Search results for: dividend distribution policy

Authors: Neha Pranav Kolhe, Harithapriya Vijaye, Arushi Kamle

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The economic growth engines are urban regions. As the economy expands, so does the need for peace and quiet, and noise pollution is one of the important social and environmental issue. Health and wellbeing are at risk from environmental noise pollution. Because of urbanisation, population growth, and the consequent rise in the usage of increasingly potent, diverse, and highly mobile sources of noise, it is now more severe and pervasive than ever before, and it will only become worse. Additionally, it will expand as long as there is an increase in air, train, and highway traffic, which continue to be the main contributors of noise pollution. The current study will be conducted in two zones of class I city of central India (population range: 1 million–4 million). Total 56 measuring points were chosen to assess noise pollution. The first objective evaluates the noise pollution in various urban habitats determined as formal and informal settlement. It identifies the comparison of noise pollution within the settlements using T- Test analysis. The second objective assess the noise pollution in silent zones (as stated in Central Pollution Control Board) in a hierarchical way. It also assesses the noise pollution in the settlements and compares with prescribed permissible limits using class I sound level equipment. As appropriate indices, equivalent noise level on the (A) frequency weighting network, minimum sound pressure level and maximum sound pressure level were computed. The survey is conducted for a period of 1 week. Arc GIS is used to plot and map the temporal and spatial variability in urban settings. It is discovered that noise levels at most stations, particularly at heavily trafficked crossroads and subway stations, were significantly different and higher than acceptable limits and squares. The study highlights the vulnerable areas that should be considered while city planning. The study demands area level planning while preparing a development plan. It also demands attention to noise pollution from the perspective of residential and silent zones. The city planning in urban areas neglects the noise pollution assessment at city level. This contributes to that, irrespective of noise pollution guidelines, the ground reality is far away from its applicability. The result produces incompatible land use on a neighbourhood scale with respect to noise pollution. The study's final results will be useful to policymakers, architects and administrators in developing countries. This will be useful for noise pollution in urban habitat governance by efficient decision making and policy formulation to increase the profitability of these systems.

Keywords: noise pollution, formal settlements, informal settlements, built environment, silent zone, residential area

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Authors: Igone Guerra, Xabier Barandiaran

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The deep crisis (economic, social and cultural) in which Europe and Gipuzkoa, in the Basque Country (Spain), have been immersed in since 2008 forces governments to face a necessary transformation. These challenges demand different solutions and answers to meet the needs of the citizens. Adapting to continuous and sometimes abrupt changes in the social and political landscape requires an undeniable will to reinvent the way in which governments practice politics. This reinvention of government should help us build different organizations that, first, develop challenging public services, second, respond effectively to the needs of the citizens, and third, manage scarce resources, ultimately offering a contemporary concept of public value. In this context, the Etorkizuna Eraikiz initiative was designed to face the future challenges of the territory in a collaborative way. The aim of the initiative is to promote an alternative form of governance to generate common good and greater public value. In Etorkizuna Eraikiz democratic values, such as collaboration, participation, and accountability are prominent. This government approach is based on several features such as the creation of relational spaces to design and deliberate about the public politics or the promotion of a team-working approach, breaking down the silos between and within organizations, as an exercise in defining a shared vision regarding the Future of the Territory. A future in which the citizens are becoming actors in the problem-solving process and in the construction of a culture of participation and collective learning. In this paper, the Etorkizuna Eraikiz initiative will be presented (vision and methodology) as a model of a local approach to public policy innovation resulting in a way of governance that is more open and collaborative. Based on this case study, this paper explores the way in which collaborative governance leads to better decisions, better leadership, and better citizenry. Finally, the paper also describes some preliminary findings of this local approach, such as the level of knowledge of the citizenry about the projects promoted within Etorkizuna Eraikiz as well as the link between the challenges of the territory, as identified by the citizenry, and the political agenda promoted by the provincial government. Regarding the former, the Survey on the socio-political situation of Gipuzkoa showed that 27.9% of the respondents confirmed that they knew about the projects promoted within the initiative and gave it a mark of 5.71. In connection with the latter, over the last three years, 65 millions of euros have been allocated for a total of 73 projects that have covered socio-economic and political challenges such as aging, climate change, mobility, participation in democratic life, and so on. This governance approach of Etorkizuna Eraikiz has allowed the local government to match the needs of citizens to the political agenda fostering in this way a shared vision about the public value.

Keywords: collaborative governance, citizen participation, public good, social listening, public innovation

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Authors: Eugene Y. J. Aw, J. W. Koh, S. H. Chew, K. E. Chua, Lionel L. J. Ang, Algernon C. S. Hong, Danette S. E. Tan, Grace H. B. Foo, K. Q. Hong, L. M. Cheng, M. L. Leong

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This paper presents a novel rapid soil classification technique that combines computer vision with four-probe soil electrical resistivity method and cone penetration test (CPT), to improve the accuracy and productivity of on-site classification of excavated soil. In Singapore, excavated soils from local construction projects are transported to Staging Grounds (SGs) to be reused as fill material for land reclamation. Excavated soils are mainly categorized into two groups (“Good Earth” and “Soft Clay”) based on particle size distribution (PSD) and water content (w) from soil investigation reports and on-site visual survey, such that proper treatment and usage can be exercised. However, this process is time-consuming and labour-intensive. Thus, a rapid classification method is needed at the SGs. Computer vision, four-probe soil electrical resistivity and CPT were combined into an innovative non-destructive and instantaneous classification method for this purpose. The computer vision technique comprises soil image acquisition using industrial grade camera; image processing and analysis via calculation of Grey Level Co-occurrence Matrix (GLCM) textural parameters; and decision-making using an Artificial Neural Network (ANN). Complementing the computer vision technique, the apparent electrical resistivity of soil (ρ) is measured using a set of four probes arranged in Wenner’s array. It was found from the previous study that the ANN model coupled with ρ can classify soils into “Good Earth” and “Soft Clay” in less than a minute, with an accuracy of 85% based on selected representative soil images. To further improve the technique, the soil strength is measured using a modified mini cone penetrometer, and w is measured using a set of time-domain reflectometry (TDR) probes. Laboratory proof-of-concept was conducted through a series of seven tests with three types of soils – “Good Earth”, “Soft Clay” and an even mix of the two. Validation was performed against the PSD and w of each soil type obtained from conventional laboratory tests. The results show that ρ, w and CPT measurements can be collectively analyzed to classify soils into “Good Earth” or “Soft Clay”. It is also found that these parameters can be integrated with the computer vision technique on-site to complete the rapid soil classification in less than three minutes.

Keywords: Computer vision technique, cone penetration test, electrical resistivity, rapid and non-destructive, soil classification

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Authors: Sumit Kumar

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The present study aims to identify the factors responsible for the internal migration of students other than push & pull factors; associated with the source region and destination region, respectively, as classified in classical geography. But in this classification of factors responsible for the migration of students, an agency of individual and the family he/she belongs to, have not been recognized which has later become the centre of the argument for describing and analyzing migration in New Economic theory of migration and New Economics of labour migration respectively. In this backdrop, the present study aims to understand the agency of an individual and the family members regarding one’s migration for higher education. Therefore, this study draws upon New Economic theory of migration and New Economics of labour migration for identifying the agency of individual or family in the context of migration. Further, migration for higher education consists not only the decision to migrate but also where to migrate (location), which university, which college and which course to pursue, also. In order to understand the role of various individuals at various stage of student migration, present study seeks help from the social networking approach for migration which identifies the individuals who facilitate the process of migration by reducing negative externalities of migration through sharing information and various other sorts of help to the migrant. Furthermore, this study also aims to rank those individuals who have helped migrants at various stages of migration for higher education in taking a decision, along with the factors responsible for their migration on the basis of their perception. In order to fulfill the above mentioned objectives of this study, quantification of qualitative data (perception of respondents) has been done employing through frequency distribution analysis. Qualitative data has been collected at two levels but questionnaire survey was the tool for data collection at both the occasions. Twenty five students who have migrated to other state for the purpose of higher education have been approached for pre-questionnaire survey consisting open-ended questions while one hundred students belonging to the same clientele have been approached for questionnaire survey consisting close-ended questions. This study has identified social pressure, peer group pressure and parental pressure; variables not constituting push & pull factors, very important for students’ migration. They have been even assigned better ranked by the respondents than push factors. Further, self (migrant themselves) have been ranked followed by parents by the respondents when it comes to take various decisions attached with the process of migration. Therefore, it can be said without sounding cynical that there are other factors other than push & pull factors which do facilitate the process of migration for higher education not only at the level to migrate but also at other levels intrinsic to the process of migration for higher education.

