Search results for: demographic factors
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 11257

Search results for: demographic factors

10417 Influences Driving the Teachers’ Adoption of Mobile Learning

Authors: L. A. Alfarani, M. McPherson, N. Morris

Abstract:

The growth of mobile learning depends primarily on the participation of teachers and their belief in the possibilities that this technology has for enhancing learning. The need to integrate technology into education seems clear-cut, however, its acceptance in Saudi higher education remains low. Thus, determining the particular factors that affect faculty acceptance of technology is vital. This paper focuses on TAM which depends on two factors: perceived usefulness and perceived ease of use, this theory are used to predict faculty members’ behavioural intentions towards using mobile learning technology. 279 faculty members in one Saudi university have responded to the online questionnaire. The findings have revealed that there is a statistically significant difference in both usefulness and ease of using m-learning factors.

Keywords: TAM theory, mobile learning technology acceptance, usefulness, ease of use

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10416 Predictor Factors in Predictive Model of Soccer Talent Identification among Male Players Aged 14 to 17 Years

Authors: Muhamad Hafiz Ismail, Ahmad H., Nelfianty M. R.

Abstract:

The longitudinal study is conducted to identify predictive factors of soccer talent among male players aged 14 to 17 years. Convenience sampling involving elite respondents (n=20) and sub-elite respondents (n=20) male soccer players. Descriptive statistics were reported as frequencies and percentages. The inferential statistical analysis is used to report the status of reliability, independent samples t-test, paired samples t-test, and multiple regression analysis. Generally, there are differences in mean of height, muscular strength, muscular endurance, cardiovascular endurance, task orientation, cognitive anxiety, self-confidence, juggling skills, short pass skills, long pass skills, dribbling skills, and shooting skills for 20 elite players and sub-elite players. Accordingly, there was a significant difference between pre and post-test for thirteen variables of height, weight, fat percentage, muscle strength, muscle endurance, cardiovascular endurance, flexibility, BMI, task orientation, juggling skills, short pass skills, a long pass skills, and dribbling skills. Based on the first predictive factors (physical), second predictive factors (fitness), third predictive factors (psychological), and fourth predictive factors (skills in playing football) pledged to the soccer talent; four multiple regression models were produced. The first predictive factor (physical) contributed 53.5 percent, supported by height and percentage of fat in soccer talents. The second predictive factor (fitness) contributed 63.2 percent and the third predictive factors (psychology) contributed 66.4 percent of soccer talent. The fourth predictive factors (skills) contributed 59.0 percent of soccer talent. The four multiple regression models could be used as a guide for talent scouting for soccer players of the future.

Keywords: soccer talent identification, fitness and physical test, soccer skills test, psychological test

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10415 Development of Pediatric Medical Trauma Stress (PMTS) Among Children at Risk

Authors: Amichai Ben ari, Daniella Margalit

Abstract:

Medical procedures, such as surgery, may have traumatic significance for some children. This study examines the relationship between maltreatment in children and the development Pediatric Medical Traumatic Stress (PMTS). To this end, differences in the level of distress of children after surgery were examined between two groups: children who were maltreated ("children at risk") and children from the control group ("children who are not at risk"). The study involved 230 parents of children who came to the hospital to undergo surgery. Parents filled out demographic questionnaires to measure socioeconomic variables and psychological questionnaires to measure the distress of the child and parent before surgery. After 6 months from the time of surgery, the parents again filled in the questionnaire measuring the child's distress. The results of the study showed that the level of distress experienced by children at risk after surgery was significantly higher relative to children who are not at risk. It was also found that the level of distress experienced by parents of children at risk in relation to their child’s surgery is significantly higher compared to parents of children who are not at risk. Finally, it was found that the variables: (1) pre-morbid psychological functioning of the child. (2) Parental and family functioning in daily life. (3) Exposure of the child to traumatic events. (4) Support factors for the family. Are variables that predict the development of PMTS in children after surgery, but only for children at risk and not for children who are not at risk. The significance of the findings in relation to the need to identify at-risk populations in the hospitals and the policies derived from them were discussed, and several directions were raised for further research.

Keywords: children at risk, pediatric medical traumatic stress (PMTS), PTSD, medical procedures

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10414 A Study on Characteristics of Hedonic Price Models in Korea Based on Meta-Regression Analysis

Authors: Minseo Jo

Abstract:

The purpose of this paper is to examine the factors in the hedonic price models, that has significance impact in determining the price of apartments. There are many variables employed in the hedonic price models and their effectiveness vary differently according to the researchers and the regions they are analysing. In order to consider various conditions, the meta-regression analysis has been selected for the study. In this paper, four meta-independent variables, from the 65 hedonic price models to analysis. The factors that influence the prices of apartments, as well as including factors that influence the prices of apartments, regions, which are divided into two of the research performed, years of research performed, the coefficients of the functions employed. The covariance between the four meta-variables and p-value of the coefficients and the four meta-variables and number of data used in the 65 hedonic price models have been analyzed in this study. The six factors that are most important in deciding the prices of apartments are positioning of apartments, the noise of the apartments, points of the compass and views from the apartments, proximity to the public transportations, companies that have constructed the apartments, social environments (such as schools etc.).

Keywords: hedonic price model, housing price, meta-regression analysis, characteristics

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10413 The Study of Factors Affecting Social Responsibility among Undergraduate Students of the Faculty of Management Science, Suan Sunandha Rajabhat University

Authors: Somtop Keawchuer

Abstract:

The purpose of the research is to study the level of social responsibility among the undergraduate students of the faculty of Management Science, Suan Sunandha Rajabhat University. The research also studies the factors affecting social responsibility of the undergraduate students. The research methodology applied a self-administered questionnaire as a quantitative method. A convenience sampling was used to distribute the questionnaire. Finally, 350 questionnaires were received for data analysis. Data were analyzed by using descriptive statistics including percentage, mean, standard deviation, and inferential statistics including regression analysis for hypothesis testing. The results indicated that the level of social responsibility of the students was at a good level. In addition, internal and external factors were related to social responsibility of the undergraduate students with the statistical significance level of 0.05.

