Search results for: socio-economic disparities minorities

Authors: Florim Grajcevci, Flamur Grajcevci, Fatos Tahiri, Hamdi Kurteshi

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The territory of Kosova is actually included in one of the most seismic-prone regions in Europe. Therefore, the earthquakes are not so rare in Kosova; and when they occurred, the consequences have been rather destructive. The importance of assessing the seismic resistance of existing masonry structures has drawn strong and growing interest in the recent years. Engineering included those of Vulnerability, Loss of Buildings and Risk assessment, are also of a particular interest. This is due to the fact that this rapidly developing field is related to great impact of earthquakes on the socioeconomic life in seismic-prone areas, as Kosova and Prishtina are, too. Such work paper for Prishtina city may serve as a real basis for possible interventions in historic buildings as are museums, mosques, old residential buildings, in order to adequately strengthen and/or repair them, by reducing the seismic risk within acceptable limits. The procedures of the vulnerability assessment of building structures have concentrated on structural system, capacity, and the shape of layout and response parameters. These parameters will provide expected performance of the very important existing building structures on the vulnerability and the overall behavior during the earthquake excitations. The structural systems of existing historical buildings in Pristina, Kosovo, are dominantly unreinforced brick or stone masonry with very high risk potential from the expected earthquakes in the region. Therefore, statistical analysis based on the observed damage-deformation, cracks, deflections and critical building elements, would provide more reliable and accurate results for the regional assessments. The analytical technique was used to develop a preliminary evaluation methodology for assessing seismic vulnerability of the respective structures. One of the main objectives is also to identify the buildings that are highly vulnerable to damage caused from inadequate seismic performance-response. Hence, the damage scores obtained from the derived vulnerability functions will be used to categorize the evaluated buildings as “stabile”, “intermediate”, and “unstable”. The vulnerability functions are generated based on the basic damage inducing parameters, namely number of stories (S), lateral stiffness (LS), capacity curve of total building structure (CCBS), interstory drift (IS) and overhang ratio (OR).

Keywords: vulnerability, ductility, seismic microzone, ductility, energy efficiency

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Authors: Khlood F. Salman, Richard Zoucha, Hani Nawafleh

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Introduction: Jordan ranks the fourth highest breast cancer prevalence after Lebanon, Bahrain, and Kuwait. Considerable evidence showed that cultural, ethnic, and economic differences influence a woman’s practice to early detection and prevention of breast cancer. Objectives: To understand women’s health beliefs and values in relation to early detection of breast cancer; and to explore the impact of these beliefs on their decisions regarding reluctance or acceptance of early detection measures such as mammogram screening. Design: A qualitative focused ethnography was used to collect data for this study. Settings: The study was conducted in the second largest city surrounded by a large rural area in Ma’an- Jordan. Participants: A total of twenty seven women, with no history of breast cancer, between the ages of 18 and older, who had prior health experience with health providers, and were willing to share elements of personal health beliefs related to breast health within the larger cultural context. The participants were recruited using the snowball method and words of mouth. Data collection and analysis: A short questionnaire was designed to collect data related to socio demographic status (SDQ) from all participants. A Semi-structured interviews guide was used to elicit data through interviews with the informants. Nvivo10 a data manager was utilized to assist with data analysis. Leininger’s four phases of qualitative data analysis was used as a guide for the data analysis. The phases used to analyze the data included: 1) Collecting and documenting raw data, 2) Identifying of descriptors and categories according to the domains of inquiry and research questions. Emic and etic data is coded for similarities and differences, 3) Identifying patterns and contextual analysis, discover saturation of ideas and recurrent patterns, and 4) Identifying themes and theoretical formulations and recommendations. Findings: Three major themes were emerged within the cultural and religious context; 1. Fear, denial, embarrassment and lack of knowledge were common perceptions of Ma’anis’ women regarding breast health and screening mammography, 2. Health care professionals in Jordan were not quick to offer information and education about breast cancer and screening, and 3. Willingness to learn about breast health and cancer prevention. Conclusion: The study indicated the disparities between the infrastructure and resourcing in rural and urban areas of Jordan, knowledge deficit related to breast cancer, and lack of education about breast health may impact women’s decision to go for a mammogram screening. Cultural beliefs, fear, embarrassments as well as providers lack of focus on breast health were significant contributors against practicing breast health. Health providers and policy makers should provide resources for the establishment health education programs regarding breast cancer early detection and mammography screening. Nurses should play a major role in delivering health education about breast health in general and breast cancer in particular. A culturally appropriate health awareness messages can be used in creating educational programs which can be employed at the national levels.

Keywords: breast health, beliefs, cultural context, ethnography, mammogram screening

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Authors: Rachel S. Chang, Samuel P. Massion, Alan Z. Grusky, Heather A. Ridinger

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Introduction Health advocacy is defined as activities that improve access to care, utilize resources, address health disparities, and influence health policy. Advocacy is increasingly being recognized as a critical component of a physician’s role, as understanding social determinants of health and improving patient care are important aspects within the American Medical Association’s Health Systems Science framework. However, despite this growing prominence, educational interventions that address advocacy topics are limited and variable across medical school curricula. Furthermore, few recent studies have evaluated attitudes toward health advocacy among physicians-in-training in the United States. This study examines medical student attitudes towards health advocacy, along with perceived knowledge, ability, and current level of engagement with health advocacy during their clerkships. Methods This study employed a cross-sectional survey design using a single anonymous, self-report questionnaire to all second-year medical students at Vanderbilt University School of Medicine (n=96) in December 2020 during clerkship rotations. The survey had 27 items with 5-point Likert scale (15), multiple choice (11), and free response questions (1). Descriptive statistics and thematic analysis were utilized to analyze responses. The study was approved by the Vanderbilt University Institutional Review Board. Results There was an 88% response rate among second-year clerkship medical students. A majority (83%) agreed that formal training in health advocacy should be a mandatory part of the medical student curriculum Likewise, 83% of respondents felt that acting as a health advocate or patients should be part of their role as a clerkship student. However, a minority (25%) felt adequately prepared. While 72% of respondents felt able to identify a psychosocial need, 18% felt confident navigating the healthcare system and only 9% felt able to connect a patient to a psychosocial resource to fill that gap. 44% of respondents regularly contributed to conversations with their medical teams when discussing patients’ social needs, such as housing insecurity, financial insecurity, or legal needs. On average, respondents reported successfully connecting patients to psychosocial resources 1-2 times per 8-week clerkship block. Barriers to participating in health advocacy included perceived time constraints, lack of awareness of resources, lower emphasis among medical teams, and scarce involvement with social work teams. Conclusions In this single-institutional study, second-year medical students on clerkships recognize the importance of advocating for patients and support advocacy training within their medical school curriculum. However, their perceived lack of ability to navigate the healthcare system and connect patients to psychosocial resources, result in students feeling unprepared to advocate as effectively as they hoped during their clerkship rotations. Our results support the ongoing need to equip medical students with training and resources necessary for them to effectively act as advocates for patients.

Keywords: clerkships, medical students, patient advocacy, social medicine

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Authors: Jonix Owino, Heather Fuller

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Refugees flee from their home countries due to civil unrest, war, persecution and migrate to Western countries such as the United States in search of a safe haven. Transitioning into a new society and culture can be challenging, thereby affecting refugee’s quality of life and well-being in the host communities. Moreover, as individuals age, they experience physical, cognitive and socioemotional changes that may impact their quality of life. However, little is known about the predictors of quality of life among aging refugees. It is not clear how quality of life varies by age, that is, between midlife refugees in comparison to their older counterparts. In addition to age, other sociodemographic factors such as gender, socioeconomic status, or country of origin are likely to have differential associations to quality of life, yet research on such variations among older refugees is sparse. Thus the present study seeks to explore factors associated with quality of life by asking the following research questions: 1) Do sociodemographic factors (such as age and gender) predict quality of life among older refugees, 2) Is there an association between social integration and quality of life, and 3) Is there an association between migratory related experiences (such as post migratory adjustments) and quality of life. The present study recruited 90 refugees (primarily originating from Bhutan, Somalia, Burundi, and Sudan) aged 50 or older living in the US. The participants completed a structured questionnaire which assessed factors such as participant’s sociodemographic attributes (e.g., age, gender, length of residence in the US, country of origin, employment, level of education, and marital status), and validated measures of social integration, post-migration living difficulties, and quality of life. Preliminary results suggest sociodemographic variability in quality of life among these refugees. Further analyses will be conducted using hierarchical regression analyses to address the following hypotheses: first, it is hypothesized that quality of life will vary by age and gender such that younger refugees and men will report higher quality of life. Second, it is expected that refugees with greater levels of social integration will also report better quality of life. Finally, post-migration factors such as language barriers and family stress are hypothesized to predict poorer quality of life. Further results will be analyzed, including potential moderating effects of age and gender, and resulting findings will be interpreted and discussed. The findings from this study have potential implications for communities on how they can better support older refugees as well as develop social programs that can effectively cater to their well-being. Conclusions will be drawn and discussed in light of policies related to both aging and refugee migration within the context of the US.

