Search results for: healthcare policy

Authors: Ketan Tamirisa, Kathleen P. Tebb

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In the U.S., annually, there are over 1 million pregnancies in teenagers and most (85%) are unintended. The need for proactive prevention measures is imperative to support adolescents with their pregnancy prevention and family planning goals. To date, there is limited research examining the extent to which support from a sexual partner(s) influences contraceptive use. To address this gap, this study assessed the relationship between sexually active adolescents, sex-assigned birth as female, and their perceived support from their sexual partner(s) about their contraceptive use in the last three months. Baseline data from sexually active adolescent females, between 13-19 years who were not currently using a long-acting contraceptive device, were recruited from 32 school-based health centers (SBHCs) in seven states in the U.S. as part of a larger study to evaluate Health-E You/ Salud iTuTM, a web-based contraceptive decision support tool. Fisher’s exact test assessed the cross-sectional association between perceived sexual partner support of contraceptive use in the past three months (felt no support, felt little support, and felt a lot of support), and current use of non-barrier contraception. A total of 91 sexually active adolescent females were eligible and completed the baseline survey. The mean age was 16.7 and nearly half (49.3%) were Hispanic/Latina. Most (85.9%) indicated it was very important to avoid becoming pregnant. A total of 60 participants (65.9%) reported use of non-barrier contraception. Of these, most used birth control pills (n=26), followed by Depo-Provera injection (n=12), patch (n=1), and ring (n=1). Most of the participants (80.2%) indicated that they perceived a lot of support from their partners and 19.8% reported no or little support. Among those reporting a lot of support, 69.9% (51/73) reported current use of non-barrier contraception compared to 50% (9/18) who felt no/little support and reported contraceptive use. This difference approached but did not reach statistical significance (p=0.096). Results from this preliminary data indicate that many adolescents who are coming in for care at SBHCs are at risk of unintended pregnancy. Many participants also reported a lot of support from their sexual partner(s) to use contraception. While the associations only approached significance, this is likely due to the small sample size. This and future research can better understand this association to inform interventions aimed at sexual partners to strengthen education and social support, increase healthcare accessibility, and ultimately reduce rates of unintended pregnancy.

Keywords: adolescents, contraception, pregnancy, SBHCs, sexual partners

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Authors: Rodrigo Coelho

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We believe that in the majority of the “recent production of public space", the overvaluation of the "image", of the "ephemeral" and of the "objectual", has come to determine the configuration of banal and (more or less) arbitrary "public spaces", mostly linked to a problem of “outdoor decoration”, reflecting a clear sign of uncertainty and arbitrariness about the meaning, the role and shape of public space and public art.This "inconsistency" which is essentially linked to the loss of urban, but also social, cultural and political, vocation of the disciplines that “shape” the urban space (but is also linked to the lack of urban and technical culture of techinicians and policy makers) converted a significant set of the recently built "public space" and “urban art” into diffuse and multi-referenced pieces, which generally shares the inability of confering to the urban space, civic, aesthetic, social and symbolic meanings. In this sense we consider it is essential to undertake a theoretical reflection on the values, the meaning(s) and the shape(s) that open space, and urban art may (or must) take in the current urban and cultural context, in order to redeem for public space its status of significant physical reference, able to embody a spatial and urban identity, and simultaneously enable the collective accession and appropriation of public space. Taking as reference public space interventions built in the last decade on the European context, we will seek to explore and defend the need of considering public space as a true place of exception, an exceptional support where the emphasis is placed on the quality of the experience, especially by the relations public space/urban art can established with the city, with nature and geography in a broad sense, referring us back to a close and inseparable and timeless relationship between nature and culture.

Keywords: art, city, nature, public space

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Authors: Mekroud Amel

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Emergency departments are known for the workload, the variety of pathologies and the difficulties in their management with the continuous influx of patients The role of our service in the management of patients with two or three mild to moderate organ failures, involving several disciplines at the same time, as well as the effect of this management on the skills and efficiency of our team has been demonstrated Borderline cases between two or three or even more disciplines, with instability of a vital function, which have been successfully managed in the emergency room, the therapeutic procedures adopted, the consequences on the quality and level of care delivered by our team, as well as that the logistical consequences, and the pedagogical consequences are demonstrated. The consequences found are Positive on the emergency teams, in rare situations are negative Regarding clinical situations, it is the entanglement of hemodynamic distress with right, left or global participation, tamponade, low flow with acute pulmonary edema, and/or state of shock With respiratory distress with more or less profound hypoxemia, with haematosis disorder related to a bacterial or viral lung infection, pleurisy, pneumothorax, bronchoconstrictive crisis. With neurological disorders such as recent stroke, comatose state, or others With metabolic disorders such as hyperkalaemia renal insufficiency severe ionic disorders with accidents with anti vitamin K With or without septate effusion of one or more serous membranes with or without tamponade It’s a Retrospective, monocentric, descriptive study Period 05.01.2022 to 10.31.2022 the purpose of our work: Search for a statistically significant link between the type of moderate to severe pathology managed in the emergency room whose problems are multivisceral on the efficiency of the healthcare team and its level of care and optional care offered for patients Statistical Test used: Chi2 test to prove the significant link between the resolution of serious multidisciplinary cases in the emergency room and the effectiveness of the team in the management of complicated cases Search for a statistically significant link : The management of the most difficult clinical cases for organ specialties has given general practitioner emergency teams a great perspective and has been able to improve their efficiency in the face of emergencies received

