Search results for: public life
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 12122

Search results for: public life

8132 Literature Analysis of Nutrition in South Africa and How SA Harvest Aims to Improve Nutrition

Authors: Ali Conn, Kimberly Allen

Abstract:

Food and nutrition play a significant role in humans. It helps them function, grow, and develop into better individuals. However, as essential as food may seem to most people, it is not the case for everyone. South Africans, for example, have been suffering from hunger and poverty for the longest time now. With the spread of the COVID-19 virus, their situations have become worse. Millions of children and their families do not have access to food, hence no proper nutrition. They could barely make ends meet, so they make sure to make the most of what little they have for their household. Fortunately, organizations like SA Harvest aim to end hunger in South Africa. However, they still need to know more about how they can help South Africans with their current diet. Currently, most of the diets are composed of maize and rice. They do not have much to spend on fruits, so these commodities are seen as a luxury. With the help of organizations like SA Harvest, South Africans will be educated and more aware of what they need to eat.

Keywords: nutrition, public health, SA Harvest, food

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8131 Efficacy and Safety of Probiotic Treatment in Patients with Liver Cirrhosis: A Systematic Review and Meta-Analysis

Authors: Samir Malhotra, Rajan K. Khandotra, Rakesh K. Dhiman, Neelam Chadha

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There is paucity of data about safety and efficacy of probiotic treatment on patient outcomes in cirrhosis. Specifically, it is important to know whether probiotics can improve mortality, hepatic encephalopathy (HE), number of hospitalizations, ammonia levels, quality of life, and adverse events. Probiotics may improve outcomes in patients with acute or chronic HE. However, it is also important to know whether probiotics can prevent development of HE, even in situations where patients do not have acute HE at the time of administration. It is also important to know if probiotics are useful as primary prophylaxis of HE. We aimed to conduct an updated systematic review and meta-analysis to evaluate the safety and efficacy of probiotics in patients with cirrhosis. We searched PubMed, Cochrane library, Embase, Scopus, SCI, Google Scholar, conference proceedings, and references of included studies till June 2017 to identify randomised clinical trials comparing probiotics with other treatments in cirrhotics. Data was analyzed using MedCalc. Probiotics had no effect on mortality but significantly reduced HE (14 trials, 1073 patients, OR 0.371; 95% CI 0.282 to 0.489). There was not enough data to conduct a meta-analysis on outcomes like hospitalizations and quality of life. The effect on plasma ammonia levels was not significant (SMD -0.429; 95%CI -1.034 – 0.177). There was no difference in adverse events. To conclude, although the included studies had a high risk of bias, the available evidence does suggest a beneficial effect on HE. Larger studies with longer periods of follow-up are needed to determine if probiotics can reduce all-cause mortality.

Keywords: cirrhosis, hepatic encephalopathy, meta-analysis, probiotic

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8130 Efficacy and Safety of Computerized Cognitive Training Combined with SSRIs for Treating Cognitive Impairment Among Patients with Late-Life Depression: A 12-Week, Randomized Controlled Study

Authors: Xiao Wang, Qinge Zhang

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Background: This randomized, open-label study examined the therapeutic effects of computerized cognitive training (CCT) combined with selective serotonin reuptake inhibitors (SSRIs) on cognitive impairment among patients with late-life depression (LLD). Method: Study data were collected from May 5, 2021, to April 21, 2023. Outpatients who met diagnostic criteria for major depressive disorder according to the fifth revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria (i.e., a total score on the 17-item Hamilton Depression Rating Scale (HAMD-17) ≥ 18 and a total score on the Montreal Cognitive Assessment scale (MOCA) <26) were randomly assigned to receive up to 12 weeks of CCT and SSRIs treatment (n=57) or SSRIs and Control treatment (n=61). The primary outcome was the change in Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog) scores from baseline to week 12 between the two groups. The secondary outcomes included changes in the HAMD-17 score, Hamilton Anxiety Scale (HAMA) score and Neuropsychiatric Inventory (NPI) score. Mixed model repeated measures (MMRM) analysis was performed on modified intention-to-treat (mITT) and completer populations. Results: The full analysis set (FAS) included 118 patients (CCT and SSRIs group, n=57; SSRIs and Control group, n =61). Over the 12-week study period, the reduction in the ADAS-cog total score was significant (P < 0.001) in both groups, while MMRM analysis revealed a significantly greater reduction in cognitive function (ADAS-cog total scores) from baseline to posttreatment in the CCT and SSRIs group than in the SSRI and Control group [(F (1,115) =13.65, least-squares mean difference [95% CI]: −2.77 [−3.73, −1.81], p<0.001)]. There were significantly greater improvements in depression symptoms (measured by the HAMD-17) in the CCT and SSRIs group than in the control group [MMRM, estimated mean difference (SE) between groups −3.59 [−5.02, −2.15], p < 0.001]. The least-squares mean changes in the HAMA scores and NPI scores between baseline and week 8 were greater in the CCT and SSRIs group than in the control group (all P < 0.05). There was no significant difference between groups on response rates and remission rates by using the last-observation-carried-forward (LOCF) method (all P > 0.05). The most frequent adverse events (AEs) in both groups were dry mouth, somnolence, and constipation. There was no significant difference in the incidence of adverse events between the two groups. Conclusions: CCT combined with SSRIs was efficacious and well tolerated in LLD patients with cognitive impairment.

Keywords: late-life depression, cognitive function, computerized cognitive training, SSRIs

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8129 Introducing Information and Communication Technologies in Prison: A Proposal in Favor of Social Reintegration

Authors: Carmen Rocio Fernandez Diaz

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This paper focuses on the relevance of information and communication technologies (hereinafter referred as ‘ICTs’) as an essential part of the day-to-day life of all societies nowadays, as they offer the scenario where an immense number of behaviors are performed that previously took place in the physical world. In this context, areas of reality that have remained outside the so-called ‘information society’ are hardly imaginable. Nevertheless, it is possible to identify a means that continue to be behind this reality, and it is the penitentiary area regarding inmates rights, as security aspects in prison have already be improved by new technologies. Introducing ICTs in prisons is still a matter subject to great rejections. The study of comparative penitentiary systems worldwide shows that most of them use ICTs only regarding educational aspects of life in prison and that communications with the outside world are generally based on traditional ways. These are only two examples of the huge range of activities where ICTs can carry positive results within the prison. Those positive results have to do with the social reintegration of persons serving a prison sentence. Deprivation of liberty entails contact with the prison subculture and the harmful effects of it, causing in cases of long-term sentences the so-called phenomenon of ‘prisonization’. This negative effect of imprisonment could be reduced if ICTs were used inside prisons in the different areas where they can have an impact, and which are treated in this research, as (1) access to information and culture, (2) basic and advanced training, (3) employment, (4) communication with the outside world, (5) treatment or (6) leisure and entertainment. The content of all of these areas could be improved if ICTs were introduced in prison, as it is shown by the experience of some prisons of Belgium, United Kingdom or The United States. However, rejections to introducing ICTs in prisons obey to the fact that it could carry also risks concerning security and the commission of new offences. Considering these risks, the scope of this paper is to offer a real proposal to introduce ICTs in prison, trying to avoid those risks. This enterprise would be done to take advantage of the possibilities that ICTs offer to all inmates in order to start to build a life outside which is far from delinquency, but mainly to those inmates who are close to release. Reforming prisons in this sense is considered by the author of this paper an opportunity to offer inmates a progressive resettlement to live in freedom with a higher possibility to obey the law and to escape from recidivism. The value that new technologies would add to education, employment, communications or treatment to a person deprived of liberty constitutes a way of humanization of prisons in the 21st century.

