Search results for: sustainable health planning

Authors: Chinasa U. Imo, Queen Chikwendu, Jonathan Ajuma, Mario Banuelos

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Background: Sociocultural norms primarily influence the health-seeking behavior of populations in rural communities. In the Nkporo community, Abia State, Nigeria, their sociocultural perception of diseases runs counter to biomedical definitions, wherein they rely heavily on traditional medicine and practices. In a state where birth asphyxia and sepsis account for the significant causes of death for neonates, malaria leads to the causes of other mortalities, followed by common preventable diseases such as diarrhea, pneumonia, acute respiratory tract infection, malnutrition, and HIV/AIDS. Most local mothers attribute their health conditions and that of their children to witchcraft attacks, the hand of God, and ancestral underlining. This influences how they see antenatal and postnatal care, choice of place of accessing care and birth delivery, response to children's illnesses, immunization, and nutrition. Method: To implement a community health improvement program, we adopted an asset-based community development model to address health's normative and social determinants. The first step was to use a qualitative approach to conduct a community health needs baseline assessment, involving focus group discussions with twenty-five (25) youths aged 18-25, semi-structured interviews with ten (10) officers-in-charge of primary health centers, eight (8) ward health committee members, and nine (9) community leaders. Secondly, we designed an intervention program. Going forward, we will proceed with implementing and evaluating this program. Result: The priority needs identified by the communities were malaria, lack of clean drinking water, and the need for behavioral change information. The study also highlighted the significant influence of youths on their peers, family, and community as caregivers and information interpreters. Based on the findings, the NGO SieDi-Hub collaborated with the Abia State Ministry of Health, the State Primary Healthcare Agency, and Empower Next Generations to design a one-year "Community Health Youth Champions Pilot Program." Twenty (20) youths in the community were trained and equipped to champion a participatory approach to bridging the gap between access and delivery of primary healthcare, to adjust sociocultural norms to improve health equity for people in Nkporo community – with limited education, lack of access to health information, and quality healthcare facilities using an innovative community-led improvement approach. Conclusion: Youths play a vital role in achieving health equity, being a vulnerable population with significant influence. To ensure effective primary healthcare, strategies must include cultural humility. The asset-based community development model offers valuable tools, and this article will share ongoing lessons from the intervention's behavioral change strategies with young people.

Keywords: asset-based community development, community health, primary health systems strengthening, youth empowerment

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Authors: Sabrina Neururer, Marco Schweitzer, Werner Hackl, Bernhard Tilg, Patrick Raudaschl, Andreas Huber, Bernhard Pfeifer

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History and the current outbreak of Covid-19 have shown the deadly potential of infectious diseases. However, infectious diseases also have a serious impact on areas other than health and healthcare, such as the economy or social life. These areas are strongly codependent. Therefore, disease control measures, such as social distancing, quarantines, curfews, or lockdowns, have to be adopted in a very considerate manner. Infectious disease modeling can support policy and decision-makers with adequate information regarding the dynamics of the pandemic and therefore assist in planning and enforcing appropriate measures that will prevent the healthcare system from collapsing. In this work, an agent-based simulation package named “survival” for simulating infectious diseases is presented. A special focus is put on SARS-Cov-2. The presented simulation package was used in Austria to model the SARS-Cov-2 outbreak from the beginning of 2020. Agent-based modeling is a relatively recent modeling approach. Since our world is getting more and more complex, the complexity of the underlying systems is also increasing. The development of tools and frameworks and increasing computational power advance the application of agent-based models. For parametrizing the presented model, different data sources, such as known infections, wastewater virus load, blood donor antibodies, circulating virus variants and the used capacity for hospitalization, as well as the availability of medical materials like ventilators, were integrated with a database system and used. The simulation result of the model was used for predicting the dynamics and the possible outcomes and was used by the health authorities to decide on the measures to be taken in order to control the pandemic situation. The survival package was implemented in the programming language Java and the analytics were performed with R Studio. During the first run in March 2020, the simulation showed that without measures other than individual personal behavior and appropriate medication, the death toll would have been about 27 million people worldwide within the first year. The model predicted the hospitalization rates (standard and intensive care) for Tyrol and South Tyrol with an accuracy of about 1.5% average error. They were calculated to provide 10-days forecasts. The state government and the hospitals were provided with the 10-days models to support their decision-making. This ensured that standard care was maintained for as long as possible without restrictions. Furthermore, various measures were estimated and thereafter enforced. Among other things, communities were quarantined based on the calculations while, in accordance with the calculations, the curfews for the entire population were reduced. With this framework, which is used in the national crisis team of the Austrian province of Tyrol, a very accurate model could be created on the federal state level as well as on the district and municipal level, which was able to provide decision-makers with a solid information basis. This framework can be transferred to various infectious diseases and thus can be used as a basis for future monitoring.

Keywords: modelling, simulation, agent-based, SARS-Cov-2, COVID-19

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Authors: Babak Nemat

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Background and Purpose: Non-alcoholic fatty liver is one of the most common liver disorders, which, as the most important cause of death from liver disease, has unpleasant consequences and complications. The aim of this study was to investigate the effect of an educational intervention based on a health belief model to prevent non-alcoholic fatty liver among women. Materials and Methods: This experimental study was performed among 110 women referring to comprehensive health service centers in Malayer City, west of Iran, in 2023. Using the available sampling method, 110 participants were divided into experimental and control groups. The data collection tool included demographic characteristics and a questionnaire based on the health belief model. In the experimental group, three one-hour training sessions were conducted in the form of pamphlets, lectures, and group discussions. Data were analyzed using SPSS software version 21, by correlation tests, paired t-tests, and independent t-tests. Results: The mean age of participants was 38.07±6.28 years, and most of the participants were middle-aged, married, housewives with academic education, middle-income, and overweight. After the educational intervention, the mean scores of the constructs include perceived sensitivity (p=0.01), perceived severity (p=0.01), perceived benefits (p=0.01), guidance for internal (p=0.01), and external action (p=0.01), and perceived self-efficacy (p=0.01) in the experimental group were significantly higher than the control group. The score of perceived barriers in the experimental group decreased after training. The perceived obstacles score in the test group decreased after the training (15.2 ± 3.9 v.s 11.2 ± 3.3, (p<0.01). Conclusion: The findings of the study showed that the design and implementation of educational programs based on the constructs of the health belief model can be effective in preventing women from developing higher levels of non-alcoholic fatty liver.

