Search results for: adult health
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 9648

Search results for: adult health

9168 Objective vs. Perceived Quality in the Cereal Industry

Authors: Albena Ivanova, Jill Kurp, Austin Hampe

Abstract:

Cereal products in the US contain rich information on the front of the package (FOP) as well as point-of-purchase (POP) summaries provided by the store. These summaries frequently are confusing and misleading to the consumer. This study explores the relationship between perceived quality, objective quality, price, and value in the cold cereal industry. A total of 270 cold cereal products were analyzed and the price, quality and value for different summaries were compared using ANOVA tests. The results provide evidence that the United States Department of Agriculture Organic FOP/POP are related to higher objective quality, higher price, but not to a higher value. Whole grain FOP/POP related to a higher objective quality, lower or similar price, and higher value. Heart-healthy POP related to higher objective quality, similar price, and higher value. Gluten-free FOP/POP related to lower objective quality, higher price, and lower value. Kid's cereals were of lower objective quality, same price, and lower value compared to family and adult markets. The findings point to a disturbing tendency of companies to continue to produce lower quality products for the kids’ market, pricing them the same as high-quality products. The paper outlines strategies that marketers and policymakers can utilize to contribute to the increased objective quality and value of breakfast cereal products in the United States.

Keywords: cereals, certifications, front-of-package claims, consumer health.

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9167 Impact of Out-Of-Pocket Payments on Health Care Finance and Access to Health Care Services: The Case of Health Transformation Program in Turkey

Authors: Bengi Demirci

Abstract:

Out-of-pocket payments have become one of the common models adopted by health care reforms all over the world, and they have serious implications for not only the financial set-up of the health care systems in question but also for the people involved in terms of their access to the health care services provided. On the one hand, out-of-pocket payments are used in raising resources for the finance of the health care system and in decreasing non-essential health care expenses by having a deterrent role on the patients. On the other hand, out-of-pocket payment model causes regressive distribution effect by putting more burdens on the lower income groups and making them refrain from using health care services. Being a relatively incipient country having adopted the out-of-pocket payment model within the context of its Health Transformation Program which has been ongoing since the early 2000s, Turkey provides a good case for re-evaluating the pros and cons of this model in order not to sacrifice equality in access to health care for raising revenue for health care finance and vice versa. Therefore this study aims at analyzing the impact of out-of-pocket payments on the health finance system itself and on the patients’ access to healthcare services in Turkey where out-of-pocket payment model has been in use for a while. In so doing, data showing the revenue obtained from out-of-pocket payments and their share in health care finance are analyzed. In addition to this, data showing the change in the amount of expenditure made by patients on health care services after the adoption of out-of-pocket payments and the change in the use of various health care services in the meanwhile are examined. It is important for the incipient countries like Turkey to be careful in striking the right balance between the objective of cost efficiency and that of equality in accessing health care services while adopting the out-of-pocket payment model.

Keywords: health care access, health care finance, health reform, out-of-pocket payments

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9166 Organ Dose Calculator for Fetus Undergoing Computed Tomography

Authors: Choonsik Lee, Les Folio

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Pregnant patients may undergo CT in emergencies unrelated with pregnancy, and potential risk to the developing fetus is of concern. It is critical to accurately estimate fetal organ doses in CT scans. We developed a fetal organ dose calculation tool using pregnancy-specific computational phantoms combined with Monte Carlo radiation transport techniques. We adopted a series of pregnancy computational phantoms developed at the University of Florida at the gestational ages of 8, 10, 15, 20, 25, 30, 35, and 38 weeks (Maynard et al. 2011). More than 30 organs and tissues and 20 skeletal sites are defined in each fetus model. We calculated fetal organ dose-normalized by CTDIvol to derive organ dose conversion coefficients (mGy/mGy) for the eight fetuses for consequential slice locations ranging from the top to the bottom of the pregnancy phantoms with 1 cm slice thickness. Organ dose from helical scans was approximated by the summation of doses from multiple axial slices included in the given scan range of interest. We then compared dose conversion coefficients for major fetal organs in the abdominal-pelvis CT scan of pregnancy phantoms with the uterine dose of a non-pregnant adult female computational phantom. A comprehensive library of organ conversion coefficients was established for the eight developing fetuses undergoing CT. They were implemented into an in-house graphical user interface-based computer program for convenient estimation of fetal organ doses by inputting CT technical parameters as well as the age of the fetus. We found that the esophagus received the least dose, whereas the kidneys received the greatest dose in all fetuses in AP scans of the pregnancy phantoms. We also found that when the uterine dose of a non-pregnant adult female phantom is used as a surrogate for fetal organ doses, root-mean-square-error ranged from 0.08 mGy (8 weeks) to 0.38 mGy (38 weeks). The uterine dose was up to 1.7-fold greater than the esophagus dose of the 38-week fetus model. The calculation tool should be useful in cases requiring fetal organ dose in emergency CT scans as well as patient dose monitoring.

Keywords: computed tomography, fetal dose, pregnant women, radiation dose

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9165 Plasma Biochemistry Values in Wild Hawksbill Turtles (Eretmochelys imbricata) during Nesting and Foraging Seasons in Qeshm Island, Persian Gulf

Authors: Fateme Afkhami, Mohsen Ehsanpour, Majid Afkhami, Maryam Ehsanpour

Abstract:

Normal reference ranges of biochemical parameters are considered important for assessing and monitoring the health status of sea turtles. For this means, serum biochemistry determinations were analyzed in normal adult nesting and foraging hawksbill turtles (Eretmochelys imbricata). Blood samples were collected in March–April during nesting season and December-November in the foraging season. Plasma biochemistry values, except for creatinine and lipase were significant between the two periods. FBS, cholesterol, triglycerides, ALP (alkaline phosphatase), AST (aspartate aminotransferase), bilirubin, total protein, LDH (lactate dehydrogenase), CK (creatine kinase) and amylase were significantly higher in nesting season than foraging season (P<0.05). On the other hand urea, ALT (alanine aminotransferase) and albumin in the nesting season were significantly lower than foraging season (P<0.05). It was concluded that the nesting E. imbricata showed significant variation in their biochemical profile due to reproductive output. This study has produced working reference intervals useful for hawksbill turtles for future conservation and rehabilitation projects in the Persian Gulf and may be of assistance in similar programs worldwide.

