Search results for: primary health care

Authors: Nwachukwu Ifeanyi

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Wind energy is a vital component of the global renewable energy portfolio, with wind turbines serving as the primary means of harnessing this abundant resource. However, the efficiency and stability of wind turbines remain critical challenges in maximizing energy output and ensuring long-term operational viability. This study proposes a comprehensive approach utilizing computational aerodynamics and aeromechanics to optimize wind turbine performance across multiple objectives. The proposed research aims to integrate advanced computational fluid dynamics (CFD) simulations with structural analysis techniques to enhance the aerodynamic efficiency and mechanical stability of wind turbine blades. By leveraging multi-objective optimization algorithms, the study seeks to simultaneously optimize aerodynamic performance metrics such as lift-to-drag ratio and power coefficient while ensuring structural integrity and minimizing fatigue loads on the turbine components. Furthermore, the investigation will explore the influence of various design parameters, including blade geometry, airfoil profiles, and turbine operating conditions, on the overall performance and stability of wind turbines. Through detailed parametric studies and sensitivity analyses, valuable insights into the complex interplay between aerodynamics and structural dynamics will be gained, facilitating the development of next-generation wind turbine designs. Ultimately, this research endeavours to contribute to the advancement of sustainable energy technologies by providing innovative solutions to enhance the efficiency, reliability, and economic viability of wind power generation systems. The findings have the potential to inform the design and optimization of wind turbines, leading to increased energy output, reduced maintenance costs, and greater environmental benefits in the transition towards a cleaner and more sustainable energy future.

Keywords: computation, robotics, mathematics, simulation

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Authors: M. A. Riurean, S. Heijnen, C. A. Knott, J. Makinde, D. Gotti, J. VD. Kamp

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Objectives: The current study is done in preparation for a randomized controlled study investigating the effects of an implicit motor learning protocol implemented using an extension-supporting glove. It will explore different protocols to find out which is preferred when studying motor learn-ing in the chronic stroke population that struggles with hand spasticity. Design: This exploratory study will follow 24 individuals who have a chronic stroke (> 6 months) during their usual care journey. We will record the results of two 9-Hole Peg Tests (9HPT) done during their therapy ses-sions with a physiotherapist or in their home before and after 4 weeks of them wearing an exten-sion-supporting glove used to employ the to-be-studied protocols. The participants will wear the glove 3 times/week for one hour while performing their activities of daily living and record the times they wore it in a diary. Their experience will be monitored through telecommunication once every week. Subjects: Individuals that have had a stroke at least 6 months prior to participation, hand spasticity measured on the modified Ashworth Scale of maximum 3, and finger flexion motor control measured on the Motricity Index of at least 19/33. Exclusion criteria: extreme hemi-neglect. Methods: The participants will be randomly divided into 3 groups: one group using the glove in a pre-set way of decreasing support (implicit motor learning), one group using the glove in a self-controlled way of decreasing support (autonomous motor learning), and the third using the glove with constant support (as control). Before and after the 4-week period, there will be an intake session and a post-assessment session. Analysis: We will compare the results of the two 9HPTs to check whether the protocols were effective. Furthermore, we will compare the results between the three groups to find the preferred one. A qualitative analysis will be run of the experience of participants throughout the 4-week period. Expected results: We expect that the group using the implicit learning protocol will show superior results.

Keywords: implicit learning, hand spasticity, stroke, error minimization, motor task

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Authors: Talal Alsulaiman, Khaldoun Khashanah

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In this paper, we provided a literature survey on the artificial stock problem (ASM). The paper began by exploring the complexity of the stock market and the needs for ASM. ASM aims to investigate the link between individual behaviors (micro level) and financial market dynamics (macro level). The variety of patterns at the macro level is a function of the AFM complexity. The financial market system is a complex system where the relationship between the micro and macro level cannot be captured analytically. Computational approaches, such as simulation, are expected to comprehend this connection. Agent-based simulation is a simulation technique commonly used to build AFMs. The paper proceeds by discussing the components of the ASM. We consider the roles of behavioral finance (BF) alongside the traditionally risk-averse assumption in the construction of agent's attributes. Also, the influence of social networks in the developing of agents’ interactions is addressed. Network topologies such as a small world, distance-based, and scale-free networks may be utilized to outline economic collaborations. In addition, the primary methods for developing agents learning and adaptive abilities have been summarized. These incorporated approach such as Genetic Algorithm, Genetic Programming, Artificial neural network and Reinforcement Learning. In addition, the most common statistical properties (the stylized facts) of stock that are used for calibration and validation of ASM are discussed. Besides, we have reviewed the major related previous studies and categorize the utilized approaches as a part of these studies. Finally, research directions and potential research questions are argued. The research directions of ASM may focus on the macro level by analyzing the market dynamic or on the micro level by investigating the wealth distributions of the agents.

Keywords: artificial stock markets, market dynamics, bounded rationality, agent based simulation, learning, interaction, social networks

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Authors: Zerrin Akter Anni

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The media's role in shaping perceptions of violence against women (VAW) and their portrayal in news reporting significantly influences our understanding of this critical issue. My research delves into the portrayal of violence against women in mainstream media, using the prominent case of Dr. Rumana Manzur, a former UBC Fulbright Scholar from Bangladesh who suffered a brutal assault by her ex-husband in June 2011. Employing a qualitative research approach, this study uses an ethnographic media analysis method to scrutinize news reports of the aforementioned case from selected newspapers in Bangladesh. The primary objectives are to investigate how the popular news media in Bangladesh addresses the issue of violence against women and frames the victims of such violence. The findings of this research highlight that news media can perpetuate gender stereotypes and subtly shift blame onto the victim through various techniques, creating intricate interactions between the reader and the text. These techniques include sensationalized headlines, textual content, and graphic images. This victim-blaming process not only retraumatizes the survivor but also distorts the actual facts when presenting the case to a larger audience. Consequently, the representation of violence against women cases in media, particularly the portrayal of women as victims during reporting, significantly impacts our collective comprehension of this issue. In conclusion, this paper asserts that the Bangladeshi media, particularly news outlets, in conjunction with society, continue to follow a pattern of depicting gender-based violence in ways that devalue the image of women. This research underscores the need for critical analysis of media representations of violence against women cases, as they can perpetuate harmful stereotypes and hinder efforts to combat this pervasive problem. Therefore, the outcome of this research is to comprehend the complex dynamics between media and violence against women, which is essential for fostering a more empathetic and informed society that actively works towards eradicating this problem from our society.