Keywords: deprivation of freedom, information and communication technologies, imprisonment, social reintegration

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8128 Temperature Susceptibility of Multigrade Bitumen Asphalt and an Approach to Account for Temperature Variation through Deep Pavements

Authors: Brody R. Clark, Chaminda Gallage, John Yeaman

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Multigrade bitumen asphalt is a quality asphalt product that is not utilised in many places globally. Multigrade bitumen is believed to be less sensitive to temperature, which gives it an advantage over conventional binders. Previous testing has shown that asphalt temperature changes greatly with depth, but currently the industry standard is to nominate a single temperature for design. For detailed design of asphalt roads, perhaps asphalt layers should be divided into nominal layer depths and different modulus and fatigue equations/values should be used to reflect the temperatures of each respective layer. A collaboration of previous laboratory testing conducted on multigrade bitumen asphalt beams under a range of temperatures and loading conditions was analysed. The samples tested included 0% or 15% recycled asphalt pavement (RAP) to determine what impact the recycled material has on the fatigue life and stiffness of the pavement. This paper investigated the temperature susceptibility of multigrade bitumen asphalt pavements compared to conventional binders by combining previous testing that included conducting a sweep of fatigue tests, developing complex modulus master curves for each mix and a study on how pavement temperature changes through pavement depth. This investigation found that the final design of the pavement is greatly affected by the nominated pavement temperature and respective material properties. This paper has outlined a potential revision to the current design approach for asphalt pavements and proposes that further investigation is needed into pavement temperature and its incorporation into design.

Keywords: asphalt, complex modulus, fatigue life, flexural stiffness, four point bending, multigrade bitumen, recycled asphalt pavement

Procedia PDF Downloads 356
8127 The Television as an Affordable and Effective Way to Promote Healthy Diet and Physical Activity to Prevent or Treat Obesity

Authors: P. Gil Del Álamo, J. García Pereda, A. Castañeda De La Paz, D. Arazola Lopez, M. D. Cubiles De La Vega, A. Enguíx González, J. M. Muñoz Pichardo

Abstract:

In the last decades, obesity has more than doubled and is, with overweight, the second leading cause of preventable death. Despite multiple strategies against obesity, no country to date has reduced the number of obese people. To achieve World Health Organization’s target to reverse this tendency we need dramatic and different actions to engage the civil society in creating demand for a healthy style of life. The objective of this study is to demonstrate that a social media as the television can be used to convince the civil society that a healthy nutrition and physical activity are affordable, effective and necessary to prevent and to treat the obesity. Methodology: 61 individuals (34 women and 27 men) with obesity (mean BMI 45,51) were recruited to follow during 22 weeks an intensive lifestyle intervention in order to lose weight in a healthy manner. They were not isolated or moved from their usual environment. This program included endocrinological and nutritional assessment, promotion of physical activity and psychological support. BMI was measured every week. Time to leave obesity between men and women was analyzed with a survival analysis. Results: BMI decreased in all the cases. Analysing Time to leave obesity, around the week 30, 25% of men leave the obesity and around the week 39, 25% of women leave the obesity too. Conclusion: We demonstrate the audience that improving the quality of the diet and increasing the physical activity is a realistic way to lose weight. This evidence can encourage the people to act in their own self-interest changing their style of life in order to prevent or to reduce their overweight.

Keywords: obesity epidemic, obesity prevention, obesity strategies, social media

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8126 Phishing Attacks Facilitated by Open Source Intelligence

Authors: Urva Maryam

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Information has become an important asset to the current cosmos. Globally, various tactics are being observed to confine the spread of information as it makes people vulnerable to security attacks. Open Source Intelligence (OSINT) is a publicly available source that has disseminated information about users or website, companies, and various organizations. This paper focuses on the quantitative method of exploring various OSINT tools that reveal public information of personals. This information could further facilitate the phishing attacks. Phishing attacks can be launched on email addresses, open ports, and unsecured web-surfing. This study allows to analyze information retrieved from OSINT tools i.e., the Harvester, and Maltego, that can be used to send phishing attacks to individuals.

Keywords: OSINT, phishing, spear phishing, email spoofing, the harvester, maltego

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8125 Use of High Hydrostatic Pressure as an Alternative Preservation Method in Camels Milk

Authors: Fahad Aljasass, Hamza Abu-Tarboush, Salah Aleid, Siddig Hamad

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The effects of different high hydrostatic pressure treatments on the shelf life of camel’s milk were studied. Treatments at 300 to 350 MPa for 5 minutes at 40°C reduced microbial contamination to levels that prolonged the shelf life of refrigerated (3° C) milk up to 28 days. The treatment resulted in a decrease in the proteolytic activity of the milk. The content of proteolytic enzymes in the untreated milk sample was 4.23 µM/ml. This content decreased significantly to 3.61 µM/ml when the sample was treated at 250 MPa. Treatment at 300 MPa decreased the content to 3.90 which was not significantly different from the content of the untreated sample. The content of the sample treated at 350 MPa dropped to 2.98 µM/ml which was significantly lower than the contents of all other treated and untreated samples. High pressure treatment caused a slight but statistically significant increase in the pH of camel’s milk. The pH of the untreated sample was 6.63, which increased significantly to 6.70, in the samples treated at 250 and 350 MPa, but insignificantly in the sample treated at 300 MPa. High pressure treatment resulted in some degree of milk fat oxidation. The thiobarbituric acid (TBA) value of the untreated sample was 0.86 mg malonaldehyde/kg milk. This value remained unchanged in the sample treated at 250 MPa, but then it increased significantly to 1.25 and 1.33 mg/kg in the samples treated at 300 and 350 MPa, respectively. High pressure treatment caused a small increase in the greenness (a* value) of camel’s milk. The value of a* was reduced from -1.17 for the untreated sample to -1.26, -1.21 and -1.30 for the samples treated at 250, 300 and 350 MPa, respectively. Δa* at the 250 MPa treatment was -0.09, which then decreased to -0.04 at the 300 MPa treatment to increase again to -0.13 at the 350 MPa treatment. The yellowness (b* value) of camel’s milk increased significantly as a result of high pressure treatment. The b* value of the untreated sample was 1.40, this value increased to 2.73, 2.31 and 2.18 after treatments at 250, 300 and 350 MPa, respectively. The Δb* value was +1.33 at the treatment 250 MPa, decreased to +0.91 at 300 MPa and further to +0.78 at 350 MPa. The pressure treatment caused slight effect on color, slight decrease in protease activity and a slight increase in the oxidation products of lipids.

