Search results for: animals healthcare dealing with proper sanitation
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5402

Search results for: animals healthcare dealing with proper sanitation

4292 Multilingualism as an Impetus to Nigerian Religious and Political Crises: the Way Forward

Authors: Kehinde, Taye Adetutu

Abstract:

The fact that Nigeria as a nation is faced by myriads of problems associated with religious crises and political insecurity is no news, the spoken statement and actions of most political giant were the major cause of this unrest. The 'unlearnt' youth within the regions has encompassed the situation. This scenario is further compounded by multilingual nature of the country as it is estimated that there exists amount 400 indigenous languages in Nigeria. It is an indisputable fact that english language which has assumed the status of an official language in Nigeria, given its status has a language of power and captivity by a few with no privilege to attend school. However, educating people in their indigenous language; crises can be averted through the proper orientation and mass literacy campaign, especially for the timid illiterate one, so as to live in unity, peace, tranquillity, and harmony as indivisible nation. In investigating the problem in this study with an emphasis on three major Nigerian language (Yoruba, Igbo and Hausa), participants observations and survey questionnaire were administered to about one hundred and twenty (120) respondents who were randomly selected throughout the three major ethnic groups in Nigeria. Findings from this study reveals that teaching and learning of cognitive words and information are more effective in ones mother tongue and helps in stimulating new ideas and changes. This paper was able to explore and critically examine the current state of affairs in Nigeria and proffer possible solutions to the prevailing situations by identifying how indigenous languages and linguistics can be used to ameliorate the present political and religious crisis for Nigeria, thus providing a proper recommendation to achieve meaningful stability and coexistence within a nation.

Keywords: multilingualism, political crisis, religious, Nigeria

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4291 Knowledge about Dementia: Why Should Family Caregivers Know that Dementia is a Terminal Disease?

Authors: Elzbieta Sikorska-Simmons

Abstract:

Dementia is a progressive terminal disease. Despite this recognition, research shows that most family caregivers do not know it, and it is unclear how this knowledge affects the quality of patient care. The aim of this qualitative study of 20 family caregivers for patients with advanced dementia is to examine how the caregiver's knowledge about dementia affects the quality of patient care in the context of healthcare decision-making, advanced care planning, and access to adequate support systems. Knowledge about dementia implies family caregivers' understanding of dementia trajectories, common symptoms/complications, and alternative treatment options (e.g., comfort feeding versus tube feeding). Data were collected in semi-structured interviews with 20 family caregivers. The interviews were conducted in person by the author and designed to elicit rich descriptions of family caregivers' experiences with healthcare decision-making and the management of common symptoms/complications of end-stage dementia as patient healthcare proxies. The study findings suggest that caregivers who recognize that dementia is a terminal disease are less likely to opt for life-extending treatments during the advanced stages. They are also more likely to seek palliative/hospice care, and consequently, they are better able to avoid unnecessary hospitalizations or medical procedures. For example, those who know that dementia is a terminal disease tend to opt for "comfort feeding" rather than "tube feeding" in managing the swallowing difficulties that accompany advanced dementia. In the context of advance care planning, family caregivers who know that dementia is a terminal disease tend to have more meaningful advance directives (e.g., Power of Attorney and Do Not Resuscitate orders). They are better prepared to anticipate common problems and pursue treatments that foster the best quality of patient life and care. Greater knowledge about advanced dementia helps them make more informed decisions that focus on enhancing the quality of patient life rather than just survival. In addition, those who know that dementia is a terminal disease are more likely to establish adequate support systems to help them cope with the complex demands of caregiving. For example, they are more likely to seek dementia-oriented primary care programs that offer house visits or respite services. Based on the study findings, knowledge about dementia as a terminal disease is critical in the optimal management of patient care needs and the establishment of adequate support systems. More research is needed to better understand what caregivers need to know to better prepare them for the complex demands of dementia caregiving.

Keywords: dementia education, family caregiver, management of dementia, quality of care

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4290 Multi-dimensional Approach to Resilience and Support in Advanced School-based Mental Health Service Delivery (MARS-SMHSD) Framework Development for Low-Resource Areas

Authors: Wan You Ning

Abstract:

Addressing the rising prevalence of mental health issues among youths, the Multi-dimensional Approach to Resilience and Support in Advanced School-based Mental Health Service Delivery (MARS-ASMHSD) framework proposes the implementation of advanced mental health services in low-resource areas to further instil mental health resilience among students in a school-based setting. Recognizing the unsustainability of direct service delivery due to rapidly growing demands and costs, the MARS-ASMHSD framework endorses the deinstitutionalization of mental healthcare and explores a tiered, multi-dimensional approach in mental healthcare provision, establishing advanced school-based mental health service delivery. The framework is developed based on sustainable and credible evidence-based practices and modifications of existing mental health service deliveries in Asia, including Singapore, Thailand, Malaysia, Japan, and Taiwan. Dissemination of the framework model for implementation will enable a more progressive and advanced school-based mental health service delivery in low-resource areas. Through the evaluation of the mental health landscape and the role of stakeholders in the respective countries, the paper concludes with a multi-dimensional framework model for implementation in low-resource areas. A mixed-method independent research study is conducted to facilitate the framework's development.

Keywords: mental health, youths, school-based services, framework development

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4289 Animal Welfare through Stockmanship Competence and Its Relationship to Productivity and Economic Profitability: The Case of Backyard Goat Production in the Philippines

Authors: M. J. Alcedo, K. Ito, K. Maeda

Abstract:

A stockperson has a significant influence on the productivity and welfare of their animals. This influence may be good or bad depending on their stockmanship competence. In this study, stockmanship competence (SC) is defined as the capacity of the stockperson to ensure the welfare of their animals by providing their animal’s needs. The study was conducted to evaluate the stockmanship competence of backyard goat raisers and to examine its relationship to productivity and economic profitability. This was made possible by interviewing 101 backyard goat raisers who have undergone farmer livestock school on integrated goat management (FLS IGM) in Region I, Philippines on September 3-30, 2012 and March 4-17, 2013. Secondary data needed were gathered from the local government agencies involved. Data on stockmanship, goat productivity and farmer’s income before and after attending FLS-IGM were gathered through a semi-structured interview. Questions for stockamnship were based on the Philippine recommends on goat production, tips on goat raising and other scientific literature. Stockmanship competence index score (SCIS) was computed by summing the raw scores derived from each components of SC divided by the total number of components. Pearson correlation through SPSS was used to see the relationship between SC, productivity and income. Result showed that majority raised native and upgraded goats. The computed mean SCIS before and after undergoing FLS-IGM was 38.53% and 75.81%, respectively, an improvement of 49.17%. Both index scores resulted in significant differences in productivity and income. The median mature weight and mortality rate of goats before FLS-IGM, where SC was low, was 14 kg and 50% respectively. On the other hand, after stockmanship had improved, the median mature weight increased to 19 kgs and mortality rate decreased to 11.11%. Likewise, fewer goat diseases were observed by farmers as compared before. With regards to income, there was 127.34% difference on the median net income derived by farmers. Result implies that improved stockmanship competence can lead not only to increased productivity and income of backyard goat raisers but also welfare of the animal.

Keywords: stockmanship, backyard goat production, animal welfare, Philippines

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4288 Error Detection and Correction for Onboard Satellite Computers Using Hamming Code

Authors: Rafsan Al Mamun, Md. Motaharul Islam, Rabana Tajrin, Nabiha Noor, Shafinaz Qader

Abstract:

In an attempt to enrich the lives of billions of people by providing proper information, security and a way of communicating with others, the need for efficient and improved satellites is constantly growing. Thus, there is an increasing demand for better error detection and correction (EDAC) schemes, which are capable of protecting the data onboard the satellites. The paper is aimed towards detecting and correcting such errors using a special algorithm called the Hamming Code, which uses the concept of parity and parity bits to prevent single-bit errors onboard a satellite in Low Earth Orbit. This paper focuses on the study of Low Earth Orbit satellites and the process of generating the Hamming Code matrix to be used for EDAC using computer programs. The most effective version of Hamming Code generated was the Hamming (16, 11, 4) version using MATLAB, and the paper compares this particular scheme with other EDAC mechanisms, including other versions of Hamming Codes and Cyclic Redundancy Check (CRC), and the limitations of this scheme. This particular version of the Hamming Code guarantees single-bit error corrections as well as double-bit error detections. Furthermore, this version of Hamming Code has proved to be fast with a checking time of 5.669 nanoseconds, that has a relatively higher code rate and lower bit overhead compared to the other versions and can detect a greater percentage of errors per length of code than other EDAC schemes with similar capabilities. In conclusion, with the proper implementation of the system, it is quite possible to ensure a relatively uncorrupted satellite storage system.

Keywords: bit-flips, Hamming code, low earth orbit, parity bits, satellite, single error upset

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4287 Rubbish to Rupees: The Story of Bishanpur Tzeco Panchayat, Bhagalpur District, State- Bihar, India

Authors: Arvind Kumar

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Bishanpur Tzecho Panchayat presents exemplary evidence of community efforts backed by convergent action by the district water and sanitation mission in management of solid waste enhancing prosperity in the area and improvement in the quality of life. BishanpurTzeco Panchayat faced a major problem of waste management with garbage, cow dung piling up in public places leading to protests by residents. To address this problem, in collaboration with the Agriculture University and support of district administration, PHED ( Public Health & Engineering Department) and the district and block coordinators of SBM ( Swachh Bharat Mission), communities decided to go for vermicomposting to get rid of the menace of cow dung and other solid home and farm waste. Today, Bishanpur is largely garbage free, as the people realize the value of waste and how can it contribute to their well-being and prosperity. The people of the Panchayat have demonstrated that waste is a resource. Bishanpur Tzecho is a panchayat of Goradih Block of Bhagalpur district, the silk city of Bihar, India.

Keywords: solid waste management in Bishanpur Tzeco Panchayat, Bhagalpur district, State- Bihar, India

Procedia PDF Downloads 400
4286 Using the Family Justice System to Respond to ISIS Returnees: The UK Experience

Authors: Fatima Ahdash

Abstract:

Over the last 6-7 years, the UK has resorted to using the family courts and the family justice system more generally as a way of dealing with children and young people either traveling to or returning from ISIS territories in the Middle East. This is an important innovation in counter-terrorism laws and practices in the UK: never before have the family courts been used for the purpose of preventing and countering terrorism anywhere in the world. This paper will examine this innovation; it will explore how, why, and the implications of the interaction between family law and counter-terrorism, particularly on the human rights of the parents and children involved. It will question whether the use of the family courts provides a more useful, and perhaps human rights compliant, method of tackling terrorism and extremism when compared to other more Draconian legal and administrative methods.

Keywords: counter-terrorism, family justice, law, human rights

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4285 Prospect for Peace: Criticism to Over-Focusing on Religion in Conflicts

Authors: Leyi Wang

Abstract:

The effect of religion on conflicts is usually over-focused. Religion is not the root cause of conflicts. There are always social, political or economic factors pushing the acceleration of conflicts. Meanwhile, the charisma of religion on calling for adherents is often utilized by political leaders as a tool of providing legitimacy to the initiating of violence and mobilizing the public during conflicts. What people identify from the connections between religion and conflicts is fake. There are some strategies used by politicians to upgrade the conflicts into violence. Consequently, there are some assumptions of which try to limit the religion’s effects on accelerating conflicts. This essay aims to discuss the roles of religion in international relations and argues that the religion difference is not the real source of conflicts in the globe, by reviewing the relevant literature for understanding the research background and gap of this topic. Also, this essay will suggest some implementations on dealing with the regional conflicts.