Keywords: emergency care teams, management of patients with dysfunction of more than one organ, learning curve, quality of care

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Authors: Nadezhda Kvatashidze

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The International Accounting Standards Board updated the conceptual framework for financial reporting. The main reason behind it is to resolve the tasks of the accounting, which are caused by the market development and business-transactions of a new economic content. Also, the investors call for higher transparency of information and responsibility for the results in order to make a more accurate risk assessment and forecast. All these make it necessary to further develop the conceptual framework for financial reporting so that the users get useful information. The market development and certain shortcomings of the conceptual framework revealed in practice require its reconsideration and finding new solutions. Some issues and concepts, such as disclosure and supply of information, its qualitative characteristics, assessment, and measurement uncertainty had to be supplemented and perfected. The criteria of recognition of certain elements (assets and liabilities) of reporting had to be updated, too and all this is set out in the updated edition of the conceptual framework for financial reporting, a comprehensive collection of concepts underlying preparation of the financial statement. The main objective of conceptual framework revision is to improve financial reporting and development of clear concepts package. This will support International Accounting Standards Board (IASB) to set common “Approach & Reflection” for similar transactions on the basis of mutually accepted concepts. As a result, companies will be able to develop coherent accounting policies for those transactions or events that are occurred from particular deals to which no standard is used or when standard allows choice of accounting policy.

Keywords: conceptual framework, measurement basis, measurement uncertainty, neutrality, prudence, stewardship

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Authors: Juhan Kim, Jinsoo Kim

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South Korea cannot import natural gas in any form other than LNG because of the division of South and North Korea. Further, the high proportion of natural gas in the national energy mix makes this resource crucial for energy security in Korea. Expansion of Panama Canal will allow for reducing the cost of shipping between the Far East and U.S East. Panama Canal expansion can have significant impacts on South Korea. Due to this situation, we review the natural gas optimal portfolio by considering the uniqueness of the Korean Natural gas market and expansion of Panama Canal. In order to assess Korea’s natural gas optimal portfolio, we developed natural gas portfolio model. The model comprises two steps. First, to obtain the optimal long-term spot contract ratio, the study examines the price level and the correlation between spot and long-term contracts by using the Markowitz, portfolio model. The optimal long-term spot contract ratio follows the efficient frontier of the cost/risk level related to this price level and degree of correlation. Second, by applying the obtained long-term contract purchase ratio as the constraint in the linear programming portfolio model, we determined the natural gas optimal import portfolio that minimizes total intangible and tangible costs. Using this model, we derived the optimal natural gas portfolio considering the expansion of Panama Canal. Based on these results, we assess the portfolio for natural gas import to Korea from the perspective of energy security and present some relevant policy proposals.

Keywords: natural gas, Panama Canal, portfolio analysis, South Korea

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

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

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

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Authors: Chidozie Celestine Uzoigwe, Thabelo Ramantswana

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Purpose: The purpose of the paper is to review the current state of knowledge in Sustainable Management (SM) practices in Facilities Management (FM) for housing estates with a view to identifying gaps and drawbacks in the existing body of knowledge. Integrating SM practices in housing estates is understood and applied in some developed countries, but little is known about the concept by practitioners in developing nations like South Africa. Indeed, South African housing studies and policy documents emphasize the significance of sustainability practices in housing estates, but regrettably, it still remains in unsustainable housing for decades. Method: This is done through a comprehensive literature review in combination with the “Preferred Reporting Items for Systematic Reviews and Meta-Analyses” (PRISMA) guidelines and the Recursive Content Abstraction (RCA) analytical approach. Finding: Findings revealed there are significant challenges to the integration of SM practices in FM for housing estates in South Africa, such as lack of understanding and expertise by practitioners, absence of support from top-level management, lack of appropriate sustainability management framework as well as people management. The review further suggests the need for an enabler to guide practitioners in integrating the SM concept in housing estates. Originality: Integrating SM principles in facilities management for housing estates are required to eliminate the detrimental impact the built environment exerts on the well-being of individuals and organizations. Thus, the study underlines the need for an enabler that will facilitate practitioners embedding sustainable management measures in the management of housing estates in South Africa.

Keywords: facilities management, housing estates, sustainable facilities management, sustainable management, south africa

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Authors: Ibrahim H. Kilic, A. B. Tugrul

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Energy is a fundamental component in economic development and energy consumption is an index of prosperity and the standard of living. The consumption of energy per capita has increased significantly over the last decades, as the standard of living has improved. Turkey’s geographical location has several advantages for extensive use of wind power. Among the renewable sources, Turkey has very high wind energy potential. Information such as installation capacity of wind power plants in installation, under construction and license stages in the country are reported in detail. Some suggestions are presented in order to increase the wind power installation capacity of Turkey. Turkey’s economic and social development has led to a massive increase in demand for electricity over the last decades. Since the Turkey has no major oil or gas reserves, it is highly dependent on energy imports and is exposed to energy insecurity in the future. But Turkey does have huge potential for renewable energy utilization. There has been a huge growth in the construction of wind power plants and small hydropower plants in recent years. To meet the growing energy demand, the Turkish Government has adopted incentives for investments in renewable energy production. Wind energy investments evaluated the impact of feed-in tariffs (FIT) based on three scenarios that are optimistic, realistic and pessimistic with APLUS software that is developed for rational evaluation for energy market. Results of the three scenarios are evaluated in the view of electricity market for Turkey.

