Search results for: societal barriers

Authors: Arsalan Salahi

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Today, the number of changes in the construction industry and urban mass house building is increasing, which makes you need to pay more attention to targeted planning for human resource management and training. The human resources working in the construction industry have various problems and deficiencies, and in order to solve these problems, there is a need for basic management and training of these people in order to lower the construction costs and increase the quality of the projects, especially in mass house building projects. The success of any project in reaching short and long-term professional goals depends on the efficient combination of work tools, financial resources, raw materials, and most importantly, human resources. Today, due to the complexity and diversity of each project, specialized management fields have emerged to maximize the potential benefits of each component of that project. Human power is known as the most important resource in construction projects for its successful implementation, but unfortunately, due to the low cost of human power compared to other resources, such as materials and machinery, little attention is paid to it. With the correct management and training of human resources, which depends on its correct planning and development, it is possible to improve the performance of construction projects. In this article, the training and motivation of construction industry workers and their effects on the effectiveness of projects in this industry have been researched. In this regard, some barriers to the training and motivation of construction workers and personnel have been identified and solutions have been provided for construction companies. Also, the impact of workers and unskilled people on the efficiency of construction projects is investigated. The results of the above research show that by increasing the use of correct and basic training for human resources, we will see positive results and effects on the performance of construction projects.

Keywords: human resources, construction industry, principled training, skilled and unskilled workers

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Authors: Monique Somma

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As special education service delivery models are shifting in order to better meet the academic and social rights of students with exceptionalities, teaching practices must also align with these goals. This phenomenological case study explored the change experiences of special education teachers who have transitioned from teaching in a self-contained special education class to an inclusive class setting. Ten special educators who had recently changed their teaching roles to inclusive classrooms, completed surveys and participated in a focus group. Of the original ten educators, five chose to participate further in individual interviews. Data collected from the three methods was examined and compared for common themes. Emergent themes included, support and training, attitudes and perceptions, inclusive practice, growth and change, and teaching practice. The overall findings indicated that despite their special education training, these educators were challenged by their own beliefs and expectations, the attitudes of others and systematic barriers in the education system. They were equally surprised by the overall social and academic performance of students with exceptionalities in inclusive classes, as well as, the social and academic growth and development of the other students in the class. Over the course of their careers, they all identified an overall personal pedagogical shift, to some degree or another, which they contributed to the successful experiences of inclusion they had. They also recognized that collaborating with others was essential for inclusion to be successful. The findings from this study suggest several implications for professional development and training needs specific to special education teachers moving into inclusive settings. Maximizing the skills of teachers with special education experience in a Professional Learning Community (PLC) and mentorship opportunities would be beneficial to all staffs working toward creating inclusive classrooms and schools.

Keywords: attitudes and perceptions, inclusion of students with exceptionalities, special education teachers, teacher change

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Authors: Nsimbe Allan

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The study examines the impact of Building Information Modeling (BIM) on the cost management of engineering projects, focusing specifically on the Mombasa Port Area Development Project. The objective of this research venture is to determine the mechanisms through which Building Information Modeling (BIM) facilitates stakeholder collaboration, reduces construction-related expenses, and enhances the precision of cost estimation. Furthermore, the study investigates barriers to execution, assesses the impact on the project's transparency, and suggests approaches to maximize resource utilization. The study, selected for its practical significance and intricate nature, conducted a Systematic Literature Review (SLR) using credible databases, including ScienceDirect and IEEE Xplore. To constitute the diverse sample, 69 individuals, including project managers, cost estimators, and BIM administrators, were selected via stratified random sampling. The data were obtained using a mixed-methods approach, which prioritized ethical considerations. SPSS and Microsoft Excel were applied to the analysis. The research emphasizes the crucial role that project managers, architects, and engineers play in the decision-making process (47% of respondents). Furthermore, a significant improvement in cost estimation accuracy was reported by 70% of the participants. It was found that the implementation of BIM resulted in enhanced project visibility, which in turn optimized resource allocation and facilitated the process of budgeting. In brief, the study highlights the positive impacts of Building Information Modeling (BIM) on collaborative decision-making and cost estimation, addresses challenges related to implementation, and provides solutions for the efficient assimilation and understanding of BIM principles.

Keywords: cost management, resource utilization, stakeholder collaboration, project transparency

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Authors: Jeaha Yang, Ahmed Khan, Donna L. Rodela, Mohammed A. Qaudeer

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Traditional supply chain silos still exist today due to the difficulty of establishing trust between various partners and technological barriers across industries. Companies lose opportunities and revenue and inadvertently make poor business decisions resulting in further challenges. Blockchain technology can bring a new level of transparency through sharing information with a distributed ledger in a decentralized manner that creates a basis of trust for business. Blockchain is a loosely coupled, hub-style communication network in which trading partners can work indirectly with each other for simpler integration, but they work together through the orchestration of their supply chain operations under a coherent process that is developed jointly. A Blockchain increases efficiencies, lowers costs, and improves interoperability to strengthen and automate the supply chain management process while all partners share the risk. Blockchain ledger is built to track inventory lifecycle for supply chain transparency and keeps a journal of inventory movement for real-time reconciliation. State design patterns are used to capture the life cycle (behavior) of inventory management as a state machine for a common, transparent and coherent process which creates an opportunity for trading partners to become more responsive in terms of changes or improvements in process, reconcile discrepancies, and comply with internal governance and external regulations. It enables end-to-end, inter-company visibility at the unit level for more accurate demand planning with better insight into order fulfillment and replenishment.

