This study aims to analyze how return on assets can be influenced by the level of financial leverage and operating efficiency at state-owned commercial banks in Indonesia. Case studies were conducted on 4 (four) state-owned commercial banks in Indonesia based on data from 2011-2022 with a sample size of 48 observation data. Data is collected from the annual report of each state-owned commercial bank which is processed based on accounting metrics. Data analysis was carried out based on a quantitative descriptive approach using panel data regression. The results showed that return on assets is simultaneously influenced by financial leverage. Partially, any increase in return on assets can be explained by increased financial leverage which is managed effectively, and more efficient bank operations.

Evaluating the content of the curriculum of economic management in order to serve the adjustment and development of curriculum, renewing the training in the field of Economic Management is one of the key tasks in the development strategy of the National Academy of Public Administration in the period of 2023-2030. In recent years, the economic management industry is one of the industries with a high degree of attracting human resources. The curriculum of Economic Management has been introduced into the organization to teach for 3 courses, has undergone 2 major training program development times from the annual training program to the academic program according to the credit studying curriculum. Through the process of organizing and implementing the curriculum, it will show positive results, besides, it will also show negative and limited results. The assessment of the current status of the Economic Management curriculum will be an important basis in the adjustment and development the curriculum of the Faculty of Economic Management and the University in the coming time.

In communities governed by customary law, the position of the land is crucial, so it is important to take care of any land that has been granted usage rights to its residents. The research objective is to analyze the concept of abandoned land in customary law communities as a foundation for national land law. The type of research used is normative legal research using secondary data to be further analyzed descriptively qualitatively. The results of the research show that the emphasis on abandoned land criteria in customary law is more on the length of time the land is not used, so that the physical land becomes unmaintained, as if it is no man's land. If the obligation to maintain and use the land is not fulfilled properly, accompanied by sanctions against some indigenous peoples, the party who neglects the land for some time will no longer be given management rights over customary land, even if they submit an application to the customary institution again. Meanwhile, customary lands that have been abandoned and returned to the control of the alliance are then used by customary institutions either by giving them to members of the customary law community or external parties who meet the requirements of the customary law community. The concept of abandoned land that exists in customary law is normalized in national land law, requiring that a new area of land rights can be declared abandoned if there is an element of intent. Even this is not instantaneous because through a series of processes to identify the land that was allegedly deliberately abandoned until the government issued a stipulation of the land as abandoned land.

The education system in Kenya plays a crucial role in shaping the country's socio-economic development and human capital. This paper provides an overview of the education system in Kenya, highlighting its structure, key components, challenges, and recent reforms from a historical perspective. The education system consists of three levels namely primary, secondary, and tertiary education. Primary education is compulsory and caters to children aged 6 to 14 years, while secondary education is divided into two cycles: junior secondary (14 to 17 years) and senior secondary (18 to 19 years). Tertiary education includes universities, technical and vocational institutions, and middle-level colleges. In recent years, Kenya has implemented several reforms to address challenges facing education and enhance its quality and standards. Furthermore, the curriculum has undergone significant revisions to align with the changing needs of the job market and the global economy. Emphasis has been placed on STEM subjects namely Science, Technology, Engineering, and Mathematics, as well as technical and vocational education and training (TVET) to foster skills development and entrepreneurship. Despite these positive changes and several challenges, Kenya can continue to foster a well-educated populace capable of driving sustainable development and economic growth in the country.

Background: The use of hormonal contraceptives is on the increase among women of reproductive age in Nigeria. In this study effort was made to examine the influence of combined oral contraceptives on some Red blood cell (RBC) parameters in women attending family planning unit. Materials and Methods: Data for this study were obtained through questionnaire administered on one hundred and twenty (120) respondents who were randomly purposively selected. The subjects blood samples were collected and analysed using appropriate techniques. One way ANOVA was adopted as statistical analysis method for the study. Results and Discussions: It was observed that while combined oral contraceptives therapy caused reduction in MCV value, MCHC was significantly raised. The significant increase in haematocrit value coupled with con-comitant reduction in haemoglobin concentration in circulation as reported by this study is of great advantage in terms of oxygen carrying and delivery capacity of red blood cells and maintenance of normal function in individuals. Conclusion: The combined oral contraceptives does not show the capacity of inducing anaemia in users.

