Search results for: poor people

Authors: Won-Seok Kim, Hyung-Ik Shin

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Self-rated health (SRH) is a subjective assessment of individual health and has been identified as a strong predictor for mortality and morbidity. However few studies have been directed to the factors associated with SRH in persons with disabilities (PWD). We used data of 7th Korean national survey for 5307 PWD in 2008. Multiple logistic regression analysis was performed to find out independent risk factors for poor SRH in PWD. As a result, indicators of physical condition (poor instrumental ADL), socioeconomic disadvantages (poor education, economically inactive, low self-rated social class, medicaid in health insurance, presence of unmet need for hospital use) and social participation and networks (no use of internet service) were selected as independent risk factors for poor SRH in final model. Findings in the present study would be helpful in making a program to promote the health and narrow the gap of health status between the PWD.

Keywords: disabilities, risk factors, self-rated health, socioeconomic disadvantages, social networks

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Authors: Dyah Larasati, Karishma Alize Huda, Sri Kusumastuti Rahayu, Martin Daniel Siyaranamual

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Indonesia continues to reform its social protection system to provide the needed protection for its citizen. Indonesia Social Protection consisted of social assistance programs (non-contributory/tax-financed) specifically targeted for the poor and at-risk and social security/insurance program (contributory system). The social assistance programs have mostly been implemented since 1998. The national health insurance has been implemented since 2014 and the employment social insurance since 2015. One major reform implemented has been improving the targeting performance of its major social assistance portfolios including (1) Food Assistance for the poor families (Rastra and BPNT/noncash foods assistance); (2) Education Assistance for poor children; (3) Conditional Cash Transfer for poor families (PKH); and (4) Subsidized beneficiaries of National Health Insurance (JKN-PBI) for the poor and at-risk individuals. For the Social Insurance (through BPJS Employment program), several initiatives have been implemented to expand the program contributing members, although it mostly benefits the formal sector workers. However, major gaps still exist especially for the emerging middle-income groups who typically work at the informal sectors. They have yet to get the protection needed to sustain their social and economic growth. Since 2017, TNP2K (the National Team for Poverty Reduction) under the Vice President office has led the social protection discourse as the government understands the need to address vulnerabilities across the lifecycle and prioritize support to the most at-risk population particularly the elderly, young children and people with disabilities. Discussion and advocacy to recommend for more investment is continuing in order for the government to establish a comprehensive social protection system in the near future (2020-2024) that protects children through an inclusive child benefit program; build a system to benefit more working-age adults (including individuals with disabilities) and a three-tier elderly protection as they reach 65 years.

Keywords: poverty reduction, social assistance, social insurance, social protection

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Authors: Yuet Wah Echo Yeung

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Working with people from minority ethnic groups, refugees and asylum seeking communities who have limited proficiency in the language of the host country often presents a major challenge for social workers. Because of language differences, social workers need to work with interpreters to ensure accurate information is collected for their assessment and intervention. Drawing from social learning theory, this paper discusses how role play was used as an experiential learning exercise in a training session to help social work students develop skills when working with interpreters. Social learning theory posits that learning is a cognitive process that takes place in a social context when people observe, imitate and model others’ behaviours. The roleplay also helped students understand the role of the interpreter and the challenges they may face when they rely on interpreters to communicate with service users and their family. The first part of the session involved role play. A tutor played the role of social worker and deliberately behaved in an unprofessional manner and used inappropriate body language when working alongside the interpreter during a home visit. The purpose of the roleplay is not to provide a positive role model for students to ‘imitate’ social worker’s behaviours. Rather it aims to active and provoke internal thinking process and encourages students to critically consider the impacts of poor practice on relationship building and the intervention process. Having critically reflected on the implications for poor practice, students were then asked to play the role of social worker and demonstrate what good practice should look like. At the end of the session, students remarked that they learnt a lot by observing the good and bad example; it showed them what not to do. The exercise served to remind students how practitioners can easily slip into bad habits and of the importance of respect for the cultural difference when working with people from different cultural backgrounds.

Keywords: role play, social learning theory, social work practice, working with interpreters

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Authors: Medani Prasad Rijal

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The study outlines the impacts of decentralized forest policy on natural Sal (shorea robusta) forests in the Terai region of Nepal. The government has implemented community forestry program to manage the forest resources and improve the livelihood of local people collectively. The forest management authorities such as conserve, manage, develop and use of forest resources were shifted to the local communities, however, the ownership right of the forestland retained by the government. Local communities took the decision on harvesting, distribution, and sell of forest products by fixing the prices independently. The local communities were putting the low value of forest products and distributed among the user households on the name of collective decision. The decision of low valuation is devaluating the worth of forest products. Therefore, the study hypothesized that decision-making capacities are equally prominent next to the decentralized policy and program formulation. To accomplish the study, individual to group level discussions and questionnaire survey methods were applied with executive committee members and user households. The study revealed that the local intuition called Community Forest User Group (CFUG) committee normally took the decisions on consensus basis. Considering to the access and affording capacity of user households having poor economic backgrounds, low pricing mechanism of forest products has been practiced, even though the Sal timber is far expensive in the local market. The local communities thought that low pricing mechanism is accessible to all user households from poor to better off households. However, the analysis of forest products distribution opposed the assumption as most of the Sal timber, which is the most valuable forest product of community forest only purchased by the limited households of better economic conditions. Since the Terai region is heterogeneous by socio-economic conditions, better off households always have higher affording capacity and possibility of taking higher timber benefits because of low price mechanism. On the other hand, the minimum price rate of forest products has poor contribution in community fund collection. Consequently, it has poor support to carry out poverty alleviation activities to poor people. The local communities have been fixed Sal timber price rate around three times cheaper than normal market price, which is a strong evidence of forest product devaluation itself. Finally, the study concluded that the capacity building of local executives as the decision-makers of natural Sal forests is equally indispensable next to the policy and program formulation for effective decentralized forest management. Unilateral decentralized forest policy may devaluate the forest products rather than devolve of power to the local communities and empower to them.