Keywords: supply chain management, inventory trace-ability, perpetual inventory system, inventory lifecycle, blockchain, inventory consignment, supply chain transparency, digital thread, demand planning, hyper ledger fabric

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Authors: Getiye Dejenu Kibret, Daniel Demant, Andrew Hayen

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Introduction: In Ethiopia, more than half of newborn babies do not have access to Emergency Obstetric and Neonatal Care (EmONC) services. Understanding the effect of distance to health facilities on service use and neonatal survival is crucial to recommend policymakers and improve resource distribution. We aimed to investigate the effect of distance to health services on maternal service use and neonatal mortality. Methods: We implemented a data linkage method based on geographic coordinates and calculated straight-line (Euclidean) distances from the Ethiopian 2016 demographic and health survey clusters to the closest health facility. We computed the distance in ESRI ArcGIS Version 10.3 using the geographic coordinates of DHS clusters and health facilities. Generalised Structural Equation Modelling (GSEM) was used to estimate the effect of distance on neonatal mortality. Results: Poor geographic accessibility to health facilities affects maternal service usage and increases the risk of newborn mortality. For every ten kilometres (km) increase in distance to a health facility, the odds of neonatal mortality increased by 1.33% (95% CI: 1.06% to 1.67%). Distance also negatively affected antenatal care, facility delivery and postnatal counselling service use. Conclusions: A lack of geographical access to health facilities decreases the likelihood of newborns surviving their first month of life and affects health services use during pregnancy and immediately after birth. The study also showed that antenatal care use was positively associated with facility delivery service use and that both positively influenced postnatal care use, demonstrating the interconnectedness of the continuum of care for maternal and neonatal care services. Policymakers can leverage the findings from this study to improve accessibility barriers to health services.

Keywords: acessibility, distance, maternal health service, neonatal mortality

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Authors: Seon-Young Lee, Harkiran Sagoo, Reem Farwana, Katharine Whitehurst, Alex Fowler, Riaz Agha

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Background/Aims: Systematic reviews and meta-analysis are becoming increasingly important way of summarizing research evidence. Researches in ophthalmology may represent further challenges, due to their potential complexity in study design. The aim of our study was to determine the reporting quality of systematic reviews and meta-analysis in ophthalmology with the PRISMA statement, by assessing the articles published between 2010 and 2015 from five major journals with the highest impact factor. Methods: MEDLINE and EMBASE were used to search systematic reviews published between January 2010 and December 2015, in 5 major ophthalmology journals: Progress in Retinal and Eye Research, Ophthalmology, Archives of Ophthalmology, American Journal of Ophthalmology, Journal of the American Optometric Association. Screening, identification, and scoring of articles were performed independently by two teams, followed by statistical analysis including the median, range, and 95% CIs. Results: 115 articles were involved. The median PRISMA score was 15 of 27 items (56%), with a range of 5-26 (19-96%) and 95% CI 13.9-16.1 (51-60%). Compliance was highest in items related to the description of rationale (item 3,100%) and inclusion of a structured summary in the abstract (item 2, 90%), while poorest in indication of review protocol and registration (item 5, 9%), specification of risk of bias affecting the cumulative evidence (item 15, 24%) and description of clear objectives in introduction (item 4, 26%). Conclusion: The reporting quality of systematic reviews and meta-analysis in ophthalmology need significant improvement. While the use of PRISMA criteria as a guideline before journal submission is recommended, additional research identifying potential barriers may be required to improve the compliance to the PRISMA guidelines.

Keywords: systematic reviews, meta-analysis, research methodology, reporting quality, PRISMA, ophthalmology

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Authors: Neeti Rustagi, Naveen Dutt, Arvind Sinha, Mahaveer S. Rhodha, Pankaja R. Raghav

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Background: Pre-hospital trauma care services are in developing stage in fast-urbanizing cities of India including Jodhpur. Training of health professionals in providing necessary pre-hospital trauma care is an essential step in decreasing accident related morbidity and mortality. The current study explores the response of a medical graduate toward helping an accident victim in a pre-hospital setting before patient can be transferred to definitive trauma facility. Methodology: This study examines the perceived competence in predicting response to an accident victim by medical graduates in Jodhpur, Rajasthan. Participants completed measures of attitude, normative influence and perceived behavior control toward providing pre-hospital care to an accident victim. Likert scale was used to measure the participant responses. Preliminary and descriptive analysis were used using SPSS 21.0. Internal consistency of the responses received was measured using Cronbach’s alpha. Results: Almost all medical graduates agreed that road accidents are common in their area (male: 92%; female: 78%). More male medical graduates (28%) reported helping an accident victim as compared to female physicians (9%) in the previous three months. Majority of study participants (96%) reported that providing immediate care to an accident victim is essential to save the life of an individual. Experience of helping an accident victim was considered unpleasant by the majority of female participants (70%) as compared to male participants (36%). A large number of participants believed that their friends (80%) and colleagues (96%) would appreciate them helping an accident victim in a pre-hospital setting. A large number of participants also believed that they possess the necessary skills and competencies (80%) towards helping a roadside accident victim in the pre-hospital care environment. Perceived competence of helping a roadside accident victim until they are transferred to a health facility was reported by less than half of the participants (male: 56%; female: 43%). Conclusion: Medical graduates have necessary attitude, competencies, and intention of helping a roadside accident victim. The societal response towards helping a road side accident victim is also supportive. In spite of positive determinants, a large proportion of medical graduates have perceived lack of competence in helping a roadside accident victim. This is essential to explore further as providing pre-hospital care to a roadside accident victim is an essential step in establishing the continuum of care to an accident victim especially in countries where pre-hospital services are in developing phase.

Keywords: prehospital care, perceived behavior, perceived competence, medical graduates

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Authors: Jessica Achebe, Susan Tighe

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The reduction of material consumption and greenhouse gas emission when maintain and rehabilitating road networks can achieve added benefits including improved life cycle performance of pavements, reduced climate change impacts and human health effect due to less air pollution, improved productivity due to an optimal allocation of resources and reduced road user cost. This is the essence of incorporating environmental sustainability into pavement management. The functionality of performance measurement approach has made it one of the most valuable tool to Pavement Management Systems (PMSs) to account for different criteria in the decision-making process. However measuring the environmental performance of road network is still a far-fetched practice in road network management, more so an ostensive agency-wide environmental sustainability or sustainable maintenance specifications is missing. To address this challenge, this present research focuses on the environmental sustainability performance of network-level pavement management. The ultimate goal is to develop a framework to incorporate environmental sustainability in pavement management systems for network-level maintenance programming. In order to achieve this goal, this paper present the first step, the intention is to review the previous studies that employed environmental performance measures, as well as the suitability of environmental performance indicators for the evaluation of the sustainability of network-level pavement maintenance strategies. Through an industry practice survey, this paper provides a brief forward regarding the pavement manager motivations and barriers to making more sustainable decisions, and data needed to support the network-level environmental sustainability. The trends in network-level sustainable pavement management are also presented, existing gaps are highlighted, and ideas are proposed for network-level sustainable maintenance and rehabilitation programming.