Keywords: APLUS, energy policy, renewable energy, wind power, Turkey

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Authors: Tanusha Raniga, Michael Boecker, Maud Mthembu

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This paper considers the formal employment sector, human capacity development and economic capital of single-mother households’ as they strive to sustain livelihoods. This paper advances empirical data in the field of economic and social development policy. The correlation between educational level, human capacity development and economic self-reliance of single-mother households is considered. This paper presents empirical evidence obtained from qualitative in-depth interviews conducted with twenty-five single mothers who were working in the formal work sector in Hagen, Germany and two provinces, namely KwaZulu-Natal and Gauteng in South Africa. This is an underexplored research area as most of the international literature focuses on pathology and victimhood related to single-mother households. Instead, this paper presents the biographic profiles and discusses two key themes that emerged from the data analysis namely; formal and informal streams of income enhanced human capital development through access to further education and training opportunities. The women perceived these themes as facilitating factors which helped them sustain their households. The paper presents some suggestions for policymakers and social work practitioners to consider to improve support systems and avoid economic exclusion of single mothers who work within the first economy.

Keywords: single mothers, formal work sector, economic capital, human capital

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Authors: Mohammad Rahim Rahnama

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The study employs Monte Carlo method for simulation of rented housing in Mashhad second largest city in Iran. A total number of 334 rental residential units in Mashhad, including both apartments and houses (villa), were randomly selected from advertisements placed in Khorasan Newspapers during the months of July and August of 2015. In order to simulate the monthly rent price, the rent index was calculated through combining the mortgage and the rent price. In the next step, the relation between the variables of the floor area and that of the number of bedrooms for each unit, in both apartments and houses(villa), was calculated through multivariate regression using SPSS and was coded in XML. The initial model was called using simulation button in SPSS and was simulated using triangular and binominal algorithms. The findings revealed that the average simulated rental index was 548.5$ per month. Calculating the sensitivity of rental index to a number of bedrooms we found that firstly, 97% of units have three bedrooms, and secondly as the number of bedrooms increases from one to three, for the rent price of less than 200$, the percentage of units having one bedroom decreases from 10% to 0. Contrariwise, for units with the rent price of more than 571.4$, the percentage of bedrooms increases from 37% to 48%. In the light of these findings, it becomes clear that planning to build rental residential units, overseeing the rent prices, and granting subsidies to rental residential units, for apartments with two bedrooms, present a felicitous policy for regulating residential units in Mashhad.

Keywords: Mashhad, Monte Carlo, simulation, rent price, residential unit

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Authors: Thomas Yeboah

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In contemporary times, the incessant movement of northern children especially girls to southern Ghana at the detriment of their education is worrisome. Due to the misplaced mindset of the migrants concerning southern Ghana, majority of them move without an idea of where to stay and what to do exposing them to hash conditions of living. Majority find menial work in cocoa farms, illegal mining and head porterage business. This study was conducted in the Kumasi Metropolis to ascertain the major causes of child migration from the northern part of Ghana to the south and their living conditions. Both qualitative and quantitative tools of data collection and analysis were employed. The purposive sampling technique was used to select 90 migrants below 18 years. Specifically, interviews, focus group discussions and questionnaires were used to elicit responses from the units of analysis. The study revealed that the major cause of child migration from northern Ghana to the south is poverty. It was evident that respondents were vulnerable to the new environment in which they lived. They are exposed to harsh environmental conditions; sexual, verbal and physical assault; and harassment from arm robbers. The paper recommends that policy decisions should be able to create an enabling environment for the labour force in the north to ameliorate the compelling effects poverty has on child migration. Efforts should also be made to create a proper psychological climate in the minds of the children regarding their destination areas through sensitization and education.

Keywords: child migration, vulnerability, social exclusion, child labour, Ghana

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Authors: Taimaz Larimian

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During recent years, sustainable development has increasingly influenced urban policy, housing and planning in cities all over the world. Debates about sustainability no longer consider it solely as an environmental concern, but also incorporate social and economic dimensions. However, while a social dimension of sustainability is extensively accepted, the exact definition of the concept is still vague and unclear. This study is addressing this lack of specificity through a detailed exploration of social sustainability as the least studied pillar of sustainable development and sheds light on the debate over the definition of social sustainability through developing a measurement model of the constitutive dimensions of the concept. With this aim, a conceptual framework is developed based on the existing literature, determining seven main dimensions of the social sustainability concept namely: social interaction, safety and security, social equity, social participation, neighborhood satisfaction, housing satisfaction and sense of place. The validity and reliability of the model is then tested using exploratory and confirmatory factor analysis. In order to do so, five case study neighborhoods from Dunedin city with a range of urban forms and characters are investigated, to define social sustainability concept and its consisting dimensions from people’s perspective. The findings of this study present a clear definition of social sustainability at neighborhood scale and highlight all different dimensions of the concept in the context of New Zealand cities. According to the results, among the investigated dimensions, neighborhood satisfaction and safety and security had the most influence on people’s feeling of social sustainability in their neighborhood.