Acute cholangitis is defined by an infection of the bile ducts due to an obstacle preventing bile flow. It is a diagnostic and therapeutic emergency. Aim of the Study: Report epidemiological, etiological, therapeutic and evolutionary cholangitis. Materials: This is a descriptive prospective study, spanning a period from September 2020 to April 2023. Patients with acute cholangitis were included. Results: We collected 102 cases. The average age was 63 years old with a Sex ratio M/W: 1.37. 18 patients (17.6%) had a history of cholecystectomy. Abdominal ultrasound was sufficient to visualize the obstruction in 32 (32%) patients. The lithiasic origin was revealed in 54 (53%) cases, pancreatic head tumor in 16 (15.7%), cholangiocarcinoma in 17 (16.6%), ruptured hydatid cyst in the biliary tract in 7 (7%). 100 (98%) patients benefited from endoscopic treatment and 2 (2%) benefited from surgical treatment. Endoscopic biliary sphincterotomy was performed in 84 (84%) patients and sphincteroclasia in 9 (9%) patients. Extraction of the stones or hydatid membranes by balloon was performed in 55 (55%) cases. Mechanical lithotricy was necessary in 1 (1%) case. A biliary prosthesis was placed in 52 (52%) patients (Picture 3). The single-stage success rate was obtained in 91 (91%) cases, 8 patients (8%) required a second stage. The early complication rate after endoscopic managment was 10% (n=10) with a death rate of 5% (n=5). Conclusion: Acute cholangitis remains a severe condition requiring urgent treatment. The prognosis has clearly improved after the advent of interventional endoscopy giving satisfactory results. Our study had shown with a technical success rate of 92.7% and a general success rate of 95%.

Helicobacter pylori (HP) infection is one of the most prevalent infections worldwide, contributing to inflammation of the gastric mucosa which is of great interest given its involvement in many gastroduodenal pathologies and some extra-digestive diseases. Aim of the Study: Report the incidence of HP from the endoscopy and anatomopathology register. Methods: This is a descriptive retrospective study performed during a period from January 2019 to November 2022, based on data from the endoscopy and anatomopathology register. We included all patients over 16 years of age who underwent esophago-gastroduodenal fibroscopy (EGD) with gastric biopsies performed according to the Sydney protocol. Results: 903 patients were included in our study. The incidence of HP infection was 60% (n=541).The average age was 50 years [17-90], the Sex Ratio W/M: 1.3, the most frequent symptom was represented by epigastralgia. The esophago-gastroduodenal fibroscopy had objectified an erythemato-congestive gastric mucosa in 481 (89%) of the cases, erythemato-whitish in 27 (5%), nodular in 16 (3%) and it was normal in 16 (3%) of the cases. On anatomopathological study, the gastritis was antro-fundal, antral and fundal in respectively 487 (90%), 43 (8%) and 11 (2%) of the cases. The intensity of gastritis was mild in 6.8%, moderate in 92% and severe in 1.2% of patients. Gastritis activity was absent in 6 (1.1%), mild in 74 (13.8%), moderate in 455 (84.1%) and severe in 5 (1%) cases. The density of HP was mild in 75 (14%), moderate in 437 (80.8%), and severe in 28 (5.2%) cases. Intestinal metaplasia was observed in only 9 cases (1.7%), as for dysplasia, it was not identified in any of our patients. Adenocarcinoma was revealed in 9 (1.7%) patients. Conclusion: The results of our study indicate an incidence of 60% (n=541). The association of chronic gastritis was important. Its pathogenic role has been revealed in many gastroduodenal pathologies in particular gastric cancer objectified in our series in 1.7% of cases, hence the interest in researching HP infection and its eradication.