Keywords: community forestry program, decentralized forest policy, Nepal, Sal forests, Terai

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Authors: Nazi Pharsadanishvili, Anastasia Kitiashvili

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The importance of studying the social-psychological features of people living in poverty is often emphasized in international research. Building a multidimensional economic framework for reducing poverty grounded in people’s experiences and values is the main goal of famous Poverty Research Centers (such as Oxford Poverty and Human Development Initiative, Abdul Latif Jameel Poverty Action Lab). The aims of the proposed research are to investigate the following characteristics of socially vulnerable people living in Georgia: 1) The features of the perceived stigma of poverty; 2) economic system justification and social justice beliefs; 3) Perceived social mobility and actual attempts at upward social mobility. Qualitative research was conducted to address the indicated research goals and descriptive research questions. Conducting in-depth interviews was considered to be the most appropriate method to capture the vivid feelings and experiences of people living in poverty. 17 respondents (registered in the unified database of socially vulnerable families) participated in in-depth interviews. According to the research results, socially vulnerable people living in Georgia perceive stigma targeted toward them. Two sub-dimensions were identified in perceived stigma: experienced stigma and internalized stigma. Experienced stigma reflects the instances of being discriminated and perceptions of negative treatment from other members of society. Internalized stigma covers negative personal emotions, the feelings of shame, the fear of future stigmatization, and self-isolation. The attitudes and justifications of the existing economic system affect people’s attempts to cope with poverty. Complex analysis of those results is important during the planning and implementing of social welfare reforms. Particularly, it is important to implement poverty stigma reduction mechanisms and help socially vulnerable people to see real perspectives on upward social mobility.

Keywords: coping with poverty, economic system justification, perceived stigma of poverty, upward social mobility

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Authors: Jiajia Peng, Jianqing Qiu, Jianjun Ren, Yu Zhao

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Background: Insufficient sleep has been focused on as a public health epidemic. However, a comprehensive analysis of disease trajectory associated with unhealthy sleep habits is still unclear currently. Objective: This study sought to comprehensively clarify the disease's trajectory in relation to the overall poor sleep pattern and unhealthy sleep behaviors separately. Methods: 410,682 participants with available information on sleep behaviors were collected from the UK Biobank at the baseline visit (2006-2010). These participants were classified as having high- and low risk of each sleep behavior and were followed from 2006 to 2020 to identify the increased risks of diseases. We used Cox regression to estimate the associations of high-risk sleep behaviors with the elevated risks of diseases, and further established diseases trajectory using significant diseases. The low-risk unhealthy sleep behaviors were defined as the reference. Thereafter, we also examined the trajectory of diseases linked with the overall poor sleep pattern by combining all of these unhealthy sleep behaviors. To visualize the disease's trajectory, network analysis was used for presenting these trajectories. Results: During a median follow-up of 12.2 years, we noted 12 medical conditions in relation to unhealthy sleep behaviors and the overall poor sleep pattern among 410,682 participants with a median age of 58.0 years. The majority of participants had unhealthy sleep behaviors; in particular, 75.62% with frequent sleeplessness, and 72.12% had abnormal sleep durations. Besides, a total of 16,032 individuals with an overall poor sleep pattern were identified. In general, three major disease clusters were associated with overall poor sleep status and unhealthy sleep behaviors according to the disease trajectory and network analysis, mainly in the digestive, musculoskeletal and connective tissue, and cardiometabolic systems. Of note, two circularity disease pairs (I25→I20 and I48→I50) showed the highest risks following these unhealthy sleep habits. Additionally, significant differences in disease trajectories were observed in relation to sex and sleep medication among individuals with poor sleep status. Conclusions: We identified the major disease clusters and high-risk diseases following participants with overall poor sleep health and unhealthy sleep behaviors, respectively. It may suggest the need to investigate the potential interventions targeting these key pathways.

Keywords: sleep, poor sleep, unhealthy sleep behaviors, disease trajectory, UK Biobank

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Authors: Mariana Calderón, Rocío Murad, Natalia Acevedo, Laura León, Juliana Fonseca, Maria de los Angeles Balaguera Villa

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Recently, different countries and international organizations have put on their agenda the elimination of violence against people with disabilities. This research aims to evaluate the social dimensions of sexual violence against people with disabilities, particularly those with psychosocial and cognitive, in Colombia. Results reveal that 55% of people with disabilities that are survivors of sexual violence are younger than 29 years and 20,4 are people with cognitive and psychosocial disabilities. Colombian regions with better social positions presented more cases of sexual violence against people with disabilities. There were found access barriers for health, education and employment among this population, and there was also found poor data quality. Despite Colombia having an important normative framework aimed at preventing and attending to gender-based violence, it does not take into account people with disabilities specific needs. Additionally, it was found an insufficient implementation and appropriation of these norms, negative attitudes, and in general, a lack of service adaptation according to the needs, identities and circumstances of people with disabilities. Furthermore, among the factors that are exposing people with disabilities to sexual violence, it was found that family members tend to be the main aggressors, there are deep gaps in the sex education received by people with disabilities, imaginaries and perceptions about their sexuality are both hypersexualizing and presenting them as asexual. On the other hand, among protective factors, there were found body self-knowledge and conscience, acknowledgment of their sexuality and their sexual and reproductive rights and access to sex ed. Although during the last few years, there has occurred a positive change toward social inclusion of people with disabilities, specifically through their role in the political agenda and the recognition of their rights. More work is needed in order to guarantee their sexual and reproductive rights, particularly for persons with psychosocial and cognitive disabilities. This research results showed the importance of transforming persisting negative imaginaries about their sexuality and also enforcing and promoting their autonomy. In this sense, it is important to acknowledge gaps and barriers faced by them and create strategies to encourage their social inclusion through education, employment, and skill development. Nevertheless, it is necessary to keep contributing new evidence of the social determinants of health that are influencing the occurrence of sexual violence. This research understands sexual violence against people with disabilities in a multidimensional manner and offers the following recommendations: 1- To foment public sensitization and understanding of disabilities. 2- To increase parents, caregivers and officers’ commitment to the prevention and reduction of sexual violence. 3- To focus on the needs, identities and circumstances of people with disabilities.

