Search results for: public health risks

Authors: Mohammad Julhas Sujan, Md. Ferdous Alam

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Maternal, neonatal, and child health (MNCH) holds one of the prime focuses in Bangladesh’s national healthcare system. To save the lives of mothers and children, knowing the stock of MNCH medicines in different healthcare facilities and when to replenish them are essential. A robust information system not only facilitates efficient management of the essential MNCH medicines but also helps effective allocation of scarce resources. In Bangladesh, Supply chain management of the 25-essential life-saving medicines are currently tracked and monitored via an electronic logistics management information system (eLMIS). Our aim was to conduct a cross-sectional study with a year (2020) worth of data from 24 districts of Bangladesh to evaluate how eLMIS is helping the Government and other stakeholders in efficient supply chain management. Data were collected from 4711 healthcare facilities ranging from primary to secondary levels within a district. About 90% (4143) are community clinics which are considered primary health care facilities in Bangladesh. After eLMIS implementation, the average reporting rate across the districts has been increased (> 97%). The month of stock (MOS) of zinc is an average 6 months compared to Inj. Magnesium Sulphate which will take 2.5 years to consume according to the current average monthly consumption (AMC). Due to first approaching expiry, Tab. Misoprostol, 7.1% Chlorhexidine and Inj. Oxytocin may become unusable. Moreover, Inj. Oxytocin is temperature sensitive and may reduce its efficacy if it is stocked for a longer period. In contrast, Zinc should be sufficiently stocked to prevent sporadic stockouts. To understand how data are collected, transmitted, processed, and aggregated for MNCH medicines in a faster and timely manner, an electronic logistics management information system (eLMIS) is necessary. We recommend the use of such a system in developing countries like Bangladesh for efficient supply chain management of essential MNCH medicines.

Keywords: adaption, eLMIS, MNCH, live-saving medicines

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Authors: Alessandra Marcelletti, Giovanni Trovato

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Corruption in public offices is found to be the reflection of country-specific features, however, the exact magnitude and the statistical significance of its determinants effect has not yet been identified. The paper aims to propose an estimation method to measure the impact of country fundamentals on corruption, showing that covariates could differently affect the extent of corruption across countries. Thus, we exploit a model able to take into account different factors affecting the incentive to ask or to be asked for a bribe, coherently with the use of the Corruption Perception Index. We assume that discordant results achieved in literature may be explained by omitted hidden factors affecting the agents' decision process. Moreover, assuming homogeneous covariates effect may lead to unreliable conclusions since the country-specific environment is not accounted for. We apply a Finite Mixture Model with concomitant variables to 129 countries from 1995 to 2006, accounting for the impact of the initial conditions in the socio-economic structure on the corruption patterns. Our findings confirm the hypothesis of the decision process of accepting or asking for a bribe varies with specific country fundamental features.

Keywords: Corruption, Finite Mixture Models, Concomitant Variables, Countries Classification

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Authors: Sabrina N. Jafralie, Arzina Zaver

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Responding to religious diversity and the need for social change, the Ethics and Religious Culture (ERC) Program was introduced as a mandatory subject for all students in Quebec, Canada. Now that the Quebec provincial government has announced the end of the ERC program, it time to discuss and assess both challenges and successes in it's implementation especially its impact on social change. Though many studies have been written around the wider concepts of religious education and religious literacy in the public system, few studies have included voices from educators. Jafralie and Zaver's qualitative research study examines the potentials and struggles of the ERC Program, and by doing so, raise important considerations around the effective teaching of.  The findings point to several consistent themes that teachers grapple with in regards to curriculum and pedagogy and highlights that in-service teachers are not thoroughly prepared to teach about ethics and religion, nor are teacher education programs effectively preparing pre-service teachers entering the field to deal with the complexities of teaching about religion or social change in their classrooms. The authors suggest avenues in which teacher education for teachers can look like in order for students and teachers to engage meaningfully with religious diversity and be agents of social change. 

Keywords: Pedagogy, Professional Development, Quebec, Teaching

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Authors: Cristina Azocar, Ivana Markova

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A survey of 565 male undergraduates examined the effects of exposure to social networking sites and entertainment media on young men’s body image. Exposure to social and to entertainment media was found to have negative effects on men’s body satisfaction, social comparison, and thin ideal internalization. Findings indicated significant differences in those men who were more exposed to social and to entertainment media than those who were not as exposed. Consistent with past studies, gay men were found to be more dissatisfied with their bodies than straight men. Gay men compared themselves to other better-looking individuals and internalized ideal body types seen in media significantly more than their straight counterparts. Surprisingly, straight men seem to care as much about their physical attractiveness/appearance as gay men do, but only in public settings such as at the beach, at athletic events (including gyms) and social events. Although on average ethnic groups were more similar than different, small but significant differences occurred with Asian men indicating significantly higher body dissatisfaction than White/European men and Middle Eastern/Arab men their counterparts. The study increases our knowledge about SNS and entertainment use and its associated body image, and body satisfaction affects among low-income ethnic minority men.

Keywords: body dissatisfaction, body image, entertainment media, gay men, race and ethnicity, social economic status, social comparison, social media

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Authors: Bibiana Matilde Bernal Gómez, Manuel Salvador Rodríguez Susa, Mildred Fernanda Lemus Perez

