Search results for: sociocultural determinants

Authors: Emrehan Ozcan, Dilek Beyazlı

Abstract:

The development of tourism depends on an accurate planning approach as well as on the right planning process. This dependency is also a key factor in ensuring sustainability of tourism. The types of tourism, social expectations, planning practice, the socio-economic and the cultural structure of the region are determinants of planning approaches for tourism development. The tourism plans prepared for the historic city centers are usually based on the revitalization of cultural and historical values. The preservation and development of the tourism potentials of the historic city centers are important for providing an economic contribution to the locality, creating livable solutions for local residents and also the sustainability of tourism. This research is about experiencing and discussing a planning approach that will provide tourism development based on historical and cultural values. Historical and cultural values in the historical city center of Trabzon -which has a settlement history of approximately 4000 years, is located on the Black Sea coast of Turkey- wear out over years and lose their tourism potential. A planning study has been experienced with strategic spatial planning approach for Trabzon, which has not done a tourism-oriented planning study until now. The stages of the planning process provided by strategic spatial planning approach are an assessment of the current situation; vision, strategies, and actions; action planning; designing and implementation of actions and monitoring-evaluation. In the discussion section, the advantages, planning process, methods and techniques of the approach are discussed for the possibilities and constraints in terms of tourism planning. In this context, it is aimed to put forth tourism planning process, stages, and implementation tools within the scope of strategic spatial planning approach by comparing approaches used in the tourism-oriented/priority planning of historical city centers. Suggestions on the position and effect of the preferred planning approach in the existing spatial planning practice are the outputs of the study.

Keywords: cultural heritage, tourism oriented planning, Trabzon, strategic spatial Planning

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Authors: Hyunjoo Park, Taehyun Kim, Taehyun Kim

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The government that declared 'de-nuclearization' pushes up renewable energy policies such as solar power and wind power as an alternative to nuclear power generation. However, local residents who are concerned about the development and natural disasters have been hit by opposition, and related businesses around the country are experiencing difficulties. There is also a voice saying that installing a large wind power generator will cause landslides, low frequencies and noise, which will have a bad influence. Renewal is only a harmful and disgusting facility for the residents. In this way, it is expected that extreme social conflicts will occur in the decision making process related to the locally unwanted land-use (LULU). The government's efforts to solve this problem have been steadily progressing, but the systematic methodology for bringing in active participation and opinion gathering of the residents has not yet been established except for the simple opinion poll or referendum. Therefore, it is time to identify the factors that concern the local residents about the wind power generation facilities, and to find ways to make policy decision-making possible. In this study, we analyze the perception of people about offshore and onshore wind power facilities through questionnaires or interviews, and examine quantitative and qualitative precedent studies to analyze them. In addition, the study evaluates what factors affect the local acceptance of wind power facilities. As a result of the factor analysis of the questionnaire items, factors affecting the residents' acceptance of the wind power facility were extracted from four factors such as environmental, economic, risk, social, and management factor. The study also found that the influence of the determinants of local acceptance on the regional acceptability differs according to the demographic characteristics such as gender and income level. This study will contribute to minimizing the conflict on the installation of wind power facilities through communication among the local residents.

Keywords: factor analysis, local acceptance, locally unwanted land-use, LULU, wind power generation facilities

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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: Yosef Ferede Bogale

Abstract:

The purpose of this study was to evaluate the degree of customer satisfaction and the variables influencing it in the instance of the Bank of Abyssinia branches in the districts of Arada and Bole in Addis Ababa. The study was carried out utilizing a mixed research approach and a descriptive and explanatory research design in Addis Ababa, the capital city of Ethiopia. Both primary and secondary data were employed in this investigation. The study's target population consisted of 1000 of the bank's most prestigious clients. With a 93% response rate, 265 respondents from both genders in the active age group had higher levels of education and work experience and were in the active age group. Customers of the case bank under consideration comprised the study's target audience. The respondents, who belonged to both gender groups, were in the active age bracket with superior levels of education and work experience. As a result, this investigation discovered that the degree of client satisfaction was assigned a medium rating. Additionally given a middling rating were the company's image practices, employee competency, technology, and service quality. Further, the results also demonstrate that corporate image, employees’ competency, technology, and service quality all positively and significantly affect customer happiness. This study found that, to varying degrees, company image, technology, competence, and high-quality financial services will all improve consumer happiness. According to this report, banks should monitor customer satisfaction and service quality at least twice a year. This is because there is a growing movement among bank service providers for accountability, and measuring these factors is crucial. This study also recommends that banks make every effort to satisfy consumers' expectations to the highest level.

Keywords: customer satisfaction, corporate image, quality service risk, banks

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Authors: Agnes Anyango Andollo, Jane Achieng Achola

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The use of Information and Communication Technologies (ICTs) has become one of the driving forces in facilitation of learning in most colleges. The ability to effectively harness the technology varies from college to college. The study objective was to determine the lecturers’, institutional attributes and policies that influence the utilization of ICT by the lecturers’. A cross sectional survey design was employed in order to empirically investigate the extent to which lecturers’ personal, institutional attributes and policies influence the utilization of ICT to facilitate learning. The target population of the study was 295 lecturers who facilitate learning at KMTC-Nairobi. Structured self-administered questionnaire was given to the lecturers. Quantitative data was scrutinized for completeness, accuracy and uniformity then coded. Data were analyzed in frequencies and percentages using Statistical Package for Social Sciences (SPSS) version 19, this was a reliable tool for quantitative data analysis. A total of 155 completed questionnaires administered were obtained from the respondents for the study that were subjected to analysis. The study found out that 93 (60%) of the respondents were male while 62 (40%) of the respondents were female. Individual’s educational level, age, gender and educational experience had the greatest impact on use of ICT. Lecturers’ own beliefs, values, ideas and thinking had moderate impact on use of ICT. And that institutional support by provision of resources for ICT related training such as internet, computers, laptops and projectors had moderate impact (p = 0.049) at 5% significant level on use of ICT. The study concluded that institutional attributes and ICT policy were keys to utilization of ICT by lecturers at KMTC Nairobi also mandatory policy on use of ICT by lecturers to facilitate learning was key. It recommended that policies should be put in place for Technical support to lecturers when in problem during utilization of ICT and also a mechanism should be put in place to make the use of ICT in teaching and learning mandatory.

