Search results for: Universal Health Coverage.
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 10144

Search results for: Universal Health Coverage.

9814 Impact of Increased Radiology Staffing on After-Hours Radiology Reporting Efficiency and Quality

Authors: Peregrine James Dalziel, Philip Vu Tran

Abstract:

Objective / Introduction: Demand for radiology services from Emergency Departments (ED) continues to increase with greater demands placed on radiology staff providing reports for the management of complex cases. Queuing theory indicates that wide variability of process time with the random nature of request arrival increases the probability of significant queues. This can lead to delays in the time-to-availability of radiology reports (TTA-RR) and potentially impaired ED patient flow. In addition, greater “cognitive workload” of greater volume may lead to reduced productivity and increased errors. We sought to quantify the potential ED flow improvements obtainable from increased radiology providers serving 3 public hospitals in Melbourne Australia. We sought to assess the potential productivity gains, quality improvement and the cost-effectiveness of increased labor inputs. Methods & Materials: The Western Health Medical Imaging Department moved from single resident coverage on weekend days 8:30 am-10:30 pm to a limited period of 2 resident coverage 1 pm-6 pm on both weekend days. The TTA-RR for weekend CT scans was calculated from the PACs database for the 8 month period symmetrically around the date of staffing change. A multivariate linear regression model was developed to isolate the improvement in TTA-RR, between the two 4-months periods. Daily and hourly scan volume at the time of each CT scan was calculated to assess the impact of varying department workload. To assess any improvement in report quality/errors a random sample of 200 studies was assessed to compare the average number of clinically significant over-read addendums to reports between the 2 periods. Cost-effectiveness was assessed by comparing the marginal cost of additional staffing against a conservative estimate of the economic benefit of improved ED patient throughput using the Australian national insurance rebate for private ED attendance as a revenue proxy. Results: The primary resident on call and the type of scan accounted for most of the explained variability in time to report availability (R2=0.29). Increasing daily volume and hourly volume was associated with increased TTA-RR (1.5m (p<0.01) and 4.8m (p<0.01) respectively per additional scan ordered within each time frame. Reports were available 25.9 minutes sooner on average in the 4 months post-implementation of double coverage (p<0.01) with additional 23.6 minutes improvement when 2 residents were on-site concomitantly (p<0.01). The aggregate average improvement in TTA-RR was 24.8 hours per weekend day This represents the increased decision-making time available to ED physicians and potential improvement in ED bed utilisation. 5% of reports from the intervention period contained clinically significant addendums vs 7% in the single resident period but this was not statistically significant (p=0.7). The marginal cost was less than the anticipated economic benefit based assuming a 50% capture of improved TTA-RR inpatient disposition and using the lowest available national insurance rebate as a proxy for economic benefit. Conclusion: TTA-RR improved significantly during the period of increased staff availability, both during the specific period of increased staffing and throughout the day. Increased labor utilisation is cost-effective compared with the potential improved productivity for ED cases requiring CT imaging.

Keywords: workflow, quality, administration, CT, staffing

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9813 The Use of STIMULAN Resorbable Antibiotic Beads in Conjunction with Autologous Tissue Transfer to Treat Recalcitrant Infections and Osteomyelitis in Diabetic Foot Wounds

Authors: Hayden R Schott, John M Felder III

Abstract:

Introduction: Chronic lower extremity wounds in the diabetic and vasculopathic populations are associated with a high degree of morbidity.When wounds require more extensive treatment than can be offered by wound care centers, more aggressive solutions involve local tissue transfer and microsurgical free tissue transfer for achieving definitive soft tissue coverage. These procedures of autologous tissue transfer (ATT) offer resilient, soft tissue coverage of limb-threatening wounds and confer promising limb salvage rates. However, chronic osteomyelitis and recalcitrant soft tissue infections are common in severe diabetic foot wounds and serve to significantly complicate ATT procedures. Stimulan is a resorbable calcium sulfate antibiotic carrier. The use of stimulan antibiotic beads to treat chronic osteomyelitis is well established in the orthopedic and plastic surgery literature. In these procedures, the beads are placed beneath the skin flap to directly deliver antibiotics to the infection site. The purpose of this study was to quantify the success of Stimulan antibiotic beads in treating recalcitrant infections in patients with diabetic foot wounds receiving ATT. Methods: A retrospective review of clinical and demographic information was performed on patients who underwent ATT with the placement of Stimulan antibiotic beads for attempted limb salvage from 2018-21. Patients were analyzed for preoperative wound characteristics, demographics, infection recurrence, and adverse outcomes as a result of product use. The primary endpoint was 90 day infection recurrence, with secondary endpoints including 90 day complications. Outcomes were compared using basic statistics and Fisher’s exact tests. Results: In this time span, 14 patients were identified. At the time of surgery, all patients exhibited clinical signs of active infection, including positive cultures and erythema. 57% of patients (n=8) exhibited chronic osteomyelitis prior to surgery, and 71% (n=10) had exposed bone at the wound base. In 57% of patients (n=8), Stimulan beads were placed beneath a free tissue flap and beneath a pedicle tissue flap in 42% of patients (n=6). In all patients, Stimulan beads were only applied once. Recurrent infections were observed in 28% of patients (n=4) at 90 days post-op, and flap nonadherence was observed in 7% (n=1). These were the only Stimulan related complications observed. Ultimately, lower limb salvage was successful in 85% of patients (n=12). Notably, there was no significant association between the preoperative presence of osteomyelitis and recurrent infections. Conclusions: The use of Stimulanantiobiotic beads to treat recalcitrant infections in patients receiving definitive skin coverage of diabetic foot wounds does not appear to demonstrate unnecessary risk. Furthermore, the lack of significance between the preoperative presence of osteomyelitis and recurrent infections indicates the successful use of Stimulan to dampen infection in patients with osteomyelitis, as is consistent with the literature. Further research is needed to identify Stimulan as the significant contributor to infection treatment using future cohort and case control studies with more patients. Nonetheless, the use of Stimulan antibiotic beads in patients with diabetic foot wounds demonstrates successful infection suppression and maintenance of definitive soft tissue coverage.

