Search results for: health and nutrition services

Authors: Shawna M. Margesson

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This research study seeks to explore the lived experience of peer support workers (PSWs) in a peer-led non-governmental organization in Denver, Colorado, USA. The Colorado Mental Wellness Network offers supportive wellness recovery services such as wellness recovery action plans (WRAP), advocacy trainings for anti-stigma campaigns, and PSWs to work with and for consumers in the community. This study suggests that a peer-run environment is a unique community setting for PSWs to work given all employees are living in mental wellness recovery. Little has been documented about PSWs' personal accounts of working within a recovery-oriented organization and their first-person accounts to working with consumers. The importance of this study is to provide an ethnographic account of both subjects; the lived experiences of PSWs of both organizational and consumer-driven recovery. This study seeks to add to the literature and the social work profession the personal accounts of PSWs as they provide services to others like themselves. It also will provide an additional lens to view the peer-driven movement in mental health and wellness recovery.

Keywords: peer to peer movement, mental health, ethnography, peer support workers

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Authors: Bing Li, Zhi Li, Yilong Yang

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Web classification can promote the quality of service discovery and management in the service repository. It is widely used to locate developers desired services. Although traditional classification methods based on supervised learning models can achieve classification tasks, developers need to manually mark web services, and the quality of these tags may not be enough to establish an accurate classifier for service classification. With the doubling of the number of web services, the manual tagging method has become unrealistic. In recent years, the attention mechanism has made remarkable progress in the field of deep learning, and its huge potential has been fully demonstrated in various fields. This paper designs a multi-head attention graph convolutional network (MHAGCN) service classification method, which can assign different weights to the neighborhood nodes without complicated matrix operations or relying on understanding the entire graph structure. The framework combines the advantages of the attention mechanism and graph convolutional neural network. It can classify web services through automatic feature extraction. The comprehensive experimental results on a real dataset not only show the superior performance of the proposed model over the existing models but also demonstrate its potentially good interpretability for graph analysis.

Keywords: attention mechanism, graph convolutional network, interpretability, service classification, service discovery

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Authors: Ademola Ibukunolu Atanda, Gbenga Nathaniel Adeola

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The study examined awareness of child rights as a determinant of effective student personnel services in public secondary schools in Southwestern Nigeria. It was survey research. The sample comprised 433 teachers, 137 school administrators, and 968 students who were drawn by simple random sampling techniques. The respondents were given copies of questionnaires tagged “school administrator/teacher’s awareness of child’s rights and student personnel services elements inventory.” Key Informant Interview (KII) was also employed. The data were analysed using frequency count, percentages, weighted average, grand mean, standard deviation, and Pearson Product Moment Correlation, while KII was qualitatively analysed. The findings of the study revealed that public secondary school administrator awareness of child rights was at a moderate level, but the awareness of child rights was low among the teachers. The study equally revealed that student personnel services are moderately provided in public secondary schools in Southwestern Nigeria, but security remains a major challenge. It was also found that there was a significant relationship between awareness of child rights and effective student personnel services. It was therefore recommended, based on the findings, that attention should be given to heightening awareness of child rights among public secondary school administrators and teachers for effective student personnel services. Copies of the Child Right Act 2003 should also be made available in all public secondary schools in Southwestern Nigeria, as the study revealed that the documents were not available.

Keywords: student personnel, child right, administrator awareness, practice of child right

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Authors: Miriam I. Jimenez-Perez, Mariana C. Orellana-Haro, Carolina Guzman-Brambila

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As part of microbiology and dietetics courses, students of medicine and nutrition analyze the main pathogenic microorganisms and perform dietary analyzes. The course of microbiology describes in a general way the main pathogens including bacteria, viruses, fungi, and parasites, as well as their interaction with the human species. We hypothesize that lack of practical application of the course causes the students not to find the value and the clinical application of it when in reality it is a matter of great importance for healthcare in our country. The courses of the medical microbiology and dietetics are mostly theoretical and only a few hours of laboratory practices. Therefore, it is necessary the incorporation of new innovative techniques that involve more practices and community fieldwork, real cases analysis and real-life situations. The purpose of this intervention was to incorporate real-world learning experiences in the instruction of medical microbiology and dietetics courses, in order to improve the learning process, understanding and the application in the field. During a period of 6 months, medicine and nutrition students worked in a community of urban poverty. We worked with 90 children between 4 and 6 years of age from low-income families with no access to medical services, to give an infectious diagnosis related to nutritional status in these children. We expect that this intervention would give a different kind of context to medical microbiology and dietetics students improving their learning process, applying their knowledge and laboratory practices to help a needed community. First, students learned basic skills in microbiology diagnosis test during laboratory sessions. Once, students acquired abilities to make biochemical probes and handle biological samples, they went to the community and took stool samples from children (with the corresponding informed consent). Students processed the samples in the laboratory, searching for enteropathogenic microorganism with RapID™ ONE system (Thermo Scientific™) and parasites using Willis and Malloy modified technique. Finally, they compared the results with the nutritional status of the children, previously measured by anthropometric indicators. The anthropometric results were interpreted by the OMS Anthro software (WHO, 2011). The microbiological result was interpreted by ERIC® Electronic RapID™ Code Compendium software and validated by a physician. The results were analyses of infectious outcomes and nutritional status. Related to fieldwork community learning experiences, our students improved their knowledge in microbiology and were capable of applying this knowledge in a real-life situation. They found this kind of learning useful when they translate theory to a real-life situation. For most of our students, this is their first contact as health caregivers with real population, and this contact is very important to help them understand the reality of many people in Mexico. In conclusion, real-world or fieldwork learning experiences empower our students to have a real and better understanding of how they can apply their knowledge in microbiology and dietetics and help a much- needed population, this is the kind of reality that many people live in our country.

