Search results for: unfavorable attitude

Authors: Elisa Menardo, Margherita Pasini, Margherita Brondino

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A growing body of empirical research from different areas of inquiry suggests that brief contact with natural environment restore mental resources. The Attention Restoration Theory (ART) is the widespread used and empirical founded theory developed to explain why exposure to nature helps people to recovery cognitive resources. It assumes that contact with nature allows people to free (and then recovery) voluntary attention resources and thus allows them to recover from a cognitive fatigue situation. However, it was suggested that some people could have more cognitive benefit after exposure to urban environment. The objective of this study is to report the results of a meta-analysis on studies (peer-reviewed articles) comparing the restorativeness (the quality to be restorative) perceived in natural environments than those perceived in urban environments. This meta-analysis intended to estimate how much nature environments (forests, parks, boulevards) are perceived to be more restorativeness than urban ones (i.e., the magnitude of the perceived restorativeness’ difference). Moreover, given the methodological difference between study, it studied the potential role of moderator variables as participants (student or other), instrument used (Perceived Restorativeness Scale or other), and procedure (in laboratory or in situ). PsycINFO, PsycARTICLES, Scopus, SpringerLINK, Web of Science online database were used to identify all peer-review articles on restorativeness published to date (k = 167). Reference sections of obtained papers were examined for additional studies. Only 22 independent studies (with a total of 1371 participants) met inclusion criteria (direct exposure to environment, comparison between one outdoor environment with natural element and one without natural element, and restorativeness measured by self-report scale) and were included in meta-analysis. To estimate the average effect size, a random effect model (Restricted Maximum-likelihood estimator) was used because the studies included in the meta-analysis were conducted independently and using different methods in different populations, so no common effect-size was expected. The presence of publication bias was checked using trim and fill approach. Univariate moderator analysis (mixed effect model) were run to determine whether the variable coded moderated the perceived restorativeness difference. Results show that natural environments are perceived to be more restorativeness than urban environments, confirming from an empirical point of view what is now considered a knowledge gained in environmental psychology. The relevant information emerging from this study is the magnitude of the estimated average effect size, which is particularly high (d = 1.99) compared to those that are commonly observed in psychology. Significant heterogeneity between study was found (Q(19) = 503.16, p < 0.001;) and studies’ variability was very high (I2[C.I.] = 96.97% [94.61 - 98.62]). Subsequent univariate moderator analyses were not significant. Methodological difference (participants, instrument, and procedure) did not explain variability between study. Other methodological difference (e.g., research design, environment’s characteristics, light’s condition) could explain this variability between study. In the mine while, studies’ variability could be not due to methodological difference but to individual difference (age, gender, education level) and characteristics (connection to nature, environmental attitude). Furthers moderator analysis are working in progress.

Keywords: meta-analysis, natural environments, perceived restorativeness, urban environments

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Authors: Rosa Nadine Danenberg

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In recent years, bottom-up urban development has started growing as an alternative to conventional top-down planning. In large proportions, citizens and communities initiate small-scale interventions; suddenly seeming to form a trend. As a result, more and more cities are witnessing not only the growth of but also an interest in these initiatives, as they bear the potential to reshape urban spaces. Such alternative city-making efforts cause new dynamics in urban governance, with inevitable consequences for the controlled city planning and its administration. The emergence of enabling relationships between top-down and bottom-up actors signals an increasingly common urban practice. Various case studies show that an enabling relationship is possible, yet, how it can be optimally realized stays rather underexamined. Therefore, the seemingly growing worldwide phenomenon of ‘municipal bottom-up urban development’ necessitates an adequate governance structure. As such, the aim of this research is to contribute knowledge to how municipalities can enable citizen-led urban initiatives from a governance innovation perspective. Empirical case-study research in Stockholm and Istanbul, derived from interviews with founders of four citizen-led urban initiatives and one municipal representative in each city, provided valuable insights to possibilities and constraints for enabling practices. On the one hand, diverging outcomes emphasize the extreme oppositional features of both cases (Stockholm and Istanbul). Firstly, both cities’ characteristics are drastically different. Secondly, the ideologies and motifs for the initiatives to emerge vary widely. Thirdly, the major constraints for citizen-led urban initiatives to relate to the municipality are considerably different. Two types of municipality’s organizational structures produce different underlying mechanisms which demonstrate the constraints. The first municipal organizational structure is steered by bureaucracy (Stockholm). It produces an administrative division that brings up constraints such as the lack of responsibility, transparency and continuity by municipal representatives. The second structure is dominated by municipal politics and governmental hierarchy (Istanbul). It produces informality, lack of transparency and a fragmented civil society. In order to cope with the constraints produced by both types of organizational structures, the initiatives have adjusted their organization to the municipality’s underlying structures. On the other hand, this paper has in fact also come to a rather unifying conclusion. Interestingly, the suggested possibilities for an enabling relationship underline converging new urban governance arrangements. This could imply that for the two varying types of municipality’s organizational structures there is an accurate governance structure. Namely, the combination of a neighborhood council with a municipal guide, with allowance for the initiatives to adopt a politicizing attitude is found as coinciding. Especially its combination appears key to redeem varying constraints. A municipal guide steers the initiatives through bureaucratic struggles, is supported by coproduction methods, while it balances out municipal politics. Next, a neighborhood council, that is politically neutral and run by local citizens, can function as an umbrella for citizen-led urban initiatives. What is crucial is that it should cater for a more entangled relationship between municipalities and initiatives with enhanced involvement of the initiatives in decision-making processes and limited involvement of prevailing constraints pointed out in this research.

Keywords: bottom-up urban development, governance innovation, Istanbul, Stockholm

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Authors: Vinti Davar

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Introduction: Childhood overweight increases the risk for certain medical and psychological conditions. Millions of school-age children worldwide are affected by serious yet easily treatable and preventable illnesses that inhibit their ability to learn. Healthier children stay in school longer, attend more regularly, learn more and become healthier and more productive adults. Schools are an important setting for nutrition education because one can reach most children, teachers and parents. These years offer a key window for shaping their lifetime habits, which have an impact on their health throughout life. Against this background, an attempt was made to impart nutrition education to school children in Haryana state of India to promote healthy food choices and assess the effectiveness of this program. Methodology: This study was completed in two phases. During the first phase, pre-intervention anthropometric and dietary survey was conducted; the teaching materials for nutrition intervention program were developed and tested; and the questionnaire was validated. In the second phase, an intervention was implemented in two schools of Kurukshetra, Haryana for six months by personal visits once a week. A total of 350 children in the age group of 6-12 years were selected. Out of these, 279 children, 153 boys and 126 girls completed the study. The subjects were divided into four groups namely: underweight, normal, overweight and obese based on body mass index-for-age categories. A power point colorful presentation to improve the quality of tiffin, snacks and meals emphasizing inclusion of all food groups especially vegetables every day and fruits at least 3-4 days per week was used. An extra 20 minutes of aerobic exercise daily was likewise organized and a healthy school environment created. Provision of clean drinking water by school authorities was ensured. Selling of soft drinks and energy-dense snacks in the school canteen as well as advertisements about soft drink and snacks on the school walls were banned. Post intervention, anthropometric indices and food selections were reassessed. Results: The results of this study reiterate the critical role of nutrition education and promotion in improving the healthier food choices by school children. It was observed that normal, overweight and obese children participating in nutrition education intervention program significantly (p≤0.05) increased their daily seasonal fruit and vegetable consumption. Fat and oil consumption was significantly reduced by overweight and obese subjects. Fast food intake was controlled by obese children. The nutrition knowledge of school children significantly improved (p≤0.05) from pre to post intervention. A highly significant increase (p≤0.00) was noted in the nutrition attitude score after intervention in all four groups. Conclusion: This study has shown that a well-planned nutrition education program could improve nutrition knowledge and promote positive changes in healthy food choices. A nutrition program inculcates wholesome eating and active life style habits in children and adolescents that could not only prevent them from chronic diseases and early death but also reduce healthcare cost and enhance the quality of life of citizens and thereby nations.

