Search results for: public health burden

Authors: Niamh Herlihy, Helen Fischer, Rainer Sauerborn, Anneliese Depoux, Avner Bar-Hen, Antoine Flauhault, Stefanie Schütte

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In the recent decades, there has been an increase in the number of publications both in the scientific and grey literature on the potential health risks associated with climate change. Though interest in climate change and health is growing, there are still many gaps to adequately assess our future health needs in a warmer world. Generating a greater understanding of the health impacts of climate change could be a key step in inciting the changes necessary to decelerate global warming and to target new strategies to mitigate the consequences on health systems. A long term and broad overview of existing scientific literature in the field of climate change and health is currently missing in order to ensure that all priority areas are being adequately addressed. We conducted a scoping review of published peer-reviewed literature on climate change and health from two large databases, PubMed and Web of Science, between 1990 and 2015. A scoping review allowed for a broad analysis of this complex topic on a meta-level as opposed to a thematically refined literature review. A detailed search strategy including specific climate and health terminology was used to search the two databases. Inclusion and exclusion criteria were applied in order to capture the most relevant literature on the human health impact of climate change within the chosen timeframe. Two reviewers screened the papers independently and any differences arising were resolved by a third party. Data was extracted, categorized and coded both manually and using R software. Analytics and infographics were developed from results. There were 7269 articles identified between the two databases following the removal of duplicates. After screening of the articles by both reviewers 3751 were included. As expected, preliminary results indicate that the number of publications on the topic has increased over time. Geographically, the majority of publications address the impact of climate change and health in Europe and North America, This is particularly alarming given that countries in the Global South will bear the greatest health burden. Concerning health outcomes, infectious diseases, particularly dengue fever and other mosquito transmitted infections are the most frequently cited. We highlight research gaps in certain areas e.g climate migration and mental health issues. We are developing a database of the identified climate change and health publications and are compiling a report for publication and dissemination of the findings. As health is a major co-beneficiary to climate change mitigation strategies, our results may serve as a useful source of information for research funders and investors when considering future research needs as well as the cost-effectiveness of climate change strategies. This study is part of an interdisciplinary project called 4CHealth that confronts results of the research done on scientific, political and press literature to better understand how the knowledge on climate change and health circulates within those different fields and whether and how it is translated to real world change.

Keywords: climate change, health, review, mapping

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Authors: Inaam Nasrallah, Pascale Salameh, Abbas El-Outa, Assem Alkak, Rihab Nasr, Wafa Toufic Bawab

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Background: Hazardous Waste Management(HWM). is critical to human health outcomes and environmental protection. This study evaluated the knowledge regarding safety measures to be applied when collecting and storing waste in scientific laboratories of two universities in Lebanon.Method: A survey-based observational study was conducted in scientific laboratories of the public university and that of a private university, where a total of 309 participants were recruited.Result: The mean total knowledge score on safety measures of HWM was 9.02±4.34 (maximum attainable score, 13). Significant association (p<0.05) was found between knowledge score and job function, years of experience, educational level, professional status, work schedule, and training on proper HWM. Participants had adequate perceptions regarding the impact of HWM on health and the environment. Linear regression modeling revealed that knowledge score was significantly higher among bachelor level lab workers compared to those with doctoral degrees (p=0.043), full-time schedule workers versus part-timers (p=0.03), and among public university participants as compared to those of the private university (p<0.001).Conclusion: This study showed good knowledge concerning HWM in the scientific laboratoriesof the studied universities in Lebanon and a good awareness of the HWM on health and the environment. It highlights the importance of culture, attitude, and practice on proper HWM in the academic scientific laboratory.

Keywords: hasardous waste, safety measures, waste management, knwoledge score, scientific laboratory workers

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Authors: Koyangbo Guere Monguia Michel Alex Emmanuel

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In e-government and especially recruitment, many researches have been conducted to build a trustworthy and reliable online or application system capable to process users or job applicant files. In this research (Government Recruitment Agency), cloud computing, identity management and public key encryption have been used to management domains, access control authorization mechanism and to secure data exchange between entities for reliable procedure of processing files.

Keywords: cloud computing network, identity management systems, public key encryption, access control and authorization

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Authors: Hanieh Sakha, Nader Nader, Haleh Farzin

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Introduction: Throughout history, pain theories have been supposed by biomedicine, especially regarding its diagnosis and treatment aspects. Therefore, the feeling of pain is not only a personal experience and is affected by social background; therefore, it involves extensive systems of signals. The challenges in emotional and sentimental dimensions of pain originate from scientific medicine (i.e., the dominant theory is also referred to as the specificity theory); however, this theory has accepted some alterations by emerging physiology. Then, Von Frey suggested the theory of cutaneous senses (i.e., Muller’s concept: the common sensation of combined four major skin receptors leading to a proper sensation) 50 years after the specificity theory. The pain pathway was composed of spinothalamic tracts and thalamus with an inhibitory effect on the cortex. Pain is referred to as a series of unique experiences with various reasons and qualities. Despite the gate control theory, the biological aspect overcomes the social aspect. Vrancken provided a more extensive definition of pain and found five approaches: Somatico-technical, dualistic body-oriented, behaviorist, phenomenological, and consciousness approaches. The Western model combined physical, emotional, and existential aspects of the human body. On the other hand, Kotarba felt confused about the basic origins of chronic pain. Freund demonstrated and argued with Durkhemian about the sociological approach to emotions. Lynch provided a piece of evidence about the correlation between cardiovascular disease and emotionally life-threatening occurrences. Helman supposed a distinction between private and public pain. Conclusion: The consideration of the emotional aspect of pain could lead to effective, emotional, and social responses to pain. On the contrary, the theory of embodiment is based on the sociological view of health and illness. Social epidemiology shows an imbalanced distribution of health, illness, and disability among various social groups. The social support and socio-cultural level can result in several types of pain. It means the status of athletes might define their pain experiences. Gender is one of the important contributing factors affecting the type of pain (i.e., females are more likely to seek health services for pain relief.) Chronic non-cancer pain (CNCP) has become a serious public health issue affecting more than 70 million people globally. CNCP is a serious public health issue which is caused by the lack of awareness about chronic pain management among the general population.

