Search results for: upper middle income localities

Authors: Rashmi Nautiyal, Sudhir Singh

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Encyrtidae is the largest family of superfamily Chalcidoidea of parasitic Hymenoptera group. They are endoparasitoids or hyperparasitoids of other arthropods and have the greatest impact on maintaining diversity. It not only forms a major component of diversity itself but also is very important in sustaining diversity in other groups. They are used as efficient biological control agents against key insect pests world over. The present study is based on the collection of Encyrtidae (Chalcidoidea: Hymenoptera) made during a survey in Doon Valley from 2008 to 2011 in all the five seasons (Spring, Summer cum Pre-monsoon, Monsoon, Post-monsoon, Winter) for each year. The collections were made from forest habitat in different localities of the Valley using sweep net and yellow pan trap methods. A total of 1346 specimens of encyrtids were collected and identified from the forest habitat (745 with a sweep net and 601with yellow pan trap).Of these, season-wise (post monsoon, spring, summer, monsoon, and winter) represented Encyrtids were 30.46%, 19.31%, 17.16%, 16.64% and 16.41%, respectively. A total of 161 species of Encyrtids belonging to 43 genera under 2 subfamilies were recorded.

Keywords: diversity, Encyrtidae, sweep net, yellow pan

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Authors: Adebola Adedugbe

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The challenge of post-harvest losses poses serious threats for food security in Nigeria and the north-eastern part with the country losing about $9billion annually due to postharvest losses in the sector. Post-harvest loss (PHL) is the quantitative and qualitative loss of food in various post-harvest operations. In Nigeria, post-harvest losses (PHL) have been a major challenge to food security and improved farmer’s income. In 2022, the Nigerian government had said over 30 percent of food produced by Nigerian farmers perish during post-harvest. For many in northeast Nigeria, agriculture is the predominant source of livelihood and income. The persistent communal conflicts, flood, decade-old attacks by boko haram and insurgency in this region have disrupted farming activities drastically, with farmlands becoming insecure and inaccessible as communities are forced to abandon ancestral homes, The impact of climate change is also affecting agricultural and fishing activities, leading to shortage of food supplies, acute hunger and loss of livelihood. This has continued to impact negatively on the region and country’s food production and availability making it loose billions of US dollars annually in income in this sector. The root cause of postharvest losses among others in crops, livestock and fisheries are lack of modern post-harvest equipment, chemical and lack of technologies used for combating losses. The 2019 Global Hunger Index showed Nigeria’s case was progressing from a ‘serious to alarming level’. As part of measures to address the problem of post-harvest losses experienced by farmers, the federal government of Nigeria concessioned 17 silos with 6000 metric tonne storage space to private sector to enable farmers to have access to storage facilities. This paper discusses the causes, effects and solutions in handling post-harvest losses and optimize returns on food security in northeast Nigeria.

Keywords: farmers, food security, northeast Nigeria, postharvest loss

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Authors: Y. S. Baraya, B. Umar, A. Aliyu, A. A. Raji, K. A. N. Esievo

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This study was performed to determine the presence of anaemia in randomly selected apparently healthy camels (Camelus dromedarius) brought for slaughter at the Sokoto metropolitan abattoir, Sokoto State, Nigeria. The camels were derived from both sexes, different age groups, functional usages and kept at various localities within and outside Sokoto town. In the study area, studies involving camels were limited in particular the emphasis on the anaemic status of camels brought daily for human consumption. A total of eighty (80) blood samples were collected once a week from these camels within the period of eight (8) weeks to investigate the haematological variations especially packed cell volume (PCV). The PCV analysis revealed anaemia in more than fifty (50) % of the camels studied. However, the actual cause of the anaemia was not investigated but could be caused by infectious agent like protozoan parasite Trypanosoma specie and non-infectious cause such as nutritional deficiency. The PCV examination as a simple, inexpensive and reliable procedure could be part of the routine ante-mortem assessment to evaluate camels for the existence of anaemia since many of the causes of anaemia besides being affecting the meat quality could also be of zoonotic significance.

Keywords: anaemia, camels, packed cell volume, Sokoto abattoir

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Authors: Nino Chikhladze, Tamar Dochviri, Nato Pitskhelauri, Maia Bitskhinashvili

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Population aging is a key social and demographic trend of the 21st century. Falls represent a prevalent geriatric syndrome that poses significant risks to the health and independence of older adults. The World Health Organization notes a lack of comprehensive data on falls in low- and middle-income countries, complicating the creation of effective prevention programs. To the authors’ best knowledge, no such studies have been conducted in Georgia. The aim of the study is to explore the epidemiology of falls in the elderly population. The hospitalization database of the National Center for Disease Control and Public Health of Georgia was used for the retrospective study. Falls-related injuries were identified using ICD-10 classifications using the class XIX (S and T codes) and class XX for the type of injury (V-Y codes). Statistical data analyses were done using SPSS software version 23.0. The total number of fall-related hospitalizations for individuals aged 65 and older from 2015 to 2021 was 29,697. The study revealed that falls accounted for an average of 63% (ranging from 59% to 66%) of all hospitalizations and 68% (ranging from 65% to 70%) of injury-related hospitalizations during this period. The 69% of all patients were women and 31%-men (Chi2=4482.1, p<0.001). The highest rate of hospitalization was in the age groups 80-84 and 75-79. The probability of fall-related hospitalization was significantly higher in women (p<0.001) compared to men in all age groups except 65-69 years. In the target age group of 65 years and older, the probability of hospitalization increased significantly with an increase in age (p<0.001). The study's results can be leveraged to create evidence-based awareness programs, design targeted multi-domain interventions addressing specific risk factors, and enhance the quality of geriatric healthcare services in Georgia.

Keywords: elderly population, falls, geriatric patients, hospitalization, injuries

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Authors: Muhammad Afzal, Shahbaz Mushtaq, Duc-Anh-An-Vo, Kathryn Reardon Smith, Thanh Ma

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Climate change has become one of the most challenging environmental issues in the 21st century. Climate change-induced natural disasters, especially floods, are the major factors of livelihood vulnerability, impacting millions of individuals worldwide. Evaluating and mitigating the effects of floods requires an in-depth understanding of the relationship between vulnerability and livelihood capital assets. Using an integrated approach, sustainable livelihood framework, and system thinking approach, the study developed a conceptual model of a generalized livelihood system in District Rajanpur, Pakistan. The model visualizes the livelihood vulnerability system as a whole and identifies the key feedback loops likely to influence the livelihood vulnerability. The study suggests that such conceptual models provide effective communication and understanding tools to stakeholders and decision-makers to anticipate the problem and design appropriate policies. It can also serve as an evaluation technique for rural livelihood policy and identify key systematic interventions. The key finding of the study reveals that household income, health, and education are the major factors behind the livelihood vulnerability of the rural poor of District Rajanpur. The Pakistani government tried to reduce the livelihood vulnerability of the region through different income, health, and education programs, but still, many changes are required to make these programs more effective especially during the flood times. The government provided only cash to vulnerable and marginalized families through income support programs, but this study suggests that along with the cash, the government must provide seed storage facilities and access to crop insurance to the farmers. Similarly, the government should establish basic health units in villages and frequent visits of medical mobile vans should be arranged with advanced medical lab facilities during and after the flood.

