Search results for: indicators of vulnerability

Authors: Derya Yucel, Nigar Angın, Dürdane Mart, Meltem Turkeri, Volkan Catalkaya, Celal Yucel

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Chickpea (Cicer arietinum L.) is one of the important legumes widely grown for dietery proteins in semi-arid Mediteranean climatic conditions. To evaluate the genetic diversity with improved heat and drought tolerance capacity in chickpea, thirty-four selected chickpea genotypes were tested under different field-growing conditions (rainfed winter sowing, irrigated-late sowing and rainfed-late sowing) in 2015 growing season. A factorial experiment in randomized complete block design with 3 reps was conducted at the Eastern Mediterranean Research Institute Adana, Turkey. Based on grain yields under different growing conditions, several indices were calculated to identify economically higher-yielding chickpea genotypes with greater heat and drought tolerance capacity. Average across chickpea genotypes, the values of tolerance index, mean productivity, yield index, yield stability index, stress tolerance index, stress susceptibility index, and geometric mean productivity were ranged between 1.1 to 218, 38 to 202, 0.3 to 1.7, 0.2 to 1, 0.1 to 1.2, 0.02 to 1.4, and 36 to 170 for drought stress and 3 to 54, 23 to 118, 0.3 to 1.7, 0.4 to 0.9, 0.2 to 2, 0.2to 2.3, and 23 to 118 for heat stress, respectively. There were highly significant differences observed among the tested chickpea genotypes response to drought and heat stresses. Among the chickpea genotypes, the Aksu, Arda, Çakır, F4 09 (X 05 TH 21-16189), FLIP 03-108 were identified with a higher drought and heat tolerance capacity. Based on our field studies, it is suggested that the drought and heat tolerance indicators of plants can be used by breeders to select stress-resistant economically productive chickpea genotypes suitable to grow under Mediteranean climatic conditions.

Keywords: irrigation, rainfed, stress susceptibility, tolerance indice

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Authors: Aline Giardin, Maria Rosa Chitolina

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Our research conducted in 8 different schools in the city of Rio Grande do Sul, Brazil, we can clearly see that, even in modern times, where the search for equality between men and women is already over 60 years of struggle in this world where you show Much more than two genres and in this world that is proving that sex is not just biological, are confronted with sexist and phallocentric situations in our Schools, and among our students. The sample consisted of 503 students with a mean age between 13 and 21 years. 107 students identified themselves as gay, lesbian, bisexual or transgender. The remainder was identified as heterosexual or none at all. Compared to LGBT students, transgender students faced the school's more hostile climates, while non-transgender female students were less likely to experience anti-LGBT victimization. In addition, transgender students experienced more negative experiences at school compared to students whose gender expression adhered to traditional gender norms. Transgender students were more likely to feel insecure at school, with 80.0% of transgender students reporting that they felt insecure at school because of their gender identity. Female students in our research reported lower frequencies of victimization based on sexual orientation and gender identity and were less likely to feel insecure at school. In all indicators of discrimination in school, high school students have outperformed elementary school students and have had fewer resources and supports related to LGBT. High school students reported higher rates of victimization on sexual orientation and gender expression than elementary school students. For example, about one-third (35.5%) of high school students suffered regular physical Very often) based on their sexual orientation, compared to less than a quarter (21.4%) of primary school students. The whole premise here is to perceive the phallocentrism and sexism hidden in our schools. Opposition between the sexes is not reflexive or articulates a biological fact, but a social construction.

Keywords: transgender students, school, psychological implications, discrimination

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Authors: Rahul Kumar

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Background: Under-FiveMortality Rate(U5MR)ofanationiswidelyacceptedandlong-standing indicators of well-beingofherchildren.They measuredtheprobability of dying before theageoffive(expressedper1000livebirths).TheU5MRisanappropriate indicator of the cumulative exposure totheriskofdeathduringthefirstfiveyearsoflife, and accepted globalindicator ofthehealthandsocioeconomicstatusofagiven population.Itisalsousefulforassessing theimpactofvariousintervention programmes aimed at improving child survival.Under-fivemortalitytrendsconstitutealeadingindicatorofthelevel ofchildhealthandoveralldevelopmentincountries. Objectives: The first aim of our research is to study the level, trends, and Pattern of Under-five mortality using different sources of data. The second objective is to examine the survival pattern of Under-five mortality by different background characteristics. Data Source and Methodology: SRS and NFHS data have been used forobservingthelevelandtrendofUnder-Five mortality rate. Kaplan Meier Estimate has been used to understand the survival Pattern of Under-five mortality. Result: WefindthatallmostallthestatesmadesomeprogressbyreducingU5MRin recent decades.During1992-93highestU5MR(per thousand live birth) was observed in Assam(142)followed by up(141),Odisha(131),MP(130),andBihar(127.5).While the least U5MR(perthousandlive birth)wasobservedinRajasthan(102). The highestU5MR(per thousandlive birth)isobservedinUP(78.1), followed by MP(64.9)and Chhattisgarh(63.7)which are far away from the national level(50). Among them, Uttarakhand(46.7)hadleastU5MR(perthousandlivebirth), followed by Odisha(48.6). TheU5MR(perthousandlivebirth)ofcombinedhighfocusstateis63.7whichisfar away fromthenationallevel(50). Weidentified thatthesurvivalprobability ofunder-fivechildrenfromadolescentmotherislessin comparisontootherchildrenbornby differentagegroupofmothers. thatduringneonatalperiodusually male mortality exceedsthefemale mortality butthisdifferentialreversedinthepostneonatalperiod. Astheirageincreasesand approachingtofiveyears,weidentifiedthatthesurvivalprobability ofbothsexdecreasesbut female’s survival probabilitydecrement is more than male as their ageincreases. The poorer children’s survival probability is minimum. Children using improved toilet facility has more survival probability throughout thefiveyearsthan who uses unimproved. The survival probability of children under five who got Full ANCis more than the survival probability of children under five who doesn’t get any ANC. Conclusions: Improvement of maternal education is an urgent need to improve their health seeking behavior and thus the health of their children. Awareness on reproductive health and environmental sanitation should be strengthened.

