Search results for: Korean smart city strategies

Authors: Mohammed Alnuwairan, Mahmoud Abdelrahman

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Based on the sustainability concept, this paper explores the current situation of construction and demolition waste (C&D) in the Kingdom of Saudi Arabia (KSA) from the source of production to final destinations. The issues that hindered the investment of recycling C&D in the context will be studied in order to identify the challenges and opportunities to improve this sector and put forward a strategic framework to reduce, reuse, recycle and minimize the disposal of this type of waste. The research, which is exploratory in nature, identified four types of organizations that were appropriate case studies. These organizations were drawn from the municipalities, city council, recyclers and manufacturers. Secondary data collection, direct observation, and elite interviewing methods were used in the case studies to facilitate comparisons with existing literature to explore opportunities to improve sustainability practices in the buildings sector. Implementation of C&D waste management and recycling in KSA is in the early stages. Resistance of virgin building material manufacturers, free usage of landfill, culture, surpluses of natural raw material, availability of land and the cost of recycling this material compared with virgin material hinders the adoption of recycled buildings martial. Although the metal material is collected and recycled but it has the lowest percentage of C&D waste in Saudi. The findings indicate that government and industry need to collaborate more closely in order to successfully implement best practices. Economic and environmental benefits can be achieved, particularly through improvements to infrastructure and legislation. Feasible solution framework and recommendations for managing C&D waste under current situation are provided. The findings can be used to extend this framework and to enable it to be applicable in other context with emerging economies similar to that found in KSA. No study of this type has been previously carried out in KSA. The findings should prove useful in creating a future research agenda for C&D waste in KSA and, possibly, other emerging countries within a similar context.

Keywords: construction and demolition waste, recycling, reuse, sustainability

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Authors: Khojesta Kawish, Tetsuya Ando, Sayed Abdul Basir Samimi

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Bagh-e Dasht area is situated in the northern part of Herat, an old city in western Afghanistan located on the Silk Road which has received a strong influence from Persian culture. Initially, the Bagh-e Dasht area was developed for gardens and palaces near Joy-e Injil canal during the Timurid Empire in the 15^th century. It is assumed Bagh-e Dasht became a settlement in the 16^th century during the Safavid Empire. The oldest area is the southern part around the canal bank which is characterized by Dalans, sun-dried brick arcades above which houses are often constructed. Traditional houses in this area are built with domical vault roofs constructed with sun-dried bricks. Bagh-e Dasht is one of the best-preserved settlements of traditional houses in Herat. This study examines the transformation of the Bagh-e Dasht area with a focus on Dalans, where traditional houses with domical vault roofs have been well-preserved until today. The aim of the study is to examine the extent of physical changes to the area as well as changes to houses and the community. This research paper contains original results which have previously not been published in architectural history. The roof types of houses in the area are investigated through examining high resolution satellite images. The boundary of each building and space is determined by both a field survey and aerial photographs of the study area. A comprehensive field survey was then conducted to examine each space and building in the area. In addition, a questionnaire was distributed to the residents of the Dalan houses and interviews were conducted with the Wakil (Chief) of the area, a local historian, residents and traditional builders. The study finds that the oldest part of Bagh-e Dasht area, the south, contains both Dalans and domical vault roof houses. The next oldest part, which is the north, only has domical vault roof houses. The rest of the area only has houses with modernized flat roofs. This observation provides an insight into the process of historical development in the Bagh-e Dasht area.

Keywords: Afghanistan, Bagh-e Dasht, Dalan, domical vault, Herat, over path house, traditional house

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Authors: Manvender Kaur Sarjit Singh

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There is a crucial mismatch between classroom written language tasks and real world written language requirements. Realizing the importance of reducing the gap between the professional needs of the legal practitioners and the higher learning institutions that offer the legislative education in Malaysia, it is deemed necessary to develop a framework that integrates real-life written communication with the teaching of content-based legislative discourse to future legal practitioners. By highlighting the actual needs of the legal practitioners in the country, the present teaching practices will be enhanced and aligned with the actual needs of the learners thus realizing the vision and aspirations of the Malaysian Education Blueprint 2013-2025 and Legal Profession Qualifying Board. The need to focus future education according to the actual needs of the learners can be realized by developing a teaching framework which is designed within the prospective requirements of its real-life context. This paper presents the steps taken to develop a specific teaching framework that fulfills the fundamental real-life context of the prospective legal practitioners. The teaching framework was developed based on real-life written communication from the legal profession in Malaysia, using the specific genre analysis approach which integrates a corpus-based approach and a structural linguistics analysis. This approach was adopted due to its fundamental nature of intensive exploration of the real-life written communication according to the established strategies used. The findings showed the use of specific moves and parts-of-speech by the legal practitioners, in order to prepare the selected genre. The teaching framework is hoped to enhance the teachings of content-based law courses offered at present in the higher learning institutions in Malaysia.

Keywords: linguistics analysis, corpus analysis, genre analysis, legislative discourse

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Authors: Zhan Jie How

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With the heightened awareness of workplace learning and its impact on improving organizational performance and developing employee competence, governments and corporations around the world are forced to intensify their cooperation to establish national workplace development programmes to guide these corporations in fostering engaging and collaborative workplace learning cultures. This conceptual paper aims to conduct a comparative study of existing workplace development programmes for small and medium-sized enterprises (SMEs) in Europe and Singapore, focusing primarily on the Swedish Production Leap, Finnish TEKES Liideri Programme, and Singapore SkillsFuture SME Mentors Programme. The study carries out a systematic review of the three workplace development programmes to examine the roles of external mentors or coaches in influencing the design and implementation of workplace learning strategies and practices in SMEs. Organizational, personal and external factors that promote or inhibit effective workplace mentorship are also scrutinized, culminating in a critical comparison and evaluation of the strengths and weaknesses of the aforementioned programmes. Based on the findings from the review and analyses, a heuristic conceptual framework is developed to illustrate the complex interrelationships among external workplace development programmes, internal learning and development initiatives instituted by the organization’s higher management, and employees' continuous learning activities at the workplace. The framework also includes a set of guiding principles that can be used as the basis for internal mediation between the competing perspectives of mentors and mentees (employers and employees of the organization) regarding workplace learning conditions, practices and their intended impact on the organization. The conceptual study provides a theoretical blueprint for future empirical research on organizational workplace learning and the impact of government-initiated workplace development programmes.