Keywords: social sustainability, factor analysis, neighborhood level, New Zealand cities

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Authors: Menouni Aziza, Chbihi Kaoutar, Duca Radu Corneliu, Gilissen Liesbeth, Bounou Salim, Godderis Lode, El Jaafari Samir

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In Africa, environmental and occupational health risks are mostly underreported. The aim of this research is to develop and implement a sentinel surveillance system comprising training and guidance of occupational physicians (OC) who will report new work-related diseases in African countries. A group of 30 OC are recruited and trained in each of the partner countries (Morocco, Benin and Ethiopia). Each committed OC is asked to recruit 50 workers during a consultation in a time-frame of 6 months (1500 workers per country). Workers are asked to fill out an online questionnaire about their health status and work conditions, including exposure to 20 chemicals. Urine and blood samples are then collected for human biomonitoring of common exposures. Some preliminary results showed that 92% of the employees surveyed are exposed to physical constraints, 44% to chemical agents, and 24% to biological agents. The most common physical constraints are manual handling of loads, noise pollution and thermal pollution. The most frequent chemical risks are exposure to pesticides and fuels. This project will allow a better understanding of effective sentinel systems as a promising method to gather high quality data, which can support policy-making in terms of preventing emerging work-related diseases.

Keywords: sentinel system, occupational diseases, human biomonitoring, Africa

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Authors: Priyanka Sharma, Manoj Jais, Poonam Gupta, Suraiya K. Ansari, Ravinder Kaur

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Introduction: As much as the Health Care is necessary for the population, so is the management of the Biomedical waste produced. Biomedical waste is a wide terminology used for the waste material produced during the diagnosis, treatment or immunization of human beings and animals, in research or in the production or testing of biological products. Biomedical waste management is a chain of processes from the point of generation of Biomedical waste to its final disposal in the correct and proper way, assigned for that particular type of waste. Any deviation from the said processes leads to improper disposal of Biomedical waste which itself is a major health hazard. Proper segregation of Biomedical waste is the key for Biomedical Waste management. Improper disposal of BMW can cause sharp injuries which may lead to HIV, Hepatitis-B virus, Hepatitis-C virus infections. Therefore, proper disposal of BMW is of upmost importance. Health care establishments segregate the Biomedical waste and dispose it as per the Biomedical waste management rules in India. Objectives: This study was done to observe the current trends of Biomedical waste generated in a tertiary care Hospital in Delhi. Methodology: Biomedical waste management rounds were conducted in the hospital wards. Relevant details were collected and analysed and sites with maximum Biomedical waste generation were identified. All the data was cross checked with the commons collection site. Results: The total amount of waste generated in the hospital during January 2014 till December 2014 was 6,39,547 kg, of which 70.5% was General (non-hazardous) waste and the rest 29.5% was BMW which consisted highly infectious waste (12.2%), disposable plastic waste (16.3%) and sharps (1%). The maximum quantity of Biomedical waste producing sites were Obstetrics and Gynaecology wards with a total Biomedical waste production of 45.8%, followed by Paediatrics, Surgery and Medicine wards with 21.2 %, 4.6% and 4.3% respectively. The maximum average Biomedical waste generated was by Obstetrics and Gynaecology ward with 0.7 kg/bed/day, followed by Paediatrics, Surgery and Medicine wards with 0.29, 0.28 and 0.18 kg/bed/day respectively. Conclusions: Hospitals should pay attention to the sites which produce a large amount of BMW to avoid improper segregation of Biomedical waste. Also, induction and refresher training Program of Biomedical waste management should be conducted to avoid improper management of Biomedical waste. Healthcare workers should be made aware of risks of poor Biomedical waste management.

Keywords: biomedical waste, biomedical waste management, hospital-tertiary care, New Delhi

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Authors: Ese Urhie, Olabisi Popoola, Obindah Gershon, Olabanji Ewetan

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Modern agriculture involves the use of improved tools and equipment (instead of crude and ineffective tools) like tractors, hand operated planters, hand operated fertilizer drills and combined harvesters - which increase agricultural productivity. Farmers in Nigeria still have huge potentials to enhance their productivity. The study argues that the increase in agricultural output due to increased productivity, orchestrated by modern agriculture will promote forward linkages and opportunities in the processing sub-sector; both the manufacturing of machines and the processing of raw materials. Depending on existing incentives, foreign investment could be attracted to augment local investment in the sector. The availability of raw materials in large quantity – which prices are competitive – will attract investment in other industries. In addition, potentials for backward linkages will also be created. In a nutshell, adopting the unbalanced growth theory in favour of the agricultural sector could engender industrialization in a country with untapped potentials. The paper highlights the numerous potentials of modern agriculture that are yet to be tapped in Nigeria and also provides a theoretical analysis of how the realization of such potentials could promote industrialization in the country. The study adopts the Lewis’ theory of structural–change model and Hirschman’s theory of unbalanced growth in the design of the analytical framework. The framework will be useful in empirical studies that will guide policy formulation.