Keywords: non-alcoholic fatty liver, health belief model, education, women

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Authors: Srushti R. Joshi, Ujjwal Rakesh, Spoorthi Sripad

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The rapid advancement of remote sensing technologies has revolutionized plant health monitoring, offering valuable insights for precision agriculture and environmental management. This paper presents a comprehensive comparative analysis between the widely employed normalized difference vegetation index (NDVI) and state-of-the-art hyperspectral sensors in the context of plant health assessment. The study aims to elucidate the weigh ups of spectral resolution. Employing a diverse range of vegetative environments, the research utilizes simulated datasets to evaluate the performance of NDVI and hyperspectral sensors in detecting subtle variations indicative of plant stress, disease, and overall vitality. Through meticulous data analysis and statistical validation, this study highlights the superior performance of hyperspectral sensors across the parameters used.

Keywords: normalized difference vegetation index, hyperspectral sensor, spectral resolution, infrared

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Authors: Chinumani Choudhury

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Heavy metal contamination is an alarming problem, which poses a serious risk to human health and the surrounding geology. Soils get contaminated with heavy metals due to the un-regularized industrial discharge of the toxic metal-rich effluents. Under such a condition, the remediation of the contaminated sites becomes imperative for a sustainable, safe, and healthy environment. Phytoextraction, which involves the removal of heavy metals from the soil through root absorption and uptake, is a viable remediation technique, which ensures extraction of the toxic inorganic compound available in the soil even at low concentrations. The soil present in the Silghat Region of Assam, India, is mostly contaminated with Zinc (Zn) and Lead (Pb), having concentrations as high as to cause a serious environmental problem if proper measures are not taken. In the present study, an extensive experimental study was carried out to understand the effectiveness of two commonly planted trees in Assam, namely, i) Indian Pennywort and ii) Fenugreek, in the removal of heavy metals from the contaminated soil. The basic characterization of the soil in the contaminated site of the Silghat region was performed and the field concentration of Zn and Pb was recorded. Various long-term laboratory pot tests were carried out by sowing the seeds of Indian Pennywort and Fenugreek in a soil, which was spiked, with a very high dosage of Zn and Pb. The tests were carried out for different concentration of a particular heavy metal and the individual effectiveness in the absorption of the heavy metal by the plants were studied. The concentration of the soil was monitored regularly to assess the rate of depletion and the simultaneous uptake of the heavy metal from the soil to the plant. The amount of heavy metal uptake by the plant was also quantified by analyzing the plant sample at the end of the testing period. Finally, the study throws light on the applicability of the studied plants in the field for effective remediation of the contaminated sites of Assam.

Keywords: phytoextraction, heavy-metals, Indian pennywort, fenugreek

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Authors: Mohammed Ali

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A flexible manufacturing system has been studied under different manufacturing strategies. The aim of this paper is to test the impact of number of pallets and routing flexibility (design strategy) on system performance operating at different sequencing and dispatching rules (control strategies) at unbalanced load condition (planning strategies). A computer simulation model is developed to evaluate the effects of aforementioned strategies on the make-span time, which is taken as the system performance measure. The impact of number of pallets is shown with the different levels of routing flexibility. In this paper, the same manufacturing system is modeled under different combination of sequencing and dispatching rules. The result of the simulation shows that there is definite range of pallets for each level of routing flexibility at which the systems performs satisfactorily.

Keywords: flexible manufacturing system, manufacturing, strategy, makespan

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Authors: R. F. Vieira, D. Lopes, I. Baptista, S. A. Figueiredo, V. F. Domingues, R. Jorge, C. Delerue-matos, O. M. Freitas

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Odours are generated in municipal solid wastes management plants as a result of decomposition of organic matter, especially when anaerobic degradation occurs. Information was collected about the substances and respective concentration in the surrounding atmosphere of some management plants. The main components which are associated with these unpleasant odours were identified: ammonia, hydrogen sulfide and mercaptans. The first is the most common and the one that presents the highest concentrations, reaching values of 700 mg/m3. Biofiltration, which involves simultaneously biodegradation, absorption and adsorption processes, is a sustainable technology for the treatment of these odour emissions when a natural packing material is used. The packing material should ideally be cheap, durable, and allow the maximum microbiological activity and adsorption/absorption. The presence of nutrients and water is required for biodegradation processes. Adsorption and absorption are enhanced by high specific surface area, high porosity and low density. The main purpose of this work is the exploitation of natural waste materials, locally available, as packing media: heather (Erica lusitanica), chestnut bur (from Castanea sativa), peach pits (from Prunus persica) and eucalyptus bark (from Eucalyptus globulus). Preliminary batch tests of ammonia removal were performed in order to select the most interesting materials for biofiltration, which were then characterized. The following physical and chemical parameters were evaluated: density, moisture, pH, buffer and water retention capacity. The determination of equilibrium isotherms and the adjustment to Langmuir and Freundlich models was also performed. Both models can fit the experimental results. Based both in the material performance as adsorbent and in its physical and chemical characteristics, eucalyptus bark was considered the best material. It presents a maximum adsorption capacity of 0.78±0.45 mol/kg for ammonia. The results from its characterization are: 121 kg/m3 density, 9.8% moisture, pH equal to 5.7, buffer capacity of 0.370 mmol H+/kg of dry matter and water retention capacity of 1.4 g H2O/g of dry matter. The application of natural materials locally available, with little processing, in biofiltration is an economic and sustainable alternative that should be explored.

Keywords: ammonia removal, biofiltration, natural materials, odour control

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Authors: Sadegh Abebi

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There are problems with estimating time of product process of products, especially when there is variable serving time, like control stage. These problems will cause overestimation of process time. Layout constraints, reworking constraints and inflexible product schedule in multi product lines, needs a precise planning to reduce volume in particular situation of line stock. In this article, by analyzing real queue systems with layout constraints and by using concepts and principles of Markov chain in queue theory, a hybrid model has been presented. This model can be a base to assess queue systems with probable parameters of service. Here by presenting a case study, the proposed model will be described. so, production lines of a home application manufacturer will be analyzed.

