Search results for: inequality of opportunity in health

Authors: Babak Nemat Shahrbabaki, Arezo Fallahi, Masoomeh Hashemian

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Introduction: Health and safety are basic components of civil right. Health care systems in different countries were influenced by political, economic and cultural circumstances. In order to health services to people, these systems are organized with different forms, methods such as: prevention, treatment and rehabilitation and in this among, public satisfaction with the services provided is important. This study aimed to determine client satisfaction with family physician and relationship with physician’ demographic variables in health care centers of Jiroft county, Iran. Methods: This is a descriptive-analytical study. The collective data tool was a self-made questionnaire with two parts. The first part comprised demographic characteristics, and the second part contained 11 items for the assessment of satisfaction with family physician from different aspects. In addition, questionnaire, reliability and validity were confirmed. Random simple sampling method was used to determine samples. 234 people referred to the health centers filled questionnaire. The data were analyzed using SPSS software, and inferential statistical analysis was performed. Findings: The majority of the study population were women, married, and aged between 18 and 62 years (mean= 30.09±10.71). Total average satisfaction score was 42.63±3.68. Overall satisfaction averages were 9.47% very high, 30.04% high, 33.09% moderate, 15.12% low, and 12.28% very low. Except lodge on of family physician none of physician’ demographic variables did not effect on satisfaction index. Discussion & Conclusion: The Results showed that mean of satisfaction indexes of family physicians was high and lodge on of family physician effected on this index. Informing people about the main goals of family-doctor program will help to promote the quality of program and increase people satisfaction.

Keywords: family physician program, satisfaction, health-care centers, client

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Authors: Nai-Jiin Yang, Tyler Renshaw

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Prior research has suggested that youth internalizing and externalizing problems significantly correlate with student subjective wellbeing (SSW) and achievement problems (SAP). Yet, only a few studies have used data from mental health screener based on the dual-factor model to explore the empirical relationships among internalizing problems, externalizing problems, academic problems, and student wellbeing. This study was conducted through a secondary analysis of previously collected data in school-wide mental health screening activities across secondary schools within a suburban school district in the western United States. The data set included 1880 student responses from a total of two schools. Findings suggest that both internalizing and externalizing problems are substantial predictors of both student wellbeing and academic problems. However, compared to internalizing problems, externalizing problems were a much stronger predictor of academic problems. Moreover, this study did not support academic problems that moderate the relationship between SSW and youth internalizing problems (YIP) and between youth externalizing problems (YEP) and SSW. Lastly, SAP is the strongest predictor of SSW than YIP and YEP.

Keywords: academic problems, externalizing problems, internalizing problems, school mental health, student wellbeing, universal mental health screening

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Authors: Ching-Ling Lin, Li-Chi Huang, Yao-Tsung Chang, Ruey-Yu Chen, Shwu-Huey Yang

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Introduction & Purpose: Diabetes and its related complications always been a major part of medical cost in Taiwan. To patient with diabetes, self-management blood sugar, improving a healthy lifestyle are the most important thing to avoid getting worse. The aim of this study was to explore the trend of the changing in blood glucose within intervention and followed-up periods of patients who participated in the health coaching program between 2017 and 2020. Design & Methods: The data was combined from two diabetes health coaching program. The intervention group had health coaching and usual care for 6 months, whereas the control had usual care only. The main outcome variables were HbA1c level at baseline, 3, 6, 9, and 12 months. Results: In total, the data were available for 99 patients in the coaching intervention group and for 88 patients in the control group, the dropout rate during the follow-up period is about 18%. Of 187 participants, 54% were female, mean age was 61.5 years (SD=10.19), only 32.1% had a bachelor’s degree or higher, and the mean duration of diabetes treatment at Cathay General Hospital was 9.9 years. Within 12 months, the intervention group had a significant decrease of 0.65% (SD=1.05) in HbA1c level, and a non-significant decrease of 0.13%(SD=0.96) was observed in the control group. The figure showed the effect was the most significant in the first three months of the intervention and can be maintained for up to six months after the intervention was over. The HbA1c values of the two groups at each follow-up point are significantly different. In addition, there were non-significant correlation between HbA1c and gender, age, and educational level. Conclusion: Health coaching might be an effective way to enhance self-management for patients with diabetes and improving their blood sugar control in Taiwan.

