Nutrition impacts of non-solid cooking fuel adoption on under-five children in developing countries

This paper examines the nutrition impacts of using non-solid cooking fuel on under-five children in developing countries.We draw on data from more than 1.12 million children in 62 developing countries from the Demographic and Health Surveys(DHS).Results from both fixed effects(FE)and instrumental variable(IV)estimates show that using non-solid cooking fuel significantly improves the nutrition outcomes of under-five children.Compared with their peers from households mainly using solid fuel,children from households mainly using non-solid fuel exhibit a lower probability of experiencing stunting(by 5.9 percentage points)and being underweight(by 1.2 percentage points).Our further investigation provides evidence for several underlying mechanisms,such as improved indoor air quality,induced reduction in children’s respiratory symptoms,benefits on maternal health,and reduction in maternal time spent on fuel collection or cooking.Heterogenous analyses suggest that the nutrition benefits of using non-solid cooking fuel are more prominent among boys,children above three years old,and those from households of lower socioeconomic status,rural areas,and Southeast Asia.

Challenges to establishing and maintaining kidney transplantation programs in developing countries:What are the coping strategies?

Kidney transplantation(KT)is the optimal form of renal replacement therapy for patients with end-stage renal diseases.However,this health service is not available to all patients,especially in developing countries.The deceased donor KT programs are mostly absent,and the living donor KT centers are scarce.Single-center studies presenting experiences from developing countries usually report a variety of challenges.This review addresses these challenges and the opposing strategies by reviewing the single-center experiences of developing countries.The financial challenges hamper the infrastructural and material availability,coverage of transplant costs,and qualification of medical personnel.The sociocultural challenges influence organ donation,equity of beneficence,and regular follow-up work.Low interests and motives for transplantation may result from high medicolegal responsibilities in KT practice,intense potential psychosocial burdens,complex qualification protocols,and low productivity or compensation for KT practice.Low medical literacy about KT advantages is prevalent among clinicians,patients,and the public.The inefficient organizational and regulatory oversight is translated into inefficient healthcare systems,absent national KT programs and registries,uncoordinated job descriptions and qualification protocols,uncoordinated on-site investigations with regulatory constraints,and the prevalence of commercial KT practices.These challenges resulted in noticeable differences between KT services in developed and developing countries.The coping strategies can be summarized in two main mechanisms:The first mechanism is maximizing the available resources by increasing the rates of living kidney donation,promoting the expertise of medical personnel,reducing material consumption,and supporting the establishment and maintenance of KT programs.The latter warrants the expansion of the public sector and the elimination of non-ethical KT practices.The second mechanism is recruiting external resources,including financial,experience,and training agreements.

Food Security in Developing Countries: Factors and Mitigation

Since 1976, eradicating hunger has become one of the priority objectives of the United Nations, which is included in the Charter of Human Rights;the right to get adequate food. The qualification of food security in time and space must analyze not only the three components it covers but also the relationships that these three components maintain. Climate change contributes to food insecurity, but it is not the only factor. To address food insecurity in various forms, greater food security must be combined with improved sustainable agricultural practices with minimal strain on the environment. This review of literature insists on the principles of food security, which in particular allows a better understanding of food insecurity in developing countries and favors a greater contribution of agriculture and food systems in general to nutritional progress.

Informing policy makers in developing countries:Practices and limitations of geriatric home medication review in Malaysia-A qualitative inquiry