Keywords: Queuing theory, Markov Chain, layout, line balance

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Authors: Kunthida Kulprateepunya, Napat Boontiam, Bunthita Phuasa, Chatsuda Kankayant, Bantoeng Polsawat, Sumran Poontong

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Frailty is the thin line between good health and illness. The syndrome is more common in the elderly who transition from strong to weak. (Vulnerability). Fragility can prevent and promote healthy recovery before it goes into disability. This research and development aim to analyze the situation analysis of frailty of the elderly, develop a program, and evaluate the effect of a health promotion program to prevent and solve the problem of frailty among the elderly. The research consisted of 3 phases: 1) analysis of the frailty situation, 2) development of a model, 3) evaluation of the effectiveness of the model. Samples were 328, 122 elderlies using the multi-stage random sampling method. The research instrument was a frailty questionnaire use of the five symptoms, the main characteristics were muscle weakness, slow walking, low physical activity. Fatigue and unintentional weight loss, criteria frailty use more than or equal to three or more symptoms are frailty. Data were analyzed by descriptive and t-test dependent test statistics. The findings showed three parts. First, frailty in the elderly was 23.05 percentage and 56.70% pre-frailty. Second, it was development of a health promotion program to prevent and solve the problem of frailty the elderly with a combination of Nine-Square Exercise, Elastic Band Exercise, Elastic Coconut Shell. Third, evaluation of the effectiveness of the model by comparison of the elderly's get up and go test, the average time before using the program was 14.42 and after using the program was 8.57. It was statistically significant at the .05 level. In conclusion, the findings can used to develop guidelines to promote the health of the frailty elderly.

Keywords: elderly, fragile, nine-square exercise, elastic coconut shell

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Authors: Yahoel Van Essen, Gordon Ho, Brett Russell, Hans-Georg Worms, Xiao Lin Long, Edward David Cooper, Avner Bachar

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Weeds reduce farm and forest productivity, invade crops, smother pastures and some can harm livestock. Farmers need to spend a significant amount of money to control weeds by means of biological, chemical, cultural, and physical methods. To solve the global agricultural labor shortage and remove poisonous chemicals, a fully autonomous, eco-friendly, and sustainable weeding technology is developed. This takes the form of a weeding robot, ‘Roboweeder’. Roboweeder includes a four-wheel-drive self-driving vehicle, a 4-DOF robotic arm which is mounted on top of the vehicle, an electromagnetic wave generator (magnetron) which is mounted on the “wrist” of the robotic arm, 48V battery packs, and a control/communication system. Cameras are mounted on the front and two sides of the vehicle. Using image processing and recognition, distinguish types of weeds are detected before being eliminated. The electromagnetic wave technology is applied to heat the individual weeds and clusters dielectrically causing them to wilt and die. The 4-DOF robotic arm was modeled mathematically based on its structure/mechanics, each joint’s load, brushless DC motor and worm gear’ characteristics, forward kinematics, and inverse kinematics. The Proportional-Integral-Differential control algorithm is used to control the robotic arm’s motion to ensure the waveguide aperture pointing to the detected weeds. GPS and machine vision are used to traverse the farm and avoid obstacles without the need of supervision. A Roboweeder prototype has been built. Multiple test trials show that Roboweeder is able to detect, point, and kill the pre-defined weeds successfully although further improvements are needed, such as reducing the “weeds killing” time and developing a new waveguide with a smaller waveguide aperture to avoid killing crops surrounded. This technology changes the tedious, time consuming and expensive weeding processes, and allows farmers to grow more, go organic, and eliminate operational headaches. A patent of this technology is pending.

Keywords: autonomous navigation, machine vision, precision heating, sustainable and eco-friendly

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Authors: Aryan Sood, Shruti Pathak, Dipanshu Chaudhary, Shreyanshi, Yogesh Pal

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In this comprehensive meta-analysis, the study delves into the widespread issue of body shaming, revealing its pervasive impact on various aspects of human life and its profound implications for mental health. The paper first explores the origins of body shaming, including societal norms, media influences, and interpersonal dynamics. It highlights the various forms it takes and its detrimental effects on self-esteem, body image, and psychological well-being. Particularly among adolescents and teenagers in today's social media-driven world, the pressure to conform to idealized beauty standards is significant, leading to negative consequences for their development and health. The research emphasizes the long-lasting mental health effects of body shaming, including depression, body dysmorphia, low self-esteem, and eating disorders. The study also discusses the emergence of body positivity movements as a means to challenge societal norms and promote inclusivity and empathy. Furthermore, the research addresses body shaming in the workplace and presents strategies to combat it, stressing the importance of awareness campaigns, education, and policy changes. In conclusion, the study underscores the critical need for a culture of acceptance and support, the promotion of positive body image, and efforts to mitigate the severe mental health toll that body shaming takes on individuals and communities. Overall, this research provides a comprehensive overview of body shaming, its root causes, and its far-reaching impacts on mental health and well-being. It highlights the urgency of addressing this issue in various contexts, from adolescence to the workplace, and offers solutions, such as awareness campaigns and societal changes, to foster a more inclusive and empathetic future.

Keywords: body shaming, mental health, age, gender, societal norms, appearance-based discrimination, cyberbullying, self-esteem, social media, depression, acceptance

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Authors: Donatella R. Fiorino, Marzia Loddo

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The practice of freeing monuments from subsequent additions crosses the entire history of conservation and it is traditionally connected to the aim of valorisation, both for cultural and educational purpose and recently even for touristic exploitation. Defence heritage has been widely interested by these cultural and technical moods from philological restoration to critic innovations. A renovated critical analysis of Italian episodes and in particular the Sardinian case of the area of San Pancrazio in Cagliari, constitute an important lesson about the limits of this practice and the uncertainty in terms of results, towards the definition of a sustainable good practice in the restoration of military architectures.

Keywords: defensive architecture, liberation, Valorisation for tourism, historical restoration

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Authors: Jiří F. Urbánek, Jiří Barta

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Societal security, continuity scenarios, and methodological cycling approach understands in this article. Namely, societal security organizational challenges ask implementation of international standards BS 25999-2 and global ISO 22300 which is a family of standards for business continuity management system. Efficient global organization system is distinguished of high entity´s complexity, connectivity, and interoperability, having not only cooperative relations in a fact. Competing business have numerous participating ´enemies´, which are in apparent or hidden opponent and antagonistic roles with prosperous organization systems, resulting to a crisis scene or even to a battle theater. Organization business continuity scenarios are necessary for such ´a play´ preparedness, planning, management, and overmastering in real environments.

