Search results for: utilization of mental health services

Authors: Medani Prasad Rijal

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Forest itself is a factory as well as product. It supplies tangible and intangible goods and services. It supplies timber, fuel wood, fodder, grass leaf litter as well as non timber edible goods and medicinal and aromatic products additionally provides environmental services. These environmental services are of local, national or even global importance. In Nepal, more than 19 thousands community forests are providing environmental service in less economic benefit than actual efficiency. There is a risk of cost of management of those forest exceeds benefits and forests get converted to open access resources in future. Most of the environmental goods and services do not have markets which mean no prices at which they are available to the consumers, therefore the valuation of these services goods and services establishment of paying mechanism for such services and insure the benefit to community is more relevant in local as well as global scale. There are few examples of carbon trading in domestic level to meet the country wide emission goal. In this contest, the study aims to explore the public attitude towards carbon offsetting and their responsibility over service providers. This study helps in promotion of environment service awareness among general people, service provider and community forest. The research helps to unveil the carbon pool scenario in community forest and willingness to pay for carbon offsetting of people who are consuming more energy than general people and emitting relatively more carbon in atmosphere. The study has assessed the carbon pool status in two community forest and valuated carbon service from community forest through willingness to pay in Dharan municipality situated in eastern. In the study, in two community forests carbon pools were assessed following the guideline “Forest Carbon Inventory Guideline 2010” prescribed by Ministry of Forest and soil Conservation, Nepal. Final outcomes of analysis in intensively managed area of Hokse CF recorded as 103.58 tons C /ha with 6173.30 tons carbon stock. Similarly in Hariyali CF carbon density was recorded 251.72 mg C /ha. The total carbon stock of intensively managed blocks in Hariyali CF is 35839.62 tons carbon.

Keywords: carbon, offsetting, sequestration, valuation, willingness to pay

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Authors: Jiazhen Zhou, Youcai Zhao

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Waste tea is commonly generated in certain areas of China and its utilization has drawn a lot of concern nowadays. In this paper, highly microporous and mesoporous activated carbons were produced from waste tea by physical activation in the presence of water vapor in a tubular furnace. The effect of activation temperature on yield and pore properties of produced activated carbon are studied. The yield decreased with the increase of activation temperature. According to the Nitrogen adsorption isotherms, the micropore and mesopore are both developed in the activated carbon. The specific surface area and the mesopore volume fractions of the activated carbon increased with the raise of activation temperature. The maximum specific surface area attained 756 m²/g produced at activation temperature 900°C. The results showed that the activation temperature had a significant effect on the micro and mesopore volumes as well as the specific surface area.

Keywords: activated carbon, nitrogen adsorption isotherm, physical activation, waste tea

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Authors: Pariwat Somnuek

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This study focused on tourism logistic services in the border areas of Thailand by an analysis and comparison of the opinions of tourists, villagers, and entrepreneurs of these services. Sample representatives of this study were a total of 600 villagers and 15 entrepreneurs in the three border areas consisting of Chong Anma, Chong Sa-Ngam, and Chong Jom checkpoints. For methodology, survey questionnaires, situation analysis, TOWS matrix, and focus group discussions were used for data collection, as well as descriptive analysis and statistics such as arithmetic means and standard deviations, were employed for data analysis. The findings revealed that business potential was at the medium level and entrepreneurs were satisfied with their turnovers. However, perspectives of transportation and tourism services provided for tourists need to be immediately improved. Recommendations for the potential development included promotion of border tourism destinations and foreign investments into accommodation, restaurants, and transport, as well as the establishment of business networks between Thailand and Cambodia, along with the introduction of new tourism destinations by co-operation between entrepreneurs in both countries. These initiatives may lead to increased visitors, collaboration of security offices, and an improved image of tourism security.

Keywords: business potential, potential development, tourism logistics, services

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Authors: Rujira Jitrwung, Kuntima Krekkeitsakul, Weerawat Patthaveekongka, Chiraphat Kumpidet, Jarukit Tepkeaw, Krissana Jaikengdee, Anantachai Wannajampa

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Flue gas discharging from coal fired or gas combustion power plant contains around 12% Carbon dioxide (CO₂), 6% Oxygen (O₂), and 82% Nitrogen (N₂).CO₂ is a greenhouse gas which has been concerned to the global warming. Carbon Capture, Utilization, and Storage (CCUS) is a topic which is a tool to deal with this CO₂ realization. Flue gas is drawn down from the chimney and filtered, then it is compressed to build up the pressure until 8 bar. This compressed flue gas is sent to three stages Pressure Swing Adsorption (PSA), which is filled with activated carbon. Experiments were showed the optimum adsorption pressure at 7bar, which CO₂ can be adsorbed step by step in 1st, 2nd, and 3rd stage, obtaining CO₂ concentration 29.8, 66.4, and 96.7 %, respectively. The mixed gas concentration from the last step is composed of 96.7% CO₂,2.7% N₂, and 0.6%O₂. This mixed CO₂product gas obtained from 3 stages PSA contained high concentration CO₂, which is ready to use for methanol synthesis. The mixed CO₂ was experimented in 5 Liter/Day of methanol synthesis reactor skid by 3 step processes as followed steam reforming, reverse water gas shift, and then hydrogenation. The result showed that proportional of mixed CO₂ and CH₄ 70/30, 50/50, 30/70 % (v/v), and 10/90 yielded methanol 2.4, 4.3, 5.6, and 6.0 Liter/day and save CO₂ 40, 30, 20, and 5 % respectively. The optimum condition resulted both methanol yield and CO₂ consumption using CO₂/CH₄ ratio 43/57 % (v/v), which yielded 4.8 Liter/day methanol and save CO₂ 27% comparing with traditional methanol production from methane steam reforming (5 Liter/day)and absent CO₂ consumption.