Keywords: wound care, stimulan antibiotic beads, free tissue transfer, plastic surgery, wound, infection

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9812 Social Networks Global Impact on Protest Movements and Human Rights Activism

Authors: Marcya Burden, Savonna Greer

Abstract:

In the wake of social unrest around the world, protest movements have been captured like never before. As protest movements have evolved, so too have their visibility and sources of coverage. Long gone are the days of print media as our only glimpse into the action surrounding a protest. Now, with social networks such as Facebook, Instagram and Snapchat, we have access to real-time video footage of protest movements and human rights activism that can reach millions of people within seconds. This research paper investigated various social media network platforms’ statistical usage data in the areas of human rights activism and protest movements, paralleling with other past forms of media coverage. This research demonstrates that social networks are extremely important to protest movements and human rights activism. With over 2.9 billion users across social media networks globally, these platforms are the heart of most recent protests and human rights activism. This research shows the paradigm shift from the Selma March of 1965 to the more recent protests of Ferguson in 2014, Ni Una Menos in 2015, and End Sars in 2018. The research findings demonstrate that today, almost anyone may use their social networks to protest movement leaders and human rights activists. From a student to an 80-year-old professor, the possibility of reaching billions of people all over the world is limitless. Findings show that 82% of the world’s internet population is on social networks 1 in every 5 minutes. Over 65% of Americans believe social media highlights important issues. Thus, there is no need to have a formalized group of people or even be known online. A person simply needs to be engaged on their respective social media networks (Facebook, Twitter, Instagram, Snapchat) regarding any cause they are passionate about. Information may be exchanged in real time around the world and a successful protest can begin.

Keywords: activism, protests, human rights, networks

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9811 Sustainable Urban Mobility: Rethinking the Bus Stop Infrastructures of Dhaka South

Authors: Hasnun Wara Khondker, M. Tarek Morad

Abstract:

Bangladesh is one of the most populous countries of the world in terms of density. Dhaka, the capital of Bangladesh currently has a population of approximately 15-16 million of which around 9 million people are accommodated in Dhaka South City Corporation (DSCC) within around 109 square kilometer area. Despite having various urban issues, country is at its pick of economic progress and Dhaka is the core of this economic growth. To ensure the proper economic development and citizens wellbeing, city needs an ingenious, congestion-free public transportation network. Bus stop/bus bay is an essential infrastructure for ensuring efficient public transportation flow within the city along with enhancing accessibility, user comfort, and safety through public amenities. At present, there is no established Mass Rapid Transit or Bus Rapid Transit network within the city and therefore these private owned buses are the only major mode of mass transportation of Dhaka city. DSCC has undertaken a project to re-design several bus stops and bus bays according to the universal standard for better urban mobility and user satisfaction. This paper will analyze the design approach of the bus stop/bay infrastructure within Dhaka South, putting the research lens on sustainable urban mobility with case studies of similar kind of urban context. The paper will also study the design process with setting several parameters, i.e., accessibility, passenger safety, comfort, sustainability, etc. Moreover, this research will recommend a guideline for designing a bus stop based on the analysis of the design methods.

Keywords: bus stop, Dhaka, public transportation, sustainable urban mobility, universal accessibility, user safety

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9810 Health Hazards of Performance Enhancing Drugs

Authors: Austin Oduor Otieno

Abstract:

There is an ingrained belief that the use of performance-enhancing drugs by athletes enable them to perform better. While this has been found to be truth, it also raises ethical and health issues. This paper analyzes the health hazards associated with performance enhancing drugs. It seeks to achieve this through the analysis of different academic journals as well as publications on the relationship between doping in sports and health. It concludes that there are inherent health hazards associated with the use of performance-enhancing drugs as they affect the physical and psychological health and wellbeing of a user (athlete).

Keywords: doping, health hazards, athletes, drugs

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9809 Determining the Sources of Sediment at Different Areas of the Catchment: A Case Study of Welbedacht Reservoir, South Africa

Authors: D. T. Chabalala, J. M. Ndambuki, M. F. Ilunga

Abstract:

Sedimentation includes the processes of erosion, transportation, deposition, and the compaction of sediment. Sedimentation in reservoir results in a decrease in water storage capacity, downstream problems involving aggregation and degradation, blockage of the intake, and change in water quality. A study was conducted in Caledon River catchment in the upstream of Welbedacht Reservoir located in the South Eastern part of Free State province, South Africa. The aim of this research was to investigate and develop a model for an Integrated Catchment Modelling of Sedimentation processes and management for the Welbedacht reservoir. Revised Universal Soil Loss Equation (RUSLE) was applied to determine sources of sediment at different areas of the catchment. The model has been also used to determine the impact of changes from management practice on erosion generation. The results revealed that the main sources of sediment in the watershed are cultivated land (273 ton per hectare), built up and forest (103.3 ton per hectare), and grassland, degraded land, mining and quarry (3.9, 9.8 and 5.3 ton per hectare) respectively. After application of soil conservation practices to developed Revised Universal Soil Loss Equation model, the results revealed that the total average annual soil loss in the catchment decreased by 76% and sediment yield from cultivated land decreased by 75%, while the built up and forest area decreased by 42% and 99% respectively. Thus, results of this study will be used by government departments in order to develop sustainable policies.

Keywords: Welbedacht reservoir, sedimentation, RUSLE, Caledon River

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9808 A Quantitative Study on the Effects of School Development on Character Development

Authors: Merve Gücen

Abstract:

One of the aims of education is to educate individuals who have embraced universal moral principles and transform universal moral principles into moral values. Character education aims to educate behaviors of individuals in their mental activities to transform moral principles into moral values in their lives. As the result of this education, individuals are expected to develop positive character traits and become morally indifferent individuals. What are the characteristics of the factors that influence character education at this stage? How should character education help individuals develop positive character traits? Which methods are more effective? These questions come to mind when studying character education. Our research was developed within the framework of these questions. The aim of our study is to provide the most effective use of the education factor that affects character. In this context, we tried to explain character definition, character development, character education and the factors affecting character education using qualitative research methods. At this stage, character education programs applied in various countries were examined and a character education program consisting of Islamic values was prepared and implemented in an International Imam Hatip High School in Istanbul. Our application was carried out with the collaboration of school and families. Various seminars were organized in the school and participation of families was ensured. In the last phase of our study, we worked with the students and their families on the effectiveness of the events held during the program. In this study, it was found that activities such as storytelling and theater in character education programs were effective in recognizing wrong behaviors in individuals. It was determined that our program had a positive effect on the quality of education. It was seen that applications of this educational program affected the behavior of the employees in the educational institution.

Keywords: character development, family activities, values education, education program

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9807 The Influence of E-Health Education on Professional Practice: A Qualitative Study

Authors: Sisira Edirippulige, Anthony C. Smith, Sumudu Wickramasinghe, Nigel R. Armfield

Abstract:

Background: E-Health is steadily integrating into modern health services, making significant changes in the way health services are traditionally delivered. To work in this new environment, healthcare workers are required to have new knowledge, skills, and competencies specific to e-Health. The aim of this study was to understand the self-reported perceptions of graduates regarding the influence of an e-Health postgraduate program on their professional careers. Methods: All graduates from 2005 to 2015 were surveyed using an online questionnaire that consisted of a mixture of closed and open-ended questions. Results: The number of participants in the study was 32. Response rate was 62%. Graduates thought that the postgraduate e-Health program had an influence on their professional practice. The majority of the participants mentioned that they had worked in the e-Health field since their graduation. Their professional roles mainly involved implementation of e-Health in health service settings and the use of e-Health in clinical practice. Conclusions: While e-Health may be steadily integrating into modern health services, e-Health specific job opportunities are still relatively limited. E-Health workforce development must be given priority.