Keywords: business continuity, societal security, crisis scenarios cycles, interoperability

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Authors: Juan C. Reyes, Linnette Rodríguez, Héctor Villanueva, Jorge Vázquez, Ivonne Rivera

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On July 2020, a private non-profit community health center (HealthProMed) that serves people without a medical insurance plan or with limited resources in one of the most populated areas in San Juan, Puerto Rico, implemented a COVID-19 case investigation and contact-tracing surveillance system. Nursing personnel at the health center completed a computerized case investigation form that was translated, adapted, and modified from CDC’s Patient Under Investigation (PUI) Form. Between July 13, 2020, and March 17, 2022, a total of 9,233 SARS-CoV-2 tests were conducted at the health center, 16.9% of which were classified as confirmed cases (positive molecular test) and 27.7% as probable cases (positive serologic test). Most of the confirmed cases were females (60.0%), under 20 years old (29.1%), and living in their homes (59.1%). In the 14 days before the onset of symptoms, 26.3% of confirmed cases reported going to the supermarket, 22.4% had contact with a known COVID-19 case, and 20.7% went to work. The symptoms most commonly reported were sore throat (33.4%), runny nose (33.3%), cough (24.9%), and headache (23.2%). The most common preexisting medical conditions among confirmed cases were hypertension (19.3%), chronic lung disease including asthma, emphysema, COPD (13.3%), and diabetes mellitus (12.8). Multiple logistic regression analysis revealed that patients who used alcohol frequently during the last two weeks (OR=1.43; 95%CI: 1.15-1.77), those who were in contact with a positive case (OR=1.58; 95%CI: 1.33-1.88) and those who were obese (OR=1.82; 95%CI: 1.24-2.69) were significantly more likely to be a confirmed case after controlling for sociodemographic variables. Implementing a case investigation and contact-tracing component at community health centers can be of great value in the prevention and control of COVID-19 at the community level and could be used in future outbreaks.

Keywords: community health center, Puerto Rico, risk factors, SARS-CoV-2

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Authors: Juliet Sorensen, Anna Maitland

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Introduction: Characterized by lack of water and sanitation, food insecurity, and low access to hospitals and clinics, informal urban settlements in Lagos, Nigeria have very poor health outcomes. With little education and a general inability to demand basic rights, these communities are often disempowered and isolated from understanding, claiming, or owning their health needs. Utilizing community-based participatory research characterized by interdisciplinary, cross-cultural partnerships, evidence-based assessments, and both primary and secondary source research, a holistic health education and advocacy program was developed in Lagos to address health barriers for targeted communities. This includes a first of its kind guide formulated to teach community-based health educators how to transmit health information to low-literacy Nigerian audiences while supporting behavior change models and social support mechanisms. This paper discusses the interdisciplinary contributions to developing a health education program while also looking at the need for greater beneficiary ownership and implementation of health justice and access. Methods: In March 2016, an interdisciplinary group of medical, legal, and business graduate students and faculty from Northwestern University conduced a Health Needs Assessment (HNA) in Lagos with a partner and a local non-governmental organization. The HNA revealed that members of informal urban communities in Lagos were lacking basic health literacy, but desired to remedy this lacuna. Further, the HNA revealed that even where the government mandates specific services, many vulnerable populations are unable to access these services. The HNA concluded that a program focused on education, advocacy, and organizing around anatomy, maternal and sexual health, infectious disease and malaria, HIV/AIDS, emergency care, and water and sanitation would respond to stated needs while also building capacity in communities to address health barriers. Results: Based on the HNA, including both primary and secondary source research on integrated health education approaches and behavior change models and responsive, adaptive material development, a holistic program was developed for the Lagos partners and first implemented in November 2016. This program trained community-nominated health educators in adult, low-literacy, knowledge exchange approaches, utilizing information identified by communities as a priority. After a second training in March 2017, these educators will teach community-based groups and will support and facilitate behavior change models and peer-support methods around basic issues like hand washing and disease transmission. They will be supported by community paralegals who will help ensure that newly trained community groups can act on education around access, such as receiving free vaccinations, maternal health care, and HIV/AIDS medicines. Materials will continue to be updated as needs and issues arise, with a focus on identifying best practices around health improvements that can be shared across these partner communities. Conclusion: These materials are the first of their kind, and address a void of health information and understanding pervasive in informal-urban Lagos communities. Initial feedback indicates high levels of commitment and interest, as well as investment by communities in these materials, largely because they are responsive, targeted, and build community capacity. This methodology is an important step in dignity-based health justice solutions, albeit in the process of refinement.

Keywords: community health educators, interdisciplinary and cross cultural partnerships, health justice and access, Nigeria

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Authors: Jill Hanass-Hancock, Bradley Carpenter, Samantha Willan, Kristin Dunkle