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In chlorinated drinking water, Haloacetic acids have been identified and are classified as disinfection byproducts originating from reaction between natural organic matter and/or bromide ions in water sources. These byproducts can be generated through a variety of chemical and pharmaceutical processes. The term ‘Total Haloacetic Acids’ (THAAs) is used to describe the cumulative concentration of dichloroacetic acid, trichloroacetic acid, monochloroacetic acid, monobromoacetic acid, and dibromoacetic acid in water samples, which are usually measured to evaluate water quality. Chronic presence of these acids in drinking water has a risk of cancer in humans. The detection of THAAs for the first time in 15 municipalities of Boyacá was accomplished in 2023. Aim is to describe the correlation between the levels of THAAs and digestive cancer in Tunja, a city in Colombia with higher rates of digestive cancer and to compare the risk across 15 towns, taking into account factors such as water quality. A research project was conducted with the aim of comparing water sources based on the geographical features of the town, describing the disinfection process in 15 municipalities, and exploring physical properties such as water temperature and pH level. The project also involved a study of contact time based on habits documented through a survey, and a comparison of socioeconomic factors and lifestyle, in order to assess the personal risk of exposure. Data on the levels of THAAs were obtained after characterizing the water quality in urban sectors in eight months of 2022. This, based on the protocol described in the Stage 2 DBP of the United States Environmental Protection Agency (USEPA) from 2006, which takes into account the size of the population being supplied. A cancer risk assessment was conducted to evaluate the likelihood of an individual developing cancer due to exposure to pollutants THAAs. The assessment considered exposure methods like oral ingestion, skin absorption, and inhalation. The chronic daily intake (CDI) for these exposure routes was calculated using specific equations. The lifetime cancer risk (LCR) was then determined by adding the cancer risks from the three exposure routes for each HAA. The risk assessment process involved four phases: exposure assessment, toxicity evaluation, data gathering and analysis, and risk definition and management. The results conclude that there is a cumulative higher risk of digestive cancer due to THAAs exposure in drinking water.

Keywords: haloacetic acids, drinking water, water quality, cancer risk assessment

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Authors: Giuliana Murfet, Heidi Behrens

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Chronic disease is Australia’s biggest health concern and obesity the leading risk factor for many. Obesity and chronic disease have a higher representation in rural Tasmania, where levels of socio-disadvantage are also higher. People living outside major cities have less access to health services and poorer health outcomes. To help primary healthcare professionals manage obesity, the Australian NHMRC evidence-based clinical practice guidelines for management of overweight and obesity in adults were developed. They include recommendations for practice and models for obesity management. To our knowledge there has been no research conducted that investigates translation of these guidelines into practice in rural-regional areas; where implementation can be complicated by limited financial and staffing resources. Also, the systematic review that informed the guidelines revealed a lack of evidence for chronic disease models of obesity care. The aim was to establish and evaluate a multidisciplinary model for obesity management in a group of adult people with type 2 diabetes in a dispersed rural population in Australia. Extensive stakeholder engagement was undertaken to both garner support for an obesity clinic and develop a sustainable model of care. A comprehensive nurse practitioner-led outpatient model for obesity care was designed. Multidisciplinary obesity clinics for adults with type 2 diabetes including a dietitian, psychologist, physiotherapist and nurse practitioner were set up in the north-west of Tasmania at two geographically-rural towns. Implementation was underpinned by the NHMRC guidelines and recommendations focused on: assessment approaches; promotion of health benefits of weight loss; identification of relevant programs for individualising care; medication and bariatric surgery options for obesity management; and, the importance of long-term weight management. A clinical pathway for adult weight management is delivered by the multidisciplinary team with recognition of the impact of and adjustments needed for other comorbidities. The model allowed for intensification of intervention such as bariatric surgery according to recommendations, patient desires and suitability. A randomised controlled trial is ongoing, with the aim to evaluate standard care (diabetes-focused management) compared with an obesity-related approach with additional dietetic, physiotherapy, psychology and lifestyle advice. Key barriers and enablers to guideline implementation were identified that fall under the following themes: 1) health care delivery changes and the project framework development; 2) capacity and team-building; 3) stakeholder engagement; and, 4) the research project and partnerships. Engagement of not only local hospital but also state-wide health executives and surgical services committee were paramount to the success of the project. Staff training and collective development of the framework allowed for shared understanding. Staff capacity was increased with most taking on other activities (e.g., surgery coordination). Barriers were often related to differences of opinions in focus of the project; a desire to remain evidenced based (e.g., exercise prescription) without adjusting the model to allow for consideration of comorbidities. While barriers did exist and challenges overcome; the development of critical partnerships did enable the capacity for a potential model of obesity care for rural regional areas. Importantly, the findings contribute to the evidence base for models of diabetes and obesity care that coordinate limited resources.

Keywords: diabetes, interdisciplinary, model of care, obesity, rural regional

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Authors: Mohammed Khalil Ur Rahman, Mohammed Alsharon, Arshad Muktar, Zahid Shaik

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Any ailment can go into terminal stages, cancer being one such disease which is many times detected in latent stages. Cancer is often characterized by constitutional symptoms which are agonizing in nature which disturbs patients and their family as well. In order to relieve such intolerable symptoms treatment modality employed is known to be ‘Palliative Care’. The goal of palliative care is to enhance patient’s quality of life by relieving or rather reducing the distressing symptoms of patients such as pain, nausea/ vomiting, anorexia/loss of appetite, excessive salivation, mouth ulcers, weight loss, constipation, oral thrush, emaciation etc. which are due to the effect of disease or due to the undergoing treatment such as chemotherapy, radiation etc. Ayurveda and Unani as well as other traditional medicines is getting more and more international attention in recent years and Ayurveda and Unani holistic perspective of the disease, it seems that there are many herbs and herbomineral preparation which can be employed in the treatment of malignancy and also in palliative care. Though many of them have yet to be scientifically proved as anti-cancerous but there is definitely a positive lead that some of these medications relieve the agonising symptoms thereby making life of the patient easy. Health is viewed in Islam in a holistic way. One of the names of the Quran is al-shifa' meaning ‘that which heals’ or ‘the restorer of health’ to refer to spiritual, intellectual, psychological, and physical health. The general aim of medical science, according to Islam, is to secure and adopt suitable measures which, with Allah’s permission, help to preserve or restore the health of the human body. Islam motivates the Physician to view the patient as one organism. The patient has physical, social, psychological, and spiritual dimensions that must be considered in synthesis with an integrated, holistic approach. Aims & Objectives: - To suggest herbs which are mentioned in Ayurveda Unani with potential palliative activity in case of Cancer patients. - Most of tibb nabawi [Prophetic Medicine] is preventive medicine and must have been divinely inspired. - Spiritual Aspects of Healing: Prayer, dua, recitation of the Quran - Remembrance of Allah play a central role.Materials & Method: Literary review of the herbs supported with experiential evidence will be discussed. Discussion: On the basis of collected data subject will be discussed in length. Conclusion: Will be presented in paper.