Keywords: religion, conflicts, criticism, international relations

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4284 Review of Concepts and Tools Applied to Assess Risks Associated with Food Imports

Authors: A. Falenski, A. Kaesbohrer, M. Filter

Abstract:

Introduction: Risk assessments can be performed in various ways and in different degrees of complexity. In order to assess risks associated with imported foods additional information needs to be taken into account compared to a risk assessment on regional products. The present review is an overview on currently available best practise approaches and data sources used for food import risk assessments (IRAs). Methods: A literature review has been performed. PubMed was searched for articles about food IRAs published in the years 2004 to 2014 (English and German texts only, search string “(English [la] OR German [la]) (2004:2014 [dp]) import [ti] risk”). Titles and abstracts were screened for import risks in the context of IRAs. The finally selected publications were analysed according to a predefined questionnaire extracting the following information: risk assessment guidelines followed, modelling methods used, data and software applied, existence of an analysis of uncertainty and variability. IRAs cited in these publications were also included in the analysis. Results: The PubMed search resulted in 49 publications, 17 of which contained information about import risks and risk assessments. Within these 19 cross references were identified to be of interest for the present study. These included original articles, reviews and guidelines. At least one of the guidelines of the World Organisation for Animal Health (OIE) and the Codex Alimentarius Commission were referenced in any of the IRAs, either for import of animals or for imports concerning foods, respectively. Interestingly, also a combination of both was used to assess the risk associated with the import of live animals serving as the source of food. Methods ranged from full quantitative IRAs using probabilistic models and dose-response models to qualitative IRA in which decision trees or severity tables were set up using parameter estimations based on expert opinions. Calculations were done using @Risk, R or Excel. Most heterogeneous was the type of data used, ranging from general information on imported goods (food, live animals) to pathogen prevalence in the country of origin. These data were either publicly available in databases or lists (e.g., OIE WAHID and Handystatus II, FAOSTAT, Eurostat, TRACES), accessible on a national level (e.g., herd information) or only open to a small group of people (flight passenger import data at national airport customs office). In the IRAs, an uncertainty analysis has been mentioned in some cases, but calculations have been performed only in a few cases. Conclusion: The current state-of-the-art in the assessment of risks of imported foods is characterized by a great heterogeneity in relation to general methodology and data used. Often information is gathered on a case-by-case basis and reformatted by hand in order to perform the IRA. This analysis therefore illustrates the need for a flexible, modular framework supporting the connection of existing data sources with data analysis and modelling tools. Such an infrastructure could pave the way to IRA workflows applicable ad-hoc, e.g. in case of a crisis situation.

Keywords: import risk assessment, review, tools, food import

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4283 Catastrophic Spending on Health: A Determinant of Access to Health Care by Migrant Slum Population

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

Abstract:

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

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

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4282 Visual, Zoological Metaphors and 'Urtiin Duu' (Long Song) in Alshaa, Inner Mongolia

Authors: Oyuna Weina

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This study examines how musicians use visual and zoological metaphors for singing technique and voice quality in a genre of traditional music called urtiin duu (‘long song’) in Alshaa, Inner Mongolia, China. Previous studies have discussed melodic contour in Mongol music, but little study of the intersection of singing technique, visual and zoological metaphors has yet been undertaken. The purpose of this study is to address this lack by analysing urtiin duu itself, traditional pedagogy and performances, all of which have been inspired and are assessed by reference to nature and mobile pastoral herding practices. This study investigates the visual and zoological metaphors related to urtiin duu especially colour, the shape of the circle and animals in the Mongol community. Urtiin duu singing is associated with certain colours in song texts, in selection of repertoire and in the status of singers. Musicians also use colour to describe timbre. These colours in turn reference worship of nature, religions, and daily practices of most Mongols in Alshaa. Moreover, voice quality and singing technique are often related to the animals not only in song text but also in the approach to breathing and to melodic contour. Additionally, the concept of boronhoi (‘the shape of circle’), not only is applied to the melodic contour but also to the voice quality and singing technique. These three factors illustrate the connections among nature, spiritual world and everyday herding life of Mongols. These different connections provide evidence of multi-layered meanings. In contemporary Alshaa, urtiin duu singers received Western musical training from the city and returned to their homelands to perform urtiin duu. In doing so, they are also trying to reconnect with the history, nature and spiritual world in order to achieve their ideal sound. Within a multicultural society, singers negotiate amongst themselves, and with ethnic groups, audiences and government officials. The power of the metaphor therefore assists and reconnects the strength of regional identity and ethnic identity in Alshaa.

Keywords: Alshaa, urtiin duu, visual, zoological metaphors

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4281 Trends in Solving Assembly Job Shop Scheduling Problem: A Review

Authors: Midhun Paul, T. Radha Ramanan

Abstract:

The objective of this work is to present a state-of-the-art literature review highlighting the challenges in the research of the scheduling of assembly job shop problem and providing an insight on how the future directions of the research would be. The number of work has been substantial that it requires a review to enable one to understand the origin of the research and how it is getting evolved. This review paper presents a comprehensive review of the literature dealing with various studies carried on assembly job shop scheduling. The review details the evolution of the AJS from the perspective of other scheduling problems and also presents a classification scheme. The work also identifies the potential directions for future research, which we believe to be worthwhile considering.

Keywords: assembly job shop, future directions, manufacturing, scheduling

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4280 Investigating Willingness to Pay for Water Services in a Newly Established Municipality in Malamulele, Vhembe District Municipality, South Africa

Authors: D. T. Chabalala

Abstract:

Currently South Africa is facing a triple challenge of poverty, unemployment and inequality. As such, communities have limited access to basic municipal services such as water, sanitation and electricity. Citizens such as those residing at Malamulele Township will be responsible to pay for the cost of water services that they consume instead of having the costs subsidised by the newly formed Municipality. The question on whether Malamulele residents would be willing to pay for water services provided for them need to be investigated. This study was conducted in Malamulele Township and surrounding villages. The article is based on a survey of 500 randomly selected households from township and villages surrounding Malamulele. The study uses the contingent valuation method to determine households’ willingness to pay for water services as well as the consequences they possibly will encounter in case their response is negative. The obtained results can be used by the Municipality and other Government Departments in order to better identify the affordable rates and the quantity of water service to be provided. Thus, it will make Municipality water supply services stable and sustainable. It will also be used as a tool to provide inform decisions about a range of infrastructure to enhance water supply systems.

