Search results for: burden sharing

Authors: Ann Dashwood

Abstract:

Using Standard Australian English with confidence is a cultural expectation of parents of primary school aged children who want to engage effectively with their children’s teachers and school administration. That confidence in support of their children’s learning at school is seldom experienced by parents whose first language is not English. Sharing language with competence in an intercultural environment is the common denominator for meaningful communication and engagement to occur in a school community. Experience in relevant, interactive sessions is known to enhance engagement and participation. The purpose of this paper is to identify a pedagogy for parents otherwise isolated from daily use of functional Australian cultural language learned to engage effectively in their children’s learning at school. The outcomes measure parents’ intercultural engagement with classroom teachers and attention to the school’s administrative procedures using quantitative and qualitative methods. A principled communicative task-based language learning approach, combined with intercultural communication strategies provide the theoretical base for intensive English inquiry-based learning and engagement. The quantitative analysis examines data samples collected by classroom teachers and administrators and parents’ writing samples. Interviews and observations qualitatively inform the study. Currently, significant numbers of projects are active in community centers and schools to enhance English language knowledge of parents from Language Backgrounds Other Than English (LBOTE). The study is significant to explore the effects of an intensive English pedagogy with parents of varied English language backgrounds, by targeting inquiry-based language use for social interactions in the school and wider community, specific engagement and cultural interaction with teachers and school activities and procedures.

Keywords: engagement, intercultural communication, language teaching pedagogy, LBOTE, school community

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Authors: Paolo Magnata

Abstract:

The energy market in the Philippines remains to have one of the highest electricity rates in the region averaging at US$0.16/kWh (PHP6.89/kWh), excluding VAT, as opposed to the overall energy market average of US$0.13/kWh. The movement towards renewable energy, specifically solar energy, will pose as an expensive one with the country’s energy sector providing Feed-in-Tariff rates as high as US$0.17/kWh (PHP8.69/kWh) for solar energy power plants. Increasing the share of renewables at the current state of the energy regulatory background would yield a three-fold increase in residential electricity bills. The issue lies in the uniform charge that consumers bear regardless of where the electricity is sourced resulting in rates that only consider costs and not the consumers. But if they are given the option to choose where their electricity comes from, a number of consumers may potentially choose economically costlier sources of electricity due to higher levels of utility coupled with the willingness to pay of consuming environmentally-friendly sourced electricity. A contingent valuation survey was conducted to determine their willingness-to-pay for solar energy on a sample that was representative of Metro Manila to elicit their willingness-to-pay and a Single Bounded Dichotomous Choice and Double Bounded Dichotomous Choice analysis was used to estimate the amount they were willing to pay. The results showed that Metro Manila residents are willing to pay a premium on top of their current electricity bill amounting to US$5.71 (PHP268.42) – US$9.26 (PHP435.37) per month which is approximately 0.97% - 1.29% of their monthly household income. It was also discovered that besides higher income of households, a higher level of self-perceived knowledge on environmental awareness significantly affected the likelihood of a consumer to pay the premium. Shifting towards renewable energy is an expensive move not only for the government because of high capital investment but also to consumers; however, the Green Energy Option (a policy mechanism which gives consumers the option to decide where their electricity comes from) can potentially balance the shift of the economic burden by transitioning from a uniformly charged electricity rate to equitably charging consumers based on their willingness to pay for renewably sourced energy.

Keywords: contingent valuation, dichotomous choice, Philippines, solar energy

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Authors: Piotr Żabicki, Paweł Skutta

Abstract:

The project of a glider with an electric motor charged by solar power is an step toward the future of Polish gliding. Due to the popularity of the SZD-50-3 glider and its type of usage, the project was developed based on this model. By placing an auxiliary engine in the glider, the pilot is guaranteed a safe return to the airport. Since it is a training glider, and routes are mainly flown by student pilots and instructors, the guarantee of returning to the airport allows flights in more challenging thermal conditions, which contributes to better pilot training. In case of worsening weather, the pilot has a reliable return option, which prevents time loss due to field landings and saves money by avoiding delays in training. The glider uses the NOVA 15 LW engine, a solar installation, and technical modifications to reduce the glider's weight. This includes the Misztal spar solution, previously used in the PZL 19 aircraft. Additionally, the use of lighter coverings and materials that handle loads from pulling, straining, and sharing improves the aerodynamic performance of the glider, enhancing its overall efficiency. Every component added to the glider's construction (battery, engine, etc.) has been placed to avoid shifting loads along the axis, thus preventing unintended spins and flat spins. Safety concerns were also addressed. In the event of a battery or engine fire, the pilot's cabin is designed as a detachable part of the structure and is made of composites covered with non-flammable resin. The batteries are also enclosed in separate boxes located in the former "luggage" compartment. Access to the installation connecting the engine, panel, and battery is convenient due to the detachable cabin from the structure and the fact that the entire installation runs under the structure. The batteries also have easy access due to the current closed hatch. Cooling for the battery is provided this way.

Keywords: engineering, girder, glider, solar, spar

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Authors: Swati Srivastava, Ashish Kumar Upadhyay

Abstract:

Background: According to United Nation Children’s Fund, it has been estimated that worldwide about 165 million children were stunted in 2012 and India alone accounts for 38% of global burden of stunting. In terms of incidence, India is home of more than 60 million stunted children worldwide. Our study aims to examine the effect of pregnancy intention and maternal postnatal depressive symptoms on early childhood stunting in India. We hypothesized that effect of pregnancy intention and postnatal maternal depressive symptoms were mediated by social support. Methods: We used data from first wave of Young Lives Study India. Out of 2011 children recruited in original cohort, 1833 children had complete information on pregnancy intention, maternal depression and other variables. A series of multivariate logistic regression model were used to examine the effect of pregnancy intention and postnatal depressive symptoms on early childhood stunting. Results: Bivariate result indicates that a higher percent of children born after unintended pregnancy (40%) were stunted than children of intended pregnancy (26%). Likewise, proportion of stunted children was also higher among women of high postnatal depressive symptoms (35%) than low level of depression (24%). Results of multivariate logistic regression model indicate that children born after unintended pregnancy were significantly more likely to be stunted than children born after intended pregnancy (Coefficient: 1.70, CI: 1.17, 2.48). Likewise, early childhood stunting was also associated with maternal postnatal depressive symptoms among women (Coefficient: 1.48, CI: 1.16, 1.88). The effect of pregnancy intention and postnatal depressive symptoms on early childhood stunting remains unchanged after controlling for social support and other variables. Conclusions: The findings of this study provide conclusive evidence regarding consequences of pregnancy intention and postnatal depressive symptoms on early childhood stunting in India. Therefore, there is need to identify the women with unintended pregnancy and incorporate the promotion of mental health into their national reproductive and child health programme.