Keywords: children, eating habits healthy food, obesity, school going, fast foods

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Authors: F. Iberraken, R. Medjoudj, D. Aissani

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The development of the smart grids concept is built around two separate definitions, namely: The European one oriented towards sustainable development and the American one oriented towards reliability and security of supply. In this paper, we have investigated reliability merits enabling decision-makers to provide a high quality of service. It is based on system behavior using interruptions and failures modeling and forecasting from one hand and on the contribution of information and communication technologies (ICT) to mitigate catastrophic ones such as blackouts from the other hand. It was found that this concept has been adopted by developing and emerging countries in short and medium terms followed by sustainability concept at long term planning. This work has highlighted the reliability merits such as: Benefits, opportunities, costs and risks considered as consistent units of measuring power customer satisfaction. From the decision making point of view, we have used the analytic hierarchy process (AHP) to achieve customer satisfaction, based on the reliability merits and the contribution of such energy resources. Certainly nowadays, fossil and nuclear ones are dominating energy production but great advances are already made to jump into cleaner ones. It was demonstrated that theses resources are not only environmentally but also economically and socially sustainable. The paper is organized as follows: Section one is devoted to the introduction, where an implicit review of smart grids development is given for the two main concepts (for USA and Europeans countries). The AHP method and the BOCR developments of reliability merits against power customer satisfaction are developed in section two. The benefits where expressed by the high level of availability, maintenance actions applicability and power quality. Opportunities were highlighted by the implementation of ICT in data transfer and processing, the mastering of peak demand control, the decentralization of the production and the power system management in default conditions. Costs were evaluated using cost-benefit analysis, including the investment expenditures in network security, becoming a target to hackers and terrorists, and the profits of operating as decentralized systems, with a reduced energy not supplied, thanks to the availability of storage units issued from renewable resources and to the current power lines (CPL) enabling the power dispatcher to manage optimally the load shedding. For risks, we have razed the adhesion of citizens to contribute financially to the system and to the utility restructuring. What is the degree of their agreement compared to the guarantees proposed by the managers about the information integrity? From technical point of view, have they sufficient information and knowledge to meet a smart home and a smart system? In section three, an application of AHP method is made to achieve power customer satisfaction based on the main energy resources as alternatives, using knowledge issued from a country that has a great advance in energy mutation. Results and discussions are given in section four. It was given us to conclude that the option to a given resource depends on the attitude of the decision maker (prudent, optimistic or pessimistic), and that status quo is neither sustainable nor satisfactory.

Keywords: reliability, AHP, renewable energy resources, smart grids

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Authors: Anzal Abbas Jaffari, Wajiha Javed, Naseem Salahuddin

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Rationale: Rabies, a vaccine preventable disease, continues to be a critical public health issue as it kills around 2000-5000 people annually in Pakistan. Along with the disease spread among animals, the dog population remains a victim of brutal culling practices by the local authorities, which adversely affects ecosystem (sinking of poison in the soil – affecting vegetation & contaminating water) and the disease spread. The dog population has been exponentially rising primarily because a lack of a consolidated nationwide Animal Birth Control program and awareness among the local communities in general and children in particular. This is reflected in Pakistan’s low SARE score - 1.5, which makes the country trails behind other developing countries like Bangladesh (2.5) and Philippines (3.5).According to an estimate, the province of Sindh alone is home to almost 2.5 million dogs. The clustering of dogs in Peri-Urban areas and inner cities localities leads to an increase of reported dog bite cases in these areas specifically. Objective: Rabies Free Pakistan (RFP), which is a joint venture of Getz Pharma Private Limited and Indus Hospital & Health Network (IHHN); it was established in 2018 to eliminate Rabies from Pakistan by 2030 using the One Health Approach. Methodology: The RFP team is actively working on advocacy and policy front with both the Federal & Provincial government to ensure that all stakeholders currently involved in dog culling in Pakistan have a paradigm shift towards humane methods of vaccination and ABC. Along with the federal government, RFP aims to declare Rabies as a notifiable disease. Whereas RFP closely works with the provincial government of Sindh to initiate a province wide Rabies Control Program.RFP program follows international standards and WHO approved protocols for this program in Pakistan.RFP team has achieved various milestones in the fight against Rabies after successfully scaling up project operations and has vaccinated more than 30,000 dogs and neutered around 7,000 dogs since 2018. Recommendations: Effective implementation of Rabies program (MDV and ABC) requires a concentrated effort to address a variety of structural and policy challenges. This essentially demands a massive shift in the attitude of individuals towards rabies. The two most significant challenges in implementing a standard policy at the structural level are lack of institutional capacity, shortage of vaccine, and absence of inter-departmental coordination among major stakeholders: federal government, provincial ministry of health, livestock, and local bodies (including local councils). The lack of capacity in health care workers to treat dog bite cases emerges as a critical challenge at the clinical level. Conclusion: Pakistan can learn from the successful international models of Sri Lanka and Mexico as they adopted the One Health Approach to eliminate rabies like RFP. The WHO advised One Health approach provides the policymakers with an interactive and cross-sectoral guide, which involves all the essential elements of the eco system (including animals, humans, and other components).