Keywords: policy, computers education, medical training institutions, ICTs

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Authors: Julius Steinkopf, Eric Rost, Aike Hessel, Sonia Lippke

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Objective: This study examined possible determinants of return to work (RTW) in individuals who participated in a medical rehabilitation program longitudinally over a time period of six months. Design/methodology/approach: N=1,044 rehabilitants were included in the baseline measurement in terms of completing a questionnaire during their medical rehabilitation. About 30% (n=350) have remained in the study in terms of participating in computer-assisted telephone interviewing (CATI) six months later. Frequency analyses and Regression analyses were run. Findings: About 70% of the rehabilitants returned to work six months after rehabilitation. Regression analyses revealed that the RTW rates were significantly predicted by gender (OR=0.12, men were more likely to return), perceived social support (OR=3.01) and current physical functioning (OR=1.25). Furthermore RTW motives, like expected monetary rewards (OR=25.2) and feelings of being needed (OR=0.18) same as motives for not returning to work (nRTW), like the wish to stop working in order to spend time with the spouse (OR=0.13) or a lack of enjoyment of work (OR=3.81), significantly predicted return to work rates. Life satisfaction, self-efficacy beliefs, mental health, current income, educational background or age did not significantly increase explained variance (all ps > .05). Practical implications: Taking theses predictors into account provides options to increase the effectiveness of interventions aiming at increasing RTW: Medical rehabilitations should not only aim at improving the physical functioning but also to enhance beneficial motives and social support as well as support women specifically in order to improve the effectiveness of medical rehabilitation and public health interventions. Originality/value: Illness-caused work absences are related to high financial costs and individual burden. Despite of the public health and societal implications, this is one of the very few studies investigating systematically fitness and health for the return to work.

Keywords: gender, fitness, health, physical functioning

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Authors: Doddy T. P. Enggarsyah, Soebowo Musa

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Covid-19 pandemic has changed business environments and has spread economic contagion rapidly, as the stringent lockdowns and social distancing, which were initially intended to cut off the spread, have instead cut off the flow of economies. With no existing experience or playbook to deal with such a crisis, the prolonged pandemic can lead to bankruptcies, despite the fact that there are cases of companies that are not only able to survive but also to increase sales and create more jobs amid the economic crisis. This quantitative research study clarifies conflicting findings on organizational inertia whether it is a better strategy to implement during a disruptive environment. 316 respondents who worked in diverse firms operating in various industry types in Indonesia have completed the survey with a response rate of 63.2%. Further, this study clarifies the roles and relationships between organizational inertia, organizational creativity, organizational agility, and organizational resilience that potentially have determinants factors on firm performance in a disruptive environment. The findings of the study confirm that the organizational inertia of the firm will set up strong protection on the organization's fundamental orientation, which eventually will confine organizations to build adequate creative and adaptability responses—such fundamental orientation built from path dependency along with past success and prolonged firm performance. Organizational inertia acts like a control mechanism to ensure the adequacy of the given responses. The term adequate is important, as being overly creative during a disruptive environment may have a contradictory result since it can burden the firm performance. During a disruptive environment, organizations will limit creativity by focusing more on creativity that supports the resilience and new technology adoption will be limited since the cost of learning and implementation are perceived as greater than the potential gains. The optimal path towards firm performance is gained through organizational resilience, as in a disruptive environment, the survival of the organization takes precedence over firm performance.

Keywords: disruptive environment, organizational agility, organizational creativity, organizational inertia, organizational resilience

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Authors: Yosef Ferede Bogale

Abstract:

The purpose of this study was to evaluate the degree of customer satisfaction and the variables influencing it in the instance of the Bank of Abyssinia branches in the districts of Arada and Bole in Addis Ababa. The study was carried out utilizing a mixed research approach and a descriptive and explanatory research design in Addis Ababa, the capital city of Ethiopia. Both primary and secondary data were employed in this investigation. The study's target population consisted of 1000 of the bank's most prestigious clients. With a 93% response rate, 265 respondents from both genders in the active age group had higher levels of education and work experience and were in the active age group. Customers of the case bank under consideration comprised the study's target audience. The respondents, who belonged to both gender groups, were in the active age bracket with superior levels of education and work experience. As a result, this investigation discovered that the degree of client satisfaction was assigned a medium rating. Additionally given a middling rating were the company's image practices, employee competency, technology, and service quality. Further, the results also demonstrate that corporate image, employees’ competency, technology, and service quality all positively and significantly affect customer happiness. This study found that, to varying degrees, company image, technology, competence, and high-quality financial services will all improve consumer happiness. According to this report, banks should monitor customer satisfaction and service quality at least twice a year. This is because there is a growing movement among bank service providers for accountability, and measuring these factors is crucial. This study also recommends that banks make every effort to satisfy consumers' expectations to the highest level.

Keywords: customer satisfaction, corporate image, quality services risk, bank

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Authors: Kalimah Ibrahiim, Israa Elmousa

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This study employed the world café method alongside semi-structured interviews within a 'conversation café' setting to engage stakeholders from the public health and primary care sectors. The objective was to collaboratively explore strategies to improve outcomes for young people not in education, employment, or training (NEET). The discussions were aimed at identifying the underlying causes of disparities faced by NEET individuals, exchanging experiences, and formulating community-driven solutions to bolster preventive efforts and shape policy initiatives. A thematic analysis of the qualitative data gathered emphasized the importance of community problem-solving through the exchange of ideas and reflective discussions. Healthcare professionals reflected on their potential roles, pinpointing a significant gap in understanding the specific needs of the NEET population and the unclear distribution of responsibilities among stakeholders. The results underscore the necessity for a unified approach in primary care and the fostering of multi-agency collaborations that focus on addressing social determinants of health. Such strategies are critical not only for the immediate improvement of health outcomes for NEET individuals but also for informing broader policy decisions that can have long-term benefits. Further research is ongoing, delving deeper into the unique challenges faced by this demographic and striving to develop more effective interventions. The study advocates for continued efforts to integrate insights from various sectors to create a more holistic and effective response to the needs of the NEET population, ensuring that future strategies are informed by a comprehensive understanding of their circumstances and challenges.