Keywords: pregnancy intention, postnatal depressive symptoms, social support, childhood stunting, young lives study, India

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Authors: Vanessa De Carvalho, Chad MacPherson, Julien Tremblay, Julie Champagne, Stephanie-Anne Girard

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Background: The interactions between bacteria and fungi in the human vaginal microbiome are fundamental to the concept of health and disease. The means by which the microbiota and mycobiota interact is still poorly understood and further studies are necessary to properly characterize this complex ecosystem. The aim of this study was to select a DNA extraction method capable of recovering high qualities of fungal and bacterial DNA from a single vaginal swab. Methods: 11 female volunteers ( ≥ 20 to < 55 years old) self-collected vaginal swabs in triplicates. Three commercial extraction kits: Masterpure Yeast Purification kit (Epicenter), PureLink™ Microbiome DNA Purification kit (Invitrogen), and Quick-DNA™ Fecal/Soil Microbe Miniprep kit (Zymo) were evaluated on the ability to recover fungal and bacterial DNA simultaneously. The extraction kits were compared on the basis of recovery, yield, purity, and the community richness of bacterial (16S rRNA - V3-V4 region) and fungal (ITS1) microbiota composition by Illumina MiSeq amplicon sequencing. Results: Recovery of bacterial DNA was achieved with all three kits while fungal DNA was only consistently recovered with Masterpure Yeast Purification kit (yield and purity). Overall, all kits displayed similar microbiota profiles for the top 20 OTUs; however, Quick-DNA™ Fecal/Soil Microbe Miniprep kit (Zymo) showed more species richness than the other two kits. Conclusion: In the present study, Masterpure Yeast purification kit proved to be a good candidate for purification of high quality fungal and bacterial DNA simultaneously. These findings have potential benefits that could be applied in future vaginal microbiome research. Whilst the use of a single extraction method would lessen the burden of multiple swab sampling, decrease laboratory workload and off-set costs associated with multiple DNA extractions, thoughtful consideration must be taken when selecting an extraction kit depending on the desired downstream application.

Keywords: bacterial vaginosis, DNA extraction, microbiota, mycobiota, vagina, vulvovaginal candidiasis, women’s health

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Authors: Maren J. Coffman, Victoria C. Scott, J. Claire Schuch, Ashley N. Kelley, Jeri L. Ryan

Abstract:

Postpartum Depression (PPD) is a leading cause of postpartum morbidity. PPD affects 7.1% of postpartum women and 19.2% of postpartum women when including minor depression. Lower-income women and ethnic minorities are more at risk for developing PPD and face multiple attitudinal and institutional barriers to receiving care. This study aims to identify PPD among low-income women and connect them to appropriate services in order to reduce the illness burden and enhance access to care. Screenings were conducted in two Women, Infants, and Children (WIC) clinics in the city of Charlotte, North Carolina, USA, from April 2017 to April 2018. WIC is a supplemental nutrition program that provides healthcare and nutrition to low-income pregnant women, breastfeeding women, and children under the age of 5. Additionally, a qualitative study was conducted to better understand the PPD continuum of care in order to identify opportunities for improvement. Mothers with infants were screened for depression risk using the PHQ-2. Mothers who scored ≥ 2 completed two additional standardized screening tools (PHQ-7, to complete the PHQ-9, and the Edinburgh) to assess depressive symptomatology. If indicated they may be suffering from depression, women were referred for case management services. Open-ended questions were used to understand treatment barriers. Four weeks after the initial survey, a follow-up telephone call was made to see if women had received care. Seven focus groups with WIC staff and managers, referral agency staff, local behavioral health professionals, and students examining the screenings, are being conducted March - April, 2018 to gather information related to current screening practices, referrals, follow up and treatment. Mothers (n = 231 as of February, 2018) were screened in English (65%) or Spanish (35%). According to preliminary results, 29% of mothers screened were at risk for postpartum depression (PHQ-2 ≥ 2). There were significant differences in preliminary screening results based on survey language (

Keywords: health disparities, maternal health, mental health, postpartum depression

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Authors: Najith Duminda Galmangoda Guruge, Nadeeka Rathnayake, Vinodani Wimalasena, Dinesha Wijesooriya

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Investing in Early Learning can improve children’ interests for education and makes them ready for school. Children in economically disadvantaged communities may have reduced readiness for schools. Health Promotion approach enables communities including disadvantaged to control over their health. Mothers of children under the age five in ‘Alapathwewa’ community (n=40) were selected as the sample with the aim to promote early learning of children to improve their school readiness. Mothers in ‘Morakeewa’ community (n=40) were the control. Interventions were for a period of 2 years and children of these mothers were followed up to school entry. Importance of early learning and possibility of providing quality learning environments for children at a low cost was discussed with mothers in an experimental setting by facilitators. Mothers were enabled to make age-appropriate baby rooms which provide learning opportunities. Collective community playhouses and play areas were developed by mothers to provide opportunities for children to interact and learn with each other. Mothers started discussing with each other and sharing experiences. The progress was monitored by mothers at regular intervals. Data regarding school competencies of children were obtained from school teachers. School teachers measured thirteen competencies of children on a scale of ‘very good, good, moderate and weak’. All children in the experimental group were in ‘very good’ level in two competencies, ‘communicate friendly with others’ and ‘express ideas well’. Children in the experimental group reported a significantly higher achievement of all thirteen competencies (p < .05) than children in control. Providing quality early learning environments for children even in economically disadvantaged settings makes them ready for schools. Through a Health Promotion approach, early learning experiences for children can be provided at a low cost.

