Search results for: occupational health management

Authors: M. Kasusse, M. Rosette, E. Burke, C. Mwangi, R. Batamwita, N. Tumwesigye, S. Aisu

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A cross-sectional survey to ascertain the capacity of laboratory persons in using ICTs was conducted in 15 Ugandan districts (July-August 2013). A self-administered questionnaire served as data collection tool, interview guide and observation checklist. 69 questionnaires were filled, 12 interviews conducted, 45 HC observed. SPSS statistics 17.0 and SAS 9.2 software were used for entry and analyses. 69.35% of participants find it difficult to access a computer at work. Of the 30.65% who find it easy to access a computer at work, a significant 21.05% spend 0 hours on a computer daily. 60% of the participants cannot access internet at work. Of the 40% who have internet at work, a significant 20% lack email address but 20% weekly read emails weekly and 48% daily. It is viable/feasible to pilot informatics projects as strategies to build bridges develop skills for e-health landscape in laboratory services with a bigger financial muscle.

Keywords: ICT behavior, clinical laboratory persons, Sub-Saharan Africa, Uganda

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Authors: Diana La Forgia, Jean Baptiste Thibord, François Verheggen

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Volatiles Organic Compound (VOCs) are one of the many features of defense used by plants in their eternal fight against pests. Their main role is to attract the natural enemies of the herbivores. But on another hand, they can be used by the same herbivores to locate plants while foraging. In an attempt to fill a gap of knowledge in a complex web of interactions, we focused on wireworms (Coleoptera:Elateridae). Wireworms whose larvae feed on roots are one of the most spread pests of valuable crops such as maize and potatoes, causing important economical damage. Little is known about the root compounds that are playing a role in the attraction of the larvae. In order to know more about these compounds, we compared four different maize varieties (Zea mays mays) that are known to have different levels of attraction, from weak to strong, for wireworms in fields. We tested the attraction of larvae in laboratory conditions in dual-choice olfactometer assays where they were offered all possible combinations of the four maize varieties. Contemporary, we collected the VOCs of each variety during 24h using a push-and-pull system. The collected samples were then analyzed by gas chromatography coupled with a mass spectrometer (GC-MS) to identify their molecular profiles. The choice of the larvae was dependent on the offered combination and some varieties were preferred to others. Differences were also observed in terms of quantitative and qualitative emissions of volatile profiles between the maize varieties. Our aim is to develop traps based on VOCs from maize roots to open a new frontier in wireworms management.

Keywords: integrated pest management, maize roots, plant defense, volatile organic compounds, wireworms

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Authors: Reihaneh Rafiemanzelat

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due to towards the rapid urbanization, cities throughout the world faced to rapid growth through gray infrastructure. Therefore designing cities based on green and blue infrastructure can offer the best solution to support healthy urban environment. This conformation with a wide range of ecosystem service has a positive impact on the regulation of air temperature, noise reduction, air quality, and also create a pleasant environment for humans activities. Research mainly focuses on the concept and principles of green and blue infrastructure in the city of Esfahan at the center of Iran in order to create a livable and healthy environment. Design principles for green and blue infrastructure are classified into two different but interconnect evaluations. Healthy green infrastructure assessing based on; volume, shape, location, dispersion, and maintenance. For blue infrastructure there are three aspects of water and ecosystem which are; the contribution of water on medical health, the contribution of water on mental health, and creating possibilities to exercise.

Keywords: healthy cities, livability, urban landscape, green and blue infrastructure

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Authors: Azeem Tariq, Stephane De Tourdonnet, Lars Stoumann Jensen, Reiner Wassmann, Bjoern Ole Sander, Quynh Duong Vu, Trinh Van Mai, Andreas De Neergaard

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Rice growing area is increasing to meet the food demand of increasing population. Mostly, rice is growing on lowland, small landholder fields in most part of the world, which is one of the major sources of greenhouse gases (GHG) emissions from agriculture fields. The strategies such as, altering water and residues (carbon) management practices are assumed to be essential to mitigate the GHG emissions from flooded rice system. The actual implementation and potential of these measures on small farmer fields is still challenging. A field study was conducted on red river delta in Northern Vietnam to identify the potential challenges and barriers to the small rice farmers for implementation of climate smart rice practices. The objective of this study was to develop and access the feasibility of climate smart rice prototypes under actual farmer conditions. Field and scientific oriented framework was used to meet our objective. The methodological framework composed of six steps: i) identification of stakeholders and possible options, ii) assessment of barrios, drawbacks/advantages of new technologies, iii) prototype design, iv) assessment of mitigation potential of each prototype, v) scenario building and vi) scenario assessment. A farm survey was conducted to identify the existing farm practices and major constraints of small rice farmers. We proposed the two water (pre transplant+midseason drainage and early+midseason drainage) and one straw (full residue incorporation) management option keeping in views the farmers constraints and barriers for implementation. To test new typologies with existing prototypes (midseason drainage, partial residue incorporation) at farmer local conditions, a participatory field experiment was conducted for two consecutive rice seasons at farmer fields. Following the results of each season a workshop was conducted with stakeholders (farmers, village leaders, cooperatives, irrigation staff, extensionists, agricultural officers) at local and district level to get feedbacks on new tested prototypes and to develop possible scenarios for climate smart rice production practices. The farm analysis survey showed that non-availability of cheap labor and lacks of alternatives for straw management influence the small farmers to burn the residues in the fields except to use for composting or other purposes. Our field results revealed that application of early season drainage significantly mitigates (40-60%) the methane emissions from residue incorporation. Early season drainage was more efficient and easy to control under cooperate manage system than individually managed water system, and it leads to both economic (9-11% high rice yield, low cost of production, reduced nutrient loses) and environmental (mitigate methane emissions) benefits. The participatory field study allows the assessment of adaptation potential and possible benefits of climate smart practices on small farmer fields. If farmers have no other residue management option, full residue incorporation with early plus midseason drainage is adaptable and beneficial (both environmentally and economically) management option for small rice farmers.

