Search results for: long term services and supports

Authors: Sharon Milberger, Jane Turner, Denise White-Perkins

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Michigan shares the overall U.S. national need for more highly qualified professionals who have knowledge and experience in the use of evidence-based practices to meet the special health care needs of children, adolescents, and adults with neurodevelopmental disabilities including autism spectrum disorder (DD/ASD). The Michigan Leadership Education in Neurodevelopmental Disabilities (MI-LEND) program is a consortium of six universities that spans the state of Michigan and serves more than 181,800 undergraduate, graduate, and professional students. The purpose of the MI LEND program is to improve the health of infants, children and adolescents with disabilities in Michigan by training individuals from different disciplines to assume leadership roles in their respective fields and work across disciplines. The MI-LEND program integrates “L.I.F.E.” perspectives into all training components. L.I.F.E. is an acronym for Leadership, Interdisciplinary, Family-Centered and Equity perspectives. This paper will describe how L.I.F.E. perspectives are embedded into all aspects of the MI-LEND training program including the application process, didactic training, community and clinical experiences, discussions, journaling and projects. Specific curriculum components will be described including content from a training module dedicated to Equity. Upon completion of the Equity module, trainees are expected to be able to: 1) Use a population health framework to identify key social determinants impacting families and children; 2) Explain how addressing bias and providing culturally appropriate linguistic care/services can influence patient/client health and wellbeing; and 3) Describe the impact of policy and structural/institutional factors influencing care and services for children with DD/ASD and their families. Each trainee completes two self-assessments: the Cultural and Linguistic Competence Health Practitioner Assessment and the other assessing social attitudes/implicit bias. Trainees also conduct interviews with a family with a child with DD/ASD. In addition, interdisciplinary Equity-related group activities are incorporated into face-to-face training sessions. Each MI-LEND trainee has multiple ongoing opportunities for self-reflection through discussion and journaling and completion of a L.I.F.E. project as a culminating component of the program. The poster will also discuss the challenges related to teaching and measuring successful outcomes related to diversity/equity perspectives.

Keywords: disability, diversity, equity, training

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Authors: Lucélia Alcântara

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Reading has been seen as a passive skill by many people for a long time. However, when one comes to study it deeply and in a such a way that the act of reading equals acquiring knowledge through living an experience that belongs to him/her, passive definitely becomes active. Material development with a focus on reading has to consider much more than reading strategies. The following questions are asked: Is the material appropriate to the students’ reality? Does it make students think and state their points of view? With that in mind a lesson has been developed to illustrate theory becoming practice. Knowledge, criticality, intercultural experience and social interaction. That is what reading is for.

Keywords: reading, culture, material development, learning

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Authors: Bridget J. Kenny, Elizabeth Hoban, Jo Williams

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Adolescent pregnancy presents a significant public health challenge for Cambodia. Despite declines in the overall fertility rate, the adolescent fertility rate is increasing. Adolescent pregnancy is particularly problematic in the Northeast provinces of Ratanak Kiri and Mondul Kiri where 34 percent of girls aged between 15 and 19 have begun childbearing; this is almost three times Cambodia’s national average of 12 percent. Language, cultural and geographic barriers have restricted qualitative exploration of the sexual and reproductive health (SRH) challenges that face indigenous adolescents in Northeast Cambodia. The current study sought to address this gap by exploring the SRH practices of adolescent mothers from indigenous populations in Ratanak Kiri Province. Twenty-two adolescent mothers, aged between 15 and 19, were recruited from seven indigenous villages in Ratanak Kiri Province and asked to participate in a combined body mapping exercise and semi-structured interview. Participants were given a large piece of paper (59.4 x 84.1 cm) with the outline of a female body and asked to draw the female reproductive organs onto the ‘body map’. Participants were encouraged to explain what they had drawn with the purpose of evoking conversation about their reproductive bodies. Adolescent mothers were then invited to participate in a semi-structured interview to further expand on topics of SRH. The qualitative approach offered an excellent avenue to explore the unique SRH challenges that face indigenous adolescents in rural Cambodia. In particular, the use of visual data collection methods reduced the language and cultural barriers that have previously restricted or prevented qualitative exploration of this population group. Thematic analysis yielded six major themes: (1) understanding of the female reproductive body, (2) contraceptive knowledge, (3) contraceptive use, (4) barriers to contraceptive use, (5) sexual practices, (6) contact with healthcare facilities. Participants could name several modern contraceptive methods and knew where they could access family planning services. However, adolescent mothers explained that they gained this knowledge during antenatal care visits and consequently participants had limited SRH knowledge, including contraceptive awareness, at the time of sexual initiation. Fear of the perceived side effects of modern contraception, including infertility, provided an additional barrier to contraceptive use for indigenous adolescents. Participants did not cite cost or geographic isolation as barriers to accessing SRH services. Child marriage and early sexual initiation were also identified as important factors contributing to the high prevalence of adolescent pregnancy in this population group. The findings support the Ministry of Education, Youth and Sports' (MoEYS) recent introduction of SRH education into the primary and secondary school curriculum but suggest indigenous girls in rural Cambodia require additional sources of SRH information. Results indicate adolescent girls’ first point of contact with healthcare facilities occurs after they become pregnant. Promotion of an effective continuum of care by increasing access to healthcare services during the pre-pregnancy period is suggested as a means of providing adolescents girls with an additional avenue to acquire SRH information.

Keywords: adolescent pregnancy, contraceptive use, family planning, sexual and reproductive health

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Authors: Chang Liu, Hanwen Zhang, Vikash Sharma, Don Eliseo Lucerno-Prisno III, Emmanuel Yujuico, Maulik Chokshi, Prashanthi Krishnakumar, Bach Xuan Tran, Giang Thu Vu, Kamilla Anna Pinter, Shenglan Tang

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Background and Aims: Globally, many health systems focus on hospital-based healthcare models targeting acute care and disease treatment, which are not effective in addressing the challenges of ageing populations, chronic conditions, multi-morbidities, and increasingly unhealthy lifestyles. Recently, integrated care programs on chronic diseases have been developed, piloted, and implemented to meet such challenges. However, integrated care programs in the Asia-Pacific region vary in the levels of integration from linkage to coordination to full integration. This study aims to identify and analyze existing cases of integrated care in the Asia-Pacific region and identify the facilitators and barriers in order to improve existing cases and inform future cases. Methods: The study is a comparative study, with a combination approach of desk-based research and key informant interviews. The selected countries included in this study represent a good mix of lower-middle income countries (the Philippines, India, Vietnam, and Fiji), upper-middle income country (China), and high-income country (Singapore) in the Asia-Pacific region. Existing integrated care programs were identified through the scoping review approach. Trigger, history, general design, beneficiaries, and objectors were summarized with barriers and facilitators of integrated care based on key informant interviews. Representative case(s) in each country were selected and comprehensively analyzed through deep-dive case studies. Results: A total of 87 existing integrated care programs on chronic diseases were found in all countries, with 44 in China, 21 in Singapore, 12 in India, 5 in Vietnam, 4 in the Philippines, and 1 in Fiji. 9 representative cases of integrated care were selected for in-depth description and analysis, with 2 in China, the Philippines, and Vietnam, and 1 in Singapore, India, and Fiji. Population aging and the rising chronic disease burden have been identified as key drivers for almost all the six countries. Among the six countries, Singapore has the longest history of integrated care, followed by Fiji, the Philippines, and China, while India and Vietnam have a shorter history of integrated care. Incentives, technologies, education, and performance evaluation would be crucial for developing strategies for implementing future programs and improve already existing programs. Conclusion: Integrated care is important for addressing challenges surrounding the delivery of long-term care. To date, there is an increasing trend of integrated care programs on chronic diseases in the Asia-Pacific region, and all six countries in our study set integrated care as a direction for their health systems transformation.

