Search results for: health services in a developing nation

Authors: Maciej Bialorudzki, Zbigniew Izdebski, Alicja Kozakiewicz, Joanna Mazur

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The quality of sleep is extremely important for physical and mental health, especially among professional groups exposed to the suffering of the people they serve. The aim of the study is to assess sleep quality and various aspects of physical and mental health. A nationwide cross-sectional survey conducted in the first quarter of 2022 included 2227 healthcare professionals from 114 Polish hospitals and specialized outpatient clinics. The following distribution for each professional group was obtained (22% doctors; 52.6% nurses; 7.3% paramedics; 10.1% other medical professionals; 7.9% other non-medical professionals). The mean age of the respondents was 46.24 (SD=11.53). The Jenkins Sleep Scale with four items (JSS-4) was used to assess sleep quality, yielding a mean value of 5.35 (SD=5.20) in the study group and 13.7% of subjects with poor sleep quality using the cutoff point of the mean JSS-4 sum score as >11. More often, women than men reported poorer sleep quality (14,8% vs. 9,1% p=0,002). Respondents with poor sleep quality were more likely to report occupational burnout as measured by the BAT-12 (43.1% vs. 12.9% p<0.001) and high levels of stress as measured by the PSS-4 (72.5% vs. 27.5% p<0.001). In addition, those who declare experiencing a traumatic event compared to those who have not experienced it has an almost two times higher risk of poorer sleep quality (OR:1.958; 95% CI:1.509-2.542; p<0.001). In contrast, those with occupational burnout had more than five times the risk of those without occupational burnout (OR:5.092; 95% CI: 3.763-6.889; p<0.001). Sleep quality remains an important predictor of stress levels, job burnout, and quality of life assessment.

Keywords: quality of sleep, medical staff, mental health, physical health, occupational burnout, stress

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Authors: Takeo Shibata, Arihito Endo, Akemi Kunimatsu, Chika Hiraga, Yoko Shimizu

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Introduction: Yuzawa Town, located in the Niigata prefecture of Japan, is famous for its hot springs. A health promotion program, Yuzawa family health plan, was initiated in 2002. It has been held for fifteen years. We evaluated the profiles of brushing teeth in adults. Subjects: 368 questionnaires were corrected from people who live in Yuzawa town. The range of age was between nineteen and sixty-four years old. Methods: Mann-Whitney’s U test and Kruskal-Wallis test were used to evaluate significant differences in frequencies of brushing teeth per a day. Chi-square test and the adjusted residuals were used to evaluate when they brush their teeth. Results: Women showed greater frequencies of brushing teeth per a day than men. No difference was shown by age. Construction workers showed fewer frequencies of brushing teeth. Specialized technicians, clerical workers, and housewives showed greater frequencies. People who know Yuzawa family health plan, take a regular life, or take a breakfast every day showed greater frequencies. People who think not healthy, don’t care a balance of foods, don’t take yearly health check-up, or smoke showed fewer frequencies. After breakfast, women and specialized technicians showed greater frequencies, and construction workers and self-employed workers showed fewer frequencies. After lunch, clerical workers and specialized technicians showed greater frequencies. There was no significant difference at after waking up, after dinner, and before going to bed. Construction workers showed a lower rate of having a marital partner and having information of health. Conclusion: Gender and occupational differences were shown in frequencies of brushing teeth per a day. A promotion of teeth brushing for male, especially construction workers and self-employed workers, is needed.

Keywords: health promotion, Yuzawa family health plan, brushing teeth, occupational difference

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Authors: Guneet Saini, Shahrukh, Sunil Sharma

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Traffic congestion is the most critical issue faced by those in the transportation profession today. Over the past few years, roundabouts have been recognized as a measure to promote efficiency at intersections globally. In developing countries like India, this type of intersection still faces a lot of issues, such as bottleneck situations, long queues and increased waiting times, due to increasing traffic which in turn affect the performance of the entire urban network. This research is a case study of a non-conventional roundabout, in terms of geometric design, in a small town in India. These types of roundabouts should be analyzed for their functionality in mixed traffic conditions, prevalent in many developing countries. Microscopic traffic simulation is an effective tool to analyze traffic conditions and estimate various measures of operational performance of intersections such as capacity, vehicle delay, queue length and Level of Service (LOS) of urban roadway network. This study involves analyzation of an unsymmetrical non-circular 6-legged roundabout known as “Kala Aam Chauraha” in a small town Bulandshahr in Uttar Pradesh, India using VISSIM simulation package which is the most widely used software for microscopic traffic simulation. For coding in VISSIM, data are collected from the site during morning and evening peak hours of a weekday and then analyzed for base model building. The model is calibrated on driving behavior and vehicle parameters and an optimal set of calibrated parameters is obtained followed by validation of the model to obtain the base model which can replicate the real field conditions. This calibrated and validated model is then used to analyze the prevailing operational traffic performance of the roundabout which is then compared with a proposed alternative to improve efficiency of roundabout network and to accommodate pedestrians in the geometry. The study results show that the alternative proposed is an advantage over the present roundabout as it considerably reduces congestion, vehicle delay and queue length and hence, successfully improves roundabout performance without compromising on pedestrian safety. The study proposes similar designs for modification of existing non-conventional roundabouts experiencing excessive delays and queues in order to improve their efficiency especially in the case of developing countries. From this study, it can be concluded that there is a need to improve the current geometry of such roundabouts to ensure better traffic performance and safety of drivers and pedestrians negotiating the intersection and hence this proposal may be considered as a best fit.

Keywords: operational performance, roundabout, simulation, VISSIM

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Authors: Mediha B. Sılaydın Aydın, Emine D. Kahraman

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One of the important impacts of climate change is the sea level rise. Turkey is a peninsula, so the coastal areas of the country are threatened by the problem of sea level rise. Therefore, the urbanized coastal areas are highly vulnerable to climate change. At the aim of enhancing spatial resilience of urbanized areas, this question arises: What should be the priority intervention subject in the urban planning process for a given city. To answer this question, by focusing on the problem of sea level rise, this study aims to determine spatial vulnerability typologies and levels of Turkey coastal cities based on morphological, physical and social characteristics. As a method, spatial vulnerability of coastal cities is determined by two steps as level and type. Firstly, physical structure, morphological structure and social structure were examined in determining spatial vulnerability levels. By determining these levels, most vulnerable areas were revealed as a priority in adaptation studies. Secondly, all parameters are also used to determine spatial typologies. Typologies are determined for coastal cities in order to use as a base for urban planning studies. Adaptation to climate change is crucial for developing countries like Turkey so, this methodology and created typologies could be a guide for urban planners as spatial directors and an example for other developing countries in the context of adaptation to climate change. The results demonstrate that the urban settlements located on the coasts of the Marmara Sea, the Aegean Sea and the Mediterranean respectively, are more vulnerable than the cities located on the Black Sea’s coasts to sea level rise.