Keywords: real-world learning experiences, medical microbiology, dietetics, nutritional status, infectious status.

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Authors: Lo Kar Yin

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In view of the increasing speed and quantity of the housing supply, building, and civil engineering infrastructure works triggered by the pandemic across the globe, contractors, professional services providers (PSP), including consultants (e.g., architect, project manager, civil/geotechnical/structural engineer, building services engineer, quantity surveyor/cost manager, etc.) and suppliers have faced tremendous challenges of the fierce market, limited manpower, and resources under contract prices fluctuation and competitive fee and price. With qualitative analysis, this paper is to review the available information from the industry stakeholders with a view to finding solutions for enhancing efficiency, safety, and quality of construction value chain services for public and private organizations/companies’ sustainable growth, not limited to checking the deliverables and data transfer from multi-disciplinary parties. Technology, contracts, and people are the key requirements for shaping the construction industry. With the integration of a modern engineering contract (e.g., NEC) collaborative approach, practical workflows are designed to address loopholes together with different levels of people employment/retention and technology adoption to achieve the best value for money.

Keywords: efficiency, safety, quality, technology, contract, people, sustainable solutions, construction, services, integration

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Authors: Rabab Makki, Deputy Chief Dietitian

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Malnutrition is commonly seen in Liver Disease patients. Prevalence of malnutrition in cirrhosis, is as high as 65-90%. Protein depletion and reduced muscle function are common. There are many mechanisms of malnutrition in liver cirrhosis e.g. insulin resistance, low respiratory quotient, increased glucogenesis etc. Nutrition support improves outcome in patients unable to maintain an intake of 35-40 Kcal/kg and 1.2-1.5 gm/kg/day. Simple methods of assessment such as subjective global assessment, calorie counting, MMC are useful. The value of BCAAs remains uncertain despite a considerable number of studies. Normal protein diets have been given safely to patients with hepatic encephalopathy. Restriction of protein not more than 48 hours pre- and pro-biotic, glutamine, fish oil etc are all part of the latest advanced techniques used.

Keywords: liver cirrhosis, omega 3 for liver disease, nutrition management, malnutrition

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Authors: Gudakesh Yadav

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Uttar Pradesh is one of the poorest performing states of India in terms of child health. Using data from the three round of NFHS and two rounds of DLHS, this paper attempts to examine tempo-spatial change in child health and care practices in Uttar Pradesh and its regions. Rate-ratio, CI, multivariate, and decomposition analysis has been used for the study. Findings demonstrate that child health care practices have improved over the time in all regions of the state. However; western and southern region registered the lowest progress in child immunization. Nevertheless, there is no decline in prevalence of diarrhea and ARI over the period, and it remains critically high in the western and southern region. These regions also poorly performed in giving ORS, diarrhoea and ARI treatment. Public health services are least preferred for diarrhoea and ARI treatment. Results from decomposition analysis reveal that rural area, mother’s illiteracy and wealth contributed highest to the low utilization of the child health care practices consistently over the period of time. The study calls for targeted intervention for vulnerable children to accelerate child health care service utilization. Poor performing regions should be targeted and routinely monitored on poor child health indicators.

Keywords: Acute Respiratory Infection (ARI), decomposition, diarrhea, inequality, immunization

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Authors: Eda Kocakaya, Sebahat Seker, Dogan Argun

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The aim of this study is to determine the process of information technologies and the connections between concepts in accounting management services in Turkey. The objective of this study is to determine the adaptation and evaluation process of information technologies and the connections between concepts and differences in accounting management services in Turkey. The situation and determination of the IT applications of Accounting Management were studied. The applications of • Billing • Order Processing • Accounts Receivable/Payable Management • Contract Management • Bank Account Management Were discussed in this study. The IT applications were demonstrated and realized in actual accounting services. The sectoral representative's companies were selected, and the IT application was searched by bibliometric analysis.

Keywords: management, accounting, information technologies, adaptation

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Authors: D. Muyama, M. Luyiga, P. Buyungo, D. Chemonges, M. Namukwaya, L. Ssekabembe, B. Lukwago, D. Kyamagwa

