Search results for: health access
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 11165

Search results for: health access

10745 Pneumoperitoneum Creation Assisted with Optical Coherence Tomography and Automatic Identification

Authors: Eric Yi-Hsiu Huang, Meng-Chun Kao, Wen-Chuan Kuo

Abstract:

For every laparoscopic surgery, a safe pneumoperitoneumcreation (gaining access to the peritoneal cavity) is the first and essential step. However, closed pneumoperitoneum is usually obtained by blind insertion of a Veress needle into the peritoneal cavity, which may carry potential risks suchas bowel and vascular injury.Until now, there remains no definite measure to visually confirm the position of the needle tip inside the peritoneal cavity. Therefore, this study established an image-guided Veress needle method by combining a fiber probe with optical coherence tomography (OCT). An algorithm was also proposed for determining the exact location of the needle tip through the acquisition of OCT images. Our method not only generates a series of “live” two-dimensional (2D) images during the needle puncture toward the peritoneal cavity but also can eliminate operator variation in image judgment, thus improving peritoneal access safety. This study was approved by the Ethics Committee of Taipei Veterans General Hospital (Taipei VGH IACUC 2020-144). A total of 2400 in vivo OCT images, independent of each other, were acquired from experiments of forty peritoneal punctures on two piglets. Characteristic OCT image patterns could be observed during the puncturing process. The ROC curve demonstrates the discrimination capability of these quantitative image features of the classifier, showing the accuracy of the classifier for determining the inside vs. outside of the peritoneal was 98% (AUC=0.98). In summary, the present study demonstrates the ability of the combination of our proposed automatic identification method and OCT imaging for automatically and objectively identifying the location of the needle tip. OCT images translate the blind closed technique of peritoneal access into a visualized procedure, thus improving peritoneal access safety.

Keywords: pneumoperitoneum, optical coherence tomography, automatic identification, veress needle

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10744 Performance Evaluation of Distributed and Co-Located MIMO LTE Physical Layer Using Wireless Open-Access Research Platform

Authors: Ishak Suleiman, Ahmad Kamsani Samingan, Yeoh Chun Yeow, Abdul Aziz Bin Abdul Rahman

Abstract:

In this paper, we evaluate the benefits of distributed 4x4 MIMO LTE downlink systems compared to that of the co-located 4x4 MIMO LTE downlink system. The performance evaluation was carried out experimentally by using Wireless Open-Access Research Platform (WARP), where the comparison between the 4x4 MIMO LTE transmission downlink system in distributed and co-located techniques was examined. The measured Error Vector Magnitude (EVM) results showed that the distributed technique achieved better system performance compared to the co-located arrangement.

Keywords: multiple-input-multiple-output (MIMO), distributed MIMO, co-located MIMO, LTE

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10743 Spiritual Symbols of African Fruits as Responsive Catalysts for Naturopathy

Authors: Orogun Daniel Oghenekevhwe

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Africa being an agrarian continent has an abundance of fruits that are both nutritional and medicinal. Regardless of the abundance of these healing elements, Africa leads the statistics of poor healthcare globally. Among others, there are two noticeable challenges in the healthcare system which are ‘Poor access and high cost of medical healthcare’. The effects of both the access and economic implications are (1) Low responsiveness and (2) High mortality rate. While the United Nations and the global health community continue to work towards reduced mortality rates and poor responsiveness to healthcare and wellness, this paper investigates how some Africans use the spiritual symbols of African fruits as responsive catalysts to embrace naturopathy thereby reducing the effects and impacts of poor healthcare challenges in Africa. The main argument is whether there are links between spiritual symbols and fruits that influence Africans' response to naturopathy and low-cost healthcare. Following that is the question of how medical healthcare responds to such development. Bitter Kola (Garcinia) is the case study fruit, and Sunnyside in Pretoria, South Africa, has been spotted as one of the high-traffic selling points of herbal fruits. A mixed research method is applicable with an expected 20 Quantitative data respondents among sellers and nutritionists and 50 Qualitative Data respondents among consumers. Based on the results, it should be clear how spirituality contributes to alternative healthcare and how it can be further encouraged to bridge the gap between the high demand and low supply of healthcare in Africa and beyond.

Keywords: spiritual symbols, naturopathy, African fruits, spirituality, healthcare

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10742 Access to the Community and Needed Supports among People with Physical Disabilities Receiving Long-Term Services and Supports in the United States

Authors: Stephanie Giordano, Eric Lam, Rosa Plasencia

Abstract:

An important piece of active aging is ensuring people have the right support to meet individual needs. Using NCI-AD data, we will look at measures of satisfaction with community access and needed services among people with physical disabilities receiving LTSS in the US. National Core Indicators—Aging and Disabilities (NCI-AD) is a voluntary effort by State Medicaid, aging, and disability agencies across the US to measure and track their own performance. NCI-AD uses a standardized survey – the Adult Consumer Survey (ACS), to hear directly from people receiving services about the quality of services and supports they receive. Data from the 2018-19 ACS found that compared to people without a physical disability, those with a physical disability were more likely to make choices about the services they receive, including when and how often they receive those services. Yet people with a physical disability were less likely to report they get enough assistance with everyday activities (e.g., shopping, housework, and taking medications) and self-care (e.g., dressing or bathing) and more likely to report that services and supports do not fully meet their needs and goals. A further breakdown by age shows that people 40-65 years old with a physical disability experienced even greater barriers to being as active in the community as they would like to be, indicating a need to better support people as they age with or into a disability. We will explore how these and other outcomes were affected by COVID-19, take a closer look at outcomes by demographics (e.g., race/ethnicity, gender, and mental health diagnoses) and discuss implications on the future needs of service systems.

