Search results for: rapid access clinic

Authors: Mustafa Mutahari, Nao Sugiki, Kojiro Matsuo

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The four decades of war, lack of job opportunities, poverty, lack of services, and natural disasters in different provinces of Afghanistan have contributed to a rapid increase in the population of Kabul, the capital city of Afghanistan. Population census has not been conducted since 1979, the first and last population census in Afghanistan. However, according to population estimations by Afghan authorities, the population of Kabul has been estimated at more than 4 million people, whereas the city was designed for two million people. Although the major transport mode of Kabul residents is public transport, responsible authorities within the country failed to supply the required means of transportation systems for the city. Besides, informal resettlement, lack of intersection control devices, presence of illegal vendors on streets, presence of illegal and unstandardized on-street parking and bus stops, driver`s unprofessional behavior, weak traffic law enforcement, and blocked roads and sidewalks have contributed to the extreme traffic congestion of Kabul. In 2018, the government of Afghanistan approved the Kabul city Urban Design Framework (KUDF), a vision towards the future of Kabul, which provides strategies and design guidance at different scales to direct urban development. Considering traffic congestion of the city and its budget limitations, the KUDF proposes a BRT route network with seven lines to reduce the traffic congestion, and it is said to facilitate more than 50% of Kabul population to benefit from this service. Based on the KUDF, it is planned to increase the BRT mode share from 0% to 17% and later to 30% in medium and long-term planning scenarios, respectively. Therefore, a detailed research study is needed to evaluate the proposed system before the implementation stage starts. The integrated land-use transport model is an effective tool to evaluate the Kabul BRT because of its future assessment capabilities that take into account the interaction between land use and transportation. This research aims to analyze and evaluate the proposed BRT route network with the application of an integrated land-use and transportation model. The research estimates the population distribution and travel behavior of Kabul within small boundary scales. The actual road network and land-use detailed data of the city are used to perform the analysis. The BRT corridors are evaluated not only considering its impacts on the spatial interactions in the city`s transportation system but also on the spatial developments. Therefore, the BRT are evaluated with the scenarios of improving the Kabul transportation system based on the distribution of land-use or spatial developments, planned development typology and population distribution of the city. The impacts of the new improved transport system on the BRT network are analyzed and the BRT network is evaluated accordingly. In addition, the research also focuses on the spatial accessibility of BRT stops, corridors, and BRT line beneficiaries, and each BRT stop and corridor are evaluated in terms of both access and geographic coverage, as well.

Keywords: accessibility, BRT, integrated land-use and transport model, travel behavior, spatial development

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Authors: Samuel Owoade, Zainab Idowu, Idris Ajibade, Abel Uzoka

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Cloud computing adoption continues to soar, with 83% of enterprise workloads estimated to be in the cloud by 2022. However, this rapid migration raises security concerns, needing strong security management solutions to safeguard sensitive data and essential applications. This paper investigates the critical role of technical project managers in orchestrating security management initiatives for cloud environments, evaluating their responsibilities, challenges, and best practices for assuring the resilience and integrity of cloud infrastructures. Drawing from a comprehensive review of industry reports and interviews with cloud security experts, this research highlights the multifaceted landscape of security management in cloud environments. Despite the rapid adoption of cloud services, only 25% of organizations have matured their cloud security practices, indicating a pressing need for effective management strategies. This paper proposes a strategy framework adapted to the demands of technical project managers, outlining the important components of effective cloud security management. Notably, 76% of firms identify misconfiguration as a major source of cloud security incidents, underlining the significance of proactive risk assessment and constant monitoring. Furthermore, the study emphasizes the importance of technical project managers in facilitating cross-functional collaboration, bridging the gap between cybersecurity professionals, cloud architects, compliance officers, and IT operations teams. With 68% of firms seeing difficulties integrating security policies into their cloud systems, effective communication and collaboration are critical to success. Case studies from industry leaders illustrate the practical use of security management projects in cloud settings. These examples demonstrate the importance of technical project managers in using their expertise to address obstacles and generate meaningful outcomes, with 92% of firms reporting improved security practices after implementing proactive security management tactics. In conclusion, this research underscores the critical role of technical project managers in safeguarding cloud environments against evolving threats. By embracing their role as guardians of the cloud realm, project managers can mitigate risks, optimize resource utilization, and uphold the trust and integrity of cloud infrastructures in an era of digital transformation.

Keywords: cloud security, security management, technical project management, cybersecurity, cloud infrastructure, risk management, compliance

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Authors: Marek Vondra, Petr Bobák

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Vacuum evaporation is a reliable and well-proven technology with a wide application range which is frequently used in food, chemical or pharmaceutical industries. Recently, numerous remarkable studies have been carried out to investigate utilization of this technology in the area of wastewater treatment. One of the most successful applications of vacuum evaporation principal is connected with seawater desalination. Since 1950’s, multi-stage flash distillation (MSF) has been the leading technology in this field and it is still irreplaceable in many respects, despite a rapid increase in cheaper reverse-osmosis-based installations in recent decades. MSF plants are conveniently operated in countries with a fluctuating seawater quality and at locations where a sufficient amount of waste heat is available. Nowadays, most of the MSF research is connected with alternative heat sources utilization and with hybridization, i.e. merging of different types of desalination technologies. Some of the studies are concerned with basic principles of the static flash phenomenon, but only few scientists have lately focused on the fundamentals of continuous multi-stage evaporation. Limited measurement possibilities at operating plants and insufficiently equipped experimental facilities may be the reasons. The aim of the presented study was to design, construct and test an up-to-date test rig with an advanced measurement system which will provide real time monitoring options of all the important operational parameters under various conditions. The whole system consists of a conventionally designed MSF unit with 8 evaporation chambers, versatile heating circuit for different kinds of feed water (e.g. seawater, waste water), sophisticated system for acquisition and real-time visualization of all the related quantities (temperature, pressure, flow rate, weight, conductivity, pH, water level, power input), access to a wide spectrum of operational media (salt, fresh and softened water, steam, natural gas, compressed air, electrical energy) and integrated transparent features which enable a direct visual control of selected physical mechanisms (water evaporation in chambers, water level right before brine and distillate pumps). Thanks to the adjustable process parameters, it is possible to operate the test unit at desired operational conditions. This allows researchers to carry out statistical design and analysis of experiments. Valuable results obtained in this manner could be further employed in simulations and process modeling. First experimental tests confirm correctness of the presented approach and promise interesting outputs in the future. The presented experimental apparatus enables flexible and efficient research of the whole MSF process.