Objective:To explore existing practices and challenges in the delivery of geriatric home medication review(HMR).The study was part of a larger study aimed to offer solution to expand the range of geriatric HMR.Methods:This study employed qualitative exploratory design through semi-structured individual in-depth interviews with the public pharmacists involved in the delivery of geriatric HMR at public hospitals.The purpose of the interviews was to explore challenges faced by them in the delivery of geriatric HMR.Results:Based on the emerging themes from the qualitative data,the study reveals that geriatric HMR in Malaysia is integrated as part of multidisciplinary home care visits,encompassing a diverse patient population with various healthcare needs.However,it faces challenges such as the lack of outcome monitoring,formal training,and workforce constraints.Despite these hurdles,there is a pressing need for the expansion of this service to better serve the community,and collaboration with community pharmacists holds potential to broaden its scope.Ultimately,the findings suggest that pharmacist-led HMR is both warranted and feasible within the Malaysian healthcare context.In order to optimize medicine-use among older people living in the community,approaches for expanding geriatric HMR services in Malaysia must be developed.Conclusions:This study holds profound implications as it attempts to illuminate policy makers in developing countries,enabling them to formulate effective HMR plans.By considering the challenges highlighted within this research,policy makers can design a comprehensive HMR service that caters adeptly to the healthcare needs of the mass population.

Epidemiological, Clinical Aspects and Outcome of Measles in a Low-Income Country in 2023

Introduction: Measles remains a worrying health problem in sub-Saharan African countries. There have been measles outbreaks in Cameroon with the most recent occurring between October 2022 and September 2023. The Centre region of Cameroon was the most affected in the country and being at the frontline of the fight against this illness, we conducted this study in order to determine the epidemiological and clinical characteristics as well as the outcome of children who contracted the measles and were hospitalized at the Yaoundé Gynaeco-Obstetric and Pediatric Hospital. Methodology: We conducted a cross-sectional descriptive and prospective study for one year from October 2022 to November 2023 corresponding to the duration of the outbreak. We included all children admitted in the pediatric unit for measles and its complications during this period. Results: In total, 60 children were enrolled. Their caregivers were mostly their mothers who had a mean age of 34.71 ± 9.55 years living in significant precarious conditions for the majority. The median age of children was 16 months (09 - 30 months). Twenty six percent of children (16) were less than 9 months. Girls were predominant (55%). Most children were not up to date with their routine EPI vaccination (80%) and most did not receive the measles and Rubella vaccine (76.67%). Clinical manifestations, included fever, conjunctivitis, and cough. Skin rash and catarrh (98.33% and 86.67% respectively) are the case definition signs of measles. The outcome was unfavorable for 4 children. One had a neurological disorder: coma and three presented with pneumonia and severe respiratory distress (6.67%). Conclusion: Measles is still being a reality and claiming lives in our context, emphasis should be made on immunization coverage and if possible, advocacies should be formulated to decrease the age of measles vaccine administration.

Narrative Empathy and Patriotism--An Analysis of the Chinese“Main-Melody”Film My People,My Country

Narrative empathy is a relatively new theory and it can guide researchers in the studies of main-melody films so as to promote the communication of the core values of the society.The rhetorical mechanism of narrative empathy can be illustrated from five rhetorical elements,including rhetor,rhetorical goal,rhetorical situation,rhetorical strategy and audience.The theory of narrative empathy can be applied to the case study of the film My People,My Country.In the production of this film,the directors are the rhetors.The rhetors uphold the tenet of closeness,choose the right rhetorical situation as the 70th birthday of the People’s Republic of China,and use appropriate rhetorical strategies in order to realize the rhetorical goals of evoking empathy and inspiring patriotic feelings in the audience’s minds.An exploration and application of narrative empathy can be conducive to the empathic communication of Chinese main-melody films in order to achieve better communication effect.

Effect of nutrition-related infodemics and social media on maternal experience: A nationwide survey in a low/middle income country