Keywords: under-five mortality, survival pattern, ANC, trend

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Authors: Aneta Binkowska, Grzegorz Michalak, Slawomir Pilip, Lukasz Bondaruk, Daniel Celinski, Robert Slotwinski

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Post-traumatic mortality rates are still very high and show an increasing tendency. Early identification of patients at high risk of severe complications has a significant impact on treatment outcomes. The aim of the study was to better understand the early pathological inflammatory response to injury and infection and to determine the usefulness of the assessment of TNF-α and sTNFR1 concentrations in the peripheral blood as early indicators of severe post-traumatic complications. The study was carried out in a group of 51 patients after trauma treated in the ED, including 32 patients that met inclusion criteria for immunological analysis. Patients were divided into two groups using the ISS scale (group A with ISS ≥20, group B with ISS <20). Serum levels of TNF-α and sTNFR1 were determined after admission to the ED and after 3, 6, 12 and 24 hours. The highest TNF-α and sTNFR1 concentrations in both groups were recorded at admission and were significantly higher in group A compared to group B (A vs B TNF-α 2.46 pg/ml vs 1.78 pg/ml; sTNFR1 1667.5 pg/ml vs 875.2 p<0.005). The concentration of sTNFR1 in patients with severe complications was significantly higher compared to patients without complications and preceded clinical symptoms of complications ( C+ vs C- 1561.5 pg/ml vs 930.6 pg/ml). Spearman's correlation showed a statistically significant positive correlation between the baseline concentrations of IL-6 (r=0.38, p<0.043) and sTNFR1 (r=0.59, p=0.001) and the ISS scores. The high diagnostic sensitivity calculated from the ROC (receiver operating characteristic) curves was found for the concentrations of both cytokines: TNF α (AUC=0.91, p=0.004) and sTNFR1 (AUC=0.86, p=0.011). Elevated levels of sTNFR1, determined in the peripheral blood shortly after injury, is significantly associated with the occurrence of later complications, which in some patients lead to death. In contrast, high levels of TNF-α shortly after injury are associated with high mortality.

Keywords: cytokine, SIRS, MODS, trauma

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Authors: Tzong-Ying Hao, Mohammad T. Rahmani

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The Torre Central building is a 9-story shear wall structure located in Santiago, Chile, and has been instrumented since 2009. Events of different intensity (ambient vibrations, weak and strong earthquake motions) have been recorded, and thus the building can serve as a full-scale benchmark to evaluate the structural health monitoring method developed. The first part of this article presents an analysis of inter-story drifts, and of changes in the first system frequencies (estimated from the relative displacement response of the 8th-floor with respect to the basement from recorded data) as baseline indicators of the occurrence of damage. During 2010 Chile earthquake the system frequencies were detected decreasing approximately 24% in the EW and 27% in NS motions. Near the end of shaking, an increase of about 17% in the EW motion was detected. The structural health monitoring (SHM) method based on changes in wave traveling time (wave method) within a layered shear beam model of structure is presented in the second part of this article. If structural damage occurs the velocity of wave propagated through the structure changes. The wave method measures the velocities of shear wave propagation from the impulse responses generated by recorded data at various locations inside the building. Our analysis and results show that the detected changes in wave velocities are consistent with the observed damages. On this basis, the wave method is proven for actual implementation in structural health monitoring systems.

Keywords: Chile earthquake, damage detection, earthquake response, impulse response, layered shear beam, structural health monitoring, Torre Central building, wave method, wave travel time

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Authors: Mei Li, Victor Meddalena

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Background: Newfoundland and Labrador (NL) has rapidly aging population and is characterized by its vast geography with high proportion of dispersed rural communities when compared to other provinces in Canada. Structural, demographic and geographic factors have created big gaps for rural residents across NL with respect to accessing various health and social services. While the barriers are well documented for patients’ access to cancer care in rural and remote areas, challenges faced by family caregivers are not fully recognized. Caregiving burden coupled with challenges associated with relocation and frequent travels create situations where caregivers are vulnerable physically, emotionally, financially and socially. This study examines the experiences of family caregivers living in rural NL through a social justice lens. It is expected to identify the gaps existing in social policy and support for rural family caregivers. It will make a novel contribution to the literature in this regard. Methods: Design: This qualitative study adopted the hermeneutic phenomenology to best describe and interpret rural-based family caregivers’ living experiences and explore the meaning, impact, and the influence of both individual experience and contextual factors shaping these experiences. Data Collection: In-depth interviews with key informants were conducted with 12 participants from various rural communities in NL. A case study was also used to explore an individual’s experience in complex social units consisting of multiple variables of in-depth understanding of the reality. Data Analysis: Thematic analysis guided by the Voice-Centred Relational (VCR) method was employed to explore the relationships and contexts of participants. Emerging Themes: Six major emerging themes were identified, namely, overwhelming caregiving burden on rural family caregivers, long existing financial hardship, separation from family and community, low level of social support and self-reliance coping strategies, and social vulnerability and isolation. Conclusion: Understanding the lived experiences of rural-based family caregivers is critical to inform the policy makers the gap of health and social service in NL. The findings of this study also have implications for family caregivers who are vulnerable in other similar contexts. This study adds innovative insights for policy making and service provision in this regard.

Keywords: family caregivers, policy, relocation, rural

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Authors: Hailemeleak Regassa

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Traditional medicines use medicinal plants as a source of ingredients, and many modern medications are indirectly derived from plants. Consumers in affluent nations are growing disenchanted with contemporary healthcare and looking for alternatives. Oxidative stress is the primary cause of multiple diseases, and exogenous antioxidant supplementation or strengthening the body's endogenous antioxidant defenses are potential ways to counteract the negative effects of oxidative damage. Plants can biosynthesize non-enzymatic antioxidants that can reduce ROS-induced oxidative damage. Aging often aids the propagation and development of carcinogenesis, and older animals and older people exhibit increased vulnerability to tumor promoters. Cancer is a major public health issue, with several anti-cancer medications in clinical use. Potential drugs such as flavopiridol, roscovitine, combretastatin A-4, betulinic acid, and silvestrol are in the clinical or preclinical stages of research. Methodology: Microbial Growth media, Dimethyl sulfoxide (DMSO), methanol, ethyl acetate, and n-hexane were obtained from Himedia Labs, Mumbai, India. plant were collected from the Herbal Garden of Shoolini University campus, Solan, India (Latitude - 30.8644° N and longitude - 77.1184° E). The identity was confirmed by Dr. Y.S. Parmar University of Horticulture and Forestry, Nauni, Solan (H.P.), India, and documented in Voucher specimens - UHF- Herbarium no. 13784; vide book no. 3818 Receipt No. 086. The plant materials were washed with tap water, and 0.1% mercury chloride for 2 minutes, rinsed with distilled water, air dried, and kept in a hot air oven at 40ºc on blotting paper until all the water evaporated and became well dried for grinding. After drying, the plant materials were grounded using a mixer grinder into fine powder transferred into airtight containers with proper labeling, and stored at 4ºc for future use (Horablaga et al., 2023). The extraction process was done according to Altemimi et al., 2017. The 5g powder was mixed with 15 ml of the respective solvents (n-hexane, ethyl acetate, and methanol), and kept for 4-5 days on the platform shaker. The solvents used are based on their increasing polarity index. Then the extract was centrifuged at 10,000rpm for 5 minutes and filtered using No.1 Whatman filter paper.

