Search results for: community health workers

Authors: Amelia Morris, Lizzie Coles-Kemp, Will Jones

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This paper examines how community welfare initiatives transform how individuals use and experience an ostensibly universal welfare system. This paper argues that the digitalisation of welfare overlooks the complex reality of being unemployed or in low-wage work, and erects digital barriers to accessing welfare. Utilising analysis of ethnographic research in food banks and community groups, the paper explores the ways that Universal Credit has not abolished face-to-face support, but relocated it to unofficial sites of welfare. The apparent efficiency and simplicity of the state’s digital welfare apparatus, therefore, is produced not by reducing the ‘messiness’ of welfare, but by rendering it invisible within the digital framework. Using the analysis of the study’s data, this paper recommends three principles of service design that would render the messiness visible to the state.

Keywords: welfare, digitalisation, food bank, Universal Credit

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Authors: Morné Roman, Robert van Zyl, Nishanth Parus, Nishal Mahatho

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Leakage current monitoring for high voltage transmission line insulators is of interest as a performance indicator. Presently, to the best of our knowledge, there is no commercially available, clamp-on type, non-intrusive device for measuring leakage current on energised high voltage direct current (HVDC) transmission line insulators. The South African power utility, Eskom, is investigating the development of such a hand-held sensor for two important applications; first, for continuous real-time condition monitoring of HVDC line insulators and, second, for use by live line workers to determine if it is safe to work on energised insulators. In this paper, a DC leakage current sensor based on magnetic field sensing techniques is developed. The magnetic field sensor used in the prototype can also detect alternating current up to 5 MHz. The DC leakage current prototype detects the magnetic field associated with the current flowing on the surface of the insulator. Preliminary HVDC leakage current measurements are performed on glass insulators. The results show that the prototype can accurately measure leakage current in the specified current range of 1-200 mA. The influence of external fields from the HVDC line itself on the leakage current measurements is mitigated through a differential magnetometer sensing technique. Thus, the developed sensor can perform measurements on in-service HVDC insulators. The research contributes to the body of knowledge by providing a sensor to measure leakage current on energised HVDC insulators non-intrusively. This sensor can also be used by live line workers to inform them whether or not it is safe to perform maintenance on energized insulators.

Keywords: direct current, insulator, leakage current, live line, magnetic field, sensor, transmission lines

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Authors: Ashima Rai

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CATV transmission systems have altered from old cable based one-way analog video transmission to two ways hybrid fiber transmission. The use of optical fiber reduces the RF amplifiers in the transmission, high transmission power or lower fiber transmission losses are required to increase system capability. This paper evaluates and compares Distributed Feedback (DFB) laser and Vertical Cavity Surface Emitting Laser (VCSEL) for CATV transmission. The simulation results exhibit the better performer among both lasers taking into consideration the parameters chosen for evaluation.

Keywords: Distributed Feedback (DFB), Vertical Cavity Surface Emitting Laser (VCSEL), Community Access Television (CATV), Composite Second Order (CSO), Composite Triple Beat (CTB), RF

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Authors: Norshaffika I. Zaiedy Nor, Andrew P. Smith

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Background: Training is essential to develop individuals’ expertise to meet current and future job demands and to improve work performance. At the same time, individuals’ well-being is crucial to ensure that they can fully and positively carry out their daily duties. In addition to the studies that have examined what constitutes well-being and the factors behind it, many researchers have investigated the predictors of training effectiveness and transfer of training. However, there has been very little integration between them. This study was an attempt to bridge the gap between training effectiveness predictors and well-being. Purpose: This research paper aimed to investigate the association between well-being among employees and psychosocial characteristics, together with training variables. Training variables consist of motivation to learn; learning; implementation intention; and cognitive dissonance. Methodology: In total, 210 workers who had undergone various training programs completed an online survey measuring various psychosocial characteristics, four training variables, and level of well-being. Findings: The results showed that certain types of positive psychosocial characteristics (e.g., positive personality, positive work behaviors, positive work and resources) predict motivation to learn, learning and implementation intention. Meanwhile, negative psychosocial characteristics (e.g. negative work demands and resources, negative coping) predict cognitive dissonance. Also, all the training variables had a moderate to high correlation with well-being. However, after controlling other variables (age, gender, education and psychosocial characteristics), none of the training variables predicted well-being. Self-determination theory, cognitive dissonance theory, and the DRIVE model were used to explain these findings. Conclusion: As there is limited research on the integration of training variables with well-being, this study gives a new perspective in the field of both training and well-being. Further investigations are needed to examine the relationships between them.

Keywords: cognitive dissonance, implementation intention, learning, motivation to learn, psychosocial characteristics, well-being

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Authors: Wanida Suwunniponth

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The purposes of this research were to investigate the perceived of a cultural image and loyalty of tourists toward the attraction at Banglumphu neighborhood in Bangkok and to study the relationship of the cultural image of Banglumphu community and loyalty to visit this area of the tourists. This study employed both quantitative approach and qualitative approach. In a quantitative research, a questionnaire was used to collect data from 300 systematic sampled tourists who visited Banglumphu area and the correlation analysis were used to analyze data. The results revealed that the overall tourists’ point of view toward Banglumphu cultural image was at a good level which lifestyle had the best image, followed by value and belief, physical dimension, community identity, tradition, and local wisdom. In addition, the overall aspect of tourists’ loyalty including satisfaction, word of mouths, and revisiting were at good levels which word of mouths received the highest value, followed by revisiting, and satisfaction, respectively. In addition, the relationship between cultural image in aspect on lifestyle, tradition, local wisdom, belief, community identity and loyalty to visit Banglumphu in each aspect on satisfaction, word of mouths, and revisiting were moderately correlated at the significant level of 0.05, except physical dimension was not correlated with each aspect of tourists’ loyalty.

