Search results for: community health

Authors: Denise Ben-Porath, Tracy Masterson

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In the past, individuals who struggled with and sought treatment for mental health difficulties were stigmatized. However, the current generation holds more open attitudes around mental health issues. Indeed, public figures such as Demi Lovato, Naomi Osaka, and Simone Biles have taken to social media to break the silence around mental health, discussing their own struggles and the benefits of treatment. Thus, there is considerable reason to believe that this generation would hold fewer stigmatizing attitudes toward mental health difficulties and treatment compared to previous ones. In this study, we explored possible changes in stigma on mental health diagnosis and treatment seeking behavior between two generations: Gen Z, the current generation, and Gen X, those born between 1965-1980. It was hypothesized that Gen Z would hold less stigmatizing views on mental illness than Gen X. To examine possible changes in stigma attitudes between these two generations, we conducted a cross-generational cohort design by using the same methodology employed 20 years ago from the Ben-Porath (2002) study. Thus, participants were randomly assigned to read one of the following four case vignettes employed in the Ben-Porath (2002) study: (a) “Tom” who has received psychotherapy due to depression (b) “Tom” who has been depressed but received no psychological help, (c) “Tom” who has received medical treatment due to a back pain, or (d) “Tom” who had a back pain but did not receive medical attention. After reading the vignette, participants rated “Tom” on various personality dimensions using the IFQ Questionnaire and answered questions about their frequency of social media use and willingness to seek mental health treatment on a scale from 1-10. Identical to the results 20 years prior, a significant main effect was found for diagnosis with “Tom” being viewed in more negative terms when he was described as having depression vs. a medical condition (back pain) [F (1, 376) = 126.53, p < .001]. However, in the study conducted 20 years earlier, a significant interaction was found between diagnosis and help-seeking behavior [F (1, 376) = 8.28, p < .005]. Specifically, “Tom” was viewed in the most negative terms when described as depressed and seeking treatment. Alternatively, the current study failed to find a significant interaction between depression and help seeking behavior. These findings suggest that while individuals who hold a mental health diagnosis may still be stigmatized as they were 20 years prior, seeking treatment for mental health issues may be less so. Findings are discussed in the context of social media use and its impact on destigmatization.

Keywords: stigma, mental illness, help-seeking, social media

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Authors: Rajendra Chetty

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Decolonial aesthetics departs and delinks from colonial ideas about ‘the arts’ and the modernist/colonial work of aesthetics. Education is trapped in the western epistemic and hermeneutical vocabulary, hence it is necessary to introduce new concepts and work the entanglement between co-existing concepts. This paper will discuss the contribution of Ronnie Govender, a South African writer, to build decolonial sensibilities and delink from the grand narrative of the colonial and apartheid literary landscape in Govender’s text, At the Edge and other Cato Manor Stories. Govender uses the world of art to make a decolonial statement. Decolonial artists have to work in the entanglement of power and engage with a border epistemology. Govender’s writings depart from an embodied consciousness of the colonial wound and moves toward healing. Border thinking and doing (artistic creativity) is precisely the decolonial methodology posited by Linda T. Smith, where theory comes in the form of storytelling. Govender’s stories engage with the wounds infringed by racism and patriarchy, two pillars of eurocentric knowing, sensing, and believing that sustain a structure of knowledge. This structure is embedded in characters, institutions, languages that regulate and mange the world of the excluded. Healing is the process of delinking, or regaining pride, dignity, and humanity, not through the psychoanalytic cure, but the popular healer. The legacies of the community of Cato Manor that was pushed out of their land are built in his stories. Decoloniality then is a concept that carries the experience of liberation struggles and recognizes the strenuous conditions of marginalized people together with their strength, wisdom, and endurance. Govender’s unique performative prose reconstructs and resurrects the lives of the people of Cato Manor, their vitality and humor, pain and humiliation: a vibrant and racially integrated community destroyed by the regime’s notorious racial laws. The paper notes that Govender’s objective with his plays and stories was to open windows to both the pain and joy of life; a mission that is not didactic but to shine a torch on both mankind’s waywardness as well as its inspiring and often moving achievements against huge odds.

Keywords: Govender, decoloniality, delinking, exclusion, racism, Cato Manor

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Authors: Eugenia Vomvoridi-Ivanovic

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It is broadly assumed that participation in field experiences will help pre-service teachers (PSTs) bridge theory to practice. However, this is often not the case since PSTs who are placed in classrooms with large numbers of students from diverse linguistic, cultural, racial, and ethnic backgrounds (culturally diverse students (CDS)) usually observe ineffective mathematics teaching practices that are in contrast to those discussed in their teacher preparation program. Over the past decades, the educational research community has paid increasing attention to investigating out-of-school learning contexts and how participation in such contexts can contribute to the achievement of underrepresented groups in Science, Technology, Engineering, and mathematics (STEM) education and their expanded participation in STEM fields. In addition, several research studies have shown that students display different kinds of mathematical behaviors and discourse practices in out-of-school contexts than they do in the typical mathematics classroom since they draw from a variety of linguistic and cultural resources to negotiate meanings and participate in joint problem solving. However, almost no attention has been given to exploring these contexts as field experiences for pre-service mathematics teachers. The purpose of this study was to explore how participation in a community based after-school field experience promotes understanding of the content pedagogy concepts introduced in elementary mathematics methods courses, particularly as they apply to teaching mathematics to CDS. This study draws upon a situated, socio-cultural theory of teacher learning that centers on the concept of learning as situated social practice, which includes discourse, social interaction, and participation structures. Consistent with exploratory case study methodology, qualitative methods were employed to investigate how a cohort of twelve participating pre-service teacher's approach to pedagogy and their conversations around teaching and learning mathematics to CDS evolved through their participation in the after-school field experience, and how they connected the content discussed in their mathematics methods course with their interactions with the CDS in the after-school. Data were collected over a period of one academic year from the following sources: (a) audio recordings of the PSTs' interactions with the students during the after-school sessions, (b) PSTs' after-school field-notes, (c) audio-recordings of weekly methods course meetings, and (d) other document data (e.g., PST and student generated artifacts, PSTs' written course assignments). The findings of this study reveal that the PSTs benefitted greatly through their participation in the after-school field experience. Specifically, after-school participation promoted a deeper understanding of the content pedagogy concepts introduced in the mathematics methods course and gained a greater appreciation for how students learn mathematics with understanding. Further, even though many of PSTs' assumptions about the mathematical abilities of CDS were challenged and PSTs began to view CDSs' cultural and linguistic backgrounds as resources (rather than obstacles) for learning, some PSTs still held negative stereotypes about CDS and teaching and learning mathematics to CDS in particular. Insights gained through this study contribute to a better understanding of how informal mathematics learning contexts may provide a valuable context for pre-service teacher's learning to teach mathematics to CDS.