Keywords: livelihood vulnerability, rural communities, flood, sustainable livelihood framework, system dynamics, Pakistan

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Authors: Yasin Kutuk, Bengi Yanik Ilhan

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Previous studies investigate the wage differentiations among regions in Turkey between couples who work in the same industry and those who work in different industries by using the models that is appropriate for cross sectional data. However, since there is no available panel data for this investigation in Turkey, pseudo panels using repeated cross-section data sets of the Household Labor Force Surveys 2004-2014 are employed in order to open a new way to examine wage differentiation patterns. For this purpose, household heads are separated into groups with respect to their household composition. These groups’ membership is assumed to be fixed over time such as age groups, education, gender, and NUTS1 (12 regions) Level. The average behavior of them can be tracked overtime same as in the panel data. Estimates using the pseudo panel data would be consistent with the estimates using genuine panel data on individuals if samples are representative of the population which has fixed composition, characteristics. With controlling the socioeconomic factors, wage differentiation of household income is affected by social, cultural and economic changes after global economic crisis emerged in US. It is also revealed whether wage differentiation is changing among the birth cohorts.

Keywords: wage income, same industry, pseudo panel, panel data econometrics

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Authors: Yousef M. Abd Algani Mr.

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Since the mid-1950s, students have been required to do homework. Literature research shows the importance of homework to teachers, parents, and students on one hand, and on the other, it exposes the emotional, social, and family problems caused by large, unintentional quantity of homework, difficult tasks, a lack explanation from the teacher and the type of parental involvement (Coutts, 2004). The objective of the present study from the importance of math homework and the achievements of students in this very field. One of the main goals of education systems across OECD countries is developing independent learners who are able to direct themselves. This issue was expressed mainly in doing homework preparation. Doing homework independently is a skill required of the student throughout his or her years of studying (Hong, Millgram and Rowell, 2001). This study aims at exposing and examining the students' perceptions of mathematics toward homework in junior-high schools (7th-10th grades) in the Arab population in northern Israel, and their impact on raising student achievements in mathematics. To answer the problem of homework in the study of mathematics, we are addressing two main questions: (1) What are the attitudes of Arab Middle School students in Israel towards the use of homework associated with mathematics? (2) What is the effect of using accompanying home exercises to raise the educational attainment of mathematics in Arab schools in northern Israel? The Study Community is: (1) 500 students to examine the attitudes of Arab Middle School students in Israel towards the use of homework associated with mathematics were chosen from junior-high schools in northern Israel, and (2) 180 students to examine the effect of using accompanying homework to raise the educational attainment of the minimum levels of thinking in Bloom's taxonomy (knowledge, comprehension, and application) of mathematics in Arab schools in northern Israel. (a) The researcher used the quantitative approach which aims to examine the attitudes of Arab Middle School students in Israel towards the use of homework associated with mathematics. (b) The researcher used the experimental approach with both pre- and post- semi-experimental design for two experimental groups, (Campbell, 1963), which aims to examine the effect of using accompanying homework to raise the educational attainment of mathematics in Arab schools in northern Israel.

Keywords: attitude, educational attainment, homework, mathematics

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Authors: Firsan Nova

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The average Indonesian watches 5.5 hours of TV a day. With a population of 242 million people and a Free-to-Air (FTA) TV penetration rate of 56%, that equates to 745 million hours of television watched each day. With such potential, it is no wonder that many companies are now attempting to get into the Pay TV market. Research firm Media Partner Asia has forecast in its study that the number of Indonesian pay-television subscribers will climb from 2.4 million in 2012 to 8.7 million by 2020, with penetration scaling up from 7 percent to 21 percent. Key drivers of market growth, the study says, include macro trends built around higher disposable income and a rising middle class, with leading players continuing to invest significantly in sales, distribution and content. New entrants, in the meantime, will boost overall prospects. This study aims to examine and analyze the effect of Market Attractiveness and the Core Competence on Value Creation and Competitive Advantage and its impact to Business Performance in the pay TV industry in Indonesia. The study using strategic management science approach with the census method in which all members of the population are as sample. Verification method is used to examine the relationship between variables. The unit of analysis in this research is all Indonesian Pay TV business units totaling 19 business units. The unit of observation is the director and managers of each business unit. Hypothesis testing is performed by using statistical Partial Least Square (PLS). The conclusion of the study shows that the market attractiveness affects business performance through value creation and competitive advantage. The appropriate value creation comes from the company ability to optimize its core competence and exploit market attractiveness. Value creation affects competitive advantage. The competitive advantage can be determined based on the company's ability to create value for customers and the competitive advantage has an impact on business performance.

Keywords: market attractiveness, core competence, value creation, competitive advantage, business performance

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Authors: Sundaram Arulmozhiraja, Kanade Shimizu, Yuta Yamamoto, Satoshi Ichikawa, Maenaka Katsumi, Hiroaki Tokiwa