Keywords: integrated healthcare, integrated care delivery, chronic diseases, Asia-Pacific region

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Authors: Dusanee Suwankhong, Pranee Liamputtong

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Breast surgery leaves undesirable scars to all women who experienced mastectomy, despite the fact that this could be a principle approach to save one life. This paper explores how Thai women living with breast cancer perceived and experienced a scarred body after breast surgery. In-depth interviews and drawing methods were employed among 20 women diagnosed with breast cancer. The interviewed data were analysed using thematic analysis method. The results showed that all women with breast cancer who underwent breast surgery perceived and experienced scar as a persisting and visible side-effect. This disfigurement appearance presented a negative image of feminine identity and led to emotional burdens among women. They responded to being scarred in different ways relating to their perceptions of body and changes. The older group had less embarrassed feelings towards being scarred comparing to the younger one. All women tried to seek means to cope with such physical impairment and keep balance life related to their condition. For example, they relied on Buddhism practice and tried to heal the keloid using natural products. Scars appeared to be an unpleasant effect for women who underwent breast mastectomy. Nurses and health care professionals in the local health service sectors need to pay close attention to how the women see the scarred body and their experiences of living with the distorted feminine appearance, and to provide sensitive support that meets the needs of these vulnerable women. The suitable supports can reduce the sense of embarrassment and increase their sense of self-confidence about their social femininity.

Keywords: breast surgery, emotional response, qualitative study, scars, Thai women

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Authors: Mathilde Blondon, Salla Aicha Dieng, Catherine Pfister

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In a paradoxical way, teenagers nowadays seem to use suicidal attempts to elaborate on their trauma abuses and regain some kind of control in their lives. As their behavior becomes life-threatening, the hospital offers a variety of expertise to address their need, with Child Protective Services also joining in, to a point when teenagers could have a feeling of losing control of their lives, which results in them making more suicidal attempts. Our goal here is to walk with these foster teenagers long enough to step therapy up first, then as their mental health is restored enough to step the therapy down in a way that is secure and will give them their life back. This would prevent them from making suicidal attempts to get a feeling of control over their life. We’ll present a clinical case of a 14-year-old girl named Sofia, who was suffering from parental deprivation, an identity disorder, and severe depression disorder. Our intervention took place in January 2024, after Sofia had undergone four hospitalizations, including a two-month period in a specialized clinic. In a stepping-up effort, a substantial setting has been built around Sofia. She was coming three days a week to therapeutic activities at the Child Psychiatry Day Hospital, she had one psychotherapy session a week at the Medical-Psychological Center, and she was meeting with the Adolescent Psychiatrist on a regular basis. However, her suicidal attempts frequency continued to increase to the point when she couldn’t stay more than four days outside the hospital unit without harming herself and being brought back to the Emergency Unit. We were all stuck in some kind of medical deadlock, writing to clinics that had no room for her while social workers were calling foster homes that wouldn’t even accept her either. At some point, a clinical decision was made by the psychiatrist to stop what appeared to be a global movement of traumatic repetition, which involved Sofia’s family, the medical team and the social workers as one. This decision to step therapy down created a surprise and put an end to the cycle. It provided a new path, a new solution where Sofia could securely settle without being unfaithful to her family. Her suicidal attempts stopped for four weeks. She had one relapse, then didn’t make another attempt so far. There is a fine line between too little and too much, a pathway with the right amount of care and support. We believe it is not a steady line but rather a path up and down the hill. It’s about building up this moment when medication and mental processes have improved the subject’s condition enough to allow the medical team to step therapy down and give more control back to the subject. These needed variations used to come from a change of hospital or medical team. Stepped care avoids any breaking of bonds and appears to be decisive in stopping teenagers’ suicidal attempts.

Keywords: child protection, adolescent psychiatry, teenager suicidal attempt, foster teenagers, parental deprivation, stepped care

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Authors: Rakesh C. Mathad, G. Y. Lokesh, Basavegowda

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In agriculture using quality seeds of improved varieties is very important to ensure higher productivity thereby food security and sustainability. To ensure good productivity, seeds should have characters as described by the breeder. To know whether the characters as described by the breeder are expressing in a variety such as genuineness or genetic purity, field grow out test (GOT) is done. In pigeon pea which is long durational crop, conducting a GOT may take very long time and expensive also. Since in pigeon pea flower character is a most distinguishing character from the contaminants, conducting a field grow out test require 120-130 days or till flower emergence, which may increase cost of storage and seed production. This will also delay the distribution of seed inventory to the pigeon pea growing areas. In this view during 2014-15 with financial support of Govt. of Karnataka, India, a project to develop a molecular genetic test for newly developed variety of pigeon pea cv.TS3R was commissioned at Seed Unit, UAS, Raichur. A molecular test was developed with the help SSR markers to identify pure variety from possible off types in newly released pigeon pea variety TS3R. In the investigation, 44 primer pairs were screened to identify the specific marker associated with this variety. Pigeon pea cv. TS3R could be clearly identified by using the primer CCM 293 based on the banding pattern resolved on gel electrophoresis and PCR reactions. However some of the markers like AHSSR 46, CCM 82 and CCM 57 can be used to test other popular varieties in the region like Asha, GRG-811 and Maruti respectively. Further to develop this in to a lab test, the seed sample size was standardized to 200 seeds and a grow out matrix was developed. This matrix was used to sample 12 days old leaves to extract DNA. The lab test results were validated with actual field GOT test results and found variations within the acceptable limit of 1%. This molecular method can now be employed to test the genetic purity in pigeon pea cv TS3R which reduces the time and can be a cheaper alternative method for field GOT.