Keywords: disabilities, sexual and reproductive rights, sexual violence, prevention

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Authors: Jamie Lee Harder

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In the context of rapidly changing social and economic circumstances in the developing world, this paper analyses access to public healthcare for poor people with disabilities in Cambodia. Like other countries of South East Asia, Cambodia is developing at rapid pace. The historical past of Cambodia, however, has set former social policy structures to zero. This past forces Cambodia and its citizens to implement new public health policies to align with the needs of social care, healthcare, and urban planning. In this context, the role of people with disabilities (PwDs) is crucial as new developments should and can take into consideration their specific needs from the beginning onwards. This paper is based on qualitative research with expert interviews and focus group discussions in Cambodia. During the field work it became clear that the identification tool for the poorest households (HHs) does not count disability as a financial risk to fall into poverty neither when becoming sick nor because of higher health expenditures and/or lower income because of the disability. The social risk group of poor PwDs faces several barriers in accessing public healthcare. The urbanization, the socio-economic health status, and opportunities for education; all influence social status and have an impact on the health situation of these individuals. Cambodia has various difficulties with providing access to people with disabilities, mostly due to barriers regarding finances, geography, quality of care, poor knowledge about their rights and negative social and cultural beliefs. Shortened budgets and the lack of prioritizations lead to the need for reorientation of local communities, international and national non-governmental organizations and social policy. The poorest HHs are identified with a questionnaire, the IDPoor program, for which the Ministry of Planning is responsible. The identified HHs receive an ‘Equity Card’ which provides access free of charge to public healthcare centers and hospitals among other benefits. The dataset usually does not include information about the disability status. Four focus group discussions (FGD) with 28 participants showed various barriers in accessing public healthcare. These barriers go far beyond a missing ramp to access the healthcare center. The contents of the FGDs were ratified and repeated during the expert interviews with the local Ministries, NGOs, international organizations and private persons working in the field. The participants of the FGDs faced and continue to face high discrimination, low capacity to work and earn an own income, dependency on others and less social competence in their lives. When discussing their health situation, we identified, a huge difference between those who are identified and hold an Equity Card and those who do not. Participants reported high costs without IDPoor identification, positive experiences when going to the health center in terms of attitude and treatment, low satisfaction with specific capacities for treatments, negative rumors, and discrimination with the consequence of fear to seek treatment in many cases. The problem of accessing public healthcare by risk groups can be adapted to situations in other countries.

Keywords: access, disability, health, inequality, Cambodia

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Authors: Alami Ilyass, Kharchoufa Loubna, Alachouri Mostafa

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Cardiovascular disease (CDV) remains the major cause of morbidity; mortality and disability throughout the world. The ethnopharmcological and ethnobotanical studies are the paramount importance to set a high value on phytogenetic resources and to address health problems of some communities; especially poor peoples. Our work presents an analysis of published data from studies, that have been undertaken, in Morocco, by different seeker teams in separately areas during the last decades. Objectives: Evaluate and identify medicinal plants used for cardiovascular treatment by Moroccan people. Methodology: All these studies have the same approaches ; they were conducted by interviewing people suffering from diabetes. We use Factorial Analysis (FA) and principal Components analysis (PCA) to analyse the aggregated data from the different studies. Results: globally; 95 plants species were listed; all these plant were used empirically by Moroccan society for treating cardiovascular problems. These plants were divided in to 42 families and 87 genus. The lamiaceae; asteraceae; Apiaceae and poaceae are the botanical families with high number of plant species. Coclusion: Traditional medecine has been widely used for treatment of cardiovascular problems and it has been recognized as an interesting alternative to conventional medicine.

Keywords: cardiovascular, ethnobotanical, medicinal plants, Morocco

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Authors: Aissa Hanifi

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People across different world societies are using information and communication technology (ICT) for different purposes. Unfortunately, in contemporary societies, some people have little access to ICT and thus cannot have effective participation in society compared with those who have better access. The purpose of this study is to test the impact of ICTs on university life in general and students' performance in particular. The study relied on an online survey questionnaire that was administered to 30 undergraduate students at Chef University. The findings of the survey revealed that there is still an important number of students who do not have easy access to ICT. Such limited access to ICTs is attributed to varied factors. Some students live in rural areas, where due to the poor internet coverage, they face difficulties in competing with students who live in urban areas with better ICT access. The lack of ICT access has hindered the students' university performance in general and their language skills, and the exchange of information with teachers and classmates.

Keywords: access, communication, ICT, performance, technology

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Authors: Rukiye Pinar Boluktas

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According to 2015 statistics, in Turkey, 46% of older people live alone in their homes, 55% have poor health perceptions, 18% face poverty, and 43% are unhappy. Prevalence of depression is between 14% and 20%. In 2013, rate of suicide was 6.5. However, the most of older people prefer to live in their community although they are lonely, they face poverty, and face limitations as a result of chronic diseases and disabilities. Community based care for older people is also encouraged by Ministry of Health as it is more cost-effective. Music therapy is a simple, effective, safe, and nonpharmacologic intervention that may be used to decrease depression and to improve cognition, and health related quality of life (HRQOL). In Turkish culture, music is typically described as ‘food for soul’. This study aimed to investigate the effect of Turkish classical music songs in 32 community dwelling older people. Participants were received interventions two or three times per week, 50-60 min per session, for 8 weeks at a day health center. Each intervention session started listening music for 15-20 min to get remember songs, then followed singing songs as a group. Participants were assessed at baseline (week 0), and two follow-up at month 1 and month 2. Compared to baseline, at two follow-up, we observed that cognition improved, depression decreased, and SF-36 scores, including 8 domains and two summary scores increased. We conclude that an intervention comprising listening and singing Turkish classical music improve cognition, depression and HRQOL in older people.