Keywords: cancer, phytomedicine, medicinal plants, oncology

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Authors: Alaa A. H. Shehada, Eman Abdelnasser Abouhassanein, Reem Mohsen Ali, Joyce J. Moawad, Hiba Bawadi, Abdelhamid Kerkadi

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Background: The association between obesity and micronutrient deficiencies is well documented. Among minerals that have been widely studied: zinc, iron and magnesium. Objectives: This study aims to determine the association between obesity indices and mineral status among Qatari adults. Methods: Secondary data was obtained from Qatar Biobank. 414 healthy Qatari aged 20-50 years old were randomly selected from the database. Anthropometric measurements (WC, Weight, and height), body fat, and mineral status (Fe, Mg, Ca, K, Na) were obtained for all selected participants. Differences in anthropometric measurements and mineral status were analyzed by t-test or ANOVA. Spearman correlation coefficients were determined to assess the association between minerals and anthropometric variables. Statistical significance for the hypothesis tests was set at p <0.05. All statistical analysis was preformed using SPSS software version 23.0. Results: Iron, calcium, and sodium levels decreased with an increase in body mass index. Moreover, only iron showed a significant correlation with waist circumference, and waist to height ratio increased. Additionally, calcium, iron, magnesium, and sodium had a statistically significant negative correlation with total body fat percentage and trunk fat percentage. There were statistically significant negative correlations of anthropometrics with minerals. Conclusion: Body fat and trunk fat percentage had a significant inverse relationship with iron, calcium, sodium, and magnesium, while there was no correlation between body fat or trunk fat percentage with potassium.

Keywords: Qatar biobank, body fat distribution, mineral status, Qatari adults

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Authors: Sanjay Sinha, Mohd Umair Khan

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The level of income inequality in India has been worrisome as the World Inequality Report termed it as a “poor and unequal country, with an affluent elite”. As important as income is to understand inequality and deprivation, it is just one dimension. But the historical roots and current realities of inequality and deprivation in India lies in many of the non-income dimensions such as housing, nutrition, education, agency, sense of inclusion etc. which are often ignored, especially in solution-oriented research. The level of inequality and deprivation among the tribal is one such case. There is a corpus of literature establishing that the tribal communities in India are disadvantageous on various grounds. Given their rural geography, issues of access and quality of basic facilities such as education and healthcare are often unaddressed. COVID-19 has further exacerbated this challenge and climate change will make it even more worrying. With this background, a succinct measurement tool at the village level is necessary to design short to medium-term actions with reference to risk mitigation for tribal communities. This research paper examines the level of inequality and deprivation among the tribal communities in the rural areas of Andhra Pradesh state of India using a Multidimensional Inequality and Deprivation Index based on the Alkire-Foster methodology. The methodology is theoretically grounded in the capability approach propounded by Amartya Sen, emphasizing on achieving the “beings and doings” (functionings) an individual reason to value. In the index, the authors have five domains, including Livelihood, Food Security, Education, Health and Housing and these domains are divided into sixteen indicators. This assessment is followed by domain-wise short-term and long-term solutions.

Keywords: Andhra Pradesh, Alkire-Foster methodology, deprivation, inequality, multidimensionality, poverty, tribal

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Authors: Paria Saadatjoo

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Given that HVAC systems are the main sources of carbon dioxide producers, developing ways to reduce dependence on these systems and making use of natural resources is too important to achieve environmentally friendly buildings. A major part of building potential in terms of using natural energy resources depends on its physical features. So architectural decisions at the first step of the design process can influence the building's energy efficiency significantly. Implementation of semi-open spaces into solid apartment blocks inspired by the concept of courtyard in ancient buildings as a passive cooling strategy is currently enjoying great popularity. However, the analysis of these features and their effect on wind behavior at initial design steps is a difficult task for architects. The main objective of this research was to investigate the influence of semi-open to closed space ratio on airflow patterns in and around midrise buildings and introduce the best ratio in terms of harnessing natural ventilation. The main strategy of this paper was semi-experimental, and the research methodology was descriptive statistics. At the first step, by changing the terrace area, 6 models with various open to closed space ratios were created. These forms were then transferred to CFD software to calculate the primary indicators of natural ventilation potentials such as wind force coefficient, air flow rate, age of air distribution, etc. Investigations indicated that modifying the terrace area and, in other words, the open to closed space ratio influenced the wind force coefficient, airflow rate, and age of air distribution.

Keywords: natural ventilation, wind, midrise, open space, energy

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Authors: Malak M. Shatnawi

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Infrastructure is the fundamental facility that plays an important part in socio-economic development for modern societies, if such sector is well planned, managed by decision makers in a way that is compatible with the population growth, safety, and national security needs; it will enrich progress, prosperity, awareness, social and economic welfare for any country. Infrastructure is the most important aspect of life because it can provide materials, products, and services that will improve and facilitate living conditions and maintain sustainability at the same time, and in order to study critical infrastructure, in general, we must think sustainability. Otherwise there will be a significant gap. The planning processes for sustainability include urban infrastructure and public transportation are considered the most important sectors for economic development for both developed and developing countries as they are linked to the civilizational and urban development, meanwhile, choosing the appropriate transportation mode that will provide a good level of service, and increase the satisfaction of the potential users is a difficult task. This research paper tries to assess where is Jordan located vs. each transportation sustainability dimensions in aspects related to social, economic and environmental dimensions based on (Zietsman et al. 2006) adopted model for sustainability transportation infrastructure. Measures of performance indicators for each dimensional goal were traced and supported with needed data, figures and statistical findings. The study uses analytical, descriptive style and methodology based on different references and previous studies from secondary data sources to support the case. Recommendations for enhancing sustainability were concluded, and future reform directions were proposed which can be applied to Jordan and generalized for other developing countries with similar circumstances.