Keywords: aging out of place, migration, older refugees, quality of life, social integration

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Authors: Rosa S. Wong, Keith T.S. Tung, H.W. Tsang, Frederick K. Ho, Patrick Ip

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Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by inattention and hyperactive-impulsive behavior. Evidence shows that ADHD and mood problems such as depression and anxiety often co-occur and yet not everyone with ADHD reported elevated emotional problems. Given that cholesterol is essential for healthy brain development including the regions governing emotion regulation, reports found lower cholesterol levels in patients with major depressive disorder and those with suicide attempt behavior compared to healthy subjects. This study explored whether ADHD adolescents experienced more emotional problems and whether emotional problems correlated with cholesterol levels in these adolescents. This study used a portion of data from the longitudinal cohort study which was designed to investigate the long-term impact of family socioeconomic status on child development. In 2018/19, parents of 300 adolescents (average age: 12.57+/-0.49 years) were asked to rate their children’s emotional problems and report whether their children had doctor-diagnosed psychiatric diseases. We further collected blood samples from 263 children to study their lipid profile (total cholesterol, high-density lipoprotein (HDL)-cholesterol, and low-density lipoprotein (LDL)-cholesterol). Regression analyses were performed to test the relationships between variables of interest. Among 300 children, 27 (9%) had ADHD diagnosis. Analysis based on overall sample found no association between ADHD and emotional problems, but when investigating the relationship by gender, there was a significant interaction effect of ADHD and gender on emotional problems (p=0.037), with ADHD males displaying more emotional problems than ADHD females. Further analyses based on 263 children (21 with ADHD diagnosis) found significant interaction effect of ADHD and gender on total cholesterol (p=0.038) and low LDL-cholesterol levels (p=0.013) after adjusting for the child’s physical disease history. Specifically, ADHD males had significantly lower total cholesterol and low lipoprotein-cholesterol levels than ADHD females. In ADHD males, more emotional problems were associated with lower LDL-cholesterol levels (B = -4.26, 95%CI (-7.46, -1.07), p=0.013). We found preliminary support for the association between more emotional problems and lower cholesterol levels in ADHD children, especially among males. Although larger prospective studies are needed to substantiate these claims, the evidence highlights the importance of healthy lifestyle to keep cholesterol levels in normal range which can have positive effects on physical and mental health.

Keywords: attention-deficit hyperactivity disorder, cholesterol, emotional problems, adolescents

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Authors: Emilio Galdeano-Gómez, Ángeles Godoy-Durán, Juan C. Pérez-Mesa, Laura Piedra-Muñoz

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Eco-efficiency is receiving ever-increasing interest as an indicator of sustainability, as it links environmental and economic performances in productive activities. In agriculture, these indicators and their determinants prove relevant due to the close relationships in this activity between the use of natural resources, which is generally limited, and the provision of basic goods to society. In this context, various analyses have focused on eco-efficiency by considering individual family farms as the basic production unit. However, not only must the measure of efficiency be taken into account, but also the existence of a series of factors which constitute socio-economic, political-institutional, and environmental determinants. Said factors have been studied to a lesser extent in the literature. The present work analyzes eco-efficiency at a micro level, focusing on small-scale family farms as the main decision-making units in horticulture in southeast Spain, a sector which represents about 30% of the fresh vegetables produced in the country and about 20% of those consumed in Europe. The objectives of this study are a) to obtain a series of eco-efficiency indicators by estimating several pressure ratios and economic value added in farming, b) to analyze the influence of specific social, economic and environmental variables on the aforementioned eco-efficiency indicators. The present work applies the method of Data Envelopment Analysis (DEA), which calculates different combinations of environmental pressures (water usage, phytosanitary contamination, waste management, etc.) and aggregate economic value. In a second stage, an analysis is conducted on the influence of the socio-economic and environmental characteristics of family farms on the eco-efficiency indicators, as endogeneous variables, through the use of truncated regression and bootstrapping techniques, following Simar-Wilson methodology. The results reveal considerable inefficiency in aspects such as waste management, while there is relatively little inefficiency in water usage and nitrogen balance. On the other hand, characteristics, such as product specialization, the adoption of quality certifications and belonging to a cooperative do have a positive impact on eco-efficiency. These results are deemed to be of interest to agri-food systems structured on small-scale producers, and they may prove useful to policy-makers as regards managing public environmental programs in agriculture.

Keywords: data envelopment analysis, eco-efficiency, family farms, horticulture, socioeconomic features

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Authors: Cynthia Zgheib, Yonna Sacre

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Pregnancy, this particular moment in the life of a woman, requires monitoring of eating behavior changes. However, the food choices during pregnancy should be varied and healthy, including the consumption of different food groups. Nutritional status is the process of acquisition and consumption of food. Therefore, a varied diet is associated with good nutritional status. This is why the nutrition education is a strategy commonly applied to improve maternal nutrition during pregnancy. Thus, it is crucial to assess 'The eating behavior and nutritional status of pregnant women living in Keserwan Lebanon.' In order to evaluate the association of different persona, socioeconomic and sociodemographic factors with the eating behavior and nutrition in the concerned study category, a cross-sectional descriptive study was conducted on a sample of 150 pregnant women aging between 18 and 40 years randomly selected from the hospitals and clinics located in Keserwan area and equally distributed between different cities and villages of the area according to altitude. The purpose of this study was to evaluate the eating behavior of the concerned population and to compare it to the recommendation of the food guide pyramid, their level of food awareness and finally to analyze their blood tests in order to detect any nutrients deficiency that they may face during the course of their pregnancy. Sociodemographic, lifestyle, eating behaviour, health, eating patterns, awareness, and food frequency questionnaire (FFQ) were collected through a validated questionnaire specifically adapted for the purpose of the study. Statistical analysis was carried out, and multivariate models were used in order to evaluate the association between several independent variables and the eating behaviour and nutritional status of Lebanese pregnant women The final analysis has shown that 48.7% of pregnant women were aged between 30 and 40 years old, 56% had a normal BMI between 18.5 and 24.9, thus age affects the eating behavior, so the older are the pregnant women, and the healthier is their eating behavior. In fact, 80.7% had acceptable food behavior which is based on an equilibrium between both quantity and quality of food, although the recommended foods are foods found in the food pyramid and available in the Lebanese diet. In addition, 68% had an acceptable level of awareness concerning the health importance of good eating habits, therefore, it is positively affecting their food choices. Moreover, 50 % have an acceptable nutritional status which is confirmed by their biological tests. Future governmental or national studies and programs could be settled aiming to increase the awareness about the good eating behaviors and nutritional status of Lebanese pregnant women.

