Search results for: socioeconomic

Authors: Syrus Zimaze, George Nsimbe, Valley Mugwanya, Matiya Lule, Edgar Watson, Patrick Gwayambadde

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Physical inactivity is a growing global epidemic, also recognised as a major public health challenge. Globally, there are alarming rates of children reported with cardiovascular disease and obesity with limited interventions. In Sub Saharan Africa, there is limited information about involvement in physical activity especially among children aged 6 to 18 years. The aim of this study was to explore factors associated with involvement in physical activity among children in Uganda. Methods: We included all parents with children aged 6 to 18 years training with Excel Soccer Academy between January 2017 and June 2018. Physical activity definition was time spent participating in routine soccer training at the academy for more than 30 days. Each child's attendance was recorded, and parents provided demographic and social economic data. Data on predictors of physical activity involvement were collected using a standardized questionnaire. Descriptive statistics and frequency were used. Binary logistic regression was used at the multi variable level adjusting for education, residence, transport means and access to information technology. Results: Overall 356 parents were interviewed; Boys 318 (89.3%) engaged more in physical activity than girls. The median age for children was 13 years (IQR:6-18) and 42 years (IQR:37-49) among parents. The median time spent at the Excel soccer academy was 13.4 months (IQR: 4.6-35.7) Majority of the children attended formal education, p < 0.001). Factors associated with involvement in physical activity included: owning a permanent house compared to a rented house (odds ratio [OR] :2.84: 95% CI: 2.09-3.86, p < 0.0001), owning a car compared to using public transport (OR: 5.64 CI: 4.80-6.63, p < 0.0001), a parent having received formal education compared to non-formal education (OR: 2.93 CI: 2.47-3.46, p < 0.0001) and daily access to information technology (OR:0.40 CI:0.25-0.66, p < 0.001). Parent’s age and gender were not associated to involvement in physical activity. Conclusions: Socioeconomic factors were positively associated with involvement in physical activity with boys participating more than girls in soccer activities. More interventions are required geared towards increasing girl’s participation in physical activity and those targeting children from less privilege homes.

Keywords: physical activity, Sub-Saharan Africa, social economic factors, children

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Authors: Rahat Zaman

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The present study was conducted to investigate psychological well-being and positive and negative affect among adults. The sample comprised 221 adults; the sample was collected from all over Pakistan. Psychological well-being was measured with the help of the psychological well-being scale developed by Ryff and Keyes (1995). Lifestyle was measured with the help of the Health Promoting Lifestyle Profile Scale developed by Walker et al. (1995). Positive and negative effects were measured by PANAS, developed by Watson, Clark, and Tellegen (1998). To check the properties of scale, the alpha reliability coefficient was calculated. To test the hypotheses of the research, correlation, independent sample t-rest, and ANOVA were computed. It was hypothesized that there would be a positive relationship between psychological well-being and lifestyles and positive affect. The results show that psychological well-being, lifestyle, and positive affect are positively related. This also supports our hypothesis. The research also searched for relationships in the study variables according to the demographics of the sample. The respondents varied according to their dominant affect levels with respect to their psychological well-being and lifestyles. The research found significant differences for the genders in life appreciation, nutrition, and negative affect. Single and married individuals differed significantly on autonomy, environmental mastery, life appreciation, nutrition, and stress management. Individuals showed significant differences with respect to their living situation, joint and nuclear family members showed significant differences in personal growth, autonomy, health responsibilities, social support, physical activities, and stress management. The sample showed significant differences in environmental mastery, personal growth, purpose in life, life appreciation, health responsibilities, physical activities, stress management, and negative affect when divided in socioeconomic status. Age-wise analysis showed significant differences in autonomy, personal growth, purpose in life, life appreciation, nutrition, and stress management. Provincially significant differences were found in life appreciation, nutrition, social support, physical activities, and stress management, and both positive and negative effects were experienced. Implications of the results are discussed.

Keywords: wellbeing, healthy lifestyle, self acceptance, positive

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Authors: Rafael Bezerra de Souza, José Ribas Vieira

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The judicial litigation on socio-economic rights (SERs), in a context of increasing centrality of the judiciary as an area of political debate for civil society actors, has assumed greater importance in the last two decades. This tendency to seek social change through the courts generated a long tradition of research on the role of legal institutions and of legal mobilization in the US and some European countries. However, little is known about these processes in Latin America, Asia and Africa. A significant portion of the Brazilian constitutional doctrine did not bother to investigate the phenomenon of constitutional judicial litigation of socio-economic rights, in a practical and empirical look, from the functioning of democratic institutions. The central issue of this study draws attention to the theoretical and analytic deficit of Brazilian constitutional doctrine: the lack of a holistic understanding of the effects and impact of judicial decisions. Consequently, for a proper understanding was analyzed if the trend of judicial litigation in Brazil - to ensure the fulfillment of its institutional mission to protect and ensure the effectiveness of socio-economic rights - has been accompanied by the establishment of institutional mechanisms that enable decision making and the implementation of SERs in complex cases involving structural and public policy. The lack of empirical studies in Law in order to verify this hypothesis justified the adoption of the case study method as an interdisciplinary methodological strategy between Law and Political Science, aiming to construct an explanation of the Raposa Serra do Sol Case and, in a complementary way, the process-tracing technique. Drawings of small-n type or case studies, when guided by theory, are more suitable to problems it is supposed to increase the potential of intensive analysis of causal processes. As a preliminary result, the Brazilian Supreme Court was not a sufficient agent to implement a relevant social change and to assure the protection of the social rights, because there were few measures that directly impacted the behavior of other institutional political actors and should, therefore, be considered another actor within a complex institutional arrangement.

Keywords: courts, case study, judicial litigation, social change

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Authors: Getahun Nigusie Demise

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Background; antiretroviral treatment reduce HIV-related morbidity, and prolonged survival of patients however, there is lack of up-to-date information concerning the treatment long term effect on the survival of HIV positive children especially in the study area. Objective: The aim of this study is to assess the incidence and predictors of mortality among HIV positive children on antiretroviral therapy (ART) in public hospitals of Harer town who were enrolled from 2011 to 2021. Methodology: Institution based retrospective cohort study was conducted among 429 HIV positive children enrolled in ART clinic from January 1st 2011 to December30th 2021. Data were collected from medical cards by using a data extraction form, Descriptive analyses were used to Summarized the results, and life table was used to estimate survival probability at specific point of time after introduction of ART. Kaplan Meier survival curve together with log rank test was used to compare survival between different categories of covariates, and Multivariate Cox-proportional hazard regression model was used to estimate adjusted Hazard rate. Variables with p-values ≤0.25 in bivariable analysis were candidates to the multivariable analysis. Finally, variables with p-values < 0.05 were considered as significant variables. Results: The study participants had followed for a total of 2549.6 child-years (30596 child months) with an overall mortality rate of 1.5 (95% CI: 1.1, 2.04) per 100 child-years. Their median survival time was 112 months (95% CI: 101–117). There were 38 children with unknown outcome, 39 deaths, and 55 children transfer out to different facility. The overall survival at 6, 12, 24, 48 months were 98%, 96%, 95%, 94% respectively. being in WHO clinical Stage four (AHR=4.55, 95% CI:1.36, 15.24), having anemia(AHR=2.56, 95% CI:1.11, 5.93), baseline low absolute CD4 count (AHR=2.95, 95% CI: 1.22, 7.12), stunting (AHR=4.1, 95% CI: 1.11, 15.42), wasting (AHR=4.93, 95% CI: 1.31, 18.76), poor adherence to treatment (AHR=3.37, 95% CI: 1.25, 9.11), having TB infection at enrollment (AHR=3.26, 95% CI: 1.25, 8.49),and no history of change their regimen(AHR=7.1, 95% CI: 2.74, 18.24), were independent predictors of death. Conclusion: more than half of death occurs within 2 years. Prevalent tuberculosis, anemia, wasting, and stunting nutritional status, socioeconomic factors, and baseline opportunistic infection were independent predictors of death. Increasing early screening and managing those predictors are required.

