Search results for: rural nurse

Authors: Rajeshwari Biradar

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Background: The anecdotal evidences indicate that utilization of HIV services especially in Government facilities is affected by stigma and discrimination among HIV positive female sex workers (FSWs) in Karnataka. To our knowledge, there is no quantitative study on this issue. In this study an attempt is made to examine these aspects among positive FSWs exposed to prevention programs. Methods: This is a cross‐ sectional quantitative survey of HIV positive FSWs in the 3 districts of northern Karnataka using a structured questionnaire. The list of HIV Positive FSWs was organized by stratification, and 607 positive FSWs were selected using a systematic random selection. The data were analyzed using both bivariate and multivariate statistical techniques. Results: Half of the sex workers (52%) are traditional (devadasi, dedicated to the temple), 22% are widowed and the mean age is 33 years. The FSWs practice sex work on an average 13 days a month with 2.3 clients per day and was in sex work for about 13 years. Almost all of them (97%) used condom with the clients they had on the last day of sex work. About 74% were ever registered in the ART center and 47% of them reported being ever on ART, of which 6% dropped out. Multivariate results support the hypothesis that the interventions addressing stigma and discrimination enabled accessing health services in the government facilities (AOR=1.37; p=0.17). Conclusions: Based on the results of the study, programs addressing stigma, discrimination and positive prevention can be implemented in places where government health services are not utilized by HIV positive FSWs. However, the study may be limited by the fact that majority of the FSWs entered into sex work through the traditional devadasi system, which may not be the case in other parts of India.

Keywords: sex work, HIV/AIDS, female sex workers, health

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Authors: Marzieh Amiri, Zahra Iranpour Mobarakeh, Fatemeh Mehrbakhsh, Mehran Amiri

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Introduction: Early diagnosis and intervention of congenital hearing loss is necessary to minimize the adverse effects of hearing loss. The aim of the present study was to report the results of newborn hearing screening in a centerin the south part of Iran, Fasa. Material and methods: In this study, the data related to 6,144 newbornsduring September 2018 up to September2021, was analyzed. Hearing screening was performed using transient evoked otoacoustic emissions (TEOAEs) and automated auditory brainstem response (AABR) tests. Results: From all 6144 newborns,3752 and 2392referred to the center from urban and rural part of Fasa, respectively. There were 2958 female and 3186 male in this study. Of 6144 newborns, 6098 ones passed the screening tests, and 46 neonates were referred to a diagnostic audiology clinic. Finally, nine neonates were diagnosed with congenital hearing loss (seven with sensorineural hearing loss and two with conductive hearing loss). The severity of all the hearing impaired neonates was moderate and above. The most important risk factors were family history of hearing loss, low gestational age, NICU hospitalization, and hyperbilirubinemia. Conclusion: Our results showed that the prevalence of hearing loss was 1.46 per 1000 infants. Boosting public knowledge by providing families with proper education appears to be helpful in preventing the negative effects of delayed implementation of health screening programs.

Keywords: newborn hearing screening, hearing loss, risk factor, prevalence

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Authors: Emmanuel Ukpe, S. M. F. D. Syed Mustapha

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Trust in an organization has been perceived as one of the key factors behind knowledge sharing, mainly in an unstructured work environment. In an informal working environment, to instill trust among individuals is a challenge and even more in the virtual environment. The study has contributed in developing the framework for building trust in an unstructured organization in performing knowledge sharing in a virtual environment. The artifact called KAPE (Knowledge Acquisition, Processing, and Exchange) was developed for knowledge sharing for the informal organization where the framework was incorporated. It applies to Cassava farmers to facilitate knowledge sharing using web-based platform. A survey was conducted; data were collected from 382 farmers from 21 farm communities. Multiple regression technique, Cronbach’s Alpha reliability test; Tukey’s Honestly significant difference (HSD) analysis; one way Analysis of Variance (ANOVA), and all trust acceptable measures (TAM) were used to test the hypothesis and to determine noteworthy relationships. The results show a significant difference when there is a trust in knowledge sharing between farmers, the ones who have high in trust acceptable factors found in the model (M = 3.66 SD = .93) and the ones who have low on trust acceptable factors (M = 2.08 SD = .28), (t (48) = 5.69, p = .00). Furthermore, when applying Cognitive Expectancy Theory, the farmers with cognitive-consonance show higher level of trust and satisfaction with knowledge and information from KAPE, as compared with a low level of cognitive-dissonance. These results imply that the adopted trust model KAPE positively improved knowledge sharing activities in an informal environment amongst rural farmers.

Keywords: trust, knowledge, sharing, knowledge acquisition, processing and exchange, KAPE

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Authors: Kerdsiri Hongthai, Darunee Jongudomkarn, Rutja Phuphaibul

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In Thailand, many adults in rural areas migrate to seek employ¬ment resulting in skipped-generation family where grandparents care for grandchildren with no other adults present. This is a preliminary study using qualitative case study methods, aimed to explore the situations of older adult grandparents' experiences in skipped-generation family in North-East of Thailand. Data were collected by in-depth inter¬views with 6 grandparents living in skipped-generation families; 5 females and 1 males grandparents, aged 62-75, some of them have diabetes mellitus, hypertension, during November to December, 2017. The finding themes are: ‘Caught up in the middle’: the older adults were pleased to have grandchildren but, at the same time, acknowledge the burden that this placed on them, especially when the migrant children failed to send enough money back to support the family. ‘Getting bad health’: they reported to be fatigued and stressed due to burden of caring for their grandchildren without support. This situation can aggravate problems of poor health status and be worsening economic status of the grandparents. In some cases of deprivation, the grandparents feel that having to be the sole care providers of their grandchildren can negative adversely affect their mental status. It is important to find out in other sectors similar to Thailand and lead to more in-depth research to answer the research questions about policy and social support in skipped-generation family in the future.