Keywords: employee competence, mentorship, organizational performance, workplace development programme, workplace learning culture

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Authors: Amanda Maria Rodrigues Barroso, Ary Paixao Borges Santana Junior, Caio Araujo Damasceno

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In Piauí, the Brazilian state, solar energy has become one of the renewable sources targeted by internal and external investments, with the intention of leveraging the development of society. However, for a residential or business consumer to be able to deploy this source, there is usually a need for a high initial investment due to its high cost. The countless high taxes on equipment and services are one of the factors that contribute to this cost and ultimately fall on the consumer. Through analysis, a way of reducing taxes is sought in order to encourage consumer adhesion to the use of photovoltaic solar energy. Thus, the objective is to implement the Piauí Solar Program in the state of Piauí in order to stimulate the deployment of photovoltaic solar energy, through benefits granted to users, providing state development by boosting the diversification of the state's energy matrix. The research method adopted was based on the analysis of data provided by the Teresina City Hall, by the Brazilian Institute of Geography and Statistics and by a private company in the capital of Piauí. The account was taken of the total amount paid in Property and Urban Territorial Property Tax (IPTU), in electricity and in the service of installing photovoltaic panels in a residence with 6 people. Through Piauí Solar, a discount of 80% would be applied to the taxes present in the budgets regarding the implementation of these photovoltaic plates in homes and businesses, as well as in the IPTU. In addition, another factor also taken into account is the energy savings generated after the implementation of these boards. In the studied residence, the annual payment of IPTU went from R $ 99.83 reais to R $ 19.96, the reduction of taxes present in the budget for the implantation of solar panels, caused the value to increase from R $ 42,744.22 to R $ 37,241.98. The annual savings in electricity bills were estimated at around R $ 6,000. Therefore, there is a reduction of approximately 24% in the total invested. The trend of the Piauí Solar program, then, is to bring benefits to the state, providing an improvement in the living conditions of the population, through the savings generated by this program. In addition, an increase in the diversification of the Piauí energy matrix can be seen with the advancement of the use of this renewable energy.

Keywords: development, economy, energy, taxes

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Authors: Tatiana A. Pozdniakova, Maria A. P. Cechinel, Luciana P. Mazur, Rui A. R. Boaventura, Vitor J. P. Vilar.

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Two brown macroalgae, Laminaria hyperborea and Pelvetia canaliculata, were employed as natural cation exchangers in a fixed-bed column for Zn(II) removal from a galvanization wastewater. The column (4.8 cm internal diameter) was packed with 30-59 g of previously hydrated algae up to a bed height of 17-27 cm. The wastewater or eluent was percolated using a peristaltic pump at a flow rate of 10 mL/min. The effluent used in each experiment presented similar characteristics: pH of 6.7, 55 mg/L of chemical oxygen demand and about 300, 44, 186 and 244 mg/L of sodium, calcium, chloride and sulphate ions, respectively. The main difference was nitrate concentration: 20 mg/L for the effluent used with L. hyperborean and 341 mg/L for the effluent used with P. canaliculata. The inlet zinc concentration also differed slightly: 11.2 mg/L for L. hyperborean and 8.9 mg/L for P. canaliculata experiments. The breakthrough time was approximately 22.5 hours for both macroalgae, corresponding to a service capacity of 43 bed volumes. This indicates that 30 g of biomass is able to treat 13.5 L of the galvanization wastewater. The uptake capacities at the saturation point were similar to that obtained in batch studies (unpublished data) for both algae. After column exhaustion, desorption with 0.1 M HNO3 was performed. Desorption using 9 and 8 bed volumes of eluent achieved an efficiency of 100 and 91%, respectively for L. hyperborean and P. canaliculata. After elution with nitric acid, the column was regenerated using different strategies: i) convert all the binding sites in the sodium form, by passing a solution of 0.5 M NaCl, until achieve a final pH of 6.0; ii) passing only tap water in order to increase the solution pH inside the column until pH 3.0, and in this case the second sorption cycle was performed using protonated algae. In the first approach, in order to remove the excess of salt inside the column, distilled water was passed through the column, leading to the algae structure destruction and the column collapsed. Using the second approach, the algae remained intact during three consecutive sorption/desorption cycles without loss of performance.

Keywords: biosorption, zinc, galvanization wastewater, packed-bed column

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Authors: Bi̇rsen Tutunis, Zuhal Aydin

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Guided digital learning has attracted many researchers as it leads to autonomous learning.The developments in Guided digital learning have led to changes in teaching and learning in English Language Teaching classes (Jeong-Bae, 2014). This study reports on tasks designed under the principles of learner autonomy in an online learning platform ‘’Webquest’’ with the purpose of teaching English to Turkish tertiary level students at a foundation university in Istanbul. Guided digital learning blog project contents were organized according to work-cycles phases (planning and negotiation phase, decision-making phase, project phase and evaluation phase) which are compatible with the principles of autonomous learning (Legenhausen,2003). The aim of the study was to implement the class blog project to find out its impact on students’ behaviours and beliefs towards autonomous learning. The mixed method research approach was taken. 24 tertiary level students participated in the study on voluntary basis. Data analysis was performed with Statistical Package for the Social Sciences. According to the results, students' attitudes towards digital learning did not differ before and after the training application. The learning styles of the students and their knowledge on digital learning scores differed. It has been observed that the students' learning styles and their digital learning scores increased after the training application. Autonomous beliefs, autonomous behaviors, group cohesion and group norms differed before and after the training application. Students' motivation level, strategies for learning English, perceptions of responsibility and out-of-class activity scores differed before and after the training application. It was seen that work-cycles in online classes create student centered learning that fosters autonomy. This paper will display the work cycles in detail and the researchers will give examples of in and beyond class activities and blog projects.

Keywords: guided digital learning, work cycles, english language teaching, autonomous learning

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Authors: Errol J. Haarhoff

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Housing in New Zealand, particularly in Auckland, is dominated by low-density suburbs. Over the past 20 years, housing intensification policies aimed to curb outward low-density sprawl and to concentrate development within an urban boundary have been implemented. This requires the greater deployment of attached housing typologies such apartments, duplexes and terrace housing. There has been strong market response and uptake for higher density development, with the number of building approvals received by the Auckland Council for attached housing units increasing from around 15 percent in 2012/13, to 54 percent in 2017/18. A key question about intensification and strong market uptake in a city where lower density has been the norm, is whether higher density neighborhoods will deliver necessary housing satisfaction? This paper reports on the findings to a questionnaire survey and focus group discussions probing resident perceptions to living at higher density in relation to their dwellings, the neighborhood and their sense of community. The findings reveal strong overall housing satisfaction, including key aspects such as privacy, noise and living in close proximity to neighbors. However, when residents are differentiated in terms of length of tenure, age or whether they are bringing up children, greater variation in satisfaction is detected. For example, residents in the 65-plus age cohort express much higher levels of satisfaction, when compared to the 18-44 year cohorts who more likely to be binging up children. This suggests greater design sensitivity to better accommodate the range of household types. Those who have live in the area longer express greater satisfaction than those with shorter duration, indicating time for adaption to living at higher density. Findings strongly underpin the instrumental role that the public amenities play in overall housing satisfaction and the emergence of a strong sense of community. This underscores the necessity for appropriate investment in the public amenities often lacking in market-led higher density housing development. We conclude with an evaluation of the PPP model, and its part in delivering housing satisfaction. The findings should be of interest to cities, housing developers and built environment professional pursuing housing policies promoting intensification and higher density.