Aim: This study aimed to investigate the impact of different meal compositions on glycemic control in healthy adults in the University of Port Harcourt by examining the order and combination of carbohydrate and vegetable consumption. Method: A randomized crossover trial was conducted with 30 male and female participants. Three groups were formed, each consuming meals consisting of carbohydrates and vegetables in different sequences. Continuous glucose monitoring and postprandial glucose tests were employed to assess blood glucose levels. The glycemic index (GI) of the meals was also determined. Results: Participants who consumed vegetables before carbohydrates exhibited significantly lower mean glucose levels compared to the other groups. The Vegetable before Carbohydrate group demonstrated a lower overall glycemic response, as indicated by the lower GI values at various time intervals. Conclusion: The findings suggest that consuming vegetables before carbohydrates can lead to better glycemic control in healthy adults. The order of food consumption plays a role in regulating postprandial blood glucose levels. Including vegetables, which have a low glycemic index, in carbohydrate meals can mitigate rapid spikes in blood glucose levels.

Nurses, especially ICU staff, complain of high level of stress regarding the workload. This can be related to many factors such as: nurse-patient ratio, doctor’s orders, timing, hospital environment to name a few. Nursing workload can be defined as all nursing work that must be carried out over a defined period of time. For example the effect of workload on covid-19 patients in intensive care units (ICUs) showed that higher RN staffing was associated with lower levels of hospital related mortality. Each additional full time equivalent RN per patient day corresponds to a 9% reduction in odds of death in ICUs. The aim of this study was to determine the extent of the effect of workload on nurses and other associated factors. A descriptive cross-sectional study was conducted in July to September 2020. 406 staff nurses were enrolled in the study. Instrument of the study was a questionnaire on the effect of workload on nursing staff who were taking care of covid-19 patients. Multiple logistic regression was utilized to identify the factors associated with high nursing workload of nurses. By using bivariate analysis; workload was found to be significantly associated with: nurse patient ratio, duty hours and type of department; the critical care units such as ICU, CCU and HD complained of higher workload (28.8, SD 3.7) than general units (20.7, SD 3.0) the P-value was 0.033. There was no significant difference between the workload and other demographic variables such as: environmental status, nationality, and type of hospital.

It is known that there is a strong link between social development and human resources policy. While the human resources policy covers the human resources of an organization in the micro sense, it covers the human resources of the nations in the macro sense. Achieving this goal will make it a center of attraction for qualified human resources; harmonious execution of growth, development, regional development and spatial development policies becomes more important than before. It is also aimed to strengthen the human resources management strategies and practices of administrations and organizations. Quantitative development will provide qualitative depth education; It is seen as a life-long process that accepts it as an investment in our future with a long-term perspective, improves the quality of life of our people, equips our country's human resources to compete with the contemporary world. In order to ensure that more qualified manpower comes to Turkey, new incentive mechanisms will be created and work permit processes are facilitated and accelerated. It is aimed to strengthen the human resources of the centers and schools to serve children better. Considering the power of human resources policy to realize social change, it is also important to consider what has been done in policy areas and future expectations.

Despite notable improvements in the understanding of the pathophysiology of sepsis, innovations in hemodynamic monitoring and methods of resuscitation, the cases of sepsis and septic shock still has a higher healthcare and economic burden and mortality. Yet, the significance of the nurses’ role is not explored and utilized enough in the fight against sepsis and septic shock. To give emphasis to the nurses’ role, this paper is a systematic review of existing reviews on sepsis following a research question: In patients with a suspected or confirmed sepsis, does specialized sepsis nursing assessment and intervention tool to standard nursing assessment tool improves management, outcome, and length of stay starting from the time of admission? This research question was formulated using the participant, intervention, (comparison), outcomes, and time frame (PICOT) formula. That is: (P) In patient with existing or confirmed sepsis, (I) does specialized nursing assessment and intervention tool (C) to standard nursing assessment tool only (O) improves management, outcome, and length of stay (T) starting from time of admission? Literature reviews and studies cited in this paper that explored sepsis recognizing the significance of the nurses’ role were published in either international or national journals and online databases including CINAHL Cochrane, Proquest, Medline, PubMed, and Google Scholars. The archives were searched using the following eligibility criteria: Nurses and Sepsis/Septic shock; Nurse Led Pathways and Sepsis/Septic Shock. Eligibility criteria of participants included suspected or confirmed blood infection. Out of 30 articles found, only 6 were included in the review based on the eligibility criteria set out. This paper found that nurse- led sepsis pathways played an important role in improving the management and outcome of sepsis. It also found a significant reduction of length of stay starting from the time of admission for those who are suspected or confirmed presence of blood infection. In its recommendation, the paper suggested the creation and implementation of a nurse-led pathway for use within the hospital initially and then throughout the catchment areas eventually.