Keywords: human immunodeficiency virus-positive children, anti-retroviral therapy, survival, treatment, Ethiopia

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Authors: Gozde Inal Kiziltepe, Ozgun Uyanik

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There is growing evidence that socioeconomic (SES)-related differences in mathematical knowledge primarily start in early childhood period. Preschoolers from low-income families are likely to perform substantially worse in mathematical knowledge than their counterparts from middle and higher income families. The differences are seen on a wide range of recognizing written numerals, counting, adding and subtracting, and comparing numerical magnitudes. Early differences in numerical knowledge have a permanent effect childrens’ mathematical knowledge in other grades. In this respect, analyzing the effect of number board game on the number knowledge of 48-60 month-old children from disadvantaged low-income families constitutes the main objective of the study. Participants were the 71 preschoolers from a childcare center which served low-income urban families. Children were randomly assigned to the number board condition or to the color board condition. The number board condition included 35 children and the color board game condition included 36 children. Both board games were 50 cm long and 30 cm high; had ‘The Great Race’ written across the top; and included 11 horizontally arranged, different colored squares of equal sizes with the leftmost square labeled ‘Start’. The numerical board had the numbers 1–10 in the rightmost 10 squares; the color board had different colors in those squares. A rabbit or a bear token were presented to children for selecting, and on each trial spun a spinner to determine whether the token would move one or two spaces. The number condition spinner had a ‘1’ half and a ‘2’ half; the color condition spinner had colors that matched the colors of the squares on the board. Children met one-on-one with an experimenter for four 15- to 20-min sessions within a 2-week period. In the first and fourth sessions, children were administered identical pretest and posttest measures of numerical knowledge. All children were presented three numerical tasks and one subtest presented in the following order: counting, numerical magnitude comparison, numerical identification and Count Objects – Circle Number Probe subtest of Early Numeracy Assessment. In addition, same numerical tasks and subtest were given as a follow-up test four weeks after the post-test administration. Findings obtained from the study; showed that there was a meaningful difference between scores of children who played a color board game in favor of children who played number board game.

Keywords: low income, numerical board game, numerical knowledge, preschool education

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Authors: Joseph Kimuli Balikuddembe

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Road traffic incidents (RTIs) continue to be a serious public health and development burden around the globe. Compared to high-income countries (HICs), the low and middle-income countries (LMICs) bear the heaviest brunt of RTIs. Like other LMICs, Uganda, a country located in Eastern Africa, has been experiencing a worryingly high burden of RTIs and their associated impacts. Over the years, the highest number of all the total registered RTIs in Uganda has taken place in the Greater Kampala Metropolitan Area (GKMA). This places a tremendous demand on the few existing emergency medical services (EMS) to adequately respond to those affected. In this regard, the overall objective of the study was to risk map RTIs in the GKMA so as to help in the better planning of EMS for the victims of RTIs. Other objectives included: (i) identifying the factors affecting the exposure, vulnerability and EMS capacity for the victims of RTIs; (ii) identifying the RTI prone-areas and estimating their associated risk factors; (iii) identifying the weaknesses and capacities which affect the EMS systems for RTIs; and (iv) determining the strategies and priority actions that can help to improve the EMS response for RTI victims in the GKMA. To achieve these objectives, a mixed methodological approach was used in four phrases for approximately 15 months. It employed a systematic review based on the preferred reporting items for systematic reviews and meta-data analysis guidelines; a Delphi panel technique; retrospective data analysis; and a cross-sectional method. With Uganda progressing forward as envisaged in its 'Vision 2040', the GKMA, which is the country’s political and socioeconomic epicenter, is experiencing significant changes in terms of population growth, urbanization, infrastructure development, rapid motorization and other factors. Unless appropriate actions are taken, these changes are likely to worsen the already alarming rate of RTIs in Uganda, and in turn also to put pressure on the few existing EMS and facilities to render care for those affected. Therefore, road safety vis-à-vis injury prevention measures, which are needed to reduce the burden of RTIs, should be multifaceted in nature so that they closely correlate with the ongoing dynamics that contribute to RTIs, particularly in the GKMA and Uganda as a whole.

Keywords: emergency medical services, Kampala, risk mapping, road traffic incidents

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Authors: Rubina Jahan, Mohammad Zayeed Bin Alam, Sazzad Chowdhury, Sadia Chowdhury

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Access to mental health services in Bangladesh is a tale of urban privilege and rural struggle. Mental health services in the country are primarily centered in urban medical hospitals, with only 260 psychiatrists for a population of more than 162 million, while rural populations face far more severe and daunting challenges. In alignment with the World Health Organization's perspective on mental health as a basic human right and a crucial component for personal, community, and socioeconomic development; SAJIDA Foundation a value driven non-government organization in Bangladesh has introduced a Community Based Mental Health (CMHI) program to fill critical gaps in mental health care, providing accessible and affordable community-based services to protect and promote mental health, offering support for those grappling with mental health conditions. The CMHI programme is being implemented in 3 districts in Bangladesh, 2 of them are remote and most climate vulnerable areas targeting total 6,797 individual. The intervention plan involves a screening of all participants using a 10-point vulnerability assessment tool to identify vulnerable individuals. The assumption underlying this is that individuals assessed as vulnerable is primarily due to biological, psychological, social and economic factors and they are at an increased risk of developing common mental health issues. Those identified as vulnerable with high risk and emergency conditions will receive Mental Health First Aid (MHFA) and undergo further screening with GHQ-12 to be identified as cases and non-cases. The identified cases are then referred to community lay counsellors with basic training and knowledge in providing 4-6 sessions on problem solving or behavior activation. In situations where no improvement occurs post lay counselling or for individuals with severe mental health conditions, a referral process will be initiated, directing individuals to ensure appropriate mental health care. In our presentation, it will present the findings from 6-month pilot implementation focusing on the community-based screening versus outcome of the lay counseling session and barriers and facilitators of implementing community based mental health care in a resource constraint country like Bangladesh.

Keywords: community-based mental health, lay counseling, rural bangladesh, treatment gap

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Authors: Mareli Fischer, Kevin G. F. Thomas

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Although Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most prevalent childhood neurobehavioural disorders, little empirical research has been published on its clinical presentation in Africa, and, globally, few studies evaluate ADHD intervention programs that emphasize parent training. Hence, Stage 1 of this research programme aimed to describe the functional impairment of South African children with ADHD, and also sought to investigate the influence of sociodemographic variables (e.g., sex, age, socioeconomic status, family environment) and clinical variables (e.g., ADHD subtype and comorbidity) on the degree of that impairment. We used the Mini International Neuropsychiatric Interview for Children and Adolescents as a diagnostic tool, and the Child Behavior Checklist, the Strengths and Difficulties Questionnaire, and the Impairment Rating Scale as measures of functional impairment. Results from this stage of the research indicated that South African children and adolescents who meet diagnostic criteria for ADHD experience most functional impairment in the school domain, as well as in the area of social functioning. None of the measured sociodemographic variables had a significant detrimental or protective effect on how ADHD symptoms impacted on functioning. In terms of comorbidity, the presence of Major Depressive Disorder, Conduct Disorder, and Oppositional Defiant Disorder were all associated with significantly impaired overall functioning. Stage 2 of the research programme aimed to design, implement, and evaluate a child-specific intervention that targeted the primary areas of impairment identified in Stage 1. Existing literature suggests that a positive parent-training programme, in the group format, is one of the best options for cost-effective and successful ADHD intervention. Hence, the intervention took that form. Parents were taught basic behaviour analysis concepts within a supportive group context. Evaluation of the intervention’s efficacy used many of the same measures as in Stage 1, but also featured semi-structured interviews with participants and naturalistic observation of parent-child interaction. We will discuss preliminary results of that evaluation. Studying functional impairment and designing intervention plans in this way will pave the way for evidence-based treatment plans for children and adolescents diagnosed with ADHD.

