Primary-school children in low- and middle-income countries are often deprived of microbiologically safe water and sanitation, often resulting in a high prevalence of gastrointestinal diseases and poor school performance. We used Quantitative Microbial Risk Assessment (QMRA) to predict the probability of infection in schoolchildren due to consumption of unsafe school water. A multistage random-sampling technique was used to randomly select 425 primary schools from ten districts of Sindh, Pakistan, to produce a representative sample of the province. We characterized water supplies in selected schools. Microbiological testing of water resulted in inputs for the QMRA model, to estimate the risks of infections to schoolchildren. Groundwater (62%) and surface water (38%) were identified as two major sources of drinking water in the selected schools, presenting varying degrees of health risks. Around half of the drinking-water samples were contaminated with Escherichia coli (49%), Shigella spp. (63%), Salmonella spp. (53%), and Vibrio cholerae (49%). Southern Sindh was found to have the highest risk of infection and illness from Campylobacter and Rotavirus. Central and Northern Sindh had a comparatively lower risk of waterborne diseases. Schoolchildren of Karachi were estimated to have the highest probability of illness per year, due to Campylobacter (70%) and Rotavirus (22.6%). Pearson correlation was run to assess the relationship between selected pathogens. V. cholerae was correlated with Salmonella spp., Campylobacter, Rotavirus, and Salmonella spp. Overall, the risk of illness due to the bacterial infection (E. coli, Salmonella spp., V. cholerae, Shigella, and Campylobacter) was high. There is a dire need for management plans in the schools of Sindh, to halt the progression of waterborne diseases in school-going children.
Background: Understanding the factors influencing nurses' turnover intention, particularly the work life quality and commitment to organization, is important to all countries suffering from nursing shortage. The study aims to determine the mediating role of commitment to organization on work life quality and its relationship with turnover intention among Malaysian nurses. Methods: A descriptive cross-sectional design, using a self-report survey was conducted on 430 nurses from a teaching hospital from February to April 2019. A structural equation model version 3 was used for testing study hypotheses. Results: The mediating effect (indirect effect) of organizational commitment on the relationship between work life quality and turnover intention (QWL→OC→IT) was negative with path coefficient − 0.234, whereas the direct effect of work life quality on turnover intention (QWL→IT) was negative with smaller path coefficient − 0.228. This means that the relationship between work life quality and turnover intention was partially mediated by the organizational commitment (P < 0.001). Conclusion: Organizational commitment has a negative partial mediating effect between work life quality of nurses and intention of turnover in teaching hospitals where the organizational commitment significantly reduced the nurses' intention to leave. The study findings can guide nursing managers to be carefully attended to the levels of nurses' commitment to their organization.
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