Keywords: design of experiment, multi-stage flash distillation, test rig, vacuum evaporation

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Authors: N. Chaitawittanun, M. Munlin

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Due to rapid advancement of powerful image processing software, digital images are easy to manipulate and modify by ordinary people. Lots of digital images are edited for a specific purpose and more difficult to distinguish form their original ones. We propose a clustering method to detect a copy-move image forgery of JPEG, BMP, TIFF, and PNG. The process starts with reducing the color of the photos. Then, we use the clustering technique to divide information of measuring data by Hausdorff Distance. The result shows that the purposed methods is capable of inspecting the image file and correctly identify the forgery.

Keywords: image detection, forgery image, copy-paste, attack detection

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Authors: Chigbu Ruth Nnena

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This paper discussed the concept of meat its nutritive value in family meals. The paper further discussed the selection, storage and preparation of meat in family meal the Nigerian way. The paper made the following recommendations among others; that families in Nigeria should rear cow meat for easy access to the meant and that family should purchase meat that are fresh from chain shops in the market to avoid meat contamination among others.

Keywords: meat, selection, storage meals, concept and preparation

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Authors: Onosedeba Mary Ayayia

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Inclusive education has emerged as a critical global imperative, aiming to provide equitable educational opportunities for all, regardless of their abilities or disabilities. In Africa, the pursuit of inclusive education faces significant challenges, particularly concerning the development and implementation of inclusive curricula tailored to the diverse needs of students with disabilities. This study delves into the heart of this issue, seeking to address the pressing problem of exclusion and marginalization of students with disabilities in mainstream educational systems across the continent. The problem is complex, entailing issues of limited access to tailored curricula, shortages of qualified teachers in special needs education, stigmatization, limited research and data, policy gaps, inadequate resources, and limited community awareness. These challenges perpetuate a system where students with disabilities are systematically excluded from quality education, limiting their future opportunities and societal contributions. This research proposes a comprehensive examination of the current state of inclusive curriculum development and implementation in Africa. Through an innovative and explicit exploration of the problem, the study aims to identify effective strategies, guidelines, and best practices that can inform the development of inclusive curricula. These curricula will be designed to address the diverse learning needs of students with disabilities, promote teacher capacity building, combat stigmatization, generate essential data, enhance policy coherence, allocate adequate resources, and raise community awareness. The goal of this research is to contribute to the advancement of inclusive education in Africa by fostering an educational environment where every student, regardless of ability or disability, has equitable access to quality education. Through this endeavor, the study aligns with the broader global pursuit of social inclusion and educational equity, emphasizing the importance of inclusive curricula as a foundational step towards a more inclusive and just society.

Keywords: inclusive education, special education, curriculum development, Africa

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Authors: Mohamed A. Hammad, Dzul Azri Mohamed Noor, Syed Azhar Syed Sulaiman, Majed Ahmed Al-Mansoub, Muhammad Qamar

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There is a progressive increase in the prevalence of early onset Type 2 diabetes mellitus. Early detection of Type 2 diabetes enhances the length and/or quality of life which might result from a reduction in the severity, frequency or prevent or delay of its long-term complications. The study aims to determine the onset age for the first diagnosis of Type 2 diabetes mellitus. A retrospective study conducted in the endocrine clinic at Hospital Pulau Pinang in Penang, Malaysia, January- December 2016. Records of 519 patients with Type 2 diabetes mellitus were screened to collect demographic data and determine the age of first-time diabetes mellitus diagnosis. Patients classified according to the age of diagnosis, gender, and ethnicity. The study included 519 patients with age (55.6±13.7) years, female 265 (51.1%) and male 254 (48.9%). The ethnicity distribution was Malay 191 (36.8%), Chinese 189 (36.4%) and Indian 139 (26.8%). The age of Type 2 diabetes diagnosis was (42±14.8) years. The female onset of diabetes mellitus was at age (41.5±13.7) years, while male (42.6±13.7) years. Distribution of diabetic onset by ethnicity was Malay at age (40.7±13.7) years, Chinese (43.2±13.7) years and Indian (42.3±13.7) years. Diabetic onset was classified by age as follow; ≤20 years’ cohort was 33 (6.4%) cases. Group >20- ≤40 years was 190 (36.6%) patients, and category >40- ≤60 years was 270 (52%) subjects. On the other hand, the group >60 years was 22 (4.2%) patients. The range of diagnosis was between 10 and 73 years old. Conclusion: Malay and female have an earlier onset of diabetes than Indian, Chinese and male. More than half of the patients had diabetes between 40 and 60 years old. Diabetes mellitus is becoming more common in younger age <40 years. The age at diagnosis of Type 2 diabetes mellitus has decreased with time.

Keywords: age of onset, diabetes diagnosis, diabetes mellitus, Malaysia, outpatients, type 2 diabetes, retrospective study

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Authors: M. L. Seretlo-Rangata, T. Sodi, S. Govender

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Despite interventions by various governments to regulate water demand and address water scarcity, literature shows that billions of people across the world continue to struggle with access because not everyone contributes equally to conservation efforts. Behavioral factors such as individual and collective aspects of cognition and commitment have been found to play an important role in water conservation. The aim of the present study was to explore the perceptions of community members in the Lephalale area, Limpopo province, towards water conservation with a view to developing an explanatory psychological model on water conservation. Twenty (20) participants who relied on communal taps to access water in Lephalale Local Municipality, Limpopo province, were selected through purposeful sampling. In-depth, semi-structured, individual face-to-face interviews were used to gather data and were analyzed utilizing thematic content analysis (TCA). The research findings revealed that there are various psychological effects of water scarcity on communities, such as emotional distress, interpersonal conflicts and disruptions of daily activities of living. Additionally, the study results showed that the coping strategies developed by participants to deal with water scarcity included adopting alternative water use behaviors as well as adjusting current behaviors and lifestyles. Derived from the study findings, a psychological model of water conservation was developed. The model incorporates some ideas from the Value-Belief-Norm (VBN) theory and the Afrocentric theory. The model suggests that people’s worldviews, including their values, beliefs and culture, are significant determinants of their pro-environmental behaviors. The study concludes by recommending that authorities and policymakers should consider psychological factors when developing water management programs, strategies and interventions with the consultation of psychology experts.