Keywords: infrastructure transportation sustainability, economic, social, environmental

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Authors: Sateesh Kumar Pisini, Swetha Priya Darshini, Sanjay Kumar Shukla

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This paper seeks to present a research study on sustainability in construction of retaining wall using geosynthetics. Sustainable construction is a way for the building and infrastructure industry to move towards achieving sustainable development, taking into account environmental, socioeconomic and cultural issues. Geotechnical engineering, being very resource intensive, warrants an environmental sustainability study, but a quantitative framework for assessing the sustainability of geotechnical practices, particularly at the planning and design stages, does not exist. In geotechnical projects, major economic issues to be addressed are in the design and construction of stable slopes and retaining structures within space constraints. In this paper, quantitative indicators for assessing the environmental sustainability of retaining wall with geosynthetics are compared with conventional concrete retaining wall through life cycle assessment (LCA). Geosynthetics can make a real difference in sustainable construction techniques and contribute to development in developing countries in particular. Their imaginative application can result in considerable cost savings over the use of conventional designs and materials. The acceptance of geosynthetics in reinforced retaining wall construction has been triggered by a number of factors, including aesthetics, reliability, simple construction techniques, good seismic performance, and the ability to tolerate large deformations without structural distress. Reinforced retaining wall with geosynthetics is the best cost-effective and eco-friendly solution as compared with traditional concrete retaining wall construction. This paper presents an analysis of the theme of sustainability applied to the design and construction of traditional concrete retaining wall and presenting a cost-effective and environmental solution using geosynthetics.

Keywords: sustainability, retaining wall, geosynthetics, life cycle assessment

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Authors: Thomas J. Bell III

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Pursuing a business degree is fraught with perplexing questions regarding the rising tuition cost and the immediate value of earning a degree. Any decision to pursue an undergraduate business degree is perceived to have value if it facilitates post-graduate job placement. Business programs have decreased value in the absence of innovation in business programs that close the skills gap between recent graduates and employment opportunities. Industry-based certifications are seemingly becoming a requirement differentiator among job applicants. Texas Wesleyan University offers a Computer Information System (CIS) program with an innovative curriculum that integrates industry-recognized certification training into its traditional curriculum with core subjects and electives. This paper explores a culture of innovation in the CIS business program curriculum that creates sustainable stakeholder value for students, employers, the community, and the university. A quantitative research methodology surveying over one-hundred students in the CIS program will be used to examine factors influencing the success or failure of students taking certification exams. Researchers will analyze control variables to identify specific correlations between practice exams, teaching pedagogy, study time, age, work experience, etc. This study compared various exam preparation techniques to corresponding exam results across several industry certification exams. The findings will aid in understanding control variables with correlations that positively and negatively impact exam results. Such discovery may provide useful insight into pedagogical impact indicators that positively contribute to certification exam success and curriculum enhancement.

Keywords: taking certification exams, exam training, testing skills, exam study aids, certification exam curriculum

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Authors: Alfiah Hasanah, Silvia Mendolia, Oleg Yerokhin

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This paper explores the impacts of adult child migration on the health of elderly parents left behind. The maternal and children health are a priority of health-related policy in most low and middle-income country, and so there is lack of evidence on the health of older population particularly in Indonesia. With increasing life expectancy and limited access to social security and social services for the elderly in this country, the consequences of increasing number of out-migration of adult children to parent health are important to investigate. This study use Indonesia Family Life Survey (IFLS), the only large-scale continuing longitudinal socioeconomic and health survey that based on a sample of households representing about 83 percent of the Indonesian population in its first wave. Using four waves of IFLS including the recent wave of 2014, several indicators of the self-rated health status, interviewer-rated health status and days of illness are used to estimate the impact of labour out-migration of adult children on parent health status. Incorporate both individual fixed effects to control for unobservable factors in migrant and non-migrant households and the ordered response of self-rated health, this study apply the ordered logit of “Blow-up and Cluster” (BUC ) estimator. The result shows that labour out-migration of adult children significantly improves the self-rated health status of the elderly parent left behind. Findings of this study are consistent with the view that migration increases family resources and contribute to better health care and nutrition of the family left behind.

Keywords: aging, migration, panel data, self-rated health

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Authors: Steve Fish, Chris Lambert

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Cumbria is a geo-political county in Northwest England within which the Lake District National Park, a UNESCO World Heritage site is located. Whilst the area has a formidable reputation for natural beauty and historic assets, the innovation ecosystem is described as ‘patchy’ for a number of reasons. The county is one of the largest in England by area and is sparsely populated. This paper describes the needs, development and delivery of an SME business-support programme funded by the European Regional Development Fund, Lancaster University and the University of Cumbria. The Cumbria Innovations Platform (CUSP) Project has been designed to respond to the nuanced needs of SMEs in this locale, whilst promoting the adoption of research and innovation. CUSP utilizes a funnel method to support rural businesses with access to university innovation intervention. CUSP has been built on a three-tier model: Communicate, Collaborate and Create. The paper describes this project in detail and presents results in terms of output indicators achieved, a beneficiary telephone survey and wider economic forecasts. From a pragmatic point-of-view, the paper provides experiences and reflections of those people who are delivering and evaluating knowledge exchange. The authors discuss some of the benefits, challenges and implications for both policy makers and practitioners. Finally, the paper aims to serve as an invitation to others who may consider adopting a similar method of university-industry collaboration in their own region.

Keywords: regional business support, rural business support, university-industry collaboration, collaborative R&D, SMEs, knowledge exchange

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Authors: J. Dharmaraj, C. Gunasekaran

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Invertebrates are the reliable ecological indicators of disturbance of the forest ecosystems and they respond to environment changes more quickly than other fauna. Among these the terrestrial invertebrates are vital to functioning ecosystems, contributing to processes such as decomposition, nutrient cycling and soil fertility. The natural ecosystems of the forests have been subject to various types of disturbances, which lead to decline of flora and fauna. The comparative diversity of micro-arthropods in natural forest, wattle plantation and eucalyptus plantations were studied in Nilgiris. The study area was divided in to five major sites (Emerald (Site-I), Thalaikundha (Site-II), Kodapmund (Site-III), Aravankad (Site-IV), Kattabettu (Site-V). The research was conducted during period from March 2014 to August 2014. The leaf and soil samples were collected and isolated by using Berlese funnel extraction methods. Specimens were isolated and identified according to their morphology (Balogh 1972). In the present study results clearly showed the variation in soil pH, NPK (Major Nutrients) and organic carbon among the study sites. The chemical components of the leaf litters of the plantation decreased the diversity of micro-arthropods and decomposition rate leads to low amount of carbon and other nutrients present in the soil. Moreover eucalyptus and wattle plantations decreases the availability of the ground water source to other plantations and micro-arthropods and hences affects the soil fertility. Hence, the present study suggests to minimize the growth of wattle and eucalyptus tree plantations in the natural areas which may help to reduce the decline of forests.