Keywords: eating behavior, nutritional status, level of awareness, pregnant woman

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Authors: S. Yesmin, N. F.Rahman, R. Akther, T. Begum, T. Tahmid, T. Chowdury, S. Afrin, J. D. Hamadani

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Abstract: Maternal depression is one of the risk factors of developmental delay in young children in low-income countries. Maternal depressions during pregnancy are rarely reported in Bangladesh. Objectives: The purpose of the present study was to examine the efficacy of a community based psychosocial intervention on women with mild to moderate depressive illness during the perinatal period and on their children from birth to 12 months on mothers’ mental status and their infants’ growth and development. Methodology: The study followed a prospective longitudinal approach with a randomized controlled design. Total 250 pregnant women aged between 15 and 40 years were enrolled in their third trimester of pregnancy of which 125 women were in the intervention group and 125 in the control group. Women in the intervention group received the “Thinking Healthy (CBT based) program” at their home setting, from their last month of pregnancy till 10 months after delivery. Their children received psychosocial stimulation from birth till 12 months. The following instruments were applied to get the outcome information- Bangla version of Edinburgh Postnatal Depression Scale (BEPDS), Prenatal Attachment Inventory (PAI), Maternal Attachment Inventory (MAI), Bayley Scale of Infant Development-Third version (Bayley–III) and Family Care Indicator (FCI). In addition, sever morbidity; breastfeeding, immunization, socio-economic and demographic information were collected. Data were collected at three time points viz. baseline, midline (6 months after delivery) and endline (12 months after delivery). Results: There was no significant difference between any of the socioeconomic and demographic variables at baseline. A very preliminary analysis of the data shows an intervention effect on Socioemotional behaviour of children at endline (p<0.001), motor development at midline (p=0.016) and at endline (p=0.065), language development at midline (p=0.004) and at endline (p=0.023), cognitive development at midline (p=0.008) and at endline (p=0.002), and quality of psychosocial stimulation at midline (p=0.023) and at endline (p=0.010). EPDS at baseline was not different between the groups (p=0.419), but there was a significant improvement at midline (p=0.027) and at endline (p=0.024) between the groups following the intervention. Conclusion: Psychosocial intervention is found effective in reducing women’s low and moderate depressive illness to cope with mental health problem and improving development of young children in Bangladesh.

Keywords: mental health, maternal depression, infant development, CBT, EPDS

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Authors: Najmeh Hamid, Vajiheh Hamedy , Zahra Rostamianasl

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Background: Cancer is one of the medical problems that have been associated with pain. Moreover, the pain is combined with negative emotions such as anxiety, depression and anger. Poor pain management causes negative effects on the quality of life, which results in negative effects that continue a long time after the painful experiences. Objectives: The aim of this research was to compare the effectiveness of Common Cognitive Behavioral Therapy for Pain and its computerized version on the reduction of pain intensity, depression, anger and anxiety in children with cancer. Methods: The research method of this “Randomized Controlled Clinical Trial” was a pre, post-test and follow-up with a control group. In this research, we have examined the effectiveness of Common Cognitive Behavioral Therapy for Pain and its computerized version on the reduction of pain intensity, anxiety, depression and anger in children with cancer in Ahvaz. Two psychological interventions (cognitive behavioral therapy for pain and the computerized version) were compared with the control group. The sample consisted of 60 children aged 8 to 12 years old with different types of cancer at Shafa hospital in Ahwaz. According to the including and excluding criteria such as age, socioeconomic status, clinical diagnostic interview and other criteria, 60 subjects were selected. Then, randomly, 45 subjects were selected. The subjects were randomly divided into three groups of 15 (two experimental and one control group). The research instruments included Spielberger Anxiety Inventory (STAY-2) and International Pain Measurement Scale. The first experimental group received 6 sessions of cognitive-behavioral therapy for 6 weeks, and the second group was subjected to a computerized version of cognitive-behavioral therapy for 6 weeks, but the control group did not receive any interventions. For ethical considerations, a version of computerized cognitive-behavioral therapy was provided to them. After 6 weeks, all three groups were evaluated as post-test and eventually after a one-month follow-up. Results: The findings of this study indicated that both interventions could reduce the negative emotions (pain, anger, anxiety, depression) associated with cancer in children in comparison with a control group (p<0.0001). In addition, there were no significant differences between the two interventions (p<0.01). It means both interventions are useful for reducing the negative effects of pain and enhancing adjustment. Conclusion: we can use CBT in situations in which there is no access to psychologists and psychological services. In addition, it can be a useful alternative to conventional psychological interventions.

Keywords: pain, children, psychological intervention, cancer, anger, anxiety, depression

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Authors: Rekha S., S. J. Nalini, S. Bhuvana, S. Kanmani, Vidhya Venugopal

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Introduction: Pregnant women's occupational heat exposure has been linked to foetal abnormalities and pregnancy complications. The presence of heat in the workplace is expected to lead to Adverse Pregnancy Outcomes (APO), especially in tropical countries where temperatures are rising and workplace cooling interventions are minimal. For effective interventions, in-depth understanding and evidence about occupational heat stress and APO are required. Methodology: Approximately 800 pregnant women in and around Chennai who were employed in jobs requiring moderate to hard labour participated in the cohort research. During the study period (2014-2019), environmental heat exposures were measured using a Questemp WBGT monitor, and heat strain markers, such as Core Body Temperature (CBT) and Urine Specific Gravity (USG), were evaluated using an Infrared Thermometer and a refractometer, respectively. Using a valid HOTHAPS questionnaire, self-reported health symptoms were collected. In addition, a postpartum follow-up with the mothers was done to collect APO-related data. Major findings of the study: Approximately 47.3% of pregnant workers have workplace WBGTs over the safe manual work threshold value for moderate/heavy employment (Average WBGT of 26.6°C±1.0°C). About 12.5% of the workers had CBT levels above the usual range, and 24.8% had USG levels above 1.020, both of which suggested mild dehydration. Miscarriages (3%), stillbirths/preterm births (3.5%), and low birth weights (8.8%) were the most common unfavorable outcomes among pregnant employees. In addition, WBGT exposures above TLVs during all trimesters were associated with a 2.3-fold increased risk of adverse fetal/maternal outcomes (95% CI: 1.4-3.8), after adjusting for potential confounding variables including age, education, socioeconomic status, abortion history, stillbirth, preterm, LBW, and BMI. The study determined that WBGTs in the workplace had direct short- and long-term effects on the health of both the mother and the foetus. Despite the study's limited scope, the findings provided valuable insights and highlighted the need for future comprehensive cohort studies and extensive data in order to establish effective policies to protect vulnerable pregnant women from the dangers of heat stress and to promote reproductive health.

Keywords: adverse outcome, heat stress, interventions, physiological strain, pregnant women

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Authors: Gustavo Cruz-Bello

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Progreso is a coastal community in Yucatan, Mexico, highly exposed to floods produced by severe storms and tropical cyclones. A participatory cartography approach was conducted to help to reduce floods disasters and assess social vulnerability within the community. The first step was to engage local authorities in risk management to facilitate the process. Two workshop were conducted, in the first, a poster size printed high spatial resolution satellite image of the town was used to gather information from the participants: eight women and seven men, among them construction workers, students, government employees and fishermen, their ages ranged between 23 and 58 years old. For the first task, participants were asked to locate emblematic places and place them in the image to familiarize with it. Then, they were asked to locate areas that get flooded, the buildings that they use as refuges, and to list actions that they usually take to reduce vulnerability, as well as to collectively come up with others that might reduce disasters. The spatial information generated at the workshops was digitized and integrated into a GIS environment. A printed version of the map was reviewed by local risk management experts, who validated feasibility of proposed actions. For the second workshop, we retrieved the information back to the community for feedback. Additionally a survey was applied in one household per block in the community to obtain socioeconomic, prevention and adaptation data. The information generated from the workshops was contrasted, through T and Chi Squared tests, with the survey data in order to probe the hypothesis that poorer or less educated people, are less prepared to face floods (more vulnerable) and live near or among higher presence of floods. Results showed that a great majority of people in the community are aware of the hazard and are prepared to face it. However, there was not a consistent relationship between regularly flooded areas with people’s average years of education, house services, or house modifications against heavy rains to be prepared to hazards. We could say that the participatory cartography intervention made participants aware of their vulnerability and made them collectively reflect about actions that can reduce disasters produced by floods. They also considered that the final map could be used as a communication and negotiation instrument with NGO and government authorities. It was not found that poorer and less educated people are located in areas with higher presence of floods.