Keywords: diabetes, health coaching, HbA1c, self-management

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Authors: Sabina Auhunas

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These days in Ukraine, Open Science dramatically develops for the sake of scientists of all branches, providing an opportunity to take a more close look on the studies by foreign scientists, as well as to deliver their own scientific data to national and international journals. However, when it comes to the generalization of data on science activities by Ukrainian scientists, these data are often integrated into E-systems that operate inconsistent and barely related information sources. In order to resolve these issues, developed countries productively use E-systems, designed to store and manage research data, such as Current Research Information Systems that enable combining uncompiled data obtained from different sources. An algorithm for selecting SARS-CoV-2 research articles was designed, by means of which we collected the set of papers published by Ukrainian scientists and uploaded by August 1, 2020. Resulting metadata (document type, open access status, citation count, h-index, most cited documents, international research funding, author counts, the bibliographic relationship of journals) were taken from Scopus and Web of Science databases. The study also considered the info from COVID-19/SARS-CoV-2-related documents published from December 2019 to September 2020, directly from documents published by authors depending on territorial affiliation to Ukraine. These databases are enabled to get the necessary information for bibliometric analysis and necessary details: copyright, which may not be available in other databases (e.g., Science Direct). Search criteria and results for each online database were considered according to the WHO classification of the virus and the disease caused by this virus and represented (Table 1). First, we identified 89 research papers that provided us with the final data set after consolidation and removing duplication; however, only 56 papers were used for the analysis. The total number of documents by results from the WoS database came out at 21641 documents (48 affiliated to Ukraine among them) in the Scopus database came out at 32478 documents (41 affiliated to Ukraine among them). According to the publication activity of Ukrainian scientists, the following areas prevailed: Education, educational research (9 documents, 20.58%); Social Sciences, interdisciplinary (6 documents, 11.76%) and Economics (4 documents, 8.82%). The highest publication activity by institution types was reported in the Ministry of Education and Science of Ukraine (its percent of published scientific papers equals 36% or 7 documents), Danylo Halytsky Lviv National Medical University goes next (5 documents, 15%) and P. L. Shupyk National Medical Academy of Postgraduate Education (4 documents, 12%). Basically, research activities by Ukrainian scientists were funded by 5 entities: Belgian Development Cooperation, the National Institutes of Health (NIH, U.S.), The United States Department of Health & Human Services, grant from the Whitney and Betty MacMillan Center for International and Area Studies at Yale, a grant from the Yale Women Faculty Forum. Based on the results of the analysis, we obtained a set of published articles and preprints to be assessed on the variety of features in upcoming studies, including citation count, most cited documents, a bibliographic relationship of journals, reference linking. Further research on the development of the national scientific E-database continues using brand new analytical methods.

Keywords: content analysis, COVID-19, scientometrics, text mining

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Authors: Kunto Nurcahyoko

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The fundamental perception used in this study is that teaching and learning activities in Indonesian classroom have potentially generated individual’s sensitivity on cross-cultural understanding. This study aims at investigating Indonesian university students’ perception on cross-cultural understanding after doing Cultural Snapshot Project. The data was critically analyzed through multicultural ideology and diversity theories. The subjects were 30 EFL college students in one of colleges in Indonesia. Each student was assigned to capture a photo which depicted the existence of any cultural manifestation in their surrounding such as discrimination, prejudice and stereotype. Students were then requested asked to reflect on the picture by writing a short description on the picture and make an exhibition using their pictures. In the end of the project, students were instructed to fill in questionnaires to show their perception before and after the project. The result reveals that Cultural Snapshot Project has given the opportunity for the students to better realize cross-cultural understanding in their environment. In conclusion, the study shows that Cultural Snapshot Project has specifically enhanced students’ perception of multiculturalism in three major areas: cultural sensitivity and empathy, social tolerance, and understanding of diversity.

Keywords: cultural snapshot, cross-cultural understanding, students’ perception, multiculturalism

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Authors: Gayathri Nagarajan, L. D. Dhinesh Babu

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Health care is one of the prominent industries that generate voluminous data thereby finding the need of machine learning techniques with big data solutions for efficient processing and prediction. Missing data, incomplete data, real time streaming data, sensitive data, privacy, heterogeneity are few of the common challenges to be addressed for efficient processing and mining of health care data. In comparison with other applications, accuracy and fast processing are of higher importance for health care applications as they are related to the human life directly. Though there are many machine learning techniques and big data solutions used for efficient processing and prediction in health care data, different techniques and different frameworks are proved to be effective for different applications largely depending on the characteristics of the datasets. In this paper, we present a framework that uses ensemble machine learning technique gradient boosted trees for data classification in health care big data. The framework is built on Spark platform which is fast in comparison with other traditional frameworks. Unlike other works that focus on a single technique, our work presents a comparison of six different machine learning techniques along with gradient boosted trees on datasets of different characteristics. Five benchmark health care datasets are considered for experimentation, and the results of different machine learning techniques are discussed in comparison with gradient boosted trees. The metric chosen for comparison is misclassification error rate and the run time of the algorithms. The goal of this paper is to i) Compare the performance of gradient boosted trees with other machine learning techniques in Spark platform specifically for health care big data and ii) Discuss the results from the experiments conducted on datasets of different characteristics thereby drawing inference and conclusion. The experimental results show that the accuracy is largely dependent on the characteristics of the datasets for other machine learning techniques whereas gradient boosting trees yields reasonably stable results in terms of accuracy without largely depending on the dataset characteristics.

Keywords: big data analytics, ensemble machine learning, gradient boosted trees, Spark platform

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Authors: C. van den Berg, C. Pokpas

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

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

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Authors: Doruk Atahan Erbas

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This paper concerns the early writings of Karl Marx, specifically The Economic and Philosophic Manuscripts of 1844, The German Ideology and Theses on Feuerbach. The two crucial themes of these early writings are the doctrine called historical materialism and, as a worker, the worker's resistance towards the current condition of society out of the division of labor. After Marx, including his closest friend Friedrich Engels, some of the philosophers, activists, and politicians have considered the historical materialism as a rigorous science which includes the explanation of historical causality manifested in the social, political sphere. However, this consideration, by its description as a science, is completely alienated from the concept of subject (as the suffering worker) nothing other than one of the abovementioned themes. Therefore, from this perspective, Marx's early doctrine seems to be self contradictory. The alternative approach which will be introduced in this essay offers a new basis for a correlation between the concept of subject and historical materiality by means of investigating materiality as phenomenality and ultimately rereading Marx as a creator of an existential subject surrounded by phenomenality. So that, it provides an opportunity to rethink the concept of historical materiality from an existential point of view.

