Search results for: health access
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 11259

Search results for: health access

6429 Structural Health Monitoring using Fibre Bragg Grating Sensors in Slab and Beams

Authors: Pierre van Tonder, Dinesh Muthoo, Kim twiname

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Many existing and newly built structures are constructed on the design basis of the engineer and the workmanship of the construction company. However, when considering larger structures where more people are exposed to the building, its structural integrity is of great importance considering the safety of its occupants (Raghu, 2013). But how can the structural integrity of a building be monitored efficiently and effectively. This is where the fourth industrial revolution step in, and with minimal human interaction, data can be collected, analysed, and stored, which could also give an indication of any inconsistencies found in the data collected, this is where the Fibre Bragg Grating (FBG) monitoring system is introduced. This paper illustrates how data can be collected and converted to develop stress – strain behaviour and to produce bending moment diagrams for the utilisation and prediction of the structure’s integrity. Embedded fibre optic sensors were used in this study– fibre Bragg grating sensors in particular. The procedure entailed making use of the shift in wavelength demodulation technique and an inscription process of the phase mask technique. The fibre optic sensors considered in this report were photosensitive and embedded in the slab and beams for data collection and analysis. Two sets of fibre cables have been inserted, one purposely to collect temperature recordings and the other to collect strain and temperature. The data was collected over a time period and analysed used to produce bending moment diagrams to make predictions of the structure’s integrity. The data indicated the fibre Bragg grating sensing system proved to be useful and can be used for structural health monitoring in any environment. From the experimental data for the slab and beams, the moments were found to be64.33 kN.m, 64.35 kN.m and 45.20 kN.m (from the experimental bending moment diagram), and as per the idealistic (Ultimate Limit State), the data of 133 kN.m and 226.2 kN.m were obtained. The difference in values gave room for an early warning system, in other words, a reserve capacity of approximately 50% to failure.

Keywords: fibre bragg grating, structural health monitoring, fibre optic sensors, beams

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6428 Motivational Factors for the Practice of Exercise in a Sample of Portuguese Fitness Center Users

Authors: N. Sena, C. Vasconcelos

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Portugal has a lower rate of people who exercise. Fitness centers are a widely recognized context for the performance of an exercise. Thus, the objective of this study is to analyze the motivational factors for the practice of exercise in a sample of Portuguese fitness center users. The sample consists of 34 users (23 men and 11 women), aged between 16 and 60 years old (24.7 ± 11,5 years old). The instrument used for data collection was the Motivation Questionnaire for Exercise (version translated and validated into Portuguese), consisting of forty-nine items grouped into ten motivational factors. Responses to the Exercise Motivation Questionnaire are given on a 6-point Likert scale (0="not at all true for me" to 5="completely true for me"). With regard to the results, it is possible to verify that the motivational factors considered most relevant by the sample of our study were “Well-being” (4.44 ± 0.28), followed by “Health” (4.29 ± 0.57) and “Stress Management” (4.06 ± 0.54). The factors “Affiliation” (3.11 ± 0.49) “Personal Appreciation” (2.26 ± 0.59) and “Medical History” (1.71 ± 0.74) were considered by the respondents to be the least important factors for performing the exercise. The conclusion of this study is that in the sample of this study, the factors that most motivated the practice of exercise were “Well-being”, “Health” and “Stress Management”. In the opposite direction, the factors that least motivated the individuals in this sample to practice exercise were “Affiliation”, “Personal Appreciation” and “Medical History”.

Keywords: exercise, fitness center users, motivational factors, Portugal

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6427 Remedying the Scourge of Poverty as a Social Problem: The Islamic Perspective

Authors: Maryam Umar Ladan, Arshad Munir

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Poverty has always been a constant feature of society throughout history. It has existed in the lives of people and it is a fact that although the majority of people lives in poverty, the remaining minority lives in luxury. While some countries called the first World countries lives in luxury, the third World countries lives in poverty. It remains an undesirable phenomenon affecting a vast number of people across the globe despite governmental, institutional and private organizations’ interventions with measures aimed at cushioning its adverse effects. Unequal distribution of societal resources, accumulated wealth in the hands of few, lack of access to education and employment, individual responsibility among others, were highlighted as factors associated with poverty. Poverty predisposes the poor individual to malnutrition and starvation, exposure to disease, thereby resulting to violence, crimes, and experiencing lifelong problems. Evidence show that about 50 percent of the world population lives on less than 2.50 dollar a day, 90 percent of whom are from Sub-Saharan Africa and South Asia including countries where Islam is the major if not one adherent religion. As a solution to poverty, Islam prescribes a system of annual Zakat (charity). The Islamic law prescribes that every person who has a saving that reaches a certain limit should give out 2.5 percent of the total annual earning (as in income, money, farm produce) to deserving and prescribed citizens. This is to, among others; reduce the level of inequality through distribution of wealth among the Muslim Ummah (community). Furthermore, Islam encourages the rich in several places in the Qur’an to spend their wealth on poor people other than the compulsory 2.5%. Therefore, it is inarguable that the Islamic system of distribution of resources (as zakat) is the best strategy to poverty eradication. Thus, strongly recommended for desired results in poverty eradication efforts. If every rich person gives Zakat sincerely, poverty will be eradicated in the world, and not a single person will die of want of food or material things.

Keywords: Islam, charity, poverty, zakat

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6426 Collateral Impact of Water Resources Development in an Arsenic Affected Village of Patna District

Authors: Asrarul H. Jeelani

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Arsenic contamination of groundwater and its’ health implications in lower Gangetic plain of Indian states started reporting in the 1980s. The same period was declared as the first water decade (1981-1990) to achieve ‘water for all.’ To fulfill the aim, the Indian government, with the support of international agencies installed millions of hand-pumps through water resources development programs. The hand-pumps improve the accessibility if the groundwater, but over-extraction of it increases the chances of mixing of trivalent arsenic which is more toxic than pentavalent arsenic of dug well water in Gangetic plain and has different physical manifestations. Now after three decades, Bihar (middle Gangetic plain) is also facing arsenic contamination of groundwater and its’ health implications. Objective: This interdisciplinary research attempts to understand the health and social implications of arsenicosis among different castes in Haldi Chhapra village and to find the association of ramifications with water resources development. Methodology: The Study used concurrent quantitative dominant mix method (QUAN+qual). The researcher had employed household survey, social mapping, interviews, and participatory interactions. However, the researcher used secondary data for retrospective analysis of hand-pumps and implications of arsenicosis. Findings: The study found 88.5% (115) household have hand-pumps as a source of water however 13.8% uses purified supplied water bottle and 3.6% uses combinations of hand-pump, bottled water and dug well water for drinking purposes. Among the population, 3.65% of individuals have arsenicosis, and 2.72% of children between the age group of 5 to 15 years are affected. The caste variable has also emerged through quantitative as well as geophysical locations analysis as 5.44% of arsenicosis manifested individual belong to scheduled caste (SC), 3.89% to extremely backward caste (EBC), 2.57% to backward caste (BC) and 3% to other. Among three clusters of arsenic poisoned locations, two belong to SC and EBC. The village as arsenic affected is being discriminated, whereas the affected individual is also facing discrimination, isolation, stigma, and problem in getting married. The forceful intervention to install hand-pumps in the first water decades and later restructuring of the dug well destroyed a conventional method of dug well cleaning. Conclusion: The common manifestation of arsenicosis has increased by 1.3% within six years of span in the village. This raised the need for setting up a proper surveillance system in the village. It is imperative to consider the social structure for arsenic mitigation program as this research reveals caste as a significant factor. The health and social implications found in the study; retrospectively analyzed as the collateral impact of water resource development programs in the village.