Keywords: after-school mathematics program, pre-service mathematical education of teachers, qualitative methods, situated socio-cultural theory, teaching culturally diverse students

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Authors: M. R. Babaei, S. M. Hosseini, S. Rahmani, L. Moradi

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Today, the quality of education and training systems and the effectiveness of the education systems of most concern to stakeholders and decision-makers of our country's development in each country. In Iran this is a double issue of concern to numerous reasons; So that governments, over the past decade have hardly even paid the running costs of education. ICT is claiming it has the power to change the structure of a program for training, reduce costs and increase quality, and do education systems and products consistent with the needs of the community and take steps to practice education. Own of the areas that the introduction of information technology has fundamentally changed is the field of education. The aim of this research is process reengineering management in schools simultaneously has been using field studies to collect data in the form of interviews and a questionnaire survey. The statistical community of this research has been the country of Iran and smart schools under the education. Sampling was targeted. The data collection tool was a questionnaire composed of two parts. The questionnaire consists of 36 questions that each question designates one of effective factors on the management of smart schools. Also each question consists of two parts. The first part designates the operating position in the management process, which represents the domain's belonging to the management agent (planning, organizing, leading, controlling). According to the classification of Dabryn and in second part the factors affect the process of managing the smart schools were examined, that Likert scale is used to classify. Questions the validity of the group of experts and prominent university professors in the fields of information technology, management and reengineering of approved and Cronbach's alpha reliability and also with the use of the formula is evaluated and approved. To analyse the data, descriptive and inferential statistics were used to analyse the factors contributing to the rating of (Linkert scale) descriptive statistics (frequency table data, mean, median, mode) was used. To analyse the data using analysis of variance and nonparametric tests and Friedman test, the assumption was evaluated. The research conclusions show that the factors influencing the management process re-engineering smart schools in school performance is affected.

Keywords: re-engineering, management process, smart school, Iran's school

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Authors: Sideri Katerina, Chanania Eleni

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The reasons why people remain unvaccinated, especially health workers, are complex. In Greece, 2 percent of health workers (around 7,000) remain unvaccinated, despite the fact that for this group of people vaccination against COVID-19 is mandatory. In April 2022, the Greek health minister repeated that unvaccinated health care workers will remain suspended from their jobs ‘for as long as the pandemic lasts,’ explaining that the suspension of the workers in question was ‘entirely their choice’ and that health professionals who do not believe in vaccines ‘do not believe in their own science.’ Although policy circles around the world often link vaccine hesitancy to ignorance of science or misinformation, various recently published qualitative studies show that vaccine hesitancy is the result of a combination of factors, which include distrust towards elites and the system of innovation and distrust towards government. In a similar spirit, some commentators warn that labeling hesitancy as “anti-science” is bad politics. In this paper, we worked within the tradition of STS taking the view that people draw upon personal associations to enact and express civic concern with an issue, the enactment of public concern involves the articulation of threats to actors’ way of life, personal values, relationships, lived experiences, broader societal values and institutional structures. To this effect, we have conducted 27 in depth interviews with unvaccinated Greek health workers and we are in the process of conducting 20 more interviews. We have so far found that rather than a question of believing in ‘facts’ vaccine hesitancy reflects deep distrust towards those charged with the making of decisions and pharmaceutical companies and that emotions (rather than rational thinking) play a crucial role in the formation of attitudes and the making of decisions. We need to dig deeper so as to understand the causes of distrust towards technical government and the ways in which public(s) conceive of and want to be part in the politics of innovation. We particularly address the question of the effectiveness of mandatory vaccination of health workers and whether such top-down regulatory measures further polarize society, to finally discuss alternative regulatory approaches and governance structures.

Keywords: vaccine hesitancy, innovation, trust in vaccines, sociology of vaccines, attitude drivers towards scientific information, governance

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Authors: Jacqueline P. Davies

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Introduction: Student nurses must develop skills in observation, communication and reflection as well as public health knowledge from their first year of training. This paper will explain a method developed for students to collect their own findings about public health in urban areas. These areas are both rich in the history of old public health that informs the content of many traditional public health walks, but are also locations where new public health concerns about chronic disease are concentrated. The learning method explained in this paper enables students to collect their own data and write original work as first year students. Examples of their findings will be given. Methodology: In small groups, health care students are instructed to walk in neighbourhoods near to the hospitals they will soon attend as apprentice nurses. On their walks, they wander slowly, engage in conversations, and enter places open to the public. As they drift, they observe with all five senses in the real three dimensional world to collect data for their reflective accounts of old and new public health. They are encouraged to stop for refreshments and taste, as well as look, hear, smell, and touch while on their walk. They reflect as a group and later develop an individual reflective account in which they write up their deep reflections about what they observed on their walk. In preparation for their walk, they are encouraged to look at studies of quality of Life and other neighbourhood statistics as well as undertaking a risk assessment for their walk. Findings: Reflecting on their walks, students apply theoretical concepts around social determinants of health and health inequalities to develop their understanding of communities in the neighbourhoods visited. They write about the treasured historical architecture made of stone, bronze and marble which have outlived those who built them; but also how the streets are used now. The students develop their observations into thematic analyses such as: what we drink as illustrated by the empty coke can tossed into a now disused drinking fountain; the shift in home-life balance illustrated by streets where families once lived over the shop which are now walked by commuters weaving around each other as they talk on their mobile phones; and security on the street, with CCTV cameras placed at regular intervals, signs warning trespasses and barbed wire; but little evidence of local people watching the street. Conclusion: In evaluations of their first year, students have reported the health walk as one of their best experiences. The innovative approach was commended by the UK governing body of nurse education and it received a quality award from the nurse education funding body. This approach to education allows students to develop skills in the real world and write original work.

Keywords: education, innovation, nursing, urban

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Authors: Salamatu Shaibu, Jan Hernning Sommer

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Integrating biodiversity conservation practices in mining landscapes ensures the continual provision of various ecosystem services to the dependent communities whilst serving as ecological insurance for corporate mining when purchasing reclamation security bonds. Climate hazards such as long dry seasons, erratic rainfall patterns, and extreme weather events contribute to biodiversity loss in addition to the impact due to mining. Both corporate mining and mine-fringe communities perceive the effect of climate on biodiversity from the context of the benefits they accrue, which motivate their conservation practices. In this study, pragmatic approaches including semi-structured interviews, field visual observation, and review were used to collect data on corporate mining employees and households of fringing communities in the southwestern mining hub. The perceived changes in the local climatic conditions and the consequences on environmental management practices that promote biodiversity conservation were examined. Using a thematic content analysis tool, the result shows that best practices such as concurrent land rehabilitation, reclamation ponds, artificial wetlands, land clearance, and topsoil management are directly affected by prolonging long dry seasons and erratic rainfall patterns. Excessive dust and noise generation directly affect both floral and faunal diversity coupled with excessive fire outbreaks in rehabilitated lands and nearby forest reserves. Proposed adaptive measures include engaging national conservation authorities to promote reforestation projects around forest reserves. National government to desist from using permit for mining concessions in forest reserves, engaging local communities through educational campaigns to control forest encroachment and burning, promoting community-based resource management to promote community ownership, and provision of stricter environmental legislation to compel corporate, artisanal, and small scale mining companies to promote biodiversity conservation.