Keywords: pavement management, environment sustainability, network-level evaluation, performance measures

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Authors: Tess Hartland, Moitree Banerjee, Sue Churchill, Antonina Pereira, Ian Tyndall, Ruth Lowry

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Background: Sexual health services and policies for middle-aged and older adults are underdeveloped, while global sexually transmitted infections in this age group are on the rise. The Interreg cross-Europe Sexual Health In Over 45s (SHIFT) project aims to increase participation in sexual health services and improve sexual health and wellbeing in people aged over 45, with an additional focus on disadvantaged groups. Methods: A two-pronged mixed-methodology is being used to develop a model for good service provision in sexual health for over 45s. (1) Following PRISMA-ScR guidelines, a scoping review is being conducted, using the databases PsychINFO, Web of Science, ERIC and PubMed. A key search strategy using terms around sexual health, good practice, over 45s and disadvantaged groups. The initial search for literature yielded 7914 results. (2) Surveys (n=1000) based on the Theory of Planned Behaviour are being administered across the UK, Belgium and Netherlands to explore current sexual health knowledge, awareness and attitudes. Expected results: It is expected that sexual health needs and potential gaps in service provision will be identified in order to inform good practice for sexual health services for the target population. Results of the scoping review are being analysed, while focus group and survey data is being gathered. Preliminary analysis of the survey data highlights barriers to access such as limited risk awareness and stigma. All data analysis will be completed by the time of the conference. Discussion: Findings will inform the development of a model to improve sexual health and wellbeing for among over 45s, a population which is often missed in sexual health policy improvement.

Keywords: adult health, disease prevention, health promotion, over 45s, sexual health

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Authors: Ali Elshabrawy

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Cloud computing is expected to be important for e Government in near future. Governments need it for solving some of its e Government, financial, infrastructure, legacy systems and integration problems. It reduces information technology (IT) infrastructure needs and support costs, and offers on-demand infrastructure and computational power, improved collaboration capabilities, which are important for e Government projects start up and sustainability. Budget pressures will continue to drive more and more government IT to hybrid and even public clouds, and more cooperation between cloud service providers and governmental agencies are expected, Or developing governmental private, community clouds. Motivation to convince governments to use cloud computing services, will create a pressure on cloud service providers to cope with government's requirements for interoperability, security standards, open data and integration between their cloud systems There will be significant legal action arising out of governmental uses of cloud computing, and legislation addressing both IT and business needs and consumer fears and protections. Cloud computing is a considered a revolution for IT and E business in general and e commerce, e Government in particular. As governments faces increasing challenges regarding IT infrastructure required for e Government projects implementation. As a result of Lack of required financial resources allocated for e Government projects in developed and developing countries. Cloud computing can play a major role to solve some of e Government projects challenges such as, lack of financial resources, IT infrastructure, Human resources trained to manage e Government applications, interoperability, cost efficiency challenges. If we could solve some security issues related to cloud computing usage which considered critical for e Government projects. Pretty sure it’s Just a matter of time before cloud service providers will find out solutions to attract governments as major customers for their business.

Keywords: cloud computing, e-government, adoption, supply side barriers, e-government requirements, challenges

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Authors: Samira Essabari

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What, unfortunately, governs the Moroccan educational philosophy and policy today is a concerning neoliberal discourse with its obsession with market logics and individualism. Critical education has been advocated to resist the neoliberal hegemony since it holds the promise to reclaim the social function of education. Significantly, the mounting forms of sexism and discrimination against women combined with hegemonic educational practices are jeopardizing the social function of teaching and learning, hence the relevance of feminist critical pedagogy. A substantial body of research worldwide has explored the ways in which feminist pedagogy can develop feminist consciousness and examine power relations in different educational contexts. In Morocco, however, the feasibility of feminist pedagogy has not been researched despite the overwhelming interest in gender issues in different educational settings. The research on critical pedagogies in Morocco remains very promising. Yet, most studies were conducted in contexts which are already engaged with issues of theory, discourse, and discourse analysis. The field of ESP ( English for Specific Purposes) is pragmatic by nature, and priority in research has been given to questions that adhere to the mainstream concerns of need analysis and study skills and ignore issues of power, gender power relations, and intersectional forms of oppression. To address these gaps in the existing literature, this participatory action research seeks to investigate the feasibility of Feminist pedagogy in ESP higher education and how it can foster feminist critical consciousness among ESP students without compromising their language learning needs. The findings of this research will contribute to research on critical applied linguistics and critical ESP more specifically and add to the practice of critical pedagogies in Moroccan higher education by providing in-depth insights into the enablers and barriers to the implementation of feminist critical pedagogy, which is still feeling its way into the educational scene in Morocco.