Keywords: plasma biochemistry, nesting, foraging, hawksbill turtles, Persian Gulf

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9164 Kidney Stones in Individuals Living with Diabetes Mellitus at King Abdul-Aziz Medical City - Tertiary Care Center, Jeddah, Saudi Arabia: A Retrospective Cohort Study

Authors: Suhaib Radi, Ibrahim Basem Nafadi, Abdullah Ahmed Alsulami, Nawaf Faisal Halabi, Abdulrhman Abdullah Alsubhi, Sami Wesam Maghrabi, Waleed Saad Alshehri

Abstract:

Background: Kidney stones greatly affect individuals. The range of these effects regarding multiple kidney stone factors (size, presence of obstruction, and modality of treatment) in stone formers with and without diabetes has not been well explored in the literature to the best of the author's knowledge. Our goal is to investigate this unexplored correlation between diabetes and kidney stones by conducting a Cohort retrospective study to precisely evaluate the effects of this condition and the existence of complications in adult individuals with diabetes in Saudi Arabia in comparison to a non-diabetic control group. Methodology: This is a retrospective cohort study aiming to evaluate the range of effects of kidney stones in stone formers in a group of adults diagnosed with type 2 diabetes mellitus and adults without diabetes between 2017 and 2019 in Jeddah, Saudi Arabia. An IRB approval has been granted for this study. The data was analyzed using SPSS. The data was collected from the 1st of December 2022 until the 1st of March 2023. Results: A total of 254 individuals diagnosed with kidney stones were included, 127 of whom were adult individuals with type 2 diabetes, and 127 were non-diabetics. Our study shows that the individuals affected with diabetes were more likely to have larger kidney stones in comparison to individuals without diabetes (13.12 mm vs. 10.53 mm, p-value = 0.03). Moreover, individuals with hypertension and dyslipidemia also had significantly larger stones. On the other hand, no significant difference was found in the presence of obstruction and modality of treatment between the two groups. Conclusion: This study done in Saudi Arabia found that individuals with kidney stones who concurrently had diabetes formed larger kidney stones, and they were also found to have other comorbidities such as HTN, dyslipidemia, obesity, and renal disease. The significance of these findings could assist in the future of primary and secondary prevention of renal stones.

Keywords: kidney stone, type 2 DM, metabolic syndrome, lithotripsy

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9163 Sustainability of Healthcare Insurance in India: A Review of Health Insurance Scheme Launched by States in India

Authors: Mohd Zuhair, Ram Babu Roy

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This paper presents an overview of the accessibility, design, and functioning of health insurance plans launched by state governments in India. In recent years, the governments of several states in India have come forward to provide health insurance coverage for the low-income group and rural population to reduce the out of pocket expenditure (OPE) on healthcare. Different health insurance schemes have different structures and offerings which differ in the different demographic factors. This study will portray a comparative analysis of the various health insurance schemes by analyzing different offerings and finance generation of the schemes. The comparative analysis will explain the lesson to be learned from these schemes and extend the existing knowledge of the health insurance in India. This would help in recognizing tension between various drivers and identifying issues pertaining to the sustainability of health insurance schemes in India.

Keywords: health insurance, out of pocket expenditure, universal healthcare, sustainability

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9162 Laboratory Evaluation of Bacillus subtilis Bioactivity on Musca domestica (Linn) (Diptera: Muscidae) Larvae from Poultry Farms in South Western Nigeria

Authors: Funmilola O. Omoya

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Muscid flies are known to be vectors of disease agents and species that annoy humans and domesticated animals. An example of these flies is Musca domestica (house fly) whose adult and immature stages occur in a variety of filthy organic substances including household garbage and animal manures. They contribute to microbial contamination of foods. It is therefore imperative to control these flies as a result of their role in Public health. The second and third instars of Musca domestica (Linn) were infected with varying cell loads of Bacillus subtilis in vitro for a period of 48 hours to evaluate its larvicidal activities. Mortality of the larvae increased with incubation period after treatment with the varying cell loads. Investigation revealed that the second instars larvae were more susceptible to treatment than the third instars treatments. Values obtained from the third instar group were significantly different (P0.05) from those obtained from the second instars group in all the treatments. Lethal concentration (LC50) at 24 hours for 2nd instars was 2.35 while LC50 at 48 hours was 4.31.This study revealed that Bacillus subtilis possess good larvicidal potential for use in the control of Musca domestica in poultry farms.

Keywords: Bacillus subtilis, Musca domestica, larvicidal activities, poultry farms

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9161 Optimizing AI Voice for Adolescent Health Education: Preferences and Trustworthiness Across Teens and Parent

Authors: Yu-Lin Chen, Kimberly Koester, Marissa Raymond-Flesh, Anika Thapar, Jay Thapar

