and traditional healthcare. In South Africa, using traditional child healthcare is popular practice. If properly controlled, integrating this aspect of traditional child-health with allopathic healthcare may be advantageous to communities that use both healthcare systems. Allopathic and traditional healthcare remain separate organisations in South Africa despite efforts and discussions to integrate them. The study sought to explore the integration of traditional and allopathic child healthcare from the perspectives of children's caregivers and traditional healthcare practitioners. The study was conducted in a semi-urban area in the city of Tshwane. An exploratory qualitative research study was conducted using semi-structured interviews to collect data from 11 traditional healthcare practitioners and 15 children's caregivers who were sampled using snowball and convenient sampling respectively. The participants expressed their understanding of the usage of traditional healthcare practitioners in the care of children as well as their support for integration, and further indicated its necessity. Religion and its effects in health-seeking behaviour were cited as a factor in why there has not been greater integration between the two healthcare systems. The undocumented and undisclosed use of traditional healthcare potentially hinders the delivery of therapeutic healthcare. As such, integrating the two systems is essential to ensure patients' safety. This article highlights understanding of culture congruence and safe child healthcare that may be brought forward by the integration of the two healthcare systems.

Cytochrome b gene as a potential DNA barcoding marker in ecoraces of tropical Tasar silkworm Antheraea mylitta Drury

BackgroundTropical Tasar silkworm Antheraea mylitta Drury plays a very crucial role in the economic development of the country employing around 9.76 million people in rural and semi-urban areas. Since the population of this species has spread over many states with varying environmental factors, the population has been isolated into many pockets, specifically adapted to that niche, and are called as “ecoraces”. Even though phenotypically these ecoraces may look similar to some level but the intra-generic genotypic variability between them is correlated to the economically important yield traits of their cocoons. The purpose of our study was to evaluate the effectiveness of Cytochrome b (Cyt b) gene of mitochondrial genome as a potential DNA barcoding marker for identification of these ecoraces as to are they really ecoraces, and attempts to establish the first country report of DNA barcode reference library of this silkworm species. Methods and resultsDNA was extracted from pupae of pure ecoraces collected from core ecozones. PCR amplicon was bead purified and further subjected to Sanger Sequencing. The parsimony tree was also created using the MEGA 11 software. The genetic distance, gene flow and relation among the ecoraces was evaluated. The conserved regions of Cyt b gene were identified along with the documentation of the mode and tempo of nucleotide variation and evolution. ConclusionThe present study confirms the efficiency of Cyt b gene as a potential DNA marker for identification of ecoraces of Tasar silkworm and is the first country report on barcoding of A. mylitta Drury. Apart from being used as an early-warning system for ecological degradation, this knowledge will help in assessing the evolutionary relationship of these economically important ecoraces and identify their position in the process of evolution aiding in the assessment of conservation priorities.

COVID-19 Vaccine Hesitancy and Associated Oral Cholera Vaccine Hesitancy in a Cholera-Endemic Country: A Community-Based Cross-Sectional Study in the Democratic Republic of Congo.

