Environmental Public Health Commons^™

The Effects Of Polychlorinated Biphenyls Exposure On Non-Alcoholic Fatty Liver Disease : Role Of Aryl Hydrocarbon Receptor., Hongxue Shi

Electronic Theses and Dissertations

Polychlorinated biphenyls (PCBs) are detectable in serum of 100% of adults in US, and has been associated with fatty liver disease in epidemiological studies. PCBs are classified as either dioxin-like (DL) or non-dioxin-like (NDL) PCB based on their ability to activate the aryl hydrocarbon receptor (AhR). We used exposures that reflect human bioaccumulation patterns, which resembles Aroclor 1260 with a low level of the DL-PCB, PCB 126. Our aim was to determine if this exposure will activate the human and mouse AhR and examine if receptor activation influences these steatotic responses due to PCB exposures. DL-PCBs exposure-induced AhR activation in …

Advancing The Understanding Of Environmental Transformations, Bioavailability And Effects Of Nanomaterials, An International Us Environmental Protection Agency—Uk Environmental Nanoscience Initiative Joint Program, Mitch M. Lasat, Kian Fan Chung, Jamie Lead, Steve Mcgrath, Richard J. Owen, Sophie Rocks, Jason M. Unrine, Junfeng Zhang

Plant and Soil Sciences Faculty Publications

Nanotechnology has significant economic, health, and environmental benefits, including renewable energy and innovative environmental solutions. Manufactured nanoparticles have been incorporated into new materials and products because of their novel or enhanced properties. These very same properties also have prompted concerns about the potential environmental and human health hazard and risk posed by the manufactured nanomaterials. Appropriate risk management responses require the development of models capable of predicting the environmental and human health effects of the nanomaterials. Development of predictive models has been hampered by a lack of information concerning the environmental fate, behavior and effects of manufactured nanoparticles. The United …

Recovering Parasites From Mummies And Coprolites: An Epidemiological Approach, Morgana Camacho, Adauto Araújo, Johnica J. Morrow, Jane E. Buikstra, Karl Reinhard

Karl Reinhard Publications

In the field of archaeological parasitology, researchers have long documented the distribution of parasites in archaeological time and space through the analysis of coprolites and human remains. This area of research defined the origin and migration of parasites through presence/absence studies. By the end of the 20th century, the field of pathoecology had emerged as researchers developed an interest in the ancient ecology of parasite transmission. Supporting studies were conducted to establish the relationships between parasites and humans, including cultural, subsistence, and ecological reconstructions. Parasite prevalence data were collected to infer the impact of parasitism on human health. In the …

Breastfeeding As A Predictor Of Serum Concentrations Of Per- And Polyfluorinated Alkyl Substances In Reproductive-Aged Women And Children: A Rapid Systematic Review, Brianna N. Vannoy, Juleen Lam, Ami R. Zota

GW Research Days 2016 - 2020

Purpose of Review: Per- and polyfluorinated alkyl substances (PFASs) are synthetic chemicals widely detected in human serum, and at low levels in breast milk. We conducted a rapid systematic review on breastfeeding practices and serum concentrations of PFASs – specifically PFOS and PFOA - among reproductive-aged women and young children using the Navigation Guide systematic review methodology.

Recent Findings: We included 14 studies examining associations between breastfeeding and PFASs in infants/toddlers or pregnant/postnatal women. Breastfeeding was significantly associated with lower PFASs exposure among women and higher PFASs exposure among children. Summary: We concluded there was “sufficient” evidence supporting an association …

Occupational Exposure To Solvents And Associated Neurotoxicity In Construction Painters: A Systematic Review, Allison Cailliau

GW Research Days 2016 - 2020

Background

Existing evidence suggests that occupational exposure to solvents can have devastating and adverse effects on cognitive function. Individuals in the construction industry, specifically construction painters, often come in contact with these harmful chemicals on a regular basis. A solvent is a liquid that can dissolve, suspend, or extract other materials without chemical change to the solvent itself. They are present in a wide range of industries and can be used for extraction of fats and oils, degreasing, or manufacturing of paints and plastics. Their main routes of exposure are through inhalation and skin absorption, and they have a tendency …

Evaluation Of Pm Emissions Of A Diesel Engine Fueled With Waste Cooking Oil Biodiesel: A Systematic Review, Omobolanle H. Oshinusi, George M. Gray

GW Research Days 2016 - 2020

Background: The Navigation Guide developed by Johnson et al was used to conduct a robust systematic review of six experimental intervention studies looking at particulate matter (PM)emissions from conventional petroleum diesel and a biodiesel alternative utilizing waste cooking oil in heavy-duty petroleum diesel engines. Waste cooking oil biodiesel is thought to be a more sustainably sourced alternative to its fossil fuel counterpart.