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Purpose: Effectively communicating adolescent health topics to teens and their parents is crucial. This study emphasizes critically evaluating the optimal use of artificial intelligence tools (AI), which are increasingly prevalent in disseminating health information. By fostering a deeper understanding of AI voice preference in the context of health, the research aspires to have a ripple effect, enhancing the collective health literacy and decision-making capabilities of both teenagers and their parents. This study explores AI voices' potential within health learning modules for annual well-child visits. We aim to identify preferred voice characteristics and understand factors influencing perceived trustworthiness, ultimately aiming to improve health literacy and decision-making in both demographics. Methods: A cross-sectional study assessed preferences and trust perceptions of AI voices in learning modules among teens (11-18) and their parents/guardians in Northern California. The study involved the development of four distinct learning modules covering various adolescent health-related topics, including general communication, sexual and reproductive health communication, parental monitoring, and well-child check-ups. Participants were asked to evaluate eight AI voices across the modules, considering a set of six factors such as intelligibility, naturalness, prosody, social impression, trustworthiness, and overall appeal, using Likert scales ranging from 1 to 10 (the higher, the better). They were also asked to select their preferred choice of voice for each module. Descriptive statistics summarized participant demographics. Chi-square/t-tests explored differences in voice preferences between groups. Regression models identified factors impacting the perceived trustworthiness of the top-selected voice per module. Results: Data from 104 participants (teen=63; adult guardian = 41) were included in the analysis. The mean age is 14.9 for teens (54% male) and 41.9 for the parent/guardian (12% male). At the same time, similar voice quality ratings were observed across groups, and preferences varied by topic. For instance, in general communication, teens leaned towards young female voices, while parents preferred mature female tones. Interestingly, this trend reversed for parental monitoring, with teens favoring mature male voices and parents opting for mature female ones. Both groups, however, converged on mature female voices for sexual and reproductive health topics. Beyond preferences, the study delved into factors influencing perceived trustworthiness. Interestingly, social impression and sound appeal emerged as the most significant contributors across all modules, jointly explaining 71-75% of the variance in trustworthiness ratings. Conclusion: The study emphasizes the importance of catering AI voices to specific audiences and topics. Social impression and sound appeal emerged as critical factors influencing perceived trustworthiness across all modules. These findings highlight the need to tailor AI voices by age and the specific health information being delivered. Ensuring AI voices resonate with both teens and their parents can foster their engagement and trust, ultimately leading to improved health literacy and decision-making for both groups. Limitations and future research: This study lays the groundwork for understanding AI voice preferences for teenagers and their parents in healthcare settings. However, limitations exist. The sample represents a specific geographic location, and cultural variations might influence preferences. Additionally, the modules focused on topics related to well-child visits, and preferences might differ for more sensitive health topics. Future research should explore these limitations and investigate the long-term impact of AI voice on user engagement, health outcomes, and health behaviors.

Keywords: artificial intelligence, trustworthiness, voice, adolescent

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9160 Factors Predicting Individual Health among Pilgrims of Kurdistan County: An Application of Health Belief Model

Authors: Arsalan Ghaderi, Behzad Karami Matin, Abdolrahim Afkhamzadeh, Abouzar Keshavarzi, Parvin Nokhasi

Abstract:

Background: Lack of individual health as one of the major health problems among the pilgrims can be followed by several complications. The main aim of this study was to determine factors predicting individual health among pilgrims of Kurdistan County; in the west of Iran and health belief model (HBM) was applied as theoretical framework. Methods: A cross-sectional study was conducted among 100 pilgrims who referred in the red crescent of Kurdistan County, the west of Iran which was randomly selected for participation in this study. A structured questionnaire was applied for collecting data and data were analyzed by SPSS version 21 using bivariate correlations and linear regression statistical tests. Results: The mean age of respondents was 59.45 years [SD: 11.56], ranged from 50 to 73 years. The HBM predictor variables accounted for 47% of the variation in the outcome measure of the individual health. The best predictors for individual health were perceived severity and cause to action. Conclusion: Based on our result, it seems that designing and implementation of educational programs to increase seriousness about complications of lack of individual health and increasing cause to action among the pilgrims may be useful in order to promote individual health among pilgrims.

Keywords: individual health, pilgrims, Iran, health belief model

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9159 Experimental Lead Toxicity in Lohi Sheep: Risks and Impact on Edible Tissues

Authors: Muhammad Younus, Muhammad Sajid, Muti-ur-Rehman Khan, Aftab Ahmad Anjum, Muhammad Asif Idrees, Iahtasham Khan, Aman Ullah Khan, Sajid Umar, Raheela Akhtar

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The present study was conducted to investigate the hazardous effects of lead on health and edible organs of Lohi sheep. The adult Lohi sheep (n=48) were randomly divided into two equal groups. The first group was administered lead acetate at dose of 70 mg/kg live body weight daily as 10% solution by oral route for a period of 90 days and the second group served as a negative control. Blood and tissue samples were collected at day 0, 30, 60 and 90 and analyzed for lead concentration by atomic absorption spectrophotometry. The kidney showed the highest lead concentration (p < 0.05) followed by liver and then muscle. Lead acetate treated sheep showed structural and behavioral changes during the last month of trial. Liver showed necrosis, hemorrhages and hyperactivation of macrophages. Kidney showed degenerative and necrotic changes in glomeruli and tubules and the characteristic intranuclear inclusion bodies in tubular epithelial cells on H and E staining. It was concluded that Lohi sheep is affected by lead intoxication at low dose for longer period and hence exhibits lead accumulation in edible tissues.

Keywords: Lohi sheep, lead acetate, edible tissue, histopathology

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9158 Death Anxiety and Life Expectancy among Older Adults in Iran

Authors: Vahid Rashedi, Banafsheh Ebrahimi, Mahtab Sharif Mohseni, Mohammadali Hosseini

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Introduction: One of the metrics used to evaluate health status is life expectancy. This index alters as people age as a result of several events, illnesses, stress, and anxiety. One of the issues that might develop into a lethal phobia is death anxiety. This study looked at older persons in Tehran, Iran, to see if there was any correlation between life expectancy and fear of dying. Methods: Cluster random sampling was used to select 208 older persons (age 60) who had been sent to adult daycare facilities in Tehran for this correlational descriptive study. A demographic questionnaire, Temper's death anxiety scale, and Snyder's life expectancy scale were used to gather the data. Statistical Package for the Social Sciences softwear version 22 was used to conduct the data analysis. Results: The average age of the senior citizens was 66.60 (6.58) years. With a mean life expectancy of 24.94, it was discovered that the average death anxiety was 12.21. Additionally, Pearson's correlation coefficient demonstrated a bad correlation between fear of dying and life expectancy. Age, residential status, and death fear were the three primary predictors of a decline in life expectancy, according to multiple regression analysis. Conclusion: The findings suggest that there is a link between death fear and a lower life expectancy, which calls for the use of appropriate strategies to increase older individuals' life expectancies as well as the teaching of anxiety coping mechanisms.

