Search results for: socio-economic disparities minorities

Authors: Ali Kassem, Mohamed Alsenbasy, Ahmed Nagaah

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Background: Diabetic foot is one of the often neglected complications of diabetes mellitus It was reported that patients of diabetic foot ulcer (DFU) have considerable morbidity and mortality. Due to arterial abnormalities, diabetic neuropathy, as well as the tendency to delayed wound healing, foot infection and or gangrene is relatively common in diabetic patients. Foot related problems are responsible for up to 50% of diabetic related hospital admissions. Aim of work: The aim of the present study is to assess the risk factors for DFU in diabetic patients attending Sohag University Hospitals (Upper Egypt) Material and methods: The present study includes 100 diabetic foot patients attending the diabetic outpatient clinic of Sohag University Hospitals. For all of the studied patients the following were done: Full medical history and clinical examination; thorough foot examination; Laboratory tests including: Blood glucose level, HBA1c, serum lipids and renal function tests, ECG and Echocardiography, Doppler study on the lower limbs. Results: Sixty eight percent of the affected patients were males versus 32 % female patients. All male patients and none of the female were smoker. Seventy nine percent of patients were living in rural areas versus 14 % in urban areas. Duration of diabetes was more than 12 years in 74%, less than 12 years in 26% of patients. Fifty percent of patients have associated hypertension, 46% have dyslipidemia, 18% have ischemic heart disease or old myocardial infarction and 8% have impaired renal function. History of previous foot ulcers was reported in 11 % and foot amputation in 2% of patients. Conclusion: Male gender, low socioeconomic status, smoking, long duration of diabetes, other cardiovascular risk factors particularly hypertension and previous history of foot ulceration are the major risk factors for diabetic foot in our locality.

Keywords: diabetic foot, diabetic neuropathy, foot gangrene, risk factors for diabetic complications

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Authors: Anastasia Papachristou, Anastasia Ntikoudi, Vasileios Saridakis

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The safety and health care needs of refugees have become an increasingly important issue all over the world especially during last few decades. Wars are the primary reason for refugees to leave their countries. Moreover, refugees are frequently exposed to a variety of stressors such as socioeconomic disadvantages, poverty, changes in family structure and functioning, losing social support, difficulty to access education, living in very crowded places, experiencing racism and isolation. This systematic review included research studies published between 2007-2017 from the search databases Medline, Scopus, Cinahl and PubMed, with keywords 'war survivors', 'war trauma', 'psychiatric disorders', 'refugees'. In order to meet the purpose of the systematic review, further research for complementary studies was conducted into the literature references of the research articles included in this study that would meet the criteria. Overall, 14 studies were reviewed and evaluated. The majority of them demonstrated that the most common psychiatric disorders observed among war refugees are post-traumatic stress disorder (PTSD), depression, anxiety and multiple somatic complaints. Moreover, significant relationship was shown between the number of traumatic events experienced by the refugees and sociodemographic features such as gender, age and previous family history of any psychological disorder. War violence is highly traumatic, causing multiple, long-term negative outcomes such as the aforementioned psychiatric disorders. The number of the studies reviewed in this systematic review is not representative of the problem and its significance. The need for care of the survivors and their families is vital. Further research is necessary in order to clarify the role of predictive factors in the development and maintenance of post-traumatic stress and the rest psychiatric disorders following war trauma. In conclusion, it is necessary to have large multicenter studies in the future in order to be able to draw reliable conclusions about the effects of war.

Keywords: psychiatric disorders, refugees, war survivors, war trauma

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Authors: Nayoma Ranawaka

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The demand for the high quality internationally comparable financial information has been increased than ever with the expansion of economic activities beyond its national boundaries. Thus, the necessity of converging accounting practices across the world is now continuously discussed with greater emphasis. The global convergence to International Financial Reporting Standards has been one of the main objectives of the International Accounting Standards Setting Board (IASB) since its establishment in 2001. Accordingly, Sri Lanka has adopted IFRSs in 2012. Among the other standards as a newly introduced standard by the IASB, IFRS 13 plays a pivotal role as it deals with the Fair Value Accounting (FVA). Therefore, it is valuable to obtain knowledge about the consequences of implementing IFRS 13 in Sri Lanka and compare results across nations. According to the IFRS Jurisdictional provision of Sri Lanka, Institute of Chartered Accountants of Sri Lanka has taken official steps to adopt IFRS 13 by introducing SLFRS 13 with de jure convergence. Then this study was identified the de facto convergence of the SLFRS 13 in measuring the Fair Value of Financial Instruments in the Sri Lankan context. Accordingly, the objective of this study is to explore the consequences to financial reporting by implementing SLFRS 13 on measuring the financial instruments. In order to achieve the objective of the study expert interview and in-depth interviews with the interviewees from the selected three case studies and their independent auditor were carried out using customized three different interview guides. These three cases were selected from three different industries; Banking, Manufacturing and Finance. NVivo version 10 was used to analyze the data collected through in-depth interviews. Then the content analysis was carried out and conclusions were derived based on the findings. Contribution to the knowledge by this study can be identified in different aspects. Findings of this study facilitate accounting practitioners to get an overall picture of application of fair value standard in measuring the financial instruments and to identify the challenges and barriers to the adoption process. Further, assist auditors in carrying out their audit procedures to check the level of compliance to the fair value standard in measuring the financial instruments. Moreover, this would enable foreign investors in assessing the reliability of the financial statements of their target investments as a result of SLFRS 13 in measuring the FVs of the FIs. The findings of the study could be used to open new avenues of thinking for policy formulators to provide the necessary infrastructure to eliminate disparities exists among different regulatory bodies to facilitate full convergence and thereby growth of the economy. Further, this provides insights to the dynamics of FVA implementation that are also relevant for other developing countries.

Keywords: convergence, fair value, financial instruments, IFRS 13

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Authors: Iman Shabanzadeh

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In terms of its geopolitical position, Iran has been one of the main centers of migration movements in the world in recent decades. However, the policy makers' lack of preparation in completing the cycle of social integration of these immigrants, especially the second and third generation, has caused these people to always be prone to leave the country and immigrate to developed and industrialized countries. In this research, the issue of integration of immigrants in Iran from the perspective of four indicators, "Identity Documents", "Access to Banking Services", "Access to Health and Treatment Services" and "Obtaining a Driver's License" will be analyzed. The research method is descriptive-analytical. To collect information, library and document sources in the field of laws and regulations related to immigrants' rights in Iran, semi-structured interviews with experts have been used. The investigations of this study show that none of the residence documents of immigrants in Iran guarantee the full enjoyment of basic citizenship rights for them. In fact, the function of many of these identity documents, such as the census card, educational support card, etc., is only to prevent crossing the border, and none of them guarantee the basic rights of citizenship. Therefore, for many immigrants, the difference between legality and illegality is only in the risk of crossing the border, and this has led to the spread of the habit of illegal presence for them. Despite this, it seems that there is no clear and coherent policy framework around the issue of foreign immigrants in the country. This policy incoherence can be clearly seen in the diversity and plurality of identity and legal documents of the citizens present in the country and the policy maker's lack of planning to integrate and organize the identity of this huge group. Examining the differences and socioeconomic inequalities between immigrants and the native Iranian population shows that immigrants have been poorly integrated into the structures of Iranian society from an economic and social point of view.