Objectives: Application of the Navigation Guide systematic review methodology to answer the question: Does the replacement of petroleum diesel with waste cooking oil biodiesel reduce hazardous PMemissions? Methods: The study question was specified, evidence was selected and the …

Implications Of Foodborne Bacteria On Human Health: Isolation And Antibiotic Resistance Of Salmonella Enterica And Campylobater Spp. On Retail Chicken Sold In California, Grace Rahman, Lance Price, Hanna-Grace Rabanes

GW Research Days 2016 - 2020

Overuse of antibiotics contributes to antimicrobial resistance (AMR), which continues to be a growing threat to human health. In the United States, industrial food animal production (IFAP) is a formidable driver for antibiotic use. Prior work has focused on the link between antimicrobial use in poultry and human AMR infections. Common foodborne pathogens such as Salmonella enterica (S. enterica) along with Campylobacter coli (C. coli) and Campylobacter jejuni (C. jejuni) are commonly associated with human gastroenteritis. However, it has been shown that these pathogens are capable of causing disease outside of the gastrointestinal tract, specifically urinary tract infections (UTIs). …

The Effect Of Ammonia On The Germination And Outgrowth Of Bacillius Globigii, Joseph B. Kunicki

Theses and Dissertations

This research investigated the germination and outgrowth of Bacillus globigii in the presence of ammonia in laboratory scale experiments. Germination was measured by monitoring the release of dipicolinic acid, an organic compound present in bacterial spores, while outgrowth was measured using phase-bright microscopy and semi-automated counting procedures. The ammonia-N concentrations investigated generally did not cause statistically significant differences in the initial 1-hr germination rates or the average 3-hr outgrowth rates of Bacillus globigii spores in batch style experiments. The average 1-hr germination rates observed in the absence of ammonia-N was 0.0258 hr^-1 for the water and buffer controls and …

Early Inititation Of Breastfeeding And Vitamin A Supplementation With Nutritional Status Of Children Aged 6-59 Months, Betty Yosephin Simanjuntak, Miratul Haya, Desri Suryani, Che An Ahmad

Kesmas

Masa balita, khususnya dua tahun pertama kehidupan merupakan usia emas bagi anak karena pertumbuhan dan perkembangannya yang cepat. Oleh karena itu, terjadinya gangguan nutrisi pada masa itu bisa bersifat permanen dan tidak dapat diubah. Penelitian ini mengkaji hubungan antara inisiasi dini pemberian air susu ibu dan vitamin A dengan status gizi. Total sampel yang dianalisis dalam penelitian ini adalah 1.592 anak di bawah lima tahun (balita) berusia 6-59 bulan yang diambil dari Pemantauan Status Gizi Indonesia 2015 di Bengkulu. Data termasuk usia, jenis kelamin, inisiasi menyusui dini, panjang kelahiran, berat lahir, suplementasi vitamin Adikumpulkan dengan menggunakan kuesioner. Berat dan tinggi …

The Effect Of Health Insurance On Institutional Delivery In Indonesia, Mazda Novi Mukhlisa, Pujiyanto Pujiyanto

Kesmas

Pemanfaatan pelayanan persalinan di fasilitas kesehatan berdampak pada menurunnya angka kematian ibu (AKI). Di Indonesia, persalinan di fasilitas kesehatan mengalami peningkatan setiap tahunnya, tetapi masih terdapat sekitar 30% ibu yang bersalin di rumah. Sayangnya, peningkatan pemanfaatan pelayanan persalinan di fasilitas kesehatan tersebut tidak diimbangi dengan penurunan AKI, sehingga Indonesia tidak berhasil mencapai target MDGs. Untuk mencapai Universal Health Coverage, Indonesia mengimplementasikan program Jaminan Kesehatan Nasional (JKN) yang mengintegrasikan empat jaminan kesehatan, yaitu Askes/ASABRI, Jamsostek, Jamkesmas, dan Jamkesda. Jaminan kesehatan dapat mengatasi kendala biaya pada persalinan di fasilitas kesehatan. Dengan menggunakan data Riset Kesehatan Dasar 2013 dan data Potensi Desa 2011 …