Keywords: cognitive function, depression, elderly, quality of life, Turkish classical music

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Authors: Haoyu Zhao, Qianshu Ma, Min Xie, Yunqi Huang, Yunjia Liu, Huan Song, Hongsheng Gui, Mingli Li, Qiang Wang

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Rationale: Bipolar disorder (BD) and major depressive disorder (MDD), as severe chronic illnesses that restrict patients’ psychosocial functioning and reduce their quality of life, are both categorized into mood disorders. Emerging evidence has suggested that the reliability of self-rated health (SRH) was wellvalidated and that the risk of various health outcomes, including mortality and health care costs, could be predicted by SRH. Compared with other lengthy multi-item patient-reported outcomes (PRO) measures, SRH was proven to have a comparable predictive ability to predict mortality and healthcare utilization. However, to our knowledge, no study has been conducted to assess the association between SRH and hospitalization among people with mental disorders. Therefore, our study aims to determine the association between SRH and subsequent all-cause hospitalizations in patients with BD and MDD. Methods: We conducted a prospective cohort study on people with BD or MDD in the UK from 2006 to 2010 using UK Biobank touchscreen questionnaire data and linked administrative health databases. The association between SRH and 2-year all-cause hospitalizations was assessed using proportional hazard regression after adjustment for sociodemographics, lifestyle behaviors, previous hospitalization use, the Elixhauser comorbidity index, and environmental factors. Results: A total of 29,966 participants were identified, experiencing 10,279 hospitalization events. Among the cohort, the average age was 55.88 (SD 8.01) years, 64.02% were female, and 3,029 (10.11%), 15,972 (53.30%), 8,313 (27.74%), and 2,652 (8.85%) reported excellent, good, fair, and poor SRH, respectively. Among patients reporting poor SRH, 54.19% had a hospitalization event within 2 years compared with 22.65% for those having excellent SRH. In the adjusted analysis, patients with good, fair, and poor SRH had 1.31 (95% CI 1.21-1.42), 1.82 (95% CI 1.68-1.98), and 2.45 (95% CI 2.22, 2.70) higher hazards of hospitalization, respectively, than those with excellent SRH. Conclusion: SRH was independently associated with subsequent all-cause hospitalizations in patients with BD or MDD. This large study facilitates rapid interpretation of SRH values and underscores the need for proactive SRH screening in this population, which might inform resource allocation and enhance high-risk population detection.

Keywords: severe mental illnesses, hospitalization, risk prediction, patient-reported outcomes

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Authors: Sakapas Saengchai

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Study on the development of people's participation in environmental development was a qualitative research method. Data were collected by participant observation, in-depth interview and discussion group in Pathumthani province. The study indicated that 1) People should be aware of environmental information from government agencies. 2) People in the community should be able to brainstorm information, exchange information about community environment development. 3) People should have a role with community leaders. 4) People in the community should have a role to play in the implementation of projects and activities in the development of the environment and 5) citizens, community leaders, village committee have directed the development of the area. Maintaining a community environment with a shared decision. By emphasizing the process of participation, self-reliance, mutual help, and responsibility for one's own community. Community empowerment strengthens the sustainable spatial development of the environment.

Keywords: people, participation, community, environment

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Authors: Abhishek Dave, Manisha Singh

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Purpose: The study aims to evaluate the outcomes of combined Penetrating keratoplasty (PKP) and Vitreo-Retinal (VR) surgery in patients having endophthalmitis with poor corneal clarity. Methods: PKP with VR Surgery was performed in 43 eyes. This is a retrospective analysis of their preoperative, intraoperative and microbiological characteristics and anatomical and functional outcomes. Results: Corneal opacification was due to corneal ulcer in 30 (69.7%), graft infection in 8 (18.6%), bullous keratopathy in 4 and corneal scar in 1 eye. Postoperative visual acuity improved in 20 (46.5%), not changed in 14 (32.5%) and deteriorated in 9 eyes (20.9%). Poor anatomic success was seen in 15 (34.88%) eyes (9-phthisis bulbi, 6-eviscerated). Graft remained clear in 24 eyes (1 year). Microbiology revealed bacteria in 26, fungus in 14 and no growth in 3 eyes. Six out of 11 patients having poor vision in the fellow eye, too, achieved functional success. Conclusion: PKP with VR surgery is a complex but globe-salvaging procedure for poor prognosis eyes, which otherwise would need evisceration.

Keywords: penetrating keratoplasty, VR surgery, endophthalmitis, corneal ulcer

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Authors: Samia Al-Shayban

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Conventionally, Fielding Author’s Farce is read as an attack on literary and theatrical establishment. This paper attempt to read it as a disguised scathing political attack upon, King George II, his court and administration. Fielding achieves his design through complex dramatization based on implicit connections between King George II and the poor poet Luckless who shifts his stand from defending the liberties of the authors into becoming one of their oppressors. Through the same connection, the king is accused of being the originator and protector of literary corruption. To strengthen the attack against the king, the court of nonsense which appeared in Luckless’ play is connected to George II’s court through the presence of opera and ignorance. Thus, Fielding’s literary dramatization is used as a medium to expose the corrupting influence of the ruling elite. The King, his court and administration are all complacent in devaluing the English theatre and turning it into a circus that generate nothing but ignorance and poverty. This practice is deliberately designed to keep people ignorant and authors poor so they remain unable to challenge their corrupt politics.