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Drug discovery is shifting from small molecule based drugs targeting local active site to middle molecules (MM) targeting large, flat, and groove-shaped binding sites, for example, protein-protein interface because at least half of all targets assumed to be involved in human disease have been classified as “difficult to drug” with traditional small molecules. Hence, MMs such as peptides, natural products, glycans, nucleic acids with various high potent bioactivities become important targets for drug discovery programs in the recent years as they could be used for ‘undruggable” intracellular targets. Cell membrane permeability is one of the key properties of pharmacodynamically active MM drug compounds and so evaluating this property for the potential MMs is crucial. Computational prediction for cell membrane permeability of molecules is very challenging; however, recent advancement in the molecular dynamics simulations help to solve this issue partially. It is expected that MMs with high membrane permeability will enable drug discovery research to expand its borders towards intracellular targets. Further to understand the chemistry behind the permeability of MMs, it is necessary to investigate their conformational changes during the permeation through membrane and for that their interactions with the membrane field should be studied reliably because these interactions involve various non-bonding interactions such as hydrogen bonding, -stacking, charge-transfer, polarization dispersion, and non-classical weak hydrogen bonding. Therefore, parameters-based classical mechanics calculations are hardly sufficient to investigate these interactions rather, quantum mechanical (QM) calculations are essential. Fragment molecular orbital (FMO) method could be used for such purpose as it performs ab initio QM calculations by dividing the system into fragments. The present work is aimed to study the cell permeability of middle molecules using molecular dynamics simulations and FMO-QM calculations. For this purpose, a natural compound syringolin and its analogues were considered in this study. Molecular simulations were performed using NAMD and Gromacs programs with CHARMM force field. FMO calculations were performed using the PAICS program at the correlated Resolution-of-Identity second-order Moller Plesset (RI-MP2) level with the cc-pVDZ basis set. The simulations clearly show that while syringolin could not permeate the membrane, its selected analogues go through the medium in nano second scale. These correlates well with the existing experimental evidences that these syringolin analogues are membrane-permeable compounds. Further analyses indicate that intramolecular -stacking interactions in the syringolin analogues influenced their permeability positively. These intramolecular interactions reduce the polarity of these analogues so that they could permeate the lipophilic cell membrane. Conclusively, the cell membrane permeability of various middle molecules with potent bioactivities is efficiently studied using molecular dynamics simulations. Insight of this behavior is thoroughly investigated using FMO-QM calculations. Results obtained in the present study indicate that non-bonding intramolecular interactions such as hydrogen-bonding and -stacking along with the conformational flexibility of MMs are essential for amicable membrane permeation. These results are interesting and are nice example for this theoretical calculation approach that could be used to study the permeability of other middle molecules. This work was supported by Japan Agency for Medical Research and Development (AMED) under Grant Number 18ae0101047.

Keywords: fragment molecular orbital theory, membrane permeability, middle molecules, molecular dynamics simulation

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Authors: Melese Tadesse Morebo

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Pastoral and agro-pastoral communities in East Africa, particularly in Ethiopia, are vulnerable to climate-related risks. The aim of this study is to characterize the annual, seasonal, and monthly rainfall and temperature of the middle and lower awash areas of Ethiopia. Start of season (SOS), end of season (EOS), length of growing season (LGS), number of rainy days, and probability of dry spell occurrences were analyzed using INSTAT Plus (v3.7) software. Daily rainfall and temperature data for 33 years (1990–2022) from six stations were analyzed. The result of the study revealed that the annual rainfall in the study area as a whole showed an increasing trend, but its trend was statistically non-significant. During the study period, the Kiremt rainfall at Amibara station showed statistically significant increasing trends. The trend analysis of SOS, EOS, and LGS shows up and down trends at all stations. The mean lengths of growing seasons in the study area ranged from 20 to 61 days during the study period. In the study area, the annual mean maximum temperature ranged between 34.1°C and 38.3°C over the last three decades. All stations within the research area during the study period, the annual minimum temperature exhibited a substantial impact.

Keywords: annual rainfall, LGS, minimum temperature, Mann-Kendall test

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Authors: E. V. Fakhrutdinova, Y. S. Kolesnikova, E. A. Karasik, V. M. Zagidullina

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Poverty as the social and economic phenomenon exists in any society and represents a many-sided problem. In this sense it is universal and for many centuries serves as a research objects for scientists. Special attention to a problem of poverty in Russia is caused, first of all, by the critical growth of inequality and by scales of expansion of poverty, considerable decrease in the level and quality of life of the population, decrease in availability of education during the period of reforming. The expansion of poverty on the working members of society, youth, which has to provide reproduction of the population is alarming. As poverty is the reason of weakening of national security of the country, degradation of the population, decline in the quality of the human capital, complication of a demographic situation, strengthening of social contradictions in society, so far as the reduction of poverty, so, the increase in production. Poverty: the characteristic of an economic situation of the individual or social group at which they can't satisfy certain minimum requirements necessary for life, preservations of working capacity and reproduction. Poverty became one of the critical factors expelling people from the system of the institutional interactions reducing social space in which their relations were building breaking their social identity. Complication of the problem of poverty in modern society happened due to penetration of the related relations into many spheres of life. It is known that negative consequences of poverty display not only at the personal level of the poor person, but also at the level of interpersonal social interactions, decline in the quality and level of development of the human capital, and also at social and economic system in general. We conducted a research on the influence of education on the change of poverty level of the population. We consider education as a resource for an increase of the income and social mobility. Dependence of the income of the population on the level of education, availability of education (level of education and quality of education) on the level of income of families is found. Differentiation of quality and number of educational services for children depending on the level of the income of families is revealed. Influence of a factor of poverty on the availability of education is also studied. We consider expenses on education as the limiter of access to education. We consider education as a factor of fixation and aggravation of a property inequality. In the solution of problems of poverty the defining condition is the state regulation of social and economic development by means of creation of the effective institutional environment. The state has to develop measures for an increase of availability of various services to all categories of citizens, in particular services of health care and education, especially for poor citizens enters. The special attention regarding an increase of availability of education services has to be paid to creation of system of social elevators.

Keywords: poverty, education, human capital, quality of life

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Authors: Reshma P. Nuri, Ebenezer Dassah

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Introduction: Raising a child with a disability can affect family members in different ways. However, this can be determined by the way in which a family member copes with the situation. There is little research that explores how families develop coping strategies to overcome barriers in raising CWDs. Objective: This study explored family members’ coping mechanism in raising a child with disability in Bangladesh. Method: A qualitative approach that involved 20 interviews with family members of CWDs. A purposive sampling procedure was used in selecting the study participants. A digital recorder was used to record all the interviews. Transcriptions were done in Bengali, translated into English, and then imported to NVivo software 12 for analysis. Thematic analysis was used to analyze the data. Results: The study revealed that family members adopted different coping strategies for their CWDs, including seeking support from formal (e.g., service providers) and informal sources (family members and friends); relying on religious beliefs; accepting the situation. Additionally, to cope with extra cost in raising CWDs, family members strategies included relying on overtime work; borrowing money from financial institutions; selling or mortgaging assets; and replying on donations from community members. Finally, some families had to reduce spending on food and buying toys for their CWDs. Conclusion: This qualitative study highlighted a range of coping mechanism adopted by family members in Bangladesh. The information provided in this study is potentially important to policy makers and service providers as it presents evidence on the coping mechanism of families in raising their CWDs. This underscores the need for policy design and service delivery in government support system in Bangladesh and potentially in other low- and middle-income contexts.