Keywords: arsenicosis, caste, collateral impact, water resources

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6425 Role of Nano-Technology on Remediation of Poly- and Perfluoroalkyl Substances Contaminated Soil and Ground Water

Authors: Leila Alidokht

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PFAS (poly- and perfluoroalkyl substances) are a large collection of environmentally persistent organic chemicals of industrial origin that have a negative influence on human health and ecosystems. Many distinct PFAS are being utilized in a wide range of applications (on the order of thousands), and there is no comprehensive source of information on the many different compounds and their roles in diverse applications. Facilities are increasingly looking into ways to reduce waste from cleanup projects. PFAS are widespread in the environment, have been found in a wide range of human biomonitoring investigations, and are a rising source of regulatory concern for federal, state, and local governments. Nanotechnology has the potential to contribute considerably to the creation of a cleaner, greener technologies with considerable environmental and health benefits. Nanotechnology approaches are being studied for their potential to provide pollution management and mitigation options, as well as to increase the effectiveness of standard environmental cleanup procedures. Diversified nanoparticles have shown useful in removing certain pollutants from their original environment, such as sewage spills and landmines. Furthermore, they have a low hazardous effect during production rates and can thus be thoroughly explored in the future to make them more compatible with lower production costs.

Keywords: PFOS, PFOA, PFAS, soil remediation

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6424 Rheological Properties and Consumer Acceptability of Supplemented with Flaxseed

Authors: A. Albaridi Najla

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Flaxseed (Linum usitatissimum) is well known to have beneficial effect on health. The seeds are rich in protein, α-linolenic fatty acid and dietary fiber. Bakery products are important part of our daily meals. Functional food recently received considerable attention among consumers. The increase in bread daily consumption leads to the production of breads with functional ingredients such as flaxseed The aim of this Study was to improve the nutritional value of bread by adding flaxseed flour and assessing the effect of adding 0, 5, 10 and 15% flaxseed on whole wheat bread rheological and sensorial properties. The total consumer's acceptability of the flaxseed bread was assessed. Dough characteristics were determined using Farinograph (C.W. Brabender® Instruments, Inc). The result shows no change was observed in water absorption between the stander dough (without flaxseed) and the bread with flaxseed (67%). An Increase in the peak time and dough stickiness was observed with the increase in flaxseed level. Further, breads were evaluated for sensory parameters, colour and texture. High flaxseed level increased the bread crumb softness. Bread with 5% flaxseed was optimized for total sensory evaluation. Overall, flaxseed bread produced in this study was highly acceptable for daily consumption as a functional foods with a potentially health benefits.

Keywords: bread, flaxseed, rheological properties, whole-wheat bread

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6423 Comprehensive Literature Review of the Humanistic Burden of Clostridium (Clostridiodes) difficile Infection

Authors: Caroline Seo, Jennifer Stephens, Kirstin H. Heinrich

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Background: Clostridiodes (formerly Clostridium) difficile infection (CDI) is an anaerobic, spore-forming bacterium with manifestations including diarrhea, pseudomembranous colitis and toxic megacolon. Despite general understanding that CDI may be associated with marked burden on patients’ health, there has been limited information available on the humanistic burden of CDI. The objective of this literature review was to summarize the published data on the humanistic burden of CDI globally, in order to better inform future research efforts and increase awareness of the patient perspective in this disease. Methods: A comprehensive literature review of the past 15 years (2002-2017) was conducted using MEDLINE, Embase and Cumulative Index of Nursing and Allied Health Literature. Additional searches were conducted from conference proceedings (2015-2017). Articles selected were studies specifically designed to examine the humanistic burden of illness associated with adult patients with CDI. Results: Of 3,325 articles or abstracts identified, 33 remained after screening and full text review. Sixty percent (60%) were published in 2016 or 2017. Data from the United States or Western Europe were most common. Data from Brazil, Canada, China and Spain also exist. Thirteen (13) studies used validated patient-reported outcomes instruments, mostly EQ-5D utility and SF-36 generic instruments. Three (3) studies used CDI-specific instruments (CDiff32, CDI-DaySyms). The burden of CDI impacts patients in multiple health-related quality of life (HRQOL) domains. SF-36 domains with the largest decrements compared to other GI diarrheal diseases (IBS-D and Crohn’s) were role physical, physical functioning, vitality, social functioning, and role emotional. Reported EQ-5D utilities for CDI ranged from 0.35-0.42 compared to 0.65 in Crohn’s and 0.72 in IBS-D. The majority of papers addressed physical functioning and mental health domains (67% for both). Across various studies patients reported weakness, lack of appetite, sleep disturbance, functional dependence, and decreased activities of daily lives due to the continuous diarrhea. Due to lack of control over this infection, CDI also impacts the psychological and emotional quality of life of the patients. Patients reported feelings of fear, anxiety, frustration, depression, and embarrassment. Additionally, the type of disease (primary vs. recurrent) may impact mental health. One study indicated that there is a decrement in SF-36 mental scores in patients with recurrent CDI, in comparison to patients with primary CDI. Other domains highlighted by these studies include pain (27%), social isolation (27%), vitality and fatigue (24%), self-care (9%), and caregiver burden (0%). Two studies addressed work productivity, with 1 of these studies reporting that CDI patients had the highest work productivity and activity impairment scores among the gastrointestinal diseases. No study specifically included caregiver self-report. However, 3 studies did provide mention of patients’ worry on how their diagnosis of CDI would impact family, caregivers, and/or friends. Conclusions: Despite being a serious public health issue there has been a paucity of research on the HRQOL among those with CDI. While progress is being made, gaps exist in understanding the burden on patients, caregivers, and families. Future research is warranted to aid understanding of the CDI patient perspective.