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Context: The study focuses on the sustainability of health interventions in Uganda, particularly in the private sector, beyond donor-funded project periods. The Population Services International (PSI) implemented the Women Health Project (WHP) to ensure continued access to quality family planning, cervical cancer screening, and post-abortion care services through private clinics. Research Aim: The aim of the study is to assess the continued access to quality family planning, cervical cancer screening, and post-abortion care services through the private sector after the closure or reduction in funding of the WHP. Methodology: PSI trained and mentored 83 clinics to establish functional systems in self-regulatory quality improvement, supply chain, referral, and demand creation. The clinics were also connected to the national reporting system and utilized Ministry of Health reporting tools. An assessment tool with six criteria was designed and used to evaluate the progress of the clinics. Clinics scoring 75% and above were considered independent and graduated from the program. Findings: Out of the 83 private clinics, 56 successfully met the graduation criteria and graduated from the program, while 25 lost interest and were gradually dropped. Two clinics failed to achieve the criteria due to leadership challenges. The 59 graduating clinics continued to provide high-quality family planning services, including IUD, implant, Depo-Provera, oral contraceptives, and post-abortion care. All graduating clinics were reassessed and found to still be capable of offering services, attributing their success to government stock availability and acquired skills through mentorships. The clinics expressed appreciation to PSI for the sustainable plan that allowed them to operate beyond the project period. Theoretical Importance: This study contributes to the understanding of sustainability planning and the importance of clinic owners' attitudes and buy-in for continued service provision. It emphasizes the implementation of sustainability plans through existing structures to leverage available resources and ensure continuity of care. Data Collection and Analysis Procedures: The study collected data through the assessment tool that evaluated the progress of clinics based on the established criteria. The tool was scored out of 100%, and clinics scoring above 75% were deemed independent. The findings were analyzed quantitatively to determine the success rate of clinics in meeting the graduation criteria. Questions Addressed: The study addresses the question of whether private clinics in Uganda can sustain the provision of family planning, cervical cancer screening, and post-abortion care services after the closure or reduction in funding of the WHP. Conclusion: The study concludes that the attitude and buy-in of clinic owners are essential for sustainability planning. Implementing sustainability plans through existing structures and leveraging available resources are crucial for the continuity of care after the end of a project or reduced funding. The findings highlight the importance of establishing sustainable plans to ensure continued access to essential health services beyond the project period. Contributions: This study contributes to the existing knowledge for programmers implementing or intending to implement donor-funded projects. It provides insights into designing sustainable plans that enable the independent operation of clinics even after the end of a project.

Keywords: graduation, family planning, systems strengthening, sustainability

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Authors: Hussein Moselhy, Islam Salam

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There have been some challenges and problems which hinder the implementation of the e-marketing systems such as the high cost of information systems infrastructure and maintenance as well as their unavailability within the institution. Also, there is no system which supports all programming languages and different platforms. Another problem is the lack of integration between these systems on one hand and the operating systems and different web browsers on the other hand. No system for customer relationship management is established which recognizes their desires and puts them in consideration while performing e-marketing functions is available. Therefore, the service-oriented architecture emerged as one of the most important techniques and methodologies to build systems that integrate with various operating systems and different platforms and other technologies. This technology allows realizing the data exchange among different applications. The service-oriented architecture represents distributed computing concepts to demonstrate its success in achieving the requirements of systems through web services. It also reflects the appropriate design for the services to use different web services in supporting the requirements of business processes and software users. In a service-oriented environment, web services are deployed on the web in the form of independent services to be accessed without knowledge of the nature of the programs and systems with in. This Paper presents a proposal for a new model which contributes to the application of methods and means of e-marketing with the integration of marketing mix elements to improve marketing efficiency (E-MSOA). And apply it in the educational city of one of the Egyptian sector.

Keywords: service-oriented architecture, electronic commerce, virtual retailing, unified modeling language

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Authors: Anjali Sharma, R. R. K. Sharma

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The purpose of this study is to examine relationships between personality factors and customer switching for services. Earlier research was directed towards establishing relationship between individual personality traits and customer switching variables considering five-factors model comprised of five personality dimensions (OCEAN), in which personality was not the only influencing factor. Moreover, these works were found to be focused on products and not services. In contrast, the current study is aimed at investigating role of personality using Myer Briggs Type indicator (MBTI) as well as Five-Big Factors, on customer switching and building the conceptual framework on services rather than products. MBTI also known as four opposite pairs or dichotomies of personality dimensions are studied using different levels Involvement (High, Low) of consumer and Value of service-offering (Value for money and Premium) as moderators associated with Consumer Switching. The study is unique in sense that consequences of these indicators of personality on switching behavior has never been studied using considering moderating effect of involvement and value of services. According to our prepositions for a more Extrovert, Intuitive Personality the switching is going to be high whereas the switching is going to be less for an Introvert, Judgmental kind of personality. Similarly, for a consumer with high Neuroticism and Agreeableness the switching would be less as compared to an Open and Conscious Personality type. These level differs with level of a consumer’s involvement and type of a service being offered based on its value.

Keywords: consumer switching, involvement, Myer Briggs personality type indicators, personality, value of service

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Authors: Sadeem A. Alolayan

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The purpose of early intervention (EI) programs and services is to minimize the impact of disability on children ages 0-5 and to reduce future special education costs. This literature review identifies the status of families of children with special needs. Four major themes emerged from this literature review. The first was the family’s needs and the expressed desire for services to be obtained or outcomes to be achieved. The second was family support, meaning any information or skills needed to facilitate parents’ role as professionals in order to enable them to train and provide their child with the best quality of life. The third theme, barriers, was defined as parents’ actions or life circumstances that hindered families in obtaining appropriate EI services. The conclusions derived from the recommendations are that effective parent participation involves careful planning, establishing and maintaining a trusted rapport between parents, and EI providers that understand parents’ individual needs and interests, thus motivating effective parent involvement in early intervention programs.

Keywords: early intervention, individuals with disabilities education act, parents, recommendations

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Authors: Helena Baffoe

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The US has developed numerous programs over the past 50 years to enhance the lives of those who suffer from mental health illnesses and substance abuse, as well as the effectiveness of their treatments. Despite these advances over the past 50 years, there hasn't been a corresponding improvement in American public attitudes and beliefs about mental health disorders and substance abuse. Highly publicized acts of violence frequently elicit comments that blame the perpetrator's perceived mental health disorder since such people are thought to be substance abusers. Despite these strong public beliefs and perception about mental disorder and substance abuse, concreate empirical evidence that entail this perception is lacking, and evidence of their effectiveness has not been integrated. A rich data was collected from Substance Abuse and Mental Health Services Administration (SAMHSA) with a hypothesis that people who are diagnosed with a mental health disorder are likely to be diagnosed with substance abuse using logit regression analysis and Instrumental Variable. It was found that depressive, anxiety, and trauma/stressor mental disorders constitute the most common mental disorder in the United States, and the study could not find statistically significant evidence that being diagnosed with these leading mental health disorders in the United States does necessarily imply that such a patient is diagnosed with substances abuse. Thus, the public has a misconception of mental health and substance abuse issues, and social workers' responsibilities are outlined in order to assist ameliorate this attitude and perception.