Keywords: cultural tourism, image, loyalty, revisit

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Authors: Dana R. Thomson, Catherine Linard, Sabine Vanhuysse, Jessica E. Steele, Michal Shimoni, Jose Siri, Waleska Caiaffa, Megumi Rosenberg, Eleonore Wolff, Tais Grippa, Stefanos Georganos, Helen Elsey

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The Sustainable Development Goals (SDGs) and Urban Health Equity Assessment and Response Tool (Urban HEART) identify dozens of key indicators to help local decision-makers prioritize and track inequalities in health outcomes. However, presentations and discussions at the International Conference on Urban Health (ICUH) 2017 suggested that additional indicators are needed to make decisions and policies. A local decision-maker may realize that malaria or road accidents are a top priority. However, s/he needs additional health determinant indicators, for example about standing water or traffic, to address the priority and reduce inequalities. Health determinants reflect the physical and social environments that influence health outcomes often at community- and societal-levels and include such indicators as access to quality health facilities, access to safe parks, traffic density, location of slum areas, air pollution, social exclusion, and social networks. Indicator identification and disaggregation are necessarily constrained by available datasets – typically collected about households and individuals in surveys, censuses, and administrative records. Continued advancements in earth observation, data storage, computing and mobile technologies mean that new sources of health determinants indicators derived from 'big data' are becoming available at fine geographic scale. Big data includes high-resolution satellite imagery and aggregated, anonymized mobile phone data. While big data are themselves not representative of the population (e.g., satellite images depict the physical environment), they can provide information about population density, wealth, mobility, and social environments with tremendous detail and accuracy when combined with population-representative survey, census, administrative and health system data. The aim of this paper is to (1) flag to data scientists important indicators needed by health decision-makers at the city and sub-city scale - ideally free and publicly available, and (2) summarize for local decision-makers new datasets that can be generated from big data, with layperson descriptions of difficulties in generating them. We include SDGs and Urban HEART indicators, as well as indicators mentioned by decision-makers attending ICUH 2017.

Keywords: health determinant, health outcome, mobile phone, remote sensing, satellite imagery, SDG, urban HEART

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Authors: Nicole Marella G. Tan, Al Joseph R. Molina, Raisa Celine R. Rosete, Soraya Elisse E. Escandor, Blythe N. Ke, Veronica Marie E. Ramos, Apolinario Ericson B. Berberabe, Jose Jonas D. del Rosario, Regina Pascua-Berba, Eileen Liesl A. Cubillan, Winlove P. Mojica

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Emergency risk and health communications play a vital role in any pandemic response. However, the Philippine General Hospital (PGH) lacked a system of information delivery that could effectively fulfill the hospital’s communication needs as a COVID-19 referral hospital. This study aimed to describe the establishment of a communication framework for information dissemination within a tertiary government hospital during the COVID-19 pandemic and evaluated the perceived usefulness of its outputs. This is a mixed quantitative-qualitative study with two phases. Phase 1 documented the formation and responsibilities of the Information Education Communication (IEC) Committee. Phase 2 evaluated its output and outcomes through a hospital-wide survey of 528 healthcare workers (HCWs) using a pre-tested questionnaire. In-depth explanations were obtained from five focused group discussions (FGD) amongst various HCW subgroups. Descriptive analysis was done using STATA 16 while qualitative data were synthesized thematically. Communication practices in PGH were loosely structured at the beginning of the pandemic until the establishment of the IEC Committee. The IEC Committee was well-represented by concerned stakeholders. Nine types of infographics tackled different aspects of the hospital’s health operations after thorough inputs from concerned offices. Internal and external feedback mechanisms ensured accurate infographics. Majority of the survey respondents (98.67%) perceived these as useful in their work or daily lives. FGD participants cited the relevance of infographics to their occupations, suggested improvements, and hoped that these efforts would be continued in the future. Sustainability and comprehensive reach were the main concerns in this undertaking. The PGH COVID-19 IEC framework was developed through trial and testing as there were no existing formal structures to communicate health risks and to properly direct the HCWs in the chaotic time of a pandemic. It is a continuously evolving framework which is perceived as useful by HCWs and is hoped to be sustained in the future.

Keywords: COVID-19, pandemic, health communication, infographics, social media

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Authors: Kelsey Fortin, Susan Harvey

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The intersection between hunger and health outcomes is beginning to gain traction among the research community. With new interventions focusing on collaborations between the medical and social service sectors, this study aimed to understand the acceptability and approach of a health coaching intervention within a county-wide Midwest food pantry. Through formative research, the study used mixed methods to review secondary data and conduct surveys and semi-structured interviews with food pantry clients (n=30), staff (n=7), and volunteers (n=10). Supplemental secondary data collected and provided by pantry staff were reviewed to understand the broader pantry context of clientele health and health behaviors, annual food donations, and current pantry programming. Results from secondary data showed that the broader pantry client population reported high rates of chronic disease, low consumption of fruits and vegetables, and poor self-reported health, while annual donation data showed increases in produce availability on pantry shelves. This disconnect between produce availability, client health status, and behaviors was supported in the current study, with pantry staff and volunteers reporting lack of knowledge in produce selection and preparation being amongst the most common client inquiries and barriers to healthy food selection. Additional supports to secondary data came from pantry clients in the current study through self-reported high rates of both individual (60%, n=18) and household (43%, n=13 ) disease diagnosis, low consumption of fruits and vegetables averaging zero to one servings of vegetables (67%, n=20) and fruits (47%, n=14) per day, and low levels of physical activity averaging zero to 120 minutes per week (67%, n=20). Further, pantry clients provided health coaching programmatic recommendations through interviews with feedback such as non-judgmental coaching, accountability measures, and providing participant incentives as considerations for future program design and approach. Volunteers and staff reported the need for client education in food preparation, basic nutrition and physical activity, and the need for additional health expertise to educate and respond to diet related nutrition recommendations. All three stakeholder groups supported hosting a health coach within the pantry to focused on nutrition, physical activity, and health programming, with one client stating, 'I am hoping it really works out [the health coaching program]. I think it would be great for something like this to be offered for someone that isn’t knowledgeable like me.' In conclusion, high rates of chronic disease, partnered with low food, nutrition, and physical activity literacy among pantry clients, demonstrates the need to address health behaviors. With all three stakeholder groups showing acceptability of a health coaching program, partnered with existing literature showing health coaching success as a behavior change intervention, further research should be conducted to pilot the design and implementation of such a program in the pantry setting.