Keywords: quality-of-life, long-term services and supports, person-centered, community

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10741 A Quantitative Case Study Analysis of Store Format Contributors to U.S. County Obesity Prevalence in Virginia

Authors: Bailey Houghtaling, Sarah Misyak

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Food access; the availability, affordability, convenience, and desirability of food and beverage products within communities, is influential on consumers’ purchasing and consumption decisions. These variables may contribute to lower dietary quality scores and a higher obesity prevalence documented among rural and disadvantaged populations in the United States (U.S.). Current research assessing linkages between food access and obesity outcomes has primarily focused on distance to a traditional grocery/supermarket store as a measure of optimality. However, low-income consumers especially, including U.S. Department of Agriculture’s Supplemental Nutrition Assistance Program (SNAP) participants, seem to utilize non-traditional food store formats with greater frequency for household dietary needs. Non-traditional formats have been associated with less nutritious food and beverage options and consumer purchases that are high in saturated fats, added sugars, and sodium. Authors’ formative research indicated differences by U.S. region and rurality in the distribution of traditional and non-traditional SNAP-authorized food store formats. Therefore, using Virginia as a case study, the purpose of this research was to determine if a relationship between store format, rurality, and obesity exists. This research applied SNAP-authorized food store data (food access points for SNAP as well as non-SNAP consumers) and obesity prevalence data by Virginia county using publicly available databases: (1) SNAP Retailer Locator, and; (2) U.S. County Health Rankings. The alpha level was set a priori at 0.05. All Virginia SNAP-authorized stores (n=6,461) were coded by format – grocery, drug, mass merchandiser, club, convenience, dollar, supercenter, specialty, farmers market, independent grocer, and non-food store. Simple linear regression was applied primarily to assess the relationship between store format and obesity. Thereafter, multiple variables were added to the regression to account for potential moderating relationships (e.g., county income, rurality). Convenience, dollar, non-food or restaurant, mass merchandiser, farmers market, and independent grocer formats were significantly, positively related to obesity prevalence. Upon controlling for urban-rural status and income, results indicated the following formats to be significantly related to county obesity prevalence with a small, positive effect: convenience (p=0.010), accounting for 0.3% of the variance in obesity prevalence; dollar (p=0.005; 0.5% of the variance), and; non-food (p=0.030; 1.3% of the variance) formats. These results align with current literature on consumer behavior at non-traditional formats. For example, consumers’ food and beverage purchases at convenience and dollar stores are documented to be high in saturated fats, added sugars, and sodium. Further, non-food stores (i.e., quick-serve restaurants) often contribute to a large portion of U.S. consumers’ dietary intake and thus poor dietary quality scores. Current food access research investigates grocery/supermarket access and obesity outcomes. These results suggest more research is needed that focuses on non-traditional food store formats. Nutrition interventions within convenience, dollar, and non-food stores, for example, that aim to enhance not only healthy food access but the affordability, convenience, and desirability of nutritious food and beverage options may impact obesity rates in Virginia. More research is warranted utilizing the presented investigative framework in other U.S. and global regions to explore the role and the potential of non-traditional food store formats to prevent and reduce obesity.

Keywords: food access, food store format, non-traditional food stores, obesity prevalence

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10740 Educational Justice as the Basis for Social Justice

Authors: Baratali Monfaredraz

Abstract:

The concept of justice has been able to occupy a lot of people’s minds and speeches for a long time. Justice has various dimensions such as economic justice, judicial justice, political justice, educational justice, ethnical justice and etc. Educational justice as one of the most basic dimensions of justice can alter our education in every field and it can flourish the talents and capabilities on macro level. One of the most efficient ways for social justice realization is to provide equal opportunities for all people in the society to be able to access equally to education as their human rights since today how progress occurs in education is regarded as the index of social development. On this basis, especially developing countries try to provide equal opportunities for all people in terms of access to education, specifically in higher education. At present, private education system violates the principles of conducting effort, meeting the needs and in part realizing the capabilities and so it cannot be justified to be a fair conductance. It seems that providing higher quality education in public schools and lowering role of teacher and educational facilities in educational achievement can be considered as a proper way to remove the discrimination in terms of unequal distribution of educational facilities. In addition, higher education development in deprived regions can initialize social activities among the inhabitants of these regions. Justice in educational field can result in access of all people to economic and social situations and job opportunities in future.

Keywords: educational justice, deprivation, private schools, higher education, job opportunities

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10739 Impact of Fluoride Contamination on Soil and Water at North 24 Parganas, West Bengal, India

Authors: Rajkumar Ghosh

Abstract:

Fluoride contamination is a growing concern in various regions across the globe, including North 24 Parganas in West Bengal, India. The presence of excessive fluoride in the environment can have detrimental effects on crops, soil quality, and water resources. This note aims to shed light on the implications of fluoride contamination and its impact on the agricultural sector in North 24 Parganas. The agricultural lands in North 24 Parganas have been significantly affected by fluoride contamination, leading to adverse consequences for crop production. Excessive fluoride uptake by plants can hinder their growth, reduce crop yields, and impact the quality of agricultural produce. Certain crops, such as paddy, vegetables, and fruits, are more susceptible to fluoride toxicity, resulting in stunted growth, leaf discoloration, and reduced nutritional value. Fluoride-contaminated water, often used for irrigation, contributes to the accumulation of fluoride in the soil. Over time, this can lead to soil degradation and reduced fertility. High fluoride levels can alter soil pH, disrupt the availability of essential nutrients, and impair microbial activity critical for nutrient cycling. Consequently, the overall health and productivity of the soil are compromised, making it increasingly challenging for farmers to sustain agricultural practices. Fluoride contamination in North 24 Parganas extends beyond the soil and affects water resources as well. The excess fluoride seeps into groundwater, making it unsafe for consumption. Long-term consumption of fluoride-contaminated water can lead to various health issues, including dental and skeletal fluorosis. These health concerns pose significant risks to the local population, especially those reliant on contaminated water sources for their daily needs. Addressing fluoride contamination requires concerted efforts from various stakeholders, including government authorities, researchers, and farmers. Implementing appropriate water treatment technologies, such as defluoridation units, can help reduce fluoride levels in drinking water sources. Additionally, promoting alternative irrigation methods and crop diversification strategies can aid in mitigating the impact of fluoride on agricultural productivity. Furthermore, creating awareness among farmers about the adverse effects of fluoride contamination and providing access to alternative water sources are crucial steps toward safeguarding the health of the community and sustaining agricultural activities in the region. Fluoride contamination poses significant challenges to crop production, soil health, and water resources in North 24 Parganas, West Bengal. It is imperative to prioritize efforts to address this issue effectively and implement appropriate measures to mitigate fluoride contamination. By adopting sustainable practices and promoting awareness, the community can work towards restoring the agricultural productivity, soil quality and ensuring access to safe drinking water in the region.