Keywords: existentialism, Karl Marx, materiality, phenomenality, subject

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Authors: Ismaila Oladunni Muhammed, Adegbenga Raphael Ashiru

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Construction industry has been attributed to be the engine growth of Nigerian economic and infrastructural development. It promotes infrastructural development and grows an average output of Nigerian Gross Domestic Profit. However, from this great prospect, yearly reports show that consistent accidents on construction sites in Zamfara State has affected a substantial number of workers as they become temporarily or permanently disabled, thereby making many construction sites a death trap. This posed a great threat to the industry’s sustainability, de- motivate workers from working in the industry, and further have negative impact on the economy as well. It is as a result of high construction site accident currently experiencing in Zamfara state that this research was carried out to appraise the sustainability of health and safety of construction workers on sites. The proper practice and compliance to Construction Health and safety laws are very vital to the output and growth of Zamfara State construction sector. However, a quantitative approach was adopted to justify the aforesaid statement which will provide a broader understanding of the study. Descriptive statistical analysis was obtained through Statistical Package for the Social Sciences (SPSS Version 20). Furthermore, the findings from the research highlighted that the performance and output of construction workers on construction sites depends on the proper practice of health and safety. The research findings also recommended ways to enhance employers and employee’s compliance with existing laws guiding health and safety on Zamfara State construction sites. Nevertheless, the purpose of the paper is to appraise the sustainability of Health and Safety on Zamfara State construction sites. This study further provided thorough information for resolving challenges of construction sites accidents to improve construction firm productivity and also ensured construction worker’s safety on site.

Keywords: construction industry, health and safety regulations, causes of accident, construction safety practices

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Authors: Haitam Emhemad, Brian Agnew, David Greenwood

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Amongst the many priorities facing Libya following the 2011 uprising is the provision of a transport infrastructure that will meet the nation’s needs and not undermine its prospects for economic prosperity as with many developing economies non-technical issues such as management, planning and financing are the major barriers to the efficient and effective provision of transport infrastructure. This is particularly true in the case of the effective incorporation of sustainability criteria, and the research upon which this paper is based involves the examination of alternative ways of approaching this problem. It is probably fair to say that criteria that relate to sustainability have not, historically, featured strongly in Libya’s approach to the development of its transport infrastructure. However, the current reappraisal of how best to redevelop the country’s transport infrastructure that has been afforded by recent events may offer the opportunity to alter this. The research examines recent case studies from a number of countries to explore ways in which sustainability has been included as a criterion for planning and procurement decisions. There will also be an in-depth investigation into the Libyan planning and legislative context to examine the feasibility of the introduction of such sustainability criteria into the process of planning and procurement of Libya’s transport infrastructure.

Keywords: Libya reconstruction, sustainability criteria, transport infrastructure, public transport

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Authors: Julie A. Baldwin, Robert T. Trotter, Mark Remiker, C. Loren Buck, Amanda Aguirre, Trudie Milner, Emma Torres, Frank A. von Hippel

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Introduction: In the past, there have been concerns about contaminants in the water sources in Yuma, Arizona, including the Colorado River. Prolonged exposure to contaminants, such as perchlorate and heavy metals, can lead to deleterious health effects in humans. This project examined the association between the concentration of environmental contaminants and patient health outcomes in Yuma residents, using a community-engaged approach to data collection. Methods: A community-engaged design allowed community partners and researchers to establish joint research goals, recruit participants, collect data, and formulate strategies for dissemination of findings. Key informant interviews were conducted to evaluate adherence to models of community-based research. Results: The training needs, roles, and expectations of community partners varied based on available resources, prior research experience, and perceived research challenges and ways to address them. Conclusions: Leveraging community-engaged approaches for studies of environmental contamination in marginalized communities can expedite recruitment efforts and stimulate action that can lead to improved community health.

Keywords: community engaged research, environmental contaminants, underserved populations, health equity

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Authors: Frederic Jumelle, Kelvin So, Didan Deng

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In this paper, we are introducing a model of artificial general intelligence (AGI), the functional neural network (FNN), for modeling human decision-making processes. The FNN is composed of multiple artificial mirror neurons (AMN) racing in the network. Each AMN has a similar structure programmed independently by the users and composed of an intention wheel, a motor core, and a sensory core racing at a specific velocity. The mathematics of the node’s formulation and the racing mechanism of multiple nodes in the network will be discussed, and the group decision process with fuzzy logic and the transformation of these conceptual methods into practical methods of simulation and in operations will be developed. Eventually, we will describe some possible future research directions in the fields of finance, education, and medicine, including the opportunity to design an intelligent learning agent with application in AGI. We believe that FNN has a promising potential to transform the way we can compute decision-making and lead to a new generation of AI chips for seamless human-machine interactions (HMI).

Keywords: neural computing, human machine interation, artificial general intelligence, decision processing

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Authors: Jakia Rajoana

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The key aim of this research is to achieve Sustainable Rural Tourism (SRT) through women’s empowerment in the Sundarbans area of Bangladesh. Women in rural areas in developing countries depend on biomass for their survival and that of their family. Yet they have an unequal access to resources as well as decision making, thus making them more vulnerable to any changes in the environment. Women in the developing countries experience gender inequality which is culturally embedded resulting into women having less access to and control over financial and material resources, information, and also a lack of recognition of their contribution as compared to men. Their disadvantaged social position is augmented by their extreme poverty, little or no power they have over their own lives vis-à-vis the disproportionate burden they bear in reproduction and child-raising. Despite the significance of the need to pay attention to gender related issues in sustainable rural tourism (SRT), research remains rather scant. For instance, there is very little research that illustrates the role of women in tourism in the Sundarbans area. Thus empirically, this research seeks to fill a significant gap by focusing on rural areas and in particular focus on considerably under-researched area, namely the Sundarbans women’s role in tourism. In order to fully comprehend their experiences and life stories, this research will apply the empowerment theory and consider it along with the research on sustainable rural tourism. Since, women’s empowerment can act as a potential tool for SRT development and also examine the role tourism plays in the lives of Sundarbans’ women. Methodologically, this study will follow a qualitative research design using an ethnographic approach. Participant observation, semi- structured interviews, and documentation will be the primary data collection instruments in four communities – Shayamnagar, Koyra, Mongla and Sarankhola – in the Sundarbans area. It is hoped that by focusing on the life stories of these invisible women, research is better able to engage with nuances inherent in marginal and significantly under-researched communities.