Keywords: animal birth control, dog population, mass dog vaccination, one health, rabies elimination

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Authors: Jayden R. Hunter, Brett A. Gordon, Stephen R. Bird, Amanda C. Benson

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The World Health Organisation recognises the workplace as an important setting for exercise promotion, with potential benefits including improved employee health and fitness, and reduced worker absenteeism and presenteeism. Despite these potential benefits to both employee and employer, there is a lack of evidence supporting the long-term effectiveness of workplace exercise programs. There is, therefore, a need for better-informed programs that cater to employee exercise preferences. Specifically, workplace exercise programs should address any time, motivation, internal and external barriers to participation reported by sub-groups of employees. This study sought to compare exercise participation to perceived barriers and facilitators to workplace exercise engagement of university employees. This information is needed to design and implement wider-reaching programs aiming to maximise long-term employee exercise adherence and subsequent health, fitness and productivity benefits. An online survey was advertised at an Australian university with the potential to reach 3,104 full-time employees. Along with exercise participation (International physical activity questionnaire) and behaviour (stage of behaviour change in relation to physical activity questionnaire), perceived barriers (corporate exercise barriers scale) and facilitators to workplace exercise participation were identified. The survey response rate was 8.1% (252 full-time employees; 95% white-collar; 60% female; 79.4% aged 30–59 years; 57% professional and 38% academic). Most employees reported meeting (43.7%) or exceeding (42.9%) exercise guidelines over the previous week (i.e. ⩾30 min of moderate-intensity exercise on most days or ⩾ 25 min of vigorous-intensity exercise on at least three days per week). Reported exercise behaviour over the previous six months showed that 64.7% of employees were in maintenance, 8.3% were in action, 10.9% were in preparation, 12.4% were in contemplation, and 3.8% were in the pre-contemplation stage of change. Perceived barriers towards workplace exercise participation were significantly higher in employees not attaining weekly exercise guidelines compared to employees meeting or exceeding guidelines, including a lack of time or reduced motivation (p < 0.001; partial eta squared = 0.24 (large effect)), exercise attitude (p < 0.05; partial eta squared = 0.04 (small effect)), internal (p < 0.01; partial eta squared = 0.10 (moderate effect)) and external (p < 0.01; partial eta squared = 0.06 (moderate effect)) barriers. The most frequently reported exercise facilitators were personal training (particularly for insufficiently active employees; 33%) and group exercise classes (20%). The most frequently cited preferred modes of exercise were walking (70%), swimming (50%), gym (48%), and cycling (45%). In conclusion, providing additional means of support such as individualised gym, swimming and cycling programs with personal supervision and guidance may be particularly useful for employees not meeting recommended moderate-vigorous volumes of exercise, to help overcome reported exercise barriers in order to improve participation, health, and fitness. While individual biopsychosocial factors should be considered when making recommendations for interventions, the specific barriers and facilitators to workplace exercise participation identified by this study can inform the development of workplace exercise programs aiming to broaden employee engagement and promote greater ongoing exercise adherence. This is especially important for the uptake of less active employees who perceive greater barriers to workplace exercise participation than their more active colleagues.

Keywords: exercise barriers, exercise facilitators, physical activity, workplace health

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Authors: Samira Hamiditehrani

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Automated vehicles (AVs) are emerging technologies that could potentially offer a wide range of opportunities and challenges for the transportation sector. The advent of AV technology has also resulted in new business models in shared mobility services where many ride hailing and car sharing companies are developing on-demand AVs including shared automated vehicles (SAVs) and pooled automated vehicles (Pooled AVs). SAVs and Pooled AVs could provide alternative shared mobility services which encourage sustainable transport systems, mitigate traffic congestion, and reduce automobile dependency. However, the success of on-demand AVs in addressing major transportation policy issues depends on whether and how the public adopts them as regular travel modes. To identify conditions under which individuals may adopt on-demand AVs, previous studies have applied human behavior and technology acceptance theories, where Theory of Planned Behavior (TPB) has been validated and is among the most tested in on-demand AV research. In this respect, this study has three objectives: (a) to propose and validate a theoretical model for behavioral intention to use SAVs and Pooled AVs by extending the original TPB model; (b) to identify the characteristics of early adopters of SAVs, who prefer to have a shorter and private ride, versus prospective users of Pooled AVs, who choose more affordable but longer and shared trips; and (c) to investigate Canadians’ intentions to adopt on-demand AVs for regular trips. Toward this end, this study uses data from an online survey (n = 3,622) of workers or adult students (18 to 75 years old) conducted in October and November 2021 for six major Canadian metropolitan areas: Toronto, Vancouver, Ottawa, Montreal, Calgary, and Hamilton. To accomplish the goals of this study, a base bivariate ordered probit model, in which both SAV and Pooled AV adoptions are estimated as ordered dependent variables, alongside a full structural equation modeling (SEM) system are estimated. The findings of this study indicate that affective motivations such as attitude towards AV technology, perceived privacy, and subjective norms, matter more than sociodemographic and travel behavior characteristic in adopting on-demand AVs. Also, the results of second objective provide evidence that although there are a few affective motivations, such as subjective norms and having ample knowledge, that are common between early adopters of SAVs and PooledAVs, many examined motivations differ among SAV and Pooled AV adoption factors. In other words, motivations influencing intention to use on-demand AVs differ among the service types. Likewise, depending on the types of on-demand AVs, the sociodemographic characteristics of early adopters differ significantly. In general, findings paint a complex picture with respect to the application of constructs from common technology adoption models to the study of on-demand AVs. Findings from the final objective suggest that policymakers, planners, the vehicle and technology industries, and the public at large should moderate their expectations that on-demand AVs may suddenly transform the entire transportation sector. Instead, this study suggests that SAVs and Pooled AVs (when they entire the Canadian market) are likely to be adopted as supplementary mobility tools rather than substitutions for current travel modes

Keywords: automated vehicles, Canadian perception, theory of planned behavior, on-demand AVs

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

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

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

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Authors: Karin Schakib-Ekbatan, Annette Roser

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According to the Federal Government’s plans, the German building stock should be virtually climate neutral by 2050. Thus, the “EnEff.Gebäude.2050” funding initiative was launched, complementing the projects of the Energy Transition Construction research initiative. Beyond the construction and renovation of individual buildings, solutions must be found at the neighborhood level. The subject of the presented pilot project is a building ensemble from the Wilhelminian period in Munich, which is planned to be refurbished based on a socially compatible, energy-saving, innovative-technical modernization concept. The building ensemble, with about 200 apartments, is part of the building cooperative. To create an optimized network and possible synergies between researchers and projects of the funding initiative, a Scientific Accompanying Research was established for cross-project analyses of findings and results in order to identify further research needs and trends. Thus, the project is characterized by an interdisciplinary approach that combines constructional, technical, and socio-scientific expertise based on a participatory understanding of research by involving the tenants at an early stage. The research focus is on getting insights into the tenants’ comfort requirements, attitudes, and energy-related behaviour. Both qualitative and quantitative methods are applied based on the Technology-Acceptance-Model (TAM). The core of the refurbishment strategy is a wall heating system intended to replace conventional radiators. A wall heating provides comfortable and consistent radiant heat instead of convection heat, which often causes drafts and dust turbulence. Besides comfort and health, the advantage of wall heating systems is an energy-saving operation. All apartments would be supplied by a uniform basic temperature control system (around perceived room temperature of 18 °C resp. 64,4 °F), which could be adapted to individual preferences via individual heating options (e. g. infrared heating). The new heating system would affect the furnishing of the walls, in terms of not allowing the wall surface to be covered too much with cupboards or pictures. Measurements and simulations of the energy consumption of an installed wall heating system are currently being carried out in a show apartment in this neighborhood to investigate energy-related, economical aspects as well as thermal comfort. In March, interviews were conducted with a total of 12 people in 10 households. The interviews were analyzed by MAXQDA. The main issue of the interview was the fear of reduced self-efficacy within their own walls (not having sufficient individual control over the room temperature or being very limited in furnishing). Other issues concerned the impact that the construction works might have on their daily life, such as noise or dirt. Despite their basically positive attitude towards a climate-friendly refurbishment concept, tenants were very concerned about the further development of the project and they expressed a great need for information events. The results of the interviews will be used for project-internal discussions on technical and psychological aspects of the refurbishment strategy in order to design accompanying workshops with the tenants as well as to prepare a written survey involving all households of the neighbourhood.