Keywords: fluoride contamination, drinking water, toxicity, soil health

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10738 Diabetes Care in Detention Settings: A Systematic Review

Authors: A. Papachristou, A. Ntikoudi, L. Makris, V. Saridakis

Abstract:

Introduction: More than 10 million people are imprisoned or detained worldwide. Figures from 2011-12 show that prison inmates are more likely than the general population to suffer from chronic or infectious diseases, while most inmates are overweight or obese, and more than a quarter have high blood pressure. In 2011/12, the proportion of prisoners reporting diabetes or hyperglycemia was 899 per 10,000 prisoners, almost double the 2004 figure (483 per 10,000). It is important to ensure that this population has access to the same standard of care as people outside prisons, as access to services should be need-based. Diabetes is a public health problem associated with increased morbidity and mortality worldwide. According to the International Diabetes Federation (IDF) in 2017, approximately 425 million people worldwide had diabetes. This number is expected to increase to 629 million by 2045. Poor management of diabetes in prisons can lead to poor blood sugar control and increase the risk of complications. Aim: The aim of this review was to systematically evaluate all the available literature on diabetes care in custodial settings. Methods: An extensive literature search was conducted through electronic databases (PubMed, Scopus and CINAHL) with the terms ‘custody’, ‘diabetes Mellitus, ‘detention centers and ‘chronic disease’. Articles published in English until September 2022, were included; no other criteria on publication dates were set. Results: Most of the studies mentioned a diabetes prevalence of approximately 10%, among other common chronic. Hypertension, obesity, smoking, sedentary lifestyle were the most common comorbidities associated with diabetes. Conclusion: Good glycemic control is fundamental to managing diabetes, and while many prisoners enter prison poorly, access to regular medication and meals, as well as exercise, offers the potential for improvement. Not being able to get help as quickly as in the past can be extremely stressful, and some prisoners may deliberately raise their blood sugar levels to avoid the risk of developing hypoglycemia, especially if they know they have had previous episodes of nocturnal hypoglycemia. Thus, appropriate training and resources are critical to providing quality care to incarcerated people with diabetes.

Keywords: custody, diabetes mellitus, detention centers, chronic disease

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10737 Multi-Level Security Measures in Cloud Computing

Authors: Shobha G. Ranjan

Abstract:

Cloud computing is an emerging, on-demand and internet- based technology. Varieties of services like, software, hardware, data storage and infrastructure can be shared though the cloud computing. This technology is highly reliable, cost effective and scalable in nature. It is a must only the authorized users should access these services. Further the time granted to access these services should be taken into account for proper accounting purpose. Currently many organizations do the security measures in many different ways to provide the best cloud infrastructure to their clients, but that’s not the limitation. This paper presents the multi-level security measure technique which is in accordance with the OSI model. In this paper, details of proposed multilevel security measures technique are presented along with the architecture, activities, algorithms and probability of success in breaking authentication.

Keywords: cloud computing, cloud security, integrity, multi-tenancy, security

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10736 Assistive Technologies and the 'Myth' of Independent Living: A Sociological Understanding of Assistive Technologies for Locomotor Disabled in India

Authors: Pavani K. Sree, Ragahava Reddy Chandri

Abstract:

Independent living and living with dignity have been the hallmarks of the movement of the persons with disabilities across the globe against the oppression perpetuated by society in the form of social and physical structural barriers. Advancements in assistive technologies have been providing a new lease of life to persons with disabilities. However, access to these technologies is marred by the issues of affordability and availability. Poor from the developing countries find it difficult to make independent living or live with dignity because of lack of access and inability to afford the advance technologies. Class and gender appear to be key factors influencing the access to modern assistive technologies. The present paper attempts to understand the dynamics of class and gender in accessing advanced technologies in the Indian context. Based on an empirical study in which data were collected from persons with locomotor disabilities and service providers, the paper finds that the advance technologies are expensive and inaccessible to all persons with disabilities. The paper also finds that men with disabilities are prioritized by the members of the family for the use of advance technologies while women with disabilities are forced to live with not so advanced technologies. The paper finds that the state institutions working in the field of prosthetics and assistive technologies fail to deliver to the requirements of the poor. It was found that because of lack of facilities at the state institutions the cost of prosthetics, in the case of orthopedically challenged, is expensive and unaffordable for the poor. It was found that while rich male access the private services the poor women depend on the state institutions. It may be said that the social, cultural stereotypes extend not only to the state organizations but also to the use of prosthetics. Thus the notions of independent living and living with dignity in third world countries context are still elusive.

Keywords: accessibility, assistive technology, class, gender, state

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10735 Design Channel Non Persistent CSMA MAC Protocol Model for Complex Wireless Systems Based on SoC

Authors: Ibrahim A. Aref, Tarek El-Mihoub, Khadiga Ben Musa

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This paper presents Carrier Sense Multiple Access (CSMA) communication model based on SoC design methodology. Such model can be used to support the modelling of the complex wireless communication systems, therefore use of such communication model is an important technique in the construction of high performance communication. SystemC has been chosen because it provides a homogeneous design flow for complex designs (i.e. SoC and IP based design). We use a swarm system to validate CSMA designed model and to show how advantages of incorporating communication early in the design process. The wireless communication created through the modeling of CSMA protocol that can be used to achieve communication between all the agents and to coordinate access to the shared medium (channel).