Keywords: mental health disorder, substance use, empirical evidence, logistic regression

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Authors: McKenna Halverson, Allison Karpyn

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Introduction: The COVID-19 pandemic posed unprecedented challenges for families with young children in the United States. The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), a federal nutrition assistance program that provides low-income mothers and young children with access to healthy foods (e.g., infant formula, milk, and peanut butter), mitigated some financial challenges for families. However, the U.S. experienced a national infant formula shortage and rising inflation rates during the pandemic, which likely impacted WIC participants’ shopping experiences and well-being. As such, this study aimed to characterize how the COVID-19 pandemic and related events impacted Delaware WIC participants’ in-store benefit redemption experiences and overall well-being. Method: The authors conducted semi-structured interviews with 51 WIC participants in Wilmington, Delaware. Survey measures included demographic questions and open-ended questions regarding participants’ experiences with WIC benefit redemption during the COVID-19 pandemic. Data were analyzed using a hybrid inductive and deductive coding approach. Findings: The COVID-19 pandemic significantly impacted WIC participants’ shopping experiences and well-being. Specifically, participants were forced to alter their shopping behaviors to account for rising food prices (e.g., used coupons, bought less food, used food banks). Additionally, WIC participants experienced significant distress during the national infant formula shortage resulting from difficulty finding formula to feed their children. Participants also struggled with in-store benefit redemption due to inconsistencies in shelf labelling, the WIC app, and low stock of WIC foods. These findings highlight the need to reexamine WIC operations and emergency food response policy in the United States during times of crisis to optimize public health and ensure federal nutrition assistance programs meeting the needs of low-income families with young children.

Keywords: benefit redemption, COVID-19 pandemic, infant formula shortage, inflation, shopping, WIC

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Authors: Roman Bieda

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The General Data Protection Regulation (GDPR) will come into force on 25 May 2018 which will create a new legal framework for the protection of personal data in the European Union. Article 20 of GDPR introduces a right to data portability. This right allows for data subjects to receive the personal data which they have provided to a data controller, in a structured, commonly used and machine-readable format, and to transmit this data to another data controller. The right to data portability, by facilitating transferring personal data between IT environments (e.g.: applications), will also facilitate changing the provider of services (e.g. changing a bank or a cloud computing service provider). Therefore, it will contribute to the development of competition and the digital market. The aim of this paper is to discuss the right to data portability and its influence on the development of new digital services.

Keywords: data portability, digital market, GDPR, personal data

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Authors: Shahryar Eslamitabar

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Currently, the internet plays an important role in the various scientific, commercial and service practices. Thanks to information and communication technology, the healthcare industry via the internet, generally known as cyber-medicine, can offer professional medical service in a wider geographical area. Having some appealing benefits such as convenience in offering healthcare services, improved accessibility to the services, enhanced information exchange, cost-effectiveness, time-saving, etc. Tele-health has increasingly developed innovative models of healthcare delivery. However, it presents many potential hazards to cyber-patients, inherent in the use of the system. First, there are legal issues associated with the communication and transfer of information on the internet. These include licensure, malpractice, liabilities and jurisdictions as well as privacy, confidentiality and security of personal data as the most important challenge brought about by this system. Additional items of concern are technological and ethical. Although, there are some rules to deal with pitfalls associated with cyber-medicine practices in the USA and some European countries, yet for all developments, it is being practiced in a legal vacuum in many countries. In addition to the domestic legislations to deal with potential problems arisen from the system, it is also imperative that some international or regional agreement should be developed to achieve the harmonization of laws among countries and states. This article discusses some implications posed by the practice of cyber-medicine in the healthcare system according to the experience of some developed countries using a comparative study of laws. It will also review the status of tele-health laws in Iran. Finally, it is intended to pave the way to outline a plan for countries like Iran, with newly-established judicial system for health laws, to develop appropriate regulations through providing some recommendations.

Keywords: tele-health, cyber-medicine, telemedicine, criminal laws, legislations, time-saving

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Authors: Kyngäs Helvi, Patala-Pudas, Kaakinen Pirjo

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It has been reported that COPD -patients may experience much emotional distress, which can compromise positive health outcomes. The aim of this study was to explore disease-related uncertainty as reported by Chronic Obstructive Pulmonary Disease (COPD) patients. Uncertainty was defined as a lack of confidence; negative feelings; a sense of confidence; and awareness of the sources of uncertainty. Research design was a non-experimental cross-sectional survey. The data (n=141) was collected by validated questionnaire during COPD -patients’ visits or admissions to a tertiary hospital. The response rate was 62%. The data was analyzed by statistical methods. Around 70% of the participants were male with COPD diagnosed many years ago. Fifty-four percent were under 65 years and used an electronic respiratory aid apparatus (52%) (oxygen concentrator, ventilator or electronic inhalation device). Forty-one percent of the participants smoked. Disease-related uncertainty was widely reported. Seventy-three percent of the participants had uncertainty about their knowledge of the disease, the pulmonary medication and nutrition. One-quarter (25%) did not feel sure about managing COPD exacerbation. About forty percent (43%) reported that they did not have a written exacerbation decision aid indicating how to act in relation to COPD symptoms. Over half of the respondents were uncertain about self-management behavior related to health habits such as exercise and nutrition. Over a third of the participants (37%) felt uncertain about self-management skills related to giving up smoking. Support from the care providers was correlated significantly with the patients’ sense of confidence. COPD -patients who felt no confidence stated that they received significantly less support in care. Disease-related uncertainty should be considered more closely and broadly in the patient care context, and those strategies within patient education that enhance adherence should be strengthened and incorporated into standard practice.