Keywords: agency, migration for higher education, perception, push and pull factors

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Authors: Fateme Aysin Anka, Farzad Kiani

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Forced migration is a situation in which people are forced to leave their homes against their will due to political conflicts, wars and conflicts, natural disasters, climate change, economic crises, or other emergencies. This type of migration takes place under conditions where people cannot lead a sustainable life due to reasons such as security, shelter and meeting their basic needs. This type of migration may occur in connection with different factors that affect people's living conditions. In addition to these general and widespread reasons, water security and resources will be one that is starting now and will be encountered more and more in the future. Forced migration may occur due to insufficient or depleted water resources in the areas where people live. In this case, people's living conditions become unsustainable, and they may have to go elsewhere, as they cannot obtain their basic needs, such as drinking water, water used for agriculture and industry. To cope with these situations, it is important to minimize the causes, as international organizations and societies must provide assistance (for example, humanitarian aid, shelter, medical support and education) and protection to address (or mitigate) this problem. From the international perspective, plans such as the Green New Deal (GND) and the European Green Deal (EGD) draw attention to the need for people to live equally in a cleaner and greener world. Especially recently, with the advancement of technology, science and methods have become more efficient. In this regard, in this article, a multidisciplinary case model is presented by reinforcing the water problem with an engineering approach within the framework of the social dimension. It is worth emphasizing that this problem is largely linked to climate change and the lack of a sustainable water management perspective. As a matter of fact, the United Nations Development Agency (UNDA) draws attention to this problem in its universally accepted sustainable development goals. Therefore, an artificial intelligence-based approach has been applied to solve this problem by focusing on the water management problem. The most general but also important aspect in the management of water resources is its correct consumption. In this context, the artificial intelligence-based system undertakes tasks such as water demand forecasting and distribution management, emergency and crisis management, water pollution detection and prevention, and maintenance and repair control and forecasting.

Keywords: water resource management, forced migration, multidisciplinary studies, artificial intelligence

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Authors: Valentina Tereshkova

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The paper shows how the relationship between international law and national sovereignty is viewed through the implementation of European Court of Human Right judgments. Methodology: Сonclusions are based on a survey of representatives of the legislative authorities and judges of the Krasnoyarsk region, the Rostov region, Sverdlovsk region and Tver region. The paper assesses the activities of the Russian Constitutional Court from 1998 to 2015 related to the establishment of the implementation mechanism and the Russian Constitutional Court judgments of 14.07.2015, № 21-P and of 19.04.2016, № 12-P where the Constitutional Court stated the impossibility of executing ECtHR judgments. I. Implementation of ECHR judgments by courts and other authorities. Despite the publication of the report of the RF Ministry of Justice on the implementation, we could not find any formal information on the Russian policy of the ECtHR judgment implementation. Using the results of the survey, the paper shows the effect of ECtHR judgments on law and legal practice in Russia. II. Implementation of ECHR judgments by Russian Constitutional Court. Russian Constitutional Court had implemented the ECtHR judgments. However, the Court determined on July, 14, 2015 its competence to consider the question of implementation of ECHR judgments. Then, it stated that the execution of the judgment [Anchugov and Gladkov case] was impossible because the Russian Constitution has the highest legal force on April, 19, 2016. Recently the CE Committee of Ministers asked Russia to provide ‘without further delay’ a compensation plan for the Yukos case. On November 11, 2016, Constitutional Court accepted a request from the Ministry of Justice to consider the possibility of execution of the ECtHR judgment in the Yukos case. Such a request has been made possible due to a lack of implementation mechanism. Conclusion: ECtHR judgments are as an effective tool to solve the structural problems of a legal system. However, Russian experts consider the ECHR as a tool of protection of individual rights. The paper shows link between the survey results and the absence of the implementation mechanism. New Article 104 par. 2 and Article 106 par. 2 of the Federal Law of the Constitutional Court are in conflict with international obligations of the Convention on the Law on Treaties 1969 and Article 46 ECHR. Nevertheless, a dialogue may be possible between Constitutional Court and the ECtHR. In its judgment [19.04.2016] the Constitutional Court determined that the general measures to ensure fairness, proportionality and differentiation of the restrictions of voting rights were possible in judicial practice. It also stated the federal legislator had the power ‘to optimize the system of Russian criminal penalties’. Despite the fact that the Constitutional Court presented the Görgülü case [Görgülü v Germany] as an example of non-execution of the ECtHR judgment, the paper proposes to draw on the experience of German Constitutional Court, which in the Görgülü case, on the one hand, stressed national sovereignty and, on the other hand, took advantage of this sovereignty, to resolve the issue in accordance with the ECHR.

Keywords: implementation of ECtHR judgments, sovereignty, supranational jurisdictions, principle of subsidiarity

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Authors: Kazuki Kohama, Hiroko Ono

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The rainfall in Japan is gradually increasing every year according to Japan Meteorological Agency and Intergovernmental Panel on Climate Change Fifth Assessment Report. It means that the rainfall difference between rainy season and non-rainfall is increasing. In addition, the increasing trend of strong rain for a short time clearly appears. In recent years, natural disasters have caused enormous human injuries in various parts of Japan. Regarding water disaster, local heavy rain and floods of large rivers occur frequently, and it was decided on a policy to promote hard and soft sides as emergency disaster prevention measures with water disaster prevention awareness social reconstruction vision. Okinawa prefecture in subtropical region has torrential rain and water disaster several times a year such as river flood, in which is caused in specific rivers from all 97 rivers. Also, the shortage of capacity and narrow width are characteristic of river in Okinawa and easily cause river flood in heavy rain. This study focuses on Kohatu River that is one of the specific rivers. In fact, the water level greatly rises over the river levee almost once a year but non-damage of buildings around. On the other hand in some case, the water level reaches to ground floor height of house and has happed nine times until today. The purpose of this research is to figure out relationship between precipitation, surface outflow and total treatment water quantity of Kohatu River. For the purpose, we perform hydrological analysis although is complicated and needs specific details or data so that, the method is mainly using Geographic Information System software and outflow analysis system. At first, we extract watershed and then divided to 23 catchment areas to understand how much surface outflow flows to runoff point in each 10 minutes. On second, we create Unit Hydrograph indicating the area of surface outflow with flow area and time. This index shows the maximum amount of surface outflow at 2400 to 3000 seconds. Lastly, we compare an estimated value from Unit Hydrograph to a measured value. However, we found that measure value is usually lower than measured value because of evaporation and transpiration. In this study, hydrograph analysis was performed using GIS software and outflow analysis system. Based on these, we could clarify the flood time and amount of surface outflow.

Keywords: disaster prevention, water disaster, river flood, GIS software

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Authors: Nelson Ponce Jr., Jonas R. Gazoli, Alessandro Sete, Roberto M. G. Velásquez, Valério L. Borges, Moacir A. S. de Andrade

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The search for increased efficiency in generation systems has been of great importance in recent years to reduce the impact of greenhouse gas emissions and global warming. For clean energy sources, such as the generation systems that use concentrated solar power technology, this efficiency improvement impacts a lower investment per kW, improving the project’s viability. For the specific case of parabolic trough solar concentrators, their performance is strongly linked to their geometric precision of assembly and the individual efficiencies of their main components, such as parabolic mirrors and receiver tubes. Thus, for accurate efficiency analysis, it should be conducted empirically, looking for mounting and operating conditions like those observed in the field. The Brazilian power generation and distribution company Eletrobras Furnas, through the R&D program of the National Agency of Electrical Energy, has developed a plant for testing parabolic trough concentrators located in Aparecida de Goiânia, in the state of Goiás, Brazil. The main objective of this test plant is the characterization of the prototype concentrator that is being developed by the company itself in partnership with Eudora Energia, seeking to optimize it to obtain the same or better efficiency than the concentrators of this type already known commercially. This test plant is a closed pipe system where a pump circulates a heat transfer fluid, also calledHTF, in the concentrator that is being characterized. A flow meter and two temperature transmitters, installed at the inlet and outlet of the concentrator, record the parameters necessary to know the power absorbed by the system and then calculate its efficiency based on the direct solar irradiation available during the test period. After the HTF gains heat in the concentrator, it flows through heat exchangers that allow the acquired energy to be dissipated into the ambient. The goal is to keep the concentrator inlet temperature constant throughout the desired test period. The developed plant performs the tests in an autonomous way, where the operator must enter the HTF flow rate in the control system, the desired concentrator inlet temperature, and the test time. This paper presents the methodology employed for design and operation, as well as the instrumentation needed for the development of a parabolic trough test plant, being a guideline for standardization facilities.