Keywords: media representation, violence against women (vaw), ethnographic media analysis, victim-blaming, sensationalized headline

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Authors: Péricles Maia Andrade, Temístocles Damasceno Silva, Hector Luiz Rodrigues Munaro

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The school physical education is going through several changes over the years, and diversification of its content from specific interests is one of the reasons for these changes, soon, the formality in education do not have to stay out, but needs to open up the possibilities offered by the world, so the Mountain Bike, an adventure sport, offers several opportunities for intervention Its application in the school allows diverse interventions in front of the psychomotor development, besides opening possibilities for other contents, respecting the previous experiences of the students in their common environment. The choice of theme was due to affinity with the practice and experience of the Mountain Bike at different levels. Both competitive as recreational, professional standard and amateur, focus as principle the bases of the Cycling, coupled with the inclusion in the Centre for Studies in Management of Sport and Leisure and of the Southwest Bahia State University and the preview of the modality's potential to help the children’s psychomotor development. The goal of this research was to demonstrate like a pilot project the effects of the Mountain Bike as psychomotor instrument in physical education at one of the psychomotor valences, Balance, evaluating Immobility, Static Balance and Dynamic Balance. The methodology used Fonseca’s Psychomotor Battery in 10 students (n=10) of a brazilian public primary’s school, with ages between 9 and 11 years old to use the Mountain Biking contents. The balance’s skills dichotomized in Regular and Good. Regarding the variable Immobility, in the initial test, regardless of gender, 70% (n = 7) were considered Regular. After four months of activity, the Good profile, which had only 30% (n = 3) of the sample, evolved to 60% (n = 6). As in Static and Dynamic Balance there was an increase of 30% (n = 3) and 50% (n = 5) respectively for Good. Between genders, female evolution was better for Good in Immobility and in Static Equilibrium. Already the male evolution was better observed in the Dynamic Equilibrium, with 66.7% (n = 4) for Good. Respecting the particularities of the motor development, an indication of the positive effects of the MTB for the evolution in the balance perceived, necessitating studies with greater sampling.

Keywords: psychomotricity, balance, mountain biking, education

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Authors: Belaynesh Tsegay, Teklay Gebrecherkos, Atsebaha Gebrekidan Kahsay, Mahmud Abdulkader

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Background: Hepatitis B and C viruses are important health and socioeconomic problem across the globe, with a remarkable number of diseases and deaths in sub-Saharan African countries. The burden of hepatitis is unknown in the prison settings of Tigray. Therefore, we aimed to describe the seroprevalence and associated factors of hepatitis B and C viruses among prisoners in Tigray, Ethiopia. Methods: A cross-sectional study was carried out from February 2020 to May 2020 at the prison facilities of Tigray. Demographics and associated factors were collected from 315 prisoners prospectively. Five milliliters of blood were collected and tested using rapid tests kits of HBsAg (Zhejiang orient Gene Biotech Co., Ltd., China) and HCV antibodies (Volkan Kozmetik Sanayi Ve Ticaret Ltd. STI, Turkey). Positive samples were confirmed using ELISA (Beijing Wantai Biological Pharmacy Enterprise Co. Ltd). Data were analyzed using the SPSS version 20, and p<0.05 was considered statistically significant. Results: The overall seroprevalence of HBV and HCV were 25 (7.9%) and 1 (0.3%), respectively. The majority of hepatitis B viral infections were identified from the age groups of 18–25 years (10.7%) and unmarried prisoners (11.8%). Prisoners greater than 100 per cell (AOR=3.95, 95% CI=1.15–13.6, p=0.029) and with a history of alcohol consumption (AOR=3.01, 95% CI=1.17–7.74, p=0.022) were significantly associated with HBV infections. Conclusion: The seroprevalence of HBV among prisoners was nearly high or borderline, with a very low HCV prevalence. HBV was most prevalent among young adults, those housed with a large number of prisoners per cell, and those who had a history of alcohol consumption. This study recommends that there should be prison-focused intervention, including regular health education, with the emphasis on the mode of transmission and introducing HBV screening policy for prisoners, especially when they enter the prison.

Keywords: seroprevalence, HBV, HCV, prisoners, tigray

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Authors: Vaibhav Singh Parihar

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Incidents of serious offenses being committed by children are increasing day by day thereby becoming a matter of great concern. The involvement of a 17-year-old boy in the incident that took place on 16th December 2012 (most commonly known as ‘Nirbhaya Case’)wherein a 23-year-old girl was brutally gang-raped and thrown out of the moving bus, took the entire nation by shock. Previously, the legislation dealing with juvenile delinquency in India considered a child to be juvenile if he/she was below the age of 18 years. As a consequence, the accused who was just six months short of attaining the age of 18 years was convicted for only three years. The primary objective of the study is to understand the gravity as to why the need for distinguishing a child and juvenile arose in this time and to what extent legislations are successful in this regard. It initially explains the history and evolution of juvenile legislation in India and the provisions contained in the Indian Constitution. It then goes on to explain the causes of juvenile delinquency in India. Further, the study focuses on the latest trends that have developed in juvenile delinquency, explaining how the Nirbhaya Case led to the amendments made to the Juvenile Justice Act, 2010. Also, it focuses on the Child Rights and Child Protection and the stand taken by the National Human Rights Commission and the international community. An attempt has been made to settle the debate as to whether the juvenile justice system in India is reformative or punitive. The need for amendment in the Juvenile Justice Act is also highlighted. The outcome of the study suggests that the legislation relating to juvenile delinquency have not been able to achieve the desired results. The age determination method in our system has been given paramount importance. The maximum punishment prescribed, even for heinous crimes, is only three years. Also, the reformative style of punishment is not adequate and more emphasis should be laid on penalization. Finally, the author concludes that the legislation has failed at creating a deterrent effect. It is suggested to strengthen the role of government authorities and to sensitize people in this regard to increase community participation. A non-doctrinal and analytical approach has been adopted and secondary sources of data have been relied upon by the author for conducting the research for the study.

Keywords: child, delinquency, juvenile, Nirbhaya case

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Authors: Dagnew Dessie Mengie

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The purpose of this study was to investigate German tourists' demand for Ethiopian tourism destinations. The author has made every effort to identify the differences in the preferences of German visitors’ demand in Ethiopia comparing with Egypt, Kenya, Tanzania, and South African tourism sectors if they are invited to visit at the same time. However, the demand of international tourism for Ethiopia currently lags behind these African countries. Therefore, to offer demand-driven tourism products, the Ethiopian government, Tour & Travel operators need to understand the important factors that affect international tourists’ decision to visit Ethiopian tourist destinations. The aim of this study was intended to analyze German Tourists’ Demand towards Ethiopian destination. The researcher aimed to identify the demand for German tourists’ preference to Ethiopian tourist destinations comparing to the above-mentioned African countries. For collecting and analysing data for this study, both quantitative and qualitative methods of research are being used in this study. The most significant data are collected by using the primary data collection method i.e. survey and interviews which are the most and large number of potential responses and feedback from nine German active tourists,12 Ethiopian tourism officials, four African embassies, and four well functioning private tour companies and secondary data collected from books, journals, previous research and electronic websites. based on the data analysis of the information gathered from interviews and questionnaires, the study disclosed that majority of German tourists have not that much high demand on Ethiopian Tourist destinations due to the following reasons; Many Germans are fascinated by adventures, safari and simply want to lie on the beach and relax. These interests have leaded them to look for other African countries which have these accesses. Uncomfortable infrastructure and transport problems attributed for the decreasing the number of German tourists in the country. Inadequate marketing operation of Ethiopian Tourism Authority and its delegates in advertising and clarifying the above irregularities which are raised by the tourists.