Keywords: disadvantaged, early learning, economically, health promotion

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Authors: Herbert Ntuli, Edwin Muchapondwa

Abstract:

This study used a sample of 336 households and community level data from 30 communities around the Gonarezhou National Park in Zimbabwe to analyse the association between ability to self-organize or cooperation and institutions on one hand and the relationship between success of biodiversity outcomes and cooperation on the other hand. Using both the ordinary least squares and instrumental variables estimation with heteroskedasticity-based instruments, our results confirmed that sound institutions are indeed an important ingredient for cooperation in the respective communities and cooperation positively and significantly affects biodiversity outcomes. Group size, community level trust, the number of stakeholders and punishment were found to be important variables explaining cooperation. From a policy perspective, our results show that external enforcement of rules and regulations does not necessarily translate into sound ecological outcomes but better outcomes are attainable when punishment is rather endogenized by local communities. This seems to suggest that communities should rather be supported in such a way that robust institutions that are tailor made to suit the needs of local condition will emerge that will in turn facilitate good environmental husbandry. Cooperation, training, benefits, distance from the nearest urban canter, distance from the fence, social capital average age of household head, fence and information sharing were found to be very important variables explaining the success of biodiversity outcomes ceteris paribus. Government programmes should target capacity building in terms of institutional capacity and skills development in order to have a positive impact on biodiversity. Hence, the role of stakeholders (e.g., NGOs) in capacity building and government effort should complement each other to ensure that the necessary resources are mobilized and all communities receive the necessary training and resources.

Keywords: institutions, self-organize, common pool resources, wildlife, conservation, Zimbabwe

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Authors: Uraib Sharaha, Guy Beck, Joseph Kapelushnik, Adam H. Agbaria, Itshak Lapidot, Shaul Mordechai, Ahmad Salman, Mahmoud Huleihel

Abstract:

Infectious diseases cause a significant burden on the public health and the economic stability of societies all over the world for several centuries. A reliable detection of the causative agent of infection is not possible based on clinical features, since some of these infections have similar symptoms, including fever, sneezing, inflammation, vomiting, diarrhea, and fatigue. Moreover, physicians usually encounter difficulties in distinguishing between viral and bacterial infections based on symptoms. Therefore, there is an ongoing need for sensitive, specific, and rapid methods for identification of the etiology of the infection. This intricate issue perplex doctors and researchers since it has serious repercussions. In this study, we evaluated the potential of the mid-infrared spectroscopic method for rapid and reliable identification of bacterial and viral infections based on simple peripheral blood samples. Fourier transform infrared (FTIR) spectroscopy is considered a successful diagnostic method in the biological and medical fields. Many studies confirmed the great potential of the combination of FTIR spectroscopy and machine learning as a powerful diagnostic tool in medicine since it is a very sensitive method, which can detect and monitor the molecular and biochemical changes in biological samples. We believed that this method would play a major role in improving the health situation, raising the level of health in the community, and reducing the economic burdens in the health sector resulting from the indiscriminate use of antibiotics. We collected peripheral blood samples from young 364 patients, of which 93 were controls, 126 had bacterial infections, and 145 had viral infections, with ages lower than18 years old, limited to those who were diagnosed with fever-producing illness. Our preliminary results showed that it is possible to determine the infectious agent with high success rates of 82% for sensitivity and 80% for specificity, based on the WBC data.

Keywords: infectious diseases, (FTIR) spectroscopy, viral infections, bacterial infections.

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Authors: Godiya Pius Atsiya

Abstract:

One of the most devastating impacts of terrorism on the Nigerian state is the danger it has posed on women, children and other vulnerable groups. The complexity of terrorism in Nigeria, especially in most parts of Northern Nigeria has entrenched unprecedented security challenges such as refugee crisis, kidnapping, food shortages, increase in death tolls, malnutrition, fear, rape and several other psychological factors. Of particular interest in this paper as it relates to terrorism is the high rate of Internally Displaced Persons(IDPs), with women, children and the aged being the most affected. Empirical evidence arising from recent development in Nigeria’s North-East geo-political zone shows that large numbers of refugees fleeing the Boko Haram attacks have doubled. The attendant consequences of this mass exodus of people in the affected areas are that the victims now suffer untold and unwarranted economic hardship. In another dimension, recent findings have it that most powerless women and young teenage girls have been forcefully conscripted into the Islamic extremist groups and used as shields. In some respect, these groups of people have been used as available tools for suicide bombing and other criminal tendencies, the result of which can be detrimental to social cohesion and integration. This work is a theoretical insight into terrorism discourses; hence, the paper relies on existing works of scholars in carrying out the research. The paper argues that the implications of terrorism on women gender have grounding effects on the moral psyche of women who are supposed to be home managers and custodians of morality in society. The burden of terrorism and all it tends to propagate has literally upturned social lives and hence, Nigeria is gradually being plunged into the Hobesian state of nature. As a panacea to resolving this social malaise, the paper submits that government and indeed, all stakeholders in the nation’s democratic project must expedite action to nip this trend in the bud. The paper sums up with conclusion and other alternative policy measures to mitigate the challenges of terrorism in Nigeria.

Keywords: changing democratic state, policy measures, terrorism, women

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Authors: Susan Diamond

Abstract:

Machine Learning workloads have traditionally been run in high-performance computing (HPC) environments, where users log in to dedicated machines and utilize the attached GPUs to run training jobs on huge datasets. Training of large neural network models is very resource intensive, and even after exploiting parallelism and accelerators such as GPUs, a single training job can still take days. Consequently, the cost of hardware is a barrier to entry. Even when upfront cost is not a concern, the lead time to set up such an HPC environment takes months from acquiring hardware to set up the hardware with the right set of firmware, software installed and configured. Furthermore, scalability is hard to achieve in a rigid traditional lab environment. Therefore, it is slow to react to the dynamic change in the artificial intelligent industry. Watson Deep Learning as a service, a cloud-based deep learning platform that mitigates the long lead time and high upfront investment in hardware. It enables robust and scalable sharing of resources among the teams in an organization. It is designed for on-demand cloud environments. Providing a similar user experience in a multi-tenant cloud environment comes with its own unique challenges regarding fault tolerance, performance, and security. Watson Deep Learning as a service tackles these challenges and present a deep learning stack for the cloud environments in a secure, scalable and fault-tolerant manner. It supports a wide range of deep-learning frameworks such as Tensorflow, PyTorch, Caffe, Torch, Theano, and MXNet etc. These frameworks reduce the effort and skillset required to design, train, and use deep learning models. Deep Learning as a service is used at IBM by AI researchers in areas including machine translation, computer vision, and healthcare. 