Keywords: burden, Clostridiodes, difficile, humanistic, infection

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6422 Comparative Analysis of Decentralized Financial Education Systems: Lessons From Global Implementations

Authors: Flex Anim

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The financial system is a decentralized studies system that was put into place in Ghana as a grassroots financial studies approach. Its main goal is to give people the precise knowledge, abilities, and training required for a given trade, business, profession, or occupation. In this essay, the question of how the financial studies system's devolution to local businesses results in responsible and responsive representation as well as long-term company learning is raised. It centers on two case studies, Asekwa Municipal and Oforikrom. The next question posed by the study is how senior high school students are rebuilding their livelihoods and socioeconomic well-being by creating new curriculum and social practices related to the finance and business studies system. The paper here concentrates on Kumasi District and makes inferences for the other two examples. The paper demonstrates how the financial studies system's establishment of representative groups creates the democratic space required for the successful representation of community goals. Nonetheless, the interests of a privileged few are advanced as a result of elite capture. The state's financial and business training programs do not adhere to the financial studies system's established policy procedures and do not transfer pertinent and discretionary resources to local educators. As a result, local educators are unable to encourage representation that is accountable and responsive. The financial studies system continues to pique the interest of rural areas, but this desire is skewed toward getting access to financial or business training institutions for higher education. Since the locals are not actively involved in financial education, the financial studies system serves just to advance the interests of specific populations. This article explains how rhetoric and personal benefits can be supported by the public even in the case of "failed" interventions.

Keywords: financial studies system, financial studies' devolution, local government, senior high schools and financial education, as well as community goals and representation

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6421 The Effect of Intimate Partner Violence Prevention Program on Knowledge and Attitude of Victims

Authors: Marzieh Nojomi, Azadeh Mottaghi, Arghavan Haj-Sheykholeslami, Narjes Khalili, Arash Tehrani Banihashemi

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Background and objectives: Domestic violence is a global problem with severe consequences throughout the life of the victims. Iran’s Ministry of Health has launched an intimate partner violence (IPV) prevention program, integrated in the primary health care services since 2016. The present study is a part of this national program’s evaluation. In this section, we aimed to examine spousal abuse victims’ knowledge and attitude towards domestic violence before and after receivingthese services. Methods: To assess the knowledge and attitudes of victims, a questionnaire designed by Ahmadzadand colleagues in 2013 was used. This questionnaire includes 15 questions regarding knowledge in the fields of definition, epidemiology, and effects on children, outcomes, and prevention of domestic violence. To assess the attitudes, this questionnaire has 10 questions regarding the attitudes toward the causes, effects, and legal or protective support services of domestic violence. To assess the satisfaction and the effect of the program on prevention or reduction of spousal violence episodes, two more questions were also added. Since domestic violence prevalence differs in different parts of the country, we chose nine areas with the highest, the lowest, and moderate prevalence of IPVfor the study. The link to final electronic version of the questionnaire was sent to the randomly selected public rural or urban health centers in the nine chosen areas. Since the study had to be completed in one month, we used newly identified victims as pre-intervention group and people who had at least received one related service from the program (like psychiatric consultation, education about safety measures, supporting organizations and etc.) during the previous year, as our post- intervention group. Results: A hundred and ninety-two newly identified IPV victims and 267 victims who had at least received one related program service during the previous year entered the study. All of the victims were female. Basic characteristics of the two groups, including age, education, occupation, addiction, spouses’ age, spouses’ addiction, duration of the current marriage, and number of children, were not statistically different. In knowledge questions, post- intervention group had statistically better scores in the fields of domestic violence outcomes and its effects on children; however, in the remaining areas, the scores of both groups were similar. The only significant difference in the attitude across the two groups was in the field of legal or protective support services. From the 267 women who had ever received a service from the program, 91.8% were satisfied with the services, and 74% reported a decrease in the number of violent episodes. Conclusion: National IPV prevention program integrated in the primary health care services in Iran is effective in improving the knowledge of victims about domestic violence outcomes and its effects on children. Improving the attitude and knowledge of domestic violence victims about its causes and preventive measures needs more effective interventions. This program can reduce the number of IPV episodes between the spouses, and satisfaction among the service users is high.

Keywords: intimate partner violence, assessment, health services, efficacy

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6420 Supply, Trade-offs, and Synergies Estimation for Regulating Ecosystem Services of a Local Forest

Authors: Jang-Hwan Jo

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The supply management of ecosystem services of local forests is an essential issue as it is linked to the ecological welfare of local residents. This study aims to estimate the supply, trade-offs, and synergies of local forest regulating ecosystem services using a land cover classification map (LCCM) and a forest types map (FTM). Rigorous literature reviews and Expert Delphi analysis were conducted using the detailed variables of 1:5,000 LCCM and FTM. Land-use scoring method and Getis-Ord Gi* Analysis were utilized on detailed variables to propose a method for estimating supply, trade-offs, and synergies of the local forest regulating ecosystem services. The analysis revealed that the rank order (1st to 5th) of supply of regulating ecosystem services was Erosion prevention, Air quality regulation, Heat island mitigation, Water quality regulation, and Carbon storage. When analyzing the correlation between defined services of the entire city, almost all services showed a synergistic effect. However, when analyzing locally, trade-off effects (Heat island mitigation – Air quality regulation, Water quality regulation – Air quality regulation) appeared in the eastern and northwestern forest areas. This suggests the need to consider not only the synergy and trade-offs of the entire forest between specific ecosystem services but also the synergy and trade-offs of local areas in managing the regulating ecosystem services of local forests. The study result can provide primary data for the stakeholders to determine the initial conditions of the planning stage when discussing the establishment of policies related to the adjustment of the supply of regulating ecosystem services of the forests with limited access. Moreover, the study result can also help refine the estimation of the supply of the regulating ecosystem services with the availability of other forms of data.

Keywords: ecosystem service, getis ord gi* analysis, land use scoring method, regional forest, regulating service, synergies, trade-offs

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6419 Zooplankton Health Status Monitoring in Bir Mcherga Dam (Tunisia)

Authors: Sabria Barka, Imen Gdara, Zouhour Ouanès, Samia Mouelhi, Monia El Bour, Amel Hamza-Chaffai

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Because dams are large semi-closed reservoirs of pollutants originating from numerous anthropogenic activities, they represent a threat to aquatic life and they should be monitored. The present work aims to use freshwater zooplankton (Copepods and Cladocerans) in order to evaluate the environmental health status of Bir M'cherga dam in Tunisia. Animals were collected in situ monthly between October and August. Genotoxicity (micronucleus test), neurotoxicity (acetylcholinesterase, AChE) and oxidative stress (catalase, CAT and malondialdehyde, MDA) biomarkers were analyzed in zooplankton. High frequencies of micronucleus were observed in zooplankton cells during summer. AChE activities were inhibited during early winter and summer. CAT and MDA biomarker levels showed high seasonal variability, suggesting that animals are permanently exposed to multiple oxidative stress. The results of this study suggest that the Bir Mcherga dam is subject to continuous multi-origin stress, probably amplified by abiotic parameters. It is then recommended to urgently monitor freshwater environments in Tunisia, especially those used for irrigation and consumption.