Keywords: immigrants, social integration, citizen services, structural inequality

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Authors: Yasser Aboel-Magd

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This research addresses the critical issue of accessibility for individuals with special needs and the broader implications of disability on one's ability to lead an independent and integrated life within society. It highlights the consequences of injury, illness, or disability not only on the physical level but also on psychological, social, educational, economic, and functional aspects of life. The study emphasizes the importance of inclusive design in urban spaces, reflecting on how a society's treatment of individuals with disabilities serves as a measure of its progress. The research delves into the challenges faced by people with special needs in the Kingdom, where, despite advancements in various sectors, there is a noticeable lack of accommodating public opportunities for this significant demographic. It argues for the necessity of a Saudi building code that considers the needs of a diverse population during the design phase. The paper discusses the role of urban space as a fundamental element in urban formation and its impact on the societal integration of individuals with special needs. The study explores a variety of inclusive design principles, ranging from physical features like ramps and tactile paving to digital and cognitive accessibility measures such as screen readers, closed captions, plain language, and visual aids. It also considers the impact of wayfinding and appropriate lighting design on the orientation and assistance of individuals within urban spaces at the lowest cost. The researchers connect inclusive design with sustainable practices, advocating for environments that are not only environmentally friendly but also adaptable and lasting. The paper concludes with the assertion that the integration of accessibility, universal design, and sustainability signifies a society's commitment to inclusivity and the empowerment of all individuals, paving the way for a future where everyone can participate fully and independently in society.

Keywords: accessibility, inclusive design, Saudi building code, disability inclusion, socioeconomic progress

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Authors: Arnold Missiame

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In Ghana, rural dwellers who depend primarily on agriculture for their livelihood constitute about 60% of the country’s population. This shows the critical role and potentials of the agricultural sector in helping to achieve Ghana’s vision 2030. With the current threat of climate change and advancements in technology, agricultural extension is not just about technology transfer and improvements in productivity, but it is also about improving the managerial and technical skills of farmers. In Ghana, the government of Ghana as well as other players in the sector like; non-governmental organizations, NGOs, local and international funding agencies, for decades now, have made capacity-building-investments in smallholder farmers by way of extension services delivery. This study sought to compare the technical efficiency of farmers who have access to agricultural extension and farmers who do not in Ghana. The study employed the stochastic meta-frontier model to analyze household survey data comprising 300 smallholder cassava farmers from the Fanteakwa district of Ghana. The farmers were selected through a two-stage sampling technique where 5 communities were purposively selected in the first stage and then 60 smallholder cassava farmers were randomly selected from each of the 5 communities. Semi-structured questionnaires were used to collect data on farmers’ socioeconomic and farm-level characteristics. The results showed that farmers who have access to agricultural extensions services have higher technical efficiencies (TE) and produce much closer to their meta-production frontiers (higher technology gap ratios (TGR) than farmers who do not have access to such extension services. Furthermore, experience in cassava cultivation and formal education significantly improves the technical efficiencies of farmers. The study recommends that the mode and scope of agricultural extension service delivery in the country should be enhanced to ensure that smallholder farmers have easy access to extension agents.

Keywords: agricultural extension, Ghana, smallholder farmers, stochastic meta-frontier model, technical efficiency

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Authors: Leticia Lengler, Jefferson Oliveira, Vania Estivalete, Jordana Marques Kneipp

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The context of social, economic and environmental transformations has driven innumerable changes in the organizational environment, influencing the social interactions that occur in this scenario. In this sense, social entrepreneurship emerges as a unique opportunity to challenge, question, rethink certain concepts and traditional theories widely discussed in relation to entrepreneurship. Therefore, the interest in studying personal values has been based on the idea that they might be predictors of the behavior of individuals. As an attempt to relate personal values with the characteristics of social entrepreneurs, this study aims to investigate the salient values and the social entrepreneurship perceptions that occur in two social projects responsible for developing sports skills among the students. For purposes of analysis, it is intended to consider: (i) a description of both Social Projects and their respective institutions, considering their history and relevance in the context; (ii) analysis of the personal values of the idealizers and teachers responsible for the projects, (iii) identification of the characteristics of social entrepreneurship manifested in the two projects, and (iv) discussion of similarities and disparities of the categories identified among the participants of the projects. Therefore, this study will carry a qualitative analysis from the interviews with 10 participants of each social project (named Projeto Remar/ASENA and Projeto Mãos Dadas/JUDÔ SANTA MARIA): 2 projects coordinators, 2 students, 2 parents of students, 2 physical education internships and 2 businessmen who stablished a partnership with each project. The data collection will be done through semi-structured interviews that are going to last around 30 minutes each, being recorded, transcribed and later analyzed, through the categorical analysis. The option for categorical analysis is supported by the fact that it is the best alternative when one wants to study values, opinions, attitudes and beliefs, through qualitative ones. In the present research, the pre-analysis phase consisted of an organization of the material collected during the research with Remar and Mãos Dadas Project, and a dynamic reading of this material, seeking to identify the characteristics of social entrepreneurship and values addressed in the study. In the analytical description phase, a more in-depth analysis of the material collected in the research will be carried out. The third phase, referred to as referential interpretation or treatment of results obtained will allow to verify the homogeneity and the heterogeneity among the participants' perceptions of the projects. Some preliminary results coming from the first interviews revealed the projects are guided by values such as cooperation, respect, well-being and nature preservation. These values are linked to the social entrepreneurship perception of the projects managers, who established their activities in behalf of the local community.