Keywords: multi-agency working, primary care, public health, social inequalities

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Authors: Bahram Soltani, Louai Ghazieh

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The responsibility has a big importance further to the financial crisis and the various pressures, which companies face their duties. The main objective of this study is to explain the variation of mechanisms of the responsibility of the manager in the company among the advanced capitalist economies. Then we study the impact of these mechanisms on the performance and the value creation in European companies. To reach our goal, we established a final sample composed on average of 284 French, British and German companies quoted in stock exchanges with 2272 annual reports examined during the period from 2005 to 2012. We examined at first the link of causalities between the determining-mechanisms bound to the company such as the characteristics of the board of directors, the composition of the shareholding and the ethics of the company on one side and the profitability of the company on the other side. The results show that the smooth running of the board of directors and its specialist committees are very important determinants of the responsibility of the managers who impact positively the performance and the value creation in the company. Furthermore, our results confirm that the presence of a solid ethical environment within the company will be effective to increase the probability that the managers realize ethical choices in the organizational decision-making. At the second time, we studied the impact of the determining mechanisms bound to the function and to the profile of manager to know its relational links, his remuneration, his training, his age and his experiences about the performance and the value creation in the company. Our results highlight the existence of a negative relation between the relational links of the manager, his very high remuneration and the general profitability of the company. This study is a contribution to the literature on the determining mechanisms of company director's responsibility (Accountability). It establishes an empirical and comparative analysis between three influential countries of Europe, to know France, the United Kingdom and Germany.

Keywords: leaders, company’s performance, accountability mechanisms, corporate governance, value creation of firm, financial crisis

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Authors: Yibeltal T. Bayou, Yohana S. Mashalla, Gloria Thupayagale-Tshweneagae

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Background: According to the World Health Organization, caesarean section delivery rates of more than 10-15% caesarean section deliveries in any specific geographic region in the world are not justifiable. The aim of the study was to describe the level and analyse determinants of caesarean section delivery in Addis Ababa. Methods: Data was collected in Addis Ababa using a structured questionnaire administered to 901 women aged 15-49 years through a stratified two-stage cluster sampling technique. Binary logistic regression model was employed to identify predictors of caesarean section delivery. Results: Among the 835 women who delivered their last birth at healthcare facilities, 19.2% of them gave birth by caesarean section. About 9.0% of the caesarean section births were due to mother’s request or service provider’s influence without any medical indication. The caesarean section delivery rate was much higher than the recommended rate particularly among the non-slum residents (27.2%); clients of private healthcare facilities (41.1%); currently married women (20.6%); women with secondary (22.2%) and tertiary (33.6%) level of education; and women belonging to the highest wealth quintile household (28.2%). The majority (65.8%) of the caesarean section clients were not informed about the consequences of caesarean section delivery by service providers. The logistic regression model shows that older age (30-49), secondary and above education, non-slum residence, high-risk pregnancy and receiving adequate antenatal care were significantly positively associated with caesarean section delivery. Conclusion: Despite the unreserved effort towards achieving MDG 5 through safe skilled delivery assistance among others, the high caesarean section rate beyond the recommend limit, and the finding that caesarean sections done without medical indications were also alarming. The government and city administration should take appropriate measures before the problems become setbacks in healthcare provision. Further investigations should focus on the effect of caesarean section delivery on maternal and child health outcomes in the study area.

Keywords: Addis Ababa, caesarean section, mode of delivery, slum residence

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Authors: Olanike A. Ojo, Akindele M. Ojo, Jacob H. Tsado, Ramatu U. Kutigi

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The study was carried out on analysis of the effect of farmers’ socio-economic factors on the net farm income of catfish farmers in Kwara State, Nigeria. Primary data were collected from selected catfish farmers with the aid of well-structured questionnaire and a multistage sampling technique was used to select 102 catfish farmers in the area. The analytical techniques involved the use of descriptive statistics and multiple regression analysis. The findings of the analysis of socio-economic characteristics of catfish farmers reveal that 60% of the catfish farmers in the study area were male gender which implied the existence of gender inequality in the area. The mean age of 47 years was an indication that they were at their economically productive age and could contribute positively to increased production of catfish in the area. Also, the mean household size was five while the mean year of experience was five. The latter implied that the farmers were experienced in fishing techniques, breeding and fish culture which would assist in generating more revenue, reduce cost of production and eventual increase in profit levels of the farmers. The result also revealed that stock capacity (X3), accessibility to credit (X7) and labour (X4) were the main determinants of catfish production in the area. In addition, farmer’s sex, household size, no of ponds, distance of the farm from market, access to credit were the main socio-economic factors influencing the net farm income of the catfish farmers in the area. The most serious constraints militating against catfish production in the study area were high mortality rate, insufficient market, inadequate credit facilities/ finance and inadequate skilled labour needed for daily production routine. Based on the findings, it is therefore recommended that, to reduce the mortality rate of catfish extension agents should organize training workshops on improved methods and techniques of raising catfish right from juvenile to market size.

Keywords: credit, income, stock, mortality

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Authors: Wei-Ting Hung

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Inbound tourist expenditure might not only have influenced by individual tourist characteristics but may also be affected by nationality characteristics. The cross national distance effects on tourist consumption behavior should be incorporated in the analytical framework. Additionally, the often used factor analysis, cluster analysis and regression analysis overlook the hierarchical tourist consumption data structure and may lead to misleading results. The objectives of the present study were twofold. First, we propose a multilevel model that takes individual and cross-national differences into account under a hierarchical framework. Second, we further sought to determine the types of cross-national differences affecting tourist expenditure. Thus, this study incorporates the individual tourist effects and cross national distance effects simultaneously, uses the data of 2010 Annual Survey Report on Visitors’ Expenditure and Trends in Taiwan to investigate the determinants of inbound tourist expenditure. Multilevel analysis was used to investigate the influence of individual tourist effects and cross national distance effects on inbound tourist expenditure. The empirical results show that cross national distance plays a crucial role in tourist consumption behavior. Our findings also indicate age and income have positive influence on tourism expenditure., whereas education and gender do not have significant impact. Regarding macro-level factors, geographic and cultural differences exhibited significant positive relationships on tourism expenditure, while economic differences did not. Based on the above empirical results, it is suggested that tour operators should take tourists’ individual attributes, particularly their income and age, into consideration when arranging tours. In addition, nationality holds sway over tourists’ consumption behavior, of which geographic and cultural differences are the two major factors at play. The empirical results of this study serve as practical suggestions for tourism marketing strategies and policy implications for government policies.