Keywords: palliative care, holistic, Ayurvedic and Unani traditional system of medicine, Quran, hadith

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Authors: Mookgo Solomon Kgatle

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Introductory Statement: The effect of corruption in South Africa has seriously constrained development of the national economy and has significantly inhibited good governance in the country. The significance of this paper is a demonstration that Corruption in a South African government is greatly influenced by the culture of greed by leaders in government. Many leaders in government are not satisfied with what they receive on monthly basis in the form of salaries and allowances. Thus, the quest to accumulate, as many material possessions by cabinet ministers and public servants is what is crippling the annual budget and disadvantaging the poor masses of our people including women, children and the elderly. Basic Methodology: In order to deal with this dilemma, this paper proposes ethical leadership as a theological and ethical alternative and antidote to the culture of greed in government. Research Findings: Ethical leadership is proposed because unlike the culture of greed, it is a leadership that is based on respect for ethical principles and standards and for the dignity and privileges of others. Ethical leadership is synonymous with principles like trust, morality, consideration, equality, and justice. Conclusion: The conclusion is that ethical leadership is one of the solutions that can assist the South African government to deal with the root causes of corruption, that is, the culture of greed.

Keywords: ethical leadership, theological ethics, culture of greed, corruption, governance

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Authors: Oluwole A. Solanke

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This article explores internal generation of revenues in higher education institutions. The research focuses on how polytechnic institutions in Nigeria generate other sources of revenues to augment government subventions and tuition fees. The study provides a qualitative case study and triangulation data on three polytechnics representing tertiary institution structure of federal, state and private ownership in Nigeria. The article argues that dependence on government subventions by the public polytechnics and tuition fees by private polytechnic would not provide funding adequacy for the activities of the institutions under study. Findings revealed that there are basically seven themes; guest houses; poly consult; part-time courses; tuition fees; capitation fees; ownership contribution; and printing and business centre by which the polytechnics generate additional sources of revenues in the management of the institutions. The research concludes that for the polytechnics to gain financial adequacy, entrepreneurial activities must be embarked upon vigorously by stakeholders of the polytechnics as this is the only way by which financial self-reliance can be achieved.

Keywords: entrepreneurial, government subventions, internal generation, polytechnics, revenues

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Authors: Stefano Sorace, Gloria Terenzi

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The study of a base isolation seismic retrofit solution for a reinforced concrete school building is presented in this paper. The building was assumed as a benchmark structure for a Research Project financed by the Italian Department of Civil Protection, and is representative of several similar public edifices designed with earlier Technical Standards editions, in Italy as well as in other earthquake-prone European countries. The structural characteristics of the building, and a synthesis of the investigation campaigns developed on it, are initially presented. The mechanical parameters, dimensions, locations and installation details of the base isolation system, incorporating double friction pendulum sliding bearings as protective devices, are then illustrated, along with the performance assessment analyses carried out in original and rehabilitated conditions according to a full non-linear dynamic approach. The results of the analyses show a remarkable enhancement of the seismic response capacities of the structure in base-isolated configuration. This allows reaching the high performance levels postulated in the rehabilitation design with notably lower costs and architectural intrusion as compared to traditional retrofit interventions designed for the same objectives.

Keywords: seismic retrofit, seismic assessment, r/c structures, school buildings, base isolation

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Authors: Foluke Dada

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The Prevalence of gender-based violence in Nigeria is of such concern and magnitude that the government has intervened by ratifying international instruments such as the convention on the elimination of all forms of discrimination against women, the declaration on the elimination of violence against women; the protocol to the African charter on human and people’s rights on the rights of women, etc. By promulgating domestic laws that sought to prevent the perpetration of Gender-based violence and also protect victims from future occurrences. Nigeria principally has two legal codes creating criminal offenses and punishments for breach of those offenses, the Criminal Code Law, applying to most states in Southern Nigeria and the Penal Code applying to states in Northern Nigeria. Individual State laws such as the Ekiti State and Lagos State Gender-Based Violence laws are also discussed. This paper addresses Gender-Based Violence in Nigeria and exposes the inadequacies in the laws and their application. The paper postulates that there is a need for more workable public policy that strengthens the social structure fortified by the law in order to engender the necessary changes and provide the opportunity for government to embark on grassroots-based advocacy that engage the victims and sensitize them of their rights and how they can enjoy some of the protections afforded by the laws.

Keywords: gender, violence, human rights, law and policy

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Authors: Maciej Kozlowski, Agnieszka Piotrowska-Piatek

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Purpose: This article analyses the most important financial participation programmes (FPP) in Poland to show the relationship between the programmes applied and the socio-economic results of enterprises and assesses the impact of participation on these results and the impact of selected factors on the introduction of FPP. Methodology: The research has been based on a questionnaire answered by senior management of listed Polish companies that had at least one out of three major FPPs in operation, namely share ownership, profit-sharing, or a stock option scheme. Findings: The results of the empirical study conducted indicate the existence of some peculiar relationships. The vast majority of schemes in Polish public companies are aimed at the participation of the management personnel; these programmes are narrow-based (only for management) and rather hermetic, with a high concentration of stocks or shares in the hands of the management. Conclusion: FPPs generally have a positive influence on enterprise functioning. However, the effects are more social than economic (no significant economic improvement after programme implementation). The paper contributes to the debate about financial participation and suggests actions to popularize these programmes on a wider scale.