Keywords: willingness to pay, contingent valuation method, water supply systems, Malamulele

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4279 The Survey of Sea Cucumber Fisheries in QESHM Island Coasts: Persian Gulf

Authors: Majid Afkhami, Maryam Ehsanpour, Rastin Afkhami

Abstract:

Sea cucumbers are aquatic animals with a wide variety useful for human health. Sea cucumbers are from the aquatic creatures that have many important and useful properties known for human health. Increasing demand for beche-de-mer along with steady price increases have led to worldwide intensification of sea cucumber harvesting. The rearing of sea cucumber with shrimp controls the environmental pollution results from extra enriched nutritious built on the pond bottom. These animals eat detritus and with devouring of organic materials on the surface, not only do they make the environment clean, but also they cause the fast growth of shrimp and themselves. Holothuria scabra is a main species for producing of Beche-de-mer and more exploited in tropical region of the world. The wall of body is used in the process of beche-de-mer production that forms the 56% of the whole body. Holothuria scabra (sandfish) is an aspidochirote holothurian widely distributed in coastal regions throughout the Indo-Pacific region. H. scabra is often found on inner reef flats and near estuaries, half buried in the silt sand during the day and emerging at night to feed. In this study upon to information from local fishermen's in Qeshm island, we Providing some data about fishing methods, processing and distribution in the Qeshm island coastline. Comparative study of fishing status with another part of the world determined that the status of sea cucumber stocks in Qeshm Island is suitable. For preventing of over exploited of sandy sea cucumber capture prohibition should be continue. In this study, 7 explotide sites are recognized, the target size for fishermen's was more than 20 cm and sandy cucumber was the target species in Qeshm Island. In this area the fishing operation was only done by scuba diving and has been done only by men's. Although in another countries women's have an important role in sea cucumber fishing operation. In the coast around Qeshm island it is found in Hmoon, Tolla, kovei, Ramchah, Messen, and Hengam. The maximum length and weight was recorded 35 cm and 1080 gr, respectively.

Keywords: sea cucumber, Holothuria scabra, fishing status, Qeshm Island

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4278 The Impact of Open Defecation on Fecal-Oral Infections: A Case Study in Burat and Ngaremara Wards of Isiolo County, Kenya

Authors: Kimutai Joan Jepkorir, Moturi Wilkister Nyaora

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The practice of open defecation can be devastating for human health as well as the environment, and this practice persistence could be due to ingrained habits that individuals continue to engage in despite having a better alternative. Safe disposal of human excreta is essential for public health protection. This study sought to find if open defecation relates to fecal-oral infections in Burat and Ngaremara Wards in Isiolo County. This was achieved through conducting a cross-sectional study. Simple random sampling technique was used to select 385 households that were used in the study. Data collection was done by use of questionnaires and observation checklists. The result show that 66% of the respondents disposed-off fecal matter in a safe manner, whereas 34% disposed-off fecal matter in unsafe manner through open defecation. The prevalence proportions per 1000 of diarrhea and intestinal worms among children under-5 years of age were 142 and 21, respectively. The prevalence proportions per 1000 of diarrhea and typhoid among children over-5 years of age were 20 and 20, respectively.

Keywords: faecal-oral infections, open defecation, prevalence proportion, sanitation

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4277 Assessment of the Contribution of Geographic Information System Technology in Non Revenue Water: Case Study Dar Es Salaam Water and Sewerage Authority Kawe - Mzimuni Street

Authors: Victor Pesco Kassa

Abstract:

This research deals with the assessment of the contribution of GIS Technology in NRW. This research was conducted at Dar, Kawe Mzimuni Street. The data collection was obtained from existing source which is DAWASA HQ. The interpretation of the data was processed by using ArcGIS software. The data collected from the existing source reveals a good coverage of DAWASA’s water network at Mzimuni Street. Most of residents are connected to the DAWASA’s customer service. Also the collected data revealed that by using GIS DAWASA’s customer Geodatabase has been improved. Through GIS we can prepare customer location map purposely for site surveying also this map will be able to show different type of customer that are connected to DAWASA’s water service. This is a perfect contribution of the GIS Technology to address and manage the problem of NRW in DAWASA. Finally, the study recommends that the same study should be conducted in other DAWASA’s zones such as Temeke, Boko and Bagamoyo not only at Kawe Mzimuni Street. Through this study it is observed that ArcGIS software can offer powerful tools for managing and processing information geographically and in water and sanitation authorities such as DAWASA.

Keywords: DAWASA, NRW, Esri, EURA, ArcGIS

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4276 Sex Education for Children with Special Needs

Authors: Nefrijanti Sutikno

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This paper highlights puberty and sexuality on children with special needs (SNC) in which they are very vulnerable to child sexual abuse (CSA). By providing sufficient knowledge and skill to teachers, they can synergise with parents to better anticipate, prevent and reduce the possibility of CSA and when it has already happened, together they are able to provide proper support and assistance to the victims of CSA.

Keywords: Special Needs Children (SNC), puberty, sexuality, child sexual abuse (CSA), prevention of CSA, anticipation of CSA

Procedia PDF Downloads 277
4275 A Systematic Review on the Effect of Climate Change on Rice Farming in Nepal

Authors: Tulsi Ram Bhusal

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Global climate change is known to have a huge impact on agriculture due to changing in rainfall pattern and elevated air temperature that lead to drought and/or flooding. This systematic study has focused on agriculture in Nepal. The study has shown that the trend of current climatic change is affecting rice production, while the farmers with technological access have tried to adapt to the changing conditions at their level. There is insufficient intervention from the government side in terms of policies and schemes. The lack of sufficient funds is one of the significant reasons in terms of governance. The climatic trends and the way it is affecting the annual riceyieldinNepal has been discussed in this study thoroughly. This study has reviewed published studies and ferred important points regarding the Nepal’s status on rice production. Mainly due to the increasing graph of average temperature and other physical conditions needed for the proper cultivation of ricearechanging due to which there is significant dropofannual rice production. Although from corners of the country, many farmers have attempted to adapt the methods of cultivation to the changing climatic conditions, lack of access to technologies, and fund allocation from the governmental level, it is difficult for the mtobringchanges in rice production by the crown without any institutional help. This systematic study effectively presents the magnitude of the impact on rice cultivation due to climatic changes inrecenttimesinNepal. This review aims to bring the current scenarioofNepal’sricefarming, and it impacts due to changing climate, which can subsequently contribute in devising plans for proper governance, formulating policies, and allocation of funds for the betterment.