Keywords: gender, sustainable rural tourism, women empowerment, Sundarbans

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Authors: Antoni Grau, Yolanda Bolea, Alberto Sanfeliu

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Embedding Sustainability in technological curricula has become a crucial factor for educating engineers with competences in sustainability. The Technical University of Catalonia UPC, in 2008, designed the Sustainable Technology Excellence Program STEP 2015 in order to assure a successful Sustainability Embedding. This Program takes advantage of the opportunity that the redesign of all Bachelor and Master Degrees in Spain by 2010 under the European Higher Education Area framework offered. The STEP program goals are: to design compulsory courses in each degree; to develop the conceptual base and identify reference models in sustainability for all specialties at UPC; to create an internal interdisciplinary network of faculty from all the schools; to initiate new transdisciplinary research activities in technology-sustainability-education; to spread the know/how attained; to achieve international scientific excellence in technology-sustainability-education and to graduate the first engineers/architects of the new EHEA bachelors with sustainability as a generic competence. Specifically, in this paper authors explain their experience in leading the STEP program, and two examples are presented: Industrial Robotics subject and the curriculum for the School of Architecture.

Keywords: sustainability, curricula improvement, robotics, STEP program

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Authors: Karl Bryant Buan, Owaida Macadadaya Jr., Mon Eleazar Nonato, Zeke Andrew Palabrica, Charistabelle Mae Santiago

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This study explored the occupational health risks faced by employees in the Business Process Outsourcing (BPO) industry, particularly in the Telco Account department of Alorica. The study used a stratified sampling method and a diagnostic tool called Workplace Integrated Safety and Health (WISH) Assessment to measure and evaluate the employees' perception of workplace health and safety. The results showed that more than 50% of call center workers reported feeling emotionally drained, sleep deprived, burnt out, and in need of anxiety or stress medication due to their work. Additionally, there was a significant difference in the perception of employee diversity, specifically in terms of leadership commitment, participation, policies, programs, and practices. The Cornell Musculoskeletal Discomfort Questionnaire (CMDQ) results revealed that most employees complained of discomfort in their lower back, shoulder, upper back, neck, and hip. The researchers recommended an implementation plan for alternative work set-up, a satisfaction survey for employees, team-building activities or programs, and motivational approaches through benefits, incentives, and rewards.

Keywords: WISH assessment, CMDQ, ANOVA, diverse SOGIESC

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Authors: Scarlet Tabot Enanga Longsti

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Community-Based Health Insurance (CBHI) schemes have been proposed as a possible means to achieve affordable health care in low-and lower-middle-income countries. The existing evidence provides mixed results on the impact of CBHI schemes on healthcare utilisation and out -of-pocket payments (OOPP) for healthcare. Over 900 CBHI schemes have been implemented in underdeveloped countries, and these schemes have undergone different modifications over the years. Prior reviews have suggested that different designs of CBHI schemes may result in different outcomes. Objectives: This review sought to determine the interventions that affect the impact of CBHI schemes on OOPP and health service utilisation. Interventions in this study referred to any action or modification in the design of a CBHI scheme that affected the impact of the scheme on OOPP and/or healthcare utilization. Methods: Any CBHI study that was done in a lower middle-income country, that used an experimental design, that included OOPP or health care utilisation as outcome variables, and that was published in either English or French was included in this study. Studies were searched for in MEDLINE, Embase, CINAHL, EconLit, IBSS, Web of Science, Cochrane Library, and Global Index Medicus from July to August 2023. Bias was assessed using Joanna Brigs Institute tools for quality assessment for randomized control trials and quasi experimental studies. A narrative synthesis was done. Results: 12 studies were included in the review, with a total of 69 villages, 13,653 households, and 62,786 participants. Average premium collection was 4.8 USD/year. Most CBHI schemes had flat rates. The study revealed that a range of interventions impact OOPP and health care utilisation. Five categories of interventions were identified. The intervention with the highest impact on OOPP and utilisation was “Audit visits”. Next in line came external funds, training scheme workers, and engaging community leaders and village heads to advertise the scheme. Free healthcare led to a significant increase in utilisation of health services, a significant reduction in Catastrophic health expenditure, but an insignificant effect on OOPP among insured compared with uninsured. Conclusions: Community-Based Health Insurance could pave the way for Universal Health Care in low and middle-income countries. However, this can only be possible if careful thought is given to how schemes are designed. Due to the heterogeneity of studies and results on CBHI schemes, there is need for further research for more effective designs to be developed.