Keywords: Bangladesh, children with disabilities, coping mechanism, family members

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Authors: Madelaine F. Gatchalian, Mary Jane D. Tepora

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This study was designed to determine the relationship between learning environment and motivation of CNHS, SY 2012-2013. There were 376 respondents taken randomly. Frequency distribution, percentage, mean, standard deviation, Mann Whitney Test, Kruskall Wallis One-way ANOVA and Spearman Rank Correlational Coefficient were used in analyzing the data. As to age, most of the respondents were 13 years old while female students outnumbered the male students. Majority of parents’ educational attainment of CNHS students were high school/vocational graduates. Most fathers worked in the private sector, while majority of the mothers were unemployed whose family income range from Php 5,000.00 to Php 14,999.00. Most of the respondents were first child composed of five family members. Findings showed no significant differences in perceived learning environment when respondents were grouped in terms of age, sex, parents’ educational attainment, parents’ occupation, sibling order and number of family members. Only monthly family income showed significant differences in perceived learning environment. There are no significant differences in perceived learning motivation when respondents were grouped in terms of age, sex, parents’ educational attainment (father), parents’ occupation (father), sibling order, and number of family members. Parents’ educational attainment (mother), parents’ occupation (mother) and monthly family income showed significant differences in perceived learning motivation. There is significant relationship between the six subscales of perceived learning environment, namely: student cohesiveness, teacher support, involvement, task orientation, cooperation and equity and perceived learning motivation of CNHS students, SY, 2012-2013. The results of this study indicated that learning environment including student cohesiveness, teachers support, involvement, task orientation, cooperation and equity is significantly related to students’ learning motivation.

Keywords: learning environment, motivation, demographic profile, secondary students

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Authors: Tissa Ravinda Perera

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An open economic policy was introduced by Sri Lanka in 1977, before many other countries in Asia to align her economy to world economic trends and it was affected indigenous businesses since they had to compete with foreign products, processes, technology, innovations and businesses. The year 2010 was a milestone in Sri Lankan history to achieve the developmental goals when Foxbuisness rated Sri Lanka as the best performing global economy. However, Sri Lanka missed her chances of achieving development with the political and social chaos, consequent the regime change in 2015. This paper argues that to support the development of the country, Sri Lanka must develop an entrepreneurial culture. In this endeavor, creativity and innovation will play a pivotal role to achieve the desired level of development. In this study, it was used secondary data from various local and international sources to understand and explore the existing scenario of Sri Lankan economy, state of entrepreneurial culture and innovation, and challenges and competencies for the development of an entrepreneurial culture in Sri Lanka. The data was collected from secondary sources were depicted in tables in this paper in a meaningful manner. Based on the tables many findings were aroused and conclusions were made to support the argument in this paper. This paper revealed that the development of an entrepreneurial culture has to be associated with creativity and innovation to gain a competitive advantage over the development strategies of other countries. It is exposed that an entrepreneurial culture will help minorities, women and underprivileged societies to empower themselves. This product will help to confront and manage youth unrest which has created anarchy in the country from time to time. Throughout this paper, it was highlighted the past, present and future scenario of Sri Lankan economy along with modification to be done to it through the development of an entrepreneur culture in light of innovation and creativity to achieve the desired level of development.

Keywords: economy, industry, creativity, innovation, entrepreneurship, entrepreneurial culture

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Authors: Dongxue Li, Zhonghua Ning, Yi’na Li, Baoshan Cui, Wasner Daniel, Sebastian Dötterl

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Most of the world's coastal alluvial plains can be significant carbon (C) eservoirs in which upland sediments are deposited and bury former topsoil, thereby contributing to soil C preservation, especially in river-controlled deltas like the Yellow River Delta, China. These deltas are affected by the continuous large amount of sediment transport and strong river dynamics from the upper reaches, which makes the river course in the deltas change frequently. However, the impact of varying river course changes on C stocks in these estuary wetlands is unclear. To investigate this, we drilled five 2 m cores along a sediment deposition sequence of the Yellow River Delta, which shifted its main course flow in the delta several times throughout the 20th century. Covering 80 years of sediment deposition, we explored both soil C stocks and their potential sources, and identified key soil physicochemical and hydrometeorological variables that correlate to C density and deposition rate. Further, the spatiotemporal C distribution and its relationship with these variables was examined. Our results showed that sediments at a soil depth of 200 cm in the main courses of the Yellow River corresponded to deposition ages ranging from 1942 to 1989. The oldest course has the lowest C stocks and showed C-enriched compared with younger courses. Contributions of soil C stemming from fresh particulate organic carbon from deposited upstream sources were significantly higher than local, in-situ vegetation. In addition, the carbon of the oldest and relatively young courses tends to be affected by interaction effects of hydrometeorological and physiochemical varibales, and that of the middle courses tends to be affected by independent variables. Our findings can help prioritize conservation efforts across different river courses and provide quantitative support for global carbon emission reduction by assessing sediment carbon reservoirs.

Keywords: alluvial plains, coastal wetland, core drilling, course diversion, organic carbon, sediment deposition rate, soil deposition

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Authors: Mary Kiviiri Nakawuka, Mary Namugalu, Andrew Otiti

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BACKGROUND Cervical cancer is the fourth most common cancer in women and seventh overall among all cancers worldwide. It accounts for about 7.5% of all female-cancer deaths with 85% occurring in low and middle-income countries and the first most common female cancer in women aged 15 to 44 years in Uganda with an annual number of new cases at 3,915 and 2,275 annual number of cervical cancer deaths in 2012 (ICO INFORMATION CENTRE ON HPV AND CANCER, 2017).Despite the available free cervical cancer screening services whose uptake has been documented to improve the chances of successful treatment of pre-cancers and cancers among women of reproductive age, there is a low uptake of these services thus we sought to examine the uptake of cervical cancer services and associated factors among women of reproductive age (25-49) attending the ART clinic of KISWA HCII in Kampala, Uganda METHODS The research was carried out in the ART clinic of KISWA HCII among 385 participants. An analytical, cross-sectional study with quantitative methods of data collection was used. The study adopted a non-probability convenience sampling method to select participants. Quantitative data was collected through structured questionnaires. RESULTS 72.2% of the participants were found to have been screened for cervical cancer. 36 % of the screened women had a positive HPV or VIA result ,59.2% of the screened women had a negative HPV or VIA result and 4.8% had an invalid HPV test result. Only 39.5% of the participants had adequate overall knowledge about cervical cancer, more than a third of the participants (50%) had moderate or low knowledge and minority of them (10.5%) had no knowledge. There was no significant association between the uptake of cervical cancer screening services among participants and their socio-demographic characteristics. CONCLUSIONS Although majority of the women surveyed had been screened for cervical cancer, a comparatively large number of participants had inadequate knowledge about cervical cancer and therefore there is still need to continue teaching about cervical cancer and this may include education campaigns, improvements to the accessibility and convenience of the screening services.