Keywords: environmental benefits of tourism, social benefits of tourism, economical benefits of tourism, political factors in tourism

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Authors: Yousef Reda

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Pancreatic cancer has an overall dismal prognosis. CT, MRI and Endoscopic Ultrasound are most often used to establish the diagnosis. We present a case of a patient found on abdominal CT and MRI to have an 8 mm cystic lesion within the head of the pancreas which was thought to be a benign intraductal papillary mucinous neoplasm (IPMN). Further evaluation by EUS demonstrated a 1 cm predominantly solid mass that was proven to be an adenocarcinoma by EUS-guided FNA. The patient underwent a Whipple procedure. The final pathology confirmed a 1 cm pT1 N0 pancreatic ductal adenocarcinoma. Case: A 63-year-old male presented with left upper quadrant pain and an abdominal CT demonstrated an 8 mm lesion within the head of the pancreas that was thought to represent a side branch IPMN. An MRI also showed similar findings. Four months later due to ongoing symptoms an EUS was performed to re-evaluate the pancreatic lesion. EUS revealed a predominantly solid hypoechoic, homogeneous mass measuring 12 mm x 9 mm. EUS-guided FNA was performed and was positive for adenocarcinoma. The patient underwent a Whipple procedure that confirmed it to be a ductal adenocarcinoma, pT1N0. The solid mass was noted to be adjacent to a cystic dilation with no papillary architecture and scant epithelium. The differential diagnosis resided between cystic degeneration of a primary pancreatic adenocarcinoma versus malignant degeneration within a side-branch IPMN. Discussion: The reported sensitivity of CT for pancreatic cancer is approximately 90%. For pancreatic tumors, less than 3 cm the sensitivity of CT is reduced ranging from 67-77%. MRI does not significantly improve overall detection rates compared to CT. EUS, however is superior to CT in the detection of pancreatic cancer, in particular among lesions smaller than 3 cm. EUS also outperforms CT and MRI in distinguishing neoplastic from non-neoplastic cysts. In this case, both MRI and CT failed to detect a small pancreatic adenocarcinoma. The addition of EUS and FNA to abdominal imaging can increase overall accuracy for the diagnosis of neoplastic pancreatic lesions. It may be prudent that when small lesions although appearing as a benign IPMN should further be evaluated by EUS as this would lead to potentially identifying earlier stage pancreatic cancers and improve survival in a disease which has a dismal prognosis.

Keywords: IPMN, MRI, EUS, CT

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Authors: Justina Ijeoma Ezebuwa, Catherine C. Ikewuchi, Eka B. Essien, Francis C. Anacletus

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Iron deficiency anemia (IDA) is a significant problem in Nigeria, especially in children under five. Intervention options for treating anemia in under-five children have also been the subject of research. This study aims to synthesize the evidence on dietary interventions for managing iron deficiency anemia in under-five children in Nigeria. This study uses a systematic review method to collect relevant studies to answer the research questions and a narrative synthesis to analyze and synthesize the findings of this study. Cochrane, PubMed, and ScienceDirect databases were thoroughly searched, and five (5) articles were selected for this study. The results show that dietary interventions, such as daily multi-nutrient fortified dairy-based drinks, biofortified (yellow/ white) cassava rich in pro-vitamin A, iron supplementation in foods, and ready-to-use therapeutic food (RUTF) may be relevant to the management of iron deficiency anemia in under-five children in Nigeria. The study also shows that daily multi-nutrient fortified dairy-based drinks may be more effective, feasible, and culturally acceptable for managing anemia in under-5 children in Nigeria. In addition, daily multi-nutrient fortified dairy-based drinks and ready-to-use therapeutic food (RUTF) were reported to have the potential to improve the growth, cognitive development, and overall health outcomes of under-five children with iron deficiency anemia in Nigeria. Recommendations for future studies in this research area and for public health practitioners and policymakers were provided.

Keywords: dietary intervention, iron deficiency anemia, under-five children, Nigeria

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Authors: Saidou Hassidou, Laminou Ary Mahaman Moustapha

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Uncontrolled urbanization of African cities, plus the lack of municipal waste management services in these cities, generate landscapes become places of multiple and varied interactions between health and environment. In this sense, under strong urban growth in a context of sub-equipment sanitation, the city of Maradi doesn’t escape to this situation which results in the spread of pollution (release of unpleasant odors, proliferation of mosquitoes) and many diseases posing multiple health problems. Our study focuses only on liquid waste especially domestic wastewater. To study the different domestic wastewater management options in the town of Maradi, a survey was conducted among 340 households in 17 districts. We note in most cases a crucial of waste management infrastructure (drainage and wastewater treatment) at the city. Thus, only the individual sanitation facilities are used. In the town of Maradi, in addition to the storm drains, there are, in old districts, ditches that discharge wastewater and unfortunately end up in rivers without treatment. Domestic wastewater total production is estimated at 86,761.28 m3 per day. This water is mostly from laundry activities, bathing, dishes, and is discharged in large part through the streets, by more than 60% of households. Also, pit emptying is performed at 39.11% by the vehicle Peugeot tank. The quality of service rendered by an actor is very important to encourage households to join. Existing autonomous sanitation facilities are poorly designed and poorly maintained. Fecal sludge is dumped in a hole near saturated latrines; this work is mainly done by manual scavengers or dumped in fields or on nearby vacant land concessions.