Keywords: high hydrostatic pressure, camel’s milk, mesophilic aerobic bacteria, clotting, protease

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8124 The Protection of Artificial Intelligence (AI)-Generated Creative Works Through Authorship: A Comparative Analysis Between the UK and Nigerian Copyright Experience to Determine Lessons to Be Learnt from the UK

Authors: Esther Ekundayo

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The nature of AI-generated works makes it difficult to identify an author. Although, some scholars have suggested that all the players involved in its creation should be allocated authorship according to their respective contribution. From the programmer who creates and designs the AI to the investor who finances the AI and to the user of the AI who most likely ends up creating the work in question. While others suggested that this issue may be resolved by the UK computer-generated works (CGW) provision under Section 9(3) of the Copyright Designs and Patents Act 1988. However, under the UK and Nigerian copyright law, only human-created works are recognised. This is usually assessed based on their originality. This simply means that the work must have been created as a result of its author’s creative and intellectual abilities and not copied. Such works are literary, dramatic, musical and artistic works and are those that have recently been a topic of discussion with regards to generative artificial intelligence (Generative AI). Unlike Nigeria, the UK CDPA recognises computer-generated works and vests its authorship with the human who made the necessary arrangement for its creation . However, making necessary arrangement in the case of Nova Productions Ltd v Mazooma Games Ltd was interpreted similarly to the traditional authorship principle, which requires the skills of the creator to prove originality. Although, some recommend that computer-generated works complicates this issue, and AI-generated works should enter the public domain as authorship cannot be allocated to AI itself. Additionally, the UKIPO recognising these issues in line with the growing AI trend in a public consultation launched in the year 2022, considered whether computer-generated works should be protected at all and why. If not, whether a new right with a different scope and term of protection should be introduced. However, it concluded that the issue of computer-generated works would be revisited as AI was still in its early stages. Conversely, due to the recent developments in this area with regards to Generative AI systems such as ChatGPT, Midjourney, DALL-E and AIVA, amongst others, which can produce human-like copyright creations, it is therefore important to examine the relevant issues which have the possibility of altering traditional copyright principles as we know it. Considering that the UK and Nigeria are both common law jurisdictions but with slightly differing approaches to this area, this research, therefore, seeks to answer the following questions by comparative analysis: 1)Who is the author of an AI-generated work? 2)Is the UK’s CGW provision worthy of emulation by the Nigerian law? 3) Would a sui generis law be capable of protecting AI-generated works and its author under both jurisdictions? This research further examines the possible barriers to the implementation of the new law in Nigeria, such as limited technical expertise and lack of awareness by the policymakers, amongst others.

Keywords: authorship, artificial intelligence (AI), generative ai, computer-generated works, copyright, technology

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8123 Planning for Sustainability in the Built Environment

Authors: Adedayo Jeremiah Adeyekun, Samuel Oluwagbemiga Ishola

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This paper aimed to identify the significance of sustainability in the built environment, the economic and environmental importance to building and construction projects. Sustainability in the built environment has been a key objective of research over the past several decades. Sustainability in the built environment requires reconciliation between economic, environmental and social impacts of design and planning decisions made during the life cycle of a project from inception to termination. Planning for sustainability in the built environment needs us to go beyond our individual disciplines to consider the variety of economic, social and environmental impacts of our decisions in the long term. A decision to build a green residential development in an isolated location may pass some of the test of sustainability through its reduction in stormwater runoff, energy efficiency, and ecological sustainability in the building, but it may fail to be sustainable from a transportation perspective. Sustainability is important to the planning, design, construction, and preservation of the built environment; because it helps these activities reflect multiple values and considerations. In fact, the arts and sciences of the built environment have traditionally integrated values and fostered creative expression, capabilities that can and should lead the sustainability movement as society seeks ways to live in dynamic balance with its own diverse needs and the natural world. This research aimed to capture the state-of-the-art in the development of innovative sustainable design and planning strategies for building and construction projects. Therefore, there is a need for a holistic selection and implication approach for identifying potential sustainable strategies applicable to a particular project and evaluating the overall life cycle impact of each alternative by accounting for different applicable impacts and making the final selection among various viable alternatives.

Keywords: sustainability, built environment, planning, design, construction

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8122 Clinical Efficacy and Tolerability of Dropsordry™ in Spanish Perimenopausal Women with Urgency Urinary Incontinence (UUI)

Authors: J. A. Marañón, L. Lozano C. De Los Santos, L. Martínez-Campesino, E. Caballero-Garrido, F. Galán-Estella

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Urinary incontinence (UI) is a significant health problem with considerable social and economic impact. An estimated 30% of women aged 30 to 60 years old have urinary incontinence (UI), while more than 50% of community-dwelling older women have the condition. Stress urinary incontinence and overactive bladder are the common types of incontinence The prevalence of stress and mixed (stress and urge) incontinence is higher than urge incontinence, but the latter is more likely to require treatment. In women, moderate and severe have a prevalence ranging from about 12% to 17% The objectives of this study was to examine the effect of the supplementation of tablets containing Dropsordry in women with urge urinary incontinence (UUI). Dropsordry is a novel active containing phytoestrogens from SOLGEN, the high genistin soy bean extract and pyrogallol plus polyphenols from standarized pumpkin seed extract,. The study was a single-center, not randomiized open prospective, study. 28 women with urinary incontinence ≥45 years were enrolled in this study (45-62 y. old age . Mean 52 y old). Items related to UI symptoms, were previously collected (T0) and these ítems were reviewed at the final of the study – 8 weeks. (T2). The presence of UI was previously diagnosed using the International Continence Society standards (ICS). Relationships between presence of UI and potential related factors as diabetes were also explored. Daily urinary test control was performed during the 8 weeks of treatment. Daily dosage was 1 g/ day (500 mg twice per day) from 0 to 4 week (T1), following a 500 mg/day daily intake from 4 to 8 week (T2). After eight weeks of treatment, the urgency grade score was reduced a 24,7%. The total urge episodes was reduced a 46%. Surprisingly there was no a significant change in daytime urinations (< 5%), however nocturia was reduced a 69,35%. Strenght Urinary Incontinence (SUI) was also tested showing a remarkably 52,17% reduction. Moreover the use of daily pantyliners was reduced a 66,25%. In addition, it was performed a panel test survey with quests when subjects of the study were enrolled (T0) and the same quests was performed after 8 weeks of supplementation (T2). 100% of the enrolled women fullfilled the ICIQ-SF quest (Spanish versión) and they were also questioned about the effects they noticed in response to taking the supplement and the change in quality of life. Interestingly no side effects were reported. There was a 96,2% of subjective satisfaction and a 85,8% objective score in the improvement of quality of life. CONCLUSION: the combination of High genistin isoflavones and pumpkin seed pyrogallol in Dropsordry tablets seems to be a safe and highly effective supplementation for the relieve of the urinary incontinence symptoms and a better quality of life in perimenopause women .

