Search results for: National Educational Policy

Authors: Tebikew Yeneabat, Tefera Belachew, Muluneh Haile

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

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

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Authors: James Barmby

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Canada’s westernmost provinces of British Columbia and Alberta are similar in many respects as they are both reliant on volatile natural resources for major portions of their economies. The two provinces have banded together to develop mutually beneficial trade, investment and labour market mobility rules, but in terms of developing systems of higher education, the two provinces are attempting to align higher education programs to economic development objectives by means that are quite different. In British Columbia, the recently announced initiative, B.C’s Skills for Jobs Blueprint will “make sure education and training programs are aligned with the demands of the labor market.” Meanwhile in Alberta, the province’s institutions of higher education are enjoying the tenth year of their membership in the Campus Alberta Quality Council, which makes recommendations to government on issues related to post-secondary education, including the approval of new programs. In B.C., public institutions of higher education are encouraged to comply with government objectives, and are rewarded with targeted funds for their efforts. In Alberta, the institutions as a system tell the government what programs they want to offer and government can agree or not agree to fund these programs through a ministerial approval process. In comparing the two higher education systems, the question emerges as to which one is more beneficial to the province: the one where change is directed primarily by financial incentives to achieve economic objectives or the one that makes recommendations to the government for changes in programs to achieve institutional objectives? How is institutional autonomy affected in each strategy? Does institutional autonomy matter anymore? In recent years, much has been written in regard to academic freedom, but less about institutional autonomy, which is seen by many as essential to protecting academic freedom. However, while institutional autonomy means freedom from government control, it does not necessarily mean self-government. In this study, a comparison of the two higher education systems is made using recent government policy initiatives in both provinces, and responses to those actions by the higher education institutions. The findings indicate that the economic needs in both provinces take precedence over issues of institutional autonomy.

Keywords: alberta, British Columbia, institutional autonomy, funding

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Authors: Neeley Current, Fatih Demir, Kenneth Haggerty, Blake Naughton, Isa Jahnke

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Educational systems seek reform using data-intensive continuous improvement processes known as strategic improvement plans (SIPs). Schools turn to digital systems to monitor, analyze and report SIPs. One technical challenge of these digital systems focuses on integrating a highly diverse set of data sources. Another challenge is to create a learnable sociotechnical system to help administrators, principals and teachers add, manipulate and interpret data. This study explores to what extent one particular system is usable and useful for strategic planning activities and whether intended users see the benefit of the system achieve the goal of improving workflow related to strategic planning in schools. In a three-phase study, researchers used sociotechnical design methods to understand the current workflow, technology use, and processes of teachers and principals surrounding their strategic improvement planning. Additionally, design review and task analysis usability methods were used to evaluate task completion, usability, and user satisfaction of the system. The resulting socio-technical models illustrate the existing work processes and indicate how and at which places in the workflow the newly developed system could have an impact. The results point to the potential of the system but also indicate that it was initially too complicated for use. However, the diverse users see the potential benefits, especially to overcome the diverse set of data sources, and that the system could fill a gap for schools in planning and conducting strategic improvement plans.

Keywords: continuous improvement process, education reform, strategic improvement planning, sociotechnical design, software development, usability

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Authors: Olufunmilayo Folaranmi

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This research was carried out to examine the impact of socio-cultural factors on the management and utilization of solid waste in Ibadan Metropolis. A descriptive survey research design was adopted for the study while a systematic and stratified random sampling technique was used to select 300 respondents which were categorized into high, middle and low-density areas. Four hypothesis were tested using chi-square test on variables of unavailability of waste disposal facilities and waste management, negligence of contractors to liaise with community members, lack of adequate environmental education and waste management and utilization, low level of motivation of sanitation workers with solid wastes management, lack of community full participation with solid waste management and utilization. Results showed that significant effect of waste disposal facilities on solid waste management and utilization (X2 +16.6, P < .05). Also, there is a significant relationship between negligence of the contractors to liaise with community elites with improper disposal (X2 = 87.5, P < .05). The motivation of sanitation workers is significantly related to solid waste management (X2 = 70.4, P < .05). Adequate environmental education and awareness influenced solid waste management. There was also a significant relationship between lack of community participation with waste management disposal and improper waste disposal. Based on the findings from the study it was recommended that the quality of life in urban centers should be improved, social welfare of the populace enhanced and environment should be adequately attended to. Poverty alleviation programmes should be intensified and made to live beyond the life of a particular administration, micro-credit facilities should be available to community members to promote their welfare. Lastly, sustained environmental education programmes for citizens at all levels of education, formal and informal through the use of agencies like Ethical and Attitudinal Reorientation Commission (EARCOM) and the National Orientation Agency (NOA).

Keywords: management, social welfare, socio-cultural factors, solid waste

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Authors: Yu Chen, Xiaoguang Yang, Lin Lin

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Traffic engineering construction is an important infrastructure for economic and social development. In the process of construction and operation, the ability to make a correct evaluation of the project's environmental impact appears to be crucial to the rational operation of existing transportation projects, the correct development of transportation engineering construction and the adoption of corresponding measures to scientifically carry out environmental protection work. Most of the existing research work on ecological and environmental impact assessment is limited to individual aspects of the environment and less to the overall evaluation of the environmental system; in terms of research conclusions, there are more qualitative analyses from the technical and policy levels, and there is a lack of quantitative research results and quantitative and operable evaluation models. In this paper, a comprehensive analysis of the ecological and environmental impacts of transportation construction projects is conducted, and factors such as the accessibility of data and the reliability of calculation results are comprehensively considered to extract indicators that can reflect the essence and characteristics. The qualitative evaluation indicators were screened using the expert review method, the qualitative indicators were measured using the fuzzy statistics method, the quantitative indicators were screened using the principal component analysis method, and the quantitative indicators were measured by both literature search and calculation. An environmental impact evaluation index system with the general objective layer, sub-objective layer and indicator layer was established, dividing the environmental impact of the transportation construction project into two periods: the construction period and the operation period. On the basis of the evaluation index system, the index weights are determined using the hierarchical analysis method, and the individual indicators to be evaluated are dimensionless, eliminating the influence of the original background and meaning of the indicators. Finally, the thesis uses the above research results, combined with the actual engineering practice, to verify the correctness and operability of the evaluation method.

