Search results for: community health center

Authors: Lida Moghaddam-Banaem, Mahmood Tavoosi, Soheila Khalili

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Objective: The main objective of this study was designing a breast cancer health literacy questionnaire and assess its psychometric properties. Methods: A comprehensive literature review was performed to develop a primary questionnaire consisting of five domains. Qualitative and quantitative content validity were assessed by relevant experts, and after some modifications, the content validity index (CVI) and content validity ratio (CVR) were calculated. Qualitative and quantitative face validity were evaluated by a number of patients, and the impact score for each item was calculated. 225 women with breast cancer were asked to fill out the questionnaire and construct validity was determined by using exploratory factor analysis. The reliability was tested by Cronbach's alpha coefficient. Results: A 36-item questionnaire with five domains of reading, having access, understanding, assessing/judgment, and decision making/behavior was designed. 2 items were omitted in the qualitative content validity process. All items achieved optimum values in CVI, CVR and impact scores. Content and face validity of the questionnaire were confirmed too. According to the exploratory factor analysis, the five-factor solution accounted for 64.98 percent of the observed variance. Conclusion: Due to the obtained satisfactory validity and reliability, this tool can be used to assess health literacy in women with breast cancer. Health policy makers can use these findings for improving health-related behaviors in breast cancer patients.

Keywords: health literacy, breast cancer, questionnaire, psychometric properties

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Authors: Stephen L. Roberts

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This article offers a critical analysis of the rise of syndromic surveillance systems for the advanced detection of pandemic threats within contemporary global health security frameworks. The article traces the iterative evolution and ascendancy of three such novel syndromic surveillance systems for the strengthening of health security initiatives over the past two decades: 1) The Program for Monitoring Emerging Diseases (ProMED-mail); 2) The Global Public Health Intelligence Network (GPHIN); and 3) HealthMap. This article demonstrates how each newly introduced syndromic surveillance system has become increasingly oriented towards the integration of digital algorithms into core surveillance capacities to continually harness and forecast upon infinitely generating sets of digital, open-source data, potentially indicative of forthcoming pandemic threats. This article argues that the increased centrality of the algorithm within these next-generation syndromic surveillance systems produces a new and distinct form of infectious disease surveillance for the governing of emergent pathogenic contingencies. Conceptually, the article also shows how the rise of this algorithmic mode of infectious disease surveillance produces divergences in the governmental rationalities of global health security, leading to the rise of an algorithmic governmentality within contemporary contexts of Big Data and these surveillance systems. Empirically, this article demonstrates how this new form of algorithmic infectious disease surveillance has been rapidly integrated into diplomatic, legal, and political frameworks to strengthen the practice of global health security – producing subtle, yet distinct shifts in the outbreak notification and reporting transparency of states, increasingly scrutinized by the algorithmic gaze of syndromic surveillance.

Keywords: algorithms, global health, pandemic, surveillance

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Authors: Adesola C. Odole, Michael O. Ogunlana, Nse A. Odunaiya, Olufemi O. Oyewole, Chidozie E. Mbada, Ogochukwu K. Onyeso, Ayomikun F. Ayodeji, Opeyemi M. Adegoke, Iyanuoluwa Odole, Comfort T. Sanuade, Moyosooreoluwa E. Odole, Oluwagbohunmi A. Awosoga

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Purpose: The Nigerian healthcare industry is bedeviled with infrastructural decay, inadequate funding and staffing, and a dysfunctional healthcare system. This study investigated the influence of health professionals’ well-being and quality of work-life (QoWL) on the quality of care (QoC) of patients in Nigeria. Methods: The study was a multicentre cross-sectional survey conducted at four tertiary health institutions in southwest Nigeria. Participants’ demographic information, well-being, quality of work-life, and quality of care were obtained using four standardized questionnaires. Data were summarized using descriptive statistics of frequency (percentage) and mean (standard deviation). Inferential statistics included Chi-square, Pearson’s correlation, and independent samples t-test analyses. Results: Medical practitioners (n=609) and nurses (n=570) constituted 74.6% of all the health professionals, with physiotherapists, pharmacists, and medical laboratory scientists constituting 25.4%. The mean (SD) participants’ well-being = 71.65% (14.65), quality of life = 61.8% (21.31), quality of work-life = 65.73% (10.52) and quality of care = 70.14% (12.77). Participants’ quality of life had a significant negative correlation with the quality of care, while well-being and quality of work-life had a significant positive correlation with the quality of care. Conclusion: We concluded that health professionals’ well-being and quality of work-life are important factors that influence their productivity and, ultimately, the quality of care rendered to patients. The hospital management and policymakers should ensure improved work-related factors to improve the well-being of health professionals. This will enhance the quality of care given to patients and ultimately reduce brain drain and medical tourism.

Keywords: health professionals, quality of care, quality of life, quality of work-life, well-being

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Authors: Laurent Bellemare

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After the showcase of traditional Indonesian performing arts at the Vancouver Expo 1986, Canadian universities inherited sets of Indonesian gamelan orchestras and soon began offering courses for music students interested in learning these diverse traditions. Among them, Université de Montréal was offered two sets of Balinese orchestras, a novelty that allowed a community of Montreal gamelan enthusiasts to form and engage with this music. A few generations later, a large body of archives have amassed, framing the history of this niche community’s achievements. This data, scattered in public and private archive collections, comes in various formats: Digital Audio Tape, audio cassettes, Video Home System videotape, digital files, photos, reel-to-reel audiotape, posters, concert programs, letters, TV shows, reports and more. Attempting to study these documents in order to unearth a chronology of gamelan in Montreal has proven to be challenging since no suitable platform for preservation, storage, and research currently exists. These files are, therefore, hard to find due to their decentralized locations. Additionally, most of the documents in older formats have yet to be digitized. In the case of recent digital files, such as pictures or rehearsal recordings, their locations can be even messier and their quantity overwhelming. Aside from the basic issue of choosing a suitable repository platform, questions of legal rights and methodology arise. For posterity, these documents should nonetheless be digitized, organized, and stored in an easily accessible online repository. This paper aims to underline the various challenges encountered in the early stages of such a project as well as to suggest ways of overcoming the obstacles to a thorough archival investigation.