Keywords: systemC, modelling, simulation, CSMA

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10734 A Qualitative Exploration of How Brazilian Immigrant Mothers Living in the United States Obtain Information about Physical Activity and Screen-Viewing for Their Young Children

Authors: Ana Cristina Lindsay, Mary L. Greaney

Abstract:

Background: Racial/ethnic minority children of low-income immigrant families remain at increased risk of obesity. Consistent with high rates of childhood obesity among racial/ethnic minority children are high rates of physical inactivity and increased levels of sedentary behaviors (e.g., TV and other screen viewing). Brazilians comprise a fast-growing immigrant population group in the US, yet little research has focused on the health issues affecting Brazilian immigrant children. The purpose of this qualitative study was to explore how Brazilian-born immigrant mothers living in the United States obtain information about physical activity and screen-time for their young children. Methods: Qualitative research including focus groups with Brazilian immigrant mothers of preschool-age children living in the U.S. Results: Results revealed that Brazilian immigrant mothers obtain information on young children’s physical activity and screen-time from a variety of sources including interpersonal communication, television and magazines, government health care programs (WIC program) and professionals (e.g., nurses and pediatricians). A noteworthy finding is the significant role of foreign information sources (Brazilian TV shows and magazines) on mothers’ access to information about these early behaviors. Future research is needed to quantify and better understanding Brazilian parents’ access to accurate and sound information related to young children’s physical activity and screen-viewing behaviors. Conclusions: To our knowledge, no existing research has examined how Brazilian immigrant mothers living in the United States obtain information about these behaviors. This information is crucial for the design of culturally appropriate early childhood obesity prevention interventions tailored to the specific needs of this ethnic group.

Keywords: physical activity, scree-time, information, immigrant, mothers, Brazilian, United States

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10733 Performance Analysis of IDMA Scheme Using Quasi-Cyclic Low Density Parity Check Codes

Authors: Anurag Saxena, Alkesh Agrawal, Dinesh Kumar

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The next generation mobile communication systems i.e. fourth generation (4G) was developed to accommodate the quality of service and required data rate. This project focuses on multiple access technique proposed in 4G communication systems. It is attempted to demonstrate the IDMA (Interleave Division Multiple Access) technology. The basic principle of IDMA is that interleaver is different for each user whereas CDMA employs different signatures. IDMA inherits many advantages of CDMA such as robust against fading, easy cell planning; dynamic channel sharing and IDMA increase the spectral efficiency and reduce the receiver complexity. In this, performance of IDMA is analyzed using QC-LDPC coding scheme further it is compared with LDPC coding and at last BER is calculated and plotted in MATLAB.

Keywords: 4G, QC-LDPC, CDMA, IDMA

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10732 Analysis of Access to Credit among Rural Farmers in Giwa Local Government Area of Kaduna State, Nigeria

Authors: S. Ibrahim, Bashir Umar

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Agricultural credit is very important for sustainable agricultural development to be achieved in any country of the world. Rural credit has proven to be a powerful instrument against poverty reduction and development in rural area. Agricultural credit enhances productivity and promotes standard of living by breaking vicious cycle of poverty of small scale farmers. This study examined access to credit among rural farmers in Giwa local government area of Kaduna state. Two stages sampling procedure was employed to select forty-two (42) respondents for the study. Primary data were collected using structured questionnaire with the help of well-trained enumerators. Data were analyzed using simple descriptive statistics. The results revealed that farmers were predominantly male (57.1%) and most (54.7%), were married with one level of education or another (66.5.%). Majority of the households’ head were between the ages of 31 to 50. majority of the farmers (68.2%) had more than 2ha of farmlands with at least 5 years of farming experience and an annual farm income of N 61,000 to 100,000 (61.9%). The Various sources of credit by the farmers in the study area were commercial banks (38.1%), Co-operative banks (47.6%), Development banks (14.2%) (formal) and Relatives (26.1%), Personal Savings (Adashi scheme) (52.3%), Moneylenders (21.4%) (informal). As regard to the amount of credit obtained by the farmers 38.1% received N 50,000-100,000, 50 % obtained N 100,001-500,000 while 11.9% obtained N 500,001-1,000,000. High interest Inadequate collateral, Complicated Procedures, lack of guarantor were the major constrains encountered by the farmers in accessing loans. The study therefore recommends that Rural farmers should be encouraged to form credit and thrift cooperative societies from which they can access much cheaper credits, Moreover, to ensure that any credit obtained may be manageable for the farmers, financial institutions should provide loans with low interest rates and government and non-governmental organizations should simplify procedures associated with accessing loans.

Keywords: analysis, access, credit, farmers

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10731 Design and Implementation of a Memory Safety Isolation Method Based on the Xen Cloud Environment

Authors: Dengpan Wu, Dan Liu

Abstract:

In view of the present cloud security problem has increasingly become one of the major obstacles hindering the development of the cloud computing, put forward a kind of memory based on Xen cloud environment security isolation technology implementation. And based on Xen virtual machine monitor system, analysis of the model of memory virtualization is implemented, using Xen memory virtualization system mechanism of super calls and grant table, based on the virtual machine manager internal implementation of access control module (ACM) to design the security isolation system memory. Experiments show that, the system can effectively isolate different customer domain OS between illegal access to memory data.