Keywords: management, urban wastewater, domestic wastewater, Maradi, Niger

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Authors: A. Al-Wandi, A. Al-Ali, R. Dali, Y. Al-Karaghouli

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Background: Non-communicable diseases (NCDs) have become an alarming health problem across the globe. The risk of developing those diseases begins in childhood and develops gradually under the influence of risk factors including obesity, hypertension, dyslipidemia, cigarette smoking and decreased physical activity. Therefore, this study aims to determine the level of knowledge, attitudes, and practices of the risk factors of lifestyle induced chronic diseases (non-communicable diseases) among secondary school students in Sharjah city. Methods: Five hundred and ninety-one school children, from grades 10 to 12, formed the study sample, using the multistage stratified cluster sampling method. Four governmental schools were chosen, for each gender. Data was collected through a pretested, close-ended questionnaire consisting of five sections; demographics, physical activity, diet, smoking and sleeping patterns. Frequencies and descriptive statistics were used to analyze data through SPSS 23. Results: The data showed 64.6% of students had low knowledge of risk factors of non-communicable diseases. Concerning physical activity, 58.2 % were physically inactive and females being less active than males. More than 2/3 of students didn’t fulfill the recommended daily intake of fruits and vegetables (75.9%). 8% reported to be smokers with cigarettes being the most encountered tobacco product. Conclusion: Our study has demonstrated a low level of knowledge and practices yet, positive attitudes towards risk factors of chronic diseases. We recommend implementation of thorough awareness campaigns through public health education about the risk factors of non-communicable diseases.

Keywords: non-communicable diseases, physical activity, diet, knowledge, attitudes, practices, smoking

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Authors: Eunice Christabel Chukwu

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Introduction: Diabetes is a chronic medical condition which is characterized by high levels of glucose in the blood and urine; it is usually diagnosed by means of a glucose tolerance test (GTT). Diabetes can cause a range of health problems if left unmanaged, as it can lead to serious complications. It is essential to manage the condition effectively, particularly in the workplace where the impact on work productivity can be significant. This paper discusses the modelling of optimal control of diabetes in the workplace using a control theory approach. Background: Diabetes mellitus is a condition caused by too much glucose in the blood. Insulin, a hormone produced by the pancreas, controls the blood sugar level by regulating the production and storage of glucose. In diabetes, there may be a decrease in the body’s ability to respond to insulin or a decrease in insulin produced by the pancreas which will lead to abnormalities in the metabolism of carbohydrates, proteins, and fats. In addition to the health implications, the condition can also have a significant impact on work productivity, as employees with uncontrolled diabetes are at risk of absenteeism, reduced performance, and increased healthcare costs. While several interventions are available to manage diabetes, the most effective approach is to control blood glucose levels through a combination of lifestyle modifications and medication. Methodology: The control theory approach involves modelling the dynamics of the system and designing a controller that can regulate the system to achieve optimal performance. In the case of diabetes, the system dynamics can be modelled using a mathematical model that describes the relationship between insulin, glucose, and other variables. The controller can then be designed to regulate the glucose levels to maintain them within a healthy range. Results: The modelling of optimal control of diabetes in the workplace using a control theory approach has shown promising results. The model has been able to predict the optimal dose of insulin required to maintain glucose levels within a healthy range, taking into account the individual’s lifestyle, medication regimen, and other relevant factors. The approach has also been used to design interventions that can improve diabetes management in the workplace, such as regular glucose monitoring and education programs. Conclusion: The modelling of optimal control of diabetes in the workplace using a control theory approach has significant potential to improve diabetes management and work productivity. By using a mathematical model and a controller to regulate glucose levels, the approach can help individuals with diabetes to achieve optimal health outcomes while minimizing the impact of the condition on their work performance. Further research is needed to validate the model and develop interventions that can be implemented in the workplace.

Keywords: mathematical model, blood, insulin, pancreas, model, glucose

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Authors: Lim Pey Huan

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In the second half of the 19th century, Vietnam has long been influenced by Han culture, so there are many similarities in religion and folk beliefs. Even after the acceptance process of the Catholic Church introduced from Europe is quite similar. Therefore, in the spiritual life of Vietnamese civil society, Confucianism, Buddhism, Taoism, Christianity, Islam, and folk beliefs can be said to be the main trend, but in the twentieth century, two indigenous new religions were born: Caodai and He Hao Jiao, both of which are produced and developed in the south, each of which has millions of believers and become important Vietnamese religions. Their political participation has a major impact on the development of the Republic of Vietnam, and their fate is also in the north and south. Significant changes have taken place after reunification. Caodai was later approved by the colonial authorities and became the third largest religion in Vietnam. The teachings of Caodai teach the ideas of the major religions of the world. The classics used in the teachings also contain important theories of various religions, with particular emphasis on the comprehensiveness of the three sects of Confucianism, Buddhism, and Taoism. The obvious manifestation lies in the interpretation of the important proposition of 'opening the three religions and returning to the five branches.' The full name of Caodaism is 'Da Dao San Qi Pu Du Gao Tai Jiao'. This name coincides with the 'Longhua Club' and the 'San Qi Mo Jie' idea and the consistent central idea. The emerging road of Caodai advocates to lead the sentient beings back to their original missions; the sentient beings will be centered on people, and the nature of the talks is nothing more than the original mission and standard. There are many opinions about the introduction of Caodaism into southern Vietnam. Caodai believers believe that Caodaism is an emerging new religion in Vietnam. If we further explore the teachings and religious rituals of Caodai, it is not difficult to find that many Chinese sects have been introduced to Vietnam. Some of the colors can be discussed from the spread and influence of Congenital Road in Vietnam. This article will present the author's analysis of the actual process of tutoring in Vietnam's Caodai, and then compare it with the consistent religious experience, trying to explore the Yi-Kuan-Tao and consistent Yi-Kuan-Tao rituals, religious organization, religious teachings, religious life care, and Funeral rituals and other comparative studies.

Keywords: Vietnam, Caodaism, Yi-Kuan-Tao, religious rituals

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Authors: Josephine Muchiri, Makena Muriithi