Keywords: feminist pedagogy, critical pedagogy, power relations, gender, ESP, intersectionality

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Authors: Fatemeh Daneshvartarigh

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New technologies and applications have radically altered construction techniques in recent years. In order to anticipate how the building will act, perform, and appear, these technologies encompass a wide range of visualization, simulation, and analytic tools. These new technologies and applications have a considerable impact on completing construction projects in today's (architecture, engineering and construction)AEC industries. The rate of changes in BIM-related topics is different worldwide, and it depends on many factors, e.g., the national policies of each country. Therefore, there is a need for comprehensive research focused on a specific area with common characteristics. Therefore, one of the necessary measures to increase the use of this new approach is to examine the challenges and obstacles facing it. In this research, based on the Delphi method, at first, the background and related literature are reviewed. Then, using the knowledge obtained from the literature, a primary questionnaire is generated and filled by experts who are selected using snowball sampling. It covered the experts' attitudes towards implementing BIM in renovation projects and their view of the benefits and obstacles in this regard. By analyzing the primary questionnaire, the second group of experts is selected among the participants to be interviewed. The results are analyzed using Theme analysis. Six themes, including Management support, staff resistance, client willingness, Cost of software and implementation, the difficulty of implementation, and other reasons, are obtained. Then a final questionnaire is generated from the themes and filled by the same group of experts. The result is analyzed by the Fuzzy Delphi method, showing the exact ranking of the obtained themes. The final results show that management support, staff resistance, and client willingness are the most critical barrier to BIM usage in renovation projects.

Keywords: building information modeling, BIM, BIM implementation, BIM barriers, BIM in renovation

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Authors: Shailendra Kumar Singh

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With the rise of New Linguistic World Order in the 21st century, the Aged Pragmatics is palpitating on the edge of theoretical irrelevance. What appears to be a new sociolinguistic reality is that the enlightening combination of alternative west, inclusive globalization and techno-revolution is adding novel recipes to communicative actions, style and gain among new linguistic breed which is being neither dominated nor powered by the western supremacy. The paper has the following main, interrelated, aims: it is intended to introduce the concept of alternative pragmatics that can offer what exactly is needed for our emerging societal realities; it asserts as to how the basic pillar of linguistic success in the new linguistic world order rests upon linguistic temptation and calibration of all; and it also reviews an inevitability of emerging economies in shaping the communication trends at a time when the western world is struggling to maintain the same control on the others exercised in the past. In particular, the paper seeks answers for the following questions: (a) Do we need an alternative pragmatics, one with alternativist leaning in an era of inclusive globalization and alternative west? (b) What are the pulses of shift which are encapsulating emergence of new communicative behavior among the new linguistic breed by breaking yesterday’s linguistic rigidity? (c) Or, what are those shifts which are making linguistic shift more perceptible? (d) Is New Linguistic World Order succeeding in reversing linguistic priorities of `who speaks, what language, where, how, why, to whom and in which condition’ with no parallel in the history? (e) What is explicit about the contemporary world of 21st century which makes linguistic world all exciting and widely celebrative phenomenon and that is also forced into our vision? (f) What factors will hold key to the future of yesterday’s `influential languages’ and today’s `emerging languages’ as world is in the paradigm transition? (g) Is the collapse of Aged Pragmatics good for the 21st century for understanding the difference between pragmatism of old linguistic world and new linguistic world order? New Linguistic world Order today, unlike in the past, is about a branding of new world with liberal world view for a particular form of ideal to be imagined in the 21st century. At this time without question it is hope that a new set of ideals with popular vocabulary will become the implicit pragmatic model as one of benign majoritarianism in all aspects of sociolinguistic reality. It appears to be a reality that we live in an extraordinary linguistic world with no parallel in the past. In particular, the paper also highlights the paradigm shifts: Demographic, Social-psychological, technological and power. These shifts are impacting linguistic shift which is unique in itself. The paper will highlight linguistic shift in details in which alternative west plays a major role without challenging the west because it is an era of inclusive globalization in which almost everyone takes equal responsibility.

Keywords: inclusive globalization, new linguistic world order, linguistic shift, world order

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Authors: Beata Patuszynska

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Children are largely absent from Polish social discourse, a fact which is mirrored in urban planning processes. Their absence creates a vicious circle – an unfriendly urban space discourages children from going outside on their own, meaning adults do not see a need to make spaces more friendly for a group, not present. The pandemic and lockdown, with their closed schools and temporary ban on unaccompanied minors on the streets, have only reinforced this. The project – co-writing with children a book concerning their first steps into urban independence - aims at empowering children, enabling them to find their voice when it comes to urban space. The foundation for the book was data collected during research and workshops with children from Warsaw primary schools, aged 7-10 - the age they begin independent travel in the city. The project was carried out with the participation and involvement of children at each creative step. Children were (1) models: the narrator is an 7-year-old boy getting ready for urban independence. He shares his experience as well as the experience of his school friends and his 10-year-old sister, who already travels on her own. Children were (2) teachers: the book is based on authentic children’s stories and experience, along with the author’s findings from research undertaken with children. The material was extended by observations and conclusions made during the pandemic. Children were (3) reviewers: a series of draft chapters from the book underwent review by children during workshops performed in a school. The process demonstrated that all children experience similar pleasures and worries when it comes to interaction with urban space. Furthermore, they also have similar needs that need satisfying. In my article, I will discuss; (1) the advantages of creating together with children; (2) my conclusions on how to work with children in participatory processes; (3) research results: perceptions of urban space by children age 7-10, when they begin their independent travel in the city; the barriers to and pleasures derived from independent urban travel; the influence of the pandemic on children’s feelings and their behaviour in urban spaces.