Keywords: adherence, COPD, disease-management, uncertainty

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Authors: Sumattana Glangkarn, Vorapoj Promasatayaprot

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Background: Proportion of population ageing in Thailand has been increased rapidly in the past decades according to living longer and the fertility rates have decreased. The most important challenge related to this situation is to consider how to improve quality and years of healthy of life. This study aimed to implement the older persons’ long term care (LTC) system for elderly care by family and community. Method: The Consolidated Framework for Implementation Research (CFIR) was employed for guiding and evaluating an implementation process in ageing care. The CFIR composed of five major domains: intervention characteristics, outer setting, inner setting, characteristics of the individuals involved, and the process of implementation. Results: most elderly participants were couples, educating primary school and living with children and grandchildren. More than half of them had chronic diseases such as diabetes mellitus and hypertension. Factor analysis revealed factors related to health care of older participants which consisted of exercise, diet, accidental prevention, relaxation, self-care capacity, joyfulness, family relationship, and personal hygiene. A pre-implementation phase showed intervention characteristics included facilities and services of the LTC policy from the Ministry of Public Health. The complexities of the LTC and relative advantages were explained. Community leaders, public health volunteers, care givers and health professionals had participated in the LTC activities. Outer and inner settings consisted of context of community, culture, and readiness. Characteristics of the individuals related to knowledge, self-efficacy, perceptions, and believes. The process consisted of planning, acting, observing, and reflecting. The implementation outcomes and service outcomes had been evaluated during-implementation phase. Conclusion: the participation of caregivers, community leaders, public health volunteers, and health professionals had supported the LTC services. Thus, family and community care could improve quality of life of the ageing.

Keywords: ageing, CFIR, long term care, implementation

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Authors: Grandmother Roberta Oshkawbewisens, Elder Isabelle Meawasige, Lynne Groulx, Chloë Hamilton, Lee Allison Clark, Dana Hickey, Wansu Qiu, Jared Leedham, Nishanthini Mahendran, Cameron Maclaine

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In March of 2020, the world suddenly shifted with the onset of the COVID-19 pandemic; in-person programs and services were unavailable and a scramble to shift to virtual service delivery began. The Native Women’s Association of Canada (NWAC) established virtual programming through the Resiliency Lodge model and connected with Indigenous women, girls, Two-Spirit, transgender, and gender-diverse people across Turtle Island and Inuit Nunangat through programs that provide a safe space to slow down and reflect on their lives, environment, and well-being. To continue to grow the virtual Resiliency Lodge model, NWAC needed to develop an understanding of three questions: how COVID-19 affects Elder-led support services, how Elder-led support services have adapted during the pandemic, and what Wise Practices need to be implemented to continue to develop, refine, and evaluate virtual Elder-led support services specifically for Indigenous women, girls, two-Spirit, transgender, and gender-diverse people. Through funding from the Canadian Institute of Health Research (CIHR), NWAC gained deeper insight into these questions and developed a series of key findings and recommendations that are outlined throughout this report. The goals of this project are to contribute to a more robust participatory analysis that reflects the complexities of Elder-led virtual cultural responses and the impacts of COVID-19 on Elder-led support services; develop culturally and contextually meaningful virtual protocols and wise practices for virtual Indigenous-led support; and develop an Evaluation Strategy to improve the capacity of the Resiliency Lodge model. Significant findings from the project include Resiliency Lodge programs, especially crafting and business sessions, have provided participants with a sense of community and contributed to healing and wellness; Elder-led support services need greater and more stable funding to offer more workshops to more Indigenous women, girls, Two-Spirit, transgender, and gender-diverse people; and Elder- and Indigenous-led programs play a significant role in healing and building a sense of purpose and belonging among Indigenous people. Ultimately, the findings and recommendations outlined in this research project help to guide future Elder-led virtual support services and emphasize the critical need to increase access to Elder-led programming for Indigenous women, girls, Two-Spirit, transgender, and gender-diverse people.

Keywords: indigenous women, traditional healing, virtual programs, covid-19

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Authors: Krishna Prasad Sharma

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Nepal’s financial sector has become deeper and wider, and the number and types of financial intermediaries have grown rapidly over the past two decades. However, access to financial services remains limited for many people in many parts of rural Nepal. While financial institutions have been expanding rapidly in an urban area in recent years, the access to the rural poor is excessively inadequate due to financial illiteracy and limited numbers of financial institutions that confined only to the district headquarters. Based on the focus group discussion, semi-structured interview of key people and literature review, this paper aims to examine the supply of and demand for financial services in Nepal and the constraints to increasing access to them, and offers way forward for making the financial sector work for all of Nepal’s people, especially the rural poor. While Nepal’s government has tried to increase access to formal financial services for small businesses and low-income households through directed lending programs for small businesses and low-income households, created specialized wholesale and retail institutions, and lowered market entry requirements, formal financial services are declining, and financial intermediation is stagnating. Supply and demand indicators show that, despite government efforts, formal financial institutions do not serve the needs of most of the Nepalese population. While access to and use of formal financial services are limited, in general, the problem is acute for small businesses and low-income households. Indeed, both access and use are closely correlated with business loan size and household income. This study concludes that banks and microfinance institutions with the use of mobile phones can connect hundreds of millions of unbanked and low-income people, especially rural poor to financial services at low costs. While there are many challenges ahead in expanding the service to rural areas, the mobile financial services will be beneficial that makes payments faster and cheaper, more convenient and accessible to a greater number of senders and recipients in rural areas. In rural areas, clients will benefit from money transfer and other mobile and online services.