Keywords: climate change, floods, Mexico, participatory mapping, social vulnerability

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Authors: Madeleine Elder, Aye Htun

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Background: Myiasis is the parasitic infestation of body tissues by fly larvae. It predominantly occurs in poor socioeconomic regions of tropical and subtropical countries where it is associated with poor hygiene and sanitation. Cutaneous and wound myiasis are the most common presentations whereas urogenital myiasis is rare, with few reported cases. Case: a 26-year-old primiparous woman with a low-risk pregnancy presented to the emergency department at 37+3-weeks’ gestation after passing a 2cm black larva during micturition, with 2 weeks of mild vulvar pruritus and dysuria. She had travelled to India 9-months prior. Examination of the external genitalia showed small white larvae over the vulva and anus and a mildly inflamed introitus. Speculum examination showed infiltration into the vagina and heavy white discharge. High vaginal swab reported Candida albicans. Urine microscopy reported bacteriuria with Enterobacter cloacae. Urine parasite examination showed myiasis caused by Clogmia albipunctata species of fly larvae from the family Psychodidae. Renal tract ultrasound and inflammatory markers were normal. Infectious diseases, urology and paediatric teams were consulted. The woman received treatment for her urinary tract infection (which was likely precipitated by bladder irritation from local parasite infestation) and vaginal candidiasis. She underwent daily physical removal of parasites with cleaning, speculum examination and removal, and hydration to promote bladder emptying. Due to the risk of neonatal exposure, aspiration pneumonitis and facial infestation, the woman was steroid covered and proceeded to have an elective caesarean section at 38+3-weeks’ gestation, with delivery of a healthy infant. She then proceeded to have a rigid cystoscopy and washout, which was unremarkable. Placenta histopathology revealed focal eosinophilia in keeping with the history of maternal parasites. Conclusion: Urogenital myiasis is very rare, especially in the developed world where it is seen in returned travellers. Treatment may include systemic therapy with ivermectin and physical removal of parasites. During pregnancy, physical removal is considered the safest treatment option, and discussion around the timing and mode of delivery should consider the risk of harm to the foetus.

Keywords: urogenital myiasis, parasitic infection, infection in pregnancy, returned traveller

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Authors: Lucrezia Crescenzi-Lanna, Silvia Cataldi, Williams Contreras, Valerio Pieri

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According to the European Commission, gender-based violence (GBV) is a violation of human rights and a form of discrimination against women in five areas: physical violence, sexual violence, psychological violence, mistreatment of women, and economic violence (henceforth EV). The TESORO project "Treatment, ExpoSition, and ORigin of economic viOlence: An innovation and internationalization project between Italy and Spain" focuses on this last dimension of gender-based violence, the least studied and the one that has received least media coverage. In Spain, 12% (2,350,684) of women over fifteen years of age have suffered economic violence from their partner or ex-partner during their lives. In Italy, another country participating in the project, many women who are welcomed in refuges and who report cases of psychological violence (79%) and/or physical violence (61%) are also victims of economic violence (34%), according to the D.i.Re. Thermometer: "Donne in Rete contro la Violenza", the association that brings together more than eighty refuges against violence in Italy. At the social level, this form of violence is incorporated into practices of inequality that manifest themselves in both the daily management of couples and families and the workplace and institutional settings. As for the mechanisms related to EV, the literature argues that it is a complex and multidimensional phenomenon that has socioeconomic and cultural roots. EV manifests itself through various strategies, which represent forms of power and control aimed at preventing women's financial independence. To analyse the issue of EV we use a multidisciplinary approach and a mixed design that includes: 1) a questionnaire administered to a stratified sample of more than a thousand Italian and Spanish citizens to study the cultural and socio-relational mechanisms and the origin of EV in family and couple contexts; and 2) interviews with those running refuges as part of the struggle against gender violence, to understand how mechanisms and educational activities in the field of economic violence are manifested in the respective region and are supportive of women. The decision to use this strategy responds to the need to combine an exploratory perspective with an explanatory one in order to understand some of the relevant concepts related to the complex phenomena of EV and the interventions dedicated to its prevention. The data will be finalized in June 2022 and presented at the ICWS conference. Among TESORO’s contributions, its collection of qualitative and quantitative data on EV in Italy and Spain stands out, deepening its origin, prevention, and treatment beyond its incidence, which has already been studied in the Macro-Survey on Violence against Women.

Keywords: gender-based violence, economic violence, economic harm, gender inequality, workplace and family contexts

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Authors: Sedigheh Kalantari

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Like many countries in the arid and semi-arid belt, Iran experiences a natural limitation in the availability of water resources. However, rapid socioeconomic development has created a serious water crisis in a nation that was once one of the world’s pioneers in sustainable water management, due to the Persians’ contribution to hydraulic engineering inventions – the Qanat – throughout history. The exogenous issues like the changing climate, frequent droughts, and international sanctions are only crisis catalyzers, not the main cause of the water crisis; and a resilient water management system is expected to be capable of coping with these periodic external pressures. The current dramatic water security issues in Iran are rooted in managerial, political, and institutional challenges rather than engineering and technical issues, and the country is suffering from challenges in water governance. The country, instead of rigorous water conservation efforts, is still focused on supply-driven approach, technology and centralized methods, and structural solutions that aim to increase water supply; while the effectiveness of water governance and management has often left unused. To solve these issues, it is necessary to assess the present situation and its evolution over time. In this respect, establishing water governance assessment mechanisms will be a significant aspect of this paper. The research framework, however, is a conceptual framework to assess governance performance of Iran to critically diagnose problematic issues and areas, as well as proffer empirically based solutions and determine the best possible steps towards transformational processes. This concept aims to measure the adequacy of current solutions and strategies designed to ameliorate these problems and then develop and prescribe adequate futuristic solutions. Thus, the analytical framework developed in this paper seeks to provide insights on key factors influencing water governance in Iranian cities, institutional frameworks to manage water across scales and authorities, multi-level management gaps and policy responses, through an evidence-based approach and good practices to drive reform toward sustainability and water resource conservation. The findings of this paper show that the current structure of the water governance system in Iran, coupled with the lack of a comprehensive understanding of the root causes of the problem, leaves minimal hope for developing sustainable solutions to Iran’s increasing water crisis. In order to follow sustainable development approaches, Iran needs to replace symptom management with problem prevention.

Keywords: governance, Iran, sustainable development, water management, water resources

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Authors: Perpetua Modjadji, Sphiwe Madiba

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Background: The growth patterns of children are good nutritional indicators of their nutritional status, health, and socioeconomic level. However, the maternal factors and the belief system of the society affect the growth of children promoting undernutrition. This study determined the influence of maternal factors on growth patterns of schoolchildren in a rural site. Methods: A convergent mixed method study was conducted among 508 schoolchildren and their mothers in Dikgale Health and Demographic Surveillance System Site, South Africa. Multistage sampling was used to select schools (purposive) and learners (random), who were paired with their mothers. Anthropometry was measured and socio-demographic, obstetrical, household information, maternal influence on children’s nutrition, and growth were assessed using an interviewer administered questionnaire (quantitative). The influence of the cultural beliefs and practices of mothers on the nutrition and growth of their children was explored using focus group discussions (qualitative). Narratives of mothers were used to best understand growth patterns of schoolchildren (mixed method). Data were analyzed using STATA 14 (quantitative) and Nvivo 11 (qualitative). Quantitative and qualitative data were merged for integrated mixed method analysis using a joint display analysis. Results: Mean age of children was 10 ± 2 years, ranging from 6 to 15 years. Substantial percentages of thinness (25%), underweight (24%), and stunting (22%) were observed among the children. Mothers had a mean age of 37 ± 7 years, and 75% were overweight or obese. A depressed socio-economic status indicated by a higher rate of unemployment with no income (82.3%), and dependency on social grants (86.8%) was observed. Determinants of poor growth patterns were child’s age and gender, maternal age, height and BMI, access to water supply, and refrigerator use. The narratives of mothers suggested that the children in most of their households were exposed to poverty and the inadequate intake of quality food. Conclusion: Poor growth patterns were observed among schoolchildren while their mothers were overweight or obese. Child’s gender, school grade, maternal body mass index, and access to water were the main determinants. Congruence was observed between most qualitative themes and quantitative constructs. A need for a multi sectoral approach considering an evidence based and feasible nutrition programs for schoolchildren, especially those in rural settings and educating mothers, cannot be over-emphasized.