Keywords: cross national distance, inbound tourist, multilevel analysis, tourist expenditure

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Authors: Tebikew Yeneabat, Tefera Belachew, Muluneh Haile

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Background: Exclusive breast-feeding (EBF) is the practice of feeding only breast milk (including expressed breast milk) during the first six months and no other liquids and solid foods except medications. The time to cessation of exclusive breast-feeding, however, is different in different countries depending on different factors. Studies showed the risk of diarrhea morbidity and mortality is higher among none exclusive breast-feeding infants, common during starting other foods. However, there is no study that evaluated the time to cessation of exclusive breast-feeding in the study area. The aim of this study was to show time to cessation of EBF and its predictors among mothers of index infants less than twelve months old. Methods: We conducted a community-based cross-sectional study from February 13 to March 3, 2012 using both quantitative and qualitative methods. This study included a total of 592 mothers of index infant using multi-stage sampling method. Data were collected by using interviewer administered structured questionnaire. Bivariate and multivariate Cox regression analyses were performed. Results: Cessation of exclusive breast-feeding occurred in 392 (69.63%) cases. Among these, 224 (57.1%) happened before six months, while 145 (37.0%) and 23 (5.9%) occurred at six months and after six months of age of the index infant respectively. The median time for infants to stay on exclusive breast-feeding was 6.36 months in rural and 5.13 months in urban, and this difference was statistically significant on a Log rank (Cox-mantel) test. Maternal and paternal occupation, place of residence, postnatal counseling on exclusive breast-feeding, mode of delivery, and birth order of the index infant were significant predictors of cessation of exclusive breast-feeding. Conclusion: Providing postnatal care counseling on EBF, routine follow-up and support of those mothers having infants stressing for working mothers can bring about implementation of national strategy on infant and young child feeding.

Keywords: exclusive breastfeeding, cessation, median duration, Ankesha Guagusa Woreda

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Authors: Diana Ivanova Bakalova, Ekaterina Evtimova Dimitrova

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The purpose of this paper is to examine the predictive power of optimistic expectations and satisfaction with life in the country of origin and residence – Bulgaria, over the attitudes towards emigration among young Bulgarians with regard to their generational belonging and differences (i.e. Generation Y or Millennials, born between 1981-1995/6, and Generation Z or Zoomers, born between 1996/7-2012). Although the correlation between satisfaction with life and migration (attitudes) has been studied in some countries, it has neither been examined to date in Bulgaria – a sending rather than receiving Eastern European country, nor scrutinized in the light of generational differences. Within a national survey(N=1200), representative of young Bulgarians aged 18-35 years – Zoomers aged 18-25years (N=444) and Millennials aged 26-35 years (N=756), carried out in September-October 2021, optimistic expectations and satisfaction with life in Bulgaria were respectively measured by a 5-item and4-item scales. The scales were designed to measure optimistic expectations and satisfaction with life in the country, as both general constructs and in terms of specific areas of life (education, profession, career, and income). The findings suggest that the higher satisfaction with life in Bulgaria is associated with more optimistic expectations about one’s further professional, financial, and career growth in the country and reasonably, with more negative attitudes towards emigration of young Bulgarians. Although no significant differences were found between Millennials and Zoomers in their optimistic expectations and satisfaction with life in Bulgaria, Millennials are still significantly less likely to emigrate than Zoomers. Positively, the population of young Bulgarians demonstrates higher than average satisfaction with life and optimism for their prospects in the country combined with neutral to negative overall attitudes towards emigration. These findings have some important interdisciplinary psychological and demographic theoretical, applied, and policy implications. The survey is carried out under Project КП-06-Н35/4 “Psychological determinants of young people's attitudes to emigration and life planning in the context of demographic challenges in Bulgaria,” funded by the NSF - MES, Bulgaria.

Keywords: optimistic expectations, life satisfaction, emigration attitudes, young bulgerians

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Authors: Dona Ghosh, Zakir Husain

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In India, the increase in share of aged has generated many social and economic issues, of which health concerns is a major challenge that society must confront in coming years. Self-reported health (SRH) is a popular health measure in this regard but has been questioned in recent years due to its heavy dependence on the socioeconomic status. So, the validity of SRH, as a measure of health status during old age, is needed to be verified. This paper emphasizes on the self-reported health and related inconsistent responses among elderly in India. The objective of the study is bifurcated into two parts: firstly, to identify the socioeconomic determinants of subjective health status and its change over time; and secondly, to analyse the role of the socioeconomic components in providing inconsistent responses regarding the health status of elderly. Inconsistency in response can rise in two ways: positive response bias (if an individual has a health problem but reports his/her health as good) and negative response bias (if bad health is reported even if there is no health problem). However, in the present study, we focus only on the negative response bias of elderly individuals. To measure the inconsistencies in responses, self-reported health is compared with two types of physical health conditions – existence of chronicle ailment and physical immobility. Using NSS dataset of 60th and 71st rounds, the study found that subjective health has worsened over time in both rural and urban areas. Findings suggest that inconsistency in responses, related to chronic ailment, vary across social classes, living environments, geographical regions, age groups and education levels. On the contrary, variation in inconsistent responses regarding physical mobility is quite rare and difficult to explain by socioeconomic characteristics because most of the indicators are found to be insignificant in this regard. The findings indicate that in case of chronicle ailment, inconsistency between objective and subjective health status largely depends on socioeconomic conditions but the importance of such factors disappears for physical immobility.

Keywords: India, aging, self-reported health, inconsistent responses

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Authors: Manuel A. Alonso-Tarajano, Roberto Mosca, Patrick Aloy

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Protein kinases participate in a myriad of cellular processes of major biomedical interest. The in vivo substrate specificity of these enzymes is a process determined by several factors, and despite several years of research on the topic, is still far from being totally understood. In the present work, we have quantified the contributions to the kinase substrate specificity of i) the phosphorylation sites and their surrounding residues in the sequence and of ii) the association of kinases to adaptor or scaffold proteins. We have used position-specific scoring matrices (PSSMs), to represent the stretches of sequences phosphorylated by 93 families of kinases. We have found negative correlations between the number of sequences from which a PSSM is generated and the statistical significance and the performance of that PSSM. Using a subset of 22 statistically significant PSSMs, we have identified specificity determinant residues (SDRs) for 86% of the corresponding kinase families. Our results suggest that different SDRs can function as positive or negative elements of substrate recognition by the different families of kinases. Additionally, we have found that human proteins with known function as adaptors or scaffolds (kAS) tend to interact with a significantly large fraction of the substrates of the kinases to which they associate. Based on this characteristic we have identified a set of 279 potential adaptors/scaffolds (pAS) for human kinases, which is enriched in Pfam domains and functional terms tightly related to the proposed function. Moreover, our results show that for 74.6% of the kinase– pAS association found, the pAS colocalize with the substrates of the kinases they are associated to. Finally, we have found evidence suggesting that the association of kinases to adaptors and scaffolds, may contribute significantly to diminish the in vivo substrate crossed- specificity of protein kinases. In general, our results indicate the relevance of several SDRs for both the positive and negative selection of phosphorylation sites by kinase families and also suggest that the association of kinases to pAS proteins may be an important factor for the localization of the enzymes with their set of substrates.