Keywords: attention deficit/hyperactivity disorder, children, intervention, parenting groups

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Authors: Keith T. S. Tung, H. W. Tsang, Rosa S. Wong, Frederick K. Ho, Patrick Ip

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Objectives: Atopic diseases are increasingly prevalent among children and adolescents, both locally and internationally. One of the possible contributing factors could be the hypercholesterolemia which leads to cholesterol accumulation in macrophages and other immune cells that would eventually promote inflammatory responses, including augmentation of toll-like receptor (TLR). Meanwhile, physical activity is well known for its beneficial effects against the condition of hypercholesterolemia and incidence of atopic diseases. This study, therefore, explored whether atopic diseases were associated with increased cholesterol levels and whether physical activity habit influenced this association. Methods: This is a sub-study derived from the longitudinal cohort study which recruited a group of children at five years of age in Kindergarten 3 (K3) to investigate the long-term impact of family socioeconomic status on child development. In 2018/19, adolescents (average age: 13 years old) were asked to report their physical activity habit and history of any atopic diseases. During health assessment, peripheral blood samples were collected from the adolescents to study their lipid profile [total cholesterol, high-density lipoprotein (HDL)-cholesterol, and low-density lipoprotein (LDL)-cholesterol]. Regression analyses were performed to test the relationships between variables of interest. Results: Among the 315 adolescents, 99 (31.4%) reported to have allergic rhinitis. There were 45 (14.3%) with eczema, 17 (5.4%) with a food allergy, and 12 (3.8%) with asthma. Regression analyses showed that adolescents with a history of any type of atopic diseases had significantly higher total cholesterol (B=13.3, p < 0.01) and LDL cholesterol (B=7.9, p < 0.05) levels. Further subgroup analyses were conducted to examine the effect of physical activity level on the association between atopic diseases and cholesterol levels. We found stronger associations among those who did not meet the World Health Organization recommendation of at least 60 minutes of moderate-to-vigorous activities each day (total cholesterol: B=15.5, p < 0.01; LDL cholesterol: B=10.4, p < 0.05). For those who met this recommendation, the associations between atopic diseases and cholesterol levels became insignificant. Conclusion: Our study results support the current research evidence on the relationship between an elevated level of cholesterol and atopic diseases. More importantly, our results provide preliminary support for the protective effect of regular exercises against elevated cholesterol level due to atopic diseases. The findings highlight the importance of a healthy lifestyle for keeping cholesterol levels in the normal range, which can bring benefits to both physical and mental health.

Keywords: atopic diseases, Chinese adolescents, cholesterol level, physical activity

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Authors: Juan C. Martínez-Alfaro, Aracely Zúñiga, Fernando Ruíz-Zarate

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In recent years, the Katahdin sheep breeds have been one of the breeds with greater acceptance by sheep farmers in southwestern Mexico. The Hair Sheep breeds from tropical latitudes (16° to 21° North Latitude) show low estrus activity from January to May. By contrast, these breeds of sheep exhibit high estrus activity from August to December. However, the reproductive management of Hair Sheep crossbred is very limited, independently of the socioeconomic levels of sheep farmers. Thus, in crossbred of Hair Sheep, occurrence of lambing is greater in autumn (84%) than spring (16%). In this sense, the aim of this study was to determine the lambing in Crossbred of Katahdin sheep during different seasons of the year. The Hypothesis was that in crossbred of Katahdin sheep, the lambing period has a behavior seasonal in the Southwestern Mexico. The study design consisted in evaluating the lambing proportion in one herds of Katahdin ewes crossbred during one year (October 1st, 2015 to October 1st, 2016). The study was realized in a farm located in the municipality of Jiquipilas, in the State of Chiapas, Mexico (16° North Latitude). A total of 40 female sheep homogeneous in terms of physical condition, age and physiological state were selected; and they were fed in grazing continuous, mainly with Africa star grass (Cynodon lemfuensis) and they are provided with water and mineral salts ad libitum; during the dry season, the ewes were supplemented with a diet of maize and sorghum, and the reproductive management was continuous mating. The lambing proportion was analyzed by chi-squared test, using SAS statistical software. The proportion of Katahdin ewes crossbred that lambed during the study period was high (100%; 40/40), the prolificacy was 1.42 (lamb/lambing). The proportion of lambing was higher (P<0.05) in autumn (67.5%; 27/40), than winter, spring and summer (32.5%; 13/40; 0%; 0/40; 0%; 0/40; respectively). The proportion of lambing was greater (P<0.05) in November (50%; 20/40), compared to October, December and January (2.5%; 1/40; 27.5%; 11/40; 20%; 8/40, respectively). The results are consistent with the fact that in the Hair Sheep Breeds, the lambing appears behave seasonally. The most important finding is that the lambing period in the crossbred of Katahdin Sheep is similar to the crossbred of Hair Sheep in tropical regions of Mexico. Therefore, the period of greater sexual activity occurs in the spring season. In conclusion, the period of lambing in crossbred of Katahdin ewes appears behave seasonally. Further researches to assess the ovarian activity in different breeds of Hair Ewes are under assessment.

Keywords: Katahdin ewes, lambing, prolificacy, seasonality

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Authors: Saima Shaikh, Andre Brown, Wallace Enegbuma

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Earthquakes strike both developed and developing countries, causing tremendous damage and the loss of lives of millions of people, mainly due to the collapsing of buildings, particularly in poorer countries. Despite the socio-economic and technological restrictions, the poorer countries have adopted proven and established housing-strengthening techniques from affluent countries. Rural communities are aware of the earthquake-strengthening mechanisms for improving housing resilience, but owing to socio-economic and technological constraints, the seismic guidelines are rarely implemented, resulting in informal construction practice. Unregistered skilled laborers make substantial contributions to the informal construction sector, particularly in rural areas where knowledge is scarce. Laborers employ their local expertise in house construction; however, owing to a lack of seismic expertise in safe building procedures, the authorities' regulated seismic norms are not applied. From the perspective of seismic knowledge transformation in safe buildings practices, the study focuses on the feasibility of seismic guidelines implementation. The study firstly employs a literature review of massive-scale reconstruction after the 2005 earthquake in rural Pakistan. The 2005-earthquake damaged over 400,000 homes, killed 70,000 people and displaced 2.8 million people. The research subsequently corroborated the pragmatic approach using questionnaire field survey among the rural people in 2005-earthquake affected areas. Using the literature and the questionnaire survey, the research analyzing people's perspectives on technical acceptability, financial restrictions, and socioeconomic viability and examines the effectiveness of seismic knowledge transfer in safe buildings practices. The findings support the creation of a knowledge transfer framework in disaster mitigation and recovery planning, assisting rural communities and builders in minimising losses and improving response and recovery, as well as improving housing resilience and lowering vulnerabilities. Finally, certain conclusions are obtained in order to continue the resilience research. The research can be further applied in rural areas of developing countries having similar construction practices.