Keywords: climate change, coastal cities, vulnerability, urban land use planning

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Authors: Abbas Sheikhtaheri, Nasim Hashemi

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Health information systems have great benefits for clinical and managerial processes of health care organizations. However, identifying and removing constraints and barriers of implementing and using health information systems before any implementation is essential. Physicians are one of the main users of health information systems, therefore, identifying the causes of their resistance and concerns about the barriers of the implementation of these systems is very important. So the purpose of this study was to determine the barriers of the development and implementation of health information systems in terms of the Iranian physicians’ perspectives. In this study conducted in 8 selected hospitals affiliated to Tehran and Iran Universities of Medical Sciences, Tehran, Iran in 2014, physicians (GPs, residents, interns, specialists) in these hospitals were surveyed. In order to collect data, a research made questionnaire was used (Cronbach’s α = 0.95). The instrument included 25 about organizational (9), personal (4), moral and legal (3) and technical barriers (9). Participants were asked to answer the questions using 5 point scale Likert (completely disagree=1 to completely agree=5). By using a simple random sampling method, 200 physicians (from 600) were invited to study that eventually 163 questionnaires were returned. We used mean score and t-test and ANOVA to analyze the data using SPSS software version 17. 52.1% of respondents were female. The mean age was 30.18 ± 7.29. The work experience years for most of them were between 1 to 5 years (80.4 percent). The most important barriers were organizational ones (3.4 ± 0.89), followed by ethical (3.18 ± 0.98), technical (3.06 ± 0.8) and personal (3.04 ± 1.2). Lack of easy access to a fast Internet (3.67±1.91) and the lack of exchanging information (3.61±1.2) were the most important technical barriers. Among organizational barriers, the lack of efficient planning for the development and implementation systems (3.56±1.32) and was the most important ones. Lack of awareness and knowledge of health care providers about the health information systems features (3.33±1.28) and the lack of physician participation in planning phase (3.27±1.2) as well as concerns regarding the security and confidentiality of health information (3.15 ± 1.31) were the most important personal and ethical barriers, respectively. Women (P = 0.02) and those with less experience (P = 0.002) were more concerned about personal barriers. GPs also were more concerned about technical barriers (P = 0.02). According to the study, technical and ethics barriers were considered as the most important barriers however, lack of awareness in target population is also considered as one of the main barriers. Ignoring issues such as personal and ethical barriers, even if the necessary infrastructure and technical requirements were provided, may result in failure. Therefore, along with the creating infrastructure and resolving organizational barriers, special attention to education and awareness of physicians and providing solution for ethics concerns are necessary.

Keywords: barriers, development health information systems, implementation, physicians

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Authors: Hrishikesh Purandare, Ashwini Pethe

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Research from developed countries has demonstrated that the built environment can have a significant effect on children’s cognitive and socio-emotional development. A majority of the studies on the relationship between the built environment and the well-being of children have been conducted in North America and Western Europe, though most of the world’s children live in the global South. Millions of children living in urban slums in India confront issues associated with poor living conditions and lack of access to basic services. It is a well-known fact that slums are places of extreme poverty, substandard housing, overcrowding, and poor sanitation. These challenges faced by children living in slums can have a significant impact on their physical, psychological, and social development. Despite the magnitude of the problem, the area of research, particularly on the impact of the built environment of slums on children and adolescent well-being, has been understudied in India. Only a few studies in the global South have investigated the impact of the built environment on children’s well-being. Apart from issues of the limited access to health and education of these children, the perception of children regarding the built environment which they inhabit is rarely addressed. A sample of 120 children living in the slums of Pune city between the ages 7 and 16 participated in this study, which employed a concurrent embedded approach of mixed method research. Questionnaires were administered to obtain quantitative data that included attributes of crowding, noise, privacy, territoriality and housing quality in the built environment. The qualitative analysis of children’s sketches highlighted aspects of the built environment with which they associated themselves the most. The study sought to examine the perception of the deprived children living in the urban slums in the city of Pune (India) towards their built environment.

Keywords: physical environment, poverty, underprivileged children, urban Indian slums

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Authors: Hala S. Mekawy

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Affordable housing delivery for low and lower middle income families is a prominent problem in many developing countries; governments alone are unable to address this challenge due to diverse financial and regulatory constraints, and the private sector's contribution is rare and assists only middle-income households even when institutional and legal reforms are conducted to persuade it to go down market. Also, the market-enabling policy measures advocated by the World Bank since the early nineties have been strongly criticized and proven to be inappropriate to developing country contexts, where it is highly unlikely that the formal private sector can reach low income population. In addition to governments and private developers, affordable housing delivery systems involve an intricate network of relationships between diverse ranges of actors. Collaboration between them was proven to be vital, and hence, an approach towards partnership schemes for affordable housing delivery has emerged. The basic premise of this paper is that addressing housing affordability challenges in Egypt demands direct public support, as markets and market actors alone would never succeed in delivering decent affordable housing to low and lower middle income groups. It argues that this support would ideally be through local level partnership schemes, with a leading decentralized local government role, and partners being identified according to specific local conditions. It attempts to identify major attributes that would ensure the fulfilment of the goals of such schemes in the Egyptian context. This is based upon evidence from diversified worldwide experiences, in addition to the main outcomes of a questionnaire that was conducted to specialists and chief actors in the field.

Keywords: affordable housing, partnership schemes, housing, urban environments

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Authors: Asifa Fitriani, Galih Prakoso

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This study aims to improve the design layout of a Micro, Small and Medium Enterprises (SMEs) to minimize material handling and redesigning the layout of production facilities based on the safety and health and standards of food production facilities. Problems layout in the one of chip making industry mushrooms in Indonesia is cross movement between work stations, work accidents, and the standard of facilities that do not conform with the standards of the food industry. Improvement layout design using CORELAP and 5S method to give recommendation and implementation of occupational health and safety standards of food production facilities. From the analysis, improved layout using CORELAP provide a smaller displacement distance is 155.84 meters from the initial displacement distance of 335.9 meters, and providing a shorter processing time than the original 112.726 seconds to 102.831 seconds. 5S method also has recommended the completion of occupational health and safety issues as well as the standard means of food production by changing the working environment better.