Keywords: food insecurity, formative research, food pantries, health coaching, hunger and health

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Authors: Bernice Boafoaa Gyapong, Anne Jones, Sam Bassett, Janet Anderson

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Background: Maternal mortality and morbidity are global concerns, especially in sub-Saharan Africa (SSA). Most maternal mortalities occur at the time of birth. Quality intrapartum care is essential for improving maternal and newborn health outcomes. This scoping review aimed to assess and describe the quality of care during childbirth in SSA to provide an overview of the regional trend of the quality of intrapartum care, the challenges to quality care provision, and identify research gaps. Methods: A scoping review based on Arksey and O’Malley’s scoping review framework was conducted. Medline, CINAHL, PsycINFO, and maternal-infant databases were searched to identify the relevant studies for this review. A narrative summary was presented using themes based on the Donabedian structure, process, and outcome quality of care model. Results: A total of five hundred and forty-seven (547) publications were identified. Fifty-six (56) studies conducted in twenty (20) countries were included in the review. Thirty-four (34) were quantitative, sixteen (16) were qualitative, and six (6) were mixed methods. Most of the studies were related to the process component of quality of care. The provision of emergency obstetric care services, infrastructure, and availability of essential staff and equipment for perinatal care was inadequate in many facilities, particularly rural and peripheral health facilities. Many women experienced disrespectful care during childbirth. Routine care during labour and delivery was observed to be sub-optimal, yet some women reported high satisfaction with care. The use of health facilities for delivery was lower in health centres compared to hospitals. Conclusion: There are variations in the quality of maternity care provided in SSA. Intrapartum care quality is generally deficient in SSA, particularly in peripheral health facilities, health centres, and community clinics. Many of the quality-of-care issues identified are related to the structure component. Stakeholders must develop interventions that comprehensively address these interrelated issues to improve maternal healthcare quality, especially in primary healthcare facilities.

Keywords: quality of care, maternity health, Sub-Saharan Africa, intrapartum

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Authors: Dinka Fikadu, Mulugeta Shegaze

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Background: Currently in health facility, provider-initiated human immunodeficiency virus testing is the key entry point to prevention, care, treatment and support services, but most people remains unaware of their HIV status due to various reasons. In many high-prevalence countries, fewer than one in ten people with HIV are aware of their HIV status. HIV, the virus that causes AIDS, “acquired immunodeficiency syndrome, "has become one of the world’s most serious health and development challenges. Reaching individuals with HIV who do not know their serostatus is a global public health priority. Objective: To assess utilization of provider initiated HIV testing and counseling and associated factors among adult outpatient department patients. Methods: Health facility based cross sectional study was conducted among 392 adult outpatient department patients in Wonchi woreda from February 24 to March 24 /2013. The study participant was recruited patients from all adult outpatient department patients of all four public health facilities of wonchi woreda using systematic sampling. A structured interviewer administered questionnaire was used to elicit all important variables from the study participants and multiple logistic regression analysis was used. Result: A total of 371 adult outpatient department patients aged between 15 to 64 years were actively participated in the study and 291(78.4%) of them utilized provider initiated HIV testing and counseling and 80(21.6%) of them refused. Knowledge on HIV is low in the study population; majority of the participants didn’t have comprehensive knowledge (64.7%) and (35.3%) fail to reject misconception about means of HIV transmission and prevention. Utilization of provider-initiated HIV testing and counseling were associated with divorced/widowed marital status[AOR (95%CI) = 0.32(0.15, 0.69)], being male sex [AOR (95%CI) =1.81(1.01, 3.24)], having comprehensive knowledge on HIV [AOR (95%CI) =0.408(0.220,0.759)],having awareness about provider initiated HIV testing and counseling [AOR(95%CI) =2.89(1.48,5.66)] and receiving test on HIV before[AOR (95%CI)=4.15(2.30, 7.47)]. Conclusion: Utilization of provider initiated HIV testing and counseling among adult outpatient departments in wonchi woreda public health facility was [(78.4%)].Strengthening health information through mass media and peer education on HIV to address barrier to testing in the community such as low awareness on PITC, to increase up take of PITC among adult OPD patients.

Keywords: utilization, human immune deficiency, testing, provider, initiate

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Authors: Kim Anema, Matthias Max, Chris Zevenbergen

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For any flood risk manager the 'safety paradox' has to be a familiar concept: low probability leads to a sense of safety, which leads to more investments in the area, which leads to higher potential consequences: keeping the aggregated risk (probability*consequences) at the same level. Therefore, it is important to mitigate potential consequences apart from probability. However, when the (perceived) probability is so low that there is no recognizable trend for society to adapt to, addressing the potential consequences will always be the lagging point on the agenda. Preparedness programs fail because of lack of interest and urgency, policy makers are distracted by their day to day business and there's always a more urgent issue to spend the taxpayer's money on. The leading question in this study was how to address the social consequences of flooding in a context of (perceived) low probability. Disruptions of everyday urban life, large or small, can be caused by a variety of (un)expected things - of which flooding is only one possibility. Variability like this is typically addressed with resilience - and we used the concept of Community Resilience as the framework for this study. Drawing on face to face interviews, an extensive questionnaire and publicly available statistical data we explored the 'whole society response' to two recent urban flood events; the Brisbane Floods (AUS) in 2011 and the Dresden Floods (GE) in 2013. In Brisbane, we studied how the societal impacts of the floods were counteracted by both authorities and the public, and in Dresden we were able to validate our findings. A large part of the reactions, both public as institutional, to these two urban flood events were not fuelled by preparedness or proper planning. Instead, more important success factors in counteracting social impacts like demographic changes in neighborhoods and (non-)economic losses were dynamics like community action, flexibility and creativity from authorities, leadership, informal connections and a shared narrative. These proved to be the determining factors for the quality and speed of recovery in both cities. The resilience of the community in Brisbane was good, due to (i) the approachability of (local) authorities, (ii) a big group of ‘secondary victims’ and (iii) clear leadership. All three of these elements were amplified by the use of social media and/ or web 2.0 by both the communities and the authorities involved. The numerous contacts and social connections made through the web were fast, need driven and, in their own way, orderly. Similarly in Dresden large groups of 'unprepared', ad hoc organized citizens managed to work together with authorities in a way that was effective and speeded up recovery. The concept of community resilience is better fitted than 'social adaptation' to deal with the potential consequences of an (im)probable flood. Community resilience is built on capacities and dynamics that are part of everyday life and which can be invested in pre-event to minimize the social impact of urban flooding. Investing in these might even have beneficial trade-offs in other policy fields.