Keywords: personal values, social entrepreneurship, social projects, sports participants

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Authors: Mohamed Abdel-Hamid, Olfat Gamil Shaker, Doha El-Sayed Ellakwa, Eman Fathy Abdel-Maksoud

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Introduction: Despite advances in the knowledge of the molecular virology of hepatitis C virus (HCV), the mechanisms of hepatocellular injury in HCV infection are not completely understood. Hepatitis C viral infection (HCV) influences the susceptibility to apoptosis. This could lead to insufficient antiviral immune response and persistent viral infection. Aim of this study: was to examine whether BCL-2 gene polymorphism at codon 43 (+127G/A or Ala43Thr) has an impact on development of hepatocellular carcinoma caused by chronic hepatitis C Egyptian patients. Subjects and Methods: The study included three groups; group 1: composing of 30 patients with hepatocellular carcinoma (HCC), group 2 composing of 30 patients with HCV, group 3 composing of 30 healthy subjects matching the same age and socioeconomic status were taken as a control group. Gene polymorphism of BCL2 (Ala43Thr) were evaluated by PCR-RFLP technique and measured for all patients and controls. Results: The summed 43Thr genotype was more frequent and statistically significant in HCC patients as compared to control group. This genotype of BCL2 gene may inhibit the programmed cell death which leads to disturbance in tissue and cells homeostasis and reduction in immune regulation. This result leads to viral replication and HCV persistence. Moreover, virus produces variety of mechanisms to block genes participated in apoptosis. This mechanism proves that HCV patients who have 43Thr genotype are more susceptible to HCC. Conclusion: The data suggest for the first time that the BCL2 polymorphism is associated with the susceptibility to HCC in Egyptian populations and might be used as molecular markers for evaluating HCC risk. This study clearly demonstrated that Chronic HCV exhibit a deregulation of apoptosis with the disease progression. This provides an insight into the pathogenesis of chronic HCV infection, and may contribute to the therapy.

Keywords: BCL2 gene, Hepatitis C Virus, Hepatocellular carcinoma, sensitivity, specificity, apoptosis

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Authors: Ambika Prasad Gupta, Harshit Sosan Lakra

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Food security is an important issue that has been widely discussed in literature. However, there is a lack of research on the specific food security challenges faced by tribal communities. Tribal food security refers to the ability of indigenous or tribal communities to consistently access and afford an adequate and nutritious supply of food. These communities often have unique cultural, social, and economic contexts that can impact their food security. The study aims to assess the food security status of all thirty-two major tribes, including Particularly Vulnerable Tribal Groups (PVTG) people living in various blocks of Jharkhand State. The methodology of this study focuses on measuring the food security index of indigenous people by developing and redefining a new Tribal Food Security Index (TFSI) as per the indigenous community-level indicators identified by the Global Food Security Index and other indicators relevant to food security. Affordability, availability, quality and safety, and natural resources were the dimensions used to calculate the overall Tribal Food Security Index. A survey was conducted for primary data collection of tribes and PVTGs at the household level in various districts of Jharkhand with a considerable tribal population. The result shows that due to the transition from rural to urban areas, there is a considerable change in TFSI and a decrease in forest dependency of tribal communities. Socioeconomic factors like occupation and household size had a significant correlation with TFSI. Tribal households living in forests have a higher food security index than tribal households residing in urban transition areas. The study also shows that alternative methodology adopted to measure specific community-level food security creates high significant impact than using commonly used indices.

Keywords: indigenous people, tribal food security, particularly vulnerable tribal groups, Jharkhand

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Authors: Ayalkibet Mekonnen, Adane Abebe

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In hydrological cycle there are many water-related human interventions that modify the natural systems. Rainwater harvesting is one such intervention that involves harnessing of water in the upstream. Water harvesting used in upstream prevents water runoff on downstream mainly disturbance on biodiversity and ecosystems. The main objectives of the study are to assess the effects of water harvesting technologies on downstream water availability in the Woreda. To address the above problem, SWAT model, cost-benefit ratio and optimal control approach was used to analyse the hydrological and socioeconomic impact and tradeoffs on water availability of the community, respectively. The downstream impacts of increasing water consumption in the upstream rain-fed areas of the Bilate and Shala Catchment are simulated using the semi-distributed SWAT model. The two land use scenarios tested at sub basin levels (1) conventional land use represents the current land use practice (Agri-CON) and (2) in-field rainwater harvesting (IRWH), improving soil water availability through rainwater harvesting land use scenario. The simulated water balance results showed that the highest peak mean monthly direct flow obtained from Agri-CON land use (127.1 m3/ha), followed by Agri-IRWH land use (11.5 mm) and LULC 2005 (90.1 m3/ha). The Agri-IRWH scenario reduced direct flow by 10% compared to Agri-CON and more groundwater flow contributed by Agri-IRWH (190 m3/ha) than Agri-CON (125 m3/ha). The overall result suggests that the water yield of the Woreda may not be negatively affected by the Agri-IRWH land use scenario. The technology in the Woreda benefited positively having an average benefit cost ratio of 4.2. Water harvesting for domestic use was not optimal that the value of the water per demand harvested was less than the amount of water needed. Storage tanks, series of check dams, gravel filled dams are an alternative solutions for water harvesting.

Keywords: water harvesting, SWAT model, land use scenario, Agri-CON, Agri-IRWH, trade off, benefit cost ratio

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Authors: Aleema Rahman

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Introduction: This study aims to estimate the prevalence of long-term otitis media with effusion (OME) and hearing loss in a prospective longitudinal cohort studyand to study the relationship between the condition and educational and psychosocial outcomes. Methods: Analysis of data from the Avon Longitudinal Study of Parents and Children (ALSPAC) will be undertaken. ALSPAC is a longitudinal birth cohort study carried out in the UK, which has collected detailed measures of hearing on ~7000 children from the age of seven. A descriptive analysis of the data will be undertaken to estimate the prevalence of OME and hearing loss (defined as having average hearing levels > 20dB and type B tympanogram) at 7, 9, 11, and 15 years as well as that of long-term OME and hearing loss. Logistic and linear regression analyses will be conducted to examine associations between long-term OME and hearing loss and educational outcomes (grades obtained from standardised national attainment tests) and psychosocial outcomes such as anxiety, social fears, and depression at ages 10-11 and 15-16 years. Results: Results will be presented in terms of the prevalence of OME and hearing loss in the population at each age. The prevalence of long-term OME and hearing loss, defined as having OME and hearing loss at two or more time points, will also be reported. Furthermore, any associations between long-term OME and hearing loss and the educational and psychosocial outcomes will be presented. Analyses will take into account demographic factors such as sex and social deprivation and relevant confounders, including socioeconomic status, ethnicity, and IQ. Discussion: Findings from this study will provide new epidemiological information on the prevalence of long-term OME and hearing loss. The research will provide new knowledge on the impact of OME for the small group of children who do not grow out of condition by age 7 but continue to have hearing loss and need clinical care through later childhood. The study could have clinical implications and may influence service delivery for this group of children.