Keywords: micro-arthropods, assemblage, berlese funnel, morphology, NPK, nilgiris

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Authors: Catharina Lindberg, Cecilia Fagerstrom, Ania Willman

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Patients in high-tech care environments are usually dependent on both formal/informal caregivers and technology, highlighting their vulnerability and challenging their autonomy. Autonomy presumes that a person has education, experience, self-discipline and decision-making capacity. Reference to autonomy in relation to patients in high-tech care environments could, therefore, be considered paradoxical, as in most cases these persons have impaired physical and/or metacognitive capacity. Therefore, to understand the prerequisites for patients to experience autonomy in high-tech care environments and to support them, there is a need to enhance knowledge and understanding of the concept of patient autonomy in this care context. The development of concepts and theories in a practice discipline such as nursing helps to improve both nursing care and nursing education. Theoretical development is important when clarifying a discipline, hence, a theoretical framework could be of use to nurses in high-tech care environments to support and defend the patient’s autonomy. A meta-synthesis was performed with the intention to be interpretative and not aggregative in nature. An amalgamation was made of the results from three previous studies, carried out by members of the same research group, focusing on the phenomenon of patient autonomy from a patient perspective within a caring context. Three basic approaches to theory development: derivation, synthesis, and analysis provided an operational structure that permitted the researchers to move back and forth between these approaches during their work in developing a theoretical framework. The results from the synthesis delineated that patient autonomy in a high-tech care context is: To be in control though trust, co-determination, and transition in everyday life. The theoretical framework contains several components creating the prerequisites for patient autonomy. Assumptions and propositional statements that guide theory development was also outlined, as were guiding principles for use in day-to-day nursing care. Four strategies used by patients to remain or obtain patient autonomy in high-tech care environments were revealed: the strategy of control, the strategy of partnership, the strategy of trust, and the strategy of transition. This study suggests an extended knowledge base founded on theoretical reasoning about patient autonomy, providing an understanding of the strategies used by patients to achieve autonomy in the role of patient, in high-tech care environments. When possessing knowledge about the patient perspective of autonomy, the nurse/carer can avoid adopting a paternalistic or maternalistic approach. Instead, the patient can be considered to be a partner in care, allowing care to be provided that supports him/her in remaining/becoming an autonomous person in the role of patient.

Keywords: autonomy, caring, concept development, high-tech care, theory development

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Authors: Savin Phoeun

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Long time civil war, economic, infrastructure, social, and political structure were destroyed and everything starts from zero. Transport and communication are the key feature of the national economic growth, especially inland transport and other mode take a complementary role which supported by government and international organization both direct and indirect to private sector and small and medium size enterprises. The objectives of this study are to study the general characteristics, capacity and competitive KPIs of Cambodian Inland Transport Operators. Questionnaire and interview were formed from capacity and competitiveness key performance indicators to take apart in survey to Inland Transport Companies in Phnom Penh capital city of Cambodia. And descriptive statistics was applied to identify the data. The result of this study divided into three distinct sectors: 1). Management ability of transport operators – capital management, financial and qualification are in similar level which can compete between local competitors (moderated level). 2). Ability in operation: customer service providing is better but seemed in high cost operation because mostly they are in family size. 3). Local Cambodian Inland Transport Service Providers are able to compete with each other because they are in similar operation level while Thai competitors mostly higher than. The suggestion and recommendation from the result that inland transport companies should access to new technology, improve strategic management, build partnership (join/corporate) to be bigger size of capital and company in order to attract truthfulness from customers and customize the services to satisfy. Inland Service Providers should change characteristic from only cost competitive to cost saving and service enhancement.

Keywords: assessment, competitiveness, inland transport, operator

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Authors: Jill Stephenson, Marie Vaganay, Robert Cameron, Caoimhe McGurk, Neil Hewitt

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Purpose: The key aim of the research was to identify the secondary stressors experienced by businesses affected by single or repeated flooding and to determine to what extent businesses were affected by these stressors, along with any resulting impact on health. Additionally, the research aimed to establish the likelihood of businesses being re-exposed to the secondary stressors through assessing awareness of flood risk, implementation of property protection measures and level of community resilience. Design/methodology/approach: The chosen research method involved the distribution of a questionnaire survey to businesses affected by either single or repeated flood events. The questionnaire included the Impact of Event Scale (a 15-item self-report measure which assesses subjective distress caused by traumatic events). Findings: 55 completed questionnaires were returned by flood impacted businesses. 89% of the businesses had sustained internal flooding while 11% had experienced external flooding. The results established that the key secondary stressors experienced by businesses, in order of priority, were: flood damage, fear of reoccurring flooding, prevention of access to the premise/closure, loss of income, repair works, length of closure and insurance issues. There was a lack of preparedness for potential future floods and consequent vulnerability to the emergence of secondary stressors among flood affected businesses, as flood resistance or flood resilience measures had only been implemented by 11% and 13% respectively. In relation to the psychological repercussions, the Impact of Event scores suggested that potential prevalence of post-traumatic stress disorder (PTSD) was noted among 8 out of 55 respondents (l5%). Originality/value: The results improve understanding of the enduring repercussions of flood events on businesses, indicating that not only residents may be susceptible to the detrimental health impacts of flood events and single flood events may be just as likely as reoccurring flooding to contribute to ongoing stress. Lack of financial resources is a possible explanation for the lack of implementation of property protection measures among businesses, despite 49% experiencing flooding on multiple occasions. Therefore it is recommended that policymakers should consider potential sources of financial support or grants towards flood defences for flood impacted businesses. Any form of assistance should be made available to businesses at the earliest opportunity as there was no significant association between the time of the last flood event and the likelihood of experiencing PTSD symptoms.