Keywords: parabolic trough, concentrated solar power, CSP, solar power, test plant, energy efficiency, performance characterization, renewable energy

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Authors: Thor Alexis Sazon, Alexander Guzman-Urbina, Yasuhiro Fukushima

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This study outlines the method of how to develop a surrogate life cycle model based on fuzzy logic using three fuzzy inference methods: (1) the conventional Fuzzy Inference System (FIS), (2) the hybrid system of Data Analytics and Fuzzy Inference (DAFIS), which uses data clustering for defining the membership functions, and (3) the Adaptive-Neuro Fuzzy Inference System (ANFIS), a combination of fuzzy inference and artificial neural network. These methods were demonstrated with a case study where the Global Warming Potential (GWP) and the Levelized Cost of Energy (LCOE) of solar photovoltaic (PV) were estimated using Solar Irradiation, Module Efficiency, and Performance Ratio as inputs. The effects of using different fuzzy inference types, either Sugeno- or Mamdani-type, and of changing the number of input membership functions to the error between the calibration data and the model-generated outputs were also illustrated. The solution spaces of the three methods were consequently examined with a sensitivity analysis. ANFIS exhibited the lowest error while DAFIS gave slightly lower errors compared to FIS. Increasing the number of input membership functions helped with error reduction in some cases but, at times, resulted in the opposite. Sugeno-type models gave errors that are slightly lower than those of the Mamdani-type. While ANFIS is superior in terms of error minimization, it could generate solutions that are questionable, i.e. the negative GWP values of the Solar PV system when the inputs were all at the upper end of their range. This shows that the applicability of the ANFIS models highly depends on the range of cases at which it was calibrated. FIS and DAFIS generated more intuitive trends in the sensitivity runs. DAFIS demonstrated an optimal design point wherein increasing the input values does not improve the GWP and LCOE anymore. In the absence of data that could be used for calibration, conventional FIS presents a knowledge-based model that could be used for prediction. In the PV case study, conventional FIS generated errors that are just slightly higher than those of DAFIS. The inherent complexity of a Life Cycle study often hinders its widespread use in the industry and policy-making sectors. While the methodology does not guarantee a more accurate result compared to those generated by the Life Cycle Methodology, it does provide a relatively simpler way of generating knowledge- and data-based estimates that could be used during the initial design of a system.

Keywords: solar photovoltaic, fuzzy logic, inference system, artificial neural networks

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Authors: Oskar Sekowski

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Current global warming causes changes in the traditional zones of viticulture worldwide. During 20th century, the average global air temperature increased by 0.89˚C. The models of climate change indicate that viticulture, currently concentrating in narrow geographic niches, may move towards the poles, to higher geographic latitudes. Global warming may cause changes in traditional viticulture regions. Therefore, there is a need to estimate the climatic conditions and climate change in areas that are not traditionally associated with viticulture, e.g., Poland. The primary objective of this paper is to prepare methodology to evaluate the climatic and meteorological potential for viticulture in Poland based on a case study. Moreover, the additional aim is to evaluate the climatic potential of a mesoregion where a university vineyard is located. The daily data of temperature, precipitation, insolation, and wind speed (1988-2018) from the meteorological station located in Łazy, southern Poland, was used to evaluate 15 climatological parameters and indices connected with viticulture. The next steps of the methodology are based on Geographic Information System methods. The topographical factors such as a slope gradient and slope exposure were created using Digital Elevation Models. The spatial distribution of climatological elements was interpolated by ordinary kriging. The values of each factor and indices were also ranked and classified. The viticultural potential was determined by integrating two suitability maps, i.e., the topographical and climatic ones, and by calculating the average for each pixel. Data analysis shows significant changes in heat accumulation indices that are driven by increases in maximum temperature, mostly increasing number of days with Tmax > 30˚C. The climatic conditions of this mesoregion are sufficient for vitis vinifera viticulture. The values of indicators and insolation are similar to those in the known wine regions located on similar geographical latitudes in Europe. The smallest threat to viticulture in study area is the occurrence of hail and the highest occurrence of frost in the winter. This research provides the basis for evaluating general suitability and climatologic potential for viticulture in Poland. To characterize the climatic potential for viticulture, it is necessary to assess the suitability of all climatological and topographical factors that can influence viticulture. The methodology used in this case study shows places where there is a possibility to create vineyards. It may also be helpful for wine-makers to select grape varieties.

Keywords: climatologic potential, climatic classification, Poland, viticulture

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Authors: John Njikem

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Attention Deficit Hyperactivity Disorder (ADHD) is one of the most commonly diagnosed behavioral disorders in children, associated with this disorder are core symptoms of inattention, hyperactivity and impulsivity. This study was purposely to enlighten and inform teachers, policy makers and other professionals concern in the education of this group of learners in inclusive schools in Buea, Cameroon. The major purpose of this study was to identify children with ADHD in elementary schools practicing inclusive education and to investigate the effect of classroom based intervention on their academic performance. The research problem stems from the fact that majority of children with ADHD in our school mostly have problems with classroom tasks like paying attention, easily distracted, and difficulties in organization and very little has been done to manage this numerous conditions, therefore it was necessary for the researcher to identify them and implement some inclusive strategies that teachers can better use in managing the behavior of this group of learners. There were four research questions and the study; the sample population used for the study was 27 pupils (3-7years old) formally identified with key symptoms of ADHD from primary 3-6 from four primary inclusive schools in Buea. Two sub-types of ADHD children were identified by using the recent DSM-IV behavioral checklist in recording their behavior after teacher and peer nomination they were later subjected to three groups for classroom intervention. Data collection was done by using interviews and other supportive methods such as document consultation, field notes and informal talks as additional sources was also used to gather information. Classroom Intervention techniques were carried out by the teachers themselves for 8 weeks under the supervision of the researcher, results were recorded for the 27 children's academic performance in the areas of math’s, writing and reading. Descriptive Statistics was applied in analyzing the data in percentages while tables and diagrams were used to represent the results. Findings obtained indicated that there was significant increase in the level of attention and organization on classroom tasks in the areas of reading, writing and mathematics. Finding also show that there was a more significant improvement made on their academic performance using the combined intervention approach which was proven to be the most effective intervention technique for pupils with ADHD in the study. Therefore it is necessary that teachers in inclusive primary schools in Buea understand the needs of these children and learn how to identify them and also use this intervention approaches to accommodate them in classroom task in order to encourage inclusive educational classroom practices in the country. Recommendations were based on each research objective and suggestions for further studies centered on other methods of classroom intervention for ADHD children in inclusive settings.

Keywords: attention deficit hyperactivity disorder, inclusive classrooms, academic performance, impulsivity

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Authors: M. Roberts

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We Are Undefeatable - is a mass marketing behaviour change campaign that aims to support the least active people living with long term health conditions to be more active. This is an important issue to address because people with long term conditions are an historically underserved community for the sport and physical activity sector and the least active of those with long term conditions have the most to gain in health and wellbeing benefits. The campaign has generated a significant change in the way physical activity is communicated and people with long term conditions are represented in the media and marketing. The goal is to create a social norm around being active. The campaign is led by a unique partnership of organisations: the Richmond Group of Charities (made up of Age UK, Alzheimer’s Society, Asthma + Lung UK, Breast Cancer Now, British Heart Foundation, British Red Cross, Diabetes UK, Macmillan Cancer Support, Rethink Mental Illness, Royal Voluntary Service, Stroke Association, Versus Arthritis) along with Mind, MS Society, Parkinson’s UK and Sport England, with National Lottery Funding. It is underpinned by the COM-B model of behaviour change. It draws on the lived experience of people with multiple long term conditions to shape the look and feel of the campaign and all the resources available. People with long term conditions are the campaign messengers, central to the ethos of the campaign by telling their individual stories of overcoming barriers to be active with their health conditions. The central messaging is about finding a way to be active that works for the individual. We Are Undefeatable is evaluated through a multi-modal approach, including regular qualitative focus groups and a quantitative evaluation tracker undertaken three times a year. The campaign has highlighted the significant barriers to physical activity for people with long term conditions. This has changed the way our partnership talks about physical activity but has also had an impact on the wider sport and physical activity sector, prompting an increasing departure from traditional messaging and marketing approaches for this audience of people with long term conditions. The campaign has reached millions of people since its launch in 2019, through multiple marketing and partnership channels including primetime TV advertising and promotion through health professionals and in health settings. Its diverse storytellers make it relatable to its target audience and the achievable activities highlighted and inclusive messaging inspire our audience to take action as a result of seeing the campaign. The We Are Undefeatable campaign is a blueprint for physical activity campaigns; it not only addresses individual behaviour change but plays a role in addressing systemic barriers to physical activity by sharing the lived experience insight to shape policy and professional practice.