Keywords: children, urban space, co-creation, participation, human rights

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Authors: André Furtado, Rafael Mineiro, Isabel Gonçalves, Cecília Santos, Telma Quintela

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The development of therapies for central nervous system (CNS) disorders is one of the biggest challenges of current pharmacology, given the unique features of brain barriers, which limit drug delivery. Efflux transporters (ABC transporters) expressed at the blood-cerebrospinal fluid barrier (BCSFB), are the main obstacles for the delivery of therapeutic compounds into the CNS, compromising the effective treatment of brain cancer, brain metastasis from peripheral cancers, or even neurodegenerative disorders. It is thus extremely important to understand the regulation of these transporters for reducing their expression while treating a brain disorder or choosing the most appropriate conditions for drug administration. Based on the fact that the BCSFB have fine-tuned biological rhythms, studying the circadian variation of drug transport processes is critical for choosing the most appropriate time of the day for drug administration. In our study, using an in vitro model of the BCSFB, we characterized the circadian transport profile of methotrexate (MTX) and donepezil (DNPZ), two drugs involved in the treatment of cancer and Alzheimer’s Disease symptoms, respectively. We found that MTX is transported across the basal and apical membranes of the BCSFB in a circadian way. The circadian pattern of an ABC transporter, Abcc4, might be partially responsible for MTX circadian transport. Furthermore, regarding the DNPZ transport study, we observed that the regulation of Abcg2 expression by the circadian rhythm will impact the circadian-dependent transport of DNPZ across the BCSFB. Overall, our results will contribute to the current knowledge on brain pharmacoresistance at the BCSFB by disclosing how circadian rhythms control drug delivery to the brain, setting the grounds for a potential application of chronotherapy to brain diseases to enhance the efficacy of medications and minimize their side effects.

Keywords: blood-cerebrospinal fluid barrier, ABC transporters, drug transport, chronotherapy

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Authors: Kwanele Shishane

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Numerous countries are faced with challenges such as disease, poverty and other social ills and inadequate government support to meet the needs of the entire population. In developing countries, the concept of child-headed households has become a ubiquitous phenomenon and lived experience. As such, migration of children is common in these countries. This study aims to explore the lived experiences of unaccompanied adolescent migrant, with regards to the utilization of health care in South Africa. The objectives of the study are to examine the lived experiences of health care utilization by unaccompanied adolescent migrants; examine the predisposing, enabling and need factors influencing utilization of health care among unaccompanied adolescent migrants; examine the social and cultural influences on health care utilization among unaccompanied adolescent migrants; and identify the health system barriers to utilization of health care by unaccompanied adolescent migrants. Andersen and Newman’s Model of Health Care Utilization (1995) which explains factors determining the utilization of healthcare will provide the theoretical framework for the empirical investigation of this study. The target population for this study is unaccompanied adolescent migrants, seeking to access services from migrant service organizations in four provinces in South Africa (Limpopo, KwaZulu-Natal, Free State, and Gauteng). Participants will be selected using a purposive sampling procedure. A qualitative research approach utilizing a descriptive phenomenological epistemology will be utilized in this study. Data will be collected through conducting in-depth interviews and focus group discussions with unaccompanied migrant adolescents, to explore their lived experiences related to access and utilization of health care, as an unaccompanied migrant in SA. The qualitative data will be analysed using Tech’s (1990) thematic analytical approach.

Keywords: health care utilisation, unaccompanied migrant youth, South Africa, lived experiences

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Authors: Dujrudee Chinwong, Chanida Prompantakorn, Ubonphan Chaichana, Surarong Chinwong

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Objective: Understanding the university students’ perceptions on smoking caused lung cancer based on the Health Belief Model should help health care providers in assisting them to quit smoking. Thus, this study aimed to investigate the University students’ health belief in smoking behaviors caused lung cancer, which based on the Health Belief Model. Methods: Data were collected from voluntary participants using a self-administered questionnaire. Participants were students studying at a University in northern Thailand who were current smokers; they were selected using snowball sampling. Results: Of 361 students, 84% were males; 78% smoked not more than 10 cigarettes a day; 68% intended to quit smoking. Our findings, based on the health belief model, showed that 1) perceived susceptibility: participants strongly believed that if they did not stop smoking, they were at high risk of lung cancer (88%); 2) perceived severity: they strongly believed that they had a high chance of death from lung cancer if they continued smoking (84%); 3) perceived benefits: they strongly believed that quitting smoking could reduce the chance of developing lung cancer; 4) perceived barriers of quitting smoking: they strongly believed in the difficulty of quitting smoking because it needed a high effort and strong intention (69%); 5) perceived self-efficacy: however, they strongly believed that they can quit smoking right away if they had a strong intention to quit smoking (70%); 6) cues to action: they strongly believed in the support of parents (85%) and lovers (78%) in helping them to quit smoking. Further, they believed that limitation on smoking area in the University and smoking cessation services provided by the University can assist them to quit smoking. Conclusion: The Health Belief Model helps us to understand students’ smoking behaviors caused lung cancer. This could lead to designing a smoking cessation program to assist students to quit smoking.

Keywords: health belief model, lung cancer, smoking, Thailand

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Authors: Pavani K. Sree, Ragahava Reddy Chandri

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Independent living and living with dignity have been the hallmarks of the movement of the persons with disabilities across the globe against the oppression perpetuated by society in the form of social and physical structural barriers. Advancements in assistive technologies have been providing a new lease of life to persons with disabilities. However, access to these technologies is marred by the issues of affordability and availability. Poor from the developing countries find it difficult to make independent living or live with dignity because of lack of access and inability to afford the advance technologies. Class and gender appear to be key factors influencing the access to modern assistive technologies. The present paper attempts to understand the dynamics of class and gender in accessing advanced technologies in the Indian context. Based on an empirical study in which data were collected from persons with locomotor disabilities and service providers, the paper finds that the advance technologies are expensive and inaccessible to all persons with disabilities. The paper also finds that men with disabilities are prioritized by the members of the family for the use of advance technologies while women with disabilities are forced to live with not so advanced technologies. The paper finds that the state institutions working in the field of prosthetics and assistive technologies fail to deliver to the requirements of the poor. It was found that because of lack of facilities at the state institutions the cost of prosthetics, in the case of orthopedically challenged, is expensive and unaffordable for the poor. It was found that while rich male access the private services the poor women depend on the state institutions. It may be said that the social, cultural stereotypes extend not only to the state organizations but also to the use of prosthetics. Thus the notions of independent living and living with dignity in third world countries context are still elusive.