Keywords: kinase, phosphorylation, substrate specificity, adaptors, scaffolds, cellular colocalization

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Authors: Prami Sengupta, Randall A. Cantrell, Tracy Johns

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A typical US household consumes more energy than households in other countries and is directly responsible for a considerable proportion of the atmospheric concentration of the greenhouse gases. This makes U.S. household a vital target group for energy conservation studies. Positive household behavior is central to residential energy conservation. However, for individuals to conserve energy they must not only know how to conserve energy but be also willing to do so. That is, a positive attitude towards residential conservation and an intention to conserve energy are two of the most important psychological determinants for energy conservation behavior. Most social science studies, to date, have studied the relationships between attitude, intention, and behavior by building upon socio-psychological theories of behavior. However, these frameworks, including the widely used Theory of Planned Behavior and Social Cognitive Theory, lack a spatial component. That is, these studies fail to capture the impact of the geographical locations of homeowners’ residences on their residential energy consumption and conservation practices. Therefore, the purpose of this study is to explore geospatial relationships between homeowners’ residential energy conservation-attitudes, conservation-intentions, and consumption behavior. The study analyzes residential conservation-attitudes and conservation-intentions of homeowners across 63 counties in Florida and compares it with quantifiable measures of residential energy consumption. Empirical findings revealed that the spatial distribution of high and/or low values of homeowners’ mean-score values of conservation-attitudes and conservation-intentions are more spatially clustered than would be expected if the underlying spatial processes were random. On the contrary, the spatial distribution of high and/or low values of households’ carbon footprints was found to be more spatially dispersed than assumed if the underlying spatial process were random. The study also examined the influence of potential spatial variables, such as urban or rural setting and presence of educational institutions and/or extension program, on the conservation-attitudes, intentions, and behaviors of homeowners.

Keywords: conservation-attitude, conservation-intention, geospatial analysis, residential energy consumption, spatial autocorrelation

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Authors: Khachen Kongpakwattana, Charungthai Dejthevaporn, Orapitchaya Krairit, Piyameth Dilokthornsakul, Devi Mohan, Nathorn Chaiyakunapruk

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Background: Although an increase in the burden of Alzheimer’s disease (AD) is evident worldwide, knowledge of costs and health-related quality of life (HR-QoL) associated with AD in Low- and Middle-Income Countries (LMICs) is still lacking. We, therefore, aimed to collect real-world cost and HR-QoL data, and investigate their associations with multiple disease-severity indicators among AD patients in Thailand. Methods: We recruited AD patients aged ≥ 60 years accompanied by their caregivers at a university-affiliated tertiary hospital. A one-time structured interview was conducted to collect disease-severity indicators, HR-QoL and caregiving information using standardized tools. The hospital’s database was used to retrieve healthcare resource utilization occurred over 6 months preceding the interview date. Costs were annualized and stratified based on cognitive status. Generalized linear models were employed to evaluate determinants of costs and HR-QoL. Results: Among 148 community-dwelling patients, average annual total societal costs of AD care were 8,014 US$ [95% Confidence Interval (95% CI): 7,295 US$ - 8,844 US$] per patient. Total costs of patients with severe stage (9,860 US$; 95% CI: 8,785 US$ - 11,328 US$) were almost twice as high as those of mild stage (5,524 US$; 95% CI: 4,649 US$ - 6,593 US$). The major cost driver was direct medical costs, particularly those incurred by AD prescriptions. Functional status was the strongest determinant for both total costs and patient’s HR-QoL (p-value < 0.001). Conclusions: Our real-world findings suggest the distinct major cost driver which results from expensive AD treatment, emphasizing the demand for country-specific cost evidence. Increases in cognitive and functional status are significantly associated with decreases in total costs of AD care and improvement on patient’s HR-QoL.

Keywords: Alzheimer's disease, associations, costs, disease-severity indicators, health-related quality of life

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Authors: Shelley Jones

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Assumptions abound that education for girls will, as a matter of course, lead to their economic empowerment as women; yet. little is known about the ways in which schooling for girls, who traditionally/historically would not have had opportunities for post-primary, or perhaps even primary education – such as the participants in this study based in rural Uganda - in reality, impacts their economic situations. There is a need forlongitudinal studies in which women share experiences, understandings, and reflections of their lives that can inform our knowledge of this. In response, this paper reports on stage four of a longitudinal case study (2004-2018) focused on education and empowerment for girls and women in rural Uganda, in which 13 of the 15 participants from the original study participated. This paper understands empowerment as not simply increased opportunities (e.g., employment) but also real gains in power, freedoms that enable agentive action, and authentic and viable choices/alternatives that offer ‘exit options’ from unsatisfactory situations. As with the other stages, this study used a critical, postmodernist, global feminist ethnographic methodology, multimodal and qualitative data collection. Participants participated in interviews, focus group discussions, and a two-day workshop, which explored their understandings of how/if they understood post-primary education to have contributed to their economic empowerment. A constructivist grounded theory approach was used for data analysis to capture major themes. Findings indicate that although all participants believe that post-primary education provided them with economic opportunities they would not have had otherwise, the parameters of their economic empowerment were severely constrained by historic and extant sociocultural, economic, political, and institutional structures that continue to disempower girls and women, as well as additional financial responsibilities that they assumed to support others. Even though the participants had post-primary education, and they were able to obtain employment or operate their own businesses that they would not likely have been able to do without post-primary education, the majority of the participants’ incomes were not sufficient to elevate them financially above the extreme poverty level, especially as many were single mothers and the sole income earners in their households. Furthermore, most deemed their working conditions unsatisfactory and their positions precarious; they also experienced sexual harassment and abuse in the labour force. Additionally, employment for the participants resulted in a double work burden: long days at work, surrounded by many hours of domestic work at home (which, even if they had spousal partners, still fell almost exclusively to women). In conclusion, although the participants seem to have experienced some increase in economic empowerment, largely due to skills, knowledge, and qualifications gained at the post-primary level, numerous barriers prevented them from maximizing their capabilities and making significant gains in empowerment. There is need, in addition to providing education (primary, secondary, and tertiary) to girls, to address systemic gender inequalities that mitigate against women’s empowerment, as well as opportunities and freedom for women to come together and demand fair pay, reasonable working conditions, and benefits, freedom from gender-based harassment and assault in the workplace, as well as advocate for equal distribution of domestic work as a cultural change.