Keywords: Layout Design, Corelap, 5S

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Authors: Yountaik Leem, Sang Ho Lee

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In this paper, different goals and the ways to reach smart cities shown in many countries during planning and implementation processes will be discussed. Each country dealt with technologies which have been embedded into space as development of ICTs (information and communication technologies) for their own purposes and by their own ways. For example, European countries tried to adapt technologies to reduce greenhouse gas emission to overcome global warming while US-based global companies focused on the way of life using ICTs such as EasyLiving of Microsoft™ and CoolTown of Hewlett-Packard™ during last decade of 20th century. In the North-East Asian countries, urban space with ICTs were developed in large scale on the viewpoint of capitalism. Ubiquitous city, first introduced in Korea which named after Marc Weiser’s concept of ubiquitous computing pursued new urban development with advanced technologies and high-tech infrastructure including wired and wireless network. Japan has developed smart cities as comprehensive and technology intensive cities which will lead other industries of the nation in the future. Not only the goals and strategies but also new directions to which smart cities are oriented also suggested at the end of the paper. Like a Finnish smart community whose slogan is ‘one more hour a day for citizens,’ recent trend is forwarding everyday lives and cultures of human beings, not capital gains nor physical urban spaces.

Keywords: smart cities, urban strategy, future direction, comparative study

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Authors: Pallavi Bhogaram, Xiaolong Wu, Min He, Onyedikachi Okenwa

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A transportation network is a realization of a spatial network, describing a structure which permits either vehicular movement or flow of some commodity. Examples include road networks, railways, air routes, pipelines, and many more. The transportation network plays a vital role in maintaining the vigor of the nation’s economy. Hence, ensuring the network stays resilient all the time, especially in the face of challenges such as heavy traffic loads and large scale natural disasters, is of utmost importance. In this paper, we used the Neo4j application to develop the graph. Neo4j is the world's leading open-source, NoSQL, a native graph database that implements an ACID-compliant transactional backend to applications. The Southern California network model is developed using the Neo4j application and obtained the most critical and optimal nodes and paths in the network using centrality algorithms. The edge betweenness centrality algorithm calculates the critical or optimal paths using Yen's k-shortest paths algorithm, and the node betweenness centrality algorithm calculates the amount of influence a node has over the network. The preliminary study results confirm that the Neo4j application can be a suitable tool to study the important nodes and the critical paths for the major congested metropolitan area.

Keywords: critical path, transportation network, connectivity reliability, network model, Neo4j application, edge betweenness centrality index

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Authors: A. Gonzalez Aguna, J. M. Santamaria Garcia, J. L. Gomez Gonzalez, R. Barchino Plata, M. Fernandez Batalla, S. Herrero Jaen

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Background: Computer Science is a field that transcends other disciplines of knowledge because it allows to support all kinds of physical and mental tasks. Health centres have a greater number and complexity of technological devices and the population consume and demand services derived from technology. Also, nursing education plans have included competencies related to and, even, courses about new technologies are offered to health professionals. However, nurses still limit their performance to the use and evaluation of products previously built. Objective: Develop a teaching-learning methodology for acquiring skills on designing applications for care. Methodology: Blended learning teaching with a group of graduate nurses through official training within a Master's Degree. The study sample was selected by intentional sampling without exclusion criteria. The study covers from 2015 to 2017. The teaching sessions included a four-hour face-to-face class and between one and three tutorials. The assessment was carried out by written test consisting of the preparation of an IEEE 830 Standard Specification document where the subject chosen by the student had to be a problem in the area of care. Results: The sample is made up of 30 students: 10 men and 20 women. Nine students had a degree in nursing, 20 diploma in nursing and one had a degree in Computer Engineering. Two students had a degree in nursing specialty through residence and two in equivalent recognition by exceptional way. Except for the engineer, no subject had previously received training in this regard. All the sample enrolled in the course received the classroom teaching session, had access to the teaching material through a virtual area and maintained at least one tutoring. The maximum of tutorials were three with an hour in total. Among the material available for consultation was an example of a document drawn up based on the IEEE Standard with an issue not related to care. The test to measure competence was completed by the whole group and evaluated by a multidisciplinary teaching team of two computer engineers and two nurses. Engineers evaluated the correctness of the characteristics of the document and the degree of comprehension in the elaboration of the problem and solution elaborated nurses assessed the relevance of the chosen problem statement, the foundation, originality and correctness of the proposed solution and the validity of the application for clinical practice in care. The results were of an average grade of 8.1 over 10 points, a range between 6 and 10. The selected topic barely coincided among the students. Examples of care areas selected are care plans, family and community health, delivery care, administration and even robotics for care. Conclusion: The applied methodology of learning-teaching for the design of technologies demonstrates the success in the training of nursing professionals. The role of expert is essential to create applications that satisfy the needs of end users. Nursing has the possibility, the competence and the duty to participate in the process of construction of technological tools that are going to impact in care of people, family and community.

Keywords: care, learning, nursing, technology

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Authors: Johnas Buhori, Meinrad Haule Lembuka