Keywords: flood event, flood resilience, flood resistance, PTSD, secondary stressors

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Authors: Bicky Agarwal, Ambika Behl, Rajiv Kumar, Ashish Dhamaniya

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India ranks second for having the largest road network in the world after the United States (U.S.). According to the National Asphalt Pavement Association (NAPA), the U.S. produced about 94.6 million tons of Reclaimed Asphalt Pavement (RAP) in 2021. Despite the benefits of RAP usage, it is not widely adopted in many countries, including India. Rising asphalt binder costs and environmental concerns have spurred interest in using RAP material in asphalt mixtures. However, increasing RAP content may have adverse effects on certain characteristics of asphalt mixtures, such as cracking resistance. Cracking is a common pavement issue that affects the lifespan and durability of hot-mix asphalt pavements. Assessing cracking resistance is crucial in pavement design. Various laboratory tests and performance indicators are utilized to evaluate cracking resistance. This study aims to use the Texas Overlay Tester (TOT) to assess the impact of reclaimed asphalt pavement (RAP) on the cracking resistance of Bituminous Concrete (BC-II) mixes. Following the Marshall Mix Design method, asphalt mixes with RAP contents of 0% (Control), 30%, 40%, 50%, and 60% were prepared and tested at their Optimum Binder Content (OBC). The ITS results showed that the control mix had an ITS value of 1.2 MPa, with slight decreases observed in mixes containing up to 60% RAP, although these changes were not statistically significant (p=0.538>0.05). The TSR tests indicated that all mixes exceeded the minimum requirement of 80%. The Texas Overlay Test (TOT) was used to evaluate cracking performance and revealed that higher RAP contents had a negative impact on fatigue resistance. The 50% RAP mix exhibited the highest CFE, indicating that it has the best resistance to crack propagation despite having a lower number of cycles to failure. All mixes were categorized as falling into the Soft-crack-resistant quadrant, indicating their ability to resist crack propagation while being more susceptible to crack initiation.

Keywords: RAP, BC-II, HMA, TOT

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Authors: William Cheng, Rini Sekartini

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Background: Sleep is essential for children because it provides enhancement for the neural system activities that give physiologic effects for the body to support growth and development. One of the modifiable factors that relates with sleep is nutrition, which includes nutritional status, iron intake, and magnesium intake. Nutritional status represents the balance between nutritional intake and expenditure, while iron and magnesium are micronutrients that are related to sleep regulation. The aim of this study is to identify prevalence of sleep disturbance among Indonesian children and to evaluate its relation with aspect to nutrition. Methods : A cross-sectional study involving children aged 5 to 7-years-old in an urban primary health care between 2012 and 2013 was carried out. Related data includes anthropometric status, iron intake, and magnesium intake. Iron and magnesium intake was obtained by 24-hours food recall procedure. Sleep Disturbance Scale for Children (SDSC) was used as the diagnostic tool for sleep disturbance, with score under 39 indicating presence of problem. Results: Out of 128 school-aged children included in this study, 28 (23,1%) of them were found to have sleep disturbance. The majority of children had good nutritional status, with only 15,7% that were severely underweight or underweight, and 12,4% that were identified as stunted. On the contrary, 99 children (81,8%) were identified to have inadequate magnesium intake and 56 children (46,3%) with inadequate iron intake. Our analysis showed there was no significant relation between all of the nutritional status indicators and sleep disturbance (p>0,05%). Moreover, inadequate iron and magnesium intake also failed to prove significant relation with sleep disturbance in this population. Conclusion: Almost fourth of school-aged children in Indonesia were found to have sleep disturbance and further study are needed to overcome this problem. According to our finding, there is no correlation between nutritional status, iron intake, magnesium intake, and sleep disturbance.

Keywords: iron intake, magnesium intake, nutritional status, school-aged children, sleep disturbance

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Authors: Rommila Chandra, Harshika Choudhary

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The present-day tourism sector is globally developing at a fast pace, searching for new ideas and new venues. In the Indian Himalayan Region (IHR), tourism has experienced a vast growth and continuous diversification over the last few years, thus becoming one of the fastest-growing economic sectors in India. With its majestic landscape, high peaks, rich floral and faunal diversity, and cultural history, the IHR has continuously attracted tourists and pilgrims from across the globe. The IHR has attracted a vast range of visitors who seek adventure sports, natural and spiritual solace, peace, cultural assets, food, and festivals, etc. Thus, the multi-functionality of the region has turned tourism into a key component of economic growth for the rural communities in the hills. For the local mountain people, it means valuable economic opportunity for income generation, and for the government and entrepreneurs, it brings profits. As the urban cities gain attention and investment in India, efforts have to be made to protect, safeguard, and strengthen the cultural, spiritual, and natural heritage of IHR for sustainable livelihood development. Furthermore, the socio-economic and environmental insecurities, along with geographical isolation, adds to the challenging survival in the tough terrains of IHR, creating a major threat of outmigration, land abandonment, and degradation. The question the paper intends to answer is: whether the rural community of IHR is aware of the new global trends in rural tourism and the extent of their willingness to adapt to the evolving tourism industry, which impacts the rural economy, including sustainable livelihood opportunity. The objective of the paper is to discuss the integrated nature of rural tourism, which widely depends upon natural resources, cultural heritage, agriculture/horticulture, infrastructural development, education, social awareness, and willingness of the locals. The sustainable management of all these different rural activities can lead to long-term livelihood development and social upliftment. It highlights some gap areas and recommends fewcommunity-based coping measures which the local people can adopt amidst the disorganized sector of rural tourism. Lastly, the main contribution is the exploratory research of the rural tourism vulnerability in the IHR, which would further help in studying the resilience of the tourism sector in the rural parts of a developing nation.

Keywords: community-based approach, sustainable livelihood development, Indian Himalayan region, rural tourism

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Authors: Lilian Mbinya Muasa

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Climate change is inevitable and a global challenge with long term implications to the sustainable development of many countries today. The negative impacts of climate change are creating far reaching social, economic and environmental problems threatening lives and livelihoods of millions of people in the world. Developing countries especially sub-Saharan countries are more vulnerable to climate change due to their weak ecosystem, low adaptive capacity and high dependency on rain fed agriculture. Countries in Sub-Saharan Africa are more vulnerable to climate change impacts due to their weak adaptive capacity and over-reliance on rain fed agriculture. In Kenya, 78% of the rural communities are poor farmers who heavily rely on rain fed agriculture thus are directly affected by climate change impacts.Currently, many parts of Kenya are experiencing successive droughts which are contributing to persistently unstable and declining agricultural productivity especially in semi arid eastern Kenya. As a result, thousands of rural communities repeatedly experience food insecurity which plunge them to an ever over-reliance on relief food from the government and Non-Governmental Organization In addition, they have adopted poverty coping strategies to diversify their income, for instance, deforestation to burn charcoal, sand harvesting and overgrazing which instead contribute to environmental degradation.This research was conducted in Makueni County which is classified as one of the most food insecure counties in Kenya and experiencing acute environmental degradation. The study aimed at analyzing the adaptive capacity to climate change across farming households of Makueni County in Kenya by, 1) analyzing adaptive capacity to climate change and agricultural productivity across farming households, 2) identifying factors that contribute to differences in adaptive capacity across farming households, and 3) understanding the relationship between climate change, agricultural productivity and adaptive capacity. Analytical Hierarchy Process (AHP) was applied to determine adaptive capacity and Total Factor Productivity (TFP) to determine Agricultural productivity per household. Increase in frequency of prolonged droughts and scanty rainfall. Preliminary findings indicate a magnanimous decline in agricultural production in the last 10 years in Makueni County. In addition, there is an over reliance of households on indigenous knowledge which is no longer reliable because of the unpredictability nature of climate change impacts. These findings on adaptive capacity across farming households provide the first step of developing and implementing action-oriented climate change policies in Makueni County and Kenya.