Keywords: water conservation, psychological model, pro-environmental behaviour, conservation psychology, water-use behaviour

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Authors: Anushka Naidoo, Veron Ramsuran, Maxwell Chirehwa, Paolo Denti, Kogieleum Naidoo, Helen McIlleron, Nonhlanhla Yende-Zuma, Ravesh Singh, Sinaye Ngcapu, Nesri Padayatachi

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Background: Despite efforts to introduce new drugs and shorter drug regimens for drug-susceptible tuberculosis (TB), the standard first-line treatment has not changed in over 50 years. Rifampicin, isoniazid, and pyrazinamide are critical components of the current standard treatment regimens. Some studies suggest that microbiologic failure and acquired drug resistance are primarily driven by low drug concentrations that result from pharmacokinetic (PK) variability independent of adherence to treatment. Wide between-patient pharmacokinetic variability for rifampin, isoniazid, and pyrazinamide has been reported in prior studies. There may be several reasons for this variability. However, genetic variability in genes coding for drug metabolizing and transporter enzymes have been shown to be a contributing factor for variable tuberculosis drug exposures. Objective: We describe the pharmacokinetics of first-line TB drugs rifampicin, isoniazid, and pyrazinamide and assess the effect of genetic variability in relevant selected drug metabolizing and transporter enzymes on pharmacokinetic parameters of isoniazid and rifampicin. Methods: We conducted the randomized-controlled Improving retreatment success TB trial in Durban, South Africa. The drug regimen included rifampicin, isoniazid, and pyrazinamide. Drug concentrations were measured in plasma, and concentration-time data were analysed using nonlinear-mixed-effects models to quantify the effects of relevant covariates and single nucleotide polymorphisms (SNP’s) of drug metabolizing and transporter genes on rifampicin, isoniazid and pyrazinamide exposure. A total of 25 SNP’s: four NAT2 (used to determine acetylator status), four SLCO1B1, three Pregnane X receptor (NR1), six ABCB1 and eight UGT1A, were selected for analysis in this study. Genotypes were determined for each of the SNP’s using a TaqMan® Genotyping OpenArray™. Results: Among fifty-eight patients studied; 41 (70.7%) were male, 97% black African, 42 (72.4%) HIV co-infected and 40 (95%) on efavirenz-based ART. Median weight, fat-free mass (FFM), and age at baseline were 56.9 kg (interquartile range, IQR: 51.1-65.2), 46.8 kg (IQR: 42.5-50.3) and 37 years (IQR: 31-42), respectively. The pharmacokinetics of rifampicin and pyrazinamide was best described using one-compartment models with first-order absorption and elimination, while for isoniazid two-compartment disposition was used. The median (interquartile range: IQR) AUC (h·mg/L) and Cmax (mg/L) for rifampicin, isoniazid, and pyrazinamide were; 25.62 (23.01-28.53) and 4.85 (4.36-5.40), 10.62 (9.20-12.25) and 2.79 (2.61-2.97), 345.74 (312.03-383.10) and 28.06 (25.01-31.52), respectively. Eighteen percent of patients were classified as rapid acetylators, and 34% and 43% as slow and intermediate acetylators, respectively. Rapid and intermediate acetylator status based on NAT 2 genotype resulted in 2.3 and 1.6 times higher isoniazid clearance than slow acetylators. We found no effects of the SLCO1B1 genotypes on rifampicin pharmacokinetics. Conclusion: Plasma concentrations of rifampicin, isoniazid, and pyrazinamide were low overall in our patients. Isoniazid clearance was high overall and as expected higher in rapid and intermediate acetylators resulting in lower drug exposures. In contrast to reports from previous South African or Ugandan studies, we did not find any effects of the SLCO1B1 or other genotypes tested on rifampicin PK. However, our findings are in keeping with more recent studies from Malawi and India emphasizing the need for geographically diverse and adequately powered studies. The clinical relevance of the low tuberculosis drug concentrations warrants further investigation.

Keywords: rifampicin, isoniazid pharmacokinetics, genetics, NAT2, SLCO1B1, tuberculosis

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Authors: Tanya Greathosue, Adrianna Taylor, Lori Darnel, Eileen Starr, Susie Ryder, Julie Clockston, Dawn Matera Bassett, Jess Retrum

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The United States has an identified need to improve the social work mental and behavioral health workforce shortage with a focus on culturally diverse and responsive mental and behavioral health practitioners to adequately serve its rapidly growing multicultural communities. The U.S. is experiencing rapid demographic changes. Ensuring that mental and behavioral health services are effective and accessible for diverse communities is essential for improving overall health outcomes. In response to this need, we developed a training program focused on interdisciplinary collaboration, evidence-based practices, and culturally responsive services. The success of the training program, funded by the Health Resource Service Administration (HRSA) Behavioral Health Workforce Education and Training (BHWET), has provided the foundation for stage two of our programming. In addition to HRSA/BHWET, we are receiving funding from Colorado Access, a state workforce development initiative, and Kaiser Permanente, a healthcare provider network in the United States. We have moved beyond improved learner outcomes to increasing recruitment of historically excluded, disproportionately mistreated learners, mentorship of students to improve retention, and successful, culturally responsive, diverse workforce development. These authors will utilize a pretest-posttest comparison group design and trend analysis to evaluate the success of the training program. Comparison groups will be matched based on age, gender identification, race, income, as well as prior experience in the field, and time in the degree program. This article describes our culturally responsive training program. Our goals are to increase the recruitment and retention of historically excluded, disproportionately mistreated learners. We achieve this by integrating cultural humility and sensitivity training into educational curricula for our scholars who participate in cohort classroom and seminar learning. Additionally, we provide our community partners who serve as internship sites with ongoing continuing education on how to promote and develop inclusive and supportive work environments for our learners. This work will be of value to mental and behavioral health care practitioners who serve historically excluded and mistreated populations. Participants will learn about culturally informed best practices to increase recruitment and retention of culturally diverse learners. Additionally, participants will hear how to create a culturally responsive training program that encourages an inclusive community for their learners through cohort learning, mentoring, community networking, and critical accountability.