Keywords: modern agriculture, industrialization, structural change model, unbalanced growth

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Authors: Kerdsiri Hongthai, Darunee Jongudomkarn, Rutja Phuphaibul

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In Thailand, many adults in rural areas migrate to seek employ¬ment resulting in skipped-generation family where grandparents care for grandchildren with no other adults present. This is a preliminary study using qualitative case study methods, aimed to explore the situations of older adult grandparents' experiences in skipped-generation family in North-East of Thailand. Data were collected by in-depth inter¬views with 6 grandparents living in skipped-generation families; 5 females and 1 males grandparents, aged 62-75, some of them have diabetes mellitus, hypertension, during November to December, 2017. The finding themes are: ‘Caught up in the middle’: the older adults were pleased to have grandchildren but, at the same time, acknowledge the burden that this placed on them, especially when the migrant children failed to send enough money back to support the family. ‘Getting bad health’: they reported to be fatigued and stressed due to burden of caring for their grandchildren without support. This situation can aggravate problems of poor health status and be worsening economic status of the grandparents. In some cases of deprivation, the grandparents feel that having to be the sole care providers of their grandchildren can negative adversely affect their mental status. It is important to find out in other sectors similar to Thailand and lead to more in-depth research to answer the research questions about policy and social support in skipped-generation family in the future.

Keywords: older adult grandparents, experiences, principle care giver, skipped-generation family

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Authors: Sudarshan Chalise, Athula Naranpanawa

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This paper attempts to investigate the viability of cropland re-allocation as an adaptation strategy to minimise the economy-wide costs of climate change on agriculture. Nepal makes an interesting case study as it is one of the most vulnerable agricultural economies within South Asia. This paper develops a comparative static multi-household Computable General Equilibrium (CGE) model for Nepal with a nested set of Constant Elasticity of Transformation (CET) functional forms to model the allocation of land within different agricultural sectors. Land transformation elasticities in these CET functions are allowed to reflect the ease of switching from one crop to another based on their agronomic characteristics. The results suggest that, in the long run, farmers in Nepal tend to allocate land to crops that are comparatively less impacted by climate change, such as paddy, thereby minimizing the economy-wide impacts of climate change. Furthermore, the results reveal that land re-allocation tends to reduce the income disparity among different household groups by significantly moderating the income losses of rural marginal farmers. Therefore, it is suggested that policy makers in Nepal should prioritise schemes such as providing climate-smart paddy varieties (i.e., those that are resistant to heat, drought and floods) to farmers, subsidising fertilizers, improving agronomic practices, and educating farmers to switch from crops that are highly impacted by climate change to those that are not, such as paddy.

Keywords: climate change, general equilibrium, land re-allocation, nepalese agriculture

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Authors: Mitra Abtahi, Esmat Nasseri, Morteza Abodllahi

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Introduction: Adequate hydration is necessary for proper physical and mental function. The aim of this study is to determine the consumption of water and all other beverages in children (8-13 years) and adolescents (14-17 years) in Tehran metropolitan city of Iran. Materials and Methods: In this cross-sectional study, 455 children (8-13 years) and 334 adolescents (14-17 years) were retrieved from north, center, and south of Tehran (18 schools). Instrument for data collection consisted of a “demographic and general health” questionnaire and a “7-day fluid record”. Data analyses were performed with SPSS 16 software. Results: The mean total consumption of fluids in school children was 1302 ± 500.6 ml/day. The highest mean intakes were observed for water (666 ± 398 ml/day), followed by milk (239 ± 183 ml/day), regular soft beverages (RSB) (188 ± 148 ml/day), and juices (60 ± 74 ml/day). Water, hot drinks (mainly tea) and soft drinks intake was significantly more in boys than girls. A significantly lower intake of milk and a higher intake of RSB and hot beverages (mainly tea) have been seen among adolescents compared to children. Conclusion: The most important finding is that mean fluid intake of children and adolescents does not meet international adequate intake references for water and fluids. This finding may suggest the necessity of development of the local references. To improve fluid intake habits of children and adolescents, relevant policy making and actions are warranted.

Keywords: adolescents, beverages, children, water

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Authors: Hwang Kwon

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Objective: To assess the efficacy of embryo transfer (ET) of accumulated vitrified embryos and compare pregnancy outcomes between ET of thawed embryos following accumulation of vitrified embryos (frozen ET) and ET of fresh and thawed frozen embryos following accumulation of vitrified embryos (fresh ET + frozen ET). Study design: Patients were poor ovarian responders defined according to the Bologna criteria as well as a subgroup of women whose previous IVF-ET cycle through controlled ovarian stimulation (COS) yielded one or no embryos. Sixty-four frozen ETs were performed following accumulation of vitrified embryos (ACCE )(ACCE Frozen) and 51 fresh + frozen ETs were performed following accumulation of vitrified embryos (ACCE Fresh + Frozen). Positive βhCG rate, clinical pregnancy rate, ongoing pregnancy rate, and good quality embryos (%, ±SD) were compared between two groups. Results: There were more good quality embryos in the ACCE Fresh + Frozen group than in the ACCE Frozen group: 60±34.7 versus 42.9±28.9, respectively (p=0.03). Positive βhCG rate [18/64(28.2%) vs. 13/51(25.5%); p=0.75] and clinical pregnancy rate [12/64 (18.8%) vs. 11/51 (10.9%); p=0.71] were comparable between the two groups. Conclusion: Accumulation of vitrified embryos is an effective method in patients with poor ovarian response who fulfill the Bologna criteria. Pregnancy outcomes were comparable between the two groups.