Keywords: growth patterns, maternal factors, rural context, schoolchildren, South Africa

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Authors: Melanie Grier, Adam Murry

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Objective: Worldwide, Indigenous Peoples experience underemployment and poverty at disproportionately higher rates than non-Indigenous people, despite similar rates of employment seeking. Euro-colonial conquest and genocidal assimilation policies are implicated as perpetuating poverty, which research consistently links to health and wellbeing disparities. Many of the contributors to poverty, such as inadequate income and lack of access to medical care, can be directly or indirectly linked to underemployment. Calls have been made to prioritize Indigenous perspectives in Industrial-Organizational (I/O) psychology research, yet the literature on Indigenous employment remains scarce. What does exist is disciplinarily diverse, topically scattered, and lacking evidence of community-based participatory research (CBPR) practices, a research project approach which prioritizes community leadership, partnership, and betterment and reduces the potential for harm. Due to the harmful colonial legacy of extractive scientific inquiry "on" rather than "with" Indigenous groups, Indigenous leaders and research funding agencies advocate for academic researchers to adopt reparative research methodologies such as CBPR to be used when studying issues pertaining to Indigenous Peoples or individuals. However, the frequency and consistency of CBPR implementation within scholarly discourse are unknown. Therefore, this project’s goal is two-fold: (1) to understand what comprises CBPR in Indigenous research and (2) to determine if CBPR has been historically used in Indigenous employment research. Method: Using a systematic literature review process, sixteen articles about CBPR use with Indigenous groups were selected, and content was analyzed to identify key components comprising CBPR usage. An Indigenous CBPR components framework was constructed and subsequently utilized to analyze the Indigenous employment empirical literature. A similar systematic literature review process was followed to search for relevant empirical articles on Indigenous employment. A total of 120 articles were identified in six global regions: Australia, New Zealand, Canada, America, the Pacific Islands, and Greenland/Norway. Each empirical study was procedurally examined and coded for criteria inclusion using content analysis directives. Results: Analysis revealed that, in total, CBPR elements were used 14% of the time in Indigenous employment research. Most studies (n=69; 58%) neglected to mention using any CBPR components, while just two studies discussed implementing all sixteen (2%). The most significant determinant of overall CBPR use was community member partnership (CP) in the research process. Studies from New Zealand were most likely to use CBPR components, followed by Canada, Australia, and America. While CBPR use did increase slowly over time, meaningful temporal trends were not found. Further, CBPR use did not directly correspond with the total number of topical articles published that year. Conclusions: Community-initiated and engaged research approaches must be better utilized in employment studies involving Indigenous Peoples. Future research efforts must be particularly attentive to community-driven objectives and research protocols, emphasizing specific areas of concern relevant to the field of I/O psychology, such as organizational support, recruitment, and selection.

Keywords: community-based participatory research, content analysis, employment, indigenous research, international, reconciliation, recruitment, reparative research, selection, systematic literature review

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Authors: Maria De Albuquerque Bercot, Caio Gustavo Mesquita Angelo, Daniela Maria Moreira Siqueira, Augusto Assucena De Vasconcellos, Rodrigo Studart Correa

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Mining is an important socioeconomic activity in Brazil although it negatively impacts the environment. Mineral operations cause irreversible changes in topography, removal of vegetation and topsoil, habitat destruction, displacement of fauna, loss of biodiversity, soil erosion, siltation of watercourses and have potential to enhance climate change. Due to the impacts and its pollution potential, mining activity in Brazil is legally subjected to environmental licensing. Unlicensed mining operations or operations that not abide to the terms of an obtained license are taken as environmental crimes in the country. This work reports a case analyzed in the Forensic Institute of the Brazilian Federal District Civil Police. The case consisted of detecting illegal aspects of sand exploitation from a licensed mine in Federal District, nearby Brasilia city. The fieldwork covered an area of roughly 6 ha, which was surveyed with an unmanned aerial vehicle (UAV) (PHANTOM 3 ADVANCED). The overflight with UAV took about 20 min, with maximum flight height of 100 m. 592 UAV georeferenced images were obtained and processed in a photogrammetric software (AGISOFT PHOTOSCAN 1.1.4), which generated a mosaic of geo-referenced images and a 3D model in less than six working hours. The 3D model was analyzed in a forensic software for accurate modeling and volumetric analysis. (MAPTEK I-SITE FORENSIC 2.2). To ensure the 3D model was a true representation of the mine site, coordinates of ten control points and reference measures were taken during fieldwork and compared to respective spatial data in the model. Finally, these spatial data were used for measuring mining area, excavation depth and volume of exploited sand. Results showed that mine holder had not complied with some terms and conditions stated in the granted license, such as sand exploration beyond authorized extension, depth and volume. Easiness, the accuracy and expedition of procedures used in this case highlight the employment of UAV imagery and computational photogrammetry as efficient tools for outdoor forensic exams, especially on environmental issues.

Keywords: computational photogrammetry, environmental monitoring, mining, UAV

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Authors: Uwizera Egide

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Introduction: Dermatological conditions are one of the most burdensome diseases in our health system. Global studies suggest that around 1 in 3 people gets a skin disease at a certain point in their life, though this does not necessarily guarantee the urge to consult. For a high-ranking disease, it is surprising how there is not enough data to support its effect on the economy and the general health system impact. It is for that reason that this study’s aim is to identify the burden of dermatological conditions in Rwanda so as to have a general picture of what our population is going through in regards to dermatological conditions. Methods: We used a cross sectional retrospective study. Data were obtained from patient’s information recorded in an open clinic at CHUB in a period of six months from July to December of the year 2021. Results: The study had a total of 4600 patients who attended dermatology service in a period of six months from July to December of the year 2021. We found a list of 102 dermatological diseases that presented at variable rates. The most prevalent disease was atopic dermatitis, at a rate of 23%. About 90% of presented conditions had only one choice of treatment from the hospital pharmacy. Most patients who presented were between 18-35 years old and with a predominance of the female gender; the level of education was either secondary or University Degree in our study, 65.4% of patients who presented were female; the majority, around 45% were between 18-35 years old, mostly being single 56%. The majority came from Southern province as it is the location of the hospital. The insurance mostly used was community-based health insurance with 63.8%, followed by RSSB with 18.5%, MS/UR, and other private insurances. The frequency of group drugs prescribed among all dermatological medications, steroids were the most commonly given medications at a rate of 39%, followed by emollients, antibiotics, and antifungal. The drugs prescribed were mostly available in the pharmacy of CHUB, with 60% and 40% being found in pharmacies outside the hospital. Conclusion: Dermatological conditions are prevalent in all age groups and distributed through all socioeconomic classes. About 9.2% of patient who consulted CHUB in 2021 presented one Dermatological condition of which 40 % of prescribed medications is never found in Hospital urging a need to buy medication in private pharmacies with more expenses and a risk of not complying on prescribed medication if in case they can’t afford paying them outside the CHUB. This finding urges a need to avail all essential dermatological drugs in hospital pharmacies to allow our patients to get them for the proper compliance of prescribed drugs in the management of skin diseases.