Keywords: Biomonitoring, Bir Mcherga Dam, cladocerans, copepods, freshwater zooplankton, genotoxicity, neurotoxicity, oxidative stress, Tunisia

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6418 Seroprevalence of Hepatitis B and C among Healthcare Workers in Dutse Metropolis, Jigawa State, Nigeria

Authors: N. M. Sani, I. Bitrus, A. M. Sarki, N. S. Mujahid

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Hepatitis is one of the neglected infectious diseases in sub Saharan Africa, and most of the available data is based on blood donors. Health care workers (HCWs) often get infected as a result of their close contact with patients. A cross-sectional study was conducted to determine the prevalence of hepatitis B and C among this group of professionals with a view to improving the quality of care to their patients. Hepatitis B and C infections pose a major public health problem worldwide. While infection is highest in the developing world particularly Asia and sub-Saharan Africa, healthcare workers are at higher risk of acquiring blood-borne viral infections, particularly Hepatitis B and C which are mostly asymptomatic. This study was aimed at determining the prevalence of Hepatitis B and C infections and associated risk factors among health care workers in Dutse Metropolis, Jigawa State - Nigeria. A standard rapid immuno-chromatographic technique i.e. rapid ELISA was used to screen all sera for Hepatitis B surface antigen (HBsAg) and Hepatitis C viral antibody (HCVAb) respectively. Strips containing coated antibodies and antigens to HBV and HCV respectively were removed from the foil. Strips were labeled according to samples. Using a separate disposable pipette, 2 drops of the sample (plasma) were added into each test strip and allowed to run across the absorbent pad. Results were read after 15 minutes. The prevalence of HBV and HCV infection in 100 healthcare workers was determined by testing the plasma collected from the clients during their normal checkup using HBsAg and HCVAb test strips. Results were subjected to statistical analysis using chi-square test. The prevalence of HBV among HCWs was 19 out of 100 (19.0%) and that of HCV was 5 out of 100 (5.0%) where in both cases, higher prevalence was observed among female nurses. It was also observed that all HCV positive cases were recorded among nurses only. The study revealed that nurses are at greater risk of contracting HBV and HCV due to their frequent contact with patients. It is therefore recommended that effective vaccination and other infection control measures be encouraged among healthcare workers.

Keywords: prevalence, hepatitis, viruses, healthcare workers, infection

Procedia PDF Downloads 350
6417 Women Entrepreneuship in Croatia: Issues and Policies

Authors: Marko Kolakovic, Mihaela Mikic, Martina Taborin

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Women entrepreneurship is often regarded as the unused economical potential in many countries, including Republic of Croatia. Although women represent a majority in the population, they are still a minority in the field of entrepreneurship and face many challenges in fulfilling their entrepreneurship potential. The reasons are often hided in historical distorted perceptions about value, credibility, competitiveness, responsibility and knowledge which women have, or can have. This is significant for at least two reasons. First, in terms of global economic crisis, the economy needs more quality, more skilled and educated people willing to face entrepreneurial challenges and create new jobs, new opportunities and higher living standards. Second, in the entrepreneurial activity, women finally have a chance to highlight their own abilities, such as knowledge, relentless work, organizational skills, communication and negotiation skills, responsibility, flexibility, etc., in order to insure their economic independence, for a better social position, and to increase confidence and faith in their own abilities. This paper empirically analyses characteristics of women entrepreneurship in Croatia and conducted policies for it improvement. An empirical research was conducted with the goal of discovering real life experiences and attitudes of Croatian women entrepreneurs. Results show that Croatian women entrepreneurs are usually highly educated, have previous work experience and operate in service sector, due to lower need for start-up capital. The biggest obstacle on their entrepreneurial path represents government bureaucracy. Although the number of women entrepreneurs is rising today and the gap between male and women entrepreneurs in Croatia, as well as women entrepreneurship levels lower than the European average, we believe that there is still a long way to reach potential and successful women entrepreneurship development. Research showed that by breaking down the barriers as access to finance, education investments, knowledge, skills and confidence development, women will be able to accomplish more significant and more efficient entrepreneurial outcome.

Keywords: Croatia, policy, SMEs, women entrepreneurial strategy, women entrepreneurship

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6416 Healthy Beverages Made from Grape Juice: Antioxidant, Energetic, and Isotonic Components

Authors: Yasmina Bendaali, Cristian Vaquero, Carlos Escott, Carmen González, Antonio Morata

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Consumer tendencies to healthy eating habits and request for organic beverages led to the production of new drinks from fruit juices as a source of nutrients and bioactive compounds. Grape juice is a rich source of sugars, organic acids, and phenolic compounds, which define its beneficial effect on health and the attractive sensory profile for consumers' choices (color, taste, flavor). Thus, grape juice was used as a source of sugars, avoiding the addition of sweeteners by diluting it with mineral water to obtain the sugar concentration recommended for isotonic drinks (6% to 8%) to provide energy during physical activities. In addition, phenolic compounds of grape juice are associated with many human health benefits, mainly antioxidant activity, which helps to prevent different diseases associated with oxidative stress, including cancers and cardiovascular and neurodegenerative diseases. Furthermore, physical exercise has been shown to increase the production of free radicals and other reactive oxygen species. Thus, athletes need to improve their antioxidant defense systems to prevent oxidative damage. Different studies have demonstrated the positive effect of grape juice consumption during physical activities, which improves antioxidant activity and performance, protects against oxidative damage, and reduces inflammation. Thus, the use of grape juice to develop isotonic drinks can provide isotonic drinks with antioxidant and biological activities in addition to their principal role of rehydration and replacement of minerals and carbohydrates during physical exercises. Moreover, attractive sensory characteristics, mainly color, which is provided by anthocyanin content, have a great contribution to making the drinks more natural and help to dispense the use of synthetic dyes in addition to the health benefits which will be a novel product in the field of healthy beverages responding on the demand of consumers for new, innovative, and healthy products.