Keywords: internal and external factors, social responsibility, Suan Sunandha Rajabhat University, undergraduate students

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10412 A User-Side Analysis of the Public-Private Partnership: The Case of the New Bundang Subway Line in South Korea

Authors: Saiful Islam, Deuk Jong Bae

Abstract:

The purpose of this study is to examine citizen satisfaction and competitiveness of a Public Private Partnership project. The study focuses on PPP in the transport sector and investigates the New Bundang Subway Line (NBL) in South Korea as the object of a case study. Most PPP studies are dominated by the study of public and private sector interests, which are classified in to three major areas comprising of policy, finance, and management. This study will explore the user perspective by assessing customer satisfaction upon NBL cost and service quality, also the competitiveness of NBL compared to other alternative transport modes which serve the Jeongja – Gangnam trip or vice versa. The regular Bundang Subway Line, New Bundang Subway Line, bus and private vehicle are selected as the alternative transport modes. The study analysed customer satisfaction of NBL and citizen’s preference of alternative transport modes based on a survey in Bundang district, South Korea. Respondents were residents and employees who live or work in Bundang city, and were divided into the following areas Pangyo, Jeongjae – Sunae, Migeun – Ori – Jukjeon, and Imae – Yatap – Songnam. The survey was conducted in January 2015 for two weeks, and 753 responses were gathered. By applying the Hedonic Utility approach, the factors which affect the frequency of using NBL were found to be overall customer satisfaction, convenience of access, and the socio economic demographic of the individual. In addition, by applying the Analytic Hierarchy Process (AHP) method, criteria factors influencing the decision to select alternative transport modes were identified. Those factors, along with the author judgement of alternative transport modes, and their associated criteria and sub-criteria produced a priority list of user preferences regarding their alternative transport mode options. The study found that overall the regular Bundang Subway Line (BL), which was built and operated under a conventional procurement method was selected as the most preferable transport mode due to its cost competitiveness. However, on the sub-criteria level analysis, the NBL has competitiveness on service quality, particularly on journey time. By conducting a sensitivity analysis, the NBL can become the first choice of transport by increasing the NBL’s degree of weight associated with cost by 0,05. This means the NBL would need to reduce either it’s fare cost or transfer fee, or combine those two cost components to reduce the total of the current cost by 25%. In addition, the competitiveness of NBL also could be obtained by increasing NBL convenience through escalating access convenience such as constructing an additional station or providing more access modes. Although these convenience improvements would require a few extra minutes of journey time, the user found this to be acceptable. The findings and policy suggestions can contribute to the next phase of NBL development, showing that consideration should be given to the citizen’s voice. The case study results also contribute to the literature of PPP projects specifically from a user side perspective.

Keywords: public private partnership, customer satisfaction, public transport, new Bundang subway line

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10411 Predicting Factors for Occurrence of Cardiac Arrest in Critical, Emergency and Urgency Patients in an Emergency Department

Authors: Angkrit Phitchayangkoon, Ar-Aishah Dadeh

Abstract:

Background: A key aim of triage is to identify the patients with high risk of cardiac arrest because they require intensive monitoring, resuscitation facilities, and early intervention. We aimed to identify the predicting factors such as initial vital signs, serum pH, serum lactate level, initial capillary blood glucose, and Modified Early Warning Score (MEWS) which affect the occurrence of cardiac arrest in an emergency department (ED). Methods: We conducted a retrospective data review of ED patients in an emergency department (ED) from 1 August 2014 to 31 July 2016. Significant variables in univariate analysis were used to create a multivariate analysis. Differentiation of predicting factors between cardiac arrest patient and non-cardiac arrest patients for occurrence of cardiac arrest in an emergency department (ED) was the primary outcome. Results: The data of 527 non-trauma patients with Emergency Severity Index (ESI) 1-3 were collected. The factors found to have a significant association (P < 0.05) in the non-cardiac arrest group versus the cardiac arrest group at the ED were systolic BP (mean [IQR] 135 [114,158] vs 120 [90,140] mmHg), oxygen saturation (mean [IQR] 97 [89,98] vs 82.5 [78,95]%), GCS (mean [IQR] 15 [15,15] vs 11.5 [8.815]), normal sinus rhythm (mean 59.8 vs 30%), sinus tachycardia (mean 46.7 vs 21.7%), pH (mean [IQR] 7.4 [7.3,7.4] vs 7.2 [7,7.3]), serum lactate (mean [IQR] 2 [1.1,4.2] vs 7 [5,10.8]), and MEWS score (mean [IQR] 3 [2,5] vs 5 [3,6]). A multivariate analysis was then performed. After adjusting for multiple factors, ESI level 2 patients were more likely to have cardiac arrest in the ER compared with ESI 1 (odds ratio [OR], 1.66; P < 0.001). Furthermore, ESI 2 patients were more likely than ESI 1 patients to have cardiovascular disease (OR, 1.89; P = 0.01), heart rate < 55 (OR, 6.83; P = 0.18), SBP < 90 (OR, 3.41; P = 0.006), SpO2 < 94 (OR, 4.76; P = 0.012), sinus tachycardia (OR, 4.32; P = 0.002), lactate > 4 (OR, 10.66; P = < 0.001), and MEWS > 4 (OR, 4.86; P = 0.028). These factors remained predictive of cardiac arrest at the ED. Conclusion: The factors related to cardiac arrest in the ED are ESI 1 patients, ESI 2 patients, patients diagnosed with cardiovascular disease, SpO2 < 94, lactate > 4, and a MEWS > 4. These factors can be used as markers in the event of simultaneous arrival of many patients and can help as a pre-state for patients who have a tendency to develop cardiac arrest. The hemodynamic status and vital signs of these patients should be closely monitored. Early detection of potentially critical conditions to prevent critical medical intervention is mandatory.

