Search results for: children of migratory families
797 Antibiogram Profile of Antibacterial Multidrug Resistance in Democratic Republic of Congo: Situation in Bukavu City Hospitals
Authors: Justin Ntokamunda Kadima, Christian Ahadi Irenge, Patient Birindwa Mulashe, Félicien Mushagalusa Kasali, Patient Wimba
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Background: Bacterial strains carrying multidrug resistance traits are gaining ground worldwide, especially in countries with limited resources. This study aimed to evaluate the spreading of multidrug-resistant bacteria strains in Bukavu city hospitals in the Democratic Republic of Congo. Methods: We analyzed 758 antibiogram data recorded in files of patients consulted between January 2016 and December 2017 at three reference hospitals selected as sentinel sites, namely the Panzi General Reference Hospital (HGP), BIO -PHARM hospital (HBP), and Saint Luc Clinic (CSL). Results: Of 758 isolates tested, the laboratories identified 12 bacterial strains in 712 isolates, of which 223 (29.42%) presented MDR profile, including Escherichia coli (11.48%), Klebsiella pneumonia (6.07%), Enterobacter (5.8%), Staphylococcus aureus and coagulase-negative Staphylococci (1.58%), Proteus mirabilis (1.85%), Salmonella enterica (1.19%), Pseudomonas aeruginosa (0.53%), Streptococcus pneumonia (0.4%)), Citrobacter (0.13%), Neisseria gonorrhea (0.13%), Enterococcus faecalis (0.13%), and Morganella morganii (0.13%). Infected patients were significantly more adults (73.1% vs. 21.5%) compared to children and mainly women (63.7% vs. 30.9%; p = 0.001). Conclusion: The observed expansion requires that hospital therapeutic committees set up an effective clinical management system and define the right combinations of antibiotics.Keywords: multidrug resistance, bacteria, antibiogram, Bukavu
Procedia PDF Downloads 89796 The Effects of Human Activities on Plant Diversity in Tropical Wetlands of Lake Tana (Ethiopia)
Authors: Abrehet Kahsay Mehari
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Aquatic plants provide the physical structure of wetlands and increase their habitat complexity and heterogeneity, and as such, have a profound influence on other biotas. In this study, we investigated how human disturbance activities influenced the species richness and community composition of aquatic plants in the wetlands of Lake Tana, Ethiopia. Twelve wetlands were selected: four lacustrine, four river mouths, and four riverine papyrus swamps. Data on aquatic plants, environmental variables, and human activities were collected during the dry and wet seasons of 2018. A linear mixed effect model and a distance-based Redundancy Analysis (db-RDA) were used to relate aquatic plant species richness and community composition, respectively, to human activities and environmental variables. A total of 113 aquatic plant species, belonging to 38 families, were identified across all wetlands during the dry and wet seasons. Emergent species had the maximum area covered at 73.45 % and attained the highest relative abundance, followed by amphibious and other forms. The mean taxonomic richness of aquatic plants was significantly lower in wetlands with high overall human disturbance scores compared to wetlands with low overall human disturbance scores. Moreover, taxonomic richness showed a negative correlation with livestock grazing, tree plantation, and sand mining. The community composition also varied across wetlands with varying levels of human disturbance and was primarily driven by turnover (i.e., replacement of species) rather than nestedness resultant(i.e., loss of species). Distance-based redundancy analysis revealed that livestock grazing, tree plantation, sand mining, waste dumping, and crop cultivation were significant predictors of variation in aquatic plant communities’ composition in the wetlands. Linear mixed effect models and distance-based redundancy analysis also revealed that water depth, turbidity, conductivity, pH, sediment depth, and temperature were important drivers of variations in aquatic plant species richness and community composition. Papyrus swamps had the highest species richness and supported different plant communities. Conservation efforts should therefore focus on these habitats and measures should be taken to restore the highly disturbed and species poor wetlands near the river mouths.Keywords: species richness, community composition, aquatic plants, wetlands, Lake Tana, human disturbance activities
Procedia PDF Downloads 133795 Vulnerability of the Rural Self-Constructed Housing with Social Programs and His Economic Impact in the South-East of Mexico
Authors: Castillo-Acevedo J, Mena-Rivero R, Silva-Poot H
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In Mexico, as largely of the developing countries, the rural housing is a study object, since the diversity of constructive idiosyncrasies for locality, involves various factors that make it vulnerable; an important aspect of study is the progressive deterioration that is seen in the rural housing. Various social programs, contribute financial resources in the field of housing to provide support for families living in rural areas, however, they do not provide a coordination with the self-construction that is usually the way in which is built in these areas. The present study, exposes the physical situation and an economic assessment that presents the rural self-constructed housing in three rural communities in the south of the state of Quintana Roo, Mexico, which were built with funding from federal social programs. The information compilation was carried out in a period of seven months in which there was used the intentional sampling of typical cases, where the object study was the housing constructed with supports of the program “Rural Housing” between the year 2009 and 2014. Instruments were used as the interview, ballot papers of observation, ballot papers of technical verification and various measuring equipment laboratory for the classification of pathologies; for the determination of some pathologies constructive Mexican standards were applied how NMX-C-192-ONNCCE, NMX-C-111-ONNCCE, NMX-C-404-ONNCCE and finally used the software of Opus CMS ® with the help of tables of the National Consumer Price Index (CPI) for update of costs and wages according to the line of being applied in Mexico, were used for an economic valuation. The results show 11 different constructive pathologies and exposes greater presence with the 22.50% to the segregation of the concrete; the economic assessment shows that 80% of self-constructed housing, exceed the cost of construction it would have compared to a similar dwelling built by a construction company; It is also exposed to the 46.10% of the universe of study represent economic losses in materials to the social activities by houses not built. The system of self-construction used by the social programs, affect to some extent the program objectives applied in underserved areas, as implicit and additional costs affect the economic capacity of beneficiaries who invest time and effort in an activity that are not specialists, which this research provides foundations for sustainable alternatives or possibly eliminate the practice of self-construction of implemented social programs in marginalized rural communities in the south of state of Quintana Roo, Mexico.Keywords: economic valuation, pathologies constructive, rural housing, social programs
Procedia PDF Downloads 533794 Image Making: The Spectacle of Photography and Text in Obituary Programs as Contemporary Practice of Social Visibility in Southern Nigeria
Authors: Soiduate Ogoye-Atanga