Keywords: educational attainment, hearing loss, otitis media with effusion, psychosocial development

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Authors: Nino Paresashvili, Nino Abesadze

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The modern world faces huge challenges. Globalization changed the socio-economic conditions of many countries. The current processes in the global environment have a different impact on countries with different cultures. However, an alleviation of poverty and improvement of living conditions is still the basic challenge for the majority of countries, because much of the population still lives under the official threshold of poverty. It is very important to stimulate youth employment. In order to prepare young people for the labour market, it is essential to provide them with the appropriate professional skills and knowledge. It is necessary to plan efficient activities for decreasing an unemployment rate and for developing the perfect mechanisms for regulation of a labour market. Such planning requires thorough study and analysis of existing reality, as well as development of corresponding mechanisms. Statistical analysis of unemployment is one of the main platforms for regulation of the labour market key mechanisms. The corresponding statistical methods should be used in the study process. Such methods are observation, gathering, grouping, and calculation of the generalized indicators. Unemployment is one of the most severe socioeconomic problems in Georgia. According to the past as well as the current statistics, unemployment rates always have been the most problematic issue to resolve for policy makers. Analytical works towards to the above-mentioned problem will be the basis for the next sustainable steps to solve the main problem. The results of the study showed that the choice of young people is not often due to their inclinations, their interests and the labour market demand. That is why the wrong professional orientation of young people in most cases leads to their unemployment. At the same time, it was shown that there are a number of professions in the labour market with a high demand because of the deficit the appropriate specialties. To achieve healthy competitiveness in youth employment, it is necessary to formulate regional employment programs with taking into account the regional infrastructure specifications.

Keywords: unemployment, analysis, methods, tendencies, regulation mechanisms

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Authors: Samantha J. Hall, Luke Taylor, Kenneth I. Cumming, Jakki Bardsley, Scott S. P. Wildman

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Medway School of Pharmacy – a joint collaboration between the University of Kent and the University of Greenwich – is a large school of pharmacy in the United Kingdom. The school primarily delivers the accredited Master or Pharmacy (MPharm) degree programme. Reportedly, some students may feel isolated from the larger student body that extends across four separate campuses, where a diverse range of academic subjects is delivered. In addition, student engagement has been noted as being limited in some areas, as evidenced in some cases by poor attendance at some lectures. In January 2015, the University of Kent launched a new initiative dedicated to Equality, Diversity and Inclusivity (EDI). As part of this project, Medway School of Pharmacy employed ‘Student Success Project Officers’ in order to analyse past and present school data. As a result, initiatives have been implemented to i) negate disparities in attainment and ii) increase engagement, particularly for Black, Asian and Minority Ethnic (BAME) students which make up for more than 80% of the pharmacy student cohort. Social media platforms are prevalent, with global statistics suggesting that they are most commonly used by females between the ages of 16-34. Student focus groups held throughout the academic year brought to light the school’s need to use social media much more actively. Prior to the EDI initiative, social media usage for Medway School of Pharmacy was scarce. Platforms including: Facebook, Twitter, Instagram, YouTube, The Student Room and University Blogs were either introduced or rejuvenated. This action was taken with the primary aim of increasing student engagement. By using a number of varied social media platforms, the university is able to capture a large range of students by appealing to different interests. Social media is being used to disseminate important information, promote equality and diversity, recognise and celebrate student success and also to allow students to explore the student life outside of Medway School of Pharmacy. Early data suggests an increase in lecture attendance, as well as greater evidence of student engagement highlighted by recent focus group discussions. In addition, students have communicated that active social media accounts were imperative when choosing universities for 2015/16. It allows students to understand more about the University and community prior to beginning their studies. By having a lively presence on social media, the university can use a multi-faceted approach to succeed in early engagement, as well as fostering the long term engagement of continuing students.

Keywords: engagement, social media, pharmacy, community

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Authors: Siqin Wang, Jonathan Corcoran, Yan Liu, Thomas Sigler

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Australia is a quintessentially immigrant nation with 28 percent of its residents being foreign-born. By 2011, People’s Republic of China (PRC) overtook the United Kingdom to become the largest source country in Australia. Significantly, the profile of PRC-born migrants has changed to mirror broader global shifts towards high-skilled labour, education-related, and investment-focussed migration, all of which reflect an increasing trend in the mobility of wealthy and/or educated cohorts. Together, these coalesce to form a more complex pattern of migrant settlement –both spatially and socio-economically. This paper focuses on the PRC-born migration, redresses these lacunae, with regard to the settlement outcomes of PRC migrants to Australia, with a particular focus on spatial evolution and residential mobility at both the metropolitan and national scales. By drawing on Census Data and migration Micro Datasets, the aim of this paper is to examine the shifting dynamics of PRC-born migrants in Australian capital cities to unveil their socioeconomic characteristics, residential patterns and change of spatial concentrations during their transition into the new host society. This paper finds out three general patterns in the residential evolution of PRC-born migrants depending on the size of capital cities where they settle down, as well as the association of socio-economic characters with the formation of enclaves. It also examines the residential mobility across states and cities from 2001 to 2011 indicating the rising status of median-size Australian capital cities for receiving PRC-born migrants. The paper concludes with a discussion of evidences for policy formation, facilitates the effective transition of PRC-born populations into the mainstream of host society and enhances social harmony to help Australia become a more successful multicultural nation.

Keywords: Australia, Chinese migrants, residential mobility, spatial evolution

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Authors: Christiana Frimpong, Mpundu Makasa, Lungowe Sitali, Charles Michelo

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Background: Toxoplasmosis is a neglected zoonotic disease which is prevalent among pregnant women especially in Africa. This study aimed to determine the seroprevalence and determinants of the disease among pregnant women attending the antenatal clinic at the University Teaching Hospital (UTH). Method: A cross-sectional study was employed where 411 pregnant women attending the antenatal clinic at UTH were interviewed using closed-ended questionnaires. Their blood was also tested for Toxoplasma gondii IgG and IgM antibodies using the OnSite Toxo IgG/IgM Combo Rapid Test cassettes by CTK Biotech, Inc, USA. Result: The overall seroprevalence of the infection (IgG) was 5.87%. There was no seropositive IgM result. Contact with cats showed 7.81 times the risk of contracting the infection in the pregnant women and being a farmer/being involved in construction work showed 15.5 times likelihood of contracting the infection. Socio-economic status of the pregnant women also presented an inverse relationship (showed association) with the infection graphically. However, though there were indications of the association between contact with cats, employment type as well as the socioeconomic status of the pregnant women with the infection, there was not enough evidence to suggest these factors as significant determining factors of Toxoplasma gondii infection in our study population. Conclusion: There is a low prevalence of Toxoplasma gondii infection among pregnant women in Lusaka, Zambia. Screening for the infection among pregnant women can be done once or twice during pregnancy to help protect both mother and child from the disease. Health promotion among women of child bearing age on the subject is of immense importance in order to help curb the situation. Further studies especially that of case-control and cohort studies should be carried out in the country in order to better ascertain the extent of the condition nationwide.