Keywords: cardiac arrest, predicting factor, emergency department, emergency patient

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10410 Factors That Contribute to Noise Induced Hearing Loss Amongst Employees at the Platinum Mine in Limpopo Province, South Africa

Authors: Livhuwani Muthelo, R. N. Malema, T. M. Mothiba

Abstract:

Long term exposure to excessive noise in the mining industry increases the risk of noise induced hearing loss, with consequences for employee’s health, productivity and the overall quality of life. Objective: The objective of this study was to investigate the factors that contribute to Noise Induced Hearing Loss amongst employees at the Platinum mine in the Limpopo Province, South Africa. Study method: A qualitative, phenomenological, exploratory, descriptive, contextual design was applied in order to explore and describe the contributory factors. Purposive non-probability sampling was used to select 10 male employees who were diagnosed with NIHL in the year 2014 in four mine shafts, and 10 managers who were involved in a Hearing Conservation Programme. The data were collected using semi-structured one-on-one interviews. A qualitative data analysis of Tesch’s approach was followed. Results: The following themes emerged: Experiences and challenges faced by employees in the work environment, hearing protective device factors and management and leadership factors. Hearing loss was caused by partial application of guidelines, policies, and procedures from the Department of Minerals and Energy. Conclusion: The study results indicate that although there are guidelines, policies, and procedures available, failure in the implementation of one element will affect the development and maintenance of employees hearing mechanism. It is recommended that the mine management should apply the guidelines, policies, and procedures and promptly repair the broken hearing protective devices.

Keywords: employees, factors, noise induced hearing loss, noise exposure

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10409 Place Attachment and Residential Satisfaction in Old Residential Buildings: A Case of Pune City

Authors: Vaishali Anagal, Vasudha Gokhale, Sharvey Dhongde

Abstract:

Old buildings have significance in many aspects. The manifold significance may include historic, architectural and cultural aspects. In a cultural city like Pune, India, numerous residential buildings exist in the core city whose age may range between 60-100 years. These represent the city’s history and culture. Most of them are still in use as residential buildings with adaptations in various degrees. Some of these buildings are enlisted as ‘Heritage Buildings’ by local municipal authority. However, there are number of buildings that have heritage value although they are not enlisted as heritage sites. A lot of these buildings have already been pulled down for several reasons such as end of technical life, inadequacy for users, increasing floor area ratios, inflating land prices and changing lifestyles etc. Literature suggest that place attachment and residential satisfaction are positively related. It also indicates that length of residency is positively correlated with the place attachment. Residential satisfaction is associated with number of factors including socio demographic characteristics of users, housing characteristics, neighborhood characteristics and behavioral characteristics. This research paper poses an inquiry about the dynamics of co-relation between place attachment and residential satisfaction in case of old residential buildings. The motive of this enquiry is to examine if place attachment can serve as a strong ground for restoration of these old buildings and evade the devastation of emblems of cultural heritage of the city. The methodology includes questionnaire survey of users as well as a qualitative assessment regarding place attachment and residential satisfaction. About 20 residential buildings in the core city of Pune are selected for this purpose. The results of survey are analyzed and conclusions are drawn.

Keywords: place attachment, residential satisfaction, old residential buildings, housing characteristics, cultural heritage

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10408 Factors Predicting Food Insecurity in Older Thai Women

Authors: Noppawan Piaseu, Surat Komindr

Abstract:

This study aimed to determine factors predicting food insecurity in older Thai women living in crowded urban communities. Through purposive sampling, 315 participants were recruited from community dwelling older women in Bangkok, Thailand. Data collection included interview from questionnaires and anthropometric measurement. Results showed that approximately half of the sample were 60-69 years old (51.1%), married (50.6%), obtained primary education (52.3%), had low family income (51.7%), lived in poor physical environment (49.9%) with normal body mass index (51.0%). Logistic regression analysis revealed that older women who were widowed/divorced/separated (OR = 1.804, 95% CI = 1.052-3.092, p = .032), who reported low family income (OR =.654, 95% CI = .523-.817, p < .001), and who had poor physical environment surrounding home (OR = 2.338, 95% CI = 1.057-5.171, p = .036) were more likely to have food insecurity. Results support that social and environmental factors are major factors predicting food insecurity in older women living in the urban community. Health professionals need to identify and monitor psychosocial, economic and environmental dimensions of food insecurity among them.

Keywords: food insecurity, older women, urban communities, Thailand

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10407 Simplified Linearized Layering Method for Stress Intensity Factor Determination

Authors: Jeries J. Abou-Hanna, Bradley Storm

Abstract:

This paper looks to reduce the complexity of determining stress intensity factors while maintaining high levels of accuracy by the use of a linearized layering approach. Many techniques for stress intensity factor determination exist, but they can be limited by conservative results, requiring too many user parameters, or by being too computationally intensive. Multiple notch geometries with various crack lengths were investigated in this study to better understand the effectiveness of the proposed method. By linearizing the average stresses in radial layers around the crack tip, stress intensity factors were found to have error ranging from -10.03% to 8.94% when compared to analytically exact solutions. This approach proved to be a robust and efficient method of accurately determining stress intensity factors.

Keywords: fracture mechanics, finite element method, stress intensity factor, stress linearization

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10406 An Approach for the Assessment of Semi-Elliptical Surface Crack

Authors: Muhammad Naweed, Usman Tariq Murtaza, Waseem Siddique

Abstract:

A pallet body approach is a finite element-based computational approach used for the modeling and assessment of a three-dimensional surface crack. The approach is capable of inserting the crack in an engineering structure and generating high-quality hexahedral mesh in the cracked region of the structure. The approach is capable of computing the stress intensity factors along a semi-elliptical surface crack numerically. The objective of this work is to present that the stress intensity factors produced by the approach can be used with confidence for capturing the parameters during the fatigue crack growth.

Keywords: pallet body approach, semi-elliptical surface crack, stress intensity factors, fatigue crack growth

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10405 Attitudes towards People with Disability and Career Interest in Disability Studies: A Study of Clinical Medical Students of a Tertiary Institution in Southeastern Nigeria

Authors: Ebele V. Okoli, Emmanuel Nwobi, Dozie Ezechukwu, Ijeoma Itanyi

Abstract:

One in seven people worldwide suffer from a disability. 80% of people with disabilities live in developing countries. Negative attitudes and misconceptions among health-care providers constitute barri¬ers to optimal health care for people with disabilities. This underscores the relevance of a study of the attitude of Nigerian medical students towards disability and their willingness to work in the disability sector. This was a descriptive cross-sectional study conducted among 254 penultimate and final year medical students of a university in southeastern Nigeria. The mean age of the students was 24.8 ± 3.12 years. Majority of the students were male (75.2%), single (96.9%), of the Igbo tribe (86.6%), Christian (97.6%) and grew up in urban areas (68.1%). Results indicated that the medical students had a predominantly positive attitude towards people with disability as 73.8% had a positive attitude and mean attitude score was 67.03 ± 0.14 (positive attitude = 61 – 120, negative attitude = 0 - 60). Chi-square analysis did not show any significant effect of demographic and social factors on the students’ attitude towards People with Disabilities. The students were mostly willing to work in areas that address the challenges of people with disability (70.4%) but a greater proportion had never heard about Disability Studies (67.5%). About a third of the students (33.2%) would like to travel abroad to practice in the disability sector. Conclusions: The students generally had a positive attitude towards people with disability and a greater percentage were willing to work in the disability sector in their future career. About two-thirds had however, never heard about disability studies. There was some potential for brain drain among the students as a third of the population intended to practice abroad on graduation.