Keywords: grape juice, isotonic, antioxidants, anthocyanins, natural, sport

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6415 Prevalence and Factors Associated With Concurrent Use of Herbal Medicine and Anti-retroviral Therapy Among HIV/Aids Patients Attending Selected HIV Clinics in Wakiso District

Authors: Nanteza Rachel

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Background: Worldwide, there were 36.7 million people living with Human Immunodeficiency Virus (HIV) in 2015, up from 35 million at the end of 2013. Wakiso district is one of the hotspots for the Human Immunodeficiency Virus (HIV)/ Acquired Immune Deficiency Syndrome (AIDS) infection in Uganda, with the prevalence of 8.1 %. Herbal medicine has gained popularity among Human Immunodeficiency Virus (HIV)/ Acquired Immune Deficiency Syndrome (AIDS) patients as adjuvant therapy to reduce the adverse effects of ART. Regardless of the subsidized and physical availability of the Anti-Retroviral Therapy (ART), majority of Africans living with Human Immunodeficiency Virus (HIV)/ Acquired Immune Deficiency Syndrome (AIDS) resort to adding to their ART traditional medicine. Result found out from a pilot observation made by the PI that indicate 13 out of 30 People Living with AIDS(PLWA) who are attending Human Immunodeficiency Virus (HIV) clinics in Wakiso district reported to be using herbal preparations despite the fact that they were taking Anti Retro Viral (ARVs) this prompted this study to be done. Purpose of the study: To determine the prevalence and factors associated with concurrent use of herbal medicine and anti-retroviral therapy among HIV/AIDS patients attending selected HIV clinics in Wakiso district. Methodology: This was a cross sectional study with both quantitative data collection (use of a questionnaire) and qualitative data collection (key informants’ interviews). A mixed method of sampling was used, that is, purposive and random sampling. Purposive sampling was based on the location in the district and used to select 7 health facilities basing on the 7 health sub districts from Wakiso. Simple random sampling was used to select one HIV clinic from each of the 7 health sub districts. Furthermore, the study units were enrolled in to the study as they entered into the HIV clinics, and 105 respondents were interviewed. Both manual and computer packages (SPSS) were used to analyze the data Results: The prevalence of concurrent use of herbal medicine and ART was 38 (36.2%). Commonly HIV symptom treated with herbs was fever 27(71.1%), diarrhea 3(7.9%) and cough 2(5.3%). Commonly used herbs for fever (Omululuza (Vernonica amydalina), Ekigagi (Aloe sp), Nalongo (Justicia betonica Linn) while for diarrhea was Ntwatwa. The side effects also included; too much pain, itchy pain of HIV, aneamia,felt sick, loss/gain appetite, joint pain and bad dreams. Herbs used to sooth the side effects were; for aneamia was avocado leaves Parea Americana mill The significant factors associated with concurrent use of herbal medicine were being familiar with herbs and conventional medicine for management HIV symptoms being expensive. The other significant factor was exhibiting hostility to patients by health personnel providing HIV care. Conclusion: Herbal medicine is widely used by clients in HIV/AIDS care. Patients being familiar with herbs and conventional medicine being expensive were associated with concurrent use of herbal medicine and ART. The exhibition of hostility to the HIV/AIDS patients by the health care providers was also associated with concurrent use of herbal medicine and ART among HIV/AIDS patients.

Keywords: HIV patients, herbal medicine, antiretroviral therapy, factors associated

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6414 Designing Electric Vehicle Charging Infrastructure to Benefit Historically-Marginalized Residents

Authors: Polly Parkinson, Emma Mecham, Fawn Groves, Amy Wilson-Lopez, Ivonne Santiago

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In the rush to meet electric vehicle (EV) adoption goals that address environmental and health concerns, engineering planners and community policy experts cannot separate the socioeconomic and equity factors from transportation needs. Two gaps are identified in existing research: concrete proposals that address affordable micromobility options and provide for needs of community members without cars, and community-engaged research that elevates the concerns and solutions brought forward by historically-marginalized community members. This data analysis from a recent case study in a vulnerable community indicates that because transportation decisions are inextricably linked to health, work, and housing, EV adoption must also address multifaceted human needs. Communities focused on building more electric vehicle charging stations must find ways for lower-income households to also benefit. This research engaged residents in the planning process and resulted in a template for charging stations to advance mobility justice with a range of options that purposefully benefit the whole community.

Keywords: community engagement, electric vehicle charging, environmental justice, participatory research, transportation equity

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6413 Analyzing the Sociolinguistic Profile of the Algerian Community in the UK in terms of French Language Use: The Case of Émigré Ph.D. Students

Authors: Hadjer Chellia

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the present study reports on second language use among Algerian international students in the UK. In Algeria, French has an important status among the Algerian verbal repertoires due to colonial reasons. This has triggered many language conflicts and many debates among policy makers in Algeria. In higher education, Algerian English students’ sociolinguistic profile is characterised by the use of French as a sign of prestige. What may leave room for debate is the effect of crossing borders towards the UK as a result of international mobility programmes, a transition which could add more complexity since French, is not so significant as a language in the UK context. In this respect, the micro-objective is to explore the fate of French use among Ph.D. students in the UK as a newly established group vis-à-vis English. To fulfill the purpose of the present inquiry, the research employs multiple approaches in which semi-structured interview is a primary source of data to know participants’ attitudes about French use, targeting both their pre-migratory experience and current one. Web-based questionnaires are set up to access larger population. Focus group sessions are further procedures of scrutiny in this piece of work to explore the actual linguistic behaviours. Preliminary findings from both interviews and questionnaires reveal that students’ current experience, particularly living in the UK, affects their pre-migratory attitudes towards French language and its use. The overall findings are expected to bring manifold contributions to the field of research among which is setting factors that influence language use among newly established émigrés communities. The research is also relevant to international students’ experience of study abroad in terms of language use in the guise of internationalization of higher education, mobility and exchange programmes. It could contribute to the sociolinguistics of the Algerian diaspora: the dispersed residence of non-native communities - not to mention its significance on the Algerian research field abroad.

Keywords: Algerian diaspora, French language, language maintenance, language shift, mobility

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6412 Deprivation of Adivasi People's Rights to Forest Resources: A Case Study from United Andhra Pradesh India

Authors: Anil Kumar Kursenge

Abstract:

In the State of united Andhra Pradesh, many Adivasi People live in areas rich in living and non-living resources, including forests that contain abundant biodiversity, water and minerals. Of united Andhra Pradesh 76.2m population, over five million are Adivasi population of forest landscape. They depend on forests for a substantial part of their livelihoods and close cultural affinity with forests. However, they are the most impoverished population of the State, and the high levels of poverty in Andhra Pradesh forest landscapes are largely an outcome of historically-rooted institutionalised marginalisation. As the State appropriated forests and forest land for itself, it deprived local people of their customary rights in the forest. The local realities of the forest rights deprivations are extremely complex, reflecting a century and a half of compounded processes. With growing population pressure and ever-increasing demands for natural and mineral resources, Adivasi Peoples' lands, which are often relatively rich in resources, become more and more attractive to 'developers.' The development projects and institutionalised marginalisation have been deprived Adivasi people's rights over natural resources has resulted in serious negative effects on Adivasi people and on their lands. Historically, the desire for development for such resources has resulted in the removal, decimation, or extermination of many tribal communities. These deprivations have led to highly conflictual relations between the State and the Adivasi people and forest areas in Andhra Pradesh. Today, the survival of the Adivasi Peoples requires recognition of their rights to the forest resources found in their lands and territories on which they depend for their economic, cultural, survival, spiritual and physical well-being. In this context, this paper attempts to discuss the issues of deprivation with regard to access to forest resources and development projects where many Adivasis in State uprooted from their homes and lands.