Keywords: archival work, archives, Balinese gamelan, Canada, Gamelan, Indonesia, Javanese gamelan, Montreal

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Authors: H. Derya Arslan

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Shopping centers have become an important part of urban life. The numbers of shopping centers have rapidly increased for ten years, in Turkey. Malls that have been built with increasing speed in the last two decades meet most social and cultural needs of people. In this study, architectural characteristics of a recent mall built in the city of Konya in Turkey have been discussed. The assessment of the mall in question has been made in the context of a growing and changing city. The study opened up new horizons and discussion areas to entrepreneurs who make significant investments in shopping centers, architects who design shopping centers as efficient commercial and social environments, and social scientists that investigate the effects of increase in these closed urban spaces on urban life.

Keywords: shopping center, architecture, city, social

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Authors: Maria Cristina Tommaso, Maria Das Graças L. Silva, Carlos Jose Pacheco

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Have the advances of the Brazilian legislation reflected or have been consonant with the inclusion of PwD in higher education? In 1990 the World Declaration on Education for All, a document organized by the United Nations Educational, Scientific and Cultural Organization (UNESCO), stated that the basic learning needs of people with disabilities, as they were called, required special attention. Since then, legislation in signatory countries such as Brazil has made considerable progress in guaranteeing, in a gradual and increasing manner, the rights of persons with disabilities to education. Principles, policies, and practices of special educational needs were created and guided action at the regional, national and international levels on the structure of action in Special Education such as administration, recruitment of educators and community involvement. Brazilian Education Law No. 3.284 of 2003 ensures inclusion of people with disabilities in Brazilian higher education institutions and also in 2015 the Law 13,146/2015 - Brazilian Law on the Inclusion of Persons with Disabilities (Statute of the Person with Disabilities) regulates the inclusion of PwD by the guarantee of their rights. This study analyses data related to people with disability inclusion in High Education in the south region of Rio de Janeiro State - Brazil during the period between 2008 and 2018, based in its correlation with the changes in the Brazilian legislation in the last ten years that were subjected by PwD inclusion processes in the Brazilian High Education Systems. The region studied is composed by sixteen cities and this research refers to the largest one, Volta Redonda that represents 25 percent of the total regional population. The PwD reception process had the dicing data at the Volta Redonda University Center with 35 percent of high education students in this territorial area. The research methodology analyzed the changes occurring in the legislation about the inclusion of people with disability in High Education in the last ten years and its impacts on the samples of this study during the period between 2008 and 2018. It was verified an expressive increasing of the number of PwD students, from two in 2008 to 190 PwD students in 2018. The data conclusions are presented in quantitative terms and the aim of this study was to verify the effectiveness of the PwD inclusion in High Education, allowing visibility of this social group. This study verified that the fundamental human rights guarantees have a strong relation to the advances of legislation and the State as a guarantor instance of the rights of the people with disability and must be considered a mean of consolidation of their education opportunities isonomy. The recognition of full rights and the inclusion of people with disabilities requires the efforts of those who have decision-making power. This study aimed to demonstrate that legislative evolution is an effective instrument in the social integration of people with disabilities. The study confirms the fundamental role of the state in guaranteeing human rights and demonstrates that legislation not only protects the interests of vulnerable social groups, but can also, and this is perhaps its main mission, to change behavior patterns and provoke the social transformation necessary to the reduction of inequality of opportunity.

Keywords: high education, inclusion, legislation, people with disability

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Authors: Muhammad Qamar Masood, Syed Abbas Raza, Umar Yousaf Raja, Imran Hassan, Bilal Afzal, Muhammad Aleem Zahir, Atika Shaheer

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Background: Cardiovascular disease (CVD) is a major burden among people with type 2 diabetes (T2D) with 1 in 3 reported to have CVD. Therefore, understanding real-world clinical characteristics and prescribing patterns could help in better care. Objective: The CONVERGE (Cardiovascular Outcomes and Value in the Real world with GLP-1RAs) study characterized demographics and medication usage patterns in T2D intensified (add-on to metformin) overall population. The data were further divided into subgroups {dipeptidyl peptidase-4 inhibitors (DPP-4is), sulfonylureas (SUs), insulins, glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and sodium-glucose cotransporter-2 inhibitors (SGLT-2is)}, according to the latest prescribed antidiabetic agent (ADA) in India/Pakistan/Thailand. Here, we report findings from Pakistan. Methods: A multi-center retrospective study utilized data from medical records between 13-Sep-2008 (post-market approval of GLP-1RAs) and 31-Dec-2017 in adults (≥18-year-old). The data for this study were collected from 05 centers / institutes located in major cities of Pakistan, including Karachi, Lahore, Islamabad, and Multan. These centers included National Hospital, Aga Khan University Hospital, Diabetes Endocrine Clinic Lahore, Shifa International Hospital, Mukhtar A Sheikh Hospital Multan. Data were collected at start of medical record and at 6 or 12-months prior to baseline based on variable type; analyzed descriptively. Results: Overall, 1,010 patients were eligible. At baseline, overall mean age (SD) was 51.6 (11.3) years, T2D duration was 2.4 (2.6) years, HbA1c was 8.3% (1.9) and 35% received ≥1CVD medications in the past 1-year (before baseline). Most frequently prescribed ADAs post-metformin were DPP-4is and SUs (~63%). Only 6.5% received GLP-1RAs and SGLT-2is were not available in Pakistan during the study period. Overall, it took a mean of 4.4 years and 5 years to initiate GLP-1RAs and SGLT-2is, respectively. In comparison to other subgroups, more patients from GLP-1RAs received ≥3 types of ADA (58%), ≥1 CVD medication (64%) and had higher body mass index (37kg/m2). Conclusions: Utilization of GLP-1RAs and SGLT-2is was low, took longer time to initiate and not before trying multiple ADAs. This may be due to lack of evidence for CV benefits for these agents during the study period. The planned phase 2 of the CONVERGE study can provide more insights into utilization and barriers to prescribe GLP-1RAs and SGLT-2is post 2018 in Pakistan.