Keywords: community based health insurance, developing countries, health service utilisation, out of pocket payment

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Authors: Susanne Ferschl, Peter Holzmüller, Elisabeth Wacker

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Ageing populations, advances in medical sciences and digitalization, diversity and social disparities, as well as the increasing need for skilled healthcare professionals, are challenging healthcare systems around the globe. To address these challenges, future healthcare systems need to center on human needs taking into account the living environments that shape individuals’ knowledge of and opportunities to access healthcare. Moreover, health should be considered as a common good and an integral part of securing livelihoods for all people. Therefore, the adoption of a systems approach, as well as inter-disciplinary and inter-sectoral cooperation among healthcare providers, are essential. Additionally, the active engagement of target groups in the planning and design of healthcare structures is indispensable to understand and respect individuals’ health and livelihood needs. We will present the research project b4 – identifying needs | building bridges | developing health care in the social space, which is situated within this reasoning and accompanies the cross-sectoral cooperation project Brückenschlag (building bridges) in a Bavarian district. Brückenschlag seeks to explore effective ways of health care linking university medicine (Maximalversorgung | maximum care) with regional inpatient, outpatient, rehabilitative, and preventive care structures (Regionalversorgung | regional care). To create advantages for both (potential) patients and the involved cooperation partners, project b4 qualitatively assesses needs and motivations among professionals, population groups, and political stakeholders at individual and collective levels. Besides providing an overview of the project structure as well as of regional population and healthcare characteristics, the first results of qualitative interviews conducted with different health experts will be presented. Interviewed experts include managers of participating hospitals, nurses, medical specialists working in the hospital and registered doctors operating in practices in rural areas. At the end of the project life and based on the identified factors relevant to the success -and also for failure- of participatory cooperation in health care, the project aims at informing other districts embarking on similar systems-oriented and human-centered healthcare projects. Individuals’ health care needs in dependence on the social space in which they live will guide the development of recommendations.

Keywords: cross-sectoral collaboration in health care, human-centered health care, regional health care, individual and structural health conditions

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Authors: Rosyidah Muhamad

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This article seeks to access the democratic implication of new media in Malaysia through three important key points of deliberative democracy; information access, rational critical deliberation and mechanism of vertical accountability. The article suggests that the Internet is expanding political opportunity in which contributed to a more diverse discourse. It is depending on how users used it; for democratic or non-democratic outcome. The Internet has been a key instrument in exposing human rights abuse, corruption, organizing protests and mobilizing voters during election campaigns. It therefore pushes for transparency and accountability and thus increasing the rise of deliberative democracy in Malaysia. While there are some elements of an emerging deliberative politics, it is also clear that the Malaysian online political discourse is acting as moderate forms of discourse as the sphere increasingly exist in a chaotic and diversified online discourse. Yet, the online sphere still allows citizens to discuss public affairs. When the public opinion is strong enough, it can influence public policies to ensure that they reflect the public interest. It is suggesting an increased space of negotiation and contestation among the previously muzzled offline situation. This is a big step in the progress democracy in Malaysia.

Keywords: Keywords: New Media, democratization, deliberative democracy, Malaysian politics

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Authors: Malika Turganova, Aigul Abduldayeva

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Modern conditions require nursing innovations at the primary ambulatory stage in the health system of Kazakhstan. There is a growing need for nurses involved in before-doctor attendance for preventive interview with a female population about reproductive health. We conducted questionnaire survey of the population of Astana in 2015. Questionnaires were drawn up according to the criteria of sexual health of World Health Organization. 3593 respondents out of 8000 questionnaires agreed to answer the questions anonymously, mM=±2,1. The average age of women comprised 37,4±11,2, Ме=31,7 years of age. Analysis of awareness about marriage hygiene revealed that 72,7% of respondents did not receive information about marriage hygiene and 89,1% respondents consider it more advisable before marriage. 45,9% of respondents specified the internet as a source of information on marriage hygiene issues, 24,5% of respondents pointed out friends, and 21,5% specified doctor. Comparing female age groups under and after 40 years old we see that proportion of cases when parents provide information about marriage hygiene issues comprises 4.3% (χ2 =9.8, p<0.05). The most important factor of preservation of women reproductive health is handling a problem of unwanted pregnancy. The responsibility lies equally in men and women. Data analysis of contraceptive methods by ranking showed three most frequently used methods: contraception sheath – 29.3%, then coitus interruptus – 18.7% and hormonal preparations – 16.9%. The most important factor of women's reproductive health preservation is a solving of the problem of unwanted pregnancy, and in this respect, the responsibility lies equally in men and women. Analyzing obtained data on contraceptive methods by ranking three of the most frequently used methods are condoms – 29,3%, then coitus interruptus – 18,7% and hormonal preparations – 16,9%. Additional oral survey of the population showed a low level of informational support of female population by family physicians, health care professionals of educational organizations (schools, universities, and colleges) about hormonal contraceptive. Females of both age groups used to think that hormonal contraceptives cause collateral damage such as blastoma, cancer, increased body weight, varix dilatation of lower limbs. Satisfaction with the frequency of sexual relations of the respondents comprised 57,6%. At that, women under 40 years of age are the most satisfied women among age groups (χ2 =5,8, p<0,05).

Keywords: nurse, public health service of Kazakhstan, reproductive and sexual health, trust of population

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Authors: Burcu Akyildiz, Cigdem Kadaifci, Y. Ilker Topcu, Burc Ulengin

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In today’s business environment, companies should make strategic decisions to gain sustainable competitive advantage. Order selection is a crucial issue among these decisions especially for steel production industry. When the companies allocate a high proportion of their design and production capacities to their ongoing projects, determining which customer order should be chosen among the potential orders without exceeding the remaining capacity is the major critical problem. In this study, it is aimed to identify and prioritize the evaluation factors for the customer order selection problem. Conjoint analysis is used to examine the importance level of each factor which is determined as the potential profit rate per unit of time, the compatibility of potential order with available capacity, the level of potential future order with higher profit, customer credit of future business opportunity, and the negotiability level of production schedule for the order.