Keywords: older adult grandparents, experiences, principle care giver, skipped-generation family

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Authors: D. A. Dakul, T. M. Akindigh, B. J. Dogonyaro, O. J. Abba, K. T. Tangtur, N. Sambo, J. A. E. Okopi, J. A. Yohanna, G. E. Imade, G. S. Mwansat, S. Oguche

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Malaria and urinary Schistosomaisis are both endemic in Nigeria and pose a serious health challenge in rural areas where co-infections are common. This descriptive cross sectional study was carried out to determine the prevalence of co-infection and the impact of concurrent infection on haemoglobin concentration, Eosinophil and CD4+ T-lymphocyte counts. Plasmodium falciparum and Schistosoma haematobium infection were determined by Malaria Rapid Diagnostic Test (MRDT) kits and the presence of visible haematuria respectively and confirmed by conventional Polymerase Chain Reaction (cPCR). P values < 0.05 were considered statistically significant. Of the 110 children examined, 13 (11.8%) had concurrent infection with Schistosoma haematobium falciparum, 46(41.8%) had Plasmodium falciparum infection while 16(14.5%) had Schistosoma haematobium infection. A strong association between co-infection and the ages of 10-15 years with a 36.4% prevalence of anaemia was observed. Malaria was significantly associated with anaemia than with concurrent infections or schistomiasis alone. Co-infection with both pathogens and a high prevalence of anaemia was observed in Jinduut community. Although the causes of anaemia are multi-factorial, further investigation into the extent to which malaria and urinary schistosomiasis contribute to anaemia is needed. Also, integrated control efforts must be strengthened to mitigate the impact of concurrent infection in this group of vulnerable members in the community. The results can be applied to other communities during control.

Keywords: co-Infection, plasmodium falciparum and scistosoma haematobium, Jinduut, Nigeria

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Authors: Sudarshan Chalise, Athula Naranpanawa

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This paper attempts to investigate the viability of cropland re-allocation as an adaptation strategy to minimise the economy-wide costs of climate change on agriculture. Nepal makes an interesting case study as it is one of the most vulnerable agricultural economies within South Asia. This paper develops a comparative static multi-household Computable General Equilibrium (CGE) model for Nepal with a nested set of Constant Elasticity of Transformation (CET) functional forms to model the allocation of land within different agricultural sectors. Land transformation elasticities in these CET functions are allowed to reflect the ease of switching from one crop to another based on their agronomic characteristics. The results suggest that, in the long run, farmers in Nepal tend to allocate land to crops that are comparatively less impacted by climate change, such as paddy, thereby minimizing the economy-wide impacts of climate change. Furthermore, the results reveal that land re-allocation tends to reduce the income disparity among different household groups by significantly moderating the income losses of rural marginal farmers. Therefore, it is suggested that policy makers in Nepal should prioritise schemes such as providing climate-smart paddy varieties (i.e., those that are resistant to heat, drought and floods) to farmers, subsidising fertilizers, improving agronomic practices, and educating farmers to switch from crops that are highly impacted by climate change to those that are not, such as paddy.

Keywords: climate change, general equilibrium, land re-allocation, nepalese agriculture

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Authors: I. Wayan Wiwin

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Poverty is one of the big problems faced by big cities in the world. Urbanization one cause, many rural communities trying to earn a living to the city in the hope that they can improve the level of economy, but not equipped with adequate skills so that it becomes an urban demographic problem. Denpasar as the capital of the province of Bali one of them, in the city area of Denpasar there are many slum dwellings inhabited by the poor, whereas Bali is known as one of the best tourist destinations in the world. This condition is very inversely proportional to the progress of tourism in Bali. For that it is necessary to attempt to overcome poverty in the city of Denpasar, one with the development of city tours in the form of charity walking tours, where tourists are invited to take a walk to see directly the state of the poor in the city of Denpasar and provide assistance to them in the form of home assistance, educational scholarships, health assistance, as well as skill and business capital assistance. This research is explorative-qualitative, that is exploring the potential of charity walking tour to overcome poverty in Denpasar City, which is written qualitatively. In the end based on potential data and information, then analyzed into a decision whether it is possible to develop. Therefore, this study only requires respondents or informants who are able to provide answers or qualitative information about matters related to the potential development of charity walking tour. Thus, informants in this study are tourism stakeholders, such as Municipal government officials, businessmen, community leaders and tourism actors, who are considered to be providing information relating to the development of urban tourism.