Keywords: transportation construction projects, ecological and environmental impact, analysis and evaluation, indicator evaluation system

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Authors: F. A. Adesoji, A. A. Ayandele

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There has been a concern over non-responsiveness of educational programme in Nigeria’s higher institutions to adequately meet social needs. The study, therefore, investigated the effectiveness of basic elements of the Social Studies Curriculum, the contributions of the Teacher–Related Variables (TRV) such as qualification, area of specialization, teaching experience, teaching methods, gender and teaching facilities to the implementation of the curriculum (IOC) in the Colleges of Education (COEs). The study adopted the descriptive survey design. Four COEs in Oyo, Osun, Ondo and Lagos States were purposively selected. Stratified sampling technique was used to select 455 Social Studies students and 47 Social Studies lecturers. Stakeholders’ Perception of Social Studies Curriculum (r = 0.86), Social Studies Curriculum Resources scale (r = 0.78) and Social Studies Basic Concepts Test (r = 0.78) were used for data collection. Data were analysed using descriptive statistics, multiple regression, and t-test at 0.05 level of significance. COEs teachers and students rated the elements of the curriculum to be effective with mean scores x̄ =3.02 and x̄ =2.80 respectively; x̄ =5.00 and x̄ = 2.50 being the maximum and minimum mean scores. The finding showed average level of availability (x̄ =1.60), adequacy (x̄ =1.55) and utilization (x̄ =1.64) of teaching materials, x̄ =3.00 and x̄ =1.50 being maximum and minimum mean scores respectively. Academic performance of the students is on average with the mean score of x̄ =51.4775 out of maximum mean score of x̄ =100. The TRV and teaching facilities had significant composite contribution to IOC (F (6,45) = 3.92:R² = 0.26) with 39% contributions to the variance of IOC. Area of specialization (β= 29, t = 2.05) and teaching facilities (β = -25, t = 1.181) contributed significantly. The implementation of bachelor degree in Social Studies curriculum was effective in the colleges of education. There is the need to beef-up the provision of facilities to improve the implementation of the curriculum.

Keywords: bachelor degree in social studies, colleges of education in southwestern Nigeria, curriculum implementation, social studies curriculum

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Authors: Md Rabiul Islam, Ben Wadham

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This paper describes how indigenous students face challenges with various school activities due to inadequate equity and diversity principles in mainstream primary schools in Bangladesh. This study focuses on indigenous students’ interactions with mainstream class teachers and students through teaching-learning activities at public primary schools. Ethnographic research methods guided data collection under a case study methodology in Chittagong Hill Tracts (CHTs) region where maximum indigenous peoples’ inhabitants. The participants (class teachers) shared information through in-depth interviews about their experiences in the four selecting schools. The authors also observed the effects of school activities by use of equity and diversity lens for indigenous students’ situations in those schools. The authors argue that the socio-economic situations of indigenous families are not supportive of the educational development of their children. Similarly, the Bangladesh government does not have enough initiative programs based on equity and diversity principles for fundamental education of indigenous children at rural schools level. Besides this, the conventional teaching system cannot improve the diversification among the students in classrooms. The principles of equity and diversity are not well embedded in professional development of teachers, and using teaching materials in classrooms. The findings suggest that implementing equitable education; there are needed to arrange teachers’ education with equitable knowledge and introducing diversified teaching materials, and implementing teaching through students centered activities that promote the diversification among the multicultural students.

Keywords: case study research, chittagong hill tracts, equity and diversity, Indigenous children

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Authors: Miroslava Markovic, Snezana Rajkovic, Ljubinko Rakonjac, Aleksandar Lucic

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Oak powdery mildew is a serious problem on seedlings in nurseries as well as on naturally and artificially introduced progeny. The experiments were set on oak seedlings in two nurseries located in Central Serbia, where control of oak powdery mildew Microsphaera alphitoides Griff. et Maubl. had been conducted through alternative protection measures by means of various dosages of AQ-10 biofungicide, with and without added polymer (which has so far never been used in this country for control of oak powdery mildew). Simultaneous testing was conducted on the efficiency of a chemical sulphur-based preparation (used in this area for many years as a measure of suppression of powdery mildews, without the possibility of developing resistance of the pathogen to the active matter). To date, the Republic of Serbia has registered no fungicides for suppression of pathogens in the forest ecosystems. In order to introduce proper use of new disease-fighting agents into a country, certain relevant principles, requirements and criteria prescribed by the Forest Stewardship Council (FSC) must be observed, primarily with respect to measures of assessment and mitigation of risks, the list of dangerous and highly dangerous pesticides with the possibility of alternative protection. One of the main goals of the research was adjustment of the protective measures to the FSC policy through selection of eco-toxicologically favourable fungicides, given the fact that only preparations named on the list of permitted active matters are approved for use in certified forests. The results of the research have demonstrated that AQ-10 biofungicide can be used as a part of integrated disease management programmes as an alternative, through application of several treatments during vegetation and combination with other active matters registered for these purposes, so as to curtail the use of standard fungicides for control of powdery mildews on oak seedlings in nurseries. The best results in suppression of oak powdery mildew were attained through use of AQ-10 biofungicide (dose 50 or 70g/ha) with added polymer Nu Film-17 (dose 1.0 or 1.5 l/ha). If the treatment is applied at the appropriate time, even fewer number of treatments and smaller doses will be just as efficient.

Keywords: oak powdery mildew, biofungicides, polymers, Microsphaera alphitoides

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Authors: D. A. S. Gamage, B. F. A. Basnayake, W. A. J. M. De Costa

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Agriculture plays an important and strategic role in the performance of Sri Lankan national economy. Rice is the staple food of Sri Lankans thus; rice cultivation is the major agricultural activity of the country. In Sri Lanka, out of the total rice production, a considerable amount of rice straw and rice husk goes wasted. Hence, there is a great potential of production of quality compost and rice husk charcoal. The concept of making rice straw compost and rice husk charcoal is practicable in Sri Lanka, where more than 40% of the farmers are engaged in rice cultivation. The application of inorganic nitrogen fertilizer has become a burden to the country. Rice husk charcoal as a coating material to retain N fertilizer is a suitable solution to gradually release nitrogenous compounds. Objective of this study was to produce rice husk charcoal coated urea as a slow releasing fertilizer with rice straw compost and to compare the leaching losses of nitrogen, phosphorus and potassium using leaching columns. Leaching column studies were prepared using 1.2 m tall PVC pipes with a diameter of 15 cm and a sampling port was attached to the bottom end of the column-cap. Leachates (100 ml/leaching column) were obtained from two sets of (each set has four leaching columns) leaching columns. The sampling was done once a week for 3 month period. Rice husk charcoal coated urea can potentially be used as a slow releasing nitrogen fertilizer which reduces leaching losses of urea. It also helps reduce the phosphate and potassium leaching. The cyclic effect of phosphate release is an important finding which could be the central issue in defining microbial behavior in soils. The fluctuations of phosphate may have cyclic effects of 28 days. In addition, rice straw compost and rice husk charcoal coating is less costly and contribute to mitigate pollution of water bodies by inorganic fertilizers.