Keywords: energy efficiency, interviews, participation, refurbishment, residential buildings

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Authors: Farwa Rizvi, Joanne Williams, Humaira Maheen, Elizabeth Hoban

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There is an increase in risky sexual behavior and unsafe sex in adolescent girls and young women aged 15 to 24 years in Cambodia, which negatively affects their reproductive health by increasing the risk of contracting sexually transmitted infections and unintended pregnancies. Risky sexual behavior includes ‘having sex at an early age, having multiple sexual partners, having sex while under the influence of alcohol or drugs, and unprotected sexual behaviors’. A systematic review of quantitative research conducted in Cambodia was undertaken, using the theoretical framework of the Social Ecological Model to identify the personal, social and cultural factors associated with risky sexual behavior and unsafe sex in young Cambodian women. PRISMA guidelines were used to search databases including Medline Complete, PsycINFO, CINAHL Complete, Academic Search Complete, Global Health, and Social Work Abstracts. Additional searches were conducted in Science Direct, Google Scholar and in the grey literature sources. A risk-of-bias tool developed explicitly for the systematic review of cross-sectional studies was used. Summary item on the overall risk of study bias after the inter-rater response showed that the risk-of-bias was high in two studies, moderate in one study and low in one study. The search strategy included a combination of subject terms and free text terms. The medical subject headings (MeSH) terms included were; contracept* or ‘birth control’ or ‘family planning’ or pregnan* or ‘safe sex’ or ‘protected intercourse’ or ‘unprotected intercourse’ or ‘protected sex’ or ‘unprotected sex’ or ‘risky sexual behaviour*’ or ‘abort*’ or ‘planned parenthood’ or ‘unplanned pregnancy’ AND ( barrier* or obstacle* or challenge* or knowledge or attitude* or factor* or determinant* or choic* or uptake or discontinu* or acceptance or satisfaction or ‘needs assessment’ or ‘non-use’ or ‘unmet need’ or ‘decision making’ ) AND Cambodia*. Initially, 300 studies were identified by using key words and finally, four quantitative studies were selected based on the inclusion criteria. The four studies were published between 2010 and 2016. The study participants ranged in age from 10-24 years, single or married, with 3 to 10 completed years of education. The mean age at sexual debut was reported to be 18 years. Using the perspective of the Social Ecological Model, risky sexual behavior was associated with individual-level factors including young age at sexual debut, low education, unsafe sex under the influence of alcohol and substance abuse, multiple sexual partners or transactional sex. Family level factors included living away from parents, orphan status and low levels of family support. Peer and partner level factors included peer delinquency and lack of condom use. Low socioeconomic status at the society level was also associated with risky sexual behaviour. There is scant research on sexual and reproductive health of adolescent girls and young women in Cambodia. Individual, family and social factors were significantly associated with risky sexual behaviour. More research is required to inform potential preventive strategies and policies that address young women’s sexual and reproductive health.

Keywords: adolescents, high-risk sex, sexual activity, unplanned pregnancies

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Authors: D. Muyama, M. Luyiga, P. Buyungo, D. Chemonges, M. Namukwaya, L. Ssekabembe, B. Lukwago, D. Kyamagwa

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Context: The study focuses on the sustainability of health interventions in Uganda, particularly in the private sector, beyond donor-funded project periods. The Population Services International (PSI) implemented the Women Health Project (WHP) to ensure continued access to quality family planning, cervical cancer screening, and post-abortion care services through private clinics. Research Aim: The aim of the study is to assess the continued access to quality family planning, cervical cancer screening, and post-abortion care services through the private sector after the closure or reduction in funding of the WHP. Methodology: PSI trained and mentored 83 clinics to establish functional systems in self-regulatory quality improvement, supply chain, referral, and demand creation. The clinics were also connected to the national reporting system and utilized Ministry of Health reporting tools. An assessment tool with six criteria was designed and used to evaluate the progress of the clinics. Clinics scoring 75% and above were considered independent and graduated from the program. Findings: Out of the 83 private clinics, 56 successfully met the graduation criteria and graduated from the program, while 25 lost interest and were gradually dropped. Two clinics failed to achieve the criteria due to leadership challenges. The 59 graduating clinics continued to provide high-quality family planning services, including IUD, implant, Depo-Provera, oral contraceptives, and post-abortion care. All graduating clinics were reassessed and found to still be capable of offering services, attributing their success to government stock availability and acquired skills through mentorships. The clinics expressed appreciation to PSI for the sustainable plan that allowed them to operate beyond the project period. Theoretical Importance: This study contributes to the understanding of sustainability planning and the importance of clinic owners' attitudes and buy-in for continued service provision. It emphasizes the implementation of sustainability plans through existing structures to leverage available resources and ensure continuity of care. Data Collection and Analysis Procedures: The study collected data through the assessment tool that evaluated the progress of clinics based on the established criteria. The tool was scored out of 100%, and clinics scoring above 75% were deemed independent. The findings were analyzed quantitatively to determine the success rate of clinics in meeting the graduation criteria. Questions Addressed: The study addresses the question of whether private clinics in Uganda can sustain the provision of family planning, cervical cancer screening, and post-abortion care services after the closure or reduction in funding of the WHP. Conclusion: The study concludes that the attitude and buy-in of clinic owners are essential for sustainability planning. Implementing sustainability plans through existing structures and leveraging available resources are crucial for the continuity of care after the end of a project or reduced funding. The findings highlight the importance of establishing sustainable plans to ensure continued access to essential health services beyond the project period. Contributions: This study contributes to the existing knowledge for programmers implementing or intending to implement donor-funded projects. It provides insights into designing sustainable plans that enable the independent operation of clinics even after the end of a project.