Keywords: type 2 diabetes, GLP-1RA, treatment intensification, cardiovascular disease

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Authors: Stephen Rulisa, Aimee Nyiramahirwe

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Background: Strategies to increase the uptake of contraception services have been adopted in Rwanda, but the unmet need for family planning remains high. Women in the postpartum period are at higher risk for unintended pregnancy due to the silent conversion from lactational amenorrhea to reactivation of ovulatory cycles. The purpose of this study was to explore the role of male partners in the uptake of postpartum contraception. Methods: A prospective cross-sectional study was conducted among women who delivered at the University Teaching Hospital of Kigali for a period of 3 months with random sampling. A questionnaire was used to collect socio-demographic and antenatal data, information on male companionship, and intent to use postpartum contraception at admission. Participants were contacted six weeks later to collect data on contraceptive use. The outcome variables were uptake of postpartum contraception and types of contraceptives taken (long-acting vs. short-acting), controlling for male companionship during the antenatal period. A Chi-square test was used and a p-value ≤0.05 was considered significant. Results: A total of 209 women were recruited with a mean age of 30.8±5.2 years. The majority (60.9%) were multigravida, and 66.5% were multiparous. More than half (55%) had male partner companionship, 18.3% had companionship for four antenatal visits, and 28.2% had education on contraception with their male partner. Factors significantly associated with uptake of postpartum contraception were: age above 30 years, owning or heading a business, multigravidity, multiparity, antenatal care at a health center or district hospital, cesarean delivery, and previous utilization of contraception. Male companionship significantly increased the intent to use contraception, uptake of modern contraception in general, and uptake of long active contraceptives but did not predict the uptake of short-acting contraceptives. Conclusions: Our study demonstrates a positive association between male companionship during antenatal care, labor and delivery with the uptake of postpartum family planning. Our study suggests more sensitization to involve the male partners, improving the education on contraception during antenatal care and further research to assess the sustained uptake of contraception beyond the postpartum period.

Keywords: postpartum, family planning, contraception, male partner, uptake

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Authors: P. Tueku, P. Supnithi, R. Wongsathan

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Heat-Assisted Magnetic Recording (HAMR) is one of the leading technologies identified to enable areal density beyond 1 Tb/in2 of magnetic recording systems. A key challenge to HAMR designing is accuracy of positioning, timing of the firing laser, power of the laser, thermo-magnetic head, head-disk interface and cooling system. We study the effect of HAMR parameters on transition center and transition width. The HAMR is model using Thermal Williams-Comstock (TWC) and microtrack model. The target and equalizer are designed by the minimum mean square error (MMSE). The result shows that the unit energy constraint outperforms other constraints.

Keywords: heat-assisted magnetic recording, thermal Williams-Comstock equation, microtrack model, equalizer

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Authors: Jaroslav Kraus

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Spatial information about demographic processes are a standard part of outputs in the Czech Republic. That was also the case of Population and Housing Census which was held on 2011. This is a starting point for a follow up study devoted to two basic types of households: single person households and households of one completed family. Single person households and one family households create more than 80 percent of all households, but the share and spatial structure is in long-term changing. The increase of single households is results of long-term fertility decrease and divorce increase, but also possibility of separate living. There are regions in the Czech Republic with traditional demographic behavior, and regions like capital Prague and some others with changing pattern. Population census is based - according to international standards - on the concept of currently living population. Three types of geospatial approaches will be used for analysis: (i) firstly measures of geographic distribution, (ii) secondly mapping clusters to identify the locations of statistically significant hot spots, cold spots, spatial outliers, and similar features and (iii) finally analyzing pattern approach as a starting point for more in-depth analyses (geospatial regression) in the future will be also applied. For analysis of this type of data, number of households by types should be distinct objects. All events in a meaningful delimited study region (e.g. municipalities) will be included in an analysis. Commonly produced measures of central tendency and spread will include: identification of the location of the center of the point set (by NUTS3 level); identification of the median center and standard distance, weighted standard distance and standard deviational ellipses will be also used. Identifying that clustering exists in census households datasets does not provide a detailed picture of the nature and pattern of clustering but will be helpful to apply simple hot-spot (and cold spot) identification techniques to such datasets. Once the spatial structure of households will be determined, any particular measure of autocorrelation can be constructed by defining a way of measuring the difference between location attribute values. The most widely used measure is Moran’s I that will be applied to municipal units where numerical ratio is calculated. Local statistics arise naturally out of any of the methods for measuring spatial autocorrelation and will be applied to development of localized variants of almost any standard summary statistic. Local Moran’s I will give an indication of household data homogeneity and diversity on a municipal level.