Keywords: attitudes, career interest, disability, medical students

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10404 Assessment of Delirium, It's Possible Risk Factors and Outcome in Patient Admitted in Medical Intensive Care Unit

Authors: Rupesh K. Chaudhary, Narinder P. Jain, Rajesh Mahajan, Rajat Manchanda

Abstract:

Introduction: Delirium is a complex, multifactorial neuropsychiatric syndrome comprising a broad range of cognitive and neurobehavioral symptoms. In critically ill patients, it may develop secondary to multiple predisposing factors. Although it can be transient and irreversible but if left untreated may lead to long term cognitive dysfunction. Early identification and assessment of risk factors usually help in appropriate management of delirium which in turn leads to decreased hospital stay, cost of therapy and mortality. Aim and Objective: Aim of the present study was to estimate the incidence of delirium using a validated scale in medical ICU patients and to determine the associated risk factors and outcomes. Material and Method: A prospective study in an 18-bed medical-intensive care unit (ICU) was undertaken. A total of 357 consecutive patients admitted to ICU for more than 24 hours were assessed. These patients were screened with the help of Confusion Assessment Method for Intensive Care Unit -CAM-ICU, Richmond Agitation and Sedation Scale, Screening Checklist for delirium and APACHE II. Appropiate statistical analysis was done to evaluate the risk factors influencing mortality in delirium. Results: Delirium occurred in 54.6% of 194 patients. Risk of delirium was independently associated with a history of hypertension, diabetes but not with severity of illness APACHE II score. Delirium was linked to longer ICU stay 13.08 ± 9.6 ver 7.07 ± 4.98 days, higher ICU mortality (35.8% % vs. 17.0%). Conclusion: Our study concluded that delirium poses a great risk factor in the outcome of the patient and carries high mortality, so a timely intervention helps in addressing these issues.

Keywords: delirium, risk factors, outcome, intervention

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10403 Orthostatic Hypotension among Patients Aged above 65 Years Admitted to Medical Wards in a Tertiary Care Hospital, Sri Lanka

Authors: G. R. Constantine, M.C.K. Thilakasiri, V.S. Mohottala, T.V. Soundaram, D.S. Rathnayake, E.G.H.E. De Silva, A.L.S. Mohamed, V.R. Weerasekara

Abstract:

Orthostatic hypotension is prevalent in the elderly population, and it is an important risk factor contributing to falls in the elderly. This study aims to evaluate the prevalence of orthostatic hypotension in hospitalized elderly patients, changes in blood pressure during the hospital stay, morbidities associated with it and its association with falls in the elderly. A cross-sectional descriptive study was conducted in the National Hospital of Sri Lanka (NHSL) in a sample of 120 patients of age 65 years or above who were admitted to the medical wards. The demographic, clinical data was obtained by an interviewer-administered questionnaire. Two validated questionnaires were used to assess symptoms and effects of orthostatic hypotension and risk factors associated with falls. Orthostatic hypotension on admission and after 3 days of hospital stay was measured by bed-side mercury sphygmomanometer. Prevalence of orthostatic hypotension among the study population was 63.3%(76 patients). But no significant change in the orthostatic hypotension noted after 3 days of hospital admission (SND 0.61, SE= 5.59, p=0.27). There was no significant association found between orthostatic hypotension and its symptoms (dizziness and vertigo, vision problems, malaise, fatigue, poor concentration, neck stiffness), impact on standing or walking and non-communicable diseases. Falls were experienced by 27.5 % (33 patients) of the study population and prevalence of patients with orthostatic hypotension who had experienced falls was 25.9% (28 patients). In conclusions, orthostatic hypotension is more prevalent among elderly patients, but It wasn’t associated with symptoms, and non-communicable diseases, or as a risk factor for falls in elderly.

Keywords: orthostatic hypotension, elderly falls, emergency geriatric, Sri Lanka

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10402 Systems Integrated Approach to Improve the Design and Construction of Green Buildings

Authors: Saleh Hayat

Abstract:

Efficiency, productivity and sustainability are important factors for structure and the application of processes in green building. Various previous studies have addressed efficiency, productivity and sustainability separately. This research study aims to investigate the implications of these three factors taking together. Frequency analysis and the ranking techniques are carried out to explore the connection between these factors. The interconnection matrix has been developed and functional grouping is made based upon data from expert opinion and field professionals. The existence of a relationship, the type of relationship and the scaled impact have been drawn. Additionally, a system diagram has been developed to show the variable correlation. The results of expert opinion show that efficiency, productivity and sustainability have a stronger impact on green buildings.

Keywords: efficiency, green building, productivity, sustainability

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10401 The Diet Adherence in Cardiovascular Disease Risk Factors Patients in the North of Iran Based on the Mediterranean Diet Adherence

Authors: Marjan Mahdavi-Roshan, Arsalan Salari, Mahboobeh Gholipour, Moona Naghshbandi

Abstract:

Background and objectives: Before any nutritional intervention, it is necessary to have the prospect of eating habits of people with cardiovascular risk factors. In this study, we assessed the adherence of healthy diet based on Mediterranean dietary pattern and related factors in adults in the north of Iran. Methods: This study was conducted on 550 men and women with cardiovascular risk factors that referred to Heshmat hospital in Rasht, northern Iran. Information was collected by interview and reading medical history and measuring anthropometric indexes. The Mediterranean Diet Adherence Screener was used for assessing dietary adherence, this screener was modified according to religious beliefs and culture of Iran. Results: The mean age of participants was 58±0.38 years. The mean of body mass index was 27±0.01 kg/m2, and the mean of waist circumference was 98±0.2 cm. The mean of dietary adherence was 5.76±0.07. 45% of participants had low adherence, and just 4% had suitable adherence. The mean of dietary adherence in men was significantly higher than women (p=0. 07). Participants in rural area and high educational participants insignificantly had an unsuitable dietary Adherence. There was no significant association between some cardiovascular disease risk factors and dietary adherence. Conclusion: Education to different group about dietary intake correction and using a Mediterranean dietary pattern that is similar to dietary intake in the north of Iran, for controlling cardiovascular disease is necessary.