COVID-19 vaccine hesitancy and its enablers shape community uptake of non-covid vaccines such as the oral cholera vaccine (OCV) in the post-COVID-19 era. This study assessed the impact of COVID-19 vaccine hesitancy and its drivers on OCV hesitancy in a cholera-endemic region of the Democratic Republic of Congo. We conducted a community-based survey in Bukavu. The survey included demographics, intention to take OCV and COVID-19 vaccines, reasons for COVID-19 hesitancy, and thoughts and feelings about COVID-19 vaccines. Poisson regression analyses were performed. Of the 1708 respondents, 84.66% and 77.57% were hesitant to OCV alone and to both OCV and COVID-19, respectively. Hesitancy to COVID-19 vaccines rose OCV hesitancy by 12% (crude prevalence ratio, [cPR] = 1.12, 95%CI [1.03-1.21]). Independent predictors of OCV hesitancy were living in a semi-urban area (adjusted prevalence ratio [aPR] = 1.10, 95%CI [1.03-1.12]), religious refusal of vaccines (aPR = 1.06, 95%CI [1.02-1.12]), concerns about vaccine safety (aPR = 1.05, 95%CI [1.01-1.11]) and adverse effects (aPR = 1.06, 95%CI [1.01-1.12]), as well as poor vaccine literacy (aPR = 1.07, 95%CI [1.01-1.14]). Interestingly, the belief in COVID-19 vaccine effectiveness reduced OCV hesitancy by 24% (aPR = 0.76, 95%CI [0.62-0.93]). COVID-19 vaccine hesitancy and its drivers exhibited a significant domino effect on OCV uptake. Addressing vaccine hesitancy through community-based health literacy and trust-building interventions would likely improve the introduction of novel non-COVID-19 vaccines in the post-COVID-19 era.

Psychiatric Co-Morbidities and Profile of Patients with Irritable Bowel Syndrome in Northern India.

To study sociodemographic and clinical variables, including psychiatric co-morbidities, in patients with irritable bowel syndrome. A total of 158 patients attending a medical gastroenterology clinic in a tertiary care center in Northern India were screened, from whom 100 were selected for the study. Rome IV criteria were used to diagnose IBS, and the severity of symptoms was assessed by the Irritable Bowel Syndrome Symptom Severity Scale (IBS-SSS). Psychiatric co-morbidities were screened via clinical evaluation, and if present, a diagnosis was made as per DSM-5. The Depression, Anxiety, and Stress Scale-21 (DASS-21) and Somatic Symptom Scale-8 (SSS-8) were used to assess depression, anxiety, stress, and somatic symptoms. The mean age of cases was 35.6 years' old, and the majority of cases (i.e., 38.0%) were between 18 and 29 years' old. Males comprised 62.0% of the sample and females 38.0%. Moderate IBS was present in 61.0% of the cases. Evaluation via DASS-21 revealed that 53.0% were in the moderate category of depression, 43.0% had moderate anxiety, and 36.0% had moderate stress. The somatic symptom scale revealed that 48.0% patients were in the high category. Psychiatric co-morbidities were present in 29.0% of cases. Depressive disorders were the most common psychiatric co-morbidity. Patients with IBS presenting to a tertiary care center in Northern India were primarily young males living in semi-urban areas who belonged to the Hindu religion, were married, and had a nuclear family. Patients with IBS commonly have associated psychiatric disorders; anxiety disorders and depression are most common.

Estimating the prevalence of cerebral palsy in a semi-urban city in Benin: a door-to-door community-based study.

Cerebral palsy (CP) is the most common cause of pediatric motor disability. While epidemiological data are widespread in high-income countries, corresponding data in low-income countries in Sub-Saharan Africa are still rare. This study aimed to estimate the prevalence of CP in Northern Benin, a French-speaking low-income country in Sub-Saharan Africa. This study was a community-based door-to-door study involving children younger than 18 years old, in Parakou, a semi-urban city in Benin. We used a two-stage procedure. The first one consisted on children screening to identify potential cases of CP. During the second stage, suspected children were examined by neurologists with high experience with CP. In total, 2630 children were screened with 10 confirmed cases of CP, resulting in a crude prevalence (95% confidence interval) of 3.8(1.4, 6.15) per 1000 children. Of the ten confirmed cases, six were younger than 5 years old, and five were male. Eight children over ten were spastic with six bilateral spastic subtype according to the SCPE classification system. Seven children had a Gross Motor Function Classification System level III-V, and six were classified level III to V of the Manual Ability Classification System. Cerebral palsy is highly prevalent in Semi-Urban area in Northern Benin. Large studies on potential risk factors are needed for the development of effective preventive strategies.