Keywords: carbon capture utilization and storage, pressure swing adsorption, reforming, reverse water gas shift, methanol

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Authors: Michael Zhang, Nicholas Marriage, Valerie Astle, Marie-Louise Ratican, Jonathan Ash, Haddijatou Hughes

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Objective: Young infants are often brought to the Emergency Department (ED) with a variety of complaints, some of them are non-specific and present as a diagnostic challenge to the attending clinician. Whilst invasive investigations such as blood tests and lumbar puncture are necessary in some cases to exclude serious infections, some basic clinical tools in additional to thorough clinical history can be useful to assess the risks of serious conditions in these young infants. This study aimed to examine the utilization of one of clinical tools in this regard. Methods: This retrospective observational study examined the medical records of infants under 6 months presenting to a mixed urban ED between January 2013 and December 2014. The infants deemed to have non-specific complaints or diagnoses by the emergency clinicians were selected for analysis. The ones with clear systemic diagnoses were excluded. Among all relevant clinical information and investigation results, utilization of Standard Paediatric Observation Chart (SPOC) was particularly scrutinized in these medical records. This specific chart was developed by the expert clinicians in local health department. It categorizes important clinical signs into some color-coded zones as a visual cue for serious implication of some abnormalities. An infant is regarded as SPOC positive when fulfills 1 red zone or 2 yellow zones criteria, and the attending clinician would be prompted to investigate and treat for potential serious conditions accordingly. Results: Eight hundred and thirty-five infants met the inclusion criteria for this project. The ones admitted to the hospital for further management were more likely to have SPOC positive criteria than the discharged infants (Odds ratio: 12.26, 95% CI: 8.04 – 18.69). Similarly, Sepsis alert criteria on SPOC were positive in a higher percentage of patients with serious infections (56.52%) in comparison to those with mild conditions (15.89%) (p < 0.001). The SPOC sepsis criteria had a sensitivity of 56.5% (95% CI: 47.0% - 65.7%) and a moderate specificity of 84.1% (95% CI: 80.8% - 87.0%) to identify serious infections. Applying to this infant population, with a 17.4% prevalence of serious infection, the positive predictive value was only 42.8% (95% CI: 36.9% - 49.0%). However, the negative predictive value was high at 90.2% (95% CI: 88.1% - 91.9%). Conclusions: Standard Paediatric Observation Chart has been applied as a useful clinical tool in the clinical practice to help identify and manage young sick infants in ED effectively.

Keywords: clinical tool, infants, non-specific complaints, Standard Paediatric Observation Chart

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Authors: Aliyu Mohammed Lawal

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The problems placed on the environment as a result of energy generation and usage in Nigeria is: potential damage to the environment health by CO, CO2, SOx, and NOx, effluent gas emissions and global warming. For instance in the year 2004 in Nigeria energy consumption was 58% oil and 34% natural gas but about 94 million metric tons of CO2 was emitted out of which 64% came from fossil fuels while about 35% came from fuel wood. The findings from this research on how to alleviate these problems are that long term sustainable development solutions should be enhanced globally; energy should be used more rationally renewable energy resources should be exploited and the existing emissions should be controlled to tolerate limits because the increase in energy demand in Nigeria places enormous strain on current energy facilities.

Keywords: effluent gas, emissions, NOx, SOx

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Authors: Victoriano Valencia García, Luis Usero Aragonés, Eugenio J. Fernández Vicente

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Nowadays, the successful implementation of ICTs is vital for almost any kind of organization. Good governance and ICT management are essential for delivering value, managing technological risks, managing resources and performance measurement. In addition, outsourcing is a strategic IT service solution which complements IT services provided internally in organizations. This paper proposes the measurement tools of a new holistic maturity model based on standards ISO/IEC 20000 and ISO/IEC 38500, and the frameworks and best practices of ITIL and COBIT, with a specific focus on IT outsourcing. These measurement tools allow independent validation and practical application in the field of higher education, using a questionnaire, metrics tables, and continuous improvement plan tables as part of the measurement process. Guidelines and standards are proposed in the model for facilitating adaptation to universities and achieving excellence in the outsourcing of IT services.

Keywords: IT governance, IT management, IT services, outsourcing, maturity model, measurement tools

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Authors: Simon Mwima, Evans Jennifer Mann, Agnes Nzomene, Edson Chipalo, Eusebius Small, Moses Okumu, Bosco Mukuba

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Introduction: In Uganda, sexual minorities experience exacerbated intersectional stigma and discrimination that exposes them to elevated HIV infections and impedes access to HIV testing and PrEP with low treatment adherence. We contribute to the lack of information about sexual minorities living with HIV in Uganda by using modified social-ecological theory to explore social influences impacting HIV services engagement. Findings from focused group discussion (FGD) involving 31 sexual minorities, ages 18-25, recruited through urban HIV clinics in Kampala reveal the protective and promotive social influence within the individual and interpersonal relationships (sexual partners and peers). Further, inhibitive social influences were found within family, community, societal, and healthcare settings. During the COVID-19 pandemic, these adolescents strategically used promotive social influences to increase their engagement with HIV care services. Interviews were recorded in English, transcribed verbatim, and analyzed using Dedoose. Conclusions: The findings revealed that young people (identified as sexual minorities) strategically used promotive social influences and supported each other to improve engagement with HIV care in the context of restrictive laws in Uganda during the COVID-19-Pandemic. Future HIV prevention, treatment, and care responses could draw on how peers support each other to navigate the heavily criminalized and stigmatized settings to access healthcare services.

