Search results for: Colombian population

Authors: Metkel Gebremedhin, Biruk Kebede, Guash Abay

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Job satisfaction largely determines the productivity and efficiency of human resources for health. There is scanty evidence on factors influencing the job satisfaction of health extension professionals (HEPs) in Addis Ababa. The objective of this study was to determine the level of and factors influencing job satisfaction among extension health workers in Addis Ababa city. This was a cross-sectional study conducted in Addis Ababa, Ethiopia. Among all public health centers found in the Addis Ababa city administration health bureau that would be included in the study, a multistage sampling technique was employed. Then we selected the study health centers randomly and urban health extension professionals from the selected health centers. In-depth interview data collection methods were carried out for a comprehensive understanding of factors affecting job satisfaction among Health extension professionals (HEPs) in Addis Ababa. HEPs working in Addis Ababa areas are the primary study population. Multivariate logistic regression with 95% CI at P ≤ 0.05 was used to assess associated factors to job satisfaction. The overall satisfaction rate was 10.7% only, while 89.3%% were dissatisfied with their jobs. The findings revealed that variables such as marital status, staff relations, community support, supervision, and rewards have a significant influence on the level of job satisfaction. For those who were not satisfied, the working environment, job description, low salary, poor leadership and training opportunities were the major causes. Other factors influencing the level of satisfaction were lack of medical equipment, lack of transport facilities, lack of training opportunities, and poor support from woreda experts. Our study documented a very low level of overall satisfaction among health extension professionals in Addis Ababa city public health centers. Considering the factors responsible for this state of affairs, urgent and concrete strategies must be developed to address the concerns of extension health professionals as they represent a sensitive domain of the health system of Addis Ababa city. Improving the overall work environment, review of job descriptions and better salaries might bring about a positive change.

Keywords: job satisfaction, extension health professionals, Addis Ababa

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Authors: Upasana G. Singh, Meera Gungea

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Learning is no more confined to the traditional classroom, teacher, and student interaction. Many universities offer courses through the Open and Distance Learning (ODL) mode, attracting a diversity of learners in terms of age, gender, and profession to name a few. The ODL mode has surfaced as one of the famous sought-after modes of learning, allowing learners to invest in their educational growth without hampering their personal and professional commitments. This mode of learning, however, requires that those who ultimately choose to adopt it must be prepared to undertake studies through such medium. The purpose of this research is to assess whether students who join universities offering courses through the ODL mode are ready to embark and study within such a framework. This study will be helpful to unveil the challenges students face in such an environment and thus contribute to developing a framework to ease adoption and integration into the ODL environment. Prior to the implementation of e-learning, a readiness assessment is essential for any institution that wants to adopt any form of e-learning. Various e-learning readiness assessment models have been developed over the years. However, this study is based on a conceptual model for e-Learning Readiness Assessment which is a ‘hybrid model’. This hybrid model consists of 4 main parameters: 1) Technological readiness, 2) Culture readiness, 3) Content readiness, and 4) Demographics factors, with 4 sub-areas, namely, technology, innovation, people and self-development. The model also includes the attitudes of users towards the adoption of e-learning as an important aspect of assessing e-learning readiness. For this study, some factors and sub-factors of the hybrid model have been considered and adapted, together with the ‘Attitude’ component. A questionnaire was designed based on the models and students where the target population were students enrolled at the Open University of Mauritius, in undergraduate and postgraduate courses. Preliminary findings indicate that most (68%) learners have an average knowledge about ODL form of learning, despite not many (72%) having previous experience with ODL. Despite learning through ODL 74% of learners preferred hard copy learning material and 48% found difficulty in reading learning material on electronic devices.

Keywords: open learning, distance learning, student readiness, a hybrid model

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Authors: Umar Rehman, Holly Roy, K. T. Tsang, D. S. Jeyaretna, W Singleton, B. Fisher, P. A. Glew, J. Greig, Peter C. Whitfield

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Introduction: A brain abscess is a life-threatening condition, carrying significant mortality. It requires rapid identification and treatment. Management involves a combination of antibiotics and surgery. The aim of the current study was to identify common bacteria responsible for cerebral abscesses as well as the long term functional and neurological outcomes of patients following treatment in a retrospective series at a single UK neurosurgical centre. Methodology: We analysed patients that had received a diagnosis of 'cerebral abscess' or 'subdural empyema' between June 2002 and June 2018. This was done in the form of a retrospective review. The search resulted in a total of 180 patients; with 37 patients being excluded (spinal abscess, below 18 or non-abscess related admissions). Data were collected from medical case notes including information about demographics, comorbidities, immunosuppression, presentation, size/location of lesions, pathogens, treatment, and outcomes. Results: In total, we analysed 143 patients between the ages of 18-90. Focal neurological deficit and headaches were seen in 84% and 68% of patients respectively. 108 positive brain cultures were seen; with the largest proportion, 59.2% being gram-positive cocci, with strep intermedius being the most common pathogen identified in 13.9% of patients. Of the patients with positive blood cultures (n=11), 72.7% showed the same organism both in the blood and on the brain cultures. Long term outcomes (n=72) revealed that 48% of patients seizure-free without requiring anti-epileptics, 51.3% of patients had full recovery of their neurological symptoms. There was a mortality rate of 13.9% in the series. Conclusion: In conclusion, the largest bacterial cause of abscess within our population was due to gram-positive cocci. The majority of the patient demonstrated full neurological recovery with close to half of patients not requiring anti-epileptics following discharge.

Keywords: bacteria, cerebral abscess, long term outcome, neurological deficit

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Authors: Laid Fekih

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Background: The purpose of this paper is to examine the psychological stressors caused by urbanization, a field study conducted on a sample range of youth who live in urban areas. Some of them reside in areas with green surroundings while others reside in lack of green areas, which saw the terrible expansion of urban. The study included the impact of urbanization on the mental health of youths; select the psychological problems most commonly caused by urbanization, and the impact of green spaces in alleviating stress. Method: The method used in this research is descriptive, as the data collected from a sample of 160 young men were analyzed. The tool used is the psychological distress test. We proceeded with some statistical techniques, which provided percentages, analysis of variance, and t-tests. Results: The findings of this research were: (i) The psychological stressors caused by urban expansion are mainly in the intensity of stress, incompetence, emotional, and psychosomatic problems. (ii) There was a statistically significant difference at the level of significance 0.02 among young people who live in places in green spaces and without green space in terms of psychological stressors, in favor of young people who live in places free of greenery. (iii) The quality of this primary variable effect of housing (rental or ownership) is statistically significant in favor of young people living in rented accommodation. Conclusion: The green spaces provided by Tlemcen city are inadequate and insufficient to fulfill the population's requirements for contact with nature, leading to such effects that may negatively affect mental health, which makes it a prominent process that should not be neglected. Incorporating green spaces into the design of buildings, homes, and communities to create shared spaces, which facilitate interaction and foster well-being, becomes the main purpose. We think this approach can support the reconstruction of the built environment with green spaces by facilitating the link between psychological stress perception studies and technologies.