Keywords: cloud security, memory isolation, xen, virtual machine

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10730 Factors Associated with Rural-Urban Migration and Its Associated Health Hazards on the Female Adolescents in Kumasi Metropolis

Authors: Freda Adomaa, Samuel Oppong Boampong, Charles Gyamfi Rahman

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The living and working environment of migrants and their access to healthcare services induce good or poor health. This study was conducted to assess the factors associated with rural-urban migration and its associated health hazards among female adolescents. A sample size of two hundred (200) was chosen in which all responded to questionnaires comprising closed-ended questions, which were distributed to gather data from the respondents, after which it was analyzed using the Statistical Package for Social Sciences (SPSS) version 20. The utilized three causes of rural-urban migration thus political, economic and socio-cultural. The study revealed that political situations such as regional inequality (65.4%) and ethnic conflicts (78.2%) whereas economic factors such as lack of amenities (82.3%), lack of employment in rural communities (77.4%), lack of education (74%), and poverty (85.3%) as well as socio-cultural factors such as divorced parents (65.6%), media influence (79.1%), family conflicts (59.4%) and appealing urban informal sector (65.2%) are major causes of migration. Respondents’ encountered challenges such as poor remuneration for services (87.2%), being maltreated by a colleague or worker (69%), sleeping in open space (73.3%), and harassment by the task force (71.4%) and teenage pregnancies (58.5%). The study concluded that the three variables play a key role in adolescent migration and when they travel they end up getting involved in serious health hazardous behaviors such as rapes as well as physical and psychological harassments’. The study, therefore, recommends that vocational training of the rural people on small scale industries (non-farm) activities that could generate an income for the rural household should be introduced.

Keywords: rural, urban, migration, female health hazards

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10729 Health Expenditure and its Place in Economy: The Case of Turkey

Authors: Ayşe Coban, Orhan Coban, Haldun Soydal, Sükrü Sürücü

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While health is a source of prosperity for individuals, it is also one of the most important determinants of economic growth for a country. Health, by increasing the productivity of labor, contributes to economic growth. Therefore, countries should give the necessary emphasis to health services. The primary aim of this study is to analyze the changes occurring in health services in Turkey by examining the developments in the sector. In this scope, the second aim of the study is to reveal the place of health expenditures in the Turkish economy. As a result of the analysis in the dataset, in which the 1999-2013 periods is considered, it was determined that some increase in health expenditures took place and that the increase in the share of health expenditures in GDP was too small. Furthermore, analysis of the results points out that in financing health expenditures, the public sector is prominent compared to the private sector.

Keywords: health, health service, health expenditures, Turkey

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10728 Social Inclusion Challenges in Indigenous Communities: Case of the Baka Pygmies Community of Cameroon

Authors: Igor Michel Gachig, Samanta Tiague

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Baka ‘Pygmies’ is an indigenous community living in the rainforest region of Cameroon. This community is known to be poor and marginalized from the political, economic and social life, regardless of sedentarization and development efforts. In fact, the social exclusion of ‘Pygmy’ people prevents them from gaining basic citizen’s rights, among which access to education, land, healthcare, employment and justice. In this study, social interactions, behaviors, and perceptions were considered. An interview guide and focus group discussions were used to collect data. A sample size of 97 was used, with 60 Baka Pygmies and 37 Bantus from two Baka-Bantu settlements/villages of the south region of Cameroon. The data were classified in terms of homogenous, exhaustive and exclusive categories. This classification has enabled factors explaining social exclusion in the Baka community to be highlighted using content analysis. The study shows that (i) limited access to education, natural resources and care in modern healthcare organizations, and (ii) different views on the development expectations and integration approaches both highlight the social exclusion in the Baka ‘Pygmies’ community. Therefore, an effective and adequate social integration of ‘Pygmies’ based on cultural peculiarities and identity, as well as reduction of disparities and improvement of their access to education should be of major concern to the government and policy makers.

Keywords: development, indigenous people, integration, social exclusion

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10727 System for Monitoring Marine Turtles Using Unstructured Supplementary Service Data

Authors: Luís Pina

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The conservation of marine biodiversity keeps ecosystems in balance and ensures the sustainable use of resources. In this context, technological resources have been used for monitoring marine species to allow biologists to obtain data in real-time. There are different mobile applications developed for data collection for monitoring purposes, but these systems are designed to be utilized only on third-generation (3G) phones or smartphones with Internet access and in rural parts of the developing countries, Internet services and smartphones are scarce. Thus, the objective of this work is to develop a system to monitor marine turtles using Unstructured Supplementary Service Data (USSD), which users can access through basic mobile phones. The system aims to improve the data collection mechanism and enhance the effectiveness of current systems in monitoring sea turtles using any type of mobile device without Internet access. The system will be able to report information related to the biological activities of marine turtles. Also, it will be used as a platform to assist marine conservation entities to receive reports of illegal sales of sea turtles. The system can also be utilized as an educational tool for communities, providing knowledge and allowing the inclusion of communities in the process of monitoring marine turtles. Therefore, this work may contribute with information to decision-making and implementation of contingency plans for marine conservation programs.

Keywords: GSM, marine biology, marine turtles, unstructured supplementary service data (USSD)

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10726 Bridging the Gaping Levels of Information Entree for Visually Impaired Students in the Sri Lankan University Libraries

Authors: Wilfred Jeyatheese Jeyaraj

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Education is a key determinant of future success, and every person deserves non-discriminant access to information for educational inevitabilities in any case. Analysing and understanding complex information is a crucial learning tool, especially for students. In order to compete equally with sighted students, visually impaired students require the unhinged access to access to all the available information resources. When the education of visually impaired students comes to a focal point, it can be stated that visually impaired students encounter several obstacles and barriers before they enter the university and during their time there as students. These obstacles and barriers are spread across technical, organizational and social arenas. This study reveals the possible approaches to absorb and benefit from the information provided by the Sri Lankan University Libraries for visually impaired students. Purposive sampling technique was used to select sample visually impaired students attached to the Sri Lankan National universities. There are 07 National universities which accommodate the visually impaired students and with the identified data, they were selected for this study and 80 visually impaired students were selected as the sample group. Descriptive type survey method was used to collect data. Structured questionnaires, interviews and direct observation were used as research instruments. As far as the Sri Lankan context spread is concerned, visually impaired students are able to finish their courses through their own determination to overcome the barriers they encounter on their way to graduation, through moral and practical support from their own friends and very often through a high level of creativity. According to the findings there are no specially trained university librarians to serve visually impaired users and less number of assistive technology equipment are available at present. This paper enables all university libraries in Sri Lanka to be informed about the social isolation of visually compromised students at the Sri Lankan universities and focuses on the rectification issues by considering their distinct case for interaction.