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Introduction: Social work expands its boundary to accommodate indigenous knowledge and practice for better competence and services. In Tanzania, Mama Mkubwa Mkubwa (MMM) (Mother’s elder sister) is an indigenous practice of alternative child care that represents other traditional practices across African societies known as Ubuntu practice. Ubuntu is African Humanism with values and approaches that are connected to the social work. MMM focuses on using the elder sister of a deceased mother or father, a trusted elder woman from the extended family or indigenous community to provide alternative care to an orphan or vulnerable child. In Ubuntu's perspective, it takes a whole village or community to raise a child, meaning that every person in the community is responsible for child care. Methodology: A desk review method guided by Ubuntu theory was applied to enrich the study. Findings: MMM resembles the Ubuntu ideal of traditional child protection of those in need as part of alternative child care throughout Tanzanian history. Social work practice, along with other formal alternative child care, was introduced in Tanzania during the colonial era in 1940s and socio-economic problems of 1980s affected the country’s formal social welfare system, and suddenly HIV/AIDS pandemic triggered the vulnerability of children and hampered the capacity of the formal sector to provide social welfare services, including alternative child care. For decades, AIDS has contributed to an influx of orphans and vulnerable children that facilitated the re-emerging of traditional alternative child care at the community level, including MMM. MMM strongly practiced in regions where the AIDS pandemic affected the community, like Njombe, Coastal region, Kagera, etc. Despite of existing challenges, MMM remained to be the remarkably alternative child care practiced in both rural and urban communities integrated with social welfare services. Tanzania envisions a traditional mechanism of family or community environment for alternative child care with the notion that sometimes institutionalization care fails to offer children all they need to become productive members of society, and later, it becomes difficult to reconnect in the society. Implications to Social Work: MMM is compatible with social work by using strengths perspectives; MMM reflects Ubuntu's perspective on the ground of humane social work, using humane methods to achieve human goals. MMM further demonstrates the connectedness of those who care and those cared for and the inextricable link between them as Ubuntu-inspired models of social work that view children from family, community, environmental, and spiritual perspectives. Conclusion: Social work and MMM are compatible at the micro and mezzo levels; thus, application of MMM can be applied in social work practice beyond Tanzania when properly designed and integrated into other systems. When MMM is applied in social work, alternative care has the potential to support not only children but also empower families and communities. Since MMM is a community-owned and voluntary base, it can relieve the government, social workers, and other formal sectors from the annual burden of cost in the provision of institutionalized alternative child care.

Keywords: ubuntu, indigenous social work, african social work, ubuntu social work, child protection, child alternative care

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Authors: Mohammad H. Yarmohamadian, Reza Safdari, Nahid Tavakoli

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In recent years, many countries have suffered various natural disasters. Disaster response continues to face the challenges in health care sector in all countries. Information and communication management is a significant challenge in disaster scene. During the last decades, rapid advances in information technology have led to manage information effectively and improve communication in health care setting. Information technology is a vital solution for effective response to disasters and emergencies so that if an efficient ICT-based health information system is available, it will be highly valuable in such situation. Of that, mobile technology represents a nearly computing technology infrastructure that is accessible, convenient, inexpensive and easy to use. Most projects have not yet reached the deployment stage, but evaluation exercises show that mHealth should allow faster processing and transport of patients, improved accuracy of triage and better monitoring of unattended patients at a disaster scene. Since there is a high prevalence of cell phones among world population, it is expected the health care providers and managers to take measures for applying this technology for improvement patient safety and public health in disasters. At present there are challenges in the utilization of mhealth in disasters such as lack of structural and financial issues in our country. In this paper we will discuss about benefits and challenges of mhealth technology in disaster setting considering connectivity, usability, intelligibility, communication and teaching for implementing this technology for disaster response.

Keywords: information technology, mhealth, disaster, effective response

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Authors: L. Laurs, A. Blazeviciene, D. Milonas

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Introduction: Nursing as a profession is grounded in moral obligation. Nursing practice is grounded in ethical standards: to not harm, to promote justice, to be accountable, and to provide safe and competent care. The nature of the nurse-patient therapeutic relationship requires acting on the patient's behalf. Moral distress consists of negative stress symptoms that occur in situations that involve ethical situations that the nurse perceives as discordant with their professional values. Aim of the Study: The purpose of this study was to assess links between moral distress of registered nurses and factors related to patient care at the end of their life. Methods and Sample: A descriptive, cross-sectional, correlational design was applied in this study. Registered nurses were recruited from seven municipal multi-profile hospitals providing both general and specialized healthcare services in Lithuania (N=1055). Research instruments included two questionnaires: Obstacles and Facilitating at the End of Life Care and Moral Distress Scale (revised). Results: Spearman’s correlation analysis was performed to assess the relationship between nurses' attitudes towards patient care at the end of life and the experienced moral distress. A statistically significant correlation between moral distress and the following factors related to patient end-of-life care has been identified: conversations with physicians on patient end-of-life problems have a positive impact on job satisfaction; some patients may be excluded from decisions about their treatment and nursing because they are questioned about their ability to assess the situation. These situations increased moral distress. Patient consciousness should not be permanently suppressed by calming medications, and the patient should be provided with all nursing care services and moral distress. Conclusions: The moral distress of nurses is significantly related to the end-of-life care of patients and their determinants: moral distress increased due to lack of discussion with doctors about problem-solving and exclusion of patients from decision-making. And it diminished by refusing calming medications to permanently suppress a patient's consciousness and providing good care for patients.

Keywords: moral distress, registered nurses, end of life, care

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Authors: Viktorya Sargsyan, Arax Hovhannesyan, Karine Abelyan

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Introduction: During the last decade, scientific studies have proven the importance of Early Childhood Development (ECD) interventions. These interventions are shown to create strong foundations for children’s intellectual, emotional and physical well-being, as well as the impact they have on learning and economic outcomes for children as they mature into adulthood. Many children in rural Armenia fail to reach their full development potential due to lack of early brain stimulation (playing, singing, reading, etc.) from their parents, and lack of community tools and services to follow-up children’s neurocognitive development. This is exacerbated by high rates of stunting and anemia among children under 3(CU3). This research study tested the effectiveness of an integrated ECD and Maternal, Newborn and Childhood Health (MNCH) model, called “Go Baby, Go!” (GBG), against the traditional (MNCH) strategy which focuses solely on preventive health and nutrition interventions. The hypothesis of this quasi-experimental study was: Children exposed to GBG will have better neurocognitive and nutrition outcomes compared to those receiving only the MNCH intervention. The secondary objective was to assess the effect of GBG on parental child care and nutrition practices. Methodology: The 14 month long study, targeted all 1,300 children aged 0 to 23 months, living in 43 study communities the in Gavar and Vardenis regions (Gegharkunik province, Armenia). Twenty-three intervention communities, 680 children, received GBG, and 20 control communities, 630 children, received MCHN interventions only. Baseline and evaluation data on child development, nutrition status and parental child care and nutrition practices were collected (caregiver interview, direct child assessment). In the intervention sites, in addition to MNCH (maternity schools, supportive supervision for Health Care Providers (HCP), the trained GBG facilitators conducted six interactive group sessions for mothers (key messages, information, group discussions, role playing, video-watching, toys/books preparation, according to GBG curriculum), and two sessions (condensed GBG) for adult family members (husbands, grandmothers). The trained HCPs received quality supervision for ECD counseling and screening. Findings: The GBG model proved to be effective in improving ECD outcomes. Children in the intervention sites had 83% higher odd of total ECD composite score (cognitive, language, motor) compared to children in the control sites (aOR 1.83; 95 percent CI: 1.08-3.09; p=0.025). Caregivers also demonstrated better child care and nutrition practices (minimum dietary diversity in intervention site is 55 percent higher compared to control (aOR=1.55, 95 percent CI 1.10-2.19, p =0.013); support for learning and disciplining practices (aOR=2.22, 95 percent CI 1.19-4.16, p=0.012)). However, there was no evidence of stunting reduction in either study arm. he effect of the integrated model was more prominent in Vardenis, a community which is characterised by high food insecurity and limited knowledge of positive parenting skills. Conclusion: The GBG model is effective and could be applied in target areas with the greatest economic disadvantages and parenting challenges to improve ECD, care practices and developmental outcomes. Longitudinal studies are needed to view the long-term effects of GBG on learning and school readiness.