Keywords: culturally diverse mental health practitioners, recruitment, mentorship, workforce development, underserved clinics, professional development

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Authors: Maja Ruzic-Baf, Vedrana Keteles, Andrea Debeljuh

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Younger and younger children are now using a smartphone, a device which has become ‘a must have’ and the life of children would be almost ‘unthinkable’ without one. Devices are becoming lighter and lighter but offering an array of options and applications as well as the unavoidable access to the Internet, without which it would be almost unusable. Numerous features such as taking of photographs, listening to music, information search on the Internet, access to social networks, usage of some of the chatting and messaging services, are only some of the numerous features offered by ‘smart’ devices. They have replaced the alarm clock, home phone, camera, tablet and other devices. Their use and possession have become a part of the everyday image of young people. Apart from the positive aspects, the use of smartphones has also some downsides. For instance, free time was usually spent in nature, playing, doing sports or other activities enabling children an adequate psychophysiological growth and development. The greater usage of smartphones during classes to check statuses on social networks, message your friends, play online games, are just some of the possible negative aspects of their application. Considering that the age of the population using smartphones is decreasing and that smartphones are no longer ‘foreign’ to children of pre-school age (smartphones are used at home or in coffee shops or shopping centers while waiting for their parents, playing video games often inappropriate to their age), particular attention must be paid to a very sensitive group, the teenagers who almost never separate from their ‘pets’. This paper is divided into two sections, theoretical and empirical ones. The theoretical section gives an overview of the pros and cons of the usage of smartphones, while the empirical section presents the results of a research conducted in three elementary schools regarding the usage of smartphones and, specifically, their usage during classes, during breaks and to search information on the Internet, check status updates and 'likes’ on the Facebook social network.

Keywords: education, smartphone, social networks, teenagers

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Authors: Carolyne Ndungu, Wesley Too, Diana Kassaman

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Diabetes is a global public health problem with an increasing morbidity and mortality rate across the globe. It is reported that 422 million people worldwide have diabetes with type 2 diabetes more common in people of African descent. Whilst prevalence of diabetes is four times more than it was in the last three decades, making it the world's ninth greatest cause of mortality, treatment of complications resulting from poor glycemic control is still high, contributing to poverty level in sub-Saharan. Poor treatment adherence has also been identified as a major contributing factor poor glycemic control among diabetic patients and still remains a significant challenge especially among patients living in rural Kenya. This study therefore seeks to identify gaps, barriers and challenges towards medication non-adherence among diabetic patients on follow-up at Kiambu County Referral Hospital, Kenya. Methods: A cross- sectional descriptive study was carried out at Gatundu Level five Hospital in Kiambu County. The study population consisted of adult patients with type two diabetes mellitus (T2DM) on follow up, at the Diabetes clinic between the month of June to July 2022. Systematic sampling of 200 participants was carried out. Ethical approvals from relevant authorities were done and ethical aspects of the study were also observed. Data analysis is ongoing using logistic regression analysis. Results, recommendations -contribution of this study will be highlighted within the next one month.

Keywords: adherence, diabetes, medication, Kenya

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Authors: Tamekloe Michael Kossivi, Kenichi Matsui

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Irrigation access is one of the essential rural development investment options that can significantly improve smallholder farmers’ agriculture productivity. Investment in irrigation infrastructural development to supply adequate water could improve food security, growth in income for farmers, poverty alleviation, and improve business and livelihood. This paper assesses smallholder farmers’ constraints and the needs to adopt small-scale irrigation for crops production in the South Tongu District of Ghana. The data collection involved database search, questionnaire survey, interview, and field work. The structured questionnaire survey was administered from September to November 2020 among 120 respondents in six purposively sampled irrigation communities in the District. The questions focused on small-scale irrigation development constraints and needs. As a result, we found that the respondents relied mainly on rainfall for agriculture production. They did not have adequate irrigation access. Even though the District is blessed with open arable lands and rich water sources for rice and vegetable production on a massive scale, water sources like the Lower Volta River, Tordzi River, and Avu Lagoon were not close enough to the respondents. The respondents faced inadequate credit support (100%), unreliable rainfall (76%), insufficient water supply (54%), and unreliable water delivery challenges on their farms (53%). Physical constraints for the respondents to adopt irrigation included flood (77%), drought (93%), inadequate irrigation technology (59%), and insufficient technical know-how (65%). Farmers were interested in investing in irrigation infrastructural development to enhance productivity on their farms only if they own the farmlands. External support from donors on irrigation systems did not allow smallholder farmers to control irrigation facilities.

Keywords: constraints, food security, needs, smallholder farmers, small-scale irrigation

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Authors: Subesh Panta

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The land is a one of the major boosting factors of production for the agricultural country like Nepal where access to land has been a major source of livelihood of tenants and small farmers. But there is an absence of secure land tenure arrangement which drastically affect the overall production of farmers leading towards food insecurity. Sharecropping is practiced in Nepal especially in tarai region from early period, but there is the gap in the academic study whether the sharecropping has benefitted tenant farmers and make them food sufficient or not. This study attempts to find out the food sufficiency among the tenant households. The research was carried in the three VDCs of Parsa district -Paterwa (Sugauli), Jitpur and Nirchuta. A total of 111 households were determined as the sample size from each of the three VDCs was randomly visited for interview in the study. The size of land rent-in was found to be very small and fragmented. At the same time, the land tenure security was not found to be secured among the tenants. Due to lack of land tenure security, on one hand tenants and small farmers were not found to be motivated to investment in agriculture as they need to share fifty percent of their production with the land owners, and on other hand land owners were also not interested in investing as they have other alternative sources of livelihood rather than agriculture. In conclusion, the study highpoint that the crop production and food sufficiency level of the tenants’ farmers of the Parsa district are decreasing. Many tenants’ farmers are seeking alternative opportunities for livelihood rather than sharecropping due to insecure land tenure, feudalistic practice, lack of storage for agriculture production, lack of proper agro-market. The situation is such that, if no action is taken timely, there may be a situation that we will have to depend on imports for all the food requirements. Thus, the study discloses that the sharecropping could act as catalyst for ensuring food sufficiency for all, if proper land tenure police are promoted to tenants/small farmers with legal titles to their land or promoted with sustainable agriculture methods.

Keywords: agriculture, food sufficiency, land, tenant farmes

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Authors: Michaels Aibangbee, Sowbhagya Micheal, Pranee Liamputtong, Elias Mpofu, Tinashe Dune

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Background: The challenges migrants and refugee youth (MRY) experience in maintaining their sexual and reproductive health and rights (SRHR) continues to be a global public health issue. Consequently, MRY is more likely to encounter adverse SRH experiences due to limited access to and knowledge of SRH services. Using a socio-ecological framework, this study examined the MRY’s SRHR micro-level experiences to macro-levels analyses of SRH-related social systems and constructions. Methods: Eighteen focus groups were conducted using participatory action research (PAR) methodology to understand the phenomena. The focus groups included MRY participants (ages 16-26) living in Greater Western Sydney and facilitated by youth project liaisons (YPL). The data was afterward synthesised and analysed using the thematic-synthesis method. Results: In total, 86 MRY (male n= 25, female n= 61) MRY (across 20 different cultural backgrounds) participated in the focus groups. The findings identified socio-ecological factors characterising MRY SRHR, highlighting facilitators such as social media and significant barriers such as lack of access to services and socio-cultural dissonance, and the under-implementation of SRHR support and services by MRY. Key themes from the data included traditional and institutional stigma, lack of SRH education, high reliance on social media for SRH information, anonymity, and privacy concerns. Conclusion: The data shows a limited extent to which MRY SRHR is considered and the intergenerational understanding and stigma affecting the rights of MRY. Therefore, these findings suggest a need for policies and practices to empower MRY’s agency through a collaborative SRHR strategy and policy design to maintain relevance in multicultural contexts.