Keywords: earthquakes, knowledge transfer, resilience, informal construction practices

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Authors: Soiduate Ogoye-Atanga

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During funeral ceremonies, it has become common for attendees to jostle for burial programs in some southern Nigerian towns. Beginning from ordinary typewritten text only sheets of paper in the 1980s to their current digitally formatted multicolor magazine style, burial programs continue to be collected and kept in homes where they remain as archival documents of family photo histories and as a veritable form of leveraging family status and visibility in a social economy through the inclusion of lots of choreographically arranged photographs and text. The biographical texts speak of idealized and often lofty and aestheticized accomplishments of deceased peoples, which are often corroborated by an accompanying section of tributes from first the immediate family members, and then from affiliations as well as organizations deceased people belonged, in the form of scanned letterheaded corporate tributes. Others speak of modest biographical texts when the deceased accomplished little. Usually, in majority of the cases, the display of photographs and text in these programs follow a trajectory of historical compartmentalization of the deceased, beginning from parentage to the period of youth, occupation, retirement, and old age as the case may be, which usually drives from black and white historical photographs to the color photography of today. This compartmentalization follows varied models but is designed to show the deceased in varying activities during his lifetime. The production of these programs ranges from the extremely expensive and luscious full colors of near fifty-eighty pages to bland and very simplified low-quality few-page editions in a single color and no photographs, except on the cover. Cost and quality, therefore, become determinants of varying family status and social visibility. By a critical selection of photographs and text, family members construct an idealized image of deceased people and themselves, concentrating on mutuality based on appropriate sartorial selections, socioeconomic grade, and social temperaments that are framed to corroborate the public’s perception of them. Burial magazines, therefore, serve purposes beyond their primary use; they symbolize an orchestrated social site for image-making and the validation of the social status of families, shaped by prior family histories.

Keywords: biographical texts, burial programs, compartmentalization, magazine, multicolor, photo-histories, social status

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Authors: Mawong R., Bussracumpakorn C.

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Millions of young people around the world have been affected by COVID-19 to their psychological and social effects. Millennials’ stresses have been shaped by a few global issues, including climate change, political instability, and financial crisis. In particular, the spread of COVID-19 has become laying psychological and socioeconomic scars on them. When end-of-life planning turns into more widely discussed, the stigma and taboos around this issue are greatly lessened. End-of-life planning is defined as a future life plan, such as financial, legacy, funeral, and memorial planning. This plan would help millennials to discover the value and meaning of life. This study explores the attitudes of Thai Millennials toward end-of-life planning as a new normal awareness of life in order to initiate an innovative service concept to fit with their value and meaning. The study conducts an in-depth interview with 12 potential participants who have awareness or action on the plan. The framework of the customer journey map is used to analyze the responses to examine trigger points, barriers, beliefs, and expectations. The findings pointed to a service concept that is suggested for a new end-of-life planning service that is suited to Thai Millennials in 4 different groups, which are 1. Social -Conscious as a socially aware who to donate time and riches to make the world and society a better place, their end-of-life planning value is inspired by the social impact of giving something or some action that they will be able to do after life or during life which provides a variety of choice based on their preference to give to society, 2. Life Fulfillment who make a life goal for themselves and attempt to achieve it before the time comes to their value will be to inspire life value with a customized plan and provide guidance to suggest, 3. Prevention of the After-Death Effect who want to plan to avoid the effects of their death as patriarch, head of the family, and anchor of someone, so they want to have a plan that brings confidence and feel relief while they are still alive and they want to find some reliable service that they can leave the death will or asset, and 4. No Guilty Planning who plan for when they wish to be worry-free as a self-responsible they want to have the plan which is easy to understand and easy to access. The overall finding of the study is to understand the new service concept of end-of-life planning which to improve knowledge of significant life worth rather than death planning, encouraging people to reassess their lives in a positive way, leading to higher self-esteem and intrinsic motivation for this generation in this time of global crisis.

Keywords: design management, end-of-life planning, millennial generation, service design solution

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Authors: P. W. G. D. P. Samarasekara, S. M. K. S. Seneviratne, D. Munidasa, S. S. Williams

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Sustaining a spinal cord injury (SCI) causes severe disruption of all aspects of a person’s life, resulting in the difficult process of coping with the distressing effects of paralysis affecting their ability to lead a meaningful life. These persons are hospitalized in the acute stage of injury and subsequently for rehabilitation and the treatment of complications. The purpose of this study was to explore coping strategies used by persons with SCI during their rehabilitation period. A qualitative study was conducted among persons with SCI, undergoing rehabilitation at the Rheumatology and Rehabilitation Hospitals, Ragama and Digana Sri Lanka. Twelve participants were selected purposively to represent both males and females, with cervical, thoracic or lumbar levels of injuries due to traumatic and non-traumatic causes as well as from different socioeconomic backgrounds. Informed consent was taken from the participants. In-depth interviews were conducted using an interview guide to collect data. Probes were used to get more information and to encourage participants. Interviews were audio taped and transcribed verbatim. Qualitative content analysis was conducted. Ethical approval for this study was obtained from the Ethics Review Committee, Faculty of Medicine, University of Kelaniya. Five themes were identified in the content analysis: social support, religious beliefs, determination, acceptance and making comparisons. Participants indicated that the support from their family members had been an essential factor in coping, after sustaining an SCI and they expressed the importance of emotional support from family members during their rehabilitation. Many participants had a strong belief towards the God, who had a personal interest in their lives, played an important role in their ability to cope with the injury. They believed that what happens to them in this life results from their actions in previous lives. They expressed that determination was essential as a factor that helps them cope with their injury. They indicated their focus on the positive aspects of the life and accepted the disability. They made comparisons to other persons who were worse off than them to help lift them out of unpleasant experience. Even some of the most severely injured and disabled participants presented evidence of using this coping strategy. Identification of coping strategies used by persons with SCI will help nurses and other health-care professionals in reinforcing the most effective coping strategies among persons with SCI. The findings recommend that engagement coping positively influences psychosocial adaptation.

Keywords: content analysis, coping strategies, rehabilitation, spinal cord injury

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Authors: Moustafa Osman Mohammed

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Construction industry, as one of the main contributor in depletion of natural resources, influences climate change. This paper discusses incremental and evolutionary development of the proposed models for optimization of a life-cycle analysis to explicit strategy for evaluation systems. The main categories are virtually irresistible for introducing uncertainties, uptake composite structure model (CSM) as environmental management systems (EMSs) in a practice science of evaluation small and medium-sized enterprises (SMEs). The model simplified complex systems to reflect nature systems’ input, output and outcomes mode influence “framework measures” and give a maximum likelihood estimation of how elements are simulated over the composite structure. The traditional knowledge of modeling is based on physical dynamic and static patterns regarding parameters influence environment. It unified methods to demonstrate how construction systems ecology interrelated from management prospective in procedure reflects the effect of the effects of engineering systems to ecology as ultimately unified technologies in extensive range beyond constructions impact so as, - energy systems. Sustainability broadens socioeconomic parameters to practice science that meets recovery performance, engineering reflects the generic control of protective systems. When the environmental model employed properly, management decision process in governments or corporations could address policy for accomplishment strategic plans precisely. The management and engineering limitation focuses on autocatalytic control as a close cellular system to naturally balance anthropogenic insertions or aggregation structure systems to pound equilibrium as steady stable conditions. Thereby, construction systems ecology incorporates engineering and management scheme, as a midpoint stage between biotic and abiotic components to predict constructions impact. The later outcomes’ theory of environmental obligation suggests either a procedures of method or technique that is achieved in sustainability impact of construction system ecology (SICSE), as a relative mitigation measure of deviation control, ultimately.