Keywords: biodiversity conservation, climate hazards, corporate mining, mining landscapes

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Authors: Abraham Addo-Bediako

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Many freshwater ecosystems are facing immense pressure from anthropogenic activities, such as agricultural, industrial and mining. Trace metal pollution in freshwater ecosystems has become an issue of public health concern due to its toxicity and persistence in the environment. Trace elements pose a serious risk not only to the environment and aquatic biota but also humans. Chromium is one of such trace elements and its pollution in surface waters and groundwaters represents a serious environmental problem. In South Africa, agriculture, mining, industrial and domestic wastes are the main contributors to chromium discharge in rivers. The common forms of chromium are chromium (III) and chromium (VI). The latter is the most toxic because it can cause damage to human health. The aim of the study was to assess the contamination of chromium in the water and sediments of two rivers in the Steelpoort River sub-catchment of the Olifants River Basin, South Africa and human health risk. The concentration of Cr was analyzed using inductively coupled plasma–optical emission spectrometry (ICP-OES). The concentration of the metal was found to exceed the threshold limit, mainly in areas of high human activities. The hazard quotient through ingestion exposure did not exceed the threshold limit of 1 for adults and children and cancer risk for adults and children computed did not exceed the threshold limit of 10-4. Thus, there is no potential health risk from chromium through ingestion of drinking water for now. However, with increasing human activities, especially mining, the concentration could increase and become harmful to humans who depend on rivers for drinking water. It is recommended that proper management strategies should be taken to minimize the impact of chromium on the rivers and water from the rivers should properly be treated before domestic use.

Keywords: land use, health risk, metal pollution, water quality

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Authors: Fernando Araujo, Sandra Cardoso, Fátima Fonseca, Sandra Cavaca

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A debureaucratization strategy for the Portuguese Health Service was assumed by the Executive Board of the SNS, in deep articulation with the Shared Services of the Ministry of Health. Two of the main dimensions were focused on sick leaves (SL), that transform primary health care (PHC) in administrative institutions, limiting access to patients. The self-declaration of illness (SDI) project, through the National Health Service Contact Centre (SNS24), began on May 1, 2023, and has already resulted in the issuance of more than 300,000 SDI without the need to allocate resources from the National Health Service (NHS). This political decision allows each citizen, in a maximum 2 times/year, and 3 days each time, if ill, through their own responsibility, report their health condition in a dematerialized way, and by this way justified the absence to work, although by Portuguese law in these first three days, there is no payment of salary. Using a digital approach, it is now feasible without the need to go to the PHC and occupy the time of the PHC only to obtain an SL. Through this measure, bureaucracy has been reduced, and the system has been focused on users, improving the lives of citizens and reducing the administrative burden on PHC, which now has more consultation times for users who need it. The second initiative, which began on March 1, 2024, allows the SL to be issued in emergency departments (ED) of public hospitals and in the health institutions of the social and private sectors. This project is intended to allow the user who has suffered a situation of acute urgent illness and who has been observed in an ED of a public hospital or in a private or social entity no longer need to go to PHC only to apply for the respective SL. Since March 1, 54,453 SLs have been issued, 242 in private or social sector institutions and 6,918 in public hospitals, of which 134 were in ED and 47,292 in PHC. This approach has proven to be technically robust, allows immediate resolution of problems and differentiates the performance of doctors. However, it is important to continue to qualify the proper functioning of the ED, preventing non-urgent users from going there only to obtain SL. Thus, in order to make better use of existing resources, it was operationalizing this extension of its issuance in a balanced way, allowing SL to be issued in the ED of hospitals only to critically ill patients or patients referred by INEM, SNS24, or PHC. In both cases, an intense public campaign was implemented to explain the way it works and the benefits for patients. In satisfaction surveys, more than 95% of patients and doctors were satisfied with the solutions, asking for extensions to other areas. The administrative simplification agenda of the NHS continues its effective development. For the success of this debureaucratization agenda, the key factors are effective communication and the ability to reach patients and health professionals in order to increase health literacy and the correct use of NHS.

Keywords: debureaucratization strategy, self-declaration of illness, sick leaves, SNS24

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Authors: Ifeoma C. Afiaenyi, Elizabeth K. Ngwu, Rufina N. B. Ayogu

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Diabetes has crept into the rural areas of Nigeria, causing devastating effects on its sufferers; most of them could not afford diabetic medications. Moringa oleifera has been used extensively in animal models to demonstrate its antilipidaemic and haematinic qualities; however, there is a scarcity of data on the effect of graded levels of Moringa oleifera leaves on the lipid profile and hematological parameters in human diabetic subjects. The study determined the effect of Moringa oleifera leaves on the lipid profile and hematological parameters of type 2 diabetic subjects in Ukehe, a rural Nigerian community. Twenty-four adult male and female diabetic subjects were purposively selected for the study. These subjects were shared into four groups of six subjects each. The diets used in the study were isocaloric. A control group (diabetics, group 1) was fed diets without Moringa oleifera leaves. Experimental groups 2, 3 and 4 received 20g, 40g and 60g of Moringa oleifera leaves daily, respectively, in addition to the diets. The subjects' lipid profile and hematological parameters were measured prior to the feeding trial and at the end of the feeding trial. The feeding trial lasted for fourteen days. The data obtained were analyzed using the computer program Statistical Product for Service Solution (SPSS) for windows version 21. A Paired-samples t-test was used to compare the means of values collected before and after the feeding trial within the groups and significance was accepted at p < 0.05. There was a non-significant (p > 0.05) decrease in the mean total cholesterol of the subjects in groups 1, 2 and 3 after the feeding trial. There was a non-significant (p > 0.05) decrease in the mean triglyceride levels of the subjects in group 1 after the feeding trial. Groups 1 and 3 subjects had a non-significant (p > 0.05) decrease in their mean low-density lipoprotein (LDL) cholesterol after the feeding trial. Groups 1, 2 and 4 had a significant (p < 0.05) increase in their mean high-density lipoprotein (HDL) cholesterol after the feeding trial. A significant (p < 0.05) decrease in the mean hemoglobin level was observed only in group 4 subjects. Similarly, there was a significant (p < 0.05) decrease in the mean packed cell volume of group 4 subjects. It was only in group 4 that a significant (p < 0.05) decrease in the mean white blood cells of the subjects was also observed. The changes observed in the parameters assessed were not dose-dependent. Therefore, a similar study of longer duration and more samples is imperative to authenticate these results.