Keywords: aged, frailty, death, anxiety, life

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9157 Urban Metis Women’s Identity and Experiences with Health Services in Toronto, Ontario

Authors: Renee Monchalin

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Métis peoples, while comprising over a third of the total Indigenous population in Canada, experience major gaps in health services that accommodate their cultural identities. This is problematic given Métis peoples experience severe disparities in health determinants and outcomes compared to the non-Indigenous Canadian population. At the same time, Métis are unlikely to engage in health services that do not value their cultural identities, often utilizing mainstream options. Given these contexts, this research aims to fill the culturally-safe health care gap for Métis peoples in Canada. It does this by engaging 56 urban Métis women who participated in a longitudinal cohort study, Our Health Counts (OHC) Toronto. Traditionally, Métis women were central to the health and well-being of their communities. However, due to decades of colonial legislation and forced land displacement, female narratives have been silenced, and Métis identities have been fractured. This has resulted in having direct implications on Métis people’s current health and access to health services. Solutions to filling the Métis health service gap may lie in the all too often unacknowledged or missing voices of Métis women. Through a conversational method, this research will explore urban Métis women’s perspectives on identity and their experiences with health services in Toronto. The goal of this research is to learn from urban Métis women on steps towards filling the health service gap. This research is currently in the data collection stage. Preliminary findings from the conversations will be disseminated. Policy recommendations for health service providers will be provided to better accommodate Métis people.

Keywords: indigenous health, Metis health, urban, health service access, identity

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9156 Adaptation to the Current Health Situation as a Determinant of Adherence in Pre - and Senior Age People

Authors: Mariola Głowacka

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The aim of the study was to determine the level of adaptation to the current health situation and its impact on the adherence state of people in the pre- and senior age. The work covers the results of the first of the fourteen parts of the study conducted in a group of 2,000 people aged 55 plus. This part of the project was carried out with the use of two standardized tools: the HLC adaptation scale (the health locus of control scale and The Adherence in Chronic DiseasesScale (ACDS). The obtained results showed the range of influence of particular areas of self-acceptance of the health state (health and disease) on their adherence, taking into account specific clinical conditions.

Keywords: adaptation to the current health situation, adherence, senior, badania

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9155 Developing Abbreviated Courses

Authors: Lynette Nickleberry Stewart

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The present presentation seeks to explore distinction across disciplines in the appropriateness of accelerated courses and suggestions for implementing accelerated courses in various disciplines. Grounded in a review of research on accelerated learning (AL), this presentation will discuss the intradisciplinary appropriateness of accelerated courses for various topics and student types, and make suggestions for implementing augmented courses. Meant to inform an emerging ‘handbook’ of accelerated course development, facilitators will lead participants in a discussion of personal challenges and triumphs in their attempts at accelerated course design.

Keywords: adult learning, abbreviated courses, accelerated learning, course design

Procedia PDF Downloads 100
9154 Patients’ Trust in Health Care Systems

Authors: Dilara Usta, Fatos Korkmaz

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Background: Individuals who utilise health services maintain relationships with health professionals, insurers and institutions. The nature of these relationships requires service receivers to have trust in the service providers because maintaining health services without reciprocal trust is very difficult. Therefore, individual evaluations of trust within the scope of health services have become increasingly important. Objective: To investigate patients’ trust in the health-care system and their relevant socio-demographical characteristics. Methods: This research was conducted using a descriptive design which included 493 literate patients aged 18-65 years who were hospitalised for a minimum of two days at public university and training&research hospitals in Ankara, Turkey. Patients’ trust in health-care professionals, insurers, and institutions were investigated. Data were collected using a demographic questionnaire and the Multidimensional Trust in Health-Care Systems Scale between September 2015 and April 2016. Results: The participants’ mean age was 47.7±13.1; 70% had a moderate income and 69% had a prior hospitalisation and 63.5% of the patients were satisfied with the health-care services. The mean Multidimensional Trust in Health-Care Systems Scale score for the sample was 61.5±8.3; the provider subscale had a mean of 38.1±5, the insurers subscale had a mean of 12.9±3.7, and institutions subscale had a mean of 10.6±1.9. Conclusion: Patients’ level of trust in the health-care system was above average and the trust level of the patients with higher educational and socio-economic levels was lower compared to the other patients. Health-care professionals should raise awareness about the significance of trust in the health-care system.

Keywords: delivery of health care, health care system, nursing, patients, trust

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9153 Self-Inflicted Major Trauma: Inpatient Mental Health Management and Patient Outcomes

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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9152 Associated Problems with the Open Dump Site and Its Possible Solutions

Authors: Pangkaj Kumar Mahanta, Md. Rafizul Islam

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The rapid growth of the population causes a substantial amount of increase in household waste all over the world. Waste management is becoming one of the most challenging phenomena in the present day. The most environmentally friendly final disposal process of waste is sanitary landfilling, which is practiced in most developing countries. However, in Southeast Asia, most of the final disposal point is an open dump site. Due to the ignominy of proper management of waste and monitoring, the surrounding environment gets polluted more by the open dump site in comparison with a sanitary landfill. Khulna is 3rd largest metropolitan city in Bangladesh, having a population of around 1.5 million and producing approximately 450 tons per day of Municipal Solid Waste. The Municipal solid waste of Khulna city is disposed of in Rajbandh open dump site. The surrounding air is being polluted by the gas produced in the open dump site. Also, the open dump site produces leachate, which contains various heavy metals like Cadmium (Cd), Chromium (Cr), Lead (Pb), Manganese (Mn), Mercury (Hg), Strontium (Sr), etc. Leachate pollutes the soil as well as the groundwater of the open dump site and also the surrounding area through seepage. Moreover, during the rainy season, the surface water is polluted by leachate runoff. Also, the plastic waste flowing out from the open dump site through various drivers pollutes the nearby environment. The health risk assessment associated with heavy metals was carried out by computing the chronic daily intake (CDI), hazard quotient (HQ), and hazard index (HI) via different exposure pathways following the USEPA guidelines. For ecological risk, potential contamination index (Cp), Contamination factor (CF), contamination load index (PLI), numerical integrated contamination factor (NICF), enrichment factor (EF), ecological risk index (ER), and potential ecological risk index (PERI) were computed. The health risk and ecological risk assessment results reveal that some heavy metals possess strong health and ecological risk. In addition, the child faces higher harmful health risks from several heavy metals than the adult for all the exposure pathways and media. The conversion of an open dump site into a sanitary landfill and a proper management system can reduce the problems associated with an open dump site. In the sanitary landfill, the produced gas will be managed properly to save the surrounding atmosphere from being polluted. The seepage of leachate can be minimized by installing a compacted clay layer (CCL) as a baseline and leachate collection in a sanitary landfill to save the underlying soil layer and surrounding water bodies from leachate. Another important component of a sanitary landfill is the conversion of plastic waste to energy will minimize the plastic pollution in the landfill area and also the surrounding soil and water bodies. Also, in the sanitary landfill, the bio-waste can be used to make compost to reduce the volume of bio-waste and proper utilization of the landfill area.