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During funeral ceremonies, it has become common for attendees to jostle for burial programs in some southern Nigerian towns. Beginning from ordinary typewritten text only sheets of paper in the 1980s to their current digitally formatted multicolor magazine style, burial programs continue to be collected and kept in homes where they remain as archival documents of family photo histories and as a veritable form of leveraging family status and visibility in a social economy through the inclusion of lots of choreographically arranged photographs and text. The biographical texts speak of idealized and often lofty and aestheticized accomplishments of deceased peoples, which are often corroborated by an accompanying section of tributes from first the immediate family members, and then from affiliations as well as organizations deceased people belonged, in the form of scanned letterheaded corporate tributes. Others speak of modest biographical texts when the deceased accomplished little. Usually, in majority of the cases, the display of photographs and text in these programs follow a trajectory of historical compartmentalization of the deceased, beginning from parentage to the period of youth, occupation, retirement, and old age as the case may be, which usually drives from black and white historical photographs to the color photography of today. This compartmentalization follows varied models but is designed to show the deceased in varying activities during his lifetime. The production of these programs ranges from the extremely expensive and luscious full colors of near fifty-eighty pages to bland and very simplified low-quality few-page editions in a single color and no photographs, except on the cover. Cost and quality, therefore, become determinants of varying family status and social visibility. By a critical selection of photographs and text, family members construct an idealized image of deceased people and themselves, concentrating on mutuality based on appropriate sartorial selections, socioeconomic grade, and social temperaments that are framed to corroborate the public’s perception of them. Burial magazines, therefore, serve purposes beyond their primary use; they symbolize an orchestrated social site for image-making and the validation of the social status of families, shaped by prior family histories.Keywords: biographical texts, burial programs, compartmentalization, magazine, multicolor, photo-histories, social status
Procedia PDF Downloads 193793 Interpretation of the Russia-Ukraine 2022 War via N-Gram Analysis
Authors: Elcin Timur Cakmak, Ayse Oguzlar
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This study presents the results of the tweets sent by Twitter users on social media about the Russia-Ukraine war by bigram and trigram methods. On February 24, 2022, Russian President Vladimir Putin declared a military operation against Ukraine, and all eyes were turned to this war. Many people living in Russia and Ukraine reacted to this war and protested and also expressed their deep concern about this war as they felt the safety of their families and their futures were at stake. Most people, especially those living in Russia and Ukraine, express their views on the war in different ways. The most popular way to do this is through social media. Many people prefer to convey their feelings using Twitter, one of the most frequently used social media tools. Since the beginning of the war, it is seen that there have been thousands of tweets about the war from many countries of the world on Twitter. These tweets accumulated in data sources are extracted using various codes for analysis through Twitter API and analysed by Python programming language. The aim of the study is to find the word sequences in these tweets by the n-gram method, which is known for its widespread use in computational linguistics and natural language processing. The tweet language used in the study is English. The data set consists of the data obtained from Twitter between February 24, 2022, and April 24, 2022. The tweets obtained from Twitter using the #ukraine, #russia, #war, #putin, #zelensky hashtags together were captured as raw data, and the remaining tweets were included in the analysis stage after they were cleaned through the preprocessing stage. In the data analysis part, the sentiments are found to present what people send as a message about the war on Twitter. Regarding this, negative messages make up the majority of all the tweets as a ratio of %63,6. Furthermore, the most frequently used bigram and trigram word groups are found. Regarding the results, the most frequently used word groups are “he, is”, “I, do”, “I, am” for bigrams. Also, the most frequently used word groups are “I, do, not”, “I, am, not”, “I, can, not” for trigrams. In the machine learning phase, the accuracy of classifications is measured by Classification and Regression Trees (CART) and Naïve Bayes (NB) algorithms. The algorithms are used separately for bigrams and trigrams. We gained the highest accuracy and F-measure values by the NB algorithm and the highest precision and recall values by the CART algorithm for bigrams. On the other hand, the highest values for accuracy, precision, and F-measure values are achieved by the CART algorithm, and the highest value for the recall is gained by NB for trigrams.Keywords: classification algorithms, machine learning, sentiment analysis, Twitter
Procedia PDF Downloads 78792 The Collaborative Advocacy Work of Language Teachers
Authors: Sora Suh, Catherine Michener
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This paper examines the collaborative forms of advocacy that a group of four public school teachers took for their emergent bilingual students in one public school district. While teacher advocacy takes many forms in and out of the classroom, much advocacy work is done by individuals and less by collective action. As a result, individual teachers risk isolation or marginalization in their school contexts when they advocate for immigrant youth. This paper is intended to contribute to the documentation and understanding of teachers’ advocacy work as a collaborative act in teacher education research. The increase of ELs in US classrooms and a corresponding lack of teacher preparation to meet the needs of ELs has motivated the training of educators in linguistically responsive education (e.g., ESL, sheltered English instruction [SEI], bilingual education). Drawing from educational theories of linguistically responsive teaching for preparing educators, we trace the linguistically responsive advocacy work of the teachers. The paper is a multiple case study that tracks how teachers’ discussions on advocacy during a teacher preparation program leading to collaborative actions in their daily teaching lives in and out of school. Data collected includes online discussion forums on the topic of advocacy, course assignments on the topic of advocacy, video-audio recordings of classroom teaching observations, and video-audio recordings of individual and focus group interviews. The findings demonstrate that the teachers’ understanding of advocacy developed through collaborative partnerships formed in the teacher preparation program and grew into active forms of collaborative advocacy in their teaching practice in and out of school. The teachers formed multi-level and collaborative partnerships with teachers, families, community members, policymakers from the local government, and educational researchers to advocate for their emergent bilingual students by planning advocacy events such as new family orientations for emergent bilinguals, professional development for general education teachers on the topic of linguistically responsive instruction, and family nights hosted by the district. The paper’s findings present types of advocacy work in which teachers engage (pedagogical, curricular, out-of-school work) and provide evidence of collaborative advocacy work by a group of engaged educators. The paper highlights the increased agency and effective advocacy of teachers through teacher education and collaborative partnerships and suggests a need for more research on collaborative forms of teacher advocacy for emergent bilinguals.Keywords: language education, teacher advocacy, language instruction, teacher education