Keywords: medium density, housing satisfaction, neighborhoods, sense of community

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Authors: Ilona Copik

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The aim of this study is to analyze the representation of memories of the forced displacement of Poles and Germans from the eastern territories in 1945 as depicted by Polish and German feature films between the years 1945-1960. The aftermath of World War II and the Allied agreements concluded at Yalta and Potsdam (1945) resulted in changes in national borders in Central and Eastern Europe and the large-scale transfer of civilians. The westward migration became a symbol of the new post-war division of Europe, new spheres of influence separated by the Iron Curtain. For years it was a controversial topic in both Poland and Germany due to the geopolitical alignment (the socialist East and capitalist West of Europe), as well as the unfinished debate between the victims and perpetrators of the war. The research premise is to take a comparative view of the conflicted cultures of Polish and German memory, to reflect on the possibility of an international dialogue about the past recorded in film images, and to discover the potential of film as a narrative warning against totalitarian inclinations. Until now, films made between 1945 and 1960 in Poland and the German occupation zones have been analyzed mainly in the context of artistic strategies subordinated to ideology and historical politics. In this study, the intention is to take a critical approach leading to the recognition of how films work as collective memory media, how they reveal the mechanisms of memory/forgetting, and what settlement topoi and migration myths they contain. The main hypothesis is that feature films about forced displacement, in addition to the politics of history - separate in each country - reveal comparable transnational individual experiences: the chaos of migration, the trauma of losing one's home, the conflicts accompanying the familiar/foreign, the difficulty of cultural adaptation, the problem of lost identity, etc.

Keywords: forced displacement, Polish and German cinema, war victims, World War II

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Authors: Joel Bonales, Venecia Solorzano, Carlos Garcia

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A great percentage of the wastewater generated in developing countries don’t receive any treatment, which leads to numerous environmental impacts. In response to this, a paradigm change in the current wastewater treatment model based on large scale plants towards a small and medium scale based model has been proposed. Nevertheless, small scale wastewater treatment (SS-WTTP) with novel technologies such as anaerobic digesters, as well as the utilization of derivative co-products such as biogas, still presents diverse environmental impacts which must be assessed. This study consisted in a Life Cycle Assessment (LCA) performed to a SS-WWTP which treats wastewater from a small commercial block in the city of Morelia, Mexico. The treatment performed in the SS-WWTP consists in anaerobic and aerobic digesters with a daily capacity of 5,040 L. Two different scenarios were analyzed: the current plant conditions and a hypothetical energy use of biogas obtained in situ. Furthermore, two different allocation criteria were applied: full impact allocation to the system’s main product (treated water) and substitution credits for replacing Mexican grid electricity (biogas) and clean water pumping (treated water). The results showed that the analyzed plant had bigger impacts than what has been reported in the bibliography in the basis of wastewater volume treated, which may imply that this plant is currently operating inefficiently. The evaluated impacts appeared to be focused in the aerobic digestion and electric generation phases due to the plant’s particular configuration. Additional findings prove that the allocation criteria applied is crucial for the interpretation of impacts and that that the energy use of the biogas obtained in this plant can help mitigate associated climate change impacts. It is concluded that SS-WTTP is a environmentally sound alternative for wastewater treatment from a systemic perspective. However, this type of studies must be careful in the selection of the allocation criteria and replaced products, since these factors have a great influence in the results of the assessment.

Keywords: biogas, life cycle assessment, small scale treatment, wastewater treatment

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Authors: Olayide Ogunsiji, Glenda McDonald

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Engendering cultural competence in nursing and midwifery students is germane to reducing disparities in contemporary health care settings, increasingly patronized by people from diverse background. Professional standards for registration in Australia require nurses and midwives to be culturally competent. Nursing and midwifery academics worldwide are responsible for preparing students for clinical practice, yet limited attention is paid to exploring how students are being prepared to care for a culturally diverse population. This paper provides insight into the perceptions of academics about how they are preparing undergraduate nursing and midwifery students for culturally competent health care. Academics were drawn from a tertiary educational institution in metropolitan Australia. They responded to a generic email indicating their interest in participating in the study. A total of nine academics who have taught undergraduate nursing and midwifery students in a unit that focused on health and illness perspectives for culturally diverse communities; and provided written consent to participate were included. These academics were engaged in a qualitative digitally-recorded semi-structured face-to-face or telephone interviews which lasted for about 45-60 minutes. Interview data were transcribed verbatim. Through constant comparison, three themes emerged: experiences of the teachers, strategies used for preparing students and challenges in preparing students. The participants spoke about their experiences of teaching in the unit and with the students. They faced challenges related to physical and relational space. They utilised a number of didactic approaches in teaching the unit and critiqued the adequacy of the content in preparing students for practice. This study demonstrated that didactic classroom approaches need to be supported with clinical practice and cultural immersion for a meaningful preparation of nursing and midwifery students to care for culturally diverse populations.

Keywords: cultural competence, nursing students, preparation, undergraduate

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Authors: Jacinta Musyoka, Wesley Too

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Cervical cancer is the second leading cause of cancer-related deaths in Kenya and the second most common cancer among women, yet preventable following prevention strategies put in place, which includes vaccination with Human Papilloma Virus Vaccine (HPPV) among the young adolescent girls. Kenya has the highest burden of cervical cancer and the leading cause of death among women of reproductive age and is a known frequent type of cancer amongst women. This is expected to double by 2025 if the necessary steps are not taken, which include vaccinating girls between the ages of 9 and 14 and screening women. Parental decision is critical in ensuring that their daughters receive this vaccine. Hence this study sought to establish parental willingness and factors associate with the acceptability to vaccine adolescent daughters against the human papilloma virus for cervical cancer prevention in Machakos County, Eastern Region of Kenya. Method: Cross-sectional study design utilizing a mixed methods approach was used to collect data from Nguluni Health Centre in Machakos County; Matungulu sub-county, Kenya. This study targeted all parents of adolescent girls seeking health care services in the Matungulu sub-county area who were aged 18 years and above. A total of 220 parents with adolescent girls aged 10-14 years were enrolled into the study after informed consent were sought. All ethical considerations were observed. Quantitative data were analyzed using Multivariate regression analysis, and thematic analysis was used for qualitative data related to perceptions of parents on HPVV. Results, conclusions, and recommendations- ongoing. We expect to report findings and articulate contributions based on the study findings in due course before October 2022