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Access to quality health care for persons with disabilities is the litmus test in our strive toward universal health coverage. Persons with disabilities experience a variety of health disparities related to increased health risks, greater socioeconomic challenges, and persistent ableism in the provision of health care. In low- and middle-income countries, the support needed to address the diverse needs of persons with disabilities and close the gaps in inclusive and accessible health care can appear overwhelming to staff with little knowledge and tools available. An action-orientated disability inclusion toolkit for health facilities was developed through consensus-building consultations and field testing in South Africa. The co-creation of the toolkit followed a bottom-up approach with healthcare staff and persons with disabilities in two developmental cycles. In cycle one, a disability facility assessment tool was developed to increase awareness of disability accessibility and service delivery gaps in primary healthcare services in a simple and action-orientated way. In cycle two, an intervention menu was created, enabling staff to respond to identified gaps and improve accessibility and inclusion. Each cycle followed five distinct steps of development: a review of needs and existing tools, design of the draft tool, consensus discussion to adapt the tool, pilot-testing and adaptation of the tool, and identification of the next steps. The continued consultations, adaptations, and field-testing allowed the team to discuss and test several adaptations while co-creating a meaningful and feasible toolkit with healthcare staff and persons with disabilities. This approach led to a simplified tool design with ‘key elements’ needed to achieve universal health coverage: universal design of health facilities, reasonable accommodation, health care worker training, and care pathway linkages. The toolkit was adapted for paper or digital data entry, produces automated, instant facility reports, and has easy-to-use training guides and online modules. The cyclic approach enabled the team to respond to emerging needs. The pilot testing of the facility assessment tool revealed that healthcare workers took significant actions to change their facilities after an assessment. However, staff needed information on how to improve disability accessibility and inclusion, where to acquire accredited training, and how to improve disability data collection, referrals, and follow-up. Hence, intervention options were needed for each ‘key element’. In consultation with representatives from the health and disability sectors, tangible and feasible solutions/interventions were identified. This process included the development of immediate/low-cost and long-term solutions. The approach gained buy-in from both sectors, who called for including the toolkit in the standard quality assessments for South Africa’s health care services. Furthermore, the process identified tangible solutions for each ‘key element’ and highlighted where research and development are urgently needed. The cyclic and consultative approach enabled the development of a feasible facility assessment tool and a complementary intervention menu, moving facilities toward universal health coverage for and persons with disabilities in low- or better-resourced contexts while identifying gaps in the availability of interventions.

Keywords: public health, disability, accessibility, inclusive health care, universal health coverage

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Authors: Jianzhou Ni, Hua Fan

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It has been determined that supervisor support has a major influence on postgraduate students' academic emotions and is considered a method of successfully anticipating postgraduates' good psychological well-being levels. As a result, by assessing the mediating influence upon academic emotions for contemporary postgraduates in China, this study investigated the tight reciprocal relationship between psychological empowerment and positive mental well-being among postgraduates. To that end, a help enables a theoretical analysis of role clarity, academic emotion, and positive psychological health was developed, and its validity and reliability were demonstrated for the first time using the normalized postgrad relationship with supervisor scale, academic emotion scale, and positive mental scale, as well as questionnaire data from Chinese postgraduate students. This study used the cross-lagged (ARCL) panel model data to longitudinally measure 798 valid data from two survey questions polls taken in 2019 (T1) and 2021 (T2) to investigate the link between supervisor support and positive graduate student mental well-being in a bidirectional relationship of influence. The study discovered that mentor assistance could have a considerable beneficial impact on graduate students' academic emotions and, as a result, indirectly help learners attain positive mental health development. This verifies the theoretical premise that academic emotions partially mediate the effect of mentor support on positive mental health development and argues for the coexistence of the two. The outcomes of this study can help researchers gain a better knowledge of the dynamic interplay among three different research variables: supervisor support, academic emotions, and positive mental health, as well as fill gaps in previous research. In this regard, the study indicated that mentor assistance directly stimulates students' academic drive and assists graduate students in developing good academic emotions, which contributes to the development of positive mental health. However, given the restricted measurement time in this study's cross-lagged panel data and the potential effect of moderating effects other than academic mood on graduate students' good mental health, the results of this study need to be more fully understood and validated.

Keywords: supervisor support, academic emotions, positive mental health, interaction effects, longitudinal cross-lagged measurements

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Authors: Saba Nuzhat

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The present ethnographic study examines how domestic violence and authoritative knowledge affect the reproductive health of females; in terms of contraceptive behavior and induced abortion. This qualitative study has been conducted by collecting in depth informal interviews and case studies of 12 female respondents living in an urban slum of Keraniganj, located Dhaka city. The study depicts how multivariable factors are linked to a woman’s ability to contracept and make abortion decisions in a cultural context where being a wife infers to submission, limited mobility, sexual availability, and restricted autonomy on her own reproduction health. This study shows how violence is being normalized and socially acceptable, every time women do not adhere to go through expected gender roles. The study primarily explores the subjective experiences and perceptions of the females about contraceptive behavior as well as abortions from a medical anthropological perspective. A number of salient examples are highlighted into this paper where women who go through abortion or adopt various measures of contraceptives get highly influenced by authoritative knowledge or under the pressure of male dominance. The lack of female autonomy or prevalence of domestic violence challenges the gender equality of Bangladeshi society and female sovereignty in accessing sexual or reproductive rights. This paper remarks the significance of medical anthropological research that helps to understand the intricate interrelationship between authoritative knowledge and male dominance with female reproductive health in order to reduce women’s risk of experiencing domestic violence and to promote reproductive health autonomy for themselves for espousing contraceptive behaviors and abortion decisions.

Keywords: abortion, authoritative knowledge, contraception, domestic violence, reproductive health

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Authors: K. Masera, A. K. Hossain

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Hardly any neat biodiesel satisfies the European EN14214 standard for compression ignition engine application. To satisfy the EN14214 standard, various additives are doped into biodiesel; however, biodiesel additives might cause other problems such as increase in the particular emission and increased specific fuel consumption. In addition, the additives could be expensive. Considering the increasing level of greenhouse gas GHG emissions and fossil fuel depletion, it is forecasted that the use of biodiesel will be higher in the near future. Hence, the negative aspects of the biodiesel additives will likely to gain much more importance and need to be replaced with better solutions. This study aims to satisfy the European standard EN14214 by blending the biodiesels derived from sustainable feedstocks. Waste Cooking Oil (WCO) and Animal Fat Oil (AFO) are two sustainable feedstocks in the EU (including the UK) for producing biodiesels. In the first stage of the study, these oils were transesterified separately and neat biodiesels (W100 & A100) were produced. Secondly, the biodiesels were blended together in various ratios: 80% WCO biodiesel and 20% AFO biodiesel (W80A20), 60% WCO biodiesel and 40% AFO biodiesel (W60A40), 50% WCO biodiesel and 50% AFO biodiesel (W50A50), 30% WCO biodiesel and 70% AFO biodiesel (W30A70), 10% WCO biodiesel and 90% AFO biodiesel (W10A90). The prepared samples were analysed using Thermo Scientific Trace 1300 Gas Chromatograph and ISQ LT Mass Spectrometer (GC-MS). The GS-MS analysis gave Fatty Acid Methyl Ester (FAME) breakdowns of the fuel samples. It was found that total saturation degree of the samples was linearly increasing (from 15% for W100 to 54% for A100) as the percentage of the AFO biodiesel was increased. Furthermore, it was found that WCO biodiesel was mainly (82%) composed of polyunsaturated FAMEs. Cetane numbers, iodine numbers, calorific values, lower heating values and the densities (at 15 ^oC) of the samples were estimated by using the mass percentages data of the FAMEs. Besides, kinematic viscosities (at 40 °C and 20 °C), densities (at 15 °C), heating values and flash point temperatures of the biomixture samples were measured in the lab. It was found that estimated and measured characterisation results were comparable. The current study concluded that biomixture fuel samples W60A40 and W50A50 were perfectly satisfying the European EN 14214 norms without any need of additives. Investigation on engine performance, exhaust emission and combustion characteristics will be conducted to assess the full feasibility of the proposed biomixture fuels.