Keywords: pain, sociology, sociological, body

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Authors: Melanie Adrian, Elspeth McCulloch, Emily-Jean Gallant

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Resources -financial, physical, and human- are increasingly constrained in higher education. University classes are getting bigger, and the concomitant grading burden on faculty is growing rapidly. Multiple-choice exams are seen by some as one solution to these changes. How much students retain, however, and what their testing experience is, continues to be debated. Are multiple-choice exams serving students well, or are they bearing the burden of these developments? Is there a way to address both the resource constraints and make these types of exams more meaningful? In short, how do we engender evaluation methods for large-scale classes that provide opportunities for heightened student learning and enrichment? The following article lays out a testing approach we have employed in four iterations of the same third-year law class. We base our comments in this paper on our initial observations as well as data gathered from an ethics-approved study looking at student experiences. This testing approach provides students with multiple opportunities for revision (thus increasing chances for long term retention), is both individually and collaboratively driven (thus reflecting the individual effort and group effort) and is automatically graded (thus draining limited institutional resources). We found that overall students appreciated the approach and found it more ‘humane’, that it notably reduced pre-exam and intra-exam stress levels, increased ease, and lowered nervousness.

Keywords: exam, higher education, multiple-choice, law

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Authors: Hummad Ch. Umar

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Most of the developing economies, including Pakistan, are confronted with high level of external debt which is adversely affecting their economic performance. The hypothesis of debt overhang is often used to assess the negative relationship between foreign debt and the economic growth of the indebted country. As first objective of the present study, this hypothesis is tested by using Pooled OLS (POLS), Generalized Method of Moment (GMM), Random Effect (RE), and Fixed effect (FE) techniques. As second objective, the study uses the concept of debt Laffer Curve to determine the eligibility condition of the indebted countries for the relief programs. According to this approach, countries lying on the right side of the Laffer Curve are stated to be trapped in the strong debt overhang making them unable to come out of the vicious circle of low growth and high foreign debt. The empirical analysis confirms that only two countries out of twenty two completely fulfill the conditions of being eligible for the debt relief. All other countries continue to face debt burden of different magnitudes. The study further confirms that the debt relief alone is not sufficient for overcoming the debt problem. Instead, sound economic policies and conducive investment decisions are required to lay the foundations of long-term growth and development. Debt relief should be the option for only those countries that meet a minimum measurable criterion of good governance, economic freedom, and consistency of policies.

Keywords: external debt, debt burden, debt overhang, debt laffer curve, debt relief, investment decisions

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Authors: Samuel Capintero, Ole H. Petersen

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This paper examines the utilization of public-private partnerships for the building and operation of wastewater treatment plants. Our research focuses on risk allocation in this kind of projects. Our analysis builds on more than hundred wastewater treatment plants built and operated through PPP projects in Aragon (Spain). The paper illustrates the consequences of an inadequate management of construction risk and an unsuitable transfer of demand risk in wastewater treatment plants. It also shows that the involvement of many public bodies at local, regional and national level further increases the complexity of this kind of projects and make time delays more likely.

Keywords: wastewater, treatment plants, PPP, construction

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Authors: Ghada M. AlSwayied, Anas N. AlHumaid

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Smoking has been linked to thousands of deaths worldwide. Around three million adults continue to use tobacco each day in Saudi Arabia; a sign that smoking is prevalent among Saudi population and obviously considered as a public health threat. Although the awareness against smoking is continuously running, it can be observed that smoking behavior increases noticeably as common practice especially among young adults across the world. Therefore, it was an essential step to guess what does motivate smokers to think about quit smoking. Can a graphic and emotional ad that is focusing on health consequences do really make a difference? A case study has been conducted on the Annual Anti-Smoking National Campaign, which was provided by Saudi Ministry of Health in the period of May 2017. To assess campaign’s effects on the number of calls, the number of visits and online access to health messages during and after the campaign period from May to August compared with the previous campaign in 2016. The educational video was selected as a primary tool to deliver the smoking health message. The Minister of Health who is acting as a role model for young adults was used to deliver a direct message to smokers with an avoidance of smoking cues usage. Due to serious consequences of smoking, the Minister of Health delivered the news of canceling the media campaign and directing the budget to smoking cessation clinics. It was shown that the positive responses and interactions on the campaign were obviously remarkable; achieving a high rate of recall and recognition. During the campaign, the number of calls to book for a visit reached 45880 phone calls, and the total online views ran to 1,253,879. Whereas, clinic visit raised up to 213 cumulative percent. Interestingly, a total number of 15,192 patients visited the clinics along three months compared with the last year campaign’s period, which was merely 4850 patients. Furthermore, around half of patients who visited the clinics were in the age from 26 to 40-year-old. There was a great progress in enhancing public awareness on: 'where to go' to assist smokers in making a quit attempt. With regard to the stages of change theory, it was predicted that by following direct-message technique; the proportion of patients in the contemplation and preparation stages would be increased. There was no process evaluation obtained to assess implementation of the campaigns’ activities.