Keywords: fielding, King George II, ignorance, theatre, plays

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Authors: Paulina Ojeda, Damaris Estrella, Hector Rubio

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Insomnia is a disorder characterized by difficulty falling asleep, staying asleep or both. It negatively affects the life quality of people, it hinders the concentration, attention, memory, motor skills, among other abilities that complicate work or learning. Some studies show that women are more susceptible to insomnia. Medicine curricula usually involve a great deal of theoretical and memory content, especially in the early years of the course. The way to accredit a university course is to demonstrate the level of competence or acquired knowledge. In Mexico the most widely used form of measurement is written exams, with numerical scales results. The prevalence of sleep disorders in university students is usually high, so it is important to know if insomnia has an effect on school performance in men and women. A cross-sectional study was designed that included a probabilistic sample of 118 regular students from the School of Medicine of the Autonomous University of Yucatan, Mexico. All on legally age. The project was authorized by the School of Medicine and all the ethical implications of the case were monitored. Participants completed anonymously the following questionnaires: Pittsburgh Sleep Quality Index, Insomnia Severity Index, AUDIT test, epidemiological and clinical data. Academic performance was assessed by the average number of official grades earned on written exams, as well as the number of approved or non-approved courses. These data were obtained officially through the corresponding school authorities. Students with at least one unapproved course or average less than 70 were considered to be poor performers. With all courses approved and average between 70-79 as regular performance and with an average of 80 or higher as a good performance. Statistical analysis: t-Student, difference of proportions and ANOVA. 65 men with a mean age of 19.15 ± 1.60 years and 53 women of 18.98 ± 1.23 years, were included. 96% of the women and 78.46% of the men sleep in the family home. 16.98% of women and 18.46% of men consume tobacco. Most students consume caffeinated beverages. 3.7% of the women and 10.76% of the men complete criteria of harmful consumption of alcohol. 98.11% of the women and 90.76% of the men are perceived with poor sleep quality. Insomnia was present in 73% of women and 66% of men. Women had higher levels of moderate insomnia (p=0.02) compared to men and only one woman had severe insomnia. 50.94% of the women and 44.61% of the men had poor academic performance. 18.86% of women and 27% of men performed well. Only in the group of women we found a significant association between poor performance with mild (p= 0.0035) and moderate (p=0.031) insomnia. The medical students reported poor sleep quality and insomnia. In women, levels of insomnia were associated with poor academic performance.

Keywords: scholar-average, sex, sleep, university

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Authors: Ruttana Phetsitong, Patama Vapattanawong, Malee Sunpuwan, Marc Voelker

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The majority of care for older people at home in Thai society falls upon caregivers resulting in caregiver’s mental health problem. Beyond individual characteristics, household factors might have a profound effect on the caregiver’s mental health. But reliable data capturing this at the household level have been limited to date. The objectives of the present study were to explore the levels of Thai caregiver’s mental health and to investigate the factors affecting the mental health at household level. Data were obtained from the 2011 National Survey of Thai Older Persons conducted by the National Statistical Office of Thailand. Caregiver’s mental health was measured by using the 15- items-short version of the Thai Mental Health Indicator (TMHI-15) developed by the Department of Mental Health, the Ministry of Public Health. Multivariate logistic regression models were used to explore the impact of potential factors on caregiver’s mental health. The THMI-15 produced an overall average caregiver mental health score of 30.9 out of 45 (SD 5.3). The score can be categorized into good (34.02-45), fair (27.01-34), and poor (0-27). Duration of care for older people, household wealth, and functional dependency of the older people significantly predicted total caregiver’s mental health. Household economic factor was key in predicting better mental health. Compared to those poorest households, the adjusted effect of the fifth quintile household wealth was high (OR=2.34; 95%CI=1.47-3.73). The findings of this study provide a fuller picture to a better understanding of the level and factors that cause the mental health of Thai caregivers. Health care providers and policymakers should consider these factors when designing interventions aimed at alleviating caregiver’s psychological burden when provided care for older people at home.

Keywords: caregiver’s mental health, household, older people, Thailand

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Authors: Jonathan Sahu, Jill Aylott

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Individuals with Autism, Intellectual and Developmental disabilities (AIDD) are one of the most vulnerable groups in society, hampered not only by their own limitations to understand and interact with the wider society, but also societal limitations in perception and understanding. Communication to express their needs and wishes is fundamental to enable such individuals to live and prosper in society. This research project was designed as an organisational case study, in a large secondary health care hospital within the National Health Service (NHS), to assess the quality of care provided to people with AIDD and to review the role of advocacy to reduce health inequalities in these individuals. Methods: The research methodology adopted was as an “insider researcher”. Data collection included both quantitative and qualitative data i.e. a mixed method approach. A semi-structured interview schedule was designed and used to obtain qualitative and quantitative primary data from a wide range of interdisciplinary frontline health care workers to assess their understanding and awareness of systems, processes and evidence based practice to offer a quality service to people with AIDD. Secondary data were obtained from sources within the organisation, in keeping with “Case Study” as a primary method, and organisational performance data were then compared against national benchmarking standards. Further data sources were accessed to help evaluate the effectiveness of different types of advocacy that were present in the organisation. This was gauged by measures of user and carer experience in the form of retrospective survey analysis, incidents and complaints. Results: Secondary data demonstrate near compliance of the Organisation with the current national benchmarking standard (Monitor Compliance Framework). However, primary data demonstrate poor knowledge of the Mental Capacity Act 2005, poor knowledge of organisational systems, processes and evidence based practice applied for people with AIDD. In addition there was poor knowledge and awareness of frontline health care workers of advocacy and advocacy schemes for this group. Conclusions: A significant amount of work needs to be undertaken to improve the quality of care delivered to individuals with AIDD. An operational strategy promoting the widespread dissemination of information may not be the best approach to deliver quality care and optimal patient experience and patient advocacy. In addition, a more robust set of standards, with appropriate metrics, needs to be developed to assess organisational performance which will stand the test of professional and public scrutiny.