Keywords: e-health, postgraduate education, clinical practice, curriculum

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9806 Implementing a Structured, yet Flexible Tool for Critical Information Handover

Authors: Racheli Magnezi, Inbal Gazit, Michal Rassin, Joseph Barr, Orna Tal

Abstract:

An effective process for transmitting patient critical information is essential for patient safety and for improving communication among healthcare staff. Previous studies have discussed handover tools such as SBAR (Situation, Background, Assessment, Recommendation) or SOFI (Short Observational Framework for Inspection). Yet, these formats lack flexibility, and require special training. In addition, nurses and physicians have different procedures for handing over information. The objectives of this study were to establish a universal, structured tool for handover, for both physicians and nurses, based on parameters that were defined as ‘important’ and ‘appropriate’ by the medical team, and to implement this tool in various hospital departments, with flexibility for each ward. A questionnaire, based on established procedures and on the literature, was developed to assess attitudes towards the most important information for effective handover between shifts (Cronbach's alpha 0.78). It was distributed to 150 senior physicians and nurses in 62 departments. Among senior medical staff, 12 physicians and 66 nurses responded to the questionnaire (52% response rate). Based on the responses, a handover form suitable for all hospital departments was designed and implemented. Important information for all staff included: Patient demographics (full name and age); Health information (diagnosis or patient complaint, changes in hemodynamic status, new medical treatment or equipment required); and Social Information (suspicion of violence, mental or behavioral changes, and guardianship). Additional information relevant to each unit included treatment provided, laboratory or imaging required, and change in scheduled surgery in surgical departments. ICU required information on background illnesses, Pediatrics required information on diet and food provided and Obstetrics required the number of days after cesarean section. Based on the model described, a flexible tool was developed that enables handover of both common and unique information. In addition, it includes general logistic information that must be transmitted to the next shift, such as planned disruptions in service or operations, staff training, etc. Development of a simple, clear, comprehensive, universal, yet flexible tool designed for all medical staff for transmitting critical information between shifts was challenging. Physicians and nurses found it useful and it was widely implemented. Ongoing research is needed to examine the efficiency of this tool, and whether the enthusiasm that accompanied its initial use is maintained.

Keywords: handover, nurses, hospital, critical information

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9805 A Feminist/Queer Global Bioethics’Perspective on Reproduction: Abortion, MAR and Surrogacy

Authors: Tamara Roma, Emma Capulli

Abstract:

Pregnancy and fertility, in other words, reproduction, has become, in the last half of the century, increasingly and globally controlled, medicalized, and regulated. The reflection proposed starts from the consequences of the inscription of reproduction into the neoliberal economic paradigm. The new biotechnologies developments have raised a new patriarchal justification for State’s control of uterus bodies and a new construction of knowledge about reproductive health. Moral discussion and juridification remove reproduction and non-reproduction from their personal and intimate context and frame them under words like “duties”, “rights”, “family planning”, “demography”, and “population policy”, reinvent them as “States business” and ultimately help to re/confirm a specific construct of fertility, motherhood, and family. Moreover, the interaction between the neoliberal economy and medical biotechnologies brought about a new formulation of the connection between feminine generative potential and value production. The widespread and contemporary debates on Medically Assisted Reproduction (MAR), surrogacy and abortion suggest the need for a “feminist/queer global bioethical discourse” capable of inserting itself into the official bioethical debate characterized by the traditional dichotomy of laic bioethics/Catholic bioethics. The contribution moves from a feminist bioethics perspective on reproductive technologies to introduce a feminist/queer global bioethics point of view on reproductive health. The comparison between reproduction and non-reproduction debates is useful to analyze and demonstrate how restrictive legislations, dichotomic bioethical discussion and medical control confirm and strengthens gender injustice in reproductive life. In fact, MAR, surrogacy, and abortion restrictions stem from a shared social and legal paradigm that depends on traditional gender roles revealing how the stratification of reproduction is based on multiple discrimination along the lines of gender, race, and class. In conclusion, the perspective of feminist/queer global bioethics tries to read the concept of universal reproductive justice, introducing an original point of view on reproductive health access.

Keywords: queer bioethics, reproductive health, reproductive justice, reproductive technologies

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9804 Water Balance in the Forest Basins Essential for the Water Supply in Central America

Authors: Elena Listo Ubeda, Miguel Marchamalo Sacristan

Abstract:

The demand for water doubles every twenty years, at a rate which is twice as fast as the world´s population growth. Despite it´s great importance, water is one of the most degraded natural resources in the world, mainly because of the reduction of natural vegetation coverage, population growth, contamination and changes in the soil use which reduces its capacity to collect water. This situation is especially serious in Central America, as reflected in the Human Development reports. The objective of this project is to assist in the improvement of water production and quality in Central America. In order to do these two watersheds in Costa Rica were selected as experiments: that of the Virilla-Durazno River, located in the extreme north east of the central valley which has an Atlantic influence; and that of the Jabillo River, which flows directly into the Pacific. The Virilla river watershed is located over andisols, and that of the Jabillo River is over alfisols, and both are of great importance for water supply to the Greater Metropolitan Area and the future tourist resorts respectively, as well as for the production of agriculture, livestock and hydroelectricity. The hydrological reaction in different soil-cover complexes, varying from the secondary forest to natural vegetation and degraded pasture, was analyzed according to the evaluation of the properties of the soil, infiltration, soil compaction, as well as the effects of the soil cover complex on erosion, calculated by the C factor of the Revised Universal Soil Loss Equation (RUSLE). A water balance was defined for each watershed, in which the volume of water that enters and leaves were estimated, as well as the evapotranspiration, runoff, and infiltration. Two future scenarios, representing the implementation of reforestation and deforestation plans, were proposed, and were analyzed for the effects of the soil cover complex on the water balance in each case. The results obtained show an increase of the ground water recharge in the humid forest areas, and an extension of the study of the dry areas is proposed since the ground water recharge here is diminishing. These results are of great significance for the planning, design of Payment Schemes for Environmental Services and the improvement of the existing water supply systems. In Central America spatial planning is a priority, as are the watersheds, in order to assess the water resource socially and economically, and securing its availability for the future.