Keywords: adaptation, climate smart agriculture, constrainsts, smallholders

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Authors: Minjeong Kim, Seungchul Lee, Iman Janghorban Esfahani, Jeong Tai Kim, ChangKyoo Yoo

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A trajectory of set-point of ventilation control systems plays an important role for efficient ventilation inside subway stations since it affects the level of indoor air pollutants and ventilation energy consumption. To maintain indoor air quality (IAQ) at a comfortable range with lower ventilation energy consumption, the optimal trajectory of the ventilation control system needs to be determined. The concentration of air pollutants inside the station shows a diurnal variation in accordance with the variations in the number of passengers and subway frequency. To consider the diurnal variation of IAQ, an iterative dynamic programming (IDP) that searches for a piecewise control policy by separating whole duration into several stages is used. When outdoor air is contaminated by pollutants, it enters the subway station through the ventilation system, which results in the deteriorated IAQ and adverse effects on passenger health. In this study, to consider the influence of outdoor air quality (OAQ), a new performance index of the IDP with the passenger health risk and OAQ is proposed. This study was carried out for an underground subway station at Seoul Metro, Korea. The optimal set-points of the ventilation control system are determined every 3 hours, then, the ventilation controller adjusts the ventilation fan speed according to the optimal set-point changes. Compared to manual ventilation system which is operated irrespective of the OAQ, the IDP-based ventilation control system saves 3.7% of the energy consumption. Compared to the fixed set-point controller which is operated irrespective of the IAQ diurnal variation, the IDP-based controller shows better performance with a 2% decrease in energy consumption, maintaining the comfortable IAQ range inside the station.

Keywords: indoor air quality, iterative dynamic algorithm, outdoor air information, ventilation control system

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Authors: Ifeanyi Charles Otuokere, Victoria Nneoma Nnochiri

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Entrepreneurship generally and specifically within the rural communities in Nigeria is a fast means of bringing development within the communities. This is made possible by utmost maximization and management of available local resources to develop rural areas through good management of these local resources. This study anchors on the rural development paradigm and the integrated rural development theories to understudy the knowledge of rural entrepreneurs on rural economic development. The research study made use of surveys and descriptive analysis. The assessable population for the study, which was randomly selected, is 100 rural entrepreneurs from ten rural communities within the Ikwuano Local Government Area of Abia State. The study made use of both primary and secondary as a source of data collection with much emphasis on a primary source, although secondary data such as journals, textbooks electronic sources were also utilised. A carefully structured questionnaire drafted to extract raw data was administered to selected entrepreneurs. The findings of the study showed that developments within rural communities can only be achieved through rural entrepreneurship. This is evidenced in increased output, job creation, and most importantly, reduction of rural to urban migration, among other things. Recommendations were also made based on these findings; the researchers recommended that infrastructural developments should be made available in the rural communities and government policies should create enabling environments along with other assistance to help these rural entrepreneurs achieve their sole aim.

Keywords: economic developments, rural communities, rural development, rural entrepreneurship

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Authors: Angesom Gebrezgabiher Tesfay, Afafaw Hailesilasie Tesfay, Muyiwa Samuel Adaramola

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The energy demand boost in Ethiopia urges sustainable fuel options while it is mainly supplemented by traditional biomass and imported conventional fuels. To satisfy the deficiency it has to be sourced from all renewables. Thus identifying resources and estimating potential is vital to the sector. This study aims at an in-depth assessment to quantify, prioritize, and analyze agricultural residue biomass energy and related characteristic forms. Biomass use management and modernization seeks successive information and a clue about the resource quantity and characteristic. Five years of crop yield data for thirteen crops were collected. Conversion factors for their 20 residues are surveyed from the literature. Then residues amount potentially available for energy and their energy is estimated regional, crop-wise, residue-wise, and shares compared. Their potential value for energy is analyzed from two perspectives and prioritized. The gross potential is estimated to be 495PJ, equivalent to 12/17 million tons of oil/coal. At 30% collection efficiency, it is the same as conventional fuel import in 2018. Maize and sorghum potential and spatial availability are preeminent. Cotton and maize presented the highest potential values for energy from application and resource perspectives. Oromia and Amhara regions' contributions are the highest. The resource collection and application trends are required for future management that implicates a prospective study.

Keywords: crop residue, biomass potential, biomass resource, Ethiopian energy

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Authors: N. Hachemi, I. Benmehdi, O. Hasnaoui

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The air like water is an essential element for living beings. Each day, a man breathes about 20m3 of air. It originally consists of a set of gas whose presence and concentrations correspond to the needs of life. This study focuses on air pollution by smoke and dust emitted from the chimney of the cement works of Beni Saf, pathological and their impact on the environment. Dust of the cement plant are harmless to permissible levels for living organisms, but the two combined phenomena namely the release of dust and aridity of the climate, which severely marked area of Beni Saf; have contributed adverse effects in on human health and the degradation of vegetation cover and species especially weakened by environmental stress. The most visible impact is certainly the deposition of dust on the surrounding areas of the cement factory, and seriously affecting the aesthetics of the landscape. Health problems are more important inside and outside the factory. Among the diseases notable caused by the cement works are: deafness, heart disease, asthma and mental. The dust of the cement works is mainly composed of fine particles of limestone, clay, free lime, silicates and also loaded of the gases such as carbon dioxide gas CO2. The accumulation of this gas in the atmosphere is directly involved in the phenomenon of increasing of greenhouse effect. Some gases, for example, are directly toxic. They can change the climate, changing precipitation types and become a greater source of stress by drought, etc. The environment also suffers from air pollution indirectly; it is more precisely the acid rain. They are produced by the combustion of non-metals in air. Acid rain has consequences for contaminating the soil, weakening the flora, fauna and acidifies lakes. Finally, the pollution problems are multiple and specific dust. It can worsen and change, it has reached epidemic proportions quantitatively and qualitatively disturbing and unpredictable.

Keywords: atmospheric pollution, cement, dust, environment

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Authors: Elzbieta Sikorska-Simmons

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Dementia is a progressive terminal disease. Despite this recognition, research shows that most family caregivers do not know it, and it is unclear how this knowledge affects the quality of patient care. The aim of this qualitative study of 20 family caregivers for patients with advanced dementia is to examine how the caregiver's knowledge about dementia affects the quality of patient care in the context of healthcare decision-making, advanced care planning, and access to adequate support systems. Knowledge about dementia implies family caregivers' understanding of dementia trajectories, common symptoms/complications, and alternative treatment options (e.g., comfort feeding versus tube feeding). Data were collected in semi-structured interviews with 20 family caregivers. The interviews were conducted in person by the author and designed to elicit rich descriptions of family caregivers' experiences with healthcare decision-making and the management of common symptoms/complications of end-stage dementia as patient healthcare proxies. The study findings suggest that caregivers who recognize that dementia is a terminal disease are less likely to opt for life-extending treatments during the advanced stages. They are also more likely to seek palliative/hospice care, and consequently, they are better able to avoid unnecessary hospitalizations or medical procedures. For example, those who know that dementia is a terminal disease tend to opt for "comfort feeding" rather than "tube feeding" in managing the swallowing difficulties that accompany advanced dementia. In the context of advance care planning, family caregivers who know that dementia is a terminal disease tend to have more meaningful advance directives (e.g., Power of Attorney and Do Not Resuscitate orders). They are better prepared to anticipate common problems and pursue treatments that foster the best quality of patient life and care. Greater knowledge about advanced dementia helps them make more informed decisions that focus on enhancing the quality of patient life rather than just survival. In addition, those who know that dementia is a terminal disease are more likely to establish adequate support systems to help them cope with the complex demands of caregiving. For example, they are more likely to seek dementia-oriented primary care programs that offer house visits or respite services. Based on the study findings, knowledge about dementia as a terminal disease is critical in the optimal management of patient care needs and the establishment of adequate support systems. More research is needed to better understand what caregivers need to know to better prepare them for the complex demands of dementia caregiving.