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Adverse mental health consequences are experienced by those that have been touched by Intimate Partner Violence (IPV), whether directly or indirectly. These negative effects are felt not only in the short term but in years to come. It is important to examine the prevalence and co-occurrence of mental disorders in order to provide strategic interventions for women who have experienced IPV. The aim of this study was to examine the prevalence and comorbidity of post-traumatic stress disorder (PTSD), Depression, and Anxiety among women who had experienced intimate Partner violence in two selected informal settlements in Nairobi County, Kenya. Participants were 116 women (15-60 years) selected through purposive and snowball sampling from the low social, economic settlements (Kawangware and Kibera) in Nairobi, Kenya. A social demographic questionnaire and the Woman Abuse Screening Tool (WAST) were used to collect data on intimate partner violence experiences. The PTSD Checklist for DSM-5 (PCL-5), Beck’s Depression Inventory, and the Beck’s Anxiety Inventory assessed for post-traumatic stress disorder, depression, and anxiety, respectively. Data analysis was conducted using the Statistical Package for Social Sciences (SPSS) version 29, utilizing descriptive and correlation analyses. Findings indicated that the women had undergone various forms of abuse from their intimate partners, which were physical abuse 111(92.5%), sexual abuse 70(88.6%), and verbal abuse 92(93.9%). The prevalence of the mental disorders was PTSD 47(32.4%); M= 44.11, S.D =14.67, depression was the highest at n=131(90.3%; M=33.37±9.98) with the levels of depression having varying prevalence rates where severe depression had the highest representation [moderate: n= 35; 24.1%, severe: n=69 (47.6%) and extremely severe: n=27(18.6%)]. Anxiety had the second highest prevalence of n=99 (68.8%; M= 28.55±13.63) with differing prevalence rates in the levels of anxiety which were normal anxiety: 45(31.3%), moderate anxiety n=62(43.1%) and severe anxiety: n=37(25.7%). Regarding comorbidities, the Pearson correlation test showed that there was a significant (p=0.000) positive relationship between PTSD and depression (r=0.379; p=.000), PTSD and anxiety (r=0.624; p=.000), and depression and anxiety (r=0.386; p=.000) such that increase in one disorder concomitantly led to increase of the other two disorders; hence comorbidity of the three disorders was ascertained. Conclusion: The study asserted the adverse impacts of IPV on women’s mental well-being, where the prevalence of PTSD, depression, and anxiety was established. Almost all the women had depressive symptoms; whereas more than half had anxiety and slightly more than a third had PTSD. Regarding the severity levels of anxiety and depression, almost half of the women with depression had severe depression whereas moderate anxiety was more prevalent for those with anxiety. The three disorders were found to co-occur where comorbidities of PTSD and anxiety had the highest probability of co-occurrence. It is thus recommended that mental health interventions with a focus on the three disorders be offered for women undergoing IPV.

Keywords: anxiety, comorbidity, depression, intimate partner violence, post-traumatic stress disorder

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Authors: Esther Mafunda, Simbarashe Muparangi

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The present paper tests the applicability of the Regression Hypothesis on the pathological language dissolution of a Shona male adult with Broca’s aphasia. It particularly assesses the prediction of the Regression Hypothesis, which states that the process according to which language is forgotten will be the reversal of the process according to which it will be acquired. The main aim of the paper is to find out whether mirror symmetries between L1 acquisition and L1 dissolution of tense in Shona and, if so, what might cause these regression patterns. The paper also sought to highlight the practical contributions that Linguistic theory can make to solving language-related problems. Data was collected from a 46-year-old male adult with Broca’s aphasia who was receiving speech therapy at St Giles Rehabilitation Centre in Harare, Zimbabwe. The primary data elicitation method was experimental, using the probe technique. The TART (Test for Assessing Reference Time) Shona version in the form of sequencing pictures was used to access tense by Broca’s aphasic and 3.5-year-old child. Using the SPSS (Statistical Package for Social Studies) and Excel analysis, it was established that the use of the future tense was impaired in Shona Broca’s aphasic whilst the present and past tense was intact. However, though the past tense was intact in the male adult with Broca’s aphasic, a reference to the remote past was made. The use of the future tense was also found to be difficult for the 3,5-year-old speaking child. No difficulties were encountered in using the present and past tenses. This means that mirror symmetries were found between L1 acquisition and L1 dissolution of tense in Shona. On the basis of the results of this research, it can be concluded that the use of tense in a Shona adult with Broca’s aphasia supports the Regression Hypothesis. The findings of this study are important in terms of speech therapy in the context of Zimbabwe. The study also contributes to Bantu linguistics in general and to Shona linguistics in particular. Further studies could also be done focusing on the rest of the Bantu language varieties in terms of aphasia.

Keywords: Broca’s Aphasia, regression hypothesis, Shona, language dissolution

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Authors: Megan Weisbart

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Background/Significance: The Intensive Care Unit (ICU) environment contributes to nurse burnout. Burnout costs include decreased employee compassion, missed workdays, worse patient outcomes, diminished job performance, high turnover, and higher organizational cost. Meaningful recognition, nurturing of interpersonal connections, and mindfulness-based interventions are associated with decreased burnout. The purpose of this quality improvement project was to decrease Neonatal ICU (NICU) nurse burnout using a Wellness Bundle that fosters meaningful recognition, interpersonal connections and includes mindfulness-based interventions. Methods: The Professional Quality of Life Scale Version 5 (ProQOL5) was used to measure burnout before Wellness Bundle implementation, after six months, and will be given yearly for three years. Meaningful recognition bundle items include Online submission and posting of staff shoutouts, recognition events, Nurses Week and Unit Practice Council member gifts, and an employee recognition program. Fostering of interpersonal connections bundle items include: Monthly staff games with prizes, social events, raffle fundraisers, unit blog, unit wellness basket, and a wellness resource sheet. Quick coherence techniques were implemented at staff meetings and huddles as a mindfulness-based intervention. Findings: The mean baseline burnout score of 14 NICU nurses was 20.71 (low burnout). The baseline range was 13-28, with 11 nurses experiencing low burnout, three nurses experiencing moderate burnout, and zero nurses experiencing high burnout. After six months of the Wellness Bundle Implementation, the mean burnout score of 39 NICU nurses was 22.28 (low burnout). The range was 14-31, with 22 nurses experiencing low burnout, 17 nurses experiencing moderate burnout, and zero nurses experiencing high burnout. Conclusion: A NICU Wellness Bundle that incorporated meaningful recognition, fostering of interpersonal connections, and mindfulness-based activities was implemented to improve work environments and decrease nurse burnout. Participation bias and low baseline response rate may have affected the reliability of the data and necessitate another comparative measure of burnout in one year.

Keywords: burnout, NICU, nurse, wellness

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Authors: Emily Simango, T. Chitura

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Background: Bovine brucellosis is among the most neglected zoonotic diseases in developing countries, where it is endemic and a growing challenge to public health. The development of cost-effective control measures for the disease can only be affirmed by the knowledge of the disease epidemiology and the ability to define its risk profiles. The aim of the study was to document the trend of bovine brucellosis and the control measures adopted following reported cases during the period 2014 to 2019 in South Africa. Methods: Data on confirmed cases of bovine brucellosis was retrieved from the website of the World Organisation of Animal Health (WOAH). Data was analysed using the Statistical Package for Social Sciences (IBM SPSS, 2022) version 29.0. Descriptive analysis (frequencies and percentages) and the Analysis of variance (ANOVA) were utilized for statistical significance (p<0.05). Results: The data retrieved in our study revealed an overall average bovine brucellosis prevalence of 8.48. There were statistically significant differences in bovine brucellosis prevalence across the provinces for the years 2016 and 2019 (p≥0.05), with the Eastern Cape Province having the highest prevalence in both instances. Documented control measures for the disease were limited to killing and disposal of disease cases as well as vaccination of susceptible animals. Conclusion: Bovine brucellosis is real in South Africa, with the risk profiles differing across the provinces. Information on brucellosis control measures in South Africa, as reported to the WOAH, is not comprehensive.