Keywords: smoking, health promotion, role model, educational material, intervention, community health

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Authors: Saira Mehnaz, Ali Jafar Abedi, Shazia Farooq Fazli, Sakeena Mushfiq, Zulfia Khan, M. Athar Ansari

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Introduction: Public health spending is a necessity in an underdeveloped country like India. The people are already suffering from poverty and that clubbed with out of pocket expenditure leads them to a very catastrophic situation, reducing the overall access to healthcare. Objectives: This study was designed to determine the usual source of medical care opted, the illness pattern, the expenditure incurred on illness and its source of procurement by the study population. It also intended to assess this expenditure as a determinant of access to health care. Methodology: Cities like Aligarh, which are classified as B grade cities in India are thought to be ripe sites for getting livelihood and hence are almost half filled with migrants living in urban slums. A cross sectional study was done to study the newer slum pockets. 3409 households with a population of 16,978 were studied with the help of pretested questionnaire; SPSS 20 was used for statistical analysis. Results and Conclusions: In our study, we found that almost all the households suffered from catastrophic health expenditure. The study population, which was already vulnerable owing to their low socio-economic and migrant status was further being forced with into poverty and indebtedness on account of expenditure on illness. This lead to a significant decrease in access to health. National health financing systems should be designed to protect households from financial catastrophe, by reducing out-of-pocket spending.

Keywords: access to healthcare, catastrophic health expenditure, new urban slums, out of pocket expenditure

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Authors: Sultan Ahmad Azizi, Gaurang J. Joshi

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Urban transportation has come to lime light in recent times due to deteriorating travel quality. The economic growth of India has boosted significant rise in private vehicle ownership in cities, whereas public transport systems have largely been ignored in metropolitan cities. Even though there is latent demand for public transport systems like organized bus services, most of the metropolitan cities have unsustainably low share of public transport. Unfortunately, Indian metropolitan cities have failed to maintain balance in mode share of various travel modes in absence of timely introduction of mass transit system of required capacity and quality. As a result, personalized travel modes like two wheelers have become principal modes of travel, which cause significant environmental, safety and health hazard to the citizens. Of late, the policy makers have realized the need to improve public transport system in metro cities for sustaining the development. However, the challenge to the transit planning authorities is to design a transit system for cities that may attract people to switch over from their existing and rather convenient mode of travel to the transit system under the influence of household socio-economic characteristics and the given travel pattern. In this context, the fast-growing industrial city of Surat is taken up as a case for the study of likely shift to bus transit. Deterioration of public transport system of bus after 1998, has led to tremendous growth in two-wheeler traffic on city roads. The inadequate and poor service quality of present bus transit has failed to attract the riders and correct the mode use balance in the city. The disaggregate travel behavior for trip generations and the travel mode choice has been studied for the West Adajan residential sector of city. Mode specific utility functions are calibrated under multi-nominal logit environment for two-wheeler, cars and auto rickshaws with respect to bus transit using SPSS. Estimation of shift to bus transit is carried indicate an average 30% of auto rickshaw users and nearly 5% of 2W users are likely to shift to bus transit if service quality is improved. However, car users are not expected to shift to bus transit system.

Keywords: bus transit, disaggregate travel nehavior, mode choice Behavior, public transport

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Authors: Adinarayana Badveeti, Mohammad Shafi Mir

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In Srinagar City, in India, traffic congestion is a condition on transport networks that occurs as use increases and is characterized by slower speeds, longer trip times, and increased vehicular queuing. Traffic congestion is conventionally measured using indicators such as roadway level-of-service, the Travel Time Index and their variants. Several measures have been taken in order to counteract congestion like road pricing, car pooling, improved traffic management, etc. While new road construction can temporarily relieve congestion in the longer term, it simply encourages further growth in car traffic through increased travel and a switch away from public transport. The full paper report, on which this abstract is based, aims to provide policymakers and technical staff with the real-time data, conceptual framework and guidance on some of the engineering tools necessary to manage congestion in such a way as to reduce its overall impact on individuals, families, communities, and societies dynamic, affordable, liveable and attractive urban regions will never be free of congestion. Road transport policies, however, should seek to manage congestion on a cost-effective basis with the aim of reducing the burden that excessive congestion imposes upon travellers and urban dwellers throughout the urban road network.

Keywords: traffic congestion, modeling, traffic management, travel time index

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Authors: Myung-Soo Lee, Sun-Jin Jo, Kyoung-Sae Na, Joo-Eon Park

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Early intervention after a disaster is important for recovery of disaster victims and each country has its own professional mental health service system such as Disaster Psychiatric Assistant Team in Japan and Crisis Counseling Program in the USA. The purpose of this study was to determine key prior components of the Korean Disaster Psychiatric Assistant Team (K-DPAT) for building up Korean disaster mental health service system. We conducted an Analytic Hierarchy Process(AHP) with disaster mental health experts using pairwise comparison questionnaire which compares the relative importance of the key components of Korean disaster mental health service system. Forty-one experts answered the first online survey, and among them, 36 responded to the second. Ten experts were participated in panel meeting and discussed the results of the survey and AHP process. Participants decided the relative importance of the Korean disaster mental health service system regarding initial professional intervention as follows. K-DPAT could be organized at a national level (43.0%) or regional level (40.0%). K-DPAT members should be managed (59.0%) and educated (52.1%) by national level than regional or local level. K-DPAT should be organized independent of the preexisting mental health system (70.1%). Funding for K-DPAT should be from the Ministry of Public Safety and the system could be managed by Ministry of Health (65.8%). Experts agreed K-DPAT leader is suitable for key decision maker for most types of disaster except infectious disease. We expect new model for disaster mental health services can improve insufficiency of the system such as fragmentation and decrease the unmet needs of early professional intervention for the disaster victims.