Keywords: tribal people, forest rights, livelihoods, deprivation, marginalisation, Andhra Pradesh

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6411 Disparity in New Born Care Practices Reducing in Uttar Pradesh: Evidences from NFHS and DLHS

Authors: Gudakesh Yadav

Abstract:

Utter Pradesh, which is one of the largest states of India with unequal distribution of resources and different socioeconomic and cultural characteristics, level of different new born health care indicators varies a lot from one district to another district. State shared more than 21 percent of total live births of India; whereas, it accounts for 28 percent of total infant deaths of the country, with the 53 per thousand infant mortality rate. The present paper attempts to examine tempo-spatial changes in new born care practices during NFHS-1 to NFHS-3 and DLHS-2 to DLHS-3 in Uttar Pradesh and different regions. Descriptive statistics, rate-ratios, concentration index, multivariate and decomposition analysis has been used for the study. Findings of the study reveal that new born care practices have improved over the time in the state and across all the regions because of giving more emphasis on venerable groups like poor, rural, less educated mothers and scheduled caste & tribes but still it did not achieve the desired successes. Regional analysis of third rounds of DLHS shows that, coverage of intuitional delivery was the lowest in the central region. Performance of the southern region was the lowest in terms of initiation of breastfeeding, keeping baby warm and dry after the birth. The study calls for proper follow up of new born children to accelerate new born and child health care service and prioritises increasing antenatal check-ups and institutional delivery, which helps to improve level of other new born care services. At the policy level there is need to reach venerable groups like scheduled caste and tribes, poor and uneducated, and new mother especially in rural areas. High focused district should be allocated for better implementation of new born care promotion programme in low performing districts. Partnership with the private sector health professional is necessary to reach the every part of population.

Keywords: decomposition, inequality, initiation of breastfeeding, institutional delivery

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6410 Characteristics and Guiding Strategies of College Students' Online Discourse: Based on the Analysis of One Student Forum

Authors: Hanwei Cheng, Chengbei Xu, Yijie Wang

Abstract:

More and more college students are accustomed to surfing the Internet everyday. As community members, college students have ability to express opinions and participate in social affairs, they not only accept information passively, but also voice their concerns on the Internet. We interpret the online discourses featured with anonymization, so it helps us more effectively and conveniently understand the behaviors and thoughts of college students, and educators can thus grasp the scales and directions in guiding online language. We analyzed online comments in both content and form aspects in one student forum (named Dandan, the BNU’s campus forum), and through methods of literature review and interview, we found that in term of content, college students pay attention to practical information online, emphasize on personal development and pursue hot issues; in term of form, college students' online language displays cross-border quality sometimes under the general feature of normative, and they often explore a certain topic in the form of question or discussion, and they like to show feelings in ironic and stream-of-consciousness ways. It is argued that college students intend to establish a community to facilitate personal development and meet emotional needs through the student forum, and by making comments at the forum they are also able to get involved in public affairs. We should pay attention to problems of college students' online discourse, such as boundary issues (like informal advertisement and information authenticity), emotional issues and the spread of gossip. Some possible solutions to solving online discourse problems can be applied, like we can improve access systems of student forum, clarify principles of Internet langue use, change oversimplified management approaches and use some other tactics, in order to form a mechanism of student self-regulation, also deepen the trust and cooperation between school administrators and students.

Keywords: online language, youth discourse, content and form, implication and strategy

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6409 Students with Hearing Impairment and Their Access to Inclusive Education in Nagpur City, India: An Exploratory Study

Authors: Avanika Gupta

Abstract:

Education plays a significant and remedial role in balancing the socio-economic fabric of a country. Inclusive education is considered as the most appropriate mode of teaching students with hearing impairment (SwHI) by various national and international legislations. But inclusive education is still an evolving concept among the disability studies scholars and policy makers in India. The study aimed to examine accessibility of SwHI in mainstream schools if there are special provisions for SwHI. The study also intended to identify if the provisions are same for deaf and hard-of-hearing students. Using stratified random sampling technique, a school was selected from each of the six administrative zones of Nagpur city. All the selected schools had primary and secondary level education and were co-educational in nature. Interview with principals of these schools and focused-group- observation method showcased lack of accessibility for SwHI in attending schools. Not even a single school had a hearing impaired student, either deaf or hard-of-hearing depicting the double marginalization of SwHI. This is despite the fact that the right to education is a fundamental right in India, and national legislation on disability has special provisions for ensuring educational opportunities to SwHI. None of the schools even had an Indian Sign Language (ISL) instructor. Both observations seemed cause and effect of one another. One of the principals informed that they have seats for all students with disabilities but they usually lie vacant due to lack of awareness among the parents. One school had 2 students with locomotive impairment while another had a student with visual impairment. Principals of two special schools were also interviewed to understand the reason behind the low enrollment rate of SwHI in mainstream schools. Guardian preference, homogeneity, relatable faculty, familiar environment were some of the chief reasons mentioned. Few suggestions for the policymakers, teachers, guardians and the students are also recommended so that Indian education system could become inclusive in true sense.

Keywords: deaf, hard-of-hearing, inclusive education, India, Nagpur, students with hearing impairment

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6408 Impact of Digitization and Diversification in Reducing Volatility in Art Markets

Authors: Nishi Malhotra

Abstract:

Art has developed as a mode of investment and saving. Art and culture of any nation is the source of foreign direct investment (FDI) generation and growth development. Several intermediaries and skill-building organizations thrive on at and culture for their earnings. Indian art market has grown to Rs. 2000 Crores. Art establishment houses access to privileged information is the main reason for arbitrariness and volatility in the market. The commercialization of art and development of the markets with refinement in the taste of the customers have led to the development of art as an investment avenue. Investors keen on investing in these products can do so, and earnings from art are taxable too, like any other capital asset. This research paper is aimed at exploring the role of art and culture as an investment avenue in India and reasons for increasing volatilities in the art market. Based on an extensive literature review and secondary research, a benchmarking study has been conducted to capture the growth of the art as an investment avenue. These studies indicate that during the financial crisis of 2008-10, the art emerged as an alternative investment avenue. The paper aims at discussing the financial engineering of various art funds and instruments. Based on secondary data available from Sotheby’s, Christies, Bonham, there is a positive correlation between strategic diversification and increasing return in the Art market. Similarly, digitization has led to disintermediation in the art markets and also helped to increase the market base. The data clearly enumerates the growing interest of the Indian investor towards art as an investment option. Much like any other broad asset class, art market too thrives on excess returns provided by diversification. Many financial intermediaries and art funds have emerged, to offer valuable investment planning advisory to a genuine investor. This paper clearly highlights the increasing returns of strategic diversification and its impact on reducing volatility in the art markets. Moreover, with coming up of e-auctions and websites, investors are able to analyse art more objectively. Digitization and commercialization of art have definitely helped in reducing volatility in world art markets.