Keywords: zoonotic, endemic, Eastern Cape province, vaccination

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Authors: Didem Kepir Savoly, Selen Demirtas Zorbaz

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This research focuses on the unique developmental stage of university students, known as emerging adulthood, which can be filled with stressors relating to academics, career aspirations, and relationships. The impact of these factors on the wellbeing and mental health of students is not well understood and requires further investigation. The aim of this study is to investigate the influence of career optimism and relationship status on the wellbeing/life satisfaction of university students. The specific hypotheses being tested are: 1) University students with higher career optimism will exhibit a higher level of life satisfaction, and 2) University students in relationships will report a higher level of life satisfaction. This research adopts a quantitative approach, utilizing scales and questionnaires to collect data from university students in Turkey. The data was collected from university students in Turkey through the administration of the Career Optimism Scale, The Satisfaction with Life Scale, and the Perceived Romantic Relationship Quality Scale. The data is then analyzed using scale implementation, correlational analysis, and group comparison. One-way ANOVA, regression, and t-test analysis techniques are employed. The research findings provide insights into the relationship between career optimism and university students’ life satisfaction, as well as the influence of relationship status on their life satisfaction. The results suggest that life satisfaction was predicted by career optimism but not by relationship status. Moreover, significant relationships between life satisfaction and relationship quality were found among the university students who were in a relationship. These results can be utilized by practitioners, particularly those in counseling centers and career services at universities, to develop tailored psychoeducational and intervention programs aimed at promoting the mental health of university students.

Keywords: career optimism, relationship status, university students, wellbeing

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Authors: V. Pentland, S. Spilsbury, A. Biswas, M. F. Mottola, S. Paplinskie, M. S. Mitchell

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Postpartum depression (PPD) is a form of major depressive disorder that afflicts 10–22% of mothers worldwide. Rising demands for traditional PPD treatment options (e.g., psychiatry), especially in the context of the COVID-19 pandemic, are increasingly difficult to meet. More accessible treatment options (e.g., walking) are needed. The objective of this review is to determine the impact of walking on PPD severity. A structured search of seven electronic databases for randomised controlled trials published between 2000 and July 29, 2021, was completed. Studies were included if walking was the sole or primary aerobic exercise modality. A random-effects meta-analysis was conducted for studies reporting PPD symptoms measured using a clinically validated tool. A simple count of positive/null effect studies was undertaken as part of a narrative summary. Five studies involving 242 participants were included (mean age=~28.9 years; 100% with mild-to-moderate depression). Interventions were 12 (n=4) and 24 (n=1) weeks long. Each assessed PPD severity using the Edinburgh Postnatal Depression Scale (EPDS) and was included in the meta-analysis. The pooled effect estimate suggests that relative to controls, walking yielded clinically significant decreases in mean EPDS scores from baseline to intervention end (pooled MD=-4.01; 95% CI:-7.18 to -0.84, I2=86%). The narrative summary provides preliminary evidence that walking-only, supervised, and group-based interventions, including 90-120+ minutes/week of moderate-intensity walking, may produce greater EPDS reductions. While limited by a relatively small number of included studies, pooled effect estimates suggest walking may help mothers manage PPD. This is the first time walking as a treatment for PPD, an exercise modality that uniquely addresses many barriers faced by mothers has been summarized in a systematic way. Trial registration: PROSPERO (CRD42020197521) on August 16th, 2020

Keywords: postpartum, exercise, depression, walking

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Authors: Atitallah Sofien, Bouyahia Olfa, Krifi farah, Missaoui Nada, Ben Rabeh Rania, Yahyaoui Salem, Mazigh Sonia, Boukthir Samir

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Introduction: Subcutaneous fat necrosis of the newborn (SCFN) is a rare acute hypodermatitis characterized by skin lesions in the form of infiltrated, hard plaques and subcutaneous nodules, with a purplish-red color, occurring between the first and sixth week of life. SCFN is generally a benign condition that spontaneously regresses without sequelae, but it can be complicated by severe hypercalcemia. Methodology: This is a retrospective case report of neonatal subcutaneous fat necrosis complicated with severe hypercalcemia and nephrocalcinosis. Results: This is a case of a female newborn with a family history of a hypothyroid mother on Levothyrox, born to non-consanguineous parents and from a well-monitored pregnancy. The newborn was delivered by cesarean section at 39 weeks gestation due to severe preeclampsia. She was admitted to the Neonatal Intensive Care Unit at 1 hour of life for the management of grade 1 perinatal asphyxia and immediate neonatal respiratory distress related to transient respiratory distress. Hospitalization was complicated by a healthcare-associated infection, requiring intravenous antibiotics for ten days, with a good clinical and biological response. On the 20th day of life, she developed skin lesions in the form of indurated purplish-red nodules on the back and on both arms. A SCFN was suspected. A calcium level test was conducted, which returned a result of 3 mmol/L. The rest of the phosphocalcic assessment was normal, with early signs of nephrocalcinosis observed on renal ultrasound. The diagnosis of SCFN complicated by nephrocalcinosis associated with severe hypercalcemia was made, and the condition improved with intravenous hydration and corticosteroid therapy. Conclusion: SCFN is a rare and generally benign hypodermatitis in newborns with an etiology that is still poorly understood. Despite its benign nature, SCFN can be complicated by hypercalcemia, which can sometimes be life-threatening. Therefore, it is important to conduct a thorough skin examination of newborns, especially those with risk factors, to detect and correct any potential hypercalcemia.

Keywords: subcutaneous fat necrosis, newborn, hypercalcemia, nephrocalcinosis

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Authors: Hung-Chun Lin, Tzu-Yuan Chao

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As the population aging has become an inevitable trend globally, issues of improving the well-being of elderly people in urban areas have been a challenging task for urban planners. Recent studies of ageing trend have also expended to explore the relationship between the built environment and mental condition of elderly people. These studies have proved that even though the built environment may not necessarily play the decisive role in affecting mental health, it can have positive impacts on individual mental health by promoting social linkages and social networks among older adults. There has been a great amount of relevant research examined the impact of the built environment attributes on depression in the elderly; however, most were conducted in the Western countries. Little attention has been paid in Asian cities with contrarily high density and mix-use urban contexts such as Taiwan regarding how the built environment attributes related to depression in elderly people. Hence, more empirical cross-principle studies are needed to explore the possible impacts of Asia urban characteristics on older residents’ mental condition. This paper intends to focus on Tainan city, the fourth biggest metropolis in Taiwan. We first analyze with data from National Health Insurance Research Database to pinpoint the empirical study area where residing most elderly patients, aged over 65, with depressive disorders. Secondly, we explore the relationship between specific attributes of the built environment collected from previous studies and elderly individuals who suffer from depression, under different socio-cultural and networking circumstances. To achieve the results, the research methods adopted in this study include questionnaire and database analysis, and the results will be proceeded by correlation analysis. In addition, through literature review, by generalizing the built environment factors that have been used in Western research to evaluate the relationship between built environment and older individuals with depressive disorders, a set of local evaluative indicators of the built environment for future studies will be proposed as well. In order to move closer to develop age-friendly cities and improve the well-being for the elderly in Taiwan, the findings of this paper can provide empirical results to grab planners’ attention for how built environment makes the elderly feel and to reconsider the relationship between them. Furthermore, with an interdisciplinary topic, the research results are expected to make suggestions for amending the procedures of drawing up an urban plan or a city plan from a different point of view.