Keywords: rice, climate change, rice production, nepal, agriculture

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4274 Breaking the Barriers: Exploring the Barriers to LGBTQ+ Accessing Palliative Care and the Hospice

Authors: Emma Worley, Mhairi De Sainte Croix, Savneet Lochab, Christopher Roberts, Mark Stroud, Mo Salehan, Kevin Jones

Abstract:

Awareness about the importance of teaching about diversity at medical school is growing. In the realm of diversity includes discussion around the LGBTQ+ community. At Bristol, diversity is taught in first or second year. However, echoing and expanding that teaching throughout the curriculum is needed. This feeds into the spiral curriculum but also highlights the relevance of the topic. It is well known that some people in the LGBTQ+ community struggle the access healthcare due to previous negative experiences. In 2019, 1 in 7 LGBTQ+ people avoided seeking medical care due to fears about discrimination. If people have fears about seeking medical help, then seeking help from Palliative care when they are at their most vulnerable situation can be even harder. To improve positive healthcare situations for people who identify as LGBTQ+ needs to start with talking. Along with some of our CTAs (clinical teaching assistants) we created a teaching session to explore the barriers faced by LGBTQ+ and incorporated communication stations into this. Our plan is to run this session as a three-hour session first discussing different topics: ethnical diversity, ‘coming out’, LGBTQ+ in the older generation, transgender. This will be followed by looking more closely at the barriers to accessing the hospice. The next part of the session will encompass two or three communication scenarios hopefully prompting further discussion and reflection on ways to improve our communication. The first scenario outline is a gay man/lesbian woman with lung cancer discussing options around the hospice. The second scenario is a transgender person with female genitalia who now has cervical cancer (as was not followed up on pap smears after the change of name). The third scenario is a HIV homosexual male patient who has been admitted with dementia. He has a partner but is not married. His next of kin is down as his parents but his parents do not know about his sexuality and HIV status. It allows discussion around confidentiality as well as broaching the meaning of ‘family’ in the LGBTQ+ community. We have chosen to pitch this teaching session to Bristol Year 4 students. They will be currently doing their 6-week Palliative care block, which fits in well. Each session will have four students attend. We have been lucky enough to have two CTAs (clinical teaching assistants) who identify as LGBTQ+ offer their experiences and help. They have been able to help us with the preparation and delivery of the session. Given anecdotal evidence and stories helps to highlight the importance and relevance of this session. The aim is to increase awareness of some factors that may contribute to people who identify as LGBTQ+ having a negative healthcare experience. By starting to talk about it allows awareness and only then will we be able to start to change and improve. Our aim, if the sessions run well, is to expand these sessions to different academy hospitals. Therefore, all Bristol 4th year students would have the opportunity to take part in the teaching session. We would like to expand our portfolio of case scenarios, to address so tricker topics such as a transgender person with dementia who reverts back to a different gender. We would also like to recruit a diverse range of actors, ideally people who identify as the patient in the scenario does. For example, a transgender person acts the transgender scenario. This would give authenticity and enhance the student’s learning experience.

Keywords: communication skills, healthcare barriers, LGBTQ+, palliative care

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4273 Adopting the Community Health Workers Master List Registry for Community Health Workforce in Kenya

Authors: Gikunda Aloise, Mjema Saida, Barasa Herbert, Wanyungu John, Kimani Maureen

Abstract:

Background: Community Health Workforce (CHW) is health care providers at the community level (Level 1) and serves as a bridge between the community and the formal healthcare system. This human resource has enormous potential to extend healthcare services and ensures that the vulnerable, marginalized, and hard-to-reach populations have access to quality healthcare services at the community and primary health facility levels. However, these cadres are neither recognized, remunerated, nor in most instances, registered in a master list. Management and supervision of CHWs is not easy if their individual demographics, training capacity and incentives is not well documented through a centralized registry. Description: In February 2022, Amref supported the Kenya Ministry of Health in developing a community health workforce database called Community Health Workers Master List Registry (CHWML), which is hosted in Kenya Health Information System (KHIS) tracker. CHW registration exercise was through a sensitization meeting conducted by the County Community Health Focal Person for the Sub-County Community Health Focal Person and Community Health Assistants who uploaded information on individual demographics, training undertaken and incentives received by CHVs. Care was taken to ensure compliance with Kenyan laws on the availability and use of personal data as prescribed by the Data Protection Act, 2019 (DPA). Results and lessons learnt: By June 2022, 80,825 CHWs had been registered in the system; 78,174 (96%) CHVs and 2,636 (4%) CHAs. 25,235 (31%) are male, 55,505 (68%) are female & 85 (1%) are transgender. 39,979. (49%) had secondary education and 2500 (3%) had no formal education. Only 27 641 (34%) received a monthly stipend. 68,436 CHVs (85%) had undergone basic training. However, there is a need to validate the data to align with the current situation in the counties. Conclusions/Next steps: The use of CHWML will unlock opportunities for building more resilient and sustainable health systems and inform financial planning, resource allocation, capacity development, and quality service delivery. The MOH will update the CHWML guidelines in adherence to the data protection act which will inform standard procedures for maintaining, updating the registry and integrate Community Health Workforce registry with the HRH system.

Keywords: community health registry, community health volunteers (CHVs), community health workers masters list (CHWML), data protection act

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4272 Effects of Potassium Sorbate on Some Sexual Maturation Parameters in Immature Female Wistar Rats

Authors: Elisabeth Louise Ndjengue Mindang, Charline Florence Awounfack, Derek Tantoh Ndinteh, Rui W. M. Krause, Dieudonne Njamen

Abstract:

The evolution of human fertility over the last 50 years has shown considerable problems due to a growing number of couples that find it difficult to procreate without medical assistance. In Africa, this inability to conceive affect 30 to 40% of couples. A number of contaminants in the environment are thought to contribute significantly to the observed infertility epidemic. Methods: On this basis, the impact of 40-days unique oral administration (between 9 and 10 am) of potassium sorbate (at of 12.5, 45, and 78 mg/kg BW doses) was evaluated on sexual maturation and hematologic parameters on immature Wistar rats (21-22 days of age). At the end of the treatment, animals were sacrificed. Vaginal opening was evaluated before the sacrifice. After the sacrifice, relative weight of reproductive organs, pituitary gonadotrophin level (LH and FSH), and sexuals steroids (estrogen and progesterone), cholesterol level in ovaries, folliculogenesis, and some hematological parameters were evaluated. Results: Compared to the control group, no significant variation was observed in the body weight of the animals treated with patassium sorbate. On the other hand, potassium sorbate, a significantly lower percentage (25%) of vaginal-opening in these rats, was observed from day 46 of age (p <0.01); likewise, a significant decrease was observed on the relative weight of the ovaries (p <0.01), number of primary follicles (p <0.01), and a significant increase of follicle number (p <0.001) at 78 mg/kg BW have been obseved. Potassium sorbate always decreased the number of white blood cells (p <0.05). Taken together, these results confirm the disturbing effects on the endocrine system, causing a decrease in fertility by increasing the number of follicles in atresia. A deleterious effect on the immune system was also observed. Overall, these results validate at least in part the global observations on the growing decline in fertility in populationsfeeding increasingly on industrial processed foods.