Keywords: conjoint analysis, order prioritization, profit management, structural steel firm

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Authors: Ana Rita Conde, Pilar Mota, Tânia Botelho, Suzana Caldeira, Isabel Rego, Jessica Pacheco, Osvaldo Silva, Áurea Sousa

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Tourism promotes well-being and health to children with ASD and their families. Literature indicates the need to provide tourist activities that integrate the therapeutic component, to promote the development and well-being of children with ASD. The study aims to implement tourist offers in Azores that integrate the therapeutic feature, assess their suitability and impact on the well-being and health of the child and caregivers. Using a mixed methodology, the study integrates families that experience and evaluate the impact of tourism products developed specifically for them.

Keywords: austism spectrum disorder, children, therapeutic tourism activities, well-being, health, inclusive tourism

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Authors: Cindy Davis, Samantha Rayner

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Secondary traumatic stress (STS) is an indirect form of trauma affecting the psychological well-being of mental health workers; STS is found to be a prevalent risk in mental health occupations. Various factors impact the development of STS within the literature; including the level of trauma individuals are exposed to and their level of empathy. Research is limited on STS in mental health workers in Australia; therefore, this study examined STS and related factors of empathetic behavior and trauma caseload among mental health workers. The research utilized an online survey quantitative research design with a purposive sample of 190 mental health workers (176 females) recruited via professional websites and unofficial social media groups. Participants completed an online questionnaire comprising of demographics, the secondary traumatic stress scale and the empathy scale for social workers. A standard hierarchical regression analysis was conducted to examine the significance of covariates, traumatized clients, traumatic stress within workload and empathy in predicting STS. The current research found 29.5% of participants to meet the criteria for a diagnosis of STS. Age and past trauma within the covariates were significantly associated with STS. Amount of traumatized clients significantly predicted 4.7% of the variance in STS, traumatic stress within workload significantly predicted 4.8% of the variance in STS and empathy significantly predicted 4.9% of the variance in STS. These three independent variables and the covariates accounted for 18.5% of the variance in STS. Practical implications include a focus on developing risk strategies and treatment methods that can diminish the impact of STS.

Keywords: mental health, PTSD, social work, trauma

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Authors: Regina Tedjasulaksana, Maria Martina Nahak, A. A. Gede Agung, Ni Made Widhiasti

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Strategic effort to realize the empowerment of community in school is through the peer group approach so that it needs to choose the students who are trained as the’ little dentist’ in order to have the cognitive and skills to participate in the school dental health effort (UKGS) program, such as providing oral health education to the other students. Aim: To assessed the effectiveness of peer group approach to enhance the oral health knowledge level of schoolchildren at primary school in Klungkung, Bali. Methods: Experimental study using the pre-post test without control group design. The differences of knowledge levels, tooth brushing behavior and oral hygiene status (using PHP-M index) of 10 students before and after trained as the little dentists were analyzed using paired t-test. The correlations between knowledge level and tooth brushing behavior and correlations between tooth brushing behavior and oral hygiene before and after trained as the little dentists were analyzed using Spearman. Furthermore, the trained little dentists provide oral health education to 102 students of grade 1 to 5 at their school once a week for 3 months. The students’ knowledge level scores of each grade were taken every 21 days as many as three times The difference of it was analyzed using Repeated Measured. Result: The mean scores among all little dentists before and after training for each of knowledge level were each 63.05 + 5.62 and 85.00 + 7.81, tooth brushing behavior were each 31.00 + 14.49 and 100.00 + 0.00 and oral hygiene status using PHP-M index were each 32.80 + 10.17 and 11.40 + 8.01. The knowledge level, tooth brushing behavior and oral hygiene status of 10 students before and after trained as the little dentists were different significantly (p<0.05). Before and after trained as the little dentists it showed that significant correlations between knowledge level with tooth brushing behavior (p<0.05) and significant correlations between tooth brushing behavior and oral hygiene (p<0.05). The mean scores of knowledge level among all students before (pre-test) and after (post-test (1),(2),(3)) getting oral health education from little dentists for each, of grade 1 were 40.00 + 17.97; 67.85 + 18.88; 81.72 +26.48 and 70.00 + 22.87, grade 2 were 40.00 + 17.97; 67.85 + 18.88; 81.72 + 26.48 and 70.00 + 22.87, grade 3 were 65.83 + 23.94; 72.50 + 26.08; 80.41 + 24.93 and 83.75 + 19.74, grade 4 were 88.57 + 12.92; 90.71 + 9.97; 92.85 + 10.69 and 93.57 + 6.33 and grade 5 were 86.66 + 13.40; 93.33 + 9.16; 94.16 + 10.17 and 98.33 + 4.81. The students’ knowledge level of grade 1,2 and 3 before and after getting oral health education from little dentists showed significant different (p<0.05), meanwhile there was no significant different on grade 4 and 5 (p<0.05) although mean scores showed an increase. Conclusion: Peer group approach can be used to enhance the oral health knowledge level of schoolchildren at primary school in Klungkung, Bali.