Keywords: adaptive capacity, agricultural productivity, climate change, vulnerability

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Authors: Batool Zarei

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This study aims to answer this question whether control criterion with two elements of power and benefit which is introduced as 'control criterion of consolidation scope' in national and international standards of accounting in public sector (and also private sector) is efficient enough or not. The methodology of this study is comparative and the results of this research are significantly generalizable, due to the given importance to the sample of countries which were studied. Findings of this study states that in spite of pervasive use of control criterion (including 2 elements of power and benefit), criteria for determining the existence of control in public sector accounting standards, are not efficient enough to determine the consolidation scope of whole of government financial statements in a way that meet decision making and accountability needs of managers, policy makers and supervisors; specially parliament. Therefore, the researcher believes that for determining consolidation scope in public sector, in addition to economic view, it is better to pay attention to budgetary, legal and statistical concepts and also to practical and financial risk and define indicators for proving the existence of control (power and benefit) which include accountability relationships (budgetary relation, legal form and nature of activity). these findings also reveals the necessity of passing a comprehensive public financial management (PFM) legislation in order to redefine the characteristics of public sector entities and whole of government financial statements scope and review Statistics organizations and central banks duties for preparing government financial statistics and national accounts in order to achieve sustainable development and resilient economy goals.

Keywords: control, consolidation scope, public sector accounting, government financial statistics, resilient economy

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Authors: Rupam Saikia, Ashim Kanti Dey

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Sonapur is an intense hilly region on the border of Assam and Meghalaya lying in North-East India and is very near to a seismic fault named as Dauki besides which makes the region seismically active. Besides, these recently two earthquakes of magnitude 6.7 and 6.9 have struck North-East India in January and April 2016. Also, the slope concerned for this study is adjacent to NH 44 which for a long time has been a sole important connecting link to the states of Manipur and Mizoram along with some parts of Assam and so has been a cause of considerable loss to life and property since past decades as there has been several recorded incidents of landslide, road-blocks, etc. mostly during the rainy season which comes into news. Based on this issue this paper reports a static and dynamic slope stability analysis of Sonapur which has been carried out in MIDAS GTS NX. The slope being highly unreachable due to terrain and thick vegetation in-situ test was not feasible considering the current scope available so disturbed soil sample was collected from the site for the determination of strength parameters. The strength parameters were so determined for varying relative density with further variation in water content. The slopes were analyzed considering plane strain condition for three slope heights of 5 m, 10 m and 20 m which were then further categorized based on slope angles 30, 40, 50, 60, and 70 considering the possible extent of steepness. Initially static analysis under dry state was performed then considering the worst case that can develop during rainy season the slopes were analyzed for fully saturated condition along with partial degree of saturation with an increase in the waterfront. Furthermore, dynamic analysis was performed considering the El-Centro Earthquake which had a magnitude of 6.7 and peak ground acceleration of 0.3569g at 2.14 sec for the slope which were found to be safe during static analysis under both dry and fully saturated condition. Some of the conclusions were slopes with inclination above 40 onwards were found to be highly vulnerable for slopes of height 10 m and above even under dry static condition. Maximum horizontal displacement showed an exponential increase with an increase in inclination from 30 to 70. The vulnerability of the slopes was seen to be further increased during rainy season as even slopes of minimal steepness of 30 for height 20 m was seen to be on the verge of failure. Also, during dynamic analysis slopes safe during static analysis were found to be highly vulnerable. Lastly, as a part of the study a comparative study on Strength Reduction Method (SRM) versus Limit Equilibrium Method (LEM) was also carried out and some of the advantages and disadvantages were figured out.

Keywords: dynamic analysis, factor of safety, slope stability, strength reduction method

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Authors: Katie E. Jennings

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The interactions between family dynamics and environmental factors with mental health vulnerability in individuals are well known and are a theme for on-going research and debate. The impact upon mental health issues and forensic issues on family dynamics, experience, and emotional wellbeing cannot be over-Emphasised. For forensic patients with diagnosed mental disorders, these relationships and environments may have also been functionally linked to the development and maintenance of those disorders; with significant adverse childhood experiences being a common feature of many Patient’s histories. Mental health hospitals remove the patient from their home environments and provide treatment outside of these relationships and often outside of the home area. There is, therefore, a major focus on Services ensuring that patients are able to build and maintain relationships with family and friends, requiring services to involve families in Patients' care and treatment wherever possible. There are standards set by Government and clinical bodies that require absolute demonstration of the inclusion of family and friends in all aspects of the care and treatment of forensic patients. For some patients and family members, this push to take on a “role” in care can be unhelpful, extremely stressful, and has constant implications for the potential delicate reparation of relationships. Based on work undertaken for over 20 years in forensic mental health settings, this paper explores the positive psychology approach to a dimensional model to family inclusion in mental health care that learns from family court work and allows for the maintenance of relationships to be at both proximal and Distil levels; to prevent the replication of abuse, decrease the need for falsehoods and assist the recovery of all. The model is based on allowing families to choose to not be involved or be involved in different ways if this is seen to be more helpful. It also allows patients to choose the level of potential involvement that they would find helpful, and for this to be reviewed at a timeframe agreed by all parties, rather than when the next survey is due or the patient has a significant care meeting. This paper is significant as there is a lack of research to support services to use a positive psychology approach to work in this area, the assumption that being asked to be involved must be positive for all seems naïve at best for this patient group. Work relating to the psychology of family can significantly contribute to the development of knowledge in this area. The development of a dimensional model will support choice within families and assist in the development of more honest and open relationships.