Keywords: atopic dermatitis, CHUB (centre hopitalier univerisitaire de butare), dermatological condition, fungal infections

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Authors: Terryann Clark, Kabir Dasgupta, Sonia Lewycka, Gail Pacheco, Alexander Plum

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This paper focused on two main research aims using data from the Growing Up in New Zealand (GUINZ) birth cohort: 1. To examine ethnic differences in life-course trajectories in the use and experience of healthcare services in early childhood years (namely immunisation, dental checks and use of General Practitioners (GPs)) 2. To quantify the contribution of relevant explanatory factors to ethnic differences. Current policy in New Zealand indicates there should be, in terms of associated direct costs, equitable access by ethnicity for healthcare services. However, empirical evidence points to persistent ethnic gaps in several domains. For example, the data highlighted that Māori have the lowest immunisation rates, across a number of time points in early childhood – despite having a higher antenatal intention to immunise relative to NZ European. Further to that, NZ European are much more likely to have their first-choice lead maternity caregiver (LMC) and use child dental services compared to all ethnicities. Method: This research explored the underlying mechanisms behind ethnic differences in the use and experience of child healthcare services. First, a multivariate regression analysis was used to adjust raw ethnic gaps in child health care utilisation by relevant covariates. This included a range of factors, encompassing mobility, socio-economic status, mother and child characteristics, household characteristics and other social aspects. Second, a decomposition analysis was used to assess the proportion of each ethnic gap that can be explained, as well as the main drivers behind the explained component. The analysis for both econometric approaches was repeated for each data time point available, which included antenatal, 9 months, 2 years and 4 years post-birth. Results: The following findings emerged: There is consistent evidence that Asian and Pacific peoples have a higher likelihood of child immunisation relative to NZ Europeans and Māori. This was evident at all time points except one. Pacific peoples had a lower rate relative to NZ European for receiving all first-year immunisations on time. For a number of potential individual and household predictors of healthcare service utilisation, the association is time-variant across early childhood. For example, socio-economic status appears highly relevant for timely immunisations in a child’s first year, but is then insignificant for the 15 month immunisations and those at age 4. Social factors play a key role. This included discouragement or encouragement regarding child immunisation. When broken down by source, discouragement by family has the largest marginal effect, followed by health professionals; whereas for encouragement, medical professionals have the largest positive influence. Perceived ethnically motivated discrimination by a health professional was significant with respect to both reducing the likelihood of achieving first choice LMC, and also satisfaction levels with child’s GP. Some ethnic gaps were largely unexplained, despite the wealth of factors employed as independent variables in our analysis. This included understanding why Pacific mothers are much less likely to achieve their first choice LMC compared to NZ Europeans; and also the ethnic gaps for both Māori and Pacific peoples relative to NZ Europeans concerning dental service use.

Keywords: child health, cohort analysis, ethnic disparities, primary healthcare

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Authors: Terefe Fuge, George Tsourtos , Emma Miller

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Objectives: Maintaining optimal adherence and viral suppression in people living with HIV (PLWHA) is essential to ensure both preventative and therapeutic benefits of antiretroviral therapy (ART). Prisoners bear a particularly high burden of HIV infection and are highly likely to transmit to others during and after incarceration. However, the level of adherence and viral suppression, as well as its associated factors in incarcerated populations in low-income countries is unknown. This study aimed to determine the prevalence of non-adherence and viral failure, and contributing factors to this amongst prisoners in South Ethiopia. Methods: A prospective cohort study was conducted between June 1, 2019 and July 31, 2020 to compare the level of adherence and viral suppression between incarcerated and non-incarcerated PLWHA. The study involved 74 inmates living with HIV (ILWHA) and 296 non-incarcerated PLWHA. Background information including sociodemographic, socioeconomic, psychosocial, behavioural, and incarceration-related characteristics was collected using a structured questionnaire. Adherence was determined based on participants’ self-report and pharmacy refill records, and plasma viral load measurements which were undertaken within the study period were prospectively extracted to determine viral suppression. Various univariate and multivariate regression models were used to analyse data. Results: Self-reported dose adherence was approximately similar between ILWHA and non-incarcerated PLWHA (81% and 83% respectively), but ILWHA had a significantly higher medication possession ratio (MPR) (89% vs 75%). The prevalence of viral failure (VF) was slightly higher (6%) in ILWHA compared to non-incarcerated PLWHA (4.4%). The overall dose non-adherence (NA) was significantly associated with missing ART appointments, level of satisfaction with ART services, patient’s ability to comply with a specified medication schedule and types of methods used to monitor the schedule. In ILWHA specifically, accessing ART services from a hospital compared to a health centre, an inability to always attend clinic appointments, experience of depression and a lack of social support predicted NA. VF was significantly higher in males, people of age 31-35 years and in those who experienced social stigma, regardless of their incarceration status. Conclusions: This study revealed that HIV-infected prisoners in South Ethiopia were more likely to be non-adherent to doses and so to develop viral failure compared to their non-incarcerated counterparts. A multitude of factors was found to be responsible for this requiring multilevel intervention strategies focusing on the specific needs of prisoners.

Keywords: Adherence , Antiretroviral therapy, Incarceration, South Ethiopia, Viral suppression

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Authors: Keiko Yamauchi, Motoyuki Nakao, Yoko Ishihara

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The increase in the number of women with breast cancer in Japan has required hospitals to provide a higher quality of medicine so that patients are satisfied with the treatment they receive. However, patients’ satisfaction following breast cancer treatment has not been sufficiently studied. Hence, we investigated the factors influencing patient satisfaction following breast cancer treatment among Japanese women. These women underwent either breast-conserving surgery (BCS) (n = 380) or total mastectomy (TM) (n = 247). In March 2016, we conducted a cross-sectional internet survey of Japanese women with breast cancer in Japan. We assessed the following factors: socioeconomic status, cancer-related information, the role of medical decision-making, the degree of satisfaction regarding the treatments received, and the regret arising from the medical decision-making processes. We performed logistic regression analyses with the following dependent variables: extreme satisfaction with the treatments received, and regret regarding the medical decision-making process. For both types of surgery, the odds ratio (OR) of being extremely satisfied with the cancer treatment was significantly higher among patients who did not have any regrets compared to patients who had. Also, the OR tended to be higher among patients who chose to play a wanted role in the medical decision-making process, compared with patients who did not. In the BCS group, the OR of being extremely satisfied with the treatment was higher if, at diagnosis, the patient’s youngest child was older than 19 years, compared with patients with no children. The OR was also higher if patient considered the stage and characteristics of their cancer significant. The OR of being extremely satisfied with the treatments was lower among patients who were not employed on full-time basis, and among patients who considered the second medical opinions and medical expenses to be significant. These associations were not observed in the TM group. The OR of having regrets regarding the medical decision-making process was higher among patients who chose to play a role in the decision-making process as they preferred, and was also higher in patients who were employed on either a part-time or contractual basis. For both types of surgery, the OR was higher among patients who considered a second medical opinion to be significant. Regardless of surgical type, regret regarding the medical decision-making process decreases treatment satisfaction. Patients who received breast-conserving surgery were more likely to have regrets concerning the medical decision-making process if they could not play a role in the process as they preferred. In addition, factors associated with the satisfaction with treatment in BCS group but not TM group included the second medical opinion, medical expenses, employment status, and age of the youngest child at diagnosis.

Keywords: medical decision making, breast-conserving surgery, total mastectomy, Japanese

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Authors: S. Mahdi Sadatmansouri, Maryam Khalili

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World, nowadays, encounters serious water scarcity problem. During the past few years, by advent of Smart Energy and Water Meter (SEWM) and its installation at the electro-pumps of the water wells, one had believed that it could be the golden key to address the groundwater resources over-pumping issue. In fact, implementation of these Smart Meters managed to control the water table drawdown for short; but it was not a sustainable approach. SEWM has been considered as law enforcement facility at first; however, for solving a complex socioeconomic problem like shared groundwater resources management, more than just enforcement is required: participation to conserve common resources. The well owners or farmers, as water consumers, are the main and direct stakeholders of this system and other stakeholders could be government sectors, investors, technology providers, privet sectors or ordinary people. Designing a socio-technical system not only defines the role of each stakeholder but also can lubricate the communication to reach the system goals while benefits of each are considered and provided. Farmers, as the key participators for solving groundwater problem, do not trust governments but they would trust a fair system in which responsibilities, privileges and benefits are clear. Technology could help this system remained impartial and productive. Social aspects provide rules, regulations, social objects and etc. for the system and help it to be more human-centered. As the design methodology, Design Thinking provides probable solutions for the challenging problems and ongoing conflicts; it could enlighten the way in which the final system could be designed. Using Human Centered Design approach of IDEO helps to keep farmers in the center of the solution and provides a vision by which stakeholders’ requirements and needs are addressed effectively. Farmers would be considered to trust the system and participate in their groundwater resources management if they find the rules and tools of the system fair and effective. Besides, implementation of the socio-technical system could change farmers’ behavior in order that they concern more about their valuable shared water resources as well as their farm profit. This socio-technical system contains nine main subsystems: 1) Measurement and Monitoring system, 2) Legislation and Governmental system, 3) Information Sharing system, 4) Knowledge based NGOs, 5) Integrated Farm Management system (using IoT), 6) Water Market and Water Banking system, 7) Gamification, 8) Agribusiness ecosystem, 9) Investment system.