Weaving Futures: Enhancing Learning and Innovation Capabilities of Rural Women in the MSME Textile Sector

Purpose: Industrialization has led to centralized development, urbanization, migration and concentration of people in selected areas, that is, cities. The current model of development is not a sustainable one. While progress has been made through this model, it has also increased social inequalities, damaged health and caused irreversible depletion of the natural environment. The need of the hour is to create a new model of development to achieve sustainable development across rural and semi-urban regions. Objective: The objective of the new development model is to find out the relation between learning and innovation capability on the customer-based performance of a textile-based micro, small and medium enterprise (MSME). The research questions that will be answered are how rural women working in textile MSMEs can improve their learning and innovation capabilities? What is the impact of learning and innovation capabilities on the customer-based performance of the MSMEs? Methodology: The research method used for this study was based on primary data collected from the stakeholders of rural textile-based MSMEs and secondary data. Findings and Suggestions: The paper suggests that localized micro-factories enable people to stay close to their roots. The need of the hour is to train people with the required skill sets. The learning and innovation capability of the MSMEs reflects on their customer-based performance. The implementation of advanced technology will make localized micro-factories profitable. These technologies will provide services to citizens efficiently and equitably. The proposed smart cities will have to create more equitable and symbiotic relationships with the surrounding semi-urban and rural areas. The emphasis should be on learning new techniques of production using locally available resources. Once the new techniques have been learned, the company should be able to implement them innovatively to improve its customer experience.

Long-COVID-19 Impact in non-hospitalized patients: Sleep and quality of life 24 months after SARS-CoV-2 infection

ABSTRACT Background and Aims: Sleep disruption and reduced quality of life are common long coronavirus disease (COVID) manifestations, affecting survivors irrespective of initial COVID-19 severity. Limited research investigates symptoms beyond 24 months post-infection. We aimed to address this gap by longitudinally studying sleep patterns and overall quality of life in non-hospitalized adults, 24 months after severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. Methods: This prospective observational study involved the enrolment of 337 adult non-hospitalized patients in a consecutive fashion. Individuals with past COVID-19 (from 15 April 2020 to 30 June 2021) were examined at two Government hospitals and completed a telephone interview between 1 May 2023 and 30 June 2023, located in Jharkhand, India. Participants were queried about their sleep patterns and quality of life, utilizing the DSM5 LEVEL 2 and EQ-ED-5L tool, respectively. Results: Among 337 non-hospitalized participants, 212 completed the survey. Within this group (59.4% men, mean age 38), 36 (17.0%) experienced sleep impairment. All five dimensions of quality of life (QoL) were adversely affected in long COVID patients. Advanced age, high income, residing in rural or semi-urban areas, and having comorbidities were associated with a higher likelihood of decreased quality of life across various domains. Conversely, participants who were married, employed in healthcare or government positions, and vaccinated exhibited a reduced likelihood of experiencing lower quality of life. Conclusion: Long COVID-19 affects sleep and quality of life, with various demographic and clinical factors influencing outcomes. This study provides insights into the extended consequences of long COVID-19 and aids healthcare systems in addressing the challenges posed by this condition.

The sociodemographic profile and the challenges associated with treatment and rehabilitation in female heroin users: A case series from Northeast India

Females with opioid use disorder (OUD) rarely seek help for addiction. We present a series of seven females with OUD attending a tertiary care addiction treatment setting in Assam between December 2022 to August 2023. Most of the patients were primary-educated, young adults, housewives, from lower to middle socioeconomic strata, and were residents of rural or semi-urban areas. All were married, and around half of them were separated. All the patients were dependent on heroin and tobacco. Five of them initiated heroin use while modeling their spouse. Three patients were injecting heroin, and one was seropositive with both HCV and HIV. Five patients received sublingual buprenorphine-naloxone, and three of them followed up subsequently. Financial difficulty, poor family support, and intimate partner violence were major challenges for treatment-seeking and regular follow-up. This case series highlights the need for systematic study and gender-responsive care of females with OUD in Assam.