Keywords: anemia, diabetic subjects, lipid profile, moringa oleifera

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Authors: Awdhesh Yadav, P. S. Saravanamurthy, Shaikh Tayyaba, Uma Shah, Ashok Agarwal

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Objectives: HIV interventions in India has leveraged Self-Help Group (SHG) as one of the key strategies under structural intervention to empower female sex workers (FSW) to reduce their risk exposure and vulnerability to STI/HIV. Understanding the role of SHGs in light of the evolving dynamics of sex work needs to be delved into to strategize HIV interventions among FSWs in India. This paper aims to study the HIV program outcome among the FSWs associated with SHGs and FSWs not associated with SHGs in Thane, Maharashtra. Study Design: This cross-sectional study, was undertaken from the Behavioral Tracking Survey (BTS) conducted among 503 FSWs in Thane in 2015. Two-stage probability based conventional sampling was done for selection of brothel and bar based FSWs, while Time Location Cluster (TLC) sampling was done for home, lodge and street-based sex workers. Methods: Bivariate and multivariate logistic regression were performed to compare and contrast between FSWs associated with SHG and those not associated with SHG with respect to the utilization of HIV related services by them. ‘Condom use’, ‘consistent condom use’, ‘contact with peer-educators’, ‘counseling sessions’ and ‘HIV testing’ were chosen as indicators on HIV service utilization. Results: 8% (38) of FSWs are registered with SHG; 92% aged ≥ 25 years, 47% illiterate, and 71% are currently married. The likelihood of utilizing HIV services including, knowledge on HIV/AIDS and its mode of transmission (OR:5.54; CI: 1.87-16.60; p < 0.05),accessed drop-in Centre (OR: 6.53; CI: 2.15-19.88; p < 0.10), heard about joint health camps (OR: 4.71; CI:2.12-10.46); p < 0.05), negotiated or stood up against police/broker/local goonda/clients (OR: 2.26; CI: 1.08-4.73; p < 0.05), turned away clients when they refused to use condom during sex (OR: 3.76; CI: 1.27-11.15; p < 0.05) and heard of ART (OR; 4.55; CI: 2.18-9.48; p < 0.01) were higher among FSWs associated with SHG in comparison to FSWs not associated with SHG. Conclusions: Considering the improved HIV program outcomes among FSWs associated with SHG; HIV interventions among FSWs could consider facilitating the formation of SHGs with FSWs as one of the key strategies to empower the community for ensuring better program outcomes.

Keywords: empowerment, female sex workers, HIV, Thane, self-help group

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Authors: Ellen Holtmaat

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With an ever increasing influence of international organizations (IOs) on national policies and with the expectation that IOs are the transmission belts of world ideologies it is interesting to see to what extent IOs express a specific ideology and what determines the dominance of this ideology. This thesis looks at the OECD as IO and higher education as a field of policy. Evidence is found that the OECD promotes neoliberal developments in higher education and that its position is influenced by business, dominant countries and the dominant beliefs that are carried by the people working for the OECD that form an epistemic community. These results can possibly be extrapolated to other IOs.

Keywords: higher education, international organizations, neoliberal, OECD

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Authors: Mukesh Lal Das, Muthukumar Muthuchamy

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Climate change Adaptation strategy (AS) is a scientific approach to dealing with the impacts of climate change (CC). Efforts are being made to contain the global emission of greenhouse gas within threshold limits, thereby limiting the rise of global temperature to an optimal level. Global Climate change is a spontaneous process; therefore, reversing the damage would take decades. The climate change adaptation strategy recommended by various stakeholders could be a key to resilience for biodiversity. The Indian Government has constituted the panel to synthesize the climate change action report at the federal and state levels. This review scavenged the published literature on the Western Ghats hotspots. And highlight the adaptation strategy recommended by diverse scientific actors to conserve biodiversity. It also reviews the grey literature adopted by state and federal governments and its effectiveness in mitigating the impacts on biodiversity. We have narrowed the scope of interest to the state action report by 6 Indian states such as Gujarat, Maharashtra, Goa, Karnataka, Kerala and Tamil Nadu, which host Western Ghats global biodiversity hotspot. Western Ghats(WGs) act as the water tower to the peninsular part of India, and its extensive watershed caters to the water demand of the Industry sector, Agriculture and urban community. Conservation of WGs is the key to the prosperity of Peninsular India. The global scientific community suggested more than 600+ Climate change adaptation strategies for the policymakers, stakeholders, and other state actors to take proactive actions. The preliminary analysis of the federal and the state action plan on climate change in the wake of CC indicate inadequacy in motion as per recommended scientific adaptation strategies. Tamil Nadu and Kerala state constitute nine effective adaptation strategies out of the 40+ recommended for Western Ghats conservation. And other four states' adaptation strategies are deficient, confusing and vague. Western Ghats' resilience capacity will soon or might have reached its threshold, and the frequency of severe drought and flash floods might upsurge manifold in the decades to come. The lack of a clear roadmap to climate change adaptation strategies in the federal and state action stirred us to identify the gap and address it by offering a holistic approach to WGs biodiversity conservation.

Keywords: adaptation strategy, biodiversity conservation, climate change, resilience, Western Ghats

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Authors: Ezeh Chukwunonso Peter Excel, Akruti Vg

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Aim/Background: To show that even after undergoing 1-5 courses of chemotherapy for Gestational Trophoblastic Disease (GTD) reproductive health of women is intact and they conceive successfully after it. Method: Retrospective cohort analysis using data from the Lugansk regional maternity hospital database of years 1993-2013, which shows n=18 females had GTD and underwent 1-5 courses of chemotherapy. Results and Discussion: Frequency of GTD was rare. All 18 patients (pts) belong to age group of 17-39 years, covering wide range of reproductive age. Out of 18 pts, 15 had hydatidiform mole (HM) while other 3 had choriocarcinoma (CC). In anamnesis, among CC pts, 1 had early pre-eclampsia at 24 weeks and 1 had 4th week of late postpartum (PP) bleeding, while all HM pts had genital inflammatory diseases, 1 pt of HM during follow-up had High hCG and 3 times curettage in 5 months. 18 women became pregnant for 25 times after chemotherapy. Chemotherapy was given under indication of either high level of HCG, luteal cyst >6cm or path-morphological results of curettage. CC 3 pts had (2 spontaneous abortions (SA), 2 term cesarean section (CS), 1 preterm CS). HM 15 pts had (3 artificial abortion, 2 SA, 7CS (5 term and 2 preterm), 8 vaginal deliveries (7 term and 1 preterm)). Conclusion: During our research we got 22.2% preterm deliveries and 55.6% CS which is higher than the normal cases, but still all the 18 women were able to have kids successfully after chemotherapy. So we can conclude that chemotherapy for GTD was successful in keeping the reproductive health of women intact.