Keywords: cervical cancer uptake, cervical cancer screening, women of reproductive age., cervical cancer knowledge

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Authors: Fidan Z. Aliyeva

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In the presented article, the formation of the microbiological regime in the Takhtakorpu water complex, as well as spatial-temporal changes in the quantitative indicators of bacterioplankton, were studied. Taktakorpu water complex was built as a continuation of the reconstruction and expansion project of the Samur-Absheron irrigation system in Shabran on the northeastern slope of our republic. It should be noted that with the implementation of the project, the water supply of up to 150 thousand ha of useful land in the northern region has been improved, and the drinking, technical, and irrigation water needs of the population of Baku, Sumgayit and also the Absheron Peninsula, and industrial and agricultural areas, joining the agricultural circulation of new soil areas, Takhtakorpu reservoir with a volume of 238.4 million m³, connected with them -Valvalachay- Takhtakorpu and Takhtakorpu-Jeyranbatan canals have been created, conditions have been created to increase the resources of the Jeyranbatan reservoir. Special attention is paid to the study of saprophytic bacteria in order to determine the development dynamics and biochemical activity of the microbiological regime in the Takhtakorpu Water Complex, which is of great strategic importance for our republic, to evaluate changes under the influence of anthropogenic factors, as well as to evaluate the properties of self-cleaning, mineralization features of organic substances of allochthon and autochthonous origin. One of the main goals of our research is to determine the main structural indicators of bacterioplankton in the upper part of Takhtakorpu water complex in the first three stations and analyzing their quantitative values in a certain time aspect.

Keywords: water, irrigation, sewage, wastewater

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Authors: Kritsada Moonpa, Kannipa Motanated, Weerapan Srichan

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Hong Hoi Formation is a Middle Triassic deep marine succession presented in outcrops throughout the Lampang Basin of northern Thailand. The primary goal of this research is to diagnose the paleoenvironment, petrographic compositions, and sedimentary sources of the Hong Hoi Formation in Ban Huat, Ngao District. The Triassic Hong Hoi Formation is chosen because the outcrops are continuous and fossils are greatly exposed and abundant. Depositional environment is reconstructed through sedimentological studies along with facies analysis. The Hong Hoi Formation is petrographically divided into two major facies, they are: sandstones with mudstone interbeds, and mudstones or shale with sandstone interbeds. Sandstone beds are lithic arenite and lithic greywacke, volcanic lithic fragments are dominated. Sedimentary structures, paleocurrent data and lithofacies arrangement indicate that the formation deposited in a part of deep marine abyssal plain environment. The sedimentological and petrographic features suggest that during the deposition the Hong Hoi Formation received sediment supply from nearby volcanic arc. This suggested that the intensive volcanic activity within the Sukhothai Arc during the Middle Triassic is the main sediment source.

Keywords: Sukhothai zone, petrography, Hong Hoi formation, Lampang, Triassic

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Authors: Salma Akter, Md. Kamal Uddin

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Quality of life is a vast and comprehensive concept refers overall well-being of society. Current research and efforts of policymakers and planners are concerned to increase the urban quality of life through the sustainable development of city and country. While such efforts effectively improve the quality of life of urban dwellers through improved social, economic and housing infrastructures, very little has been paid to improve low-income settlement users more specifically government provided shelter projects. The top-down shelter policies and its objective indicators (physical design elements and physical environmental elements) indicators on low-income groups merely can ensure grassroots needs, aspiration and well-being refer as subjective qualities obliged to compromise with the quality of life. This research, therefore, aims to measure the quality of life of such government-provided low-income settlements. To do so, a conceptual framework has been developed to measure quality of life with arguing that quality of life depends on both objective and subjective indicators and needs to measure across three scales of living environment refers to macro (community), meso (neighborhood or shelter/built environment), and micro (family). The top-down shelter project, Dakshin Chandani Mahal Ashrayan Prakalpa is a resettlement/housing project of Government of Bangladesh for providing shelters and human resources development activities like education, microcredit, and training programme to landless, homeless and rootless people has been taken as case study. The study area is located at Dighalia Upazila, Khulna Bangladesh. In terms of methodology, this research is primarily exploratory and adopts a case study method and deductive approach for evaluating the quality of life. Data have been obtained from relevant literature review, key informant interview, focus group discussion, necessary drawings, photographs and participant observation across dwelling, neighborhood, and community level. Findings have revealed that Shelter users mostly compromise the quality of life at community level due to insufficient physical design elements and facilities while neighborhood and dwelling level have been manifested similar result like former ones. Thus, the outcome of this study can be beneficial for a global-level understating of the compromising the ‘quality of life’ under top-down shelter policy. Locally, for instance, in the context of Bangladesh, it can help policymakers and concerned authorities to formulate the shelter policies and take initiatives to improve the well-being of marginalized.

Keywords: Ashrayan Prakalpa, compromise, displaced people, quality of life

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Authors: Khanday Pervaiz Ahmad

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It was in 19th century when the Indian educated class started to reform their socio-religious set up as an imperative to respond to the challenges put forward by the colonial empire. The colonial discourse on India from the very beginning was gendered, as the colonized society was feminized and its ‘effeminate’ character, as opposed to ‘colonial masculinity’ was held to be a justification for its loss of independence. The ‘women health figure’ is prominently in these gender discourses. The women’s health received a much place in the colonial discourse. Lack of health consciousness, illiteracy, and belief in myths, rituals and superstitions were deemed the main factors taken as an indicator of miserable condition of Indian women’s health. As the low position of women caused shame to the natives, reforming the condition of women, its health occupied a major place in their intellectual as well as activist engagements. Magazines (journals) for women began to appear in various Indian languages in the mid to late 19th century with Bengal leading the front. These sources (Magazines) like Harm, Tehzib un Niswan, Saheli, Khatoon etc. are essential for the study of the emergence of an ideology of respectable domesticity in Indian Muslim upper middle class. Similarly for the study of development of Women’s health consciousness, women’s magazines are very essential. These earliest women Urdu magazines were first started by men, and then followed by the women’s own magazines. Various health issues, like pregnancy, child-rearing, menstruation, midwives training, Pardah, and health etc. were discussed at a time when it was impossible to discuss them in public sphere. These women magazines were brave pioneers, expanding the frontiers of women’s roles, and consciousness at a time when those frontiers were severely limited. This paper will try to focus on how women responded to the question of colonial discourse about their bodies. How health consciousness developed among Indian Muslim women and in what way it contributed in the development of feminist consciousness in South Asian Muslim Women community.