Keywords: tourism, city tours, charity walking tours, poverty

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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: Sibnath Sarkar

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Developing countries are facing many Social problems. In India, too there are several such problems. The problem of street children is one of them. No country or city anywhere in the world today is without the presence of street children, but the problem is most acute in developing countries. Thousands of street children can be seen in our populous cities like Mumbai, Kolkata, Delhi, and Chennai. Most of them are in the age group of 5-15 years. The number of street children is increasing gradually. Poverty, unemployment, rapid urbanization, rural-urban migrations are the root causes of street children. Being deprive from many of their, they have escaped to the street as a safe place for living. Street children always related with the urban spaces in the developing world and it represents a sad outcome of the rapid urbanization process. After coming to the streets, these children have to cope with the new situation every day. They also adopt or develop many complex survival strategies and a variety of different informal or even illegal activities in public space and form supportive social networks in order to survive in street life. Street children use the different suitable urban spaces as their earning, living, entertaining spot. Therefore, the livelihoods of young people on the street should analyze in relation to the spaces they use, as well as their age and length of stay on the streets. This paper tries to explore the livelihood strategies and copping situation of street children in Sealdah station area. One hundred seventy-five street living children are included in the study living in and around the railway station.

Keywords: strategies, street children, survive, urban-space

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Authors: G. Salavwa, P. Erhijakpor Jr., H. Ukwu

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This study will explore child labour issues in Nigeria because it is capable of affecting the physical and general well-being of children who perform hazardous work. This feat will be achieved through qualitative research methodology. Data collection shall be elicited by oral interviews and documental content analysis to delve on the application of the Convention on the Rights of the Child (CRC), International Labour Organization ILO and Geneva Convention relating to child labour practices in Nigeria. This will include the relevance of present domestic laws relating to child labour as implemented in Nigeria, together with factors that contribute to the practice of child labour in the country. The oral interview data analysis will be performed by breaking the interview data into significant statements and themes. This shall be done by comparing and determining the commonalities that are prevalent in the participants’ views regarding child labour menace in Nigeria. Presumably, findings from this study shall unveil that a poor educational policy, a widespread poverty level which is mostly prevalent amongst families in the rural areas of the country, a lack of employment for adults, have led to the ineffectiveness of the local child labour laws in Nigeria. These has in turn culminated into a somewhat non-implementation of the international laws of the CRC, ILO and Geneva Declaration on child labour to which the Nigerian government is a signatory. Based on the finding, this study will calls on the government of Nigeria to extend its free educational policy from the elementary, secondary to tertiary educations. The government also has to ensure that offenders of children’s rights should face a severe punishment.

Keywords: commonalities, tertiary, constitution, qualitative

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Authors: Akachi Odoemene

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Climate change and land grabbing are tightly interconnected in ways that are both diverse and complex. They have impacted each other in significant ways too. Both phenomena are not only a political reality, but have diverse dire implications, especially for food and livelihood security of vulnerable populations in developing economies. The critical nexus and interactions of climate change and land grabbing remain one of the challenges of sustainable development in modern times. The nuanced understanding of the nexus, importance and implications of climate change and land grabbing are the primary focus of this chapter. It begins with conceptual clarifications, particularly arguing that the absence of some important principles of engagement underline and define a land grab. It also analyses and notes a good number of contemporary land deals as 'one-sided', in which wealthy entities connive with local elites to exploit and disposes rural poor populations. The paper not only examines both global and local factors that drive land grabbing and, in some cases, their connections with the incidence of climate change, but also explores their crucial links with such sector as agriculture. It is argued and exhibited in the paper why certain societies are susceptible to the incidence of climate change and land grabbing, while the overall consequences of these phenomena on the affected societies are further interrogated. The paper concludes that the lack of political will by global political leaders to effectively combat and resolve critical issues associated with both climate change and land grabbing remains a daunting challenge. It notes that these phenomena – climate change and land grabbing – if not abated, will certainly become another set of global tragic episodes to be regretted in the future.

Keywords: climate change, land grabbing, global governance, developing economies

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Authors: S. Shalaweh, P. Bouic, F. Weitz, R. Henkel

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More than 3000 plants of notable phyto-therapeutic value grow in South Africa; these include Cissampelos capensis, commonly known in Afrikaans as dawidjie or dawidjiewortel. C. capensis is the most significant and popular medicinal plant used by the Khoisan as well as other rural groups in the Western region of South Africa. Its rhizomes are traditionally used to treat male fertility problems. Yet, no studies have investigated the effects of this plant or its extracts on human spermatozoa. Therefore, this study aimed at investigating the effects of C. capensis rhizome extract (CRE) fractions on ejaculated human spermatozoa in vitro. Spermatozoa from a total of 77 semen samples were washed with human tubular fluid medium supplemented with bovine serum albumin (HTF-BSA) and incubated for 2 hourswith 20 µg/ml progesterone (P4) followed by incubation with different concentrations (0, 0.05, 0.5, 5, 50, 200 µg/ml) of fractionated CRE (F1=0% MeOH, F2=30% MeOH, F3=60% MeOH and F4=100% MeOH) for 1.5 hours at 37°C. A sample without addition of CRE fractions served as control. Samples were analyzed for sperm motility, reactive oxygen species (ROS), DNA-fragmentation, acrosome reaction and capacitation. Results showed that F1 resulted in significantly higher values for ROS, capacitation and hyper-activation compared to F2, F3, and F4 with P4-stimulated samples generally having higher values. No significant effect was found for the other parameters. In conclusion, alkaloids present in F1 of CRE appear to have triggered sperm intrinsic ROS production leading to sperm capacitation and acrosome reaction induced by P4.