Keywords: community resilience, disaster response, social consequences, preparedness

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Authors: Meiliana, Achmad Eko Prabowo, Muhammad Fathan Mubina

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AFTA agreement in 2015 will bring a significant impact on Indonesian society. Indonesia’s people will face competition both in the economic, political, and cultural regionally among ten countries in ASEAN. Indonesia is a rich country in culture and has a large enough demographic bonus when compared to other ASEAN countries. Indonesia also has a lot of cultural enrichment in every its region. It’s mean, the role of society and culture of Indonesia's abundant if combined properly it will help Indonesia in the face of the ASEAN Economic Community (AEC) in 2015. This paper will discuss the role of one-stop culture workshop (OSCW) concept at Saung Angklung Udjo (SAU), a cultural tourist area of Angklung which is located in Bandung. OSCW is a concept that implemented a cultural tour in SAU that invites the visitor to engage in the cultural empowerment. In this research, we will answer how the concepts are applied by SAU can be an alternative to re-discover the potential of Indonesia in the face of the AEC 2015. Units of analysis that we used is among the programs, outcomes, and community empowerment. This study used a qualitative approach with in-depth interviews and observation. The finding of this study prove that OSCW concept is an opportunity for Indonesia to encourage a culture to go international. The concept of OSCW can really be used other communities to develop cultures of Indonesia so that later institutionalized culture that not only can be used as a tourist attraction but also as an educational laboratory for the community.

Keywords: OSCW concept, citizen empowerment, cultural tour, AEC 2015

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Authors: Sujith Gunawardhana

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The circular economy is a system in which resources and energy are derived from renewable sources, utilized efficiently, recycled, and reused to reduce waste, reduce nonrenewable resource consumption, and mitigate negative environmental impacts. However, it poses moral questions about sustainability, the environment, and societal issues. Many societies face challenges when implementing the circular economy, as the concept is still young. The equitable distribution of the advantages and costs of circularity should be ensured during implementation, as some communities, particularly disadvantaged or marginalized ones, may suffer unfairly disproportionately from the harmful effects of production and recycling facilities. Prioritizing the health and safety of workers, communities, and the environment is essential, and strict rules must be implemented to guard against harm. However, most underdeveloped countries need a legal safeguard for this situation. The ultimate objective of the circular economy is to improve social, environmental, and economic performance, but its implementation also requires consideration of the ethics of care and non-epistemic values. Those are often hindered in underdeveloped countries, as the availability of infrastructure and technology, affordability, and legislative framework are poor. To achieve long-term success in the circular economy, evaluating implementation steps and considering health, safety, environmental, and social risks is crucial. To implement the circular economy, respect ethics of care and non-epistemic values. Adopt Kantian Ethics and control technology design to ensure equal benefits for all involved. Ethical gaps may lead underdeveloped countries to generate social pressure against the circular economy.

Keywords: circular economy, ethics, values, sustainability

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Authors: C. Annapurna, Rao M. Srinivasa, Bhanu C. H. Vijaya, M. Sivalakshmi, Rao P. V. Surya

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A study on the community structure of meiobenthic fauna was undertaken during three cruises (June 2008, October 2008 and March 2009). Ten stations at depth between 10 and 40 m off Pudimadaka in Visakhapatnam (Lat.17º29′12″N and Long. 83º00′09″), East coast of India were investigated. Ninety species representing 3 major (meiofaunal) taxa namely foraminifera (2), copepoda (9), nematoda (58) and polychaeta (21) were encountered. Overall, meiofaunal (mean) abundance ranged from 2 individuals to 63 ind. 10cm-² with an average of 24.3 ind.10cm-2. The meiobenthic biomass varied between 0.135 to 0.48 mg.10cm-2 with an average 0.27 ± 0.12. On the whole, nematodes constituted 73.62% of the meiofauna in terms of numerical abundance. Shannon –Wiener index values were 2.053 ± 0.64 (June, 2008), 2.477 ± 0.177 (October 2008) and 2.2815±0.24 (March 2009). Multivariate analyses were used to define the most important taxon in nematode assemblages. Three nematode associations could be recognized off Pudimadaka coast, namely Laimella longicaudata, Euchromodora vulgaris and Sabatieria elongata assemblage (June, 2008); Catanema sp. and Leptosomatum sp. assemblage (October 2008) assemblage; Sabatieria sp. and Setosabatieria sp. assemblage (March 2009). Canonical correspondence analysis showed that temperature, organic matter, silt and mean particle diameter were important in controlling nematode community structure.

Keywords: meiofauna, marine nematode, biodiversity, community structure, India

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Authors: Mahmoud M. AbuAlSamen, Tamam El-Elimat

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Amid the economic crisis in Jordan, the Jordanian government has opted for a knowledge economy where education is promoted as a mean for economic development. University education usually comes at the expense of study-related stress that may adversely impact the health of students. Since stress is a latent variable that is difficult to measure, a valid tool should be used in doing so. The effort-reward imbalance (ERI) is a model used as a measurement tool for occupational stress. The model was built on the notion of reciprocity, which relates ‘effort’ to ‘reward’ through the mediating ‘over-commitment’. Reciprocity assumes equilibrium between both effort and reward, where ‘high’ effort is adequately compensated with ‘high’ reward. When this equilibrium is violated (i.e., high effort with low reward), this may elicit negative emotions and stress, which have been correlated to adverse health conditions. The theory of ERI was established in many different parts of the world, and associations with chronic diseases and the health of workers were explored at length. While much of the effort-reward imbalance was investigated in work conditions, there has been a growing interest in understanding the validity of the ERI model when applied to other social settings such as schools and universities. The ERI questionnaire was developed in Arabic recently to measure ERI among high school teachers. However, little information is available on the validity of the ERI questionnaire in university students. A cross-sectional study was conducted on 833 students in Jordan to measure the validity and reliability of the ERI questionnaire in Arabic among university students. Reliability, as measured by Cronbach’s alpha of the effort, reward, and overcommitment scales, was 0.73, 0.76, and 0.69, respectively, suggesting satisfactory reliability. The factorial structure was explored using principal axis factoring. The results fitted a five-solution model where both the effort and overcommitment were uni-dimensional while the reward scale was three-dimensional with its factors, namely being ‘support’, ‘esteem’, and ‘security’. The solution explained 56% of the variance in the data. The established ERI theory was replicated with excellent validity in this study. The effort-reward ratio in university students was 1.19, which suggests a slight degree of failed reciprocity. The study also investigated the association of effort, reward, overcommitment, and ERI with participants’ demographic factors and self-reported health. ERI was found to be significantly associated with absenteeism (p < 0.0001), past history of failed courses (p=0.03), and poor academic performance (p < 0.001). Moreover, ERI was found to be associated with poor self-reported health among university students (p=0.01). In conclusion, the Arabic ERI questionnaire is reliable and valid for use in measuring effort-reward imbalance in university students in Jordan. The results of this research are important in informing higher education policy in Jordan.