Keywords: graduation, family planning, systems strengthening, sustainability

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Authors: Kedar Baral

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This study was carried out in Mustang, Kaski, Tanahun, Baitadi, and Jhapa districts of Nepal. The study explored the spatial and temporal pattern of HWC, socio economic factors associated with it, impacts of conflict on life / livelihood of people and survival of wildlife species, and impact of climate change and forest fire onHWC. Study also evaluated people’s attitude towards wildlife conservation and assessed relevant policies and programs. Questionnaire survey was carried out with the 250 respondents, and both socio-demographic and HWC related information werecollected. Secondary information were collected from Divisional Forest Offices and Annapurna Conservation Area Project.HWC events were grouped by season /months/sites (forest type, distances from forest, and settlement), and the coordinates of the events were exported to ArcGIS. Collected data were analyzed using descriptive statistics in Excel and R Program. A total of 1465 events were recorded in 5 districts during 2015 and 2019. Out of that, livestock killing, crop damage, human attack, and cattle shed damage events were 70 %, 12%, 11%, and 7%, respectively. Among 151 human attack cases, 23 people were killed, and 128 were injured. Elephant in Terai, common leopard and monkey in Middle Mountain, and snow leopard in high mountains were found as major problematic animals. Common leopard attacks were found more in the autumn, evening, and on human settlement area. Whereas elephant attacks were found higher in winter, day time, and on farmland. Poor people farmers were found highly victimized, and they were losing 26% of their income due to crop raiding and livestock depredation. On the other hand, people are killing many wildlife in revenge, and this number is increasing every year. Based on the people's perception, climate change is causing increased temperature and forest fire events and decreased water sources within the forest. Due to the scarcity of food and water within forests, wildlife are compelled to dwell at human settlement area, hence HWC events are increasing. Nevertheless, more than half of the respondents were found positive about conserving entire wildlife species. Forests outside PAs are under the community forestry (CF) system, which restored the forest, improved the habitat, and increased the wildlife.However, CF policies and programs were found to be more focused on forest management with least priority on wildlife conservation and HWC mitigation. Compensation / relief scheme of government for wildlife damage was found some how effective to manage HWC, but the lengthy process, being applicable to the damage of few wildlife species and highly increasing events made it necessary to revisit. Based on these facts, the study suggest to carry out awareness generation activities to the poor farmers, linking the property of people with the insurance scheme, conducting habitat management activities within CF, promoting the unpalatable crops, improvement of shed house of livestock, simplifying compensation scheme and establishing a fund at the district level and incorporating the wildlife conservation and HWCmitigation programs in CF. Finally, the study suggests to carry out rigorous researches to understand the impacts of current forest management practices on forest, biodiversity, wildlife, and HWC.

Keywords: community forest, conflict mitigation, wildlife conservation, climate change

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Authors: Elham Abbas Aljaaly, Nahlaa Abdulwahab Khalifa

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The active method of disease prevention is seen as the most affordable and sustainable action to deal with risks of non-communicable diseases such as obesity. This eight-week project aimed to pilot the feasibility and acceptability of a school-based programme, which is proposed to prevent and modify overweight status and possible related risk factors among student girls 'at the intermediate level' in Jeddah city. The programme was conducted through comprehensible approach targeting physical environment and school policies (nutritional/exercise/behavioural approach). The programme was designed to cultivate the personal and environmental awareness in schools for girls. This was applied by promoting healthy eating and physical activity through policies, physical education, healthier options for school canteens, and the creation of school health teams. The prevention programme was applied on 68 students (who agreed to participate) from grades 7th, 8th and 9th. A pre and post assessment questionnaire was employed on 66 students. The questionnaires were designed to obtain information on students' knowledge about health, nutrition and physical activity. Survey questions included information about nutrients, food consumption patterns, food intake and lifestyle. Physical education included training sessions for new opportunities for physical activities to be performed during school or after school hours. A running competition 'to enhance students’ performance for physical activities' was also conducted during the school visit. A visit to the school canteen was conducted to check, observe, record and assess all available food/beverage items and meals. The assessment method was a subjective method for the type of food/beverages if high in saturated fat, salt and sugar (HFSS) or non-HFSS. The school canteen administrators were encouraged to provide healthy food/beverage items and a sample healthy canteen was provided for implementation. Two healthy options were introduced to the school canteen. A follow up for students’ preferences for the introduced options and the purchasing power were assessed. Thirty-eight percent of young girls (n=26) were not participating in any form of physical activities inside or outside school. Skipping breakfast was stated by 42% (n=28) of students with no daily consumption (19%, n=13) for fruit/vegetables. Significant changes were noticed in students’ (n=66) overall responses to the pre and post questions (P value=.001). All students had participated in the conducted running competition sessions and reported satisfaction and enjoyment about the sessions. No absence was reported by the research team for attending physical education and activity sessions throughout the delivered programme. The purchasing power of the introduced healthy options of 'Salad and oatmeal' was increased to 18% in 8 weeks at the school canteen, and slightly affected the purchase for other less healthy options. The piloted programme indorsed better health and nutrition knowledge, healthy eating and lifestyle attitude, which could help young girls to obtain sustainable changes. It is expected that the outcomes of the programme will be a cornerstone for the futuristic national study that will assist policy makers and participants to build a knowledgeable health promotion scenario and make sure that school students have access to healthy foods, physical exercise and healthy lifestyle.

Keywords: adolescents, diet, exercise, behaviours, overweight/obesity, prevention-intervention programme, Saudi Arabia, schoolgirls

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Authors: Keroles Akram Saed Ghatas

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The political violence that characterized 1992 continued into 1993, creating a major security crisis for President Hosni Mubarak's government as the death toll and human rights abuses soared. Increasingly sensitive to criticism of 's human rights activities, the government established human rights departments in key ministries, beginning with the Foreign Office in February. Similar offices have been set up in the Justice and Agriculture Ministries, and plans to set up an office in the Home Office have been announced. It turned out that the main task of the law unit was to overturn the conclusions of international human rights organizations.President Mubarak was elected in a national referendum on October 4 for a third six-year term after being appointed on July 21 by the People's Assembly, an elected parliament overwhelmingly dominated by the in-power National Democratic Party will Mr. Mubarak ran unhindered. The Interior Ministry announced that nearly 16 million people cast their votes (84% of eligible voters), of which 96.28%. voted for presidential re-election.In 1993, armed Islamic extremists escalated their attacks on Christian citizens, government officials, police officers and senior security officials, resulting in casualties among the intended victims and bystanders. Sporadic attacks on buses, boats and tourist attractions also occurred throughout the year. From March 1992 to October 28, 1993, a total of 222 people lost their lives in the riots: 36 Coptic Christians and 38 other citizens; If one is a foreigner; sixty-six members of the Security Forces; and seventy-six known or suspected activists who were killed while resisting arrest. The latter was killed in airstrikes and firefights with security forces and at the site of planned attacks. On March 9-10, a series of airstrikes in Cairo, Giza, Qalyubiya province north of the capital and Aswan killed fifteen suspected militants and five members of the security forces.One of the airstrikes in Giza, part of Greater Cairo, killed the wife and son of Khalifa Mahmoud Ramadan, a suspected militant who was himself killed. The government agency Middle East News Agency reported on March 10 that the raids were part of a "broad confrontational plan aimed at ofterrorist elements"The state of emergency declared in October 1981 after the assassination of President Anwar el-Sadat was still in force in Egypt. The law, previously in effect continuously from June 1967 to May 1980, continued to grant the executive branch unique legal powers that effectively overrode the human rights guarantees of the Egyptian constitution. These provisions included wide discretionary powers in arresting and detaining individuals, as well as the ability to try civilians in military courts. The Cairo-based Independent Organization for Human Rights said so in a document sent to the United Nations in July 1993The human rights committee said the continued imposition of the state of emergency had resulted in "another constitution for the country" and "led to widespread misconduct by the security apparatus".