Keywords: analytic hierarchy process, decision making, disaster, DPAT, mental health services

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Authors: Lesley Metibogun, Regan Potangaroa

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Some existing sustainable public libraries in New Zealand now depend on air conditioning system for cooling. This seems completely contradictory to sustainable building initiatives. A sustainable building should be ‘self- sufficient’ and must aim at optimising the use of natural ventilation, wind and daylight and avoiding too much summer heat penetration into the building, to save energy consumption and enhance occupants’ comfort. This paper demonstrates that with appropriate architectural passive design input public libraries do not require air conditioning. Following a brief outline of how our dependence on air conditioning has spread over the full range of building types and climatic zones, this paper focuses on public libraries in temperate climates where passive cooling should be feasible for long periods of mild outside temperature. It was found that current design policies, regulations and guidelines and current building design practices militate passive cooling strategies. Perceived association with prestige, inflexibility of design process, rigid planning regulations and sustainability rating systems were identified as key factors forcing the need for air conditioning. Recommendations are made on how to further encourage development in this direction from the perspective of architectural design. This paper highlights how architectural passive cooling design strategies should be implemented in government initiated policies and regulations to develop a more sustainable public libraries.

Keywords: public library, sustainable design, temperate climate, passive cooling, air conditioning

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Authors: Abdelmanie Suleimat, Nagham Abu Shaqra, Sawsan Majali, Issam Adawi, Heba Abo Shindi, Anas Al Mohtaseb

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The Government of Jordan recognizes that maternal mortality constitutes a grave public health problem. Over the past two decades, there has been significant progress in improving the quality of maternal health services, resulting in improved maternal and child health outcomes. Despite these efforts, measurement and analysis of maternal mortality remained a challenge, with significant discrepancies from previous national surveys that inhibited accuracy. In response with support from USAID, the Jordan Maternal Mortality Surveillance Response (JMMSR) System was established to collect, analyze, and equip policymakers with data for decision-making guided by interdisciplinary multi-levelled advisory groups aiming to eliminate preventable maternal deaths, A 2016 Public Health Bylaw required the notification of deaths among women of reproductive age. The JMMSR system was launched in 2018 and continues annually, analyzing data received from health facilities, to guide policy to prevent avoidable deaths. To date, there have been four annual national maternal mortality reports (2018-2021). Data is collected, reviewed by advisory groups, and then consolidated in an annual report to inform and guide the Ministry of Health (MOH); JMMSR collects the necessary information to calculate an accurate maternal mortality ratio and assists in identifying leading causes and contributing factors for each maternal death. Based on this data, national response plans are created. A monitoring and evaluation plan was designed to define, track, and improve implementation through indicators. Over the past four years, one of these indicators, ‘percent of facilities notifying respective health directorates of all deaths of women of reproductive age,’ increased annually from 82.16%, 92.95%, and 92.50% to 97.02%, respectively. The Government of Jordan demonstrated commitment to the JMMSR system by designating the MOH to primarily host the system and lead the development and dissemination of policies and procedures to standardize implementation. The data was translated into practical and evidence-based recommendations. The successful impact of results deepened the understanding of maternal mortality in Jordan, which convinced the MOH to amend the Bylaw now mandating electronic reporting of all births and neonatal deaths from health facilities to empower the JMMSR system, by developing a stillbirths and neonatal mortality surveillance and response system.

Keywords: maternal health, maternal mortality, preventable maternal deaths, maternal morbidity

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Authors: Priyoth Kittiteerasack, Alana Steffen, Alicia K. Matthews

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Depression is a leading cause of the worldwide burden of disability and disease burden. Notably, lesbian, gay, bisexual, and transgender (LGBT) populations are more likely to be a high-risk group for depression compared to their heterosexual and cisgender counterparts. To date, little is known about the rates and predictors of depression among Thai LGBT populations. As such, the purpose of this study was to: 1) measure the prevalence of depression among a diverse sample of Thai LGBT adults and 2) determine the influence of minority stress variables (discrimination, victimization, internalized homophobia, and identity concealment), general stress (stress and loneliness), and coping strategies (problem-focused, avoidance, and seeking social support) on depression outcomes. This study was guided by the Minority Stress Model (MSM). The MSM posits that elevated rates of mental health problems among LGBT populations stem from increased exposures to social stigma due to their membership in a stigmatized minority group. Social stigma, including discrimination and violence, represents unique sources of stress for LGBT individuals and have a direct impact on mental health. This study was conducted as part of a larger descriptive study of mental health among Thai LGBT adults. Standardized measures consistent with the MSM were selected and translated into the Thai language by a panel of LGBT experts using the forward and backward translation technique. The psychometric properties of translated instruments were tested and acceptable (Cronbach’s alpha > .8 and Content Validity Index = 1). Study participants were recruited using convenience and snowball sampling methods. Self-administered survey data were collected via an online survey and via in-person data collection conducted at a leading Thai LGBT organization. Descriptive statistics and multivariate analyses using multiple linear regression models were conducted to analyze study data. The mean age of participants (n = 411) was 29.5 years (S.D. = 7.4). Participants were primarily male (90.5%), homosexual (79.3%), and cisgender (76.6%). The mean score for depression of study participant was 9.46 (SD = 8.43). Forty-three percent of LGBT participants reported clinically significant levels of depression as measured by the Beck Depression Inventory. In multivariate models, the combined influence of demographic, stress, coping, and minority stressors explained 47.2% of the variance in depression scores (F(16,367) = 20.48, p < .001). Minority stressors independently associated with depression included discrimination (β = .43, p < .01) victimization (β = 1.53, p < .05), and identity concealment (β = -.54, p < .05). In addition, stress (β = .81, p < .001), history of a chronic disease (β = 1.20, p < .05), and coping strategies (problem-focused coping β = -1.88, p < .01, seeking social support β = -1.12, p < .05, and avoidance coping β = 2.85, p < .001) predicted depression scores. The study outcomes emphasized that minority stressors uniquely contributed to depression levels among Thai LGBT participants over and above typical non-minority stressors. Study findings have important implications for nursing practice and the development of intervention research.