Keywords: leaching, mitigate, rice husk charcoal, slow releasing fertilizer

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Authors: Ruiyi Zhang, Wanglin Yan

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Strict land-use plan is issued based on city planning act for controlling urbanization and conserving semi-natural landscape. And the agrarian land resource in the suburbs has indispensable socio-economic value and contributes to the sustainability of the regional environment. However, the agrarian hinterland of metropolitan is witnessing severe farmland conversion and abandonment, while the contribution of land-use planning to farmland conservation remains unclear in those areas. Hypothetically, current land-use plan contributes to farmland loss. So, this research investigated the relationship between farmland loss and land-use planning at municipality level to provide base data for zoning in the metropolitan suburbs, and help to develop a sustainable land-use plan that will conserve the agrarian hinterland. As data and methods, 1) Farmland data of Census of Agriculture and Forestry for 2005 to 2015 and population data of 2015 and 2018 were used to investigate spatial distribution feathers of farmland loss in Tokyo Metropolitan District (TMD) for two periods: 2005-2010;2010-2015. 2) And the samples were divided by four urbanization facts. 3) DID data and zoning data for 2006 to 2018 were used to specify urbanization level of zones for describing land-use plan. 4) Then we conducted multiple regression between farmland loss, both abandonment and conversion amounts, and the described land-use plan in each of the urbanization scenario and in each period. As the results, the study reveals land-use plan has unignorable relation with farmland loss in the metropolitan suburbs at ward-city-town-village level. 1) The urban promotion areas planned larger than necessity and unregulated urbanization promote both farmland conversion and abandonment, and the effect weakens from inner suburbs to outer suburbs. 2) And the effect of land-use plan on farmland abandonment is more obvious than that on farmland conversion. The study advocates that, optimizing land-use plan will hopefully help the farmland conservation in metropolitan suburbs, which contributes to sustainable regional policy making.

Keywords: Agrarian land resource, land-use planning, urbanization level, multiple regression

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Authors: Seyyed Payman Ziapour, Ahmadali Enayati, Sadegh Kheiri, Farzaneh Sahraei-Rostami, Reza Ali Mohammadpour, Mahmoud Fazeli-Dinan, Mohsen Aarabi, Fatemeh Asgarian, Seyed Hassan Nikookar, Mohammad Sarafrazi

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Rhipicephalus bursa (R. bursa) is a two-host ixodid tick with wide distribution in north of Iran especially in domestic animals of Mazandaran Province. The prolonged or incorrect use of chemical insecticides has led to build up of resistance in hard ticks in many areas of the world. Lack of basic information on resistance status of R. bursa was the reason behind this study to determine the susceptibility status of the species to lambda-cyhalothrin insecticide in Mazandaran Province. From May 2013 to March 2014, R. bursa ticks were collected on sheep, goat and cattle in different districts of Mazandaran Province. The engorged female ticks were reared in a controlled insectary for producing 12-18 days old larvae for larval packet test (LPT) bioassay against discriminant doses of lambda-cyhalothrin 5% EC (MAC SILAT®). 80% of ten pooled tick populations were susceptible to lambda-cyhalothrin as resistance ratios (RR50s) varied from 1 to 2.94 when compared with the most susceptible population NH-16. Only GK-12 and BF-6 populations (from plain areas of Galugah and Fereydunkenar Counties, respectively) were classified as resistant level I at LC50 level. Population NK-2 (from woodland areas of Kojour district in Nowshahr County) showed the highest resistance ratio of RR99 = 4.32 and 30% of tick populations were resistant at LC99 level. Our research showed initiation of lambda-cyhalothrin resistance in Rhipicephalus bursa populations in Mazandaran Province, Northern Iran. This is considered a warning to policy makers for disease control in the study area. This research is a part of the PhD thesis of SP. Ziapour by grant No. 92-89 in Student Research Committee, Mazandaran University of Medical Sciences, Iran.

Keywords: Rhipicephalus bursa, hard tick, lambda-cyhalothrin resistance, Iran

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Authors: Gayani K. Nandasiri, Tilak Dias, William Hurley

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Venous disease of human lower limb could range from minor asymptomatic incompetence of venous valves to chronic venous ulceration. The sheer prevalence of varicose veins and its associated significant costs of treating late complications such as chronic ulcers contribute to a higher burden on health care resources. In most of western countries with developed health care systems, treatment costs associated with Venous disease accounts for a considerable portion of their total health care budget, and it has become a high-cost burden to National Health Service (NHS), UK. The established gold standard of treatment for the venous disease is the graduated compression, where the pressure at the ankle being highest and decreasing towards the knee and thigh. Currently, medical practitioners use two main methods to treat venous disease; i.e. compression bandaging and compression stockings. Both these systems have their own disadvantages which lead to the current programme of research. The aim of the present study is to revolutionize the compression therapy by using a novel active compression system to deliver a controllable and more accurate pressure profiles using a series of inflatable mini bladders. Two types of commercially available silicones were tested for the application. The mini bladders were designed with a special fabrication procedure to provide required pressure profiles, and a series of experiments were conducted to characterise the mini bladders. The inflation/deflation heights of these mini bladders were investigated experimentally and using a finite element model (FEM), and the experimental data were compared to the results obtained from FEM simulations, which showed 70-80% agreement. Finally, the mini bladders were tested for its pressure transmittance characteristics, and the results showed a 70-80% of inlet air pressure transmitted onto the treated surface.