Keywords: genuineness, grow-out matrix, molecular genetic purity, SSR markers

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Authors: Tomasz Holecki, Hanna Dobrowolska

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In the Polish health care system, nurses and midwives are obliged to regularly update their professional knowledge. It is all regulated by the Law on the nurse and midwife’s profession and the code of ethics. The professional self-governing body (County Chamber of Nurses and Midwives) is obliged to organize ongoing training for them so that maintaining accessibility and availability to the high quality of educational services could be possible at all levels of post-graduate education. The aim of this study is an analysis of post-graduate education organized by the County Chamber of Nurses and Midwives in the city of Katowice, Poland, as a professional self-governing body operating in the area of Silesian province inhabited by almost 5 million citizens which bring together more than 30 thousand professionally active nurses and midwives. In the years 2000-2017, the self-government of nurses and midwives trained over 50,000 people. The education and supervision system over the labour of nurses and midwives establishes exercising control by a self-governing body. In practice, this means that conducting activities aimed at creating legal regulations and organizational conditions, as well as the practical implementation of courses, belongs to the professional self-government of nurses and midwives. The most of specialization courses that were provided from their own funds came from membership fees. The biggest group was participants of specializations in the fields of cardiac, anesthesia, and preventive nursing. The smallest group of people participated in such specializations as neonatal, emergency, and obstetrics nursing. The most popular specialist courses were in the fields of the electrocardiogram and cardiopulmonary resuscitation, whereas the least popular were the ones in the fields of protective vaccinations of neonates. So-called 'soft training-courses' in the fields of improvement of social skills and management were also provided. The research shows that a vast majority of nurses and midwives are interested in raising their professional qualifications. Specialist courses and selected fields of qualification courses received the most concrete attention. In light of conducted research, one can assert that cooperation inside the community of nurses and midwives provides access to high-quality education and training services regularly used by a wide circle of them. The presented results exemplify a level of real interest in specialist and qualification training-courses and also show sources of financing them.

Keywords: nurses and midwives, ongoing training, postgraduate education, specialist training-courses

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Authors: Jamie Wong, Daisy Sang, Chang-Shyh Peng

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Geofence is a virtual fence defined by a preset physical radius around a target location. Geofencing App provides location-based services which define the actionable operations upon the crossing of a geofence. Geofencing requires continual location tracking, which can consume noticeable amount of battery power. Additionally, location updates need to be frequent and accurate or order so that actions can be triggered within an expected time window after the mobile user navigate through the geofence. In this paper, we build an Android mobile geofencing Application to remotely and autonomously control a power switch.

Keywords: location based service, geofence, autonomous, remote switch

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Authors: Alan Collins

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This study explains how The People’s Tribunal empowered survivors of child abuse. It examines how People’s tribunals can be effective mean of empowerment; the challenges of empowerment – expectation v. reality; the findings and how they reflect other inquiry findings; and the importance of listening and learning from survivors. UKCSAPT “The People’s Tribunal” was established by survivors of child sex abuse and members of civil society to investigate historic cases of institutional sex abuse. The independent inquiry, led by a panel of four judges, listened to evidence spanning four decades from survivors and experts. A common theme throughout these accounts showed that a series of institutional failures prevented abuse from being reported; and that there are clear links between children being rendered vulnerable by these failures and predatory abuse on an organised scale. It made a series of recommendations including the establishment of a permanent and open forum for victims to share experiences and give evidence, better links between mental health services and police investigations, and training for police and judiciary professionals on the effects of undisclosed sexual abuse. The main findings of the UKCSAPT report were:-There are clear links between children rendered vulnerable by institutional failures and predatory abuse on an organised scale, even if these links often remain obscure. -UK governmental institutions have failed to provide survivors with meaningful opportunities for either healing or justice. -The vital mental health needs of survivors are not being met and this undermines both their psychological recovery and access to justice. -Police and other authorities often lack the training to understand the complex reasons for the inability of survivors to immediately disclose a history of abuse. -Without far-reaching changes in institutional culture and practices, the sexual abuse of children will continue to be a significant scourge in the UK. The report also outlined a series of recommendations for improving reporting and mental health provision, and access to justice for victims were made, including: -A permanent, government-funded popular tribunal should be established to enable survivors to come forward and tell their stories. -Survivors giving evidence should be assigned an advocate to assist their access to justice. -Mental health services should be linked to police investigations to help victims disclose abuse. -Victims who fear reprisals should be provided with a channel though which to give evidence anonymously.

Keywords: empowerment, survivors, sexual, abuse

Procedia PDF Downloads 252

Authors: Niraimathi Kesavan, Sangeeta Sharma, Deepa Jagan, Sridhar Sukumar, Mohan Ramachandran, Vidhubala Elangovan

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Background: Childhood is a dynamic period for growth and development. Optimum nutrition during this period forms a strong foundation for growth, development, resistance to infections, long-term good health, cognition, educational achievements, and work productivity in a later phase of life. Underprivileged children living in a resource constraint settings like shelter homes are at high risk of malnutrition due to poor quality diet and nutritional inadequacy. In low-income countries, underprivileged children are vulnerable to being deprived of nutritious food, which stands as a major challenge in the health sector. The present aims to assess the dietary intake, nutritional status, and nutritional inadequacy and their association with malnutrition among children residing in shelter homes in rural Tamil Nadu. Methods: The study was a descriptive survey conducted among all the children aged between 8-18 years residing in two selected shelter homes (Anbu illam, a home for female children, and Amaidhi illam, a home for male children), rural Tirunelveli, Tamil Nadu, India. A total of 57 children were recruited, including 18 boys and 39 girls, for the study. Dietary intake was measured using seven days 24 hours recall. The average nutrient intake was considered for further analysis. Results: Of the 57 children, about 60% (n=35) were undernutrition. The mean daily energy intake was 1298 (SD 180) kcal for boys and 952 (SD155) kcal for girls. The total calorie intake was 55-60% below the estimated average requirement (EAR) for adolescent boys and girls in the age group 13-15 years and 16-18 years. Carbohydrates were the major source of energy (boys 53% and girls 51%), followed by fat (boys 31.5% and girls 34.5%) and protein (boys 14% and girls 12.9%). Dairy intake (<200ml/day) was less than the recommendation (500ml/day). Micro-nutrient-rich foods such as fruits, vegetables, and green leafy vegetables in the diet were <200g/day, which was far less than the recommended dietary guidelines of 400g- 600g/day for the age group of 7-18 years. Nearly 26% of girls reported experiencing menstrual problems. The majority (76.9%) of the children exhibited nutrient deficiency-related signs and symptoms. Conclusion: The total energy, minerals, and micro-nutrient intake were inadequate and below the Recommended Dietary Allowance for children and adolescents. The diet predominantly consists of refined cereals, rice, semolina, and vermicelli. Consumption of whole grains, milk, fruits, vegetables, and leafy vegetables was far below the recommended dietary guidelines. Dietary inadequacies among these children pose a serious concern for their overall health status and its consequences in the later phase of life.