Keywords: capacitaion, acrosome reaction, DNA fragmentation, ROS

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Authors: Mohammad Abbasi

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Cooperatives around the world, relying on the policy of mutual self-help, are a natural tool for Social and economic development, and securing the interests of local communities and social systems has changed. The social economy consists of institutions, cooperatives, bilateral organizations, and unions and associations and their activities have social and economic aspects. Due to the nature of cooperative companies, it can be claimed that all cooperatives have social and economic goals; Because every company A cooperative is formed with the aim of meeting the common needs of society members. These needs sometimes It is aimed at housing or health services, and sometimes cooperative members want to go through it Products and services, employment, and continuous income (for example, in most rural areas of Iran, needs are of this type) to have access. This article also examines the broad methods of participation of Iran's cooperatives in the economy It deals with social issues and provides innovative solutions to solve social issues and problems, and the potential for innovation and growth in using the cooperative model in order to meet economic needs and It proves the sociality of Canadians. In this article, cooperatives whose activities are mostly "social" are mentioned And the activity of many of them in cooperation with government programs in the fields of health, housing, etc. It is a kindergarten and they have proven that they have a cost-effective model in providing services. The conclusion of this discussion shows that the cooperative model for economic activity, with A hundred years of history in Iran has been able to show its value as a tool of innovation in the fields to to prove social, technological, and economic. Cooperatives with about 10 million members in Iran have shown that they are well-known and trusted by the people.

Keywords: types of cooperatives, social economy, Iran, non-governmental organizations, justice, consumption pattern

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Authors: Oluwagbemiga Paul Agboola, Cornelius Olatunji Omojola, Dayo Martins Oyeshomo

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The role of a recreational park in human and environmental development has attracted much interest in the recent time. Recreation parks' development could act as an effective planning strategy to enhance environmental sustainability, social cohesiveness, and users' quality of life. Similarly, parks enhance neighbourhood's aesthetics, refresh the air and enhance humans' contact with nature. In this connection, recreation parks create natural surroundings of rural areas for leisure, relaxation, recreation, psychological and physical comfort of the people. The purpose of this paper is to investigate the effectiveness of the two recreational parks' development as a strategy for neighbourhood's environmental improvement, sustainability and the recreationists' cohesiveness. A total number of 158 survey questionnaires were distributed to the tourists at Ikogosi cold and warm spring in Ekiti state as well as Olumirin waterfalls, Erin-Ijesa, Osun State, in South-West, Nigeria. The quantitative results of the analyzed data with Relative Importance Index (RII) revealed that recreation parks provide optimum opportunities for users' social cohesiveness and well-being while parks' sustainable environment could be enhanced base on the provision of essential facilities, services, and future developmental plans. It is recommended that for recreation parks to realize their full potential in environmental sustainability, adequate maintenance and provision of essential facilities becomes imperative.

Keywords: environmental sustainability, neighbourhood development, recreational park, Nigeria

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Authors: S. M. Amin Hosseini, Oriol Pons, Albert de la Fuente

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After natural disasters, displaced people (DP) require important numbers of housing units, which have to be erected quickly due to emergency pressures. These tight timeframes can cause the multiplication of the environmental construction impacts. These negative impacts worsen the already high energy consumption and pollution caused by the building sector. Indeed, post-disaster housing, which is often carried out without pre-planning, usually causes high negative environmental impacts, besides other economic and social impacts. Therefore, it is necessary to establish a suitable strategy to deal with this problem which also takes into account the instability of its causes, like changing ratio between rural and urban population. To this end, this study aims to present a model that assists decision-makers to choose the most suitable building technology for post-disaster housing units. This model focuses on the alternatives sustainability and fulfillment of the stakeholders’ satisfactions. Four building technologies have been analyzed to determine the most sustainability technology and to validate the presented model. In 2003, Bam earthquake DP had their temporary housing units (THUs) built using these four technologies: autoclaved aerated concrete blocks (AAC), concrete masonry unit (CMU), pressed reeds panel (PR), and 3D sandwich panel (3D). The results of this analysis confirm that PR and CMU obtain the highest sustainability indexes. However, the second life scenario of THUs could have considerable impacts on the results.

Keywords: sustainability, post-disaster temporary housing, integrated value model for sustainability assessment, life cycle assessment

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Authors: Louiza C. Duncker, Duarte Gonçalves

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Wildlife crime is a complex problem with many interconnected facets, which are generally responded to in parts or fragments in efforts to “break down” the complexity into manageable components. However, fragmentation increases complexity as coherence and cooperation become diluted. A whole-of-society approach has been developed towards finding a common goal and integrated approach to preventing wildlife crime. As part of this development, research was conducted in rural communities adjacent to conservation areas in South Africa to define and comprehend the challenges faced by them, and to understand their perceptions of wildlife crime. The results of the research showed that the perceptions of community members varied - most were in favor of conservation and of protecting rhinos, only if they derive adequate benefit from it. Regardless of gender, income level, education level, or access to services, conservation was perceived to be good and bad by the same people. Even though people in the communities are poor, a willingness to stop rhino poaching does exist amongst them, but their perception of parks not caring about people triggered an attitude of not being willing to stop, prevent or report poaching. Understanding the nuances, the history, the interests and values of community members, and the drivers behind poaching mind-sets (intrinsic or driven by transnational organized crime) is imperative to create sustainable and resilient communities on multiple levels that make a substantial positive impact on people’s lives, but also conserve wildlife for posterity.