Keywords: deep learning, machine learning, cognitive computing, model training

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Authors: Sonto Maputle

Abstract:

Background: Support during labour increase women's chances of having positive childbirth experiences as well as childbirth outcomes. The purpose of this study was to determine the support provided by midwives to women during labour at the public hospital in Limpopo Province. The study was conducted at the Tertiary hospital in Limpopo Province. Methods: A qualitative, participant observation approach was used. Population consisted of all women that were admitted to deliver their babies and the midwives who provided midwifery care in the obstetric unit of one tertiary public hospital in Limpopo Province. Non-probability, purposive and convenience sampling were used to sample 24 women and 12 midwives. Data were collected through participant observations which included unstructured conversations with the use of observational guide, field notes of events and conversations that occurred when women interact with midwives were recorded verbatim and a Visual Analog Scale to complement the observations. Data was analysed qualitatively but were presented in the tables and bar graphs. Results: Five themes emerged as support provided by midwives during labour, namely; communication between women and midwives, informational support, emotional support activities, interpretation of the experienced labour pain and supportive care activities during labour. Conclusion: The communication was occurring when the midwife was rendering midwifery care and very limited for empowering. The information sharing focused on the assistive actions rather than on the activities that would promote mothers’ participation. The emotional support activities indicated lack of respect and disregard cultural preferences and this contributed to inability to exercise choices in decision-making. The study recommended the implementation of Batho Pele principles in order to provide woman-centred care during labour.

Keywords: communication between women and midwives, labour pains, informational and emotional support, physical comforting measures

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Authors: Bilgen Özlük, Ülkü Baykal

Abstract:

The study was conducted with the aim of determining the evaluations of nurses directed at the restructuring process carried out in the nursing services of a private hospital, and reveal how they have been affected by this process, in an integrated manner between a prospective approach and methods of quantitative and qualitative research, and as a comparative study, comparing the changes over a period of three years. The sample for the study is comprised of all of the nurses employed at a private hospital, and data has been collected from 17 nurses (a total of 30 interviews) for the qualitative part 377 nurses in 2013 and 429 nurses in 2014 for the quantitative part. As vehicles of data collection, the study used a form directed at identifying the changes in the organisational and management structure of the hospital, a nurses' interview form, a questionnaire identifying the personal and occupational characteristics of the nurses, the "Minnesota Job Satisfaction Scale", the "Organisational Citizenship Behaviour Scale" and the "Organisational Trust Scale". Qualitative data by researchers, quantitative data was analysed using number and percentage tests, a t-test, and ANOVA, progressive analysis Tukey and regression tests. While in the qualitative part of the study the nurses stated in the first year of the restructuring that they were satisfied with their relationship with top level management, the increases in salaries and changes in the working environment such as the increase in the number of staff, in later years, they stated that there had been a fall in their satisfaction levels due to reasons such as nursing services instead of nurse practitioners in a position they are not satisfied that the director, nursing services outside the nursing profession appointment of persons to positions of management and the lack of appropriate training and competence of these persons, increases in the burden of work, insufficient salaries and the lack of a difference in the salaries of senior and more junior staff. On the other hand, in the quantitative part, it was found that there was no difference in the levels of job satisfaction and organisational trust in any of the two years, that as the level of organisational trust increased the level of job satisfaction also increased, and that as the levels of job satisfaction and organisational trust a positive impact on organisational citizenship behaviour also increased.

Keywords: services, nursing management, re-structuring, job satisfaction, organisational citizenship behaviour, organisational trust

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Authors: Natasha Yasmin Felles, Gerard Riley

Abstract:

Background and Aims: Relationship breakdown is typical when one partner lives with an acquired brain injury caused by issues like a stroke. Research has found that the perception of relationship satisfaction decreases following such an injury among non-injured partners. Non-injured partners also are found to experience caregiver stress/burden as they immediately have to take the role of a caregiver along with being a partner of the injured. Research has also found that the perception of a continuous relationship, i.e. the perception of the relationship to be essentially the same as it was before the injury, also changes among those caregiving partners. However, there is a lack of available intervention strategies that can help those partners with both individual and relationship difficulties. The aim of this case study was to conduct a pilot test of an intervention aimed to explore whether it is possible to support a partner to experience greater continuity within the relationship poststroke, and what benefits such a change might have. Method: A couple, where one partner experienced an acquired brain injury poststroke were provided with Integrated Behavioural Couples Therapy for 3-months. The intervention addressed goals identified as necessary by the couple and by the formulation of their individual and relationship difficulties, alongside the goal of promoting relationship continuity. Before and after measures were taken using a battery of six questionnaires to evaluate changes in perceptions of continuity, stress, and other aspects of the relationship. Results: Both quantitative and qualitative data showed that relationship continuity was improved after the therapy, as were the measures of stress and other aspects of the relationship. The stress felt by the person with the acquired brain injury also showed some evidence of improvement. Conclusion: The study found that perceptions of relationship continuity can be improved by therapy and that improving these might have a beneficial impact on the stress felt by the carer, their satisfaction with the relationship and overall levels of conflict and closeness within the relationship. The study suggested the value of further research on enhancing perceptions of continuity in the relationship after an acquired brain injury. Currently, the findings of the study have been used to develop a pilot feasibility study to collect substantive evidence on the impact of the intervention on the couples and assess its feasibility and acceptability, which will help in further developing a specific generalized relationship continuity intervention, that will be beneficial in preventing relationship breakdown in the future.

Keywords: acquired brain injury, couples therapy, relationship continuity, stroke

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Authors: Syed Afrozuddin Ahmed, Junaid Saghir Siddiqi, Sabah Quaiser

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Various studies have reported that global warming causes unstable climate and many serious impact to physical environment and public health. The increasing incidence of dengue incidence is now a priority health issue and become a health burden of Pakistan. In this study it has been investigated that spatial pattern of environment causes the emergence or increasing rate of dengue fever incidence that effects the population and its health. The climatic or environmental structure data and the Dengue Fever (DF) data was processed by coding, editing, tabulating, recoding, restructuring in terms of re-tabulating was carried out, and finally applying different statistical methods, techniques, and procedures for the evaluation. Five climatic variables which we have studied are precipitation (P), Maximum temperature (Mx), Minimum temperature (Mn), Humidity (H) and Wind speed (W) collected from 1980-2012. The dengue cases in Karachi from 2010 to 2012 are reported on weekly basis. Principal component analysis is applied to explore the climatic variables and/or the climatic (structure) which may influence in the increase or decrease in the number of dengue fever cases in Karachi. PC1 for all the period is General atmospheric condition. PC2 for dengue period is contrast between precipitation and wind speed. PC3 is the weighted difference between maximum temperature and wind speed. PC4 for dengue period contrast between maximum and wind speed. Negative binomial and Poisson regression model are used to correlate the dengue fever incidence to climatic variable and principal component score. Relative humidity is estimated to positively influence on the chances of dengue occurrence by 1.71% times. Maximum temperature positively influence on the chances dengue occurrence by 19.48% times. Minimum temperature affects positively on the chances of dengue occurrence by 11.51% times. Wind speed is effecting negatively on the weekly occurrence of dengue fever by 7.41% times.