Keywords: sustainability, environmental impact assessment, environemtal management, construction ecology

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Authors: Trude Tørset, María Díez Gutiérrez

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The west coast of Norway features numerous islands and fjords. Ferry services connect the roads when these features make the construction challenging. Currently, scientific effort is designated to assess potential ferry replacement projects along the European road E-39. The inconvenience of ferry dependency is imprecisely represented in the transport models, thus transport analyses of ferry replacement projects appear as guesstimates rather than reliable input to decision-making processes of such costly projects. Trips including ferry connections imply more inconvenient elements than just travel time and cost. The goal of this paper is to understand and explain the extra inconveniences associated to the dependency of the ferry. The first scientific approach is to identify the characteristics of the ferry travelers and their trips’ features, as well as whether the ferry represents an obstacle for some specific trip types. In doing so, a survey was conducted in 2011 in eight E-39 ferries and in 2013 in 18 ferries connecting different road categories. More than 20,000 passengers answered with their trip and socioeconomic characteristics. The travel patterns in the different ferry connections were compared. The analysis showed that the trip features differed based on the location of the ferry connections, yet independently of the road category. Additionally, the patterns were compared to the national travel survey to detect differences in the travel patterns due to the use of the ferry connections. The results showed that the share of commuting trips within the same travel time was lower if the ferry was part of the trip. The second scientific approach is to know how the different travelers perceive potential benefits for a ferry replacement project. In the 2011 survey, some of the questions were about the relevance of nine different benefits this project might bring. Travelers identified the better access to public services and job market as the most valuable benefits, followed by the reduced planning of the trip. In 2016, a follow-up survey in some of the ferry connections was carried out in order to investigate variations in travelers’ perceptions. The growing interest in ferry replacement projects might make travelers more aware of the potential benefits these would bring to their daily lives. This paper describes the travel behaviour of travelers using a ferry connection as part of their trips, as well as the potential inconveniences associated to these trips. The findings might provide valuable input to further development of transport models, concept evaluations and cost benefit analysis methods.

Keywords: ferry connections, ferry trip, inconvenience costs, travel behaviour

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Authors: Franklin Chu Buh, Irene Ule Ngole Sumbele, Andrew I. R. Maas, Mathieu Motah, Jogi V. Pattisapu, Eric Youm, Basil Kum Meh, Firas H. Kobeissy, Kevin W. Wang, Peter J. A. Hutchinson, Germain Sotoing Taiwe

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Introduction: Studying TBI characteristics and their relation to outcomes can identify initiatives to improve TBI prevention and care. The objective of this study was to define the features and outcomes of TBI patients seen over a 1-year period in a level-I trauma center in Cameroon. Methods: Data on demographics, causes, injury mechanisms, clinical aspects, and discharge status were prospectively collected over a period of 12 months. The Glasgow Outcome Scale-Extended (GOSE) and the Quality of Life Questionnaire after Brain Injury (QoLIBRI) were used to evaluate outcomes 6-months after TBI. Categorical variables were described as frequencies and percentages. Comparisons between 2 categorical variables were done using Pearson's Chi-square test or Fisher's exact test. Results: A total of 160 TBI patients participated in the study. The age group 15-45 years (78%; 125) was most represented. Males were more affected (90%; 144). Low educational level was recorded in 122 (76%) cases. Road traffic incidents (RTI) were the main cause of TBI (85%), with professional bike riders being frequently involved (27%, 43/160). Assaults (7.5%) and falls (2.5%) represent the second and third most common causes of TBI in Cameroon, respectively. Only 15 patients were transported to the hospital by ambulance, and 14 of these were from a referring hospital. CT-imaging was performed in 78% (125/160) of cases intracranial traumatic abnormality was identified in 77/125 (64%) cases. Financial constraints were the main reason for not performing a CT scan on 35 patients. A total of 46 (33%) patients were discharged against medical advice (DAMA) due to financial constraints. Mortality was 14% (22/160) but disproportionately high in patients with severe TBI (46%). DAMA had poor outcomes with QoLIBRI. Only 4 patients received post-injury physiotherapy services. Conclusion: TBI in Cameroon mainly results from RTIs and commonly affects young adult males, and low educational or socioeconomic status and commercial bike riding appear to be predisposing factors. Lack of pre-hospital care, financial constraints limiting both CT-scanning and medical care, and lack of acute physiotherapy services likely influenced care and outcomes adversely.

Keywords: characteristics, traumatic brain injury, outcome, disparities in care, prospective study

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Authors: Florim Grajcevci, Flamur Grajcevci, Fatos Tahiri, Hamdi Kurteshi

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The territory of Kosova is actually included in one of the most seismic-prone regions in Europe. Therefore, the earthquakes are not so rare in Kosova; and when they occurred, the consequences have been rather destructive. The importance of assessing the seismic resistance of existing masonry structures has drawn strong and growing interest in the recent years. Engineering included those of Vulnerability, Loss of Buildings and Risk assessment, are also of a particular interest. This is due to the fact that this rapidly developing field is related to great impact of earthquakes on the socioeconomic life in seismic-prone areas, as Kosova and Prishtina are, too. Such work paper for Prishtina city may serve as a real basis for possible interventions in historic buildings as are museums, mosques, old residential buildings, in order to adequately strengthen and/or repair them, by reducing the seismic risk within acceptable limits. The procedures of the vulnerability assessment of building structures have concentrated on structural system, capacity, and the shape of layout and response parameters. These parameters will provide expected performance of the very important existing building structures on the vulnerability and the overall behavior during the earthquake excitations. The structural systems of existing historical buildings in Pristina, Kosovo, are dominantly unreinforced brick or stone masonry with very high risk potential from the expected earthquakes in the region. Therefore, statistical analysis based on the observed damage-deformation, cracks, deflections and critical building elements, would provide more reliable and accurate results for the regional assessments. The analytical technique was used to develop a preliminary evaluation methodology for assessing seismic vulnerability of the respective structures. One of the main objectives is also to identify the buildings that are highly vulnerable to damage caused from inadequate seismic performance-response. Hence, the damage scores obtained from the derived vulnerability functions will be used to categorize the evaluated buildings as “stabile”, “intermediate”, and “unstable”. The vulnerability functions are generated based on the basic damage inducing parameters, namely number of stories (S), lateral stiffness (LS), capacity curve of total building structure (CCBS), interstory drift (IS) and overhang ratio (OR).

Keywords: vulnerability, ductility, seismic microzone, ductility, energy efficiency

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Authors: Jonix Owino, Heather Fuller

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Refugees flee from their home countries due to civil unrest, war, persecution and migrate to Western countries such as the United States in search of a safe haven. Transitioning into a new society and culture can be challenging, thereby affecting refugee’s quality of life and well-being in the host communities. Moreover, as individuals age, they experience physical, cognitive and socioemotional changes that may impact their quality of life. However, little is known about the predictors of quality of life among aging refugees. It is not clear how quality of life varies by age, that is, between midlife refugees in comparison to their older counterparts. In addition to age, other sociodemographic factors such as gender, socioeconomic status, or country of origin are likely to have differential associations to quality of life, yet research on such variations among older refugees is sparse. Thus the present study seeks to explore factors associated with quality of life by asking the following research questions: 1) Do sociodemographic factors (such as age and gender) predict quality of life among older refugees, 2) Is there an association between social integration and quality of life, and 3) Is there an association between migratory related experiences (such as post migratory adjustments) and quality of life. The present study recruited 90 refugees (primarily originating from Bhutan, Somalia, Burundi, and Sudan) aged 50 or older living in the US. The participants completed a structured questionnaire which assessed factors such as participant’s sociodemographic attributes (e.g., age, gender, length of residence in the US, country of origin, employment, level of education, and marital status), and validated measures of social integration, post-migration living difficulties, and quality of life. Preliminary results suggest sociodemographic variability in quality of life among these refugees. Further analyses will be conducted using hierarchical regression analyses to address the following hypotheses: first, it is hypothesized that quality of life will vary by age and gender such that younger refugees and men will report higher quality of life. Second, it is expected that refugees with greater levels of social integration will also report better quality of life. Finally, post-migration factors such as language barriers and family stress are hypothesized to predict poorer quality of life. Further results will be analyzed, including potential moderating effects of age and gender, and resulting findings will be interpreted and discussed. The findings from this study have potential implications for communities on how they can better support older refugees as well as develop social programs that can effectively cater to their well-being. Conclusions will be drawn and discussed in light of policies related to both aging and refugee migration within the context of the US.