Keywords: ecological risk, health risk, open dump site, sanitary landfill

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9151 Influence of Engaging Female Caregivers in Households with Adolescent Girls on Adopting Equitable Family Eating Practices: A Quasi-Experimental Study

Authors: Hanna Gulema, Meaza Demissie, Alemayehu Worku, Tesfaye Assebe Yadeta, Yemane Berhane

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Background: In patriarchal societies, female caregivers decide on food allocation within a family based on prevailing gender and age norms, which may lead to inequality that does not favor young adolescent girls. This study evaluated the effect of a community-based social norm intervention involving female caregivers in West Hararghe, Ethiopia. The intervention was engaging female caregivers along with other adult influential community members to deliberate and act on food allocation social norms in a process referred to as Social Analysis and Action (SAA). Method: We used data from a large quasi-experimental study to compare family eating practices between those who participated in the Social Analyses and Action intervention and those who did not. The respondents were female caregivers in households with young adolescent girls (ages 13 and 14 years). The study’s outcome was the practice of family eating together from the same dish. The difference in difference (DID) analysis with the Mixed effect logistic regression model was used to examine the effect of the intervention. Result: The results showed improved family eating practices in both groups, but the improvement was greater in the intervention group. The DID analysis showed an 11.99 percentage points greater improvement in the intervention arm than in the control arm. The mixed-effect regression produced an adjusted odds ratio of 2.08 (95% CI [1.06–4.09]) after controlling selected covariates, p-value 0.033. Conclusions: The involvement of influential adult community members significantly improves the family practice of eating together in households where adolescent girls are present in our study. The intervention has great potential to minimize household food allocation inequalities and thus improve the nutritional status of young adolescents. Further studies are necessary to evaluate the effectiveness of the intervention in different social norm contexts to formulate policy and guidelines for scale-up.

Keywords: family eating practice, social norm intervention, adolescence girls, caregiver

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9150 Using Health Literacy and Medico-Legal Guidance to Improve Restorative Dentistry Patient Information Leaflets

Authors: Hasneet K. Kalsi, Julie K. Kilgariff

Abstract:

Introduction: Within dentistry, the process for gaining informed consent has become more complex. To consent for treatment, patients must understand all reasonable treatment options and associated risks and benefits. Consenting is therefore deeply embedded in health literacy. Patients attending for dental consultation are often presented with an array of information and choices, yet studies show patients recall less than half of the information provided immediately after. Appropriate and comprehensible patient information leaflets (PILs) may be useful aid memories. In 2016 the World Health Organisation set improving health literacy as a global priority. Soon after, Scotland’s 2017-2025 Making it Easier: A Health Literacy Action Plan followed. This project involved the review of Restorative PILs used within Dundee Dental Hospital to assess the Content and Readability. Method: The current PIL on Root Canal Treatment (RCT) was created in 2011. This predates the Montgomery vs. NHS Lanarkshire case, a ruling which significantly impacted dental consenting processes, as well as General Dental Council’s (GDC’s) Standards for the Dental Team and Faculty of General Dental Practice’s Good Practice Guidance on Clinical Examination and Record-Keeping. Current evidence-based guidance, including that stipulated by the GDC, was reviewed. A 20-point Essential Content Checklist was designed to conform to best practice guidance for valid consenting processes. The RCT leaflet was scored against this to ascertain if the content was satisfactory. Having ensured the content satisfied medicolegal requirements, health literacy considerations were reviewed regarding readability. This was assessed using McLaughlin’s Simple Measure of Gobbledygook (SMOG) formula, which identifies school stages that would have to be achieved to comprehend the PIL. The sensitivity of the results to alternative readability methods were assessed. Results: The PIL was not sufficient for modern consenting processes and reflected a suboptimal level of health literacy. Evaluation of the leaflet revealed key content was missing, including information pertaining to risks and benefits. Only five points out of the 20-point checklist were present. The readability score was 16, equivalent to a level 2 in National Adult Literacy Standards/Scottish Credit and Qualification Framework Level 5; 62% of Scottish adults are able to read to this standard. Discussion: Assessment of the leaflet showed it was no longer fit for purpose. Reasons include a lack of pertinent information, a text-heavy leaflet lacking flow, and content errors. The SMOG score indicates a high level of comprehension is required to understand this PIL, which many patients may not possess. A new PIL, compliant with medicolegal and health literacy guidance, was designed with patient-driven checklists, notes spaces for annotations/ questions and areas for clinicians to highlight important case-specific information. It has been tested using the SMOG formula. Conclusion: PILs can be extremely useful. Studies show that interactive use can enhance their effectiveness. PILs should reflect best practice guidance and be understood by patients. The 2020 leaflet designed and implemented aims to fulfill the needs of a modern healthcare system and its service users. It embraces and embeds Scotland’s Health Literacy Action Plan within the consenting process. A review of further leaflets using this model is ongoing.