Keywords: Costa Rica, infiltration, soil, water

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9803 Appraising the Evolution of Architecture as the Representation of Material Culture: The Nigerian Digest

Authors: Ikenna Emmanuel Idoko

Abstract:

Evolution and evolutionary processes are phenomena that have come to stay in the fabrics of the universal living, hence expressions such as universal evolution. These evolutions in the universe cut across all facets of human accomplishments, which architecture is a part of. There is a notion in political sciences that politics and the act of politicking are local, meaning that politics and political processes are unique and peculiar to a people, all dependent on their sociocultural makeup. The notion is also applicable in architecture because the architecture of a people is mostly dependent on several factors such as climatic conditions, material availability, socio-cultural beliefs and religious inclinations. Stemming from the cultural dimension, it is of course common knowledge that every society is driven by its own unique culture. The fusion of architecture and culture creates the actual uniqueness which underlines the “archi-cultural” representation of a people’s material culture. This paper is aimed at appraising architectural evolution as it affects the representation of the material culture of a people. For effective systemization of the aim, various spectacular kinds of literature were reviewed, coupled with the visitation and study of existing buildings in Nigeria to properly understand the live peculiarity in the architecture of the selected area. Since architecture needs a lot of pictorial pieces of evidence, pictures and graphical representations were extensively utilized, and channelled to aid a better understanding of the study. Amongst all, an important part of this paper is that it adds to the body of existing knowledge in the Arts and Humanities by speaking extensively to the tenets of cultural representation on buildings. Similarly, the field of architecture, specifically, traditional architecture, would be gaining some extra knowledge owing to the study of some important almost-neglected or forgotten architectural elements of various traditional buildings.

Keywords: evolution, architecture, material, culture

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9802 Multiscale Hub: An Open-Source Framework for Practical Atomistic-To-Continuum Coupling

Authors: Masoud Safdari, Jacob Fish

Abstract:

Despite vast amount of existing theoretical knowledge, the implementation of a universal multiscale modeling, analysis, and simulation software framework remains challenging. Existing multiscale software and solutions are often domain-specific, closed-source and mandate a high-level of experience and skills in both multiscale analysis and programming. Furthermore, tools currently existing for Atomistic-to-Continuum (AtC) multiscaling are developed with the assumptions such as accessibility of high-performance computing facilities to the users. These issues mentioned plus many other challenges have reduced the adoption of multiscale in academia and especially industry. In the current work, we introduce Multiscale Hub (MsHub), an effort towards making AtC more accessible through cloud services. As a joint effort between academia and industry, MsHub provides a universal web-enabled framework for practical multiscaling. Developed on top of universally acclaimed scientific programming language Python, the package currently provides an open-source, comprehensive, easy-to-use framework for AtC coupling. MsHub offers an easy to use interface to prominent molecular dynamics and multiphysics continuum mechanics packages such as LAMMPS and MFEM (a free, lightweight, scalable C++ library for finite element methods). In this work, we first report on the design philosophy of MsHub, challenges identified and issues faced regarding its implementation. MsHub takes the advantage of a comprehensive set of tools and algorithms developed for AtC that can be used for a variety of governing physics. We then briefly report key AtC algorithms implemented in MsHub. Finally, we conclude with a few examples illustrating the capabilities of the package and its future directions.

Keywords: atomistic, continuum, coupling, multiscale

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9801 The Impact of COVID-19 on Women’s Health in Bangladesh

Authors: Dil Ware Alam, Faiza Zebeen, Sumaya Binte Masud

Abstract:

COVID-19) has impacted the whole world, including Bangladesh. The epidemic has reduced access to health care, particularly for women, creating challenges for an increasingly disadvantaged population. Women's health and well-being in Bangladesh are susceptible to a rise in domestic violence and need to be addressed quickly. The planet has been greatly influenced by Coronavirus disease 2019 (COVID-19), and Bangladesh is no difference. The pandemic has resulted in a decline in the availability of health care, notably for women's health problems, leading to an increase in difficulties for an increasingly marginalized group. Maternity care, maternal health programs, medical interventions, nutritional counseling and mental health care, are not discussed, and women's health and well-being in Bangladesh is vulnerable with a spike in domestic violence and needs to be resolved urgently.

Keywords: Covid-19, mental health, reproductive health, Bangladesh

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9800 A Universal Troupe, “Athens Dramatic Company”: Tours and Performances (1887-1935)

Authors: Papazafeiropoulou Olga

Abstract:

The “Athens Dramatic Company” was one of the longest-running and most widely traveled troupes in the history of modern Greek theatre. The theatre company had been established since 1887, and the following: Euthychios Vonaseras, Eleni Kotopoulis, etc., like the founder of the troupe Theodoros Pofantis, referred to the distribution of the works presented in Patras: The price of a crime, The niece of her uncle, Agathopoulos, Amphitryon, The Two Sergeants, Lawyer and Actors, The Crusaders, The Daughter of Pantopolos, He Will Kill Himself, Macbeth, The Two Orphans, The Auction, Pistis Hope and Mercy, Love Attempt, The Crusaders, The lady is in Loutra, Markos Votsaris. In 1921, after peregrinations in Cyprus, Constantinople, Romania, Crete, Thessaloniki, Volos, Smyrna, the “Athens Dramatic Company” toured in Africa, where the Greek communities flourished. In 1923, the collaborations of troupe’s members and the repertoire varied several times, such as in Johannesburg, from where they traveled via Cape Town to Australia, where they presented the works: Dikaioma o Eros, Enochos, Psychokori, Kolokotronis. Atimoi, Voskopoula, Golfo, etc., while they impressed with the tragedy Oedipus Tyrannus, which was watched by Australians. Alongside the “Athens Dramatic Company” was also touring “Vrysoula’s Pantopoulos Troupe” and most of the members of the two troupes went to America, uniting their formation. In 1927, the old leader of “Athens Dramatic Company” (Theodoros Pofantis) decided to re-establish his troupe, but after unpleasant adventures, he passed away. In the year 1934, the Greek Dramatic Troupe of Athens revived with works including: The Man of the Day, A Dying Heart, A Dream Was and Gone, An Inspection, The Two Sergeants, The Mother, the Father-in-Law and the Non-existent Son-in-law, before finally expiring in 1935, after nearly 40 years of historical passage.