Keywords: Ashraf class, khatoon, haram women, feminism

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Authors: Hamed Najafi, Ghasem Nikjou

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Nowadays, there is an increasing attention to the resources scarcity issues. Because of failure in present patterns in the field of the allocation of exhaustible resources between generations and the challenges related to economic justice supply, it is supposed, to present a pattern from the Islamic perspective in this essay. By using content analysis of religious texts, we conclude that governments should remove the gap which is exists between the per capita income of the poor and their minimum consumption (necessary consumption). In order to preserve the exhaustible resources for poor people) not for all), between all generations, government should invest exhaustible resources on endless resources according to Hartwick’s criteria and should spend these benefits for poor people. But, if benefits did not cover the gap between minimum consumption and per capita income of poor levels in one generation, in this case, the government is responsible for covering this gap through the direct consumption of exhaustible resources. For an exact answer to this question, ‘how much of exhaustible resources should expense to maintain justice between generations?’ The theoretical and mathematical modeling has been used and proper function has been provided. The consumption pattern is presented for economic policy makers in Muslim countries, and non-Muslim even, it can be useful.

Keywords: exhaustible resources, Islamic justice, intergenerational justice, distribution of resources, Hartwick criteria

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Authors: B. W. Kenny, D.Mansour, K. G. Mansour, J. Attia, B. Meads

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There is currently insufficient evidence to make a conclusive statement about safety while immobilized in a short arm cast. There is a paucity of published literature on this topic. The purpose of this study is to specifically evaluate short arm casts and their effect on driving abilities, particularly steering and avoidance of obstacles. The ability to drive safely is extrapolated from this data. In this study, a randomised, controlled, crossover design was used to assess 30 subjects randomised into 2 groups. A Logitech force feedback steering column and simulated driving program with a standardised road course was used. Objective outcome measures were the number of times subjects drove off the track, the number of crashes, time to lap completion and subjective assessment on whether wearing a short arm plaster cast impeded their steering. Recruited subjects had no upper limb pathology. The side of the applied plaster cast was randomised. The mean lap completion time reduced with repetition, the difference being statistically significant. There was no significant difference in mean number of times subjects in casts drove off the track (3 with vs. 3.07 without casts), average number of crashes (1.27 vs 0.97). Steering ability was not reduced whilst a subject was immobilised in a short arm Plaster of Paris cast, despite subject’s own impressions that their steering was impeded. This may help guide doctors in their advice to patients regarding driving in these casts.

Keywords: upper limb, arm injury, plaster cast, splint, driving, automobile, bone fracture

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Authors: Marah Joy A. Nanglegan

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A survey was conducted to describe knowledge, attitude, practices, information needs, and information seeking behavior of small-scale farmers on Organic Agriculture Production (OAP) in a rural community in Ifugao, Philippines. Respondents’ age ranged from 23-67 years old. Most of them are male, married, and have reached high school level. The major source of income is farming with an average monthly income of less than Php 5,000 for a household size of seven. More than fifty percent of the respondents are members of a farmer’s organization. Farm size is less than one hectare. Majority of them own their farms and have been farming for more than twenty years. Very few attended training on Organic Agriculture Production (OAP). Most of them are not aware of any OAP program in their community. Hence, their farming practices are mostly conventional. The overall level of knowledge on OAP among all respondents was below the average. On attitude, most of the respondents agreed that organic farming would decrease production costs by reducing input purchases. They believe it benefits both the consumer and the producer. In fact, they are aware of the many benefits of organic farming, especially on health. Likewise, many of them agreed on the benefits of organic farming to soil fertility, to the environment, and to increase the income of farmers. Many of them, however, see organic farming as troublesome and difficult in terms of time and effort, obtaining organic inputs, limited production, and marketing aspects. They also have heavy reliance on pesticides and herbicides to control pests and diseases. On practices, majority of the respondents stated that they practiced crop rotation, manual weeding, and the use of animal manure. Most of them desired to do organic farming but needed information such as production techniques, costs, and marketing opportunities. Their most preferred communication channel is through extension agents and contact farmers. Their most preferred communication method is through trainings and seminars as well as through farm demonstrations. Results of this study will serve as a basis for developing appropriate communication strategies to improve knowledge, attitude, and practices of respondents on organic agriculture as well as enhance the promotion of organic agriculture production in the community.

Keywords: Ifugao, knowledge attitude practices, organic agriculture, Philippines

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Authors: Jelena Popović, Andrijana Mićanović

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Officially, 60% of Montenegrin territory is covered in forests, but they are continually being destroyed by illegal cutting, concession politics and wildfires. Montenegrin Ecologists Society started the first dendrochronology lab in Montenegro, and data collection began in the Summer of 2021. The cores were taken from 3 localities around the peak Lisac on the mt. Prekornica, where biggest P.heldreichii forests existed until recent huge wildfires. This research is the first step towards comprehensive dendrochronology research in Montenegro. It will show how old certain forest stands of Pinus heldreichii on mountain Prekornica are, that were not destroyed in huge wildfires from the recent years. It will also show how do they correlate between each other. Per locality 15 trees were sampled. Electric sanders (150 - 2000) were used for preparation. Cores were scanned, then measured in CooRecorder. Analysis is done in Cofecha. Process will be repeated with Lintab 6 and TSAP (Time Series Analysis and Presentation for Dendrochronology and Related Applications) - Win Scientific software by Rinntech. Since this is the first dendrochronology research entirely done in Montenegro it is a foundation for the dendroclimatology research. Besides, it’ll contribute to the understanding of the life of these forests in this part of its areal, and in designing good management practices.