Keywords: behaviour change, long term conditions, partnership, relatable

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Authors: Edna Negron-Martinez

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Our time's global challenges and trends —like those associated with climate change, demographics displacements, growing health inequalities, and increasing burden of diseases— have complex connections to the determinants of health. Information on the burden of disease causes and prevention is fundamental for public health actions, like preparedness and responses for disasters, and recovery resources after the event. For instance, there is an increasing consensus about key findings of the effects and connections of the global burden of disease, as it generates substantial healthcare costs, consumes essential resources and prevents the attainment of optimal health and well-being. The goal of this research endeavor is to promote a comprehensive understanding of the connections between social, environmental, and economic influences on health. These connections are illustrated by pulling from clearly the core curriculum of multidisciplinary areas —as urban design, energy, housing, and economy— as well as in the health system itself. A systematic review of primary and secondary data included a variety of issues as global health, natural disasters, and critical pollution impacts on people's health and the ecosystems. Environmental health is challenged by the unsustainable consumption patterns and the resulting contaminants that abound in many cities and urban settings around the world. Poverty, inadequate housing, and poor health are usually linked. The house is a primary environmental health context for any individual and especially for more vulnerable groups; such as children, older adults and those who are sick. Nevertheless, very few countries show strong decoupling of environmental degradation from economic growth, as indicated by a recent 2017 Report of the World Bank. Worth noting, the environmental fraction of the global burden of disease in a 2016 World Health Organization (WHO) report estimated that 12.6 million global deaths, accounting for 23% (95% CI: 13-34%) of all deaths were attributable to the environment. Among the environmental contaminants include heavy metals, noise pollution, light pollution, and urban sprawl. Those key findings make a call to the significance to urgently adopt in a global scale the United Nations post-2015 Sustainable Development Goals (SDGs). The SDGs address the social, environmental, and economic factors that influence health and health inequalities, advising how these sectors, in turn, benefit from a healthy population. Consequently, more actions are necessary from an inter-sectoral and systemic paradigm to enforce an integrated sustainability policy implementation aimed at the environmental, social, and economic determinants of health.

Keywords: building capacity for workforce development, ecological and environmental health effects of pollution, public health education, sustainability

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Authors: Heena Dabas, Anju Paul, Suman Chaurasia, Ramesh Agarwal, M. Jeeva Sankar, Anurag Bajpai, Manju Saksena

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Background: Traumatic lumbar puncture (LP) is a common occurrence and causes substantial diagnostic ambiguity. There is paucity of data regarding its epidemiology. Objective: To assess the incidence and risk factors of traumatic LP in newborns. Design/Methods: In a prospective cohort study, all inborn neonates admitted in NICU and planned to undergo LP for a clinical indication of sepsis were included. Neonates with diagnosed intraventricular hemorrhage (IVH) of grade III and IV were excluded. The LP was done by operator - often a fellow or resident assisted by bedside nurse. The unit has policy of not routinely using any sedation/analgesia during the procedure. LP is done by 26 G and 0.5-inch-long hypodermic needle inserted in third or fourth lumbar space while the infant is in lateral position. The infants were monitored clinically and by continuous measurement of vital parameters using multipara monitor during the procedure. The occurrence of traumatic tap along with CSF parameters and other operator and assistant characteristics were recorded at the time of procedure. Traumatic tap was defined as presence of visible blood or more than 500 red blood cells on microscopic examination. Microscopic trauma was defined when CSF is not having visible blood but numerous RBCs. The institutional ethics committee approved the study protocol. A written informed consent from the parents and the health care providers involved was obtained. Neonates were followed up till discharge/death and final diagnosis was assigned along with treating team. Results: A total of 362 (21%) neonates out of 1726 born at the hospital were admitted during the study period (July 2016 to January, 2017). Among these neonates, 97 (26.7%) were suspected of sepsis. A total of 54 neonates were enrolled who met the eligibility criteria and parents consented to participate in the study. The mean (SD) birthweight was 1536 (732) grams and gestational age 32.0 (4.0) weeks. All LPs were indicated for late onset sepsis at the median (IQR) age of 12 (5-39) days. The traumatic LP occurred in 19 neonates (35.1%; 95% C.I 22.6% to 49.3%). Frank blood was observed in 7 (36.8%) and in the remaining, 12(63.1%) CSF was detected to have microscopic trauma. The preliminary risk factor analysis including birth weight, gestational age and operator/assistant and other characteristics did not demonstrate clinically relevant predictors. Conclusion: A significant number of neonates requiring lumbar puncture in our study had high incidence of traumatic tap. We were not able to identify modifiable risk factors. There is a need to understand the reasons and further reduce this issue for improving management in NICUs.

Keywords: incidence, newborn, traumatic, lumbar puncture

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Authors: Takuya Suzuki, Atsushi Shirai, Takashi Seki

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Acupuncture therapy is one of the treatments in traditional Chinese medicine. Recently, some reports have shown the effectiveness of acupuncture. However, its full acceptance has been hindered by the lack of understanding on mechanism of the therapy. Acupuncture applied to Zusanli (ST-36) enhances blood flow volume in superior mesenteric artery (SMA), yielding peripheral vascular resistance – regulated blood flow of SMA dominated by the parasympathetic system and inhibition of sympathetic system. In this study, a lumped-parameter approximation model of blood flow in the systemic arteries was developed. This model was extremely simple, consisting of the aorta, carotid arteries, arteries of the four limbs and SMA, and their peripheral vascular resistances. Here, the individual artery was simplified to a tapered tube and the resistances were modelled by a linear resistance. We numerically investigated contribution of the peripheral vascular resistance of SMA to the systemic blood distribution using this model. In addition to the upstream end of the model, which correlates with the left ventricle, two types of boundary condition were applied; mean left ventricular pressure which correlates with blood pressure (BP) and mean cardiac output which corresponds to cardiac index (CI). We examined it to reproduce the experimentally obtained hemodynamic change, in terms of the ratio of the aforementioned hemodynamic parameters from their initial values before the acupuncture, by regulating the peripheral vascular resistances and the upstream boundary condition. First, only the peripheral vascular resistance of SMA was changed to show contribution of the resistance to the change in blood flow volume in SMA, expecting reproduction of the experimentally obtained change. It was found, however, this was not enough to reproduce the experimental result. Then, we also changed the resistances of the other arteries together with the value given at upstream boundary. Here, the resistances of the other arteries were changed simultaneously in the same amount. Consequently, we successfully reproduced the hemodynamic change to find that regulation of the upstream boundary condition to the value experimentally obtained after the stimulation is necessary for the reproduction, though statistically significant changes in BP and CI were not observed in the experiment. It is generally known that sympathetic and parasympathetic tones take part in regulation of whole the systemic circulation including the cardiac function. The present result indicates that stimulation to ST-36 could induce vasodilation of peripheral circulation of SMA and vasoconstriction of that of other arteries. In addition, it implies that experimentally obtained small changes in BP and CI induced by the acupuncture may be involved in the therapeutic response.