Keywords: finite element analysis, graduated compression, inflatable bladders, venous disease

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Authors: Natalia Uribe Corrales, Carolina Cano Arroyave, Santiago Henao Villegas

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Introduction: Stunning is an important stage in the meat industry due to the repercussions on the characteristics of the carcass. It has been demonstrated that inadequate stun can lead to hematomas, fractures and promote the appearance of pale, soft and exudative meat due to the stress caused in animals. In Colombia, gas narcosis and electrical stunning are the two authorized methods in pigs. Objective: To describe the practices of stunning in the Valle de Aburrá and its relation with animal welfare. Methods: A descriptive cross - sectional study was carried out in Valle de Aburrá slaughterhouses, which were authorized by National Institute for Food and Medicine Surveillance (INVIMA). Variables such as stunning method, presence of vocalization, falls, slips, rhythmic breathing, corneal reflex and attempts to incorporate after stunning, stun time and time between stun and bleeding were analyzed. Results: 225 pigs were analyzed, finding that 50.2% had electrical stun, whose amperage and voltage were 1.23 (A) and 120 (V) respectively; 49.8% of the animals were stunned with CO2 chamber whose concentration was always above 95%, the mean desensitization time was 16.8 seconds (d.e.5.37); the mean time of stunning - bleeding was 47.9 seconds (d.e.13.9); similarly, it was found that 27.1% had vocalizations after stunning; 12% had falls; 10.7% showed rhythmic breathing; 33.3% exhibited corneal reflex; and 10.7% had reincorporation attempts. Conclusions: The methods of stunning used in the Valle de Aburrá, although performed with those permitted by law, are shortcomings in relation to the amperage and voltage used for each type of pig, as well, it is found that welfare animal is being violated to find signology of an inadequate desensitization. It is necessary to promote compliance with the principles of stunning according to Animal Welfare, and keep in mind that in electrical desensitization, the calibration of the equipment must be guaranteed (pressure according to the type of animal or current applied and the position where the electrodes are) and in the narcosis the equipment should be calibrated to ensure proper gas concentration and exposure time.

Keywords: animal welfare, pigs, quality of meat, stun methods

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Authors: N. Nalini, Bhanu Prakash Gopularam

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The term data security refers to the degree of resistance or protection given to information from unintended or unauthorized access. The core principles of information security are the confidentiality, integrity and availability, also referred as CIA triad. Cloud computing services are classified as SaaS, IaaS and PaaS services. With cloud adoption the confidential enterprise data are moved from organization premises to untrusted public network and due to this the attack surface has increased manifold. Several cloud computing platforms like OpenStack, Eucalyptus, Amazon EC2 offer users to build and configure public, hybrid and private clouds. While the traditional encryption based on PKI infrastructure still works in cloud scenario, the management of public-private keys and trust certificates is difficult. The Identity based Public Key Cryptography (also referred as ID-PKC) overcomes this problem by using publicly identifiable information for generating the keys and works well with decentralized systems. The users can exchange information securely without having to manage any trust information. Another advantage is that access control (role based access control policy) information can be embedded into data unlike in PKI where it is handled by separate component or system. In OpenStack cloud platform the keystone service acts as identity service for authentication and authorization and has support for public key infrastructure for auto services. In this paper, we explain OpenStack security architecture and evaluate the PKI infrastructure piece for data confidentiality. We provide method to integrate ID-PKC schemes for securing data while in transit and stored and explain the key measures for safe guarding data against security attacks. The proposed approach uses JPBC crypto library for key-pair generation based on IEEE P1636.3 standard and secure communication to other cloud services.

Keywords: data confidentiality, identity based cryptography, secure communication, open stack key stone, token scoping

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Authors: B. O. Diyaolu

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The web created by sport in academics has made it difficult for it to be separated from adolescent educational development. The enthusiasm expressed towards sport by students in higher institutions is quite enormous. Primarily, academic performance should be the pride of all students but whether sports affect the academic performance of student-athletes remain an unknown fact. This study investigated the influence of sports participation on academic performance among Afe Babalola University student-athletes. Ex post facto research design was used. Two groups of students were used for the study; Student-athlete (SA) and Regular Students (RS). Purposive sampling technique was used to select 224 student-athletes, only those that are regular in the university sports team training were considered and their records (i.e. name, department, level, matriculation number, and phone number) were collected through the assistance of their coaches. For the regular students, purposive sampling technique was used to select 224 participants, only those that have no interest in sports were considered and their records were retrieved from the college registration officer. The first and second semester examination results of the two groups were compared in 10 general study courses without their knowledge, using descriptive statistics of frequency counts, mean, and standard deviation. Out of the 10 compared courses, 7 courses result showed no significant difference between students-athlete and regular students while student-athletes perform better in 3 practically oriented courses. Sports role in academics is quite significant. Exposure to sports can help build the confidence that athletes need especially when it comes to practical courses. Student-athletes can perform better in academics if the environment is friendly and not intimidating. Lecturers and coaches need to work together in order to build a well cultured and intelligent graduate.

Keywords: academic performance, regular students, sports participation, student-athlete, university sports team

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Authors: Sisay Tiroro Salato

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Background: Ethiopia has been implementing the maternal death surveillance and response system to provide real-time actionable information, including causes of death and contributing factors. Analysis of maternal mortality surveillance data was conducted to identify the causes and underlying factors in Addis Ababa, Ethiopia. Methods: We carried out a retrospective surveillance data analysis of 324 maternal deaths reported in Addis Ababa, Ethiopia, from 2017 to 2021. The data were extracted from the national maternal death surveillance and response database, including information from case investigation, verbal autopsy, and facility extraction forms. The data were analyzed by computing frequency and presented in numbers, proportions, and ratios. Results: Of 324 maternal deaths, 92% died in the health facilities, 6.2% in transit, and 1.5% at home. The mean age at death was 28 years, ranging from 17 to 45. The maternal mortality ratio per 100,000 live births was 77for the five years, ranging from 126 in 2017 to 21 in 2021. The direct and indirect causes of death were responsible for 87% and 13%, respectively. The direct causes included obstetric haemorrhage, hypertensive disorders in pregnancy, puerperal sepsis, embolism, obstructed labour, and abortion. The third delay (delay in receiving care after reaching health facilities) accounted for 57% of deaths, while the first delay (delay in deciding to seek health care) and the second delay (delay in reaching health facilities) and accounted for 34% and 24%, respectively. Late arrival to the referral facility, delayed management after admission, andnon-recognition of danger signs were underlying factors. Conclusion: Over 86% of maternal deaths were attributed by avoidable direct causes. The majority of women do try to reach health services when an emergency occurs, but the third delays present a major problem. Improving the quality of care at the healthcare facility level will help to reduce maternal death.