Keywords: accumulation of embryos, frozen embryo transfer, poor responder, Bologna criteria

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Authors: Peter Adekunle, Clinton Aigbavboa, Matthew Ikuabe, Opeoluwa Akinradewo

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Contemporary building methods typically pay little attention to the built environment's greater economic, environmental, or social impacts or energy efficiency. Green construction aims to sever ties with these conventions. In order to provide better living and working conditions and lessen environmental consequences, green building today combines numerous building design, construction, and operation and maintenance approaches. As one of Sub-Saharan Africa's most industrialized nations, South Africa has a good number of green building projects. Therefore, this study examines the elements impacting the adoption of green buildings and regulations created to encourage the growth of green buildings using South Africa as a case study. The study has a survey-style design. A total of one hundred fifty (150) questionnaires were distributed to professionals in the construction industry in South Africa, of which one hundred and twenty-four (128) were returned and judged appropriate for investigation. The gathered data was examined using percentage, mean item scores, standard deviation, and Kruskal-Wallis. The findings show that cost and market circumstances are the two main elements impacting the adoption of green construction, while leadership advice is the most important policy. The study concluded that in order to encourage the construction of green buildings, additional Sub-Saharan nations should adopt these suggested policies.

Keywords: green building, Sub-Saharan Africa, building design, environmental conditions

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Authors: Gina Cynthia Raphita Hasibuan

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The housing sector in Indonesia is in critical condition where majority of low-income citizens live in substandard dwellings, and the number housing backlog is increasing every year. The housing problem becomes more urgent when the term 'sustainability' is considered, and sustainable affordable housing is yet to gain its successful implementation. Global urbanization develops fastest in developing countries like Indonesia where informal settlements are rapidly escalating, hence, making sustainable affordable housing strategies very critical in this context. The problem in developing countries like Indonesia lies on the institutional capacity of newly-established local governments having greater power to determine a development policy but apparently still lacking institutional capability and coordination with the central government and collaborative governance are still not established yet. The concept of upgrading informal settlements are seen changed over time and inconsistent. Despite much research on theme such as sustainable housing concept within Indonesian context, there has been a dearth of research examining the role of collaborative governance, as the current approach still shows fragmented approach between the stakeholders and the lack of community participation as the end user, and thus this research attempts to fill the gap on the aforementioned problems. By using case study with multi-methods conducted in Jakarta, this research has an overall aim to critically assess the role of collaborative governance in addressing sustainable affordable housing in Indonesia and to understand informal settlements and interventions in Indonesia rather than imposing a framework from western perspectives.

Keywords: affordable housing, collaborative governance, sustainability, urban planning

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Authors: Veenapani Rajeev Verma

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Context: Assessing facility readiness is paramount as it can indicate capacity of facilities to provide essential care for resilience to health challenges. In the context of decentralization, estimation of supply side readiness indices at sub national level is imperative for effective evidence based policy but remains a colossal challenge due to lack of dependable and representative data sources. Setting: District Poonch of Jammu and Kashmir was selected for this study. It is remote, rural district with unprecedented topographical barriers and is identified as high priority by government. It is also a fragile area as is bounded by Line of Control with Pakistan bearing the brunt of cease fire violations, military skirmishes and sporadic militant attacks. Hilly geographical terrain, rudimentary/absence of road network and impoverishment are quintessential to this area. Objectives: Objective of the study is to a) Evaluate the service readiness of health facilities and create a concise index subsuming plethora of discrete indicators and b) Ascertain supply side barriers in service provisioning via stakeholder’s analysis. Study also strives to expand analytical domain unravelling context and area specific intricacies associated with service delivery. Methodology: Mixed method approach was employed to triangulate quantitative analysis with qualitative nuances. Facility survey encompassing 90 Subcentres, 44 Primary health centres, 3 Community health centres and 1 District hospital was conducted to gauge general service availability and service specific availability (depth of coverage). Compendium of checklist was designed using Indian Public Health Standards (IPHS) in form of standard core questionnaire and scorecard generated for each facility. Information was collected across dimensions of amenities, equipment, medicines, laboratory and infection control protocols as proposed in WHO’s Service Availability and Readiness Assesment (SARA). Two stage polychoric principal component analysis employed to generate a parsimonious index by coalescing an array of tracer indicators. OLS regression method used to determine factors explaining composite index generated from PCA. Stakeholder analysis was conducted to discern qualitative information. Myriad of techniques like observations, key informant interviews and focus group discussions using semi structured questionnaires on both leaders and laggards were administered for critical stakeholder’s analysis. Results: General readiness score of health facilities was found to be 0.48. Results indicated poorest readiness for subcentres and PHC’s (first point of contact) with composite score of 0.47 and 0.41 respectively. For primary care facilities; principal component was characterized by basic newborn care as well as preparedness for delivery. Results revealed availability of equipment and surgical preparedness having lowest score (0.46 and 0.47) for facilities providing secondary care. Presence of contractual staff, more than 1 hr walk to facility, facilities in zone A (most vulnerable) to cross border shelling and facilities inaccessible due to snowfall and thick jungles was negatively associated with readiness index. Nonchalant staff attitude, unavailability of staff quarters, leakages and constraint in supply chain of drugs and consumables were other impediments identified. Conclusions/Policy Implications: It is pertinent to first strengthen primary care facilities in this setting. Complex dimensions such as geographic barriers, user and provider behavior is not under precinct of this methodology.