Keywords: advocacy, autism, health inequalities, intellectual developmental disabilities, quality of care

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Authors: Mohammad Mahbub Alam Talukder, Shahnewaz, Hasanat-E-Rabbi, Mohammed Nazrul Islam

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Road traffic accident is a global problem which is severe in the developing countries like Bangladesh. In consequence, in developing countries road trauma has now been recognized as an increasing public health hazards and economic burning issue. And after road traffic accidents the lack of management and economic costs related with health seeking behavior have a disproportionate impact on lower income groups, thus contributing to the persistence of poverty in conjunction with disability. This cross sectional study, carried out during July 2012 to June 2013, aimed to explore health seeking decision and culture of handling the road traffic accident related victims, as taken from experiences of the poor disabled people of slum dwellers of Dhaka city. The present study has been designed based on qualitative techniques such as in-depth interview and case studies. Additionally, a survey questionnaire was used to collect the demographic characteristics of the study population (n=150) and to select participants purposely for in-depth interview (n=50) and case study (n=30). Content analysis of qualitative data was done through theme coding and matrix analysis of case study was done to use relevant verbatim. Most of the time the health seeking decision totally depended on the surrounded people of the accidental place, their knowledge, awareness and remaining facility and capacity regarding proper management of the victims. However, most of the cases the victims did not get any early treatment and it took 2-12 hours to get even the first aid because of distance, shortage of money, lack of availability of getting the aid, lack of mass awareness etc. Under the reality of discriminated and unaffordable health service provision better treatment could not turn out due to economic inability of the poor victims. To avoid the severe trauma, treatment delay must be reduced by providing first aid within very short time and to do so, mass awareness campaign is necessary for handing the victims. Moreover, necessary measures should be taken to ensure cost free health service provision to treat the chronic disabled condition of the road traffic accident related poor victims.

Keywords: accident, injury, disabled, qualitative, slum

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Authors: Issam Jebreen, Eman Al-Qbelat

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Outsourcing software development projects can be challenging, and there are several common challenges that organizations face. A study was conducted with a sample of 46 papers on outsourcing challenges, and the results show that there are several common challenges faced by organizations when outsourcing software development projects. Poor outsourcing relationship was identified as the most significant challenge, with 35% of the papers referencing it. Lack of quality was the second most significant challenge, with 33% of the papers referencing it. Language and cultural differences were the third most significant challenge, with 24% of the papers referencing it. Non-competitive price was another challenge faced by organizations, with 21% of the papers referencing it. Poor coordination and communication were also identified as a challenge, with 21% of the papers referencing it. Opportunistic behavior, lack of contract negotiation, inadequate user involvement, and constraints due to time zone were also challenges faced by organizations. Other challenges faced by organizations included poor project management, lack of technical capabilities, vendor employee high turnover, poor requirement specification, IPR issues, poor management of budget, schedule, and delay, geopolitical and country instability, the difference in development methodologies, failure to manage end-user expectations, and poor monitoring and control. In conclusion, outsourcing software development projects can be challenging, but organizations can mitigate these challenges by selecting the right outsourcing partner, having a well-defined contract and clear communication, having a clear understanding of the requirements, and implementing effective project management practices.

Keywords: software outsourcing, vendor, outsourcing challenges, quality model, continent, country, global outsourcing, IT workforce outsourcing.

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Authors: Rajapaksha J. S. R. L., Rajapaksha R. G. D. T., Ranawaka A. U. R., Rangalla R. D. M. P., Ranwala R. D. E. B., Chandratilake M. N.

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Introduction: Lesbian, gay, bisexual, and transgender (LGBT) patients experience discrimination, insensitivity, and ignorance about LGBT-specific health needs among healthcare providers. Developing the correct attitudes among medical students towards LGBT may help provide them with optimal healthcare. Objectives: This study aimed at assessing the attitudes of medical students towards the LBGT community. Methodology: A cross-sectional descriptive study was among all the medical students in the Faculty of Medicine, University of Kelaniya, Sri Lanka, using a validated online questionnaire. The questionnaire focused on eight areas. The data were descriptively analyzed, and the demographic groups were compared. Results: 358 students completed the survey. The response rate was 34.26%. Their attitudes on traditional gender roles and comfortability in interacting with LGBT people were moderate, and they disagreed with negative LGBT social beliefs. They knew less about the origin of sexuality/gender of LGBT. Although they accepted LGBT as a part of diversity, they discouraged normalizing the social practices of LGBT people. Their acceptance and association of LGBT were moderately positive. A minority has encountered LGBT in close social circles, and the majority of them were batch-mates. Although males’ knowledge about the origin of LGBT was higher, they favoured traditional gender roles more. The religious groups showed no differences. The favourability of attitudes towards LGBT reflected respondents’ political ideology. Conclusion: Although medical students’ knowledge on the sexuality/gender basis of LGBT is poor, they have moderately favourable attitudes towards them. They accept LGBT as a part of social diversity but not their social practices. Poor knowledge, lack of encounters, cultural influences, and political ideology may have influenced their attitudes.

Keywords: medical students, attitude, LGBT, diversity

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Authors: Hong Wu, Naiji Lu, Chenguang Wang, Xinming Tu

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This article analyzes the causal effects of informal care, mental health, and physical health on falls and other accidents (e.g. traffic accidents) among elderly people. To purge potential reversal causal effects, e.g., past accidents induce more future informal care, we use two-stage least squares to identify the impacts. By using longitudinal data from a representative national China Health and retirement longitudinal study of people aged 45 and older in China, our findings indicate that informal care decreases while poor health conditions increase the occurrence of accidents. We also find heterogeneous impacts on the occurrence of accidents, varying by gender, urban status, and past accident history. Our findings suggest the following three policy implications. First, policy makers who aim to decrease accidents should take informal care to elders into account. Second, ease of birth policy and postponed retirement policy are urgent to meet the demand of informal care. Third, medical policies should attach great importance to not only physical health but also mental health of elderly parents especially for older people with accident history.