Keywords: biodiesel, blending, characterisation, CI engine

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Authors: Jiashu Shen

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With the increase in the prevalence of divorce, the impact of divorce on children’s sexual and reproductive health has received wide attention, while few studies have investigated parent marital relationship. This study aims to study the relation of both parent divorce and perceived parental marital relationship with children’s sexual behaviors among Chinese university or vocational college students. The study used data from “National College Student Survey on Sexual and Reproductive Health 2019”, an internet-based survey conducted from November 2019 to February 2020, in 241 universities or vocational colleges in China. Statistical analyses were conducted to assess the relationship of perceived parental marital relationship and parents’ divorce of distinct occurrence time with sexual intercourse, risky sexual behaviors, unintended health outcomes and sexual abuse. Among 51,124 university or vocational college students, those whose parents had divorced accounted for 10.72%. Better perceived parental relationship was associated with a lower likelihood to have sexual intercourse (male: OR: 0.83, 95%CI: 0.80-0.86; female: OR: 0.73, 95%CI: 0.70-0.75), sexual abuse, risky sexual behaviors and unintended health outcomes. Divorce was also found to be associated with higher risk of sexual abuse, risky sexual behaviors and unintended health outcomes. The findings highlight the importance of parental marital relationship and divorce in risky sexual behavior among young adults. The findings may provide implications on intervention programs targeting at children with divorced parents from an early stage.

Keywords: college students, divorce, family relationship, sexual behavior

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Authors: Styliani Soulioti, Helen Fiddler

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The aim of this study was to investigate the approaches used by physiotherapists in the education of patients with chronic low back pain (cLBP) and the rationale that underpins their choice of approach. Therapeutic patient education (TPE) is considered to be an important aspect of modern physiotherapy practice, as it helps patients achieve better self-management and a better understanding of their problem. Previous studies have explored this subject, but the reasoning behind the choices physiotherapists make as educators has not been widely explored, thus making it difficult to understand areas that could be addressed in order to improve the application of TPE.A qualitative study design, guided by a constructivist epistemology was used in this research project. Semi-structured interviews were used to collect data from 7 physiotherapists. Inductive coding and thematic analysis were used, which allowed key themes to emerge. Data analysis revealed two overarching themes: 1) patient-centred versus therapist-centred educational approaches, and 2) behaviourist versus constructivist educational approaches. Physiotherapists appear to use a patient-centred-approach when they explore patients’ beliefs about cLBP and treatment expectations. However, treatment planning and goal-setting were guided by a therapist-centred approach, as physiotherapists appear to take on the role of the instructor/expert, whereas patients were viewed as students. Using a constructivist approach, physiotherapists aimed to provide guidance to patients by combining their professional knowledge with the patients’ individual knowledge, to help the patient better understand their problem, reflect upon it and find a possible solution. However, educating patients about scientific facts concerning cLBP followed a behaviourist approach, as an instructor/student relationship was observed and the learning content was predetermined and transmitted in a one-way manner. The results of this study suggest that a lack of consistency appears to exist in the educational approaches used by physiotherapists. Although patient-centeredness and constructivism appear to be the aims set by physiotherapists in order to optimise the education they provide, a student-teacher relationship appears to dominate when it comes to goal-setting and delivering scientific information.

Keywords: chronic low back pain, educational approaches, health education, patient education

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Authors: Devanandan Govender

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Curriculum design and development in higher education is a complex and challenging process. Amongst others, the extent to which higher education curriculum responds to a country's imperatives, industry requirements, and societal demands are some important considerations. Added to this is the whole notion of sustainable development, climate change and in the South African context the issue of ‘Africanising the curriculum’ is also significant. In this paper, the author describes and analyses the various challenges related to curriculum transformation, design and development within an ODL context and how we at Unisa engage and address curriculum transformation in mainstream curriculum design and development both at course design level and programme/ qualification level.

Keywords: curriculum transformation, curriculum creep, curriculum drift, curriculum mapping

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Authors: Sutida Maneeanakekul, Dusit Wechakit, Somsak Piriyayota

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Coastal erosion is a major problem in Thailand, in both the Gulf of Thailand and the Andaman Sea coasts. According to the Department of Marine and Coastal Resources, land erosion occurred along the 200 km coastline with an average rate of 5 meters/year. Coastal erosion affects public and government properties, as well as the socio-economy of the country, including emigration in coastal communities, loss of habitats, and decline in fishery production. To combat the problem of coastal erosion, projects utilizing bamboo sticks for coastal defense against erosion were carried out in 5 areas beginning in November, 2010, including: Pak Klong Munharn- Samut Songkhram Province; Ban Khun Samutmaneerat, Pak Klong Pramong and Chao Matchu Shrine-Samut Sakhon Province,and Pak Klong Hongthong – Chachoengsao Province by Marine and Coastal Resources Department. In 2012, an evaluation of the effectiveness of solving the problem of coastal erosion by using bamboo stick was carried out, with a focus on three aspects. Firstly, the change in physical and biological features after using the bamboo stick technique was assessed. Secondly, participation of people in the community in the way of managing the problem of coastal erosion were these aspects evaluated as part of the study. The last aspect that was evaluated is the satisfaction of the community toward this technique. The results of evaluation showed that the amounts of sediment have dramatically changed behind the bamboo sticks lines. The increase of sediment was found to be about 23.50-56.20 centimeters (during 2012-2013). In terms of biological aspect, there has been an increase in mangrove forest areas, especially at Bang Ya Prak, Samut Sakhon Province. Average tree density was found to be about 4,167 trees per square meter. Additionally, an increase in production of fisheries was observed. Presently, the change in the evaluated physical features tends to increase in every aspect, including the satisfaction of people in community toward the process of solving the erosion problem. People in the community are involved in the preparatory, operation, monitoring and evaluation process to resolve the problem in the medium levels.