Antenatal Care Provider And Cesarean Section In Urban Areas In Indonesia, Terry Yuliana Rahadian Pristya, Milla Herdayati, Besral Besral, Dheni Fidyah Fika

Kesmas

Tren persalinan sesar di Indonesia (2007-2012) mengalami peningkatan dua kali lipat berisiko pada munculnya masalah kesehatan jangka panjang maupun pendek. Penelitian ini bertujuan mengetahui hubungan tenaga kesehatan pemeriksa kehamilan dengan persalinan sesar. Penelitian kuantitatif ini menggunakan desain potong lintang dengan sampel penelitian 5143 wanita usia subur berusia 15-49 tahun yang melahirkan anak terakhirnya, baik melahirkan sesar maupun tidak di wilayah perkotaan yang terpilih dalam sampel Survei Demografi Kesehatan Indonesia tahun 2012. Analisis multivariat regresi logistik digunakan untuk mengetahui hubungan tenaga pemeriksa kehamilan dengan persalinan sesar, dikontrol oleh usia ibu, tempat periksa kehamilan, paritas, dan tempat melahirkan. Hasil penelitian menunjukkan bahwa …

Family Support As A Factor Influencing The Provision Of Exclusive Breastfeeding Among Adolescent Mothers In Bantul, Yogyakarta, Maulida Lailatussu’Da, Niken Meilani, Nanik Setiyawati, Sammy Onyapidi Barasa

Kesmas

Kehamilan remaja di Indonesia cukup tinggi. Kecamatan Sewon memiliki angka persalinan remaja tertinggi di Kabupaten Bantul pada tahun 2015-2016. Penelitian ini bertujuan untuk mengetahui faktor-faktor yang memengaruhi pemberian ASI eksklusif pada ibu usia remaja di Kecamatan Sewon, Kabupaten Bantul. Penelitian ini menggunakan desain potong lintang dan sampel penelitian berjumlah 45 orang ibu usia remaja yang mempunyai bayi usia 6-24 bulan. Pengumpulan data menggunakan kuesioner terstruktur. Analisis bivariat menggunakan kai kuadrat dan fisher’s exact test, sedangkan analisis multivariat menggunakan regresi logistik. Hasil penelitian menunjukkan bahwa 53.3% ibu usia remaja tidak memberikan ASI eksklusif. Analisis bivariat menunjukkan faktor status kehamilan (nilai p …

Risk Of Adolescent Pregnancy Toward Maternal And Infant Health, Analisis Of Idhs 2012, Anni Fithriyatul Mas'udah, Besral Besral, Bimandra Adiputra Djaafara

Kesmas

Dampak kehamilan pada remaja erat kaitannya dengan risiko kesehatan ibu dan bayi. Penelitian ini bertujuan untuk mengembangkan komposit indeks kesehatan ibu, indeks kesehatan bayi dan untuk menelaah pengaruh kehamilan remaja terhadap kesehatan ibu dan bayi. Penelitian ini menggunakan data Survei Demografi Kesehatan Indonesia tahun 2012, dengan sampel 2.167 responden yang memenuhi syarat inklusi (wanita usia subur yang pernah melahirkan anak pertama sejak Januari 2007 sampai survei dilaksanakan). Analisis menggunakan Polychoric Principal Component Analysis untuk menentukan komposit indeks kesehatan ibu dan bayi, serta regresi logistik untuk mengetahui besar hubungan kehamilan remaja terhadap kesehatan ibu dan bayi. Kesehatan ibu dapat ditentukan melalui …

Effect Of Nutrition Counseling Knowledge And Attitude Toward Mother Breastfeeding And Baby Growth In Sub Lubuk Pakam, Herta Masthalina, Zein Agustina