Procedia PDF Downloads 118791 Bullying with Neurodiverse Students and Education Policy Reform
Authors: Fharia Tilat Loba
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Studies show that there is a certain group of students who are more vulnerable to bullying due to their physical appearance, disability, sexual preference, race, and lack of social and behavioral skills. Students with autism spectrum disorders (ASD) are one of the most vulnerable groups among these at-risk groups. Researchers suggest that focusing on vulnerable groups of students who can be the target of bullying helps to understand the causes and patterns of aggression, which ultimately helps in structuring intervention programs to reduce bullying. Since Australia ratified the United Nations Convention on the Rights of Persons with Disabilities in 2006, it has been committed to providing an inclusive, safe, and effective learning environment for all children. In addition, the 2005 Disability Standards for Education seeks to ensure that students with disabilities can access and participate in education on the same basis as other students, covering all aspects of education, including harassment and victimization. However, bullying hinders students’ ability to fully participate in schooling. The proposed study aims to synthesize the notions of traditional bullying and cyberbullying and attempts to understand the experiences of students with ASD who are experiencing bullying in their schools. The proposed study will primarily focus on identifying the gaps between policy and practice related to bullying, and it will also attempt to understand the experiences of parents of students with ASD and professionals who have experience dealing with bullying at the school level in Australia. This study is expected to contribute to the theoretical knowledge of the bullying phenomenon and provide a reference for advocacy at the school, organization, and government levels.Keywords: education policy, bullying, Australia, neurodiversity
Procedia PDF Downloads 59790 Immunoinformatic Design and Evaluation of an Epitope-Based Tetravalent Vaccine against Human Hand, Foot, and Mouth Disease
Authors: Aliyu Maje Bello, Yaowaluck Maprang Roshorm
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Hand, foot, and mouth disease (HFMD) is a highly contagious viral infection affecting mostly infants and children. Although the Enterovirus A71 (EV71) is usually the major causative agent of HFMD, other enteroviruses such as coxsackievirus A16, A10, and A6 are also found in some of the recent outbreaks. The commercially available vaccines have demonstrated their effectiveness against only EV71 infection but no protection against other enteroviruses. To address the limitation of the monovalent EV71 vaccine, the present study thus designed a tetravalent vaccine against the four major enteroviruses causing HFMD and primarily evaluated the designed vaccine using an immunoinformatics approach. The immunogen was designed to contain the EV71 VP1 protein and multiple reported epitopes from all four distinct enteroviruses and thus designated a tetravalent vaccine. The 3D structure of the designed tetravalent vaccine was modeled, refined, and validated. Epitope screening showed the presence of B-cell, CTL, CD4 T cell, and IFN epitopes with vast application among the Asian population. Docking analysis confirmed the stable and strong binding interactions between the immunogen and immune receptor B-cell receptor (BCR). In silico cloning and immune simulation analyses guaranteed high efficiency and sufficient expression of the vaccine candidate in humans. Overall, the promising results obtained from the in-silico studies of the proposed tetravalent vaccine make it a potential candidate worth further experimental validation.Keywords: enteroviruses, coxsackieviruses, hand foot and mouth disease, immunoinformatics, tetravalent vaccine
Procedia PDF Downloads 75789 Caregiver Experiences of Attachment-Based Interventions
Authors: Mikaela E. Flood, Elaine Greidanus
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This study will examine how caregivers construct and interpret their experience in applying attachment-based interventions, guided by the research question: How do caregivers construct and interpret their experiences when attempting to apply attachment-based interventions in their relationships? Using a constructivist paradigm, this qualitative study aims to explore caregivers' experiences of attachment-based interventions through semi-structured interviews with five individuals. The research aims to uncover how caregivers perceive, implement, and reflect upon attachment-based interventions, focusing on challenges and successes encountered. Thematic analysis of interview data seeks to reveal recurring patterns and themes, offering insights into the practical implications of attachment theory and interventions within caregiver contexts. The findings may impact the field by integrating theoretical insights with practical applications. They may also inform therapeutic approaches and support services, as well as how attachment-based interventions are implemented, thereby enhancing caregivers' capacity to foster secure attachments. Moreover, this research may inform existing bodies of knowledge by providing empirical support and a deeper understanding of attachment theory's application in real-world caregiving scenarios. In terms of future research, this study may identify potential avenues for further exploration of the application and implementation of attachment-based interventions. Ultimately, this research aims to advance both theoretical understanding and practical applications of attachment-based interventions for enhancing relationship dynamics and emotional well-being in caregiving settings.Keywords: children, attachment, intervention, caregiver
Procedia PDF Downloads 18788 A Conceptual Model of Social Entrepreneurial Intention Based on the Social Cognitive Career Theory
Authors: Anh T. P. Tran, Harald Von Korflesch
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Entrepreneurial intention play a major role in entrepreneurship academia and practice. The spectrum ranges from the first model of the so-called Entrepreneurial Event, then the Theory of Planned Behavior, the Theory of Planned Behavior Entrepreneurial Model, and the Social Cognitive Career Theory to some typical empirical studies with more or less diverse results. However, little is known so far about the intentions of entrepreneurs in the social areas of venture creation. It is surprising that, since social entrepreneurship is an emerging field with growing importance. Currently, all around the world, there is a big challenge with a lot of urgent soaring social and environmental problems such as poor households, people with disabilities, HIV/AIDS infected people, the lonely elderly, or neglected children, some of them even actual in the Western countries. In addition, the already existing literature on entrepreneurial intentions demonstrates a high level of theoretical diversity in general, especially the missing link to the social dimension of entrepreneurship. Seeking to fill the mentioned gaps in the social entrepreneurial intentions literature, this paper proposes a conceptual model of social entrepreneurial intentions based on the Social Cognitive Career Theory with two main factors influencing entrepreneurial intentions namely self-efficacy and outcome expectation. Moreover, motives, goals and plans do not arise from empty nothingness, but are shaped by interacting with the environment. Hence, personalities (i.e., agreeableness, conscientiousness, extraversion, neuroticism, openness) as well as contextual factors (e.g., role models, education, and perceived support) are also considered as the antecedents of social entrepreneurship intentions.Keywords: entrepreneurial intention, social cognitive career theory, social entrepreneurial intention, social entrepreneurship