Keywords: HIV/AIDS services, intersectional stigma, discrimination, adolescents, sexual minorities, COVID-19 pandemic Uganda

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Authors: Inyoung Park, Youngjoo Woo, Euiseong Seo

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With the advent of WebGL, Web apps are now able to provide high quality graphics by utilizing the underlying graphic processing units (GPUs). Despite that the Web apps are becoming common and popular, the current power management schemes, which were devised for the conventional native applications, are suboptimal for Web apps because of the additional layer, the Web browser, between OS and application. The Web browser running on a CPU issues GL commands, which are for rendering images to be displayed by the Web app currently running, to the GPU and the GPU processes them. The size and number of issued GL commands determine the processing load of the GPU. While the GPU is processing the GL commands, CPU simultaneously executes the other compute intensive threads. The actual user experience will be determined by either CPU processing or GPU processing depending on which of the two is the more demanded resource. For example, when the GPU work queue is saturated by the outstanding commands, lowering the performance level of the CPU does not affect the user experience because it is already deteriorated by the retarded execution of GPU commands. Consequently, it would be desirable to lower CPU or GPU performance level to save energy when the other resource is saturated and becomes a bottleneck in the execution flow. Based on this observation, we propose a power management scheme that is specialized for the Web app runtime environment. This approach incurs two technical challenges; identification of the bottleneck resource and determination of the appropriate performance level for unsaturated resource. The proposed power management scheme uses the CPU utilization level of the Window Manager to tell which one is the bottleneck if exists. The Window Manager draws the final screen using the processed results delivered from the GPU. Thus, the Window Manager is on the critical path that determines the quality of user experience and purely executed by the CPU. The proposed scheme uses the weighted average of the Window Manager utilization to prevent excessive sensitivity and fluctuation. We classified Web apps into three categories using the analysis results that measure frame-per-second (FPS) changes under diverse CPU/GPU clock combinations. The results showed that the capability of the CPU decides user experience when the Window Manager utilization is above 90% and consequently, the proposed scheme decreases the performance level of CPU by one step. On the contrary, when its utilization is less than 60%, the bottleneck usually lies in the GPU and it is desirable to decrease the performance of GPU. Even the processing unit that is not on critical path, excessive performance drop can occur and that may adversely affect the user experience. Therefore, our scheme lowers the frequency gradually, until it finds an appropriate level by periodically checking the CPU utilization. The proposed scheme reduced the energy consumption by 10.34% on average in comparison to the conventional Linux kernel, and it worsened their FPS by 1.07% only on average.

Keywords: interactive applications, power management, QoS, Web apps, WebGL

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Authors: Arthur C. Tsai, Chii-Shyang Kuo, Vincent S. C. Chien, Michelle Liou, Philip E. Cheng

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Meditation enhances mental abilities and it is an antidote to anxiety. However, very little is known about brain mechanisms and cortico-subcortical interactions underlying meditation-induced anxiety relief. In this study, the changes of phase-amplitude coupling (PAC) in which the amplitude of the beta frequency band were modulated in phase with delta rhythm were investigated after eight-week of meditation training. The study hypothesized that through a concentrate but relaxed mental training the delta-beta coupling in the frontal regions is attenuated. The delta-beta coupling analysis was applied to within and between maximally-independent component sources returned from the extended infomax independent components analysis (ICA) algorithm on the continuous EEG data during mediation. A unique meditative concentration task through relaxing body and mind was used with a constant level of moderate mental effort, so as to approach an ‘emptiness’ meditative state. A pre-test/post-test control group design was used in this study. To evaluate cross-frequency phase-amplitude coupling of component sources, the modulation index (MI) with statistics to calculate circular phase statistics were estimated. Our findings reveal that a significant delta-beta decoupling was observed in a set of frontal regions bilaterally. In addition, beta frequency band of prefrontal component were amplitude modulated in phase with the delta rhythm of medial frontal component.

Keywords: phase-amplitude coupling, ICA, meditation, EEG

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Authors: Shah Muhammad Butt, Ahmed Masaud Ansair

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Present financial crisis in Higher Educational Institutes (HEIs) is causing lots of problems such as considerable budget cuts, which makes it difficult to meet the ever growing IT based research and learning needs. Institutions are rapidly planning and promoting cloud based approaches for their academic and research needs. A cost-effective hybrid cloud framework for HEIs will provide educational services for campus or intercampus communication. Hybrid cloud framework comprises private and public cloud approaches. This paper will propose the framework based on the Open Source Cloud (OpenNebula for Virtualization, Eucalyptus for Infrastructure and Aneka for programming development environment) combined with CSPs services which are delivered to the end-user via the internet from public clouds such as Google, Microsoft, Zoho, and Salesforce.

Keywords: educational services, hybrid campus cloud, open source, higher educational institutes

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Authors: Khadiza Akter, Tammy Greer, Raegan Bishop

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An in-depth study of the psycho-social effects of gynecological health disparities among immigrant women in the USA is the goal of this integrative review paper. Immigrant women frequently encounter unique obstacles that have severe psycho-social repercussions when it comes to receiving high-quality gynecological treatment. The review investigates the interaction of psychological, sociological, and health factors that affect the psycho-social effects that immigrant women experience in recognition of the significance of addressing these imbalances. The difficulties that immigrant women face in providing high-quality gynecological treatment in the USA are examined in this study. These difficulties are caused by a variety of psychological issues, including acculturation stress and stigma, as well as by social problems like prejudice, language hurdles, and cultural norms. Additionally, variations in healthcare access and affordability have a role. This study highlights the particular challenges that immigrant women have in receiving high-quality gynecological treatment in the United States. These difficulties are caused by both social problems like language obstacles, cultural norms, and biases, as well as psychological ones like acculturation stress and stigma. Additionally, variations in gynecological care for immigrant women are greatly influenced by variances in healthcare availability and price. To find pertinent research looking at the psychological effects of gynecological health disparities among immigrant women in the USA, a thorough search of numerous databases was done. Numerous approaches, including mixed, quantitative, and qualitative ones, were used in the studies. The important findings from various investigations were extracted and synthesized after they underwent a careful evaluation. In order to lessen these discrepancies and enhance the overall well-being of immigrant women, healthcare professionals, legislators, and researchers must collaborate to create specialized treatments, regulations, and health system reforms.

