Objective To estimate the lifetime and cumulative direct medical burden associated with childhood overweight and obesity in Kazakhstan using a dynamic age-structured modeling approach. Methods A dynamic age-structured Markov cohort model was developed to simulate the progression of children aged 5–9 years through successive age groups and weight states (normal weight, exclusive overweight, and obesity). Transition probabilities were reconstructed using a synthetic cohort approach based on repeated cross-sectional prevalence data and were calibrated to reproduce observed epidemiological patterns. State-specific annual direct medical costs were estimated using a normative costing approach based on national clinical protocols and tariffs. Lifetime burden was calculated as the discounted sum of future medical costs (3% discount rate). Furthermore, cumulative short-term was estimated for the period 2024–2035. Deterministic sensitivity analysis and structural scenario analysis were conducted to assess model robustness. Policy scenarios examined the impact of reducing childhood obesity prevalence by 5 and 10%. Results The average discounted lifetime cost per child was 96,996.26 KZT (USD 206.37), resulting in a total national lifetime financial impact of 194 billion KZT (USD 413 million) for the 2024 cohort of children aged 5–9 years. Over the 2024–2035 horizon, cumulative discounted direct healthcare expenditure reached 128.72 billion KZT (USD 273.9 million), with approximately 71% attributable to obesity. Sensitivity analysis showed that model results were most responsive to parameters related to obesity prevalence and costs. Structural scenarios indicated that the base-case model likely underestimates cost, with age-varying adult costs increasing estimates by up to 13.6%. Policy scenarios demonstrated that a 5 and 10% reduction in childhood obesity prevalence could reduce lifetime burden by 4.8 and 9.4%, respectively. Conclusion Childhood obesity imposes a substantial and persistent economic impact on Kazakhstan's healthcare system. Preventive interventions targeting obesity in early life may yield significant long-term cost savings and should be prioritized in national health policy.
Berik Koichubekov, Khamida Abdikadirova, Nazgul Omarbekova et al.
Social criticism is an analytical approach used to examine social structures, institutions, and power relations in order to reveal inequalities and injustices within a society. This study investigates the forms of social criticism presented in Charlotte Brontë’s novel Jane Eyre using a Marxist theoretical framework developed by Karl Marx. The data were collected from the novel through a qualitative descriptive method focusing on narrative events, character interactions, and social settings. The analysis reveals the rigid class hierarchy of Victorian English society, in which the bourgeoisie controlled economic resources and social power, while the proletariat experienced dependency, exploitation, and alienation. The findings show that the novel portrays various forms of social inequality through the experiences of Jane Eyre as an impoverished orphan and governess navigating a stratified social structure. Furthermore, the social criticism expressed in the novel remains relevant to contemporary societal issues, including gender oppression, power imbalances in the workplace, and struggles for individual autonomy. Therefore, Jane Eyre can be understood as a significant literary work that not only reflects social realities of its time but also encourages readers to critically examine injustice and inequality in modern society.
Andi Nurul Mawaddah Malik, Burhanuddin Arafah, Herawaty Abbas et al.
Objectives This study investigated the effects of a nanocomposite comprising N-acyl -homoserine lactonase Est816 and silver nanoparticles (Ag-Est816) on the microbial community of an enriched in vitro biofilm model derived from supragingival plaque of children with early childhood caries (ECC). Materials and methods Supragingival plaque samples were collected from 30 children aged younger than 6 years (15 males and 15 females) diagnosed with ECC. These samples were cultured in vitro to form biofilms, which were then treated with or without the Ag-Est816 composite for two days. The composition of the biofilms was analyzed by 16S rRNA sequencing to assess changes in α - and β -diversity, taxonomic composition, and predicted microbial functions. Biofilm morphology and biomass were evaluated using scanning electron microscopy (SEM) and crystal violet assays. Results The Ag-Est816 composite significantly reduced microbial α -diversity, including species richness and phylogenetic diversity (Chao1, Observed species, Faith's PD, p < 0.05). It also significantly altered overall bacterial community composition, as demonstrated by principal coordinate analysis (PCoA) and paired permutational multivariate analysis of variance (PERMANOVA), although the effect size was modest ( R 2 = 0.0286, P = 0.002). At the genus level, the abundances of Actinomyces , Lactobacillus , and Moryella were markedly decreased, whereas Haemophilus and Granulicatella were enriched. LEfSe analysis revealed Actinomyces and Lactobacillus as characteristic taxa enriched in the Control group, while Enterococcus and Granulicatella were significantly enriched following treatment. Functional prediction revealed that Ag-Est816 influenced pathways related to carbohydrate metabolism, amino acid biosynthesis, nucleotide metabolism, and nucleotide sugar biosynthesis. SEM imaging and biomass quantification confirmed that the Ag-Est816 composite disrupted biofilm architecture and significantly reduced total biomass. Conclusion The Ag-Est816 composite suppressed several low-abundance cariogenic genera while reducing overall community richness, altered microbial metabolic functions, and compromised biofilm structural integrity. These findings indicated this non-invasive nanocomposite has potential as an adjunctive therapy for caries prevention in children.