Keywords: adolescents, children, dietary intake, malnutrition, nutritional inadequacy, shelter home

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Authors: Wenqian Bai

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Background: In response to the post-pandemic directives of Xi Jinping concerning the new era of ecological civilization, China has embarked on ecological restoration projects across its territorial spaces. This initiative faces challenges such as complex evaluation metrics and subpar informatization standards. Methodology: This research focuses on Mianzhu City, Sichuan Province, to assess its resource and environmental carrying capacities and the appropriateness of land use for development from ecological, agricultural, and urban perspectives. The study incorporates a range of spatial data to evaluate factors like ecosystem services (including water conservation, soil retention, and biodiversity), ecological vulnerability (addressing issues like soil erosion and desertification), and resilience. Utilizing the Minimum Cumulative Resistance model along with the ‘Three Zones and Three Lines’ strategy, the research maps out ecological corridors and significant ecological networks. These frameworks support the ecological restoration and environmental enhancement of the area. Results: The study identifies critical ecological zones in Mianzhu City's northwestern region, highlighting areas essential for protection and particularly crucial for water conservation. The southeastern region is categorized as a generally protected ecological zone with respective ratings for water conservation functionality and ecosystem resilience. The research also explores the spatial challenges of three ecological functions and underscores the substantial impact of human activities, such as mining and agricultural expansion, on the ecological baseline. The proposed spatial arrangement for ecological restoration, termed ‘One Mountain, One Belt, Four Rivers, Five Zones, and Multiple Corridors’, strategically divides the city into eight major restoration zones, each with specific tasks and projects. Conclusion: With its significant ‘mountain-plain’ geography, Mianzhu City acts as a crucial ecological buffer for the Yangtze River's upper reaches. Future development should focus on enhancing ecological corridors in agriculture and urban areas, controlling soil erosion, and converting farmlands back to forests and grasslands to foster ecosystem rehabilitation.

Keywords: ecological restoration, resource and environmental carrying capacity, land development suitability, ecosystem services, ecological vulnerability, ecological networks

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Authors: Jeffrey A. Humenik

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Environmental, Limited Liability Corporation (EMR) provided civil construction services to the U.S. Army Corps of Engineers, Kansas City District, for the placement of a protective riprap blanket on the west bank of the Smoky Hill River, construction of 2 shore abutments and the construction of a 140 foot long sill wall spanning the Smoky Hill River in Salina, Kansas. The purpose of the project was to protect the riverbank from erosion and hold back water to a specified elevation, creating a pool to ensure adequate water intake for the municipal water supply. Geotextile matting and riprap were installed for streambank erosion protection. An inflatable bladder (AquaDam®) was designed to the specific river dimension and installed to divert the river and allow for dewatering during the construction of the sill walls and cofferdam. AquaDam® consists of water filled polyethylene tubes to create aqua barriers and divert water flow or prevent flooding. A challenge of the project was the fact that 100% of the sill wall was constructed within an active river channel. The threat of flooding of the work area, damage to the aqua dam by debris, and potential difficulty of water removal presented a unique set of challenges to the construction team. Upon completion of the West Sill Wall, floating debris punctured the AquaDam®. The manufacturing and delivery of a new AquaDam® would delay project completion by at least 6 weeks. To keep the project ahead of schedule, the decision was made to construct an earthen cofferdam reinforced with rip rap for the construction of the East Abutment and East Sill Wall section. During construction of the west sill wall section, a deep scour hole was encountered in the wall alignment that prevented EMR from using the natural rock formation as a concrete form for the lower section of the sill wall. A formwork system was constructed, that allowed the west sill wall section to be placed in two horizontal lifts of concrete poured on separate occasions. The first sectional lift was poured to fill in the scour hole and act as a footing for the second sectional lift. Concrete wall forms were set on the first lift and anchored to the surrounding riverbed in a manner that the second lift was poured in a similar fashion as a basement wall. EMR’s timely decision to keep the project moving toward completion in the face of changing conditions enabled project completion two (2) months ahead of schedule. The use of inflatable bladders is an effective and cost-efficient technology to divert river flow during construction. However, a secondary plan should be part of project design in the event debris transported by river punctures or damages the bladders.

Keywords: abutment, AquaDam®, riverbed, scour

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Authors: João Boaventura Branco De Matos

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Currently, in Brazil, there is a considerable collection of publications on the supplementary health sector, but the vast majority is limited to retrospective examination of the sector. The present contribution starts from the diagnosis of an overwhelming change in the role of the State and its institutions, as well as an accelerated and no less forceful change in the way of producing goods and services, resulting in a clash between these different waves (state and market). This shock produces unique energy, capable of imposing major changes in the most varied sectors. Based on this diagnosis, there was an opportunity to offer the perspective and propositional study of regulatory measures relevant to the best conduct and performance of this sector in the future.

Keywords: private health regulation, state and market, forecasts in Brazilian regulation, political economy

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Authors: Anshita Sharma

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India is one of the countries to initiate family planning with intention to control the growing population by reducing fertility. In effort to this, India had introduced the National family planning programme in 1952. The level of unmet need in India shows a reducing trend with increasing effectiveness of family planning services as in NFHS-1 the unmet need for limiting, spacing and total was 46 percent, 14 percent & 9 percent, respectively. The demand for spacing has reduced to at 8 percent, 8 percent for limiting and total unmet need was 16 percent in NFHS-2. The total unmet need has reduced to 13 percent in NFHS-3 for all currently married women and the demand for limiting and spacing is 7 percent and 6 percent respectively. The level of unmet need in India shows a reducing trend with increasing effectiveness of family planning services. Despite the progress, there is chunk of women who are deprived of controlling unintended and unwanted pregnancies. The present paper examines the socio-cultural and economic and demographic correlates of unmet need for contraception in India. It also examines the effect of women’s autonomy and unmet need for contraception on family size among different socio-economic groups of population. It uses data from national family health survey-3 carried out in 2005-06 and employs bi-variate techniques and multivariate techniques for analysis. The multiple regression analysis has done to seek the level and direction of relationship among various socio-economic and demographic factors. The result reveals that women with higher level of education and economic status have low level of unmet need for family planning. Women living in non-nuclear family have high unmet need for spacing and women living in nuclear family have high unmet need for limiting and family size is slightly higher of women of nuclear family. In India, the level of autonomy varies at different life point; usually women with higher age enjoy higher autonomy than their junior female member in the family. The finding shows that women with higher autonomy have large family size counter to women with low autonomy have low family size. Unmet need for family planning decrease with women’s increasing exposure to mass- media. The demographic factors like experience of child loss are directly related to family size. Women who experience higher child loss have low unmet need for spacing and limiting. Thus, It is established with the help that women’s autonomy status play substantial role in fulfilling demand of contraception for limiting and spacing which affect the family size.