Kesmas

Untuk dapat menjalankan program ASI eksklusif, ibu menyusui harus memiliki pengetahuan yang baik. Salah satu cara dalam menambah pengetahuan yaitu dengan memberikan konseling gizi. Penelitian ini bertujuan untuk mengetahui pengaruh konseling gizi tentang ASI eksklusif dan status gizi terhadap pengetahuan dan sikap ibu menyusui di wilayah Puskesmas Kecamatan Lubuk Pakam. Jenis penelitian ini adalah quasi experimental non-equivalent control group design. Sampel sejumlah 60 ibu dibagi ke dalam dua kelompok, yaitu 30 ibu yang diberikan konseling gizi intensif pada kelompok intervensi di wilayah kerja Puskesmas Lubuk Pakam dan 30 ibu pada kelompok kontrol di wilayah kerja Puskesmas Tanjung Morawa. Kelompok perlakuan …

Exclusive Breastfeeding Intention Among Pregnant Women, Tria Astika Endah Permatasari, Ratu Ayu Dewi Sartika, Endang Laksminingsih Achadi, Urip Purwono, Anies Irawati, Dwiana Ocviyanti, Evi Martha

Kesmas

Intensi pemberian ASI eksklusif adalah intensi ibu untuk memberikan hanya ASI pada bayinya sejak dilahirkan hingga berusia enam bulan. Intensi pada periode prenatal merupakan penentu langsung pemberian ASI eksklusif. Penelitian ini bertujuan mengetahui faktor paling dominan berhubungan dengan intensi pemberian ASI eksklusif pada ibu hamil di sebuah rumah sakit ibu dan anak di Kota Tangerang Selatan. Penelitian dengan desain studi potong lintang dilakukan secara primer. Sampel berjumlah 143 ibu hamil trimester ketiga dipilih secara purposive sampling. Intensi pemberian ASI eksklusif diukur menggunakan kuesioner the Infant Feeding Intentions scale. Sedangkan sikap, norma subjektif dan persepsi kontrol perilaku dinilai menggunakan modifikasi kuesioner …

Assessment Of Temperature And Ultraviolet Radiation Effects On Sunburn At An Inland U.S. Beach: A Cohort Study, Jason W. Marion, Jiyoung Lee, James Rosenblum, Timothy J. Buckley

EKU Faculty and Staff Scholarship

Background

Increases in outdoor temperature may lead to increases in sunburn, outdoor exposure, and skin cancer in human populations.

Objective

This study aimed to quantify sunburn incidence and risk for Ohio beachgoers exposed to varying outdoor conditions.

Methods

Sunburn incidence data were obtained through a prospective cohort study at East Fork Lake (Cincinnati, Ohio, USA). Recruitment occurred over 26 weekend days. Beach interviews and follow-up telephone interviews obtained exposure and health information. New sunburns were self-reported 8–9 days post-enrollment. Survey data were paired with ultraviolet radiation (UVR) index and temperature data for statistical analysis.

Results

Among 947 beachgoers, new sunburns …

Food Insecurity: United States, Courtney Handzel

Global Issues in Public Health

Food insecurity is a global issue and has caused struggles to millions of people, specifically in the United States. This environmental issue involves not having the resources to obtain adequate food supply. The economic and social influences that affect food insecurity leave vulnerable populations, such as low-income families and minority races, at a greater disadvantage. This issue causes serious health complications to arise too, the most common being diabetes. The increased risk of diabetes due to food insecurity has been studied on several occasions and the results all show the correlation, lack of food security increases the risk of diabetes. …

Regulation Of Radioactive Fracking Waste, Elizabeth Ann Glass Geltman, Nichole Leclair

Publications and Research

Natural gas extracted form shale reached record production totals in 2015 in the United States and the US Energy Information Administration (EIA) forecasts natural gas production will continue to increase. Wastes from shale gas extraction can contain the radioactive isotopes radium-226 (Ra-226) and radium-228 (Ra-228), which decay further into radon (Rn). Exposure to radon, a form of naturally occurring radioactive materials (NORM), is the leading cause of lung cancer in the United States, after smoking. This article explores how states handle the disposal of technologically enhanced naturally occurring radioactive materials (TENORM) and/or NORM waste from oil and gas operations to …

Paleoparasitology And Pathoecology In Russia: Investigations And Perspectives, Sergey Slepchenko, Karl Reinhard

Karl Reinhard Publications

Russia, both as the USSR and the Russian federation, provided a source of parasitological theory for decades. A key figure in Russian parasitology was Yevgeny Pavlovsky. He developed the nidus concept, the conceptual basis for the field of pathoecology. He also coined the term “paleoparasitology.” Pathoecology is a foundation concept in archaeological parasitology. Paleoparasitology, as defined by Pavlovsky, is an avenue for understanding of host parasite evolution over very long time periods. These contributions are not fully recognized internationally. Similarly, the long history of Russian paleontological and archaeological investigations are not fully known. Most recently, discoveries from archaeological sites show …