Keywords: reproductive health, chemotherapy, gestational trophoblastic disease, women

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Authors: Kristen Emory, Jerry Flores

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Purpose: We explore the unique and underrepresented experiences of Indigenous women living in Toronto, Canada, during the first year of the COVID-19 pandemic. The purpose of this study is to better document the impacts of COVID-19 on the mental health and well-being of Indigenous women in Toronto, Canada, in order to better understand unmet needs, as well as lay the groundwork for more targeted research and potential interventions based on these needs. Background: It has been fairly well documented that the COVID-19 pandemic has increased mental health concerns among various populations globally. There have also been numerous studies indicating increases in substance use and abuse in response to the stress of the pandemic. There is also evidence that the COVID-19 pandemic has disproportionately impacted a variety of historically marginalized populations in Canada, the US, and globally, including Indigenous populations. While these studies provide some insight into how the COVID-19 pandemic is impacting the global population, much less is known about the lived experiences of Indigenous populations during the time of COVID-19. Better understanding these experiences will allow public health professionals, governments, and non-governmental organizations better combat health inequities related to the pandemic. Methods: In-depth qualitative semi-structured virtual (due to COVID-19) interviews with 13 Indigenous women were conducted during the first year of the COVID-19 pandemic (2020). Interviews were recorded, transcribed, and analyzed by team members using Dedoose qualitative analysis software. Findings: COVID-19 negatively affected Indigenous females identifying participants’ mental health and corresponding reported increases in substance use. In addition to the daily stress of the unpredictability of life in the time of the COVID-19 pandemic, participants cited job loss, economic concerns, homeschooling, and lack of access to medical resources as primary factors in increasing their stress and decreasing mental health and wellbeing. In response to these stressors, a majority of participants cited coping mechanisms such as increased substance use to help deal with the uncertainty. In particular, alcohol and tobacco emerged as coping mechanisms to help participants cope with stress related to the pandemic (as well as its social and economic toll on respondents' lives). We will present qualitative data to be presented, including participant direct quotes, explaining their experiences with COVID-19, mental health, and increased substance use, as well as analysis and synthesis with the existing scientific evidence base. Conclusion: This research is among the good studies to our knowledge that scientifically explore the impact of COVID-19 on mental health and well-being and corresponding increases in reported substance use.

Keywords: mental health, covid-19, indigenous, inequity, anxiety, depression, stress

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Authors: M. M. Fercan, A. S. Kipcak, O. Dere Ozdemir, M. B. Piskin, E. Moroydor Derun

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Coffee is a widely consumed beverage with many components such as caffeine, flavonoids, phenolic compounds, and minerals. Coffee consumption continues to increase due to its physiological effects, its pleasant taste, and aroma. Robusta and Arabica are two basic types of coffee beans. The coffee bean used for Turkish coffee is Arabica. There are many elements in the structure of coffee and have various effect on human health such as Sodium (Na), Boron (B), Magnesium (Mg) and Iron (Fe). In this study, the amounts of Mg, Na, Fe, and B contents in Turkish coffee are determined and effect of sugar addition is investigated for conscious consumption. The analysis of the contents of coffees was determined by using inductively coupled plasma optical emission spectrometry (ICP-OES). From the results of the experiments the Mg, Na, Fe and B contents of Turkish coffee after sugar addition were found as 19.83, 1.04, 0.02, 0.21 ppm, while without using sugar these concentrations were found 21.46, 0.81, 0.008 and 0.16 ppm. In addition, element contents were calculated for 1, 3 and 5 cups of coffee in order to investigate the health effects.

Keywords: health effect, ICP-OES, sugar, Turkish coffee

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Authors: Abolade Olajoke, Adigun Folasade Oyenike, Odunjo Oluronke Omolola Olaleye, Babajide Rotimi

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Against the shortfall associated with unprecedented urbanization in most cities of the world, coupled with rapid expansion of outer boundaries, is the resultant birth of the development of new towns. The paper therefore examines the impacts of Ibeju - Lekki New Town on Neighbouring communities of Ibeju Lekki. Random systematic sampling was employed elicit relevant information from a total number of 269 residents at interval of five buildings in four neighbouring communities. Descriptive statistics was employed to test for the socioeconomic characteristics of respondents, problems faced by government officials during the implementation and monitoring process. Likert scale was employed to ascertain respondents view on the impact of the new town on neighbouring communities. Result from the findings shows that male (56.9%) are the most dominant occupant in the study area of which most (68.1%) fall within the most the active age group (18-39 and 40-59 years). Results further shows that 36% of the total respondents are traders and majority (32%) earn below government salary wage cap of ₦18000 thus indicating that majority of the respondents are petty traders. Results of findings from development authority reveals that the major problem encountered during monitoring and implementation is harassment of government officials (35%). Result of likert scale further show that new town has brought increase in intensity of land use within neighbouring communities (RAI 3.65), provision of job opportunity (RAI 3.57). This have consequently improve standard of living of the neighbouring community (RAI 3.27). On the contrary some (RAI 1.97) opined that attention should paid to provision of power supply and provision of recreation facilities (RAI I.63). The study recommends that government should make adequate provisions for basic facilities such power supply, adequate health care system, basic education and provision of healthy portable water. This should be given utmost priority to enhance the living condition of residents. To forestall attack from residents’ adequate security measures should be provided as backup for Government official during implementation and monitoring. Appropriate sanction to illegal occupants and demolition of illegal structures should be fully implemented, This will indubitably prevent haphazard development and also promote a liveable environment. Against the shortfall associated with unprecedented urbanization in most cities of the world, coupled with rapid expansion of outer boundaries, is the resultant birth of the development of new towns. The paper therefore examines the impacts of Ibeju - Lekki New Town on Neighbouring communities of Ibeju Lekki. Random systematic sampling was employed elicit relevant information from a total number of 269 residents at interval of five buildings in four neighbouring communities. Descriptive statistics was employed to test for the socioeconomic characteristics of respondents, problems faced by government officials during the implementation and monitoring process. Likert scale was employed to ascertain respondents view on the impact of the new town on neighbouring communities. Result from the findings shows that male (56.9%) are the most dominant occupant in the study area of which most (68.1%) fall within the most the active age group (18-39 and 40-59 years). Results further shows that 36% of the total respondents are traders and majority (32%) earn below government salary wage cap of ₦18000 thus indicating that majority of the respondents are petty traders. Results of findings from development authority reveals that the major problem encountered during monitoring and implementation is harassment of government officials (35%) Result of likert scale further show that new town has brought increase in intensity of land use within neighbouring communities (RAI 3.65), provision of job opportunity (RAI 3.57). This have consequently improve standard of living of the neighbouring community (RAI 3.27). On the contrary some (RAI 1.97) opined that attention should paid to provision of power supply and provision of recreation facilities (RAI I.63). The study recommends that government should make adequate provisions for basic facilities such power supply, adequate health care system, basic education and provision of healthy portable water. This should be given utmost priority to enhance the living condition of residents. To forestall attack from residents’ adequate security measures should be provided as backup for Government official during implementation and monitoring. Appropriate sanction to illegal occupants and demolition of illegal structures should be fully implemented, This will indubitably prevent haphazard development and also promote a liveable environment.