Keywords: migrant and refugee youth, sexual health, reproductive health, sexual and reproductive health and rights, culture, agency

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Authors: Leandra Prempeh, Emily Malugen

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Prenatal drug exposure can have a molecular impact on the hypothalamic and reward genes that regulate feeding behavior. This can impact feeding regulation, resulting in feeding difficulties and growth failure. This was potentially seen in “McKayla,” a 19- month old girl with a history of in-utero drug exposure, patent ductus arteriosus, and gastroesophageal reflux disease who presented for intensive day treatment feeding therapy. She was diagnosed with Avoidant Restrictive Food Intake Disorder, described as total food refusal and meeting 100% of her caloric needs from a gastrostomy tube. The primary goals during intensive feeding therapy were to increase her oral intake and decrease her reliance on supplementation with formula. Several behavioral antecedent manipulations were implemented to establish consistent responding and make progress towards treatment goals. This included multiple modified bolus placements (using underloaded and Nuk brush), reinforcement contingencies, and variety fading before stability was finally achieved. Following, increasing retention of bites then increasing volume and variety were goals targeted. From treatment onset to the last 3 days of treatment, McKayla's rate of rapid acceptance of bite presentations increased significantly from 33.33% to 93.13%, rapid swallowing went from 0.00% to 92.32%, and her percentage of inappropriate mealtime behavior and expels decreased from 58.33% and 100% to 2.31% and 7.68%, respectively. Overall, the treatment team successfully introduced and increased the bite size of 7 pureed foods, generalize the treatment to caregivers with high integrity, and began facilitating tube weaning. She was receiving about 33.42% of her needs by mouth at the time of discharge. Other nutritional concerns addressed during treatment included drinking a nutritionally complete drink out of an open cup and age appropriate growth. McKayla continued to have emesis almost daily, as was her baseline before starting treatment; however, the frequency during mealtime decreased. Overall, McKayla responded well to treatment. She had a very slow response to treatment and required a lot of antecedent manipulations to establish consistent responding. As the literature suggests, [drug]-exposed neonates, like McKayla, may be at increased risk for nutritional and growth challenges that may persist throughout development. This supports the need for longterm follow-up of infant growth.

Keywords: behavioral intervention, feeding problems, in-utero drug exposure, intensive multidisciplinary intervention

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Authors: Mandana Karimi, Martha McMahon

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One of the most important consequences of water scarcity worldwide is the increase in conflicts over water issues, reduced access to clean water, food shortages, energy shortages, and reduced economic development. The extreme weather conditions in British Columbia are because of climate change, which is leading to water scarcity becoming a serious issue affecting British Columbians, aquatic ecosystems, the BC water policy, agriculture, and the economy. In light of climate change and water stress, the British Columbia government introduced a new water legislation in 2016 named the Water Sustainability Act to manage water resources in British Columbia. So, this study aimed to present a deep understanding emanating from the political and social dimensions of the new water policy in BC in the agriculture sector and which sociological paradigm governs the current water policy (WSA) in BC. Policy analysis based on the water problem representation approach was used to present the problem and solutions identified by the water policy in the agricultural sector in BC. The results of the policy analysis highlighted that the Water Sustainability Act is governed by a positivist and modernist approach because the groundwater license is the measurable situation to access the adequate quantity of water for the farmers. In addition, by the positivist paradigm water resources are conceptualized as a commodity to be bought and sold. Under the positivist approach, the measurable parameter of groundwater is also applied based on the top-down approach for water management to show the use of water resources for economic development. In addition, the findings of the policy analysis suggest that alternative paradigms, such as relational ontology, ecofeminism, and indigenous knowledge, could be applied in introducing water policies to shift from the positivist or modernist paradigm. These new paradigms present the potential for environmental policies like the Water Sustainability Act, based on partnership, and collaboration and with an explicit emphasis on protecting water for nature.

Keywords: water governance, Water Sustainability Act, water policy, small-scale farmer, policy analysis

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Authors: Rajib Husain, Mezbah Uddin, Mohammad Shamsal Islam, Rabeya Siddiquee

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Purpose: To determine the improvement of visual acuity in patients undergoing occlusion therapy. Methods: This was a prospective hospital-based study of newly diagnosed of amblyopia seen at the pediatric clinic of Chittagong Eye Infirmary & Training Complex. There were 32 refractive amblyopia subjects were examined & questionnaire was piloted. Included were all patients diagnosed with refractive amblyopia between 5 to 8 years, without previous amblyopia treatment, and whose parents were interested to participate in the study. Patients diagnosed with strabismic amblyopia were excluded. Patients were first corrected with the best correction for a month. When the VA in the amblyopic eye did not improve over a month, then occlusion treatment was started. Occlusion was done daily for 6-8 h together with vision therapy. The occlusion was carried out for three months. Results: Out of study 32 children, 31 of them have a good compliance of amblyopic treatment whereas one child has poor compliance. About 6% Children have amblyopia from Myopia, 7% Hyperopia, 32% from myopic astigmatism, 42% from hyperopic astigmatism and 13% have mixed astigmatism. The mean and Standard deviation of present average VA was 0.452±0.275 Log MAR and after an intervention of amblyopia therapy with vision therapy mean and Standard deviation VA was 0.155±0.157 Log MAR. Out of total respondent 21.85% have BCVA in range from (0-.2) log MAR, 37.5% have BCVA in range from (0.22-0.5) log MAR, 35.95% have in range from (0.52-0.8) log MAR, 4.7% have in range from (0.82-1) log MAR and after intervention of occlusion therapy with vision therapy 76.6% have VA in range from (0-.2) log MAR, 21.85% have VA in range from (0.22-0.5) log MAR, 1.5% have in range from (0.52-0.8) log MAR. Conclusion: Amblyopia is a most important factor in pediatric age group because it can lead to visual impairment. Thus, this study concludes that occlusion therapy with vision therapy is probably one of the best treatment methods for amblyopic patients (age 5-8 years), and compliance and age were the most critical factor predicting a successful outcome.