Keywords: cultural barriers, gynecological health disparities, health care access, immigrant women, mental health, psycho-social consequences, social stigma

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Authors: Vibha Kriti

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Background: Polycystic ovary syndrome (PCOS) is a common endocrine disorder generally found in reproductive women. It is associated with significant reproductive, metabolic, cosmetic, and psychological consequences. Objective: There is a high prevalence of PCOS found among reproductive-age women, therefore, the major objective of the present study is to identify the illness perception of PCOS women and to explore the relationship between illness perception and health-related quality of life (HRQoL). Material and Method: A cross-sectional study was conducted in a university tertiary-care center, Sir Sunder Lal Hospital, Banaras Hindu University (B.H.U). Tools used for data collection were self-structured, which included socio-demographic status, illness perception questionnaire (revised version), and short-form 36 for assessing illness perception and health-related quality of life, respectively. Statistical analysis was done by SPSS version ‘24’. Results: The results of correlation analyses indicated that there is a strong relationship between strong illness perception and HRQoL. Stepwise regression indicated that illness identity, long illness duration, and severe consequences were associated with the worse outcome on emotional functioning and on social functioning. A high score on the controllability of the disease and seeking social support was significantly related to better functioning. Conclusion: Illness perception is an important factor in self-care behaviors in PCOS females and has a strong association with health-related quality of life and has a profound effect on it.

Keywords: polycystic ovary syndrome, illness perception, quality of life, young females, mental health

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Authors: Carlos Roncero-Parra, Alfonso Parreño-Torres, Jorge Mateo Sotos, Alejandro L. Borja

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In this research, different methods based on machine/deep learning algorithms are presented for the classification and diagnosis of patients with mental disorders such as alzheimer. For this purpose, the signals obtained from 32 unipolar electrodes identified by non-invasive EEG were examined, and their basic properties were obtained. More specifically, different well-known machine learning based classifiers have been used, i.e., support vector machine (SVM), Bayesian linear discriminant analysis (BLDA), decision tree (DT), Gaussian Naïve Bayes (GNB), K-nearest neighbor (KNN) and Convolutional Neural Network (CNN). A total of 668 patients from five different hospitals have been studied in the period from 2011 to 2021. The best accuracy is obtained was around 93 % in both ADM and ADA classifications. It can be concluded that such a classification will enable the training of algorithms that can be used to identify and classify different mental disorders with high accuracy.

Keywords: alzheimer, machine learning, deep learning, EEG

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Authors: Anastasios Rodis

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Background: Case studies of walkers, climbers, and campers exposed to cold and wet conditions without limb water/windproof protection revealed experiences of muscle weakness and fatigue. It is reasonable to assume that a part of the fatigue could occur due to an alteration in substrate utilization, since reduction of performance in extreme cold conditions, may partially be explained by higher anaerobic glycolysis, reflecting higher carbohydrate oxidation and an increase accumulation rate of blood lactate. The aim of this study was to assess the effects of pre-exercise lower limb cooling on substrate utilization rate during sub-maximal exercise. Method: Six male university students (mean (SD): age, 21.3 (1.0) yr; maximal oxygen uptake (V0₂ max), 49.6 (3.6) ml.min⁻¹; and percentage of body fat, 13.6 (2.5) % were examined in random order after either 30min cold water (12°C) immersion utilized as the cooling strategy up to the gluteal fold, or under control conditions (no precooling), with tests separated by minimum of 7 days. Exercise consisted of 60min cycling at 50% V0₂ max, in a thermoneutral environment of 20°C. Subjects were also required to record a diet diary over the 24hrs prior to the each trial. Means (SD) for the three macronutrients during the 1 day prior to each trial (expressed as a percentage of total energy) 52 (3) % carbohydrate, 31 (4) % fat, and 17 (± 2) % protein. Results: The following responses to lower limb cooling relative to control trial during exercise were: 1) Carbohydrate (CHO) oxidation, and blood lactate (Bₗₐc) concentration were significantly higher (P < 0.05); 2) rectal temperature (Tᵣₑc) was significantly higher (P < 0.05), but skin temperature was significantly lower (P < 0.05); no significant differences were found in blood glucose (Bg), heart rate (HR) and oxygen consumption (V0₂). Discussion: These data suggested that lower limb cooling prior to submaximal exercise will shift metabolic processes from Fat oxidation to CHO oxidation. This shift from Fat to CHO oxidation will probably have important implications in the surviving scenario, since people facing accidental localized cooling of their limbs either through wading/falling in cold water or snow even if they do not perform high intensity activity, they have to rely on CHO availability.

Keywords: exercise in wet conditions, leg cooling, outdoors exercise, substrate utilization

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Authors: Nasser Marshad Alzeer

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This study examines the spatial distribution of secondary schools in Riyadh. It considers both public girls and boys sector provision and assesses the efficiency of the spatial distribution of secondary schools. Since the establishment of the Ministry of Education (MOE) in 1953 and General Presidency for Female Education, (GPFE) in 1960, there has been a great expansion of education services in Saudi Arabia, particularly during the 1980s. However, recent years have seen much slower rates of increase in the public education sector but the population continues to grow rapidly. This study investigates the spatial distribution of schools through the use of questionnaire surveys and applied GIS. Overall, the results indicate a shortage of public secondary schools, especially in the north of the city. It is clear that there is overcrowding in the majority of secondary schools. The establishment of new schools has been suggested to solve the problem of overcrowding. A number of socio-economic and demographic factors are associated with differences in the utilization of the public secondary schools. A GIS was applied in this study in order to assess the spatial distribution of secondary schools including the modification of existing catchment area boundaries and locating new schools. This modification could also reduce the pupil pressure on certain schools and further benefits could probably be gained.