Keywords: aging out of place, migration, older refugees, quality of life, social integration

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Authors: Rosa S. Wong, Keith T.S. Tung, H.W. Tsang, Frederick K. Ho, Patrick Ip

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Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by inattention and hyperactive-impulsive behavior. Evidence shows that ADHD and mood problems such as depression and anxiety often co-occur and yet not everyone with ADHD reported elevated emotional problems. Given that cholesterol is essential for healthy brain development including the regions governing emotion regulation, reports found lower cholesterol levels in patients with major depressive disorder and those with suicide attempt behavior compared to healthy subjects. This study explored whether ADHD adolescents experienced more emotional problems and whether emotional problems correlated with cholesterol levels in these adolescents. This study used a portion of data from the longitudinal cohort study which was designed to investigate the long-term impact of family socioeconomic status on child development. In 2018/19, parents of 300 adolescents (average age: 12.57+/-0.49 years) were asked to rate their children’s emotional problems and report whether their children had doctor-diagnosed psychiatric diseases. We further collected blood samples from 263 children to study their lipid profile (total cholesterol, high-density lipoprotein (HDL)-cholesterol, and low-density lipoprotein (LDL)-cholesterol). Regression analyses were performed to test the relationships between variables of interest. Among 300 children, 27 (9%) had ADHD diagnosis. Analysis based on overall sample found no association between ADHD and emotional problems, but when investigating the relationship by gender, there was a significant interaction effect of ADHD and gender on emotional problems (p=0.037), with ADHD males displaying more emotional problems than ADHD females. Further analyses based on 263 children (21 with ADHD diagnosis) found significant interaction effect of ADHD and gender on total cholesterol (p=0.038) and low LDL-cholesterol levels (p=0.013) after adjusting for the child’s physical disease history. Specifically, ADHD males had significantly lower total cholesterol and low lipoprotein-cholesterol levels than ADHD females. In ADHD males, more emotional problems were associated with lower LDL-cholesterol levels (B = -4.26, 95%CI (-7.46, -1.07), p=0.013). We found preliminary support for the association between more emotional problems and lower cholesterol levels in ADHD children, especially among males. Although larger prospective studies are needed to substantiate these claims, the evidence highlights the importance of healthy lifestyle to keep cholesterol levels in normal range which can have positive effects on physical and mental health.

Keywords: attention-deficit hyperactivity disorder, cholesterol, emotional problems, adolescents

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Authors: Emilio Galdeano-Gómez, Ángeles Godoy-Durán, Juan C. Pérez-Mesa, Laura Piedra-Muñoz

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Eco-efficiency is receiving ever-increasing interest as an indicator of sustainability, as it links environmental and economic performances in productive activities. In agriculture, these indicators and their determinants prove relevant due to the close relationships in this activity between the use of natural resources, which is generally limited, and the provision of basic goods to society. In this context, various analyses have focused on eco-efficiency by considering individual family farms as the basic production unit. However, not only must the measure of efficiency be taken into account, but also the existence of a series of factors which constitute socio-economic, political-institutional, and environmental determinants. Said factors have been studied to a lesser extent in the literature. The present work analyzes eco-efficiency at a micro level, focusing on small-scale family farms as the main decision-making units in horticulture in southeast Spain, a sector which represents about 30% of the fresh vegetables produced in the country and about 20% of those consumed in Europe. The objectives of this study are a) to obtain a series of eco-efficiency indicators by estimating several pressure ratios and economic value added in farming, b) to analyze the influence of specific social, economic and environmental variables on the aforementioned eco-efficiency indicators. The present work applies the method of Data Envelopment Analysis (DEA), which calculates different combinations of environmental pressures (water usage, phytosanitary contamination, waste management, etc.) and aggregate economic value. In a second stage, an analysis is conducted on the influence of the socio-economic and environmental characteristics of family farms on the eco-efficiency indicators, as endogeneous variables, through the use of truncated regression and bootstrapping techniques, following Simar-Wilson methodology. The results reveal considerable inefficiency in aspects such as waste management, while there is relatively little inefficiency in water usage and nitrogen balance. On the other hand, characteristics, such as product specialization, the adoption of quality certifications and belonging to a cooperative do have a positive impact on eco-efficiency. These results are deemed to be of interest to agri-food systems structured on small-scale producers, and they may prove useful to policy-makers as regards managing public environmental programs in agriculture.

Keywords: data envelopment analysis, eco-efficiency, family farms, horticulture, socioeconomic features

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Authors: Giorgia Zotti

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This research comprehensively investigates the multifaceted interplay determining school performance, individual backgrounds, and regional disparities within the landscape of Italian secondary education. Leveraging data gleaned from the INVALSI 2021-2022 database, the analysis meticulously scrutinizes two fundamental distributions of educational achievements: the standardized Invalsi test scores and official grades in Italian and Mathematics, focusing specifically on final-year secondary school students in Italy. Applying a comprehensive methodology, the study initially employs Data Envelopment Analysis (DEA) to assess school performances. This methodology involves constructing a production function encompassing inputs (hours spent at school) and outputs (Invalsi scores in Italian and Mathematics, along with official grades in Italian and Math). The DEA approach is applied in both of its versions: traditional and conditional. The latter incorporates environmental variables such as school type, size, demographics, technological resources, and socio-economic indicators. Additionally, the analysis delves into regional disparities by leveraging the Theil Index, providing insights into disparities within and between regions. Moreover, in the frame of the inequality of opportunity theory, the study quantifies the inequality of opportunity in students' educational achievements. The methodology applied is the Parametric Approach in the ex-ante version, considering diverse circumstances like parental education and occupation, gender, school region, birthplace, and language spoken at home. Consequently, a Shapley decomposition is applied to understand how much each circumstance affects the outcomes. The outcomes of this comprehensive investigation unveil pivotal determinants of school performance, notably highlighting the influence of school type (Liceo) and socioeconomic status. The research unveils regional disparities, elucidating instances where specific schools outperform others in official grades compared to Invalsi scores, shedding light on the intricate nature of regional educational inequalities. Furthermore, it emphasizes a heightened inequality of opportunity within the distribution of Invalsi test scores in contrast to official grades, underscoring pronounced disparities at the student level. This analysis provides insights for policymakers, educators, and stakeholders, fostering a nuanced understanding of the complexities within Italian secondary education.

Keywords: inequality, education, efficiency, DEA approach

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Authors: Cynthia Zgheib, Yonna Sacre

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Pregnancy, this particular moment in the life of a woman, requires monitoring of eating behavior changes. However, the food choices during pregnancy should be varied and healthy, including the consumption of different food groups. Nutritional status is the process of acquisition and consumption of food. Therefore, a varied diet is associated with good nutritional status. This is why the nutrition education is a strategy commonly applied to improve maternal nutrition during pregnancy. Thus, it is crucial to assess 'The eating behavior and nutritional status of pregnant women living in Keserwan Lebanon.' In order to evaluate the association of different persona, socioeconomic and sociodemographic factors with the eating behavior and nutrition in the concerned study category, a cross-sectional descriptive study was conducted on a sample of 150 pregnant women aging between 18 and 40 years randomly selected from the hospitals and clinics located in Keserwan area and equally distributed between different cities and villages of the area according to altitude. The purpose of this study was to evaluate the eating behavior of the concerned population and to compare it to the recommendation of the food guide pyramid, their level of food awareness and finally to analyze their blood tests in order to detect any nutrients deficiency that they may face during the course of their pregnancy. Sociodemographic, lifestyle, eating behaviour, health, eating patterns, awareness, and food frequency questionnaire (FFQ) were collected through a validated questionnaire specifically adapted for the purpose of the study. Statistical analysis was carried out, and multivariate models were used in order to evaluate the association between several independent variables and the eating behaviour and nutritional status of Lebanese pregnant women The final analysis has shown that 48.7% of pregnant women were aged between 30 and 40 years old, 56% had a normal BMI between 18.5 and 24.9, thus age affects the eating behavior, so the older are the pregnant women, and the healthier is their eating behavior. In fact, 80.7% had acceptable food behavior which is based on an equilibrium between both quantity and quality of food, although the recommended foods are foods found in the food pyramid and available in the Lebanese diet. In addition, 68% had an acceptable level of awareness concerning the health importance of good eating habits, therefore, it is positively affecting their food choices. Moreover, 50 % have an acceptable nutritional status which is confirmed by their biological tests. Future governmental or national studies and programs could be settled aiming to increase the awareness about the good eating behaviors and nutritional status of Lebanese pregnant women.