Keywords: adolescents, human papilloma virus, kenya, parents

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Authors: Joseph Omeiza Alao

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The wobbly state of waste management and the high level of environmental irresponsibility is a threat to environmental security, which invariably endangered public health, regional groundwater systems and atmospheric condition. The dumping of waste materials in water bodies and gutters and the frequent burning of waste materials heaped at dumpsites as well depict the highest level of environmental indiscipline. These unruly human factors have compelled this study to apply four different techniques for environmental impact assessment and the possible public health risks of poor waste management in Nigeria. The techniques include a geophysical survey (resistivity data acquisition), dispatched questionnaire surveys, physiochemical water analysis and a physical survey of several dumpsites. While the resistivity data indicates high-level dumpsite leachate invading the ground soil down to the water table, the physiochemical water analysis depicts high content of BOD (401 – 711) mg/l, COD (731 – 1312) mg/l, TDS (419 – 1871) mg/l and heavy metals (0.014 – 1.971) mg/l present in the regional groundwater systems, which have altered the chemistry of the regional groundwater. The resistivity data shows that the overburdened soil layer overlaying the regional groundwater systems was very low (4.5 Ωm – 151 Ωm) as against the existing data (180 Ωm – 3500 Ωm). However, the physical surveys and the dispatched questionnaire surveys explore the depth of environmental irresponsibility among the citizen. While the imprints of gross environmental indiscipline may be absolutely irreversible, adequate knowledge of the environmental implications of careless waste disposal. After a critical examination of the current waste management strategies in Nigeria, the study suggests a future direction for environmental security and sustainability. Several influential regional factors, such as geology, climatic conditions, and hydrology, were also discussed.

Keywords: groundwater, environmental indiscipline, waste management, water analysis, leachate plumes, public health

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Authors: Wenru Wang

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Over the past decades, Asia has emerged as the ‘diabetes epicentre’ in the world due to rapid economic development, urbanization and nutrition transition. There is an urgent need to develop more effective and cost-effective care management strategies in response to this rising diabetes epidemic. This study aims to develop and compare a nurse-led smartphone-based self-management programme with an existing nurse-led diabetes service on health-related outcomes among type 2 diabetes patients with poor glycemic control in Singapore. We proposed a randomized controlled trial with pre- and repeated post-tests control group design. A total of 128 type 2 diabetes patients with poor glycemic control will be recruited from the diabetes clinic of an acute public hospital in Singapore through convenience sampling. Study participants will be either randomly allocated to the experimental group or control group. Outcome measures used will include the 10-item General Self-Efficacy Scale, 11-item Revised Summary of Diabetes Self-care Activities, and 19-item Diabetes-Dependent Quality of Life. Data will be collected at 3-time points: baseline, three months and six months from the baseline, respectively. It is expected that this programme will be an alternative offered to diabetes patients to master their self-care management skills, in addition to the existing diabetes service provided in diabetes clinics in Singapore hospitals. Also, the self-supporting and less resource-intensive nature of this programme, through the use of smartphone app as a mode of intervention delivery, will greatly reduce nurses’ direct contact time with patients and allow more time to be allocated to those who require more attention. The study has been registered with clinicaltrials.gov. The trial registration number is NCT03088475.

Keywords: type 2 diabetes, poor glycaemic control, nurse-led, smartphone-based, self-management, health-relevant outcomes

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Authors: Amer Obaid Saud

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Water quality index (WQI) is considered as an effective tool in categorization of water resources for its quality and suitability for different uses. The Canadian version of water quality index (CCME WQI) which based on the comparison of the water quality parameters to regulatory standards and give a single value to the water quality of a source was applied in this study to assess the water quality of Euphrates river in Iraq at Babylon Governorate north of Baghdad and determine its suitability for aquatic environment (GWQI), drinking water (PWSI) and irrigation(IWQI). Five stations were selected on the river in Babylon (Euphrates River/AL-Musiab, Hindia barrage, two stations at Hilla city and the fifth station at Al-Hshmeya north of Hilla. Fifteen water samples were collected every month during August 2013 to July 2014 at the study sites and analyzed for the physico-chemical parameters like (Temperature, pH, Electrical Conductivity, Total Dissolved Solids(TDS), Total Suspended Solids(TSS), Total Alkalinity, Total Hardness, Calcium and Magnesium Concentration, some of nutrient like Nitrite, Nitrate, Phosphate also the study of concentration of some heavy metals (Fe, Pb, Zn, Cu, Mn, and Cd) in water and comparison of measures to benchmarks such as guidelines and objectives to assess change in water quality. The result of Canadian version of(CCME .WQI) to assess the irrigation water quality (IWQI) of Euphrates river was (83-good) at site one during second seasonal period while the lowest was (66-Fair) in the second station during the fourth seasonal period, the values of potable water supply index (PWSI)that the highest value was (68-Fair) in the fifth site during the second period while the lowest value (42 -Poor) in the second site during the first seasonal period,the highest value for general water quality (GWQI) was (74-Fair) in site five during the second seasonal period, the lowest value (48-Marginal) in the second site during the first seasonal period. It was observed that the main cause of deterioration in water quality was due to the lack of, unprotected river sites ,high anthropogenic activities and direct discharge of industrial effluent.

Keywords: Babylon governorate, Canadian version, water quality, Euphrates river

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Authors: Ashenafi Ayele, Shewit Haftu, Tesfalem Araya

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Background: “Post-psychotic depression”, “post schizophrenic depression”, and “secondary depression” have been used to describe the occurrence of depressive symptoms during the chronic phase of schizophrenia. Post-psychotic depression is the most common cause of death due to suicide in schizophrenia patients. Overall lifetime risk for patients with schizophrenia is 50% for suicide attempts and 9-13% lifetime risk for completed suicide and also it is associated with poor prognosis and poor quality of life. Objective: To assess determinant of post psychotic depression in schizophrenia patients ACSH and Mekelle General Hospital, Tigray Ethiopia 2019. Methods: An institutional based unmatched case control study was conducted among 69 cases and 138 controls with the ratio of case to control 1 ratio 2. The sample is calculated using epi-info 3.1 to assess the determinant factors of post-psychotic depression in schizophrenia patients. The cases were schizophrenia patients who have been diagnosed at least for more than one-year stable for two months, and the controls are any patients who are diagnosed as schizophrenia patients. Study subjects were selected using a consecutive sampling technique. The Calgary depression scale for schizophrenia self-administered questionnaire was used. Before the interview, it was assessed the client’s capacity to give intended information using a scale called the University of California, San Diego Brief Assessment of Capacity to Consent (UBACC). Bivariant and multiple Logistic regression analysis was performed to determine between the independent and dependent variables. The significant independent predictor was declared at 95% confidence interval and P-value of less than 0.05. Result: Females were affected by post psychotic depression with the (AOR=2.01, 95%CI: 1.003- 4.012, P= 0.49).Patients who have mild form of positive symptom of schizophrenia affected by post psychotic depression with (AOR =4.05, 95%CI: 1.888- 8.7.8, P=0001).Patients who have minimal form of negative symptom of schizophrenia are affected by post psychotic depression with (AOR =4.23, 95%CI: 1.081-17.092, P=.038). Conclusion: In this study, sex (female) and presence of positive and negative symptoms of schizophrenia were significantly associated. It is recommended that the post psychotic depression should be assessed in every schizophrenia patient to decrease the severity of illness, and to improve patient’s quality of life.