Keywords: depression, LGBT, minority stress, sexual and gender minority, Thailand

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Authors: Prince Amartey

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Water is critical to public health, quality of life, environmental preservation, economic activity, and long-term growth. In this environment, it is critical to ensure the ongoing improvement of all processes and practices that contribute to the quality and safety of water. Water safety plans (WSPs) developed by water companies are an essential public policy instrument for achieving these objectives. This manuscript examines international evidence of water safety planning adoption and implementation and reports on the current situation in Portugal as part of the necessary adaptation of the national legal framework to the publication of the Directive on water quality for human consumption. The goal is to take lessons from various successful WSP projects throughout the world while writing new legislation in Ghana and elsewhere. According to the findings, four crucial aspects and key factors of success in establishing and implementing WSPs exist commitment from leadership, technical proficiency, administration, and cooperation among agencies.

Keywords: safe drinking, risk, policy, implementation

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Authors: Lucia Mavudzi

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Socioeconomic and demographic factors influence male attendance of antenatal care (ANC) activities which are beneficial in improving maternal health and birth outcome. When a male, as the head of the family is expected to solely make decisions of how finances are managed, when and where health services are sought, it impacts on the woman’s health seeking behavior. Using the data from the Zimbabwe Demographic and Health Survey 2010-2011 this paper seeks to assess the prevalence of male ANC attendance in Zimbabwe and factors that influence male ANC attendance. We hypothesized that socioeconomic and demographic factors do not influence male ANC attendance. To achieve the objectives of this paper, descriptive analysis was used to describe the characteristics of men and the Binomial logistic modelling was used to assess the relationship between male ANC attendance and selected socioeconomic and demographic factors. Male ANC attendance was used as the dependent variable, and the independent variables are age, marital status, place of residence, wealth, education, religion and employment. A high percentage of males did not attend ANC with their pregnant partners. Religion, education, and place of residence were found to be significantly associated with male ANC attendance. There was no evidence to show that there was a difference in male ANC attendance by employment, marital status, and age. Findings from this paper are relevant to public health. They will be used to develop strategies and intervention programs to improve pregnant women’s attendance of ANC attendance by involving men in maternal health.

Keywords: antenatal care, male participation, maternal health, socio-economic and demographic factors

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Authors: Ana Lambelho

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Nowadays is very common that an activity may be performed independently or dependently. In Portugal, the Labour Law exclusively protects the dependent labour relations. The independent work is regulated by civil law, where the autonomy of the will is the main principle. For companies is more advantageous to hire people under a service agreement since, in that case, the relation is not submitted to the limits established in Labour law and collective bargaining. This practice has nothing wrong, if the performance of work is, in fact, made autonomously. The problem is the increased frequency of the celebration of service agreements to hide a legal relation of subordination. Aware of this and regarding the huge difficulty to demonstrate the existence of subordinated work (that often runs against the employee), the Portuguese legislator devoted some legislative rules in order to facilitate the evidence of legal subordination and, on the other hand, to avoid the misuse of the provision of service agreements. This study focuses precisely on the analysis of this solution, namely the so-called presumption of ‘laboralidade’ and on the lawsuit to recognize the existence of a labour contract. The presumption of the existence of a labour contract is present in the Portuguese legal system since 2003, and received, with the 2009 Labour Code, a new redaction that, according to the doctrine and the jurisprudence, finally approached it to a legal presumption, with the consequent reversal of the burden of proof and, in consequence, made easier to proof the legal subordination, because the employee will just have to plead and prove the existence of two of the elements described in the law to use this presumption. Another change in the Portuguese legal framework is related with the competencies of the Authority for Working Conditions (AWC): now, if during an inspection, the Authority finds a situation that seems to be an undeclared employment situation, it may access the company and, if it does not regularize voluntarily the situation, AWC has a duty to communicate to the public prosecutor, who will begin the lawsuit for the recognition of the existence of an employment contract. To defend the public interest, the action to recognize the existence of an employment contract will follow its terms, even against the employee will. Although the existence of these mechanisms does not solve by itself the problem of evasion of labour law and false ‘green receipts’, it is undeniable that it is an important step in combating fraud in this field.

Keywords: independent work, labour contract, Portugal, service agreement

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Authors: Jie Li, Nick Manning

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The mass rural-urban migrants in China associated with the urbanization processes bear significant implications on public health, which is an important yet under-researched area. Urban social and built environment, such as noise, air pollution, high population density, and social segregation, has the potential to contribute to mental illness. In China, rural-urban migrants are also faced with institutional discrimination tied to the hukou (household registration) system, through which they are denied of full citizenship to basic social welfare and services, which may elevate the stress of urban living and exacerbate the risks to mental illness. This paper aims to link the sociospatial exclusion, everyday life experiences and its mental health consequences on rural to urban migrants living in the mega-city of Shanghai. More specifically, it asks what the daily experience of being a migrant in Shanghai is actually like, particularly regarding sources of stress from housing, displacement, service accessibility, and cultural conflict, and whether these stresses affect mental health? Secondary data from literature review on migration, urban studies, and epidemiology research, as well as primary data from preliminary field trip observations and interviews are used in the analysis.