Background Data exist on adolescents’ screen time behavior, but are lacking on urban–rural differences. We compared daily screen time exposures and associated anthropometric parameters, frequency of outdoor physical activity, and psychological parameters of urban and rural school-going adolescents. Methods This was a cross-sectional study. Using five districts of one of the administrative divisions of a western Indian state as the sampling frame, the first two urban and first two rural schools were selected from a randomly reordered list of schools. We included 627 students from 5th, 7th, and 9th standards as representatives of the adolescent age group (10–19 years). Self-reported outdoor physical activity, psychological assessment using the Strengths and Difficulties Questionnaire (SDQ) and daily time spent on each were recorded. We determined associations between area of residence, frequency of outdoor physical activity, and SDQ scores and screen time using the chi-square test or Fisher’s exact test. Multivariable regression analysis was used to determine the predictors of excessive screen time (>2 h/day). Adjusted odds ratios (aOR) and 95% confidence intervals (CI) were calculated. Results There were 334 (53.3%) urban and 293 (46.7%) rural students. The mean age was 12.5 ± 1.4 years. Mean daily total screen time was 111.9 ± 71.7 min. Urban compared to rural [121.5 ± 75.9 min vs. 100.9 ± 65.0 min; p = 0.001] and boys compared to girls [122.9 ± 81.9 min vs. 100.9 ± 58.0 min; p < 0.000] had longer total screen time exposure. Being a rural resident was significantly associated with a >2 days/week of outdoor physical activity [78.8% (rural) vs. 35.9% (urban), respectively; OR 6.64, 95% CI 4.64–9.51, p < 0.000]. Students with daily screen time of >2 h had some/high needs on the SDQ hyperactivity scale [11.4% vs. 5.7%; p = 0.022]. Males had significantly higher odds of >2 h of total daily screen time than females (aOR = 1.51, 95% CI 1.05–2.17; p = 0.026). Conclusion The associations between longer screen time exposure and worse physical and psychological factors warrant interventions with special attention to urban–rural differences.
Gauri A. Oka, Ashish S Ranade, Mayur Kiran Shinde et al.
Background: Verbal violence by teachers in classroom interactions may affect students’ psychological well-being and learning motivation, particularly in situations characterized by unequal power relations. Objective: This study aims to describe forms of verbal violence committed by an Indonesian language teacher in Class VIII of SMP Negeri 4 Arso, Keerom Regency, and to examine teacher domination through conflictive, competitive, and collaborative speech acts. Methods: This descriptive qualitative single-case study involved one Indonesian language teacher and 83 Class VIII students, consisting of 24 boys and 59 girls. Data were collected through classroom observation, interviews, questionnaires, video recordings, and field notes. The primary data consisted of teacher utterances containing elements of verbal violence and students’ statements related to these experiences. Data were analyzed using the Miles-Huberman interactive model. Results: Thirty verbal utterances were identified. Competitive speech acts were the most frequent, comprising 14 utterances (50%), followed by conflictive speech acts with 13 utterances (43%) and collaborative speech acts with 3 utterances (7%). Teacher domination was manifested through satire, warnings, commands, protests, belittling, mocking, cursing, threatening, demanding, stating, and announcing. Student responses included tolerance, fear, discomfort, and reduced motivation to learn. Conclusion: Teacher verbal violence in this case was predominantly expressed through competitive and conflictive speech acts. The findings emphasize the importance of respectful and child-friendly communication in classroom interactions.
Viksit Bharat 2047 vision focuses on making India a developed, inclusive, and sustainable country by its 100th anniversary of independence. This paper offers a multidimensional and sequential model of incorporating the major pillars of development including human rights, empowerment of women, social development and skill improvement with special emphasis on fempreneurs as the economic growth agents. Gender Equity as underlined in SDG 5- Gender Equality, is a main pillar towards sustainable development since they will be able to enjoy equal rights, opportunities and access to resources as women (Jameel, 2025). It is an important move beyond development to women to development with women where women are seen as the agents of development both economic and social. The availability of good education under SDG 4 Quality Education reinforces this process by empowering women with knowledge, skills and decision-making power, which results in better family and societal performance. This is then illustrated by economic empowerment which is in line with SDG 8 (Decent work and Economic Growth) in which financial independence via fempreneurship, innovation and financial literacy increase the contribution of women to national productivity. As a result, SDG 3 Good Health and Well-being is improved in terms of maternal and child health, which enhances human capital. With the empowerment, women are now actively involved in decision making process, which also consists of reduced inequalities according to SDG 10 Reduced Inequalities. Nevertheless, the key to the development of their full potential lies in reducing social barriers like discrimination and gender-based violence. In this regard, gender equity is relevant in providing inclusive business environments to fempreneurs to ensure sustainable development and social equity. Its effect goes beyond generations, with empowered females investing in education, food, and health of children, so that the development of society is guaranteed in the long term. In summary, gender equity on these SDGs should be enhanced to achieve the Viksit Bharat 2047 vision and create an inclusive, sustainable and resilient country.
This study examines the legacy of Tun Dr. Siti Hasmah Mohamad Ali in Malaysia, focusing on her contributions to rural healthcare, women’s empowerment, and community development. The study was conducted through a qualitative documentary review of academic literature, institutional publications, government reports, and credible historical sources concerning her medical career and public-health activities. Particular attention was given to her early service in Kedah, her work in maternal and child health, her leadership in rural health training, and her broader advocacy for women and community well-being. Historical evidence indicates that her professional career was closely connected with Malaysia’s development of rural health services, particularly services addressing mothers and children. The study also examined contemporary Malaysian statistics to situate her legacy within continuing issues of gender equality, healthcare access, and community development. The findings indicate that her legacy can be understood through the interaction of professional medical service, public-health leadership, women’s participation, and community-oriented development rather than through her public position alone.