Keywords: constitution, human rights, legal power, president, anwar, el-sadat, assassination, state of emergency, middle east, news, agency, confrontational, arresting, fugitive, leaders, terrorist, elements, armed islamic extremists.

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Authors: Marija Mihajlovic Pereira

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Teaching and learning a musical instrument is challenging for both teachers and students. Teachers generally use diverse strategies to resolve students' particular issues in a one-to-one context. Considering individual sessions as a supportive educational context, the teacher can play a decisive role in stimulating and promoting self-regulated learning strategies, especially with beginning learners. The teachers who promote self-controlling behaviors, strategic monitoring, and regulation of actions toward goals could expect their students to practice more qualitatively and consciously. When encouraged to adopt self-regulation habits, students' could benefit from greater productivity on a longer path. Founded on Bary Zimmerman's cyclical model that comprehends three phases - forethought, performance, and self-reflection, this work aims to articulate self-regulated and music learning. Self-regulated learning appeals to the individual's attitude in planning, controlling, and reflecting on their performance. Furthermore, this study aimed to present an observation grid for perceiving teaching instructions that encourage students' controlling cognitive behaviors in light of the belief that conscious promotion of self-regulation may motivate strategic actions toward goals in musical performance. The participants, two teachers, and two students have been involved in the social inclusion project in Lisbon (Portugal). The author and one independent inter-observer analyzed six video-recorded string instrument lessons. The data correspond to three sessions per teacher lectured to one (different) student. Violin (f) and violoncello (m) teachers hold a Master's degree in music education and approximately five years of experience. In their second year of learning an instrument, students have acquired reasonable skills in musical reading, posture, and sound quality until then. The students also manifest positive learning behaviors, interest in learning a musical instrument, although their study habits are still inconsistent. According to the grid's four categories (parent codes), in-class rehearsal frames were coded using MaxQda software, version 20, according to the grid's four categories (parent codes): self-regulated learning, teaching verbalizations, teaching strategies, and students' in-class performance. As a result, selected rehearsal frames qualitatively describe teaching instructions that might promote students' body and hearing awareness, such as "close the eyes while playing" or "sing to internalize the pitch." Another analysis type, coding the short video events according to the observation grid's subcategories (child codes), made it possible to perceive the time teachers dedicate to specific verbal or non-verbal strategies. Furthermore, a coding overlay analysis indicated that teachers tend to stimulate. (i) Forethought – explain tasks, offer feedback and ensure that students identify a goal, (ii) Performance – teach study strategies and encourage students to sing and use vocal abilities to ensure inner audition, (iii) Self-reflection – frequent inquiring and encouraging the student to verbalize their perception of performance. Although developed in the context of individual string instrument lessons, this classroom observation grid brings together essential variables in a one-to-one lesson. It may find utility in a broader context of music education due to the possibility to organize, observe and evaluate teaching practices. Besides that, this study contributes to cognitive development by suggesting a practical approach to fostering self-regulated learning.

Keywords: music education, observation grid, self-regulated learning, string instruments, teaching practices

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Authors: E. O. Aluta, C. A. Booth, D. G. Proverbs, T. Appleby

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Challenges in the effective management of potable water have attracted global attention in recent years and remain many world regions’ major priorities. Scarcity and unavailability of potable water may potentially escalate poverty, obviate democratic expression of views and militate against inter-sectoral development. These challenges contra-indicate the inherent potentials of the resource. Thus, while creation of poverty may be regarded as a broad-based problem, it is capable of reflecting life-span reduction diseases, the friction of interests manifesting in threats and warfare, the relegation of democratic principles for authoritarian definitions and Human Rights abuse. The challenges may be identified as manifestations of ineffective management of potable water resource and therefore, regarded as major problems in environmental protection. In reaction, some nations have re-examined their laws and policies, while others have developed innovative projects, which seek to ameliorate difficulties of providing sustainable potable water. The problems resonate in Nigeria, where the legal framework supporting the supply and management of potable water has been criticized as ineffective. This has impacted more on rural community members, often regarded as ‘voiceless’. At that level, the participation of non-state actors has been identified as an effective strategy, which can improve water supply. However, there are indications that there is no pragmatic application of this, resulting in over-centralization and top-down management. Thus, this study focuses on how the participatory process may enable the development of participatory water governance framework, for use in Nigeria rural communities. The Rural Advisory Board (RAB) is proposed as a governing body to promote proximal relationships, institute democratisation borne out of participation, while enabling effective accountability and information. The RAB establishes mechanisms for effectiveness, taking into consideration Transparency, Accountability and Participation (TAP), advocated as guiding principles of decision-makers. Other tools, which may be explored in achieving these are, Laws and Policies supporting the water sector, under the direction of the Ministries and Law Courts, which ensure non-violation of laws. Community norms and values, consisting of Nigerian traditional belief system, perceptions, attitude and reality (often undermined in favour of legislations), are relied on to pave the way for enforcement. While the Task Forces consist of community members with specific designation of duties, which ensure compliance and enforceability, a cross-section of community members are assigned duties. Thus, the principle of participation is pragmatically reflected. A review of the literature provided information on the potentials of the participatory process, in potable water governance. Qualitative methodology was explored by using the semi-structured interview as strategy for inquiry. The purposive sampling strategy, consisting of homogeneous, heterogeneous and criterion techniques was applied to enable sampling. The samples, sourced from diverse positions of life, were from the study area of Delta State of Nigeria, involving three local governments of Oshimili South, Uvwie and Warri South. From the findings, there are indications that the application of the participatory process is inhered with empowerment of the rural community members to make legitimate demands for TAP. This includes the obviation of mono-decision making for the supply and management of potable water. This is capable of restructuring the top-down management to a top-down/bottom-up system.