The Paleoepidemiology Of Enterobius Vermicularis (Nemata: Oxyuridae) Among The Loma San Gabriel At La Cueva De Los Muertos Chiquitos (600–800 Ce), Rio Zape Valley, Durango, Mexico, Johnica J. Morrow, Karl Reinhard

Karl Reinhard Publications

One hundred coprolites excavated from La Cueva de los Muertos Chiquitos (600–800 CE) in the Rio Zape Valley of present-day Durango, Mexico, were examined for the presence of helminth eggs utilizing standard archaeoparasitological techniques. Eggs of the human pinworm (Enterobius vermicularis) were recovered from 34 of the 100 coprolites examined. Eggs of parasites were photographed and measured before egg concentration values were calculated for each positive sample. Egg concentration values demonstrated an overdispersed pattern of distribution among the samples (66% uninfected, 25% less than 100 eggs/g, 8% between 100 and 500 eggs/g, and 1% more than 500 eggs/g). …

Autologous Bone Flap Resorption Years After Subtemporal Craniotomy, John Oladapo Obafunwa, Emily E. Hammerl, David Jaskierny, Livia A. Taylor, Lynette Russell, Karl Reinhard

Karl Reinhard Publications

In Spring of 2012, the partially undressed and skeletonized remains of a homeless adult Hispanic male was found in a fairly open wooded area in Nebraska. The remains showed evidence of extensive pathologies, which included healed traumas and surgeries. Examination of the decedent's medical records revealed that he had a history of kidney and liver problems, alcohol abuse, several traumas including a major head injury that necessitated a craniotomy, and radiological features of neurocysticercosis. The autologous bone flap, which was replaced after the craniotomy, had resorbed significantly away from the edges of the injury. Death was variously attributed to craniocerebral …

Examining The Issue Of Compliance With Personal Protective Equipment Among Wastewater Workers Across The Southeast Region Of The United States, Tamara L. Wright

College of Graduate Studies: Theses & Dissertations

Wastewater workers are exposed to different occupational hazards such as chemicals, gases, viruses, and bacteria. Personal Protective Equipment (PPE) is a significant factor that can reduce or increase the probability of an accident from hazardous exposures to chemicals and microbial contaminants. The purpose of this study was to identify wastewater worker’s beliefs and practices on wearing PPE and protections offered by PPE through the integration of the Health Belief Model (HBM). Participants were workers in the wastewater industry, which included wastewater operators, laboratory analysts, maintenance workers, wastewater collection workers, equipment operators, managers, and supervisors (n=272). The instrument was a self-administered …

Taphonomic Considerations On Pinworm Prevalence In Three Ancestral Puebloan Latrines, Morgana Camacho, Alena M. Iñiguez, Karl Reinhard

Karl Reinhard Publications

For archaeological studies it is always necessary to consider taphonomic factors that could have influenced in ancient material preservation. Parasite eggs are usually highly degraded in ancient sites dated from all periods of time and taphonomic factors are mentioned to explain absence and low quantity of eggs found. In this study, we compare parasite egg recovery of three Great House latrines: two from Aztec Ruins (Rooms 219 and 225) and one from Salmon Ruins. We compared through statistical regression the recovery of eggs with the abundance of two classes of decomposers: mites and nematodes. These microorganisms have relation with nematode …

New Evidence Of Ancient Parasitism Among Late Archaic And Ancestral Puebloan Residents Of Chaco Canyon, Rachel E. Paseka, Carrie C. Heitman, Karl Reinhard

Karl Reinhard Publications

Archaeoparasitology provides a unique perspective on the health and habits of ancient cultures through the identification of parasite remains in archaeological materials. We identified eggs of the human whipworm, Trichuris trichiura, in coprolites recovered from Late Archaic (1926–1751 cal. BCE) and Ancestral Puebloan (1039–1163 cal. CE) sites in Chaco Canyon, New Mexico. Our findings represent the earliest record of T. trichiura in North America, the first record of the species from Chaco Canyon, and the first record of a macroparasite from a Late Archaic site (Atlatl Cave) on the Colorado Plateau. T. trichiura is common in the …