Keywords: dendrochronology, bosnian pine, pinus heldreichii, montenegro, forests

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Authors: Hadi S. Hosseini, Larry A. Taber

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In the embryo, heart is initially a simple tubular structure that undergoes complex morphological changes as it transforms into a four-chambered pump. This work focuses on mechanisms that create heart tube (HT). The early embryo is composed of three relatively flat primary germ layers called endoderm, mesoderm, and ectoderm. Precardiac cells located within bilateral regions of the mesoderm called heart fields (HFs) fold and fuse along the embryonic midline to create the HT. The right and left halves of this plate fold symmetrically to bring their upper edges into contact along the midline, where they fuse. In a region near the fusion line, these layers then separate to generate the primitive HT and foregut, which then extend vertically. The anterior intestinal portal (AIP) is the opening at the caudal end of the foregut, which descends as the HT lengthens. The biomechanical mechanisms that drive this folding are poorly understood. Our central hypothesis is that folding is caused by differences in growth between the endoderm and mesoderm while subsequent extension is driven by contraction along the AIP. The feasibility of this hypothesis is examined using experiments with chick embryos and finite-element modeling (FEM). Fertilized white Leghorn chicken eggs were incubated for approximately 22-33 hours until appropriate Hamburger and Hamilton stage (HH5 to HH9) was reached. To inhibit contraction, embryos were cultured in media containing blebbistatin (myosin II inhibitor) for 18h. Three-dimensional models were created using ABAQUS (D. S. Simulia). The initial geometry consists of a flat plate including two layers representing the mesoderm and endoderm. Tissue was considered as a nonlinear elastic material with growth and contraction (negative growth) simulated using a theory, in which the total deformation gradient is given by F=F^*.G, where G is growth tensor and F* is the elastic deformation gradient tensor. In embryos exposed to blebbistatin, initial folding and AIP descension occurred normally. However, after HFs partially fused to create the upper part of the HT, fusion, and AIP descension stopped, and the HT failed to grow longer. These results suggest that cytoskeletal contraction is required only for the later stages of HT formation. In the model, a larger biaxial growth rate in the mesoderm compared to the endoderm causes the bilayered plate to bend ventrally, as the upper edge moves toward the midline, where it 'fuses' with the other half . This folding creates the upper section of the HT, as well as the foregut pocket bordered by the AIP. After this phase completes by stage HH7, contraction along the arch-shaped AIP pulls the lower edge of the plate downward, stretching the two layers. Results given by model are in reasonable agreement with experimental data for the shape of HT, as well as patterns of stress and strain. In conclusion, results of our study support our hypothesis for the creation of the heart tube.

Keywords: heart tube formation, FEM, chick embryo, biomechanics

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Authors: Elise Machline

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Policy instruments have been developed worldwide to reduce the energy demand of buildings. Two types of such instruments have been green building rating systems and energy efficiency standards for buildings -such as Green Star (Australia), LEED (United States, Leadership in Energy and Environmental Design), Energy Star (United States), and BREEAM (United Kingdom, Building Research Establishment Environmental Assessment Method). The popularity of the idea of sustainable development has allowed the actors to consider the potential value generated by the environmental performance of buildings, labeled “green value” in the literature. Sustainable performances of buildings are expected to improve their attractiveness, increasing their value. A growing number of empirical studies demonstrate that green buildings yield rental/sale premia, as well as higher occupancy rates and thus higher asset values. The results suggest that green buildings are not affordable to all and that their construction tends to have a gentrifying effect. An increasing number of countries are institutionalizing green strategies for affordable housing. In that sense, making green buildings affordable to all will depend on government policies. That research aims to investigate whether green building fosters inequality in Israel, under the banner of sustainability. The method is comparison (of the market value). This method involves comparing the green buildings sale prices with non-certified buildings of the same type that have undergone recent transactions. The “market value” is deduced from those sources by analogy. The results show that, in Israel, green building projects are usually addressed to the middle to upper classes. The green apartment’s sale premium is about 19% (comparing to non-certified dwelling). There is a link between energy and/or environmental performance and the financial value of the dwellings. Moreover, price differential is much higher than the value of energy savings. This perpetuates socio-spatial and socio-economic inequality as well as ecological vulnerability for the poor and other socially marginal groups. Moreover, there are no green affordable housings and the authorities do not subsidy green building or retrofitting.

Keywords: green building, gentrification, social housing, green value, green building certification

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Authors: Shaidatul Azdawiyah Abdul Talib, Wan Mohd Razi Idris, Liew Ju Neng, Tukimat Lihan, Muhammad Zamir Abdul Rasid

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Climate change has received great attention worldwide due to the impact of weather causing extreme events. Rainfall and temperature are crucial weather components associated with climate change. In Malaysia, increasing temperatures and changes in rainfall distribution patterns lead to drought and flood events involving agricultural areas, especially rice fields. Muda Agricultural Development Authority (MADA) is the largest rice growing area among the 10 granary areas in Malaysia and has faced floods and droughts in the past due to changing climate. Changes in rainfall and temperature patter affect rice yield. Therefore, trend analysis is important to identify changes in temperature and rainfall patterns as it gives an initial overview for further analysis. Six locations across the MADA area were selected based on the availability of meteorological station (MetMalaysia) data. Historical data (1991 to 2020) collected from MetMalaysia and future climate projection by multi-model ensemble of climate model from CMIP5 (CNRM-CM5, GFDL-CM3, MRI-CGCM3, NorESM1-M and IPSL-CM5A-LR) have been analyzed using Mann-Kendall test to detect the time series trend, together with standardized precipitation anomaly, rainfall anomaly index, precipitation concentration index and temperature anomaly. Future projection data were analyzed based on 3 different periods; early century (2020 – 2046), middle century (2047 – 2073) and late-century (2074 – 2099). Results indicate that the MADA area does encounter extremely wet and dry conditions, leading to drought and flood events in the past. The Mann-Kendall (MK) trend analysis test discovered a significant increasing trend (p < 0.05) in annual rainfall (z = 0.40; s = 15.12) and temperature (z = 0.61; s = 0.04) during the historical period. Similarly, for both RCP 4.5 and RCP 8.5 scenarios, a significant increasing trend (p < 0.05) was found for rainfall (RCP 4.5: z = 0.15; s = 2.55; RCP 8.5: z = 0.41; s = 8.05;) and temperature (RCP 4.5: z = 0.84; s = 0.02; RCP 8.5: z = 0.94; s = 0.05). Under the RCP 4.5 scenario, the average temperature is projected to increase up to 1.6 °C in early century, 2.0 °C in the middle century and 2.4 °C in the late century. In contrast, under RCP 8.5 scenario, the average temperature is projected to increase up to 1.8 °C in the early century, 3.1 °C in the middle century and 4.3 °C in late century. Drought is projected to occur in 2038 and 2043 (early century); 2052 and 2069 (middle century); and 2095, 2097 to 2099 (late century) under RCP 4.5 scenario. As for RCP 8.5 scenario, drought is projected to occur in 2021, 2031 and 2034 (early century); and 2069 (middle century). No drought is projected to occur in the late century under the RCP 8.5 scenario. Thus, this information can be used for the analysis of the impact of climate change scenarios on rice growth and yield besides other crops found in MADA area. Additionally, this study, it would be helpful for researchers and decision-makers in developing applicable adaptation and mitigation strategies to reduce the impact of climate change.