Keywords: isoflavones, pumpkin, menopause, incontinence, genistin

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8121 Social Media as a Tool for Political Communication: A Case Study of India

Authors: Srikanth Bade

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This paper discusses how the usage of social media has altered certain discourses and communicated with the political institutions for major actions in Indian scenario. The advent of new technology in the form of social media has engrossed the general public to discuss in the open forum. How they promulgated their ideas into action is captured in this study. Moreover, these discourses happening in the social media is analyzed from certain philosophical traditions by adopting a framework. Hence, this paper analyses the role of social media in political communication and change the political discourse. Also, this paper tries to address the issue that whether the deliberation made through social media had indeed communicated the issue of political matters to the decision making authorities.

Keywords: collective action and social capital, political communication, political discourse, social media

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8120 The Potential of Role Models in Enhancing Smokers' Readiness to Change (Decision to Quit Smoking): A Case Study of Saudi National Anti-Smoking Campaign

Authors: Ghada M. AlSwayied, Anas N. AlHumaid

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Smoking has been linked to thousands of deaths worldwide. Around three million adults continue to use tobacco each day in Saudi Arabia; a sign that smoking is prevalent among Saudi population and obviously considered as a public health threat. Although the awareness against smoking is continuously running, it can be observed that smoking behavior increases noticeably as common practice especially among young adults across the world. Therefore, it was an essential step to guess what does motivate smokers to think about quit smoking. Can a graphic and emotional ad that is focusing on health consequences do really make a difference? A case study has been conducted on the Annual Anti-Smoking National Campaign, which was provided by Saudi Ministry of Health in the period of May 2017. To assess campaign’s effects on the number of calls, the number of visits and online access to health messages during and after the campaign period from May to August compared with the previous campaign in 2016. The educational video was selected as a primary tool to deliver the smoking health message. The Minister of Health who is acting as a role model for young adults was used to deliver a direct message to smokers with an avoidance of smoking cues usage. Due to serious consequences of smoking, the Minister of Health delivered the news of canceling the media campaign and directing the budget to smoking cessation clinics. It was shown that the positive responses and interactions on the campaign were obviously remarkable; achieving a high rate of recall and recognition. During the campaign, the number of calls to book for a visit reached 45880 phone calls, and the total online views ran to 1,253,879. Whereas, clinic visit raised up to 213 cumulative percent. Interestingly, a total number of 15,192 patients visited the clinics along three months compared with the last year campaign’s period, which was merely 4850 patients. Furthermore, around half of patients who visited the clinics were in the age from 26 to 40-year-old. There was a great progress in enhancing public awareness on: 'where to go' to assist smokers in making a quit attempt. With regard to the stages of change theory, it was predicted that by following direct-message technique; the proportion of patients in the contemplation and preparation stages would be increased. There was no process evaluation obtained to assess implementation of the campaigns’ activities.

Keywords: smoking, health promotion, role model, educational material, intervention, community health

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8119 Transmission of Intergenerational Trauma: Protecting Those who Still Suffer from Pain of their Ancestors’ Trauma

Authors: Bonnie Pollak

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As the world continues to suffer grievous injuries, future generations will suffer from trauma that was inflicted on innocent victims. Trauma can result from refugees fleeing their homes, exposure to warfare, loss of loved ones, and lack of shelter and basic necessities. The Holocaust continues to cause pain even though WWII ended nearly 80 years ago. One cannot forget the inhumane treatment and murder of relatives. The pain and trauma may continue for generations. The purpose of the Final Solution was to eliminate Jews in totality. Though Hitler’s plan was not successful, he managed to cause trauma that will continue with no end date in sight. “The Effects of Trauma and Secondary Trauma,” Trauma can cause life-long challenges, eating disorders, cardiovascular disease, cancer, sleeping difficulties, fear of going outside, guilt, separation problems, and epigenetic changes. Secondary Trauma, witnessing a loved one in danger or hearing about the danger, can cause similar symptoms as seen in primary trauma. The transmission of trauma was demonstrated in children of Holocaust survivors and in communities where oppression was commonplace. We are witnessing a repeat of widescale death and horrific injuries today in Ukraine and in other parts of the world, where concern for pain and trauma is not acknowledged by perpetrators. Lessons from the Holocaust can be applied to help others who have been traumatized by widescale terrorism resulting in death of loved ones, loss of home and shelter, food and other life-sustaining measures. The world must help victims by providing basic necessities but also by using trauma-informed care, focusing on strength and resilience, and helping individuals to feel pride in their identity.