Keywords: psychological stressors, urbanization, psychological problems, green spaces

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Authors: Chigozie Azunna, Botes Lucius

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Child homelessness remains a significant challenge in South Africa in the upcoming decade. Despite children making up a substantial portion of South Africa's population, the issue of child homelessness continues to pose a socio-economic crisis with diverse impacts. Achieving the UN 2050 Agenda for Sustainable Development Goals (SDGs), especially in terms of equality and non-discrimination, requires an effective approach to curb child homelessness. Addressing this issue will positively influence the economic trajectory of South Africa's evolving demographic landscape. This research uses content analysis through an extensive review of current literature on child homelessness in South Africa. Findings indicate alignment between national policies and international agendas in tackling child homelessness in South Africa. However, the following statistics depict the ongoing challenge: In metropolitan areas, homelessness stands at 74.1%, whereas non-metro regions account for 25.9%. The City of Tshwane has the highest number of homeless individuals at 18.1%, followed by the City of Johannesburg at 15.6%, while Nelson Mandela Bay Metropolitan has the lowest at 2.7%. Despite existing national policy frameworks, child homelessness persists. The lack of accurate data, compounded by issues such as economic challenges, the lingering impacts of the COVID-19 pandemic, poverty, the HIV/AIDS epidemic, and gaps in policy implementation, has exacerbated the problem. The consequences are dire, affecting children’s physical and emotional health, education, and future opportunities. The study recommends reinforcing actionable policies to address child homelessness effectively. Bridging the urban-rural divide and establishing intra-community networks are crucial for tackling this issue comprehensively. This includes addressing multifaceted challenges such as access to education, disease susceptibility, and the overall vulnerability of homeless children.

Keywords: South Africa, child, homeless, SDGs, COVID, urban, rural

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Authors: Elissar Mansour, Emily Chen, Tracee Fernandez, Mariam Basheti, Christopher Gordon, Bandana Saini

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Sleep is an essential process for the maintenance of several neurobiological processes such as memory consolidation, mood, and metabolic processes. It is known that sleep patterns vary with age and is affected by multiple factors. While non-pharmacological strategies are generally considered first-line, sedatives are excessively used in the older population. This study aimed to explore the management of sleep in residential aged care facilities (RACFs) by nurse professionals and to identify the key factors that impact provision of optimal sleep health care. An inductive thematic qualitative research method was employed to analyse the data collected from semi-structured interviews with registered nurses working in RACF. Seventeen interviews were conducted, and the data yielded three themes: 1) the nurses’ observations and knowledge of sleep health, 2) the strategies employed in RACF for the management of sleep disturbances, 3) the organizational barriers to evidence-based sleep health management. Nurse participants reported the use of both non-pharmacological and pharmacological interventions. Sedatives were commonly prescribed due to their fast action and accessibility despite the guidelines indicating their use in later stages. Although benzodiazepines are known for their many side effects, such as drowsiness and oversedation, temazepam was the most commonly administered drug. Sleep in RACF was affected by several factors such as aging and comorbidities (e.g., dementia, pain, anxiety). However, the were also many modifiable factors that negatively impacted sleep management in RACF. These include staffing ratios, nursing duties, medication side effects, and lack of training and involvement of allied health professionals. This study highlighted the importance of involving a multidisciplinary team and the urge to develop guidelines and training programs for healthcare professionals to improve sleep health management in RACF.

Keywords: registered nurses, residential aged care facilities, sedative use, sleep

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Authors: Mariana Mangas, Yaroslava Martins, M. Suárez, Célia Santos, Ana Matos Pires

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Baixo Alentejo is a region of Portugal characterized by an aging population, geographic isolation, social deprivation and a lack of medical staff. It is one of the most problematic regions in regards to mental health, particularly due to the factors mentioned. The aim of this study is a presentation of liaison psychiatry in Hospital José Joaquim Fernandes; a sample of the work done, the current situation and future perspectives. The aim is to present a retrospective study of internal psychiatric emergencies from January 1st, 2016 to August 31st, 2016. Liaison psychiatry of Department of Psychiatry and Mental Health (Psychiatry Service) of ULSBA includes the following activities: internal psychiatry emergencies, HIV consultation (comprised in the general consultation) and liaison psychology (oncology and pain), consisting of a total of 111 internal psychiatry emergencies during the identified period. Gender distribution was uniform. The most prevalent age group was 71-80 years, and 66,6% of patients were 60 years old and over. The majority of the emergency observations was requested by hospital services of medicine (56,8%) and surgery (24,3%). The most frequent reasons for admission were: respiratory disease (18,0%); tumors (15.3%); other surgical and orthopedic pathology (14,5%) and stroke (11,7%). The most frequent psychiatric diagnoses were: neurotic and organic depression (24,3%); delirium (26,1%) and adjustment reaction (14,5%). Major psychiatric pathology (schizophrenia and affective disorders) was found in 10,8%. Antidepressive medication was prescribed in 37,8% patients; antipsychotics in 34,2%. In 9.9% of the cases, no psychotropic drug was prescribed, and 5,4% of patients received psychologic support. Regarding hospital discharge, 42,4% of patients were referred to the general practitioner or to the medical specialist; 22,5% to outpatient gerontopsychiatry; 17,1% to psychiatric outpatient and 14,4% deceased. A future perspective is to start liaison in areas of HIV and psycho oncology in multidisciplinary approach and to improve collaboration with colleagues of other specialties for refining psychiatric referrals.

Keywords: psychiatry, liaison, internal emergency, psychiatric referral

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Authors: Mahera Abdulrahman, Satish Chandrasekhar Nair

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Growing demand for human health research in the United Arab Emirates (UAE) has prompted the need to develop a robust research ethics oversight, particularly given the large unskilled-worker immigrant population and the elderly citizens utilizing health services. Examination of the structure, function, practices and outcomes of the human research ethics committees (HREC) was conducted using two survey instruments, reliable and validated. Results indicate that in the absence of a national ethics regulatory body, the individual emirate’s governed 21 HRECs covering health facilities and academic institutions in the UAE. Among the HRECs, 86% followed International Council for Harmonization-Good Clinical Practice guidelines, 57% have been in operation for more than five years, 81% reviewed proposals within eight weeks, 48% reviewed for clinical and scientific merit apart from ethics, and 43% handled more than 50 research proposals per year. However, researcher recognition, funding transparency, adverse event reporting systems were widespread in less than one-third of all HRECs. Surprisingly, intellectual property right was not included as a research output. Research was incorporated into the vision and mission statements of many (62%) organizations and, mechanisms such as research publications, collaborations, and recognitions were employed as key performance indicators to measure research output. In spite, resources to generate research output such as dedicated budget (19%), support staff (19%) and continuous training and mentoring program for medical residents and HREC members were somehow lacking. HREC structure and operations in the UAE are similar to other regions of the world, resources allocation for efficient, quality monitoring, continuous training, and the creation of a clinical research network are needed to strengthen the clinical research enterprise to scale up for the future. It is anticipated that the results of this study will benefit investigators, regulators, pharmaceutical sponsors and the policy makers in the region.