Keywords: financial inclusion, financial enabling environment, microfinance, branchless banking, rural poor

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Authors: Jiazhi Zeng, Leiyu Shi, Xia Zou, Wen Chen, Li Ling

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Background: China is facing the unprecedented challenge of rapidly increasing rural-to-urban migration. Due to the household registration system, migrants are in a vulnerable state when they attempt to access to primary care services. A strong primary care system can reduce health inequities and mitigate socioeconomic disparities in healthcare utilization. Literature indicated that migrants were more reliant on the primary care system than local residents. Although the Chinese government has attached great importance to creating an efficient health system, primary care services are still underutilized. The referral system between primary care institutions and hospitals has not yet been completely established in China. The general populations often go directly to hospitals instead of primary care institutions for their primary care. Primary care institutions generally consist of community health centers (CHCs) and community health stations (CHSs) in urban areas, and township health centers (THCs) and rural health stations (THSs) in rural areas. In addition, primary care services are also provided by the outpatient department of municipal hospitals and tertiary hospitals. A better understanding of migrants’ experiences with primary care in the above-mentioned medical institutions is critical for improving the performance of primary care institutions and providing indications of the attributes that require further attention. The purpose of this pioneering study is to explore rural-to-urban migrants’ experiences in primary care, compare their primary care experiences in four types of medical institutions in Guangzhou, China, and suggest implications for targeted interventions to improve primary care for the migrants. Methods: This was a cross-sectional study conducted with 736 rural-to-urban migrants in Guangzhou, China, in 2014. A multistage sampling method was employed. A validated Chinese version of Primary Care Assessment Tool - Adult Short Version (PCAT-AS) was used to collect information on migrants’ primary care experiences. The PCAT-AS consists of 10 domains. Analysis of covariance was conducted for comparison on PCAT domain scores and total scores among migrants accessing four types of medical institutions. Multiple linear regression models were used to explore factors associated with PCAT total scores. Results: After controlling for socio-demographic characteristics, migrant characteristics, health status and health insurance status, migrants accessing primary care in tertiary hospitals had the highest PCAT total scores when compared with those accessing primary care THCs/ RHSs (25.49 vs. 24.18, P=0.007) and CHCs/ CHSs(25.49 vs. 24.24, P=0.006). There was no statistical significant difference for PCAT total scores between migrants accessing primary care in CHCs/CHSs and those in municipal hospitals (24.24 vs. 25.02, P=0.436). Factors positively associated with higher PCAT total scores also included insurance covering parts of healthcare payment (P < 0.001). Conclusions: This study highlights the need for improvement in primary care provided by primary care institutions for rural-to-urban migrants. Migrants receiving primary care from THCs, RHSs, CHSs and CHSs reported worse primary care experiences than those receiving primary care from tertiary hospitals. Relevant policies related to medical insurance should be implemented for providing affordable healthcare services for migrants accessing primary care. Further research exploring the specific reasons for poorer PCAT scores of primary care institutions users will be needed.

Keywords: China, PCAT, primary care, rural-to-urban migrants

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Authors: Helga Martins, Idália Matias

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Background:Multiple sclerosis is a chronic inflammatory autoimmune demyelinating disease that affects young adults. Multiple sclerosis is a chronic disease in which the patient needs to self-manage the disease and the therapeutic regimen. Consequently, the promotion of health literacy assumes a relevant role for the accessibility, understanding, and use of information in order to promote and maintain the health of patients with multiple sclerosis. Aim: To determine the impact of lower health literacy in the self-management of patients with a multiple sclerosis. Methods: Literature review based on a search on the following electronic databases: CINAHLand MEDLINE; comprising all results published between September 2016 and September 2021. The search strategy was: (“Self-management [MeSH]” AND “Multiple sclerosis[MeSH]”AND “Health literacy[MeSH]”). The inclusion criteria were: original papers reporting about multiple sclerosis patients; participants with age above 18 years old, written in English, Spanish, French, or Portuguese. Two independent reviewers have done the screening and analysis of the results. 38 citations were identified, and after duplicates removal, a total of 25 results were screened; 14 were included after the application of the inclusion criteria. Results: The lower health literacy in the self-management of patients with a multiple sclerosis is related toless healthy choices, riskier health behavior, poor health outcomes, decreased of adhering to the therapeutic regimen after discharge, less self-management of chronic illness, and increased the time of hospitalization. Conclusion: Inadequate levels of health literacy contribute to poor health outcomes, unsuccessful self-management of chronic illness, and inadequate adherence to the therapeutic regimen. Therefore, health literacy is important for health policy and the healthcare services, as it can be understood as a mediator of self-management of multiple sclerosis disease.