Keywords: accessibility, assistive technology, class, gender, state

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Authors: Sireen Irsheid

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Despite concerted efforts to improve education attainment with progress in recent years, student achievement and attainment remain among the most significant challenges for school districts across the United States. Many scholars have argued that students who do not complete high school do not drop out of school voluntarily but are ‘pushed out’ of schools through multiple mechanisms related to structural and socioeconomic barriers, behavioral health challenges, pedagogical practices, and administrative procedures. Extant literature has shown that living in historically disadvantaged neighborhoods or attending under-resourced schools exacerbates student-level risk factors for grade retention and school pushout. Most efforts to respond to the school pushout phenomenon have focused on individual characteristics of students, with relatively little attention to addressing these multiple system-level characteristics related to perpetuating inequities. This study is built on a growing body of social justice-oriented research concerned with the systemic influences that shape the experiences and mental health challenges of young people. Specifically, this study examined how young people who have been experiencing education inequities make meaning and navigate the structural factors related to neighborhood and school disinvestment and access to resources and supports, and their risk for school pushout. Furthermore, schools as political, cultural, and ideologically reproductive spaces often serve as sites of resistance and can support students who are impacted by educational inequity. Study findings provide education, neighborhood, school psychology, social work practice, and policy considerations.

Keywords: education policy, mental health, school prison nexus, school pushout, structural trauma

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Authors: Shannon Rappe, Elizabeth Morse, David Phillippi

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Postpartum women with an opioid use disorder (OUD) are at high risk for treatment disengagement, leaving them vulnerable to overdose and death between seven and twelve months postpartum. Intensive case management programs have been proposed as an effective strategy to reduce barriers and increase treatment engagement among postpartum women. The purpose of this project is to determine the effects of early engagement in an intensive case management program on postpartum engagement and infant health outcomes among postpartum women with opioid use. This retrospective review of secondary data was collected on 225 infants, and 221 postpartum women enrolled in an intensive case management program in Tennessee between May 1, 2019, and May 5, 2020. Chi-squares were computed to examine the timing of engagement during pregnancy, maternal treatment outcomes, and infant health outcomes, including neonatal abstinence syndrome (NAS), birth weight, gestational age, and length of stay. The mean prenatal program engagement was 109 days (SD = 67.6); 16.7% (n = 37) enrolled during the first trimester, 37.6% (n = 83) in the second trimester, and 45.7% (n = 101) in the third trimester. Of the 221 women engaged, 45.2% (n = 100) remained engaged in the case of management at the time of data collection, and 40% (n = 89) remained engaged in MAT at the time of data collection. Twenty- five percent (n = 25) of mothers who graduated sustained engagement in MAT. Of 225 infants 28.9% (n = 65) had a positive NAS status, mean birth weight was 6.5 lbs. (SD = 19.3); mean gestational age was 38.3 weeks (SD = 19.3) and mean length of stay was 8.19 days (SD = 9.8). This study's findings identified that engaging mothers during pregnancy in a program designed to meet their unique challenges positively impacts both the mother and infant outcomes, regardless of their timing.

Keywords: intensive case management, neonatal abstinence syndrome, opioid addiction, opioid crisis, opioid use in pregnant women, postpartum addiction

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Authors: Lemi Tolu

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Background: Postpartum family planning (PPFP) focuses on the prevention of unintended and closely spaced pregnancies through the first 12 months following childbirth. Objective: This study assesses the barriers to uptake of long-term and permanent family planning methods among immediate post-partum mothers at Saint Paul’s Hospital Millennium Medical College in Addis Ababa, Ethiopia. Methodology: An institution-based cross-sectional study was conducted from January 1 to June 30, 2017. The six months of study were used as strata, and systematic sampling used to select participants in each month. Post-partum mothers were interviewed using pretested structured questionnaires. Data entry and analysis were done using SPSS version 17. Bivariate and multivariable logistic regressions were fitted to identify determinants of post-partum family planning uptake. An OR with 95% CIs was calculated, and p values set at 005 were used to determine the statistical significance of associations. Results: Four hundred and twenty-two post-partum women were interviewed. Two hundred sixty-eight (63%) women received counselling on family planning, and 241 (66.8 %) got information about contraception. One hundred and fifty-two (45%) of the women accepted long-term and permanent contraception on their immediate postpartum period before discharge. Contraceptive counselling (OR = 2.13, 95% CI 1.004-3.331), getting information from the health facility (OR = 15.15, 95% CI 1.848-19.242), and partner support (OR = 1.367, 95% CI 1.175-2.771) were significantly associated with long-term and permanent contraception uptake. Conclusion: Postpartum counselling on family planning and provision of contraception information improve immediate postpartum FP acceptance, and, hence postpartum programs need to strengthen such services.

Keywords: contraception, immediate postpartum, long-term family planning, post-partum family planning

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Authors: C. van den Berg, C. Pokpas

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Popular discourse touts entrepreneurship as a universal solution for underdevelopment, unemployment, and poverty. Moreover, claims are made that women and other disadvantaged groups can achieve material and personal success through digital entrepreneurship. This paper examines the potential of digital technology in entrepreneurial ventures to stimulate economic growth for marginalized groups and communities. Although digital entrepreneurship is hailed as a means to empower under-resourced and socially marginalized people, these opportunities still exist within the confines of existing social and cultural practices. The perspectives of female digital entrepreneurs in developing countries are sorely understudied, particularly concerning an understanding of the complex underlying socio-cultural factors impeding women’s entrepreneurial behaviors. This qualitative study, guided by a feminist phenomenological perspective, focused on the experiences of digital female entrepreneurs in the Western Cape of South Africa. Data were collected via semi-structured interviews and analyzed through the interpretative phenomenological analysis (IPA) approach to determine the relationships between digital entrepreneurship and structural and agential enabling conditions. Findings show that digital entrepreneurship is not a panacea for economic growth in marginalized groups and communities and highlight the importance of addressing socio-cultural gender inequality to enable successful entrepreneurial activity. The paper concludes with recommendations for specialized training initiatives aimed at female entrepreneurs that address internalized constraints and barriers that keep women subservient and measures to shift gender and power beliefs. The outcome will benefit the stimulation of gender-specific public policies to develop a successful digital start-up ecosystem further.