Keywords: family size, socio-economic correlates, unmet need for limiting, unmet need for spacing, women`s autonomy

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Authors: Ummeh Saika, Toshio Kikuchi

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Population growth and urbanization is a global phenomenon. As the rapid progress of technology, many cities in the international community are facing serious problems of urbanization. There is no doubt that the urbanization will proceed to have significant impact on the ecology, economy and society at local, regional, and global levels. The inhabitants of Dhaka city suffer from lack of proper urban facilities. The green spaces are needed for different functional and leisure activities of the urban dwellers. Again growing densification, a number of green space are transferred into open space in the Dhaka city. As a result greenery of the city's decreases gradually. Moreover, the existing green space is frequently threatened by encroachment. The role of green space, both at community and city level, is important to improve the natural environment and social ties for future generations. Therefore, it seems that the green space needs to be more effective for public interaction. The main objective of this study is to address the effectiveness of urban green space (Urban Park) of Dhaka City. Two approaches are selected to fulfill the study. Firstly, analyze the long-term spatial changes of urban green space using GIS and secondly, investigate the relationship of urban park network with physical and social environment. The case study site covers eight urban parks of Dhaka metropolitan area of Bangladesh. Two aspects (Physical and Social) are applied for this study. For physical aspect, satellite images and aerial photos of different years are used to find out the changes of urban parks. And for social aspect, methods are used as questionnaire survey, interview, observation, photographs, sketch and previous information of parks to analyze about the social environment of parks. After calculation of all data by descriptive statistics, result is shown by maps using GIS. According to physical size, parks of Dhaka city are classified into four types: Small, Medium, Large and Extra Large parks. The observed result showed that the physical and social environment of urban parks varies with their size. In small size parks physical environment is moderate by newly tree plantation and area expansion. However, in medium size parks physical environment are poor, example- tree decrease, exposed soil increase. On the other hand, physical environment of large size and extra large size parks are in good condition, because of plenty of vegetation and well management. Again based on social environment, in small size parks people mainly come from surroundings area and mainly used as waiting place. In medium-size parks, people come to attend various occasion from different places. In large size and extra large size parks, people come from every part of the city area for tourism purpose. Urban parks are important source of green space. Its influence both physical and social environment of urban area. Nowadays green space area gradually decreases and transfer into open space. The consequence of this research reveals that changes of urban parks influence both physical and social environment and also impact on urban life.

Keywords: physical environment, social environment, urban life, urban parks

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Authors: Mohamed Ouazene

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The insulating properties of the polymers are widely used in electrical engineering for the production of insulators and various supports, as well as for the insulation of electric cables for medium and high voltage, etc. These polymeric materials have significant advantages both technically and economically. However, although the insulation with polymeric materials has advantages, there are also certain disadvantages such as the influence of the heat which can have a detrimental effect on these materials. Polyvinyl chloride (PVC) is one of the polymers used in a plasticized state in the cable insulation to medium and high voltage. The studied material is polyvinyl chloride (PVC 4000 M) from the Algerian national oil company whose formula is: Industrial PVC 4000 M is in the form of white powder. The test sample is a pastille of 1 mm thick and 1 cm in diameter. The consequences of increasing the temperature of a polymer are modifications; some of them are reversible and others irreversible [1]. The reversible changes do not affect the chemical composition of the polymer, or its structure. They are characterized by transitions and relaxations. The glass transition temperature is an important feature of a polymer. Physical aging of PVC is to maintain the material for a longer or shorter time to its glass transition temperature. The aim of this paper is to study this phenomenon by the method of thermally stimulated depolarization currents. Relaxations within the polymer have been recorded in the form of current peaks. We have found that the intensity decreases for more residence time in the polymer along its glass transition temperature. Furthermore, it is inferred from this work that the phenomenon of physical aging can have important consequences on the properties of the polymer. It leads to a more compact rearrangement of the material and a reconstruction or reinforcement of structural connections.

Keywords: depolarization currents, glass transition temperature, physical aging, polyvinyl chloride (PVC)

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Authors: Marco E. O. Jardim, Frederico A. M. Souza, Valeria M. Bastos, Myrian C. A. Costa, Nelson F. F. Ebecken

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Urban public transportation in Rio de Janeiro is based on bus lines, powered by diesel, and four limited metro lines that support only some neighborhoods. This work presents an infrastructure built to better understand microclimate variations related to massive urban transportation in some specific areas of the city. The use of sensor nodes with small analytics capacity provides environmental information to population or public services. The analyses of data collected from a few small sensors positioned near some heavy traffic streets show the harmful impact due to poor bus route plan.

Keywords: big data, IoT, public transportation, public health system

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Authors: Zeynep Aykul Yavuz

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Misconception about design is about making a product pretty. However, the holistic approaches such as design thinking or human-centered design could take the design from making things nice to things inspired by real people and work with real-world limitations. Design thinking helps companies to understand not only problem area but also opportunities. It can be used by any people from any background which provide a space for companies where employees from different departments work together to solve the same problem. While demanding skills changing year to year into the market, previous technical skills are commons anymore. The frontier companies in the sectors look for interactive methods to solve problems. Moreover, the recruiter aims to understand the candidate’s design thinking skills (. The study includes a case study where a 21st century creative services company “ATÖLYE” offers innovation transformation with design thinking to a banking company. Both companies are located in İstanbul in Turkey. The banking company contacted with the ATÖLYE in January 2018 because they heard design thinking in different markets and how it transformed the way of working. The transformation process had 3 phases which were basic training of teams while getting coaching from ATÖLYE’s employees, coaching training with graduates of basic training, facilitator training. Employees built new skills while solving the banking company’s strategic problems. ATÖLYE offered experiential learning which helped employees’ making sense of new skills and knowledge. One day workshops were organized to create awareness about the practice of design thinking. In addition to these, a community of practice was built to create an environment to make reflections and discuss good practice. Not only graduates from the training program but also other employees from the company participated in the community gatherings. ATÖLYE did not train some employees in the company. Rather than that, its aim was to build a contemporary organization for the company. This provided a sustainable system in terms of human resources and motivation. At the beginning of 2020, employees from the first cohort in the basic training who took coaching training and facilitator training have started to design training for different groups in the company. They have considered what could be better in their training experience and designed new ones according to that, so they have been using design thinking to design the design training. This is one of the outcomes which shows the impact of all process clearly.

Keywords: design thinking, learning community, professional development, training, organizational transformation

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Authors: M. Walmsley, S. Elmatarri, S. Mannion