Keywords: determinants, post-psychotic depression, Mekelle city

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Authors: Alfredo Fortunato, Carmelofrancesco Origlia, Sara Laurita, Rossella Nicoletti

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In the post-pandemic recovery phase of tourism, the role of a Destination Management Organization (DMO) as a coordinated management system of all the elements that make up a destination (attractions, access, marketing, human resources, brand, pricing, etc.) is also becoming relevant for local territories. The objective of a DMO is to maximize the visitor's perception of value and quality while ensuring the competitiveness and sustainability of the destination, as well as the long-term preservation of its natural and cultural assets, and to catalyze benefits for the local economy and residents. In carrying out the multiple functions to which it is called, the DMO can leverage a collective intelligence that comes from the ability to pool information, explicit and tacit knowledge, and relationships of the various stakeholders: policymakers, public managers and officials, entrepreneurs in the tourism supply chain, researchers, data journalists, schools, associations and committees, citizens, etc. The DMO potentially has at its disposal large volumes of data and many of them at low cost, that need to be properly processed to produce value. Based on these assumptions, the paper presents a conceptual framework for building an information system to support the DMO in the intelligent management of a tourist destination tested in an area of southern Italy. The approach adopted is data-informed and consists of four phases: (1) formulation of the knowledge problem (analysis of policy documents and industry reports; focus groups and co-design with stakeholders; definition of information needs and key questions); (2) research and metadatation of relevant sources (reconnaissance of official sources, administrative archives and internal DMO sources); (3) gap analysis and identification of unconventional information sources (evaluation of traditional sources with respect to the level of consistency with information needs, the freshness of information and granularity of data; enrichment of the information base by identifying and studying web sources such as Wikipedia, Google Trends, Booking.com, Tripadvisor, websites of accommodation facilities and online newspapers); (4) definition of the set of indicators and construction of the information base (specific definition of indicators and procedures for data acquisition, transformation, and analysis). The framework derived consists of 6 thematic areas (accommodation supply, cultural heritage, flows, value, sustainability, and enabling factors), each of which is divided into three domains that gather a specific information need to be represented by a scheme of questions to be answered through the analysis of available indicators. The framework is characterized by a high degree of flexibility in the European context, given that it can be customized for each destination by adapting the part related to internal sources. Application to the case study led to the creation of a decision support system that allows: •integration of data from heterogeneous sources, including through the execution of automated web crawling procedures for data ingestion of social and web information; •reading and interpretation of data and metadata through guided navigation paths in the key of digital story-telling; •implementation of complex analysis capabilities through the use of data mining algorithms such as for the prediction of tourist flows.

Keywords: collective intelligence, data framework, destination management, smart tourism

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Authors: Sevelina Ndlovu

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Financial Technology (fintech) advancement is recognised as one of the most transformational innovations in the financial industry. Fintech has given rise to internet-only digital banking, a novel financial technology advancement, and innovation that allows banking services through internet applications with no need for physical branches. This technology is becoming a new banking normal among consumers for its ubiquitous and real-time access advantages. There is evident switching and migration from traditional banking towards these fintech facilities, which could possibly pose a systemic risk if not properly understood and monitored. Fintech advancement has also brought about the emergence and escalation of financial technology consumption themes such as trust, security, perceived risk, and sustainability within the banking industry, themes scarcely covered in existing theoretic literature. To that end, the objective of this research is to investigate factors that determine fintech adoption and propose an integrated adoption model. This study aims to establish what the significant drivers of adoption are and develop a conceptual model that integrates technological, behavioral, and environmental constructs by extending the Unified Theory of Acceptance and Use of Technology 2 (UTAUT2). It proposes integrating constructs that influence financial consumption themes such as trust, perceived risk, security, financial incentives, micro-investing opportunities, and environmental consciousness to determine the impact of these factors on the adoption and intention to use digital banking apps. The main advantage of this conceptual model is the consolidation of a greater number of predictor variables that can provide a fuller explanation of the consumer's adoption of digital banking Apps. Moderating variables of age, gender, and income are incorporated. To the best of author’s knowledge, this study is the first that extends the UTAUT2 model with this combination of constructs to investigate user’s intention to adopt internet-only digital banking apps in the UK context. By investigating factors that are not included in the existing theories but are highly pertinent to the adoption of internet-only banking services, this research adds to existing knowledge and extends the generalisability of the UTAUT2 in a financial services adoption context. This is something that fills a gap in knowledge, as highlighted to needing further research on UTAUT2 after reviewing the theory in 2016 from its original version of 2003. To achieve the objectives of this study, this research assumes a quantitative research approach to empirically test the hypotheses derived from existing literature and pilot studies to give statistical support to generalise the research findings for further possible applications in theory and practice. This research is explanatory or casual in nature and uses cross-section primary data collected through a survey method. Convenient and purposive sampling using structured self-administered online questionnaires is used for data collection. The proposed model is tested using Structural Equation Modelling (SEM), and the analysis of primary data collected through an online survey is processed using Smart PLS software with a sample size of 386 digital bank users. The results are expected to establish if there are significant relationships between the dependent and independent variables and establish what the most influencing factors are.

Keywords: banking applications, digital banking, financial technology, technology adoption, UTAUT2

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Authors: Yi Shan Cheng, Ya Hui Yeh, Hsiao Wen Hsu

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Delirium is an acute state of confusion, which is mainly the result of the interaction of many factors, including: age>65 years, comorbidity, cognitive function and visual/auditory impairment, dehydration, pain, sleep disorder, pipeline retention, general anesthesia and major surgery… etc. Researches show the prevalence of delirium in hospitalized elderly patients over 50%. If it doesn't improve in time, may cause cognitive decline or impairment, not only prolong the length of hospital stay but also increase mortality. Some studies have shown that multiple nonpharmacological interventions are the most effective and common strategies, which are reorientation, early mobility, promoting sleep and nutritional support (including water intake), could improve or prevent delirium in the hospitalized elderly. In Taiwan, only one research to compare the delirium incidence of the older patients who have received orthopedic surgery between multi-nonpharmacological interventions and general routine care. Therefore, the purpose of this study is to address the prevention or improvement of delirium incidence density in medical hospitalized elderly, provide clinical nurses as a reference for clinical implementation, and develop follow-up related research. This study is a quasi-experimental design using purposive sampling. Samples are from two wards: the geriatric ward and the general medicine ward at a medical center in central Taiwan. The sample size estimated at least 100, and then the data will be collected through a self-administered structured questionnaire, including: demographic and professional evaluation items. Case recruiting from 5/13/2023. The research results will be analyzed by SPSS for Windows 22.0 software, including descriptive statistics and inferential statistics: logistic regression、Generalized Estimating Equation(GEE)、multivariate analysis of variance(MANOVA).