Keywords: principal component analysis, dengue fever, negative binomial regression model, poisson regression model

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Authors: Yun-Tsuen Chen, Shih-Ting Huang, Pi-Fen Cheng, Heng-Hua Wang, Hui-Zhu Chen

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This paper discusses the experience of caring for a patient diagnosed with breast cancer and later received total mastectomy during a 2nd trimester pregnancy. She was hospitalized from January 31 to February 4, 2018. Using 'Gordon’s 11 Functional Health Patterns' through physical exams and interviews, the researcher assessed the patient’s physical and mental health and determined the patient to have anxiety, acute pain, and body image disturbance. After establishing a strong relationship with the patient, the researcher helped the patient express her anxiety and personal feelings. A multi-specialist team was formed to evaluate both the patient and her unborn child, before, during, and after surgery. This individualized care allowed the patient and her child to optimize the post-operative results. Aside from medication, the patient also received non-medicinal treatment, including improvement of sleep quality with body positioning, diaphragmatic breathing exercises for pain and stress relief after surgery. Throughout hospitalization, the patient’s physical and emotional needs were addressed daily with listening sessions and empathy. The patient’s husband was also incorporated in the patient’s recovery by teaching both he and the patient how to change the sterile wound dressing, which may have the added benefit of improving marital relationships through shared activities of nurturing. The patient was also given advice about how to improve self-confidence through clothing. Lastly, the patient was encouraged to join a support group for breast cancer patients. Through the sharing of experience in groups and within the family, the patient was helped to adapt to the change of her appearance and re-establish her self-confidence. This level of care expedited the patient’s return to her family life and role of being a mother.

Keywords: anxiety, body image disturbance, breast cancer during pregnancy, multi-specialist team

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Authors: Ahmed Sami Hammami, Mohamed Jellazi

Abstract:

Background: The aim of the study is to evaluate the magnitude of different psychological outcomes among Tunisian health care professionals (HCP) during the COVID-19 pandemic and to identify the associated factors. Methods: HCP completed a cross-sectional questionnaire from April 4th to April, 28th 2020. The survey collected demographic information, factors that may interfere with the psychological outcomes, behavior changes and mental health measurements. The latter was assessed through 3 scales; the 7-item questions Insomnia Severity Index, the 2-item Patient Health Questionnaire and the 2-item Generalized Anxiety Disorder. Multivariable logistic regression was conducted to identify factors associated with psychological outcomes. Results: A total of 503 HCP successfully completed the survey; among those, n=493 consented to enroll in the study, 411 [83.4%] were physicians, 323 [64.2%] were women and 271 [55%] had a second-line working position. A significant proportion of HCP had anxiety 35.7%, depression 35.1% and insomnia 23.7%. Females, those with psychiatric history and those using public transport exhibited the highest proportions for overall symptoms compared to other groups e.g., depression among females vs. males: 44,9% vs. 18,2%, P=0.00. Those with a previous medical history and nurses, had more anxiety and insomnia compared to other groups e.g. anxiety among nurses vs. interns/residents vs. attending 45,1% vs 36,1% vs 27,5%; p=0.04. Multivariable logistic regression showed that female gender was a risk factor for all psychological outcomes e.g. female sex increased the odds of anxiety by 2.86; 95% confidence interval [CI], 1, 78-4, 60; P=0.00, whereas having a psychiatric history was a risk factor for both anxiety and insomnia. (e.g. for insomnia OR=2,86; 95% [CI], 1,78-4,60; P=0.00), Having protective equipment was associated with lower risk for depression (OR=0,41; 95% CI, 0,27-0,62; P=0.00) and anxiety. Physical activity was also protective against depression and anxiety (OR=0,41, 95% CI, 0,25-0,67, P=0.00). Conclusion: Psychological symptoms are usually undervalued among HCP, though the COVID-19 pandemic played a major role in exacerbating this burden. Prompt psychological support should be endorsed and simple measures such as physical activity and ensuring the necessary protection are paramount to improve mental health outcomes and the quality of care provided to patients.

Keywords: COVID-19 pandemic, health care professionals, mental health, protective factors, psychological symptoms, risk factors

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Authors: Ann Dashwood

Abstract:

Using standard Australian English with confidence is a cultural expectation of parents of primary school aged children who want to engage effectively with their children’s teachers and school administration. That confidence in support of their children’s learning at school is seldom experienced by parents whose first language is not English. Sharing language with competence in an intercultural environment is the common denominator for meaningful communication and engagement to occur in a school community. Experience in relevant interactive sessions is known to enhance engagement and participation. The purpose of this paper is to identify interactional settings for which parents who are isolated from the daily use of functional Australian cultural language learned to engage more effectively in their children’s learning at school. The outcomes measured parents’ intercultural engagement with classroom teachers and attention to the school’s administrative procedures. The study used quantitative and qualitative methods. The principles of communicative task-based language learning combined with intercultural communication principles provided the theoretical base for intensive English task-based learning and engagement. The quantitative analysis examined data samples collected by classroom teachers and administrators and parents’ writing samples. Interviews and observations qualitatively informed the study. Currently significant numbers of projects are active in community centres and schools to enhance English language knowledge of parents from Language Backgrounds Other Than English (LBOTE). The study was significant to explore the effects of conducting intensive English with parents of varied English language backgrounds by targeting language use for social interactions in the community, specific engagement in school activities, cultural interaction with teachers and responsiveness to complying with school procedures.

Keywords: engagement, intercultural communication, LBOTE, school community

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Authors: Ana Lambelho

Abstract:

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

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

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Authors: A. Priyanka, Sunil Kumar Kainoor, Parinitha Nayaka

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Introduction: Ever since the ancient times, rape and other sexual offences are considered to be heinous crimes. Rape is not just another word in the dictionary, but it is the most barbaric act of violence committed with sex being the weapon. Rape is among the highest forms of crime experienced by women and children in all sectors of the society. In recent years, there has been an alarming rise in ratio of rape in India. The burden of such crimes on the society is very huge. The venereal diseases are the worst consequence along with unwanted pregnancies. Aims and Objectives: To determine the socio-demographic profile of the survivors of sexual offences reported to Dept. of Forensic Medicine of a South Indian medical college. Material methods: This retrospective study was conducted in the Department of Forensic Medicine of Raichur Institute of Medical Sciences, Raichur, Karnataka, India. Only survivors of sexual offences cases were included in the study group. Examination of all survivors was carried out by doctors of the said Department. Study period is one year six months, January 2015 to June 2016. Results/ case history: In total 140 cases of sexual offences were examined during study period of which the total survivors accounted to 62.85% i.e. 88 cases. Of the 88 survivors, 61 (69.31%) were registered under POCSO Act. The most affected age group of victims was 10-18 years in 59 (67%) cases. 61% were in acquaintance with the assailants, 18% were classmates/ friends, 13% of accused were Family members/ Relatives, 8% were strangers. 85% of the survivors were hailing from rural setup, while 15% were from urban. 60.65% of the survivors were students, 37.7% were doing Coolie/ Agricultural works. Conclusion: Delay in reporting of cases resulted in loss of vital physical evidences as no concrete report could be generated from the forensic lab after examination of specimens thus there should be coordination among doctors, forensic experts and investigating agency. It is worth mentioning that though a large number of cases of sexual offences are reported as rape many among them are consented acts and hence definite evidence of forceful sexual intercourse is lagging.