Keywords: climate projection, drought, flood, rainfall, RCP 4.5, RCP 8.5, temperature

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Authors: A. G. Back

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Urban planning is a relevant tool to address, in a systemic way, several sectoral policies capable of linking the urban agenda with the reduction of socio-environmental risks. The Sao Paulo’s master plan (2014) presents innovations capable of promoting the transition to sustainability in the urban space, with a view to its regulatory instruments related to i) promotion of density in the axes of mass transport involving the mixture of commercial, residential, services, and leisure uses (principles related to the compact city); ii) vulnerabilities reduction based on housing policies including regular sources of funds for social housing and land reservation in urbanized areas; iii) reserve of green areas in the city to create parks and environmental regulations for new buildings focused on reducing the effects of heat island and improving urban drainage. However, its long-term implementation involves distributive conflicts and can undergo changes in different political, economic, and social contexts over time. Thus, the main objective of this paper is to identify and analyze the dynamics of conflicts of interest between social groups in the implementation of Sao Paulo’s urban development policy, particularly in relation to recent attempts at a (re) interpretation of the Master Plan guidelines, in view of the proposals for revision of the urban zoning law. In this sense, we seek to identify the demands, narratives of urban actors, including the real estate market, middle-class neighborhood associations ('not in my backyard' movements), and social housing rights movements. And we seek to analyze the power resources that these actors mobilize to influence the decision-making process, involving five categories: social capital, political access; discursive resource; media, juridical resource. The major findings of this research suggest that the interests and demands of the real estate market do not always prevail in urban regulation. After all, other actors also press for the definition of urban law with interests opposite to those of the real estate market. This is the case of associations of middle-class neighborhoods, which work to protect the characteristics of the locality, acting, in general, to prevent constructive and population densification in neighborhoods well located near the center, in São Paulo. One of the main demands of these “not in my backyard” movements is the delimitation of exclusively residential areas in the central region of the city, which is not only contrary to the interests of the real state market but also contrary to the principles of the compact city. On the other hand, social housing rights movements have also made progress in delimiting special areas of social interest in well-located and valued areas in the city dedicated to building social housing, also contrary to the interests of the real estate market. An urban development that follows the principles of the compact city must take into account the insertion of low-income populations in well-located regions; otherwise, such a development model may continue to push the less favored to the peripheries towards the preservation areas and/or risk areas.

Keywords: interest groups, Sao Paulo, sustainable urban development, urban policies implementation

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Authors: Sathvika Reddy, Devi Revathi

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Background: In India, deliberate self-harm (DSH) with poisoning agents carries a significant impact on morbidity and mortality. Changes in the patterns of poisoning vary across various geographical locations. It is important to know the patterns in a given region in order to facilitate rapid clinical diagnosis, appropriate treatment to reduce associated morbidity and mortality. Aim and Objective: To study the patterns, treatment outcomes of acute poisoning in patients admitted to emergency wards in a tertiary care hospital and to provide poison information services. Materials and Methods: This study was conducted at M.S Ramaiah Memorial and Teaching Hospital from November 2016 to March 2017. The patient’s data was obtained from patient case sheet, interaction with health care professionals, interviewing patients and their caretakers (if possible), and were documented in a suitably designed form. Results: The study involved 131 patients with a mean age of 27.76 ± 15.5 years. Majority of the patients were in the age group 21-30 years, literates (n=53) dwelling in urban (n=113) areas belonging to upper middle class (n=50). Analgesics and antipyretics were commonly utilized in intentional drug overdosage (n=49). Envenomation constituted n=21(16.03%). Furthermore, a significant relationship was observed between marital status and self-poisoning (n=64) (P < 0.001) which commonly occurred through oral ingestion. The outcomes were correlated with the GCS and PSS system and n=85 recovered, n=17 were discharged against medical advice, and n=4 died, and n=4 were lost to follow up respectively. The poison information queries include drug overdose (n=29) and management related queries (n=22) provided majorly by residents (n=45) to update knowledge (n=11) and for better patient care (n=40). Conclusion: The trend in poisoning is dynamic. Medications were identified as the main cause of poisoning in urban areas of India. Educational programs with more emphasis on preventive measures are necessary to create awareness among the general public.

Keywords: poisoning, suicides, clinical pharmacist, envenomation, poison information services

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Authors: Peiyin Hung, Katy Kozhimannil, Michelle Casey, Ira Moscovice

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Background/Objective: The loss of obstetric services has been a pressing concern in urban and rural areas nationwide. This study aims to determine factors that contribute to the loss of obstetric care through closures of a hospital or obstetric unit. Methods: Data from 2002-2013 American Hospital Association annual surveys were used to identify hospitals providing obstetric services. We linked these data to Medicare Healthcare Cost Report Information for hospital financial indicators, the US Census Bureau’s American Community Survey for zip-code level characteristics, and Area Health Resource files for county- level clinician supply measures. A discrete-time multinomial logit model was used to determine contributing factors to obstetric unit or hospital closures. Results: Of 3,551 hospitals providing obstetrics services during 2002-2013, 82% kept units open, 12% stopped providing obstetrics services, and 6% closed down completely. State-level variations existed. Factors that significantly increased hospitals’ probability of obstetric unit closures included lower than 250 annual birth volume (adjusted marginal effects [95% confidence interval]=34.1% [28%, 40%]), closer proximity to another hospital with obstetric services (per 10 miles: -1.5% [-2.4, -0.5%]), being in a county with lower family physician supply (-7.8% [-15.0%, -0.6%), being in a zip code with higher percentage of non-white females (per 10%: 10.2% [2.1%, 18.3%]), and with lower income (per $1,000 income: -0.14% [-0.28%, -0.01%]). Conclusions: Over the past 12 years, loss of obstetric services has disproportionately affected areas served by low-volume urban and rural hospitals, non-white and low-income communities, and counties with fewer family physicians, signaling a need to address maternity care access in these communities.

Keywords: access to care, obstetric care, service line discontinuation, hospital, obstetric unit closures

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