Keywords: dementia education, family caregiver, management of dementia, quality of care

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Authors: Staci McGill, Morgan Hayes, Robert Coleman, Kimberly Tumlin

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The interaction and relationships between horses and humans have been shown to be positive for physical, mental, and emotional wellbeing, however equine spaces where these interactions occur do include some environmental risks. There are 1.7 million jobs associated with the equine industry in the United States in addition to recreational riders, owners, and volunteers who interact with horses for substantial amounts of time daily inside built structures. One specialized facility, an “indoor arena” is a semi-indoor structure used for exercising horses and exhibiting skills during competitive events. Typically, indoor arenas have a sand or sand mixture as the footing or surface over which the horse travels, and increasingly, silica sand is being recommended due to its durable nature. It was previously identified in a semi-qualitative survey that the majority of individuals using indoor arenas have environmental concerns with dust. 27% (90/333) of respondents reported respiratory issues or allergy-like symptoms while riding with 21.6% (71/329) of respondents reporting these issues while standing on the ground observing or teaching. Frequent headaches and/or lightheadedness was reported in 9.9% (33/333) of respondents while riding and in 4.3% 14/329 while on the ground. Horse respiratory health is also negatively impacted with 58% (194/333) of respondents indicating horses cough during or after time in the indoor arena. Instructors who spent time in indoor arenas self-reported more respiratory issues than those individuals who identified as smokers, highlighting the health relevance of understanding these unique structures. To further elucidate environmental concerns and self-reported health issues, 35 facility assessments were conducted in a cross-sectional sampling design in the states of Kentucky and Ohio (USA). Data, including air speeds, were collected in a grid fashion at 15 points within the indoor arenas and then mapped spatially using krigging in ARCGIS. From the spatial maps, standard variances were obtained and differences were analyzed using multivariant analysis of variances (MANOVA) and analysis of variances (ANOVA). There were no differences for the variance of the air speeds in the spaces for facility orientation, presence and type of roof ventilation, climate control systems, amount of openings, or use of fans. Variability of the air speeds in the indoor arenas was 0.25 or less. Further analysis yielded that average air speeds within the indoor arenas were lower than 100 ft/min (0.51 m/s) which is considered still air in other animal facilities. The lack of air movement means that dust clearance is reliant on particle size and weight rather than ventilation. While further work on respirable dust is necessary, this characterization of the semi-indoor environment where animals and humans interact indicates insufficient air flow to eliminate or reduce respiratory hazards. Finally, engineering solutions to address air movement deficiencies within indoor arenas or mitigate particulate matter are critical to ensuring exposures do not lead to adverse health outcomes for equine professionals, volunteers, participants, and horses within these spaces.

Keywords: equine, indoor arena, ventilation, particulate matter, respiratory health

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Authors: Jiashu Shen

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This study aims at exploring the characteristics of sexual knowledge, attitudes, and behaviors of Chinese college students from the 'one-child' families compared with those with siblings. This study utilized the data from the 'National College Student Survey on Sexual and Reproductive Health 2019'. Multiple logistic regression analyses were used to assess the association between the 'only-child' and their sexual knowledge, sexual attitudes, sexual behaviors, and risky sexual behaviors (RSB) stratified by sex and home regions, respectively. Compared with students with siblings, the 'only-child' students scored higher in sex-related knowledge (only-child students: 4.49 ± 2.28, students with siblings: 3.60 ± 2.27). Stronger associations between only-child and more liberal sexual attitudes were found in urban areas, including the approval of premarital sexual intercourse (OR: 1.51, 95% CI: 1.50-1.65) and multiple sexual partners (OR: 1.85, 95% CI: 1.72-1.99). For risky sexual behaviors, being only-child is more likely to use condoms in first sexual intercourse, especially among male students (OR: 0.68, 95% CI: 0.58-0.80). Only-child students are more likely to have more sexual knowledge, more liberal sexual attitude, and less risky sexual behavior. Further health policy and sex education should focus more on students with siblings.

Keywords: attitudes and behaviors, only-child students, sexual knowledge, students with siblings

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Authors: Aidan Jacobsen, Morgan Motia, David Sam, Jonathan Mudge

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Background: The Centers for Disease Control (CDC) lists vaccine requirements for children under two years old to correlate with development markers. CDC lists the coverage by age 24 months to be at least 90% nationally and 84% for Rhode Island Blackstone Valley Community Health Center (BVCHC) in Central Falls, Rhode Island, currently has a completed vaccination rate of 51% for children by the age of 24 months. Current barriers to care for up to date well child vaccinations include lack of transportation, parental work, childcare, and other social stressors. Objective: Increase the vaccination rate of children under the age of 24 months at BVCHC. Conduct a literature review to identify the common barriers preventing children under 24 months from receiving vaccinations. Reduce the barriers to expand access to vaccination care for infants Methods: Setting: Blackstone Valley Community Health Center, Pawtucket, RI Participants: (n=41), Patients between the age of 20-24 months, not up to date with the CDC vaccination recommendations and without a future appointment. QI Intervention: Patients were contacted via phone and offered an appointment during extra Saturday clinic hours in order to receive up to date vaccine care. A Saturday vaccine clinic was established specifically for patients in need of vaccines and having identified barriers to care. Conclusions: Expanding clinic hours and targeting non vaccine up –to-date patients can increase the current standard of childhood immunizations at BVCHC. Overcoming barriers preventing childhood immunization can improve access to providing up to date vaccinations. Other barriers still deter from reaching the national standard of immunizations rates.