Keywords: consensual sex, India, POCSO Act- 2012, India, pregnancy, rape, sexual offence

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Authors: Kayode Oshinubi, Brice Kammegne, Jacques Demongeot

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The use of mathematical tools like Partial Differential Equations and Ordinary Differential Equations have become very important to predict the evolution of a viral disease in a population in order to take preventive and curative measures. In December 2019, a novel variety of Coronavirus (SARS-CoV-2) was identified in Wuhan, Hubei Province, China causing a severe and potentially fatal respiratory syndrome, i.e., COVID-19. Since then, it has become a pandemic declared by World Health Organization (WHO) on March 11, 2020 which has spread around the globe. A reaction-diffusion system is a mathematical model that describes the evolution of a phenomenon subjected to two processes: a reaction process in which different substances are transformed, and a diffusion process that causes a distribution in space. This article provides a mathematical study of the Susceptible, Exposed, Infected, Recovered, and Vaccinated population model of the COVID-19 pandemic by the bias of reaction-diffusion equations. Both local and global asymptotic stability conditions for disease-free and endemic equilibria are determined using the Lyapunov function are considered and the endemic equilibrium point exists and is stable if it satisfies Routh–Hurwitz criteria. Also, adequate conditions for the existence and uniqueness of the solution of the model have been proved. We showed the spatial distribution of the model compartments when the basic reproduction rate $\mathcal{R}_0 < 1$ and $\mathcal{R}_0 > 1$ and sensitivity analysis is performed in order to determine the most sensitive parameters in the proposed model. We demonstrate the model's effectiveness by performing numerical simulations. We investigate the impact of vaccination and the significance of spatial distribution parameters in the spread of COVID-19. The findings indicate that reducing contact with an infected person and increasing the proportion of susceptible people who receive high-efficacy vaccination will lessen the burden of COVID-19 in the population. To the public health policymakers, we offered a better understanding of the COVID-19 management.

Keywords: COVID-19, SEIRV epidemic model, reaction-diffusion equation, basic reproduction number, vaccination, spatial distribution

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Authors: Nadia Nisar

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Background: In the temperate regions Influenza activities occur sporadically all year round with peaks coinciding during cold months. Meteorological and environmental conditions play significant role in the transmission of influenza globally. In this study, we assessed the relationship between meteorological parameters and influenza activity in two geographical areas of Pakistan. Methods: Influenza data were collected from Islamabad (north) and Multan (south) regions of national influenza surveillance system during 2010-2015. Meteorological database was obtained from National Climatic Data Center (Pakistan). Logistic regression model with a stepwise approach was used to explore the relationship between meteorological parameters with influenza peaks. In statistical model, we used the weekly proportion of laboratory-confirmed influenza positive samples to represent Influenza activity with metrological parameters as the covariates (temperature, humidity and precipitation). We also evaluate the link between environmental conditions associated with seasonal influenza epidemics: 'cold-dry' and 'humid-rainy'. Results: We found that temperature and humidity was positively associated with influenza in north and south both locations (OR = 0.927 (0.88-0.97)) & (OR = 0.1.078 (1.027-1.132)) and (OR = 1.023 (1.008-1.037)) & (OR = 0.978 (0.964-0.992)) respectively, whilst precipitation was negatively associated with influenza (OR = 1.054 (1.039-1.070)) & (OR = 0.949 (0.935-0.963)). In both regions, temperature and humidity had the highest contribution to the model as compared to the precipitation. We revealed that the p-value for all of climate parameters is <0.05 by Independent-sample t-test. These results demonstrate that there were significant relationships between climate factors and influenza infection with correlation coefficients: 0.52-0.90. The total contribution of these three climatic variables accounted for 89.04%. The reported number of influenza cases increased sharply during the cold-dry season (i.e., winter) when humidity and temperature are at minimal levels. Conclusion: Our findings showed that measures of temperature, humidity and cold-dry season (winter) can be used as indicators to forecast influenza infections. Therefore integrating meteorological parameters for influenza forecasting in the surveillance system may benefit the public health efforts in reducing the burden of seasonal influenza. More studies are necessary to understand the role of these parameters in the viral transmission and host susceptibility process.

Keywords: influenza, climate, metrological, environmental

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Authors: Glenda Wrenn, Juliet Muzere, Meldra Hall, Allyson Belton, Kisha Holden, Chanita Hughes-Halbert, Martha Kent, Bekh Bradley

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Understanding the help seeking decision making process and experiences of health disparity populations with posttraumatic stress disorder (PTSD) is central to development of trauma-informed, culturally centered, and patient focused services. Yet, little is known about the decision making process among adult Black women who are non-treatment seekers as they are, by definition, not engaged in services. Methods: Audiotaped interviews were conducted with 30 African American adult women with clinically significant PTSD symptoms who were engaged in primary care, but not in treatment for PTSD despite symptom burden. A qualitative interview guide was used to elucidate key themes. Independent coding of themes mapped to theory and identification of emergent themes were conducted using qualitative methods. An existing quantitative dataset was analyzed to contextualize responses and provide a descriptive summary of the sample. Results: Emergent themes revealed that active mental avoidance, the intermittent nature of distress, ambivalence, and self-identified resilience as undermining to help seeking decisions. Participants were stuck within the help-seeking phase of ‘recognition’ of illness and retained a sense of “it is my decision” despite endorsing significant social and environmental negative influencers. Participants distinguished ‘help acceptance’ from ‘help seeking’ with greater willingness to accept help and importance placed on being of help to others. Conclusions: Elucidation of the decision-making process from the perspective of non-treatment seekers has implications for outreach and treatment within models of integrated and specialty systems care. The salience of responses to trauma symptoms and stagnation in the help seeking recognition phase are findings relevant to integrated care service design and community engagement.