Keywords: new town, urbanization, infrastructure boundary

Procedia PDF Downloads 409

Authors: Preeti Madan, Shalini Malhotra, Nirmaljit Kaur, Charoo Hans, VK Sabarwal

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Hospital is one of the most diverse and complex institutions frequented by people from every walk of life without any distinction between age, sex, gender, religion or intellect. This is over and above the normal inhabitant of hospital i.e. doctors, patients, and paramedical staff. The hospital waste generated 85% is non hazardous, 10% infectious and around 5% are non-infectious but hazardous waste. The management of biomedical waste is still in its infancy. There is a lot of confusion with the problems among the generators, operators, decision makers, and general community about the safe management of biomedical waste prompt action initiated to seek new scientific, safe, and cost-effective management of waste.

Keywords: biomedical waste, nosocomial infection, waste management, hospitals

Procedia PDF Downloads 446

Authors: Sum Lau, Wing Chung Cleo Lau, Wing Yan Chu, Long Ching Ip, Wan Yin Lo, Jo Long Sam Yau, Ka Ho Hui, Sze Yi Mak

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Biomedical engineering (BME) is an interdisciplinary subject where knowledge about biology and medicine is applied to novel applications, solving clinical problems. This subject is crucial for cities such as Hong Kong, where the burden on the medical system is rising due to reasons like the ageing population. Hong Kong, who is actively boosting technological advancements in recent years, sets BME, or biotechnology, as a major category, as reflected in the 2018-19 Budget, where biotechnology was one of the four pillars for development. Over the years, while resources in terms of money and space have been provided, there has been a lack of talents expressed by both the academia and industry. While exogenous factors, such as COVID, may have hindered talents from outside Hong Kong to come, endogenous factors should also be considered. In particular, since there are already a few local universities offering BME programmes, their curriculum or style of education requires to be reviewed to intensify the network of the BME community and support post-academic career development. It was observed that while undergraduate (UG) studies focus on knowledge teaching with some technical training and postgraduate (PG) programmes concentrate on upstream research, the programmes are generally confined to the academic sector and lack connections to the industry. In light of that, a “Biomedical Innovation and Outreach Programme 2022” (“B.I.O.2022”) was held to connect students and professors from academia with clinicians and engineers from the industry, serving as a comparative approach to conventional education methods (UG and PG programmes from tertiary institutions). Over 100 participants, including undergraduates, postgraduates, secondary school students, researchers, engineers, and clinicians, took part in various outreach events such as conference and site visits, all held from June to July 2022. As a case study, this programme aimed to tackle the aforementioned problems with the theme of “4Cs” (connection, communication, collaboration, and commercialisation). The effectiveness of the programme is investigated by its ability to serve as an adult and continuing education and the effectiveness of causing social change to tackle current societal challenges, with the focus on tackling the lack of talents engaging in biomedical engineering. In this study, B.I.O.2022 is found to be able to complement the traditional educational methods, particularly in terms of knowledge exchange between the academia and the industry. With enhanced communications between participants from different career stages, there were students who followed up to visit or even work with the professionals after the programme. Furthermore, connections between the academia and industry could foster the generation of new knowledge, which ultimately pointed to commercialisation, adding value to the BME industry while filling the gap in terms of human resources. With the continuation of events like B.I.O.2022, it provides a promising starting point for the development and relationship strengthening of a BME community in Hong Kong, and shows potential as an alternative way of adult education or learning with societal benefits.

Keywords: biomedical engineering, adult education for social change, comparative methods and principles, lifelong learning, faced problems, promises, challenges and pitfalls

Procedia PDF Downloads 114

Authors: Andreas Savvides, Chloe Kadi

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The objective of this study is to investigate how the planning and design of open parks within neighborhoods and communities can promote physical activity in order to enhance the health of the local population. An extensive literature review was conducted for studies regarding the relationship between health and physical activity and the park characteristics that can promote physical activity among people. The findings of the literature review were then compared and analysed, in order to identify the main characteristics of urban parks that can promote physical activity and enhance public health. In order to find out how the characteristics identified in the literature were applied in real life, an analysis of three existing parks in three different countries was conducted. The parks, apart from their geographical location, also vary in size and layout. The parks were chosen because they are urban open parks and they include facilities for physical activity.

Keywords: urban planning, active living behaviour, open parks, sustainable mobility

Procedia PDF Downloads 127

Authors: Dessy Laksyana Utami

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Manual material handling activities often make it difficult for humans to work like this. Muscle injury due to incorrect posture.Workers need to facilitate their activities. One tool to assist their activities in the transportation of ordinary materials is a trolley. This tool is very useful because it can be used.It can bring many items without having to spend more energy to operate it. Very Comfortable used a trolley in the community. But the old design still have a complaint by worker, because lack of grip and capacity. After posture analysis with the REBA method, the value of risk need to be increased is obtained tool. Re design use Indonesian anthropometric data with the 50th percentile.

Keywords: Material Handling, REBA method, postural assessment, Trolley.

Procedia PDF Downloads 137

Authors: J. Casteleiro- Pitrez

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The interest in Virtual Reality (VR) keeps increasing among the community of designers. To develop this type of immersive experience, the understanding of new processes and methodologies is as fundamental as its complex implementation which usually implies hiring a specialized team. In this paper, we introduce a case study, a platform that allows designers to easily create complex VR experiences, present its features, and its development process. We conclude that this platform provides a complete solution for the design and development of VR experiences, no-code needed.