Keywords: transmission of intergenerational trauma, impact on religious beliefs and practices, 2nd generation, identity

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8118 A View from inside: Case Study of Social Economy Actors in Croatia

Authors: Drazen Simlesa, Jelena Pudjak, Anita Tonkovic Busljeta

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Regarding social economy (SE), Croatia is, on general level, considered as ex-communist country with good tradition, bad performance in second part of 20th Century because of political control in the business sector, which has in transition period (1990-1999) became a problem of ignorance in public administration (policy level). Today, social economy in Croatia is trying to catch up with other EU states on all important levels of SE sector: legislative and institutional framework, financial infrastructure, education and capacity building, and visibility. All four are integral parts of Strategy for the Development of Social Entrepreneurship in the Republic of Croatia for the period of 2015 – 2020. Within iPRESENT project, funded by Croatian Science Foundation, we have mapped social economy actors and after many years there is a clear and up to date social economy base. At the ICSE 2016 we will present main outcomes and results of this process. In the second year of the project we conducted a field research across Croatia carried out 19 focus groups with most influential, innovative and inspirational social economy actors. We divided interview questions in four themes: laws on social economy and public policies, definition/ideology of social economy and cooperation on SE scene, the level of democracy and working conditions, motivation and existence of intrinsic values. The data that are gathered through focus group interviews has been analysed via qualitative data analysis software (Atlas ti.). Major finding that will be presented in ICSA 2016 are: Social economy actors are mostly unsatisfied with legislative and institutional framework in Croatia and consider it as unsupportive and confusing. Social economy actors consider SE to be in the line with WISE model and as a tool for community development. The SE actors that are more active express satisfaction with cooperation amongst SE actors and other partners and stakeholders, but the ones that are in more isolated conditions (spatially) express need for more cooperation and networking. Social economy actors expressed their praise for democratic atmosphere in their organisations and fair working conditions. And finally, they expressed high motivation to continue to work in the social economy and are dedicated to the concept, including even those that were at the beginning interested just in getting a quick job. It means that we can detect intrinsic values for employees in social economy organisations. This research enabled us to describe for the first time in Croatia the view from the inside, attitudes and opinion of employees of social economy organisations.

Keywords: employees, focus groups, mapping, social economy

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8117 Fatigue Life Prediction under Variable Loading Based a Non-Linear Energy Model

Authors: Aid Abdelkrim

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A method of fatigue damage accumulation based upon application of energy parameters of the fatigue process is proposed in the paper. Using this model is simple, it has no parameter to be determined, it requires only the knowledge of the curve W–N (W: strain energy density N: number of cycles at failure) determined from the experimental Wöhler curve. To examine the performance of nonlinear models proposed in the estimation of fatigue damage and fatigue life of components under random loading, a batch of specimens made of 6082 T 6 aluminium alloy has been studied and some of the results are reported in the present paper. The paper describes an algorithm and suggests a fatigue cumulative damage model, especially when random loading is considered. This work contains the results of uni-axial random load fatigue tests with different mean and amplitude values performed on 6082T6 aluminium alloy specimens. The proposed model has been formulated to take into account the damage evolution at different load levels and it allows the effect of the loading sequence to be included by means of a recurrence formula derived for multilevel loading, considering complex load sequences. It is concluded that a ‘damaged stress interaction damage rule’ proposed here allows a better fatigue damage prediction than the widely used Palmgren–Miner rule, and a formula derived in random fatigue could be used to predict the fatigue damage and fatigue lifetime very easily. The results obtained by the model are compared with the experimental results and those calculated by the most fatigue damage model used in fatigue (Miner’s model). The comparison shows that the proposed model, presents a good estimation of the experimental results. Moreover, the error is minimized in comparison to the Miner’s model.

Keywords: damage accumulation, energy model, damage indicator, variable loading, random loading

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8116 Social Networks as a Tool for Sports Marketing

Authors: Márcia Aparecida Teixeira

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Sports, in particular football, boosts considerably the financial market of a certain locality, be it city or even a country. The financial transactions involving this medium stand out from other existing businesses, such as small industries. Strategically, social networks are inserted in this sporting environment, in order to promote and attract new fans of this modality. The present study analyzes the use of social networks in Sports Marketing with a focus on football. For the object of this study, it was chosen a specific club, the Club Atlético Mineiro, a Brazilian club of great national notoriety. The social networks on focus will be: Facebook, Twitter, and Instagram. It will be analyzed the content and frequency of the posts, reception of the target public in relation to the content made available and its feedback.

Keywords: social network, sport, strategy, marketing

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8115 Employees’ Work Performance Quality Development for Organizational Competency

Authors: Pornpong Porpraphant

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This paper aimed to demonstrate how work performance quality development activity carried out for employees in an organization could lead to the organizational success and competency as a whole. The case studies selected for this research were the Thai huge corporate including Siam Cement Group or SCG, PTT Public Company Limited, and Electricity Generating Authority of Thailand or EGAT. The in- depth interview was applied with the three main groups that included the facilitator group, the managerial group, and the operational officer group. The Plan- Do- Check- Act approach was also utilized as to build up a conceptual model in corporate management that fostered employees’ knowledge acquisition, resulting in an improved work performance.

Keywords: high performance organization, quality, work performance quality development

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8114 Mineralogical Characterization and Petrographic Classification of the Soil of Casablanca City

Authors: I. Fahi, T. Remmal, F. El Kamel, B. Ayoub

Abstract:

The treatment of the geotechnical database of the region of Casablanca was difficult to achieve due to the heterogeneity of the nomenclature of the lithological formations composing its soil. It appears necessary to harmonize the nomenclature of the facies and to produce cartographic documents useful for construction projects and studies before any investment program. To achieve this, more than 600 surveys made by the Public Laboratory for Testing and Studies (LPEE) in the agglomeration of Casablanca, were studied. Moreover, some local observations were made in different places of the metropolis. Each survey was the subject of a sheet containing lithological succession, macro and microscopic description of petrographic facies with photographic illustration, as well as measurements of geomechanical tests. In addition, an X-ray diffraction analysis was made in order to characterize the surficial formations of the region.

Keywords: Casablanca, guidebook, petrography, soil

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8113 Social Justice and Castes Discrimination: Experiences of Scheduled Castes Students in India

Authors: Dhaneswar Bhoi

Abstract:

In Indian History, the Dalits (Scheduled Castes) were exploited with caste, since the Vedic Age (1500 BCE). They were deprived of many rights in the society and their education was also restricted by the upper castes since the introduction of the Law of Manu (1500 BCE). The Dalits were treated as lower castes (Sudras and Ati-Sudra) in the society. Occupation of these caste groups were attached to some low profile and menial occupation. Whereas, the upper caste (Brahamins) declared themselves as the top most caste groups who chose the occupation of priests and had the supreme right to education. During those days occupation was not decided by the caliber of a person rather, it was decided by the upper caste Brahamins and kept on transferring from one generation to another generation. At this juncture of the society, the upper caste people oppressed and suppressed the lower caste people endlessly. To get rid of these social problems the emancipator and the charismatic leader (Prophet for the lower caste communities), Dr. Babasaheb Ambedkar appeard in the scene of Indian unjust society. Restlessly he fought against the caste oppression, social dogmas and tyranny on the basis of caste. Finally, he succeeded to affirm statutory safeguards for the oppressed and depressed or lower caste communities. Today these communities are scheduled as Scheduled Castes to access social justice for their upliftment and development. Through the liberty, equality and fraternity, he established social justice for the first time in the Indian history with the implementation of Indian Constitution on 26th January 1950. Since then the social justice has been accessed through the Constitution and Indian Republics. However, even after sixty five years of the Indian Republic and Constitutional safeguards the Scheduled Castes (SCs) are suffering many problems in the phases of their life. Even if there are special provisions made by the state aimed to meet the challenges of the weaker sections, they are still deprived of access to it, which is true especially for the Dalits or SCs. Many of the people of these communities are still not accessing education and particularly, higher education. Those who are managing to access the education have been facing many challenges in their educational premises as well as in their social life. This paper tries to find out the problem of discrimination in educational and societal level. Secondly, this paper aims to know the relation between the discrimination and access to social justice for the SCs in the educational institution and society. It also enquires the experiences of SCs who faced discrimination in their educational and social life. This study is based on the both quantitative and qualitative methods. Both of which were interpreted through the data triangulation method in mixed methodology approach. In this paper, it is found that the SCs are struggling with injustice in their social and educational spheres. Starting from their primary level to higher education, they were discriminated in curricular, co-curricular and extra-curricular activities.