Keywords: accident, China, fall, informal care, mental health, physical health

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Authors: Louiza C. Duncker, Duarte Gonçalves

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Wildlife crime is a complex problem with many interconnected facets, which are generally responded to in parts or fragments in efforts to “break down” the complexity into manageable components. However, fragmentation increases complexity as coherence and cooperation become diluted. A whole-of-society approach has been developed towards finding a common goal and integrated approach to preventing wildlife crime. As part of this development, research was conducted in rural communities adjacent to conservation areas in South Africa to define and comprehend the challenges faced by them, and to understand their perceptions of wildlife crime. The results of the research showed that the perceptions of community members varied - most were in favor of conservation and of protecting rhinos, only if they derive adequate benefit from it. Regardless of gender, income level, education level, or access to services, conservation was perceived to be good and bad by the same people. Even though people in the communities are poor, a willingness to stop rhino poaching does exist amongst them, but their perception of parks not caring about people triggered an attitude of not being willing to stop, prevent or report poaching. Understanding the nuances, the history, the interests and values of community members, and the drivers behind poaching mind-sets (intrinsic or driven by transnational organized crime) is imperative to create sustainable and resilient communities on multiple levels that make a substantial positive impact on people’s lives, but also conserve wildlife for posterity.

Keywords: community perceptions, conservation, rhino poaching, whole-of-society approach, wildlife crime

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Authors: Keshav Raj Acharya, Thakur Silwal, Neelam C. Poudyal

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Buffer zones, the peripheral areas around the national parks and wildlife reserves, are available for the purpose of benefitting the local inhabitants by providing forest products for subsistence needs of basic forest products outside the protected areas. The forest area within the buffer zone has been managed as a buffer zone community forest (BZCF) for the last 25 years after the approval of the buffer zone management regulation 1996. With a case study of select BZCF in Bardia National Park, this study aims to analyze whether the benefit provided by BZCF is equally available to poor users among other socioeconomic classes of the users. The findings are based on the analysis of cross-sectional data involving household surveys (n=305) and key informants’ interviews (n=10) as well as office records available at different 5 buffer zone community forest user groups offices. Results indicate that despite the provisions of subsidized rates for poor; poor households were more deprived due to higher forest products price particularly, the timber price in buffer zone. Evidence also indicate that due to the increased forest coverage, the incidence of wildlife damage has also increased and impacted the poor more due to lack of land ownership as well as limited alternatives. Clear community forest management guidelines with equitable benefit sharing and compensatory mechanisms to the users of poor socioeconomic class have been identified as a solution to increase the benefit to poor users in BZCFUGs.

Keywords: crop depredation, forest products, users, wellbeing ranking

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Authors: Fatemeh Aghamohammadzadeh, Mahdi Asghari Ozma

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SARS-CoV-2 was transmitted from animals to humans in China and through air transport to almost all world countries, including Iran, creating the first pandemic of the 21st century. The virus was spread through droplets from sneezing, coughing, loud talking, and exhalation of sick and asymptomatic people, even during incubation. It was transmitted from human to human directly by inhalation of viruses in droplets or indirectly through contact with infected surfaces, resulting in the death of a significant number of patients, especially the elderly and those with underlying diseases. The virus is more likely to be transmitted in places with high population densities. The chain of transmission of infection can be broken by observing the following: risk perception, reduced travel, complete quarantine in a particular area, home quarantine, social distancing, use of personal protective equipment (PPE), prevention of gatherings, cleaning and disinfection of public utilities and busy places, identifying, isolating and treating infected people, tracking calls, continuing health education, following health principles by people, especially in poor areas, and washing their hands frequently with soap and water or disinfecting them with 70% ethanol.

Keywords: COVID-19, transmission, population density, home quarantine, social distancing

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Authors: Alison Wilde, Stephen Millett

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The cultural value of disabled people has largely been overlooked within forms of media and cultural analysis until the 1980s, when disabled people and disability studies highlighted the cultural misrecognition of disabled people and called for improved forms of cultural recognition and representation. Despite an increase in cultural analysis of representations of disabled people, much has been assumed about how images are read, and little work has been done on the value attributed to disabled people by media audiences and the viewing interests and encounters of film audiences. In particular, there has been little work on film reception, or on the way that young people interpret images of disability. We set out to understand some of the ways that young people read disability imagery, by showing small groups of young people different types of film featuring impairments, chosen from three different eras in film. These were Freaks, Rear Window (remake), and Finding Nemo. The discussions after these films allowed them to explore their own experiences of disability alongside the evolution of cultural representations; in so doing they discussed significant themes of cultural value and reflected on their own identities, e.g. in/dependency, autonomy, and competency and the ways these intersected with self-identity, and attitudes to disabled people.