Procedia PDF Downloads 481787 Prevalence and Risk Factors for Postpartum Depression: A Cross-Sectional Study
Authors: Laura Saraf, Katarina Alagić, Karmen Znaor
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Background: One of the most important public health problems affecting the health of the mother and child is postpartum depression. This study aimed to determine the frequency and risk factors that contribute to postpartum depression (PPD). Methods: The research was conducted from November 2022 to April 2023 on a convenient sample of mothers (N=195) who have children up to 6 months of age during home visits by visiting nurses in the Zagreb area or during the breastfeeding support group ‘Vita’. The Edinburgh Postpartum Depression Questionnaire and the Multidimensional Scale of Perceived Social Support were used. Results: Symptoms of PPD of varying intensity were present in 43 (22.05%) participants. It was found that mothers with previous mental disorders and those who are less satisfied with their husband's support have more depressive symptoms than mothers who do not have previous mental disorders and are satisfied with their husband's support. Also, it was found that mothers with depressive symptoms had a lower level of support from significant others, family and friends than mothers without depressive symptoms. Conclusion: The prevalence of postpartum depression (PPD) in the sample was high, and it was shown that the following risk factors influence its occurrence: previous mental disorders, dissatisfaction with emotional support from the husband, and a lower level of social support from significant others, family and friends. It is important to raise awareness of the problem and recognize the symptoms in time to provide adequate psychosocial support to women in labor.Keywords: postpartum depression (PPD), prevalence, emotional support, social support
Procedia PDF Downloads 8786 Oedipus as Victim of Fate and Human Psychology: The Fatal Curiosity
Authors: Soham Das
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Oedipus in Oedipus Rex is necessarily a victim of fate and his own psychology. His curiosity brings about his downfall. Ancient Greek plays weren't just portrayals of some obscure tale but were insights into human nature. Oedipus, although a victim of circumstances, digs his own grave by curiously unravelling his past. Jocasta foresees his doom and begs him to stop, but to no avail. The curiosity of Oedipus forces him, almost like a drug, to explore the mystery regarding his birth. This curiosity is not something extraordinary in Oedipus - it is an intrinsic attribute of human nature. Knowledge is not always desired - whether it is Adam or Oedipus, their curiosity caused their eventual downfall. Oedipus was ill-fated since birth. He did not know that Laius was his biological father and therefore killed him. He arrived at Thebes, solved the riddle of the Sphinx, and married Jocasta without knowing that she, in fact, was his biological mother. He begot children and was living happily with his family when a sudden calamity struck Thebes. The calamity, though at first seemed public in nature, but later proved to be very personal for Oedipus. It drives home the fundamental truth about uncertainty of human life. That Laius was slayed by his own son, even after many precautions, proves the helplessness of humans in front of the designs of fate. Oedipus's mutilation of his eyes is also fated. It was committed by him in the heat of the moment and was certainly not a rational decision. It is evident to any modern reader that Oedipus does not have justice. Destiny treats him unfairly. Oedipus, in fact, defends his actions in Oedipus Rex in its sequel Oedipus At Colonus. The research paper discusses the unhappy fate of Oedipus and the role of destiny and his own curiosity in achieving it.Keywords: ancient Greek drama, Oedipus Rex, Sophocles, destiny
Procedia PDF Downloads 1033785 Toward Sustainable Solutions: Indonesia's Humanitarian Approach to the Rohingya Refugee Crisis
Authors: Hengki
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This study explores Indonesia's approach to addressing the Rohingya refugee crisis, emphasizing its efforts to balance humanitarian principles with national and regional challenges. Employing a qualitative, normative legal analysis, the research integrates data from government reports, ASEAN and UN documents, and prior studies. Indonesia's strategies include facilitating temporary shelter, promoting education for refugee children, and advancing international cooperation through partnerships with United Nations High Commissioner for Refugees (UNHCR) and International Organization for Migration (IOM). While not a signatory to the 1951 Refugee Convention, Indonesia adheres to the principle of non-refoulement and seeks to address the crisis through its Presidential Regulation No. 125/2016, quiet diplomacy, and ASEAN-led initiatives. Despite these efforts, challenges persist, such as limited legal frameworks, coordination barriers between government levels, and slow regional collaboration. The study underscores the urgency of developing sustainable solutions, including revising domestic policies, enhancing ASEAN's collective response, and aligning with international standards. By addressing these challenges, Indonesia can not only uphold refugee rights but also promote regional stability and human rights values. This research contributes to understanding the complexities of refugee management in Indonesia and offers a foundation for future studies aimed at refining policies and strategies.Keywords: rohingya refugees, indonesia, humanitarian aid, international collaboration, refugee law
Procedia PDF Downloads 10784 Need for a National Newborn Screening Programme in India: Pilot Study Data
Authors: Sudheer Moorkoth, Leslie Edward Lewis, Pragna Rao
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Newborn screening (NBS) is a part of routine newborn care in many countries worldwide to detect early any rare treatable conditions and inborn errors of metabolism (IEM). India has not started this program yet. In an attempt to understand the challenges in implementing a national newborn screening program in India, we initiated a pilot newborn screening project funded by the Government of Canada. Along with initiating the newborn screening at Kasturba Hospital, Manipal in South India, for screening six disorders (Congenital Hypothyroidism(CH), Congenital Adrenal Hyperplasia (CAH), Galactosemia, Biotinidase deficiency, Glucose-6-Phosphate Dehydrogenase deficiency (G-6PD) and Phenylketonurea), we also studied the awareness of various stakeholders on the newborn screening. In a period of nine months from August 2017 to March 2018 we could screen 1915 newborns (999 male and 916 female). The result showed that there were seven babies screened positive. This interim result points to an incidence rate of 1 in 270 children for these rare disorders collectively. This includes three confirmed cases of CH, two cases of G-6PD deficiency, and one case each for Galctosemia and CAH. A questionnaire based study to understand the awareness among various stakeholders revealed that there is little awareness among parents, adolescents and anganwadi workers (public health worker). The interim data points to the need for a national newborn screening programme in India. There is also an immediate need to undertake large-scale awareness programme to create knowledge on NBS among the various stakeholders.Keywords: awareness, inborn errors of metabolism (IEM), newborn screening, rare disease
Procedia PDF Downloads 251783 Development of a Symbiotic Milk Chocolate Using Inulin and Bifidobacterium Lactis