Keywords: social justice, discrimination, caste, scheduled castes, education

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8112 Contemporary Mexican Shadow Politics: The War on Drugs and the Issue of Security

Authors: Lisdey Espinoza Pedraza

Abstract:

Organised crime in Mexico evolves faster that our capacity to understand and explain it. Organised gangs have become successful entrepreneurs in many ways ad they have somehow mimicked the working ways of the authorities and in many cases, they have successfully infiltrated the governmental spheres. This business model is only possible under a clear scheme of rampant impunity. Impunity, however, is not exclusive to the PRI. Nor the PRI, PAN, or PRD can claim the monopoly of corruption, but what is worse is that none can claim full honesty in their acts either. The current security crisis in Mexico shows a crisis in the Mexican political party system. Corruption today is not only a problem of dishonesty and the correct use of public resources. It is the principal threat to Mexican democracy, governance, and national security.

Keywords: security, war on drugs, drug trafficking, Mexico, Latin America, United States

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8111 The Integration of Prosecutorial Discretion in the Anti-Money Laundering Regime in Nigeria: A Focus on Politically Exposed Persons

Authors: Chineduum Okpala

Abstract:

Nigeria, since her independence, has been engulfed in financial crimes of different forms. From embezzlement and conversion of public funds by public servants to stealing, contract inflation, and money laundering. Money laundering in Nigeria, particularly by political exposed persons, has been an issue of concern since independence. Corruption has been endemic, and Nigeria needs to integrate pro-active measures to show to the international community that it is ready to move against this vice. This paper discusses the negative effect of corruption and its effect on prosecutorial discretion. It also takes cognisance of the policy and aims of the anti-money laundering (AML) policy as enacted in Nigeria. It also takes as valid the assumption that the effective application of the rule of law will improve the efficacy of the Nigerian regime. In this regard, the perspective is internal to the Nigerian regime and its internal policy discourse which also reflect its policy discourse at international level. This paper takes notice of the typology of money laundering (ML) offences that most affect Nigeria, which hinges on corruption and abuse of office by a specific type of person, politically exposed persons (PEP). This typology of money laundering offence appears to be the most prevalent in developing nations like Nigeria. The application of essential principles of law provides an opportunity for the internalisation of the rule of law in the anti-money laundering regime in Nigeria, which could aid the successful prosecution of politically exposed persons on money laundering offences. The rule of law and how well the Nigerian legal system manages to deal with the interface between high level politics and the criminal justice system in Nigeria cannot be understood from internal sources but must be developed as a genuine but critical account informed by perspectives external to the Nigerian regime. If the efficacy of the regime is to be assessed in view of notorious failures of the regime, an external assessment is needed. Hence the paper discusses the need to integrate the essential principles of law in the application of prosecutorial discretion in the anti-money laundering regime in Nigeria, particularly with politically exposed persons. The paper highlights jurisdiction where prosecutorial discretion is integrated into the anti-money laundering regime in accordance to the rule of law which forms a basis for comparative analysis of the success of the anti-money laundering regime in Nigeria. This paper discusses why the application of prosecutorial discretion should not be used as a tool to extricate or avail the rich and powerful in the society from justice. The paper aims to argue that the successful prosecution of politically exposed persons, will raise the confidence of the citizens and the international community in the anti-money laundering regime in Nigeria.

Keywords: money laundering, politically exposed persons, corruption, Nigeria

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8110 Delhi Metro: A Race towards Zero Emission

Authors: Pramit Garg, Vikas Kumar

Abstract:

In December 2015, all the members of the United Nations Framework Convention on Climate Change (UNFCCC) unanimously adopted the historic Paris Agreement. As per the convention, 197 countries have followed the guidelines of the agreement and have agreed to reduce the use of fossil fuels and also reduce the carbon emission to reach net carbon neutrality by 2050 and reduce the global temperature by 2°C by the year 2100. Globally, transport accounts for 23% of the energy-related CO2 that feeds global warming. Decarbonization of the transport sector is an essential step towards achieving India’s nationally determined contributions and net zero emissions by 2050. Metro rail systems are playing a vital role in the decarbonization of the transport sector as they create metro cities for the “21st-century world” that could ensure “mobility, connectivity, productivity, safety and sustainability” for the populace. Metro rail was introduced in Delhi in 2002 to decarbonize Delhi-National Capital Region and to provide a sustainable mode of public transportation. Metro Rail Projects significantly contribute to pollution reduction and are thus a prerequisite for sustainable development. The Delhi Metro is the 1ˢᵗ metro system in the world to earn carbon credits from Clean Development Mechanism (CDM) projects registered under United Nations Framework Convention on Climate Change. A good Metro Project with reasonable network coverage attracts a modal shift from various private modes and hence fewer vehicles on the road, thus restraining the pollution at the source. The absence of Greenhouse Gas emissions from the vehicle of modal shift passengers and lower emissions due to decongested roads contribute to the reduction in Green House Gas emissions and hence overall reduction in atmospheric pollution. The reduction in emission during the horizon year 2002 to 2019 has been estimated using emission standards and deterioration factor(s) for different categories of vehicles. Presently, our results indicate that the Delhi Metro system has reduced approximately 17.3% of motorized trips by road resulting in an emission reduction significantly. Overall, Delhi Metro, with an immediate catchment area of 17% of the National Capital Territory of Delhi (NCTD), is helping today to reduce 387 tonnes of emissions per day and 141.2 ktonnes of emissions yearly. The findings indicate that the Metro rail system is driving cities towards a more livable environment.