Keywords: athens, dramatic, company, universal, troupe

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9799 Levels and Trends of Under-Five Mortality in South Africa from 1998 to 2012

Authors: T. Motsima, K. Zuma, E Rapoo

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Childhood mortality is a key sign of the coverage of child survival interventions, social and economic progressions. Although the level of under-five mortality has been declining, it is still unacceptably high. The primary aim of this paper is to establish and analyse the levels and trends of under-five mortality for the periods 1998, 2003 and 2012 in South Africa. Methods: The data used for analysis came from the 1998 SADHS, the 2003 SADHS and the 2012 SABSSM which collected information on the survival status of children. The Kaplan-Meier estimate of the survival function method was used to determine the probabilities of failure (death) from birth up to 59 months. Results and Conclusion: The overall U5MR declined by 28.2% from 53.1 in 1998 to 38.1 in 2012. The U5MR of male children declined from 59.2 in 1998 to 46.2 in 2003 and dropped further to 41.4 in 2012. The U5MR of children of mothers aged 40 years and older increased from 64.0 in 1998 to 89.0 in 2003 and rose further to 129.9 in 2012. The U5MR of children of mothers with education level of 12 years or more increased from 32.2 in 1998 to 35.2 in 2003 and declined substantially to 17.5 in 2012.

Keywords: demographic and health survey, Kaplan-Meier, levels and trends, under-five mortality

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9798 Dosimetric Comparison of Conventional Optimization Methods with Inverse Planning Simulated Annealing Technique

Authors: Shraddha Srivastava, N. K. Painuly, S. P. Mishra, Navin Singh, Muhsin Punchankandy, Kirti Srivastava, M. L. B. Bhatt

Abstract:

Various optimization methods used in interstitial brachytherapy are based on dwell positions and dwell weights alteration to produce dose distribution based on the implant geometry. Since these optimization schemes are not anatomy based, they could lead to deviations from the desired plan. This study was henceforth carried out to compare anatomy-based Inverse Planning Simulated Annealing (IPSA) optimization technique with graphical and geometrical optimization methods in interstitial high dose rate brachytherapy planning of cervical carcinoma. Six patients with 12 CT data sets of MUPIT implants in HDR brachytherapy of cervical cancer were prospectively studied. HR-CTV and organs at risk (OARs) were contoured in Oncentra treatment planning system (TPS) using GYN GEC-ESTRO guidelines on cervical carcinoma. Three sets of plans were generated for each fraction using IPSA, graphical optimization (GrOPT) and geometrical optimization (GOPT) methods. All patients were treated to a dose of 20 Gy in 2 fractions. The main objective was to cover at least 95% of HR-CTV with 100% of the prescribed dose (V100 ≥ 95% of HR-CTV). IPSA, GrOPT, and GOPT based plans were compared in terms of target coverage, OAR doses, homogeneity index (HI) and conformity index (COIN) using dose-volume histogram (DVH). Target volume coverage (mean V100) was found to be 93.980.87%, 91.341.02% and 85.052.84% for IPSA, GrOPT and GOPT plans respectively. Mean D90 (minimum dose received by 90% of HR-CTV) values for IPSA, GrOPT and GOPT plans were 10.19 ± 1.07 Gy, 10.17 ± 0.12 Gy and 7.99 ± 1.0 Gy respectively, while D100 (minimum dose received by 100% volume of HR-CTV) for IPSA, GrOPT and GOPT plans was 6.55 ± 0.85 Gy, 6.55 ± 0.65 Gy, 4.73 ± 0.14 Gy respectively. IPSA plans resulted in lower doses to the bladder (D₂

Keywords: cervical cancer, HDR brachytherapy, IPSA, MUPIT

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9797 The Impact of Universal Design for Learning Implementation on Teaching Practices for Students with Intellectual Disabilities in the Kingdom of Saudi Arabia

Authors: Adnan Alhazmi

Abstract:

Background: UDL can be understood as a framework that holds the potential to elaborate the alternatives and platforms for the students with intellectual disabilities within general education settings and aims at offering flexible pathways that can support all the students in gaining a mastering over the goals of learning. This system of learning addresses the problem of the variability of the learner by delineating the diverse ways in which the individuals can understand, conceive, express and deal with the information. Goal: The aim of the proposed research is to examine the impact of the implementation of UDL in teaching practices for the students with intellectual disabilities in Saudi Arabian schools. Method: This research has used a combination of quantitative and qualitative designs. Survey questionnaires were used to gather the data for under this analytical descriptive method. The application of the qualitative interpretive approach was applied with the help of the interview to gather a detailed understanding on the aim of the research. For this purpose, the semi-structured interviews were conducted. Thus, the primary data will be gathered with the help of survey and interview to examine the impact of universal design learning implementation on teaching practices for intellectually disabled students in Saudi Arabian schools. The survey was conducted to examine the prevailing teaching practices for the students with intellectual disabilities in Saudi Arabia and evaluate if the teaching experience influences the current practices or not. The surveys were distributed to 50 teachers who teach the students with intellectual disabilities. However, the interviews were conducted to explore barriers of implementing UDL in Saudi Arabia and provide suggested guideline for the implementation of UDL in Saudi Arabia. The interviews, therefore, were with 10 teachers teaching the same subject. Findings: A key findings highlighted in this study revealed that the UDL framework serves as a crucial guide for teachers within inclusive settings to undertake meaningful planning for the individuals with intellectual disabilities so that they are able to access, participate, and grow within the general education curriculum. Other findings of the study highlighted the need to prepare the educators and all faculty members to understand the purpose and need for inclusion, the UDL framework so that better information about academic and social expectations for individuals with intellectual disabilities can be delivered. Conclusion: On the basis of the preliminary study undertaken on the subject of research, it could be suggested that UDL can serve to be an effective support for undertaking a meaningful inclusion of students with intellectual disability (ID) in general educational settings. It holds the potential role of working as an institutional design framework that could be used for designing curriculum for students with intellectual disabilities.

Keywords: intellectual disability, inclusion, universal design for learning, teaching practice

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9796 Teacher Professional Development in Saudi Arabia through the Implementation of Universal Design for Learning

Authors: Majed A. Alsalem

Abstract:

Universal Design for Learning (UDL) is common theme in education across the US and an influential model and framework that enables students in general and particularly students who are deaf and hard of hearing (DHH) to access the general education curriculum. UDL helps teachers determine how information will be presented to students and how to keep students engaged. Moreover, UDL helps students to express their understanding and knowledge to others. UDL relies on technology to promote students' interaction with content and their communication of knowledge. This study included 120 DHH students who received daily instruction based on UDL principles. This study presents the results of the study and discusses its implications for the integration of UDL in day-to-day practice as well as in the country's education policy. UDL is a Western concept that began and grew in the US, and it has just begun to transfer to other countries such as Saudi Arabia. It will be very important to researchers, practitioners, and educators to see how UDL is being implemented in a new place with a different culture. UDL is a framework that is built to provide multiple means of engagement, representation, and action and expression that should be part of curricula and lessons for all students. The purpose of this study is to investigate the variables associated with the implementation of UDL in Saudi Arabian schools and identify the barriers that could prevent the implementation of UDL. Therefore, this study used a mixed methods design that use both quantitative and qualitative methods. More insights will be gained by including both quantitative and qualitative rather than using a single method. By having methods that different concepts and approaches, the databases will be enriched. This study uses levels of collecting date through two stages in order to insure that the data comes from multiple ways to mitigate validity threats and establishing trustworthiness in the findings. The rationale and significance of this study is that it will be the first known research that targets UDL in Saudi Arabia. Furthermore, it will deal with UDL in depth to set the path for further studies in the Middle East. From a perspective of content, this study considers teachers’ implementation knowledge, skills, and concerns of implementation. This study deals with effective instructional designs that have not been presented in any conferences, workshops, teacher preparation and professional development programs in Saudi Arabia. Specifically, Saudi Arabian schools are challenged to design inclusive schools and practices as well as to support all students’ academic skills development. The total participants in stage one were 336 teachers of DHH students. The results of the intervention indicated significant differences among teachers before and after taking the training sessions associated with their understanding and level of concern. Teachers have indicated interest in knowing more about UDL and adopting it into their practices; they reported that UDL has benefits that will enhance their performance for supporting student learning.

Keywords: deaf and hard of hearing, professional development, Saudi Arabia, universal design for learning

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9795 Influence of Magnetized Water on the Split Tensile Strength of Concrete

Authors: Justine Cyril E. Nunag, Nestor B. Sabado Jr., Jienne Chester M. Tolosa

Abstract:

Concrete has high compressive strength but a low-tension strength. The small tensile strength of concrete is regarded as its primary weakness, which is why it is typically reinforced with steel, a material that is resistant to tension. Even with steel, however, cracking can occur. In strengthening concrete, only a few researchers have modified the water to be used in a concrete mix. This study aims to compare the split tensile strength of normal structural concrete to concrete prepared with magnetic water and a quick setting admixture. In this context, magnetic water is defined as tap water that has undergone a magnetic process to become magnetized water. To test the hypothesis that magnetized concrete leads to higher split tensile strength, twenty concrete specimens were made. There were five groups, each with five samples, that were differentiated by the number of cycles (0, 50, 100, and 150). The data from the Universal Testing Machine's split tensile strength were then analyzed using various statistical models and tests to determine the significant effect of magnetized water. The result showed a moderate (+0.579) but still significant degree of correlation. The researchers also discovered that using magnetic water for 50 cycles did not result in a significant increase in the concrete's split tensile strength, which influenced the analysis of variance. These results suggest that a concrete mix containing magnetic water and a quick-setting admixture alters the typical split tensile strength of normal concrete. Magnetic water has a significant impact on concrete tensile strength. The hardness property of magnetic water influenced the split tensile strength of concrete. In addition, a higher number of cycles results in a strong water magnetism. The laboratory test results show that a higher cycle translates to a higher tensile strength.

Keywords: hardness property, magnetic water, quick-setting admixture, split tensile strength, universal testing machine

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9794 The Future of Insurance: P2P Innovation versus Traditional Business Model

Authors: Ivan Sosa Gomez

Abstract:

Digitalization has impacted the entire insurance value chain, and the growing movement towards P2P platforms and the collaborative economy is also beginning to have a significant impact. P2P insurance is defined as innovation, enabling policyholders to pool their capital, self-organize, and self-manage their own insurance. In this context, new InsurTech start-ups are emerging as peer-to-peer (P2P) providers, based on a model that differs from traditional insurance. As a result, although P2P platforms do not change the fundamental basis of insurance, they do enable potentially more efficient business models to be established in terms of ensuring the coverage of risk. It is therefore relevant to determine whether p2p innovation can have substantial effects on the future of the insurance sector. For this purpose, it is considered necessary to develop P2P innovation from a business perspective, as well as to build a comparison between a traditional model and a P2P model from an actuarial perspective. Objectives: The objectives are (1) to represent P2P innovation in the business model compared to the traditional insurance model and (2) to establish a comparison between a traditional model and a P2P model from an actuarial perspective. Methodology: The research design is defined as action research in terms of understanding and solving the problems of a collectivity linked to an environment, applying theory and best practices according to the approach. For this purpose, the study is carried out through the participatory variant, which involves the collaboration of the participants, given that in this design, participants are considered experts. For this purpose, prolonged immersion in the field is carried out as the main instrument for data collection. Finally, an actuarial model is developed relating to the calculation of premiums that allows for the establishment of projections of future scenarios and the generation of conclusions between the two models. Main Contributions: From an actuarial and business perspective, we aim to contribute by developing a comparison of the two models in the coverage of risk in order to determine whether P2P innovation can have substantial effects on the future of the insurance sector.

Keywords: Insurtech, innovation, business model, P2P, insurance

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9793 Is More Inclusive More Effective? The 'New Style' Public Distribution System in India

Authors: Avinash Kishore, Suman Chakrabarti

Abstract:

In September 2013, the parliament of India enacted the National Food Security Act (NFSA) which entitles two-thirds of India’s population to five kilograms of rice, wheat or coarse cereals per person per month at one to three rupees per kilogram. Five states in India—Andhra Pradesh, Chhattisgarh, Tamil Nadu, Odisha and West Bengal—had already implemented somewhat similar changes in the TPDS a few years earlier using their own budgetary resources. They made rice—coincidentally, all five states are predominantly rice-eating—available in fair price shops to a majority of their population at very low prices (less than Rs.3/kg). This paper tries to account for the changes in household consumption patterns associated with the change in TPDS policy in these states using data from household consumption surveys by the National Sample Survey Organization (NSSO). NSS data show improvement in the coverage of TPDS and average off-take of grains from fair price shops between 2004-05 and 2009-10 across all states of India. However, the increase in coverage and off-take was significantly higher in four out of these five states than in the rest of India. An average household in these states purchased three kilos more rice per month from fair price shops than its counterpart in non-treated states as a result of more generous TPDS policies backed by administrative reforms. The increase in consumption of PDS rice was the highest in Chhattisgarh, the poster state of PDS reforms. Households in Chhattisgarh used money saved on rice to spend more on pulses, edible oil, vegetables and sugar and other non-food items. We also find evidence that making TPDS more inclusive and more generous is not enough unless it is supported by administrative reforms to improve grain delivery and control diversion to open markets.

Keywords: public distribution system, social safety-net, national food security act, diet quality, Chhattisgarh

Procedia PDF Downloads 373
9792 Offenders and Victims in Public Focus: Media Coverage about Crime and Its Consequences

Authors: Melanie Verhovnik

Abstract:

Media shape the image of crime, peoples’ believes, attitudes and sometimes also behaviors. Media not only gives the impression that crime is increasing, it also suggest that very violent crime is more common than it actually is. It is also no wonder that humans are more afraid of being involved in a crime committed by strangers than committed by somebody they know – because this is the media construct. With the help of three case studies, the paper analyzes how media frames crime and criminals and gives valuable hints as to what better reporting could look like.