Keywords: financial participation, profit sharing, stock options, worker attitude, worker ownership

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Authors: Sharon Garyn-Tal, Shoshana Shahrabani

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Military service in general, and in combat units in particular, can be physically and psychologically stressful. Therefore, type of service may have significant implications for soldiers during and after their military service including emotions, judgments and risk perceptions. Previous studies have focused on risk propensity and risky behavior among soldiers, however there is still lack of knowledge on the impact of type of army service on risk perceptions. The current study examines the effect of type of army service (combat versus non-combat service) and negative incidental emotions on risk perceptions. In 2014 a survey was conducted among 153 combat and non-combat Israeli soldiers. The survey was distributed in train stations and central bus stations in various places in Israel among soldiers waiting for the train/bus. Participants answered questions related to the levels of incidental negative emotions they felt, to their risk perceptions (chances to be hurt by terror attack, by violent crime and by car accident), and personal details including type of army service. The data in this research is unique because military service in Israel is compulsory, so that the Israeli population serving in the army is wide and diversified. The results indicate that currently serving combat participants were more pessimistic in their risk perceptions (for all type of risks) compared to the currently serving non-combat participants. Since combat participants probably experienced severe and distressing situations during their service, they became more pessimistic regarding their probabilities of being hurt in different situations in life. This result supports the availability heuristic theory and the findings of previous studies indicating that those who directly experience distressing events tend to overestimate danger. The findings also indicate that soldiers who feel higher levels of incidental fear and anger have pessimistic risk perceptions. In addition, respondents who experienced combat army service also have pessimistic risk perceptions if they feel higher levels of fear. In addition, the findings suggest that higher levels of the incidental emotions of fear and anger are related to more pessimistic risk perceptions. These results can be explained by the compulsory army service in Israel that constitutes a focused threat to soldiers' safety during their period of service. Thus, in this stressful environment, negative incidental emotions even during routine times correlate with higher risk perceptions. In conclusion, the current study results suggest that combat army service shapes risk perceptions and the way young people control their negative incidental emotions in everyday life. Recognizing the factors affecting risk perceptions among soldiers is important for better understanding the impact of army service on young people.

Keywords: army service, combat soldiers, incidental emotions, risk perceptions

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Authors: Alan Ruiz-Padilla, Brando Villalobos-Villalobos, Yeniley Ruiz-Noa, Claudia Mendoza-Macías, Claudia Palafox-Sánchez, Miguel Marín-Rosales, Álvaro Cruz, Rubén Rangel-Salazar

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Introduction: In patients with rheumatoid arthritis, resistance or poor response to disease modifying antirheumatic drugs (DMARD) may be a reflection of the increase in g-P. The expression of g-P may be important in mediating the effluence of DMARD from the cell. In addition, P-glycoprotein is involved in the transport of cytokines, IL-1, IL-2 and IL-4, from normal lymphocytes activated to the surrounding extracellular matrix, thus influencing the activity of RA. The involvement of P-glycoprotein in the transmembrane transport of cytokines can serve as a modulator of the efficacy of DMARD. It was shown that a number of lymphocytes with glycoprotein P activity is increased in patients with RA; therefore, P-glycoprotein expression could be related to the activity of RA and could be a predictor of poor response to therapy. Objective: To evaluate in RA patients, if the G2677T/A MDR1 polymorphisms is associated with differences in the rate of therapeutic response to disease-modifying antirheumatic agents in patients with rheumatoid arthritis. Material and Methods: A prospective cohort study was conducted. Fifty seven patients with RA were included. They had an active disease according to DAS-28 (score >3.2). We excluded patients receiving biological agents. All the patients were followed during 6 months in order to identify the rate of therapeutic response according to the American College of Rheumatology (ACR) criteria. At the baseline peripheral blood samples were taken in order to identify the G2677T/A MDR1 polymorphisms using PCR- Specific allele. The fragment was identified by electrophoresis in polyacrylamide gels stained with ethidium bromide. For statistical analysis, the genotypic and allelic frequencies of MDR1 gene polymorphism between responders and non-responders were determined. Chi-square tests as well as, relative risks with 95% confidence intervals (95%CI) were computed to identify differences in the risk for achieving therapeutic response. Results: RA patients had a mean age of 47.33 ± 12.52 years, 87.7% were women with a mean for DAS-28 score of 6.45 ± 1.12. At the 6 months, the rate of therapeutic response was 68.7 %. The observed genotype frequencies were: for G/G 40%, T/T 32%, A/A 19%, G/T 7% and for A/A genotype 2%. Patients with G allele developed at 6 months of treatment, higher rate for therapeutic response assessed by ACR20 compared to patients with others alleles (p=0.039). Conclusions: Patients with G allele of the - G2677T/A MDR1 polymorphisms had a higher rate of therapeutic response at 6 months with DMARD. These preliminary data support the requirement for a deep evaluation of these and other genotypes as factors that may influence the therapeutic response in RA.

Keywords: pharmacogenetics, MDR1, P-glycoprotein, therapeutic response, rheumatoid arthritis

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Authors: Riham A. Ragheb

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Water is a fundamental attraction in all cultures and among all classes of people, tourists and citizens. It is a favorite location for major tourism initiatives, celebrations and ceremonies. The vitality of any city depends on citizen action to take part in creating the neighborhoods they desire. Waterfront can provide extensive new areas of high quality public open space in parts of the city that are popular venues for social activities and also have the highest land values. Each city must have a character that can be used as a key attraction for the development. The morphology of a waterfront can be identified by both its physical characteristics and the socio-cultural activities that take place in the area. Alexandria has been selected as an area of study because it has a unique character due to its possession of a variety of waterfronts. This paper aims to set some criteria of successful waterfront development and then through these criteria analyzing the development of the Qaitbay waterfront in the eastern harbor in Alexandria, Egypt. Hence, a comprehensive improvement of the waterfront areas is certainly needed to ensure a successful waterfront development radiated the sense of uniformity and coherence. Alexandria can benefit from these criteria to develop its urban waterfront in order to preserve and revitalize its unique waterfront character and achieve mixed uses and tourism development.

Keywords: place making, Qaitbay, responsive environment, sustainable urban design, waterfront development

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Authors: Sivia Amado Cordeiro, Bruna Rodrigues, Maria Do Ceu Taveira, Catia Marques, Iris Oliveira, Ana Daniela Silva, Cristina Costa-Lobo

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This work intends to analyse the teaching of Psychology in Portugal and, particularly, the teaching of Career Psychology, reflecting about the changes that have occurred to date. Were analysed the educational offerings of 31 Portuguese higher education institutions, 12 public and 19 private, who teach the course of Psychology. The three degrees of study were considered, namely, bachelors, masters and doctoral. The analysis of the data focused on the curricular plans of the different degrees of studies in Psychology made available online by higher education institutions. Through them, we identified the curricular units with themes related to the teaching of Career Psychology. The results show the existence of 89 higher psychology courses in Portugal, distributed throughout the three degrees of studies. Concerning to the teaching of Career Psychology there were registered 49 curricular units with themes dedicated to this area of knowledge. There were identified 16 curricular units in the bachelor’s degree, 31 in master’s degree, and two in doctoral degree. It was observed a reduction in the number of degrees in Psychology in the last nine years in Portugal. We discuss the current situation of Psychology teaching, particularly the teaching of Career Psychology. The aim is to stimulate reflection about future perspectives of Psychology teaching, and specifically, specialized training in Psychology of Career, in Portugal.