Authors: Guity Karim, Valiollah Ayareh
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Probiotic dairy products are those that contain biologically active components that may affect beneficially one or more target functions in the body, beyond their adequate nutritional effects. As far as chocolate milk is a popular dairy product in the country especially among children and youth, production of a symbiotic (probiotic + peribiotic) new product using chocolate milk, Bifidobacterium lactis (DSM, Netherland) and inulin (Bene, Belgium) would help to promote the nutritional and functional properties of this product. Bifidobacterium Lactis is used as a probiotic in a variety of foods, particularly dairy products like yogurt and as a probiotic bacterium has benefit effects on the human health. Inulin as a peribiotic agent is considered as functional food ingredient. Experimental studies have shown its use as bifidogenic agent. Chocolate milk with different percent of fat (1 and 2 percent), 6 % of sugar and 0.9 % cacao was made, sterilized (UHT) and supplemented with Bifidobacterium lactis and inulin (0.5 %) after cooling . A sample was made without inulin as a control. Bifidobacterium lactis population was enumerated at days 0, 4, 8 and 12 together with measurement of pH, acidity and viscosity of the samples. Also sensory property of the product was evaluated by a 15 panel testers. The number of live bacterial cells was maintained at the functional level of 106-108 cfu/ml after keeping for 12 days in refrigerated temperature (4°C). Coliforms were found to be absent in the products during the storage. Chocolate milk containing 1% fat and inulin has the best effect on the survival and number of B. lactis at day 8 and after that. Moreover, the addition of inulin did not affect the sensorial quality of the product. In this work, chocolate has been evaluated as a potential protective carrier for oral delivery of B. lactis and inulin.Keywords: chocolate milk, synbiotic, bifidobacterium lactis, inulin
Procedia PDF Downloads 362782 The Impact of Maternity Leave Reforms: Evidence from Finland
Authors: Claudia Troccoli
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Childbearing constitutes one of the key factors affecting labour market differences between men and women, accounting for almost a quarter of the gender wage gap. Family leave policies, such as maternity, paternity, and parental leave, represent potential key policy tools to address these inequalities, as they can promote mothers' job continuity and career progression. This paper analyses four major reforms implemented in Finland between the 1960s and the early 1980s. It studies the effects of these maternity and parental leave extensions on mothers' short- and long-run labour market outcomes. Eligibility to longer leave was determined on the basis of the child's date of birth. Therefore, estimation of the causal effects of the reforms is possible by exploiting random variation in children's birthdates and comparing the outcomes of mothers giving birth just before and just after the reform cutoff date. Overall, the three maternity leave reforms did not significantly improve mothers' earnings or employment rates. On the contrary, the estimates, although imprecise, seem to indicate negative effects on women's labour market outcomes. The extension of parental leave is, on the other hand, the only reform that improved mothers' short- and long-term labour market outcomes, both in terms of earnings and employment rate. At the same time, fathers appeared to be negatively affected by the reform. These results provide suggestive evidence that shareable parental leave might have more beneficial effects on mothers' job continuity, as it weakens the connotation of childcare as a task reserved for mothers.Keywords: family policies, Finland, maternal labour market outcomes, maternity leave
Procedia PDF Downloads 138781 The Effect of Varying Cone Beam Computed Tomography Image Resolution and Field-of-View Centralization on the Effective Radiation Dose
Authors: Fatima M. Jadu, Asmaa A. Alzahrani, Maha A. Almutairi, Salma O. Al-Amoudi, Mawya A. Khafaji
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Introduction: Estimating the potential radiation risk for a widely used imaging technique such as cone beam CT (CBCT) is crucial. The aim of this study was to examine the effect of varying two CBCT technical factors, the voxel size (VOX) and the Field-of-View (FOV) centralization, on the radiation dose. Methodology: The head and neck slices of a RANDO® man phantom (Alderson Research Laboratories) were used with nanoDot™ OSLD dosimeters to measure the absorbed radiation dose at 25 predetermined sites. Imaging was done using the i-CAT® (Imaging Science International, Hatfield, PA, USA) CBCT unit. The VOX was changed for every three cycles of exposures from 0.2mm to 0.3mm and then 0.4mm. Then the FOV was centered on the maxilla and mandible alternatively while holding all other factors constant. Finally, the effective radiation dose was calculated for each view and voxel setting. Results: The effective radiation dose was greatest when the smallest VOX was chosen. When the FOV was centered on the maxilla, the highest radiation doses were recorded in the eyes and parotid glands. While on the mandible, the highest radiation doses were recorded in the sublingual and submandibular glands. Conclusion: Minor variations in the CBCT exposure factors significantly affect the effective radiation dose and thus the radiation risk to the patient. Therefore, extreme care must be taken when choosing these parameters especially for vulnerable patients such as children.Keywords: CBCT, cone beam CT, effective dose, field of view, mandible, maxilla, resolution, voxel
Procedia PDF Downloads 265780 Care at the Intersection of Biomedicine and Traditional Chinese Medicine: Narratives of Integration, Negotiation, and Provision
Authors: Jessica Ding
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The field of global health is currently advocating for a resurgence in the use of traditional medicines to improve people-centered care. Healthcare policies are rapidly changing in response; in China, the increasing presence of TCM in the same spaces as biomedicine has led to a new term: integrative medicine. However, the existence of TCM as a part of integrative medicine creates a pressing paradoxical tension where TCM is both seen as a marginalized system within ‘modern’ hospitals and as a modality worth integrating. Additionally, the impact of such shifts has not been fully explored: the World Health Organization for one focuses only on three angles —practices, products, and practitioners— with regards to traditional medicines. Through ten weeks of fieldwork conducted at an urban hospital in Shanghai, China, this research expands the perspective of existing strategies by looking at integrative care through a fourth lens: patients and families. The understanding of self-care, health-seeking behavior, and non-professional caregiving structures are critical to grasping the significance of traditional medicine for people-centered care. Indeed, those individual and informal health care expectations align with the very spaces and needs that traditional medicine has filled before such ideas of integration. It specifically looks at this issue via three processes that operationalize experiences of care: (1) how aspects of TCM are valued within integrative medicine, (2) how negotiations of care occur between patients and doctors, and (3) how 'good quality' caregiving presents in integrative clinical spaces. This research hopes to lend insight into how culturally embedded traditions, bureaucratic and institutional rationalities, and social patterns of health-seeking behavior influence care to shape illness experiences at the intersection of two medical modalities. This analysis of patients’ clinical and illness experiences serves to enrich the narratives of integrative medical care’s ability to provide patient-centered care to determine how international policies are realized at the individual level. This anthropological study of the integration of Traditional Chinese medicine in local contexts can reveal the extent to which global strategies, as promoted by the WHO and the Chinese government actually align with the expectations and perspectives of patients receiving care. Ultimately, this ethnographic analysis of a local Chinese context hopes to inform global policies regarding the future use and integration of traditional medicines.Keywords: emergent systems, global health, integrative medicine, traditional Chinese medicine, TCM