Keywords: census, geo-demography, households, the Czech Republic

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Authors: Farida Naceur

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Algerian cities experienced after the independence of the country a rapid urbanisation process fostered by population growth. In order to deal with the severe housing shortage resulted, large social public housing programs totally financed by the government were launched across the country during the eighty. Unfortunately, the standardized multistory buildings produced underwent intense deterioration and turned very quickly after their occupancy into sources of nuisance and distress. The government adopted a new housing policy in 2000, which aims to diversify housing types according to household incomes and encourage access to housing property. The model of participatory social housing emerged; it was designed for the intermediate groups, allowing them to benefit from direct financial aid and to borrow credit from banks in order to purchase their dwellings. Twenty years afterward, no assessment to date has been established to evaluate the real impact of such a strategy. The aim of this paper is to examine whether this type of housing helped to stimulate a participative dynamism among its occupants to strengthen their commitment, their involvement in the maintenance and keeping of their surroundings. For the purpose of the study, we focus our attention on various participatory social housing settlements in Batna and Biskra, two medium-sized cities in eastern Algeria. The investigation is structured in various types of analysis: a spatial analysis, observations, interviews with public authorities representatives, chief planners, and experts. In addition to this, informal interviews with occupants of various participatory social housing settlements were arranged to collect qualitative data. Occupants were asked open questions focusing on their daily life and practices in order to examine their degree of involvement in their neighbourhood’s life.

Keywords: participatory social housing, rental social housing, involvement, maintenance, social interactions, community life

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Authors: Shaojun Zheng, Lei Xu, Yunzi Wang

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The main purpose of the research is to use the cultural ecology to analyze the renewal of Shenzhen urban village in the process of China's urbanization and to evaluate and guide the renewal, which will combine the society value and economic efficiency and activate urban villages. The urban village has a long history. There are also many old buildings, various residents, and a strong connection with the surrounding environment. Cultural ecology, which uses the knowledge of ecology to study culture, provides us a cultural perspective in the renewal. We take Hubei village in Shenzhen as our example. By using cultural ecology, we find a new way dealing with the relationship between culture and other factors. It helps us to give the buildings and space the culture meanings from different scales. It enables us to find a unique development pattern of urban village. After analyzing several famous cultural blocks cases, we find it is possible to connect the unique culture of urban village with the renovation of its buildings, community, and commerce. We propose the following strategies with specific target: 1. Building renovation: We repair and rebuild the origin buildings as little as possible, and retain the original urban space tissue as much as possible to keep the original sense of place and the cultural atmosphere. 2. Community upgrade: We reshape the village stream, fix the original function, add event which will activate people to complete the existing cultural circle 3. District commerce: We implant food and drink district, boutique commercial, and creative industries, to make full use of the historical atmosphere of the site to enhance the culture feelings For the renewal of a seemingly chaotic mixed urban village, it is important to break out from the conventional practices of building shopping malls or residential towers. Without creating those building landmarks, cultural ecology activates the urban village by exploiting its unique culture, which makes the old and new combine and becomes a new stream of energy, forming the new cultural, commercial and stylish landmark of the city.

Keywords: cultural ecology, urban village, renewal, combination

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Authors: Kristen Erekson, Sarah Spendlove Caswell

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Nurse educators have the challenge of training future nurses that will provide compassionate care to an increasingly diverse population of patients in a culturally sensitive way. One approach to this challenge is an immersive public and global health experience as part of the nursing program curriculum. Undergraduate nursing students at our institution are required to participate in a Public and Global Health course. They participate in a didactic preparatory course followed by a 3-to-4-week program in one of the following locations: The Czech Republic, Ecuador, Finland/Poland, Ghana, India, Spain, Taiwan, Tonga, an Honor Flight to Washington D.C. with Veterans, or in local (Utah) communities working with marginalized populations (including incarcerated individuals, refugees, etc.). The students are required to complete 84 clinical hours and 84 culture hours (which involve exposure to local history, art, architecture, customs, etc.). As Faculty, we feel strongly that these public and global health experiences help cultivate cultural awareness in our students and prepare nurses who are better prepared to serve a diverse population of patients throughout their careers. This presentation will highlight our experiences and provide ideas for other nurse educators who have an interest in developing similar programs in their schools but do not know where to start. Suggestions about how to start building relationships that can lead to these opportunities, along with logistics for continuing the programs, will be highlighted.

Keywords: global health nursing, nursing education, clinical education, public health nursing

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Authors: Amanda M. McLeroy, Tiera Tanksley

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The 2020 movement for Black Lives, ignited by anti-Black police brutality and exemplified by the public execution of George Floyd, underscored the dual potential of social media for political activism and perilous exposure to traumatic content for Black students. This study employs Critical Race Technology Theory (CRTT) to scrutinize algorithmic anti-blackness and its impact on Black youth's lives and educational experiences. The research investigates the consequences of vicarious exposure to police brutality on social media among Black adolescents through qualitative interviews and quantitative scale data. The findings reveal an unprecedented surge in exposure to viral police killings since 2020, resulting in profound physical, socioemotional, and educational effects on Black youth. CRTT forms the theoretical basis, challenging the notion of digital technologies as post-racial and neutral, aiming to dismantle systemic biases within digital systems. Black youth, averaging over 13 hours of daily social media use, face constant exposure to graphic images of Black individuals dying. The study connects this exposure to a range of physical, socioemotional, and mental health consequences, emphasizing the urgent need for understanding and support. The research proposes questions to explore the extent of police brutality exposure and its effects on Black youth. Qualitative interviews with high school and college students and quantitative scale data from undergraduates contribute to a nuanced understanding of the impact of police brutality exposure on Black youth. Themes of unprecedented exposure to viral police killings, physical and socioemotional effects, and educational consequences emerge from the analysis. The study uncovers how vicarious experiences of negative police encounters via social media lead to mistrust, fear, and psychosomatic symptoms among Black adolescents. Implications for educators and counselors are profound, emphasizing the cultivation of empathy, provision of mental health support, integration of media literacy education, and encouragement of activism. Recognizing family and community influences is crucial for comprehensive support. Professional development opportunities in culturally responsive teaching and trauma-informed approaches are recommended for educators. In conclusion, creating a supportive educational environment that addresses the emotional impact of social media exposure to police brutality is crucial for the well-being and development of Black adolescents. Counselors, through safe spaces and collaboration, play a vital role in supporting Black youth facing the distressing effects of social media exposure to police brutality.