Keywords: Delhi metro, GHG emission, sustainable public transport, urban transport

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8109 The Importance of Development Evaluation to Preterm Children in Remote Area

Authors: Chung-Yuan Wang, Min Hsu, Bo-Ya Juan, Hsiv Ching Lin, Hsveh Min Lin, Hsiu-Fang Yeh

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The success of Taiwan's National Health Insurance (NHI) system attracts widespread praise from the international society. However, the availability of medical care in a emote area is limited. Without the convenient public transportation system and mature social welfare policy, these people are difficult to regain their health and prevent disability. Preterm children have more risk to get development delay. Preterm children in a remote area have the human right to get rehabilitation resources as those in the city area. Therefore, the aim of this study was to show the importance of development screening to preterm children in a remote area and a tract the government to notice the issue. In Pingtung, children who are suspected development delay would be suggested to take a skillful screening evaluation in our hospital. Those preterm children (within 1-year-old) visited our pediatric clinic would also be referred to take the development evaluation. After the physiatrist’s systemic evaluation, the subjects would be scheduled to take the development evaluation. Gross motor, fine motor, speech comprehension/expression and mental study were included. The evaluation was in-charged by a physical therapist, occupational therapy, speech therapist and pediatric psychologist. The tools were Peabody developmental scale, Bayley Scales of Infant and Toddler Development (Bayley-III) and Wechsler Preschool & Primary Scale of Intelligence-Revised (WPPSI-R). In 2013, 459 children received the service in our hospital. Among these children, fifty-seven were noted with preterm baby history (gestation within 37 weeks). Thirty-six of these preterm children, who had never receive development evaluation, were included in this study. Thirty-six subjects (twenty-six male and ten female) were included. Nineteen subjects were found development delay. Six subjects were found suspected development delay. In gross motor, six subjects were development delay and eight were suspected development delay. In fine motor, five subjects were development delay and three were suspected development delay. In speech, sixteen subjects were development delay and six were suspected development delay. In our study, through the provision of development evaluation service, 72.2% preterm baby were found their development delay or suspected delay. They need further early intervention rehabilitation service. We made their parents realize that when development delay was recognized at the early stage, they are often reversible. No only the patients but also their families were improved their health status. The number of the subjects was limited in our study. Further study might be needed. Compared with 770 physical therapist (PT) and 370 occupational therapy (OT) in Taipei, there are only 108 PT and 54 OT in Pingtung. Further, there are much fewer therapists working on the field of pediatric rehabilitation. Living healthy is a human's right, no matter where does he live. For those development delay children in remote area, particularly preterm children, early detection, and early intervention rehabilitation service could play an important role in decreasing their disability and improving their quality of life. Through this study, we suggest the government to add more national resources on the development evaluation to preterm children in a remote area.

Keywords: development, early intervention, preterm children, rehabilitation

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8108 Corporate Social Responsibility, Earnings, and Tax Avoidance: Evidence from Indonesia

Authors: Cahyaningsih Cahyaningsih, Fu'ad Rakhman

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This study examines empirically the association between corporate social responsibility (CSR) and tax avoidance. This study also investigates the effect of earnings on the relation between CSR and tax avoidance. Effective tax rate (ETR) and cash effective tax rate (CETR) were used to measure tax avoidance. Corporate social responsibility fund (CSRF) and corporate social responsibility disclosure (CSRD) were used as proxies for CSR. Test was conducted for public firms which were listed in the Indonesia Stock Exchange during the period of 2011-2014. Based on slack resource theory, this study finds that the relation between CSR and tax avoidance is moderated by earnings.

Keywords: corporate social responsibility disclosure, corporate social responsibility fund, earnings, tax avoidance

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8107 Technical Non-Destructive Evaluation of Burnt Bridge at CH. 57+450 Along Abuja-Abaji-Lokoja Road, Nigeria

Authors: Abraham O. Olaniyi, Oluyemi Oke, Atilade Otunla

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The structural performance of bridges decreases progressively throughout their service life due to many contributing factors (fatigue, carbonation, fire incidents etc.). Around the world, numerous bridges have attained their estimated service life and many have approached this limit. The structural integrity assessment of the burnt composite bridge located at CH57+450, Koita village along Abuja-Abaji-Lokoja road, Nigeria, is presented as a case study and shall be forthwith referred to as the 'Koita bridge' in this paper. From the technical evaluation, the residual compressive strength of the concrete piers was found to be below 16.0 N/mm2. This value is very low compared to the expected design value of 30.0 N/mm2. The pier capping beam at pier location 1 has a very low residual compressive strength. The cover to the reinforcement of certain capping beams has an outline of reinforcement which signifies poor concrete cover and the mean compressive strength is also less than 20.0 N/mm2. The steel girder indicated black colouration as a result of the fire incident without any significant structural defect like buckling or warping of the steel section. This paper reviews the structural integrity assessment and repair methodology of the Koita bridge; a composite bridge damaged by fire, highlighting the various challenges of limited obtainable guidance documents about the bridge. The objectives are to increase the understanding of processes and versatile equipment required to test and assess a fire-damaged bridge in order to improve the quality of structural appraisal and rehabilitation; thus, eliminating the prejudice associated with current visual inspection techniques.

Keywords: assessment, bridge, rehabilitation, sustainability

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8106 The Role Support Groups Play in Decreasing Depression and PTSD in Cancer Survivors: A Literature Review

Authors: Julianne Macmullen

Abstract:

Due to advances in technology and early detection and treatment of cancer, many cancer patients are surviving longer than five years post-diagnosis. Most cancer patients suffer from depression, anxiety, and post-traumatic stress disorder (PTSD) at some point during diagnosis, treatment, and survivorship. A subgroup of patients will continue to suffer from depression and PTSD and require early intervention. Support groups provide patients with the emotional and informational support they require while also giving survivors a sense of community, friendship, and purpose. This type of support is recognized by researchers to improve the quality of life while also decreasing depression and PTSD symptoms. The gaps in the literature include cultural diversity, minorities, and support groups involving cancer types other than breast cancer. Another gap in the literature includes the perceptions of cancer patients as well as longitudinal studies to determine the relationships between support groups and decreased depression and PTSD rates over time. Future research is required to fill the gaps in the literature mentioned previously. Future research is also needed to analyze the difference in age groups and different types of support groups such as professionally-led, peer-led, and online. Implications for practice involve providers assessing for the symptoms of depression and PTSD in order to offer prompt treatment and support services to those patients. In conclusion, social support by way of support groups improves the quality of life, gives survivors a sense of purpose to help others while also gaining the support they need, and reduces the rate of depressive episodes related to PTSD.