Keywords: determinants, pregnant women, seroprevalence, toxoplasmosis, University Teaching Hospital (UTH), Zambia

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Authors: Lina María Martínez Sánchez, Juliana Molina Valencia, Esteban Vallejo Agudelo, Daniel Gallego González, María Isabel Pérez Palacio, Juan Ricardo Gaviria García, María De Los Ángeles Rodríguez Gázquez, Gloria Inés Martínez Domínguez

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Alternative and complementary therapies constitute a vast and complex combination of interventions, philosophies, approaches, and therapies that acquire a holistic healthcare point of view, becoming an alternative for the treatment of patients with chronic pain. Objective: determine the characteristics of the use of alternative and complementary therapies in patients with chronic pain who consulted in a medical institution. Methodology: cross-sectional and descriptive study, with a population of patients that assisted to the outpatient consultation and met the eligibility criteria. Sampling was not conducted. A form was used for the collection of demographic and clinical variables and the Holistic Complementary and Alternative Medicine Questionnaire (HCAMQ) was validated. The analysis and processing of information was carried out using the SPSS program vr.19. Results: 220 people with chronic pain were included. The average age was 54.7±16.2 years, 78.2% were women, and 75.5% belonged to the socioeconomic strata 1 to 3. Musculoskeletal pain (77.7%), migraine (15%) and neuralgia (9.1%) were the most frequently types of chronic pain. 33.6% of participants have used some kind of alternative and complementary therapy; the most frequent were: homeopathy (14.5%), phytotherapy (12.7%), and acupuncture (11.4%). The total average HCAMQ score for the study group was 30.2±7.0 points, which shows a moderate attitude toward the use of complementary and alternative medicine. The highest scores according to the type of pain were: neuralgia (32.4±5.8), musculoskeletal pain (30.5±6.7), fibromyalgia (29.6±7.3) and migraine (28.5±8.8). The reliability of the HCAMQ was acceptable (Cronbach's α: 0.6). Conclusion: it was noted that the types of chronic pain and the clinical or therapeutic management of patients correspond to the data available in current literature. Despite the moderate attitude toward the use of these alternative and complementary therapies, one of every three patients uses them.

Keywords: chronic pain, complementary therapies, homeopathy, acupuncture analgesia

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Authors: Arezou Rezazadeh, Nasrin Omidvar, Hassan Eini-Zinab, Mahmoud Ghazi-Tabatabaie, Reza Majdzadeh, Saeid Ghavamzadeh, Sakineh Nouri-Saeidlou

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Dietary pattern analysis method can reflect more information about the nutritional etiology of chronic diseases such as obesity. The aim of this study was to determine the relationship between major dietary patterns and anthropometric measures in men and women living in the city of Urmia. In this cross-sectional study, 723 participants (427 women and 296 men), aged 20–64 in Urmia city were selected from all four zones of Urmia city, in the north-west of Iran. Anthropometrics (weight, height, waist and hip circumference) were measured with standard methods. Body Mass Index (BMI) was calculated by dividing weight (in kilograms) by the square of height (in meter). Dietary intake information was collected by a semi-quantitative food frequency questionnaire in the last year. Dietary patterns were determined using principal component analysis. The relationship between dietary patterns and obesity was analyzed by logistic regression. Three major dietary patterns (DPs) were identified that were named ‘Traditional Higher SES (THS)’, ‘Traditional Low SES (TLS)’ and ‘Transitional’. THS DP was positively and Transitional DP was negatively associated with BMI and waist circumference (W.C), however, after adjusting for confounding variables (age, gender, ethnicity, energy intake, physical activity and SES), the associations were not significant. The TLS was not significantly associated with BMI, but after adjusting for confounders, a significant positive association was detected with W.C and Waist to hip ratio (WHR). Findings showed that both traditional patterns were positively and the western type transitional pattern was reversely associated with anthropometric indices. But this relationship was highly affected by demographic, socioeconomic and energy input and output determinants. The results indicate the inevitable effect of environmental factors on the relationship between dietary patterns and anthropometric indices.

Keywords: anthropometric indices, dietary pattern, Iran, North-west

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Authors: Aparna Lal, Ashwin Swaminathan, Teisa Holani

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Background: Clostridium difficile infections (CDIs) have been on the rise globally. In Australia, rates of CDI in all States and Territories have increased significantly since mid-2011. Identifying risk factors for CDI in the community can help inform targeted interventions to reduce infection. Methods: We examine the role of neighbourhood socio-economic status, demography, testing practices and the number of residential aged care facilities on spatial patterns in CDI incidence in the Australian Capital Territory. Data on all tests conducted for CDI were obtained from ACT Pathology by postcode for the period 1st January 2004 through 31 December 2014. Distribution of age groups and the neighbourhood Index of Relative Socio-economic Advantage Disadvantage (IRSAD) were obtained from the Australian Bureau of Statistics 2011 National Census data. A Bayesian spatial conditional autoregressive model was fitted at the postcode level to quantify the relationship between CDI and socio-demographic factors. To identify CDI hotspots, exceedance probabilities were set at a threshold of twice the estimated relative risk. Results: CDI showed a positive spatial association with the number of tests (RR=1.01, 95% CI 1.00, 1.02) and the resident population over 65 years (RR=1.00, 95% CI 1.00, 1.01). The standardized index of relative socio-economic advantage disadvantage (IRSAD) was significantly negatively associated with CDI (RR=0.74, 95% CI 0.56, 0.94). We identified three postcodes with high probability (0.8-1.0) of excess risk. Conclusions: Here, we demonstrate geographic variations in CDI in the ACT with a positive association of CDI with socioeconomic disadvantage and identify areas with a high probability of elevated risk compared with surrounding communities. These findings highlight community-based risk factors for CDI.