Keywords: acupuncture, hemodynamics, lumped-parameter approximation, modeling, systemic vascular resistance

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Authors: Caitlin Bailey, Marian Frattarola Saulino, Beth Steinberg

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Today, virtually all programs offered to people with intellectual and developmental disabilities tout themselves as person-centered, community-based and inclusive, yet there is a vast range in type and quality of services that use these similar descriptors. The issue is exacerbated by the fields’ measurement practices around quality, inclusion, independent living, choice and person-centered outcomes. For instance, community inclusion for people with disabilities is often measured by the number of times person steps into his or her community. These measurement approaches set standards for quality too low so that agencies supporting group home residents to go bowling every week can report the same outcomes as an agency that supports one person to join a book club that includes people based on their literary interests rather than disability labels. Ultimately, lack of delineation in measurement contributes to the confusion between face value “quality” and true quality services and supports for many people with disabilities and their families. This exploratory study adopts alternative approaches to quality measurement including co-production methods and systems theoretical framework in order to identify the factors that 1) lead to high-quality supports and, 2) differentiate high-quality services. Project researchers have partnered with community practitioners who are all committed to providing quality services and supports but vary in the degree to which they are actually able to provide them. The study includes two parts; first, an online survey distributed to more than 500 agencies that have demonstrated commitment to providing high-quality services; and second, four in-depth case studies with agencies in three United States and Israel providing a variety of supports to children and adults with disabilities. Results from both the survey and in-depth case studies were thematically analyzed and coded. Results show that there are specific factors that differentiate service quality; however meaningful quality measurement practices also require that researchers explore the contextual factors that contribute to quality. These not only include direct services and interactions, but also characteristics of service users, their environments as well as organizations providing services, such as management and funding structures, culture and leadership. Findings from this study challenge researchers, policy makers and practitioners to examine existing quality service standards and measurements and to adopt alternate methodologies and solutions to differentiate and scale up evidence-based quality practices so that all people with disabilities have access to services that support them to live, work, and enjoy where and with whom they choose.

Keywords: co-production, inclusion, independent living, quality measurement, quality supports

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Authors: Meng Xu, Alexis K. H. Lau, Ming Xu, Bill Barron, Narges Shahraki

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As an emerging unconventional energy, shale gas has been an economically viable step towards a cleaner energy future in U.S. China also has shale resources that are estimated to be potentially the largest in the world. In addition, China has enormous unmet for a clean alternative to substitute coal. Nonetheless, the geological complexity of China’s shale basins and issues of water scarcity potentially impose serious constraints on shale gas development in China. Further, even if China could replicate to a significant degree the U.S. shale gas boom, China faces the problem of transporting the gas efficiently overland with its limited pipeline network throughput capacity and coverage. The aim of this study is to identify the potential bottlenecks in China’s gas transmission network, as well as to examine the shale gas development affecting particular supply locations and demand centers. We examine this through application of three scenarios with projecting domestic shale gas supply by 2020: optimistic, medium and conservative shale gas supply, taking references from the International Energy Agency’s (IEA’s) projections and China’s shale gas development plans. Separately we project the gas demand at provincial level, since shale gas will have more significant impact regionally than nationally. To quantitatively assess each shale gas development scenario, we formulated a gas pipeline optimization model. We used ArcGIS to generate the connectivity parameters and pipeline segment length. Other parameters are collected from provincial “twelfth-five year” plans and “China Oil and Gas Pipeline Atlas”. The multi-objective optimization model uses GAMs and Matlab. It aims to minimize the demands that are unable to be met, while simultaneously seeking to minimize total gas supply and transmission costs. The results indicate that, even if the primary objective is to meet the projected gas demand rather than cost minimization, there’s a shortfall of 9% in meeting total demand under the medium scenario. Comparing the results between the optimistic and medium supply of shale gas scenarios, almost half of the shale gas produced in Sichuan province and Chongqing won’t be able to be transmitted out by pipeline. On the demand side, the Henan province and Shanghai gas demand gap could be filled as much as 82% and 39% respectively, with increased shale gas supply. To conclude, the pipeline network in China is currently not sufficient in meeting the projected natural gas demand in 2020 under medium and optimistic scenarios, indicating the need for substantial pipeline capacity expansion for some of the existing network, and the importance of constructing new pipelines from particular supply to demand sites. If the pipeline constraint is overcame, Beijing, Shanghai, Jiangsu and Henan’s gas demand gap could potentially be filled, and China could thereby reduce almost 25% its dependency on LNG imports under the optimistic scenario.

Keywords: energy policy, energy systematic analysis, scenario analysis, shale gas in China

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Authors: Gashin Shahsavari, Gilles Arnaud-Fassetta, Alberto Campisano, Roberto Bertilotti, Fabien Riou

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Sewer deposits have been identified as a major cause of dysfunctions in combined sewer systems regarding sewer management, which induces different negative consequents resulting in poor hydraulic conveyance, environmental damages as well as worker’s health. In order to overcome the problematics of sedimentation, flushing has been considered as the most operative and cost-effective way to minimize the sediments impacts and prevent such challenges. Flushing, by prompting turbulent wave effects, can modify the bed form depending on the hydraulic properties and geometrical characteristics of the conduit. So far, the dynamics of the bed-load during high-flow events in combined sewer systems as a complex environment is not well understood, mostly due to lack of measuring devices capable to work in the “hostile” in combined sewer system correctly. In this regards, a one-episode flushing issue from an opening gate valve with weir function was carried out in a trunk sewer in Paris to understanding its cleansing efficiency on the sediments (thickness: 0-30 cm). During more than 1h of flushing within 5 m distance in downstream of this flushing device, a maximum flowrate and a maximum level of water have been recorded at 5 m in downstream of the gate as 4.1 m3/s and 2.1 m respectively. This paper is aimed to evaluate the efficiency of this type of gate for around 1.1 km (from the point -50 m to +1050 m in downstream from the gate) by (i) determining bed grain-size distribution and sediments evolution through the sewer channel, as well as their organic matter content, and (ii) identifying sections that exhibit more changes in their texture after the flush. For the first one, two series of sampling were taken from the sewer length and then analyzed in laboratory, one before flushing and second after, at same points among the sewer channel. Hence, a non-intrusive sampling instrument has undertaken to extract the sediments smaller than the fine gravels. The comparison between sediments texture after the flush operation and the initial state, revealed the most modified zones by the flush effect, regarding the sewer invert slope and hydraulic parameters in the zone up to 400 m from the gate. At this distance, despite the increase of sediment grain-size rages, D50 (median grain-size) varies between 0.6 mm and 1.1 mm compared to 0.8 mm and 10 mm before and after flushing, respectively. Overall, regarding the sewer channel invert slope, results indicate that grains smaller than sands (< 2 mm) are more transported to downstream along about 400 m from the gate: in average 69% before against 38% after the flush with more dispersion of grain-sizes distributions. Furthermore, high effect of the channel bed irregularities on the bed material evolution has been observed after the flush.

Keywords: bed-load evolution, combined sewer systems, flushing efficiency, sediments transport

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Authors: Shayla He

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Background and Purpose: According to Chamie (2017), it’s estimated that no less than 150 million people, or about 2 percent of the world’s population, are homeless. The homeless population in the United States has grown rapidly in the past four decades. In New York City, the sheltered homeless population has increased from 12,830 in 1983 to 62,679 in 2020. Knowing the trend on the homeless population is crucial at helping the states and the cities make affordable housing plans, and other community service plans ahead of time to better prepare for the situation. This study utilized the data from New York City, examined the key factors associated with the homelessness, and developed systematic modeling to predict homeless populations of the future. Using the best model developed, named HP-RNN, an analysis on the homeless population change during the months of 2020 and 2021, which were impacted by the COVID-19 pandemic, was conducted. Moreover, HP-RNN was tested on the data from Seattle. Methods: The methodology involves four phases in developing robust prediction methods. Phase 1 gathered and analyzed raw data of homeless population and demographic conditions from five urban centers. Phase 2 identified the key factors that contribute to the rate of homelessness. In Phase 3, three models were built using Linear Regression, Random Forest, and Recurrent Neural Network (RNN), respectively, to predict the future trend of society's homeless population. Each model was trained and tuned based on the dataset from New York City for its accuracy measured by Mean Squared Error (MSE). In Phase 4, the final phase, the best model from Phase 3 was evaluated using the data from Seattle that was not part of the model training and tuning process in Phase 3. Results: Compared to the Linear Regression based model used by HUD et al (2019), HP-RNN significantly improved the prediction metrics of Coefficient of Determination (R2) from -11.73 to 0.88 and MSE by 99%. HP-RNN was then validated on the data from Seattle, WA, which showed a peak %error of 14.5% between the actual and the predicted count. Finally, the modeling results were collected to predict the trend during the COVID-19 pandemic. It shows a good correlation between the actual and the predicted homeless population, with the peak %error less than 8.6%. Conclusions and Implications: This work is the first work to apply RNN to model the time series of the homeless related data. The Model shows a close correlation between the actual and the predicted homeless population. There are two major implications of this result. First, the model can be used to predict the homeless population for the next several years, and the prediction can help the states and the cities plan ahead on affordable housing allocation and other community service to better prepare for the future. Moreover, this prediction can serve as a reference to policy makers and legislators as they seek to make changes that may impact the factors closely associated with the future homeless population trend.