Keywords: institutional review board, ethics committee, human research ethics, United Arab Emirates (UAE)

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Authors: Peter David Reiss

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The concept of the psychosis prodrome has allowed for the identification of adolescent and young adult patients who have a significantly elevated risk of developing schizophrenia spectrum disorders. A number of different interventions have been tested in order to prevent or delay progression of symptoms. To date, there has been no consistent meta-analytical evidence to support efficacy of antipsychotic treatment for patients in the prodromal state, and their use remains therefore inconclusive. Although antipsychotics may manage symptoms transiently, they have not been found to prevent or delay onset of psychotic disorders. Furthermore, pharmacological intervention in high-risk individuals remains controversial, because of the antipsychotic side effect profile in a population in which only about 20 to 35 percent will eventually convert to psychosis over a two-year period, with even after two years conversion rates not exceeding 30 to 40 percent. This general estimate is additionally problematic, in that it ignores the fact that there is significant variation in individual risk among clinical high-risk cases. The current lack of reliable tests for at-risk patients makes it difficult to justify individual treatment decisions. Preventive treatment should ideally be dictated by an individual’s risk while minimizing potentially harmful medication exposure. This requires more accurate predictive assessments by using valid and accessible prognostic markers. The following will compare prediction and risk modification potential of behavioral biomarkers such as disturbances of basic sense of self and emotion awareness, neurocognitive biomarkers such as attention, working and declarative memory, and neurophysiological biomarkers such as glutamatergic abnormalities and NMDA receptor dysfunction. Identification of robust biomarkers could therefore not only provide more reliable means of psychosis prediction, but also help test and develop new clinical interventions targeted at the prodromal state.

Keywords: at-risk mental state, biomarkers, glutamatergic system, NMDA receptor, psychosis prodrome, schizophrenia

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Authors: Rashmi Tomar, A. Srinivasan, Nayan K. Mohanty, Arun K. Jain

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Phthalates have been used as additives in industrial products since the 1930s, and are universally considered to be ubiquitous environmental contaminants. The general population is exposed to phthalates through consumer products, as well as diet and medical treatments. Animal studies showing the existence of an association between some phthalates and testicular toxicity have generated public and scientific concern about the potential adverse effects of environmental changes on male reproductive health. Unprecedented declines in fertility rates and semen quality have been reported during the last half of the 20th century in developed countries and increasing interest exists on the potential relationship between exposure to environmental contaminants, including phthalates, and human male reproductive health Studies. Phthalates may be associated with altered endocrine function and adverse effects on male reproductive development and function, but human studies are limited. The aim of the present study was detection of phthalate compounds, estimation of their metabolites in infertile & fertile male. Blood and urine samples were collected from 150 infertile patients & 75 fertile volunteers recruited through Department of Urology, Safdarjung Hospital, New Delhi. Blood have been collected in separate glass tubes from the antecubital vein of the patients, serum have been separate and estimate the phthalate level in serum samples by Gas Chromatography / Mass Spectrometry using NIOSH / OSHA detailed protocol. Urine of Infertile & Fertile Subjects was collected & extracted using solid phase extraction method, analysis by HPLC. In conclusion, to the best of our knowledge the present study based on human is first to show the presence of phthalate in human serum samples and their metabolites in urine samples. Significant differences were observed between several phthalates in infertile and fertile healthy individuals.

Keywords: Gas Chromatography, HPLC, male infertility, phthalates, serum, toxicity, urine

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Authors: Daria Zabolotnaya, Svetlana Degtyareva, Veronika Kanestri, Danila Konnov

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An adequate choice of the initial antiretroviral treatment determines the treatment efficacy. In the clinical guidelines in Russia non-nucleoside reverse transcriptase inhibitors (NNRTIs) are still considered to be an option for first-line treatment while pretreatment drug resistance (PDR) testing is not routinely performed. We conducted a cohort retrospective study in HIV-positive treatment naïve patients of the H-clinic (Moscow, Russia) who performed PDR testing from July 2017 to November 2021. All the information was obtained from the medical records anonymously. We analyzed the mutations in reverse transcriptase and protease genes. RT-sequences were obtained by AmpliSens HIV-Resist-Seq kit. Drug resistance was defined using the HIVdb Program v. 8.9-1. PDR was estimated using the Stanford algorithm. Descriptive statistics were performed in Excel (Microsoft Office, 2019). A total of 261 HIV-1 infected patients were enrolled in the study including 197 (75.5%) male and 64 (24.5%) female. The mean age was 34.6±8.3 years. The median CD4 count – 521 cells/µl (IQR 367-687 cells/µl). Data on risk factors of HIV-infection were scarce. The total quantity of strains containing mutations in the reverse transcriptase gene was 75 (28.7%). From these 5 (1.9%) mutations were associated with PDR to nucleoside reverse transcriptase inhibitors (NRTIs) and 30 (11.5%) – with PDR to NNRTIs. The number of strains with mutations in protease gene was 43 (16.5%), from these only 3 (1.1%) mutations were associated with resistance to protease inhibitors. For NNRTIs the most prevalent PDR mutations were E138A, V106I. Most of the HIV variants exhibited a single PDR mutation, 2 were found in 3 samples. Most of HIV variants with PDR mutation displayed a single drug class resistance mutation. 2/37 (5.4%) strains had both NRTIs and NNRTIs mutations. There were no strains identified with PDR mutations to all three drug classes. Though earlier data demonstrated a lower level of PDR in HIV treatment naïve population in Russia and our cohort can be not fully representative as it is taken from the private clinic, it reflects the trend of increasing PDR especially to NNRTIs. Therefore, we consider either pretreatment testing or giving the priority to other drugs as first-line treatment necessary.