Keywords: multiple nonpharmacological interventions, hospitalized elderly, delirium incidence, delirium

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Authors: Adam J. Carinci

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Background: The opioid epidemic is the most pressing healthcare crisis of our time. There is increasing recognition that opioids have limited long-term efficacy and are associated with hyperalgesia, addiction, and increased morbidity and mortality. Therefore, alternative strategies to combat chronic pain are paramount. We initiated a multicenter retrospective case series to review the efficacy of DRG stimulation in facilitating opioid tapering, opioid discontinuation and as a viable alternative to chronic opioid therapy. Purpose: The dorsal root ganglion (DRG) plays a key role in the development and maintenance of pain. Recent innovations in neuromodulation, specifically, dorsal root ganglion stimulation, offers an effective alternative to opioids in the treatment of chronic pain. This retrospective case series demonstrates preliminary evidence that DRG stimulation facilitates opioid tapering, opioid discontinuation and presents a viable alternative to chronic opioid therapy. Procedure: This small multicenter retrospective case series provides preliminary evidence that DRG stimulation facilitates opioid weaning, opioid tapering and is a viable option to opioid therapy in the treatment of chronic pain. A retrospective analysis was completed. Visual analog scale pain scores and pain medication usage were collected at the baseline visit and after four weeks, 3 months and 6 months of treatment. Ten consecutive patients across two study centers were included. The pain was rated 7.38 at baseline and decreased to 1.50 at the 4-week follow-up, a reduction of 79.5%. All patients significantly decreased their opioid pain medication use with an average > 30% reduction in morphine equivalents and four were able to discontinue their medications entirely. Conclusion: This Retrospective case series demonstrates preliminary evidence that DRG stimulation facilitates opioid tapering, opioid discontinuation and presents a viable alternative to chronic opioid therapy.

Keywords: dorsal root ganglion, neuromodulation, opioid sparing, stimulation

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Authors: Pankaj Dhiman, Simranjeet Kaur

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This research paper presents a comprehensive sentiment analysis of social media responses to videos on Facebook, YouTube, Twitter, and Instagram during the 2024 Indian general elections. The study focuses on the sentiment patterns of voters towards the National Democratic Alliance (NDA) and The Indian National Developmental Inclusive Alliance (INDIA) on these platforms. The analysis aims to understand the impact of social media on voter sentiment and its correlation with the election outcome. The study employed a mixed-methods approach, combining both quantitative and qualitative methods. With a total of 200 posts analysed during general election-2024 final phase, the sentiment analysis was conducted using natural language processing (NLP) techniques, including sentiment dictionaries and machine learning algorithms. The results show that NDA received significantly more positive sentiment responses across all platforms, with a positive sentiment score of 47% compared to INDIA's score of 38.98 %. The analysis also revealed that Twitter and YouTube were the most influential platforms in shaping voter sentiment, with 60% of the total sentiment score coming from these two platforms. The study's findings suggest that social media sentiment analysis can be a valuable tool for understanding voter sentiment and predicting election outcomes. The results also highlight the importance of social media in shaping public opinion and the need for political parties to engage effectively with voters on these platforms. The study's implications are significant, as they indicate that social media can be a key factor in determining the outcome of elections. The findings also underscore the need for political parties to develop effective social media strategies to engage with voters and shape public opinion.

Keywords: Indian Elections-2024, NDA, INDIA, sentiment analysis, social media, democracy

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Authors: N. R. Prasannakumar, M. N. Maruthi

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The whitefly, Bemisia tabaci (Gennadius) (Hemiptera; Aleyrodidae) is a highly polyphagous pest reported to infest over 600 plant hosts globally. About 42 genetic groups/cryptic species of B. tabaci exist in the world on different hosts. The species have variable behaviour with respect to feeding, development and transmission of viral diseases. Feeding on diverse host plants affect both whitefly development and the population of the endosymbionts harboured by the insects. Due to changes in the level of endosymbionts, the virus transmission efficiency by the vector also gets affected. We investigated these interactions on five host plants – egg plant, tomato, beans, okra and cotton - using a single whitefly species Asia 1 infected with three different bacteria Portiera, Wolbachia and Arsenophonus. The Asia 1 transmits the Tomato leaf curl Bangalore virus (ToLCBV) effectively and thus was used in the interaction studies. We found a significant impact of hosts on whitefly growth and development; eggplant was most favourable host, while okra and tomato were least favourable. Among the endosymbiotic bacteria, the titre of Wolbachia was significantly affected by feeding of B. tabaci on different host plants whereas Arsenophonus and Portiera were unaffected. When whitefly fed on ToLCBV-infected tomato plants, the Arsenophonus population was significantly increased, indicating its previously confirmed role in ToLCBV transmission. Further, screening of total proteins of B. tabaci Asia 1 genetic group interacting with ToLCBV coat protein was carried out using Y2H system. Some of the proteins found to be interacting with ToLCBV CP were HSPs 70kDa, GroEL, nucleoproteins, vitellogenins, apolipophorins, lachesins, enolase. The reported protein thus would be the potential targets for novel whitefly control strategies such as RNAi or novel insecticide target sites for sustainable whitefly management after confirmation of genuine proteins.

Keywords: cDNA, whitefly, ToLCBV, endosymbionts, Y2H

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Authors: Omuvwie R. Ewien

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Palm oil production in Delta State, Nigeria, is a significant economic activity. However, ensuring its sustainability is crucial to mitigate environmental impacts, promote social equity, and maintain long-term economic viability. This abstract provides an overview of palm oil production sustainability in Delta State, focusing on environmental, social, and economic aspects. In terms of environmental sustainability, the impact of palm oil plantations on deforestation and biodiversity loss is explored. The adoption of sustainable land use practices and measures to reduce greenhouse gas emissions, such as conserving high conservation value areas and utilizing methane capture systems, are highlighted. Social sustainability considerations encompass the inclusion and empowerment of smallholders, ensuring fair labor practices and community engagement. Supporting small-scale farmers, promoting fair working conditions, and investing in local infrastructure and services are identified as key strategies. Economic sustainability is emphasized through yield improvement, efficiency, and value addition. Enhancing productivity and profitability for farmers, promoting downstream processing and market diversification, and building economic resilience is crucial for long-term sustainability. Government policies, including regulatory frameworks and public-private collaborations, play a pivotal role in promoting sustainable palm oil production. Enabling policies and partnerships with industry stakeholders and NGOs facilitates the adoption of sustainable practices. Challenges such as illegal activities, the need to balance economic development with environmental conservation, and leveraging technology for sustainability are discussed. The abstract concludes by emphasizing the importance of stakeholders' commitment to prioritize sustainable palm oil production in Delta State, Nigeria, for a sustainable future.