Keywords: art, investment avenue, diversification, digitization

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6407 Neo-liberalism and Theoretical Explanation of Poverty in Africa: The Nigerian Perspective

Authors: Omotoyosi Bilikies Ilori, Adekunle Saheed Ajisebiyawo

Abstract:

After the Second World War, there was an emergence of a new stage of capitalist globalization with its Neo-liberal ideology. There were global economic and political restructurings that affected third-world countries like Nigeria. Neo-liberalism is the driving force of globalization, which is the latest manifestation of imperialism that engenders endemic poverty in Nigeria. Poverty is severe and widespread in Nigeria. Poverty entails a situation where a person lives on less than one dollar per day and has no access to basic necessities of life. Poverty is inhuman and a breach of human rights. The Nigerian government initiated some strategies in the past to help in poverty reduction. Neo-liberalism manifested in the Third World, such as Nigeria, through the privatization of public enterprises, trade liberalization, and the rollback of the state investments in providing important social services. These main ideas of Neo-liberalism produced poverty in Nigeria and also encouraged the abandonment of the social contract between the government and the people. There is thus a gap in the provision of social services and subsidies for the masses, all of which Neo-liberal ideological positions contradict. This paper is a qualitative study which draws data from secondary sources. The theoretical framework is anchored on the market theory of capitalist globalization and public choice theory. The objectives of this study are to (i) examine the impacts of Neo-liberalism on poverty in Nigeria as a typical example of a Third World country and (ii) find out the effects of Neo-liberalism on the provision of social services and subsidies and employment. The findings from this study revealed that (i) the adoption of the Neo-liberal ideology by the Nigerian government has led to increased poverty and poor provision of social services and employment in Nigeria; and (ii) there is an increase in foreign debts which compounds poverty situation in Nigeria. This study makes the following recommendations: (i) Government should adopt strategies that are pro-poor to eradicate poverty; (ii) The Trade Unions and the masses should develop strategies to challenge Neo-liberalism and reject Neo-liberal ideology.

Keywords: neo-liberalism, poverty, employment, poverty reduction, structural adjustment programme

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6406 Empirical Study of Health Behaviors of Employees in Information Technology and Business Process Outsourcing

Authors: Yogesh Pawar

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The purpose of this paper is to investigate the behaviors of information technology (IT) and business process outsourcing (BPO) employees in relation to diet, exercise, sleep, stress, and social habits. This was a qualitative research study, using in-depth,semi-structured interviews. Descriptive data were collected from a two-stage purposive sample of 28 IT-BPO employees from two IT companies and one BPOs in Pune. The majority of interviewees reported having an unhealthy diet and/or sedentary lifestyle. Lack of time due to demanding work schedules was the largest barrier to diet and exercise. Given the qualitative study design and limited sampling frame, results may not be generalizable. However, the qualitative data suggests that Pune’s young IT-BPO employees may be at greater risk of lifestyle-related diseases than the general population. The data also suggests that interventions incorporating social influence may be a promising solution, particularly at international call centers. The results from this study provide qualitative insight on the motives for health behaviors of IT-BPO employees, as well as the barriers and facilitators for leading a healthy lifestyle in this industry. The findings provide the framework for future workplace wellness interventions.

Keywords: exercise, information technology, qualitative research, wellness

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6405 Approach for Evaluating Wastewater Reuse Options in Agriculture

Authors: Manal Elgallal, Louise Fletcher, Barbara Evans

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Water scarcity is a growing concern in many arid and semi-arid countries. The increase of water scarcity threatens economic development and sustainability of human livelihoods as well as environment especially in developing countries. Globally, agriculture is the largest water consumption sector, accounting for approximately 70% of all freshwater extraction. Growing competition between the agricultural and higher economic value in urban and industrial uses of high-quality freshwater supplies, especially in regions where water scarcity major problems, will increase the pressure on this precious resource. In this circumstance, wastewater may provide reliable source of water for agriculture and enable freshwater to be exchanged for more economically valuable purposes. Concern regarding the risks from microbial and toxic components to human health and environment quality is a serious obstacle for wastewater reuse particularly in agriculture. Although powerful approaches and tools for microbial risk assessment and management for safe use of wastewater are now available, few studies have attempted to provide any mechanism to quantitatively assess and manage the environmental risks resulting from reusing wastewater. In seeking pragmatic solutions to sustainable wastewater reuse, there remains a lack of research incorporating both health and environmental risk assessment and management with economic analysis in order to quantitatively combine cost, benefits and risks to rank alternative reuse options. This study seeks to enhance effective reuse of wastewater for irrigation in arid and semi-arid areas, the outcome of the study is an evaluation approach that can be used to assess different reuse strategies and to determine the suitable scale at which treatment alternatives and interventions are possible, feasible and cost effective in order to optimise the trade-offs between risks to protect public health and the environment and preserving the substantial benefits.

Keywords: environmental risks, management, life cycle costs, waste water irrigation

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6404 Vocational Education and Gender Equality in Nigeria: Challenges and Opportunities

Authors: Josephine Emebiziogo Anene-Okeakwa

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This study investigates the challenges and opportunities for gender equality in vocational education in Awka South, Anambra State, Nigeria. Recognizing the critical role of vocational education in economic development, the research aims to evaluate the current state of gender equality, identify key barriers faced by female students, assess the impact of government policies, and explore opportunities for enhancing gender equality in this sector. Ten vocational schools within Awka South were randomly selected, and a total of 1,000 questionnaires were distributed among students, with 991 completed and returned, yielding a high response rate of 99.1%, and the retrieved data were analyzed using SPSS. The findings indicate significant gender disparities in vocational education enrollment and participation, with male students overwhelmingly outnumbering female students in most technical and engineering-related programs. Key barriers identified include cultural norms discouraging females from pursuing technical fields, economic constraints, lack of female role models, and social stereotypes regarding gender roles. Despite various government policies aimed at promoting gender equality, their implementation and effectiveness remain inadequate, as reflected in persistent gender disparities. However, opportunities for improving gender equality were identified, such as implementing gender-sensitive curricula, expanding mentorship programs for female students, and adopting best practices from other countries. The study recommends enhancing access to vocational training resources, implementing gender-sensitive curricula, expanding mentorship programs, and strengthening the implementation and monitoring of government policies. Addressing these challenges through targeted interventions is essential for achieving gender parity in vocational education, thereby empowering female students and contributing to Nigeria's socio-economic development.