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Introduction: Self-inflicted injury is a recognised cause of major trauma in adults and is an independent indicator of a reduced functional outcome compared to non-intentional major trauma. There is little literature available on the inpatient mental health (MH) management of this vulnerable group. A retrospective review was conducted of inpatient MH management of major trauma patients admitted to a UK regional Major Trauma Centre (MTC). Their outcomes were compared to all major trauma patients. This group of patients required multiple MH interventions whilst on the Major Trauma Ward (MTW) and a had worse functional outcome compared to non-intentional trauma. Method: The national TARN (Trauma Audit and Research Network) database was used to identify patients admitted to a regional MTC over a 2-year period from June 2018 to July 2020. Patients with an ISS (Injury Severity Score) of greater than 15 with a mechanism of either self-harm or high-risk behavior were included for further analysis. Inpatient medical notes were reviewed for MH interventions on the MTW. Further outcomes, including mortality, length of stay (LOS) and Glasgow Outcome Score (GOS) were compared with all major trauma patients for the same time period. Results: A total of 60 patients were identified in the time period and of those, 27 spent time on the MTW. A total of 23 (85%) had a prior MH diagnosis, with 11 (41%) under the care of secondary MH services. Adequate inpatient records for review were available for 24 patients. During their inpatient stay, 8 (33%) were reviewed on the ward by the inpatient MH team. There were 10 interventions required for 6 (25%) patients on the MTW including, sections under the Mental Health Act, transfer to specialist MH facility, pharmacological sedation and security being called to the MTW. When compared to all major trauma patients, those admitted due to self-harm or high-risk behavior had a statistically significantly higher ISS (31.43 vs 24.22, p=0.0001) and LOS (23.51d vs 16.06d, p=0.002). Functional outcomes using the GOS were reduced in this group of patients, GOS 5 (low disability) (51.66% vs. 61.01%) and they additionally had a higher level of mortality, GOS 1 (15.00% vs 11.67%). Discussion: Intentional self-harm is a recognised cause of major trauma in adults and this patient group sustains more severe injuries, requiring a longer hospital stay with worse outcomes compared to all major trauma patients. Inpatient MH interventions are required for a significant proportion of these patients and therefore, there needs to be a close relationship with MH services. There is limited available evidence for how this patient group is best managed as an inpatient to aid their recovery and further work is needed on how outcomes in this vulnerable group can be improved.

Keywords: adult major trauma, attempted suicide, self-inflicted major trauma, inpatient management

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Authors: Olcay Çam, Ayşegül Bilge, Merve Uğuryol, Hacer Demirkol

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Complementary and alternative medicine are important for human health. It has stood out that from past to present people have resorted to particularly Turkish bath houses, cupping therapy, mud bath, hirudotheraphy and healing waters for the purpose of recovering from diseases and refresh their souls. Now, methods such as herbal treatments, massage, aromatherapy, prayer, meditation, yoga and thermal springs have been recently observed to be the most frequently used complementary therapies in Turkey. These methods are not known by people exactly. As a result, complementary therapies are applied along with the modern therapies in Turkey, we are considered to be effective in maintaining and improving individuals’ health.

Keywords: complementary therapy, health, health services, modern therapies

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Authors: Arnab Hazra

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Breath analysis is a quick, noninvasive and inexpensive technique for disease diagnosis can be used on people of all ages without any risk. Only a limited number of volatile organic compounds (VOCs) can be associated with the occurrence of specific diseases. These VOCs can be considered as disease markers or breath markers. Selective detection with specific concentration of breath marker in exhaled human breath is required to detect a particular disease. For example, acetone (C₃H₆O), ethanol (C₂H₅OH), ethane (C₂H₆) etc. are the breath markers and abnormal concentrations of these VOCs in exhaled human breath indicates the diseases like diabetes mellitus, renal failure, breast cancer respectively. Nanomaterial-based vapor sensors are inexpensive, small and potential candidate for the detection of breath markers. In practical measurement, selectivity is the most crucial issue where trace detection of breath marker is needed to identify accurately in the presence of several interfering vapors and gases. Current article concerns a novel technique for selective and lower ppb level detection of breath markers at very low temperature based on TiO₂ nanotube array based vapor sensor devices. Highly ordered and oriented TiO₂ nanotube array was synthesized by electrochemical anodization of high purity tatinium (Ti) foil. 0.5 wt% NH₄F, ethylene glycol and 10 vol% H₂O was used as the electrolyte and anodization was carried out for 90 min with 40 V DC potential. Au/TiO₂ Nanotube/Ti, sandwich type sensor device was fabricated for the selective detection of VOCs in low concentration range. Initially, sensor was characterized where resistive and capacitive change of the sensor was recorded within the valid concentration range for individual breath markers (or organic vapors). Sensor resistance was decreased and sensor capacitance was increased with the increase of vapor concentration. Now, the ratio of resistive slope (mR) and capacitive slope (mC) provided a concentration independent constant term (M) for a particular vapor. For the detection of unknown vapor, ratio of resistive change and capacitive change at any concentration was same to the previously calculated constant term (M). After successful identification of the target vapor, concentration was calculated from the straight line behavior of resistance as a function of concentration. Current technique is suitable for the detection of particular vapor from a mixture of other interfering vapors.

Keywords: breath marker, vapor sensors, selective detection, TiO₂ nanotube array

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Authors: Seyed Nima Tayarani Bathaie

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In this paper, an image-receiving system was designed and implemented through optimization of object detection algorithms using Haar features. This optimized algorithm served as face and eye detection separately. Then, cascading them led to a clear image of the user. Utilization of this feature brought about higher security by preventing fraud. This attribute results from the fact that services will be given to the user on condition that a clear image of his face has already been captured which would exclude the inappropriate person. In order to expedite processing and eliminating unnecessary ones, the input image was compressed, a motion detection function was included in the program, and detection window size was confined.

Keywords: face detection algorithm, Haar features, security of ATM

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Authors: Tatiana Ponomarenko, Oksana Marinina, Marina Nevskaya

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Modern corporate social responsibility (CSR) is a sphere of multilevel responsibility of a company toward society represented by various stakeholders. The relevance of CSR management grows due to the active development of socially responsible investing (principles for responsible investment) taking into account factors of environmental, social and corporate governance (ESG), growing attention of the investment community in general to the long-term stability of companies and the quality of control of nonfinancial risks. The modern approach to CSR strategic management is aimed at the creation of trustful relationships with stakeholders, on the basis of which a contribution to the sustainable development of companies, regions, and national economics is insured. However, the practical concepts of social responsibility in mining companies are different, which leads to various degrees of application of CSR. A number of companies implement CSR using a traditional (limited) understanding of responsibility toward employees and counteragents, the others understand CSR much wider and try to use leverages of efficient cooperation. As in large mining companies the scope of CSR measures is diverse and characterized by different indices, the study was aimed at evaluating CSR efficiency on the basis of a proprietary methodology and determining the level of development of CSR management in terms of anti-crisis, reactive and proactive development. The methodology of the research includes analysis of integrated global reporting initiative (GRI) reports of large mining companies; choice of most representative sectoral agents by a criterion of the regularity of issuance and publication of reports; calculation of indices of evaluation of CSR level of the selected companies in dynamics. The methodology of evaluation of CSR level is based on a rating score of changes in standard indices of GRI reports by economic, environmental, and social directions. Result. By the results of the analysis, companies of fuel and energy and metallurgic complexes, in overwhelming majority, reflecting three indices out of a wide range of possible indicators of SDGs (Sustainable Development Goals), were selected for the study. The evaluation of the scopes of CSR of the companies Gazprom, LUKOIL, Metalloinvest, Nornikel, Rosneft, Severstal, SIBUR, SUEK corresponds to the reactive type of development according to a scale of CSR strategic management, which is the average value out of the possible values. The chief drawback is that companies, in the process of analyzing global goals, often choose the goals which relate to their own activities, paying insufficient attention to the interests of the stakeholders inside the country. This fact evidences the necessity of searching for more effective mechanisms of CSR control. Acknowledgment: This article is prepared within grant support of the RFBR, project 19-510-44013 'Development of the concept of mineral resources value formation in the context of sustainable development in resource-oriented economies'.