Keywords: creatives, designers, virtual reality, virtual reality design platform, virtual reality system, no-coding

Procedia PDF Downloads 154

Authors: Hossein Miri, Zhou YongQi, Chan Bormei-Suy

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The development of advanced technologies and innovative solutions has opened up exciting new possibilities for revolutionizing healthcare systems. One such emerging concept is the use of virtual and holographic health information platforms that aim to provide interactive and personalized medical information to users. This paper provides a review of notable virtual and holographic health information platforms. It begins by highlighting the need for information visualization and 3D representation in healthcare. It then proceeds to provide background knowledge on information visualization and historical developments in 3D visualization technology. Additional domain knowledge concerning holography, holographic computing, and mixed reality is then introduced, followed by highlighting some of their common applications and use cases. After setting the scene and defining the context, the need and importance of virtual and holographic visualization in medicine are discussed. Subsequently, some of the current research areas and applications of digital holography and holographic technology are explored, alongside the importance and role of virtual and holographic visualization in genetics and genomics. An analysis of the key principles and concepts underlying virtual and holographic health information systems is presented, as well as their potential implications for healthcare are pointed out. The paper concludes by examining the most notable existing mixed-reality applications and systems that help doctors visualize diagnostic and genetic data and assist in patient education and communication. This paper is intended to be a valuable resource for researchers, developers, and healthcare professionals who are interested in the use of virtual and holographic technologies to improve healthcare.

Keywords: virtual, holographic, health information platform, personalized interactive medical information

Procedia PDF Downloads 86

Authors: Lawrence Babatunde Ogunsanya

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The university has been in existence, in one form or another, for over a thousand years and has contributed in multiple ways to modern society. It is considered a center of culture, aesthetic direction, and moral forces shaping the civilized society. Universities also contribute in important ways to the economic health and physical landscape of neighborhoods and cities, serving as permanent fixtures of the urban economy and the built environment. Due to the size and location of university campuses, they put demands on the urban character, systems, and infrastructure of the neighboring communities. These demands or impacts have substantial implications for the built environment. It is important to understand the impacts university campuses have on their surrounding communities and urban environments because the destiny of the university is inextricably linked to the destiny of the adjacent neighborhoods. This paper identifies the diverse factors generated by universities in shaping the built environments of their local communities within different spatial contexts such as urban, rural, and township regions situated in South Africa.By applying a mixed methods approach in four university campuses within the province of KwaZulu-Natal in South Africa. Several data collection instruments were used, such as in-depth interviews, a survey, remote sensing, and onsite observations. The thematic findings revealed numerous factors which influence the morphology of neighbourhood built environments and the myriad of relationships the university has with its local community. This paper also reveals that the university campus is more than a precinct which accommodates buildings and academic endeavours, the role of the university in this century has changed dramatically from its traditional roots of being an elite enclave of academics to a more inclusive and engaged entity that is concerned about providing relevant holistic solutions to society’s current challenges in the built environment.

Keywords: university campus, built environment, architecture, neighborhood planning

Procedia PDF Downloads 122

Authors: Balázs Ádám, Randi Nørgaard Fløe Pedersen, Jørgen Riis Jepsen

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Volatile chemicals that accumulate and release from freight containers constitute significant health risks. Fumigation to prevent spread of pests and off-gassing of freight are sources of hazardous chemicals. The aim of our study was to investigate the regulation and practice of container handling with focus on preventive measures applied against chemical exposures in Denmark. A comprehensive systematic search of scientific literature and organizational domains of international and Danish regulatory bodies was performed to explore regulations related to safe work with transport containers. The practice of container work was investigated in a series of semi-structured interviews with managers and health and safety representatives of organizations that handle transport containers. Although there are several international and national regulations and local safety instructions that relate to container handling, the provided information is not specific or up-to-date enough to conduct safe practice in many aspects. The interviewees estimate high frequency of containers with chemical exposure and deem that they can potentially damage health, although recognizable health effects are rare. Knowledge is limited about the chemicals and most of them cannot be measured by available devices. Typical preventive measures are passive ventilation and personal protective equipment but their use is not consistent and may not provide adequate protection. Hazardous chemicals are frequently present in transport containers; however, managers, workers and even occupational health professionals have limited knowledge about the problem. Detailed risk assessment and specific instructions on risk management are needed to provide safe conditions for work with containers.

Keywords: chemical exposure, fumigation, occupational health and safety regulation, transport container

Procedia PDF Downloads 379

Authors: Amanda Aliende da Matta

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In different fields, there are people who have something that stands out. In the educational world, for example, it is clear when some teachers have something: they are the best teachers, but this is not directly attributed to their disciplines, methodologies, etc. It is that they have something that captivates, inspires, and motivates. But we also find this something in other contexts. In this thesis, the interest is in something that some marginalized people, such as Ab (fictitious name), have. Ab was born in a rural community and saw the lifestyle of his family change drastically as a consequence of structural changes in his village. The community became impoverished, and together with a group of teenagers, he decided to migrate to Spain in search of opportunities. His best friend drowned during the crossing. After arriving, he lived in indecent conditions and felt unsafe. He now suffers from anxiety and frequently faints from it. Yet, he’s linked to Joves x la pau (a Christian project, although he is a Muslim), distributing food for people who live on the streets every Thursday afternoon. When he asked about what happens on cold and rainy days, he explained simply: "if it rains, I distribute the food, and immediately I get home, take a bath, and sleep warm under my roof. That is when we most have to go." This something he has will be called caring. And one of the general objectives of the thesis is to discover what are the meaning structures of this caring what is the lived experience of this caring. In this communication, preliminary results of an Applied Hermeneutic Phenomenology (AHP) study on the lived experience of caring as a vulnerable person are presented. The research means to answer what is the lived experience of caring as a vulnerable person. That is, to describe and explain what it is like to caregive for a vulnerable person, what it is, essentially, to caregive for a vulnerable person, what makes the lived experience of caregiving for a vulnerable person different from any other. In order to investigate the meaning of the phenomenon of caregiving as a vulnerable person, as already stated, the method used will be Applied Hermeneutic Phenomenology (AHP). We base ourselves, initially, on the proposal of Raquel Ayala-Carabajo and Max Van Manen. As Van Manen (1990) explains, AHP is a method that works essentially through fieldwork, with the collection of data on lived experience (experiential material). It is a phenomenology of practice. We here present the provisional themes we found: caregiving as a vulnerable person is seeing yourself in the other, identifying with the care-receiver; Caregiving as a vulnerable person is putting the other’s need before oneself’s; Caregiving as a vulnerable person is temporarily overcoming your weaknesses to make yourself strong for the other; Caregiving as a vulnerable person is going beyond the conventional approach; and Caregiving as a vulnerable person is taking responsibility even if it’s not yours.