Keywords: health literacy, multiple sclerosis, review, self-management

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Authors: Kylie Henderson

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Adapting mental health interventions is important when providing support to those experiencing difficulties. This analysis aimed to explore and evaluate the effectiveness of various forms of mental health interventions. Literature that has analysed face-to-face (F2F), phone (Telehealth), mobile (mHealth) and online (e-interventions) interferences found all interventions were effective in reducing and treating symptoms of mental health disorders. F2F and Telehealth interventions facilitated greater engagement and client satisfaction. Due to accessibility and privacy, mHealth and e-interventions were the preferred methods of engagement with health services for youth and young adults. Regardless, these interventions still identified several barriers of high dropout, low adherence, and lack of awareness. Additionally, a large proportion of interventions lacked evidence-based foundations. Exploration of interventions that utilise a variety of interfaces, as well as incorporated evidence-based literature and clinician experience, show that they benefit those experiencing mental health difficulties. Applications like YourHealth+ provide a combination of interventions (F2F, mHealth, and e-interventions) to improve the wellbeing of job seekers and employment consults. Individuals that have used the application in conjunction with therapy have reported feeling more empowered and demonstrated improved wellbeing. Practitioners have also described improved confidence in their ability to provide support to clients. Therefore, it can be proposed that utilising a variety of interventions as well as incorporating literature and experience is beneficial to those experiencing mental health difficulties and to health practitioners.

Keywords: face-to-face, e-interventions, mHealth, YourHealth+

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Authors: Mohammad Shahjahan, Md. Monoarul Haque

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In the research work information and data were collected from both types of sources, direct and indirect. Numerological, qualitative and participatory analysis methods have been followed. There were two principal sources of collecting information and data. Firstly, the data provided by the service recipients (300 nos. of women and children victims) in the Victim Support Centre and service providing policemen, executives and staffs (60 nos.). Secondly, data collected from Specialists, Criminologists and Sociologists involved in victim support services through Consultative Interview, KII, Case Study and FGD etc. The initial data collection has been completed with the help of questionnaires as per strategic variations and with the help of guidelines. It is to be noted that the main objective of this research was to determine whether services provided to the victims for their facilities, treatment/medication and rehabilitation by different government/non-government organizations was veritable at all. At the same time socio-economic background and demographic characteristics of the victims have also been revealed through this research. The results of the study show that although the number of victims has increased gradually due to socio-economic, political and cultural realities in Bangladesh, the number of victim support centers has not increased as expected. Awareness among the victims about the effectiveness of the 8 centers working in this regard is also not up to the mark. Two thirds of the victims coming to get service were not cognizant regarding the victim support services at all before getting the service. Most of those who have finally been able to come under the services of the Victim Support Center through various means, have received sheltering (15.5%), medical services (13.32%), counseling services (13.10%) and legal aid (12.66%). The opportunity to stay in security custody and psycho-physical services were also notable. Usually, women and children from relatively poor and marginalized families of the society come to victim support center for getting services. Among the women, young unmarried women are the biggest victims of crime. Again, women and children employed as domestic workers are more affected. A number of serious negative impacts fall on the lives of the victims. Being deprived of employment opportunities (26.62%), suffering from psycho-somatic disorder (20.27%), carrying sexually transmitted diseases (13.92%) are among them. It seems apparent to urgently enact distinct legislation, increase the number of Victim Support Centers, expand the area and purview of services and take initiative to increase public awareness and to create mass movement.

Keywords: crime, victim, support, Bangladesh

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Authors: Omnia Saidani Neffati, Rim Samia Kaabi, Naoufel Kraiem

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In this paper, we propose an approach aiming at (i) representing services at two levels: the intentional level and the organizational level, and (ii) establishing mechanisms allowing to make a transition from the first level to the second one in order to execute intentional services. An example is used to validate our approach.

Keywords: intentional service, business process, BPMN, MDE, intentional service execution

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Authors: Helena Baffoe

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The US has developed numerous programs over the past 50 years to enhance the lives of those who suffer from mental health illnesses and substance abuse, as well as the effectiveness of their treatments. Despite these advances over the past 50 years, there hasn't been a corresponding improvement in American public attitudes and beliefs about mental health disorders and substance abuse. Highly publicized acts of violence frequently elicit comments that blame the perpetrator's perceived mental health disorder since such people are thought to be substance abusers. Despite these strong public beliefs and perception about mental disorder and substance abuse, concreate empirical evidence that entail this perception is lacking, and evidence of their effectiveness has not been integrated. A rich data was collected from Substance Abuse and Mental Health Services Administration (SAMHSA) with a hypothesis that people who are diagnosed with a mental health disorder are likely to be diagnosed with substance abuse using logit regression analysis and Instrumental Variable. It was found that depressive, anxiety, and trauma/stressor mental disorders constitute the most common mental disorder in the United States, and the study could not find statistically significant evidence that being diagnosed with these leading mental health disorders in the United States does necessarily imply that such a patient is diagnosed with substances abuse. Thus, the public has a misconception of mental health and substance abuse issues, and social workers' responsibilities are outlined in order to assist ameliorate this attitude and perception.