Keywords: HIV, resistance, mutations, treatment

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Authors: Magdy Danial Riad

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Introduction: The ability of our world to support the expanding population after 2050 is at risk due to the food system's global role in poor health, climate change, and resource depletion. Healthy, equitable, and sustainable food systems must be achieved from the point of production through consumption in order to meet several of the sustainable development goals (SDG) targets. There is evidence that changing the local food environment can effectively change dietary habits in a community. The purpose of this article is to outline the policy initiatives taken by local governments to support environmentally friendly eating habits. Methods: Five databases were searched for peer-reviewed articles that described local government authorities' implementation of environmentally sustainable eating habits, were located in cities that had signed the Milan Urban Food Policy Pact, were published after 2015, were available in English, and described policy interventions. Data extraction was a two-step approach that started with extracting information from the included study and ended with locating information unique to policies in the grey literature. Results: 45 papers that described a variety of policy initiatives from low-, middle-, and high-income countries met the inclusion criteria. A variety of desired dietary behaviors were the focus of policy action, including reducing food waste, procuring food locally and in season, boosting breastfeeding, avoiding overconsumption, and consuming more plant-based meals and fewer items derived from animals. Conclusions: In order to achieve SDG targets, local governments are under pressure to implement evidence-based interventions. This study can help direct local governments toward evidence-based policy measures to improve regional food systems and support ecologically friendly eating habits.

Keywords: meals, planet, poor health, eating habits

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Authors: Mahnoor Shoaib

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Sustainable development involves meeting present needs without compromising future generations’ capacity to meet their own while enhancing the quality of life through a healthy and safe environment. In the context of rapid urbanization and globalization, architects and planners bear the responsibility of designing residential buildings that are sustainable and conducive to quality living. Residential buildings serve as multifunctional spaces for personal and family life, making them essential for fostering healthy communities. Therefore, sustainable housing must address not only economic and environmental factors but also social, historical, and cultural dimensions to enhance residents' social lives. This research investigates the socio-cultural aspects of tall residential buildings in Karachi, Pakistan, a developing community characterized by rapid population growth and urbanization. A mixed-methods approach, including qualitative interviews and surveys, was employed to assess residents' perceptions of sustainability in tall buildings, focusing on socio-cultural design constraints and their impact on residential satisfaction. The study finds that socio-cultural elements, such as liveability, social cohesion, and spatial agency, significantly influence residents’ satisfaction with high-rise developments. Moreover, it highlights the need for contextual design solutions that integrate local cultural values into the architecture of tall buildings rather than imposing Western design principles. In conclusion, this research provides valuable insights for architects, designers, and urban planners, emphasizing the importance of understanding community needs and preferences in developing sustainable residential environments. By prioritizing socio-cultural sustainability, we can enhance the overall quality of life for residents in tall buildings, contributing to healthier and more vibrant communities.

Keywords: high-rise residential buildings, quality of life, social cohesion, socio-cultural sustainability

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Authors: Maja Ruzic-Baf, Vedrana Keteles, Andrea Debeljuh

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Younger and younger children are now using a smartphone, a device which has become ‘a must have’ and the life of children would be almost ‘unthinkable’ without one. Devices are becoming lighter and lighter but offering an array of options and applications as well as the unavoidable access to the Internet, without which it would be almost unusable. Numerous features such as taking of photographs, listening to music, information search on the Internet, access to social networks, usage of some of the chatting and messaging services, are only some of the numerous features offered by ‘smart’ devices. They have replaced the alarm clock, home phone, camera, tablet and other devices. Their use and possession have become a part of the everyday image of young people. Apart from the positive aspects, the use of smartphones has also some downsides. For instance, free time was usually spent in nature, playing, doing sports or other activities enabling children an adequate psychophysiological growth and development. The greater usage of smartphones during classes to check statuses on social networks, message your friends, play online games, are just some of the possible negative aspects of their application. Considering that the age of the population using smartphones is decreasing and that smartphones are no longer ‘foreign’ to children of pre-school age (smartphones are used at home or in coffee shops or shopping centers while waiting for their parents, playing video games often inappropriate to their age), particular attention must be paid to a very sensitive group, the teenagers who almost never separate from their ‘pets’. This paper is divided into two sections, theoretical and empirical ones. The theoretical section gives an overview of the pros and cons of the usage of smartphones, while the empirical section presents the results of a research conducted in three elementary schools regarding the usage of smartphones and, specifically, their usage during classes, during breaks and to search information on the Internet, check status updates and 'likes’ on the Facebook social network.

Keywords: education, smartphone, social networks, teenagers

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Authors: Cristine P. Canlas, Crislene Mae L. Gever, Patricia Bea R. Rosialda, Ma. Nina Regina M. Quibod, Perry Archival C. Buenavente, Normandy M. Barbecho, Cynthia Adeline A. Layusa, Michael Day

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Invasive plants have an impact on global biodiversity and ecosystem function, and their management is a complex and formidable task. Two of these invasive plant species, Lantana camara and Chromolaena odorata, are found in the Philippines. Lantana camara has the ability to suppress the growth of and outcompete neighboring plants. Chromolaena odorata causes serious agricultural and economical damage and causes fire hazards during dry season. In addition, both species has been reported to poison livestock. One of the known global management strategies to control invasive plants is the introduction of biological control agents. These natural enemies of the invasive plants reduce population density and impacts of the invasive plants, resulting in the balance of the nature in their invasion. Through secondary data sources, interviews, and field validation (e.g. microhabitat searches, sweep netting, opportunistic sampling, photo-documentation), we investigated whether the biocontrol agents previously released by the Philippine Coconut Authority (PCA) in their Davao Research Center to control these invasive plants are still present and are affecting their respective host weeds. We confirm the presence of the biocontrol agent of L. camara, Uroplata girardi, which was introduced in 1985, and Cecidochares connexa, a biocontrol agent of C. odorata released in 2003. Four other biocontrol agents were found to affect L. camara. Signs of damage (e.g. stem galls in C. odorata, and leaf mines in L. camara) signify that these biocontrol agents have successfully established outside of their release site in Davao. Further investigating the extent of the spread of these biocontrol agents in the Philippines and their damage to the two weeds will contribute to the management of invasive plant species in the country.