Keywords: career psychology, higher education, psychology, Portugal

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Authors: Nashi Khan, Amina Khalid

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Aim: The purpose of this research was to find the psychiatric morbidity and level of sexual satisfaction among women with polycystic ovarian syndrome and their comparison with women with general medical conditions and to examine the correlation between psychiatric morbidity and sexual satisfaction among these women. Design: Cross sectional research design was used. Method: A total of 176 (M age = 30, SD = 5.83) women were recruited from both private and public sector hospitals in Pakistan. About 88 (50%) of the participants were diagnosed with polycystic ovarian syndrome (cases), whereas other 50% belonged to control group. Data were collected using semi structured interview. Sexual satisfaction scale for women (SSS-W) was administered to measure sexual satisfaction level and psychiatric morbidity was assessed by Symptom Checklist-Revised. Results: Results showed that participant’s depression and anxiety level had significant negative correlation with their sexual satisfaction level, whereas, anxiety and depression shared a significant positive correlation. There was a significant difference in the scores for sexual satisfaction, depression and anxiety for both cases and controls. These results suggested that women suffering from polycystic ovarian syndrome tend to be less sexually satisfied and experienced relatively more symptoms of depression and anxiety as compared to controls.

Keywords: level of sexual satisfaction, psychiatric morbidity, polycystic ovarian syndrome

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Authors: Mustofa Mahmud Al Mamun

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Government spending, one of the major components of gross domestic product (GDP), is composed of government consumption, investment, and transfer payments. A change in government spending during recessionary periods can generate an increase in GDP greater than the increase in spending. This is called the "multiplier effect". Accurate estimation of government spending multiplier is important because fiscal policy has been used to stimulate a flagging economy. Many recent studies have focused on identifying parts of the economy that responds more to a stimulus under a variety of circumstances. This paper used the US dataset from 1966 to 2020 and local projection method assuming standard identification strategy to estimate the multipliers. The model includes important macroaggregates and controls for forecasted government spending, interest rate, consumer price index (CPI), export, import, and level of public debt. Investment multipliers are found to be positive and larger than the consumption multipliers. Consumption multipliers are either negative or not significantly different than zero. Results do not vary across the business cycle. However, the consumption multiplier estimated from pre-1980 data is positive.

Keywords: business cycle, consumption multipliers, forecasted government spending, investment multipliers, local projection method, zero lower bound

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Authors: Gali Pesin, Yuliya Lipshits-Braziler, Sima Amram-Vaknin, Moshe Tatar

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The present study introduces four different patterns of seeking and providing help online among adolescents: (I) ‘Transceivers’ - adolescents who both seek as well as provide help online; (II) ‘Receivers’ - adolescents who seek help online, yet don’t provide it; (III) ‘Transmitters’ - adolescents who provide help online, yet don’t seek it; and (IV) ‘Idles’ - adolescents who refrain from seeking and providing help online. The study examined differences in seeking and providing help online between possible combinations of the four patterns, as well as gender differences within each pattern. Data was collected from 528 adolescents in Israel (59% were girls). Findings revealed that Transceivers are the largest group (45%) in this study, with higher representation of girls (65%). These adolescents seek help mainly around social difficulties, and they turn to peers who are both known and unknown to them. In addition, their preferred way to seek and provide help is through social network sites. Moreover, they often accept and give others emotional support. Receivers are the smallest group (5%) in this study. They turn to both known and unknown professionals more often than to friends and family. In addition, they seek help mostly around health and nutrition issues, and they usually receive instrumental support. For Receivers, the most important factor for seeking help online is anonymity, and the least important factor is familiarity with the help giver. Transmitters represent 16% of the adolescents in this study, with a greater representation of boys (52%). Their main reason to refrain from seeking help online is self-reliance. Nevertheless, these adolescents provide help to others online, mainly to those known to them through posting or responding to posts on social network sites. Idles represent 34% of the adolescents in this study. They refrain from seeking help online mainly due to their preference to seek help face to face, and due to their lack of trust in the internet or those using it. Idles and Transmitters are willing to seek help online mostly from friends and family. In addition, they are willing seek help online mainly regarding questions concerning military or civil service. They consider the most important facilitators for seeking help online as confidentiality and reliability. The present study’s main contribution is exploring the role of providing online help in understanding the adolescent behavior of seeking help online. In addition, the results of the present study have practical implications for the work of mental health providers, such as counseling psychologists and online mental health support.

Keywords: adolescents, counseling, online help-seeking, online help-providing

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Authors: Rungpansa Noichan, Bart Julien Dewancker

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Access to the mass transit system, including rapid elevated and underground transport has become an outstanding issue for many cities. The mass transit access development should focus on behavioral responses of the different passenger groups. Moreover, it should consider about the appearance of intent-oriented action related accessibility that was explored from user’s satisfaction and attitudes related to services quality. This study aims to evaluate mass transit accessibility from passenger’s satisfaction, therefore, understanding the passenger’s attitudes about mass transit accessibility. The study area of this research is Bangkok Mass Transit system (BTS Skytrain) at Saphan Taksin station. 200 passengers at Saphan Taksin station were asked to rate the questionnaires survey that considers accessibility aspects of convenience, safety, feeder connectivity, and other dimensions. The survey was to find out the passenger attitudes and satisfaction for access to the BTS station, and the result shows several factors that influence the passenger choice of using the BTS as a public transportation mode and passenger’s opinion that needs to concern for the development mass transit system and accessibility performance.