Keywords: court reporting, offenders in media, quantitative content analysis, victims in media

Procedia PDF Downloads 385
9791 Optimization of Interface Radio of Universal Mobile Telecommunication System Network

Authors: O. Mohamed Amine, A. Khireddine

Abstract:

Telecoms operators are always looking to meet their share of the other customers, they try to gain optimum utilization of the deployed equipment and network optimization has become essential. This project consists of optimizing UMTS network, and the study area is an urban area situated in the center of Algiers. It was initially questions to become familiar with the different communication systems (3G) and the optimization technique, its main components, and its fundamental characteristics radios were introduced.

Keywords: UMTS, UTRAN, WCDMA, optimization

Procedia PDF Downloads 383
9790 Interactive Fun Activities for Blind and Sighted Teenagers

Authors: Haif Alharthy, Samar Altarteer

Abstract:

Blind and sighted teenagers might find it challenging to communicate and have fun interaction with each other. The previous studies emphasize the importance of the interactive communication of the blind with the sighted people in developing the interpersonal and social skills of the blind people . Playing games is one of the effective ways used to engage the blind with the sighted people and help in enhancing their social skills. However, it is difficult to find a fun game that is designed to encourage interaction between blind and sighted teenagers in which the blind can play it independently without help and that the sighted find its design attractive and satisfying. The aim of this paper is to examine how challenging is to have fun interaction between blind and sighted people and offer interactive tabletop game solution in which both of them can independently participate and enjoy. The paper discusses the importance and the impact of the interactive fun communication between blind and sighted people and how to get them involved with each other through games. The paper investigates several approaches to design a universal game. A survey was conducted for blind teenager’s family members to discover what difficulties they face while playing and communicating with their blind family member and to identify the blind’s needs and interests in games. The study reveals that although families like to play tabletop games with their blind member, they find difficulties in finding universal games that is interesting and adequate for both. Also, qualitative interviews were conducted with blind teenager shows the sufficiency in tabletop games that do not require help from another family member to play the game. The results suggested that an effective approach is to develop an interactive tabletop game embedded with audio and tactile techniques. The findings of the pilot study highlighted the necessary information such as tools, visuals, and game concepts that should be considered in developing interactive card game for blind and sighted teenagers.

Keywords: Blind, card game, communication, interaction, play, tabletop game, teenager

Procedia PDF Downloads 209
9789 Testing of Canadian Integrated Healthcare and Social Services Initiatives with an Evidence-Based Case Definition for Healthcare and Social Services Integrations

Authors: S. Cheng, C. Catallo

Abstract:

Introduction: Canada's healthcare and social services systems are failing high risk, vulnerable older adults. Care for vulnerable older Canadians (65 and older) is not optimal in Canada. It does not address the care needs of vulnerable, high risk adults using a holistic approach. Given the growing aging population, and the care needs for seniors with complex conditions is one of the highest in Canada's health care system, there is a sense of urgency to optimize care. Integration of health and social services is an emerging trend in Canada when compared to European countries. There is no common and universal understanding of healthcare and social services integration within the country. Consequently, a clear understanding and definition of integrated health and social services are absent in Canada. Objectives: A study was undertaken to develop a case definition for integrated health and social care initiatives that serve older adults, which was then tested against three Canadian integrated initiatives. Methodology: A limited literature review was undertaken to identify common characteristics of integrated health and social care initiatives that serve older adults, and comprised both scientific and grey literature, in order to develop a case definition. Three Canadian integrated initiatives that are located in the province of Ontario, were identified using an online search and a screening process. They were surveyed to determine if the literature-based integration definition applied to them. Results: The literature showed that there were 24 common healthcare and social services integration characteristics that could be categorized into ten themes: 1) patient-care approach; 2) program goals; 3) measurement; 4) service and care quality; 5) accountability and responsibility; 6) information sharing; 7) Decision-making and problem-solving; 8) culture; 9) leadership; and 10) staff and professional interaction. The three initiatives showed agreement on all the integration characteristics except for those characteristics associated with healthcare and social care professional interaction, collaborative leadership and shared culture. This disagreement may be due to several reasons, including the existing governance divide between the healthcare and social services sectors within the province of Ontario that has created a ripple effect in how professions in the two different sectors interact. In addition, the three initiatives may be at maturing levels of integration, which may explain disagreement on the characteristics associated with leadership and culture. Conclusions: The development of a case definition for healthcare and social services integration that incorporates common integration characteristics can act as a useful instrument in identifying integrated healthcare and social services, particularly given the emerging and evolutionary state of this phenomenon within Canada.

Keywords: Canada, case definition, healthcare and social services integration, integration, seniors health, services delivery

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9788 World Peace and Conflict Resolution: A Solution from a Buddhist Point of View

Authors: Samitharathana R. Wadigala

Abstract:

The peace will not be established until the self-consciousness would reveal in the human beings. In this nuclear age, the establishment of a lasting peace on the earth represents the primary condition for the preservation of human civilization and survival of human beings. Nothing perhaps is so important and indispensable as the achievement and maintenance of peace in the modern world today. Peace in today’s world implies much more than the mere absence of war and violence. In the interdependent world of today the United Nations needs to be representative of the modern world and democratic in its functioning because it came into existence to save the generations from the scourge of war and conflict. Buddhism is the religion of peaceful co-existence and philosophy of enlightenment. Violence and conflict from the perspective of the Buddhist theory of interdependent origination (Paṭiccasamuppāda) are same with everything else in the world a product of causes and conditions. Buddhism is totally compatible with the congenial and peaceful global order. The canonical literature, doctrines, and philosophy of Buddhism are the best suited for inter-faith dialogue, harmony, and universal peace. Even today Buddhism can resurrect the universal brotherhood, peaceful co-existence and harmonious surroundings in the comity of nations. With its increasing vitality in regions around the world, many people today turn to Buddhism for relief and guidance at the time when peace seems to be a deferred dream more than ever. From a Buddhist point of view the roots of all unwholesome actions (Conflict) i. e. greed, hatred and delusion are viewed as the root cause of all human conflicts. Conflict often emanates from attachment to material things: pleasures, property, territory, wealth, economic dominance or political superiority. Buddhism has some particularly rich resources for deployment in dissolving conflict. Buddhism addresses the Buddhist perspective on the causes of conflict and ways to resolve conflict to realize world peace. The world has enough to satisfy every body’s needs but not every body’s greed.