Keywords: invasive alien species, biological control agent, entomology, worst weeds

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Authors: Juan-Pedro Rica-Peromingo

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Teachers constantly need to innovate and redefine materials for their lectures, especially in areas such as Language for Specific Purposes (LSP) and Translation Studies (TS). It is therefore essential for the lecturers to be technically skilled to handle the never-ending evolution in software and technology, which are necessary elements especially in certain courses at university level. This need becomes even more evident in Audiovisual Translation (AVT) Modules and Courses. AVT has undergone considerable growth in the area of teaching and learning of languages for academic purposes. We have witnessed the development of a considerable number of masters and postgraduate courses where AVT becomes a tool for L2 learning. The teaching and learning of different AVT modes are components of undergraduate and postgraduate courses. Universities, in which AVT is offered as part of their teaching programme or training, make use of professional or free software programs. This paper presents an approach in AVT withina specific university context, in which technology is used by means of professional and nonprofessional software. Students take an AVT subject as part of their English Linguistics Master’s Degree at the Complutense University (UCM) in which they are using professional (Spot) and nonprofessional (Subtitle Workshop, Aegisub, Windows Movie Maker) software packages. The students are encouraged to develop their tasks and projects simulating authentic professional experiences and contexts in the different AVT modes: subtitling for hearing and deaf and hard of hearing population, audio description and dubbing. Selected scenes from TV series such as X-Files, Gossip girl, IT Crowd; extracts from movies: Finding Nemo, Good Will Hunting, School of Rock, Harry Potter, Up; and short movies (Vincent) were used. Hence, the complexity of the audiovisual materials used in class as well as the activities for their projects were graded. The assessment of the diverse tasks carried out by all the students are expected to provide some insights into the best way to improve their linguistic accuracy and oral and written productions with the use of different AVT modes in a very specific ESP university context.

Keywords: ESP, audiovisual translation, technology, university teaching, teaching

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Authors: Fatima Alkhayat, Abu Hassan Ahmed

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Qatar as the one of Middle East and Gulf country is growing rapidly due to urbanization. Urbanization, population’s movement and goods transportation in addition to climatic change all together create suitable environments for remerging and/or introduction of new disease vectors species. Unfortunately, knowledge on mosquito species composition and their geographical distribution in Qatar is extremely limited. The objective of present study is to provide update information on species composition and distribution. Mosquito larval survey carried out in six sentinel sites in Qatar. The collection was made on monthly basis in period from October 2013 to May 2015 using dipping techniques and identified to species level using appropriate pictorial keys. In total about 3,085 mosquito larvae were collected and identified to species compromising three mosquito genera, Culex 87.4% (n=2697), Ochlerotatus 9.9% (n= 305) and Anopheles 2.6% (n= 81). Among Culex genera; Culex quinquefasciatus represent 87.8% (n= 2369), Cx. pipiens 8.7% (n=237), and Cx. mattinglyi 3.4% (n=91). Culex quinquefasciatus was the most commonly collected species, representing 93.5% in Alwakra (n= 2216) which was observed in November, December, March, April and May when reached the peak. 6.4% in Nuaija (n= 151) was found in February and March and reached the peak in March. 0.1% in Alkaraana (n=2) only observed in April. Cx. pipiens was observed 50.2% in Rwdat Alfaras (n=120) and 48.9% in Hazm Almurkhiya (n=117). While in Rowdat Alfaras it was observed in Oct-May and in Hazm Almurkhiya from Oct-April. Cx. mattinglyi (n= 91) was only found in Nuaija from October to December. Ochlerotatus genera account 1 species Oc. dorsalis (n=305). The majority of Oc. dorsalis were observed in March and May, 98% in Nuaija (n= 299), followed by 2% in Alkhor (n=6) which was observed in January and February. Anopheles was only represented by An. stephensi which was found 69% in Alwakra (n= 56) in November, December, April and May, while 25.9% in Hazm Almurkhiya (n=21) and found in May and November. 6.2% in Rwadat Alfaras and was observed only in November and 1.2% in Nuaija (n=1) and observed in October. Further investigation is required on the composition and distribution of mosquito for implementing a surveillance program and control of mosquito-borne diseases in Qatar.

Keywords: composition, distribution, mosquito, Qatar

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Authors: Cristy Stagnar, Nina Hubig, Diana Ivankovic

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The epigenome is a compelling candidate for mediating long-term responses to environmental effects modifying disease risk. The main goal of this research is to develop a machine learning-based DNA methylation score, which will be valuable in delineating the unique contribution of paternal epigenetic modifications to the germline impacting childhood health outcomes. It will also be a useful tool in validating self-reports of nonsmoking and in adjusting epigenome-wide DNA methylation association studies for this early-life exposure. Using secondary data from two population-based methylation profiling studies, our DNA methylation score is based on CpG DNA methylation measurements from cord blood gathered from children whose fathers smoked pre- and peri-conceptually. Each child’s mother and father fell into one of three class labels in the accompanying questionnaires -never smoker, former smoker, or current smoker. By applying different machine learning algorithms to the accessible resource for integrated epigenomic studies (ARIES) sub-study of the Avon longitudinal study of parents and children (ALSPAC) data set, which we used for training and testing of our model, the best-performing algorithm for classifying the father smoker and mother never smoker was selected based on Cohen’s κ. Error in the model was identified and optimized. The final DNA methylation score was further tested and validated in an independent data set. This resulted in a linear combination of methylation values of selected probes via a logistic link function that accurately classified each group and contributed the most towards classification. The result is a unique, robust DNA methylation score which combines information on DNA methylation and early life exposure of offspring to paternal smoking during pregnancy and which may be used to examine the paternal contribution to offspring health outcomes.

Keywords: epigenome, health outcomes, paternal preconception environmental exposures, supervised machine learning

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Authors: J. Cadby, K. Miyazawa

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Information and Communication Technology (ICT) has been widely adopted into the agricultural landscape with advancements of mobile connectivity and data accessibility. In developed nations, mobile-technology is well integrated into marketing transactions, and also plays a crucial role in making data-driven decisions on-farm. In developing nations, mobile banking and access to agricultural extension services allow for informed decision-making and smoother transactions. In addition, the availability of updated and readily available market and climate data provides a negotiation platform, reducing economic risks for farmers worldwide. The total usage of mobile technology has risen over the past 20 years, and almost three-quarters of the world’s population subscribes to mobile technology. This study reviewed mobile technology integration into agricultural systems in developing and developed nations. Data from secondary sources were collected and investigated. The objectives of the study include a review of the success of mobile banking transactions in developing nations, and a review of application and SMS based services for direct marketing in both developed and developing nations. Rural farmers in developing countries with access to diverse m-banking options experienced increased access to farm investment resources with the use of mobile banking technology. Rural farmers involved in perishable crop production were also more likely to benefit from mobile platform sales participation. ICT programs reached through mobile application and SMS increased access to agricultural extension materials and marketing tools for demographics that faced literacy-challenges and isolated markets. As mobile technology becomes more ubiquitous in the global agricultural system, training and market opportunities to facilitate mobile usage in developing agricultural systems are necessary. Digital skills training programs are necessary in order to improve equal global adoption of ICT in agriculture.