Keywords: urban transportation, user satisfaction, accessibility, Bangkok mass transit

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Authors: Rajiv Kumar, Amit Sachan, Arindam Mukherjee

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Despite the transparency and benefits of e-government, and its potential to serve citizens better, there is low diffusion and adoption of e-government services in India. Limited access to computer and internet, lack of computer and internet skills, low trust in technology, and risk associated in using e-government services are major hindrances in e-government adoption in India. Despite a large number of citizens belonging to the non-adopter category, the government has made some services mandatory to be accessed online where citizens have no other choice. Also despite the digital divide, a large number of citizens prefer online access to government services. In such cases intermediaries like common service centers, internet café and services agents’ roles are significant for accessing e-government services. Hence research is needed to explore this. The study aims to investigate the role of intermediaries in online access to public services by citizens. Qualitative research methodology using semi-structured interview was used. The results show that intermediaries play an important role in bridging the digital divide. The study also highlights on what circumstances citizens are taking help of these intermediaries. The study then highlights its limitations and discusses scope for future study.

Keywords: adoption, digital divide, e-government, India, intermediaries

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Authors: Melanie Redding

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Historic widespread nitrate contamination of the Lower Yakima Valley aquifer in Washington State initiated a community-based effort to reduce nitrate concentrations to below-drinking water standards. This group commissioned studies on characterizing local nitrogen sources, deep soil assessments, drinking water, and assessing nitrate concentrations at the water table. Nitrate is the most prevalent groundwater contaminant with common sources from animal and human waste, fertilizers, plants and precipitation. It is challenging to address groundwater contamination when common sources, such as agriculture, on-site sewage systems, and animal production, are widespread. Remediation is not possible, so mitigation is essential. The Lower Yakima Valley is located over 175,000 acres, with a population of 56,000 residents. Approximately 25% of the population do not have access to safe, clean drinking water, and 20% of the population is at or below the poverty level. Agriculture is the primary economic land-use activity. Irrigated agriculture and livestock production make up the largest percentage of acreage and nitrogen load. Commodities include apples, grapes, hops, dairy, silage corn, triticale, alfalfa and cherries. These commodities are important to the economic viability of the residents of the Lower Yakima Valley, as well as Washington State. Mitigation of nitrate in groundwater is challenging. The goal is to ensure everyone has safe drinking water. There are no easy remedies due to the extensive and pervasiveness of the contamination. Monitoring at the water table indicates that 45% of the 30 spatially distributed monitoring wells exceeded the drinking water standard. This indicates that there are multiple sources that are impacting water quality. Washington State has several areas which have extensive groundwater nitrate contamination. The groundwater in these areas continues to degrade over time. However, the Lower Yakima Valley is being successful in addressing this health issue because of the following reasons: the community is engaged and committed; there is one common goal; there has been extensive public education and outreach to citizens; and generating credible data using sound scientific methods. Work in this area is continuing as an ambient groundwater monitoring network is established to assess the condition of the aquifer over time. Nitrate samples are being collected from 170 wells, spatially distributed across the aquifer. This research entails quarterly sampling for two years to characterize seasonal variability and then continue annually afterward. This assessment will provide the data to statistically determine trends in nitrate concentrations across the aquifer, over time. Thirty-three of these wells are monitoring wells that are screened across the aquifer. The water quality from these wells are indicative of activities at the land surface. Additional work is being conducted to identify land use management practices that are effective in limiting nitrate migration through the soil column. Tracking nitrate in the soil column every season is an important component of bridging land-use practices with the fate and transport of nitrate through the subsurface. Patience, tenacity, and the ability to think outside the box are essential for dealing with widespread nitrate contamination of groundwater.

Keywords: community, groundwater, monitoring, nitrate

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Authors: Aksana N. Popel, Volha A. Sujayeva, Olga V. Kоshlataja, Irеna S. Karpava

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Introduction: It is a known fact that cardiovascular pathology and its complications cause a more severe course and worse prognosis in patients with comorbid kidney pathology. Chronic kidney disease (CKD) is associated with inflammation, endothelial dysfunction, and increased activity of the sympathoadrenal system. This circumstance increases the risk of cardiovascular diseases and the progression of kidney pathology. The above determines the need to identify cardiorenal changes at early stages to reduce the risks of cardiovascular complications and the progression of CKD. Objective: To identify risk factors (RF) for the development of CKD in elderly patients with chronic ischemic heart disease (CIHD). Methods: The study included 64 patients (40 women and 24 men) with a mean age of 74.4±4.5 years with coronary heart disease, without a history of structural kidney pathology and CKD. All patients underwent transthoracic echocardiography (TTE) and kidney ultrasound (KU) using GE Vivid 9 equipment (GE HealthCare, USA), and cardiac computed tomography (CCT) using Siemens Somatom Force equipment (Siemens Healthineers AG, Germany) in 3 months and in 1 year. Data obtained were analyzed using multiple regression analysis and nonparametric Mann-Whitney test. Statistical analysis was performed using the STATISTICA 12.0 program (StatSoft Inc.). Results: Initially, CKD was not diagnosed in all patients. In 3 months, CKD was diagnosed: stage C1 had 11 people (18%), stage C2 had 4 people (6%), stage C3A had 11 people (18%), stage C3B had 2 people (3%). After 1 year, CKD was diagnosed: stage C1 had 22 people (35%), stage C2 had 5 people (8%), stage C3A had 17 people (27%), stage C3B had 10 people (15%). In 3 months, statistically significant (p<0.05) risk factors were: 1) according to TTE: mitral peak E-wave velocity (U=678, p=0.039), mitral E-velocity DT (U=514, p=0.0168), mitral peak A-wave velocity (U=682, p=0.013). In 1 year, statistically significant (p<0.05) risk factors were: according to TTE: left ventricular (LV) end-systolic volume in B-mode (U=134, p=0.006), LV end-diastolic volume in B-mode (U=177, p=0.04), LV ejection fraction in B-mode (U=135, p=0.006), left atrial volume (U=178, p=0.021), LV hypertrophy (U=294, p=0.04), mitral valve (MV) fibrosis (U=328, p=0.01); according CCT: epicardial fat thickness (EFT) on the right ventricle (U=8, p=0.015); according to KU: interlobar renal artery resistance index (RI) (U=224, p=0.02), segmental renal artery RI (U=409, p=0.016). Conclusions: Both TTE and KU are very informative methods to determine the additional risk factors of CKD development and progression. The most informative risk factors were LV global systolic and diastolic functions, LV and LA volumes. LV hypertrophy, MV fibrosis, interlobar renal artery and segmental renal artery RIs, EFT.