BACKGROUND Undernutrition is a crucial cause of morbidity and mortality among children in low-or middle-income countries(LMICs).A better understanding of maternal general healthy nutrition knowledge,as well as misbeliefs,is highly essential,especially in such settings.In the current era of infodemics,it is very strenuous for mothers to select not only the right source for maternal nutrition information but the correct information as well.AIM To assess maternal healthy nutritional knowledge and nutrition-related misbeliefs and misinformation in an LMIC,and to determine the sources of such information and their assessment methods.METHODS This cross-sectional analytical observational study enrolled 5148 randomly selected Egyptian mothers who had one or more children less than 15 years old.The data were collected through online questionnaire forms:One was for the general nutrition knowledge assessment,and the other was for the nutritional myth score.Sources of information and ways of evaluating internet sources using the Currency,Relevance,Authority,Accuracy,and Purpose test were additionally analyzed.RESULTS The mean general nutrition knowledge score was 29±9,with a percent score of 70.8%±12.1%(total score:41).The median myth score was 9(interquartile range:6,12;total score:18).The primary sources of nutrition knowledge for the enrolled mothers were social media platforms(55%).Half of the mothers managed information for currency and authority,except for considering the author's contact information.More than 60%regularly checked information for accuracy and purpose.The mothers with significant nutrition knowledge checked periodically for the author's contact information(P=0.012).The nutrition myth score was significantly lower among mothers who periodically checked the evidence of the information(P=0.016).Mothers dependent on their healthcare providers as the primary source of their general nutritional knowledge were less likely to hold myths by 13%(P=0.044).However,using social media increased the likelihood of having myths among mothers by approximately 1.2(P=0.001).CONCLUSION Social media platforms were found to be the primary source of maternal nutrition information in the current era of infodemics.However,healthcare providers were the only source for decreasing the incidence of maternal myths among the surveyed mothers.

Experiencing the Abject Female Body and Writing the Female Self:Body Narrative of In the Heart of the Country

In the Heart of the Country,the second novel by J.M.Coetzee,has been traditionally read as a disembodied writing that focuses on the problem of writing per se instead of the reality.This paper contends that the work is actually a body narrative that explores the visceral pain suffered by Magda whose infertile body impedes her being a qualified subject.As the heroine in a postcolonial novel,Magda is not just a body that is restricted and constructed by the politics of the body,but also a thinking and writing body that consciously questions and resists the gendered bodily norms under whose yardstick her subjecthood is barred.Written in the metafictional manner,Magda’s narrative of the body is not just a record of her corporeal experience,but also a self-conscious negotiation with,and challenge of,the bodily norms under whose yardstick her body has been debased or,in terms of Judith Butler,abjected.Taking her female bodily experience as the starting point,Magda writes a feminine text that values passion,fluidity and non-linearity to disrupt the patriarchal discourse underpinned with logical reasoning.The feminine body narrative endeavors to achieve a new way of communication through which a reciprocal cross race/gender relationship might be established.

Towards Lessening Learners’Aversive Emotions and Promoting Their Mental Health:Developing and Validating a Measurement of English Speaking Demotivation in the Chinese EFL Context

While a plethora of studies has been conducted to explore demotivation and its impact on mental health in second language(L2)education,scanty research focuses on demotivation in L2 speaking learning.Particularly,little research explores the measures to quantify L2 speaking demotivation.The present two-phase study attempts to develop and validate an English Speaking Demotivation Scale(ESDS).To this end,an independent sample of 207 Chinese tertiary learners of English as a Foreign Language(EFL)participated in the development phase,and another group of 188 Chinese EFL learners was recruited for the validation of the scale.Exploratory Factor Analysis(EFA)and Confirmatory Factor Analysis(CFA)were employed to determine the factor structure of the scale.The EFA results revealed a six-factor solution with Teacher-related Factors in Learning Spoken English(TFLSE),Interest and Valence in Learning Spoken English(IVLSE),Self-efficacy in Learning Spoken English(SELSE),Negative Peer Influence in Learning Spoken English(NPILSE),Undesirable Environment for Learning Spoken English(UELSE),and Negative Influence of Assessment and Learning Materials in speaking class(NIALM).In the validation phase,Confirmatory Factor Analysis(CFA)was performed to validate the internal structure of the scale.The CFA results showed that the model fits the data well.Overall,the ESDS is a robust and trustworthy psychometric tool that could be utilized to examine L2 speaking demotivation.Implications for diminishing EFL learners’demotivation,lessening their aversive emotions and promoting their mental health are also discussed.