Keywords: sustainable development, corporate social responsibility, development strategies, efficiency assessment

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Authors: Seung Ju Yeon, Seul Ki Min, Jun Sang Park, Yeo Seon Kwon, Hoo Cheol Lee, Hyun Jung Shim, Il-Doo Kim, Ja Kyeong Lee, Hwa Sung Shin

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In brain injury, depleting oxidative stress is the most effective way to reduce the brain infarct size. C-phycocyanin (C-Pc) is a well-known antioxidant protein that has neuroprotective effects obtained from green microalgae. Astrocyte is glial cell that supports the nerve cell such as neuron, which account for a large portion of the brain. In brain injury, such as ischemia and reperfusion, astrocyte has an important rule that overcomes the oxidative stress and protect from brain reactive oxygen species (ROS) injury. However little is known about how C-Pc regulates the anti-oxidants effects of astrocyte. In this study, when the C-Pc was treated in oxidized astrocyte, we confirmed that inflammatory factors Interleukin-6 and Interleukin-3 were increased and antioxidants enzyme, Superoxide dismutase (SOD) and catalase was upregulated, and neurotrophic factors, brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF) was alleviated. Also, it was confirmed to reduce infarct size of the brain in ischemia and reperfusion because C-Pc has anti-oxidant effects in middle cerebral artery occlusion (MCAO) animal model. These results show that C-Pc can help astrocytes lead neuroprotective activities in the oxidative stressed environment of the brain. In summary, the C-PC protects astrocytes from oxidative stress and has anti-oxidative, anti-inflammatory, neurotrophic effects under ischemic situations.

Keywords: c-phycocyanin, astrocyte, reactive oxygen species, ischemia and reperfusion, neuroprotective effect

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Authors: Niamh Herlihy, Helen Fischer, Rainer Sauerborn, Anneliese Depoux, Avner Bar-Hen, Antoine Flauhault, Stefanie Schütte

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In the recent decades, there has been an increase in the number of publications both in the scientific and grey literature on the potential health risks associated with climate change. Though interest in climate change and health is growing, there are still many gaps to adequately assess our future health needs in a warmer world. Generating a greater understanding of the health impacts of climate change could be a key step in inciting the changes necessary to decelerate global warming and to target new strategies to mitigate the consequences on health systems. A long term and broad overview of existing scientific literature in the field of climate change and health is currently missing in order to ensure that all priority areas are being adequately addressed. We conducted a scoping review of published peer-reviewed literature on climate change and health from two large databases, PubMed and Web of Science, between 1990 and 2015. A scoping review allowed for a broad analysis of this complex topic on a meta-level as opposed to a thematically refined literature review. A detailed search strategy including specific climate and health terminology was used to search the two databases. Inclusion and exclusion criteria were applied in order to capture the most relevant literature on the human health impact of climate change within the chosen timeframe. Two reviewers screened the papers independently and any differences arising were resolved by a third party. Data was extracted, categorized and coded both manually and using R software. Analytics and infographics were developed from results. There were 7269 articles identified between the two databases following the removal of duplicates. After screening of the articles by both reviewers 3751 were included. As expected, preliminary results indicate that the number of publications on the topic has increased over time. Geographically, the majority of publications address the impact of climate change and health in Europe and North America, This is particularly alarming given that countries in the Global South will bear the greatest health burden. Concerning health outcomes, infectious diseases, particularly dengue fever and other mosquito transmitted infections are the most frequently cited. We highlight research gaps in certain areas e.g climate migration and mental health issues. We are developing a database of the identified climate change and health publications and are compiling a report for publication and dissemination of the findings. As health is a major co-beneficiary to climate change mitigation strategies, our results may serve as a useful source of information for research funders and investors when considering future research needs as well as the cost-effectiveness of climate change strategies. This study is part of an interdisciplinary project called 4CHealth that confronts results of the research done on scientific, political and press literature to better understand how the knowledge on climate change and health circulates within those different fields and whether and how it is translated to real world change.

Keywords: climate change, health, review, mapping

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Authors: J. H. Boonzaaier, A. C. Brent

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South Africa, a water scarce country, experiences the phenomenon that its life supporting natural water resources is seriously threatened by the users that are totally dependent on it. South Africa is globally applauded to have of the best and most progressive water laws and policies. There are however growing concerns regarding natural water resource quality deterioration and a critical void in the management of natural resources and compliance to policies due to increasing institutional uncertainties and failures. These are in accordance with concerns of many South African researchers and practitioners that call for a change in paradigm from talk to practice and a more constructive, practical approach to governance challenges in the management of water resources. A qualitative theory-building case study through longitudinal action research was conducted from 2014 to 2017. The research assessed whether a strategic positioned institutional agent can be parlayed to facilitate and execute WRM on catchment level by engaging multiple stakeholders in a polycentric setting. Through a critical realist approach a distinction was made between ex ante self-deterministic human behaviour in the realist realm, and ex post governance-management in the constructivist realm. A congruence analysis, including Toulmin’s method of argumentation analysis, was utilised. The study evaluated the unique case of a self-steering local water management institution, the Impala Water Users Association (WUA) in the Pongola River catchment in the northern part of the KwaZulu-Natal Province of South Africa. Exploiting prevailing water resource threats, it expanded its ancillary functions from 20,000 to 300,000 ha. Embarking on WRM activities, it addressed natural water system quality assessments, social awareness, knowledge support, and threats, such as: soil erosion, waste and effluent into water systems, coal mining, and water security dimensions; through structured engagement with 21 different catchment stakeholders. By implementing a proposed polycentric governance-management model on a catchment scale, the WUA achieved to fill the void. It developed a foundation and capacity to protect the resilience of the natural environment that is critical for freshwater resources to ensure long-term water security of the Pongola River basin. Further work is recommended on appropriate statutory delegations, mechanisms of sustainable funding, sufficient penetration of knowledge to local levels to catalyse behaviour change, incentivised support from professionals, back-to-back expansion of WUAs to alleviate scale and cost burdens, and the creation of catchment data monitoring and compilation centres.