Keywords: analysis, distribution, Saudi, GIS, schools

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Authors: Elaheh Ezami, Behzad Mohammadian, Elham Aznab

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Health service design will need to change due to bringing in new digital health tools. This highlights the importance of innovation in adopting Health Information Technology (HIT). It can be argued that innovation in the health sector correlates with entrepreneurship. Various reasons exist for health entrepreneurs to advocate increased investment in HIT to compensate for shortcomings in the health sector and improve the quality of healthcare. Furthermore, every innovative program presents challenges and motivations for entrepreneurs that may distract or encourage the adoption of technology. Our study used a systematic literature review to identify relevant articles that defined the frustrations and promotions of using health information technology in organizations or enterprises. A meta-analysis of the articles was conducted to identify the factors driving or pulling entrepreneurs to use HIT.

Keywords: health information technology, health entrepreneurship, health enterprise, health entrepreneurs' innovation

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Authors: Chan Hui-Ya, Ding Shin-Tan

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Background and Aim: The discharge planning is considered helpful to reduce the hospital length of stay and readmission rate, and then increased satisfaction with healthcare for patients and professionals. In order to decrease the waiting time of long-term care and boost the care quality of patients after discharge from the hospital, the Ministry of Health and Welfare department in Taiwan initiates a program “discharge planning connects with long-term care 2.0 services” in 2017. The purpose of this study is to investigate the outcome of the pilot of this program in a medical center. Methods: By purpose sampling, the study chose five wards in a medical center as pilot units. The researchers compared the beds of service, the numbers of cases which were transferred to the long-term care center and transferred rates per month between the pilot units and the other units, and analyze the basic data, the long-term care service needs and the approval service items of cases transfer to the long-term care center in pilot units. Results: From June to September 2017, a total of 92 referrals were made, and 51 patients were enrolled into the pilot program. There is a significant difference of transferring rate between the pilot units and the other units (χ = 702.6683, p < 0.001). Only 20 cases (39.2% success rate) were approved to accept the parts of service items of long-term care in the pilot units. The most approval item was respite care service (n = 13; 65%), while it was third at needs ranking of service lists during linking services process. Among the reasons of patients who cancelled the request, 38.71% reasons were related to the services which could not match the patients’ needs and expectation. Conclusion: The results indicate there is a requirement to modify the long-term care services to fit the needs of cases. The researchers suggest estimating the potential cases by screening data from hospital informatics systems and to hire more case manager according the service time of potential cases. Meanwhile, the strategies shortened the assessment scale and authorized hospital case managers to approve some items of long-term care should be considered.

Keywords: discharge planning, long-term care, case manager, patient care

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Authors: Yenisleidy Martinez Martinez, Yannay Casas-Ledon, Jo Dewulf

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The ecosystem services (ES) concept has contributed to draw attention to the benefits ecosystems generate for people and how necessary natural resources are for human well-being. The identification and prioritization of the ES constitute the first steps to undertake conservation and valuation initiatives on behalf of people. Additionally, mapping the supply of ES is a powerful tool to support decision making regarding the sustainable management of landscape and natural resources. In this context, the present study aimed to identify, prioritize and map the primary ES in Biobio and Nuble regions using a methodology that combines expert judgment, multi-attribute evaluation methods, and Geographic Information Systems (GIS). Firstly, scores about the capacity of different land use/cover types to supply ES and the importance attributed to each service were obtained from experts and stakeholders via an online survey. Afterward, the ES assessment matrix was constructed, and the weighted linear combination (WLC) method was applied to mapping the overall capacity of supply of provisioning, regulating and maintenance, and cultural services. Finally, prioritized ES for the study area were selected and mapped. The results suggest that native forests, wetlands, and water bodies have the highest supply capacities of ES, while urban and industrial areas and bare areas have a very low supply of services. On the other hand, fourteen out of twenty-nine services were selected by experts and stakeholders as the most relevant for the regions. The spatial distribution of ES has shown that the Andean Range and part of the Coastal Range have the highest ES supply capacity, mostly regulation and maintenance and cultural ES. This performance is related to the presence of native forests, water bodies, and wetlands in those zones. This study provides specific information about the most relevant ES in Biobio and Nuble according to the opinion of local stakeholders and the spatial identification of areas with a high capacity to provide services. These findings could be helpful as a reference by planners and policymakers to develop landscape management strategies oriented to preserve the supply of services in both regions.

Keywords: ecosystem services, expert judgment, mapping, multi-criteria decision making, prioritization

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Authors: Pedram Saadati, Zahra Nazari

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Today, the role and importance of financial technology businesses in Iran have increased significantly. Although, in Iran, there is no Islamic or non-Islamic personal financial planning field of study in the universities or educational centers, the profession of personal financial planning is not defined, and there is no software introduced in this regard for advisors or consumers. The largest sales network of financial services in Iran belongs to the insurance industry, and there is an untapped market for international companies in Iran that can contribute to 130 thousand representatives in the insurance industry and 28 million families by providing training and personal financial advisory software. To the best of the author's knowledge, despite the lack of previous internal studies in this field, the present study investigates the level of readiness of the salesforce of the insurance industry to accept this career and its technology. The statistical population of the research is made up of managers, insurance sales representatives, assistants and heads of sales departments of insurance companies. An 18-minute video was prepared that introduced and taught the job of Islamic personal financial planning and explained its difference from its non-Islamic model. This video was provided to the respondents. The data collection tool was a research-made questionnaire. To investigate the factors affecting technology acceptance and job change, independent T descriptive statistics and Pearson correlation were used, and Friedman's test was used to rank the effective factors. The results indicate the mental perception and very positive attitude of the insurance industry activists towards the usefulness of this job and its technology, and the studied sample confirmed the intention of training in this knowledge. Based on research results, the change in the customer's attitude towards the insurance advisor and the possibility of increasing income are considered as the reasons for accepting. However, Restrictions on using investment opportunities due to Islamic financial services laws and the uncertainty of the position of the central insurance in this regard are considered as the most important obstacles.