Keywords: girls' post-primary education, women's empowerment, uganda, employment

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Authors: Kevin T. Inks

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India’s Brahmaputra River Valley has, since independence, experienced consistent low-intensity guerrilla warfare between ethnic and religious groups. These groups are often organized around perceived ethnic territoriality, and target civilians, communities, and especially migrants belonging to other ethnic and religious groups. Intense flooding and erosion have led to widespread displacement, and disaster relief funds are largely tied to legal land tenure. Displaced residents of informal settlements receive little or no resettlement aid, and their subsequent migration strategies and risk from guerrilla violence are poorly understood. Semi-structured interviews and comprehensive surveys focused on perceptions of risk, efficacy of disaster relief, and migration and adaptation strategies were conducted with households identified as being ‘at-risk’ of catastrophic flooding and erosion in Majuli District, Assam. Interviews with policymakers and government workers were conducted to assess disaster relief efforts in informal settlements, and remote sensing methods were used to identify informal settlement and hydrogeomorphic change. The results show that various ethnic and religious groups have differential strategies and preferences for resettlement. However, these varying strategies are likely to lead to differential levels of risk from guerrilla violence. Members of certain ethnic groups residing in informal settlements, in the absence of resettlement assistance, are more likely to seek out unofficial settlement on land far from the protection of the state and experience greater risk of becoming victims of political violence. As climate change and deforestation are likely to increase the severity of the displacement crisis in the Brahmaputra River Valley, more comprehensive disaster relief and surveying efforts are vital for limiting migration and informal settlement in potential sites of guerrilla warfare.

Keywords: climate, displacement, flooding, India, violence

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Authors: Ali A. Bazzi, Ameer Hamza, Riley O’Hara, Kimberly Kado, Karen H. Hagglund, Lamia Fathallah, Robert T. Morris

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Introduction: Endometrial Cancer is a common gynecologic malignancy primarily treated with complete surgical staging, which may include complete pelvic and para-aortic lymphadenectomy. The role of lymphadenectomy is controversial, especially the intraoperative indications for the procedure. Three factors are important in decision to proceed with lymphadenectomy: Myometrial invasion, maximum tumor dimension, and histology. Many institutions incorporate these criteria in varying degrees in the decision to proceed with lymphadenectomy. This investigation assesses the use of intraoperatively measured MTD with and without pre-operative histologic grade. Methods: This study compared retrospectively EEC patients with intraoperatively measured MTD ≤2 cm to those with MTD >2 cm from January 1, 2002 to August 31, 2017. This assessment compared those with MTD ≤ 2cm with endometrial biopsy (EB) grade 1-2 to patients with MTD > 2cm with EB grade 3. Lymph node metastasis (LNM), recurrence, and survival were compared in these groups. Results: This study reviewed 222 patient cases. In tumors > 2 cm, LNM occurred in 20% cases while in tumors ≤ 2 cm, LNM was found in 6% cases (p=0.04). Recurrence and mean survival based on last follow up visit in these two groups were not statistically different (p=0.78 and 0.36 respectively). Data demonstrated a trend that when combined with preoperative EB International Federation of Gynecology and Obstetrics (FIGO) grade, a higher proportion of patients with EB FIGO Grade 3 and MTD > 2 cm had LNM compared to those with EB FIGO Grade 1-2 and MTD ≤ 2 cm (43% vs, 11%, p=0.06). LNM was found in 15% of cases in which lymphadenectomy was performed based on current practices, whereas if the criteria of EB FIGO 3 and MTD > 2 cm were used the incidence of LNM would have been 44% cases. However, using this criterion, two patients would not have had their nodal metastases detected. Compared to the current practice, the sensitivity and specificity of the proposed criteria would be 60% and 81%, respectively. The PPV and NPV would be 43% and 90%, respectively. Conclusion: The results indicate that MTD combined with EB FIGO grade can detect LNM in a higher proportion of cases when compared to current practice. MTD combined with EB FIGO grade may eliminate the need of frozen section sampling in a substantial number of cases.

Keywords: endometrial cancer, FIGO grade, lymphadenectomy, tumor size

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Authors: Kalkidan Worku, Eniyew Tegegne, Menichil Amsalu, Samuel Derbie Habtegiorgis

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Introduction: Because of the seasonal nature of the work, day laborers are exposed to risky sexual practices. Since the majority of them are living far away from their birthplace and family, they engage in unplanned and multiple sexual practices. These unplanned and unprotected sexual experiences are a risk for different types of sexual-related health crises. This study aimed to assess the pooled prevalence of risky sexual practices and its determinants among day laborers in Ethiopia. Methods: Online databases, including PubMed, Google Scholar, Science Direct, African Journal of Online, Academia Edu, Semantic Scholar, and university repository sites, were searched from database inception until March 2023. PRISMA 2020 guideline was used to conduct the review. Among 851 extracted studies, ten articles were retained for the final quantitative analysis. To identify the source of heterogeneity, a sub-group analysis and I² test were performed. Publication bias was assessed by using a funnel plot and the Egger and Beg test. The pooled prevalence of risky sexual practices was calculated. Besides, the association between determinant factors and risky sexual practice was determined using a pooled odds ratio (OR) with a 95% confidence interval. Result: The pooled prevalence of risky sexual practices among day laborers was 46.00% (95% CI: 32.96, 59.03). Being single (OR: 2.49; 95% CI: 1.29 to 4.83), substance use (OR: 1.79; 95% CI: 1.40 to 2.29), alcohol intake (OR: 4.19; 95% CI: 2.19 to 8.04), watching pornographic (OR: 5.49; 95% CI: 2.99 to 10.09), discussion about SRH (OR: 4.21; 95% CI: 1.34 to 13.21), visiting night clubs (OR: 2.86 95% CI: 1.79 to 4.57) and risk perception (OR: 0.37 95% CI: 0.20 to 0.70) were the possible factors for risky sexual practice of day laborers in Ethiopia. Conclusions: A large proportion of day laborers engaged in risky sexual practices. Interventions targeting creating awareness of sexual and reproductive health for day laborers should be implemented. Continuous peer education on sexual health should be given to day laborers. Sexual and reproductive health services should be accessible in their workplaces to maximize condom utilization and to facilitate sexual health education for all day laborers.