Keywords: early childhood development, integrated interventions, parental practices, quasi-experimental study

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Authors: Ahmad Alsaber

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This paper aims to understand the intermediary role of the payment platform applications by analyzing the various factors that can influence the desirability of utilizing said payment services in Kuwait, as well as to determine the effect of the presence of different types of payment platforms on the variables of the “Unified Theory of Acceptance and Use of Technology” (UTAUT) model. The UTAUT model's findings will provide an important understanding of the moderating role of payment platform mobile applications. This study will explore the influence of payment platform mobile applications on customer purchase intentions in Kuwait by employing a quantitative survey of 200 local customers. Questions will cover their usage of payment platforms, purchase intent, and overall satisfaction. The information gathered is then analyzed using descriptive statistics and correlation analysis in order to gain insights. The research hopes to provide greater insight into the effect of mobile payment platforms on customer purchase intentions in Kuwait. This research will provide important implications to marketers and customer service providers, informing their strategies and initiatives, as well as offer recommendations to payment platform providers on how to improve customer satisfaction and security. The study results suggest that the likelihood of a purchase is affected by performance expectancy, effort expectancy, social influence, risk, and trust. The purpose of this research is to understand the advancements in the different variables that Kuwaiti customers consider while dealing with mobile banking applications. With the implementation of stronger security measures, progressively more payment platform applications are being utilized in the Kuwaiti marketplace, making them more desirable with their accessibility and usability. With the development of the Kuwaiti digital economy, it is expected that mobile banking will have a greater impact on banking transactions and services in the future.

Keywords: purchase intention, UTAUT, performance expectancy, social influence, risk, trust

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Authors: Ali Alotaibi, Francis Edum-Fotwe, Andrew Price /

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Mega construction projects create buildings and major infrastructure to respond to work and life requirements while playing a vital role in promoting any nation’s economy. However, the industry is often criticised for not balancing economic, environmental and social dimensions of their projects, with emphasis typically on one aspect to the detriment of the others. This has resulted in many negative impacts including environmental pollution, waste throughout the project lifecycle, low productivity, and avoidable accidents. The identification of comprehensive Social Responsibility (SR) indicators, which combine social, environmental and economic aspects, is urgently needed. This is particularly the case in the context of the Kingdom of Saudi Arabia (KSA), which often has mega public construction projects. The aim of this paper is to develop a set of wide-ranging SR indicators which encompass social, economic and environmental aspects unique to the KSA. A qualitative approach was applied to explore relevant indicators through a review of the existing literature, international standards and reports. A list of appropriate indicators was developed, and its comprehensiveness was corroborated by interviews with experts on mega construction projects working with SR concepts in the KSA. The findings present 39 indicators and their metrics, covering 10 economic, 12 environmental and 17 social aspects of SR mapped against their references. These indicators are a valuable reference for decision-makers and academics in the KSA to understand factors related to SR in mega construction projects. The indicators are related to mega construction projects within the KSA and require validation in a real case scenario or within a different industry to demonstrate their generalisability.

Keywords: social responsibility, construction projects, economic, social, environmental, indicators

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Authors: Mohsen Ehsanpour, Maryam Ehsanpour, ‎Majid Afkhami, Fatemeh Afkhami ‎

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Heavy metals are increasingly being released into natural waters from geological and anthropogenic sources. The distribution of several heavy metals (Cd, Pb) was investigated in muscle, liver in six different fish species seasonally collected in Persian Gulf (autumn 2009-summer 2010). The concentrations of all metals were lower in flesh than those recorded in liver due to their physiological roles. The THQ index for fish was calculated. Estimation of target hazard quotients calculations for the contaminated fish consumption was calculated to evaluate the effect of pollution on health. Total metal THQs values (Pb and Cd) for adults were 0.05 and 0.04 in Bushehr and Bandar-Genaveh, respectively, and for children they were 0.08 and 0.05 in Bandar-Abbas and Bandar-Lengeh, respectively.

Keywords: Persian Gulf, heavy metals, health risks, THQ index

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Authors: Friday I. Joseph

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Background: Nigeria has an under-five mortality rate that is 128 per 1000 live birth which is higher than the rate for the African region. Optimal breastfeeding practice has the potential to reduce under-five mortality by 13% in developing countries. However, documented exclusive breastfeeding rate in Nigeria from birth to six months is just 17%. Aim: To explore perceptions of the sociocultural factors that influence exclusive breastfeeding for six months among rural mothers in Bindawa and Baure Local Government Area (LGA), Katsina state, North West Nigeria, to inform policies, intervention or strategies to improve exclusive breastfeeding practice in Nigeria. Methods: The social constructionism-interpretivist epistemological approach informed the use of an exploratory study to understand mothers’ experiences and views. Twenty mothers, all from rural areas between 19-35 years old were conveniently sampled from two LGA in Katsina state, north –west Nigeria for semi-structured interviews. Sample size had representation of both Hausa and Fulani ethnic group. Thematic content analysis was utilized for analysis. Results: Three major themes emerged from the study: (1) Breastfeeding initiation - Immediate traditional newborn care practices, birth attendant, place of delivery, the perception of about colostrum determines how soon a mother initiate breastfeeding. (2) Exclusive breastfeeding and introduction of food-Motivation to sustain exclusive breastfeeding relies on the interplay between the obligation to perform traditional rites; mother’s awareness and family support. (3) Decision making about infant feeding – It is not independent of the influence of key social figures like the father, mother-in-law, traditional birth attendant and the health workers. Overall, in spite of awareness of exclusive breastfeeding benefits, mothers expressed concerns that they may not win their family support if they shared contrary views. Conclusions: Health promotion intervention should be tailored, taking cognizant and addressing the sociocultural barriers to the practice of optimal breastfeeding by a focused community and family-based participatory approach. Implementers of interventions should employ culture-sensitive approaches in community-based intervention.