Keywords: effective coverage, principal component analysis, readiness index, universal health coverage

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Authors: Saranchuluun Otgon, Sugarmaa Myagmarjav, Khorolsuren Lkhagvasuren, Fabio Casati

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Background: Flourishing is a eudaimonic dimension of psychological well-being that has been associated with positive social and health-related outcomes. Determining the factors associated with health and well-being is important to the development of evidence-based intervention programs, policies, and action plans targeting the older adult population, especially in low- and middle-income countries, such as Mongolia, where evidence-based research on aging, health, and well-being is still scarce. This study makes important contributions to the study of well-being in later age and also to policy activities for the older population in Mongolia. Methods: We employed multiple regression models to predict the factors of flourishing using data from 304 older adults living in urban and rural Mongolia. Data is collected by the standardized and validated questionnaire adopted by Ed Diener. Results: The median score of the flourishing of urban and rural older adults in Mongolia was significantly different, 53 and 50, respectively. The sex (β = 2.52,p = 0.034), level of education(β = 0.94, p = 0.026), receive help for the activity of daily living (β = 2.16, p = 0.022) determine the flourishing of older adults living in a rural area, while self-reported health (β = 0.94, p = 0.026), the number of social activities, friends network determine to flourish of older adults living urban area. Conclusion: Older adults who live in urban areas have more psychological resources and strengths than those in rural areas. Determinants of flourishing are different in different settings. For instance, individual and family factors determine flourishing in rural areas, and social ties determine flourishing in urban areas.

Keywords: flourishing, predictors, older adults, Mongolia, psychological well-being

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Authors: Irfan Ahmad, Raza Ghafoor, Hammad Raza Ahmad, Muhammad Asif, Farrakh Nawaz, M. Tahir Siddiqui

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Due to the exploding population of Pakistan the pressure on natural forests is increasing to meet the demands of wood and wood based products. Agroforestry is being practiced throughout the world on scientific basis but unfortunately the farmers of Pakistan are reluctant in its adoption. The presents study was designed to assess the adoption of agroforestry practices in Faisalabad with respect to land holdings of farmers and future suitability by using Geographic information system (GIS). Faisalabad is the third largest city of the country and is famous due to the textile industry. A comprehensive survey from target villages of the Lyallpur town of Faisalabad district was carried out. Out of total 65 villages, 40 were selected for study. From each selected village, one farmer who was actively engaged in farming activities was selected. It was observed that medium sized farmers having 10-20 acre were more in number as compared to small and large farmers. Number of trees was found maximum in large farm lands, ratio of diseased trees was almost similar in all categories with maximum in small farmlands (24.1%). Regarding the future prospects 35% farmer were interested in agroforestry practices 65% were not interested in the promotion of trees due to the non-availability of technical guidance and proper markets. Geographic images of the study site can further help the researchers and policy makers in the promotion of agroforestry.

Keywords: agroforestry trends, adoption, Faisalabad, geographic information system (GIS)

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Authors: Hana A. Jameel Alsaeed, Rayyan Ibrahim Khaleel, Hanaa Hussein Mukhlif

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Background: Contamination in Iraq's hospitals is a localized problem with high rates of disease And deaths that mainly affect poor areas. Thus, this study aims to evaluate hospital infections in the city of Mosul and to identify the etiology. So to assess environmental infection prevention in pediatric wards and newborn critical care units in Mosul city. Methods: The present study is a cross-sectional hospital based in Mosul-Iraq between (10th February to 1st April 2022). Purposive sample of 60 nurses from neonatal intensive care units and pediatric wards in three pediatric teaching hospitals in Mosul city; Data was gathered using a questionnaire created by the researchers after reviewing previous studies. Results: The study showed that the majority of the study infection prevention and control policy isn't available in 46.7% of departments, and 45% of hospital workers in Iraq don't know if there is an Iraqi version of it. 70% of the study group had participated in an infection control training program. Conclusions: In the majority of samples 55% of respondents to the study claimed not to be aware of these rules. 60% of the study's participants had never attended a course on infection prevention and control, according to the study's findings on education and training programs. In the neonatal and critical care unit, nurses' skill levels, years of experience, and actual duties varied by wide statistically significant differences.

Keywords: pediatric, infection control, assessment, mosul city

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Authors: Shilpa Bagade Poharkar

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The basis for traditional notion of security was the use of force to preserve vital interest which based on either realism or power politics. The modern approach to security extends beyond the traditional notions of security which focus on issues as development and respect for human rights. In global politics, the issue of human security plays a vital role in most of the policy matter. In modern era, the protection of human rights is now recognized as one of the main functions of any legitimate modern state. The research paper will explore the relationship between human rights and security. United Nations is facing major challenges like rampant poverty, refugee outflows, human trafficking, displacement, conflicts, terrorism, intra-inter ethnic conflicts, proliferation of small arms, genocide, piracy, climate change, health issues and so on. The methodology is observed in this paper is doctrinaire which includes analytical and descriptive comparative method. The hypothesis of the paper is the relationship between human rights and a goal of United Nations to attain peace and security. Although previous research has been done in this field but this research paper will try to find out the challenges in the human security through human rights in the contemporary world and will provide measures for it. The study will focus on the following research questions: What are the issues and challenges United Nations facing while advancing human security through human rights? What measures the international community would take for ensuring the protection of human rights while protecting state security and contribute in the attainment of goals of United Nations?