Keywords: digital innovation, female digital entrepreneurs, feminist phenomenology, gender, marginalised communities

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Authors: Lindy Van Vliet, Saloni Phadke, Anthea Nelson, Ann Gallant

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Holistic and patient-centred palliative care and support require an integrated system of care that includes health and social service providers working together to ensure that patients and families have access to the care they need. The objective of this study is to further explore and understand the benefits and challenges of mobilizing multidisciplinary care teams for health care professionals and social service providers. Drawing on an interpretivist, exploratory, qualitative design, our multidisciplinary research team (medicine, nursing and social work) conducted interviews with 15 health care and social service providers in the Ottawa region. Interview data was audio-recorded, transcribed, and analyzed using a reflexive thematic analysis approach. The data deepens our understandings of the facilitators and barriers posed by multidisciplinary care teams. Three main findings emerged: First, the data highlighted the benefits of multidisciplinary care teams for both patient outcomes and quality of life and provider mental health; second, the data showed that the lack of a system-wide integrated communication system reduces the quality of patient care and increases provider stress while working in multidisciplinary care teams; finally, the data demonstrated the existence of implicit hierarchies between disciplines, this coupled with different disciplinary perspectives of palliative care provision can lead to friction and challenges within care teams. These findings will have important implications for the future of palliative care as they will help to facilitate and build stronger person-centred/relationship-centred palliative care practices by naming the challenges faced by multidisciplinary palliative care teams and providing examples of best practices.

Keywords: public health palliative care, palliative care nursing, care networks, integrated health care, palliative care approach, public health, multidisciplinary work, care teams

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Authors: Renee Fabian, Jordan Davidson

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Current research on non-suicidal self-injury (NSSI) provides ample insights on best practices for caregivers and clinicians to address and reduce NSSI behavior among adolescents. However, the efficacy of evidenced-based NSSI interventions and their delivery from the perspective of adolescent patients does not receive significant attention, creating a gap between the efficacy of research-based NSSI interventions and adolescent perceptions of NSSI treatment and adolescent willingness to engage in NSSI interventions. To address the gap between practice and patient perspectives and inform more effective treatment outcomes, the current survey aims to identify major patient-reported adverse reactions to NSSI disclosures from caregivers, treating mental health clinicians, and medical professionals using a mixed methods survey of 2,500 people with a history of NSSI completed by editors at a consumer-facing health publication. Based on the analyzed results of the survey, a majority of adolescents with a history of NSSI found parents and caregivers ineffective at empathetically addressing NSSI, and a significant number of participants reported at least one treating mental health professional inadequately responded to NSSI behaviors, in addition to other findings of adverse reactions to NSSI disclosures that serve as a barrier to treatment. NSSI is a significant risk factor for future suicide attempts. Addressing patient-reported adverse reactions to NSSI disclosures in the adolescent population can remove barriers to the effectiveness of caregiver and clinician NSSI interventions and reduce the risk of NSSI-related harm and lower the risk of future suicide attempts or completions.

Keywords: adolescent self-injury, non-suicidal self-injury, patient perspectives, self-harm interventions

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Authors: Krithika Lakshmi Sathiya Moorthy

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Introduction: Young people’s attitude towards Intimate partner violence (IPV) is likely to influence their indulgence in or abstinence from IPV in future. We aimed to assess the knowledge and attitudes of college students in a south Indian city regarding IPV, its associated factors and redressal mechanisms. Methods: A convenient sample of 247 students, pursuing medicine and engineering, participated in this analytical cross sectional study. They responded to a self-administered questionnaire developed and pretested for this study. The questionnaire comprises statements from a third person’s perspective and vignettes to reduce social desirability bias. Clearance was obtained from the Institute Ethical Committee of Velammal Medical College Hospital and Research Institute, Madurai, India. Data were entered in Epidata Entry v3.1, Odense, Denmark and analysed using SPSS v20.0. Results: Among 247 students, 116 (47%) were males and 59 (24.9%) hailed from rural areas. About 18% (43) of students believed that IPV was a problem only among females. Almost half of the students had witnessed IPV; at home between their parents (9.7%), other family members (13.4%), in their neighbourhood (13%) or public places (15%). Only 118 (47.8%) were aware that a law was in place in India to address IPV. The perceived risk factors for IPV were alcoholic spouse (78.9%), low income families (53.8%), personality traits (52.2%) and dowry system (51%). A sizeable number of students (38.4%) believed that some amount of physical violence was allowable in a marital relationship while 57.6% even considered IPV as an expression of love. Males as compared to females were more in agreement with negative gender stereotypes such as husband can– ‘threaten wife to ensure welfare of family’ (55% vs. 34%, p < 0.001), ‘spy on wife to check fidelity’ (41% vs. 27%, p < 0.001), ‘financially deprive housewife to punish’ (13% vs. 3.8%, p=0.001) and agreed with the statement that it is ‘duty of wife to comply with demands for sex from the husband’ (9.5% vs 4.6%, p=0.3). About 32% males and 25.6% females foresaw themselves as perpetrators of IPV in future. Conclusion: Knowledge about IPV and the associated risk factors among the study population was satisfactory. However, there was widespread acceptance of negative societal gender stereotypes, more so among males and some degrees of IPV were acceptable between married couples. The study advocates the need to halt the propagation of negative gender stereotypes in the impressionable young minds and the necessity to spread the awareness that no degree of IPV is acceptable. This knowledge is also required to plan the content and choose the appropriate media to effectively communicate the awareness about IPV among young persons.