Keywords: vocational education, gender equality, barriers, government policies

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6403 A Strategy for Reducing Dynamic Disorder in Small Molecule Organic Semiconductors by Suppressing Large Amplitude Thermal Motions

Authors: Steffen Illig, Alexander S. Eggeman, Alessandro Troisi, Stephen G. Yeates, John E. Anthony, Henning Sirringhaus

Abstract:

Large-amplitude intermolecular vibrations in combination with complex shaped transfer integrals generate a thermally fluctuating energetic landscape. The resulting dynamic disorder and its intrinsic presence in organic semiconductors is one of the most fundamental differences to their inorganic counterparts. Dynamic disorder is believed to govern many of the unique electrical and optical properties of organic systems. However, the low energy nature of these vibrations makes it difficult to access them experimentally and because of this we still lack clear molecular design rules to control and reduce dynamic disorder. Applying a novel technique based on electron diffraction we encountered strong intermolecular, thermal vibrations in every single organic material we studied (14 up to date), indicating that a large degree of dynamic disorder is a universal phenomenon in organic crystals. In this paper a new molecular design strategy will be presented to avoid dynamic disorder. We found that small molecules that have their side chains attached to the long axis of their conjugated core have been found to be less likely to suffer from dynamic disorder effects. In particular, we demonstrate that 2,7-dioctyl[1]benzothieno[3,2-b][1]benzothio-phene (C8-BTBT) and 2,9-di-decyl-dinaphtho-[2,3-b:20,30-f]-thieno-[3,2-b]-thiophene (C10DNTT) exhibit strongly reduced thermal vibrations in comparison to other molecules and relate their outstanding performance to their lower dynamic disorder. We rationalize the low degree of dynamic disorder in C8-BTBT and C10-DNTT with a better encapsulation of the conjugated cores in the crystal structure which helps reduce large amplitude thermal motions. The work presented in this paper provides a general strategy for the design of new classes of very high mobility organic semiconductors with low dynamic disorder.

Keywords: charge transport, C8-BTBT, C10-DNTT, dynamic disorder, organic semiconductors, thermal vibrations

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6402 Vaccination Coverage and Its Associated Factors in India: An ML Approach to Understand the Hierarchy and Inter-Connections

Authors: Anandita Mitro, Archana Srivastava, Bidisha Banerjee

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The present paper attempts to analyze the hierarchy and interconnection of factors responsible for the uptake of BCG vaccination in India. The study uses National Family Health Survey (NFHS-5) data which was conducted during 2019-21. The univariate logistic regression method is used to understand the univariate effects while the interconnection effects have been studied using the Categorical Inference Tree (CIT) which is a non-parametric Machine Learning (ML) model. The hierarchy of the factors is further established using Conditional Inference Forest which is an extension of the CIT approach. The results suggest that BCG vaccination coverage was influenced more by system-level factors and awareness than education or socio-economic status. Factors such as place of delivery, antenatal care, and postnatal care were crucial, with variations based on delivery location. Region-specific differences were also observed which could be explained by the factors. Awareness of the disease was less impactful along with the factor of wealth and urban or rural residence, although awareness did appear to substitute for inadequate ANC. Thus, from the policy point of view, it is revealed that certain subpopulations have less prevalence of vaccination which implies that there is a need for population-specific policy action to achieve a hundred percent coverage.

Keywords: vaccination, NFHS, machine learning, public health

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6401 The Epidemiology of Hospital Maternal Deaths, Haiti 2017-2020

Authors: Berger Saintius, Edna Ariste, Djeamsly Salomon

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Background: Maternal mortality is a preventable global health problem that affects developed, developing, and underdeveloped countries alike. Globally, maternal mortality rates have declined since 1990, but 830 women die every day from pregnancy and childbirth-related causes that are often preventable. Haiti, with a number of 529 maternal deaths per 100,000 live births, is one of the countries with the highest maternal mortality rate in the Caribbean. This study consists of analyzing maternal death surveillance data in Haiti from 2017-2020. Method : A descriptive study was conducted; data were extracted from the National Epidemiological Surveillance Network of maternal deaths from 2017 to 2020. Sociodemographic variables were analyzed. Excel and Epi Info 7.2 were used for data analysis. Frequency and proportion measurements were calculated. Results: 756 deaths were recorded for the study period: 42 (6%) in 2017, 168 (22%) in 2018, 265 (35%) in 2019, and 281 (37%) in 2020. The North Department recorded the highest number of deaths, 167 (22%). 83(11%) in Les Cayes. 96% of these deaths are people aged between 15 and 49. Conclusion. Maternal mortality is a major health problem in Haiti. Mobilization, participation, and involvement of communities, increase in obstetric care coverage and promotion of Family Planning are among the strategies to fight this problem.

Keywords: epidemiology, maternal death, hospital, Haiti

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6400 Developing a Culturally Adapted Family Intervention for Relatives Living with Schizophrenia in Oman

Authors: Aziza Al-Sawafi

Abstract:

Introduction: The evidence of family interventions in schizophrenia is robust primarily in high-income settings. However, they have been adapted to other settings and cultures to improve effectiveness and acceptability. In Oman, there is limited integration of psychosocial interventions in the treatment of schizophrenia. Therefore, the adaptation of family intervention to the Omani culture may facilitate its uptake. Most service users in Oman live with their families outside the healthcare system, and nothing is known about their experience, needs, or resources. Furthermore, understanding caregivers' and mental health professionals' preferences, perceptions, and experience is a fundamental element in the process of intervention development. Therefore, this study aims to develop a culturally sensitive, feasible, and acceptable family intervention for relatives living with schizophrenia in Oman. Method: The Medical Research Council's framework for the evaluation of complex health care interventions provided the conceptual structure for the study. The development phase was carried out, which involved three stages: 1) systematically reviewing the available literature regarding culturally adapted family interventions in the Arab world 2) In-depth interviews with caregivers to explore their experience and perceived needs and preferences regarding intervention 3) A focus group study involving health professionals to explore the acceptability and feasibility of delivering the family intervention in the Omani context. Data synthesis determined the design of the proposed intervention according to the findings obtained from the previous stages. Results: Stage one: The systematic review found limited evidence of culturally-adapted family interventions in the Arab region. However, the cultural adaptation process was comprehensive, and the implementation was reported to be feasible and acceptable. Stage two: The experience of family caregivers illuminated four main themes: burden, stigma, violence, and family needs. Burdens of care included objective and subjective burdens, positive feelings, and coping mechanisms. Caregivers gave their opinion about the content and preference of the intervention from their personal experiences. Stage three: mental health professionals discussed the delivery system of the intervention from a clinical standpoint concerning issues and barriers to implementation. They recommended modifications to the components of the intervention to ensure its acceptability and feasibility in the local setting. Data synthesis was carried out, and the intervention was designed. Conclusion: This study provides evidence of the potential applicability and acceptability of a culturally sensitive family intervention for families of individuals with schizophrenia in Oman. However, more work needs to be done to test the feasibility of the study and overcome the practical challenges.

Keywords: cultural-adaptation, family intervention, Oman, schizophrenia

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