Keywords: fintech, insurance, personal financial planning, wealth management

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Authors: Savannah Rugg, Carlo Moreno, Pushpa Soti, Alexis Racelis

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Situated in deep South Texas, the Lower Rio Grande Valley (LRGV) is considered one the most productive agricultural regions in the southern US. With the highest concentration of organic farms in the state (Hidalgo county), the LRGV has a strong potential to be leaders in sustainable agriculture. Finding management practices that comply with organic certification and increase the health of the agroecosytem and the farmers working the land is increasingly pertinent. Cover cropping, or the intentional planting of non-cash crop vegetation, can serve multiple functions in an agroecosystem by decreasing environmental pollutants that originate from the agroecosystem, reducing inputs needed for crop production, and potentially decreasing on-farm costs for farmers—overall increasing the sustainability of the farm. Use of cover crops on otherwise fallow lands have shown to enhance ecosystem services such as: attracting native beneficial insects (pollinators), increase nutrient availability in topsoil, prevent nutrient leaching, increase soil organic matter, and reduces soil erosion. In this study, four cover crops (Lablab, Sudan Grass, Sunn Hemp, and Pearl Millet) were analyzed in the subtropical region of south Texas to see how their multiple functions enhance ecosystem services. The four cover crops were assessed to see their potential to harbor native insects, their potential to increase soil nitrogen, to increase soil organic matter, and to suppress weeds. The preliminary results suggest that these subtropical varieties of cover crops have potential to enhance ecosystem services on agricultural land in the RGV by increasing soil organic matter (in all varieties), increasing nitrogen in topsoil (Lablab, Sunn Hemp), and reducing weeds (Sudan Grass).

Keywords: cover crops, ecosystem services, subtropical agriculture, sustainable agriculture

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Authors: Mustapha Saidu, Bilyaminu Mohammed

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The study was conducted in Udubo Grazing Reserve between July 2019 and October 2019 to assess forage utilization for pasture-based livestock production in reserve. The grazing land was cross-divided into grids, where 15 coordinates were selected as the sample points. Grids of one-kilometer interval were made. The grids were systematically selected 1 grid after 7 grids. 1 × 1-meter quadrat was made at the coordinate of the selected grids for measurement, estimation, and sample collection. The results of the study indicated that Zornia glochidiatah has the highest percent of species composition (42%), while Mitracarpus hirtus has the lowest percent (0.1%). Urochloa mosambicensis has 48 percent of height removed and 27 percent used by weight, Zornia glochidiata 60 percent of height removed and 57 percent used by weight, Alysicapus veginalis has 55 percent of height removed, and 40 percent used by weight, and Cenchrus biflorus has 40 percent of height removed and 28 percent used by weight. The target is 50 percent utilization of forage by weight during a grazing period as well as at the end of the grazing season. The study found that Orochloa mosambicensis, Alysicarpus veginalis, and Cenchrus biflorus had lower percent by weight which is normal, while Zornia glochidiata had a higher percent by weight which is an indication of danger. The study recommends that the identification of key plant species in pasture and rangeland is critical to implementing a successful grazing management plan. There should be collective action and promotion of historically generated grazing knowledge through public and private advocacies.

Keywords: forage, grazing reserve, live stock, pasture, plant species

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Authors: Jessica Raven Gates, Gemma Wilson-Menzfeld, Professor Alison Steven

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In 2019, the Primary Care system in the UK National Health Service (NHS) was subject to reform and restructuring. Primary Care Networks (PCNs) were established, which aligned with a trend towards integrated care both within the NHS and internationally. The introduction of PCNs brought groups of GP practices in a locality together, to operate as a network, build on existing services and collaborate at a larger scale. PCNs were expected to bring a range of benefits to patients and address some of the workforce pressures in the NHS, through an expanded and collaborative workforce. The early establishment of PCNs was disrupted by the emerging COVID-19 pandemic. This study, set in the context of the pandemic, aimed to explore experiences of the PCN workforce, and their perceptions of the establishment of PCNs. Specific objectives focussed on examining factors perceived as enabling or hindering the success of a PCN, the impact on day-to-day work, the approach to implementing change, and the influence of the COVID-19 pandemic upon PCN development. This study is part of a three-phase PhD project that utilized qualitative approaches and was underpinned by social constructionist philosophy. Phase 1: a systematic narrative review explored the provision of preventative healthcare services in UK primary settings and examined facilitators and barriers to delivery as experienced by the workforce. Phase 2: informed by the findings of phase 1, semi-structured interviews were conducted with fifteen participants (PCN workforce). Phase 3: follow-up interviews were conducted with original participants to examine any changes to their experiences and perceptions of PCNs. Three main themes span across phases 2 and 3 and were generated through a Framework Analysis approach: 1) working together at scale, 2) network infrastructure, and 3) PCN leadership. Findings suggest that through efforts to work together at scale and collaborate as a network, participants have broadly accepted the concept of PCNs. However, the workforce has been hampered by system design and system complexity. Operating against such barriers has led to a negative psychological impact on some PCN leaders and others in the PCN workforce. While the pandemic undeniably increased pressure on healthcare systems around the world, it also acted as a disruptor, offering a glimpse into how collaboration in primary care can work well. Through the integration of findings from all phases, a new theoretical model has been developed, which conceptualises the findings from this Ph.D. study and demonstrates how the workforce has experienced change associated with the establishment of PCNs. The model includes a contextual component of the COVID-19 pandemic and has been informed by concepts from Complex Adaptive Systems theory. This model is the original contribution to knowledge of the PhD project, alongside recommendations for practice, policy and future research. This study is significant in the realm of health services research, and while the setting for this study is the UK NHS, the findings will be of interest to an international audience as the research provides insight into how the healthcare workforce may experience imposed policy and service changes.