Keywords: migration, urbanisation, mental health, China

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Authors: Duane Booysen, Ashraf Kagee

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There is a high prevalence of violent crime and trauma exposure in South African society. Considering the prevalence of continuous violent crimes and traumatization in South Africa, the public mental health sector is required to combat the burgeoning effect of traumatic stress in South Africa. Trauma counselors, especially, provide important mental health services at primary health care to persons affected by traumatic events. Therefore, the evaluation and implementation of evidence-based trauma therapies is essential at a primary health care level in treating traumatic stress. A single-case design was used to evaluate the treatment effect of a Brief Trauma Treatment Programme treating persons who present with symptoms of posttraumatic stress disorder at a primary care trauma centre in Cape Town, South Africa. The sample consisted of six adult participants who presented with symptoms of posttraumatic stress and were assessed at baseline, during treatment, post-intervention and at 3-month follow. All participants received six sessions of trauma therapy. Assessment measures included the posttraumatic stress disorder symptom scale interviews for Diagnostic and Statistical Manual fifth edition (DSM5), the posttraumatic disorder checklist for DSM5, Beck Depression Inventory and Beck Anxiety Inventory. Results demonstrate that participants had noticeable reduced symptoms for traumatic stress, anxiety and depression despite living in contexts of violent crime and trauma. In conclusion, the article critically reflects on the need to evaluate and implement evidence-based treatments for the South African context, and how evidence-based treatments are used in developing socio-economic and cultural diverse contexts with continuous levels of violence and traumatization.

Keywords: psychological interventions, public mental health, traumatic stress, single-case design

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Authors: Tallal Abdel Karim Bouzir, Nourdinne Zemmouri, Djihed Berkouk

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In this research, a quantitative assessment of the urban sound environment of the city of Biskra, Algeria, was conducted. To determine the quality of the soundscape based on in-situ measurement, using a Landtek SL5868P sound level meter in 47 points, which have been identified to represent the whole city. The result shows that the urban noise level varies from 55.3 dB to 75.8 dB during the weekdays and from 51.7 dB to 74.3 dB during the weekend. On the other hand, we can also note that 70.20% of the results of the weekday measurements and 55.30% of the results of the weekend measurements have levels of sound intensity that exceed the levels allowed by Algerian law and the recommendations of the World Health Organization. These very high urban noise levels affect the quality of life, the acoustic comfort and may even pose multiple risks to people's health.

Keywords: road traffic, noise pollution, sound intensity, public health

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Authors: Donato Vese

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According to the common interpretation, in a legal system, public powers are established by law. Exceptions are admitted in an emergency or particular relationship with public power. However, we currently agree that law allows public administration a margin of decision, even in the case of non-discretionary acts. Hence, the administrative decision not exclusively established by law becomes the rule in the ordinary state of things, non-only in state of exception. This paper aims to analyze and discuss different ideas on discretionary power on the Rule of Law and Rechtsstaat. Observing the legal literature in Europe and Nord and South America, discretionary power can be described as follow: it could be considered a margin that law accords to the executive power for political decisions or a choice between different interpretations of vague legal previsions. In essence, this explanation admits for the executive a decision not established by law or anyhow not exclusively established by law. This means that the discretionary power of public administration integrates the law. However, integrating law does not mean to decide according to the law, but it means to integrate law with a decision involving public power. Consequently, discretionary power is essentially free will. In this perspective, also the Rule of Law and the Rechtsstaat are notions explained differently. Recently, we can observe how the European notion of Rechtsstaat is founded on the formal validity of the law; therefore, for this notion, public authority’s decisions not regulated by law represent a problem. Thus, different systems of law integration have been proposed in legal literature, such as values, democracy, reasonableness, and so on. This paper aims to verify how, looking at those integration clauses from a logical viewpoint, integration based on the recourse to the legal system itself does not resolve the problem. The aforementioned integration clauses are legal rules that require hard work to explain the correct meaning of the law; in particular, they introduce dangerous criteria in favor of the political majority. A different notion of public power can be proposed. This notion includes two main features: (a) sovereignty belongs to persons and not the state, and (b) fundamental rights are not grounded but recognized by Constitutions. Hence, public power is a system based on fundamental rights. According to this approach, it can also be defined as the notion of public interest as concrete maximization of fundamental rights enjoyments. Like this, integration of the law, vague or subject to several interpretations, must be done by referring to the system of fundamental individual rights. We can think, for instance, to fundamental rights that are right in an objective view but not legal because not established by law.

Keywords: administrative discretion, free will, fundamental rights, public power, sovereignty

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Authors: Wabinyai Fidel Raja, Gideon Lubisa

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Air pollution is becoming a growing concern in Africa due to rapid industrialization and urbanization, leading to implications for public health and the environment. Establishing a comprehensive air quality monitoring network is crucial to combat this issue. However, conventional methods of monitoring are insufficient in African cities due to the high cost of setup and maintenance. To address this, low-cost sensors (LCS) can be deployed in various urban areas through the use of participatory air quality network siting (PAQNS). PAQNS involves stakeholders from the community, local government, and private sector working together to determine the most appropriate locations for air quality monitoring stations. This approach improves the accuracy and representativeness of air quality monitoring data, engages and empowers community members, and reflects the actual exposure of the population. Implementing PAQNS in African cities can build trust, promote accountability, and increase transparency in the air quality management process. However, challenges to implementing this approach must be addressed. Nonetheless, improving air quality is essential for protecting public health and promoting a sustainable environment. Implementing participatory and data-informed air quality monitoring can take a significant step toward achieving these important goals in African cities and beyond.