Keywords: applied hermeneutic phenomenology, care ethics, hermeneutics, phenomenology

Procedia PDF Downloads 92

Authors: Xiaohong Xu, Tianchu Zhang, Yangfan Chen, Rongtai Tan

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In Canada, Air Quality Health Index (AQHI) is a scale designed to help residences understand the impact of air quality on human health. In Ontario, Canada, AQHI was implemented in June 2015. This study investigated temporal variability of daily AQHI and impact of regional transport on AQHI in Windsor, Ontario, Canada from 2016 to 2019. During 2016–2019, 1428 daily AQHIs were recorded in Windsor Downtown Station. Among those, the AQHIs were at the low health risk level (AQHI = 1, 2 or 3) in 82% of days, only a few days at high risk level (AQHI = 7), the rest were at moderate health risk level (AQHI = 4, 5, 6), indicating air quality in Windsor was fairly good with relatively low health risk. The annual mean AQHI value decreased from 2.95 in 2016 to 2.81 in 2019, demonstrating the improvement of air quality. Half of the days, AQHI were 3 regardless of season. AQHI was higher in the warm season (3.1) than in the cold season (2.6) due to more frequent moderate risk days (27%, AQHI = 4) in warm season and more frequent low risk days (42%, AQHI = 2) in the cold season. Among the three pollutants considered in AQHI calculation, O3 was the most frequently reported dominant contributor to daily AQHI (88% of days), followed by NO2 (12%), especially in the cold season, with small contribution from PM2.5 (<1%). In the past two decades, NO2 concentrations had decreased significantly and O3 concentrations had increased, resulting in daily AQHI being less reliance on NO2 (from 51% of days being the primary contributor during 2003–2010 to 12% during 2016–2019) and more on O3 concentrations (49% to 88%). Trajectory analysis found that AQHI ≤ 3 days were closely associated with air masses from the north and northwest, whereas AQHI > 3 days were closely associated with air masses from the west and southwest. This is because northerly flows brought in clear air mass owing to less industrial facilities, while polluted air masses were transported from the south of Windsor, where several industrial states of the US were located. Overall, O3 concentrations dictate the daily AQHI values, the seasonal variability of AQHI, and the impact of regional transport on AQHI in Windsor. This makes further reductions of AQHI challenging because O3 concentrations are likely to continue increasing due to weakened consumption of O3 by NO owing to decreasing NO emissions and more hot days because of climate change. The predominant and increasing contribution of O3 to AQHI calls for more effective control measures to mitigate O3 pollution and its impact on human health and the environment.

Keywords: air quality, Air Quality Health Index (AQHI), hysplit, regional transport, windsor

Procedia PDF Downloads 63

Authors: Samia Hassan, Fouzia Latif

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In many countries, education is still far from being a knowledge industry in the sense of own practices that are not yet being transformed by knowledge about the efficacy of those practices. The core question of this paper is why students get bored in class? Have we balanced between the creation and advancement of an engaging learning community and effective learning environment? And between, giving kids confidence to achieve their maximum and potential goals, we sand managing student’s behavior. We conclude that creating a positive learning environment enhances opportunities for young children to feel safe, secure, and to supported in order to do their best learning. Many factors can use in classrooms aid to the positive environment like course content, class preparation, and behavior.

Keywords: effective, environment, learning, positive

Procedia PDF Downloads 565

Authors: Titir Bhattacharya, Tanika Chakraborty, Prabal K. De

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Maternal and child health continue to be a significant policy focus in developing countries, including India. An emerging model in health care is the creation of public and private partnerships. Since the construction of physical infrastructure is costly, governments at various levels have tried to implement social health insurance schemes where a trust calculates insurance premiums and medical payments. Typically, qualifying families get full subsidization of the premium and get access to private hospitals, in addition to low cost public hospitals, for their tertiary care needs. We analyze one such pioneering social insurance scheme in the Indian state of Andhra Pradesh (AP). The Rajiv Aarogyasri program (RA) was introduced by the Government of AP on a pilot basis in 2007 and implemented in 2008. In this paper, we first examine the extent to which access to reproductive health care changed. For example, the RA scheme reimburses hospital deliveries leading us to expect an increase in institutional deliveries, particularly in private hospitals. Second, we expect an increase in institutional deliveries to also improve child health outcomes. Hence, we estimate if the program improved infant and child mortality. We use District Level Health Survey data to create annual birth cohorts from 2000-2015. Since AP was the only state in which such a state insurance program was implemented, the neighboring states constituted a plausible control group. Combined with the policy timing, and the year of birth, we employ a difference-indifference strategy to identify the effects of RA on the residents of AP. We perform several checks against threats to identification, including testing for pre-treatment trends between the treatment and control states. We find that the policy significantly lowered infant and child mortality in AP. We also find that deliveries in private hospitals increased, and government hospitals decreased, showing a substitution effect of the relative price change. Finally, as expected, out-of-pocket costs declined for the treatment group. However, we do not find any significant effects for usual preventive care such as vaccination, showing that benefits of insurance schemes targeted at the tertiary level may not trickle down to the primary care level.

Keywords: public health insurance, maternal and child health, public-private choice

Procedia PDF Downloads 95

Authors: Meidesta Pitria, Akiko Okabe

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In high-density informal settlement, extension area at the outside of the houses could primarily happen as a spatial modification response. House extension in high-density informal settlement is not only becoming a physical spatial modification that makes a blur zone between private and public but also supporting the growth and existence of informal economy and other daily activities in both individuals and communities. This research took a case study in an informal settlement named Kampung Cikini, a densely populated area in Central Jakarta. The aim of this study is to identify and clarify house extension as a strategy in dealing with urbanization in an informal settlement. By using the perspective and information from housewives, the analysis is based on the assumption that land ownership transformation and the activities in house extension area influence the different kinds of house extension’s spatial modification and local planning policy in relation with the implementation of house extension strategy. The data collection was done in four sites, two sites are located in outer-wide alley and another two sites are located in inner-narrow alley. In this research, data of 104 housewives in 86 houses were collected through representatives of housewives and local leader of each sites. The research was started from participatory mapping process, deep interview with local leader, and initiated collaboration with housewives community in having a celebration as communal event to cultivate together the issue. This study shows that land ownership, activities, and alley are indispensable in the decision of extension space making. The more permanency status of land ownership the more permanent and various extension could be implemented. However, in some blocks, the existence of origin house or first land owner also has a significant role in coordination and agreement in using and modifying extension space. In outer-wide alley, the existence of more various activities in front area of the houses is significantly related with the chance given by having wider alley, particularly for informal income generating activities. In the inner-narrow alley, limited space in front of the houses affects more negotiations in the community for having more shared spaces, even inside their private space.

Keywords: house extension, housewives, informal settlement, kampung, high density

Procedia PDF Downloads 205