Keywords: amblyopia, occlusion therapy, vision therapy, eccentric fixation, visuoscopy

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Authors: Molla Tadesse Lakew

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This study was intended to identify the factors influencing the use of mobile phones in vegetable marketing in Fogera district. The use of mobile phones in vegetable marketing and factors influencing mobile phone use were specific objectives of the study. Three kebeles from the Fogera district were selected purposively based on their vegetable production potential. A simple random sampling technique (lottery method) was used to select 153 vegetable producer farmers. Interview schedule and key informants interviews were used to collect primary data. For analyzing the data, descriptive statistics like frequency and percentage, two independent t-tests, and chi-square were used. Furthermore, econometric analysis (binary logistic model) was used to assess the factors influencing mobile phone use for vegetable market information. Contingency coefficient and variance inflation factor were used to check multicollinearity problems between the independent variables. Of 153 respondents, 82 (61.72%) were mobile phone users, while 71 (38.28 %) were mobile phone nonusers. Moreover, the main use of mobile phones in vegetable marketing includes communicating at a distance to save time and minimizing transport costs, getting vegetable marketing price information, identifying markets and buyers to sell the vegetable, deciding when to sell the vegetable, negotiating with buyers for better vegetable prices and for searching of the fast market to avoid from losing of product through perishing. The model result indicated that the level of education, size of land, income, access to credit, and age were significant variables affecting the use of mobile phones in vegetable marketing. It could be recommended to encourage adult education or give training for farmers on how to operate mobile phones and create awareness for the elderly rural farmers as they are able to use the mobile phone for their vegetable marketing. Moreover, farmers should be aware that mobile phones are very important for those who own very small land to get maximum returns from their production. Lastly, providing access to credit and improving and diversifying income sources for the farmers to have mobile phones were recommended to improve the livelihood of farmers.

Keywords: mobile phone, farmers, vegetable marketing, Fogera District

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Authors: Carol Cameletti

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The goal of this study was to perform a pilot survey to assess pain frequency and intensity in an elderly population and to assess treatment options for chronic pain that include complementary and alternative medicines (CAM). Ten participants were recruited from an independent and supportive living housing facility in Northern Ontario and asked to complete two questionnaires: 1) a self-assessment on pain, and 2) the use of CAM for pain. Results from our study show that 80% of the participants experienced pains other than the regular everyday pains such as minor headaches, sprains or toothaches. Although participants stated that on average the highest level of pain they experienced within the past 24 hours had a score of 6.5 (0=no pain, 10=worst pain imaginable) the level of pain they experienced moderately interfered with their daily activities. Unfortunately, participants stated that they were only able to attain minimal levels of pain relief using treatments or medications causing some of the participants to seek alternative therapies or self-help practices. The most commonly used CAMs were vitamins/minerals, herbs and supplements, and self-help practices such as meditation, prayer, visualization and relaxation techniques. Although some of the participants stated that they had received complementary treatments directly from their physician, four of the nine participants said that they had not disclosed CAM use to their physician thereby indicating a need to open the lines of communication between healthcare providers and patients with regards to CAM use. It is our hope that the data generated from this study will serve as the platform for a pain management clinic that is client-centered, consumer-driven and truly integrative and tailored in order to meet the unique needs of older adults in Great Sudbury, Ontario.

Keywords: alternative, complementary, elderly, medicine

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Authors: Mirna Diab

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Mobile learning, or M-learning, drives the development of new teaching, learning, and assessment strategies in schools and colleges. With initiatives across states, districts, and institutions, the United States leads mobile learning, significantly impacting education. Since 2010, over 2,3 million American pupils have received their education via mobile devices, demonstrating its rapid expansion. Nonetheless, mobile learning lacks a consistent and explicit definition that helps educators, students, and stakeholders grasp its essence and implement it effectively. This article addresses the need for a revised definition by introducing readers to various mobile learning concepts and understandings. It seeks to raise awareness, clarify, and encourage making well-informed decisions regarding its incorporation as a potent learning tool.

Keywords: mobile learning, mobile pedagogy, mobile technological devices, learner mobility

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Authors: Raj Chavan

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The City of Jal serves a population of approximately 3,500 people, including 2,100 permanent inhabitants and 1,400 oil and gas sector workers and RV park occupants. Over the past three years, Jal's population has increased by about 70 percent, mostly due to the oil and gas industry. The City anticipates that the population will exceed 4,200 by 2020, necessitating the construction of a new wastewater treatment plant (WWTP) because the old plant (aerated lagoon system) cannot accommodate such rapid population expansion without major renovations or replacement. Adhering to discharge permit restrictions has been challenging due to aging infrastructure and equipment replacement needs, as well as increasing nutrient loading to the wastewater collecting system from the additional oil and gas residents' recreational vehicles. The WWTP has not been able to maintain permit discharge standards for total nitrogen of less than 20 mg N/L and other characteristics in recent years. Based on discussions with the state's environmental department, it is likely that the future permit renewal would impose stricter conditions. Given its location in the dry, western part of the country, the City must rely on its meager groundwater supplies and scant annual precipitation. The city's groundwater supplies will be depleted sooner than predicted due to rising demand from the growing population for drinking, leisure, and other industrial uses (fracking). The sole type of reuse the city was engaging in (recreational reuse for a golf course) had to be put on hold because of an effluent water compliance issue. As of right now, all treated effluent is evaporated. The city's long-term goal is to become a zero-waste community that sends all of its treated wastewater effluent either to the golf course, Jal Lake, or the oil and gas industry for reuse. Hydraulic fracturing uses a lot of water, but if the oil and gas industry can use recycled water, it can reduce its impact on freshwater supplies. The City's goal of 100% reuse has been delayed by the difficulties of meeting the constraints of the regular discharge permit due to the large rise in influent loads and the aging infrastructure. The City of Jal plans to build a new WWTP that can keep up with the city's rapid population increase due to the oil and gas industry. Several treatment methods were considered in light of the City's needs and its long-term goals, but MBR was ultimately chosen recommended since it meets all of the permit's requirements while also providing 100 percent beneficial reuse. This talk will lay out the plan for the city to reach its goal of 100 percent reuse, as well as the various avenues for funding the small community that have been considered.