Keywords: low-cost sensors, participatory air quality network siting, air pollution, air quality management

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Authors: Tya M. Arthur

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Purpose: BIPOC (Black, Indigenous, and People of Color) adolescents face racism and discrimination at a young age. These early experiences have short- and long-term impacts on their health and overall well-being. The purpose of this study was to determine the relationships between perceived racial discrimination at school and health risk behaviors and experiences of BIPOC adolescents. Methods: Data from the 2021 Adolescent Behaviors and Experiences Survey (ABES) were analyzed. All demographic data were summarized using frequencies and chi-squared tests. A univariate and multivariate logistic regression model was used to test the relationship between perceived racial discrimination and selected health risk factors. All analyses were conducted using STATA SE 18. Results: A total of 42.2% of the BIPOC adolescents in the study indicated being treated unfairly at school due to their race. The majority of those who reported being discriminated against were Black/African American or Multiple Race-Hispanic. Asian adolescents were almost 5 times more likely to face racial discrimination at school compared to their American Indian/Alaska Native counterparts (OR = 4.86, 95% CI [2.69-8.77], p < 0.001). Other risk predictors of racial discrimination included being female (OR = 1.38, 95% CI [1.13-1.68], p = 0.002) and feeling disconnected at school (OR = 1.76, 95% CI [1.30-2.38], p < 0.001). After adjustment for health risk behaviors and experiences, BIPOC adolescents were still more likely to face racial discrimination with even higher odds. Conclusions: The results of this study highlight the depth of racial discrimination faced by BIPOC adolescents at school. Greater attention should be placed on racial discrimination as a social determinant of health and a public health crisis.

Keywords: racial discrimination, adolescents, heath risk factors, BIPOC

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Authors: Elida Tafupenji Kamanga

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Cancer of the cervix remains one of the high causes of death among Malawian women. Despite the government introduction of free screening services throughout the country, patronage still remains low and lack of knowledge high. Given the critical role mass media plays in relaying different information to the public including health and its influence on health behaviours, the study sought to analyse Malawi media coverage of the disease and its effectiveness. The findings of the study will help inform media advocacy directed at changing any coverage impeding the effective dissemination of cervical cancer message which consequently will help increase awareness and accessing of screening behaviours among women. A content analysis of 29 newspapers and promotional messages on cervical from a local radio station was conducted for the period from 2012 to 2015. Overall the results showed media coverage in terms of content and frequency increased for the four-year period. However, of concern was the quality of information both media presented to the public. The lapse in information provided means there is little education taking place through the media which could be contributing to the knowledge gap the women have thereby affecting their decision to screen. Also lack of adequate funding to media institutions and lack of collaboration between media institutions and stakeholders involved in the fight against the disease were noted as other contributing factors to low coverage of the disease. Designing messages that are not only informative and educative but also innovative may help increase awareness; improve the knowledge gap and potential adoption of preventive screening behaviour by Malawian women. Conversely, good communication between the media institutions and researchers involved in the fight against the disease through the channelling of new findings back to the public as well as increasing funding towards similar cause should be considered.

Keywords: cervical cancer, effectiveness, media coverage, screening

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Authors: Ringisai Abigail Mawondo-Dhliwayo, Kahilu Kajimo-Shakantu

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Due to financial challenges which governments in general face, it is becoming more difficult for many to continually use their limited resources to undertake infrastructural development. Governments increasingly now need other delivery approaches, in particular, the Public-Private Partnerships which make it possible for the public sector to achieve infrastructural development without incurring any/minimum cost. The literature reviewed outlined that benefits of PPPs include timely delivery of quality projects with cost limits. The methodology utilized for the empirical study comprised six interviews and sixty questionnaires which were undertaken and administered by construction consultants and government officials involved in PPPs projects. The results obtained showed that PPPs are not widely used in Zimbabwe although the need for their use exists. The study also found some challenges which prevent or derail the rate at which PPPs are utilized, of which the primary one was a political influence. It is concluded that despite limitations, PPPs remain the most effective and viable option for the delivery of government projects. The study recommends that policy and framework for the implementation of PPPs be developed. More useful information could have been obtained if final users of PPPs projects were included in the sample for data collection.

Keywords: construction projects, procurement, public private partnerships, public sector

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Authors: Tamara Jimah, Priscilla Kehoe, Pamela Pimentel, Amir Rahmani, Nikil Dutt, Yuqing Guo

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Ensuring equitable access to maternal health care is critical for public health. Particularly for underserved women, community health workers (CHWs) have been invaluable in providing support through health education and strategies for improved maternal self-care management. Our research aimed to assess the acceptance of technology by CHWs and perinatal women to promote healthy pregnancy and postpartum wellness. This pilot study was conducted at a local community organization in Orange County, California, where CHWs play an important role in supporting low-income women through home visitations. Questionnaires were administered to 14 CHWs and 114 pregnant and postpartum women, literate in English and/or Spanish. CHWs tested two wearable devices (Galaxy watch and Oura ring) and shared their user experience, including potential reception by the perinatal women they served. In addition, perinatal women provided information on access to a smart phone and the internet, as well as their interest in using wearable devices to self-monitor personal health with guidance from a CHW. Over 85% of CHWs agreed that it was useful to track pregnancy with the smart watch and ring. The majority of perinatal women owned a smartphone (97.4%), had access to the internet (80%) and unlimited data plans (78%), expressed interest in using the smart wearable devices to self-monitor health, and were open to receiving guidance from a CHW (87%). Community health workers and perinatal women embraced the use of wearable technology to monitor maternal health. These preliminary findings have formed the basis of an ongoing research study that integrates CHW guidance and technology (i.e., smart watch, smart ring, and a mobile phone app) to promote self-efficacy and self-management among underserved perinatal women.