Keywords: dietary adherence, Mediterranean dietary pattern, cardiovascular disease, north of Iran

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10400 Factors Responsible for the Activities of the Transitional Rites of Passage on Youth’s Morality in South Africa: A Study of Thulamela Municipality

Authors: Rofem Inyang Bassey, Pfarelo Matshidze, Dolphin Mabale, Ishmael Iwara

Abstract:

This article strove to establish the factors responsible for the activities of the transitional rites of passage on youth’s morality. South Africa, among other countries, has serious effects on the moral systems of youths. Factors responsible for the activities of the transitional rites of passage on youth’s morality has been brought to the fore by on-going transitional rites depicted by weekend’s social activities with the practice of substance use and abuse among the youths at various recreational spots. The transitional rites are structured under the guise of “freaks” as an evolving culture among the youths. The freaks culture is a counterculture of the usual initiation’s schools for transitional rites of passage which instil morality among youths. Qualitative design was used to obtain data from custodians, parents of the youths, and the youths themselves. The findings widely show that the factors responsible for the activities of the transitional rites is the act of the current on-going transitional rites effect as an inappropriate behaviour towards youth morality. This study concluded that to establish the factors responsible for the activities of the transitional rites of passage on youth’s morality, activities and practices evolved as a current socialization standard for quick maturity status, as a result of that, it will be harder to provide a complete change of this evolving culture. However, what will work is to build on the existing transitional rites of passage to moderate appropriate youths’ morality in Thulamela communities.

Keywords: behaviour, morality, transitional rites, youths, socials activities, freak culture

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10399 Climate Change and Rural-Urban Migration in Brazilian Semiarid Region

Authors: Linda Márcia Mendes Delazeri, Dênis Antônio Da Cunha

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Over the past few years, the evidence that human activities have altered the concentration of greenhouse gases in the atmosphere have become stronger, indicating that this accumulation is the most likely cause of climate change observed so far. The risks associated with climate change, although uncertain, have the potential to increase social vulnerability, exacerbating existing socioeconomic challenges. Developing countries are potentially the most affected by climate change, since they have less potential to adapt and are those most dependent on agricultural activities, one of the sectors in which the major negative impacts are expected. In Brazil, specifically, it is expected that the localities which form the semiarid region are among the most affected, due to existing irregularity in rainfall and high temperatures, in addition to economic and social factors endemic to the region. Given the strategic limitations to handle the environmental shocks caused by climate change, an alternative adopted in response to these shocks is migration. Understanding the specific features of migration flows, such as duration, destination and composition is essential to understand the impacts of migration on origin and destination locations and to develop appropriate policies. Thus, this study aims to examine whether climatic factors have contributed to rural-urban migration in semiarid municipalities in the recent past and how these migration flows will be affected by future scenarios of climate change. The study was based on microeconomic theory of utility maximization, in which, to decide to leave the countryside and move on to the urban area, the individual seeks to maximize its utility. Analytically, we estimated an econometric model using the modeling of Fixed Effects and the results confirmed the expectation that climate drivers are crucial for the occurrence of the rural-urban migration. Also, other drivers of the migration process, as economic, social and demographic factors were also important. Additionally, predictions about the rural-urban migration motivated by variations in temperature and precipitation in the climate change scenarios RCP 4.5 and 8.5 were made for the periods 2016-2035 and 2046-2065, defined by the Intergovernmental Panel on Climate Change (IPCC). The results indicate that there will be increased rural-urban migration in the semiarid region in both scenarios and in both periods. In general, the results of this study reinforce the need for formulations of public policies to avoid migration for climatic reasons, such as policies that give support to the productive activities generating income in rural areas. By providing greater incentives for family agriculture and expanding sources of credit for the farmer, it will have a better position to face climate adversities and to settle in rural areas. Ultimately, if migration becomes necessary, there must be the adoption of policies that seek an organized and planned development of urban areas, considering migration as an adaptation strategy to adverse climate effects. Thus, policies that act to absorb migrants in urban areas and ensure that they have access to basic services offered to the urban population would contribute to the social costs reduction of climate variability.

Keywords: climate change, migration, rural productivity, semiarid region

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10398 The Experiences of Rural Family Caregivers of Cancer Patients in Newfoundland and Labrador and Their Challenges and Needs in Relocating to Urban Settings for Treatment

Authors: Mei Li, Victor Meddalena

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Background: Newfoundland and Labrador (NL) has rapidly aging population and is characterized by its vast geography with high proportion of dispersed rural communities when compared to other provinces in Canada. Structural, demographic and geographic factors have created big gaps for rural residents across NL with respect to accessing various health and social services. While the barriers are well documented for patients’ access to cancer care in rural and remote areas, challenges faced by family caregivers are not fully recognized. Caregiving burden coupled with challenges associated with relocation and frequent travels create situations where caregivers are vulnerable physically, emotionally, financially and socially. This study examines the experiences of family caregivers living in rural NL through a social justice lens. It is expected to identify the gaps existing in social policy and support for rural family caregivers. It will make a novel contribution to the literature in this regard. Methods: Design: This qualitative study adopted the hermeneutic phenomenology to best describe and interpret rural-based family caregivers’ living experiences and explore the meaning, impact, and the influence of both individual experience and contextual factors shaping these experiences. Data Collection: In-depth interviews with key informants were conducted with 12 participants from various rural communities in NL. A case study was also used to explore an individual’s experience in complex social units consisting of multiple variables of in-depth understanding of the reality. Data Analysis: Thematic analysis guided by the Voice-Centred Relational (VCR) method was employed to explore the relationships and contexts of participants. Emerging Themes: Six major emerging themes were identified, namely, overwhelming caregiving burden on rural family caregivers, long existing financial hardship, separation from family and community, low level of social support and self-reliance coping strategies, and social vulnerability and isolation. Conclusion: Understanding the lived experiences of rural-based family caregivers is critical to inform the policy makers the gap of health and social service in NL. The findings of this study also have implications for family caregivers who are vulnerable in other similar contexts. This study adds innovative insights for policy making and service provision in this regard.