Keywords: bamboo sticks, coastal erosion, rehabilitate, Thailand sustainable development approach

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Authors: Chiedu C. Ifekandu, Olusegun Sangowawa, Jean E. Njab

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Background: Health care providers (HCPs) in Nigeria receive little or no training of the healthcare needs of men who have sex with men (MSM) limiting the quality and effectiveness of comprehensive HIV prevention and treatment services. Consequently, most MSM disguise themselves to access services which limit the quality of care provided partly due to challenges related to stigma and discrimination, and breach of confidentiality. Objective: To assess the knowledge of healthcare providers on effective intervention for MSM. Methods: We trained 122 HIV focal persons drawn from 60 health facilities from twelve Nigerian states. , the participants were requested to complete a pre-training questionnaire to assess their level of working experience with key populations as a baseline. Participants included male and female doctors, nurses and counselors/testers. A test was administered to measure their knowledge on MSM sexual risk practices, HIV prevention and healthcare needs and also to assess their attitudes (including homophobia) and beliefs and how it affects service uptake by key populations particularly MSM prior and immediately after the training to ascertain the impact of the training. Results: The mean age of the HCP was 38 years +/- SD Of the 122 HCPs (45 % female, 55 % male; 85 % counsellor/testers; 15 % doctors and nurses; 92 % working in government facilities) from 42 health facilities were trained, of which 105 attempted the test questions. At the baseline, few HCPs reported any prior sensitivity training on MSM. Most of the HCPs had limited knowledge of MSM sexual health needs. Over 90% of the HCPs believed that homosexuality is a mental illness. 8 % do not consider MSM, FSW and PWID as key populations for HIV infection. 45 % lacked knowledge on MSM anal sexual practices. The post-test showed that homophobic attitudes had decreased significantly by the end of the training; the health care providers have acquired basic knowledge compared to the pre-test. Conclusions: Scaling up MSM sensitivity training for Nigerian HCPs is likely to be a timely and effective means to improve their understanding of MSM-related health issues, reduce homophobic sentiments and enhance their capacity to provide responsive HIV prevention, treatment and care services in a supportive and non-stigmatizing environment.

Keywords: healthcare providers, key population, men who have sex with men, HCT

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Authors: S. K. M. Basha

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Nallamalas one of the centres of Plant Diversity (CPD) (WWF&IUCN,1995) is located in the central eastern Ghats between latitudes 15.20’-16.30’N and Longitude 78.30-80.10E in Andhra Pradesh, extended to an area of 7640 Sq.Km. No Comprehensive work available for RET Plants in the study area, therefore the objective of the present paper is to document the RET Medicinal Plants of Nallamalias and their uses by the local people of the area. In India, one of the major resources to know about the number of plant species and their medicinal values is the groups who are habituated in near and deep forests. The most common groups in south Indian forests are Yanadis and Yerukulas. These two groups of people are residing in the forest, which is located very far from the modern society, towns and cities. They are following traditional methods obtained from their forefathers in all respects, including medication. They are the only source to know many medicinal plants in the areas where they reside and are also important to record the medicinal properties of various plant species which are not reported. The new reports may help in drug industry in order to develop pharmaceutical herbal medicine for human health. In the present study, nearly 150 rare species have been found to be used for various ailments. Out of these 23 species are critically endangered, over 25 are vulnerable and around 22 comes under the category of near threatened. Some important species like Christella dentate, Careya arborea are used for curing cough and cold. Piper attnuatum, piper nigrum are used for curing skin disease. Ipomoea mauritiana is used against male impotency.Glycosmis cochinensis, Entada perseatha are used as contraceptives. The roots of Andrographis nallamalayana and Acrocephalus indicus are used for leucorrhoea. While the stem barks of Gyrocarpus americanus is given orally for spider bite. Piper hymenophyllum leaves mixed with turmeric and gingerly oil is used externally for mouth ulcers in cattle. Piper nigrum fruits are used for skin diseases. Vernonia anthelmentica seeds are used for indigestion. It was widely distributed in this hills. Due to over exploitation this species was in declined condition. Sterculia urens which is a sorce of gum for tribal, due to over exploitation this species declaimed in these hills. Hence, there is an urgent need to conserve the medicinal plants and prevent their exploitation and extinction with the help of tribals. There is a need to adopt sustainable utilization, cultivation and micro propagation techniques. Medicinal plants are as potent and effective today as they were thousands of years ago. They are natures wonderful gift to mankind and are involved in India as a very rich ancient heritage of traditional systems medicine i.e., ayurveda, siddha and unani. Unfortunately, these traditions have been largely eroded because of lack of support and recognition as well as rapid destruction of natural habitats which has led to shrinkage of medicinal plants therefore the conservation of medicinal plants and the revitalization of local health traditions has been taken up on priority basis.

Keywords: RET plants CPD, IUCN, nallamalas, yanadis, yerukulas

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Authors: Gheyder Concha Bendezu, Rodrigo Lescano Loli, Aldo Bravo Lizano

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In big urbanized cities of Latin America, motor vehicles have priority over non-motor vehicles and pedestrians. There is an important problem that affects people's health and quality of life; lack of inclusion towards pedestrians makes it difficult for them to move smoothly and safely since the city has been planned for the transit of motor vehicles. Faced with the new trend for sustainable and economical transport, the city is forced to develop infrastructure in order to incorporate pedestrians and users with non-motorized vehicles in the transport system. The present research aims to study the influence of non-motorized vehicles on an avenue, the optimization of a cycle using traffic lights based on simulation in Synchro software, to improve the flow of non-motor vehicles. The evaluation is of the microscopic type; for this reason, field data was collected, such as vehicular, pedestrian, and non-motor vehicle user demand. With the values of speed and travel time, it is represented in the current scenario that contains the existing problem. These data allow to create a microsimulation model in Vissim software, later to be calibrated and validated so that it has a behavior similar to reality. The results of this model are compared with the efficiency parameters of the proposed model; these parameters are the queue length, the travel speed, and mainly the travel times of the users at this intersection. The results reflect a reduction of 27% in travel time, that is, an improvement between the proposed model and the current one for this great avenue. The tail length of motor vehicles is also reduced by 12.5%, a considerable improvement. All this represents an improvement in the level of service and in the quality of life of users.