Keywords: attitude, India, intimate partner violence, knowledge, students

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Authors: Reshma P. Nuri, Ebenezer Dassah

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

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

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Authors: Simone Huber, Bianca Schnalzer, Baptiste Alcalde, Sten Hanke, Lampros Mpaltadoros, Thanos G. Stavropoulos, Spiros Nikolopoulos, Ioannis Kompatsiaris, Lina Pérez- Breva, Vallivana Rodrigo-Casares, Jaime Fons-Martínez, Jeroen de Bruin

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Developing new medicine and health solutions and improving patient health currently rely on the successful execution of clinical trials, which generate relevant safety and efficacy data. For their success, recruitment and retention of participants are some of the most challenging aspects of protocol adherence. Main barriers include: i) lack of awareness of clinical trials; ii) long distance from the clinical site; iii) the burden on participants, including the duration and number of clinical visits and iv) high dropout rate. Most of these aspects could be addressed with a new paradigm, namely the Remote Decentralized Clinical Trials (RDCTs). Furthermore, the COVID-19 pandemic has highlighted additional advantages and challenges for RDCTs in practice, allowing participants to join trials from home and not depend on site visits, etc. Nevertheless, RDCTs should follow the process and the quality assurance of conventional clinical trials, which involve several processes. For each part of the trial, the Building Blocks, existing software and technologies were assessed through a systematic search. The technology needed to perform RDCTs is widely available and validated but is yet segmented and developed in silos, as different software solutions address different parts of the trial and at various levels. The current paper is analyzing the availability of technology to perform RDCTs, identifying gaps and providing an overview of Basic Building Blocks and functionalities that need to be covered to support the described processes.

Keywords: architectures and frameworks for health informatics systems, clinical trials, information and communications technology, remote decentralized clinical trials, technology availability

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Authors: Fulufhelo Oscar Makananise

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Digital technologies have played a significant role in bridging the information gap between the haves and the have nots in society. In developing countries such as South Africa, historically marginalised groups such as women in rural communities have an opportunity to use digital technologies to network among themselves as well as interact with their government, thereby enhancing prospects for poverty eradication, political participation, community development and democracy. However, the extent to which these goals can be achieved in a developing context through harnessing digital technologies is not quite clear, particularly given the fact that access to these technologies is not evenly distributed and the fact that women’s access to digital technologies is hampered by factors that go beyond the question of infrastructure. Informed by the technological dependency theory, this paper is about how female youth in rural South Africa are deploying digital media tools for socio-economic empowerment. In particular, the study investigated the extent to which female youth in Limpopo province, South Africa access and use digital media platforms and gadgets and the extent to which those technologies are breaking down barriers that stand in the way of female youth empowerment. Data were gathered using a self-administered questionnaire disseminated to selected 100 female youth in Limpopo Province, South Africa. The data were analysed using SPSS version 9, and the results were analysed using descriptive statistics. The paper argues that wider and constant access to digital media by female youth in rural areas is indicative of the great potential for empowering female youth in rural areas through harnessing digital media. The study established that the majority of female youth had access to digital media technologies and used them to share valuable information among themselves. The study further established that female youth are active users of digital media in South Africa, which is the significant driver for socio-economic empowerment.

Keywords: digital technologies, empowerment, female youth, South Africa, survey, technological dependency

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Authors: Abdelrhman Elagez, Rolla Monib

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This empirical study investigates the observed risks associated with adopting Artificial Intelligence (AI) technologies in the construction industry and proposes potential mitigation strategies. While AI has transformed several industries, the construction industry is slowly adopting advanced technologies like AI, introducing new risks that lack critical analysis in the current literature. A comprehensive literature review identified a research gap, highlighting the lack of critical analysis of risks and the need for a framework to measure and mitigate the risks of AI implementation in the construction industry. Consequently, an online survey was conducted with 24 project managers and construction professionals, possessing experience ranging from 1 to 30 years (with an average of 6.38 years), to gather industry perspectives and concerns relating to AI integration. The survey results yielded several significant findings. Firstly, respondents exhibited a moderate level of familiarity (66.67%) with AI technologies, while the industry's readiness for AI deployment and current usage rates remained low at 2.72 out of 5. Secondly, the top-ranked barriers to AI adoption were identified as lack of awareness, insufficient knowledge and skills, data quality concerns, high implementation costs, absence of prior case studies, and the uncertainty of outcomes. Thirdly, the most significant risks associated with AI use in construction were perceived to be a lack of human control (decision-making), accountability, algorithm bias, data security/privacy, and lack of legislation and regulations. Additionally, the participants acknowledged the value of factors such as education, training, organizational support, and communication in facilitating AI integration within the industry. These findings emphasize the necessity for tailored risk assessment frameworks, guidelines, and governance principles to address the identified risks and promote the responsible adoption of AI technologies in the construction sector.

Keywords: risk management, construction, artificial intelligence, technology

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Authors: Julia Brudzinski, Ashley Croswell, Jade Mardin, Hannah Shilling, Jennifer Berg-Carnegie

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Adults with brain injuries and mental illnesses commonly experience cognitive impairments that interfere with their participation in activities of daily living (ADLs). Prior research states that electronic reminder systems can support adults with cognitive impairments; however, previous studies focus primarily on one-way reminder systems. Research on adults with chronic diseases reported that two-way reminder systems yield better health outcomes and disease self-management compared to one-way reminder systems. Literature was identified through systematically searching 7 databases and hand-searching relevant reference lists. Retrieved studies were independently screened and reviewed by at least two members of the research team. Data was extracted on study design, participant characteristics, intervention details, study objectives, outcome measures, and important results. 574 articles were screened and reviewed. Nine articles met all inclusion criteria and were included. The literature focused on three main areas: system feasibility (n=8), stakeholder satisfaction (n=6), and efficacy of the two-way reminder systems (n=6). Participants in eight of the studies had brain injuries, with participants in only one study having a mental illness (i.e., schizophrenia). Two-way reminder systems were used to support participation in a wide range of ADLs. The current literature on two-way reminder systems to support ADLs for adults with cognitive impairments focuses on feasibility, stakeholder satisfaction, and system efficacy. Future research should focus on addressing the barriers to accessing and implementing two-way reminder systems and identifying specific client characteristics that would benefit most from using these systems.

Keywords: brain injury, digital health, occupational therapy, activities of daily living, two-way reminder systems

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