Keywords: institutional agent, water governance, polycentric water resource management, water resource management

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Authors: Pantana Tor-Ngern

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In the global water cycle, tree water use (Tr) largely contributes to evapotranspiration which is the total amount of water evaporated from terrestrial ecosystems to the atmosphere, regulating climates. Tree water use responds to environmental factors, including atmospheric humidity and sunlight (represented by vapor pressure deficit or VPD and photosynthetically active radiation or PAR, respectively) and soil moisture. In forests, Tr responses to such factors depend on species and their spatial and temporal variations. Tropical forests in Southeast Asia (SEA) have experienced land-use conversion from abandoned agricultural practices, resulting in patches of forests at different stages including old-growth and secondary forests. Because the inherent structures, such as canopy height and tree density, significantly vary among forests at different stages and can strongly affect their respective microclimate, Tr and its responses to changing environmental conditions in successional forests may differ. Daily and seasonal variations in the environmental factors may exert significant impacts on the respective Tr patterns. Extrapolating Tr data from short periods of days to longer periods of seasons or years can be complex and is important for estimating long-term ecosystem water use which often includes normal and abnormal climatic conditions. Thus, this study aims to investigate the diurnal variation of Tr, using measured sap flux density (JS) data, with changes in VPD in eight evergreen tree species in an old-growth forest (hereafter OF; >200 years old) and a young forest (hereafter YF, <10 years old) in Khao Yai National Park, Thailand. The studied species included Sysygium syzygoides, Aquilaria crassna, Cinnamomum subavenium, Nephelium melliferum, Altingia excelsa in OF, and Syzygium nervosum and Adinandra integerrima in YF. Only Sysygium antisepticum was found in both forest stages. Specifically, hysteresis, which indicates the asymmetrical changes of JS in response to changing VPD across daily timescale, was examined in these species. Results showed no hysteresis in all species in OF, except Altingia excelsa which exhibited a 3-hour delayed JS response to VPD. In contrast, JS of all species in YF displayed one-hour delayed responses to VPD. The OF species that showed no hysteresis indicated their well-coupling of their canopies with the atmosphere, facilitating the gas exchange which is essential for tree growth. The delayed responses in Altingia excelsa in OF and all species in YF were associated with higher JS in the morning than that in the afternoon. This implies that these species were sensitive to drying air, closing stomata relatively rapidly compared to the decreasing atmospheric humidity (VPD). Such behavior is often observed in trees growing in dry environments. This study suggests that detailed investigation of JS at sub-daily timescales is imperative for better understanding of mechanistic responses of trees to the changing climate, which will benefit the improvement of earth system models.

Keywords: sap flow, tropical forest, forest succession, thermal dissipcation probe

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Authors: Abdullah Almilaibary, Jeremy Jolley, Mark Hayter

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Background: Despite recent progress in enhancing the accessibility of HIV-related health services worldwide, opportunities to diagnose patients are often missed due to genuine barriers at different levels. The aim of the study is to explore the factors that affect the utilization of HIV testing services by young people aged 17-25 in Saudi Arabia. Methods: A non-experimental descriptive cross-sectional design was used to predict factors that influenced HIV testing among Umm- Al Qura University students aged 17-25 years. A newly developed self-completed online questionnaire was used and the study sample was drawn using a convenience sampling technique. The questionnaire consisted of 52 items divided into three scales: 12 items for HIV/AIDS-related knowledge, 3 items for risk perception, and 37 items for attitudes toward HIV testing. Five experts in the field of HIV/AIDS validated the contents of the questionnaire and agreed that the items included were related to the construct being measured. The reliability of the questionnaire was also assessed using a test/re-test strategy with 27 participants recruited from the population under study. The reliability assessment revealed that the questionnaire was consistent as Cronbach’s Alpha was 0.80 for HIV/ADS knowledge, 0.88 for risk perception and 0.78 for attitudes towards HIV testing. The data were collected between 14th of July and 14th of October 2014. Results: 394 participants completed the questionnaires: 116 (29.4%) male and 278 (70%) female. 50.5% of the participants were aged 20 to 22 years, 34.8% were 17-19 years and 14.7% were aged between 23-25 years; about 93% of the participants were single. Only 20 (6%) participants had previously been tested for HIV. The main reasons for not being tested for HIV were: exposure to HIV was considered unlikely (48%), HIV test was not offered (36%) and unawareness of HIV testing centres (16%). On HIV/AIDS-related knowledge, the male participants scored higher than the females as the mean score for males was (M = 6.4, SD = 2.4) while for females it was (M 5.7, SD 2.5). In terms of risk perception, female participants appeared to have lower levels of risk perception than male participants, with the mean score for males being (M 11.7, SD 2.5) and (M 10.5, SD 2.4) for females. The female participants showed slightly more positive attitudes towards HIV testing than male participants: the mean score for males was (M = 108.14, SD = 17.9) and was (M = 111.32, SD = 17.3) for females. Conclusions: The data reveal that misconceptions about HIV/AIDS in Saudi Arabia are still a challenge. Although the attitudes towards HIV testing were reasonably positive, the utilization of the HIV test was low. Thus, tailoring HIV/AIDS preventive strategies in Saudi Arabia should focus on the needs of young people and other high risk groups in the country.

Keywords: attitude toward hiv testing, hiv testing, hiv/aids related knowledge, risk perception

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Authors: David Amoah Oduro

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In the ever-evolving terrain of international business, a profound revolution is underway, guided by the swift integration and advancement of disruptive technologies like digital analytics. In today's international business landscape, where competition is fierce, and decisions are data-driven, the essence of this paper lies in offering a tangible roadmap for practitioners. It is a guide that bridges the chasm between theory and actionable insights, helping businesses, investors, and entrepreneurs navigate the complexities of international expansion into sub-Saharan Africa. This practitioner paper distils essential insights, methodologies, and actionable recommendations for businesses seeking to leverage digital analytics in their pursuit of market entry and expansion across the African continent. What sets this paper apart is its unwavering focus on a region ripe with potential: sub-Saharan Africa. The adoption and adaptation of digital analytics are not mere luxuries but essential strategic tools for evaluating countries and entering markets within this dynamic region. With the spotlight firmly fixed on sub-Saharan Africa, the aim is to provide a compelling resource to guide practitioners in their quest to unearth the vast opportunities hidden within sub-Saharan Africa's digital desert. The paper illuminates the pivotal role of digital analytics in providing a data-driven foundation for market entry decisions. It highlights the ability to uncover market trends, consumer behavior, and competitive landscapes. By understanding Africa's incredible diversity, the paper underscores the importance of tailoring market entry strategies to account for unique cultural, economic, and regulatory factors. For practitioners, this paper offers a set of actionable recommendations, including the creation of cross-functional teams, the integration of local expertise, and the cultivation of long-term partnerships to ensure sustainable market entry success. It advocates for a commitment to continuous learning and flexibility in adapting strategies as the African market evolves. This paper represents an invaluable resource for businesses, investors, and entrepreneurs who are keen on unlocking the potential of digital analytics for informed market entry in Africa. It serves as a guiding light, equipping practitioners with the essential tools and insights needed to thrive in this dynamic and diverse continent. With these key insights, methodologies, and recommendations, this paper is a roadmap to prosperous and sustainable market entry in Africa. It is vital for anyone looking to harness the transformational potential of digital analytics to create prosperous and sustainable ventures in a region brimming with promise. In the ever-advancing digital age, this practitioner paper becomes a lodestar, guiding businesses and visionaries toward success amidst the unique challenges and rewards of sub-Saharan Africa's international business landscape.

Keywords: global analytics, digital analytics, sub-Saharan Africa, data analytics

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