Keywords: family caregivers, policy, relocation, rural

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10397 Non-Communicable Diseases: Knowledge, Attitudes and Practices of Risk Factors among Secondary School Students in Sharjah, UAE

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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10396 Investigating the Subjective Factors Related to the Need for Psychological Help of the College Students

Authors: Ismail Ay

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In this study, it is aimed to analyze the relations of the factors such as the learned resourcefulness, self-efficacy, self-regulation and subjective well-being which are thought to affect the needs of the university students for psychological help and to determine if the subjective well-being mediates other factors in the prediction of the needs of the university students for psychological help. The population of the study is formed of undergraduates who get education in 16 faculties in the central campus of the University of Atatürk in the spring term of 2012-2013 academic years. The sample of the study is formed of 1205 undergraduates (female=666, 55,3 %; male=539, 44,7 %; average of age =21,49; Sd=2,18) selected from the mentioned universe by convenience sampling method. “Need for Psychological Help Scale” has been developed as a part of the study to determine the needs for psychological help. “Short Self-Regulation Questionnaire” has been adapted into Turkish to determine the self-regulation skills. Apart from these, Rosenbaum’s Learned Resourcefulness Scale, General Self-Efficacy Scale and to determine subjective well-being; Satisfaction with Life Scale and Positive and Negative Affect Scale have been used within the study. SPSS 22.0 and LISREL 9.1 have been used in the analysis of the data. Pearson product-moment correlation, descriptive analysis, factor analysis and path analysis to test the research hypothesis has been used in the study. According to obtained data, the learned resourcefulness factor does not predict the subjective well-being; however, it highly predicts the self-regulation and self-efficacy factors. It has been determined that the self-regulation and self-efficacy factors predict the subjective well-being in a positive way and medium level, and subjective well-being mediates self-regulation and self-efficacy factors to predict the needs for psychological help. It was also determined that subjective well-being predicts the needs for psychological help in a negative way and fair level. All these results have been discussed in terms of the related theories and literature, and several suggestions have been made.

Keywords: need for psychological help, self-regulation, self-efficacy, learned resourcefulness, subjective well-being, Maslow, psychological needs

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10395 The Consequences of Cyberbullying and School Violence: Risk and Protective Factors

Authors: Ifigenia Stylianou

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As more than three-quarters of students going online daily via computers, tablets, and smartphones, the phenomenon of cyberbullying is growing rapidly. Knowing that victims of online bullying are often also victims of traditional bullying and that traditional bullying is considered as an extension of cyberbullying. In this study, we aim to identify (1) whether cyberbullying lead to more intense forms of school bullying, and (2) whether some biological and environmental factors mediate between this relation, and act protectively to bullying and inappropriate behaviour in school. To answer this questions, a sample of X students, aged X, were asked to complete eight questionnaires (Personal Experiences Checklist, Inventory of Peers Attachment, Questionnaire on Teacher Interaction, School Climate Survey for Bullying, Strengths and Difficulties Questionnaire, Youth Psychopathic Traits Inventory-Short Form, Barratt Impulsiveness Scale-11) in X time periods. Results can provide us important information to improve understanding the factors that are related to bullying. In addition, the results can assist in developing intervention programs to tangle the issue of bullying at schools. All data have been collected and are currently being processed for statistical analyses.

Keywords: cyberbullying, bullying, school climate, psychopathy traits, attachment, mediation factors

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10394 Knowledge, Attitude and Practice Towards the Attendance of Antenatal Care Services at Mukono General Hospital

Authors: Nabaweesi Josephine, Namwanje Regina Germina

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Antenatal care is referred to as the totality of care given to pregnant women from conception to delivery from a certified health care setting. A number of 8 contacts is recommended throughout pregnancy, according to WHO, 2016. Antenatal services are free in Uganda courtesy of the government of Uganda, though attendance is still very low, which has continued to cause maternal and infant mortality and morbidity from preventable causes. Early booking has an advantage for proper pregnancy information sharing and pregnancy monitoring. The purpose of this study was to determine pregnant women's knowledge, attitudes, and practices towards attendance of antenatal care at Mukono General Hospital. A sample of 60 pregnant women was used, and a descriptive quantitative design was employed. Data was collected using a structured questionnaire consisting of questions about socio-demographic factors, knowledge, attitude, and practice, and this was affected using the structured interview method. Pregnant women had good practice at 90.2%, a positive attitude of 94.6%, and slightly less knowledge of 66.7%. Only 12% were knowledgeable about the number of antenatal care visits recommended, 45% had knowledge about when to initiate first antenatal care visit, and 79% had a positive attitude towards the early booking. We recommend that pregnant women are given all the necessary information regarding antenatal care with special emphasis on the recommended number of visits and when to initiate their first visit and encourage early booking in order to achieve the 8 contacts WHO policy for antenatal care since when we increase knowledge, we increase antenatal care utilization according to Anderson's behavioral model.

Keywords: ANC- antenatal care, contacts, mortality, morbidity

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10393 Deep Learning Approach for Chronic Kidney Disease Complications

Authors: Mario Isaza-Ruget, Claudia C. Colmenares-Mejia, Nancy Yomayusa, Camilo A. González, Andres Cely, Jossie Murcia

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Quantification of risks associated with complications development from chronic kidney disease (CKD) through accurate survival models can help with patient management. A retrospective cohort that included patients diagnosed with CKD from a primary care program and followed up between 2013 and 2018 was carried out. Time-dependent and static covariates associated with demographic, clinical, and laboratory factors were included. Deep Learning (DL) survival analyzes were developed for three CKD outcomes: CKD stage progression, >25% decrease in Estimated Glomerular Filtration Rate (eGFR), and Renal Replacement Therapy (RRT). Models were evaluated and compared with Random Survival Forest (RSF) based on concordance index (C-index) metric. 2.143 patients were included. Two models were developed for each outcome, Deep Neural Network (DNN) model reported C-index=0.9867 for CKD stage progression; C-index=0.9905 for reduction in eGFR; C-index=0.9867 for RRT. Regarding the RSF model, C-index=0.6650 was reached for CKD stage progression; decreased eGFR C-index=0.6759; RRT C-index=0.8926. DNN models applied in survival analysis context with considerations of longitudinal covariates at the start of follow-up can predict renal stage progression, a significant decrease in eGFR and RRT. The success of these survival models lies in the appropriate definition of survival times and the analysis of covariates, especially those that vary over time.