Keywords: family dynamics, forensic, mental disorder, positive psychology

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Authors: Dagem Alemayehu, Samson Gebersilassie, Jan Frank

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Climate change is impacting nutrition through reducing food quantity and access, limiting dietary diversity, and decreased nutritional food content as well as strongly affecting seasonal rainfall in Ethiopia. Nevertheless, only a few data is available on the impacts of seasonality in Infant, and Young Child Feeding (IYCF) practices undernutrition among 6-23 months old children in different agro-ecological zones of poor resource settings of Ethiopia. Methods: Socio-demographic, anthropometry, and IYCF indicators were assessed in the harvest and lean seasons among children aged 6–23 months of age randomly selected from rural villages of lowland and midland agro-ecological zones. Results: Child stunting and underweight increased from prevalence of 32.8 % and 23.9 % (lowland &midland respectively) in the lean season to 36.1% and 33.8 % harvest seasons, respectively. The biggest increase in the prevalence of stunting and underweight between harvest and lean seasons was noted in the lowland zone. Wasting decreased from 11.6% lean to 8.5% harvest, with the biggest decline recorded in the midland zone. Minimum meal frequency, minimum acceptable diet, and poor dietary diversity increased considerably in harvest compared to a lean season in the lowland zone. Feeding practices and maternal age were predictors of wasting, while women's dietary diversity and children's age was a predictor of child dietary diversity in both seasons. Conclusion: There is seasonal variation in undernutrition and IYCF practices among children 6-23 months of age with more pronounced effect lowland agro-ecological zone.

Keywords: agroecology, seasonality, stunting, wasting

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Authors: Achilles Kameas, Eleni Georgakakou, Anna Lisa Amodeo, Aideen Quilty, Aisling Malone, Roberta Albertazzi, Moises Carmona, Concetta Esposito, Ruben David Fernandez Carrasco, Carmela Ferrara, Francesco Garzillo, Mojca Pusnik, Maria Cristina Scarano

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While researchers, especially in academia, study and research the phenomena of inclusion of sexual minority and gender marginalized groups, seldom the European Higher Education Institutions (HEI) act on lowering the cultural and educational barriers to their proactive inclusion. The challenge in European HEIs is that gender, and sexual orientation discrimination remains an issue not adequately addressed. Following a mixed methods research design of quantitative and qualitative research techniques and tools, which is applied in five (5) European countries (Italy, Greece, Ireland, Slovenia, and Spain) and that combines desk research, evaluation, and weighting processes for a Matrix-based on Objective indicators and Survey for students and staff of the HEI to gauge the perception of inclusiveness in the HEI context, XENIA HEI Inclusiveness Index is an instrument that will allow universities to gauge and assess their inclusiveness in the domain of discrimination and exclusion based on gender identity and sexual orientation. The index will allow capturing the depth and reach of policies, programmes, and initiatives of HEIs in tackling the phenomena and dynamics of exclusion of LGBT+ (lesbian, gay, bisexual, trans, and other marginalized groups on the basis of gender and sexual identity) and cisgender women exposed to the risk of discrimination.

Keywords: gender identity, higher education, LGBT+ rights, XENIA inclusiveness index

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Authors: Sukriti Sabharwal, Sonali Bhattar, Shikhar Saxena

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Introduction: COVID-19 molecular diagnostic laboratory is the cornerstone of the COVID-19 disease diagnosis as the patient’s treatment and management protocol depend on the molecular results. For this purpose, it is extremely important that the laboratory conducting these results adheres to the quality management processes to increase the accuracy and validity of the reports generated. We started our own molecular diagnostic setup at the onset of the pandemic. Therefore, we conducted this study to generate our quality management data to help us in improving on our weak points. Materials and Methods: A total of 14561 samples were evaluated by the retrospective observational method. The quality variables analysed were classified into pre-analytical, analytical, and post-analytical variables, and the results were presented in percentages. Results: Among the pre-analytical variables, sample leaking was the most common cause of the rejection of samples (134/14561, 0.92%), followed by non-generation of SRF ID (76/14561, 0.52%) and non-compliance to triple packaging (44/14561, 0.3%). The other pre-analytical aspects assessed were incomplete patient identification (17/14561, 0.11%), insufficient quantity of samples (12/14561, 0.08%), missing forms/samples (7/14561, 0.04%), samples in the wrong vials/empty VTM tubes (5/14561, 0.03%) and LIMS entry not done (2/14561, 0.01%). We are unable to obtain internal quality control in 0.37% of samples (55/14561). We also experienced two incidences of cross-contamination among the samples resulting in false-positive results. Among the post-analytical factors, a total of 0.07% of samples (11/14561) could not be dispatched within the stipulated time frame. Conclusion: Adherence to quality control processes is foremost for the smooth running of any diagnostic laboratory, especially the ones involved in critical reporting. Not only do the indicators help in keeping in check the laboratory parameters but they also allow comparison with other laboratories.

Keywords: laboratory quality management, COVID-19, molecular diagnostics, healthcare

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Authors: Rasha Shoumar

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Background: Since the onset of the Syria crisis in 2011, Jordan has hosted many Syrian refugees, many of which are residing in urban and rural areas. Vulnerability of refugees has increased due to the COVID-19 pandemic, adding to their already existing challenge in access to medical services, rendering them vulnerable to the complications of untreated medical conditions and amplifying their risk for severe COVID-19 disease. To improve health outcomes and access to health care services in a COVID-19 context, IOM (The International Organization for Migration) provided health services including awareness raising, direct primary health care through mobile teams and referrals to secondary services were extended to the vulnerable populations of refugees. Method: 6 community health volunteers were trained and deployed to different governorates to provide COVID-19 and non-communicable disease awareness and collect data rated to non-communicable disease and access to medical health services. Primary health care services were extended to 7 governorates through a mobile medical team, providing medical management. The collected Data was reviewed and analyzed. Results: 2150 refugees in rural areas were reached out by community health volunteers, out of which 78 received their medications through the Ministry of Health, 121 received their medications through different non-governmental organizations, 665 patients couldn’t afford buying any medications, 1286 patients were occasionally buying their medications when they were able to afford it. 853 patients received medications and follow up through IOM mobile clinics, the most common conditions were hypertension, diabetes, hyperlipidemia, anemia, heart disease, thyroid disease, asthma, seizures, and psychiatric conditions. 709 of these patients had more than 3 of the comorbidities. Multiple cases were referred for secondary and tertiary lifesaving interventions. Conclusion: Non communicable diseases are highly prevalent among refugee population in Jordan, access to medical services have proven to be a challenge in rural areas especially during the COVID-19 era, many of the patients have multiple uncontrolled medical conditions placing them at risk for complications and risk for severe COVID-19 disease. Deployment of mobile clinics to rural areas plays an essential role in managing such medical conditions, thus improving the continuum of health care approach, physical and mental wellbeing of refugees and reducing the risk for severe COVID-19 disease among this group, taking us one step forward toward universal health access.

Keywords: COVID-19, refugees, mobile clinics, primary health care

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