Keywords: Buddhism, conflict-violence, peace, self-consciousness

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9787 Interpersonal Variation of Salivary Microbiota Using Denaturing Gradient Gel Electrophoresis

Authors: Manjula Weerasekera, Chris Sissons, Lisa Wong, Sally Anderson, Ann Holmes, Richard Cannon

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The aim of this study was to characterize bacterial population and yeasts in saliva by Polymerase chain reaction followed by denaturing gradient gel electrophoresis (PCR-DGGE) and measure yeast levels by culture. PCR-DGGE was performed to identify oral bacteria and yeasts in 24 saliva samples. DNA was extracted and used to generate DNA amplicons of the V2–V3 hypervariable region of the bacterial 16S rDNA gene using PCR. Further universal primers targeting the large subunit rDNA gene (25S-28S) of fungi were used to amplify yeasts present in human saliva. Resulting PCR products were subjected to denaturing gradient gel electrophoresis using Universal mutation detection system. DGGE bands were extracted and sequenced using Sanger method. A potential relationship was evaluated between groups of bacteria identified by cluster analysis of DGGE fingerprints with the yeast levels and with their diversity. Significant interpersonal variation of salivary microbiome was observed. Cluster and principal component analysis of the bacterial DGGE patterns yielded three significant major clusters, and outliers. Seventeen of the 24 (71%) saliva samples were yeast positive going up to 10³ cfu/mL. Predominately, C. albicans, and six other species of yeast were detected. The presence, amount and species of yeast showed no clear relationship to the bacterial clusters. Microbial community in saliva showed a significant variation between individuals. A lack of association between yeasts and the bacterial fingerprints in saliva suggests the significant ecological person-specific independence in highly complex oral biofilm systems under normal oral conditions.

Keywords: bacteria, denaturing gradient gel electrophoresis, oral biofilm, yeasts

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9786 Quantum Conductance Based Mechanical Sensors Fabricated with Closely Spaced Metallic Nanoparticle Arrays

Authors: Min Han, Di Wu, Lin Yuan, Fei Liu

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Mechanical sensors have undergone a continuous evolution and have become an important part of many industries, ranging from manufacturing to process, chemicals, machinery, health-care, environmental monitoring, automotive, avionics, and household appliances. Concurrently, the microelectronics and microfabrication technology have provided us with the means of producing mechanical microsensors characterized by high sensitivity, small size, integrated electronics, on board calibration, and low cost. Here we report a new kind of mechanical sensors based on the quantum transport process of electrons in the closely spaced nanoparticle films covering a flexible polymer sheet. The nanoparticle films were fabricated by gas phase depositing of preformed metal nanoparticles with a controlled coverage on the electrodes. To amplify the conductance of the nanoparticle array, we fabricated silver interdigital electrodes on polyethylene terephthalate(PET) by mask evaporation deposition. The gaps of the electrodes ranged from 3 to 30μm. Metal nanoparticles were generated from a magnetron plasma gas aggregation cluster source and deposited on the interdigital electrodes. Closely spaced nanoparticle arrays with different coverage could be gained through real-time monitoring the conductance. In the film coulomb blockade and quantum, tunneling/hopping dominate the electronic conduction mechanism. The basic principle of the mechanical sensors relies on the mechanical deformation of the fabricated devices which are translated into electrical signals. Several kinds of sensing devices have been explored. As a strain sensor, the device showed a high sensitivity as well as a very wide dynamic range. A gauge factor as large as 100 or more was demonstrated, which can be at least one order of magnitude higher than that of the conventional metal foil gauges or even better than that of the semiconductor-based gauges with a workable maximum applied strain beyond 3%. And the strain sensors have a workable maximum applied strain larger than 3%. They provide the potential to be a new generation of strain sensors with performance superior to that of the currently existing strain sensors including metallic strain gauges and semiconductor strain gauges. When integrated into a pressure gauge, the devices demonstrated the ability to measure tiny pressure change as small as 20Pa near the atmospheric pressure. Quantitative vibration measurements were realized on a free-standing cantilever structure fabricated with closely-spaced nanoparticle array sensing element. What is more, the mechanical sensor elements can be easily scaled down, which is feasible for MEMS and NEMS applications.

Keywords: gas phase deposition, mechanical sensors, metallic nanoparticle arrays, quantum conductance

Procedia PDF Downloads 274
9785 Wealth-Based Inequalities in Child Health: A Micro-Level Analysis of Maharashtra State in India

Authors: V. Rekha, Rama Pal

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The study examines the degree and magnitude of wealth-based inequalities in child health and its determinants in India. Despite making strides in economic growth, India has failed to secure a better nutritional status for all the children. The country currently faces the double burden of malnutrition as well as the problems of overweight and obesity. Child malnutrition, obesity, unsafe water, sanitation among others are identified as the risk factors for Non-Communicable Diseases (NCDs). Eliminating malnutrition in all its forms will catalyse improved health and economic outcomes. The assessment of the distributive dimension of child health across various segments of the population is essential for effective policy intervention. The study utilises the fourth round of District Level Health Survey for 2012-13 to analyse the inequalities among children in the age group 0-14 years in Maharashtra, a state in the western region of India with a population of 11.24 crores which constitutes 9.3 percent of the total population of India. The study considers the extent of health inequality by state, districts, sector, age-groups, and gender. The z-scores of four child health outcome variables are computed to assess the nutritional status of pre-school and school children using WHO reference. The descriptive statistics, concentration curves, concentration indices, correlation matrix, logistic regression have been used to analyse the data. The results indicate that magnitude of inequality is higher in Maharashtra and child health inequalities manifest primarily among the weaker sections of society. The concentration curves show that there exists a pro-poor inequality in child malnutrition measured by stunting, wasting, underweight, anaemia and a pro-rich overweight inequality. The inequalities in anaemia are observably lower due to the widespread prevalence. Rural areas exhibit a higher incidence of malnutrition, but greater inequality is observed in the urban areas. Overall, the wealth-based inequalities do not vary significantly between age groups. It appears that there is no gender discrimination at the state level. Further, rural-urban differentials in gender show that boys from the rural area and girls living in the urban region experience higher disparities in health. The relative distribution of undernutrition across districts in Maharashtra reveals that malnutrition is rampant and considerable heterogeneity also exists. A negative correlation is established between malnutrition prevalence and human development indicators. The findings of logistic regression analysis reveal that lower economic status of the household is associated with a higher probability of being malnourished. The study recognises household wealth, education of the parent, child gender, and household size as factors significantly related to malnutrition. The results suggest that among the supply-side variables, child-oriented government programmes might be beneficial in tackling nutrition deficit. In order to bridge the health inequality gap, the government needs to target the schemes better and should expand the coverage of services.

Keywords: child health, inequality, malnutrition, obesity

Procedia PDF Downloads 146