Keywords: community perceptions, conservation, rhino poaching, whole-of-society approach, wildlife crime

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Authors: Bavneet Kaur Sidhu, Manoj Tiwari

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Global Developmental Delay (GDD) is a common pediatric condition. Etiologies of GDD might, however, differ in developing countries. In the last decade, sporadic families are being reported in various countries. As to the author’s best knowledge, many risk factors and their correlation with the prevalence of GDD have been studied but its statistical correlation has not been done. Thus we propose the present study by targeting the risk factor, prevalence and their statistical correlation with GDD. FMR1 gene was studied to confirm the disease and its penetrance. A complete questionnaire-based performance was designed for the statistical studies having a personal, past and present medical history along with their socio-economic status as well. Methods: We distributed the children’s age in 4 different age groups having 5-year intervals and applied structural equation modeling (SEM) techniques, Spearman’s rank correlation coefficient, Karl Pearson correlation coefficient, and chi-square test.Result: A total of 1100 families were enrolled for this study; among them, 330 were clinically and biologically confirmed (radiological studies) for the disease, 204 were males (61.8%), 126 were females (38.18%). We found that 27.87% were genetic and 72.12 were sporadic, out of 72.12 %, 43.277% cases from urban and 56.72% from the rural locality, the mothers' literacy rate was 32.12% and working women numbers were 41.21%. Conclusions: There is a significant association between mothers' age and GDD prevalence, which is also followed by mothers' literacy rate and mothers' occupation, whereas there was no association between fathers' age and GDD.

Keywords: global developmental delay, FMR1 gene, spearman’ rank correlation coefficient, structural equation modeling

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Authors: Nam Sze Cheng, P. C. Janita Chau

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Background: Eczema is a chronic inflammatory disease with high global prevalence rates in many childhood populations. It is also the most common paediatric skin problem. Although eczema education and proper skin care were effective in controlling eczema symptoms, the lack of both sufficient time for patient consultation and structured eczema education programme hindered the transferability of knowledge to patients and their parents. As a result, these young patients and their families suffer from a significant physical disability and psychological distress, which can substantially impair their quality of life. Objectives: This integrative review is to examine the effects of educational interventions for children with eczema and identify the core elements associated with an effective intervention. Methods: This integrative review targeted all articles published in 10 databases between May 2016 and February 2017 that reported the outcomes of disease interventions of any format for children and adolescents with the clinical diagnosis of eczema who were under 18 years of age. Five randomized controlled trials (RCT) and one systematic review of 10 RCTs were identified for review. All these publications had high methodological quality, except one study of web-based eczema education that was limited by selection bias and poor subject blinding. Findings: This review found that most studies adopted nurse-led or multi-disciplinary parental eczema education programme at the outpatient clinic setting. The format of these programmes included individual lectures, demonstration and group sharing, and the educational materials covered basic eczema knowledge and management as well as methods to interrupt itch-scratch cycle. The main outcome measures of these studies included severity of eczema symptoms, treatment adherence and quality of life of both patients and their families. Nine included studies reported statistically significant improvement in the primary outcome of symptom severity of these eczematous children. On the other hand, all these reviews failed to identify an effective dosage of intervention under these educational programmes that was attributed to the heterogeneity of the interventions. One study that was designed based on the social cognitive theory to guide the interventional content yielded statistically significant results. The systematic review recommended the importance of measuring parental self-efficacy. Implication: This integrative review concludes that structured educational programme can help nurses understand the theories behind different health interventions. They can then deliver eczema education to their patients in a consistent manner. These interventions also result in behavioral changes through patient education. Due to the lack of validated educational programmes in Chinese, it is imperative to conduct an RCT of eczema educational programme to investigate its effects on eczema severity, quality of life and treatment adherence in Hong Kong children as well as to promote the importance of parental self-efficacy.

Keywords: children, eczema, education, intervention

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Authors: Dalia Almaghaslah, A. Alsayari, R. Asiri, N. Albugami

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The aim of this study was to evaluate the pharmacy workforce in Saudi Arabia in terms of supply, geographical distribution, nationality and gender distribution, as well as to assess the employment rate. A retrospective cross-sectional approach was used to address these objectives. Relevant data was identified and retrieved from the latest version of the Health Statistical Yearbook— Kingdom of Saudi Arabia, 2016; Saudi Commission for Health Specialties publications, 2018; and national pharmacy organisation websites. In general, the exponential increase in the number of pharmacy schools has helped to produce more pharmacists in the rural areas of the country, but inequitable distribution of the workforce still exists. The reliance on non-indigenous pharmacists, especially in the private sector, is substantial. Male pharmacists outnumber females, mainly due to the cultural and social factors that limit the participation of women in community pharmacy, which is the largest employment sector. The employment rate shows limited opportunities for Saudi pharmacists at the Ministry of Health (MOH) as they have already Saudised almost all pharmacy positions at the MOH healthcare facilities. However, the private sector needs to assume responsibility for their share of the re-nationalisation of the profession in order to provide jobs for local pharmacists. Regular, more detailed profiling of the pharmacy workforce is an essential step to achieving effective pharmacy workforce planning. Currently, a large gap exists in our knowledge of the workforce in the country, especially regarding their supply and demand and employment prospects.