Keywords: maternal death, surveillance, delays, factors

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Authors: Patricia Kopetz

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Too often our youngest children with disabilities receive diagnostic labels and accompanying treatment plans based upon perceptions that the children are of limited aptitude and/or ambition. However, children of varied-ability levels who are diagnosed with ‘multiple disabilities,’ can participate and excel in school-based instruction that aligns with their desires, interests, and fortitude – criteria components not foretold by scores on standardized assessments. The paper represents theoretical work in Special Education Innovative Instruction, and includes presenting research materials, some developed by the author herself. The majority of students with disabilities are now served in general education settings in the United States, embracing inclusive practices in our schools. ‘There is now a stronger call for special education to step up and improve efficiency, implement evidence-based practices, and provide greater accountability on key performance indicators that support successful academic and post-school outcomes for students with disabilities.’ For example, in the United States, the Office of Special Education Programs (OSEP) is focusing on results-driven indicators to improve outcomes for students with disabilities. School personnel are appreciating the implications of research-driven approaches for students diagnosed with multiple disabilities, and aim to align their practices toward such focus. The paper presented will provide updates on current theoretical principles and perspectives, and explore advancements in latest, evidence-based and results-driven instructional practices that can motivate children with multiple disabilities to advance their skills and engage in learning activities that as nonconventional, innovative, and proven successful.

Keywords: childhood special education, educational technology , innovative instruction, multiple disabilities

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Authors: Pedro Ferreira, Alexandre Frugoli, Pedro Frugoli, Lucio Leonardo, Thais Cavalheri

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The teaching of fluid mechanics in engineering courses is, in general, a source of great difficulties for learning. The possibility of the use of experiments with didactic wind tunnels can facilitate the education of future professionals. The objective of this proposal is the development of a low-cost aerodynamic balance to be used in a didactic wind tunnel. The set is comprised of an Arduino microcontroller, programmed by an open source software, linked to load cells built by students from another project. The didactic wind tunnel is 5,0m long and the test area is 90,0 cm x 90,0 cm x 150,0 cm. The Weq® electric motor, model W-22 of 9,2 HP, moves a fan with nine blades, each blade 32,0 cm long. The Weq® frequency inverter, model WEGCFW 08 (Vector Inverter) is responsible for wind speed control and also for the motor inversion of the rotational direction. A flat-convex profile prototype of airfoil was tested by measuring the drag and lift forces for certain attack angles; the air flux conditions remained constant, monitored by a Pitot tube connected to a EXTECH® Instruments digital pressure differential manometer Model HD755. The results indicate a good agreement with the theory. The choice of all of the components of this proposal resulted in a low-cost product providing a high level of specific knowledge of mechanics of fluids, which may be a good alternative to teaching in countries with scarce educational resources. The system also allows the expansion to measure other parameters like fluid velocity, temperature, pressure as well as the possibility of automation of other functions.

Keywords: aerodynamic balance, wind tunnel, strain gauge, load cell, Arduino, low-cost education

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Authors: Floyd Misheck Mwanza, Paul Boniface Majura

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The paper looked at highways/ roadside waste generation, disposal and the consequent environmental impacts. The dramatic increase in vehicular and paved roads in the recent past in Zambia, has given rise to the indiscriminate disposal of litter that now poses a threat to health and the environment. Primary data was generated by carrying out oral interviews and field observations for holistic and in–depth assessment of the environment and the secondary data was obtained from desk review method, information on effects of roadside wastes on environment were obtained from relevant literatures. The interviews were semi structured and a purposive sampling method was adopted and analyzed descriptively. The results of the findings showed that population growth and unplanned road expansion has exceeded the expected limit in recent time with resultant poor system of roadside wastes disposal. Roadside wastes which contain both biodegradable and non-biodegradable roadside wastes are disposed at the shoulders of major highways in temporary dumpsites and are never collected by a road development agency (RDA). There is no organized highway to highway or street to street collection of the wastes in Zambia by the key organization the RDA. The study revealed that roadside disposal of roadside wastes has serious impacts on the environment. Some of these impacts include physical nuisance of the wastes to the environment, the waste dumps also serve as hideouts for rodents and snakes which are dangerous. Waste are blown around by wind making the environment filthy, most of the wastes are also been washed by overland flow during heavy downpour to block drainage channels and subsequently lead to flooding of the environment. Most of the non- biodegradable wastes contain toxic chemicals which have serious implications on the environmental sustainability and human health. The paper therefore recommends that Government/ RDA should come up with proper orientation and environmental laws should be put in place for the general public and also to provide necessary facilities and arrange for better methods of collection of wastes.

Keywords: biodegradable, disposal, environment, impacts

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Authors: Georgios Pardalis, Krushna Mahapatra, Brijesh Mainali

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Compared to other sectors, the residential and service sector in Sweden is responsible for almost 40% of the national final energy use and faces great challenges towards achieving reduction of energy intensity. The one- and two-family (henceforth 'detached') houses, constituting 60% of the residential floor area and using 32 TWh for space heating and hot water purposes, offers significant opportunities for improved energy efficiency. More than 80% of those houses are more than 35 years of old and a large share of them need major renovations. However, the rate of energy renovations for such houses is significantly low. The renovation market is dominated by small and medium-sized local companies (SMEs), who mostly offer individual solutions. A one-stop-shop business framework, where a single actor collaborates with other actors and coordinates them to offer a full package for holistic renovations, may speed up the rate of renovation. Such models are emerging in some European countries. This paper aims to understand the willingness of the SMEs to adopt a one-stop-shop business framework. Interviews were conducted with 13 SMEs in Kronoberg county in Sweden, a geographic region known for its initiatives towards sustainability and energy efficiency. The examined firms seem reluctant to adopt one-stop-shop for nonce due to the perceived risks they see in such a business move and due to their characteristics, although they agree that such a move will advance their position in the market and their business volume. By using threat-rigidity and prospect theory, we illustrate how this type of companies can move from being reluctant to adopt one-stop-shop framework to its adoption. Additionally, with the use of behavioral theory, we gain deeper knowledge on those exact reasons preventing those firms from adopting the one-stop-shop framework.