Keywords: black youth, mental health, police brutality, social media

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Authors: Mdoe Mwajuma Bakari, Mselle Lilian Teddy, Kibusi Stephen Mathew

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Background: Due to the increase of caesarean section (CS), many women are discharge early to their home. Women should be aware on how to take care of themselves at home after CS. Evidence shows non-uniform health education on home care after CS are provided to post CS mothers because of lack of standard home care guideline on home after CS; as existing guidelines explore only care of women in hospital setting, for health care workers. There is a need to develop post CS home care guide; exploring contents of home based care education after CS provided by nurse midwives will inform the development of the guide. Objective: To explore the content of health education provided by nurse midwives to post CS mother about home care after hospital discharge in Dodoma, Tanzania. Methodology: An exploratory qualitative study using in-depth interview was conducted in this study using triangulation of data collection method; where 14 nurse midwives working in maternity unit and 11 post CS mother attending their post-natal clinic were recruited. Content analysis was used to generate themes that describe health education information provided by nurse midwives to post CS mother about home care after hospital discharge. Results: The study found that, nutrition health education, maternal and newborn hygiene care of caesarean wound at home were the component of health education provided to post CS mothers by nurse midwives. Contradicting instruction were found to be provided to post CS mothers. Conclusion: This study reported non-uniform health education provided by the nurse midwives on home care after CS. Despite of the fact that nurse midwives recognizes the need to provide health education to the post CS mothers, there is a need to develop home care guideline as a reference for their education to ensure uniform package of education is provided to post CS mothers in order to improve recovery of post CS mothers from CS.

Keywords: caesarean section, home care, discharge education, homecare after caesarean section

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Authors: Nancy Njoka, Manuela Ramos Cacciatore

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In Kenya, refugee situations are becoming increasingly protracted, stretching over the years or even decades. As urbanization rates increase, so do the numbers of urban refugees in the country. Refugees living in urban areas face a range of challenges. In their efforts to pursue livelihoods, refugees have identified strategies to confront these challenges. In the same manner, humanitarian actors have come up with different interventions to promote access to livelihoods working through obstacles and barriers created by host governments. This paper seeks to understand the experience of Somali urban refugees living in the urban area of Eastleigh, Nairobi, both by investigating their own actions towards creating avenues to access livelihoods and by understanding their social, economic and policy context in which they forge livelihoods. The empirical data collected through fieldwork in Nairobi in 2020 serves as the basis of this qualitative case study. Drawing upon the themes of urban refugee movement, Somali ethnicity, citizenship discrimination and the livelihoods of refugees, the paper highlights how the actions of the Kenyan government and international non-governmental organization (INGO)s affect access to livelihoods and the consequences of these actions for Somali urban refugees. The results of the paper found that Somali urban refugees are taking active steps to create livelihoods for themselves. This is seen in the growth of Eastleigh as an economic hub in Kenya which is owned and run mostly by Somalis. Indeed, the Somali community is central to the establishment of networks in the neighborhood. Somali urban refugees are marginalized by the Kenyan government, reducing their opportunity to create dignified lives in Eastleigh. Findings also point out the community-based approaches used by INGOs in livelihood interventions. The relevance of this research lies in the interconnection of humanitarian development interventions for protracted refugees and the promotion of livelihoods in an urban and global context.

Keywords: Kenya, livelihoods, Somali, urban refugees

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Authors: Okwan Frank

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Maternal health outcome is one of the major population development challenges in Sub-Saharan Africa. The region has the highest maternal mortality ratio, despite the progressive economic growth in the region during the global economic crisis. It has been hypothesized that increase in economic growth will reduce the level of maternal mortality. The purpose of this study is to investigate the existence of the negative relationship between health outcome proxy by maternal mortality ratio and economic growth in Sub-Saharan Africa. The study used the Pooled Mean Group estimator of ARDL Autoregressive Distributed Lag (ARDL) and the Kao test for cointegration to examine the short-run and long-run relationship between maternal mortality and economic growth. The results of the cointegration test showed the existence of a long-run relationship between the variables considered for the study. The long-run result of the Pooled Mean group estimates confirmed the hypothesis of an inverse relationship between maternal health outcome proxy by maternal mortality ratio and economic growth proxy by Gross Domestic Product (GDP) per capita. Thus increasing economic growth by investing in the health care systems to reduce pregnancy and childbirth complications will help reduce maternal mortality in the sub-region.

Keywords: economic growth, maternal mortality, pool mean group, Sub-Saharan Africa

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Authors: Pranil Kumar Upadhayaya

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While peace is dividend to tourism, tourism can also be a vital force for world peace. The existing body of knowledge on a tripartite complex nexus between tourism, peace and conflict reveals that tourism is benefactor to peace and sensitive to conflict. By contextualizing the ongoing sporadic structural conflict in the transitional phase in the aftermath of a decade long (1996-2006), Maoist armed conflict in Nepal, the purpose of this study is to explore the potentials of tourism in peace-building. The outcomes of this research paper is based on the mixed methods of research (qualitative and quantitative). Though the armed conflict ended with the comprehensive peace agreement in 2006 but there is constant manifestations of non-violent structural conflicts, which continue to threaten the sustainability of tourism industry. With the persistent application of coping strategies, tourism is found resilient during the ongoing structural political conflict. The strong coping abilities of the private sector of tourism industry have also intersected with peace-building efforts with more reactive and less proactive (pro-peace) engagements. This paper ascertains about the application of the ‘theory of tourism security’ by Nepalese tourism industry while coping with conflict and reviving, and sustaining. It reveals that the multiple verities of tourism at present has heterogeneous degree of peace potentials. The opportunities of ‘peace through tourism’ can be promoted subject to its molding with responsible, sustainable and participatory characteristics. This paper comes out with pragmatic policy recommendations for strengthening the position of tourism as a true peace-builder: (a) a broad shift from mainstream conventional tourism to the community based rural with local participation and ownership to fulfill Nepal’s potentials for peace, and (b) building and applications of the managerial and operational codes of conducts for owners and workers (labor unions) at all tourism enterprises and strengthen their practices.