Keywords: human rights, human security, peace, security, United Nations

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Authors: Clara T. Fatoye, April Betts, Abayomi Odeyemi, Francis A. Fatoye, Isaac O. Odeyemi

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Background: The post-launch stage is the last stage in the development of a pharmaceutical product. It is important to involve patients in the development of pharmaceutical products at the post-launch stage, as patients are the end-users of pharmaceutical products. It is expected that involving them might ensure an effective working relationship among the various stakeholders. However, involving patients in the development of pharmaceutical products comes with its problems. Hence, this study examined how to resolve problems experienced by involving patients in the developments of pharmaceutical products’ at post-launch consisting of Positioning of pharmaceutical products (POPP), detailing of pharmaceutical products (DOPP) and reimbursement and Formulary Submission (R&FS). Methods: A questionnaire was used for the present study. It was administered at the ISPOR Glasgow 2017 to 104 participants, all of which were professionals from Market access (MA) and health economics and outcomes research (HEOR) backgrounds. They were asked how the issues experienced by patients can be resolved. Participants responded under six domains as follows: communication, cost, effectiveness, external factors, Quality of life (QoL) and safety. Thematic analysis was carried out to identify strategies to resolve issues experienced by patients at the post-launch stage. Results: Three (3) factors cut across at POPP, DOPP, and R&FS that is (external factors, communication and QoL). The first resolution method was an external factor that is, the relationship with stakeholders and policymakers. Communication was also identified as a resolution method that can help to resolve problems experienced by patients at the post-launch stage. The third method was QoL as perceived by the patients based on professionals’ opinions. Other strategies that could be used to resolve problems experienced were the effectiveness of pharmaceutical products at the DOPP level and cost at R&FS. Conclusion: The study showed that focusing on external factors, communication, and patients’ QoL are methods for resolving issues experienced by involving patients at the post-launch stage of pharmaceutical product development. Hence, effective working relationships between patients, policymakers and stakeholders may help to resolve problems experienced at the post-launch stage. Healthcare policymakers are to be aware of these findings as they may help them to put appropriate strategies in place to enhance the involvement of patients in pharmaceutical product development at the post-launch stage, thereby improving the health outcomes of the patients.

Keywords: patients, pharmaceutical products, post-launch stage, quality of life, QoL

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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

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Authors: Daniel Chen, Chengyi Li, Naifu Xu, Shangxuan Yang

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Climate change has led to substantial changes in coastal ecosystems, including elevated ocean temperatures, increased acidity, and disrupted marine habitats. These environmental impacts have also resulted in the decline of traditional Indigenous food sources on the coast of British Columbia, including clams and salmon, which have been essential to the diet and cultural practices of the coastal Indigenous communities. This research evaluates and analyzes the costs and benefits of restoring and building clam gardens, an ancestral Indigenous mariculture technique in the Pacific Northwest. Clam gardens, which involve the construction of intertidal rock walls to enhance clam production, have been shown to more than triple clam yields compared to non-walled beaches. This research analyzes the costs and benefits to Indigenous individuals, including factors such as travel, equipment, time, food supply, and cultural engagement; then it discusses the potential of clam gardens as a significant food resource with additional environmental co-benefits, given the prevalence of clam gardens and coastlines in British Columbia. Moreover, the study concludes with policy recommendations to support the restoration and preservation of clam gardens, highlighting their potential to provide sustainable seafood production, environmental co-benefits, and social-environmental educational opportunities for Indigenous communities and the wider public.

Keywords: British Columbia coastline, clam garden, coastal resource management, Indigenous communities

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Authors: Mario Jose Paillacho Silva, José Ángel Pérez López

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This article delves into the critical role of circular economy principles in unlocking sustainable growth and addressing environmental inequalities in emerging markets. Circular economy practices, rooted in regenerative systems and resource conservation, offer a transformative pathway for dynamic economies to achieve prosperity while minimizing environmental impact. The article comprehensively explores the understanding of the circular economy in emerging markets, emphasizing its economic benefits, social implications, and environmental advantages. It highlights key challenges and opportunities faced by these markets and emphasizes the crucial role of governments in creating supportive policy frameworks. It emphasizes how circular economy practices empower local communities and promote social inclusion and equality. Furthermore, the article underscores how the adoption of circular economy practices can mitigate waste, pollution, and resource scarcity, thus contributing to climate change mitigation and adaptation. Integrating circular economy principles with the United Nations' sustainable development goals (SDGs), the article showcases the potential of circularity in fostering responsible consumption and production, sustainable economic growth, and environmental protection. Overall, the article advocates for cross-sector collaboration and knowledge sharing to overcome barriers and scale circular economy practices in emerging markets, ultimately leading to a more equitable, prosperous, and environmentally sustainable future.

Keywords: circular economy, sustainability, emerging markets, circularity

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