Keywords: day laborers, sexual health, risky sexual practice, unsafe sex, multiple sexual partners

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Authors: S. P. Singh, Priya, Komal Sajwan

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With the increasing spread of organic farming in India, costs, returns, efficiency, and social and environmental sustainability of organic vis-a-vis conventional farming systems have become topics of interest among agriculture scientists, economists, and policy analysts. A study on technical efficiency estimation under these farming systems, particularly in the Ganga River Basin, where the promotion of organic farming is incentivized, can help to understand whether the inputs are utilized to their maximum possible level and what measures can be taken to improve the efficiency. This paper, therefore, analyses the technical efficiency of wheat farms operating under organic and conventional farming systems. The study is based on a primary survey of 600 farms (300 organic ad 300 conventional) conducted in 2021 in two districts located in the Middle Ganga River Basin, India. Technical, managerial, and scale efficiencies of individual farms are estimated by applying the data envelopment analysis (DEA) methodology. The per hectare value of wheat production is taken as an output variable, and values of seeds, human labour, machine cost, plant nutrients, farm yard manure (FYM), plant protection, and irrigation charges are considered input variables for estimating the farm-level efficiencies. The post-DEA analysis is conducted using the Tobit regression model to know the efficiency determining factors. The results show that technical efficiency is significantly higher in conventional than organic farming systems due to a higher gap in scale efficiency than managerial efficiency. Further, 9.8% conventional and only 1.0% organic farms are found operating at the most productive scale size (MPSS), and 99% organic and 81% conventional farms at IRS. Organic farms perform well in managerial efficiency, but their technical efficiency is lower than conventional farms, mainly due to their relatively lower scale size. The paper suggests that technical efficiency in organic wheat can be increased by upscaling the farm size by incentivizing group/collective farming in clusters.

Keywords: organic, conventional, technical efficiency, determinants, DEA, Tobit regression

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Authors: M. L. Seretlo-Rangata, T. Sodi, S. Govender

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Despite interventions by various governments to regulate water demand and address water scarcity, literature shows that billions of people across the world continue to struggle with access because not everyone contributes equally to conservation efforts. Behavioral factors such as individual and collective aspects of cognition and commitment have been found to play an important role in water conservation. The aim of the present study was to explore the perceptions of community members in the Lephalale area, Limpopo province, towards water conservation with a view to developing an explanatory psychological model on water conservation. Twenty (20) participants who relied on communal taps to access water in Lephalale Local Municipality, Limpopo province, were selected through purposeful sampling. In-depth, semi-structured, individual face-to-face interviews were used to gather data and were analyzed utilizing thematic content analysis (TCA). The research findings revealed that there are various psychological effects of water scarcity on communities, such as emotional distress, interpersonal conflicts and disruptions of daily activities of living. Additionally, the study results showed that the coping strategies developed by participants to deal with water scarcity included adopting alternative water use behaviors as well as adjusting current behaviors and lifestyles. Derived from the study findings, a psychological model of water conservation was developed. The model incorporates some ideas from the Value-Belief-Norm (VBN) theory and the Afrocentric theory. The model suggests that people’s worldviews, including their values, beliefs and culture, are significant determinants of their pro-environmental behaviors. The study concludes by recommending that authorities and policymakers should consider psychological factors when developing water management programs, strategies and interventions with the consultation of psychology experts.

Keywords: water conservation, psychological model, pro-environmental behaviour, conservation psychology, water-use behaviour

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Authors: Misganaw Chere Siferih

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This study assessed the impact of crossbreed dairy cows on household income and food security. The study area is found in Dejen Woreda, East Gojam Zone, and Amhara region of Ethiopia. Random sampling technique was used to obtain a sample of 80 crossbreed dairy cow owners and 176 indigenous dairy cow owners. The study employed food consumption score analytical framework to measure food security status of the household. No Statistical significant mean difference is found between crossbreed owners and indigenous owners. Logistic regression was employed to investigate crossbreed dairy cow adoption determinants , the result indicates that gender, education, labor number, land size cultivated, dairy cooperatives membership, net income and food security status of the household are statistically significant independent variables, which explained the binary dependent variable, crossbreed dairy cow adoption. Propensity score matching (PSM) was employed to analyze the impact of crossbreed dairy cow owners on farmers’ income and food security. The average net income of crossbreed dairy cow owners was found to be significantly higher than indigenous dairy cow owners. Estimates of average treatment effect of the treated (ATT) indicated that crossbreed dairy cow is able to impact households’ net income by 42%, 38.5%, 30.8% and 44.5% higher in kernel, radius, nearest neighborhood and stratification matching algorithms respectively as compared to indigenous dairy cow owners. However, estimates of average treatment of the treated (ATT) suggest that being an owner of crossbreed dairy cow is not able to affect food security significantly. Thus, crossbreed dairy cow enables farmers to increase income but not their food security in the study area. Finally, the study recommended establishing dairy cooperatives and advice farmers to become a member of them, attention to promoting the impact of crossbreed dairy cows and promotion of nutrition focus projects.

Keywords: crossbreed dairy cow, net income, food security, propensity score matching

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Authors: Billy Angel B. Bayot, Hubert Clyde Z. Guillermo, Daniela Eve Margaret S. Olano, Lian Angeli Kaye E. Suarez

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A utilization of Nipa palm fibers (Nypa fruticans) and Asian green mussel shells (Perna viridis) as additive materials in making fiber-reinforced concrete was carried out. The researchers collected Asian green mussel shells and Nipa palm fibers as additive materials in the production of fiber-reinforced concrete and were used to make 3 Setups containing 20g, 15g, and 10g of Nipa palm fiber varying to 10g, 20g, 30g of Asian green mussel shell powder and a traditional concrete with respect to curing period 7, 14, and 28 days. The concrete blocks were delivered to the UP Institute of Building Materials and Structures Laboratory (CoMSLab) following each curing test in order to evaluate their compressive strength. Researchers employed a Two-Way Analysis of Variance (ANOVA) and determined that curing days, concrete mixture, and the combined curing days with concrete have an effect on the compressive strength of concrete. ANOVA results indicating significant differences had been subjected to post hoc analysis using Tukey's HSD. These results then yielded the comparison of each curing time and different concrete mixtures with traditional concrete, which comes to the conclusion that a longer curing period leads to a higher compressive strength and Setup 3 (30g Asian green mussel shell with 10g Nipa palm fiber) has the larger mean compressive strength, making it the best proportion among the fiber-reinforced concrete mixtures and the only proportion that has significant effect to traditional one. As a result, the study concludes that certain curing times and concrete mix proportions of Asian green mussel shell and Nipa palm fiber are critical determinants in determining concrete compressive strength.