Keywords: palm oil production, environmental sustainability, community development, yield improvement, future outlook

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Authors: Jessica Federman

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The current research offers a longitudinal and qualitative study design to examine how reciprocity improves relations between the homeless and various stakeholders within a community. The study examines a homeless shelter that sought to establish a facility within a community of Los Angeles, that was initially met with strong resistance and opposition from a variety of organizations due to deeply entrenched views about the negative impact of having homeless individuals within the community. The project tested an intervention model that targets the reduction of stigmatization of homeless individuals and promotes synergistic exchanges between conflicted organizational entities in communities. Years later, the data show that there has been a remarkable reversal in the perception of the agency by the very forces that initially prevented it from being established. This reversal was achieved by a few key strategic decisions. Community engagement was the first step toward changing people’s minds and demonstrating how the homeless shelter was helping to alleviate the problem of homelessness instead of contributing to it. Central to the non-profit’s success was the agency’s pioneering formulation of a treatment model known as, Reciprocal Community Engagement Model (RCEM). The model works by reintegrating the homeless back into society through relationship building within a network of programs that foster positive human connections. This approach aims to draw the homeless out of the debilitating isolation of their situation, reintegrate them through purposeful roles in the community while simultaneously providing a reciprocal benefit to the community at large. Through multilevel, simultaneous social interaction, RCEM has a direct impact not only on the homeless shelter’s clients but also for the community as well. The agency’s approach of RCEM led to their homeless clients getting out of the shelter and getting to work in the community directly alongside other community volunteers and for the benefit of other city and community organizations. This led to several opportunities for community members and residents to interact in meaningful ways. Through each successive exposure, the resident and community members’ distrust in one another was gradually eased and a mutually supportive relationship restored. In this process, the community member becomes the locus of change as much as the residents of the shelter. Measurements of community trust and resilience increased while negative perceptions of homeless people decreased.

Keywords: stigma, homelessness, reciprocity, identity

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Authors: Saad Bin Ismail, Muhammad Ateeq Qureshi, Rao Muhammad Zahid Khalil

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In the last few decades, urbanization worldwide has been sprawled manifold, which is denunciated in the growth of urban infrastructure and transportation. Urban Heat Island (UHI) can induce deterioration of the living environment, disabilities, and rises in energy usages. In this study, the prevalence/presence of Surface Urban Heat Island (SUHI) effect in major cities of Pakistan, including Islamabad, Rawalpindi, Lahore, Karachi, Quetta, and Peshawar has been investigated. Landsat and SPOT satellite images were acquired for the assessment of urban sprawl. MODIS Land Surface Temperature product MOD11A2 was acquired between 1000-1200 hours (local time) for assessment of urban heat island. The results of urban sprawl informed that the extent of Islamabad and Rawalpindi urban area increased from 240 km2 to 624 km2 between 2000 and 2016, accounted 24 km2 per year, Lahore 29 km2, accounted 1.6 km2 per year, Karachi 261 km2, accounted for 16 km2/ per year, Peshawar 63 km2, accounted 4 km2/per year, and Quetta 76 km2/per year, accounted 5 km2/per year approximately. The average Surface Urban Heat Island (SUHI) magnitude is observed at a scale of 0.63 ᵒC for Islamabad and Rawalpindi, 1.25 ᵒC for Lahore, and 1.16 ᵒC for Karachi, which is 0.89 ᵒC for Quetta, and 1.08 ᵒC for Peshawar from 2000 to 2016. The pixel-based maximum SUHI intensity reaches up to about 11.40 ᵒC for Islamabad and Rawalpindi, 15.66 ᵒC for Lahore, 11.20 ᵒC for Karachi, 14.61 ᵒC for Quetta, and 15.22 ᵒC for Peshawar from the baseline of zero degrees Centigrade (ᵒC). The overall trend of SUHI in planned cities (e.g., Islamabad) is not found to increase significantly. Spatial and temporal patterns of SUHI for selected cities reveal heterogeneity and a unique pattern for each city. It is well recognized that SUHI intensity is modulated by land use/land cover patterns (due to their different surface properties and cooling rates), meteorological conditions, and anthropogenic activities. The study concluded that the selected cities (Islamabad, Rawalpindi, Lahore, Karachi, Quetta, and Peshawar) are examples where dense urban pockets observed about 15 ᵒC warmer than a nearby rural area.

Keywords: urban heat island , surface urban heat island , urbanization, anthropogenic source

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Authors: Komal Rathore, Aydin Sunol, Gita Iranipour, Luke Mulford

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Advanced wastewater treatment plants have complex biological kinetics, time variant influent flow rates and long processing times. Due to these factors, the modeling and operational control of advanced wastewater treatment plants become complicated. However, development of a robust model for advanced wastewater treatment plants has become necessary in order to increase the efficiency of the plants, reduce energy costs and meet the discharge limits set by the government. A dynamic model was designed using the Envirosim (Canada) platform software called BioWin for several wastewater treatment plants in Hillsborough County, Florida. Proper control strategies for various parameters such as mixed liquor suspended solids, recycle activated sludge and waste activated sludge were developed for models to match the plant performance. The models were tuned using both the influent and effluent data from the plant and their laboratories. The plant SCADA was used to predict the influent wastewater rates and concentration profiles as a function of time. The kinetic parameters were tuned based on sensitivity analysis and trial and error methods. The dynamic models were validated by using experimental data for influent and effluent parameters. The dissolved oxygen measurements were taken to validate the model by coupling them with Computational Fluid Dynamics (CFD) models. The Biowin models were able to exactly mimic the plant performance and predict effluent behavior for extended periods. The models are useful for plant engineers and operators as they can take decisions beforehand by predicting the plant performance with the use of BioWin models. One of the important findings from the model was the effects of recycle and wastage ratios on the mixed liquor suspended solids. The model was also useful in determining the significant kinetic parameters for biological wastewater treatment systems.