Keywords: vaccinations, well child care, barriers to care, social determinants of health

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Authors: Md. Nurul Alom Siddikqe

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The purpose of this intervention was to describe how the marginalized people protect their rights and increase their self-dignity and self-esteem among brothel-based sex workers in 6 cities which are the victim of trafficked who came from different periphery areas Bangladesh. Eventually the sex workers are tortured by the pimp, clients, Msahi (so called guardian of bonded sex workers), Babu (So called husband) highly discriminated, vulnerable and stigmatized due to their occupation, movement, behavior and activities, which has got social disapproval. However, stigma, discrimination and violation of human rights not only bar them to access legal services, education of their kids, health, movement of outside of brothel, deprived of funeral after death, but also make them inaccessible due to their invisibility. Conducted an assessment among brothel-based sex workers setup to know their knowledge on human rights and find out their harassment and violence in their community. Inspired them to think about to be united and also assisted them to formation of self help group (SHG). Developed capacity of the SHG and developed leadership of its members through different trainings like administrative, financial management, public speaking and resource mobilization. Developed strategy to enhance the capacity of SHG so that they can collectively claim their rights and develop strategic partnership and network with the relevant service provider’s for restoring all sorts of rights. Conducted meeting with stakeholder including duty bearers, civil society organizations, media people and local government initiatives. Developed Networking with human rights commission, local elite, religious leaders and form human right watch committees at community level. Organized rally and observed national and international days along with government counterparts. By utilizing the project resources the members of SHG became capable to raise their collective voices against violence, discrimination and stigma as well as protected them from insecurity. The members of SHG have been participating in social program/event the SHG got membership of district level NGO coordination meeting through invitation from Deputy Commissioner, Civil Surgeon and Social welfare office of Government of Bangladesh. The Law Enforcement Agency is ensuring safety and security and the education department of government enrolled their children in primary level education. The Government provided land for grave yard after death for the Muslim sex workers and same for the other religious group. The SHGs are registered with government respective authorities. The SHGs are working with support from different development partners and implementing different projects sometime as consortium leaders. Opportunity created to take the vocational training from the government reputed department. The harassment by the clients reduced remarkably, babu, Mashi and other counterparts recognized the sex workers rights and ensure security with government counterpart access increased in legal, health and education. Indications are that the brothel based sex workers understood about their rights and became capable of ensuring their security through working under the self-help groups meaningfully.

Keywords: brothel, discrimination, harassment, stigma

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Authors: Claudineia Brazil, Elison Eduardo Bierhals, Francisco Pereira, José Leandro Néris, Matheus Rippel, Luciane Salvi

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The global concern about climate change has been increasing, since the emission of gases from human activities contributes to the greenhouse effect in the atmosphere, indicating significant impacts to the planet in the coming years. The study of precipitation regime is fundamental for the development of research in several areas. Among them are hydrology, agriculture, and electric sector. Using the climatic projections of the models belonging to the CMIP5, the main objective of the paper was to present an analysis of the impacts of climate change without rainfall in the Uruguay River basin. After an analysis of the results, it can be observed that for the future climate, there is a tendency, in relation to the present climate, for larger numbers of dry events, mainly in the winter months, changing the pluviometric regime for wet summers and drier winters. Given this projected framework, it is important to note the importance of adequate management of the existing water sources in the river basin, since the value of rainfall is reduced for the next years, it may compromise the dynamics of the ecosystems in the region. Facing climate change is fundamental issue for regions and cities all around the world. Society must improve its resilience to phenomenon impacts, and spreading the knowledge among decision makers and citizens is also essential. So, these research results can be subsidies for the decision-making in planning and management of mitigation measures and/or adaptation in south Brazil.

Keywords: climate change, hydrological potential, precipitation, mitigation

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Authors: Mukesh K. Dwivedi, Rajeshwar N. Srivastava, Amit K. Bhagat, Saloni Raj

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Introduction: Management of Pressure Ulcer (PU) is an ongoing clinical challenge particularly in traumatic paraplegia patients in developing countries where socio economic conditions often dictate treatment modalities. When negative pressure wound therapy (NPWT) was introduced, there were a series of devices (V.A.C., KCI, San Antonio, TX) manufactured. These devices for NPWT are costly and hard to afford by patients in developing countries like India. Considering this limitation, this study was planned to design an RCT to compare NPWT by an indigenized locally constructed NPD and conventional gauze dressing for the treatment of PU. Material and Methods: This RCT (CTRI/2014/09/0050) was conducted in the Department of Orthopaedic Surgery at King George’s Medical University (KGMU), India. Thirty-four (34) subjects of traumatic paraplegia having PU of stage 3 or 4, were enrolled and randomized in two treatment groups (NPWT Group & Conventional dressing group). The outcome measures of this study were surface area and depth of PU, exudates, microorganisms and matrix metalloproteinase-8 (MMP-8) during 0 to 9 weeks follow-ups. Levels of MMP-8 were analyzed in the tissues of PU at week 0, 3, 6 and week 9 by Enzyme Linked Immuno Sorbent Assay (ELISA). Results: Significantly reduced length of PU in NPWT group was observed at week 6 (p=0.04) which further reduced at week 9 (p=0.001) as compared to conventionally treated group. Similarly significant reduction of width and depth of PU was observed in NPWT at week 9 (p<0.05). The exudate became significantly (p=0.001) lower in NPWT group as compared with conventionally treated group from 6th to 9th week. Clearance and conversion of slough into red granulation tissue was significantly higher in NPWT group (p=0.001). At week 9, the wound culture was negative in all the subjects of NPWT group, while it was positive in 10 (41⋅6%) subjects of conventional group. Significantly lower level of MMP-8 was observed in subjects of NPWT group at week 6 (0.006**), and continually more reduction was observed at week 9 (<0.0001**) as compared to the conventional group. Conclusion: NPWT by locally constructed NPD is better wound care procedure for management of PU. Our device gave similar results as commercially available devices. Reduction of level of MMP-8 and increased rate of healing was achieved by negative pressure wound therapy (NPWT) as compared to conventional dressing.

Keywords: NPWT, NPD, MMP8, ELISA

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Authors: Zunnu Raen Akhtar, U. Irshad, M. Majid

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Due to the widespread cultivation of transgenic cotton, intense selection pressure resulted in resistant allele in pink bollworm, Pectinophora gossypiella (Gelechiidae: Lepidoptera). A resistant strain of pink bollworm against transgenic cotton has become a challenge to Integrated Resistance Management (IRM) in the World. Laboratory and field studies were conducted to determine the resistant strains of pink bollworm by performing bioassay, extracting the DNA, conducting PCR of both laboratory as well as field collected pink bollworms to observe the developed resistance. In all of the studies, two Bt varieties FH-142 and FH-118 expressing Cry1Ac compared to non-Bt (Control) were tested against pink bollworm. In the laboratory, bioassay results showed that there was no significant mortality difference between Bt and non-Bt varieties. Similar mortality percentage was observed in transgenic and non-transgenic (control) variety. Insects which were survived after bioassay, as well as those collected from the Bt cotton fields, were selected for further molecular studies. DNA extraction followed by PCR was conducted to check the resistant strains in pink bollworm. In field studies, we also observed the population dynamics of pink boll worms on Bt as compared to non-Bt varieties. Laboratory and field studies confirmed that resistant strains occurs in Pakistani Bt cotton fields. Different strategies should be adopted to combat that serious prevailing resistance issues.