Keywords: film, audience, identity, disability

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Authors: Timothy Akinwande, Eddie C. M. Hui

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Housing the urban poor has remained a challenge for many years across the world, especially in developing economies, despite the apparent research attention and policy interventions. It is apt to investigate the prevalent affordable housing (AH) provision challenges using unconventional approaches. It is pragmatic to thoroughly examine housing experts to provide supply-side solutions to AH challenges and investigate informal settlers to deduce solutions from AH demand viewpoints. This study being the supply-side investigation of an ongoing research, interrogated housing experts to determine significant expert solutions. Focus group discussions and in-depth interviews were conducted with housing experts in Nigeria. Through descriptive, content, and systematic thematic analyses of data, major findings are that deliberate finance models designed for the urban poor are the most significant housing finance solution in developing economies. Other findings are that adequately implemented rent control policies, deliberate PPP approaches like inclusionary housing and land-value capture, and urban renewal programmes to enlighten and tutor the urban poor on how to earn more, spend wisely, and invest in their own better housing will effectively solve AH finance challenges. Study findings are informative for the best approaches to achieve effective, affordable housing finance for the urban poor in Nigeria, which is indispensable for the achievement of sustainable development goals. This research’s originality lies in the exploration of experts’ opinions in relation to AH finance to produce an equation model of critical solutions to AH finance challenges. Study data are useful resources for future pro-poor housing studies. This study makes housing policy-oriented recommendations toward effective, affordable housing for the urban poor in developing countries.

Keywords: affordable housing, effective affordable housing, housing policy, housing research, sustainable development, urban poor

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Authors: Noha El Toukhy

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The ‘beauty is good” stereotype suggests that people perceive attractive people as having several positive characteristics. Likewise, an “anomalous-is-bad” stereotype is hypothesized to facilitate biases against people with anomalous or less attractive faces. Researchers integrated both into a stereotype content model, which is one of the frameworks used in this study to assess how facial anomalies influence people’s social attitudes and, specifically, people’s ratings of warmth and competence. The mind perception theory, as well as the assessment of animalistic and mechanistic dehumanization against facially anomalous people, are two further frameworks that we are using in this study. This study will test the hypothesis that people have negative attitudes towards people with facial anomalies. We also hypothesize that people have negative biases toward faces with visible differences compared to faces without such differences regardless of the specific type of anomaly, as well as that individual differences in psychological dispositions bear on the expression of the anomalous-is-bad stereotype. Using highly controlled and some never-before-used face stimuli, this pre-registered study examines whether moral character influences perceptions of attractiveness, warmth, and competence for facial anomalies.

Keywords: adolescents, attractiveness, competence, social attitudes, warmth

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Authors: Jegede Kehinde Jacob, Ola Akeem Bayonle, Adewale Yemi Yekeen

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The rapid rate of urban growth in most developing countries of the world in recent times is alarming. Mass movement of people from rural areas to the urban centres, the consequence of the uncontrolled rapid urbanisation resulting to many un-conforming environmental challenges such as inadequate infrastructure, land, water and air pollution, poor environmental sanitation, poor and inadequate housing, urban degradation, sprawl and slums, urban violence, crime, robbery and prostitution as well as many other social vices that make the cities unsustainable. The resultant effects of all these are abysmal failure in the management of cities on the part of the governing authorities and other relevant stakeholders as well as unconducive and unwholesome condition of living of the people. This paper attempts to examine holistically the issue of environmental planning management (EPM) process development and management concept with a view for dynamic and interactive approach for various stakeholders as partners in achieving sustainable cities of our dream. The areas of discussion including conceptual and contextual issues, sustainable cities concept, good urban governance including literature review. The paper goes further to examine opportunities and challenges of built environment generally, the nature and context of environmental problems in particular, the role and duties of environmental planning and management (EPM) process in sustainable urban development. The paper further reviewed briefly the various levels of institutionalisation of EPM process with a typical case study of sustainable Ibadan project (SIP). The paper concludes with a list of recommendations to ensure effective and lasting solutions to cities problems through initiation of EPM process achievable in a sustainable manner.

Keywords: built environment, environmental planning, sustainable cities, sustainable development, urbanization

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Authors: P.V. Lostelius, M.Mattebo, E. Thors Adolfsson, A. Söderlund, Å. Revenäs

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Adolescents are vulnerable in healthcare settings. Early detection of poor health in young people is important to support a good quality of life and adult social functioning. Youth Health Clinics (YHCs) in Sweden provide healthcare for young people ages 13-25 years old. Using an overall mixed methods approach, the project’s main objective was to develop and evaluate an electronic health system, including a health questionnaire, a case report form, and an evaluation questionnaire to assess young people’s health risks in early stages, increase health, and quality of life. In total, 72 young people, 16-23 years old, eleven healthcare professionals and eight researchers participated in the three project studies. Results from interviews with fifteen young people gave that an electronic health questionnaire should include questions about physical-, mental-, sexual health and social support. It should specifically include questions about self-harm and suicide risk. The young people said that the questionnaire should be appealing, based on young people’s needs and be user-friendly. It was important that young people felt safe when responding to the questions, both physically and electronically. Also, they found that it had the potential to support the face-to face-meeting between young people and healthcare professionals. The electronic health report system was developed by the researchers, performing a structured development of the electronic health questionnaire, construction of a case report form to present the results from the health questions, along with an electronic evaluation questionnaire. An Information Technology company finalized the development by digitalizing the electronic health system. Four young people, three healthcare professionals and seven researchers evaluated the usability using interviews and a usability questionnaire. The electronic health questionnaire was found usable for YHCs but needed some clarifications. Essentially, the system succeeded in capturing the overall health of young people; it should be able to keep the interest of young people and have the potential to contribute to health assessment planning and young people’s self-reflection, sharing vulnerable feelings with healthcare professionals. In advance of effect studies, a feasibility study was performed by collecting electronic questionnaire data from 54 young people and interview data from eight healthcare professionals to assess the feasibility of the use of the electronic evaluation questionnaire, the case report form, and the planned recruitment method. When merging the results, the research group found that the evaluation questionnaire and the health report were feasible for future research. However, the COVID-19 pandemic, commitment challenges and drop-outs affected the recruitment of young people. Also, some healthcare professionals felt insecure about using computers and electronic devices and worried that their workload would increase. This project contributes knowledge about the development and use of electronic health tools for young people. Before implementation, clinical routines need for using the health report system need to be considered.

Keywords: adolescent health, developmental studies, electronic health questionnaire, mixed methods research

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