Keywords: built environment, depression, elderly, Tainan

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Authors: Koo Ja-Choon, Seok Hyun-Deok, Park So-Hee

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Even though developed countries have supported aid projects for restoring degraded and deforested mountain, recent North Korean authorities announced that North Korean forest is still very serious. Last 12 years, more than 16 thousand ha of forest were destroyed. Most of previous researches concluded that food and fuel problems should be solved for preventing people from deforesting and degrading forest in North Korea. It means that mountain restoration projects such as A/R(afforestation/reforestation) and REDD(Reducing Emissions from Deforestation and Forest Degradation) project should be implemented with the agroforestry and the forest tending project. Because agroforestry and the forest tending can provide people in the project area with foods and fuels, respectively. Especially, Agroforestry has been operated well with the support of Swiss agency of Development and cooperation since 2003. This paper aims to find the priority sites for mountain restoration project where all types of projects including agroforesty can be implemented simultaneously. We tried to find the primary counties where the areas of these activities were distributed widely and evenly. Recent spatial data of 186 counties representing altitude, gradient and crown density were collected from World Forest Watch. These 3 attributes were used to determine the type of activities; A/R, REDD, Agroforestry and forest tending project. Finally, we calculated the size of 4 activities in 186 counties by using GIS technique. Result shows that Chongjin in Hamgyeongbuk-do, Hoeryong in Hamgyeongbuk-do and Tongchang in Pyeonganbuk-do are on the highest priority of counties. Most of feasible counties whose value of richness and uniformity were greater than the average were located near the eastern coast of North Korea. South Korean government has not supported any aid projects in North Korea since 2010. Recently, South Korea is trying to continue the aid projects for North Korea. Forest project which is not affected by the political situation between North- and South- Korea can be considered as a priority activities. This result can be used when South Korean government determine the priority sites for North Korean mountain restoration project in near future.

Keywords: agroforestry, forest restoration project, GIS, North Korea, priority

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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: E Tambo, O. O. Olalubi, E. C. Ugwu, J. Y. Ngogang

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Despite the World Health Organization (WHO) declaration of international health emergency concern, the status quo of responses and efforts to stem the worst-recorded Ebola epidemic Ebola outbreak is still precariously inadequate in most of the affected in West. Mining natural resources have been shown to play a key role in both motivating and fuelling ethnic, civil and armed conflicts that have plagued a number of African countries over the last decade. Revenues from the exploitation of natural resources are not only used in sustaining the national economy but also armies, personal enrichment and building political support. Little is documented on the mining and ecological impact on the emergence and geographical distribution of Ebola in Africa over time and space. We aimed to provide a better understanding of the interconnectedness among issues of mining natural, resource management, mining conflict and post-conflict on Ebola outbreak and how wealth generated from abundant natural resources could be better managed in promoting research and development towards strengthening environmental, socioeconomic and health systems sustainability on Ebola outbreak and other emerging diseases surveillance and responses systems prevention and control, early warning alert, durable peace and sustainable development rather than to fuel conflicts, resurgence and emerging diseases epidemics in the perspective of community and national/regional approach. Our results showed the first assessment of systematic impact of all major minerals conflict events diffusion over space and time and mining activities on nine Ebola genesis and geo-distribution in affected countries across Africa. We demonstrate how, where and when mining activities in Africa increase ecological degradation, conflicts at the local level and then spreads violence across territory and time by enhancing the financial capacities of fighting groups/ethnics and diseases onset. In addition, led process of developing minimum standards for natural resource governance; improving governmental and civil society capacity for natural resource management, including the strengthening of monitoring and enforcement mechanisms; understanding the post-mining and conflicts community or national reconstruction and rehabilitation programmes in strengthening or developing community health systems and regulatory mechanisms. In addition the quest for the control over these resources and illegal mining across the landscape forest incursion provided increase environmental and ecological instability and displacement and disequilibrium, therefore affecting the intensity and duration of mining and conflict/wars and episode of Ebola outbreaks over time and space. We highlight the key findings and lessons learnt in promoting country or community-led process in transforming natural resource wealth from a peace liability to a peace asset. The imperative necessity for advocacy and through facilitating intergovernmental deliberations on critical issues and challenges affecting Africa community transforming exploitation of natural resources from a peace liability to outbreak prevention and control. The vital role of mining in increasing government revenues and expenditures, equitable distribution of wealth and health to all stakeholders, in particular local communities requires coordination, cooperative leadership and partnership in fostering sustainable developmental initiatives from mining context to outbreak and other infectious diseases surveillance responses systems in prevention and control, and judicious resource management.

Keywords: mining, mining conflicts, mines, ecological, Ebola, outbreak, mining companies, miners, impact

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Authors: Naci Büyükkaracığan, Murat Ahmet Ökmen

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In parallel with the population growth rate, the need of human being for energy sources in the world is gradually increasing incessant. The addition of this situation that demand for energy will be busier in the future, industrialization, the rise in living standards and technological developments, especially in developing countries. Alternative energy sources have aroused interest due to reasons such as serious environmental issues that were caused by fossil energy sources, potentially decreasing reserves, different social, political and economic problems caused by dependency on source providing countries and price instability. Especially in developed countries as European countries and also U.S.A particularly, alternative energy sources such as wind, geothermal, solar and biomass energy, hydrolic and hydrogen have been utilized in different forms, especially in electricity production. It includes a review of technical and environmental factors for energy sources that are potential replacements for fossil fuels and examines their fitness to supply the energy for a high standard of living on a worldwide basis. Despite all developments, fossil energy sources have been overwhelmingly used all around the world in primary energy sources consumption and they will outnumber other energy sources in the short term. Today, parallel to population growth and economy in Turkey, energy sources consumption is increasingly continuing. On one side, Turkey, currently 80% dependent on energy providing countries, has been heavily conducting fossil energy sources raw material quest within its own borders in order to lower the percentage, and the other side, there have been many researches for exploring potential of alternative energy sources and utilization. This case will lead to both a decrease in foreign energy dependency and a variety of energy sources. This study showed the current energy potential of Turkey and presents historical development of these energy sources and their share in electricity production. The research also seeked for answers to arguments that if the potential can be sufficient in the future. As a result of this study, it was concluded that observed geothermal energy, particularly active tectonic regions of Turkey, to have an alternative energy potential could be considered to be valuable on bass wind and solar energy.