Keywords: market participation, mobile banking, mobile technology, rural farming

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Authors: Pelin Yılmaz Çetiner, Metin Mert İlgün, Nazlı Çetindağ, Emine Birci, Gizemnur Yıldız Uysal, Özcan Hatipoğlu, Ehsan Tuzcuoğlu, Gökhan Sır

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Water scarcity is an inevitable problem affecting more and more people day by day. It is a worldwide crisis and a consequence of rapid population growth, urbanization and overexploitation. Thus, the solutions providing the reclamation of the wastewater are the desired approach. Wastewater contains various substances such as organic, soaps and detergents, solvents, biological substances, and inorganic substances. The physical properties of the wastewater differs regarding to its origin such as commerical, domestic or hospital usage. Thus, the treatment strategy of this type of wastewater is should be comprehensively investigated and properly treated. The advanced oxidation process comes up as a hopeful method associated with the formation of reactive hydroxyl radicals that are highly reactive to oxidize of organic pollutants. This process has a priority on other methods such as coagulation, flocuation, sedimentation and filtration since it was not cause any undesirable by-products. In the present study, it was aimed to investigate the applicability of advanced oxidation process for the treatment of household appliances wastewater. For this purpose, the laboratory studies providing the effectively addressing of the formed radicals to organic pollutants were carried out. Then the effect of process parameters were comprehensively studied by using response surface methodology, Box-Benhken experimental desing. The final chemical oxygen demand (COD) was the main output to evaluate the optimum point providing the expected COD removal. The linear alkyl benzene sulfonate (LAS), total dissolved solids (TDS) and color were measured for the optimum point providing the expected COD removal. Finally, present study pointed out that advanced oxidation process might be efficiently preffered to treat of the household appliances wastewater and the optimum process parameters provided that expected removal of COD.

Keywords: advanced oxidation process, household appliances wastewater, modelling, water reuse

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Authors: Amal Shehata

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Low back pain related to disc prolapse is localized in the lumbar area and it may be radiated to the lower extremities, starting from neurons near or around the spinal canal. Most of the population may be affected with disc prolapse within their lifetime and leads to lost productivity, disability and loss of function. The study purpose was to examine the effect of rehabilitative nursing program on pain intensity and functional status among patients with discectomy. Design: Aquasi experimental design was utilized. Setting: The study was carried out at neurosurgery department and out patient's clinic of Menoufia University and Teaching hospitals at Menoufia governorate, Egypt. Instrument of the study: Five Instruments were used for data collection: Structured interviewing questionnaire, Functional assessment instrument, Observational check list, Numeric rating Scale and Oswestry low back pain disability questionnaire. Results: There was an improvement in mean total knowledge score about disease process, discectomy and rehabilitation program in study group (25.32%) than control group (7.32%). There was highly statistically significant improvement in lumbar flexibility among study group (80%) than control group (30%) after rehabilitation program than before. Also there was a decrease in pain score in study group (58% no pain) than control group (28% no pain) after rehabilitation program. There was an improvement in total disability score of study group (zero %) regarding effect of pain on the activity of daily living after rehabilitation program than control group (16%). Conclusion: Application of rehabilitative nursing program for patient with discectomy had proven a positive effect in relation to knowledge score, pain reduction, activity of daily living and functional abilities. Recommendation: A continuous rehabilitative nursing program should be carried out for all patients immediately after discectomy surgery on regular basis. Also A colored illustrated booklet about rehabilitation program should be available and distributed for all patients before surgery.

Keywords: discectomy, rehabilitative nursing program, pain intensity, functional status

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Authors: F. Fatoye, C. E. Mbada, T. Gebrye, A. O. Ogunsola, C. Fatoye, O. Oyewole

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Musculoskeletal disorders (MSDs) such as low back pain (LBP), cervical spondylosis (CSPD), sprain, osteoarthritis (OA), and post immobilization stiffness (PIS) have a major impact on individuals, health systems and society in terms of morbidity, long-term disability, and economics. This study estimated the direct and indirect costs of common MSDs in Osun State, Nigeria. A review of medical charts for adult patients attending Physiotherapy Outpatient Clinic at the Obafemi Awolowo University Teaching Hospitals Complex, Osun State, Nigeria between 2009 and 2018 was carried out. The occupational class of the patients was determined using the International Labour Classification (ILO). The direct and indirect costs were estimated using a cost-of-illness approach. Physiotherapy related health resource use, and costs of the common MSDs, including consultation fee, total fee charge per session, costs of consumables were estimated. Data were summarised using descriptive statistics mean and standard deviation (SD). Overall, 1582 (Male = 47.5%, Female = 52.5%) patients with MSDs population with a mean age of 47.8 ± 25.7 years participated in this study. The mean (SD) direct costs estimate for LBP, CSPD, PIS, sprain, OA, and other conditions were $18.35 ($17.33), $34.76 ($17.33), $32.13 ($28.37), $35.14 ($44.16), $37.19 ($41.68), and $15.74 ($13.96), respectively. The mean (SD) indirect costs estimate of LBP, CSPD, PIS, sprain, OA, and other MSD conditions were $73.42 ($43.54), $140.57 ($69.31), $128.52 ($113.46), sprain $140.57 ($69.31), $148.77 ($166.71), and $62.98 ($55.84), respectively. Musculoskeletal disorders contribute a substantial economic burden to individuals with the condition and society. The unacceptable economic loss of MSDs should be reduced using appropriate strategies. Further research is required to determine the clinical and cost effectiveness of strategies to improve health outcomes of patients with MSDs. The findings of the present study may assist health policy and decision makers to understand the economic burden of MSDs and facilitate efficient allocation of healthcare resources to alleviate the burden associated with these conditions in Nigeria.

Keywords: economic burden, low back pain, musculoskeletal disorders, real-world

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Authors: Roberto Cassino, Valeria Dissette, Carlo Alberto Bignozzi, Daniele Pazzi

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Background and Aims: The aim of this work was to investigate, both ‘in vitro’ and ‘in vivo’, if the new SCX technology (SiO2-Ag+Chlorex) can easily defeat infections and it is really more effective than SSD (SilverSulfaDiazine). ‘In vitro’ methods: we tested ‘in vitro’ the effectiveness of both silver materials using a pool of 5 strains: Pseudomonas Aeruginosa, Staphylococcus aureus, Escherichia Coli, Enterococcus hirae and Candida Albicans. 100 µl of this pool have been seeded on Petri dishes and kept for 24 hours in incubation at 37 C°. ‘In vivo’ methods: we enrolled patients with multiple infectious chronic wounds (according with cutting & harding criteria for infection); after a qualitative evaluation of the wounds bacterial population, taking a sample by plug, we included in the study 6 patients for a total of 10 wounds, infected by one or more of the microorganisms used for the ‘in vitro’ test. The protocol consisted of a treatment with a spray powder of SSD every 48 hours for 14 days; in case of worsening we should have to start a new treatment with a spray powder containing silicon dioxide, ionic silver and chlorexidine (SiO2-Ag+Chlorex) every 48 hours for 14 days. We evaluated the number of clinical signs of infection and the disappearance or not of the wound edge erithema. ‘In vitro’ results: SSD demonstrated a wide zone of inhibition within 24 hours, but after 5 days there was no more signs of inhibition; on the contrary SCX had a good inhibition ring that lasted more than 5 days. ‘In vivo’ results: all wounds treated with SSD got worse; the signs of infection increased and the wound edge erithema did not disappear. According with the protocol, we treated then all wounds with SCX and they all improved within the period of observation with complete disappearance of clinical signs of infection and no more wound edge erithema. Conclusions: the study demonstrated the effectiveness of SiO2-Ag+Chlorex, especially in terms of long lasting antimicrobial action. We had the same results ‘in vitro’, so that there has been a perfect correspondence between the laboratory outcomes and the clinical ones.