Keywords: potassium sorbate, early puberty, folliculogenesis, endocrine disruptor, immatur wistar rat

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4271 Epidemiology of Healthcare-Associated Infections among Hematology/Oncology Patients: Results of a Prospective Incidence Survey in a Tunisian University Hospital

Authors: Ezzi Olfa, Bouafia Nabiha, Ammar Asma, Ben Cheikh Asma, Mahjoub Mohamed, Bannour Wadiaa, Achour Bechir, Khelif Abderrahim, Njah Mansour

Abstract:

Background: In hematology/oncology, health care improvement has allowed increasingly aggressive management in diagnostic and therapeutic procedures. Nevertheless, these intensified procedures have been associated with higher risk of healthcare associated infections (HAIs). We undertook this study to estimate the burden of HAIs in the cancer patients in an onco -hematology unit in a Tunisian university hospital. Materials/Methods: A prospective, observational study, based on active surveillance for a period of 06 months from Mars through September 2016, was undertaken in the department of onco-hematology in a university hospital in Tunisia. Patients, who stayed in the unit for ≥ 48 h, were followed until hospital discharge. The Centers for Disease Control and Prevention criteria (CDC) for site-specific infections were used as standard definitions for HAIs. Results: One hundred fifty patients were included in the study. The gender distribution was 33.3% for girls and 66.6% boys. They have a mean age of 23.12 years (SD = 18.36 years). The main patient’s diagnosis is: Acute Lymphoblastic Leukemia (ALL): 48.7 %( n=73). The mean length of stay was 21 days +/- 18 days. Almost 8% of patients had an implantable port (n= 12), 34.9 % (n=52) had a lumber puncture and 42.7 % (n= 64) had a medullary puncture. Chemotherapy was instituted in 88% of patients (n=132). Eighty (53.3%) patients had neutropenia at admission. The incidence rate of HAIs was 32.66 % per patient; the incidence density was 15.73 per 1000 patient-days in the unit. Mortality rate was 9.3% (n= 14), and 50% of cases of death were caused by HAIs. The most frequent episodes of infection were: infection of skin and superficial mucosa (5.3%), pulmonary aspergillosis (4.6%), Healthcare associated pneumonia (HAP) (4%), Central venous catheter associated infection (4%), digestive infection (5%), and primary bloodstream infection (2.6%). Finally, fever of unknown origin (FUO) incidence rate was 14%. In case of skin and superficial infection (n= 8), 4 episodes were documented, and organisms implicated were Escherichia.coli, Geotricum capitatum and Proteus mirabilis. For pulmonary aspergillosis, 6 cases were diagnosed clinically and radiologically, and one was proved by positive aspergillus antigen in bronchial aspiration. Only one patient died due this infection. In HAP (6 cases), four episodes were diagnosed clinically and radiologically. No bacterial etiology was established in these cases. Two patients died due to HAP. For primary bloodstream infection (4 cases), implicated germs were Enterobacter cloacae, Geotricum capitatum, klebsiella pneumoniae, and Streptococcus pneumoniae. Conclusion: This type of prospective study is an indispensable tool for internal quality control. It is necessary to evaluate preventive measures and design control guides and strategies aimed to reduce the HAI’s rate and the morbidity and mortality associated with infection in a hematology/oncology unit.

Keywords: cohort prospective studies, healthcare associated infections, hematology oncology department, incidence

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4270 Protective Effect of N-Acetyl Cysteine and Alpha Lipoic Acid on Rats Chronically Exposed to Cadmium Chloride

Authors: S. El Ballal, H. El Sabbagh, M. Abd El Gaber, A. Eisa, A. Al Gamal

Abstract:

Cadmium is one of the most harmful heavy metals able to induce severe injury. In this study, sixty four male Sprague Dawley rats weighing (70-80 gm) were used. Rats were divided into 4 groups each group of 16 rats. Group A: served as control and received commercial ration and distilled water Group B: cadmium chloride was administered orally in water at dose of 300 ppm cadmium (560 mg/L as CdCl2). Group C: Animals received cadmium in drinking water in addition to administration of N-acetylcysteine (NAC) orally at a dose of 150 mg/kg body weight, equivalent to 1500 ppm in food. Group D: Animals received cadmium in drinking water in addition to administration of alpha lipoic acid (ALA) orally at a dose of 150 mg/kg body weight, equivalent to 1500 ppm in food. The experiment was continued for 2 months. Collection of blood and tissue samples was performed at 2, 4, 6, 8 weeks. Blood sample were collected for serum biochemical analysis including malondialdehyde (MDA), total antioxidants, aspartate aminotransferase (AST), alanine aminotransferase (ALT), total protein, albumin, urea and uric acid. Tissue specimens were collected for histopathological examination including liver, kidney, brain and testis. Histopathological examination revealed that cadmium choloride induces pathological alterations which increased in severity with time. The use of NAC and ALA can ameliorate toxic effect of CdCl2. The results showed significant decrease MDA and significant increase total antioxidants in group C and D compared to group B, Liver enzymes include AST and ALT showed significant decrease. Regarding to results of total protein and albumin, they revealed significant increase. Urea and uric acid showed significant decrease. From our study we conclude that NAC and ALA have protective effect against cadmium toxicity.

Keywords: ALA, cadmium, histopathology, NAC

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4269 Concept, Modules and Objectives of the Syllabus Course: Small Power Plants and Renewable Energy Sources

Authors: Rade M. Ciric, Nikola L. J. Rajakovic

Abstract:

This paper presents a curriculum of the subject small power plants and renewable energy sources, dealing with the concept of distributed generation, renewable energy sources, hydropower, wind farms, geothermal power plants, cogeneration plants, biogas plants of agriculture and animal origin, solar power and fuel cells. The course is taught the manner of connecting small power plants to the grid, the impact of small generators on the distribution system, as well as economic, environmental and legal aspects of operation of distributed generators.