Keywords: information access, Sri Lanka, university libraries, visual impairment

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10725 The Perspectives of Adult Learners Towards Online Learning

Authors: Jacqueline Żammit

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Online learning has become more popular as a substitute for traditional classroom instruction because of the COVID-19 epidemic. The study aimed to investigate how adult Maltese language learners evaluated the benefits and drawbacks of online instruction. 35 adult participants provided data through semi-structured interviews with open-ended questions. NVivo software was used to analyze the interview data using the thematic analysis method in order to find themes and group the data based on common responses. The advantages of online learning that the participants mentioned included accessing subject content even without live learning sessions, balancing learning with household duties, and lessening vulnerability to problems like fatigue, time-wasting traffic, school preparation, and parking space constraints. Conversely, inadequate Internet access, inadequate IT expertise, a shortage of personal computers, and domestic distractions adversely affected virtual learning. Lack of an Internet connection, IT expertise, a personal computer, or a phone with Internet access caused inequality in access to online learning sessions. Participants thought online learning was a way to resume academic activity, albeit with drawbacks. In order to address the challenges posed by online learning, several solutions are proposed in the research's conclusion.

Keywords: adult learners, online education, e-learning, challenges of online learning, benefits ofonline learning

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10724 The Impact of COVID-19 on the Mental Health of Residents of Saudi Arabia

Authors: Khaleel Alyahya, Faizah Alotaibi

Abstract:

The coronavirus disease 19 (COVID-19) pandemic has caused an increase in general fear and anxiety around the globe. With the public health measures, including lockdown and travel restrictions, the COVID-19 period further resulted in a sudden increase in the vulnerability of people too ill mental health. This becomes greater among individuals who have a history of mental illness or are undergoing treatment and do not have easy access to medication and medical consultations. The study aims to measure the impact of COVID-19 and the degree of distress with the DASS scale on the mental health of residents living in Saudi Arabia. The study is a quantitative, observational, and cross-sectional conducted in Saudi Arabia to measure the impact of COVID-19 on the mental health of both citizens and residents of Saudi Arabia during pandemics. The study ran from February 2021 to June 2021, and a validated questionnaire was used. The targeted population of the study was Saudi citizens and non-Saudi residents. A sample size of 800 participants was calculated with a single proportion formula at 95% level of significance and 5% allowable error. The result revealed that participants who were always doing exercise experienced the lowest level of depression, anxiety, and stress. The highest prevalence of severe and extremely severe depression was among participants who sometimes do exercise at 53.2% for each. Similar results were obtained for anxiety and stress, where the extremely severe form was reported by those who sometimes did exercise at 54.8% and 72.2%, respectively. There was an inverse association between physical activity levels and levels of depression, anxiety, and stress during the COVID-19. Similarly, the levels of depression, anxiety, and stress differed significantly according to the exercise frequency during COVID-19.

Keywords: mental, COVID-19, pandemic, lockdown, depression, anxiety, stress

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10723 Rescaling Global Health and International Relations: Globalization of Health in a Low Security Environment

Authors: F. Argurio, F. G. Vaccaro

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In a global environment defined by ever-increasing health issues, in spite of the progress made by modern medicine, this paper seeks to readdress the question of global health in an international relations perspective. The research hypothesis is: the lower the security environment, the higher the spread of communicable diseases. This question will be channeled by re-scaling the connotation of 'global' and 'international' dimension through the theoretical lens of glocalization, a theory by Bauman that starts its analysis from simple systems to get to the most complex ones. Glocalization theory will be operationalized by analyzing health in an armed-conflict context. In this respect, the independent variable 'low security environment' translates into the cases of Syria and Yemen, which provide a clear example of the all-encompassing nature of conflict on national health and the effects on regional development. In fact, Syria and Yemen have been affected by poliomyelitis and cholera outbreaks respectively. The dependent variable will be constructed on said communicable diseases which belong to the families of sanitation-related and vaccine-preventable diseases. The research will be both qualitative and quantitative, based on primary (interviews) and secondary (WHO and other NGO’s reports) sources. The methodology is based on the assessment of the vaccine coverage and case-analysis in time and space using epidemiological data. Moreover, local health facilities’ functioning and efficiency will be studied. The article posits that the intervention and cooperation of international organizations with the local authorities becomes crucial to provide the local populations with their primary health needs. In Yemen, the majority of fatal cholera cases were in the regions controlled by the Houthi rebels, not officially accredited by the International Community. Similarly, the polio outbreak in Syria primarily affected the areas not controlled by the Syrian Arab Republic forces, recognized as the leading interlocutor by the WHO. The jeopardized possibilities to access these countries have been pivotal to the determining the problem in controlling sanitation-related and vaccine preventable diseases. This represents a potential threat to global health.

Keywords: health in conflict-affected areas, cholera, polio, Yemen, Syria, glocalization

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10722 Improving Diagnostic Accuracy in Rural Medicine

Authors: Kelechi Emmanuel, Kyaw Thein Aung, William Burch

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Introduction: Although rewarding in more ways than one, rural medicine can be challenging. The factors that lead to the challenges experienced in rural medicine include but are not limited to scarcity of resources, poor patient education inadequately trained professionals. This is the first single center study done on the challenges of and ways to improve diagnosis in rural medicine. Materials and Methods: Questionnaires were given to providers in a single hospital in rural Tennessee USA. In which providers were asked the question ‘In the past six months, what measures have you taken to improve your diagnostic accuracy given limited resources. Results: The questionnaire was passed to ten physicians working in a two hundred and twentyfive hospital bed. Physicians who participated included physicians in hospital medicine, emergency medicine, surgery, cardiology and gastroenterology. The study found that improved physical examination skills, access to specialist especially via telemedicine and affiliation to centers with more experienced professionals improved diagnosis and overall patient outcome in rural medicine. Conclusion: From this single center study, there is evidence to show that in addition to honing physical examination skills and having access to immediate results of testing done; hospital collaborations and access to highly trained specialist via telemedicine does improve diagnosis in rural medicine.