Procedia PDF Downloads 146779 Explaining the Steps of Designing and Calculating the Content Validity Ratio Index of the Screening Checklist of Preschool Students (5 to 7 Years Old) Exposed to Learning Difficulties
Authors: Sajed Yaghoubnezhad, Sedygheh Rezai
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Background and Aim: Since currently in Iran, students with learning disabilities are identified after entering school, and with the approach to the gap between IQ and academic achievement, the purpose of this study is to design and calculate the content validity of the pre-school screening checklist (5-7) exposed to learning difficulties. Methods: This research is a fundamental study, and in terms of data collection method, it is quantitative research with a descriptive approach. In order to design this checklist, after reviewing the research background and theoretical foundations, cognitive abilities (visual processing, auditory processing, phonological awareness, executive functions, spatial visual working memory and fine motor skills) are considered the basic variables of school learning. The basic items and worksheets of the screening checklist of pre-school students 5 to 7 years old with learning difficulties were compiled based on the mentioned abilities and were provided to the specialists in order to calculate the content validity ratio index. Results: Based on the results of the table, the validity of the CVR index of the background information checklist is equal to 0.9, and the CVR index of the performance checklist of preschool children (5 to7 years) is equal to 0.78. In general, the CVR index of this checklist is reported to be 0.84. The results of this study provide good evidence for the validity of the pre-school sieve screening checklist (5-7) exposed to learning difficulties.Keywords: checklist, screening, preschoolers, learning difficulties
Procedia PDF Downloads 105778 Pattern and Risk Factors of Menstrual Regulation Service Use among Ever-married Women in Bangladesh: Evidence from a Nationally Representative Cross-sectional Study
Authors: Md. Rashed Aalm, Md. Nuruzzaman Khan, Yothin Sawangdee
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Background: Around 47% of the total pregnancies are unintended in Bangladesh, which lead to several adverse consequences, including maternal and child mortality. Use of menstrual regulation (MR) can help women to reduce unintended pregnancy related adverse consequences. We explored the prevalence and determinants of MR services among ever-married women in Bangladesh. Methods: Total of 14,346 ever-married women data were analysed from the 2017 Bangladesh Demographic and Health Survey. Our study variable was use or non-use of MR services. Individual, household, and community level factors were the explanatory factors. Multilevel mixed-effect Poisson regression model was used to determine the factors associated with MR services in Bangladesh. Results: Nearly 7% of the total women in Bangladesh use MR services. Use of MR services was found higher among women who were aged 20-30 ages (IRR 1.60, 95% CI: 1.17–2.17), who were overweight (IRR 1.43, 95% CI: 1.13–1.81), had at least 1 child (IRR 2.97, 95% CI: 2.34– 3.77) or > 2 children (IRR 3.22, 95% CI: 2.45–4.20), and the birth preceding birth interval was(2 – 4) years (IRR 1.56, 95% CI: 1.13–2.15). Around 1.39 times (95% CI: 1.11–1.73) higher likelihood of MR was found among women whose husbands were engage with business. At the community level, MR service was found lower among the women who resided in the community with higherilliteracy (IRR 0.67, 95% CI: 0.42–0.96) and the Mymensingh division (IRR 0.39, 95% CI: 0.31–0.91). Conclusion: Use of MR service is comparatively low, which indicate a significant proportion of unintended pregnancy continued toward life-birth. This could be responsible for higher adverse maternal and child health outcomes in Bangladesh. Initiatives should be taken to ensure MR services is available when women need this service.Keywords: menstrual regulation, pattern, risk, maternal health, Bangladesh
Procedia PDF Downloads 164777 A Qualitative Study of a Workplace International Employee Health Program
Authors: Jennifer Bradley
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With opportunities to live and work abroad on the rise, effective preparation and support for international employees needs to be addressed within the work-site. International employees must build new habits, routines and social networks in an unfamiliar culture. Culture shock typically occurs within the first year and can affect both physical and psychological health. Employers have the opportunity to support staff through the adaptation process and foster healthy habits and routines. Cross-cultural training that includes a combination of instructional teaching, cultural experiences, and practice, is shown to increase the international employee adaptation process. However, little evidence demonstrates that organizations provide all of these aspects for international employees. The occupational therapy practitioner (OTP) offers a unique perspective focusing on the employee transactional relationship and engagement of meaningful occupations to enhance and enable participation in roles, habits and routines within new cultural contexts. This paper examines one such program developed and implemented by an OTP at the New England Center for Children, in Abu Dhabi, United Arab Emirates. The effectiveness of the program was assessed via participant feedback and concluded that an international employee support program that focuses on a variety of meaningful experiences and knowledge can empower employees to navigate healthy practices, develop habits and routines, and foster positive inter-cultural relationships in the organization and community.Keywords: occupational therapy practitioner, cross cultural training, international employee health, international employee support
Procedia PDF Downloads 162776 The Relevance of the U-Shaped Learning Model to the Acquisition of the Difference between C'est and Il Est in the English Learners of French Context
Authors: Pooja Booluck
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A U-shaped learning curve entails a three-step process: a good performance followed by a bad performance followed by a good performance again. U-shaped curves have been observed not only in language acquisition but also in various fields such as temperature face recognition object permanence to name a few. Building on previous studies of the curve child language acquisition and Second Language Acquisition this empirical study seeks to investigate the relevance of the U-shaped learning model to the acquisition of the difference between cest and il est in the English Learners of French context. The present study was developed to assess whether older learners of French in the ELF context follow the same acquisition pattern. The empirical study was conducted on 15 English learners of French which lasted six weeks. Compositions and questionnaires were collected from each subject at three time intervals (after one week after three weeks after six weeks) after which students work were graded as being either correct or incorrect. The data indicates that there is evidence of a U-shaped learning curve in the acquisition of cest and il est and students did follow the same acquisition pattern as children in regards to rote-learned terms and subject clitics. This paper also discusses the need to introduce modules on U-shaped learning curve in teaching curriculum as many teachers are unaware of the trajectory learners undertake while acquiring core components in grammar. In addition this study also addresses the need to conduct more research on the acquisition of rote-learned terms and subject clitics in SLA.Keywords: child language acquisition, rote-learning, subject clitics, u-shaped learning model