Keywords: human centered design, participatory management, smart energy and water meter (SEWM), social object, socio-technical system, water table drawdown

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

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

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

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Authors: Steven G. Sclan

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Background: Since December 2019, the world has been afflicted by the spread of the Severe Acute Respiratory Syndrome-Corona Virus-2 (SARS-CoV-2), which is responsible for the condition referred to as Covid-19. The illness has had a cataclysmic impact on the political, social, economic, and overall well-being of the population of the entire globe. While Covid-19 has had a substantial universal fatality impact, it may have an even greater effect on the socioeconomic, medical well-being, and healthcare planning for remaining societies. Significance: As these numbers illustrate, many more persons survive the infection than die from it, and many of those patients have noted ongoing, persistent symptoms after successfully enduring the acute phase of the illness. Recognition and understanding of these symptoms are crucial for developing and arranging efficacious models of care for all patients (whether or not having been hospitalized) surviving acute covid illness and plagued by post-acute symptoms. Furthermore, regarding Covid infection in children (< 18 y/o), although it may be that Covid “+” children are not major vectors of infective transmission, it now appears that many more children than initially thought are carrying the virus without accompanying obvious symptomatic expression. It seems reasonable to wonder whether viral effects occur in children – those children who are Covid “+” and now asymptomatic – and if, over time, they might also experience similar symptoms. An even more significant question is whether Covid “+” asymptomatic children might manifest increased multiple health problems as they grow – i.e., developmental complications (e.g., physical/medical, metabolic, neurobehavioral, etc.) – in comparison to children who had been consistently Covid “ - ” during the pandemic. Topics Addressed and Theoretical Importance: This review is important because of the description of both quantitative and qualitative methods for clinical and biomedical research. Topics reviewed will consider the importance of well-designed, comprehensive (i.e., quantitative and qualitative methods) longitudinal studies of Post Covid-19 symptoms in both adults and children. Also reviewed will be general characteristics of longitudinal studies and a presentation of a model for a proposed study. Also discussed will be the benefit of longitudinal studies for the development of efficacious interventions and for the establishment of cogent, practical, and efficacious community healthcare service planning for post-acute covid patients. Conclusion: Results of multi-dimensional, longitudinal studies will have important theoretical implications. These studies will help to improve our understanding of the pathophysiology of long COVID and will aid in the identification of potential targets for treatment. Such studies can also provide valuable insights into the long-term impact of COVID-19 on public health and socioeconomics.

Keywords: COVID-19, post-COVID-19, long COVID, longitudinal research, quantitative research, qualitative research

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Authors: Amina Naidja, Zedira Khammar, Ines Soltani

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This study investigates the impact of urban development on the urban heat island (UHI) effect in the semi-arid Aures region of Algeria, integrating remote sensing data with statistical analysis and community surveys to examine the interconnected environmental and social dynamics. Using Landsat 8 satellite imagery, temporal variations in the Normalized Difference Vegetation Index (NDVI), Normalized Difference Built-up Index (NDBI), and land use/land cover (LULC) changes are analyzed to understand patterns of urbanization and environmental transformation. These environmental metrics are correlated with land surface temperature (LST) data derived from remote sensing to quantify the UHI effect. To incorporate the social dimension, a structured questionnaire survey is conducted among residents in selected urban areas. The survey assesses community perceptions of urban heat, its impacts on daily life, health concerns, and coping strategies. Statistical analysis is employed to analyze survey responses, identifying correlations between demographic factors, socioeconomic status, and perceived heat stress. Preliminary findings reveal significant correlations between built-up areas (NDBI) and higher LST, indicating the contribution of urbanization to local warming. Conversely, areas with higher vegetation cover (NDVI) exhibit lower LST, highlighting the cooling effect of green spaces. Social survey results provide insights into how UHI affects different demographic groups, with vulnerable populations experiencing greater heat-related challenges. By integrating remote sensing analysis with statistical modeling and community surveys, this study offers a comprehensive understanding of the environmental and social implications of urban development in semi-arid climates. The findings contribute to evidence-based urban planning strategies that prioritize environmental sustainability and social well-being. Future research should focus on policy recommendations and community engagement initiatives to mitigate UHI impacts and promote climate-resilient urban development.

Keywords: urban heat island, remote sensing, social analysis, NDVI, NDBI, LST, community perception

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Authors: Haiyan Huang, Jan Blommaert, Ellen Van Praet

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The embrace of neoliberal economic system in China has engendered the entry of global commodity capitalism into domestic Chinese market and ushered in the post-feminism that is closely associated with consumerism from western culture. Chinese women are instilled and thus hold the belief of empowering themselves and expressing their individualism through consumption. To unravel the consumerist ideologies embedded in Li’s discursive practices, we rely on critical discourse analysis (CDA) as our research framework. The data analyses suggest that cosmopolitanism and class are two repeating themes when Li engages in persuading consumerist behaviors from the female audience. Through hints and cues such as “going on business trips”, “traveling abroad”, “international brands” and among others, Li provides the access to and possibility of imagining cosmopolitan and middle class identity for his audience. Such yearning for western culture and global citizen identity also implicates the aspiration for a well-off socioeconomic status, proving that post-feminism in China not only embodies western consumerism but also implicates the struggle of class movement. These defining elements of choice and freedom are well-situated in contemporary Chinese society where women are enjoying more educational and economic independence than before. However a closer examination reveals conflicts between hegemonic discourse of post-feminism and the status quo. First, propagating women’s power through consumption obscure the entrenched gender inequality in China. Philosophies such as employment discrimination, equal payment, education right, etc., the cornerstones of feminism did not exist in China, leading to historical gender issues unsolved. Second, the lengthy broadcastings (which normally last more than 2 hours) featured with big discounts on products beg the question who are the real audience of ecommerce livestreaming. Seemingly addressing to young well-off Chinese females, Li’s discursive practice can be targeting at young but not wealthy girls who aspire to mimic the lifestyle of middle class women. By selling the idea of empowering and constructing identity through consuming beauty products (e.g., lipsticks), capitalists are endeavoring to create the post-feminism illusion and cause anxieties among Chinese females. Through in-depth analyses of hegemonic discourse on ecommerce livestreaming of lipsticks, the paper contributes to a better understanding of post-feminism in contemporary China and meanwhile illustrates the problems Chinese women face in securing power and equality.

Keywords: Chinese women, critical discourse analysis, ecommerce livestreaming, post-feminism

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Authors: Dina Dahood Dabash

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Refugee camps are habitually defined as receptive sites, transient spaces of exile and nondescript depoliticized places of exception. However, such arguments form partial sides of reality, especially in countries that are geopolitically challenged and rely immensely on international aid. In Jordan, the dynamics brought with the floating population of refugees (Palestinian amongst others) have resulted in spatial after-effects that cannot be easily overlooked. For instance, Palestine refugee camps have turned by time into socioeconomic centers of gravity and cores of spatial evolution. Yet, such a position is not instantaneous. Amongst various reasons, it can be related, according to this paper, to a distinctive institutional climate that has been co-produced by the refugees, host community and the state. This paper aims to investigate the evolution of urban and spatial regulations in Jordan between 1948 and 1995, more specifically, state regulations, community regulations and refugee-self-regulation that all dynamically interacted that period. The paper aims to unpack the relations between refugee camps and their environs to further explore the agency of such floating populations in establishing rooted networks that extended the time and place boundaries. The paper’s argument stems from the fact that the spatial configuration of urban systems is not only an outcome of a historical evolutionary process but is also a result of interactions between the actors. The research operationalizes Marka camp in Jordan as a case study. Marka Camp is one of the six "emergency" camps erected in 1968 to shelter 15,000 Palestine refugees and displaced persons who left the West Bank and Gaza Strip. Nowadays, camp shelters more than 50,000 refugees in the same area of land. The camp is located in Russeifa, a city in Zarqa Governorate in Jordan. Together with Amman and Zarqa, Russeifa is part of a larger metropolitan area that acts as a home to more than half of Jordan’s businesses. The paper aspires to further understand the post-conflict strategies which were historically applied in Jordan and can be employed to handle more recent geopolitical challenges such as the Syrian refugee crisis. Methodological framework: The paper traces the evolution of the refugee-camp regulating norms in Jordan, parallel with the horizontal and vertical evolution of the Marka camp and its surroundings. Consequently, the main methods employed are historical and mental tracing, Interviews, in addition to using available Aerial and archival photos of the Marka camp and its surrounding.