Keywords: eating behavior, nutritional status, level of awareness, pregnant woman

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Authors: S. Yesmin, N. F.Rahman, R. Akther, T. Begum, T. Tahmid, T. Chowdury, S. Afrin, J. D. Hamadani

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Abstract: Maternal depression is one of the risk factors of developmental delay in young children in low-income countries. Maternal depressions during pregnancy are rarely reported in Bangladesh. Objectives: The purpose of the present study was to examine the efficacy of a community based psychosocial intervention on women with mild to moderate depressive illness during the perinatal period and on their children from birth to 12 months on mothers’ mental status and their infants’ growth and development. Methodology: The study followed a prospective longitudinal approach with a randomized controlled design. Total 250 pregnant women aged between 15 and 40 years were enrolled in their third trimester of pregnancy of which 125 women were in the intervention group and 125 in the control group. Women in the intervention group received the “Thinking Healthy (CBT based) program” at their home setting, from their last month of pregnancy till 10 months after delivery. Their children received psychosocial stimulation from birth till 12 months. The following instruments were applied to get the outcome information- Bangla version of Edinburgh Postnatal Depression Scale (BEPDS), Prenatal Attachment Inventory (PAI), Maternal Attachment Inventory (MAI), Bayley Scale of Infant Development-Third version (Bayley–III) and Family Care Indicator (FCI). In addition, sever morbidity; breastfeeding, immunization, socio-economic and demographic information were collected. Data were collected at three time points viz. baseline, midline (6 months after delivery) and endline (12 months after delivery). Results: There was no significant difference between any of the socioeconomic and demographic variables at baseline. A very preliminary analysis of the data shows an intervention effect on Socioemotional behaviour of children at endline (p<0.001), motor development at midline (p=0.016) and at endline (p=0.065), language development at midline (p=0.004) and at endline (p=0.023), cognitive development at midline (p=0.008) and at endline (p=0.002), and quality of psychosocial stimulation at midline (p=0.023) and at endline (p=0.010). EPDS at baseline was not different between the groups (p=0.419), but there was a significant improvement at midline (p=0.027) and at endline (p=0.024) between the groups following the intervention. Conclusion: Psychosocial intervention is found effective in reducing women’s low and moderate depressive illness to cope with mental health problem and improving development of young children in Bangladesh.

Keywords: mental health, maternal depression, infant development, CBT, EPDS

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Authors: Najmeh Hamid, Vajiheh Hamedy , Zahra Rostamianasl

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Background: Cancer is one of the medical problems that have been associated with pain. Moreover, the pain is combined with negative emotions such as anxiety, depression and anger. Poor pain management causes negative effects on the quality of life, which results in negative effects that continue a long time after the painful experiences. Objectives: The aim of this research was to compare the effectiveness of Common Cognitive Behavioral Therapy for Pain and its computerized version on the reduction of pain intensity, depression, anger and anxiety in children with cancer. Methods: The research method of this “Randomized Controlled Clinical Trial” was a pre, post-test and follow-up with a control group. In this research, we have examined the effectiveness of Common Cognitive Behavioral Therapy for Pain and its computerized version on the reduction of pain intensity, anxiety, depression and anger in children with cancer in Ahvaz. Two psychological interventions (cognitive behavioral therapy for pain and the computerized version) were compared with the control group. The sample consisted of 60 children aged 8 to 12 years old with different types of cancer at Shafa hospital in Ahwaz. According to the including and excluding criteria such as age, socioeconomic status, clinical diagnostic interview and other criteria, 60 subjects were selected. Then, randomly, 45 subjects were selected. The subjects were randomly divided into three groups of 15 (two experimental and one control group). The research instruments included Spielberger Anxiety Inventory (STAY-2) and International Pain Measurement Scale. The first experimental group received 6 sessions of cognitive-behavioral therapy for 6 weeks, and the second group was subjected to a computerized version of cognitive-behavioral therapy for 6 weeks, but the control group did not receive any interventions. For ethical considerations, a version of computerized cognitive-behavioral therapy was provided to them. After 6 weeks, all three groups were evaluated as post-test and eventually after a one-month follow-up. Results: The findings of this study indicated that both interventions could reduce the negative emotions (pain, anger, anxiety, depression) associated with cancer in children in comparison with a control group (p<0.0001). In addition, there were no significant differences between the two interventions (p<0.01). It means both interventions are useful for reducing the negative effects of pain and enhancing adjustment. Conclusion: we can use CBT in situations in which there is no access to psychologists and psychological services. In addition, it can be a useful alternative to conventional psychological interventions.

Keywords: pain, children, psychological intervention, cancer, anger, anxiety, depression

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Authors: Rekha S., S. J. Nalini, S. Bhuvana, S. Kanmani, Vidhya Venugopal

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Introduction: Pregnant women's occupational heat exposure has been linked to foetal abnormalities and pregnancy complications. The presence of heat in the workplace is expected to lead to Adverse Pregnancy Outcomes (APO), especially in tropical countries where temperatures are rising and workplace cooling interventions are minimal. For effective interventions, in-depth understanding and evidence about occupational heat stress and APO are required. Methodology: Approximately 800 pregnant women in and around Chennai who were employed in jobs requiring moderate to hard labour participated in the cohort research. During the study period (2014-2019), environmental heat exposures were measured using a Questemp WBGT monitor, and heat strain markers, such as Core Body Temperature (CBT) and Urine Specific Gravity (USG), were evaluated using an Infrared Thermometer and a refractometer, respectively. Using a valid HOTHAPS questionnaire, self-reported health symptoms were collected. In addition, a postpartum follow-up with the mothers was done to collect APO-related data. Major findings of the study: Approximately 47.3% of pregnant workers have workplace WBGTs over the safe manual work threshold value for moderate/heavy employment (Average WBGT of 26.6°C±1.0°C). About 12.5% of the workers had CBT levels above the usual range, and 24.8% had USG levels above 1.020, both of which suggested mild dehydration. Miscarriages (3%), stillbirths/preterm births (3.5%), and low birth weights (8.8%) were the most common unfavorable outcomes among pregnant employees. In addition, WBGT exposures above TLVs during all trimesters were associated with a 2.3-fold increased risk of adverse fetal/maternal outcomes (95% CI: 1.4-3.8), after adjusting for potential confounding variables including age, education, socioeconomic status, abortion history, stillbirth, preterm, LBW, and BMI. The study determined that WBGTs in the workplace had direct short- and long-term effects on the health of both the mother and the foetus. Despite the study's limited scope, the findings provided valuable insights and highlighted the need for future comprehensive cohort studies and extensive data in order to establish effective policies to protect vulnerable pregnant women from the dangers of heat stress and to promote reproductive health.