Procedia PDF Downloads 295775 Clinical Characteristics and Antibiotic Resistance of Mycoplasma Pneumoniae Pneumonia in Gyeongnam, Korea in 2024
Authors: Sun Hyoung Park
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A total of 151 children admitted to a secondary hospital in Gyeongnam, South Korea, with respiratory infection caused by M. pneumoniae from January to November 2024 participated in this study. Of the 151 patients, 52% were boys, and the median age was 13.2 years (interquartile range: 7.8 – 15.6 years). The average duration of fever before hospitalization was 4.7 days ((interquartile range: 3.5 - 6.4 days). M. pneumoniae infection was confirmed through ELISA with a more than 4-fold increase in M. pneumoniae antibody values compared to the 5-day interval. Antibiotic resistance was measured by whether clinical improvement occurred after taking macrolide (roxithromycin) for 3 days. Of the 39 patients showing antibiotic resistance, 37 patients were administered doxycycline for 14 days, and 2 patients developed vomiting and rashes after taking doxycycline, so the medication was changed to levofloxacin. The antibiotic-resistance group presented significantly longer febrile days compared to the no-resistance group (P = 0.006). The number of febrile days after macrolide treatment was also longer in antibiotic antibiotic-resistance group than in no resistance group (P = 0.058). Patients who received doxycycline early, within 3 days, improved faster than those who received it later (P=0.008). This study aims to analyze the clinical characteristics and antibiotic resistance of Mycoplasma pneumoniae pneumonia (MP) patients in Gyeongnam, Korea, providing valuable information for the management of patients with MP. Macrolide antibiotic resistance is gradually increasing, and it was found that switching to doxycycline or levofloxacin within 3 days of taking macrolide was helpful for clinical improvement.Keywords: mycoplasma pneumoniae, macrolide, antibiotic resistance, macrolide resistance
Procedia PDF Downloads 6774 Nigeria's Distressed Economy and Achievement of Child-Friendly School Model
Authors: Onyeke Paul Chuks
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Nigeria is ranked among the developing nations and a country with a low income per capita. The consequences of this economic situation have led to the low achievement records below UN benchmark especially in the area of basic education for her citizens. The country is, however, making relentless efforts at arresting the situation by making budgetary allocations to ensure the realization of Millennium Development Goal No. 2 which is achieving universal basic education, her distressed economy notwithstanding. Basic education which comprises primary and lower secondary education as well as pre-primary and/or adult literacy programs have suffered serious setbacks orchestrated by the dwindling of the nation’s economy. This category of education being the bedrock of all other levels of education is regarded as a priority by developing countries and also the focus of the Education for All Movement led by UNESCO. The introduction of child-friendly school model is one of the strategies designed by UNESCO to achieving this all important MDGs goal No. 2. Child-friendly education model is aimed at replacing the out-dated, mundane, regimented and officious school administrative model where the basic rights of school children are trampled upon with impunity and community participation in school activities is viewed as unnecessary interference by school managers. This paper ex-rayed the potential obstacles likely to impinge on the implementation of child-friendly school model in Nigeria especially from the angle of her distressed economy and the colossal effects of the corrupt practices bedeviling the nation. The paper as well outlines prospects for the successful implementation of the child-friendly school model in Nigeria.Keywords: child-friendly school, distressed economy, model, Nigeria
Procedia PDF Downloads 284773 Assessment of the Illustrated Language Activities of the Portage Guide to Early Education
Authors: Ofelia A. Damag
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The study was focused on the development and assessment of the illustrated language activities of the 1996 Edition of the Portage Guide to Early Education. It determined the extent of appropriateness, applicability, time efficiency and aesthetics of the illustrated language activities to be used as instructional material not only by teachers, but parents and caregivers as well. The eclectic research design was applied in this study using qualitative and quantitative methods. To determine the applicability and time efficiency of the study, a try out was done. Since the eclectic research design was used, it made use of a researcher-made survey questionnaire and focus group discussion. Analysis of the data was done through weighted mean and ANOVA. The respondents of the study were representatives of Special Education (SPED) teachers, caregivers and parents of a special-needs child, particularly with difficulties in learning basic language skills. The results of the study show that a large number of respondents are SPED teachers and caregivers and are mostly college graduates. Many of them have earned units towards Master’s studies. Moreover, a majority of the respondents have not attended seminars or in-service training in early intervention for them to be more competent in the area of specialization. It is concluded that the illustrated language activities under review in this study are appropriate, applicable, time efficient and aesthetic for use as a tool in teaching. The recommendations are focused on the advocacy for SPED teachers, caregivers and parents of special-needs children to be more consistent in the implementation of the new instructional materials as an aid in an intervention program.Keywords: illustrated language activities, inclusion, portage guide to early education, special educational needs
Procedia PDF Downloads 163772 Investigating Non-suicidal Self-Injury Discussions on Twitter
Authors: Muhammad Abubakar Alhassan, Diane Pennington
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Social networking sites have become a space for people to discuss public health issues such as non-suicidal self-injury (NSSI). There are thousands of tweets containing self-harm and self-injury hashtags on Twitter. It is difficult to distinguish between different users who participate in self-injury discussions on Twitter and how their opinions change over time. Also, it is challenging to understand the topics surrounding NSSI discussions on Twitter. We retrieved tweets using #selfham and #selfinjury hashtags and investigated those from the United kingdom. We applied inductive coding and grouped tweeters into different categories. This study used the Latent Dirichlet Allocation (LDA) algorithm to infer the optimum number of topics that describes our corpus. Our findings revealed that many of those participating in NSSI discussions are non-professional users as opposed to medical experts and academics. Support organisations, medical teams, and academics were campaigning positively on rais-ing self-injury awareness and recovery. Using LDAvis visualisation technique, we selected the top 20 most relevant terms from each topic and interpreted the topics as; children and youth well-being, self-harm misjudgement, mental health awareness, school and mental health support and, suicide and mental-health issues. More than 50% of these topics were discussed in England compared to Scotland, Wales, Ireland and Northern Ireland. Our findings highlight the advantages of using the Twitter social network in tackling the problem of self-injury through awareness. There is a need to study the potential risks associated with the use of social networks among self-injurers.Keywords: self-harm, non-suicidal self-injury, Twitter, social networks