Keywords: small dentists, oral health, peer group approach, school children

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Authors: Alessandra Swiny, Michalis Georgiou, Yiorgos Hadjichristou

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This paper focuses on the questions raised through the work of Unit 5: ‘In/Out of crisis, emergent and adaptive’; an architectural research-based studio at the University of Nicosia. It focusses on sustainable architectural and urban explorations tackling with the ever growing crises in its various types, phases and locations. ‘Great crisis situations’ are seen as ‘great chances’ that trigger investigations for further development and evolution of the built environment in an ultimate sustainable approach. The crisis is taken as an opportunity to rethink the urban and architectural directions as new forces for inventions leading to emergent and adaptive built environments. The Unit 5’s identity and environment facilitates the students to respond optimistically, alternatively and creatively towards the global current crisis. Mark Wigley’s notion that “crises are ultimately productive” and “They force invention” intrigued and defined the premises of the Unit. ‘Weather and nature are coauthors of the built environment’ Jonathan Hill states in his ‘weather architecture’ discourse. The weather is constantly changing and new environments, the subnatures are created which derived from the human activities David Gissen explains. The above set of premises triggered innovative responses by the Unit’s students. They thoroughly investigated the various kinds of crisis and their causes in relation to their various types of Terrains. The tools used for the research and investigation were chosen in contradictive pairs to generate further crisis situations: The re-used/salvaged competed with the new, the handmade rivalling with the fabrication, the analogue juxtaposed with digital. Students were asked to delve into state of art technologies in order to propose sustainable emergent and adaptive architectures and Urbanities, having though always in mind that the human and the social aspects of the community should be the core of the investigation. The resulting unprecedented spatial conditions and atmospheres of the emergent new ways of living are deemed to be the ultimate aim of the investigation. Students explored a variety of sites and crisis conditions such as: The vague terrain of the Green Line in Nicosia, the lost footprints of the sinking Venice, the endangered Australian coral reefs, the earthquake torn town of Crevalcore, and the decaying concrete urbanscape of Athens. Among other projects, ‘the plume project’ proposes a cloud-like, floating and almost dream-like living environment with unprecedented spatial conditions to the inhabitants of the coal mine of Centralia, USA, not just to enable them to survive but even to prosper in this unbearable environment due to the process of the captured plumes of smoke and heat. Existing water wells inspire inversed vertical structures creating a new living underground network, protecting the nomads from catastrophic sand storms in the Araoune of Mali. “Inverted utopia: Lost things in the sand”, weaves a series of tea-houses and a library holding lost artifacts and transcripts into a complex underground labyrinth by the utilization of the sand solidification technology. Within this methodology, crisis is seen as a mechanism for allowing an emergence of new and fascinating ultimate sustainable future cultures and cities.

Keywords: adaptive built environments, crisis as opportunity, emergent urbanities, forces for inventions

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Authors: Alexander Suuk Laar, Emmanuel Bekyieriya, Sylvester Isang, Benjamin Baguune

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Introduction: In Ghana, despite the implementation of strategies and initiatives to ensure universal access to reproductive health and family planning (FP) services for the past two decades, interventions have not adequately addressed the access and utilization needs of women of reproductive age, especially in rural Ghana. To improve access and use of reproductive and maternal health services in Ghana, a free maternal care exemption policy under the universal health coverage of the National Health Insurance Scheme was implemented in 2005. Despite the importance of FP, this service was left out of the benefit package of the policy. Low or no use of FP services is often associated with poor health among women. However, to date, there has been limited research on perspectives of women for not making FP services as part of the benefit package of the free maternal health services. This qualitative study explored perceptions of women on the comprehensiveness of the free maternal health benefit package and the effects on utilisation of services in the rural Upper West region of Ghana to improve services. Methods: This exploratory qualitative study used focus group discussions with pregnant and lactating women in three rural districts in the Upper West region of Ghana. Six focus groups were held with both pregnant women and lactating mothers at the time of the interview. Three focus group discussions were organised with the same category of women in each district. We used a purposive sampling procedure to select the participants from the districts. The interviews with the written consent of the participants lasted between 60 minutes and 120 minutes. Interviews were audio-recorded and transcribed verbatim. Data were analysed using Braun and Clarke thematic framework guidelines. Results: This research presents an in-depth account of women's perceptions on the effects associated with the uptake of FP services and its exclusion from the benefit package of the free maternal health policy. Our study found that participants did not support the exclusion of FP services in the benefit package. Participants mentioned factors hampering their access to and use of FP and contraceptive services to include the cost of services, distance and cost of transport to health facilities, lack of knowledge about FP services, socio-cultural norms and negative attitude of healthcare professionals. Participants are of the view that making FP services part of the benefit package could have addressed the cost aspect of services which act as the main barrier to improve the use of services by poor rural women. Conclusion: Women of reproductive age face cost barriers that limit their access to and use of FP and contraception services in the rural Upper West region of Ghana and need health policymakers to revise the free maternal health package to include FP services. It is essential for policymakers to begin considering revising the free maternal health policy benefit package to include FP services to help address the cost barrier for rural poor women to use services.

Keywords: benefit package, free maternal policy, women, Ghana, rural Upper West Region, Universal Health Coverage.

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Authors: Ammal M. Metwally, Ghada A. Abdel-Latif, Walaa A. Fouad, Thanaa M. Rabah, Amira Mohsen, Fatma A. Shaaban, Iman I. Salama

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The study aimed at determining the impact of chronic hepatitis C virus (HCV) infection on patients’ Quality of Life (QoL) , its relation to geographical characteristics of patients, awareness of the disease, treatment regimen, co-morbid psychiatric or other diseases. 457 patients were randomly selected from ten National Treatment Reference Centers of Ministry of Health hospitals from four community locations representing Egypt. Health related QoL assessment questionnaire with the 36-item Short Form used for assessment of the enrolled patients. The study showed no significant difference between HCV patients in different governorates as regards total QoL. Females, illiterate patients and those had bilharziasis, diabetes mellitus, hypertension or were depressed had significantly the lowest QoL score. HCV patients who knew the danger of the disease had significant lower mean score of physical and mental health components. Optimal care of overall well-being of HCV patients requires adequate knowledge of their neurological and psychological status. It is important to know that any patient will need to take the time to know that his new physical limitations do not limit him as a person, as soul, no matter what other people are thinking as a positive hopeful attitude is essential for combating HCV.