Keywords: artificial intelligence, chronic kidney disease, deep neural networks, survival analysis

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10392 Risk Factors and Regional Difference in the Prevalence of Fecal Carriage Third-Generation Cephalosporin-Resistant E. Coli in Taiwan

Authors: Wan-Ling Jiang, Hsin Chi, Jia-Lu Cheng, Ming-Fang Cheng

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Background: Investigating the risk factors for the fecal carriage of third-generation cephalosporin-resistant E.coli could contribute to further disease prevention. Previous research on third-generation cephalosporin-resistant prevalence in children in different regions of Taiwan is limited. This project aims to explore the risk factors and regional differences in the prevalence of third-generation cephalosporin-resistant and other antibiotic-resistant E. coli in the northern, southern, and eastern regions of Taiwan. Methods: We collected data from children aged 0 to 18 from community or outpatient clinics from July 2022 to May 2023 in southern, northern, and eastern Taiwan. The questionnaire was designed to survey the characteristics of participants and possible risk factors, such as clinical information, household environment, drinking water, and food habits. After collecting fecal samples and isolating stool culture with E.coli, antibiotic sensitivity tests and MLST typing were performed. Questionnaires were used to analyze the risk factors of third-generation cephalosporin-resistant E. coli in the three different regions of Taiwan. Results: In the total 246 stool samples, third-generation cephalosporin-resistant E.coli accounted for 37.4% (97/246) of all isolates. Among the three different regions of Taiwan, the highest prevalence of fecal carriage with third-generation cephalosporin-resistant E.coli was observed in southern Taiwan (42.7%), followed by northern Taiwan (35.5%) and eastern Taiwan (28.4%). Multi-drug resistant E. coli had prevalence rates of 51.9%, 66.3%, and 37.1% in the northern, southern, and eastern regions, respectively. MLST typing revealed that ST131 was the most prevalent type (11.8%). The prevalence of ST131 in northern, southern, and eastern Taiwan was 10.1%, 12.3%, and 13.2%, respectively. Risk factors analysis identified lower paternal education, overweight status, and non-vegetarian diet as statistical significance risk factors for third-generation cephalosporin-resistant E.coli. Conclusion: The fecal carriage rates of antibiotic-resistant E. coli among Taiwanese children were on the rise. This study found regional disparities in the prevalence of third-generation cephalosporin-resistant and multi-drug-resistant E. coli, with southern Taiwan having the highest prevalence. Lower paternal education, overweight, and non-vegetarian diet were the potential risk factors of third-generation cephalosporin-resistant E. coli in this study.

Keywords: Escherichia coli, fecal carriage, antimicrobial resistance, risk factors, prevalence

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10391 An Ecological Systems Approach to Risk and Protective Factors of Sibling Conflict for Children in the United Kingdom

Authors: C. A. Bradley, D. Patsios, D. Berridge

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This paper presents evidence to better understand the risk and protective factors related to sibling conflict and the patterns of association between sibling conflict and negative adjustment outcomes by incorporating additional familial and societal factors within statistical models of risk and adjustment. It was conducted through the secondary analysis of a large representative cross-sectional dataset of children in the UK. The original study includes proxy interviews for young children and self-report interviews for adolescents. The study applies an ecological systems framework for the analyses. Hierarchical regression models assess risk and protective factors and adjustment outcomes associated with sibling conflict. Interactions reveal differential effect between contextual risk factors and the social context of influence. The general pattern of findings suggested that, although factors affecting likelihood of experiencing sibling conflict were often determined by child age, some remained consistent across childhood. These factors were often conditional on each other, reinforcing the importance of an ecological framework. Across both age-groups, sibling conflict was associated with siblings closer in age; male sibling groups; most advantaged socio-economic group; and exposure to community violence, such as witnessing violent assault or robbery. The study develops the evidence base on the influence of ethnicity and socio-economic group on sibling conflict by exploring interactions between social context. It also identifies key new areas of influence – such as family structure, disability, and community violence in exacerbating or reducing risk of conflict. The study found negative associations between sibling conflict and young children’s mental well-being and adolescents' mental well-being and anti-social behaviour, but also more context specific associations – such as sibling conflict moderating the negative impact of adversity and high risk experiences for young children such as parental violence toward the child.

Keywords: adjustment, conflict, ecological systems, family systems, risk and protective factors, sibling

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10390 The Relationship between Depression, HIV Stigma and Adherence to Antiretroviral Therapy among Adult Patients Living with HIV at a Tertiary Hospital in Durban, South Africa: The Mediating Roles of Self-Efficacy and Social Support