Keywords: membrane bioreactor, nitrogent, reuse, small community

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Authors: Akbar Khodavirdizadeh, Ali Nemati Babaylou, Hassan Moomivand

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The history of human access to water technique has been one of the factors in the formation of human civilizations in the ancient world. The technique that makes surface water and groundwater accessible to humans on the ground has been a clever technique in human life to reach the water. In this study, while examining the water technique of ancient Iran using the Qanats technique, the water supply system of different regions of the ancient world were also studied and compared. Six groups of the ancient region of ancient Greece (Archaic 480-750 BC and Classical 223-480 BC), Urartu in Tuspa (600-850 BC), Petra (106-168 BC), Ancient Rome (265 BC), and the ancient United States (1450 BC) and ancient Iranian water technologies were studied under water supply systems. Past water technologies in these areas: water transmission systems in primary urban centers, use of water structures in water control, use of bridges in water transfer, construction of waterways for water transfer, storage of rainfall, construction of various types of pottery- ceramic, lead, wood and stone pipes have been used in water transfer, flood control, water reservoirs, dams, channel, wells, and Qanat. The central plateau of Iran is one of the arid and desert regions. Archaeological, geomorphological, and paleontological studies of the central region of the Iranian plateau showed that without the use of Qanats, the possibility of urban civilization in this region was difficult and even impossible. Zarch aqueduct is the most important aqueduct in Yazd region. Qanat of Zarch is a plain Qanat with a gallery length of 80 km; its mother well is 85 m deep and has 2115 well shafts. The main purpose of building the Qanat of Zārch was to access the groundwater source and transfer it to the surface of the ground. Regarding the structure of the aqueduct and the technique of transferring water from the groundwater source to the surface, it has a great impact on being different from other water techniques in the ancient world. The results show that the use of water technologies in ancient is very important to understand the history of humanity in the use of hydraulic techniques.

Keywords: ancient water technologies, groundwaters, qanat, human history, Ancient Iran

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Authors: Sontana Mimapan, Phattarawadee Wattanasuntorn, Phanom Saijit

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Aflatoxin contamination in maize, one of several agriculture crops grown for livestock feeding, is still a problem throughout the world mainly under hot and humid weather conditions like Thailand. In this study Aspergillus flavus (A. Flavus), the key fungus for aflatoxin production especially aflatoxin B1 (AFB1), isolated from naturally infected maize were identified and characterized according to colony morphology and PCR using ITS, Beta-tubulin and calmodulin genes. The strains were analysed for the presence of four aflatoxigenic biosynthesis genes in relation to their capability to produce AFB1, Ver1, Omt1, Nor1, and aflR. Aflatoxin production was then confirmed using immunoaffinity column technique. A loop-mediated isothermal amplification (LAMP) was applied as an innovative technique for rapid detection of target nucleic acid. The reaction condition was optimized at 65C for 60 min. and calcein flurescent reagent was added before amplification. The LAMP results showed clear differences between positive and negative reactions in end point analysis under daylight and UV light by the naked eye. In daylight, the samples with AFB1 producing A. Flavus genes developed a yellow to green color, but those without the genes retained the orange color. When excited with UV light, the positive samples become visible by bright green fluorescence. LAMP reactions were positive after addition of purified target DNA until dilutions of 10⁻⁶. The reaction products were then confirmed and visualized with 1% agarose gel electrophoresis. In this regards, 50 maize samples were collected from dairy farms and tested for the presence of four aflatoxigenic biosynthesis genes using LAMP technique. The results were positive in 18 samples (36%) but negative in 32 samples (64%). All of the samples were rechecked by PCR and the results were the same as LAMP, indicating 100% specificity. Additionally, when compared with the immunoaffinity column-based aflatoxin analysis, there was a significant correlation between LAMP results and aflatoxin analysis (r= 0.83, P < 0.05) which suggested that positive maize samples were likely to be a high- risk feed. In conclusion, the LAMP developed in this study can provide a simple and rapid approach for detecting AFB1 producing A. Flavus genes from maize and appeared to be a promising tool for the prediction of potential aflatoxigenic risk in livestock feedings.

Keywords: Aflatoxin B1, Aspergillus flavus genes, maize, loop-mediated isothermal amplification

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Authors: Wang Xiaoqing, Fang Youyuan, Zheng Yanxing, Gu Tianyang, Zong Jianjian, Tong Jinrong

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Compared with traditional distributed environment, the net-centric environment brings on more demanding challenges for information sharing with the characteristics of ultra-large scale and strong distribution, dynamic, autonomy, heterogeneity, redundancy. This paper realizes an information sharing model and a series of core services, through which provides an open, flexible and scalable information sharing platform.

Keywords: net-centric environment, information sharing, metadata registry and catalog, cross-domain data access control

Procedia PDF Downloads 572

Authors: Amina Sa'id Muhammad, Asmau Ishaq Alhassan, Beba Raymond, Fatima Bello

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Severe acute malnutrition (SAM) remains a major killer of children under five years of age. Nigeria has the second highest burden of stunted children in the world, with a national prevalence rate of 32 percent of children under five. An estimated 2 million children in Nigeria suffer from severe acute malnutrition (SAM), and 3.9% of children in northwest Nigeria suffer from SAM, which is significantly higher than the national average of 2.1%. Community-Based Management of Acute Malnutrition (CMAM) has proven to be an effective intervention in the treatment of SAM in children using Ready-to-Use Therapeutic Food (RUTF). Ready-to-use therapeutic food (RUTF) is a key component for the treatment of Severe Acute Malnutrition. It contains all the energy and nutrients required for rapid catch-up growth and used particularly in the treatment of children over 6 months of age with SAM without medical complications. However, almost all RUTFs are currently imported to Nigeria from other countries. Shortages of RUTF due to logistics (shipping costs, delays, donor fatigue etc) and funding issues present a threat to the achievement of the 2030 World Health Assembly (WHA) targets for reducing malnutrition in addition to 2030 SDGs 2 (Zero Hunger), 3 (Good Health and Wellbeing), 12 (Responsible Consumption and Production), and 17 (Partnerships for the Goals), thus undermining its effectiveness in combating malnutrition On the other hand, the availability of human and material resources that will aid local production of RUTF presents an opportunity to fill in the gap in regular RUTF supply. About one thousand Nigerian children die of malnutrition-related causes every day, reaching a total of 361,000 each year. Owing to the high burden of malnutrition in Nigeria, the local production of RUTF is a logical step, that will ensure increased availability, acceptability, access, and efficiency in supply, and at lower costs. Objective(s): The objectives of this study were therefore, to formulate RUTF from locally available resources and to determine its energy and nutrients composition, incommensurate with the standard/commercial RUTF. Methods: Three samples of RUTF were formulated using locally available resources (soya beans, wheat, rice, baobab, brown-sugar, date palm and soya oil); which were subjected to various analysis to determine their energy/proximate composition, vitamin and mineral contents and organoleptic properties were also determined using sensory evaluation. Results: The energy values of the three samples of locally produced RUTF were found to be in conformity with WHO recommendation of ≥ 500 kcal per 100g. The energy values of the three RUTF samples produced in the current study were found to be 563.08, 503.67 and 528.98 kcal respectively. Sample A, B and C had protein content of 13.56% 16.71% and 14.62% respectively, which were higher than that of commercial RUTF (10.9%). Conclusions/recommendations: The locally formulated RUTF samples had energy value of more than 500 kcal per 100g; with an appreciable amount of macro and micro nutrients. The appearance, taste, flavor and general acceptability of the formulated RUTF samples were also commendable.