Keywords: code of conduct, community based tourism, conflict, peace-building, tourism

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Authors: Agodo Mugenyi Herbert

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Background: A high prevalence of both HIV infection and mental disorders exists in Sub-Saharan Africa, however there is little integration of care for mental health disorders among HIV-infected individuals. The study aimed at determining the management of common mental disorders among HIV/AIDS clients attending Antiretroviral clinic in Hoima regional referral hospital. Significancy of the study: The information generated by this study would help mental health advocates, ministry of health, Civil society organizations in HIV programming to advocate for enhanced mental health care for PLWHA. The result will be used in policy development and lobbying for integration of mental health care in HIV/AIDS care. Methods: This study applied a cross sectional design. It involved data collection from clients with HIV/AIDS attending ART clinic in Hoima regional referral hospital at one specific point in time. It aimed at providing data on the entire population under study. Data was collected from Hoima Regional Referral Hospital at the ART clinic. Data analysis was performed using SPSS version 24. Results: 66 HIV/AIDS clients and 10 health workers in the ART clinic who participated fully completed the study. The overall prevalence of at least one form of mental disorder was 83%. Majority of the health care practitioner do not use pharmacological, psychological, and social interventions to manage such disorders. Conclusion: These results are suggestive of a significant proportion of the HIV-infected patients experiencing psychological difficulty for which they do not receive treatment Recommendations: Current care practices applied to patients with HIV/AIDS should be integrated more generally to include treatment services to identify and manage common mental disorders.

Keywords: common mental disorders, mental health, mental illness, and severe mental illness

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Authors: K. Malak, A. Nourah, S.Liyakathunisa

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Nowadays, healthcare services are facing many challenges since they are becoming more complex and more needed. Every detail of a patient’s interactions with health care providers is maintained in Electronic Health Records (ECR) and Healthcare information systems (HIS). However, most of the existing systems are often focused on documenting what happens in manual health care process, rather than providing the highest quality patient care. Healthcare business processes and stakeholders can no longer rely on manual processes, to provide better patient care and efficient utilization of resources, Healthcare processes must be automated wherever it is possible. In this research, a detail survey and analysis is performed on the existing health care systems in Saudi Arabia, and an automated smart medical healthcare business process model is proposed. The business process management methods and rules are followed in discovering, collecting information, analysis, redesign, implementation and performance improvement analysis in terms of time and cost. From the simulation results, it is evident that our proposed smart medical records system can improve the quality of the service by reducing the time and cost and increasing efficiency

Keywords: business process management, electronic health records, efficiency, cost, time

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Authors: Nkrumak Micheal Atta Ofori

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The Vocational System is a decentralized Studies System implemented in Ghana as vocation studies strategy for grassroot that focuses on providing individuals with the specific skills, knowledge, and training necessary for a particular trade, craft, profession, or occupation. This article asks how devolution of vocational studies to local level authorities produces responsive and accountable representation and sustainable vocational learning under the vocational Studies System. It focuses on two case studies: Asokore Mampong and Atwima kwanwoma Municipal. Then, the paper asks how senior high school are developing new material and social practices around the vocational studies System to rebuild their livelihoods and socio-economic wellbeing. Here, the article focusses on Kumasi District, drawing lessons for the two other cases. The article shows how the creation of representative groups under the Vocational Studies System provides the democratic space necessary for effective representation of community aspirations. However, due to elite capture, the interests of privilege few people are promoted. The state vocational training fails to devolve relevant and discretionary resources to local teachers and do not follow the prescribed policy processes of the Vocational Studies System. Hence, local teachers are unable to promote responsive and accountable representation. Rural communities continue to show great interest in the Vocational Studies System, but the interest is bias towards gaining access to vocational training schools for advancing studies. There is no active engagement of the locals in vocational training, and hence, the Vocational Studies System exists only to promote individual interest of communities. This article shows how ‘failed’ interventions can gain popular support for rhetoric and individual gains.

Keywords: vocational studies system, devolution of vocational studies, local-level authorities, senior high schools and vocational learning, community aspirations and representation

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Authors: Vitalijs Lusis, Andrejs Krasnikovs

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Fiber reinforced concrete is important material for load bearing structural elements. Usually fibers are homogeneously distributed in a concrete body having arbitrary spatial orientations. At the same time, in many situations, fiber concrete with oriented fibers is more optimal. Is obvious, that is possible to create constructions with oriented short fibers in them, in different ways. Present research is devoted to one of such approaches- fiber reinforced concrete prisms having dimensions 100 mm×100 mm×400 mm with layers of non-homogeneously distributed fibers inside them were fabricated. Simultaneously prisms with homogeneously dispersed fibers were produced for reference as well. Prisms were tested under four point bending conditions. During the tests vertical deflection at the center of every prism and crack opening were measured (using linear displacements transducers in real timescale). Prediction results were discussed.