Keywords: homeless, prediction, model, RNN

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Authors: Shima Nabinejad, Holger Schüttrumpf

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Farmers who are living in flood-prone areas such as coasts are exposed to storm surges increased due to climate change. Crop cultivation is the most important economic activity of farmers, and in the time of flooding, agricultural lands are subject to inundation. Additionally, overflow saline water causes more severe damage outcomes than riverine flooding. Agricultural crops are more vulnerable to salinity than other land uses for which the economic damages may continue for a number of years even after flooding and affect farmers’ decision-making for the following year. Therefore, it is essential to assess what extent the agricultural areas are flooded and how much the associated flood damage to each individual farmer is. To address these questions, we integrated farmers’ decision-making at farm-scale with flood risk management. The integrated model includes identification of hazard scenarios, failure analysis of structural measures, derivation of hydraulic parameters for the inundated areas and analysis of the economic damages experienced by each farmer. The present study has two aims; firstly, it attempts to investigate the flooded cropland and potential crop damages for the whole area. Secondly, it compares them among farmers’ field for three flood scenarios, which differ in breach locations of the flood protection structure. To achieve its goal, the spatial distribution of fields and cultivated crops of farmers were fed into the flood risk model, and a 100-year storm surge hydrograph was selected as the flood event. The study area was Pellworm Island that is located in the German Wadden Sea National Park and surrounded by North Sea. Due to high salt content in seawater of North Sea, crops cultivated in the agricultural areas of Pellworm Island are 100% destroyed by storm surges which were taken into account in developing of depth-damage curve for analysis of consequences. As a result, inundated croplands and economic damages to crops were estimated in the whole Island which was further compared for six selected farmers under three flood scenarios. The results demonstrate the significance and the flexibility of the proposed model in flood risk assessment of flood-prone areas by integrating flood risk management and decision-making.

Keywords: crop damages, flood risk analysis, individual farmer, inundated cropland, Pellworm Island, storm surges

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Authors: Muritala Babatunde Hassan

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In the contemporary global political economy, foreign direct investment (FDI) is gaining currency on daily basis. Notably, the end of the Cold War has brought about the dominance of neoliberal ideology with its mantra of private-sector-led economy. As such, nation-states now see FDI attraction as an important element in their approach to national development. Governments and policy makers are preoccupying themselves with unraveling the best strategies to not only attract more FDI but also to attain the desired socio-economic development status. In Nigeria, the perceived development potentials of FDI have brought about aggressive hunt for foreign investors, most especially since transition to civilian rule in May 1999. Series of liberal and market oriented strategies are being adopted not only to attract foreign investors but largely to stimulate private sector participation in the economy. It is on this premise that this study interrogates the politics of FDI attraction for domestic development in Nigeria between 1999 and 2014, with the ultimate aim of examining the nexus between regime type and the ability of a state to attract and benefit from FDI. Building its analysis within the framework of institutional utilitarianism, the study posits that the essential FDI strategies for achieving the greatest happiness for the greatest number of Nigerians are political not economic. Both content analysis and descriptive survey methodology were employed in carrying out the study. Content analysis involves desk review of literatures that culminated in the development of the study’s conceptual and theoretical framework of analysis. The study finds no significant relationship between transition to democracy and FDI inflows in Nigeria, as most of the attracted investments during the period of the study were market and resource seeking as was the case during the military regime, thereby contributing minimally to the socio-economic development of the country. It is also found that the country placed much emphasis on liberalization and incentives for FDI attraction at the neglect of improving the domestic investment environment. Consequently, poor state of infrastructure, weak institutional capability and insecurity were identified as the major factors seriously hindering the success of Nigeria in exploiting FDI for domestic development. Given the reality of the currency of FDI as a vector of economic globalization and that Nigeria is trailing the line of private-sector-led approach to development, it is recommended that emphasis should be placed on those measures aimed at improving the infrastructural facilities, building solid institutional framework, enhancing skill and technological transfer and coordinating FDI promotion activities by different agencies and at different levels of government.

Keywords: foreign capital, politics, socio-economic development, FDI attraction strategies

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Authors: Priscila A. Bernardes, Marcos E. Buzanskas, Luciana C. A. Regitano, Ricardo V. Ventura, Danisio P. Munari

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The best linear unbiased predictor (BLUP) is a method commonly used in genetic evaluations of breeding programs. However, this approach can lead to higher inbreeding coefficients in the population due to the intensive use of few bulls with higher genetic potential, usually presenting some degree of relatedness. High levels of inbreeding are associated to low genetic viability, fertility, and performance for some economically important traits and therefore, should be constantly monitored. Unreliable pedigree data can also lead to misleading results. Genomic information (i.e., single nucleotide polymorphism – SNP) is a useful tool to estimate the inbreeding coefficient. Runs of homozygosity have been used to evaluate homozygous segments inherited due to direct or collateral inbreeding and allows inferring population selection history. This study aimed to evaluate runs of homozygosity (ROH) and inbreeding in a population of Nelore beef cattle. A total of 814 animals were genotyped with the Illumina BovineHD BeadChip and the quality control was carried out excluding SNPs located in non-autosomal regions, with unknown position, with a p-value in the Hardy-Weinberg equilibrium lower than 10⁻⁵, call rate lower than 0.98 and samples with the call rate lower than 0.90. After the quality control, 809 animals and 509,107 SNPs remained for analyses. For the ROH analysis, PLINK software was used considering segments with at least 50 SNPs with a minimum length of 1Mb in each animal. The inbreeding coefficient was calculated using the ratio between the sum of all ROH sizes and the size of the whole genome (2,548,724kb). A total of 25.711 ROH were observed, presenting mean, median, minimum, and maximum length of 3.34Mb, 2Mb, 1Mb, and 80.8Mb, respectively. The number of SNPs present in ROH segments varied from 50 to 14.954. The longest ROH length was observed in one animal, which presented a length of 634Mb (24.88% of the genome). Four bulls were among the 10 animals with the longest extension of ROH, presenting 11% of ROH with length higher than 10Mb. Segments longer than 10Mb indicate recent inbreeding. Therefore, the results indicate an intensive use of few sires in the studied data. The distribution of ROH along the chromosomes showed that chromosomes 5 and 6 presented a large number of segments when compared to other chromosomes. The mean, median, minimum, and maximum inbreeding coefficients were 5.84%, 5.40%, 0.00%, and 24.88%, respectively. Although the mean inbreeding was considered low, the ROH indicates a recent and intensive use of few sires, which should be avoided for the genetic progress of breed.