基于POA的读写结合教学实践--以外研版高中英语教材Developing Ideas板块为例

读写结合是实施综合性语言学习的重要途径。产出导向法(POA)强调通过语言输入为语言输出搭建支架,有助于落实读写结合教学,实现语言文化知识的学习理解和迁移应用。本文以外研版高中英语教材Developing Ideas板块为例,阐述基于POA进行高中英语读写结合教学的策略:(1)输出驱动--呈现任务、尝试写作、激发动机。(2)输入促成--以读促写、搭建支架、迁移应用。(3)以评为学--师生合作、典型分析、完善修订。在此过程中,写作任务设计、阅读文本的选择等都有所要求。

Comparative analysis of open and laparoscopic colectomy for malignancy in a developing country

AIM: To compare the short-term, including oncologic, outcomes of open vs laparoscopic colectomy for cancer in a developing country. METHODS: The records of patients who underwent elective open and laparoscopic colectomies for cancer at the University Hospital of the West Indies between January 2005 and December 2010 were retrospectively reviewed. Demographic(age, gender, Charlson comorbidity index score), peri-operative, post-operative and oncologic data were collected for each patient. Specific oncologic variables included lymph node yield, pathologic stage, grade, proximal, distal and circumferential margin involvement. Fisher's exact, Mann-Whitney, and binary logistic regression tests were used for analysis. Significance level was set atP < 0.05. RESULTS: There were 87 cases for open colectomy(OC) and 17 cases for laparoscopic colectomy(LC). Demographics did not significantly differ between OC and LC groups. Intra-operative blood loss and postoperative analgesic requirements did not significantly differ between groups. There was a trend towards longer operating times in OC group and shorter hospital stay in the LC group. Lymph node yield(14 vs 14, P = 0.619), proximal(10 cm vs 7 cm, P = 0.353) and distal(8 cm vs 8 cm, P = 0.57) resection margin distance and circumferential margin involvement(9 vs 0, P = 0.348) did not significantly differ between groups. Thirty-day morbidity was equivalent between groups(22 vs 6, P = 0.774). There were 6 deaths within 30 d of initial procedure, all in the OC group(6.9%). CONCLUSION: Laparoscopic colectomy in a developing country is oncologically safe and represents a option for colonic malignancies in these regions. Such data encourage the continued laparoscopic development.

The microbial content of unexpired pasteurized milk from selected supermarkets in a developing country

Objective:To determine the presence and levels of microbes in unexpired pasteurized milk from randomly selected supermarkets in Kingston,Jamaica.Methods:The quantitative study used a stratified random sampling technique in the selection of the 20 representative milk samples from six(6) supermarkets.Microbiological tests such as methylene blue reduction,standard plate count(SPC),coliform plate count(CPC),purity plate culture,gram staining and biochemical tests were performed to examine the microbes in purchased unexpired pasteurized milk.Results:One sample(BCr016) had a pH of 4.0.a rancid odour and curdled appearance.It decolourized within one hour during the methylene blue reduction test and was classified as class 4 milk.Seven of the samples were sterile with no microbe growth on the plate count agar and violet red bile salt agar(VRBA).The milk samples that appeared to be safe for consumption were all 10,11,12 and 13 days before expiration.The VRBA sample BCr016,had a colony count of 13 400 CFU/ mL.There was the presence of Escherichia coli in sample LCr021 which had a standard plate count of 1 580 SPC/mL and a coliform count of 500 CFU/mL.Enterobacter sp.was present in colonies from BCr016 and all the other milk samples.Conclusions:Unacceptable levels of Entembacter spp.and Escherichia coli were found in most of the samples.Effective measures to ensure safe milk for human consumption such as the phosphatase test and methylene blue reduction test should be routinely performed on each batch of milk processed by dairy plants.