Keywords: exclusive breastfeeding, perception, qualitative, sociocultural determinants

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Authors: Tamas Molnar

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Electronic government systems are currently in the same development stage as e-commerce applications were about in the late 1990s. Wide adoption by the majority of population is near, as such services are not only more and more desired by the users, but also strongly advocated and pushed by the state, as a means to increase effectiveness and cut expenses at the same time. Diffusion is however hampered by the low motivation caused by usability issues which will cause more and more frustration as the general population ages. Usability centred design is essential when creating such services. Elderly users, who have statistically the least experience, have the most problems, and therefore reject unusable systems first. The goal of our research was to find a way to map the needs of the elderly and create guidelines for the design of electronic government systems which are usable for the whole population. The first phase of our research, started mid-2009, was centred on the idea to gather information about the needs of the target group, in both Germany and Hungary with over 70 participants. This was done with the help of scenarios, interviews and questionnaires. The supplied data enabled to choose an eGovernment system for tests on the target group. Tests conducted in Germany and Hungary were based on the design and functions of the German electronic ID card, in the native languages. Scenarios mirroring common, every day transactions requiring an identification procedure were used. The obtained results allowed us to develop a generalised solution, the IGUAN guideline. This guideline makes a standardised approach to the usability improvement process possible. It contains the special requirements of elderly users, and a catalogue of criteria, which helps to develop an application in line with the set requirements. The third phase of our research was used a proof of concept for the IGUAN. The guideline was evaluated and tested with an iterative prototyping. The successful completion of this phase indicates that the IGUAN can be used to measurably increase the acceptance of e-government systems by elderly users. We could therefore demonstrate that improvements in the interface make e-government application possible which are perceived useful and easy to use by elderly users. These improvements will measurably increase the user motivation and experience. This can however only be achieved with a structured design process, and requires a framework which takes the requirements of the elderly users into account.

Keywords: e-Government, usability, acceptance, guidelines

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Authors: Dong Zhan

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China sports science is the core periodical of scientific research in the field of sports in China at present. It is the first academic periodical ranked in China. The author has studied the characteristics and trends of articles on sports medicine and physical fitness published in the journal since it founded. Now, the articles on sports medicine and physical fitness published in the Journal of Sports Science from 2013 to 2017 are reviewed. The results show that 1) The characteristics of previous sports medicine articles showed that there were more articles on the basis of sports medicine than that on the application. The research on animal experiments was far more than that on the human body. Moreover, the trend was getting worse and worse as time goes on. But in the past five years, there had been a marked improvement. The basic/application has been improved from 2.1/1 to 1.3/1. This shows that sports medicine researchers have been paid more attention to the application research in sports medicine. 2) There are few articles on sports injury, because the state put the sports injury specialty into the medical colleges, and the research scope of sports research institutes does not include sports injury. It cannot meet the need for the development of sports medicine, and it should change sooner or later. 3) In the past, researchers’ effort was on athletes' physical health, not on ordinary people. Now, there is a great change, they not only research on the sportsmen’s health but also research on the health of the ordinary people. 4) Researchers mainly studied on the young people’s physical fitness in the past; now, it has been greatly improved. Researchers study on the physical health of the elderly, especially those over the age of 60. Numbers of paper researching on the young were much more than those on the old. In the past 10 years, the ratio of number of paper researching on the young to the old people was (young/old) 16.6/1, while in the past 5 years, this ratio was 6.3/1. However, this is not enough. China has a large population and needs to focus on promoting the health of the people. Conclusion: It is important to pay more attention to the application research on sports medicine and on the physical fitness, and it is also important to make a research on physical health of the elderly.

Keywords: sports medicine, people's health, the young, the old

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Authors: Janeth Chepkemoi, Richard Onwonga, Noel Templer, Elkana Kipkoech, Angela Gitau

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Conventional agriculture is one of the leading causes of land degradation, threatening the sustainability of food production. Organic farming promotes practices that have the potential of feeding the world while also promoting ecological health. A study was therefore carried out with the aim of conceptualizing how such farming systems are contributing to ecological health in Trans Nzoia County. 71 farmers were interviewed and data was collected on parameters such as land preparation, agroforestry, soil fertility management, soil and water conservation, and pests and diseases. A soil sample was also collected from each farm for laboratory analysis. Data collected were analyzed using Microsoft Excel and SPSS version 21. Results showed that 66% of the respondents practiced organic farming whereas 34% practiced conventional farming. Intercropping and crop rotations were the most common cropping systems and the most preferred land preparation tools among both organic and conventional farmers were tractors and hand hoes. Organic farms fared better in agroforestry, organic soil amendments, land and water conservation, and soil chemical properties. Pests and disease, however, affected organic farms more than conventional. The average nitrogen (%), K (Cmol/ kg and P (ppm) of organic soils were 0.26, 0.7 and 26.18 respectively, conventional soils were 0.21, 0.66 and 22.85. Soil organic carbon content of organic farms averaged a higher percentage of 2.07% as compared to 1.91 for the conventional. In conclusion, most farmers in Trans Nzoia County had transitioned into ecologically friendly farming practices that improved the quality and health of the soil and therefore promoted its sustainability.