Keywords: employment prospects, pharmacy workforce, Saudi Arabia, supply and demand

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Authors: Garima Singh

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Objectives: Behavioral Crisis Center (BCC) is a community solution to a community problem. There has been an exponential increase in the incidence and prevalence of mental health crises around the world. The effects of the crisis negatively impact our patients and their families and strain the law enforcement and emergency room. The goal of the multi-disciplinary care model is to break the crisis cycle and provide 24-7 rapid access to an acre and crisis stabilization. We initiated our first BCC care center in 2020 in the midst of the COVID pandemic and have seen a remarkable improvement in patient ‘care and positive financial outcome. Background: Mental illnesses are common in the United States. Nearly one in five U.S. adults live with a mental illness (52.9 million in 2020). This number represented 21.0% of all U.S. adults. To address some of these challenges and help our community, In May 2020, we opened our first Behavioral crisis center (BCC). Since then, we have served more than 2500 patients and is the first southwest Missouri’s first 24/7 facility for crisis–level behavioral health and substance use needs. It has been proven to be a more effective place than emergency departments, jails, or local law enforcement. Methods: BCC was started in 2020 to serve the unmet need of the community and provide access to behavioral health and substance use services identified in the community. Funding was possible with significant investment from the county and Missouri Foundation for Health, with contributions from medical partners. It is a multi-disciplinary care center consisting of Physicians, nurse practitioners, nurses, behavioral technicians, peer support specialists, clinical intake specialists, and clinical coordinators and hospitality specialists. The center provides services including psychiatry care, outpatient therapy, community support services, primary care, peer support and engagement. It is connected to a residential treatment facility for substance use treatment for continuity of care and bridging the gap, which has resulted in the completion of treatment and better outcomes. Results: BCC has proven to be a great resource to the community and the Missouri Health Coalition is providing funding to replicate the model in other regions and work on a similar model for children and adolescents. Overall, 29% of the patients seen at BCC are stabilized and discharged with outpatient care. 50% needed acute stabilization in a hospital setting and 21% required long-term admission, mostly for substance use treatment. The local emergency room had a 42% reduction in behavioral health encounters compared to the previous 3 years. Also, by a quick transfer to BCC, the average stay in ER was reduced by 10 hours and time to follow up behavioral health assessment decreased by an average of 4 hours. Uninsured patients are also provided Medicaid application assistance which has benefited 55% of individuals receiving care at BCC. Conclusions: BCC is impacting community health and improving access to quality care and substance use treatment. It is a great investment for our patients and families.

Keywords: BCC, behvaioral health, community health care, addiction treatment

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Authors: Save Kumwenda, Khumbo Kalulu, Kondwani Chidziwisano, Limbani Kalumbi, Vincent Doyle, Bagrey Ngwira

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Introduction: The Malawi Government in partnership with Non-Governmental Organizations adopted Community Led Total Sanitation (CLTS) in 2008 as an approach in sanitation and hygiene promotion with an aim of declaring Malawi Open Defeacation Free (ODF) by 2015. While there is a significant body of research into CLTS available in public domain, there is little research done on challenges faced in implementing CLTS in Malawi. Methods: A cross-sectional qualitative study was carried out in three districts of Ntcheu, Balaka, and Phalombe. Data was collected using Focus Group Discussions (FGDs) and Key informant interviews (KII) and analysed manually. Results: In total, 96 people took part in FGDs and 9 people in KII. It was shown that choice of leaders after triggering was commonly done by chiefs, facilitators, and VHC without following CLTS principles as opposed to identifying individuals who showed leadership skills. Despite capacity building initiatives involving District Coordinating Teams, lack of resources to undertake follow-ups contributed to failure to sustain ODF in the community. It was also found that while most respondents appreciating the need for no subsidies, the elderly and those with disabilities felt the need for external support because do not have money for buying strong logs, slabs for durable toilet floor and also to hire people to build latrines for them. Conclusion: Effective implementation of CLTS requires comprehensive consideration of various issues that may affect its success.

Keywords: open defecation, community-led, sanitation, faecal matter, hygiene, Malawi

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Authors: Mukhtiar Singh, Sumeet Nagar

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Vehicle routing problem (VRP) is a combinatorial optimization and nonlinear programming problem aiming to optimize decisions regarding given set of routes for a fleet of vehicles in order to provide cost-effective and efficient delivery of both services and goods to the intended customers. This paper proposes the application of integrated particle swarm optimization (PSO) and genetic optimization algorithm (GA) to address the Vehicle routing problem in sugarcane industry in India. Suger industry is very prominent agro-based industry in India due to its impacts on rural livelihood and estimated to be employing around 5 lakhs workers directly in sugar mills. Due to various inadequacies, inefficiencies and inappropriateness associated with the current vehicle routing model it costs huge money loss to the industry which needs to be addressed in proper context. The proposed algorithm utilizes the crossover operation that originally appears in genetic algorithm (GA) to improve its flexibility and manipulation more readily and avoid being trapped in local optimum, and simultaneously for improving the convergence speed of the algorithm, level set theory is also added to it. We employ the hybrid approach to an example of VRP and compare its result with those generated by PSO, GA, and parallel PSO algorithms. The experimental comparison results indicate that the performance of hybrid algorithm is superior to others, and it will become an effective approach for solving discrete combinatory problems.