Keywords: distributed generation, renewable energy sources, energy policy, curriculum

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4268 Critical Success Factors Quality Requirement Change Management

Authors: Jamshed Ahmad, Abdul Wahid Khan, Javed Ali Khan

Abstract:

Managing software quality requirements change management is a difficult task in the field of software engineering. Avoiding incoming changes result in user dissatisfaction while accommodating to many requirement changes may delay product delivery. Poor requirements management is solely considered the primary cause of the software failure. It becomes more challenging in global software outsourcing. Addressing success factors in quality requirement change management is desired today due to the frequent change requests from the end-users. In this research study, success factors are recognized and scrutinized with the help of a systematic literature review (SLR). In total, 16 success factors were identified, which significantly impacted software quality requirement change management. The findings show that Proper Requirement Change Management, Rapid Delivery, Quality Software Product, Access to Market, Project Management, Skills and Methodologies, Low Cost/Effort Estimation, Clear Plan and Road Map, Agile Processes, Low Labor Cost, User Satisfaction, Communication/Close Coordination, Proper Scheduling and Time Constraints, Frequent Technological Changes, Robust Model, Geographical distribution/Cultural differences are the key factors that influence software quality requirement change. The recognized success factors and validated with the help of various research methods, i.e., case studies, interviews, surveys and experiments. These factors are then scrutinized in continents, database, company size and period of time. Based on these findings, requirement change will be implemented in a better way.

Keywords: global software development, requirement engineering, systematic literature review, success factors

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4267 An Integrated Solid Waste Management Strategy for Semi-Urban and Rural Areas of Pakistan

Authors: Z. Zaman Asam, M. Ajmal, R. Saeed, H. Miraj, M. Muhammad Ahtisham, B. Hameed, A. -Sattar Nizami

Abstract:

In Pakistan, environmental degradation and consequent human health deterioration has rapidly accelerated in the past decade due to solid waste mismanagement. As the situation worsens with time, establishment of proper waste management practices is urgently needed especially in semi urban and rural areas of Pakistan. This study uses a concept of Waste Bank, which involves a transfer station for collection of sorted waste fractions and its delivery to the targeted market such as recycling industries, biogas plants, composting facilities etc. The management efficiency and effectiveness of Waste Bank depend strongly on the proficient sorting and collection of solid waste fractions at household level. However, the social attitude towards such a solution in semi urban/rural areas of Pakistan demands certain prerequisites to make it workable. Considering these factors the objectives of this study are to: [A] Obtain reliable data about quantity and characteristics of generated waste to define feasibility of business and design factors, such as required storage area, retention time, transportation frequency of the system etc. [B] Analyze the effects of various social factors on waste generation to foresee future projections. [C] Quantify the improvement in waste sorting efficiency after awareness campaign. We selected Gujrat city of Central Punjab province of Pakistan as it is semi urban adjoined by rural areas. A total of 60 houses (20 from each of the three selected colonies), belonging to different social status were selected. Awareness sessions about waste segregation were given through brochures and individual lectures in each selected household. Sampling of waste, that households had attempted to sort, was then carried out in the three colored bags that were provided as part of the awareness campaign. Finally, refined waste sorting, weighing of various fractions and measurement of dry mass was performed in environmental laboratory using standard methods. It was calculated that sorting efficiency of waste improved from 0 to 52% as a result of the awareness campaign. The generation of waste (dry mass basis) on average from one household was 460 kg/year whereas per capita generation was 68 kg/year. Extrapolating these values for Gujrat Tehsil, the total waste generation per year is calculated to be 101921 tons dry mass (DM). Characteristics found in waste were (i) organic decomposable (29.2%, 29710 tons/year DM), (ii) recyclables (37.0%, 37726 tons/year DM) that included plastic, paper, metal and glass, and (iii) trash (33.8%, 34485 tons/year DM) that mainly comprised of polythene bags, medicine packaging, pampers and wrappers. Waste generation was more in colonies with comparatively higher income and better living standards. In future, data collection for all four seasons and improvements due to expansion of awareness campaign to educational institutes will be quantified. This waste management system can potentially fulfill vital sustainable development goals (e.g. clean water and sanitation), reduce the need to harvest fresh resources from the ecosystem, create business and job opportunities and consequently solve one of the most pressing environmental issues of the country.

Keywords: integrated solid waste management, waste segregation, waste bank, community development

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4266 TeleEmergency Medicine: Transforming Acute Care through Virtual Technology

Authors: Ashley L. Freeman, Jessica D. Watkins

Abstract:

TeleEmergency Medicine (TeleEM) is an innovative approach leveraging virtual technology to deliver specialized emergency medical care across diverse healthcare settings, including internal acute care and critical access hospitals, remote patient monitoring, and nurse triage escalation, in addition to external emergency departments, skilled nursing facilities, and community health centers. TeleEM represents a significant advancement in the delivery of emergency medical care, providing healthcare professionals the capability to deliver expertise that closely mirrors in-person emergency medicine, exceeding geographical boundaries. Through qualitative research, the extension of timely, high-quality care has proven to address the critical needs of patients in remote and underserved areas. TeleEM’s service design allows for the expansion of existing services and the establishment of new ones in diverse geographic locations. This ensures that healthcare institutions can readily scale and adapt services to evolving community requirements by leveraging on-demand (non-scheduled) telemedicine visits through the deployment of multiple video solutions. In terms of financial management, TeleEM currently employs billing suppression and subscription models to enhance accessibility for a wide range of healthcare facilities. Plans are in motion to transition to a billing system routing charges through a third-party vendor, further enhancing financial management flexibility. To address state licensure concerns, a patient location verification process has been integrated through legal counsel and compliance authorities' guidance. The TeleEM workflow is designed to terminate if the patient is not physically located within licensed regions at the time of the virtual connection, alleviating legal uncertainties. A distinctive and pivotal feature of TeleEM is the introduction of the TeleEmergency Medicine Care Team Assistant (TeleCTA) role. TeleCTAs collaborate closely with TeleEM Physicians, leading to enhanced service activation, streamlined coordination, and workflow and data efficiencies. In the last year, more than 800 TeleEM sessions have been conducted, of which 680 were initiated by internal acute care and critical access hospitals, as evidenced by quantitative research. Without this service, many of these cases would have necessitated patient transfers. Barriers to success were examined through thorough medical record review and data analysis, which identified inaccuracies in documentation leading to activation delays, limitations in billing capabilities, and data distortion, as well as the intricacies of managing varying workflows and device setups. TeleEM represents a transformative advancement in emergency medical care that nurtures collaboration and innovation. Not only has advanced the delivery of emergency medicine care virtual technology through focus group participation with key stakeholders, rigorous attention to legal and financial considerations, and the implementation of robust documentation tools and the TeleCTA role, but it’s also set the stage for overcoming geographic limitations. TeleEM assumes a notable position in the field of telemedicine by enhancing patient outcomes and expanding access to emergency medical care while mitigating licensure risks and ensuring compliant billing.