Keywords: chronic kidney disease, ischemic heart disease, prognosis, risk factors

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Authors: Zoe Lynch, Kirsty Zieschank

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There are several factors that compromise the utility and wide-spread use of existing emotional and behavioural distress screening instruments. Some of these factors include lengthy administration times, high costs, feasibility issues, and a lack of self-report options for children under 12 years of age. This animation-based resource was developed to overcome as many of these factors as possible. Developed for educators and medical and mental health professionals, this resource offers children a self-guided mechanism for reporting any current emotional and behavioural distress. An avatar assistant, selected by the child, accompanies them through each stage of the screening process, offering further instruction if prompted. Children enter their age and gender before viewing comparative animations conveying common childhood emotional and behavioural difficulties. The child then selects the most relatable animations, along with the frequency with which they experience the depicted emotions. From a perspective of intellectual development, an engaging, animated format means that outcomes will not be constrained by children’s reading, writing, cognitive, or verbal expression abilities. Having been user-tested with children aged 6 to 12, this resource shows promising results as a self-guided screening instrument.

Keywords: animation-based screening instrument, mental health, primary-aged children, self-guided

Procedia PDF Downloads 153

Authors: Elysa V. Largo, Lormaine Anne A. Branzuela, Julie Marisol D. Pagalilauan, Neil C. Concibido, Monet Concepcion M. Detras

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The energy demand in the country is increasing; thus, nuclear energy is recently mandated to add to the energy mix. The Philippines has the Bataan Nuclear Power Plant (BNPP), which can be a source of nuclear energy; however, it has not been operated since the completion of its construction. Thus, evaluating the safety of BNPP is vital. This study explored the possible deviations that may occur in the operation of a nuclear power plant with a pressurized water reactor, which is similar to BNPP, through a virtual process hazard analysis (PHA) using the hazard and operability (HAZOP) technique. Temperature, pressure, and flow were used as parameters. A total of 86 causes of various deviations were identified, wherein the primary system and line from reactor coolant pump to reactor vessel are the most critical system and node, respectively. A total of 348 scenarios were determined. The critical events are radioactive leaks due to nuclear meltdown and sump overflow that could lead to multiple worker fatalities, one or more public fatalities, and environmental remediation. There were existing safeguards identified; however, further recommendations were provided to have additional and supplemental barriers to reduce the risk.

Keywords: PSM, PHA, HAZOP, nuclear power plant

Procedia PDF Downloads 143

Authors: Pierre van Tonder, Dinesh Muthoo, Kim twiname

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Many existing and newly built structures are constructed on the design basis of the engineer and the workmanship of the construction company. However, when considering larger structures where more people are exposed to the building, its structural integrity is of great importance considering the safety of its occupants (Raghu, 2013). But how can the structural integrity of a building be monitored efficiently and effectively. This is where the fourth industrial revolution step in, and with minimal human interaction, data can be collected, analysed, and stored, which could also give an indication of any inconsistencies found in the data collected, this is where the Fibre Bragg Grating (FBG) monitoring system is introduced. This paper illustrates how data can be collected and converted to develop stress – strain behaviour and to produce bending moment diagrams for the utilisation and prediction of the structure’s integrity. Embedded fibre optic sensors were used in this study– fibre Bragg grating sensors in particular. The procedure entailed making use of the shift in wavelength demodulation technique and an inscription process of the phase mask technique. The fibre optic sensors considered in this report were photosensitive and embedded in the slab and beams for data collection and analysis. Two sets of fibre cables have been inserted, one purposely to collect temperature recordings and the other to collect strain and temperature. The data was collected over a time period and analysed used to produce bending moment diagrams to make predictions of the structure’s integrity. The data indicated the fibre Bragg grating sensing system proved to be useful and can be used for structural health monitoring in any environment. From the experimental data for the slab and beams, the moments were found to be64.33 kN.m, 64.35 kN.m and 45.20 kN.m (from the experimental bending moment diagram), and as per the idealistic (Ultimate Limit State), the data of 133 kN.m and 226.2 kN.m were obtained. The difference in values gave room for an early warning system, in other words, a reserve capacity of approximately 50% to failure.

Keywords: fibre bragg grating, structural health monitoring, fibre optic sensors, beams

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Authors: Raptis Sotirios

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Health and social care (HSc) services planning and scheduling are facing unprecedented challenges due to the pandemic pressure and also suffer from unplanned spending that is negatively impacted by the global financial crisis. Data-driven can help to improve policies, plan and design services provision schedules using algorithms assist healthcare managers’ to face unexpected demands using fewer resources. The paper discusses services packing using statistical significance tests and machine learning (ML) to evaluate demands similarity and coupling. This is achieved by predicting the range of the demand (class) using ML methods such as CART, random forests (RF), and logistic regression (LGR). The significance tests Chi-Squared test and Student test are used on data over a 39 years span for which HSc services data exist for services delivered in Scotland. The demands are probabilistically associated through statistical hypotheses that assume that the target service’s demands are statistically dependent on other demands as a NULL hypothesis. This linkage can be confirmed or not by the data. Complementarily, ML methods are used to linearly predict the above target demands from the statistically found associations and extend the linear dependence of the target’s demand to independent demands forming, thus groups of services. Statistical tests confirm ML couplings making the prediction also statistically meaningful and prove that a target service can be matched reliably to other services, and ML shows these indicated relationships can also be linear ones. Zero paddings were used for missing years records and illustrated better such relationships both for limited years and in the entire span offering long term data visualizations while limited years groups explained how well patients numbers can be related in short periods or can change over time as opposed to behaviors across more years. The prediction performance of the associations is measured using Receiver Operating Characteristic(ROC) AUC and ACC metrics as well as the statistical tests, Chi-Squared and Student. Co-plots and comparison tables for RF, CART, and LGR as well as p-values and Information Exchange(IE), are provided showing the specific behavior of the ML and of the statistical tests and the behavior using different learning ratios. The impact of k-NN and cross-correlation and C-Means first groupings is also studied over limited years and the entire span. It was found that CART was generally behind RF and LGR, but in some interesting cases, LGR reached an AUC=0 falling below CART, while the ACC was as high as 0.912, showing that ML methods can be confused padding or by data irregularities or outliers. On average, 3 linear predictors were sufficient, LGR was found competing RF well, and CART followed with the same performance at higher learning ratios. Services were packed only if when significance level(p-value) of their association coefficient was more than 0.05. Social factors relationships were observed between home care services and treatment of old people, birth weights, alcoholism, drug abuse, and emergency admissions. The work found that different HSc services can be well packed as plans of limited years, across various services sectors, learning configurations, as confirmed using statistical hypotheses.