Keywords: autozygosity, Bos taurus indicus, genomic information, single nucleotide polymorphism

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Authors: Anne-Loes K. Warps, Rob A. E. M. Tollenaar, Pieter J. Tanis, Jan Willem T. Dekker

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Anastomotic leakage after colorectal cancer surgery remains a severe complication. Early diagnosis and treatment are essential to prevent further adverse outcomes. In the literature, it has been suggested that earlier reintervention is associated with better survival, but anastomotic leakage can occur with a highly variable time interval to index surgery. This study aims to evaluate the time-interval between rectal cancer resection with primary anastomosis creation and reoperation, in relation to short-term outcomes, stratified for the use of a defunctioning stoma. Methods: Data of all primary rectal cancer patients that underwent elective resection with primary anastomosis during 2013-2019 were extracted from the Dutch ColoRectal Audit. Analyses were stratified for defunctioning stoma. Anastomotic leakage was defined as a defect of the intestinal wall or abscess at the site of the colorectal anastomosis for which a reintervention was required within 30 days. Primary outcomes were new stoma construction, mortality, ICU admission, prolonged hospital stay and readmission. The association between time to reoperation and outcome was evaluated in three ways: Per 2 days, before versus on or after postoperative day 5 and during primary versus readmission. Results: In total 10,772 rectal cancer patients underwent resection with primary anastomosis. A defunctioning stoma was made in 46.6% of patients. These patients had a lower anastomotic leakage rate (8.2% vs. 11.6%, p < 0.001) and less often underwent a reoperation (45.3% vs. 88.7%, p < 0.001). Early reoperations (< 5 days) had the highest complication and mortality rate. Thereafter the distribution of adverse outcomes was more spread over the 30-day postoperative period for patients with a defunctioning stoma. Median time-interval from primary resection to reoperation for defunctioning stoma patients was 7 days (IQR 4-14) versus 5 days (IQR 3-13 days) for no-defunctioning stoma patients. The mortality rate after primary resection and reoperation were comparable (resp. for defunctioning vs. no-defunctioning stoma 1.0% vs. 0.7%, P=0.106 and 5.0% vs. 2.3%, P=0.107). Conclusion: This study demonstrated that early reinterventions after anastomotic leakage are associated with worse outcomes (i.e. mortality). Maybe the combination of a physiological dip in the cellular immune response and release of cytokines following surgery, as well as a release of endotoxins caused by the bacteremia originating from the leakage, leads to a more profound sepsis. Another explanation might be that early leaks are not contained to the pelvis, leading to a more profound sepsis requiring early reoperations. Leakage with or without defunctioning stoma resulted in a different type of reinterventions and time-interval between surgery and reoperation.

Keywords: rectal cancer surgery, defunctioning stoma, anastomotic leakage, time-interval to reoperation

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Authors: Anisur Rahman, Sabyasachi Behera, Pawan Pathak, Benazir Patil, Rajesh Khanna

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Background: Nearly half of India’s population is expected to reside in urban areas by 2030. The extent to which India's health system can provide for this large and growing city-based population will determine the country's success in achieving universal health coverage and improved national health indices. National Urban Health Mission (NUHM) strive for improving access to primary health care in urban areas. Implementation of NUHM solicits sensitive, effective and sustainable strategies to strengthen the service delivery mechanisms. The Challenge Initiative for Healthy Cities (TCIHC) is working with the Government of India and three provincial states to develop effective service delivery mechanisms for reproductive, maternal, newborn and child health (RMNCH) through a health systems approach for the urban poor. Method: A rapid assessment study was conceptualized and executed to generate evidence in order to address the challenges impeding in functioning of urban health facilities to deliver effective, efficient and equitable health care services in 7 cities spread across two project States viz. Madhya Pradesh and Odisha. Results: The findings of the assessment reflect: 1. The overall ecosystem pertaining to planning and management of public health interventions is not conducive. 2. The challenges regarding population dynamics like migration keeps on influencing the demand-supply-enabling environment triangle for both public and private service providers. 3. Lack of norms for planning and benchmark for service delivery further impedes urban health system as a whole. 4. Operationalization of primary level services have enough potential to meet the demand of slum dwellers at large. 5. Lack of policy driven strategies on how to integrate the NUHM with other thematic areas of Maternal, Newborn & Child Health (MNCH) and Family Planning (FP). 5. The inappropriate capacity building and acute shortage of Human Resources has huge implication on service provisioning and adherence to the service delivery protocols. Conclusion: The findings from rapid assessment are aimed to inform pertinent stakeholders to develop a multiyear city health action plan to strengthen the health systems in order to improve the efficacy of service delivery mechanism in urban settings.

Keywords: city health plan, health system, rapid assessment, urban mission

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Authors: Tassana Boontong, Vilaivan Thongcharoen, Orapan Thosingha, Suphamon Chansakul, Anorut Jenwitheesuk, Chanin Chakkrapopyodhin, Isara Phiwchai, Mattika Chaichan, Rungnapha Khiewchaum

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According to Thailand health policy, subdistrict health promoting hospitals (SHPHs) serve as forefront facilities for inclusive health care service. Those services include health promotion, disease prevention, primary medical care and rehabilitation. However, SHPHs residing in some distant area, such as SHPHs residing on the islands, would deliver different services relevant to health needs of the local people and the tourists. This research aimed to study health care delivery services at SHPHs on the islands in Thailand. Data were collected using questionnaires. The result revealed that in Thailand, there are 58 SHPHs on the islands. During data collection process, the researchers were not allowed to collect data in 5 SHPHs in the southern part due to Covid-19 pandemic. The report is based on 53 SHPHs on the islands. Numbers of health care personnel were 201, 72.14 % were female, with the ages ranged from 22 to 60 years (mean = 35.56 years). About 53% were community health personnel, while 26.08% were professional nurses. In regard to work experiences, the range of year varied from less than 1 year to 30 years, with the mean of 8.36 years. The majority of their responsibilities focused on providing primary medical care (86.34%), caring of people with chronic illnesses (85.30%) and providing medical care procedures for patients with chronic illnesses at home (84.36%). Nurses were main health care personnel in performing primary medical care. Due to difficulty transportation from the islands to the mainland, nurses had to provide prompt emergency medical care while the patients arrived with emergency and critical illnesses such as severe head trauma, stroke or coronary artery disease. Although some medical procedures were complex and not covered by nursing and midwifery license, they decided to protect patients from life- threatening conditions and make them stable before transportation. In SHPHs, the workload exceeded manpower, health care personnel had to work overtime almost every day. In the famous tourist islands, health care personnel had to carry 3-4 folds of their workload during the holidays because of the large crowds of foreign and Thai tourists. It is recommended that SHPHs on the islands should scale up the level of services to cover advanced medical care. Health care personnel, in particular, professional nurses, should be equipped with emergency and critical care skills. The expected outcomes of the services should emphasize on rescuing patients with emergency and life-threatening illnesses and providing comprehensive care for people living on or visiting the islands.

Keywords: distant area, islands, sub district health promoting hospital, heath care services, Thailand

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Authors: Anil K. Giri, Dipak Subedi, Kathleen Kassel, Ashok Mishra

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The United States Department of Agriculture’s programs has been accused of being discriminatory in the past based on the race of the farmer, especially African-American producers. This study examines if there was racial discrimination in payments from the most recent new USDA programs, including those made in response to the pandemic. This study uses the Analysis of Variance (ANOVA) to examine the payments after normalizing them relative to cash receipts to test if discrimination in the number of payments received exists. Three programs investigated in this study are: i) the Coronavirus Food Assistance Program (CFAP), ii) the Market Facilitation Program (MFP), and (iii) the Paycheck Protection Program (PPP). The PPP program was administered by the Small Business Administration, whereas the other two were designed and implemented by the USDA. The PPP made forgivable loans to small businesses and, initially, was heavily criticized for not reaching minority businesses (in general). The Small Business Administration then initiated a second draw of PPP loans, prioritizing minority-owned businesses. This study compares attributes of PPP loans made to African-American farming businesses and other farming businesses in the two draws of the PPP. We find that the number of African-American farming businesses participating in the second draw of PPP loans decreased significantly from the first draw. However, the average amount of PPP loans to African-American farming businesses increased in the second draw. In the first draw, the average cost of jobs reported per loan was higher for African-American farming businesses than for other producers. In the second draw, the average cost of jobs reported per loan was significantly higher for other farming businesses than for African-American businesses. The share of PPP loans forgiven for African-American farming businesses is significantly below the national rate of 89 percent. The rate of forgiveness for PPP loans made to African-American producers is unlikely to increase significantly without policy changes. This can increase financial burdens in the future to farm operations operated by African- Americans. Finally, we conclude that the initial goal of increasing minority participation in PPP loans in the second draw, at least among African-Americans in the agricultural sector, did not meet. CFAP made almost $600 million in direct payments to minority producers, including Black producers. Black or African American producers received more than $52 million in CFAP payments. CFAP payments were proportional to the value of agricultural commodities sold for most minority producers. The 2017 Census of Agriculture showed that the majority of minority producers, including African American producers but excluding Asian producers, raised livestock. CFAP made the highest payments to livestock minority producers.