Keywords: emergency medicine, TeleEM, rural healthcare, telemedicine

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4265 Sensor Network Structural Integration for Shape Reconstruction of Morphing Trailing Edge

Authors: M. Ciminello, I. Dimino, S. Ameduri, A. Concilio

Abstract:

Improving aircraft's efficiency is one of the key elements of Aeronautics. Modern aircraft possess many advanced functions, such as good transportation capability, high Mach number, high flight altitude, and increasing rate of climb. However, no aircraft has a possibility to reach all of this optimized performance in a single airframe configuration. The aircraft aerodynamic efficiency varies considerably depending on the specific mission and on environmental conditions within which the aircraft must operate. Structures that morph their shape in response to their surroundings may at first seem like the stuff of science fiction, but take a look at nature and lots of examples of plants and animals that adapt to their environment would arise. In order to ensure both the controllable and the static robustness of such complex structural systems, a monitoring network is aimed at verifying the effectiveness of the given control commands together with the elastic response. In order to achieve this kind of information, the use of FBG sensors network is, in this project, proposed. The sensor network is able to measure morphing structures shape which may show large, global displacements due to non-standard architectures and materials adopted. Chord -wise variations may allow setting and chasing the best layout as a function of the particular and transforming reference state, always targeting best aerodynamic performance. The reason why an optical sensor solution has been selected is that while keeping a few of the contraindication of the classical systems (like cabling, continuous deployment, and so on), fibre optic sensors may lead to a dramatic reduction of the wires mass and weight thanks to an extreme multiplexing capability. Furthermore, the use of the ‘light’ as ‘information carrier’, permits dealing with nimbler, non-shielded wires, and avoids any kind of interference with the on-board instrumentation. The FBG-based transducers, herein presented, aim at monitoring the actual shape of adaptive trailing edge. Compared to conventional systems, these transducers allow more fail-safe measurements, by taking advantage of a supporting structure, hosting FBG, whose properties may be tailored depending on the architectural requirements and structural constraints, acting as strain modulator. The direct strain may, in fact, be difficult because of the large deformations occurring in morphing elements. A modulation transducer is then necessary to keep the measured strain inside the allowed range. In this application, chord-wise transducer device is a cantilevered beam sliding trough the spars and copying the camber line of the ATE ribs. FBG sensors array position are dimensioned and integrated along the path. A theoretical model describing the system behavior is implemented. To validate the design, experiments are then carried out with the purpose of estimating the functions between rib rotation and measured strain.

Keywords: fiber optic sensor, morphing structures, strain sensor, shape reconstruction

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4264 Association between Carbon Dioxide (CO2) Emission and Under-Five Mortality: Panel Data Evidence from 100 Countries

Authors: Mahadev Bhise, Nabanita Majumder

Abstract:

Recent studies have found association between air pollutants and mortality, particularly how concentration of air pollutant explains under-five mortality across the countries. Thus, the present study evaluates the relationship between Carbon dioxide (CO2) emission and under-five mortality, while controlling other well-being determinant of Under-five mortality in 100 countries using panel unbalanced cross sectional data. We have used PCSE and GMM model for the period 1990-2011 to meet our objectives. Our findings suggest that, the positive relationship between lagged periods of carbon dioxide and under-five mortality; the percentage of rural population with access of improved water is negatively associated with under-five mortality, while in case of urban population with access of improved water, is positively related to under-five mortality. Access of sanitation facility, food production index, GDP per capita, and concentration of urban population have significant negative impact on under-five mortality. Further, total fertility rate is significantly associated (positive) with under-five mortality which indicates relative change in fertility is related to relative change in under-five mortality.

Keywords: arbon dioxide (CO2), under-five mortality (0q5), gross domestic product (GDP), urban population, food production, panel corrected standard errors (PCSE), generalized method of moments (GMM)

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4263 Healthcare Social Entrepreneurship: A Positive Theory Applied to the Case of YOU Foundation in Nepal

Authors: Simone Rondelli, Damiano Rondelli, Bishesh Poudyal, Juan Jose Cabrera-Lazarini

Abstract:

One of the main obstacles for Social Entrepreneurship is to find a business model that is financially sustainable. In other words, the captured value generates enough cash flow to ensure business continuity and reinvestment for growth. Providing Health Services in poor countries for the uninsured population affected by a high-cost chronical disease is not the exception for this challenge. As a prime example, cancer has become a high impact on a global disease not only because of the high morbidity but also of the financial impact on both the patient family and health services in underdeveloped countries. Therefore, it is relevant to find a Social Entrepreneurship Model that provides affordable treatment for this disease while maintaining healthy finances not only for the patient but also for the organization providing the treatment. Using the methodology of Constructive Research, this paper applied a Positive Theory and four business models of Social Entrepreneurship to a case of a Private Foundation model whose mission is to address the challenge previously described. It was found that the Foundation analyzed, in this case, is organized as an Embedded Business Model and complies with the four propositions of the Positive Theory considered. It is recommended for this Private Foundation to explore implementing the Integrated Business Model to ensure more robust sustainability in the long term. It evolves as a scalable model that can attract investors interested in contributing to expanding this initiative globally.

Keywords: affordable treatment, global healthcare, social entrepreneurship theory, sustainable business model

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