Keywords: construction SMEs, innovation adoption, one-stop-shop, perceived risks

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Authors: Budhvin T. Withana, Sulochana Rupasinghe

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The problem of Dyslexia and Dysgraphia, two learning disabilities that affect reading and writing abilities, respectively, is a major concern for the educational system. Due to the complexity and uniqueness of the Sinhala language, these conditions are especially difficult for children who speak it. The traditional risk detection methods for Dyslexia and Dysgraphia frequently rely on subjective assessments, making it difficult to cover a wide range of risk detection and time-consuming. As a result, diagnoses may be delayed and opportunities for early intervention may be lost. The project was approached by developing a hybrid model that utilized various deep learning techniques for detecting risk of Dyslexia and Dysgraphia. Specifically, Resnet50, VGG16 and YOLOv8 were integrated to detect the handwriting issues, and their outputs were fed into an MLP model along with several other input data. The hyperparameters of the MLP model were fine-tuned using Grid Search CV, which allowed for the optimal values to be identified for the model. This approach proved to be effective in accurately predicting the risk of Dyslexia and Dysgraphia, providing a valuable tool for early detection and intervention of these conditions. The Resnet50 model achieved an accuracy of 0.9804 on the training data and 0.9653 on the validation data. The VGG16 model achieved an accuracy of 0.9991 on the training data and 0.9891 on the validation data. The MLP model achieved an impressive training accuracy of 0.99918 and a testing accuracy of 0.99223, with a loss of 0.01371. These results demonstrate that the proposed hybrid model achieved a high level of accuracy in predicting the risk of Dyslexia and Dysgraphia.

Keywords: neural networks, risk detection system, Dyslexia, Dysgraphia, deep learning, learning disabilities, data science

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Authors: M. Kuzhko, M. Gumeniuk, D. Butov, T. Tlustova, O. Denysov, T. Sprynsian

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Abstract: The objective of this work was to study the efficacy and safety of inhaled nebulized chemotherapy in the treatment of patients with newly diagnosed pulmonary tuberculosis in comparison with standard antimycobacterial therapy. Materials and methods: The study involved 68 patients aged between 20 and 70 years with newly diagnosed pulmonary tuberculosis. Patients were allocated to two groups. The first (main, n=21) group of patients received standard chemotherapy and further 0.15 g of isoniazid and rifampicin 0.15 g inhaled through a nebulizer, also they received salmeterol 50 mcg + fluticasone propionate 250 mcg at 2 breaths twice a day for 2 months. The second (control, n=47) group of patients received standard chemotherapy, consisting of orally administered isoniazid (0.3 g), rifampicin (0.6 g), pyrazinamide (2 g), ethambutol (1.2 g) with a dose reduction after the intensive phase of the therapy. The anti-TB drugs were procured through the Ukraine’s centralized national supply system. Results: Intoxication symptoms in the first group reduced following 1.39±0.18 months, whereas in the second group, intoxication symptoms reduced following 2.7±0.1 months, p<.001. Moreover, respiratory symptoms regression in the first group was observed following 1.6±0.2 months, whereas in the second group – following 2.5±0.2 months, p<0.05. Bacillary excretion period evaluated within 1 month was reduced, as it was shown by 66.6±10.5% in the main group compared to 27.6±6.5%, p<0.05, in the control group. In addition, period of cavities healing was reduced to 2.9±0.2 months in the main group compared to 3.7±0.1 months, p<0.05, in the control group. Residual radiological lung damage findings (large residual changes) were observed in 22 (23.8±9.5 %) patients of the main group versus 24 (51.0±7.2 %) patients in the control group, p<0.05. After completion of treatment scar stenosis of the bronchi II-III art. diagnosed in 3 (14.2±7.8%) patients in main group and 17 (68.0±6.8%) - control group, p<0.05. The duration of hospital treatment was 2.4±0.4 months in main group and 4.1±0.4 months in control group, p<0.05. Conclusion: Administration of of inhaled nebulized chemotherapy in patients with newly diagnosed pulmonary tuberculosis resulted in a comparatively quick reduction of disease manifestation.

Keywords: inhaled nebulized chemotherapy, pulmonary tuberculosis, tuberculosis, treatment of tuberculosis

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Authors: Subas Chandra Biswas, Kazi Sameen Naser, Farzana Misha

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Little is known about the sexual behavior of male youth, particularly unmarried young men in Bangladesh as most of the sexual and reproductive health and rights-related research and intervention are mainly focused on females and married couples. To understand the unmarried youth’s sexual behavior, data from a nationwide survey conducted in all 64 districts of Bangladesh were analyzed. Using multistage systematic random sampling, a survey was conducted among 11,113 male youth aged 15-24 years from May-August, 2019. This article analyzed and presented findings of the sexual behavior of unmarried respondents based on the data collected from 10,026 unmarried male youth. Findings showed that 18% had ever experience of sexual relationship, and the reported mean age of first sexual intercourse was 16.5years. For unmarried male youth, those who had a sexual experience, their first sexual partners were female friends/classmate (57%), female neighbors (16%), and female sex workers (12%), relatives (6%) and girlfriends with whom they had love relationship (4%). However, about 36% reported that they had a love relationship with girlfriends, and among them, 23% reported that they had sexual intercourse with their girlfriend. Those who had sexual relations with their girlfriend, 47% reported that they did not use the condom in their last sex with their girlfriend. Furthermore, 29% reported that they had sexual relationships with others besides their girlfriends. Other reported partners were female sex workers (32%), neighbors (29%), female friends (19%), relatives (12%), and cousins (5%). Also, 46% reported that they did not even use the condom during sex with other partners. About 9% used some sort of sexual stimulant to increase their libido. Among the respondents, 376 reported that they bought sex in the last six months, and the mean expenditure of buying sex for the respondent was 1,140 Taka (13.46 US Dollar). Though premarital sexual relations are not socially accepted, findings showed a large portion of male youth are engaged in these relationships and risky sexual behavior. Lack of awareness of sexual and reproductive health, unprotected sexual intercourse, use of the drug during sexual intercourse also increase the threats to health. Thus these findings are important to understand the sexual behavior of male youth in policy and programmatic implications. Therefore, to ensure a healthy sexual life and wellbeing, an immediate and culturally sensitive sexual health promotion intervention is needed for male youth in Bangladesh.