Keywords: chronic wounds, infections, ionic silver, SSD

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Authors: Ezat Vahidian, Babak Eshrati

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Introduction: Elder abuse, a very complex issue with diverse definitions and names, has been very slow to capture the public eye and public policy since it is manifested at many levels. It requires the involvement of different types of professionals. While elder abuse is not a new phenomenon, the speed of population ageing world-wide is likely to lead to an increase in its incidence and prevalence. Elder abuse has devastating consequences for older persons such as poor quality of life, psychological distress, and loss of property and security. It is also associated with increased mortality and morbidity. Elder abuse is a problem that manifests itself in both rich and poor countries and at all levels of society. Purpose: The purpose of this study is to determine the prevalence of elder abuse and effects of social factor on it in Markazi Province. Materials and methods: The society of the study was all of the elders in Markazi Province that were available by geographical address in the table of rural and urban household societies. The study was cross sectional and multi phases in sampling the first one was classification according rural and urban area and the second one was cluster sampling with equal cluster. Estimation of samples were 472 persons and increased by design effect to 1110 persons. Collection data was done by questionnaire and analyzed by SPSS and chi 2 exam. Results: This study showed 70 persons were abused (42/8% male and 57/2% female) mean of ages was 74/7 years. 64% were marred and 31% were widows. There were not any significant meaningful association between elder abuse and area of living (pv=0.299),occupation (p.v=0.104), education (pv=0.358) and age (P.value=0.104) there were significant meaningful association between physical impairment (pv=0.08), and movement impairment (P.value=0.008). Conclusion: Results verify that maltreatment occurred in the aged persons. Analysis of data indicated that elder abuse exist in every socioeconomic group with any context of education in urban area and rural area and in men and women. Prevalence of elder abuse was 6.3% (70 persons) that verify the data of developed countries with limited sample.

Keywords: elder abuse, education, occupation, area of living

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Authors: Olufunke O. Obanla, Oluseye O. Onabanjo, Silifat A. Sanni, Mojisola O. Adegunwa, Wasiu A. O. Afolabi, Omolola O. Oyawoye, Atinuke Titilola Lano-Maduagu

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Background: Dietary fat is implicated in the increasing development of chronic diseases in developing countries while dietary fibre plays a major role in the management of these diseases. Accurate nutrient composition data for composite dishes unique to a population is essential for the development of a nutrient database and the calculation of dietary intake. Methods: Representative samples of standardized Nigerian soups and dishes were analyzed for fatty acids using gas chromatography-mass spectrophotometry (GC-MS) and dietary fibre using an enzymatic-gravimetric standard method of AOAC. Results: The total Saturated Fatty acids (SFAs) ranged from 0.74+0.3g/100g to 73.82+0.07g/100g. The total monounsaturated fatty acids (MUFAs) and polyunsaturated fatty acids (PUFAs) ranged from 2.16+1.13g/100g for Yam pottage to 22.25+0.58g/100g for Okazi soup and eba, and from 0.42+0.10g/100g for Yam pottage to 10.22+0.1g/100g for Pounded yam with egusi ball soup, respectively. Trans fat was observed in Alapafubu and Tuwo shinkafa (2.80+0.2g/100g), Yam pottage (0.20+0.15g/100g), Steamed bean pudding (1.28+0.53g/100g) and Ikokore (5.33+0.41g/100g). The Total Dietary Fibre (TDF) contents of the dishes ranged from 12.95+2.99g/100g in Jollof rice to 62.00+0.94g/100g in Melon seed and vegetable soup, the Soluble Dietary Fibre (SDF) ranged from 2.05+0.32g/100g in Steamed bean pudding to 7.81+0.74g/100g in Ikokore while the Insoluble Dietary Fibre (IDF) ranged from 8.20+0.43g/100g in Jollof rice to 57.91+4.69g/100g in melon seed and vegetable soup. Conclusions: The study has indicated that some Nigerian dishes are characterized by high SFAs, TFAs and dietary fibre, moderate MUFAs and very low levels of PUFAs. High levels of SFAs in some soups and dishes are a major public health concern.

Keywords: healthy diet, dietary fibre, fatty acid profile, chronic diseases, Nigerian dishes

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Authors: Zhang Cong, Cai Runlin, Jia Fengjiao

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The evolution of the urban agglomeration spatial structure requires strong support of the inter-city traffic system. And the inter-city traffic system can not only meet the demand of the urban agglomeration transportation but also guide the economic development. To correctly understand the relationship between inter-city traffic planning and urban agglomeration can help the urban agglomeration coordinated developing with the inter-city traffic system. The Yangtze River Delta is one of the most representative urban agglomerations in China with strong economic vitality, high city levels, diversified urban space form, and improved transport infrastructure. With the promotion of industrial division in the Yangtze River Delta and the regional travel facilitation brought by inter-city traffic, the urban agglomeration is characterized by highly increasing of inter-city transportation demand, the urbanization of regional traffic, adjacent regional transportation links breaking administrative boundaries, the networked channels and so on. Therefore, the development of inter-city traffic system presents new trends and challenges. This paper studies the interactions between inter-city traffic system and regional economic growth, regional factor flow, and regional spatial structure evolution in the Yangtze River Delta from two dimensions of time and space. On this basis, the adaptability of inter-city traffic development mode and urban agglomeration space structure is analyzed. First of all, the coordination between urban agglomeration planning and inter-city traffic planning is judged from the planning level. Secondly, the coordination between inter-city traffic elements and industries and population distributions is judged from the perspective of space. Finally, the coordination of the cross-regional planning and construction of inter-city traffic system is judged. The conclusions can provide an empirical reference for intercity traffic planning in Yangtze River Delta region and other urban agglomerations, and it is also of great significance to optimize the allocation of urban agglomerations and the overall operational efficiency.