Keywords: fuzzy logic, genetic algorithm, particle swarm optimization, vehicle routing problem

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Authors: Yuki Hara

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Entrepreneurs are welcomed to the landscaping industry, conserving practically and theoretically biological diversity in landscaping construction, although there are limited reports on corporative trials making a market with a new logistics system of native plants (NP) between landscaping companies and nurserymen. This paper explores the entrepreneurial process of a landscaping company, “5byMidori” for NP marketing. This paper employs a case study design. Data are collected in interviews with the manager and designer of 5byMidori, 2 scientists, 1 organization, and 18 nurserymen, fieldworks at two nurseries, observations of marketing activities in three years, and texts from published documents about the business concept and marketing strategy with NP. These data are analyzed by qualitative methods. The results show that NP is suitable for the vision of 5byMidori improving urban desertified environment with closer urban-rural linkage. Professional landscaping team changes a forestry organization into NP producers conserving a large nursery of a mountain. Multifaceted PR based on the entrepreneurial context and personal background of a landscaping venture can foster team members' businesses and help customers and users to understand the biodiversity value of the product. Wider partnerships with existing nurserymen at other sites in many regions need socio-economic incentives and environmental reliability. In conclusion, the entrepreneurial marketing of a landscaping company needs to add more meanings and a variety of merits in terms of ecosystem services, as NP tends to be in academic definition and independent from the cultures like nurseryman and forestry.

Keywords: biological diversity, landscaping industry, marketing, native plants

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Authors: Gift Salawa, Perkins Erhijakpor, Henry Ukwu

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This study will explore child labour issues in Nigeria because it is capable of affecting the physical and general well-being of children who perform hazardous work. This feat will be achieved through qualitative research methodology. Data collection shall be elicited by oral interviews and documental content analysis to delve on the application of the Convention on the Rights of the Child (CRC), International Labour Organization ILO and Geneva Convention relating to child labour practices in Nigeria. This will include the relevance of present domestic laws relating to child labour as implemented in Nigeria, together with factors that contribute to the practice of child labour in the country. The oral interview data analysis will be performed by breaking the interview data into significant statements and themes. This shall be done by comparing and determining the commonalities that are prevalent in the participants’ views regarding child labour menace in Nigeria. Presumably, findings from this study shall unveil that a poor educational policy, a widespread poverty level which is mostly prevalent amongst families in the rural areas of the country, a lack of employment for adults, have led to the ineffectiveness of the local child labour laws in Nigeria. These has in turn culminated into a somewhat non-implementation of the international laws of the CRC, ILO and Geneva Declaration on child labour to which the Nigerian government is a signatory. Based on the finding, this study will calls on the government of Nigeria to extend its free educational policy from the elementary, secondary to tertiary educations. The government also has to ensure that offenders of children’s rights should face a severe punishment.

Keywords: child labour, educational policy, human right, protection right

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Authors: Carolina Nunes, Sónia Ribeiro, Hélio Faustinho, Hélia Sales, Rita Pontes, João Nunes

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Pine resin activity in Portugal was one of the most important and major non-wood forestry, representing a strategic natural resource for Portuguese Bioeconomy and an important social activity for rural regions. Pine forests representing a stock of atmospheric carbon, contributing to greenhouse effect mitigation and social and environmental important services returns. They are important sources of numerous useful products, including not only wood and cellulose but also nonwood products used by the chemical, food, and pharmaceutical industries, as well as for biorefineries. Portuguese pine forest area decreases from 1 million hectares to 400 mil hectares in the last 20 years. Portugal, in 80´s decade, was one of the world´s TOP 3 producers, with a middle annual production of 140 mil tones.year-1. With the pressure of the social desertification, forest fires, phytosanitary problems (e.g. nematode of the pine wood) and the decrease of economic value and competitivity of the Portuguese forest, the actual middle annual production is less than 10 mil tones.year-1 (lesser 92%). This significant decrease representing an annual economic loss of approximately 130-140 million Euros. year⁻¹ for forest primary sector in Portugal. The Biopinus project design new forestry approach and strategic biotechnologies knowledge to increase the economic value of Pine resin in Portugal, with an impact on the growth of the economic value of Pine resin from 1,1 to 1,5 Euros/kg.

Keywords: pine resin, bioeconomy, economic value, biotecnology

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Authors: Kiranmay Sarma

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Recent decades have witnessed rapid increase in urbanization, for which, rural-urban migration is stated to be the principal reason. Urban growth throughout the world has already outstripped the capacities of most of the cities to provide basic amenities to the citizens, including clean drinking water and consequently, they are struggling to get fresh and clean water to meet water demands. Delhi, the capital of India, is one of the rapid fast growing metropolitan cities of the country. As a result, there has been large influx of population during the last few decades and pressure exerted to the limited available water resources, mainly on groundwater. Considering this important aspect, the present research has been designed to study the effects of urbanization on the green cover and groundwater and their relationships of Delhi. For the purpose, four different land uses of the study area have been considered, viz., protected forest area, trees outside forest, maintained park and settlement area. Samples for groundwater and vegetation were collected seasonally in post-monsoon (October), winter (February) and summer (June) at each study site for two years during 2012 and 2014. The results were integrated into GIS platform. The spatial distribution of groundwater showed that the concentration of most of the ions is decreasing from northern to southern parts of Delhi, thus groundwater shows an improving trend from north to south. The depth was found to be improving from south to north Delhi, i.e., opposite to the water quality. The study concludes the groundwater properties in Delhi vary spatially with depending on the types of land cover.