Keywords: effort-reward imbalance, factor analysis, validity, self-reported health

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Authors: Tatenda Manomano, Moreblessing Memory Ndonga

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In South Africa and the world over, despite an array of commendable policies to protect the rights of children, the situation on the ground indicates that HIV/AIDS continues to pose increasing challenges on the children’s’ right to education due to the death of their parents. This study sought to validate the home experiences of children that negatively impact on their right to education in South Africa with a case of HIV/AIDS orphans and vulnerable children (OVCs) in Amatole District. The study utilized a qualitative research method in collecting the feelings, views and attitudes of these children to establish the children’s home experiences. An interview guide with semi-structured questions was used to steer the one-on-one in-depth interviews with children from Parkside Primary School, Langa-Liphumile High School and one anonymous school in East London, Eastern Cape Province. 5 learners were purposively selected from each school and subjected to a one-on-one interview with the researcher. The researcher purposively selected one teacher per school, 2 members each from 3 community based organizations (CBOs) who were also subjected to a one-on-one in-depth interview. The findings indicated these negative experiences of the OVCs in their homes such as; attendance to a school was poor; academic performance was low; enrollment in schools was very low and abuse of these children was high. These researchers recommend for psychosocial support for these children to be placed in the schools; integration of HIV/AIDS programmes to target especially the OVCs; social workers should ensure that they regularly do home visits to these OVCs to establish whether the home circumstances these children are still conducive for them. It is hoped that the findings from this paper will be an asset that other researchers, policy makers, the government and NGOs/CBOs will take into consideration for the benefit of OVCs.

Keywords: orphaned and vulnerable children (OVCs), HIV, AIDS, home experiences

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Authors: Temesgen Kassa Getahun, Gezahegn Mamo, Beksisa Urge

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A cross-sectional study was conducted from December 2019 to May 2020 with the aim of determining the seroprevalence of brucellosis in dairy cows and their owners in the central highland of Oromia, Ethiopia. A total of 352 blood samples from dairy cattle, 149 from animal owners, and 17 from farm workers were collected and initially screened using the Rose Bengal Plate test and confirmed by the Complement Fixation test. Overall seroprevalence was 0.6% (95% CI: 0.0016–0.0209) in bovines and 1.2% (95% CI: 0.0032–0.0427) in humans. Market-based stock replacement (OR=16.55, p=0.002), breeding by artificial insemination (OR=7.58, p=0.05), and parturition pen (OR = 11.511, p=0.027) were found to be significantly associated with the seropositivity for Brucella infection in dairy cattle. Human housing (OR=1.8, p=0.002), contact with an aborted fetus (OR=21.19, p=0.017), drinking raw milk from non-aborted (OR=24.99, p=0.012), aborted (OR=5.72, p=0.019) and retained fetal membrane (OR=4.22, p=0.029) cows had a significant influence on human brucellosis. A structured interview question was administered to 284 respondents. Accordingly, most respondents had no knowledge of brucellosis (93.3%), and in contrast, 90% of them consumed raw milk. In conclusion, the present seroprevalence study revealed that brucellosis was low among dairy cattle and exposed individuals in the study areas. However, since there were no control strategies implemented in the study areas, there is a potential risk of transmission of brucellosis in dairy cattle and the exposed human population in the study areas. Implementation of a test and slaughter strategy with compensation to farmers is recommended, while in the case of human brucellosis, continuous social training and implementing one health approach framework must be applied.

Keywords: abortion, bovine brucellosis, human brucellosis, risk factors, seroprevalence

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Authors: Hsiu-Hua Cheng

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In recent years, the number of social-oriented virtual communities users has increased significantly. Corporate investment in advertising on social-oriented virtual communities increases quickly. With the gigantic commercial value of the digital market, competitions between virtual communities are keen. In this context, how to retain existing customers to continue using social-oriented virtual communities is an urgent issue for virtual community managers. This study employs the perspective of automaticity mechanism and combines the social embeddedness theory with the literature of involvement and habit in order to explore antecedents of users’ continuous usage on social-oriented virtual communities. The results can be a reference for scholars and managers of social-oriented virtual communities.

Keywords: continued usage, habit, social embeddedness, involvement, virtual community

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Authors: Jennifer F. Moore

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The wellness wheel as a tool for school growth and change is currently being piloted by a startup school in Chicago, IL. In this case study, members of the school community engaged in the appreciative inquiry process to plan their organizational development around the wellness wheel. The wellness wheel (comprised of physical, emotional, social, spiritual, environmental, cognitive, and financial wellness) is used as a planning tool by teachers, students, parents, and administrators. Through the appreciative inquiry method of change, the community is reflecting on their individual level of wellness and developing organizational structures to ensure the well being of children and adults. The goal of the case study is to test the appropriateness of the use of appreciative inquiry (as a method) and the wellness wheel (as a tool) for school growth and development. Findings of the case study will be realized by the conference. The research is in process now.

Keywords: education, schools, well being, wellness

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Authors: Omar Bendjimaa, Karzabi Abdelatif

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Small and medium enterprises have witnessed several developments in recent years thanks to the policies and programs of support given by the state, and that is due to their importance in local and national development. Nevertheless, the success and development of these firms depends on a number of factors, especially the human element, for instance, the culture of the manager has its origin in the culture of the community and is of crucial influence in these firms. In fact, this culture is nothing more than a set of values, perceptions, beliefs, symbols and practices repeated, in addition to the knowledge it has received from the readings and the modern means of education. All these factors have an impact on the effectiveness of governance, its resolutions, instructions and performance of its function as a manager of a medium or small enterprise is inevitably affected by these cultural values, it is the driving force, the leader, and the observer at the same time.