Keywords: transgenic cotton, resistance, pectinophora gossypiella, , integrated resistance management (IRM), polymerase chain reaction (PCR)

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Authors: J. George, M. Al Mutairi, W. Aljuryyad, A. Alhussanan, A. Alkashan, T. Aldoghiri, Z. Alamari, A. Albakr

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Introduction: Students make plans for their career and are keen in exploring options of employment in those carriers. They make their employment choice based on their desires and preferences. This study aims to identify if students of King Saud Bin Abdulaziz for Health Sciences, College of Applied Medical Sciences after obtaining appropriate education prefer to work as clinicians, university faculty, or full-time researchers. There are limited studies in Saudi Arabia exploring the university student’s employment choices and preferences. This study would help employers to build the required job positions and prevent misleading employers from opening undesired positions in the job market. Methodology: The study included 394 students from third and fourth years both male and female among the eighth programs of college of applied medical sciences, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh campus. A prospective quantitative cross-sectional study was conducted; data were collected by distributing a seven item questionnaire and analyzed using SPSS. Results: Among the participants, 358 (90.9%) of them chose one of the three listed career choices, 263 (66.8%) decided to work as hospital staff after their education, 75 students (19.0%) chose to work as a faculty member in a university after obtaining appropriate degree, 20 students (5.1%) preferred to work as full-time researcher after obtaining appropriate degree, the remaining 36 students (9.1%) had different career goals, such as obtaining a master degree after graduating, to obtain a bachelor of medicine and bachelor in surgery degree, and working in the private sector. The most recurrent reason behind the participants' choice was "career goal", where 276 (70.1%) chose it as a reason. Conclusion: The findings of the study showed that most student’s preferred to work in hospitals as clinicians, followed by choice of working as a faculty in a university, the least choice was to be working as full-time researchers.

Keywords: College of Applied Medical Sciences, employment ambitions, graduating students, King Saud bin Abdulaziz University for Health Sciences

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Authors: Nikhilesh Singh, Shishir Gaur, Anitha K. Sharma

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Climate change and anthropogenic stress have severely affected ecosystems all over the globe. Indian rivers are under immense pressure, facing challenges like pollution, encroachment, extreme fluctuation in the flow regime, local ignorance and lack of coordination between stakeholders. To counter all these issues a holistic river rejuvenation plan is needed that tests, innovates and implements sustainable solutions in the river space for sustainable river management. Smart Laboratory for Clean Rivers (SLCR) an Indo-Danish collaboration project, provides a living lab setup that brings all the stakeholders (government agencies, academic and industrial partners and locals) together to engage, learn, co-creating and experiment for a clean and sustainable river that last for ages. Just like every mega project requires piloting, SLCR has opted for a small catchment of the Varuna River, located in the Middle Ganga Basin in India. Considering the integrated approach of river rejuvenation, SLCR embraces various techniques and upgrades for rejuvenation. Likely, maintaining flow in the channel in the lean period, Managed Aquifer Recharge (MAR) is a proven technology. In SLCR, Floa-TEM high-resolution lithological data is used in MAR models to have better decision-making for MAR structures nearby of the river to enhance the river aquifer exchanges. Furthermore, the concerns of quality in the river are a big issue. A city like Varanasi which is located in the last stretch of the river, generates almost 260 MLD of domestic waste in the catchment. The existing STP system is working at full efficiency. Instead of installing a new STP for the future, SLCR is upgrading those STPs with an IoT-based system that optimizes according to the nutrient load and energy consumption. SLCR also advocate nature-based solutions like a reed bed for the drains having less flow. In search of micropollutants, SLCR uses fingerprint analysis involves employing advanced techniques like chromatography and mass spectrometry to create unique chemical profiles. However, rejuvenation attempts cannot be possible without involving the entire catchment. A holistic water management plan that includes storm management, water harvesting structure to efficiently manage the flow of water in the catchment and installation of several buffer zones to restrict pollutants entering into the river. Similarly, carbon (emission and sequestration) is also an important parameter for the catchment. By adopting eco-friendly practices, a ripple effect positively influences the catchment's water dynamics and aids in the revival of river systems. SLCR has adopted 4 villages to make them carbon-neutral and water-positive. Moreover, for the 24×7 monitoring of the river and the catchment, robust IoT devices are going to be installed to observe, river and groundwater quality, groundwater level, river discharge and carbon emission in the catchment and ultimately provide fuel for the data analytics. In its completion, SLCR will provide a river restoration manual, which will strategise the detailed plan and way of implementation for stakeholders. Lastly, the entire process is planned in such a way that will be managed by local administrations and stakeholders equipped with capacity-building activity. This holistic approach makes SLCR unique in the field of river rejuvenation.

Keywords: sustainable management, holistic approach, living lab, integrated river management

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Authors: Nina Dziatzko, Christopher Stehr, Franziska Struve

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Intercultural competence as an explicit required skill nearly never appears in job advertisements in international or even global contexts. But especially those who have to deal with different nationalities and cultures in their everyday business need to have several intercultural competencies and further a global mind-set. This way the question arises how potential future global managers can be trained to learn these competencies. In this regard, it might be helpful to see if different types of intercultural trainings have different effects on those skills. This paper outlines lessons learned based on the evaluation of two different intercultural trainings for management students. The main differences between the observed intercultural trainings are the amount of theoretical input in relation to hands-on experiences, the number of trainers as well as the used methods to teach implicit cultural rules. Both groups contain management students with the willingness and perspective to work abroad or to work in international context. The research is carried out with a pre-training-survey and a post-training-survey which consists of questions referring the international context of the students and a self-estimation of 19 identified intercultural and global mind-set skills, such as: cosmopolitanism, empathy, differentiation and adaptability. Whereas there is no clear result which training gets overall a significant higher increase of skills, there is a clear difference between the focus of competencies trained by each of the intercultural trainings. This way this research provides a guideline for both academicals institutions as well as companies for the decision between different types of intercultural trainings, if the to be trained required skills are defined. Therefore the efficiency and the accuracy of fit of the education of future global managers get optimized.