Authors: Muziwandile Luthuli

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Although numerous factors predicting adherence to antiretroviral therapy (ART) among people living with HIV/AIDS (PLWHA) have been broadly studied on both regional and global level, up-to-date adherence of patients to ART remains an overarching, dynamic and multifaceted problem that needs to be investigated over time and across various contexts. There is a rarity of empirical data in the literature on interactive mechanisms by which psychosocial factors influence adherence to ART among PLWHA within the South African context. Therefore, this study was designed to investigate the relationship between depression, HIV stigma, and adherence to ART among adult patients living with HIV at a tertiary hospital in Durban, South Africa, and the mediating roles of self-efficacy and social support. The health locus of control theory and the social support theory were the underlying theoretical frameworks for this study. Using a cross-sectional research design, a total of 201 male and female adult patients aged between 18-75 years receiving ART at a tertiary hospital in Durban, KwaZulu-Natal were sampled, using time location sampling (TLS). A self-administered questionnaire was employed to collect the data in this study. Data were analysed through SPSS version 27. Several statistical analyses were conducted in this study, namely univariate statistical analysis, correlational analysis, Pearson’s chi-square analysis, cross-tabulation analysis, binary logistic regression analysis, and mediational analysis. Univariate analysis indicated that the sample mean age was 39.28 years (SD=12.115), while most participants were females 71.0% (n=142), never married 74.2% (n=147), and most were also secondary school educated 48.3% (n=97), as well as unemployed 65.7% (n=132). The prevalence rate of participants who had high adherence to ART was 53.7% (n=108), and 46.3% (n=93) of participants had low adherence to ART. Chi-square analysis revealed that employment status was the only statistically significant socio-demographic influence of adherence to ART in this study (χ2 (3) = 8.745; p < .033). Chi-square analysis showed that there was a statistically significant difference found between depression and adherence to ART (χ2 (4) = 16.140; p < .003), while between HIV stigma and adherence to ART, no statistically significant difference was found (χ2 (1) = .323; p >.570). Binary logistic regression indicated that depression was statistically associated with adherence to ART (OR= .853; 95% CI, .789–.922, P < 001), while the association between self-efficacy and adherence to ART was statistically significant (OR= 1.04; 95% CI, 1.001– 1.078, P < .045) after controlling for the effect of depression. However, the findings showed that the effect of depression on adherence to ART was not significantly mediated by self-efficacy (Sobel test for indirect effect, Z= 1.01, P > 0.31). Binary logistic regression showed that the effect of HIV stigma on adherence to ART was not statistically significant (OR= .980; 95% CI, .937– 1.025, P > .374), but the effect of social support on adherence to ART was statistically significant, only after the effect of HIV stigma was controlled for (OR= 1.017; 95% CI, 1.000– 1.035, P < .046). This study promotes behavioral and social change effected through evidence-based interventions by emphasizing the need for additional research that investigates the interactive mechanisms by which psychosocial factors influence adherence to ART. Depression is a significant predictor of adherence to ART. Thus, to alleviate the psychosocial impact of depression on adherence to ART, effective interventions must be devised, along with special consideration of self-efficacy and social support. Therefore, this study is helpful in informing and effecting change in health policy and healthcare services through its findings

Keywords: ART adherence, depression, HIV/AIDS, PLWHA

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10389 Prevalence of Bovine Mastitis and Associated Risk Factors in Selected Dairy Farms in Zoba Anseba, Eritrea

Authors: Redie Kidane Ghebrehawariat, Betiel Habte Hadgu, Filmon Berhane Kahsay, Rim Berhane Fisehaye, Samuel Haile Kahsay, Saron Yemane Yosief, Selemawit Mosazghi Gilazghi

Abstract:

A cross-sectional study was conducted from 22 February to 9 April 2022 on small, medium, and large holder dairy farms to determine the bovine mastitis prevalence and associated risk factors in the Anseba region, Eritrea. A total of 34 dairy farms and 193 dairy cows were randomly selected. Dairy cows were physically examined for any change on the udder and milk; a California mastitis test was performed to check sub-clinical mastitis; a closed-ended semi-structured questionnaire composed of 28 variables/risk factors (21 management risk factors and 7 animal-level risk factors) was used to determine the risk factors responsible for clinical and sub-clinical mastitis in the dairy cows. The overall cow-level prevalence of mastitis was 147 (76.2%). The animal level prevalence rate of clinical and sub-clinical mastitis was found to be 22 (11.4%) and 125 (64.8%), respectively, while herd level prevalence both for clinical and subclinical mastitis was found to be 14 (41.2%) and 26 (76.5%) respectively. Based on the already set P-value, which is <0.05, a number of risk factors were found to have a significant relationship with the occurrence of clinical and sub-clinical mastitis. Generally, animal risk factors such as animal age, parity, injury on the udder or teat, and previous history of mastitis presence of injury on the udder and lactation stage were risk factors with a significant relationship with the occurrence of clinical and sub-clinical mastitis. On the other hand, management risk factors with a significant relationship to the occurrence of clinical and sub-clinical mastitis were herd size, failure to milk mastitic cow, at last, educational level, floor type, failure to use a towel, using one towel for more than one cow and failure to practice mastitis test. From a total of 772 quarters, 280 (36.3%) were found positive for sub-clinical mastitis using the California mastitis test; of these, 70 (9%) were weakly positive, 90 (11.7%) were distinct positive, and 120 (15.5%) were strongly positive. Furthermore, 13 (1.7%) quarters were blocked. Quarter level prevalence was right front 80 (41.5%), left front 64 (33.3%), right hind 69 (35.8%) and left hind 67 (34.7%). The study has shown that mastitis is a major problem for dairy farms and the findings suggested that mastitis is one of the limiting factors in increasing milk production. Subclinical mastitis was found to be a devastating problem, and it occurred in all three breeds of lactating dairy cattle. Therefore, farmers should work hard to avoid the above-mentioned risk factors to minimize the infection of their dairy cattle by mastitis and thereby increase their profit. On the other hand, the Ministry of Agriculture, through the extension unit, should work in close contact with the farmers to increase awareness of the economic importance of the disease and associated risk factors.

Keywords: mastitis, prevalence, dairy cattle, Anseba, Eritrea

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10388 Policy Analysis on Family Planning in Pakistan: Providing Options to Improve Service Provision

Authors: M. Moiz

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Family planning has been known and accepted as a key tool to decrease fertility, provides birth spacing and plays a vital role to attain better outcomes for maternal and child health. Pakistan initiated various family planning programs to preserve maternal and child health for six decades. However, less contraceptive use leading to high fertility and low birth spacing is ultimately a risk for increasing morbidity and mortality. As an outcome of 2012 London Summit on Family Planning where 20 countries including Pakistan made its commitment to increase contraceptive prevalence rate by 55% and provide a universal access to reproductive health to protect human rights of women and ensure safe, choice informed and affordable contraceptives throughout the country. This paper will assess some of the factors of service delivery, coverage and the role of Ministry of Health and Population Welfare Department in providing Family Planning services and how it can be improved in Pakistan. In view of Pakistan Demographic Health Survey 2017-18, there are total nine million potential users of contraceptives and one third among them never used with unmet need while every fifth pregnancy ends into abortion indicates need for Family Planning services. In order to explain this concern, a comprehensive analysis has been done on role of governance in implementing family planning policy and its limitations are discussed. Moreover, this paper highlights policy options and recommendations for improving service provision through public and private sector in creating demand for Family Planning services in Pakistan.

Keywords: contraceptive prevalence rate, family planning, maternal and child health, policy options

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