Keywords: cancer survivor, survivorship, post-traumatic stress disorder (PTSD), depression, support groups

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8105 Impact of Reproductive Technologies on Women's Lives in New Delhi: A Study from Feminist Perspective

Authors: Zairunisha

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This paper is concerned with the ways in which Assisted Reproductive Technologies (ARTs) affect women’s lives and perceptions regarding their infertility, contraception and reproductive health. Like other female animals, nature has ordained human female with the biological potential of procreation and becoming mother. However, during the last few decades, this phenomenal disposition of women has become a technological affair to achieve fertility and contraception. Medical practices in patriarchal societies are governed by male scientists, technical and medical professionals who try to control women as procreator instead of providing them choices. The use of ARTs presents innumerable waxed ethical questions and issues such as: the place and role of a child in a woman’s life, freedom of women to make their choices related to use of ARTs, challenges and complexities women face at social and personal levels regarding use of ARTs, effect of ARTs on their life as mothers and other relationships. The paper is based on a survey study to explore and analyze the above ethical issues arising from the use of Assisted Reproductive Technologies (ARTs) by women in New Delhi, the capital of India. A rapid rate of increase in fertility clinics has been noticed recently. It is claimed that these clinics serve women by using ARTs procedures for infertile couples and individuals who want to have child or terminate a pregnancy. The study is an attempt to articulate a critique of ARTs from a feminist perspective. A qualitative feminist research methodology has been adopted for conducting the survey study. An attempt has been made to identify the ways in which a woman’s life is affected in terms of her perceptions, apprehensions, choices and decisions regarding new reproductive technologies. A sample of 18 women of New Delhi was taken to conduct in-depth interviews to investigate their perception and response concerning the use of ARTs with a focus on (i) successful use of ARTs, (ii) unsuccessful use of ARTs, (iii) use of ARTs in progress with results yet to be known. The survey was done to investigate the impact of ARTs on women’s physical, emotional, psychological conditions as well as on their social relations and choices. The complexities and challenges faced by women in the voluntary and involuntary (forced) use of ARTs in Delhi have been illustrated. A critical analysis of interviews revealed that these technologies are used and developed for making profits at the cost of women’s lives through which economically privileged women and individuals are able to purchase services from lesser ones. In this way, the amalgamation of technology and cultural traditions are redefining and re-conceptualising the traditional patterns of motherhood, fatherhood, kinship and family relations within the realm of new ways of reproduction introduced through the use of ARTs.

Keywords: reproductive technologies, infertilities, voluntary, involuntary

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8104 Deployment of Armed Soldiers in European Cities as a Source of Insecurity among Czech Population

Authors: Blanka Havlickova

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In the last ten years, there are growing numbers of troops with machine guns serving on streets of European cities. We can see them around government buildings, major transport hubs, synagogues, galleries and main tourist landmarks. As the main purpose of armed soldier’s presence in European cities authorities declare the prevention of terrorist attacks and psychological support for tourists and domestic population. The main objective of the following study is to find out whether the deployment of armed soldiers in European cities has a calming and reassuring effect on Czech citizens (if the presence at armed soldiers make the Czech population feel more secure) or rather becomes a stress factor (the presence of soldiers standing guard in full military fatigues recalls serious criminality and terrorist attacks which are reflected in the fears and insecurity of Czech population). The initial hypothesis of this study is connected with the priming theory, the idea that when we are exposed to an image (armed soldier), it makes us unconsciously focus on a topic connected with this image (terrorism). This paper is based on a quantitative public survey, which was carried out in the form of electronic questioning among the citizens of the Czech Republic. Respondents answered 14 questions about two European cities – London and Paris. Besides general questions investigating the respondents' awareness of these cities, some of the questions focused on the fear that the respondents had when picturing themselves leaving next Monday for the given city (London or Paris). The questions asking about respondent´s travel fears and concerns were accompanied by different photos. When answering the question about fear some respondents have been presented with a photo of Westminster Palace and the Eiffel with ordinary citizens while other respondents have been presented with a picture of the Westminster Palace, the and Eiffel's tower not only with ordinary citizens, but also with one soldier holding a machine gun. The main goal of this paper is to analyse and compare data about concerns for these two groups of respondents (presented with different pictures) and find out if and how an armed soldier with a machine gun in front of the Westminster Palace or the Eiffel Tower affects the public's concerns about visiting the site. In other words, the aim of this paper is to confirm or rebut the hypothesis that the look at a soldier with a machine gun in front of the Eiffel Tower or the Westminster Palace automatically triggers the association with a terrorist attack leading to an increase in fear and insecurity among Czech population.

Keywords: terrorism, security measures, priming, risk perception

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8103 Jordan, Towards Eliminating Preventable Maternal Deaths

Authors: Abdelmanie Suleimat, Nagham Abu Shaqra, Sawsan Majali, Issam Adawi, Heba Abo Shindi, Anas Al Mohtaseb

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The Government of Jordan recognizes that maternal mortality constitutes a grave public health problem. Over the past two decades, there has been significant progress in improving the quality of maternal health services, resulting in improved maternal and child health outcomes. Despite these efforts, measurement and analysis of maternal mortality remained a challenge, with significant discrepancies from previous national surveys that inhibited accuracy. In response with support from USAID, the Jordan Maternal Mortality Surveillance Response (JMMSR) System was established to collect, analyze, and equip policymakers with data for decision-making guided by interdisciplinary multi-levelled advisory groups aiming to eliminate preventable maternal deaths, A 2016 Public Health Bylaw required the notification of deaths among women of reproductive age. The JMMSR system was launched in 2018 and continues annually, analyzing data received from health facilities, to guide policy to prevent avoidable deaths. To date, there have been four annual national maternal mortality reports (2018-2021). Data is collected, reviewed by advisory groups, and then consolidated in an annual report to inform and guide the Ministry of Health (MOH); JMMSR collects the necessary information to calculate an accurate maternal mortality ratio and assists in identifying leading causes and contributing factors for each maternal death. Based on this data, national response plans are created. A monitoring and evaluation plan was designed to define, track, and improve implementation through indicators. Over the past four years, one of these indicators, ‘percent of facilities notifying respective health directorates of all deaths of women of reproductive age,’ increased annually from 82.16%, 92.95%, and 92.50% to 97.02%, respectively. The Government of Jordan demonstrated commitment to the JMMSR system by designating the MOH to primarily host the system and lead the development and dissemination of policies and procedures to standardize implementation. The data was translated into practical and evidence-based recommendations. The successful impact of results deepened the understanding of maternal mortality in Jordan, which convinced the MOH to amend the Bylaw now mandating electronic reporting of all births and neonatal deaths from health facilities to empower the JMMSR system, by developing a stillbirths and neonatal mortality surveillance and response system.

Keywords: maternal health, maternal mortality, preventable maternal deaths, maternal morbidity

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