Keywords: small and medium enterprises, the culture of the manager, the culture of the community, values, perceptions, beliefs, symbols, performance

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Authors: Md. Omar Bin Harun Khan

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The collapse of the infamous Rana Plaza, a multi-storeyed commercial building in Savar, near Dhaka, Bangladesh has brought with it a plethora of positive and negative consequences. Bangladesh being a key player in the export of clothing, found itself amidst a wave of economic upheaval following this tragic incident that resulted in numerous Bangladeshis, most of whom were factory workers. This paper compares the consequences that the country’s Ready Made Garments (RMG) sector is facing now, two years into the incident. The paper presents a comparison of statistical data from study reports and brings forward perspectives from all dimensions of Labour, Employment and Industrial Relations in Bangladesh following the event. The paper brings across the viewpoint of donor organizations and donor countries, the impacts of several initiatives taken by foreign organizations like the International Labour Organization, and local entities like the Bangladesh Garment Manufacturers and Exporters Association (BGMEA) in order to reinforce compliance and stabilize the shaky foundation that the RMG sector had found itself following the collapse. Focus of the paper remains on the stance taken by the suppliers in Bangladesh, with inputs from buying houses and factories, and also on the reaction of foreign brands. The paper also focuses on the horrific physical, mental and financial implications sustained by the victims and their families, and the consequent uproar from workers in general regarding compliance with work safety and workers’ welfare conditions. The purpose is to get across both sides of the scenario: the economic impact that suppliers / factories/ sellers/ buying houses/exporters have faced in Bangladesh as a result of complete loss of reliability on them regarding working standards; and also to cover the aftershock felt on the other end of the spectrum by the importers/ buyers, particularly the foreign entities, in terms of the sudden accountability of being affiliated with non- compliant factories. The collapse of Rana Plaza has received vast international attention and strong criticism. Nevertheless, the almost immediate strengthening of labourrights and the wholesale reform undertaken on all sides of the supply chain, evidence a move of all local and foreign stakeholders towards greater compliance and taking of precautionary steps for prevention of further disasters. The tragedy that Rana Plaza embodies served as a much-needed epiphany for the soaring RMG Sector of Bangladesh. Prompt co-operation on the part of all stakeholders and regulatory bodies now show a move towards sustainable development, which further ensures safeguarding against any future irregularities and pave the way for steady economic growth.

Keywords: economy, employment standards, Rana Plaza, RMG

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Authors: Audrey Hudson

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In 2020, educational field trips went virtual for all students. At the Art Gallery of Ontario (AGO) in Canada, our solution was to create a virtual school program that addressed three pillars of access—economic, geographic and cultural—with art at the center. Now, at the close of three years, we have reached 1.6 million students! Exponentially more than we have ever welcomed for onsite school visits. In 2022, we partnered with the Museum of Modern Art (MoMA), the Hong Kong University Museum and the National Gallery of Singapore, which has pushed the boundaries of art education into the expanse of the global community. Looking forward to our fourth year of the program, we are using the platform of technology to expand our program of art, access and learning to a global platform. In 2023/24, we intend to connect across more borders to expand the pedagogical benefits of art education for a global community. We invite you to listen to how you can join this journey.

Keywords: technology, museums, art education, pedagogy

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Authors: Maryam Alkhalosi, Ahmad Naddaf, Rana Alani

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Qatar National Library has its main accounts on social media, which presents the general image of the library and its daily news. A paper will be presented based on a case study researching the outcome of having a separate Instagram account led by librarians, not the Communication Department of the library. The main purpose of the librarians-led account is to promote librarians’ services and events, such as research consultation, reference questions, community engagement programs, collection marketing, etc. all in the way that librarians think it reflects their role in the community. Librarians had several obstacles to help users understanding librarians' roles. As was noticed that Instagram is the most popular social media platform in Qatar, it was selected to promote how librarians can help users through a focused account to create a direct channel between librarians and users. Which helps librarians understand users’ needs and interests. This research will use a quantitative approach depending on the case study, librarians have used their case in the department of Research and learning to find out the best practices might help in promoting the librarians' services and reaching out to a bigger number of users. Through the descriptive method, this research will describe the changes observed in the numbers of community users who interact with the Instagram account and engaged in librarians’ events. Statistics of this study are based on three main sources: 1. The internal monthly statistics sheet of events and programs held by the Research and Learning Department. 2. The weekly tracking of the Instagram account statistics. 3. Instagram’s tools such as polls, quizzes, questions, etc. This study will show the direct effect of a librarian-led Instagram account on the number of community members who participate and engage in librarian-led programs and services. In addition to highlighting the librarians' role directly with the community members. The study will also show the best practices on Instagram, which helps reaching a wider community of users. This study is important because, in the region, there is a lack of studies focusing on librarianship, especially on contemporary problems and its solution. Besides, there is a lack of understanding of the role of a librarian in the Arab region. The research will also highlight how librarians can help the public and researchers as well. All of these benefits can come through one popular easy channel in social media. From another side, this paper is a chance to share the details of this experience starting from scratch, including the phase of setting the policy and guidelines of managing the social media account, until librarians reached to a point where the benefits of this experience are in reality. This experience had even added many skills to the librarians.

Keywords: librarian’s role, social media, instagram and libraries, promoting libraries’ services

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Authors: Nepton Kiani

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Dental decay is one of the most common chronic diseases worldwide and imposes significant costs annually on people and healthcare systems. Addressing this issue is among the important programs of the World Health Organization in the field of oral and dental disease prevention and health promotion. In this context, oral and dental health in vulnerable groups, especially pregnant women, is of greater importance due to the health maintenance of the mother and fetus. The aim of this study is to investigate the DMFT index and various factors affecting it in order to identify different factors influencing the process of dental decay and to take an effective step in reducing the progression of this disease, control, and prevention. In this cross-sectional descriptive study, 120 pregnant women attending Nepton Policlinica clinic in Malaga, Spain, were evaluated for the DMFT index and oral and dental hygiene. In this regard, interviews, precise observations, and data collection were used. Subsequently, data analysis was performed using SPSS software and employing correlation tests, Kruskal-Wallis, and Mann-Whitney tests. The DMFT index for pregnant women in three age groups 22-26, 27- 31, and 32-36 years was respectively 2.8, 4.5, and 5.6. The results of logistic regression analysis showed that demographic variables (age, education, job, economic status) and the frequency of brushing and flossing lead to preventive behavior up to 49.58 percent (P<0.05). Generally, the results indicated that oral and dental care during pregnancy is poor. Only a small number of pregnant women regularly used toothbrush and dental floss or visited the dentist regularly. On the other hand, poor performance in adopting oral and dental care was more observed in pregnant women with lower economic and educational status. The present study showed that raising the level of awareness and education on oral and dental health in pregnant women is essential. In this field, it is necessary to focus on conducting educational-care courses at the level of healthcare centers for midwives, healthcare personnel, and at the community level for families, to prevent and perform dental treatments before the pregnancy period

Keywords: Malaga, oral and dental health, pregnant women, Spain

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Authors: Kai Way Li, Lang Gan