Keywords: culture, help-seeking, integrated care, PTSD

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Authors: Bendes Ákos

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Digital evidence will be the most widely used type of evidence in the future. With the development of the modern world, more and more new types of crimes have evolved and transformed. For this reason, it is extremely important to examine these types of crimes in order to get a comprehensive picture of them, with which we can help the authorities work. In 1865, with early technologies, people were able to forge a picture of a quality that is not even recognized today. With the help of today's technology, authorities receive a lot of false evidence. Officials are not able to process such a large amount of data, nor do they have the necessary technical knowledge to get a real picture of the authenticity of the given evidence. The digital world has many dangers. Unfortunately, we live in an age where we must protect everything digitally: our phones, our computers, our cars, and all the smart devices that are present in our personal lives and this is not only a burden on us, since companies, state and public utilities institutions are also forced to do so. The training of specialists and experts is essential so that the authorities can manage the incoming digital evidence at some level. When analyzing evidence, it is important to be able to examine it from the moment it is created. Establishing authenticity is a very important issue during official procedures. After the proper acquisition of the evidence, it is essential to store it safely and use it professionally. After the proper acquisition of the evidence, it is essential to store it safely and use it professionally. Otherwise, they will not have sufficient probative value and in case of doubt, the court will always decide in favor of the defendant. One of the most common problems in the world of digital data and evidence is doubt, which is why it is extremely important to examine the above-mentioned problems. The most effective way to avoid digital crimes is to prevent them, for which proper education and knowledge are essential. The aim is to present the dangers inherent in the digital world and the new types of digital crimes. After the comparison of the Hungarian investigative techniques with international practice, modernizing proposals will be given. A sufficiently stable yet flexible legislation is needed that can monitor the rapid changes in the world and not regulate afterward but rather provide an appropriate framework. It is also important to be able to distinguish between digital and digitalized evidence, as the degree of probative force differs greatly. The aim of the research is to promote effective international cooperation and uniform legal regulation in the world of digital crimes.

Keywords: digital crime, digital law, cyber crime, international cooperation, new crimes, skepticism

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Authors: Akram Rasheed

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Background: Simulation in the health care field has been increasingly used over the last years in the training of resuscitation and life support practices. It has shown the advantage of improving the decision-making and technical skills through deliberate practice and return demonstration. Local Problem: This article reports on the integration of simulation-based training (SBT) in the training program about proper team dynamics and leadership skills during cardiopulmonary resuscitation (CPR) in the intensive care unit (ICU). Method and Intervention: Training of 180 critical care nurses was conducted using SBT between 1st January and 30th 2020. We had conducted 15 workshops, with the integration of SBT using high fidelity manikins and using demonstration and return-demonstration approach to train the nursing staff about proper team dynamics and leadership skills during CPR. Results: After completing the SBT session, all 180 nurses completed the evaluation form. The majority of evaluation items were rated over 95% for the effectiveness of the education; four items were less than 95% (88–94%). Lower rated items considered training and practice time, improved competency, and commitment to apply to learn. The team dynamics SBT was evaluated as an effective means to improve team dynamics and leadership skills during CPR in the intensive care unit (ICU). Conclusion: The use of simulation-based training to improve team dynamics and leadership skills is an effective method for better patient management during CPR. Besides skills competency, closed-loop communication, clear messages, clear roles, and assignments, knowing one’s limitations, knowledge sharing, constructive interventions, re-evaluating and summarizing, and mutual respect are all important concepts that should be considered during team dynamics training. However, participants reported the need for a repeated practice opportunity to build competency.

Keywords: cardiopulmonary resuscitation, high fidelity manikins, simulation-based training, team dynamics

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Authors: Renga Rao Krishnamoorthy, Raihan Tahir

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The quality of classroom learning and teaching delivery has been and will continue to be debated at various levels worldwide. The regional cooperation programme to improve the quality and labour market orientation of the Technical and Vocational Education and Training (RECOTVET), ‘Deutsche Gesellschaft für Internationale Zusammenarbeit’ (GIZ), in line with the sustainable development goals (SDG), has taken the initiative in the development of quality TVET in the ASEAN region by developing the Quality Toolbox for Better TVET Delivery (Quality Toolbox). This initiative aims to provide quick and practical materials to trainers, instructors, and personnel involved in education and training at an institute to shape the quality of classroom learning and teaching. The Quality Toolbox for Better TVET Delivery was developed in three stages: literature review and development, validation, and finalization. Thematic areas in the Quality Toolbox were derived from collective input of concerns and challenges raised from experts’ workshops through moderated sessions involving representatives of TVET institutes from 9 ASEAN Member States (AMS). The sessions were facilitated by professional moderators and international experts. TVET practitioners representing AMS further analysed and discussed the structure of the Quality Toolbox and content of thematic areas and outlined a set of specific requirements and recommendations. The application exercise of the Quality Toolbox was carried out by TVET institutes among ASM. Experience sharing sessions from participating ASEAN countries were conducted virtually. The findings revealed that TVET institutes use two types of approaches in shaping the quality of learning and teaching, which is ascribed to inductive or deductive, shaping of quality in learning and teaching is a non-linear process and finally, Q-tools can be adopted and adapted to shape the quality of learning and teaching at TVET institutes in the following: improvement of the institutional quality, improvement of teaching quality and improvement on the organisation of learning and teaching for students and trainers. The Quality Toolbox has good potential to be used at education and training institutes to shape quality in learning and teaching.