Keywords: United States department of agriculture (USDA), coronavirus food assistance program (CFAP), paycheck protection program (PPP), African-American producers, minority American producers

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Authors: Ayodeji Oluleye

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This study used Total Ozone Mapping Spectrometer (TOMS) Aerosol Index (AI) and reanalysis dataset of thirty years (1983-2012) to investigate the influence of the atmospheric circulation on dust transport during the Harmattan period over WestAfrica using TOMS data. The Harmattan dust mobilization and atmospheric circulation pattern were evaluated using a kernel density estimate which shows the areas where most points are concentrated between the variables. The evolution of the Inter-Tropical Discontinuity (ITD), Sea surface Temperature (SST) over the Gulf of Guinea, and the North Atlantic Oscillation (NAO) index during the Harmattan period (November-March) was also analyzed and graphs of the average ITD positions, SST and the NAO were observed on daily basis. The Pearson moment correlation analysis was also employed to assess the effect of atmospheric circulation on Harmattan dust transport. The results show that the departure (increased) of TOMS AI values from the long-term mean (1.64) occurred from around 21st of December, which signifies the rich dust days during winter period. Strong TOMS AI signal were observed from January to March with the maximum occurring in the latter months (February and March). The inter-annual variability of TOMSAI revealed that the rich dust years were found between 1984-1985, 1987-1988, 1997-1998, 1999-2000, and 2002-2004. Significantly, poor dust year was found between 2005 and 2006 in all the periods. The study has found strong north-easterly (NE) trade winds were over most of the Sahelianregion of West Africa during the winter months with the maximum wind speed reaching 8.61m/s inJanuary.The strength of NE winds determines the extent of dust transport to the coast of Gulf of Guinea during winter. This study has confirmed that the presence of the Harmattan is strongly dependent on theSST over Atlantic Ocean and ITD position. The locus of the average SST and ITD positions over West Africa could be described by polynomial functions. The study concludes that the evolution of near surface wind field at 925 hpa, and the variations of SST and ITD positions are the major large scale atmospheric circulation systems driving the emission, distribution, and transport of Harmattan dust aerosols over West Africa. However, the influence of NAO was shown to have fewer significance effects on the Harmattan dust transport over the region.

Keywords: atmospheric circulation, dust aerosols, Harmattan, West Africa

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Authors: Aisha Giwa, Mohammed-Faosy Adeniran, Olufunke Femi-Ojo

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Four decades ago, the World Health Organization (WHO) launched the Expanded Programme on Immunization (EPI). The EPI blueprint laid out the technical and managerial functions necessary to routinely vaccinate children with a limited number of vaccines, providing protection against diphtheria, tetanus, whooping cough, measles, polio, and tuberculosis, and to prevent maternal and neonatal tetanus by vaccinating women of childbearing age with tetanus toxoid. Despite global efforts, the Routine Immunization (RI) coverage in two of the World Health Organization (WHO) regions; the African Region and the South-East Asia Region, still remains short of its targets. As a result, the WHO Regional Director for Africa declared 2012 as the year for intensifying RI in these regions and this also coincided with the declaration of polio as a programmatic emergency by the WHO Executive Board. In order to intensify routine immunization, the National Routine Immunization Strategic Plan (2013-2015) stated that its core priority is to ensure 100% adequacy and availability of vaccines for safe immunization. To achieve 100% availability, the “PUSH System” and then “Push-Plus” were adopted for vaccine distribution, which replaced the inefficient “PULL” method. The NPHCDA plays the key role in coordinating activities in area advocacy, capacity building, engagement of 3PL for the state as well as monitoring and evaluation of the vaccine delivery process. eHealth Africa (eHA) is a player as a 3PL service provider engaged by State Primary Health Care Boards (SPHCDB) to ensure vaccine availability through Vaccine Direct Delivery (VDD) project which is essential to successful routine immunization services. The VDD project ensures the availability and adequate supply of high-quality vaccines and immunization-related materials to last-mile facilities. eHA’s commitment to the VDD project saw the need for an assessment of the project vis-a-vis the overall project performance, evaluation of a process for necessary improvement suggestions as well as general impact across Kano State (Where eHA had transitioned to the state), Bauchi State (currently manage delivery to all LGAs except 3 LGAs currently being managed by the state), Sokoto State (eHA currently covers all LGAs) and Zamfara State (Currently, in-sourced and managed solely by the state).

Keywords: cold chain logistics, health supply chain system strengthening, logistics management information system, vaccine delivery traceability and accountability

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Authors: Aditi Madan, Jayant Kumar Routray

Abstract:

Purpose: Over the years flood related risks have compounded due to increasing vulnerability caused by rapid urbanisation and growing population. This increase is an indication of the need for enhancing the preparedness of institutions to respond to floods. The study describes disaster management structure and its linkages with institutions involved in managing disasters. It addresses issues and challenges associated with readiness of disaster management institutions to respond to floods. It suggests policy options for enhancing the current state of readiness of institutions to respond by considering factors like institutional, manpower, financial, technical, leadership & networking, training and awareness programs, monitoring and evaluation. Methodology: The study is based on qualitative data with statements and outputs from primary and secondary sources to understand the institutional framework for disaster management in India. Primary data included field visits, interviews with officials from institutions managing disasters and the affected community to identify the challenges faced in engaging national, state, district and local level institutions in managing disasters. For focus group discussions, meetings were held with district project officers and coordinators, local officials, community based organisation, civil defence volunteers and community heads. These discussions were held to identify the challenges associated with preparedness to respond of institutions to floods. Findings: Results show that disasters are handled by district authority and the role of local institutions is limited to a reactive role during disaster. Data also indicates that although the existing institutional setup is well coordinated at the district level but needs improvement at the local level. Wide variations exist in awareness and perception among the officials engaged in managing disasters. Additionally, their roles and responsibilities need to be clearly defined with adequate budget and dedicated permanent staff for managing disasters. Institutions need to utilise the existing manpower through proper delegation of work. Originality: The study suggests that disaster risk reduction needs to focus more towards inclusivity of the local urban bodies. Wide variations exist in awareness and perception among the officials engaged in managing disasters. In order to ensure community participation, it is important to address their social and economic problems since such issues can overshadow attempts made for reducing risks. Thus, this paper suggests development of direct linkages among institutions and community for enhancing preparedness to respond to floods.

Keywords: preparedness, response, disaster, flood, community, institution

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Authors: Gulcin Satir, Ahmet Yildirim

Abstract:

Globally, including Turkey, health problems associated with malnutrition and nutrient deficiencies in childhood will remain major public health problems in future. Nutrition is a major environmental influence on physical and mental growth and development in early life. Many studies support the fact that nutritional knowledge makes contribution to wellbeing of children and their school performance. The purpose of this study was to examine nutritional knowledge and eating habits of primary school children and to investigate differences in these variables by socioeconomic status. A quasi-experimental one group pretest/posttest design study was conducted in five primary schools totaling 200 children aging 9-10 years in grade 4 to determine the effect of nutritional awareness programme on eating habits of primary school children. The schools were chosen according to parents’ social and demographic characteristics. The implemented nutritional awareness education programme focused on healthy lifestyle such as beneficial foods, eating habits, personal hygiene, physical activity and the programme consisted of eight lessons. The teaching approaches used included interactive teaching, role-playing, demonstration, small group discussions, questioning, and feedback. The lessons were given twice a week for four weeks totaling eight lessons. All lessons lasted 45-60 minutes and first 5 minutes of this was pre-assessment and last 5 minutes post assessment evaluation. The obtained data were analyzed for normality, and the distribution of the variables was tested by the Kolmogorov-Smirnov test. Paired t-test was used to evaluate the effectiveness of education programme and to compare the above-mentioned variables in each school separately before and after the lessons. The result of the paired t-test conducted separately for each school showed that on average after eight lessons, there was a 25-32% increase in nutritional knowledge of students regardless of the school they attend to and this rate was significant (P < 0.01). This shows that increase in nutritional awareness in these five schools having different socio-economic status was similar to each other. This study suggests that having children involved directly in lessons help to achieve nutritional awareness leading to healthy eating habits. It is concluded that nutritional awareness is a valuable tool to change eating habits. Study findings will provide information for developing nutrition education programmes for the healthy life and obesity prevention in children.

Keywords: children, nutritional awareness, obesity, socioeconomic status

Procedia PDF Downloads 144