Keywords: global mind-set, intercultural competencies, intercultural training, learning experiences

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Authors: Àidan Higgins

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Higher education will be crucial in the coming decades in helping to make Ireland a nation is known for innovation, competitive enterprise, and ongoing academic success, as well as a desirable location to live and work with a high quality of life, vibrant culture, and inclusive social structures. Higher education institutions will actively connect with each student community, society, and business; they will help students develop a sense of place and identity in Ireland and provide the tools they need to contribute significantly to the global community. It will also serve as a catalyst for novel ideas through research, many of which will become the foundation for long-lasting inventive businesses in the future as part of the 2030 National Strategy on Education focuses on change and developing our education system with a focus on how we carry out Research. The emphasis is central to knowledge transfer and a consistent research framework with exploiting opportunities and having the necessary expertise. The newly formed Technological Universities (TU) in Ireland are based on a government initiative to create a new type of higher education institution that focuses on applied and industry-focused research and education. The basis of the TU is to bring together two or more existing institutes of technology to create a larger and more comprehensive institution that offers a wider range of programs and services to students and industry partners. The TU model aims to promote collaboration between academia, industry, and community organizations to foster innovation, research, and economic development. The TU model also aims to enhance the student experience by providing a more seamless pathway from undergraduate to postgraduate studies, as well as greater opportunities for work placements and engagement with industry partners. Additionally, the TUs are designed to provide a greater emphasis on applied research, technology transfer, and entrepreneurship, with the goal of fostering innovation and contributing to economic growth. A project is a collection of organised tasks carried out precisely to produce a singular output (product or service) within a given time frame. Project management is a set of activities that facilitates the successful implementation of a project. The significant differences between research and development projects are the (lack of) precise requirements and (the inability to) plan an outcome from the beginning of the project. The evaluation criteria for a research project must consider these and other "particularities" in works; for instance, proving something cannot be done may be a successful outcome. This study intends to explore how a newly established multi-campus technological university manages research projects effectively. The study will identify the potential and difficulties of managing research projects, the tools, resources and processes available in a multi-campus Technological University context and the methods and approaches employed to deal with these difficulties. Key stakeholders like project managers, academics, and administrators will be surveyed as part of the study, which will also involve an explorative investigation of current literature and data. The findings of this study will contribute significantly to creating best practices for project management in this setting and offer insightful information about the efficient management of research projects within a multi-campus technological university.

Keywords: project management, research and research-related projects, multi-campus technology university, processes

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Authors: Protik Basu, Indranil Ghosh, Pranab K. Dan

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Lean management is an integrated socio-technical system to bring about a competitive state in an organization. The purpose of this paper is to explore and integrate the role of customers and suppliers with the internal practices of the Indian manufacturing industries towards successful implementation of lean manufacturing (LM). An extensive literature survey is carried out. An attempt is made to build an exhaustive list of all the input manifests related to customers, suppliers and internal practices necessary for LM implementation, coupled with a similar exhaustive list of the benefits accrued from its successful implementation. A structural model is thus conceptualized, which is empirically validated based on the data from the Indian manufacturing sector. With the current impetus on developing the industrial sector, the Government of India recently introduced the Lean Manufacturing Competitiveness Scheme that aims to increase competitiveness with the help of lean concepts. There is a huge scope to enrich the Indian industries with the lean benefits, the implementation status being quite low. Hardly any survey-based empirical study in India has been found to integrate customers and suppliers with the internal processes towards successful LM implementation. This empirical research is thus carried out in the Indian manufacturing industries. The basic steps of the research methodology followed in this research are the identification of input and output manifest variables and latent constructs, model proposition and hypotheses development, development of survey instrument, sampling and data collection and model validation (exploratory factor analysis, confirmatory factor analysis, and structural equation modeling). The analysis reveals six key input constructs and three output constructs, indicating that these constructs should act in unison to maximize the benefits of implementing lean. The structural model presented in this paper may be treated as a guide to integrating customers and suppliers with internal practices to successfully implement lean. Integrating customers and suppliers with internal practices into a unified, coherent manufacturing system will lead to an optimum utilization of resources. This work is one of the very first researches to have a survey-based empirical analysis of the role of customers, suppliers and internal practices of the Indian manufacturing sector towards an effective lean implementation.

Keywords: customer management, internal manufacturing practices, lean benefits, lean implementation, lean manufacturing, structural model, supplier management

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Authors: Adeyinka Adeniran, Omowunmi Bakare, Esther Oluwole, Florence Chieme, Temitope Durojaiye, Modupe Akinyinka, Omobola Ojo, Babatunde Olujobi, Marcus Ilesanmi, Akintunde Ogunsakin

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Introduction: Globally, COVID-19 has greatly impacted the human race physically, socially, mentally, and economically. However, healthcare workers seemed to bear the greatest impact. The study, therefore, sought to assess the impact of COVID-19 on the primary healthcare workers in Ekiti, South-west Nigeria. Methods: The study was a cross-sectional descriptive study using a quantitative data collection method of 716 primary healthcare workers in Ekiti state. Respondents were selected using an online convenience sampling method via their social media platforms. Data was collected, collated, and analyzed using SPSS version 25 software and presented as frequency tables, mean and standard deviation. Bivariate and multivariate analyses were conducted using a t-test, and the level of statistical significance was set at p<0.05. Results: Less than half (47.1%) of respondents were between 41-50 age group and a mean age of 44.4+6.4SD. A majority (89.4%) were female, and almost all (96.2%) were married. More than (90%) had ever heard of Coronavirus, and (85.8%) had to spend more money on activities of daily living such as transportation (90.1%), groceries (80.6%), assisting relations (95.8%) and sanitary measures (disinfection) at home (95.0%). COVID-19 had a huge negative impact on about (89.7%) of healthcare workers, with a mean score of 22+4.8. Conclusion: COVID-19 negatively impacted the daily living and professional duties of primary healthcare workers, which reflected their psychological, physical, social, and economic well-being. Disease outbreaks are unlikely to disappear in the near future. Hence, global proactive interventions and homegrown measures should be adopted to protect healthcare workers and save lives.

Keywords: Covid-19, health workforce, primary health care, health systems, depression

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Authors: Marjone Van Der Bank, C. M. Van Der Bank

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This paper presents an overview of the foundation and evolution of environmental related problems in local governments with specific reference on air pollution in South Africa. Local government has a direct mandate in terms of the Constitution of the Republic of South Africa, 1996 (hereafter, the Constitution). This mandate to protect, fulfil, respect and promote the Bill of Rights by local governments in respect of the powers and functions creates confusion around the role of where a local government fits in, in addressing the problem of climate change in South Africa. A reflection of the evolving legislations, developments, and processes regarding climate change that shaped local government dispensation in South Africa is addressed by the notion of developmental local governments. This paper seeks to examine the advances for mitigation and adaptation regulation of air pollution and application in South Africa. This study involves a qualitative approach that will involve South African national legislation as well as an interpretation of international strategies. A literature review study was conducted to undertake the various aspects of law in order to support the argument undertaken of mitigation and adaptation strategies. The paper presents a detailed discussion of the current legislation and the position as it currently stands, as well as the relevant protections as outlined in the National Environmental Management Act and the National Environmental Management: Air Quality Act. It then proceeds to outline the responsibilities of local governments in South Africa to mitigate and adapt to air pollution strategies.