Keywords: health services research, qualitative research, NHS workforce, primary care

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Authors: Odufu Ifakachukwu Clifford

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Developing country governments are struggling to meet the basic needs and demands of citizens, especially so for the rural poor. With tightly constrained budgets, these governments have followed the lead of developed countries that have sought to restructure public service delivery through privatization, contracting out, public-private partnerships, and similar reforms. Such reforms in service delivery are generally welcomed when it is believed that private sector partners are better equipped to provide certain services than are governments. With respect to basic and essential services, however, a higher degree of uncertainty and apprehension exists as the focus shifts from simply minimizing the costs of delivering services to broadening access to all citizens. The constitution stipulates that everyone has the right to have access to sufficient food and water. Affordable and/or subsidized water, then, is not a privilege but a basic right of all citizens. Citizens elect political representatives to serve in office, with their sole mandate being to provide for the needs of the citizenry. As governments pass on some amount of responsibility for service delivery to private businesses, these governments must be able to exercise control in order to account to the people for the work done by private partners. This paper examines the legislative and policy frameworks as well as the environment within which PPPs take place in South Africa and the extent to which accountability can be strengthened in this environment. Within the aforementioned backdrop of PPPs and accountability, the constricted focus area of the paper aims to assess the extent to which the provision of clean and safe consumable water in South Africa is sustainable, cost-effective in terms of provision, and affordable to all.

Keywords: privatisation, accountability, essential services, government

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Authors: Nurcan Cetinkaya

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The aim of this paper is to bring about the utilization of Juncus acutus as an alternative roughage resource in ruminant nutrition. In Turkey, JA is prevailing plant of the natural grassland in Kizilirmak Delta, Samsun. Crude nutrient values such as crude protein (CP), ether extract (EE), organic matter (OM), neutral detergent fiber (NDF), acid detergent fiber (ADF), and acid detergent lignin(ADL) including antioxidant activity, total phenolic and flavonoid compounds, total organic matter digestibility (OMD) and metabolisable energy (ME) values of Juncus acutus stem, seed, and also its mixture with maize silage were estimated. and published. Furthermore, the effects of JA over rumen cellulolitic bacteria were studied. The obtained results from different studies conducted on JA by our team show that Juncus acutus may be a new roughage source in ruminant nutrition.

Keywords: antioxidant activity, cellulolytic bacteria, Juncus acutus, organic matter digestibility

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Authors: Tacho Rubby Kong

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Community health workers’ performances are known to influence members’ behaviours and practices while translating policies into service delivery. However, little remains known about the extent to which this remains true within interventions aimed at addressing malaria burden in low-resource settings like Cameroon. The objective of this study was to examine the health workers’ performance and their influence on the adoption of strategies to address the malaria burden at a subnational level health system in Cameroon. A qualitative exploratory design was adopted on a purposively selected sample of 18 key informants. The study was conducted in Konye health district among sub-national health systems, managers, health facility in-charges, and frontline community health workers. Data was collected using semi-structured interview guides in a face-to-face interview with respondents. The analysis adopted a thematic approach utilising journals, credible authors, and peer review articles for data management. Participants acknowledged that workplace networks were influential during the implementation of policies to address malaria. The influence exerted was in form of linkage with other services, caution, and advice regarding strict adherence to policy recommendations, perhaps reflective of the level of trust in providers’ ability to adhere to policy provisions. At the district health management level and among non-state actors, support in perceived areas of weak performance in policy implementation was observed. In addition, timely initiation of contact and subsequent referral was another aspect where community health workers exerted influence while translating policies to address the malaria burden. While the level of support from among network peers was observed to influence community health workers’ adoption and implementation of strategies to address the malaria burden, different mechanisms triggered subsequent response and level of adherence to recommended policy aspects. Drawing from the elicited responses, it was infer that community health workers’ performance influence the direction and extent of success in policy implementation to address the malaria burden at the subnational level.

Keywords: subnational, community, malaria, strategy

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Authors: Afshin Azari, Farzad Peiravian, Nazila Yousefi

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Introduction: Community pharmacies have been always played an important role in public health. Therefore, having a decent service provided by these pharmacies is of paramount importance for the healthcare system. The issue of pharmacy ownership and its possible impact on the quality of services and amount of violations has been argued for many years, and there are different opinions around this debate. Since, so far, no scientific research has been performed to investigate this issue in Iran, this study aimed to examine the differences between these two types of pharmacies ownership in terms of violations and service quality. Method: This study investigates the impact of two different kinds of pharmacy ownership (pharmacists and non-pharmacist’s ownership) on the pharmacies’ amount of violations and services quality. Pharmacies’ amount of violations was examined using “pharmacy inspection reports” between September 2018 and September 2019, in their distinguishable categories: minor, major and critical violations. Then, service quality was examined using a questionnaire from the perspective of pharmacy customers. Results: Considering violations, there was no evidence to prove a significant relationship between critical violations and major violations with the type of pharmacy ownership. However, in minor violations, the average of violations was higher in pharmacies owned by pharmacists in comparison to their non-pharmacist owned counterparts. Regarding service quality, the results showed that there is no significant relationship between the quality of service and the type of pharmacy ownership. Discussion and Conclusion: In this study, no significant relationship was found between the amount of violations and the type of pharmacy ownership. This could indicate that the pharmacy ownership would not influence the rate of violations. Considering that more inspections have been carried out in non-pharmacist owned pharmacies, it can be concluded that these pharmacies are more under control, and in fact, this monitoring has reduced violations in these pharmacies. The quality of services in the two types of pharmacies were not significantly different from each other, and this shows that non-pharmacist-owned pharmacies also try to maintain the desired level of service in competition with their competitors.