Keywords: Bangladesh, male youth, sexual and reproductive health, sexual behavior

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Authors: Lawong Damian Bernsah

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Neglected Tropical Diseases (NTDs) are most predominant among the poor and rural populations and are endemic in 149 countries. These diseases are the most prevalent and responsible for infecting 1.4 billion people worldwide. There are 17 neglected tropical diseases recognized by WHO that constitute the fourth largest disease health and economic burden of all communicable diseases. Five of these 17 diseases are considered for the cost analysis of this paper: lymphatic filariasis, onchocerciasis, trachoma, schistosomiasis, and soil transmitted helminth infections. WHO has proposed a roadmap for eradication and elimination by 2020 and treatments have been donated through the London Declaration by pharmaceutical manufacturers. The paper estimates the cost of NTD control programme and elimination for each NTD disease and total in Nigeria. This is necessary as it forms the bases upon which programme budget and expenditure could be based. Again, given the opportunity cost the resources for NTD face it is necessary to estimate the cost so as to provide bases for comparison. Cost of NTDs control and elimination programme is estimated using the population at risk for each NTD diseases and for the total. The population at risk is gotten from the national master plan for the 2015 - 2020, while the cost per person was gotten for similar studies conducted in similar settings and ranges from US$0.1 to US$0.5 for Mass Administration of Medicine (MAM) and between US$1 to US$1.5 for each NTD disease. The combined cost for all the NTDs was estimated to be US$634.88 million for the period 2015-2020 and US$1.9 billion for each NTD disease for the same period. For the purpose of sensitivity analysis and for robustness of the analysis the cost per person was varied and all were still high. Given that health expenditure for Nigeria (% of GDP) averages 3.5% for the period 1995-2014, it is very clear that efforts have to be made to improve allocation to the health sector in general which is hoped could trickle to NTDs control and elimination. Thus, the government and the donor partners would need to step-up budgetary allocation and also to be aware of the costs of NTD control and elimination programme since they have alternative uses. Key Words: Neglected Tropical Disease, Cost Analysis, NTD Programme Control and Elimination, Cost per Person

Keywords: Neglected Tropical Disease, Cost Analysis, Neglected Tropical Disease Programme Control and Elimination, Cost per Person

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Authors: Christos Lampropoulos, Maria Konsta, Vicky Dradaki, Irini Dri, Konstantina Panouria, Tamta Sirbilatze, Ifigenia Apostolou, Vaggelis Lambas, Christina Kordali, Georgios Mavras

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Objectives: Malnutrition in hospitalized patients is related to increased morbidity and mortality. The purpose of our study was to compare various nutritional scores in order to detect the most suitable one for assessing the nutritional status of elderly, hospitalized patients and correlate them with mortality and extension of admission duration, due to patients’ critical condition. Methods: Sample population included 150 patients (78 men, 72 women, mean age 80±8.2). Nutritional status was assessed by Mini Nutritional Assessment (MNA full, short-form), Malnutrition Universal Screening Tool (MUST) and short Nutritional Appetite Questionnaire (sNAQ). Sensitivity, specificity, positive and negative predictive values and ROC curves were assessed after adjustment for the cause of current admission, a known prognostic factor according to previously applied multivariate models. Primary endpoints were mortality (from admission until 6 months afterwards) and duration of hospitalization, compared to national guidelines for closed consolidated medical expenses. Results: Concerning mortality, MNA (short-form and full) and SNAQ had similar, low sensitivity (25.8%, 25.8% and 35.5% respectively) while MUST had higher sensitivity (48.4%). In contrast, all the questionnaires had high specificity (94%-97.5%). Short-form MNA and sNAQ had the best positive predictive value (72.7% and 78.6% respectively) whereas all the questionnaires had similar negative predictive value (83.2%-87.5%). MUST had the highest ROC curve (0.83) in contrast to the rest questionnaires (0.73-0.77). With regard to extension of admission duration, all four scores had relatively low sensitivity (48.7%-56.7%), specificity (68.4%-77.6%), positive predictive value (63.1%-69.6%), negative predictive value (61%-63%) and ROC curve (0.67-0.69). Conclusion: MUST questionnaire is more advantageous in predicting mortality due to its higher sensitivity and ROC curve. None of the nutritional scores is suitable for prediction of extended hospitalization.

Keywords: duration of admission, malnutrition, nutritional assessment scores, prognostic factors for mortality

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Authors: Magdalena Bury-Kaminska, Aneta Szudy-Szczyrek, Aleksandra Nowaczynska, Olga Jankowska-Lecka, Marek Hus, Klaudia Kot

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Introduction: The aim of the research was to determine the changes in cognitive functioning in patients with plasma cell myeloma by comparing patients’ state before the treatment and during chemotherapy as well as to determine the biological factors that can be used to predict patients’ cognitive state. Methods: The patients underwent the research procedure twice: before chemotherapy and after 4-6 treatment cycles. A psychological test and measurement of the following biological variables were carried out: TNF-α (tumor necrosis factor), IL-6 (interleukin 6), IL-10 (interleukin 10), BDNF (brain-derived neurotrophic factor). The following research methods were implemented: the Montreal Cognitive Assessment (MoCA), Battery of Tests for Assessing Cognitive Functions PU1, experimental and clinical trials based on the Choynowski’s Memory Scale, Stroop Color-Word Interference Test (SCWT), depression measurement questionnaire. Results: The analysis of the research showed better cognitive functions of patients during chemotherapy in comparison to the phase before it. Moreover, neurotrophin BDNF allows to predict the level of selected cognitive functions (semantic fluency and execution control) already at the diagnosis stage. After 4-6 cycles, it is also possible to draw conclusions concerning the extent of working memory based on the level of BDNF. Cytokine TNF-α allows us to predict the level of letter fluency during anti-cancer treatment. Conclusions: It is possible to presume that BDNF has a protective influence on patients’ cognitive functions and working memory and that cytokine TNF-α co-occurs with a diminished execution control and better material grouping in terms of phonological fluency. Acknowledgment: This work was funded by the National Science Center in Poland [grant no. 2017/27/N/HS6/02057.

Keywords: chemobrain, cognitive impairment, non−central nervous system cancers, hematologic diseases

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Authors: Kaczmarzyk Piotr, Anna Dziechciarz, Wojciech Klapsa

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The purpose of this paper is demonstration the test results of research influence of temperature on the velocity of flame propagation using gas and air mixtures for selected gas mixtures. The research was conducted on the test apparatus in the form of duct 2 m long. The test apparatus was funded from the project: “Development of methods to neutralize threats of explosion for determined tanks contained technical gases, including alternative sources of supply in the fire environment, taking into account needs of rescuers” number: DOB-BIO6/02/50/2014. The Project is funded by The National Centre for Research and Development. This paper presents the results of measurement of rate of pressure rise and rate in flame propagation, using test apparatus for mixtures air and methane or air and propane. This paper presents the results performed using the test apparatus in the form of duct measuring the rate of flame and overpressure wave. Studies were performed using three gas mixtures with different concentrations: Methane (3% to 8% vol), Propane (3% to 6% vol). As regard to the above concentrations, tests were carried out at temperatures 20 and 30 ̊C. The gas mixture was supplied to the inside of the duct by the partial pressure molecules. Data acquisition was made using 5 dynamic pressure transducers and 5 ionization probes, arranged along of the duct. Temperature conditions changes were performed using heater which was mounted on the duct’s bottom. During the tests, following parameters were recorded: maximum explosion pressure, maximum pressure recorded by sensors and voltage recorded by ionization probes. Performed tests, for flammable gas and air mixtures, indicate that temperature changes have an influence on overpressure velocity. It should be noted, that temperature changes do not have a major impact on the flame front velocity. In the case of propane and air mixtures (temperature 30 ̊C) was observed DDT (Deflagration to Detonation) phenomena. The velocity increased from 2 to 20 m/s. This kind of explosion could turn into a detonation, but the duct length is too short (2 m).