Keywords: adaptation, climate change, disaster, local governments and mitigation

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Authors: Nicole Selvi Hill, Archchana Radhakrishnan

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Introduction: Traumatic brain injury (TBI) is a leading cause of mortality among trauma patients. In the management of TBI, the main principle is avoiding cerebral ischemia, as this is a strong determiner of neurological outcomes. The use of vasoactive drugs, such as vasopressin, has an important role in maintaining cerebral perfusion pressure to prevent secondary brain injury. Current guidelines do not suggest a preferred vasoactive drug to administer in the management of TBI, and there is a paucity of information on the therapeutic potential of vasopressin following TBI. Vasopressin is also an endogenous anti-diuretic hormone (AVP), and pathways mediated by AVP play a large role in the underlying pathological processes of TBI. This creates an overlap of discussion regarding the therapeutic potential of vasopressin following TBI. Currently, its popularity lies in vasodilatory and cardiogenic shock in the intensive care setting, with increasing support for its use in haemorrhagic and septic shock. Methodology: This is a review article based on a literature review. An electronic search was conducted via PubMed, Cochrane, EMBASE, and Google Scholar. The aim was to identify clinical studies looking at the therapeutic administration of vasopressin in severe traumatic brain injury. The primary aim was to look at the neurological outcome of patients. The secondary aim was to look at surrogate markers of cerebral perfusion measurements, such as cerebral perfusion pressure, cerebral oxygenation, and cerebral blood flow. Results: Eight papers were included in the final number. Three were animal studies; five were human studies, comprised of three case reports, one retrospective review of data, and one randomised control trial. All animal studies demonstrated the benefits of vasopressors in TBI management. One animal study showed the superiority of vasopressin in reducing intracranial pressure and increasing cerebral oxygenation over a catecholaminergic vasopressor, phenylephrine. All three human case reports were supportive of vasopressin as a rescue therapy in catecholaminergic-resistant hypotension. The retrospective review found vasopressin did not increase cerebral oedema in TBI patients compared to catecholaminergic vasopressors; and demonstrated a significant reduction in the requirements of hyperosmolar therapy in patients that received vasopressin. The randomised control trial results showed no significant differences in primary and secondary outcomes between TBI patients receiving vasopressin versus those receiving catecholaminergic vasopressors. Apart from the randomised control trial, the studies included are of low-level evidence. Conclusion: Studies favour vasopressin within certain parameters of cerebral function compared to control groups. However, the neurological outcomes of patient groups are not known, and animal study results are difficult to extrapolate to humans. It cannot be said with certainty whether vasopressin’s benefits stand above usage of other vasoactive drugs due to the weaknesses of the evidence. Further randomised control trials, which are larger, standardised, and rigorous, are required to improve knowledge in this field.

Keywords: catecholamines, cerebral perfusion pressure, traumatic brain injury, vasopressin, vasopressors

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Authors: Arnold Sanda Layuk

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Fraud in the disclosure of financial statements by management shows that agency conflict is an important issue in the company. The conflict has consequences for the agency costs that must be borne and has an impact on the firm's performance. The effect of agency costs on firm performance is investigated in this study, as well as whether several variables such as corporate governance mechanisms can positively moderate the agency cost and firm performance relationship. The agency cost is measured by the asset utilization ratio and discretionary expenditure ratio. The firm's performance is represented by the return on equity. Data was collected from the manufacturing companies listed on the Indonesia Stock Exchange from 2015 to 2019, then regressed on the panel data using the panel corrected standard error model (PCSE). According to the findings, agency costs are negatively related to firm performance, which supports previous empirical research findings. It also found that the agency cost and firm performance relationship is significantly moderated by board size and ownership concentration as the representatives of corporate governance mechanisms. It suggests that corporate governance can become tools to reduce agency costs and increase firm performance as well. The empirical evidence adds to previous research on agency conflict, particularly in emerging markets. These findings are expected to supplement previous research and provide additional information to shareholders in order to control opportunistic management decisions that affect their investments and discretionary operational expenses.

Keywords: agency cost, corporate governance, asset utilization ratio, firm performance

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Authors: Pavitra Sharma, Anuradha Singh, Nupur Mathur

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There exist more than 100 trillion bacteria in the digestive system of human-beings. Such bacteria are referred to as gut microbiota. Gut microbiota comprises around 75% of our immune system. The bacteria that comprise the gut microbiota are unique to every individual and their composition keeps changing with time owing to factors such as the host’s age, diet, genes, environment, and external medication. Of these factors, the variable easiest to control is one’s diet. By modulating one’s diet, one can ensure an optimal composition of the gut microbiota yielding several health benefits. Prebiotics and probiotics are two compounds that have been considered as viable options to modulate the host’s diet. Prebiotics are basically plant products that support the growth of good bacteria in the host’s gut. Examples include garden asparagus, aloe vera etc. Probiotics are living microorganisms that exist in our intestines and play an integral role in promoting digestive health and supporting our immune system in general. Examples include yogurt, kimchi, kombucha etc. In the context of modulating the host’s diet, the key attribute of prebiotics is that they support the growth of probiotics. By developing the right combination of prebiotics and probiotics, food products or supplements can be created to enhance the host’s health. An effective combination of prebiotics and probiotics that yields health benefits to the host is referred to as synbiotics. Synbiotics comprise of an optimal proportion of prebiotics and probiotics, their application benefits the host’s health more than the application of prebiotics and probiotics used in isolation. When applied to food supplements, synbiotics preserve the beneficial probiotic bacteria during storage period and during the bacteria’s passage through the intestinal tract. When applied to the gastrointestinal tract, the composition of the synbiotics assumes paramount importance. Reason being that for synbiotics to be effective in the gastrointestinal tract, the chosen probiotic must be able to survive in the stomach’s acidic environment and manifest tolerance towards bile and pancreatic secretions. Further, not every prebiotic stimulates the growth of a particular probiotic. The prebiotic chosen should be one that not only maintains 2 balance in the host’s digestive system, but also provides the required nutrition to probiotics. Hence in each application of synbiotics, the prebiotic-probiotic combination needs to be carefully selected. Once the combination is finalized, the exact proportion of prebiotics and probiotics to be used needs to be considered. When determining this proportion, only that amount of a prebiotic should be used that activates metabolism of the required number of probiotics. It was observed that while probiotics are active is both the small and large intestine, the effect of prebiotics is observed primarily in the large intestine. Hence in the host’s small intestine, synbiotics are likely to have the maximum efficacy. In small intestine, prebiotics not only assist in the growth of probiotics, but they also enable probiotics to exhibit a higher tolerance to pH levels, oxygenation, and intestinal temperature

Keywords: microbiota, probiotics, prebiotics, synbiotics

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Authors: Ramya Rachel S.