Keywords: participation, participatory process, participatory water governance, rural advisory board

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Authors: Norma Kok, Diemo Masuko, Thandokazi Dlongwana, Komala Pillay

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CONTEXT: While many school principals have been outstanding teachers and have inherent leadership potential, many have not had access to the quality of leadership development or support that empowers them to produce high-quality education outcomes in extremely challenging circumstances. Further, school leaders in under-served communities face formidable challenges arising from insufficient infrastructure, overcrowded classrooms, socio-economic challenges within the community, and insufficient parental involvement, all of which put a strain on principals’ ability to lead their schools effectively. In addition few school leaders have access to other supportive networks, and many do not know how to build and leverage social capital to create opportunities for their schools and learners. Moreover, we know that fostering parental involvement in their children’s learning improves a child’s morale, attitude, and academic achievement across all subject areas, and promotes better behaviour and social adjustment. Citizen Leader Lab facilitates the Partners for Possibility (PfP) programme to provide leadership development and support to school leaders serving under-resourced communities in South Africa to create effective environments of learning. This is done by creating partnerships between school leaders and private-sector business leaders over a 12-month period. (185) OBJECTIVES: To explore school leaders’ perceptions of their leadership capacities and changes at their schools after being exposed to a year-long leadership development training programme. METHODS: School leaders gained new leadership capacities e.g. resilience, improved confidence, communication and conflict resolution skills - catalysing into improved cultures of collaborative decision-making and environments for enhanced teaching and learningprogramme based on the 70:20:10 model whereby: 10% of learning comes from workshops, 20% of learning takes place through peer learning and 70% of learning occurs through experiential learning as partnerships work together to identify and tackle challenges in targeted schools. Participants completed a post-programme questionnaire consisting of structured and unstructured questions and semi-structured interviews were conducted with them and their business leader. The interviews were audio-recorded, transcribed and thematic content analysis was undertaken. The analysis was inductive and emerging themes were identified. A code list was generated after coding was undertaken using computer software (Dedoose). Quantitative data gathered from surveys was aggregated and analysed. RESULTS: School leadership found the programme interesting and rewarding. They gained new leadership capacities such as resilience, improved confidence, communication and conflict resolution skills - catalyzing into improved cultures of collaborative decision-making and environments for enhanced teaching and learning. New networks resulted in tangible outcomes such as upgrades to school infrastructure, water and sanitation, vegetable gardens at schools resulting in nutrition for learners and/or intangible outcomes such as skills for members of school management teams (SMTs). Collaborative leadership led to SMTs being more aligned, efficient, and cohesive; and teachers being more engaged and motivated. Notable positive changes at the school inspired parents and community members to become more actively involved in the school and in their children’s education. CONCLUSION: The PfP programme leads to improved leadership capacities and improved school culture which leads to improved teaching and learning and new resources for schools.

Keywords: collaborative decision-making, collaborative leadership, community involvement, confidence

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Authors: Francois Brambati, Daniele Ruscio, Federica Biassoni, Rebecca Hueting, Alessandra Tedeschi

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This research, in the frame of social acceptance of renewable energies and community-based production and consumption models, aims at (1) supporting a data-driven approachable to dealing with climate change and (2) identifying & quantifying the psycho-sociological dimensions and factors that could support the transition from a technology-driven approach to a consumer-driven approach throughout the emerging “prosumer business models.” In addition to the existing Social Acceptance dimensions, this research tries to identify a purely individual psychological fourth dimension to understand processes and factors underling individual acceptance and adoption of renewable energy business models, realizing a Prosumer Acceptance Index. Questionnaire data collection has been performed throughout an online survey platform, combining standardized and ad-hoc questions adapted for the research purposes. To identify the main factors (individual/social) influencing the relation with renewable energy technology (RET) adoption, a Factorial Analysis has been conducted to identify the latent variables that are related to each other, revealing 5 latent psychological factors: Factor 1. Concern about environmental issues: global environmental issues awareness, strong beliefs and pro-environmental attitudes rising concern on environmental issues. Factor 2. Interest in energy sharing: attentiveness to solutions for local community’s collective consumption, to reduce individual environmental impact, sustainably improve the local community, and sell extra energy to the general electricity grid. Factor 3. Concern on climate change: environmental issues consequences on climate change awareness, especially on a global scale level, developing pro-environmental attitudes on global climate change course and sensitivity about behaviours aimed at mitigating such human impact. Factor 4. Social influence: social support seeking from peers. With RET, advice from significant others is looked for internalizing common perceived social norms of the national/geographical region. Factor 5. Impact on bill cost: inclination to adopt a RET when economic incentives from the behaviour perception affect the decision-making process could result in less expensive or unvaried bills. Linear regression has been conducted to identify and quantify the factors that could better predict behavioural intention to become a prosumer. An overall scale measuring “acceptance of a renewable energy solution” was used as the dependent variable, allowing us to quantify the five factors that contribute to measuring: awareness of environmental issues and climate change; environmental attitudes; social influence; and environmental risk perception. Three variables can significantly measure and predict the scores of the “Acceptance in becoming a prosumer” ad hoc scale. Variable 1. Attitude: the agreement to specific environmental issues and global climate change issues of concerns and evaluations towards a behavioural intention. Variable 2. Economic incentive: the perceived behavioural control and its related environmental risk perception, in terms of perceived short-term benefits and long-term costs, both part of the decision-making process as expected outcomes of the behaviour itself. Variable 3. Age: despite fewer economic possibilities, younger adults seem to be more sensitive to environmental dimensions and issues as opposed to older adults. This research can facilitate policymakers and relevant stakeholders to better understand which relevant psycho-sociological factors are intervening in these processes and what and how specifically target when proposing change towards sustainable energy production and consumption.

Keywords: behavioural intention, environmental risk perception, prosumer, renewable energy technology, social acceptance

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Authors: Veenapani Rajeev Verma

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Context: Assessing facility readiness is paramount as it can indicate capacity of facilities to provide essential care for resilience to health challenges. In the context of decentralization, estimation of supply side readiness indices at sub national level is imperative for effective evidence based policy but remains a colossal challenge due to lack of dependable and representative data sources. Setting: District Poonch of Jammu and Kashmir was selected for this study. It is remote, rural district with unprecedented topographical barriers and is identified as high priority by government. It is also a fragile area as is bounded by Line of Control with Pakistan bearing the brunt of cease fire violations, military skirmishes and sporadic militant attacks. Hilly geographical terrain, rudimentary/absence of road network and impoverishment are quintessential to this area. Objectives: Objective of the study is to a) Evaluate the service readiness of health facilities and create a concise index subsuming plethora of discrete indicators and b) Ascertain supply side barriers in service provisioning via stakeholder’s analysis. Study also strives to expand analytical domain unravelling context and area specific intricacies associated with service delivery. Methodology: Mixed method approach was employed to triangulate quantitative analysis with qualitative nuances. Facility survey encompassing 90 Subcentres, 44 Primary health centres, 3 Community health centres and 1 District hospital was conducted to gauge general service availability and service specific availability (depth of coverage). Compendium of checklist was designed using Indian Public Health Standards (IPHS) in form of standard core questionnaire and scorecard generated for each facility. Information was collected across dimensions of amenities, equipment, medicines, laboratory and infection control protocols as proposed in WHO’s Service Availability and Readiness Assesment (SARA). Two stage polychoric principal component analysis employed to generate a parsimonious index by coalescing an array of tracer indicators. OLS regression method used to determine factors explaining composite index generated from PCA. Stakeholder analysis was conducted to discern qualitative information. Myriad of techniques like observations, key informant interviews and focus group discussions using semi structured questionnaires on both leaders and laggards were administered for critical stakeholder’s analysis. Results: General readiness score of health facilities was found to be 0.48. Results indicated poorest readiness for subcentres and PHC’s (first point of contact) with composite score of 0.47 and 0.41 respectively. For primary care facilities; principal component was characterized by basic newborn care as well as preparedness for delivery. Results revealed availability of equipment and surgical preparedness having lowest score (0.46 and 0.47) for facilities providing secondary care. Presence of contractual staff, more than 1 hr walk to facility, facilities in zone A (most vulnerable) to cross border shelling and facilities inaccessible due to snowfall and thick jungles was negatively associated with readiness index. Nonchalant staff attitude, unavailability of staff quarters, leakages and constraint in supply chain of drugs and consumables were other impediments identified. Conclusions/Policy Implications: It is pertinent to first strengthen primary care facilities in this setting. Complex dimensions such as geographic barriers, user and provider behavior is not under precinct of this methodology.