Keywords: rural medicine, diagnostic accuracy, diagnosis, telemedicine

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10721 Access to Livelihoods for Urban Refugees in Kenya: The Case Study of Somalis Living in Eastleigh

Authors: Nancy Njoka, Manuela Ramos Cacciatore

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In Kenya, refugee situations are becoming increasingly protracted, stretching over the years or even decades. As urbanization rates increase, so do the numbers of urban refugees in the country. Refugees living in urban areas face a range of challenges. In their efforts to pursue livelihoods, refugees have identified strategies to confront these challenges. In the same manner, humanitarian actors have come up with different interventions to promote access to livelihoods working through obstacles and barriers created by host governments. This paper seeks to understand the experience of Somali urban refugees living in the urban area of Eastleigh, Nairobi, both by investigating their own actions towards creating avenues to access livelihoods and by understanding their social, economic and policy context in which they forge livelihoods. The empirical data collected through fieldwork in Nairobi in 2020 serves as the basis of this qualitative case study. Drawing upon the themes of urban refugee movement, Somali ethnicity, citizenship discrimination and the livelihoods of refugees, the paper highlights how the actions of the Kenyan government and international non-governmental organization (INGO)s affect access to livelihoods and the consequences of these actions for Somali urban refugees. The results of the paper found that Somali urban refugees are taking active steps to create livelihoods for themselves. This is seen in the growth of Eastleigh as an economic hub in Kenya which is owned and run mostly by Somalis. Indeed, the Somali community is central to the establishment of networks in the neighborhood. Somali urban refugees are marginalized by the Kenyan government, reducing their opportunity to create dignified lives in Eastleigh. Findings also point out the community-based approaches used by INGOs in livelihood interventions. The relevance of this research lies in the interconnection of humanitarian development interventions for protracted refugees and the promotion of livelihoods in an urban and global context.

Keywords: Kenya, livelihoods, Somali, urban refugees

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10720 Health Economics in the Cost-Benefit Analysis of Transport Schemes

Authors: Henry Kelly, Helena Shaw

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This paper will seek how innovative methods from Health Economics and, to a lesser extent, wellbeing analysis can be applied in the Cost-Benefit Analysis (CBA) of transport infrastructure and policy interventions. The context for this will focus on the framework articulated by the UK Treasury (finance department) and the English Department for Transport. Both have well-established methods for undertaking CBA, but there is increased policy interest, particularly at a regional level of exploring broader strategic goals beyond those traditionally associated with transport user benefits, productivity gains, and labour market access. Links to different CBA approaches internationally, such as New Zealand, France, and Wales will be referenced. By exploring a complementary method of accessing the impacts of policies through the quantification of health impacts is a fruitful line to explore. In a previous piece of work, 14 impact pathways were identified, mapping the relationship between transport and health. These are wide-ranging, from improved employment prospects, the stress of unreliable journey times, and air quality to isolation and loneliness. Importantly, we will consider these different measures of health from an intersectional point of view to ensure that the basis that remains in the health industry does not get translated across to this work. The objective is to explore how a CBA based on these pathways may, through quantifying forecast impacts in terms of Quality-Adjusted Life Years may, produce different findings than a standard approach. Of particular interest is how a health-based approach may have different distributional impacts on socio-economic groups and may favour distinct types of interventions. Consideration will be given to the degree this approach may double-count impacts or if it is possible to identify additional benefits to the established CBA approach. The investigation will explore a range of schemes, from a high-speed rail link, highway improvements, rural mobility hubs, and coach services to cycle lanes. The conclusions should aid the progression of methods concerning the assessment of publicly funded infrastructure projects.

Keywords: cost-benefit analysis, health, QALYs transport

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10719 A User Identification Technique to Access Big Data Using Cloud Services

Authors: A. R. Manu, V. K. Agrawal, K. N. Balasubramanya Murthy

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Authentication is required in stored database systems so that only authorized users can access the data and related cloud infrastructures. This paper proposes an authentication technique using multi-factor and multi-dimensional authentication system with multi-level security. The proposed technique is likely to be more robust as the probability of breaking the password is extremely low. This framework uses a multi-modal biometric approach and SMS to enforce additional security measures with the conventional Login/password system. The robustness of the technique is demonstrated mathematically using a statistical analysis. This work presents the authentication system along with the user authentication architecture diagram, activity diagrams, data flow diagrams, sequence diagrams, and algorithms.

Keywords: design, implementation algorithms, performance, biometric approach

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10718 The Food and Nutritional Effects of Smallholders’ Participation in Milk Value Chain in Ethiopia

Authors: Geday Elias, Montaigne Etienne, Padilla Martine, Tollossa Degefa

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Smallholder farmers’ participation in agricultural value chain identified as a pathway to get out of poverty trap in Ethiopia. The smallholder dairy activities have a huge potential in poverty reduction through enhancing income, achieving food and nutritional security in the country. However, much less is known about the effects of smallholder’s participation in milk value chain on household food security and nutrition. This paper therefore, aims at evaluating the effects of smallholders’ participation in milk value chain on household food security taking in to account the four pillars of food security measurements (availability, access, utilization and stability). Using a semi-structured interview, a cross sectional farm household data collected from a randomly selected sample of 333 households (170 in Amhara and 163 in Oromia regions).Binary logit and propensity score matching( PSM) models are employed to examine the mechanisms through which smallholder’s participation in the milk value chain affects household food security where crop production, per capita calorie intakes, diet diversity score, and food insecurity access scale are used to measure food availability, access, utilization and stability respectively. Our findings reveal from 333 households, only 34.5% of smallholder farmers are participated in the milk value chain. Limited access to inputs and services, limited access to inputs markets and high transaction costs are key constraints for smallholders’ limited access to the milk value chain. To estimate the true average participation effects of milk value chain for participated households, the outcome variables (food security) of farm households who participated in milk value chain are compared with the outcome variables if the farm households had not participated. The PSM analysis reveals smallholder’s participation in milk value chain has a significant positive effect on household income, food security and nutrition. Smallholder farmers who are participated in milk chain are better by 15 quintals crops production and 73 percent of per capita calorie intakes in food availability and access respectively than smallholder farmers who are not participated in the market. Similarly, the participated households are better in dietary quality by 112 percents than non-participated households. Finally, smallholders’ who are participated in milk value chain are better in reducing household vulnerability to food insecurity by an average of 130 percent than non participated households. The results also shows income earned from milk value chain participation contributed to reduce capital’s constraints of the participated households’ by higher farm income and total household income by 5164 ETB and 14265 ETB respectively. This study therefore, confirms the potential role of smallholders’ participation in food value chain to get out of poverty trap through improving rural household income, food security and nutrition. Therefore, identified the determinants of smallholder participation in milk value chain and the participation effects on food security in the study areas are worth considering as a positive knock for policymakers and development agents to tackle the poverty trap in the study area in particular and in the country in general.