Primary intestinal lymphangiectasia (PIL) is a rare disorder in children and it is more exceptional in adults. PIL is caused by a diffuse or localized dilatation and/or rupture of intestinal lymphatic vessels in the mucosa, submucosa, or subserosa due to high pressure in lymphatic vessels. The diagnosis is made on clinical grounds with the support of small bowel biopsies. The following report present a case of intestinal lymphangiectasia revealed by capsule endoscopy examination. This work shows that standard EGD and colonoscopy may miss characteristic lesions of PIL, and capsule endoscopy (or enteroscopy) may be required for the diagnosis because lesions are typically located in distal duodenum/jejunoileum.

Poor sterilizing is led to transfer of so many human diseases such as dysentery, cholera, hepatitis A and cholera. In this review, the important of sanitization to the human diseases is explained and the dynamical relationship between them is illustrated. Sterilizing and hygiene are very important to defeat diseases by washing hands and using alcohol sanitizer to clean floor, stairs offices and indoors. In addition, many types of sterilizers that used to clean are introduced with their components. The risk of using alcohol a lot is discussed also it is compared with normal washing with soaps and non-alcohol materials use. Moreover, the important relation between sterilizing and recent disease such as MARS and Covid-19 is covered in details. Eventually, the antimicrobial resistance that produced from the overuse of the sanitizers is discussed with the aim of covid-19 pandemic.

Scholars have divergent views on the classifications of Hausa dialects. Their classifications were based on the Hausa dialects' linguistic features and the geographical locations of the dialects in the Hausa land. Bargery (1934) was the first scholar who classifies the Hausa dialects into two broad divisions of Eastern and Western Hausa dialects in the introduction of his famous dictionary. He made the classification based on their common linguistic features and their regional or geographical locations. Most of the subsequent research of scholars conducted after Bargery’s 1934 dictionary followed the same footsteps of the Eastern and Western dialects classifications, though some scholars had different views on the individual dialects constituting the earlier two broad divisions. Some of the works of these scholars include; Jaggar (1945), Muhammad (1978), Abubakar (1982), Amfani (1993), Bello (1992), Musa (1995), Fagge (2002), Sani (2003), Yakasai (2006), Muhammad (2010), Bello (2015), Musa (2015) and Bello (2016). However, the research works of Ahmed and Daura (1970), Malka (1978), Wurma (2005), and Zulyadaini (2005) on the other hand classified Hausa dialects on the basis of major and minor dialects. They argued that the dialects are supposed to be classified and studied based on popularity and populations of speakers. In essence, the population of speakers of a dialect determines its status of being either a major or a minor Hausa dialect. This paper attempts to make a critical review of the scholars' classifications of Hausa regional dialects of Eastern and Western Hausa dialect divisions with a view to highlighting some of the neglected Western Hausa dialects found in Nigeria today that were not earlier considered in the scholars' two broad divisions. The data of this research was sourced mostly from the Hausa dialect works conducted by scholars and researchers. The research discovered that the earlier classification of individual Western Hausa dialects made by scholars was too narrow, which resulted in merging a number of independent Hausa Western dialects into one, instead of classifying the dialects and studying each dialect independently and broadly.

Many individuals are exposed to bacteria especially those who are raising pets. This interaction between household pets such as cats and dogs and human gives the chance for bacteria to transmit easily. Thereby, these bacteria could transfer from pet’s food and scratching to the owners. In this review, a bacteria gene transmission between pets and human is introduced and discussed. This transmission is happened due to the raising and owning these small animals. In addition, studies on Zoonotic diseases transfer between humans and animals especially pets are presented. Furthermore, the risk of pet ownership by people is reviewed and how should they interact with each other. Also, researches on how Antimicrobial-resistant pathogenic bacteria transmitting between human and pets are discussed. Eventually, gene transfer types between human and pet are explained with their consequences.