Keywords: spatial, socio-demographic, infection, Clostridium difficile

Procedia PDF Downloads 320

Authors: Flex Anim

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

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

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Authors: Samson Obiene, Khamati Shilabukha, Geoffrey Muga, James Kairo

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Mangroves play a vital role in the achievement of multiple goals of global sustainable development (SDG’s), particularly SDG SDG 14 (life under water). Their management, however, is faced with several shortcomings arising from inadequate knowledge on the perceptions of their ecosystem services, hence a need to map mangrove goods and services within SDGs while interrogating the disaggregated perceptions. This study therefore aimed at exploring the parities and disparities in attitudes and perceptions of mangrove ecosystem services among community members of Vanga and the link of the ecosystem services (ESs) to specific SDG targets. The study was based at the Kenya-Tanzania transboundary area in Vanga; where a carbon-offset project on mangroves is being up scaled. Mixed methods approach employing surveys, focus group discussions (FGDs) and reviews of secondary data were used in the study. A two stage cluster samplings was used to select the study population and the sample size. FGDs were conducted purposively selecting active participants in mangrove related activities with distinct socio-demographic characteristics. Sampled respondents comprised of males and females of different occupations and age groups. Secondary data review was used to select specific SDG targets against which mangrove ecosystem services identified through a value chain analysis were mapped. In Vanga, 20 ecosystem services were identified and categorized under supporting, cultural and aesthetic, provisioning and regulating services. According to the findings of this study, 63.9% (95% ci 56.6-69.3) perceived of the ESs as very important for economic development, 10.3% (95% ci 0-21.3) viewed them as important for environmental and ecological development while 25.8% (95% ci 2.2-32.8) were not sure of any role they play in development. In the social-economic disaggregation, ecosystem service values were found to vary with the level of interaction with the ecosystem which depended on gender and other social-economic classes within the study area. The youths, low income earners, women and those with low education levels were also identified as the primary beneficiaries of mangrove ecosystem services. The study also found that of the 17 SDGs, mangroves have a potential of influencing the achievement 12, including, SDGs 1, 2, 3, 4, 6, 8 10, 12, 13, 14, 15 and 17 either directly or indirectly. Generally therefore, the local community is aware of the critical importance mangroves for enhanced livelihood and ecological services but challenges in sustainability still occur as a result the diverse values and of the services and the contradicting interests of the different actors around the ecosystem. It is therefore important to consider parities in values and perception to avoid a ‘tragedy of the commons’ while striving to enhance sustainability of the Mangrove ecosystem.

Keywords: sustainable development, community values, socio-demographics, Vanga, mangrove ecosystem services

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Authors: Mirza Waseem Abbas, Syed Danish Raza

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For many countries agriculture is still the major force driving the economy and a critically important socioeconomic sector, despite exceptional industrial development across the globe. In countries like Pakistan, this sector is considered the backbone of the economy, and most of the economic decision making revolves around agricultural outputs and data. Timely and accurate facts and figures about this vital sector hold immense significance and have serious implications for the long-term development of the economy. Therefore, any significant improvements in the statistics and other forms of data regarding agriculture sector are considered important by all policymakers. This is especially true for decision making for the betterment of crops and the agriculture sector in general. Provincial and federal agricultural departments collect data for all cash and non-cash crops and the sector, in general, every year. Traditional data collection for such a large sector i.e. agriculture, being time-consuming, prone to human error and labor-intensive, is slowly but gradually being replaced by remote sensing techniques. For this study, remotely sensed data were used for change detection (machine learning, supervised & unsupervised classification) to assess the increase or decrease in area under agriculture over the last fifteen years due to urbanization. Detailed Landsat Images for the selected agricultural districts were acquired for the year 2000 and compared to images of the same area acquired for the year 2016. Observed differences validated through detailed analysis of the areas show that there was a considerable decrease in vegetation during the last fifteen years in four major agricultural districts of the Punjab province due to urbanization (housing societies).

Keywords: change detection, area estimation, machine learning, urbanization, remote sensing

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Authors: Sepideh Mirzaee

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Gender-transformative (G-TE) education is a challenging concept in the field of education and it is a matter of hot debate in the contemporary world. Paulo Freire as the prominent advocate of transformative education considers it as an alternative to conventional banking model of education. Besides, a more inclusive concept has been introduced, namely, G-TE, as an unbiased education fostering an environment of gender justice. As its main tenet, G-TE eliminates obstacles to education and improves social shifts. A plethora of contemporary research indicates that G-TE could completely revolutionize education systems by displacing inequalities and changing gender stereotypes. Despite significant progress in female education and its effects on gender equality in Iran, challenges persist. There are some deficiencies regarding gender disparities in the society and, education, specifically. As an example, the number of women with university degrees is on the rise; thus, there will be an increasing demand for employment in the society by them. Instead, many job opportunities remain occupied by men and it is seen as intolerable for the society to assign such occupations to women. In fact, Iran is regarded as a patriarchal society where educational contexts can play a critical role to assign gender ideology to its learners. Thus, such gender ideologies in the education can become the prevailing ideologies in the entire society. Therefore, improving education in this regard, can lead to a significant change in a society subsequently influencing the status of women not only within their own country but also on a global scale. Notably, higher education plays a vital role in this empowerment and social change. Particularly higher education can have a crucial part in imparting gender neutral ideologies to its learners and bringing about substantial change. It has the potential to alleviate the detrimental effects of gender inequalities. Therefore, this study aims to conceptualize the pivotal role of G-TE and its potential power in developing gender equality within the higher educational system of Iran presented within a theoretical framework. The study emphasizes the necessity of stablishing a theoretical grounding for citizenship, and transformative education while distinguishing gender related issues including gender equality, equity and parity. This theoretical foundation will shed lights on the decisions made by policy-makers, syllabus designers, material developers, and specifically professors and students. By doing so, they will be able to promote and implement gender equality recognizing the determinants, obstacles, and consequences of sustaining gender-transformative approaches in their classes within the Iranian higher education system. The expected outcomes include the eradication of gender inequality, transformation of gender stereotypes and provision of equal opportunities for both males and females in education.

Keywords: citizenship education, gender inequality, higher education, patriarchal society, transformative education

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Authors: Jennifer A. Kowalkowski