Keywords: fiber reinforced concrete, 4-point bending, steel fiber, construction engineering

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Authors: Hsin-Jen Chen

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Primary schooling in Taiwan is in a process of radical restructuring during the decade. At the center of these restructuring is the position of the principal and questions to do with how principals, as school leaders, respond to radical change. Adopting a case-study approach, the study chose a middle Taiwanese primary school to investigate how the principal learned to be political. Using micropolitical leadership, the principal at the researched site successfully coped with internal change and external demands. On the whole, judging from the principal’s leadership style on the mediation between parents and teachers, as well as school-based curriculum development, it could be argued that the principal was on the stance of being a leader of the cultural transformation instead of cultural reproduction. In doing so, the qualitative evidence has indicated that the principal seemed to be successful in coping with the demands of rapid change. Continuing learning for leadership is the core of working as a principal.

Keywords: micropolitics, leadership, micropolitical leadership, learning for leadership

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Authors: Juhi Sah

Abstract:

Habitat is characterized by the inter-dependency of environmental elements. Anthropocentric development approach is increasing our vulnerability towards natural hazards. Hence, manmade interventions should have a higher level of sensitivity towards the natural settings. Sensitivity towards the environment can be assessed by the behavior of the stakeholders involved. This led to the establishment of a hypothesis: there exists a legitimate relationship between the behavioral sciences, land use evolution and environment conservation, in the planning process. An attempt has been made to establish this relationship by reviewing the existing set of knowledge and case examples pertaining to the three disciplines under inquiry. Understanding the scarce & deteriorating nature of fresh-water reserves of earth and experimenting the above concept, a case study of a growing urban center's river flood plain is selected, in a developing economy, India. Cases of urban flooding in Chennai, Delhi and other mega cities of India, imposes a high risk on the unauthorized settlement, on the floodplains of the rivers. The issue addressed here is the encroachment of floodplains, through psychological enlightenment and modification through knowledge building. The reaction of an individual or society can be compared to a cognitive process. This study documents all the stakeholders' behavior and perception for their immediate natural environment (water body), and produce various land uses suitable along a river in an urban settlement as per different stakeholder's perceptions. To assess and induce morally responsible behavior in a community (small scale or large scale), tools of psychological inquiry is used for qualitative analysis. The analysis will deal with varied data sets from two sectors namely: River and its geology, Land use planning and regulation. Identification of a distinctive pattern in the built up growth, river ecology degradation, and human behavior, by handling large quantum of data from the diverse sector and comments on the availability of relevant data and its implications, has been done. Along the whole river stretch, condition and usage of its bank vary, hence stakeholder specific survey questionnaires have been prepared to accurately map the responses and habits of the rational inhabitants. A conceptual framework has been designed to move forward with the empirical analysis. The classical principle of virtues says "virtue of a human depends on its character" but another concept defines that the behavior or response is a derivative of situations and to bring about a behavioral change one needs to introduce a disruption in the situation/environment. Owing to the present trends, blindly following the results of data analytics and using it to construct policy, is not proving to be in favor of planned development and natural resource conservation. Thus behavioral assessment of the rational inhabitants of the planet is also required, as their activities and interests have a large impact on the earth's pre-set systems and its sustenance.

Keywords: behavioral assessment, flood plain encroachment, land use planning, river sustenance

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Authors: Jung-Ho Moon, Myung-Gon Yoon, Tae Kwon Ha

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This paper presents a wireless sensor network protocol for a car parking monitoring system. A wireless sensor network for the purpose is composed of multiple sensor nodes, a sink node, a gateway, and a server. Each of the sensor nodes is equipped with a 3-axis AMR sensor and deployed in the center of a parking space. The sensor node reads its sensor values periodically and transmits the data to the sink node if the current and immediate past sensor values show a difference exceeding a threshold value. The operations of the sink and sensor nodes are described in detail along with flow diagrams. The protocol allows a low-duty cycle operation of the sensor nodes and a flexible adjustment of the threshold value used by the sensor nodes.

Keywords: car parking monitoring, sensor node, wireless sensor network, network protocol

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Authors: Areej Al-Hamad, Cheryl Forchuk, Abe Oudshoorn, Gerald Patrick Mckinley

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Syrian refugee women face many obstacles when accessing health services in host countries that are influenced by various cultural, structural, and practical factors. This paper is based on critical ethnographic research undertaken in Canada to explore Syrian refugee women's migration experiences. Also, we aim to critically examine how the intersection of gender, trauma, violence and the political and economic conditions of Syrian refugee women shapes their everyday lives and health. The study also investigates the strategies and practices by which Syrian refugee women are currently addressing their healthcare needs and the models of care that are suggested for meeting their physical and mental health needs. Findings show that these women experienced constant worries, hardship, vulnerability, and intrusion of dignity. These experiences and challenges were aggravated by the structure of the Canadian social and health care system. This study offers a better understanding of the impact of migration and trauma on Syrian refugee women's roles, responsibilities, gender dynamics, and interaction with Ontario's healthcare system to improve interaction and outcomes. Health care models should address these challenges among Syrian refugee families in Canada.

Keywords: Syrian refugee women, intersectionality, critical ethnography, migration

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Authors: T. Theodosiou, P. Polychronidou, A. G. Karasavvoglou

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The latest years the number of immigrants at Greece has increased dramatically. Their impact on the National Health System (NHS) has not been yet thoroughly investigated. This paper analyses the cost of immigrants to the NHS hospitals of the region of Eastern Macedonia and Thrace. The data are collected from 2005 to 2011 from five different hospitals and are analysed using linear mixed effects models in order to investigate the effects of nationality and year on the cost of hospitalization and treatment. The results show that generally the Greek nationality patients have a higher mean cost of hospitalization compared to the immigrants and that there is an increasing trend for the cost except for the year 2010.