Keywords: organic farming, conventional farming, ecological health, soil health

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Authors: Jemima C. A. Sumboh

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Given the urgency and consensus for countries to move towards Universal Health Coverage (UHC), health financing systems need to be accurately and consistently monitored to provide valuable data to inform policy and practice. Most of the indicators for monitoring UHC, particularly catastrophe and impoverishment, are established based on the impact of out-of-pocket health payments (OOPHP) on households’ living standards, collected through varied household surveys. These surveys, however, vary substantially in survey methods such as the length of the recall period or the number of items included in the survey questionnaire or the farming of questions, potentially influencing the level of OOPHP. Using different survey instruments can provide inaccurate, inconsistent, erroneous and misleading estimates of UHC, subsequently influencing wrong policy decisions. Using data from a household budget survey conducted by the Navrongo Health Research Center in Ghana from May 2017 to December 2018, this study intends to explore the potential implications of using surveys with varied levels of disaggregation of OOPHP data on estimates of financial risk protection. The household budget survey, structured around food and non-food expenditure, compared three OOPHP measuring instruments: Version I (existing questions used to measure OOPHP in household budget surveys), Version II (new questions developed through benchmarking the existing Classification of the Individual Consumption by Purpose (COICOP) OOPHP questions in household surveys) and Version III (existing questions used to measure OOPHP in health surveys integrated into household budget surveys- for this, the demographic and health surveillance (DHS) health survey was used). Version I, II and III contained 11, 44, and 56 health items, respectively. However, the choice of recall periods was held constant across versions. The sample size for Version I, II and III were 930, 1032 and 1068 households, respectively. Financial risk protection will be measured based on the catastrophic and impoverishment methodologies using STATA 15 and Adept Software for each version. It is expected that findings from this study will present valuable contributions to the repository of knowledge on standardizing survey instruments to obtain estimates of financial risk protection that are valid and consistent.

Keywords: Ghana, household budget surveys, measuring financial risk protection, out-of-pocket health payments, survey instruments, universal health coverage

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Authors: Minu Bharati, Priyanka Rai, Satarupa Dutta, Dhiraj Saha

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Culex quinquefasciatus Say, is a mosquito of immense public health concern due to its role in transmission of filariasis, which is an endemic disease in 20 states and union territories of India, putting about 600 million people at the risk of infection. The main strategies to control filaria in India include anti-larval measures in urban areas, Indoor Residual Spray (IRS) in rural areas and mass diethylcarbamazine citrate (DEC) administration. Larval destruction measures and IRS are done with the use of insecticides. In this study, Susceptibility/ Resistance to insecticides were assessed in Culex quinquefasciatus mosquitoes collected from eight densely populated areas of Siliguri subdivision, which has a high rate of filarial infection. To unveil the insecticide susceptibility status of Culex quinquefasciatus, bioassays were performed on field-caught mosquitoes against two major groups of insecticides, i.e. Synthetic Pyrethroids (SPs): 0.05% deltamethrin and 0.05% lambda-cyhalothrin and Organophosphates (OPs): 5% malathion and temephos using World Health Organisation (WHO) discriminating doses. The knockdown rates and knockdown times (KDT50) were also noted against deltamethrin, lambda-cyhalothrin and malathion. Also, activities of major detoxifying enzymes, i.e. α-carboxylesterases, β-carboxylesterases and cytochrome P450 (CYP450) monooxygenases were determined to find the involvement of biochemical mechanisms in resistance phenomenon (if any). The results obtained showed that, majority of the mosquito populations were moderately to severely resistant against both the SPs and one OP, i.e. temephos. Whereas, most of the populations showed 100% susceptibility to malathion. The knockdown rates and KDT50 in response to above-mentioned insecticides showed significant variation among different populations. Variability in activities of carboxylesterases and CYP450 monooxygenases were also observed with hints of their involvement in contribution towards insecticide resistance in some of the tested populations. It may be concluded that, Culex quinquefasciatus has started developing resistance against deltamethrin, lambda-cyhalothrin and temephos in Siliguri subdivision. Malathion seems to hold the greatest potentiality for control of these mosquitoes in this area as revealed through this study. Adoption of Integrated mosquito management (IMM) strategy should be the prime objective of the concerned authorities to delimit the insecticide resistance phenomenon and filariasis infections.

Keywords: Culex quinquefasciatus, detoxifying enzymes, insecticide resistance, knockdown rate

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Authors: Gyan Kashyap, Shri Kant Singh

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Improved mental health can be articulated as a good physical health and quality of life. Mental health plays an important role in survival of any one’s life. In today’s time people living with stress in life due to their personal matters, health problems, unemployment, work environment, living environment, substance use, life style and many more important reasons. Many studies confirmed that the significant proportion of mental health people increasing in India. This study is focused on mental well-being of male leather tannery workers in Kanpur city, India. Environment at work place as well as living environment plays an important health risk factors among leather tannery workers. Leather tannery workers are more susceptible to many chemicals and physical hazards, just because they are liable to be affected by their exposure to lots of hazardous materials and processes during tanning work in very hazardous work environment. The aim of this study to determine the level of mental health disorder and quality of life among male leather tannery and non-tannery workers in Kanpur city, India. This study utilized the primary data from the cross- sectional household study which was conducted from January to June, 2015 on tannery and non-tannery workers as a part of PhD program from the Jajmau area of Kanpur city, India. The sample of 286 tannery and 295 non-tannery workers has been collected from the study area. We have collected information from the workers of age group 15-70 those who were working at the time of survey for at least one year. This study utilized the general health questionnaire (GHQ-12) and work related stress scale to test the mental wellbeing of male tannery and non-tannery workers. By using GHQ-12 and work related stress scale, Polychoric factor analysis method has been used for best threshold and scoring. Some of important question like ‘How would you rate your overall quality of life’ on Likert scale to measure the quality of life, their earnings, education, family size, living condition, household assets, media exposure, health expenditure, treatment seeking behavior and food habits etc. Results from the study revealed that around one third of tannery workers had severe mental health problems then non-tannery workers. Mental health problem shown the statistically significant association with wealth quintile, 56 percent tannery workers had severe mental health problem those belong to medium wealth quintile. And 42 percent tannery workers had moderate mental health problem among those from the low wealth quintile. Work related stress scale found the statistically significant results for tannery workers. Large proportion of tannery and non-tannery workers reported they are unable to meet their basic needs from their earnings and living in worst condition. Important result from the study, tannery workers who were involved in beam house work in tannery (58%) had severe mental health problem. This study found the statistically significant association with tannery work and mental health problem among tannery workers.