Keywords: Asian green mussel shells (Perna viridis), Nipa palm fibers (Nypa fruticans), additives, fiber-reinforced concrete

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Authors: Mojo Mengistu Gelasso

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The tropical forest is considered the most important forest ecosystem for mitigating climate change by sequestering a high amount of carbon. The potential carbon stock of the forest can be influenced by many factors. Therefore, studying these factors is crucial for understanding the determinants that affect the potential for woody carbon storage in the forest. This study was conducted to evaluate the potential for woody carbon stock and how it varies based on plant community types, as well as along altitudinal, slope, and aspect gradients in the Munessa dry Afromontane forest. Vegetation data was collected using systematic sampling. Five line transects were established at 100 m intervals along the altitudinal gradient between two consecutive transect lines. On each transect, 10 quadrats (20 x 20 m), separated by 200 m, were established. The woody carbon was estimated using an appropriate allometric equation formulated for tropical forests. The data was analyzed using one-way ANOVA in R software. The results showed that the total woody carbon stock of the Munessa forest was 210.43 ton/ha. The analysis of variance revealed that woody carbon density varied significantly based on environmental factors, while community types had no significant effect. The highest mean carbon stock was found at middle altitudes (2367-2533 m.a.s.l), lower slopes (0-13%), and west-facing aspects. The Podocarpus falcatus-Croton macrostachyus community type also contributed a higher woody carbon stock, as larger tree size classes and older trees dominated it. Overall, the potential for woody carbon sequestration in this study was strongly associated with environmental variables. Additionally, the uneven distribution of species with larger diameter at breast height (DBH) in the study area might be linked to anthropogenic factors, as the current forest growth indicates characteristics of a secondary forest. Therefore, our study suggests that the development and implementation of a sustainable forest management plan is necessary to increase the carbon sequestration potential of this forest and mitigate climate change.

Keywords: munessa forest, woody carbon stock, environmental factors, climate mitigation

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Authors: Mengistu Gelasso Mojo

Abstract:

The tropical forest is considered the most important forest ecosystem for mitigating climate change by sequestering a high amount of carbon. The potential carbon stock of the forest can be influenced by many factors. Therefore, studying these factors is crucial for understanding the determinants that affect the potential for woody carbon storage in the forest. This study was conducted to evaluate the potential for woody carbon stock and how it varies based on plant community types, as well as along altitudinal, slope, and aspect gradients in the Munessa dry Afromontane forest. Vegetation data was collected using systematic sampling. Five line transects were established at 100 m intervals along the altitudinal gradient between two consecutive transect lines. On each transect, 10 quadrats (20 x 20 m), separated by 200 m, were established. The woody carbon was estimated using an appropriate allometric equation formulated for tropical forests. The data was analyzed using one-way ANOVA in R software. The results showed that the total woody carbon stock of the Munessa forest was 210.43 ton/ha. The analysis of variance revealed that woody carbon density varied significantly based on environmental factors, while community types had no significant effect. The highest mean carbon stock was found at middle altitudes (2367-2533 m.a.s.l), lower slopes (0-13%), and west-facing aspects. The Podocarpus falcatus-Croton macrostachyus community type also contributed a higher woody carbon stock, as larger tree size classes and older trees dominated it. Overall, the potential for woody carbon sequestration in this study was strongly associated with environmental variables. Additionally, the uneven distribution of species with larger diameter at breast height (DBH) in the study area might be linked to anthropogenic factors, as the current forest growth indicates characteristics of a secondary forest. Therefore, our study suggests that the development and implementation of a sustainable forest management plan is necessary to increase the carbon sequestration potential of this forest and mitigate climate change.

Keywords: munessa forest, woody carbon stock, environmental factors, climate mitigation

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Authors: Arti Singh, Carolyn Jenkins, Oyedunni S. Arulogun, Mayowa O. Owolabi, Fred S. Sarfo, Bruce Ovbiagele, Enzinne Sylvia

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Background: Stroke, the leading cause of adult-onset disability and the second leading cause of death, is a major public health concern particularly pertinent in Sub-Saharan Africa (SSA), where nearly 80% of all global stroke mortalities occur. The Stroke Investigative Research and Education Network (SIREN) seeks to comprehensively characterize the genomic, sociocultural, economic, and behavioral risk factors for stroke and to build effective teams for research to address and decrease the burden of stroke and other non communicable diseases in SSA. One of the first steps to address this goal was to effectively engage the communities that suffer the high burden of disease in SSA. This study describes how the SIREN project engaged six sites in Ghana and Nigeria over the past three years, describing the community engagement activities that have arisen since inception. Aim: The aim of community engagement (CE) within SIREN is to elucidate information about knowledge, attitudes, beliefs, and practices (KABP) about stroke and its risk factors from individuals of African ancestry in SSA, and to educate the community about stroke and ways to decrease disabilities and deaths from stroke using socioculturally appropriate messaging and messengers. Methods: Community Advisory Board (CABs), Focus Group Discussions (FGDs) and community outreach programs. Results: 27 FGDs with 168 participants including community heads, religious leaders, health professionals and individuals with stroke among others, were conducted, and over 60 CE outreaches have been conducted within the SIREN performance sites. Over 5,900 individuals have received education on cardiovascular risk factors and about 5,000 have been screened for cardiovascular risk factors during the outreaches. FGDs and outreach programs indicate that knowledge of stroke, as well as risk factors and follow-up evidence-based care is limited and often late. Other findings include: 1) Most recognize hypertension as a major risk factor for stroke. 2) About 50% report that stroke is hereditary and about 20% do not know organs affected by stroke. 3) More than 95% willing to participate in genetic testing research and about 85% willing to pay for testing and recommend the test to others. 4) Almost all indicated that genetic testing could help health providers better treat stroke and help scientists better understand the causes of stroke. The CABs provided stakeholder input into SIREN activities and facilitated collaborations among investigators, community members and stakeholders. Conclusion: The CE core within SIREN is a first-of-its kind public outreach engagement initiative to evaluate and address perceptions about stroke and genomics by patients, caregivers, and local leaders in SSA and has implications as a model for assessment in other high-stroke risk populations. SIREN’s CE program uses best practices to build capacity for community-engaged research, accelerate integration of research findings into practice and strengthen dynamic community-academic partnerships within our communities. CE has had several major successes over the past three years including our multi-site collaboration examining the KABP about stroke (symptoms, risk factors, burden) and genetic testing across SSA.

Keywords: community advisory board, community engagement, focus groups, outreach, SSA, stroke

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