Procedia PDF Downloads 136771 Teacher Support and Academic Resilience in Vietnam: An Analysis of Low Socio-Economic Status Students in Programme for International Student Assessment 2018
Authors: My Ha, Suwei Lin, Huiying Zou
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This study aimed at investigating the association between teacher support and academic resilience in a developing country. Using the data from PISA 2018 Student Questionnaire and Cognitive Tests, the study provided evidence of the significant impact teacher support had on reading literacy among 15-year-old students from low socio-economic status (SES) homes in Vietnam. From a total of 5773 Vietnamese participants from all backgrounds, a sample of 1765 disadvantaged students was drawn for analysis. As a result, 32 percent of the low SES sample was identified as resilient. Through their response to the PISA items regarding the frequency of support they received from teachers, the result of Latent Class Analysis (LCA) divides children into three subgroups: High Support (74.6%), Fair Support (21.6%), and Low Support (3.8%). The high support group reported the highest proportion of resilient students. Meanwhile, the low support group scored the lowest mean on reading test and had the lowest rate of resilience. Also, as the level of support increases, reading achievement becomes less dependent on socioeconomic status, reflected by the decrease in both the slope and magnitude of their correlation. Logistic regression revealed that 1 unit increase in standardized teacher support would lead to an increase of 29.1 percent in the odds of a student becoming resilient. The study emphasizes the role of supportive teachers in promoting resilience, as well as lowering educational inequity in general.Keywords: academic resilience, disadvantaged students, teacher support, inequity, PISA
Procedia PDF Downloads 94770 The Effect of Dementia on Family Members
Authors: Shakeela Ahmed, Nabanita Hazarika
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The study aims to understand the effects of dementia on family members. The primary objectives of this research are to identify the main reasons for dementia among the elderly, understand the struggles and stigmas faced by the family members, and understand the effects of dementia on family members. The research employs a qualitative method and utilizes unstructured interviews with family members, counselors and caregivers. A descriptive research design is employed, and thematic analysis is used to analyze the data. A total of 17 family members in the age group of 54-69 years were interviewed, along with 2 counselors and 2 caretakers. In understanding dementia, the researcher has reviewed articles, and the studies revealed diverse meanings, symptoms, stages attached to dementia, and the complex interplay of protective and risk factors for dementia. However, in understanding dementia and its effects on families, there is a lack of studies in relation to the significant effects of dementia on family members and their role as primary caregivers. Therefore, an attempt has been made to understand the effects of dementia on family members, along with ways to improve dementia care for family members. The purpose of the study was to understand the effects and challenges of dementia on family members, the psychosocial reasons for dementia among the elderly, and the various struggles and stigmas faced by the family members of dementia patients. The major findings of the study indicate that people with dementia are cared for by family members at home. Dementia has a significant impact on family members. Family member's quality of life is affected; they experience feelings of anxiety, stress, irritation, frustration, and fear as they watch their loved ones struggle with dementia. They also experience financial strain, as dementia care, medication, and therapy are expensive. Another common impact is the role reversal of family members for their loved ones with dementia. There is a lack of awareness and social understanding about dementia, which leads to family members experiencing stigma and struggles. Caregivers are unable to take care of themselves, and many times, the primary caregiver, a spouse who is elderly, experiences acute stress and a physical inability to meet the demands of being a caregiver. Strategies to improve dementia care are understanding dementia, being patient with the person, showing love and care for the person, avoiding provoking the person, distracting them, offering reassurance, playing their favorite music, talking about things they love, going through old memories, following a structured routine, and remaining calm. The study has made an attempt to provide strategies to manage dementia care, understanding the struggles family members go through, and raising awareness about dementia that will enable further research and investigations.Keywords: elderly, dementia, stigma, family members
Procedia PDF Downloads 36769 Elderly Care for Bereaved Parents Following the Death of an Only Child in Mainland China
Authors: Chao Fang
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Due to the Confucian emphasis on filial piety and an undeveloped social welfare system in mainland China, adult children are both socially and legally obliged to care for their parents, including financial assistance and physical care as well as emotional and social support. Thus a family-centred care pattern for elderly people has been firmly established in China. However, because of the nationwide ‘One Child Policy’, over one million parents are excluded from such care because of the death of their only child and, therefore, their primary caregiver. Without their child’s support, these parents must manage the day to day challenges of growing old alone, with little support from society. By overturning established expectations of a ‘good’ elderly life, the loss of an only child may be accompanied by social and self-stigmatization, pushing these bereaved parents to the margin of society and threatening their economic, physical, emotional and social well-being. More importantly, since the One Child Policy was implemented from the late 1970s and early 1980s, the first generation of bereaved or ‘Shidu’ parents has reached an age at which those parents need elderly care. However, their predicament has been largely ignored. This paper reports on a qualitative interview study that found elderly care to be the main concern for Shidu parents’ everyday life. The paper identifies and discusses the concerns these bereaved parents raised about the prospect of having nowhere to turn at a time of increased need for financial, physical, social and emotional support in old age. The paper also identifies how Shidu parents have been coming together in grief and negotiate to make their predicament known to the government and wider society and to re-define their elderly life by rebuilding a sense of ‘family’.Keywords: culture, bereavement, China, elderly care
Procedia PDF Downloads 276768 Impacts of Public Insurance on Health Access and Outcomes: Evidence from India
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
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