Keywords: energy, malnutrition, nutrients, RUTF

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Authors: Wadea Ameen

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Rapid prototyping (RP) technology, such as fused deposition modeling (FDM), is gaining popularity because it can produce functioning components with intricate geometric patterns in a reasonable amount of time. A multitude of process variables influences the quality of manufactured parts. In this study, four important process parameters such as layer thickness, model interior fill style, support fill style and orientation are considered. Their influence on three responses, such as build time, model material, and support material, is studied. Experiments are conducted based on factorial design, and the results are presented.

Keywords: fused deposition modeling, factorial design, optimization, 3D printing

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Authors: E. M. Vieira, C. S. Vieira, L. P. Bonifácio, L. M. de Oliveira Ciabati, A. C. A. Franzon, F. S. Zaratini, J. A. C. Sanchez, M. S. Andrade, J. P. Dias de Souza

Abstract:

The quality of prenatal care is key to reduce maternal morbidity and mortality. Communication between the health service and users can stimulate prevention and care. M-health has been an important and low cost strategy to health education. The PRENACEL programme (prenatal in the cell phone) was developed. It consists of a programme of information via SMS from the 20^th week of pregnancy up to 12^th week after delivery. Messages were about prenatal care, birth, contraception and breastfeeding. Communication of the pregnant woman asking questions about their health was possible. The objective of this study was to evaluate the implementation of PRENACEL as a useful complement to the standard prenatal care. Twenty health clinics were selected and randomized by cluster, 10 as the intervention group and 10 as the control group. In the intervention group, women and their partner were invited to participate. The control group received the standard prenatal care. All women were interviewed in the immediate post-partum and in the 12^th and 24^th week post-partum. Most women were married, had more than 8 years of schooling and visit the clinic more than 6 times during prenatal care. The intervention group presented lowest percentage of higher economic participants (5.6%), less single mothers and no drug user. It also presented more prenatal care visits than the control group and it was less likely to present Severe Acute Maternal Mortality when compared to control group as well as higher percentage of partners (75.4%) was present at the birth compared to control group. Although the study is still being carried out, preliminary data are showing positive results of the compliance of women to prenatal care.

Keywords: cellphone, health technology, prenatal care, prevention

Procedia PDF Downloads 389

Authors: Aldona Guzik

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Experts have always played a special role in society. Drawing on their opinions was and most certainly is one of the most important strategies that direct people when they make decisions; something often used with the aim of exerting influence and ensuring social conformism. Many factors decide on who becomes an expert. The most important of these have hitherto been: the possession of extensive knowledge, charisma, authority as well as experience. Increasingly, however, these factors are insufficient and may even be deemed unnecessary. This state of affairs has been brought about (among other things) by the development of the media and the media’s influence on our lives. The inspiration to write the present article has its grounding in the book by Tom Nichols The Death of Expertise. The Campaign Against Established Knowledge and Why it Matters, in which the author claims that in our present-day open society experts and their expertise count for increasingly less for everyone who has unlimited access to the Internet and education. This has, in turn, resulted in the creation of so-called ‘collective wisdom,’ which is placed higher than any of the specialist knowledge proclaimed by experts. However, this is an incomplete picture, because admittedly, access to knowledge is nowadays unlimited, but on the other hand, the ubiquitous risk causes that the expert is someone who allows them to minimize it. Therefore, a modern society so readily refers to their opinion; from the smallest matters, eg home appliance, to important political issues. Hence, many information services include numerous experts (scientists, journalists, specialists, celebrities), whose task is to explain to the viewers in a simple way the presented reality. However, more and more often their role is also to give credence to what they explain. Hence the questions arise: who are the experts, what is their typology and what roles they play in Polish information services? To answer them, quantitative and qualitative research was used, such as analysis of lists of 100 most influential experts, analysis of expert profiles and their statements in three differentiated information services (TVN - commercial, TVP1 - public, TV Trwam - non-commercial/religious). They will be the basis for answering the above-mentioned questions and, above all, determining their role in information services in Poland.

Keywords: experts, media, public discours, symbolic elites

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Authors: Abhay Vir Singh Kanwar

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The pharmaceutical industry today is a multi-billion dollar business and yet disadvantages people in many corners of the globe who are still dying in large numbers from curable illnesses for lack of access to drugs. The astronomical prices of essential and life-saving drugs is not just an economic problem that can be settled through clever market strategies but is an ethical issue, given the accumulated wealth of today’s humanity and the sense of global justice that it increasingly comes to share. In this paper, I make a very practical argument for what I shall call ‘the ethical healthcare paradigm’, which, I propose, can replace the economistic paradigm that can still drive the healthcare sector without creating spillover effects on the market. Taking off from the ethical-philosophical argument for recognizing every individual’s right to capability to be healthy, I shall come to the focused practical proposal of the cost-rationalization and universal availability of essential, life-saving drugs through the undertaking of research and development funding for drug innovation by the business establishment as such in terms of the concept of CSR. The paper will first expose the concepts of basic and fundamental capabilities in relation to education and health, after which it will focus on the right to capability to be healthy of every person. In the third section, it will discuss the ‘ethical healthcare paradigm’ as opposed to the economistic health paradigm and will argue that the patient will have to be considered the primary stakeholder of this paradigm or the very ‘subject’ of healthcare. The next section will be on an ethical-historical critique of the pharmaceutical industry’s profit driven economism. The section after that will look at the business operation and the stages in the life cycle of a drug that comes to the market in order to understand the risks, strengths and problems of the pharmaceutical industry. Finally, the paper will discuss the concept of CSR in relation to the ethical healthcare paradigm in order to propose CSR funding in research and development for innovation on drugs so that life-saving drugs can be made available to every sick person cost-effectively.

Keywords: capability approach, healthcare, CSR, patient

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