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Production agriculture (farming) is a physically, emotionally, and cognitively stressful occupation, where workers have little control over the stressors that impact both their work and their lives. In an occupation already rife with hazards, these occupational-related stressors have been shown to increase farm workers’ risks for illness, injury, disability, and death associated with their work. Despite efforts to mitigate the negative health effects from occupational-related stress (ORS) and to promote health and well-being (HWB) among farmers in the US, marked improvements have not been attained. Social support accessed through social networks has been shown to buffer against the negative health effects from stress, yet no studies have directly examined these relationships among farmers. The purpose of this study was to use social network analysis to explore the social networks of farm owner-operators and the social supports available to them for mitigating the negative health effects of ORS. A convenience sample of 71 farm owner-operators from a Midwestern County in the US completed and returned a mailed survey (55.5% response rate) that solicited information about their social networks related to ORS. Farmers reported an average of 2.4 individuals in their personal networks and higher levels of comfort discussing ORS with female network members. Farmers also identified few connections (3.4% density) and indicated low comfort with members of affiliation networks specific to ORS. Findings from this study highlighted that farmers accessed different social networks and resources for their personal HWB than for issues related to occupational(farm-related) health and safety. In addition, farmers’ social networks for personal HWB were smaller, with different relational characteristics than reported in studies of farmers’ social networks related to occupational health and safety. Collectively, these findings suggest that farmers conceptualize personal HWB differently than farm health and safety. Therefore, the same research approaches and targets that guide occupational health and safety research may not be appropriate for personal HWB for farmers. Interventions and programming targeting ORS and HWB have largely been offered through the same platforms or mechanisms as occupational health and safety programs. This may be attributed to the significant overlap between the farm as a family business and place of residence, or that ORS stems from farm-related issues. However, these assumptions translated to health research of farmers and farm families from the occupational health and safety literature have not been directly studied or challenged. Thismay explain why past interventions have not been effective at improving health outcomes for farmers and farm families. A close examination of findings from this study raises important questions for researchers who study agricultural health. Findings from this study have significant implications for future research agendas focused on addressing ORS, HWB, and health disparities for farmersand farm families.

Keywords: agricultural health, occupational-related stress, social networks, well-being

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Authors: Jonathan R. Olsen, Natalie Nicholls, Jenna Panter, Hannah Burnett, Michael Tornow, Richard Mitchell

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The 20-minute neighborhood is a policy priority for governments worldwide and a key feature of this policy is providing access to natural space within 800 meters of home. The study aims were to (1) examine the association between distance to nearest natural space and frequent use over time and (2) examine whether frequent use and changes in use were patterned by income and housing tenure over time. Bi-annual Scottish Household Survey data were obtained for 2013 to 2019 (n:42128 aged 16+). Adults were asked the walking distance to their nearest natural space, the frequency of visits to this space and their housing tenure, as well as age, sex and income. We examined the association between distance from home of nearest natural space, housing tenure, and the likelihood of frequent natural space use (visited once a week or more). Two-way interaction terms were further applied to explore variation in the association between tenure and frequent natural space use over time. We found that 87% of respondents lived within 10 minute walk of a natural space, meeting the policy specification for a 20-minute neighbourhood. Greater proximity to natural space was associated with increased use; individuals living a 6 to 10 minute walk and over 10 minute walk were respectively 53% and 78% less likely to report frequent natural space use than those living within a 5 minute walk. Housing tenure was an important predictor of frequent natural space use; private renters and homeowners were more likely to report frequent natural space use than social renters. Our findings provide evidence that proximity to natural space is a strong predictor of frequent use. Our study provides important evidence that time-based access measures alone do not consider deep-rooted socioeconomic variation in use of Natural space. Policy makers should ensure a nuanced lens is applied to operationalising and monitoring the 20-minute neighbourhood to safeguard against exacerbating existing inequalities.

Keywords: natural space, housing, inequalities, 20-minute neighbourhood, urban design

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Authors: Gokul Prasad, Pennan Chinnasamy

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The degradation of groundwater resources, attributed to factors such as excessive abstraction and contamination, has emerged as a global concern. This study delves into the stable isotopes of water) in a hard-rock aquifer situated in the Upper Godavari watershed, an agriculturally rich region in India underlain by Basalt. The higher groundwater draft (> 90%) poses significant risks; comprehending groundwater sources, flow patterns, and their environmental impacts is pivotal for researchers and water managers. The region has faced five droughts in the past 20 years; four are categorized as medium. The recharge rates are variable and show a very minimum contribution to groundwater. The rainfall pattern shows vast variability, with the region receiving seasonal monsoon rainfall for just four months and the rest of the year experiencing minimal rainfall. This research closely monitored monsoon precipitation inputs and examined spatial and temporal fluctuations in δ18O and δ2H in both groundwater and precipitation. By discerning individual recharge events during monsoons, it became possible to identify periods when evaporation led to groundwater quality deterioration, characterized by elevated salinity and stable isotope values in the return flow. The locally derived meteoric water line (LMWL) (δ2H = 6.72 * δ18O + 1.53, r² = 0.6) provided valuable insights into the groundwater system. The leftward shift of the Nashik LMWL in relation to the GMWL and LMWL indicated groundwater evaporation (-33 ‰), supported by spatial variations in electrical conductivity (EC) data. Groundwater in the eastern and northern watershed areas exhibited higher salinity > 3000uS/cm, expanding > 40% of the area compared to the western and southern regions due to geological disparities (alluvium vs basalt). The findings emphasize meteoric precipitation as the primary groundwater source in the watershed. However, spatial variations in isotope values and chemical constituents indicate other contributing factors, including evaporation, groundwater source type, and natural or anthropogenic (specifically agricultural and industrial) contaminants. Therefore, the study recommends focused hydro geochemistry and isotope analysis in areas with strong agricultural and industrial influence for the development of holistic groundwater management plans for protecting the groundwater aquifers' quantity and quality.

Keywords: groundwater quality, stable isotopes, salinity, groundwater management, hard-rock aquifer

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Authors: Reeta Devi, Hitender Kumar Tyagi, Dinesh Kumar

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In present scenario, cardiovascular problems are growing challenge for researchers and physiologists. As heart disease have no geographic, gender or socioeconomic specific reasons; detecting cardiac irregularities at early stage followed by quick and correct treatment is very important. Electrocardiogram is the finest tool for continuous monitoring of heart activity. Heart rate variability (HRV) is used to measure naturally occurring oscillations between consecutive cardiac cycles. Analysis of this variability is carried out using time domain, frequency domain and non-linear parameters. This paper presents HRV analysis of the online dataset for normal sinus rhythm (taken as healthy subject) and sudden cardiac death (SCD subject) using all three methods computing values for parameters like standard deviation of node to node intervals (SDNN), square root of mean of the sequences of difference between adjacent RR intervals (RMSSD), mean of R to R intervals (mean RR) in time domain, very low-frequency (VLF), low-frequency (LF), high frequency (HF) and ratio of low to high frequency (LF/HF ratio) in frequency domain and Poincare plot for non linear analysis. To differentiate HRV of healthy subject from subject died with SCD, k –nearest neighbor (k-NN) classifier has been used because of its high accuracy. Results show highly reduced values for all stated parameters for SCD subjects as compared to healthy ones. As the dataset used for SCD patients is recording of their ECG signal one hour prior to their death, it is therefore, verified with an accuracy of 95% that proposed algorithm can identify mortality risk of a patient one hour before its death. The identification of a patient’s mortality risk at such an early stage may prevent him/her meeting sudden death if in-time and right treatment is given by the doctor.