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Slip &Fall are common in Taiwan. They could result in injuries and even fatalities. Official statistics indicate that more than 15% of all occupational incidences were slip/fall related. All the workers in Taiwan are required by the law to join the worker’s insurance program administered by the Bureau of Labor Insurance (BLI). The BLI is a government agency under the supervision of the Ministry of Labor. Workers claim with the BLI for insurance compensations when they suffer fatalities or injuries at work. Injuries statistics based on worker’s compensation claims were rarely studied. The objective of this study was to quantify the injury statistics and financial cost due to slip-fall incidences based on the BLI compensation records. Compensation records in the BLI during 2007 to 2013 were retrieved. All the original application forms, approval opinions, results for worker’s compensations were in hardcopy and were stored in the BLI warehouses. Xerox copies of the claims, excluding the personal information of the applicants (or the victim if passed away), were obtained. The content in the filing forms were coded in an Excel worksheet for further analyses. Descriptive statistics were performed to analyze the data. There were a total of 35,024 claims including 82 deaths, 878 disabilities, and 34,064 injuries/illnesses which were slip/fall related. It was found that the average losses for the death cases were 40 months. The total dollar amount for these cases paid was 86,913,195 NTD. For the disability cases, the average losses were 367.36 days. The total dollar amount for these cases paid was almost 2.6 times of those for the death cases (233,324,004 NTD). For the injury/illness cases, the average losses for the illness cases were 58.78 days. The total dollar amount for these cases paid was approximately 13 times of those of the death cases (1134,850,821 NTD). For the applicants/victims, 52.3% were males. There were more males than females for the deaths, disability, and injury/illness cases. Most (57.8%) of the female victims were between 45 to 59 years old. Most of the male victims (62.6%) were, on the other hand, between 25 to 39 years old. Most of the victims were in manufacturing industry (26.41%), next the construction industry (22.20%), and next the retail industry (13.69%). For the fatality cases, head injury was the main problem for immediate or eventual death (74.4%). For the disability case, foot (17.46%) and knee (9.05%) injuries were the leading problems. The compensation claims other than fatality and disability were mainly associated with injuries of the foot (18%), hand (12.87%), knee (10.42%), back (8.83%), and shoulder (6.77%). The slip/fall cases studied indicate that the ratios among the death, disability, and injury/illness counts were 1:10:415. The ratios of dollar amount paid by the BLI for the three categories were 1:2.6:13. Such results indicate the significance of slip-fall incidences resulting in different severity. Such information should be incorporated in to slip-fall prevention program in industry.

Keywords: epidemiology, slip and fall, social burden, workers’ compensation

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Authors: Ali Raza

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The dynamic landscape of communication has brought about significant advancements that intersect with the realms of public health and journalism. This abstract explores the evolving synergy between these fields, highlighting how their intersection has contributed to informed societies and improved public health outcomes. In the digital age, communication plays a pivotal role in shaping public perception, policy formulation, and collective action. Public health, concerned with safeguarding and improving community well-being, relies on effective communication to disseminate information, encourage healthy behaviors, and mitigate health risks. Simultaneously, journalism, with its commitment to accurate and timely reporting, serves as the conduit through which health information reaches the masses. Advancements in communication technologies have revolutionized the ways in which public health information is both generated and shared. The advent of social media platforms, mobile applications, and online forums has democratized the dissemination of health-related news and insights. This democratization, however, brings challenges, such as the rapid spread of misinformation and the need for nuanced strategies to engage diverse audiences. Effective collaboration between public health professionals and journalists is pivotal in countering these challenges, ensuring that accurate information prevails. The synergy between public health and journalism is most evident during public health crises. The COVID-19 pandemic underscored the pivotal role of journalism in providing accurate and up-to-date information to the public. However, it also highlighted the importance of responsible reporting, as sensationalism and misinformation could exacerbate the crisis. Collaborative efforts between public health experts and journalists led to the amplification of preventive measures, the debunking of myths, and the promotion of evidence-based interventions. Moreover, the accessibility of information in the digital era necessitates a strategic approach to health communication. Behavioral economics and data analytics offer insights into human decision-making and allow tailored health messages to resonate more effectively with specific audiences. This approach, when integrated into journalism, enables the crafting of narratives that not only inform but also influence positive health behaviors. Ethical considerations emerge prominently in this alliance. The responsibility to balance the public's right to know with the potential consequences of sensational reporting underscores the significance of ethical journalism. Health journalists must meticulously source information from reputable experts and institutions to maintain credibility, thus fortifying the bridge between public health and the public. As both public health and journalism undergo transformative shifts, fostering collaboration between these domains becomes essential. Training programs that familiarize journalists with public health concepts and practices can enhance their capacity to report accurately and comprehensively on health issues. Likewise, public health professionals can gain insights into effective communication strategies from seasoned journalists, ensuring that health information reaches a wider audience. In conclusion, the convergence of public health and journalism, facilitated by communication advancements, is a cornerstone of informed societies. Effective communication strategies, driven by collaboration, ensure the accurate dissemination of health information and foster positive behavior change. As the world navigates complex health challenges, the continued evolution of this synergy holds the promise of healthier communities and a more engaged and educated public.

Keywords: public awareness, journalism ethics, health promotion, media influence, health literacy

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Authors: Amrita Sen

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In the face of a growing insurgent movement and the perceived failure of the state and the market towards sustainable resource management, a range of decentralized forest management policies was formulated in the last two decades, which recognized the need for community representations within the statutory methods of forest management. The recognition conceded on the virtues of ecological sustainability and traditional environmental knowledge, which were considered to be the principal repositories of the forest dependent communities. The present study, in the light of empirical insights, reflects on the contemporary disjunctions between the preconceived communitarian ethic in environmentalism and the lived reality of forest based life-worlds. Many of the popular as well as dominant ideologies, which have historically shaped the conceptual and theoretical understanding of sociology, needs further perusal in the context of the emerging contours of empirical knowledge, which lends opportunities for substantive reworking and analysis. The image of the community appears to be one of those concepts, an identity which has for long defined perspectives and processes associated with people living together harmoniously in small physical spaces. Through an ethnographic account of the implementation of Joint Forest Management (JFM) in a forest fringe village in Sundarban, the study explores the ways in which the idea of ‘community’ gets transformed through the process of state-making, rendering the necessity of its departure from the standard, conventional definition of homogeneity and internal equity. The study necessitates an attention towards the anthropology of micro-politics, disaggregating an essentially constructivist anthropology of ‘collective identities’, which can render the visibility of political mobilizations plausible within the seemingly culturalist production of communities. The two critical questions that the paper seeks to ask in this context are: how the ‘local’ is constituted within community based conservation practices? Within the efforts of collaborative forest management, how accurately does the depiction of ‘indigenous environmental knowledge’, subscribe to its role of sustainable conservation practices? Reflecting on the execution of JFM in Sundarban, the study critically explores the ways in which the state ceases to be ‘trans-national’ and interacts with the rural life-worlds through its local factions. Simultaneously, the study attempts to articulate the scope of constructing a competing representation of community, shaped by increasing political negotiations and bureaucratic alignments which strains against the usual preoccupations with tradition primordiality and non material culture as well as the amorous construction of indigeneity.