Challenges in the management of paediatric cataract in a developing country

AIM:To review the management of cataract in children in a tertiary hospital in a developing country,and to highlight the challenges therein.· METHODS:The hospital records of children aged 15 years or less that had cataract surgery at University of Nigeria Teaching Hospital,Enugu from 2005 to 2008 were reviewed retrospectively.Information was obtained on bio-data,pre-and post-operative visual acuity(VA),biometry,and type of surgery,use of intraocular lens(IOL) and presence of co-morbidity.SPSS was used for data entry and analysis.· RESULTS:The hospital records of 21 children(26 eyes) were analyzed.There were 12 males(57.1%) and 9 females(42.9%).Pre-operative VA could not be assessed in 11 eyes(42.3%),14 eyes(53.9%) had VA <3/60 and one eye(3.8%) had VA 6/60.Biometry was done in only 5 eyes(19.2%).All eyes had standard extracapsular cataract extraction without primary posterior capsulectomy;12 eyes(46.2%) had posterior chamber intraocular lens(PC-IOL) implant while 13 eyes(50.0%) had no IOL.After 12 weeks of follow up,vision assessment was available in only 15 eyes.With best correction,VA of 6/18 or better was achieved in only 5 eyes(33.3%).· CONCLUSION:Inadequate facilities and inadequate follow up after surgery are some of the challenges in managing paediatric cataract in the developing countries.If these challenges are not addressed,cataract will remain a major cause of childhood blindness and low vision in Africa for many years.There should be collaboration between Paediatric Ophthalmology Centres in industrialized and developing countries to enhance skill transfer.Governmental and International Non-governmental Organizations can go a long way to facilitate this exchange.

Extra-financial Analysis of IFRS Adoption and Application in Developing Country： The Case of Indonesia

This study was aimed to investigate the challenges and impacts of International Financial Reporting Standards （IFRS） adoption and implementation in Indonesia, an emerging country by focusing on extra-financial factors analysis. A series of questionnaires was built up regarding some selected items which have a marginal effect on IFRS adoption and implementation by Indonesian companies, the first part of the questionnaires was designed to gather information relating participants background, the second part of the questionnaire was set to collect participants opinion regarding IFRS adoption and implementation in Indonesia, and the third part of the questionnaire was an open questionnaire to enable the participants to give them suggestion or any additional information they feel can help IFRS adoption and implementation in Indonesia. The findings of this investigation reveal that Indonesia companies have facing several challenges and impacts in their IFRS adoption and implementation such as legal system, taxation system, economy and political ties, accounting education and its infrastructure, and culture structure. To ensure adoption and effective implementation of IFRS, Institute of Indonesia chartered accountants （IAI）, Indonesia government, Indonesia accounting body and academic must work together to reform the consistence of accounting standard for better applicability of IFRS in ensuring transparent information environment.

Profile of Geriatric Trauma in a Developing Country

Geriatric trauma patients require special consideration. They frequently have comorbidities and reduced physiologic reserves, influencing treatment decisions and outcomes. Hence, a comprehensive approach is fundamental to ensure better results. The authors retrospectively evaluated the profile of 332 cases of geriatric trauma over ten years (January 2010-December 2019) at National Orthopaedic Hospital Enugu, in South-East Nigeria. The mean age of patients was 74.78 years (SD = 8.69), with females presenting at a later age than men (76.05 vs 73.69 years), p = 0.013. The commonest mechanism of injury was ground-level fall (47.59%), with proximal femoral fractures being the most common (41.27%). Only 47% of geriatric patients presented to a hospital within 24 hours following injury, and the mean duration of admission was 28 days. Approximately 77% of patients had operative care, and 68.67% expressed satisfaction with the outcome of their management. The mortality rate was 2.11%. In conclusion, most geriatric fractures require surgical intervention and education to facilitate early hospital presentation is needed.

Stakeholders Theory:An Analysis of Eco-Labeling of Commercial Products in A Developing Country(Kenya) Stock Exchange Listed Companies

International environmental organizations propose voluntary eco-labeling as a market incentive to promote industry to operate in an ecologically sustainable and environmentally friendly manner,for instance,with the introduction of ISO 14000.These standards assist organizations to minimize their operations negatively affecting the environment and comply with applicable laws and regulations.Support for eco-labeling has been one of the ways that

Surgical and Anaesthesiology Management of Esophageal Atresia: What Are the Mortality Factors in a Developing Country?