Keywords: hepatitis C virus chronic infection - physical health component and mental health component of QoL– total quality of life

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Authors: Ali Soroush, Mehdi Mirzaei Alavijeh, Touraj Ahmadi Jouybari, Fazel Zinat-Motlagh, Abbas Aghaei, Mari Ataee

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Diabetes is a disease with long cardiovascular, renal, ophthalmic and neural complications. It is prevalent all around the world including Iran, and its prevalence is increasing. The aim of this study was to determine the factors related to self-care behavior based on health belief model among sample of Iranian diabetic patients. This cross-sectional study was conducted among 301 type 2 diabetic patients in Gachsaran, Iran. Data collection was based on an interview and the data were analyzed by SPSS version 20 using ANOVA, t-tests, Pearson correlation, and linear regression statistical tests at 95% significant level. Linear regression analyses showed the health belief model variables accounted for 29% of the variation in self-care behavior; and perceived severity and perceived self-efficacy are more influential predictors on self-care behavior among diabetic patients.

Keywords: diabetes, patients, self-care behaviors, health belief model

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Authors: Maciej Bialorudzki, Zbigniew Izdebski, Alicja Kozakiewicz, Joanna Mazur

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The quality of sleep is extremely important for physical and mental health, especially among professional groups exposed to the suffering of the people they serve. The aim of the study is to assess sleep quality and various aspects of physical and mental health. A nationwide cross-sectional survey conducted in the first quarter of 2022 included 2227 healthcare professionals from 114 Polish hospitals and specialized outpatient clinics. The following distribution for each professional group was obtained (22% doctors; 52.6% nurses; 7.3% paramedics; 10.1% other medical professionals; 7.9% other non-medical professionals). The mean age of the respondents was 46.24 (SD=11.53). The Jenkins Sleep Scale with four items (JSS-4) was used to assess sleep quality, yielding a mean value of 5.35 (SD=5.20) in the study group and 13.7% of subjects with poor sleep quality using the cutoff point of the mean JSS-4 sum score as >11. More often, women than men reported poorer sleep quality (14,8% vs. 9,1% p=0,002). Respondents with poor sleep quality were more likely to report occupational burnout as measured by the BAT-12 (43.1% vs. 12.9% p<0.001) and high levels of stress as measured by the PSS-4 (72.5% vs. 27.5% p<0.001). In addition, those who declare experiencing a traumatic event compared to those who have not experienced it has an almost two times higher risk of poorer sleep quality (OR:1.958; 95% CI:1.509-2.542; p<0.001). In contrast, those with occupational burnout had more than five times the risk of those without occupational burnout (OR:5.092; 95% CI: 3.763-6.889; p<0.001). Sleep quality remains an important predictor of stress levels, job burnout, and quality of life assessment.

Keywords: quality of sleep, medical staff, mental health, physical health, occupational burnout, stress

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Authors: Takeo Shibata, Arihito Endo, Akemi Kunimatsu, Chika Hiraga, Yoko Shimizu

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Introduction: Yuzawa Town, located in the Niigata prefecture of Japan, is famous for its hot springs. A health promotion program, Yuzawa family health plan, was initiated in 2002. It has been held for fifteen years. We evaluated the profiles of brushing teeth in adults. Subjects: 368 questionnaires were corrected from people who live in Yuzawa town. The range of age was between nineteen and sixty-four years old. Methods: Mann-Whitney’s U test and Kruskal-Wallis test were used to evaluate significant differences in frequencies of brushing teeth per a day. Chi-square test and the adjusted residuals were used to evaluate when they brush their teeth. Results: Women showed greater frequencies of brushing teeth per a day than men. No difference was shown by age. Construction workers showed fewer frequencies of brushing teeth. Specialized technicians, clerical workers, and housewives showed greater frequencies. People who know Yuzawa family health plan, take a regular life, or take a breakfast every day showed greater frequencies. People who think not healthy, don’t care a balance of foods, don’t take yearly health check-up, or smoke showed fewer frequencies. After breakfast, women and specialized technicians showed greater frequencies, and construction workers and self-employed workers showed fewer frequencies. After lunch, clerical workers and specialized technicians showed greater frequencies. There was no significant difference at after waking up, after dinner, and before going to bed. Construction workers showed a lower rate of having a marital partner and having information of health. Conclusion: Gender and occupational differences were shown in frequencies of brushing teeth per a day. A promotion of teeth brushing for male, especially construction workers and self-employed workers, is needed.

Keywords: health promotion, Yuzawa family health plan, brushing teeth, occupational difference

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Authors: Anurag Sharma, Arun Khosla, Mamta Khosla, Yogeswara Rao M.

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Multimedia devices have received repute in the special desires community. The wide display screen makes it appealing and easy to use, specifically for the ones who've susceptible pleasant motor skill. This paper highlights how an Android-based game named as 'KIDDY' can be used to enhance confront face perceiving capacities in adults with autism and aid the children to develop social interaction capabilities. This game improved concentration and imagination via repetitive movement and visual commentary. Four students with autism, diverse in the historic period, social behavior and communiqué ability had been enrolled in the program and provided an opportunity to recognize new faces thrilling way. This paper offers resultant role based on 'Social Skills Rating System' that shows how cellular generation used as an academician intervention to decorate studying and communiqué among children with autism and additionally proven the tremendous behavior toward cell primarily based game.

Keywords: autism spectrum disorder, screen-based technology, mobile phone-based intercession

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