Keywords: flame propagation, flame propagation velocity, explosion, propane, methane

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Authors: J. D. Villanueva, N. Peyraube, I. Allan, G. D. Salvosa, M. Reid, C. Harman, K. D. Salvosa, J. M. V. Castro, M. V. O. Espaldon, J. B. Sevilla-Nastor, P. Le Coustumer

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The main objectives of this research are to (1) assess the occurrence of the pharmaceutical compounds and (2) present the environmental challenges posed by the existence of these pharmaceutical compounds in the surface water. These pharmaceuticals were measured in Napindan Lake, Philippines. This lake is not only a major tributary of the Pasig River (an estuary) and Laguna Lake (freshwater). It also joins these two important surface waters of the National Capital Region. Pharmaceutical compounds such as Atenolol, Carbamazepine, and two other over the counter medicines: Cetirizine, and Ibuprofen were measured in Napindan Lake. Atenolol is a beta blocker that helps in lowering hypertensions. Carbamazepine is an anticonvulsant used as treatment for epilepsy and neuropathic pain. Cetirizine is an antihistamine that can relieve allergies. Ibuprofen is a non-steroidal anti-inflammatory drug normally used to relieve pains. Three different climatological conditions with corresponding hydro physico chemical characteristics were considered. First, was during a dry season with a simultaneous dredging. Second was during a transition period from dry to wet season. Finally, the third was during a continuous wet event. Based from the results of the study, most of these pharmaceuticals can be found in Napindan Lake. This is a proof that these pharmaceutical compounds are being released to a natural surface water. Even though climatological conditions were different, concentrations of these pharmaceuticals can still be detected. This implies that there is an incessant supply of these pharmaceutical compounds in Napindan Lake. Chronic exposure to these compounds even at low concentrations can lead to possible environmental and health risks. Given this information and since consistent occurrence of these compounds can be expected, the main challenge, at present, is on how to control the sources of these pharmaceutical compounds. Primarily, there is a need to manage the disposal of the pharmaceutical compounds. Yet, the main question is how to? This study would like to present the challenges and institutional roles in helping manage the pharmaceutical disposals in a developing country like the Philippines.

Keywords: atenolol, carbamazepine, cetirizine, ibuprofen, institutional roles, Napindan lake, pharmaceutical compound disposal management, surface water, urban lake

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Authors: Ayesha Ali, Emilia Lindquist, Arif Jalal, Hannah Yusuf, Kayan Cheung, Rowan Eastabrook

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It is currently estimated that over a third of deaths in children under five in Tanzania are caused by acute respiratory infections (ARIs). However, despite being one of the leading causes of morbidity and mortality across the developing world, its risk factors are poorly understood. Therefore, a systematic review of the literature published between 2015 and 2020 was conducted, focusing on risk factors for ARI in Tanzanian children under the age of five. 2015 Demographic and Health Survey (DHS) for Tanzania was analysed to supplement these findings with national data. 2224 papers were retrieved from two databases and were analysed by three independent reviewers. Thirteen papers were eligible for inclusion, covering a wide range of risk factors among which comorbidities (n=6), malnutrition (n=5), lack of parental education (n=4), poor socio-economic status (n=3), and delay in seeking healthcare (n=3) were the most cited risk factors. The risk factors with the highest reported risk ratios/odds ratios were lack of parental education (RR=11.5-14.5), followed by enrolment in school (RR=4.4), delay in seeking healthcare (RR=3.8) and cooking indoors (aOR =1.8-RR=5.5). The DHS data provided local context to these risk factors. For instance, the number of children experiencing symptoms of ARI in both urban and rural areas ranged between 4.5-5% in the two weeks prior to the survey. However, 79% of symptomatic children in Zanzibar received antibiotics for treatment compared to just 34% of those in the Southern Highlands. As demonstrated by both the systematic review and the DHS analysis, risk factors for ARI are predominantly socially determined, with Tanzania’s poorer rural children possessing the highest risk for ARI and more adverse health outcomes. Therefore, the burden of ARIs in Tanzanian children may be alleviated through the provision of appropriate treatment and parental education in rural areas.

Keywords: acute respiratory infection, child, health education, morbidity, mortality, pneumonia, Tanzania

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Authors: Matthew Scott Lau

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This study addresses the research question: How effective has the Community Health Assist Scheme (CHAS) been in reducing market failure in Singapore’s healthcare sector? The CHAS policy, introduced in 2012 in Singapore, aims to improve accessibility and affordability of healthcare by offering subsidies to low and middle-income groups and elderly individuals for general practice consultations and healthcare. The investigation was undertaken by acquiring and analysing primary and secondary research data from 3 main sources, including handwritten survey responses of 334 individuals who were valid CHAS subsidy recipients (CHAS cardholders) from 5 different locations in Singapore, interview responses from two established general practitioner doctors with working knowledge of the scheme, and information from literature available online. Survey responses were analysed to determine how CHAS has affected the affordability and consumption of healthcare, and other benefits or drawbacks for CHAS users. The interview responses were used to explain the benefits of healthcare consumption and provide different perspectives on the impacts of CHAS on the various parties involved. Online sources provided useful information on changes in healthcare consumerism and Singapore’s government policies. The study revealed that CHAS has been largely effective in reducing market failure as the subsidies granted to consumers have improved the consumption of healthcare. This has allowed for the external benefits of healthcare consumption to be realized, thus reducing market failure. However, the study also revealed that CHAS cannot be fully effective in reducing market failure as the scope of CHAS prevents healthcare consumption from fully reaching the socially optimal level. Hence, the study concluded that CHAS has been effective to a large extent in reducing market failure in Singapore’s healthcare sector, albeit with some benefits to third parties yet to be realised. There are certain elements of the investigation, which may limit the validity of the conclusion, such as the means used to determine the socially optimal level of healthcare consumption, and the survey sample size.

Keywords: healthcare consumption, health economics, market failure, subsidies

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