Keywords: consent, health literacy, patient information leaflet, restorative dentistry

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9149 The Experience of Applying Multi-Sensory Stimulation ICU for Arousing a Patient with Traumatic Brain Injury in Intensive Care

Authors: Hsiao-Wen Tsai

Abstract:

Motor vehicle accident is the first cause of head injury in the world; severe head injury cases may cause conscious disturbance and death. This is a report about a case of a young adult patient suffering from motor vehicle accident leading to severe head injury who passed through three time surgical procedures, and his mother (who is the informal caregiver). This case was followed from 28th January to 15th February 2011 by using Gordon’s 11 functional health patterns. Patient’s cognitive-perceptual and self-perception-self-concept patterns were altered. Anxiety was also noted on his informal caregiver due to patients’ condition. During the intensive care period, maintaining patient’s vital signs and cerebral perfusion pressure were essential to avoid secondary neuronal injury. Multi-sensory stimulation, caring accompanying, supporting, listening and encouraging patient’s family involved in patient care were very important to reduce informal caregiver anxiety. Finally, the patient consciousness improved from GCS 4 to GCS 11 before discharging from ICU. Patient’s primary informal caregiver, his mother, also showed anxiety improvement. This is was successful case with traumatic brain injury recovered from coma.

Keywords: anxiety, multi-sensory stimulation, reduce intracranial adaptive capacity, traumatic brain injury

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9148 Effectiveness of Public Health Laws and Study of Social Aspects: With Special Reference to India

Authors: Arun Karoriya, Mrinal Agrawal

Abstract:

Health is one of the basic requirements of human being. And today India is facing a major degradation of health at every age group. As society evolves and flourishes, there are different types of rules, norms, standards which are required to control the conduct of the human being for its well-being and growth. Right to health is one of those aspects that can be counted, discovered and examined under the purview of constitutional provisions of India. The condition of health is at downfall despite the fact that there are several policies framed by the government. There is an urgent call for rigid public health laws to ensure safe and disease free society. The effectiveness of health law has to be examined by keeping in mind that it is hampering growth and economy and society establishment. Health in any society is a main social aspect as it plays a major role for economic development. The multidimensional approach to determine it is by discussing i) rational selection and use of medicines ii) sustainable adequate financing iii) affordable prices iv)reliable health and supply systems.

Keywords: degradation, flourish, multidimensional, policies

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9147 Cognition in Crisis: Unravelling the Link Between COVID-19 and Cognitive-Linguistic Impairments

Authors: Celine Davis

Abstract:

The novel coronavirus 2019 (COVID-19) is an infectious disease caused by the virus SARS-CoV-2, which has detrimental respiratory, cardiovascular, and neurological effects impacting over one million lives in the United States. New researches has emerged indicating long-term neurologic consequences in those who survive COVID-19 infections, including more than seven million Americans and another 27 million people worldwide. These consequences include attentional deficits, memory impairments, executive function deficits and aphasia-like symptoms which fall within the purview of speech-language pathology. The National Health Interview Survey (NHIS) is a comprehensive annual survey conducted by the National Center for Health Statistics (NCHS), a branch of the Centers for Disease Control and Prevention (CDC) in the United States. The NHIS is one of the most significant sources of health-related data in the country and has been conducted since 1957. The longitudinal nature of the study allows for analysis of trends in various variables over the years, which can be essential for understanding societal changes and making treatment recommendations. This current study will utilize NHIS data from 2020-2022 which contained interview questions specifically related to COVID-19. Adult cases of individuals between the ages of 18-50 diagnosed with COVID-19 in the United States during 2020-2022 will be identified using the National Health Interview Survey (NHIS). Multiple regression analysis of self-reported data confirming COVID-19 infection status and challenges with concentration, communication, and memory will be performed. Latent class analysis will be utilized to identify subgroups in the population to indicate whether certain demographic groups have higher susceptibility to cognitive-linguistic deficits associated with COVID-19. Completion of this study will reveal whether there is an association between confirmed COVID-19 diagnosis and heightened incidence of cognitive deficits and subsequent implications, if any, on activities of daily living. This study is distinct in its aim to utilize national survey data to explore the relationship between confirmed COVID-19 diagnosis and the prevalence of cognitive-communication deficits with a secondary focus on resulting activity limitations. To the best of the author’s knowledge, this will be the first large-scale epidemiological study investigating the associations between cognitive-linguistic deficits, COVID-19 and implications on activities of daily living in the United States population. These findings will highlight the need for targeted interventions and support services to address the cognitive-communication needs of individuals recovering from COVID-19, thereby enhancing their overall well-being and functional outcomes.

Keywords: cognition, COVID-19, language, limitations, memory, NHIS

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9146 Assessing the Adoption of Health Information Systems in a Resource-Constrained Country: A Case of Uganda

Authors: Lubowa Samuel

Abstract:

Health information systems, often known as HIS, are critical components of the healthcare system to improve health policies and promote global health development. In a broader sense, HIS as a system integrates data collecting, processing, reporting, and making use of various types of data to improve healthcare efficacy and efficiency through better management at all levels of healthcare delivery. The aim of this study is to assess the adoption of health information systems (HIS) in a resource-constrained country drawing from the Unified Theory of Acceptance and Use of Technology 2 (UTAUT2) model. The results indicate that the user's perception of the technology and the poor information technology infrastructures contribute a lot to the low adoption of HIS in resource-constrained countries.

Keywords: health information systems, resource-constrained countries, health information systems

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9145 The Interactive Wearable Toy "+Me", for the Therapy of Children with Autism Spectrum Disorders: Preliminary Results

Authors: Beste Ozcan, Valerio Sperati, Laura Romano, Tania Moretta, Simone Scaffaro, Noemi Faedda, Federica Giovannone, Carla Sogos, Vincenzo Guidetti, Gianluca Baldassarre

Abstract:

+me is an experimental interactive toy with the appearance of a soft, pillow-like, panda. Shape and consistency are designed to arise emotional attachment in young children: a child can wear it around his/her neck and treat it as a companion (i.e. a transitional object). When caressed on paws or head, the panda emits appealing, interesting outputs like colored lights or amusing sounds, thanks to embedded electronics. Such sensory patterns can be modified through a wirelessly connected tablet: by this, an adult caregiver can adapt +me responses to a child's reactions or requests, for example, changing the light hue or the type of sound. The toy control is therefore shared, as it depends on both the child (who handles the panda) and the adult (who manages the tablet and mediates the sensory input-output contingencies). These features make +me a potential tool for therapy with children with Neurodevelopmental Disorders (ND), characterized by impairments in the social area, like Autism Spectrum Disorders (ASD) and Language Disorders (LD): as a proposal, the toy could be used together with a therapist, in rehabilitative play activities aimed at encouraging simple social interactions and reinforcing basic relational and communication skills. +me was tested in two pilot experiments, the first one involving 15 Typically Developed (TD) children aged in 8-34 months, the second one involving 7 children with ASD, and 7 with LD, aged in 30-48 months. In both studies a researcher/caregiver, during a one-to-one, ten-minute activity plays with the panda and encourages the child to do the same. The purpose of both studies was to ascertain the general acceptability of the device as an interesting toy that is an object able to capture the child's attention and to maintain a high motivation to interact with it and with the adult. Behavioral indexes for estimating the interplay between the child, +me and caregiver were rated from the video recording of the experimental sessions. Preliminary results show how -on average- participants from 3 groups exhibit a good engagement: they touch, caress, explore the panda and show enjoyment when they manage to trigger luminous and sound responses. During the experiments, children tend to imitate the caregiver's actions on +me, often looking (and smiling) at him/her. Interesting behavioral differences between TD, ASD, and LD groups are scored: for example, ASD participants produce a fewer number of smiles both to panda and to a caregiver with respect to TD group, while LD scores stand between ASD and TD subjects. These preliminary observations suggest that the interactive toy +me is able to raise and maintain the interest of toddlers and therefore it can be reasonably used as a supporting tool during therapy, to stimulate pivotal social skills as imitation, turn-taking, eye contact, and social smiles. Interestingly, the young age of participants, along with the behavioral differences between groups, seem to suggest a further potential use of the device: a tool for early differential diagnosis (the average age of a child

Keywords: autism spectrum disorders, interactive toy, social interaction, therapy, transitional wearable companion

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9144 Economic Cost of Malaria: A Threat to Household Income in Nigeria

Authors: Nsikan Affiah, Kayode Osungbade, Williams Uzoma

Abstract:

Malaria remains one of the major killers of humans worldwide, threatening the lives of more than one-third of the world’s population. Some people refers it to; a disease of poverty because it contributes towards national poverty through its impact on foreign direct investment, tourism, labour productivity, and trade. At the micro level, it may cause poverty through spending on health care, income losses, and premature deaths. Unfortunately, malaria is a disease that affects both low-income household and its high-income counterpart, but low-income households are still at greater risk because significant part of the available monthly income is dedicated to various preventive and treatment measures. The objective of this study is to estimate direct and indirect cost of malaria treatment in households in a section of South-South Region (Akwa Ibom State) of Nigeria. A cross-sectional study of Six Hundred and Forty (640) heads of households or any adult representative of households in three local government areas of Akwa Ibom State, Nigeria from May 1-31, 2015 were ascertained through interviewer-administered questionnaire adapted from Nigerian Malaria Indicator Survey Report. The clustering technique was used to select 640 households with the help of Primary Health Care (PHC) house numbering system. Using exchange rate of 197 Naira/USD, result shows that direct cost of malaria treatment was 8,894.44 USD while the indirect cost of malaria treatment was 11,012.81 USD. Total cost of treatment made up of 44.7% direct cost and 55.3% indirect cost, with average direct cost of malaria treatment per household estimated at 20.6 USD and the average indirect cost of treatment per household estimated at 25.1 USD. Average total cost for each episode (888) of malaria was estimated at 22.4 USD. While at household level, the average total cost was estimated at 45.5 USD. From the average total cost, low-income households would spend 36% of monthly household income on treating malaria and the impact could be said to be catastrophic, compared to high-income households where only 1.2% of monthly household income is spent on malaria treatment. It could be concluded that the cost of malaria treatment is well beyond the means of households and given the reality of repeated bouts of malaria and its contribution to the impoverishment of households, there is a need for urgent action.

Keywords: direct cost, indirect cost, low income households, malaria

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9143 Parent and Child Body Dissatisfaction: The Roles of Implicit Behavior and Child Gender in Middle Childhood

Authors: Vivienne Langhorne, Helen Sharpe

Abstract:

Body dissatisfaction begins developing in middle childhood, with wide-ranging implications for mental health and well-being. Previous research on parent behavior has focused on the role of explicit parent behaviors in adolescent and young adult body dissatisfaction, leaving a gap in understanding how implicit parent behaviors relate to body dissatisfaction in childhood. The current study investigated how implicit parent behavior (such as modeling own body dissatisfaction and dieting) relates to parent and child body dissatisfaction. It was hypothesized that implicit behavior would be directly related to parent and child body dissatisfaction and mediate the relationship between the two. Furthermore, this study aimed to examine child gender as a potential moderator in this mediation, as research shows that boys and girls experience body dissatisfaction differently. This study analyzed survey responses on parent body dissatisfaction, implicit behavior, and child body dissatisfaction measures from a sample of 166 parent-child dyads with children between the ages of 6 to 9 years old. Regression analyses revealed that parent body dissatisfaction is related to both parent-implicit behavior and child body dissatisfaction. However, implicit behavior did not mediate the relationship between the two body dissatisfaction variables. Additionally, the results of moderated mediation indicated there were no child gender differences in the strength of the association between parental implicit behaviors and child body dissatisfaction. These findings highlight the need for further research into the mechanisms behind parent and child body dissatisfaction to better understand the process through which intergenerational transmission occurs.