Keywords: cost, Eastern Macedonia and Thrace, immigrants, national health system

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Authors: Frieda Eivazi, Nikita L. Mullings

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Soils are recipient for surfactants in herbicide formulations. Surfactants entering the soil environment can possibly disrupt different chemical, physical and biological interactions. Therefore, it is critical that we understand the fate, behavior and transport of surfactants upon entering the soil. A comprehensive study was conducted to examine effect of surfactants on nutrient uptake, microbial community, and enzyme activity. The research was conducted in the greenhouse growing corn (Zea mays) as a test plant in a factorial experiment (three surfactants at two different rates with control, and three herbicides) organized as randomized blocked design. Surfactants evaluated were Activator 90, Agri-Dex, and Thrust; herbicides were glyphosate, atrazine, and bentazon. Treatments examined were surfactant only, herbicide only, and surfactant + herbicide combinations. Corn was planted in fertilized soils (silt loam and silty clay) with moisture content maintained at the field capacity for optimum growth. This paper will report results of above mentioned treatments on acid phosphatase, beta-glucosidase, arylsulfatase, beta-glucosaminidase, and dehydrogenase activities. In general, there were variations in the enzyme activities with some inhibition and some being enhanced by the treatments. Activator 90 appeared to have the highest inhibitory effect on enzymatic activities. Atrazine application significantly decreased the activities of acid phosphatase, beta-glucosidase, and dehydrogenase in both soils; however, combination of Atrazine + Agridex increased the acid phosphatase activity while significantly inhibiting the other enzyme activities in soils. It was concluded that long-term field studies are needed to validate changes in nutrient uptake, microbial community and enzyme activities due to surfactant-herbicide combination effects.

Keywords: herbicides, nutrient cycling, soil enzymes, surfactant

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Authors: Wandera Stephen Ojumbo

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People living with hearing impairment in Uganda are one of the most excluded minority groups in the country. The Uganda National Association of the Deaf estimates that deaf people make up 3.4% of Uganda’s 43 million people. Deaf Children and youth often appear withdrawn because they face social stigma. In 2009, photojournalist Stephen Wandera Ojumbo conducted an exhibition in Kampala titled “Silent Voices with colourful Hearts” showcasing the life of deaf children at Uganda School for the Deaf, Ntinda, in order to create awareness of their plight, raising funds for the construction of a vocational centre for the deaf that didn’t continue their education due to: lack of funds, non-inclusive educational institutions, and for those who cannot read and write. These children, whose lives were exhibited in 2009, are currently youths. In Uganda, there are just five primary schools for the deaf (three of these are located in Kampala, the capital city), and barely five secondary schools for the deaf. At the moment, some deaf children only receive special needs training equivalent to primary seven levels and the majority don’t make it to secondary school education level due to the fact that English is a second language to them. There is a communication gap between speaking parents and deaf children, which leads to the breakage of family bonds. The deaf youth run away from their homes to form a community where they can communicate freely. Likewise, employment opportunities for the deaf are equally very limited. It’s for this reason that a follow-up photo exhibition was conducted to expose more about what the youthful deaf people and their guardians go through in Uganda to get jobs, live and fit in the community, how they communicate and get understood, bonding with families instead of running away to bond with fellow deaf persons. The photo exhibition under the theme “Loud Silence” was significant in showcasing the ability of deaf youths in Uganda and eliciting solutions to make a more inclusive society for the deaf. It is hoped that partners in development will join in for intervention. The methodology used included individual interviews with the deaf youth and their parents and caretakers; photography at household and community levels; document review at organizations working with the deaf; observations; and key informant interviews with relevant personnel working with the deaf. Some of the major findings include: i) Effective sign language communication is key in deaf education, family bonding, and developing a sense of belonging; ii) Love and intimacy can keep the deaf bound together; iii) Education is important; everybody should struggle even if alone; iv) Games and sports are a unifying factor and most loved among the deaf; and v) better communication skills build confidence in deaf youth. In conclusion, concerted efforts are still needed to make Uganda schools more inclusive for deaf persons. This will enable a secure future for deaf youths.

Keywords: deaf, education, excluded, photo exhibition

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Authors: Nilgün Katrancı, Pınar Göv

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The privatization of public services has intensified and extended the delivery of healthcare services at hospitals, which leads to an increase in health and safety risks for healthcare professionals. More efficient and effective delivery of healthcare services can be realized through the provision of occupational safety of healthcare professionals. However, healthcare professionals are exposed to more dangers, accidents, and diseases because of such reasons as present working conditions, hospital infections, lack of ergonomic design, medication, wastes, excessive work load, negligent attitudes of workers, violence, psychological risks, etc. Unsafe working conditions cause fear, injury and wearing impacts in healthcare professionals in many countries. Thus, it is emphasized that the protection of the health of healthcare professionals is important to have educated, healthy workers and adequate workforce. Occupational health and safety measures applied in health facilities are aimed at protecting workers and providing the safety of services and facilities. All activities to be undertaken at hospitals with regard to occupational safety in accordance with these goals will help to reduce costs and provide continuous services. At the same time, a safe working environment will increase worker satisfaction and motivation, sense of institutional belonging and indirectly patient safety and satisfaction. In addition, the control and correction of occupational safety activities are also as important as the implementation. Occupational health and safety practices in the facilities will also lead to positive developments for national economy and society. This study emphasizes that approaching occupational safety practices for healthcare professionals in a sensitive manner is important for enabling healthcare professionals to do more productive works in terms of physical, social and psychological aspects, maintaining the continuity of healthcare services and social and economic contributions.

Keywords: health facilities, healthcare professional, occupational health, occupational safety

Procedia PDF Downloads 385