Keywords: GHQ-12, mental well-being, factor analysis, quality of life, tannery workers

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Authors: Tirtha Raj Dhakal, Brian Davidson, Bob Farquharson

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Irrigation management transfer has been taken as the important policy instrument for effective irrigation resource management in many developing countries. The change in governance of the irrigation schemes for its day-to-day operation and maintenance has been centered in recent Nepalese irrigation policies also. However, both farmer- and agency-managed irrigation schemes in Nepal are performing well below than expected. This study tries to link the present concerns of poor performance of both forms of schemes with the institutions for its operation and management. Two types of surveys, management and farm surveys; were conducted as a case study in the command area of Narayani Lift Irrigation Project (agency-managed) and Khageri Irrigation System (farmer-managed) of Chitwan District. The farm survey from head, middle and tail regions of both schemes revealed that unequal water distribution exists in these regions in both schemes with greater percentage of farmers experiencing this situation in agency managed scheme. In both schemes, the cost recovery rate was very low, even below five percent in Lift System indicating poor operation and maintenance of the schemes. Also, the institution on practice in both schemes is unable to create any incentives for farmers’ willingness to pay as well as for its economical use in the farm. Thus, outcomes from the study showed that only the management transfer programs may not achieve the goal of efficient irrigation resource management. This may suggest water professionals to rethink about the irrigation policies for refining institutional framework irrespective of the governance of schemes for improved cost recovery and better water distribution throughout the irrigation schemes.

Keywords: cost recovery, governance, institution, irrigation management transfer, willingness to pay

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Authors: Jayant Balaji Athavale, Sean Clarke

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Background: According to the WHO, every year, more than 700,000 people die by suicide, which is one person around every 45 seconds. Suicide is the fourth leading cause of death among 15 to 29-year-olds globally. The most common situations or life events that might cause suicidal thoughts are financial problems/unemployment, rejections, relationship breakups, sexual/substance abuse and mental illnesses. Mental/psychological weakness caused due to defects in one’s personality is one of the main reasons why people feel they cannot cope in such situations and contemplate suicide. A WHO Mental Health Action Plan 2013–2020 lists a 4-point strategy to enhance mental health by ‘implementing strategies for promotion and prevention in mental health.’ Methodology: With 40 years of spiritual research background, the team at the Maharshi University of Spirituality has studied the spiritual root causes that can significantly affect one’s mental health and the solutions to improve it. Results/Findings: According to spiritual science, the time and nature of death are mostly due to spiritual reasons. A person would mostly contemplate and attempt suicide when he is spiritually most vulnerable. Spiritual practice, as per universal principles, helps in protecting a person spiritually and prevents him from getting such thoughts of self-harm or acting upon them by controlling such impulses. The University has had much success in helping people to overcome the defects in their personalities, including those with suicidal thoughts, through spiritual practices such as chanting the Name of God and the Personality Defect Removal (PDR) process developed by the Author. Conclusion: If such techniques were taught in educational institutions, they could be simple yet effective self-help tools to prevent thoughts of suicide and enhance mental health and well-being.

Keywords: suicide, mental health, abuse, suicide prevention, personality defect removal

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Authors: Hsiao-Yung Wang

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This essay aims to examine how the discursive formation of the 'transing-nationalism' (which is extended and slightly modified from 'homonationalism') had been constructed in the Taiwanese news media before the legalization of 'sex reassignment surgery (SRS)' in 1988. Samples for rhetorical analysis were selected from two mainstream newspapers, including China Times, and United Daily. The time frame for sample selection is from August 1953 (when the first transgender case was reported) to 1988, while the SRS was legalized in Taiwan. To enhance understanding of media representation as contextualized-based, the author refers to the representative of spatial rhetoric Mikhail Bakhtin for his late study on 'emergence' and 'visualization of time' in Bildungsroman; thereby categorizing the media discourse of transgender into two critical period: (1) transgender as 'misrecognized' and 'included' into the rhetoric of modern medical space; (2) transgender as 'institutionalized' into discourse of protection and salvation by the reified sympathy of nation-state. These two periods and relevant spatial rhetoric were of no immediate concern on the vital interest of transgender individuals; therefore constructed the imagery of transgender for the service of nationalism rather than gender consciousness or human right rhetoric. Based on the research findings, this essay concludes that 'queer multiplicity' should be regarded as not only the guideline for the amendment of the gendered policies and laws but the rhetorical resources for the mobilization of transgender movement in Taiwan from now on.

Keywords: Bakhtin, legalization, rhetoric, sex reassignment surgery, transgender, transing-nationalism

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Authors: Marie Kristel A. Gabawa

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The accessibility of health programs, specifically family planning programs and maternal and child health care (FP/MCH), are generally low in urban poor communities. Moreover, most of FP/MCH programs are directed toward medical terms that are usually not included in ideation of the body of urban poor dwellers. This study aims to explore the beliefs on reproduction that will encompass, but not limited to, beliefs on conception, pregnancy, and maternal and child health care. The site of study will be the 2 barangays of North Bay Boulevard South 1 (NBBS1) and North Bay Boulevard South 2 (NBBS2). These 2 barangays are the nearest residential community within the Navotas Fish Port Complex (NFPC). Data gathered will be analyzed using grounded-theory method of analysis, with the theories of cultural materialism and equity feminism as foundation. Survey questionnaires, key informant interviews, and focus group discussions will be utilized in gathering data. Further, the presentation of data will be recommended to health program initiators and use the data gathered as a tool to customize FP/MCH programs to the perception and beliefs of women residing in NBBS1and NBBS2, and to aid any misinformation for FP/MCH techniques.

Keywords: beliefs on reproduction, fish port community, family planning, maternal and child health care, Navotas

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Authors: Omogboyega Abe

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This paper examines the relationships between socio-economic inequalities of power, race, wealth engendered by corporate structure, and domination in postcolonial Africa. The paper further considers how land as an epitome of property and power for the locals paved the way for capitalist accumulation and control in the hands of transnational corporations. European colonization of Africa was contingent on settler colonialism, where properties, including land, were re-modified as extractive resources for primitive accumulation. In developing Africa's extractive resources, transnational corporations (TNCs) usurped states' structures and domination over native land. The usurpation/corporate capture that exists to date has led to remonstrations and arguably a counter-productive approach to development projects. In some communities, the mention of extractive companies triggers resentment. The paradigm of state capture and state autonomy is simply inadequate to either describe or resolve the play of forces or actors responsible for severe corporate-induced human rights violations in emerging markets. Moreover, even if the deadly working conditions are conceived as some regulatory failure, it is tough to tell whose failure. The analysis in this paper is that the complexity and ambiguity evidenced by the multiple regimes and political and economic forces shaping production, consumption, and distribution of socio-economic variables are not exceptional in emerging markets. Instead, the varied experience in developing countries provides a window for seeing what we face in understanding and theorizing the structure and operation of the global economic and regulatory order in general.

Keywords: colonial, emerging markets, business, human rights, corporation

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