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For women in a developing country like India, poverty is an ever-clinging problem which has rooted itself without any trace of absolute abolition. Poverty is a deprivation of many imminent needs and must be measured accordingly. Therefore, it is important to study the dimensions of education, health, and standard of living to understand the true nature of the impoverished. The study focused on studying the deprivation on these aspects using the Alkire-Foster methodology to estimate the Multidimensional Poverty Index. The study has utilized the individual data of women aged 15 to 49 of the National Family Health Survey (NFHS) for the year 2015-16. Findings reveal that women in India still face extreme levels of deprivation in various dimensions. More than one-third of the total women aged 15 to 24 in India were multidimensionally poor. Dimensional breakdown of the levels of multidimensional poverty indicates that the dimension of Education is the highest contributor to poverty. Decomposition of the multidimensional poverty among various demographic sub-groups, reveals that the multidimensional poverty level increases with age. Results point out that deprivations were higher among widowed and married women, and among women who lived alone. There was also a huge rural-urban divide with respect to poverty. The basic needs of these women must be targeted and met so that they are withdrawn from all forms of poverty.

Keywords: deprivations, multidimensional poverty, sub-group decomposition, women

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Authors: Hady Hamidyan

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As the global population continues to grow, the demand for clean water and effective wastewater treatment becomes increasingly critical. By 2030, global water demand is projected to exceed supply by 40%, driven by population growth, increased water usage, and climate change. Currently, about 4.2 billion people lack access to safely managed sanitation services. The wastewater treatment sector faces numerous challenges, including the need for energy-efficient solutions, cost-effectiveness, ease of use, and low maintenance requirements. This abstract presents a groundbreaking wastewater treatment technology that addresses these challenges by offering an energy-saving approach, wastewater recovery capabilities, and a ready-made, affordable, and user-friendly package with minimal maintenance costs. The unique design of this ready-made package made it possible to eliminate the need for pumps, filters, airlift, and other common equipment. Consequently, it enables sustainable wastewater treatment management with exceptionally low energy and cost requirements, minimizing investment and maintenance expenses. The operation of these packages is based on continuous aeration, which involves injecting oxygen gas or air into the aeration chamber through a tubular diffuser with very small openings. This process supplies the necessary oxygen for aerobic bacteria. The recovered water, which amounts to almost 95% of the input, can be treated to meet specific quality standards, allowing safe reuse for irrigation, industrial processes, or even potable purposes. This not only reduces the strain on freshwater resources but also provides economic benefits by offsetting the costs associated with freshwater acquisition and wastewater discharge. The ready-made, affordable, and user-friendly nature of this technology makes it accessible to a wide range of users, including small communities, industries, and decentralized wastewater treatment systems. The system incorporates user-friendly interfaces, simplified operational procedures, and integrated automation, facilitating easy implementation and operation. Additionally, the use of durable materials, efficient equipment, and advanced monitoring systems significantly reduces maintenance requirements, resulting in low overall life-cycle costs and alleviating the burden on operators and maintenance personnel. In conclusion, the presented wastewater treatment technology offers a comprehensive solution to the challenges faced by the industry. Its energy-saving approach, combined with wastewater recovery capabilities, ensures sustainable resource management and enhances environmental stewardship. This affordable, ready-made, and low-maintenance package promotes broad adoption across various sectors and communities, contributing to a more sustainable future for water and wastewater management.

Keywords: wastewater treatment, energy saving, wastewater recovery, affordable package, low maintenance costs, sustainable resource management, environmental stewardship

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Authors: Anuruddha Jagoda, Samiddhi Samarakoon, Anil Jasinghe

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In an emergency department ‘where every second count for patient’s management’ timely availability of X- rays play a vital role in early diagnosis and management of patients. Trauma care centers rely heavily on timely radiologic imaging for patient care and radiology plays a crucial role in the emergency department (ED) operations. A research study was carried out to assess timeliness of availability of X-rays and total turnaround time at the Accident Service of National Hospital of Sri Lanka which is the premier trauma center in the country. Digital Radiology system was implemented as an intervention to improve the timeliness of availability of X-rays. Post-implementation assessment was carried out to assess the effectiveness of the intervention. Reduction in all three aspects of waiting times namely waiting for initial examination by doctors, waiting until X –ray is performed and waiting for image availability was observed after implementation of the intervention. However, the most significant improvement was seen in waiting time for image availability and reduction in time for image availability had indirect impact on reducing waiting time for initial examination by doctors and waiting until X –ray is performed. The most significant reduction in time for image availability was observed when performing 4-5 X rays with DR system. The least improvement in timeliness was seen in patients who are categorized as critical.

Keywords: emergency department, digital radilogy, timeliness, trauma care

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Authors: Nilam Bano, Uzma Iram

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Globally, the dilemma of undernutrition has become a notable concern for the researchers, academicians, and policymakers because of its severe consequences for many centuries. The nutritional deficiencies create hurdles for the people to achieve goals related to live a better lifestyle. Not only at micro level but also at the macro level, the consequences of undernutrition affect the economic progress of the country. The initial five years of a child’s life are considered critical for the physical growth and brain development. In this regard, children require special care and good quality food (nutrient intake) to fulfill their nutritional demand of the growing body. Having the sensitive stature and health, children specially under the age of 5 years are more vulnerable to the poor economic, housing, environmental and other social conditions. Beside confronting economic challenges and political upheavals, Pakistan is also going through from a rough patch in the context of social development. Majority of the children are facing serious health problems in the absence of required nutrition. The complexity of this issue is getting severe day by day and specially children are left behind with different type of immune problems and vitamins and mineral deficiencies. It is noted that children from the well-off background are less likely affected by the undernutrition. In order to underline this issue, the present study aims to highlight the existing nutritional inequalities among the children of under five years in Pakistan. Moreover, this study strives to decompose those factors that severely affect the existing nutritional inequality and standing in the queue to capture the consideration of concerned authorities. Pakistan Demographic and Health Survey 2012-13 was employed to assess the relevant indicators of undernutrition such as stunting, wasting, underweight and associated socioeconomic factors. The objectives were executed through the utilization of the relevant empirical techniques. Concentration indices were constructed to measure the nutritional inequalities by utilizing three measures of undernutrition; stunting, wasting and underweight. In addition to it, the decomposition analysis following the logistic regression was made to unfold the determinants that severely affect the nutritional inequalities. The negative values of concentration indices illustrate that children from the marginalized background are affected by the undernutrition more than their counterparts who belong from rich households. Furthermore, the result of decomposition analysis indicates that child age, size of a child at birth, wealth index, household size, parents’ education, mother’s health and place of residence are the most contributing factors in the prevalence of existing nutritional inequalities. Considering the result of the study, it is suggested to the policymakers to design policies in a way so that the health sector of Pakistan can stimulate in a productive manner. Increasing the number of effective health awareness programs for mothers would create a notable difference. Moreover, the education of the parents must be concerned by the policymakers as it has a significant association with the present research in terms of eradicating the nutritional inequalities among children.

Keywords: concentration index, decomposition analysis, inequalities, undernutrition, Pakistan

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