Keywords: body dissatisfaction, implicit behaviour, middle childhood, parenting

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9142 Input and Interaction as Training for Cognitive Learning: Variation Sets Influence the Sudden Acquisition of Periphrastic estar 'to be' + verb + -ndo*

Authors: Mary Rosa Espinosa-Ochoa

Abstract:

Some constructions appear suddenly in children’s speech and are productive from the beginning. These constructions are supported by others, previously acquired, with which they share semantic and pragmatic features. Thus, for example, the acquisition of the passive voice in German is supported by other constructions with which it shares the lexical verb sein (“to be”). This also occurs in Spanish, in the acquisition of the progressive aspectual periphrasis estar (“to be”) + verb root + -ndo (present participle), supported by locative constructions acquired earlier with the same verb. The periphrasis shares with the locative constructions not only the lexical verb estar, but also pragmatic relations. Both constructions can be used to answer the question ¿Dónde está? (“Where is he/she/it?”), whose answer could be either Está aquí (“He/she/it is here”) or Se está bañando (“He/she/it is taking a bath”).This study is a corpus-based analysis of two children (1;08-2;08) and the input directed to them: it proposes that the pragmatic and semantic support from previously-acquired constructions comes from the input, during interaction with others. This hypothesis is based on analysis of constructions with estar, whose use to express temporal change (which differentiates it from its counterpart ser [“to be”]), is given in variation sets, similar to those described by Küntay and Slobin (2002), that allow the child to perceive the change of place experienced by nouns that function as its grammatical subject. For example, at different points during a bath, the mother says: El jabón está aquí “The soap is here” (beginning of bath); five minutes later, the soap has moved, and the mother says el jabón está ahí “the soap is there”; the soap moves again later on and she says: el jabón está abajo de ti “the soap is under you”. “The soap” is the grammatical subject of all of these utterances. The Spanish verb + -ndo is a progressive phase aspect encoder of a dynamic state that generates a token. The verb + -ndo is also combined with verb estar to encode. It is proposed here that the phases experienced in interaction with the adult, in events related to the verb estar, allow a child to generate this dynamicity and token reading of the verb + -ndo. In this way, children begin to produce the periphrasis suddenly and productively, even though neither the periphrasis nor the verb + -ndo itself are frequent in adult speech.

Keywords: child language acquisition, input, variation sets, Spanish language

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9141 A Strategy Therapy for Retinitis Pigmentosa Induced by Argon Laser in Rabbits by High Dose Adult Stem Cells

Authors: Hager E. Amer, Hany El Saftawy, Laila Rashed, Ahmed M. Ata, Fatma Metwally, Hesham Mettawei, Hossam E. Sayed, Tamer Adel, Kareem M. El Sawah

Abstract:

Aim: The purpose of this study is to regenerate the damaged photoreceptor cells as a result of argon laser as a model of Retinitis Pigmentosa in rabbits' retina by using adult stem cells from rabbits' bone marrow. Background: Retinitis pigmentosa (RP) is a group of inherited disorders that primarily affect photoreceptor and pigment epithelium function. RP leads to loss of the rod outer segment and shorten the photoreceptor layer and expose the photoreceptor cell body to high-pressure levels in oxygen (oxidative stress) leads to apoptosis to the rod and cone cells. In particular, there is no specific treatment for retinitis pigmentosa. Materials and Methods: Forty Two Giant (Rex) rabbits were used in this experiment divided into 3 groups: Group 1: Control (6 rabbits), Group 2: Argon laser radiated as a model of retinitis pigmentosa (12 rabbits), Group 3: Laser radiated and treated by 6 million stem cells (12 rabbits). The last two groups are divided each into two subgroups each subgroup contains 6 rabbits, the ophthalmological examination was performed on rabbits, blood samples and retina samples were taken after 25 days and after 36 days from the laser radiation (10 days and 21 days after stem cells insertion in group 3) to perform the biochemical analysis. Results: Compared to control Group, a decrease of ERG wave amplitude and antioxidant substances (Glutathione) in blood and retina in group 2, and an increase of oxidative stress substances (Nitric oxide, Malonaldehyde, and carponyl protein) and apoptotic substances (Advanced glycation end product and M-metalloproteinase) in blood and retina. Compared to group 2, mostly increases of antioxidant substances and ERG wave amplitude in group 3, and mostly decreases in oxidative stress substances and apoptotic substances. Conclusion: Insertion of 6 million stem cells intravitreous gives good results in regeneration of the damaged photoreceptor cells after 21 days.

Keywords: retinitis pigmentosa, stem cells, argon laser, oxidative stress, apoptosis

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9140 Encouraging Girl-Child Education for Better Reproductive Health in Nigeria

Authors: Alikeju F. Maji

Abstract:

The role of girl child education on reproductive health of any nation cannot be over emphasized. Today this has become a global concern because of the awareness that girl child education has direct proven impact on reproductive health and sustainable development of a national. Thus, this paper attempts to re-emphasize and re-awaken the mind of humanity on the undisputable importance of girl-child education as a tool for improving reproductive health in Nigeria. The paper further examine that despite government’s effort in attaining education for all by the year 2015, the numbers of girls attending schools remain abysmally low in Nigeria. The paper noted that if the trend persists, personal health of women and their contribution to national development will reduce. The paper recommends that women in Nigeria should be availed with good educational opportunities to enhance their improved reproductive health, and greater participating in national development.

Keywords: girl-child education, reproductive health, sustainable development, personal health

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9139 Water Accessibility at Household Levels in Zambia: A Case Study of Fitobaula Settlement

Authors: Emmanuel Sachikumba, Micheal Msoni, Westone Mafuleka

Abstract:

Zambia has a good climate with favourable rainfall pattern; this provides sufficient recharge for the surface and groundwater resources. In spite of the sufficient surface and ground water resources, accessibility to water at household levels is problematic both in quality and quantity. The study examined water accessibility as well as water quality at the household level. The research looked at the sources of water for the households and considered the complications of accessibility to water and the available opportunities therein. The investigation involved fifty households and the data was collected by the use of questionnaires (to assess accessibility) and laboratory tests (for ascertaining water quality). In addition to this, government departments such as the health, agriculture, forestry and education as well as the municipal council were interviewed on the topic under study. The study was descriptive in nature where clustered sampling procedures using simple random methods were utilised to select the households which were to participate in the study. The key findings were that; accessibility to water household levels is still a challenge in the settlement as most of the point sources (shallow wells, the stream and the river) were found to be contaminated. In addition to this, it was found that there was no direct relationship between the economic performance of a household and the accessibility to water. The study also observed that there were opportunities for the people in the settlement as they were increasingly getting into the education system, and adult literacy was being encouraged in the settlement. Furthermore, the settlement has groundwater resources which indicate that there can be sufficient water provision for the settlers.

Keywords: accessibility, household, water, settlement

Procedia PDF Downloads 417