Keywords: evolution, interaction, inter-city traffic system, spatial structure

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Authors: Faith Eweluegim Enahoro-Ofagbe

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Water is essential for sustaining life. As a limited resource, effective water management is vital. Water scarcity has become more common due to the effects of climate change, land degradation, deforestation, and population growth, especially in rural communities, which are more susceptible to water-related issues such as water shortage, water-borne disease, et c., due to the unsuccessful implementation of water policies and projects in Nigeria. Since rural communities generate the majority of agricultural products, they significantly impact on water management for sustainability. The development of methods to advance this goal for residential and agricultural usage in the present and the future is a challenge for rural residents. This study evaluated rural water supply systems and irrigation management techniques to conserve water in Kwara State, North-Central Nigeria. Suggesting some measures to conserve water resources for sustainability, off-season farming, and socioeconomic security that will remedy water degradation, unemployment which is one of the causes of insecurity in the country, by considering the use of fabricated or locally made irrigation equipment, which are affordable by rural farmers, among other recommendations. Questionnaires were distributed to respondents in the study area for quantitative evaluation of irrigation methods practices. For physicochemical investigation, samples were also gathered from their available water sources. According to the study's findings, 30 percent of farmers adopted intelligent irrigation management techniques to conserve water resources, saving 45% of the water previously used for irrigation. 70 % of farmers practice seasonal farming. Irrigation water is drawn from river channels, streams, and unlined and unprotected wells. 60% of these rural residents rely on private boreholes for their water needs, while 40% rely on government-supplied rural water. Therefore, the government must develop additional water projects, raise awareness, and offer irrigation techniques that are simple to adapt for water management, increasing socio-economic productivity, security, and water sustainability.

Keywords: water resource management, sustainability, irrigation, rural water management, irrigation management technique

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Authors: Avani Maniar, Shivani Mehta

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Population aging is one of the most challenging issues of the twenty-first century, facing both developed and developing countries worldwide. In the developed world, there has already been a substantial amount of research on aging and work to help understand the capacity and potential of older people. They attract ever ones attention. Their existence in human society gives rise to variety of responses, reactions and apprehensions, because it connotes on greater part, to some kind of compulsion or willingness that prompt elderly to decide to work after retirement. Work due to social attention and assurance for security both economical and social. In this age, elderly aspire for psychological security with due attention. But the fact remains that despite age related limitations good number of persons in their age of sixty and beyond were hunting for work that would support them and get them some kind of support and in it turns helps them to remain physically and mentally active. Based on the existing diversities in the ageing process, it may be stated that there is a need to pay greater attention to the increasing awareness on the ageing issues and its socio-economic effects and to promote the development of policies and programmes for dealing with an ageing society. Addressing the needs, wants, and well-being of elderly people is essential for maintaining a healthy productive workforce in an aging society. This paper will draw on the results of the study about reasons of elderly working post retirement, problems faced by them and about the future of retirement to ask how widespread negative attitudes and stereotypes among employers are and whether these attitudes influence behavior towards older employees. The aim of research is not only to point out certain stereotypes concerning the elderly labour force, but also to stress that unless preconditions for overcoming these stereotypes are created and employment opportunities are given to this segment of the labour force, full employment as an ultimate goal of global economic policy cannot be achieved.

Keywords: employers, India, inequality, problems, reasons of working, silver workers

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Authors: Denise Muro

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Conflict in Syria, producing over 11 million displaced persons, has incited global attention to displacement. Although neighboring countries have borne the largest part of the displacement burden, due to the influx of refugees into Europe, the so-called ‘refugee crisis’ is taking place on two fronts: Syria’s neighboring countries, with millions of refugees, and Europe, a destination goal for so many that European states face unprecedented challenges. With increasing attention to displacement, forcibly displaced persons are consistently portrayed as either un-agentic victims, or as dangerous free agents. Recognizing that these dominant portrayals involve discourses of power and inequality, this research investigates the extent to which this victim-agent dichotomy affects refugees and organizations that work closely with them during initial integration processes in Berlin, Germany. The research measures initial integration based on German policy measures regarding integration juxtaposed with the way refugees and those who work with them understand integration. Additionally, the study examines day-to-day interactions of refugees in Germany as a way to gauge social integration in a bottom-up approach. This study involved a discourse analysis of portrayals of refugees and participant observation and interviews with refugees and those who work closely with them, which took place during fieldwork in Berlin in the summer of 2016. Germany is unique regarding their migration history and lack of successful integration, in part due to the persistent refrain, ‘Wir sind kein einwanderungsland’ (‘We are not an immigration country’). Still, their accepted asylum seeker population has grown exponentially in the past few years. Findings suggest that the victim-agent dichotomy is present and impactful in the process of refugees entering and integrating into Germany. Integration is hindered due to refugees either being patronized or criminalized to such an extent that, despite being constantly told that they must integrate, they cannot become part of German society.

Keywords: discourse analysis, Germany, integration, refugee crisis

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Authors: Mohammad Ranjbar, Mohammad Bazyar, Blake Angell, Thomas Lung, Yibeltal Assefa

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Background: Current health insurance programs in Iran suffer from low enrolment and are not sufficient to attain the country to universal health coverage (UHC). We hypothesize that improving the enrollment rate and moving towards a more sustainable UHC can be achieved by improving the benefits package and providing new incentives. The objective of this study is to assess public preferences and willingness to pay (WTP) for social health insurance (SHI) in Iran. Methods: A discrete choice experiment (DCE) was conducted in 2021, using a self-administered questionnaire on 500 participants to estimate WTP and determine individual preferences for the SHI in Yazd, Iran. Respondents were presented with an eight-choice set and asked to select their preferred one. In each choice set, scenarios were described by eight attributes with varying levels. The conditional logit regression model was used to analyze the participants' preferences. Willingness to pay for each attribute was also calculated. Results: Most included attributes were significant predictors of the choice of a health insurance package. The maximum coverage of hospitalization costs in the private sector, ancillary services such as glasses, canes, etc., as well as coverage for hospitalization costs in the public sector and drug costs, were the most important determining factors for this choice. Coverage of preventive dental care did not significantly influence respondent choices. Estimating WTP showed that individuals are willing to pay more for higher financial protection, particularly against private sector costs; the WTP to increase the coverage of hospitalization costs in the private sector from 50% to 90% is estimated at 362,068 IR, Rials per month. Conclusion: This study identifies the key factors that the population value with regard to health insurance and the tradeoffs they are willing to make between them. Hospitalization, drugs, and ancillary services were the most important determining factors for their choice. The data suggest that additional resources coming into the Iranian health system might best be prioritized to cover hospitalization and drug costs and those associated with ancillary services.

Keywords: social health insurance, preferences, discrete choice experiment, willingness to pay

Procedia PDF Downloads 90