Keywords: early stage prediction, heart rate variability, linear and non-linear analysis, sudden cardiac death

Procedia PDF Downloads 339

Authors: Briony Gray, Glenn Simpson, Hajira Dambha-Miller, Andrew Farmer

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Multimorbidity may be strongly affected by a variety of conditions, factors, and variables requiring higher demands on health and social care services, infrastructure, and expenses. Holding one or more conditions increases one’s risk for development of future conditions; with patients over 65 years old at highest risk. Psychosocial factors such as anxiety and depression are rising exponentially globally, which has been amplified by the COVID19 pandemic. These are highly correlated and predict poorer outcomes when held in coexistence and increase the likelihood of comorbid physical health conditions. While possible future reform of social and healthcare systems may help to alleviate some of these mounting pressures, there remains an urgent need to better understand the potential role health behaviours and psychosocial conditions - such as anxiety and depression – may have on aging populations. Using the UK healthcare scene as a lens for analysis, this study uses big data collected in the UK Longitudinal Study of Aging (ELSA) to examine the role of anxiety and depression in ageing populations (65yrs+). Using logistic regression modelling, results identify the 10 most significant variables correlated with both anxiety and depression from data categorised into the areas of health behaviour, psychosocial, socioeconomic, and life satisfaction (each demonstrated through literature review to be of significance). These are compared with wider global research findings with the aim of better understanding the areas in which social and healthcare reform can support multimorbidity interventions, making suggestions for improved patient-centred care. Scope of future research is outlined, which includes analysis of 59 total multimorbidity variables from the ELSA dataset, going beyond anxiety and depression.

Keywords: multimorbidity, health behaviours, patient centred care, psychosocial factors

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Authors: Mohammed Sghir Taleb

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Introduction The date palm (Phoenix dactylifera L.) represents an essential element of the oasis ecosystem for Saharan and pre-Saharan regions of Morocco. It plays an important role, not only due to its economic importance, but also its ecological adaptation to, firstly, to ensure necessary protection for crops against underlying warm and dry sales, and secondly to contribute to the fight against desertification. This is one of the oldest cultivated plant species best adapted to difficult climatic conditions of the Saharan and pre-Saharan regions, because of its ecological requirements and economically most suitable for investing in oasis agriculture. Methodology The methodology is mainly based on a literature review of principal theses and projects for the conservation of flora and vegetation. Results The date palm has multiple uses. Indeed, it produces fruits rich in nutrients, provides a multitude of secondary products and generates needed revenue for the survival of oasis populations. In Morocco, the development and modernization of the date palm sector face, both upstream and downstream of the industry, several major constraints. In addition to climate constraints (prolonged drought), in its environment (lack of water resources), to the incessant invasion of disease Bayoud, Moroccan palm ecosystem suffers from a low level of technical and traditional practices prevail and traditional, from the choice of variety and site preparation up to harvesting and recycling of products. Conclusion The date palm plays an important role in the socioeconomic development of local and national level. However, this ecosystem however, is subject to numerous degradation factors caused by anthropogenic action and climate change. to reverse the trends, several programs have been developed by Morocco for the restoration of degraded areas and the development of the Phoenix dactylifera ecosystem to meet the needs of local populations and the development of the national economy.

Keywords: efforts, flora, ecosystem, forest, conservation, Morocco

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Authors: Mequanint Birhan

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Modern urban environments present a dynamically growing field where, notwithstanding shared goals, several mutually conflicting interests frequently collide. However, it has a big impact on the city's socioeconomic standing, waiting lines and queues are common occurrences. This results in extremely long lines for both vehicles and people on incongruous routes, service coagulation, customer murmuring, unhappiness, complaints, and looking for other options sometimes illegally. The root cause of this is corruption, which leads to traffic jams, stopping, and packing vehicles beyond their safe carrying capacity, and violating the human rights and freedoms of passengers. This study focused on the optimizing time of passengers had to wait in public vehicle stations. This applied research employed both data gathering sources and mixed approaches, then 166 samples of key informants of transport station were taken by using the Slovin sampling formula. The length of time vehicles, including the drivers and auxiliary drivers ‘Weyala', had to wait was also studied. To maximize the service level at vehicle stations, a queuing model was subsequently devised ‘Menaharya’. Time, cost, and quality encompass performance, scope, and suitability for the intended purposes. The minimal response time for passengers and vehicles queuing to reach their final destination at the stations of the Tepi, Mizan, and Bonga towns was determined. A new bus station system was modeled and simulated by Arena simulation software in the chosen study area. 84% improvement on cost reduced by 56.25%, time 4hr to 1.5hr, quality, safety and designed load performance calculations employed. Stakeholders are asked to put the model into practice and monitor the results obtained.

Keywords: Arena 14 automatic rockwell, queue, transport services, vehicle stations

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Authors: Halimatus Sakdiah Minhat, Hamizah Sulaiman

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Introduction: Old age is commonly link with menopause among women. The main purpose of this study is to explore the views of middle-aged women and its association with menopause. Methods: Qualitative interviews in the form of focus group discussions (FGD) were conducted among women aged between 35 and 59 years old living in urban localities in two different states in Malaysia. Selection of respondents were conducted using the maximum variation sampling, focussing on five age categories which are between 35 to 39, 40 to 44, 45 to 49, 50 to 54 and 55 to 59 years old. Each FGD involved 5 to 7 respondents and lasted for 1 to 2 hours each. The content of the interviews were recorded, transcribed verbatim after each interview before the next focus group discussion is conducted. Field notes of reflexive observations were recorded by the rapporteur. Individual transcripts were analysed using standard methods of qualitative thematic analysis. The material was read through twice and later coded. The codes were further collapsed into several key themes related to perceptions towards menopause among the respondents. Results: A total number of 36 middle-aged women were consented for the interviews. The contents of the interviews revealed that younger women tend to associate menopause with being old, which were dominated by the younger aged categories of less than 50 years old. Majority of the respondents linked menopause with end of woman’s reproductive capacity or inability to give birth, lethargic or endless feeling of tiredness and insomnia, emotional instability or having more sensitive feelings and also the beginning of many health problems such as osteoarthritis which they perceived very synonyms with being old. Conclusion: The findings of this study indirectly reflect the negative views towards menopause among the middle-aged women in Malaysia. Being residents in the urban areas equipped with advanced technology and health information, do not exclude them from having negative views about menopause. However, this is a qualitative study which only focussing on age ranges, regardless of their socioeconomic and demographic background, which make further studies on related issues are necessaries. The fact that it was a qualitative interview, the findings could not be generalised and only specific to the targeted population.

Keywords: Menopause, Middle-aged women, old, Malaysia

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