Keywords: bikeway, microsimulation, pedestrians, queue length, traffic light cycle, travel time

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Authors: Samuel Bonato, Cineia Santos, Roberta Leite, Carla Ten Caten

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This paper aims to apply the A3 strategy deployment in a local department for healthcare. As a literature review, it was evaluated articles related to the period 2009 - 2018, considering the key-words A3, healthcare, public services and strategy deployment. The methodology used was action research, involving all the actors inside the secretary, beginning with the top management and deploying it through meetings and evaluation conferences with the participation of all secretary coordination. As main results, it is possible to highlight the development of 8 A3, one as the "mother A3" and 7 as "son A3", each one related to each coordination. In each A3, past results, new goals, new projects to achieve these goals and control deadlines were defined and implemented to a management strategy. In addition to this result, this paper is planning to present the use of this A3 during 6 months in 2019.

Keywords: A3 Strategy, strategy deployment, healthcare, Public services

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Authors: M. Goerke, J. Gehrmann

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Caused by shorter product life cycles and higher product variety the importance of production ramp ups is increasing. Even though companies are aware of that fact, up to 40% of the ramp up projects still miss technical and economical requirements. The success of a ramp up depends on the planning of human factors, organizational aspects and technological solutions. Since only partly considered in scientific literature, this paper lays its focus on the human factor during production ramp up. There are only incoherent methods which address the problems in this area. A systematic and holistic method to improve the capabilities of the employees during ramp up is missing. The Harada Method is a relatively young approach for developing highly-skilled workers. It consists of different worksheets which help employees to set guidelines and reach overall objectives. This approach is going to be transferred into a tool for ramp up management.

Keywords: employee development, Harada, production ramp up, organizational aspects

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Authors: Ben J. Lippe

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Consult Liaison Psychology services are overgrowing, given the robust empirical support of the utility of this service in hospital settings. These psychological services, including clinical assessment, applied psychotherapy, and consultation with other healthcare providers, have been shown to improve health outcomes for patients and bolster important areas of administrative interest such as decreased length of patient admission. However, there is little descriptive literature outlining the process and mechanisms of building or developing a Consult Liaison Psychology service. The main findings of this current conceptual work are intended to be clear in nature to elucidate the essential methods involved in developing consult liaison psychology programs, including thorough reviews of relevant behavioral health literature and inclusion of experiential outcomes. The diverse range of hospital settings and healthcare systems makes a “blueprint” method of program development challenging to define, yet important structural frameworks presented here based on the relevant literature and applied practice can help lay critical groundwork for program development in this growing area of psychological service. This conceptual approach addresses the prominent processes, as well as common programmatic and clinical pitfalls, involved in the event of a Consult Liaison Psychology service. This paper, including a systematic review of relevant literature, is intended to serve as a key program development reference for the development of Consult Liaison Psychology services, other related behavioral health programs, and to help inform further research efforts.

Keywords: behavioral health, consult liaison, health psychology, psychology program development

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Authors: Vidhya Venugopal, Jeremiah Chinnadurai, Rebekah A. I. Lucas, Tord Kjellstrom, Bruno Lemke

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Introduction: The effects of climate change (CC) are largely discussed across the globe in terms of impacts on the environment and the general population, but the impacts on workers remain largely unexplored. The predicted rise in temperatures and heat events in the CC scenario have health implications on millions of workers in physically exerting jobs. The current health and productivity risks associated with heat exposures are characterized, future risk estimates as temperature rises and recommendations towards developing protective and preventive occupational health and safety guidelines for India are discussed. Methodology: Cross-sectional studies were conducted in several occupational sectors with workers engaged in moderate to heavy labor (n=1580). Quantitative data on heat exposures (WBGT°C), physiological heat strain indicators viz., Core temperature (CBT), Urine specific gravity (USG), Sweat rate (SwR) and qualitative data on heat-related health symptoms and productivity losses were collected. Data were analyzed for associations between heat exposures, health and productivity outcomes related to heat stress. Findings: Heat conditions exceeded the Threshold Limit Value (TLV) for safe manual work in 66% of the workers across several sectors (Avg.WBGT of 28.7°C±3.1°C). Widespread concerns about heat-related health outcomes (86%) were prevalent among workers exposed to high TLVs, with excessive sweating, fatigue and tiredness being commonly reported by workers. The heat stress indicators, core temperature (14%), Sweat rate (8%) and USG (9%), were above normal levels in the study population. A significant association was found between rise in Core Temperatures and WBGT exposures (p=0.000179) Elevated USG and SwR in the worker population indicate moderate dehydration, with potential risks of developing heat-related illnesses. In a steel industry with high heat exposures, an alarming 9% prevalence of kidney/urogenital anomalies was observed in a young workforce. Heat exposures above TLVs were associated with significantly increased odds of various adverse health outcomes (OR=2.43, 95% CI 1.88 to 3.13, p-value = <0.0001) and productivity losses (OR=1.79, 95% CI 1.32 to 2.4, p-value = 0.0002). Rough estimates for the number of workers who would be subjected to higher than TLV levels in the various RCP scenarios are RCP2.6 =79%, RCP4.5 & RCP6 = 81% and at RCP 8.5 = 85%. Rising temperatures due to CC has the capacity to further reduce already compromised health and productivity by subjecting the workers to increased heat exposures in the RCP scenarios are of concern for the country’s occupational health and economy. Conclusion: The findings of this study clearly identify that health protection from hot weather will become increasingly necessary in the Indian subcontinent and understanding the various adaptation techniques needs urgent attention. Further research with a multi-targeted approach to develop strategies for implementing interventions to protect the millions of workers is imperative. Approaches to include health aspects of climate change within sectoral and climate change specific policies should be encouraged, via a number of mechanisms, such as the “Health in All Policies” approach to avert adverse health and productivity consequences as climate change proceeds.

Keywords: heat stress, occupational health, productivity loss, heat strain, adverse health outcomes

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