Keywords: effects, food security and nutrition, milk, participation, smallholders, value chain

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10717 A Scoping Review of the Relationship Between Oral Health and Wellbeing: The Myth and Reality

Authors: Heba Salama, Barry Gibson, Jennifer Burr

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Introduction: It is often argued that better oral health leads to better wellbeing, and the goal of dental care is to improve wellbeing. Notwithstanding, to our best knowledge, there is a lack of evidence to support the relationship between oral health and wellbeing. Aim: The scoping review aims to examine current definitions of health and wellbeing as well as map the evidence to examine the relationship between oral health and wellbeing. Methods: The scoping review followed the Preferred Reporting Items for Systematic Reviews Extension for Scoping Review (PRISMA-ScR). A two-phase search strategy was followed because of the unmanageable number of hits returned. The first phase was to identify how well-being was conceptualised in oral health literacy, and the second phase was to search for extracted keywords. The extracted keywords were searched in four databases: PubMed, CINAHL, PsycINFO, and Web of Science. To limit the number of studies to a manageable amount, the search was limited to the open-access studies that have been published in the last five years (from 2018 to 2022). Results: Only eight studies (0.1%) of the 5455 results met the review inclusion criteria. Most of the included studies defined wellbeing based on the hedonic theory. And the Satisfaction with Life Scale is the most used. Although the research results are inconsistent, it has generally been shown that there is a weak or no association between oral health and wellbeing. Interpretation: The review revealed a very important point about how oral health literature uses loose definitions that have significant implications for empirical research. That results in misleading evidence-based conclusions. According to the review results, improving oral health is not a key factor in improving wellbeing. It appears that investing in oral health care to improve wellbeing is not a top priority to tell policymakers about. This does not imply that there should be no investment in oral health care to improve oral health. That could have an indirect link to wellbeing by eliminating the potential oral health-related barriers to quality of life that could represent the foundation of wellbeing. Limitation: Only the most recent five years (2018–2022), peer-reviewed English-language literature, and four electronic databases were included in the search. These restrictions were put in place to keep the volume of literature at a manageable level. This suggests that some significant studies might have been omitted. Furthermore, the study used a definition of wellbeing that is currently being evolved and might not everyone agrees with it. Conclusion: Whilst it is a ubiquitous argument that oral health is related to wellbeing, and this seems logical, there is little empirical evidence to support this claim. This question, therefore, requires much more detailed consideration. Funding: This project was funded by the Ministry of Higher Education and Scientific Research in Libya and Tripoli University.

Keywords: oral health, wellbeing, satisfaction, emotion, quality of life, oral health related quality of life

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10716 Investigating Income Diversification Strategies into Off-Farm Activities Among Rural Households in Ethiopia

Authors: Kibret Berhanu Getinet

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Off-farm income diversification by farm rural households has gained the attention of researchers and policymakers due to the fact that agriculture failed to meet the needs of people in developing countries like Ethiopia. The objective of this study was to investigate income diversification strategies into off-farm activities among rural households in Hawassa Zuria Woreda, Sidama National Regional State, Ethiopia. The study used primary and secondary data sources for the primary data collection questionnaire employed as a data collection instrument. A multistage sampling technique was used to collect data from a total of 197 sample households from four kebeles of the study area. Descriptive statistics, as well as econometrics methods of data analysis, were employed. The descriptive statistics result indicates that the majority of sample rural households (68.53 %) have engaged in off-farm income diversification activities while the remaining 31.47% of households did not participate in the diversification in the study area. The choice of participants among the strategies indicates that 6.60% of respondents participated in off-farm wage employment, 30.46% participated in off-farm self-employment, and about 31.47% of them participated in both off-farm wage employment. The study revealed that the share of off-farm income in total annual earnings of households was about 48.457%, and thus, the off-farm diversification significantly contributes to the rural household income. Moreover, binary and multinomial logistic regression models were employed to identify factors that affect the participation and the choices of the off-farm income diversification strategies, respectively. The binary logit model result indicated that agro-ecological zone, education status of the households, available technical skills of the household, household saving, total livestock owned by the households, access to electricity, road access and being married of household head were significant and positively affected the chance of diversification in off-farm activities while the on-farm income of households is negatively affected the chance of diversification. Similarly, the multinomial logistic regression model estimate revealed that agroecological zone, on-farm income, available technical skills, household savings, and access to electricity are positively related and significantly influenced the household’s choice of employment into off-farm wage employment. The off-farm self-employment diversification choice is significantly influenced by on-farm income, available technical skills, household savings, total livestock owned, and access to electricity. Moreover, the result showed that the factors that affect the choice of farm households to engage in both off-farm wage and self-employment are ecological zone, education status, on-farm income, available technical skills, household own saving, market access, total livestock owned, access to electricity and road access. Thus, due attention should be given to addressing the demographic, socio-economic, and institutional constraints to strengthen off-farm income diversification strategies to improve the income of rural households.

Keywords: off-farm, incoem, diversification, logit model

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