Keywords: community, environmentalism, JFM, state-making, identities, indigenous

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Authors: Shailender Kumar

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Current health policy pronouncements in India advocate for insurance-based financing mechanism to achieve universal health coverage (UHC), while undermine the role of comprehensive healthcare provision system. UHC is achieved when all people receive the health services they need without suffering financial hardship. This study, using 68th & 71st NSS rounds data, examines their relative and combined strength in achieving the above objective. Health-insurance has been unsuccessful in reducing prevalence and catastrophic effects of out-of-pocket payment and even dismantle the effectiveness of traditional way of health financing system. Healthcare provision is the best way forward to enhance health and well-being of households in condition if India removes existing inadequacies and inequalities in service provision across districts/states and ensure free/low cost medicines/diagnostics to the citizens.

Keywords: health policy, demand-side financing, supply-side financing, incidence of health payment

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Authors: Awatef Ahmed Ben Ramadan, Aqsa Arshad

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Background: There is a huge Muslim migration movement to North America and Europe for several reasons, primarily refuge from war areas and partly to search for better work and educational chances. There are always concerns regarding first-Generation Immigrant women's health and computer literacy, an adequate understanding of the health systems, and the use of the existing healthcare technology and services effectively and efficiently. Language proficiency level, preference for cultural and traditional remedies, socioeconomic factors, fear of stereotyping, limited accessibility to health services, and general unfamiliarity with the existing health services and resources are familiar variables among these women. Aims: The current study aims to assess the health and digital literacy of first-generation Muslim women in Atlanta city. Also, the study aims to examine how the COVID-19 pandemic has encouraged the use of health information technology and increased technology awareness among the targeted women. Methods: The study design is cross-sectional correlational research. The study will be conducted to produce preliminary results that the investigators want to have to supplement an NIH grant application about leveraging information technology to reduce the health inequalities amongst the first-generation immigrant Muslim women in Atlanta City. The investigators will collect the study data in two phases using different tools. Phase one was conducted in June 2022; the investigators used tools to measure health and digital literacy amongst 42 first-generation immigrant Muslim women. Phase two was conducted in November 2022; the investigators measured the Knowledge, Attitude, and Practice (KAP) of using health information technology such as telehealth from a sample of 45 first-generation Muslim immigrant women in Atlanta; in addition, the investigators measured how the current pandemic has affected their KAP to use telemedicine and telehealth services. Both phases' study participants were recruited using convenience sampling methodology. The investigators collected around 40 of 18 years old or older first-generation Muslim immigrant women for both study phases. The study excluded Immigrants who hold work visas and second-generation immigrants. Results: At the point of submitting this abstract, the investigators are still analyzing the study data to produce preliminary results to apply for an NIH grant entitled "Leveraging Health Information Technology (Health IT) to Address and Reduce Health Care Disparities (R01 Clinical Trial Optional)". This research will be the first step of a comprehensive research project to assess and measure health and digital literacy amongst a vulnerable community group. The targeted group might have different points of view from the U.S.-born inhabitants on how to: promote their health, gain healthy lifestyles and habits, screen for diseases, adhere to health treatment and follow-up plans, perceive the importance of using available and affordable technology to communicate with their providers and improve their health, and help in making serious decisions for their health. The investigators aim to develop an educational and instructional health mobile application considering the language and cultural factors that affect immigrants' ability to access different health and social support sources, know their health rights and obligations in their communities, and improve their health behavior and behavior lifestyles.

Keywords: first-generation immigrant Muslim women, telehealth, COVID-19 pandemic, health information technology, health and digital literacy

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Authors: Shyam lamsal

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Introduction: Karnali Academy of Health Sciences (KAHS) has been established in 2011, by an Act of parliament of Nepal, in Jumla, to provide health services in easy way in backward areas, to produce skilled health professionals & conduct research. The backward areas mentioned in act of KAHS are Humla, Jumla, Kalikot, Dolpa, Mugu districts of Karnali zone, Jajarkot district of Bheri zone & Bajura, Baghang & Achham districts of Seti zone in Nepal occupying around 25 % of the total national geography. Backward area of Nepal is specific to having worst health indicators with life expectancy (47 years), HDI (0.35), Literacy rate (58%), global acute malnutrition (13%), crude birth rate (33.6), crude death rate (9.6), Total fertility rate (4.2), infant mortality rate (61.5 per 1000 live births), under five mortality rate (59 per 1000 live births) and maternal mortality ratio (400 per 1000 live births). History of health facilities in backward region: All the nine districts of this region have a district hospital with very few grass root level health manpower. Government of Nepal regularly deploys one or two medical officers to each district who generally are not regular to their care. Jumla district itself was having one medical officer before the establishment of KAHS. Development activities: Establishment of 100 bedded specialty teaching hospital with 10 medical officers and five specialists, accredited its own nursing school for running diploma nursing programme, started “Karnali health survey” which covers 55 thousand households of backward region, started community care and school health camps, planning phase completed for 300 bedded teaching hospital construction. Future Plan: Expansion of the teaching hospital to 300 beds within 3 years, start health assistant and bachelor midwifery course in 2015 AD, start bachelor in laboratory and bachelor in public health course in 2016 AD and start MBBS course in 2018 AD. Deploy the medical officers and family physicians to all the district hospitals within 3 years. KAHS provides reservation up to 45% students from backward region with the commitment to stay for at least five years of their service period. Conclusion: This institution may be the example for the rest of the world in providing nursing care, education in remote areas as well as the best model for nursing manpower retention in remote areas of developing countries.

Keywords: backward area, nursing school

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