Keywords: AMS, GIZ, RECOTVET, quality tools

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Authors: Amos Sunday Onikanni, Bashir Lawal, Babatunji Emmanuel Oyinloye, Gomaa Mostafa-Hedeab, Mohammed Alorabi, Simona Cavalu, Augustine O. Olusola, Chih-Hao Wang, Gaber El-Saber Batiha

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The increasing global burden of diabetes mellitus has called for the search for a therapeutic alternative that offers better activities and safety than conventional chemotherapy. Herein, we evaluated the neuroprotective and antioxidant properties of different fractions (ethyl acetate, N-butanol and residual aqueous) of Clompanus pubescens leaves in streptozotocin (STZ)-induced diabetic rats. Our results revealed a significant elevation in the levels of blood glucose, pro-inflammatory cytokines, lipid peroxidation, neuronal activities of acetylcholinesterase, butyrylcholinesterase, nitric oxide, epinephrine, norepinephrine, and Na+/K+-ATPase in diabetic non treated rats. In addition, decreased levels of enzymatic and non-enzymatic antioxidants were observed. Treatment with different fractions of C. pubescens leaves resulted in a significant reversal of the biochemical alteration and improved the neurocognitive deficit in STZ-induced diabetic rats. However, the ethyl-acetate fraction demonstrated higher activities than the other fractions and was characterized for its phytoconstituents, revealing the presence of Gallic acid (713.00 ppm), catechin (0.91 ppm), ferulic acid (0.98 ppm), rutin (59.82 ppm), quercetin (3.22 ppm) and kaempferol (4.07 ppm). Our molecular docking analysis revealed that these compounds exhibited different binding affinities and potentials for targeting BChE/AChE/ IL-1 β/Na+-K+-ATPase. However, only Kampferol and ferulic exhibited good drug-like, ADMET, and permeability properties suitable for use as a neuronal drug target agent. Hence, the ethyl-acetate fraction of C. pubescent leaves could be considered a source of promising bioactive metabolite for the treatment and management of cognitive impairments related to type II diabetes mellitus.

Keywords: diabetes mellitus, neuroprotective, antioxidant, pro-inflammatory cytokines

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Authors: Heba Salem

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This paper aims to share the researcher’s experience of using e-Portfolios as an assessment tool to follow up on students’ learning experiences and performance throughout the semester. It also aims at highlighting the importance of students’ self-reflection in the process of language learning. The paper begins by introducing the advanced media course, with its focus on listening and speaking skills, and introduces the students’ profiles. Then it explains the students’ role in the e-portfolio process as they are given the option to choose a listening text they studied throughout the semester and to choose a recorded oral production of their collection of artifacts throughout the semester. Students showcase and reflect on their progress in both listening comprehension and speaking. According to the research, re-listening to work given to them and to their production is a means of reflecting on both their progress and achievement. And choosing the work students want to showcase is a means to promote independent learning as well as self-expression. Students are encouraged to go back to the class learning outcomes in the process of choosing the work. In their reflections, students express how they met the specific learning outcome. While giving their presentations, students expressed how useful the experience of returning and going over what they covered to select one and going over their production as well. They also expressed how beneficial it was to listen to themselves and literally see their progress in both listening comprehension and speaking. Students also reported that they grasped more details from the texts than they did when first having it as an assignment, which coincided with one of the class learning outcomes. They also expressed the fact that they had more confidence speaking as well as they were able to use a variety of vocabulary and idiomatic expressions that students have accumulated. For illustration, this paper includes practical samples of students’ tasks and instructions as well as samples of their reflections. The results of students’ reflections coincide with what the research confirms about the effectiveness of the e-portfolios as a means of assessment. The employment of e-Portfolios has two-folded benefits; students are able to measure the achievement of the targeted learning outcomes, and teachers receive constructive feedback on their teaching methods.

Keywords: e-portfolios, assessment, self assessment, listening and speaking progress, foreign language, reflection, learning out comes, sharing experience

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Authors: Isaac Kofi Mensah

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E-government has been adopted and used by many governments/countries around the world including Ghana to provide citizens and businesses with more accurate, real-time, and high quality services and information. The objective of this paper is to present an overview of the Government of Ghana’s (GoG) adoption and implement of e-government and its usage by the Ministries, Departments and its agencies (MDAs) as well as other public sector institutions to deliver efficient public service to the general public i.e. citizens, business etc. Government implementation of e-government focused on facilitating effective delivery of government service to the public and ultimately to provide efficient government-wide electronic means of sharing information and knowledge through a network infrastructure developed to connect all major towns and cities, Ministries, Departments and Agencies and other public sector organizations in Ghana. One aim for the Government of Ghana use of ICT in public administration is to improve productivity in government administration and service by facilitating the exchange of information to enable better interaction and coordination of work among MDAs, citizens and private businesses. The study was prepared using secondary sources of data from government policy documents, national and international published reports, journal articles, and web sources. This study indicates that through the e-government initiative, currently citizens and businesses can access and pay for services such as renewal of driving license, business registration, payment of taxes, acquisition of marriage and birth certificates as well as application for passport through the GoG electronic service (eservice) and electronic payment (epay) portal. Further, this study shows that there is an enormous commitment from GoG to adopt and implement e-government as a tool not only to transform the business of government but also to bring efficiency in public services delivered by the MDAs. To ascertain this, a further study need to be carried out to determine if the use of e-government has brought about the anticipated improvements and efficiency in service delivery of MDAs and other state institutions in Ghana.

Keywords: electronic government, electronic services, electronic pay, MDAs

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Authors: Esabelle Lo Yan Yam, Pheak Chhoun, Sovannary Tuot, Emily Lancsar, Siyan Yi

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Persons living with HIV (PLHIV) need lifelong antiretroviral treatment (ART) to keep their viral load suppressed to an undetectable level, maintain a healthy immune system, and reduce the risk of transmitting HIV to others. However, many factors affect PLHIV's adherence to ART, including access to antiretrovirals (ARV), stigma, lack of social support, and the burden of seeking lifelong care. Community-based care has been shown to be instrumental in the experience of PLHIV in many countries, including Cambodia. In this study based in Cambodia, a community-based ART delivery (CAD) intervention involving community action workers (CAWs) who are PLHIVs was introduced. These workers collect pre-packaged ARVs from the ART clinics and dispense them to PLHIVs in the communities. The quasi-experimental study involved approximately 2000 stable PLHIV in the intervention arm and another 2000 PLHIV in the control arm (receiving usual care). A cost-effectiveness analysis is currently conducted to complement the clinical effectiveness of the CAD intervention on the care continuum and treatment outcomes for stable PLHIV, as well as the operational effectiveness in increasing the efficiency of the ART clinics and the health system. The analysis will consider health system and societal perspectives based on primary outcomes, including retention in care, viral load suppression, and adherence to ART. Additionally, a consultation with the National Centre for HIV/AIDS, Dermatology, and STD under the Cambodia Ministry of Health will be done to discuss the conduct of a budget impact analysis that can quantify the financial impact on the government's budget when adopting the CAD intervention at the provincial and national levels. The budget impact analysis will take into consideration various scaling-up scenarios for the interventions in the country. The research will assess the cost-effectiveness of the CAD intervention to support national stakeholders in Cambodia to make an informed decision on the adoption and scaling up of the intervention in Cambodia. The results are currently being analyzed and will be available at the time of the conference.

Keywords: Cambodia, community intervention, economic evaluation, global health, HIV/AIDs, implementation research

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