Esophageal atresia is an extreme neonatal surgical emergency whose mortality remains high in our country. We report 8 cases collected over 7 years in a tertiary hospital in Abidjan, C?te d’Ivoire. The purpose of the study is to identify the elements of surgical and anaesthesiological man-agement in our department that influences mortality.

Primary Results of Late Surgical Treatment in Children with Tetralogy of Fallot from a Developing Country

Objectives: The purpose was to show how important is to operate on the Senegalese African children presenting with Tetralogy of Fallot (TOF) regardless of their age. Methods: It is a retrospective, descriptive analysis of data from the Department of Pediatric Cardiology, University Hospital of Tuebingen’s data base which was searched for all cases of TOF in foreign patients younger than 15 years between 05/2004-10/2016. Results: 16 children from Senegal with TOF were referred for treatment. Mean age of patients was 7.0 years (range 0.9 - 14.8 years). Primary corrective surgery was performed in 13/16 patients. A primary shunt procedure was required in 3/16 patients. All patients were discharged in good condition with a median 13 postoperative days. We did not register any deaths. All became asymptomatic with pulse oximetry oxygen saturations greater than 95%. The right ventricular outflow tract (RVOT) gradient was less than 30 mmHg in all patients and 2 patients had moderate pulmonary valvular insufficiency. Conclusions: It was still necessary to operate Senegalese children presenting with TOF irrespective of their age.

Prognosis of Breast Cancer Patients Underwent Surgery in a Developing Country

Background: We aim to review different factors associated with the relapse and the mortality in breast cancer patients in restricted-resource settings over a five-year period. Method: A retrospective cohort study including 133 women underwent breast cancer surgery was performed at the Surgical Oncology Unit of the Conakry University Hospital in Guinea. Socio-demographical characteristics, clinical information, treatment and data on relapse and survival were retrieved from medical files. Predictor factors of relapse were analyzed by using univariate and multivariate logistic regression. Factors associated with mortality were analyzed by Kaplan Meier survival and Cox models. Results: Breast cancer surgery was conservative in 13 cases (9.8%) and radical in 120 cases (90.2%). Five-year relapse was 33.8% ± 8.0% and the predictor factors of this relapse were age and stage III (p = 0.005). The overall 5-year mortality was 42.1% and the risk factors independently associated with death were body mass index (p = 0.01), origin of patients (p = 0.02), radiotherapy (p = 0.01) and cancer relapse (p = 0.001). Conclusion: The proportions of relapse and death were higher in breast cancer patients. The age and the stage of cancer at the time of surgery were the predictor factors of relapse. Body mass index, origin of patients, radiotherapy and cancer relapse were associated with death.

How to Implement Change in Asthma Management in a Developing Country

The goal of asthma management is to control symptoms, reduce the need for short acting beta agonist, and maintain optimal pulmonary function, and normal physical activities. Uncontrolled asthma can lead to obesity, suboptimal pulmonary function, poor quality of life and mortality. Children with bronchial asthma in River State University Teaching Hospital were just receiving acute care in the emergency room with no concrete plan for a follow up care for their chronic asthma;as a result most of the patients had uncontrolled asthma. In the hospital, the situation led to increased emergency hospitalization, resulting in decreased bed availability, increased burden on manpower and health resource utilization thereby putting more pressure on the limited health resources. Using the Kotter’s model for change management, transformational and situational leadership style, the change in the desired quality and scope of health service rendered to asthmatic patients was successfully implemented;as a result there was a decrease in emergency room visit for acute asthma by 57.5% and an increase in the uptake of scheduled clinic visits for asthma control services. The effect of these changes was an improvement in the control of asthma and quality of life of our patient cohort. Implementation of change in health service delivery is a delicate process that needs a stepwise approach in order to successfully implement and sustain the desired change.