Keywords: adverse outcome, heat stress, interventions, physiological strain, pregnant women

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Authors: Gustavo Cruz-Bello

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Progreso is a coastal community in Yucatan, Mexico, highly exposed to floods produced by severe storms and tropical cyclones. A participatory cartography approach was conducted to help to reduce floods disasters and assess social vulnerability within the community. The first step was to engage local authorities in risk management to facilitate the process. Two workshop were conducted, in the first, a poster size printed high spatial resolution satellite image of the town was used to gather information from the participants: eight women and seven men, among them construction workers, students, government employees and fishermen, their ages ranged between 23 and 58 years old. For the first task, participants were asked to locate emblematic places and place them in the image to familiarize with it. Then, they were asked to locate areas that get flooded, the buildings that they use as refuges, and to list actions that they usually take to reduce vulnerability, as well as to collectively come up with others that might reduce disasters. The spatial information generated at the workshops was digitized and integrated into a GIS environment. A printed version of the map was reviewed by local risk management experts, who validated feasibility of proposed actions. For the second workshop, we retrieved the information back to the community for feedback. Additionally a survey was applied in one household per block in the community to obtain socioeconomic, prevention and adaptation data. The information generated from the workshops was contrasted, through T and Chi Squared tests, with the survey data in order to probe the hypothesis that poorer or less educated people, are less prepared to face floods (more vulnerable) and live near or among higher presence of floods. Results showed that a great majority of people in the community are aware of the hazard and are prepared to face it. However, there was not a consistent relationship between regularly flooded areas with people’s average years of education, house services, or house modifications against heavy rains to be prepared to hazards. We could say that the participatory cartography intervention made participants aware of their vulnerability and made them collectively reflect about actions that can reduce disasters produced by floods. They also considered that the final map could be used as a communication and negotiation instrument with NGO and government authorities. It was not found that poorer and less educated people are located in areas with higher presence of floods.

Keywords: climate change, floods, Mexico, participatory mapping, social vulnerability

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Authors: Madeleine Elder, Aye Htun

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Background: Myiasis is the parasitic infestation of body tissues by fly larvae. It predominantly occurs in poor socioeconomic regions of tropical and subtropical countries where it is associated with poor hygiene and sanitation. Cutaneous and wound myiasis are the most common presentations whereas urogenital myiasis is rare, with few reported cases. Case: a 26-year-old primiparous woman with a low-risk pregnancy presented to the emergency department at 37+3-weeks’ gestation after passing a 2cm black larva during micturition, with 2 weeks of mild vulvar pruritus and dysuria. She had travelled to India 9-months prior. Examination of the external genitalia showed small white larvae over the vulva and anus and a mildly inflamed introitus. Speculum examination showed infiltration into the vagina and heavy white discharge. High vaginal swab reported Candida albicans. Urine microscopy reported bacteriuria with Enterobacter cloacae. Urine parasite examination showed myiasis caused by Clogmia albipunctata species of fly larvae from the family Psychodidae. Renal tract ultrasound and inflammatory markers were normal. Infectious diseases, urology and paediatric teams were consulted. The woman received treatment for her urinary tract infection (which was likely precipitated by bladder irritation from local parasite infestation) and vaginal candidiasis. She underwent daily physical removal of parasites with cleaning, speculum examination and removal, and hydration to promote bladder emptying. Due to the risk of neonatal exposure, aspiration pneumonitis and facial infestation, the woman was steroid covered and proceeded to have an elective caesarean section at 38+3-weeks’ gestation, with delivery of a healthy infant. She then proceeded to have a rigid cystoscopy and washout, which was unremarkable. Placenta histopathology revealed focal eosinophilia in keeping with the history of maternal parasites. Conclusion: Urogenital myiasis is very rare, especially in the developed world where it is seen in returned travellers. Treatment may include systemic therapy with ivermectin and physical removal of parasites. During pregnancy, physical removal is considered the safest treatment option, and discussion around the timing and mode of delivery should consider the risk of harm to the foetus.

Keywords: urogenital myiasis, parasitic infection, infection in pregnancy, returned traveller

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Authors: Lucrezia Crescenzi-Lanna, Silvia Cataldi, Williams Contreras, Valerio Pieri

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According to the European Commission, gender-based violence (GBV) is a violation of human rights and a form of discrimination against women in five areas: physical violence, sexual violence, psychological violence, mistreatment of women, and economic violence (henceforth EV). The TESORO project "Treatment, ExpoSition, and ORigin of economic viOlence: An innovation and internationalization project between Italy and Spain" focuses on this last dimension of gender-based violence, the least studied and the one that has received least media coverage. In Spain, 12% (2,350,684) of women over fifteen years of age have suffered economic violence from their partner or ex-partner during their lives. In Italy, another country participating in the project, many women who are welcomed in refuges and who report cases of psychological violence (79%) and/or physical violence (61%) are also victims of economic violence (34%), according to the D.i.Re. Thermometer: "Donne in Rete contro la Violenza", the association that brings together more than eighty refuges against violence in Italy. At the social level, this form of violence is incorporated into practices of inequality that manifest themselves in both the daily management of couples and families and the workplace and institutional settings. As for the mechanisms related to EV, the literature argues that it is a complex and multidimensional phenomenon that has socioeconomic and cultural roots. EV manifests itself through various strategies, which represent forms of power and control aimed at preventing women's financial independence. To analyse the issue of EV we use a multidisciplinary approach and a mixed design that includes: 1) a questionnaire administered to a stratified sample of more than a thousand Italian and Spanish citizens to study the cultural and socio-relational mechanisms and the origin of EV in family and couple contexts; and 2) interviews with those running refuges as part of the struggle against gender violence, to understand how mechanisms and educational activities in the field of economic violence are manifested in the respective region and are supportive of women. The decision to use this strategy responds to the need to combine an exploratory perspective with an explanatory one in order to understand some of the relevant concepts related to the complex phenomena of EV and the interventions dedicated to its prevention. The data will be finalized in June 2022 and presented at the ICWS conference. Among TESORO’s contributions, its collection of qualitative and quantitative data on EV in Italy and Spain stands out, deepening its origin, prevention, and treatment beyond its incidence, which has already been studied in the Macro-Survey on Violence against Women.

Keywords: gender-based violence, economic violence, economic harm, gender inequality, workplace and family contexts

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Authors: Sedigheh Kalantari

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Like many countries in the arid and semi-arid belt, Iran experiences a natural limitation in the availability of water resources. However, rapid socioeconomic development has created a serious water crisis in a nation that was once one of the world’s pioneers in sustainable water management, due to the Persians’ contribution to hydraulic engineering inventions – the Qanat – throughout history. The exogenous issues like the changing climate, frequent droughts, and international sanctions are only crisis catalyzers, not the main cause of the water crisis; and a resilient water management system is expected to be capable of coping with these periodic external pressures. The current dramatic water security issues in Iran are rooted in managerial, political, and institutional challenges rather than engineering and technical issues, and the country is suffering from challenges in water governance. The country, instead of rigorous water conservation efforts, is still focused on supply-driven approach, technology and centralized methods, and structural solutions that aim to increase water supply; while the effectiveness of water governance and management has often left unused. To solve these issues, it is necessary to assess the present situation and its evolution over time. In this respect, establishing water governance assessment mechanisms will be a significant aspect of this paper. The research framework, however, is a conceptual framework to assess governance performance of Iran to critically diagnose problematic issues and areas, as well as proffer empirically based solutions and determine the best possible steps towards transformational processes. This concept aims to measure the adequacy of current solutions and strategies designed to ameliorate these problems and then develop and prescribe adequate futuristic solutions. Thus, the analytical framework developed in this paper seeks to provide insights on key factors influencing water governance in Iranian cities, institutional frameworks to manage water across scales and authorities, multi-level management gaps and policy responses, through an evidence-based approach and good practices to drive reform toward sustainability and water resource conservation. The findings of this paper show that the current structure of the water governance system in Iran, coupled with the lack of a comprehensive understanding of the root causes of the problem, leaves minimal hope for developing sustainable solutions to Iran’s increasing water crisis. In order to follow sustainable development approaches, Iran needs to replace symptom management with problem prevention.

Keywords: governance, Iran, sustainable development, water management, water resources

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