Keywords: groundwater, urbanization, GIS, green cover, Delhi

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Authors: Maria Luisa Nozawa Ribeiro, Maria Teresa Miceli Kerbauy

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This paper aims to present the theories of public participation in order to understand the context of the public GMO (Genetic Modified Organisms) policies in Brazil, highlighting the characteristics of its configuration and the dialog with the experts. As a controversy subject, the commercialization of GMO provoked manifestation of some popular and environmental representative groups questioning the decisions of policy makers and experts on the matter. Many aspects and consequences of the plantation and consumption of this crops emerged and the safety of this technology was questioned. Environmentalists, Civil Right's movement, representatives of rural workers, farmers and organics producers, etc. demonstrated their point of view, also sustained by some experts of medical, genetical, environmental, agronomical sciences, etc. fields. Despite this movement, the precautionary principle (risk management), implemented in 1987, suggested precaution facing new technologies and innovations in the sustainable development society. This principle influenced many legislation and regulation on GMO around the world, including Brazil, which became a reference among the world regulatory GMO systems. The Brazilian legislation ensures the citizens participation on GMO discussion, characteristic that was important to establish the connection between the subject and the participation theory. These deliberation spaces materialized in Brazil through the "Public Audiences", which are managed by the National Biosafety Technical Commission (CTNBio), the department responsible for controlling the research, production and commercialization of GMOs in Brazil.

Keywords: public engagement, public participation, science and technology studies, transgenic politics

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Authors: Amidu Owolabi Ayeni

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Studies have shown that spatio-temporal distribution and variability of climatic variables, urban land use, and population have had substantial impact on water supply. It is based on these facts that the impacts of climate, urbanization, and population on water supply in Lagos State Nigeria remain the focus of this study. Population and water production data on Lagos State between 1963 and 2006 were collected, and used for time series and projection analyses. Multi-temporal land-sat images of 1975, 1995 and NigeriaSat-1 imagery of 2007 were used for land use change analysis. The population of Lagos State increased by about 557.1% between 1963 and 2006, correspondingly, safe water supply increased by 554%. Currently, 60% of domestic water use in urban areas of Lagos State is from groundwater while 75% of rural water is from unsafe surface water. Between 1975 and 2007, urban land use increased by about 235.9%. The 46years climatic records revealed that temperature and evaporation decreased slightly while rainfall and Relatively Humidity (RH) decreased consistently. Based on these trends, the Lagos State population and required water are expected to increase to about 19.8millions and 2418.9ML/D respectively by the year 2026. Rainfall is likely to decrease by -6.68mm while temperature will increase by 0.950C by 2026. Urban land use is expected to increase by 20% with expectation of serious congestion in the suburb areas. With these results, over 50% of the urban inhabitants will be highly water poor in future if the trends continue unabated.

Keywords: challenges, climate change, urbanization, water supply

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Authors: Sharmin Sultana, Palash Chandra Banik, Shirin Jahan Mumu, Liaquat Ali

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Santals are one of the oldest indigenous groups of South Asia who, according to anthropological evidence, are thought to be the origins of the Bengali race. The aim of the study was to explore, according to our best knowledge for the first time, the prevalence and determinants of hypertension in this relatively isolated and marginalized indigenous group who still live mostly in a traditional style. Under a cross-sectional analytical design, the study was conducted on the adult (age≥18 years) Santals (n=389, M/F 184/205, age in years, 38±15.3) of a village located in a remote rural area of northern Bangladesh. Subjects were selected by purposive sampling, and data were collected by interviewer-administered pretested questionnaire. Blood pressure was measured by following the WHO guideline of JNC-7 has been used to classify the blood pressure. The prevalence of hypertension was 4.9% among the respondents. Females had a much higher prevalence (5.4%) of hypertension compared to males (4.3%). Among the risk indicators of hypertension, more than half (50.9%) of the study population took extra salt in their meals, whereas 10.5% of respondents used extra salt occasionally, which is an important risk factor for high blood pressure. High waist circumference was found in 19% of the study subjects in terms of central obesity. Older age group (p=0.003, OR=1.1, 95%CI-1.02-1.10), respondents who completed more than primary school (p=0.038, OR=7.1, CI-1.11, 44.6), overweight and obesity (p=0.004, OR=17.1, CI-2.5, 118.1), were the major determinant for hypertension as found from the binary logistic model. None of the respondents received any medication, neither they visit any doctor ever for their hypertension control. The prevalence of hypertension was found to be low but not ignorable. Pre-hypertension in the case of systolic blood pressure needs attention among Santal indigenous population.

Keywords: hypertension, indigenous group, Santals, Bangladesh

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Authors: Bethany Leake, Samantha Caton, Paul Norman, Jill Edmondson

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With the majority of the UK population residing in urban areas and with the pressures both environmentally and socially on rural agriculture, the role of urban food production, particularly urban horticulture (UH), is increasingly important in the future of UK food security. UH has the potential to provide an important contribution to urban diets and to provide additional benefits to human health and well-being. While allotments are the traditional focus of UH and play an important role, as access to this type of land is limited and unequal across cities, other forms of UH space, such as domestic growing, will need to be utilized to provide a significant contribution to urban diets. It is theorized that this smaller scale of growing may also be a more accessible way of engaging novice growers in UH. A collaborative research project, Urban Harvest, was designed between the University of Sheffield and Sheffield-based food organizations, which aimed to engage inexperienced gardeners in UH by providing them with home food-growing kits (Grow-Kits). Grow-Kits were provided to 189 participants across Sheffield in 2022, 48% of whom had never grown food before. Data collected through surveys and interviews will help us to evaluate the effect of small-scale food growing on health and wellbeing and the potential of this type of scheme to encourage future UH engagement. This data and increasing evidence on the co-benefits of UH have important implications not only for local food security but also for urban health inequalities and the potential use of this activity for preventative healthcare.

Keywords: urban horticulture, health and wellbeing, food security, nutrition

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