Teachers’ Perception on Implementing the Revised Lower Secondary Curriculum in Selected Schools in Uganda: A Focus on Emerging Issues and Coping Strategies

This study explored teachers’ perception on the implementation of Comptency-based Curriculum (CBC) in lower secondary schools in Uganda that was rolled out in 2020. The shift from the Knowledge-Based Curriculum (KBC) to CBC caused a cultural shock to those who had been nurtured in a purely teacher-centred curriculum! Teachers got challenged over their authority and autonomy in the delivery of instruction. Discussion was centred on teachers’ readiness to implement; pedagogical competences to plan, facilitate and assess CBC. In this phenomenological study, data was collected from 12 randomly selected secondary schools in urban, semi-urban and rural areas of Uganda. The population comprised teachers of Lower Secondary, Directors of Studies and Headteachers. Data was analyzed qualitatively through codes and themes and reported thematically, backed with verbatim quotations and statements from participants. Majority of the teachers were struggling with gaps in planning and content delivery, CBC stimulated hands-on-learning, teachers’ preparedness was considerably low due to lack of prior training, ICT integration was still an uphill task, majority of teachers were still stuck to traditional methodologies. CBC is too demanding and ambitious! NCDC should, therefore, design retooling packages for continuous capacity building, schools should promote peer mentorship, collaboration and Network initiatives.

Difficulties of Spanish Primary Health Care nurses to assist emergencies: A cross-sectional study

BackgroundThe competence of a Primary Health Care nurse to handle emergency situations depends largely on prior acquisition of theoretical knowledge to make appropriate decisions, combined with the corresponding practical skills to carry out swift and effective interventions. MethodsCross-sectional study conducted in through a survey auto-administered to a simple random sample of 269 nurses (n) with replacement of Asturias, Spain from the total nursing staff of 730 members (N) in Asturias. ResultsIn rural areas, the most frequently mentioned reasons were the lack of practical skills (18.9%) and the absence of adequate material (14.4 %). In the semi-urban area, the most common reasons were the lack of practical skills (13.2 %) and the lack of theoretical knowledge (10.3 %). Finally, in the urban area, the main reasons were the lack of practical skills (14.4 %) and the absence of adequate material (7.2 %). The differences were significant (p = 0.025). ConclusionsDespite the requirement that they acquire the necessary theoretical and practical skills, not all PHC nurses perceive themselves to be sufficiently prepared. The degree of self-perceived acquisition of this knowledge and skills, which is so important and necessary, is heterogeneous, with clear differences according to the respective field of work.

Enhancing the Random Forest Model via Synthetic Minority Oversampling Technique for Credit-Card Fraud Detection

Fraudsters increasingly exploit unauthorized credit card information for financial gain, targeting un-suspecting users, especially as financial institutions expand their services to semi-urban and rural areas. This, in turn, has continued to ripple across society, causing huge financial losses and lowering user trust implications for all cardholders. Thus, banks cum financial institutions are today poised to implement fraud detection schemes. Five algorithms were trained with and without the application of the Synthetic Minority Over-sampling Technique (SMOTE) to assess their performance. These algorithms included Random Forest (RF), K-Nearest Neighbors (KNN), Naïve Bayes (NB), Support Vector Machines (SVM), and Logistic Regression (LR). The methodology was implemented and tested through an API using Flask and Streamlit in Python. Before applying SMOTE, the RF classifier outperformed the others with an accuracy of 0.9802, while the accuracies for LR, KNN, NB, and SVM were 0.9219, 0.9435, 0.9508, and 0.9008, respectively. Conversely, after the application of SMOTE, RF achieved a prediction accuracy of 0.9919, whereas LR, KNN, NB, and SVM attained accuracies of 0.9805, 0.9210, 0.9125, and 0.8145, respectively. These results highlight the effectiveness of combining RF with SMOTE to enhance prediction accuracy in credit card fraud detection.