Keywords: effective coverage, principal component analysis, readiness index, universal health coverage

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Authors: Fani Sakellariadou

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The Blue Economy includes all marine-based and marine-related activities. They correspond to established, emerging as well as unborn ocean-based industries. Seabed mining is an emerging marine-based activity; its operations depend particularly on cutting-edge science and technology. The 21st century will face a crisis in resources as a consequence of the world’s population growth and the rising standard of living. The natural capital stored in the global ocean is decisive for it to provide a wide range of sustainable ecosystem services. Seabed mineral deposits were identified as having a high potential for critical elements and base metals. They have a crucial role in the fast evolution of green technologies. The major categories of marine mineral deposits are deep-sea deposits, including cobalt-rich ferromanganese crusts, polymetallic nodules, phosphorites, and deep-sea muds, as well as shallow-water deposits including marine placers. Seabed mining operations may take place within continental shelf areas of nation-states. In international waters, the International Seabed Authority (ISA) has entered into 15-year contracts for deep-seabed exploration with 21 contractors. These contracts are for polymetallic nodules (18 contracts), polymetallic sulfides (7 contracts), and cobalt-rich ferromanganese crusts (5 contracts). Exploration areas are located in the Clarion-Clipperton Zone, the Indian Ocean, the Mid Atlantic Ridge, the South Atlantic Ocean, and the Pacific Ocean. Potential environmental impacts of deep-sea mining include habitat alteration, sediment disturbance, plume discharge, toxic compounds release, light and noise generation, and air emissions. They could cause burial and smothering of benthic species, health problems for marine species, biodiversity loss, reduced photosynthetic mechanism, behavior change and masking acoustic communication for mammals and fish, heavy metals bioaccumulation up the food web, decrease of the content of dissolved oxygen, and climate change. An important concern related to deep-sea mining is our knowledge gap regarding deep-sea bio-communities. The ecological consequences that will be caused in the remote, unique, fragile, and little-understood deep-sea ecosystems and inhabitants are still largely unknown. The blue economy conceptualizes oceans as developing spaces supplying socio-economic benefits for current and future generations but also protecting, supporting, and restoring biodiversity and ecological productivity. In that sense, people should apply holistic management and make an assessment of marine mining impacts on ecosystem services, including the categories of provisioning, regulating, supporting, and cultural services. The variety in environmental parameters, the range in sea depth, the diversity in the characteristics of marine species, and the possible proximity to other existing maritime industries cause a span of marine mining impact the ability of ecosystems to support people and nature. In conclusion, the use of the untapped potential of the global ocean demands a liable and sustainable attitude. Moreover, there is a need to change our lifestyle and move beyond the philosophy of single-use. Living in a throw-away society based on a linear approach to resource consumption, humans are putting too much pressure on the natural environment. Applying modern, sustainable and eco-friendly approaches according to the principle of circular economy, a substantial amount of natural resource savings will be achieved. Acknowledgement: This work is part of the MAREE project, financially supported by the Division VI of IUPAC. This work has been partly supported by the University of Piraeus Research Center.

Keywords: blue economy, deep-sea mining, ecosystem services, environmental impacts

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Authors: Oluwaseun Adeleke, Samuel O. Ikani, Simeon Christian Chukwu, Fidelis Edet, Anthony Nwala, Mopelola Raji, Simeon Christian Chukwu

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Background: Health service providers are offered in-service training periodically to strengthen their ability to deliver services that are ethical, quality, timely and safe. Not all capacity-building courses have successfully resulted in intended service delivery outcomes because of poor training content, design, approach, and ambiance. The Delivering Innovations in Selfcare (DISC) project developed a Moment of Truth innovation, which is a proven training model focused on improving consumer/provider interaction that leads to an increase in the voluntary uptake of subcutaneous depot medroxyprogesterone acetate (DMPA-SC) self-injection among women who opt for injectable contraception. Methodology: Six months after training on a moment of truth (MoT) training manual, the project conducted two intensive rounds of qualitative data collection and triangulation that included provider, client, and community mobilizer interviews, facility observations, and routine program data collection. Respondents were sampled according to a convenience sampling approach, and data collected was analyzed using a codebook and Atlas-TI. Providers and clients were interviewed to understand their experience, perspective, attitude, and awareness about the DMPA-SC self-inject. Data were collected from 12 health facilities in three states – eight directly trained and four cascades trained. The research team members came together for a participatory analysis workshop to explore and interpret emergent themes. Findings: Quality-of-service delivery and performance outcomes were observed to be significantly better in facilities whose providers were trained directly trained by the DISC project than in sites that received indirect training through master trainers. Facilities that were directly trained recorded SI proportions that were twice more than in cascade-trained sites. Direct training comprised of full-day and standalone didactic and interactive sessions constructed to evoke commitment, passion and conviction as well as eliminate provider bias and misconceptions in providers by utilizing human interest stories and values clarification exercises. Sessions also created compelling arguments using evidence and national guidelines. The training also prioritized demonstration sessions, utilized job aids, particularly videos, strengthened empathetic counseling – allaying client fears and concerns about SI, trained on positioning self-inject first and side effects management. Role plays and practicum was particularly useful to enable providers to retain and internalize new knowledge. These sessions provided experiential learning and the opportunity to apply one's expertise in a supervised environment where supportive feedback is provided in real-time. Cascade Training was often a shorter and abridged form of MoT training that leveraged existing training already planned by master trainers. This training was held over a four-hour period and was less emotive, focusing more on foundational DMPA-SC knowledge such as a reorientation to DMPA-SC, comparison of DMPA-SC variants, counseling framework and skills, data reporting and commodity tracking/requisition – no facility practicums. Training on self-injection was not as robust, presumably because they were not directed at methods in the contraceptive mix that align with state/organizational sponsored objectives – in this instance, fostering LARC services. Conclusion: To achieve better performance outcomes, consideration should be given to providing training that prioritizes practice-based and emotive content. Furthermore, a firm understanding and conviction about the value training offers improve motivation and commitment to accomplish and surpass service-related performance outcomes.

Keywords: training, performance outcomes, innovation, family planning, contraception, DMPA-SC, self-care, self-injection.

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