Keywords: class, cohorts, data frames, grouping, prediction, prob-ability, services

Procedia PDF Downloads 224

Authors: N. Sena, C. Vasconcelos

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Portugal has a lower rate of people who exercise. Fitness centers are a widely recognized context for the performance of an exercise. Thus, the objective of this study is to analyze the motivational factors for the practice of exercise in a sample of Portuguese fitness center users. The sample consists of 34 users (23 men and 11 women), aged between 16 and 60 years old (24.7 ± 11,5 years old). The instrument used for data collection was the Motivation Questionnaire for Exercise (version translated and validated into Portuguese), consisting of forty-nine items grouped into ten motivational factors. Responses to the Exercise Motivation Questionnaire are given on a 6-point Likert scale (0="not at all true for me" to 5="completely true for me"). With regard to the results, it is possible to verify that the motivational factors considered most relevant by the sample of our study were “Well-being” (4.44 ± 0.28), followed by “Health” (4.29 ± 0.57) and “Stress Management” (4.06 ± 0.54). The factors “Affiliation” (3.11 ± 0.49) “Personal Appreciation” (2.26 ± 0.59) and “Medical History” (1.71 ± 0.74) were considered by the respondents to be the least important factors for performing the exercise. The conclusion of this study is that in the sample of this study, the factors that most motivated the practice of exercise were “Well-being”, “Health” and “Stress Management”. In the opposite direction, the factors that least motivated the individuals in this sample to practice exercise were “Affiliation”, “Personal Appreciation” and “Medical History”.

Keywords: exercise, fitness center users, motivational factors, Portugal

Procedia PDF Downloads 79

Authors: Scott Caizley

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Widening participation amongst state schooled and British and Minority Ethnic (BME) students in UK conservatoires throughout the past years has persisted to remain at an all time low despite major efforts to increase access for those from underrepresented backgrounds. In the academic year of 2017/18, two of the UK’s leading music conservatoires recruited less state school students than Oxbridge. Whilst conservatories face further public stigmatisation and heavy financial penalties for failing to meet government benchmarks; there appears to be a more costly outcome to this crisis. This of course, is the lack of sociocultural diversity, which is perpetuated both within the conservatoire sector and the classical music industry. This research investigates the lived experiences of former state-schooled students who attended a UK music conservatoire. Given the participant’s underrepresented status, the research seeks to answer whether or not the students are fitting in or standing out within the conservatoire environment. The research will explore the findings through a Bourdieusian contextual framework with hope of generating a wealth of new practises to the field of Higher Music Education. It is through illuminating the underrepresented voices within these elite spaces, which could aid future research and policy to help tackle the diversity dilemma and give classical music the social and cultural renewal it so desperately needs.

Keywords: classical music, lived experiences, higher music education, Bourdieusian

Procedia PDF Downloads 130

Authors: Asrarul H. Jeelani

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Arsenic contamination of groundwater and its’ health implications in lower Gangetic plain of Indian states started reporting in the 1980s. The same period was declared as the first water decade (1981-1990) to achieve ‘water for all.’ To fulfill the aim, the Indian government, with the support of international agencies installed millions of hand-pumps through water resources development programs. The hand-pumps improve the accessibility if the groundwater, but over-extraction of it increases the chances of mixing of trivalent arsenic which is more toxic than pentavalent arsenic of dug well water in Gangetic plain and has different physical manifestations. Now after three decades, Bihar (middle Gangetic plain) is also facing arsenic contamination of groundwater and its’ health implications. Objective: This interdisciplinary research attempts to understand the health and social implications of arsenicosis among different castes in Haldi Chhapra village and to find the association of ramifications with water resources development. Methodology: The Study used concurrent quantitative dominant mix method (QUAN+qual). The researcher had employed household survey, social mapping, interviews, and participatory interactions. However, the researcher used secondary data for retrospective analysis of hand-pumps and implications of arsenicosis. Findings: The study found 88.5% (115) household have hand-pumps as a source of water however 13.8% uses purified supplied water bottle and 3.6% uses combinations of hand-pump, bottled water and dug well water for drinking purposes. Among the population, 3.65% of individuals have arsenicosis, and 2.72% of children between the age group of 5 to 15 years are affected. The caste variable has also emerged through quantitative as well as geophysical locations analysis as 5.44% of arsenicosis manifested individual belong to scheduled caste (SC), 3.89% to extremely backward caste (EBC), 2.57% to backward caste (BC) and 3% to other. Among three clusters of arsenic poisoned locations, two belong to SC and EBC. The village as arsenic affected is being discriminated, whereas the affected individual is also facing discrimination, isolation, stigma, and problem in getting married. The forceful intervention to install hand-pumps in the first water decades and later restructuring of the dug well destroyed a conventional method of dug well cleaning. Conclusion: The common manifestation of arsenicosis has increased by 1.3% within six years of span in the village. This raised the need for setting up a proper surveillance system in the village. It is imperative to consider the social structure for arsenic mitigation program as this research reveals caste as a significant factor. The health and social implications found in the study; retrospectively analyzed as the collateral impact of water resource development programs in the village.

Keywords: arsenicosis, caste, collateral impact, water resources

Procedia PDF Downloads 106