Keywords: mental health disorder, substance abuse, role of a social worker, evidence based research

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Authors: Folasade R. Sulaiman

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Pupils’ health and nutrition are basically important to their schooling. The preponderance of avoidable deaths among children in Africa (WHO, 2000) may not be unconnected with the nutritional and health education status of families and communities that have their children as school clients. This study adopted a descriptive survey design focusing on the assessment of the level of nutritional and health education of families and community members in the rural riverine areas of Ogun State. Two research questions were raised. The Nutritional and Health Education of Families and Communities Inventory (NHEFCI) was used to collect data from 250 rural child-bearing aged women, and 0.73 test-retest reliability coefficient was established to determine the strength of the instrument. Data collected were analysed using descriptive statistics of frequency counts, percentages and mean in accordance with research questions raised in the study. The findings revealed amongst others: that 65% of the respondents had low level of nutritional and health education among the families and community members; while 72% had low level of awareness of the possible influence of nutritional and health education on the learning outcomes of the children. Based on the findings, it was recommended among others that government should intensify efforts on sensitization, mass literacy campaign etc.; also improve upon the already existing School Feeding Programme in Nigerian primary schools to provide at least one balanced diet for children while in school; community health workers, social workers, Non-Governmental Organizations (NGO) should collaborate with international Organizations like UNICEF, UNESCO, WHO etc. to organize sensitization programmes for members of the rural riverine communities on the importance of meeting the health and nutritional needs of their children in order to attain their educational potentials.

Keywords: nutritional and health education, learning capacities, school-age children, universal basic education, rural riverine areas

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Authors: Azizollah Arbabisarjou, Leila Safabakhsh, Mozhgan Jahantigh, Mahshid Nazemzadeh, Shahindokht Navabi

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Background: Health promotion is an essential strategy for reduction of health disparities. Health promotion includes all activities that encourage optimum physical, spiritual, and mental function. The aim of this study was to determine the impact of a Health Promotion Program (HPP) on behavior in terms of the dimensions of the Health Promoting Lifestyle Profile (HPLP) in patients after Coronary Artery Bypass Graft (CABG). Methods and Materials: In this clinical trial study, 80 patients who had undergone CABG surgery (2011-2012) were selected and randomly divided in two groups: Experimental and Control that investigated by (HPLP II). Then the experimental group was educated about diet, walking and stress management. The program process was followed up for 3months and after that all variables were investigated again. The overall score and the scores for the six dimensions of the HPLP (self-actualization, health responsibility, exercise, nutrition, interpersonal support and stress management) were measured in the pre- and post-test periods. Statistical analysis was performed using Student's t-test and paired t-test. Results: Results showed that Score of stress management (p=.036), diet (p=.002), Spiritual Growth (p=.001) and interrelationship (p=002) increase in experimental group after intervention .Average scores after 3 months in the control group had no significant changes; except responsibility for health (p < .05). Results of the study revealed that comparison the scores of the experimental group were significantly different from the control group in all lifestyle aspects except for spiritual growth. Conclusion: This study showed that Health promoting program on lifestyle and health promotion in patients who suffer from CAD could enhance patient's awareness of healthy behaviors and improves the quality of life.

Keywords: coronary artery bypass graft, health promotion, lifestyle, education

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Authors: A. Alssbaiheen, S. Love

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Mobile government (m-government) is one of the promising technologies for developing the governance of developing countries. While developing countries often have less advanced internet infrastructure compared to the developed world, mobile phone penetration is very high in the Gulf Cooperation Council (GCC) countries and mobile internet use offers a means to transcend traditional logistical barriers to accessing government services. The study explores the challenges and opportunities of the mobile government in Saudi Arabia. Semi-structured interviews were conducted with a diverse cohort of Saudi mobile users. A total of 77 semi-structured interviews were collected and subsequently analysed using open, axial, and selective coding. The participants’ responses revealed that many opportunities exist for the development of m-government in Saudi Arabia, including high popular awareness of government initiatives in e-government, and willingness to use such services, largely due to the time-saving and convenience aspects it offers compared with traditional bureaucratic services. However, numerous barriers were identified, including the low quality and speed of the internet, service customization, and concerns about privacy data security. It was also felt that in addition to infrastructure challenges, the traditional bureaucratic attitude of government department would itself hinder the effective deployment and utilization of m-government services.

Keywords: awareness, barriers, challenges, government services, mobile government, m-government, opportunities

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Authors: S. O. Ayansina, R. A. Oyeyinka, K. K. Bolarinwa

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There is an increasing demand for a functional extension delivery services in Nigeria with a view to meet up with the food and fiber needs of the ever growing population of human and animal respectively. This study was designed to examine farmers’ involvement in public and private extension services in southwestern Nigeria, specifically to explore the farmers’ participation in the two types of organizations involved. It also evaluates the performances of personnel in the organizations. A multi-stage random sampling technique was used to select 30 respondents from each of the three selected organizations in Ogun, Osun and Oyo states in Southwestern Nigeria. Data was collected with interview schedule and analyzed both at descriptive and inferential levels. Kruskal Wallis one-way Analysis of variance was used to test the differences between the participation of beneficiaries who are farmers under the public and private extension services and the level of benefit accrued to them from the various extension organizations involved in the study. Results revealed that private extension organizations were performing better and were more preferred by the beneficiaries. Results of the tested hypotheses as shown by Kruskal Wallis test of difference (x2 = 0.709) S no significant difference between farmers’ participation in the extension services of public and private organizations but however showed significant difference (X2 =12.074) in the benefits achieved by respondents in the two organizations. These include: increased quantity of crop produced, farm income, skill acquisition, and improved education in private extension organizations. Based on this result, it could be inferred that beneficiaries generally preferred private extension organizations because of their effectiveness and vibrancy in programme administration. Public extension is therefore recommended for general overhauling and possibly privatization in order to cater for teeming population of farmers demanding for efficient and functional extension services to better their lots in production, processing and marketing of agricultural produce.

Keywords: public and private involvement, extension services, farmers' participation

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