Range Expansion Of Tick Disease Vectors In North America: Implications For Spread Of Tick-Borne Disease, Daniel E. Sonenshine

Biological Sciences Faculty Publications

Ticks are the major vectors of most disease-causing agents to humans, companion animals and wildlife. Moreover, ticks transmit a greater variety of pathogenic agents than any other blood-feeding arthropod. Ticks have been expanding their geographic ranges in recent decades largely due to climate change. Furthermore, tick populations in many areas of their past and even newly established localities have increased in abundance. These dynamic changes present new and increasing severe public health threats to humans, livestock and companion animals in areas where they were previously unknown or were considered to be of minor importance. Here in this review, the geographic …

Behavioral Ecology And Associated Virology Of Mosquito-Host Interactions In Southern California, Oliver Eshun

Loma Linda University Electronic Theses, Dissertations & Projects

Elucidating characteristics of mosquito-host interactions are critical for understanding the ecology and epidemiology of mosquito-borne diseases. In this dissertation, I conducted three studies to explore potential mosquito-host interactions and associated virus infection rates. I first demonstrated that mosquito captures at CO2-baited traps decreased most markedly with height above ground, and also decreased with distance from water at a riparian area but not at an open water source lacking a vegetated border. Birds might therefore prefer elevated nests or roosts to avoid mosquitoes. The second study examined the anti-mosquito behaviors of budgerigars (Melopsittacus undulatus) in a laboratory study. The birds defended …

Husband’S Education Level And Alcohol Drinking Habit As Risk Factors Of Hiv Infection Among Housewives In Pati District, Nurul Aeni, Annemarie Westendorp

Kesmas

Cases of Human Immunodeficiency Virus (HIV) infection in Pati District increase, particularly among housewives. The aim of this study was to analyse the risk factors of HIV infection among housewives in Pati District using case-control study design. The respondents were 90 housewives divided into case and control group. The case group consisted of 30 housewives living with HIV, while the control group comprised 60 housewives living in the similar area of the counterparts. The data collection was focused on demographic, sexual behaviour, and sociocultural variables possessed by housewives and their husbands. The study resulted that the risk factors of HIV …

Effect Of Health Education On Community Participation To Eradicate Aedes Aegypti-Breeding Sites In Buahbatu And Cinambo Districts, Bandung, Zahratul Elsa, Uun Sumardi, Lia Faridah

Kesmas

Dengue hemorrhagic fever (DHF) is still a major public health problem in many regions in Indonesia including Bandung City. Community participation in implementing Eradication of Mosquito-Breeding Sites is still needed as it is considered the most effective method in controlling the dengue fever. This study aimed to determine the influence of health education towards community participation to eradicate mosquito-breeding sites, which was measured by knowledge level and larva index conducted in Bandung, specifically in two different locations with the highest and the lowest incidence rates of DHF. This study used quasi-experimental method. Samples were 100 people living in Cijawura and …

Increasing Use Of Research Findings In Improving Evidence-Based Health Policy At The National Level, Meiwita Budiharsana

Kesmas

In February 2016, the Minister of Health decided to increase the use of research findings in improving the quality of the national health policy and planning. The Ministry of Health has instructed the National Institute of Health Research and Development or NIHRD to play a stronger role of monitoring and evaluating all health programs, because “their opinion and research findings should be the basis for changes in national health policies and planning”. Compared to the past, the Ministry of Health has increased the research budget for evidence-based research tremendously. However, there is a gap between the information needs of program …

Implementation Of Cigarette Excise Policy Against Cigarette Consumption Reduction Among Adolescent In Kuningan, Indonesia, Jani Ramjani, Fitri Kurnia Rahim, Icca Stella Amalia, Wahyu Manggala Putra

Kesmas

Indonesia has the highest prevalence of smoking (50.68%) compared to other ASEAN countries. On January 1st, 2017, the Indonesian government raised cigarette excise taxes. The purpose of this study was to analysis the impact of cigarette excise increase on cigarette consumption among adolescents aged 17 to 25 years. The study design used cross-sectional survey. A total of 153 adolescents were recruited in this study through simple random sampling technique. Questionnaires and observation papers were used in this study. A face-to-face interview was conducted to fulfill the data collection through home visit for each respondent. The data were obtained during May …