Keywords: BioWin, kinetic modeling, flowsheet simulation, dynamic modeling

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Authors: Dib Imane, Chettah Wahid, Khedidja Abdelhamid

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The plain of Gadaïne - Ain Yaghout, located in the wilaya of Batna (Eastern Algeria), experiences intensive human activities, particularly in agricultural practices which are accompanied by an increasing use of chemical fertilizers and manure. These activities lead to a degradation of the quality of water resources. In order to protect the quality of groundwater in this plain and formulate effective strategies to mitigate or avoid any contamination of groundwater, a risk assessment using the European method known as “COSTE Action 620” was applied to the mio-. plio-quaternary aquifer of this plain. Risk assessment requires the identification of existing dangers and their potential impact on groundwater by using a system of evaluation and weighting. In addition, it also requires the integration of the hydrogeological factors that influence the movement of contaminants by means of the intrinsic vulnerability maps of groundwater, which were produced according to the modified DRASTIC method. The overall danger on the plain ranges from very low to high. Farms containing stables, houses detached from the public sewer system, and sometimes manure piles were assigned a weighting factor expressing the highest degree of harmfulness; this created a medium to high danger index. Large areas for agricultural practice and grazing are characterized, successively, by low to very low danger. Therefore, the risks present at the study site are classified according to a range from medium to very high-risk intensity. These classes successively represent 3%, 49%, and 0.2% of the surface of the plain. Cultivated land and farms present a high to very high level of risk successively. In addition, with the exception of the salt mine, which presents a very high level of risk, the gas stations and cemeteries, as well as the railway line, represent a high level of risk.

Keywords: semi-arid, quality of water resources, risk assessment, vulnerability, contaminants

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Authors: Hanwei Cheng, Chengbei Xu, Yijie Wang

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More and more college students are accustomed to surfing the Internet everyday. As community members, college students have ability to express opinions and participate in social affairs, they not only accept information passively, but also voice their concerns on the Internet. We interpret the online discourses featured with anonymization, so it helps us more effectively and conveniently understand the behaviors and thoughts of college students, and educators can thus grasp the scales and directions in guiding online language. We analyzed online comments in both content and form aspects in one student forum (named Dandan, the BNU’s campus forum), and through methods of literature review and interview, we found that in term of content, college students pay attention to practical information online, emphasize on personal development and pursue hot issues; in term of form, college students' online language displays cross-border quality sometimes under the general feature of normative, and they often explore a certain topic in the form of question or discussion, and they like to show feelings in ironic and stream-of-consciousness ways. It is argued that college students intend to establish a community to facilitate personal development and meet emotional needs through the student forum, and by making comments at the forum they are also able to get involved in public affairs. We should pay attention to problems of college students' online discourse, such as boundary issues (like informal advertisement and information authenticity), emotional issues and the spread of gossip. Some possible solutions to solving online discourse problems can be applied, like we can improve access systems of student forum, clarify principles of Internet langue use, change oversimplified management approaches and use some other tactics, in order to form a mechanism of student self-regulation, also deepen the trust and cooperation between school administrators and students.

Keywords: online language, youth discourse, content and form, implication and strategy

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Authors: Marybec Griffin

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Purpose: The purpose of this cross-sectional study was to get a better understanding of healthcare usage and satisfaction among young adult gay men (YAGM), including the facility used as the usual source of healthcare, preference for coordinated healthcare, and if their primary care provider (PCP) adequately addressed the health needs of gay men. Methods: Interviews were conducted among n=800 YAGM in New York City (NYC). Participants were surveyed about their sociodemographic characteristics and healthcare usage and satisfaction access using multivariable logistic regression models. The surveys were conducted between November 2015 and June 2016. Results: The mean age of the sample was 24.22 years old (SD=4.26). The racial and ethnic background of the participants is as follows: 35.8% (n=286) Black Non-Hispanic, 31.9% (n=225) Hispanic/Latino, 20.5% (n=164) White Non-Hispanic, 4.4% (n=35) Asian/Pacific Islander, and 6.9% (n=55) reporting some other racial or ethnic background. 31.1% (n=249) of the sample had an income below $14,999. 86.7% (n=694) report having either public or private health insurance. For usual source of healthcare, 44.6% (n=357) of the sample reported a private doctor’s office, 16.3% (n=130) reported a community health center, and 7.4% (n=59) reported an urgent care facility, and 7.6% (n=61) reported not having a usual source of healthcare. 56.4% (n=451) of the sample indicated a preference for coordinated healthcare. 54% (n=334) of the sample were very satisfied with their healthcare. Findings from multivariable logistical regression models indicate that participants with higher incomes (AOR=0.54, 95% CI 0.36-0.81, p < 0.01) and participants with a PCP (AOR=0.12, 95% CI 0.07-0.20, p < 0.001) were less likely to use a walk-in facility as their usual source of healthcare. Results from the second multivariable logistic regression model indicated that participants who experienced discrimination in a healthcare setting were less likely to prefer coordinated healthcare (AOR=0.63, 95% CI 0.42-0.96, p < 0.05). In the final multivariable logistic model, results indicated that participants who had disclosed their sexual orientation to their PCP (AOR=2.57, 95% CI 1.25-5.21, p < 0.01) and were comfortable discussing their sexual activity with their PCP (AOR=8.04, 95% CI 4.76-13.58, p < 0.001) were more likely to agree that their PCP adequately addressed the healthcare needs of gay men. Conclusion: Understanding healthcare usage and satisfaction among YAGM is necessary as the healthcare landscape changes, especially given the relatively recent addition of urgent care facilities. The type of healthcare facility used as a usual source of care influences the ability to seek comprehensive and coordinated healthcare services. While coordinated primary and sexual healthcare may be ideal, individual preference for this coordination among YAGM is desired but may be limited due to experiences of discrimination in primary care settings.

Keywords: healthcare policy, gay men, healthcare access, Affordable Care Act

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Authors: Naomi Huang Wenya, Xin Xiaohui, Vijaya Rao, Wong Ting Hway, Chow Kah Hoe Pierce, Tan Hiang Khoon

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Background: The majority of the cancelled elective surgeries caused by the COVID-19 pandemic globally were estimated to occur in low- and middle-income countries (LMICs), where surgical services had long been in short supply even before the pandemic. Therefore, minimising disruption to existing surgical care in LMICs is of crucial importance during a pandemic. This study aimed to explore contributory factors to the continuity of surgical care in LMICs, in the face of a pandemic. Methods: Semi-structured interviews were conducted over zoom, with surgical leaders of 25 tertiary hospitals from 11 LMICs in South and Southeast Asia, from September to October 2020. Key themes were subsequently identified from the interview transcripts, using Braun and Clarke's method of thematic analysis. Results: The COVID-19 pandemic affected all surgical services of participating institutions but to varying degrees. Overall, elective surgeries suffered the gravest disruption, followed by outpatient surgical care, and finally, emergency surgeries. Keeping healthcare workers safe and striving for continuity of essential surgical care emerged as notable response strategies observed across all participating institutions. Conclusion: This study suggested that four factors are important for the resilience of surgical care against COVID-19: adequate COVID-19 testing capacity and effective institutional infection control measures, designated COVID-19 treatment facilities, a whole-system approach to balancing pandemic response and meeting essential surgical needs, and active community engagement. These findings can inform healthcare institutions in other countries, especially LMICs, in their effort to tread a fine line between preserving healthcare capacity for pandemic response and protecting surgical services against pandemic disruption.

Keywords: COVID-19, pandemic, LMICs, continuity of surgical service

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