Keywords: alternative energy sources, energy productions, hydroenergy, solar energy, wind energy

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Authors: Jane N. O'Sullivan

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In most studies relating change in fertility to potentially causal factors (such as girls’ educational attainment, infant mortality or urbanization), the presence or nature of family planning efforts are not examined, potentially misattributing their contributions. Modest impacts of voluntary family planning programs on fertility change have been claimed, citing the near-term effects of historical quasi-experimental projects – notably in Bangladesh and in Ghana – where recipients and non-recipients could be contrasted. By their nature, such experiments lacked the wider cultural impacts of national programs. Concurrently, analyses relating population growth with economic advancement have been equivocal, discrediting previous widespread concern which prevailed before the 1980s. This neutral view has been revised more recently with demographic dividend theory crediting higher working-age proportion with some economic stimulus if supported by sufficient institutional and human capacity. In this study of country-level data, cross-country comparisons spanning six decades relate fertility decline with family planning effort, GDP per capita and female education, finding that the timing of rapid fertility decline aligns with commencement of voluntary family planning programs, while economic betterment came after substantial fertility fall. The relationship between fertility and primary education completion was inconsistent, with potential channels of causation operating in both directions. GDP per capita was unrelated to rate of fertility decline, but total fertility rates above three children per woman strongly impeded enrichment. By synchronizing countries with respect to their fertility transition, strong relationships are revealed which suggest lower fertility enables economic betterment, rather than the other way around. These results argue in favour of elevating voluntary family planning as a development priority.

Keywords: economic advance, family planning effort, fertility decline, population growth rate

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Authors: Katarzyna Wyka, Dana Sylvan, JoAnn Difede

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Background and significance: The following disaster, population-based screening programs are routinely established to assess physical and psychological consequences of exposure. These data sets are highly skewed as only a small percentage of trauma-exposed individuals develop health issues. Commonly used statistical methodology in post-disaster mental health generally involves population-averaged models. Such models aim to capture the overall response to the disaster and its aftermath; however, they may not be sensitive enough to accommodate population heterogeneity in symptomatology, such as post-traumatic stress or depressive symptoms. Methods: We use an archival longitudinal data set from Weill-Cornell 9/11 Mental Health Screening Program established following the World Trade Center (WTC) terrorist attacks in New York in 2001. Participants are rescue and recovery workers who participated in the site cleanup and restoration (n=2960). The main outcome is the post-traumatic stress symptoms (PTSD) severity score assessed via clinician interviews (CAPS). For a detailed understanding of response to the disaster and its aftermath, we are adapting quantile regression methodology with particular focus on predictors of extreme distress and resilience to trauma. Results: The response variable was defined as the quantile of the CAPS score for each individual under two different scenarios specifying the unconditional quantiles based on: 1) clinically meaningful CAPS cutoff values and 2) CAPS distribution in the population. We present graphical summaries of the differential effects. For instance, we found that the effect of the WTC exposures, namely seeing bodies and feeling that life was in danger during rescue/recovery work was associated with very high PTSD symptoms. A similar effect was apparent in individuals with prior psychiatric history. Differential effects were also present for age and education level of the individuals. Conclusion: We evaluate the utility of quantile regression in disaster research in contrast to the commonly used population-averaged models. We focused on assessing the distribution of risk factors for post-traumatic stress symptoms across quantiles. This innovative approach provides a comprehensive understanding of the relationship between dependent and independent variables and could be used for developing tailored training programs and response plans for different vulnerability groups.

Keywords: disaster workers, post traumatic stress, PTSD, quantile regression

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Authors: A. Pascual Ramsay

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Accounts of the management of the economic and euro crisis in Spain have been dominated by an emphasis on external constraints. However, this approach leaves unanswered important questions about the role of domestic political factors. Using systematic qualitative primary research and employing elite interviewing and process tracing, this paper aims to fill this gap for the period of the Partido Socialista Obrero Español (PSOE) administration. The paper shows that domestic politics played a crucial role in the management of the crisis, most importantly by determining the shape of the measures undertaken. In its three distinct stages – downplaying/inaction, reaction/stimulus, and austerity/reform – the PSOE's response was certainly constrained by external factors, most notably EMU membership and the actions of sovereign-bond investors, the ECB and Germany. Yet while these external constraints forced the government to act, domestic political factors fundamentally shaped the content of key measures: the fiscal stimulus, the labour, financial and pension reforms, the refusal to accept a bailout or the reform of the Constitution. Seven factors were particularly influential: i) electoral and political cost, ii) party and partisanship, iii) organised interests, iv) domestic institutions, v) ideological preferences, vi) ineffective decision-making, and vii) judgement and personal characteristics of decision-makers. In conclusion, domestic politics played an important role in the management of the crisis, a role that has been underestimated by dominant approaches focusing on external constraints and weak domestic policy autonomy. The findings provide empirical evidence to support research agendas that identify significant state discretion in the face of international economic integration and an important role for domestic political factors such as institutions, material interests, partisanship and ideology in shaping economic outcomes.

Keywords: economic crisis, Euro, PSOE, Spain

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Authors: Trina Isabel Santiago, Daniel Chua, Jumee Tayaban, Joseph Daniel Timbol, Joshua Yanes

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Numerous instances of human rights violations on healthcare workers have been reported during the COVID-19 pandemic in the Philippines. This brief aims to explore these civil and political rights violations and propose recommendations to address these. Our review shows that a wide range of civic and political human rights violations have been committed by individual citizens and government agencies on individual healthcare workers and health worker groups. These violations include discrimination, red-tagging, evictions, illegal arrests, and acts of violence ranging from chemical attacks to homicide. If left unchecked, these issues, compounded by the pandemic, may lead to the exacerbations of the pre-existing problems of the Philippine healthcare system. Despite all pre-existing reports by human rights groups and public media articles, there still seems to be a lack of government action to condemn and prevent these violations. The existence of government agencies which directly contribute to these violations with the lack of condemnation from other agencies further propagate the problem. Given these issues, this policy brief recommends the establishment of an interagency task force for the protection of human rights of healthcare workers as well as the expedited passing of current legislative bills towards the same goal. For more immediate action, we call for the establishment of a dedicated hotline for these incidents with adequate appointment and training of point persons, construction of clear guidelines, and closer collaboration between government agencies in being united against these issues.

Keywords: human rights violations, healthcare workers, COVID-19 pandemic, Philippines

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