Keywords: forced migration, Palestine refugee camps, spatial agency, urban regulations

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Authors: Yusuf Berkay Metinal, Gulden Gumusburun Ayalp

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Architectural education is characterized by its distinctive amalgamation of studio-based pedagogy and theoretical instruction. It offers students a comprehensive learning experience that blends practical skill development with critical inquiry and conceptual exploration. Design studios are central to this educational paradigm, which serve as dynamic hubs of creativity and innovation, providing students with immersive environments for experimentation and collaborative engagement. The physical presence and interactive dynamics inherent in studio-based learning underscore the indispensability of face-to-face instruction and interpersonal interaction in nurturing the next generation of architects. However, architectural education underwent a seismic transformation in response to the global COVID-19 pandemic, precipitating an abrupt transition from traditional, in-person instruction to online education modalities. While this shift introduced newfound flexibility in terms of temporal and spatial constraints, it also brought many challenges to the fore. Chief among these challenges was maintaining effective communication and fostering meaningful collaboration among students in virtual learning environments. Besides these challenges, lack of peer learning emerged as a vital issue of the educational experience, particularly crucial for novice students navigating the intricacies of architectural practice. Nevertheless, the pivot to online education also laid bare a discernible decline in educational efficacy, prompting inquiries regarding the enduring viability of online education in architectural pedagogy. Moreover, as educational institutions grappled with the exigencies of remote instruction, discernible disparities between different institutional contexts emerged. While state universities often contended with fiscal constraints that shaped their operational capacities, private institutions encountered challenges from a lack of institutional fortification and entrenched educational traditions. Acknowledging the multifaceted nature of these challenges, this study endeavored to undertake a comprehensive inquiry into the dynamics of online education within architectural pedagogy by interrogating variables such as class level and type of university; the research aimed to elucidate demographic critical success factors that underpin the effectiveness of online education initiatives. To this end, a meticulously constructed questionnaire was administered to architecture students from diverse academic institutions across Turkey, informed by an exhaustive review of extant literature and scholarly discourse. The resulting dataset, comprising responses from 232 participants, underwent rigorous statistical analysis, including independent samples t-test and one-way ANOVA, to discern patterns and correlations indicative of overarching trends and salient insights. In sum, the findings of this study serve as a scholarly compass for educators, policymakers, and stakeholders navigating the evolving landscapes of architectural education. By elucidating the intricate interplay of demographical factors that shape the efficacy of online education in architectural pedagogy, this research offers a scholarly foundation upon which to anchor informed decisions and strategic interventions to elevate the educational experience for future cohorts of aspiring architects.

Keywords: architectural education, COVID-19, distance education, online education

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Authors: Ozgul Kartal, Wade Tillett, Lyn D. English

Abstract:

Despite its global significance in curricula, mathematical modeling encounters persistent disparities in recognition and emphasis within regular mathematics classrooms and teacher education across countries with diverse educational and cultural traditions, including variations in the perceived role of mathematical modeling. Over the past two decades, increased attention has been given to the integration of mathematical modeling into national curriculum standards in the U.S. and other countries. Therefore, the mathematics education research community has dedicated significant efforts to investigate various aspects associated with the teaching and learning of mathematical modeling, primarily focusing on exploring the applicability of modeling in schools and assessing students', teachers', and preservice teachers' (PTs) competencies and engagement in modeling cycles and processes. However, limited attention has been directed toward examining potential resistance hindering teachers and PTs from effectively implementing mathematical modeling. This study focuses on how PTs, without prior modeling experience, resist and/or embrace mathematical modeling and its pedagogy as they learn about models and modeling perspectives, navigate the modeling process, design and implement their modeling activities and lesson plans, and experience the pedagogy enabling modeling. Model eliciting activities (MEAs) were employed due to their high potential to support the development of mathematical modeling pedagogy. The mathematical modeling module was integrated into a mathematics methods course to explore how PTs embraced or resisted mathematical modeling and its pedagogy. The module design included reading, reflecting, engaging in modeling, assessing models, creating a modeling task (MEA), and designing a modeling lesson employing an MEA. Twelve senior undergraduate students participated, and data collection involved video recordings, written prompts, lesson plans, and reflections. An open coding analysis revealed acceptance and resistance toward teaching mathematical modeling. The study identified four overarching themes, including both acceptance and resistance: pedagogy, affordance of modeling (tasks), modeling actions, and adjusting modeling. In the category of pedagogy, PTs displayed acceptance based on potential pedagogical benefits and resistance due to various concerns. The affordance of modeling (tasks) category emerged from instances when PTs showed acceptance or resistance while discussing the nature and quality of modeling tasks, often debating whether modeling is considered mathematics. PTs demonstrated both acceptance and resistance in their modeling actions, engaging in modeling cycles as students and designing/implementing MEAs as teachers. The adjusting modeling category captured instances where PTs accepted or resisted maintaining the qualities and nature of the modeling experience or converted modeling into a typical structured mathematics experience for students. While PTs displayed a mix of acceptance and resistance in their modeling actions, limitations were observed in embracing complexity and adhering to model principles. The study provides valuable insights into the challenges and opportunities of integrating mathematical modeling into teacher education, emphasizing the importance of addressing pedagogical concerns and providing support for effective implementation. In conclusion, this research offers a comprehensive understanding of PTs' engagement with modeling, advocating for a more focused discussion on the distinct nature and significance of mathematical modeling in the broader curriculum to establish a foundation for effective teacher education programs.

Keywords: mathematical modeling, model eliciting activities, modeling pedagogy, secondary teacher education

Procedia PDF Downloads 65

Authors: Kristine Demilou Santiago

Abstract:

In a context of a developing nation, how important is the role of Corporate Social Responsibility health programs? Is there a possibility that this will render a large impact in a society where health benefits are insufficient? The Philippine government has been in an unceasing battle to provide its citizens competitive health benefits through launching various health programs. As the efforts are being claimed by the government, the numbers just show that all the health benefits being offered such as PhilHealth health cards, medical missions and other subsidized government health benefits are not effective and sufficient at the minimum level. This is a major characteristic of a developing nation which the Philippine government is focusing on addressing as it becomes a national concern under the effects of poverty. Industrial companies, through Corporate Social Responsibility, are playing an important role in the aspiration to resolve this problem on health programs as supposed to be basic services to citizens of the Philippine government. The rise of commitment by these industrial companies to render health programs to communities as part of their corporate citizenship has covered a large portion of the basic health services that the Filipino citizens are supposed to be receiving. This is the most salient subject that a developing nation should focus on determining the important contribution of industrial companies present in their country as part of the citizens’ access to basic health services. The use of survey forms containing quantitative and qualitative questions which aim to give numerical figures and support answers as to the role of CSR Health programs in helping the communities receive the basic health services they need was the methodological procedure followed in this research. A sample population in a community where the largest industrial company in a province of the Philippines was taken through simple random sampling. The assumption is that this sample population which represents the whole of the community has the highest opportunities to access both the government health services and the CSR health program services of the industrial company located in their community. Results of the research have shown a significant level of participation by industrial companies through their CSR health programs in the attainment of basic health services that should be rendered by the Philippine government to its citizens as part of the state’s health benefits. In a context of a developing nation such as the Philippines, the role of Corporate Social Responsibility is beyond the expectation of initiating to resolve environmental and social issues. It is moving deeper in the concept of the corporate industries being a pillar of the government in catering the support needed by the individuals in the community for its development. As such, the concept of the presence of an industrial company in a community is said to be a parallel progress: by which when an industrial company expands because it is becoming more profitable, so is the community gaining the same step of progress in terms of socioeconomic development.

Keywords: basic health services, CSR health program, health services in a developing nation, Philippines health benefits

Procedia PDF Downloads 207