Keywords: pharmacy ownership, quality of service, violation, community pharmacy

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Authors: Prajwal Paudel, Shreeprasad Adhikari, Shailendra Bir Karmacharya, Kalpana Upadhyaya

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Background: Human milk banks have been recommended by the World Health Organization (WHO) for newborn and child nourishment in the provision of optimum nutrition as an alternative to breastfeeding in circumstances when direct breastfeeding is inaccessible. The vulnerable group of babies, mainly preterm, low birth weight, and sick newborns, are at a greater risk of mortality and possibly benefit from the safe use of donated human milk through milk banks. In this study, we aimed to shed light on the process involved during the setting up of the nation’s first milk bank and its vitality in small and sick newborn nutrition and care. Methods: The study was conducted in Paropakar Maternity and Women’s Hospital, where the first human milk (HMB) was established. The establishment involved a stepwise process of need assessment meeting, formation of the HMB committee, learning visit to HMB in India, studying the strengths and weaknesses of promoting breastfeeding and HMB system integration, procurement, installation, and setting up the infrastructure, and developing technical competency, launching of the HMB. After the initiation of HMB services, information regarding the recruited donor mothers and the volume of milk pasteurized and consumed by the needy recipient babies were recorded. Descriptive statistics with frequencies and percentages were used to describe the utilization of HMB services. Results: During the study period, a total of 506113 ml of milk was collected, while 49930 ml of milk was pasteurized. Of the pasteurized milk, 381248 ml of milk was dispensed. The total volume of milk received was from a total of 883 after proper routine screening tests. Similarly, the total number of babies who received the donated human milk (DHM) was 912 with different neonatal conditions. Among the babies who received DHM, 527(57.7%) were born via CS, and 385 (42.21%) were delivered normally. In the birth weight category,9 (1%) of the babies were less than 1000 grams, 75 (8.2%) were less than 1500 grams, 405 (44.4%) were between 1500 to less than 2500 grams whereas, 423 (46.4%) of the babies who received DHM were normal weight babies. Among the sick newborns, perinatal asphyxia accounted for 166 (18.2%), preterm with other complications 372 (40.7%), preterm 23 (2.02%), respiratory distress 140 (15.35%), neonatal jaundice 150 (16.44%), sepsis 94 (10.30%), meconium aspiration syndrome 9(1%), seizure disorder 28 (3.07%), congenital anomalies 13 (1.42%) and others 33(3. 61%). The neonatal mortality rate dropped to 6.2/1000 live births from 7.5/1000 live births in the first year of establishment as compared to the previous year. Conclusion: The establishment of the first HMB in Nepal involved a comprehensive approach to integrate a new system with the existing newborn care in the provision of safe DHM. Premature babies with complication, babies born via CS, perinatal asphyxia and babies with sepsis consumed the greater proportion of DHM. Rigorous research is warranted to assess the impact of DHM in small and sick newborn who otherwise would be fed formula milk.

Keywords: human milk bank, sick-newborn, mortality, neonatal nutrition

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Authors: Zicheng Zhang, Linli Zhang

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As China's biggest social media platform, Weibo has taken on essential health communication responsibilities during the pandemic. This research takes 105 posters in 15 health-related official Weibo accounts as the analysis objects to explore COVID19 health information communication and visualisation. First, the interaction between the audiences and Weibo, including forwarding, comments, and likes, is statistically analysed. The comments about the information design are extracted manually, and then the sentiment analysis is carried out to verdict audiences' views about the poster's design. The forwarding and comments are quantified as the attention index for a reference to the degree of likes. In addition, this study also designed an evaluation scale based on the standards of Health Literacy Resource by the Centers for Medicare& Medicaid Services (US). Then designers scored all selected posters one by one. Finally, combining the data of the two parts, concluded that: 1. To a certain extent, people think that the posters do not deliver substantive and practical information; 2. Non-knowledge posters(i.e., cartoon posters) gained more Forwarding and Likes, such as Go, Wuhan poster; 3. The analysis of COVID posters is still mainly picture-oriented, mainly about encouraging people to overcome difficulties; 4. Posters for pandemic prevention usually contain more text and fewer illustrations and do not clearly show cultural differences. In conclusion, health communication usually involves a lot of professional knowledge, so visualising that knowledge in an accessible way for the general public is challenging. The relevant posters still have the problems of lack of effective communication, superficial design, and insufficient content accessibility.

Keywords: weibo, visualisation, covid posters, poster design

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Authors: Veronica Ramirez

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For over 40 years now, the Philippines has been supplying Household Service Workers (HSWs) globally. As a requirement of the Philippine Overseas Employment Agency (POEA), all Filipinos applying for overseas work undergo medical examination and a certificate of good health is submitted to the foreign employer before hiring. However, there are workplace-related health problems that develop during employment such as musculoskeletal strain or injury, back pain, hypertension and other illnesses. Some workers are in good working conditions but are on call more than 12 hours per day. There are also those who experience heavy physical work with short rest periods or time off. They can also be easily exposed to disease outbreaks and epidemics. It was the objective of this study to determine the common health problems of Filipino Overseas Service Workers and analyze their implications to wellness in the workplace. Specifically, it sought to describe the work conditions of HSWs and determine the work-related factors affecting their health. It also identified the medical care they avail of and how they perceive their health and wellness as determinants of well-being. Finally, it proposes ways to promote wellness among HSWs. This study focused on physical illnesses and does not include mental problems experienced by HSWs. Using a questionnaire, primary data were gathered online and through survey of HSW rehires who were retaking Pre-Departure Orientation Seminar at recruitment agencies. The 2010 Health Benefit Availment data from the Overseas Workers Welfare Administration (OWWA) was also utilized. Descriptive analysis was employed on the data gathered. Key stakeholders in the migration industry were also interviewed. Previous research studies, reports and literature on migration and wellness were used as secondary data. The study found that Filipino overseas HSWs are vulnerable to physical injury and experience body pains such as back, hip and shoulder pain. Long hours of work, work hazards and lack of rest due to poor accommodations can aggravate their physical condition. Although health insurance and health care are available, HSWs are not aware how to avail them. On the basis of the findings, a Wellness Program can be designed that include health awareness, health care availment, occupational ergonomics, safety and health, work and leisure balance, developing emotional intelligence, anger management and spirituality.

Keywords: health, household service worker, overseas, wellness

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