Keywords: community health workers, health promotion and education, health equity, maternal and child health, technology

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Authors: Ratih Indraswari

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As it occupies a new status in international relations, Indonesia needs to re-organize its resources in projecting the preferred image internationally. Attractiveness becomes crucial as Indonesia needs to maintain its posture as a reliable contributor to the world. This paper tries to scrutinize the un-tap potential of ideational powers Indonesia possesses. Herein the ideational power is assumed to be translated into a soft power, intangible and rely on its influential degree to persuade and attract other countries, through its public diplomacy activities. A specific correlation will be dedicated to the effort of Indonesia public diplomacy on international education. It is believed that international education progresses mutual understanding in disseminating Indonesia values and engages public audience. As a result these exchanges and engagements support the attainment of Indonesia’s interests and forwarding Indonesia’s foreign policies. A case study on KNB (Kemitraan Negara berkembang) scholarship scheme will be provided and its impact towards building people-to-people connections.

Keywords: Indonesia, international education, KNB (Kemitraan Negara Berkembang), public diplomacy

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Authors: Sabah Khan

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The idea of universal Islam tends to exaggerate the extent of homogeneity in Islamic beliefs and practices across Muslim communities. In the age of migration, various Muslim communities are in diaspora. The immediate implication of this is what happens to Islam in diaspora? How Islam gets represented in new forms? Such pertinent questions need to be dealt with. This paper shall draw on the idea of religious transnationalism, primarily transnational Islam. There are multiple ways to conceptualize transnational phenomenon with reference to Islam in terms of flow of people, transnational organizations and networks; Ummah oriented solidarity and the new Muslim public sphere. This paper specifically deals with the new Muslim public sphere. It primarily refers to the space and networks enabled by new media and communication technologies, whereby Muslim identity and Islamic normativity are rehearsed, debated by people in different locales. A new sense of public is emerging across Muslim communities, which needs to be contextualized. This paper uses both primary and secondary data. Primary data elicited through content analysis of audio-visuals on social media and secondary sources of information ranging from books, articles, journals, etc. The basic aim of the paper is to focus on the emerging Muslim public sphere and the role of media in expanding public spheres of Islam. It also explores how Muslims in diaspora negotiate Islam and Islamic practices through media and the new Muslim public sphere. This paper cogently weaves in discussions firstly, of re-intellectualization of Islamic discourse in the public sphere. In other words, how Muslims have come to reimagine their collective identity and critically look at fundamental principles and authoritative tradition. Secondly, the emerging alternative forms of Islam by young Muslims in diaspora. In other words, how young Muslims search for unorthodox ways and media for religious articulation, including music, clothing and TV. This includes transmission and distribution of Islam in diaspora in terms of emerging ‘media Islam’ or ‘soundbite Islam’. The new Muslim public sphere has offered an arena to a large number of participants to critically engage with Islam, which leads not only to a critical engagement with traditional forms of Islamic authority but also emerging alternative forms of Islam and Islamic practices.

Keywords: Islam, media, Muslims, public sphere

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Authors: Alvaro Valera Sosa

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Background: In recent years, childhood overweight and obesity have become an increasing and challenging phenomenon in Berlin and Germany in general. The highest shares of childhood overweight in Berlin are district localities within the inner city ring with lowest socio-economic levels and the highest number of migration background populations. Most factors explaining overweight and obesity are linked to individual dispositions and nutrition balances. Among various strategies, to target drinking behaviors of children and adolescents has been proven to be effective. On the one hand, encouraging the intake of water – which does not contain energy and thus may support a healthy weight status – on the other hand, reducing the consumption of sugar-containing beverages – which are linked to weight gain and obesity. Anyhow, these preventive approaches have mostly developed into individual or educational interventions widely neglecting environmental modifications. Therefore, little is known on how urban physical environment patterns and features can act as influence factors for childhood overweight. Aiming the development of a physical environment intervention tackling children overweight, this study evaluated urban situations surrounding public playgrounds in Berlin where the issue is evident. It verified the presence and state of physical environmental conditions that can be conducive for children to engage physical activity and water intake. Methods: The study included public playgrounds for children from 0-12 y/o within district localities with the highest prevalence of childhood overweight, highest population density, and highest mixed uses. A systematic observation was realized to describe physical environment patterns and features that may affect children health behavior leading to overweight. Neighborhood walkability for all age groups was assessed using the Walkability for Health framework (TU-Berlin). Playground physical environment conditions were evaluated using Active Living Research assessment sheets. Finally, the food environment in the playground’s pedestrian catchment areas was reviewed focusing on: proximity to suppliers offering sugar-containing beverages, and physical access for 5 y/o children and up to drinking water following the Drinking Fountains and Public Health guidelines of the Pacific Institute. Findings: Out of 114 locations, only 7 had a child population over 3.000. Three with the lowest socio-economic index and highest percentage of migration background were selected. All three urban situations presented similar walkability: large trafficked avenues without buffer bordering at least one side of the playground, and important block to block disconnections for active travel. All three playgrounds rated equipment conditions from good to very good. None had water fountains at the reach of a 5 y/o. and all presented convenience stores and/or fast food outlets selling sugar-containing beverages nearby the perimeter. Conclusion: The three playground situations selected are representative of Berlin locations where most factors that influence children overweight are found. The results delivered urban and architectural design directives for an environmental intervention, used to study children health-related behavior. A post-intervention evaluation could prove associations between designed spaces and children overweight rate reduction creating a precedent in public health interventions and providing novel strategies for the health sector.

Keywords: children overweight, evaluation research, public playgrounds, urban design, urban health

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