Search results for: vulnerable population

Authors: Filiz Celik, Rachel Harrad, Rob Keasley, Paul Bennett

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The COVID-19 pandemic has posed a significant challenge to many, with some groups with particular vulnerability to adverse psychological impacts. These include those disadvantaged by mental ill health, either pre-existing or occurring during pregnancy or post-partum. Using a qualitative approach, the research aimed to identify the challenges posed by COVID-19 to women, their infants and families during the perinatal period and to suggest what further support can help alleviate the adverse mental health impact of COVID-19. 21 expectant and new mothers who were currently receiving support via a peri-natal mental health service participated in semi-structured interviews. In these interviews, participants explored the impact of changes in social circumstances and healthcare providers as a result of COVID-19 restrictions, with the resultant audio recordings transcribed and analyzed using Reflexive Thematic Analysis (RTA). Based on these accounts, it was concluded that women, their partners and potentially their infants experienced heightened peri-natal distress, and their experience at this time increased their risk for future mental health problems. Women described emerging as more vulnerable, owing to their role as primary caregivers during the perinatal period and also explained how social isolation and limited access to services meant protective buffers against mental health deterioration were reduced and the resources they needed in order to develop resilience were weakened. Although partners were invited to take part in the research, a sizeable volume of data could not be generated to fully assess the impact of the pandemic on a partner’s mental well-being. However, women expressed concerns about the paternal mental health of partners and husbands which invites us to be further vigilant to paternal mental health and associated experiences. Overall, these interviews serve to highlight and provide a voice to these women and their families who describe experiencing disadvantage at an already vulnerable time in their lives, as well as illustrating the need for services to prioritize the needs of this population when acute events strike, be those future pandemics or other disasters.

Keywords: patient experience, perinatal mental health, covid-19 pandemic, heightened anxiety, birth trauma, post-natal well-being

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Authors: Jason M. Hegenauer, Nicholas Fucci

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In the late 1990s, a major deinstitutionalization movement of elderly patients took place, since which, the design of long-term care facilities has not been adequately analyzed in the United States. Over the course of the last 25 years, major innovations in construction methods, technology, and medicine have been developed, drastically changing the landscape of healthcare architecture. In light of recent events, and the expected increase in elderly populations with the aging of the baby-boomer generation, it is evident that reconsideration of these facilities is essential for the proper care of aging populations. The global response has been effective in stifling this pandemic; however, widespread disease still poses an imminent threat to the human race. Having witnessed the devastation Covid-19 has reaped throughout nursing homes and long-term care facilities, it is evident that the current strategies for protecting our most vulnerable populations are not enough. Light renovation of existing facilities and previously overlooked considerations for new construction projects can drastically lower the risk at nursing homes and long-term care facilities. A reconfigured entry sequence supplements several of the features which have been long-standing essentials of the design of these facilities. This research focuses on several aspects identified as needing improvement, including indoor environment quality, security measures incorporated into healthcare architecture and design, and architectural mitigation strategies for sick building syndrome. The results of this study have been compiled as 'best practices' for the design of future healthcare construction projects focused on the health, safety, and quality of life of the residents of these facilities. These design strategies, which can easily be implemented through renovation of existing facilities and new construction projects, minimize risk of infection and spread of disease while allowing routine functions to continue with minimal impact, should the need for future lockdowns arise. Through the current lockdown procedures, which were implemented during the Covid-19 pandemic, isolation of residents has caused great unrest and worry for family members and friends as they are cut off from their loved ones. At this time, data is still being reported, leaving infection and death rates inconclusive; however, recent projections in some states list long-term care facility deaths as high as 60% of all deaths in the state. The population of these facilities consists of residents who are elderly, immunocompromised, and have underlying chronic medical conditions. According to the Centers for Disease Control, these populations are particularly susceptible to infection and serious illness. The obligation to protect our most vulnerable population cannot be overlooked, and the harsh measures recently taken as a response to the Covid-19 pandemic prove that the design strategies currently utilized for doing so are inadequate.

Keywords: building security, healthcare architecture and design, indoor environment quality, new construction, sick building syndrome, renovation

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Authors: Kalpana Gupta

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Sexually transmitted infections (STIs) are infections that are spread primarily through sexual contact. In our daily practice, we see gonorrhea, chancroid, syphilis, and chlamydial infections that can be cured, as well as HIV, genital herpes, HPV, and hepatitis B infections that cannot be cured but can be managed with available treatments. Many people in India are infected with Sexually transmitted diseases (STDs), and the figures are quite high because of a lack of awareness and communication, as well as a taboo against these diseases. Numerous taboos and associated stigma shape patients’ lives and have a significant impact on health care policies, medical research, and current issues in medical ethics. Current statistics emphasize the importance of delivering sex education to this important demographic promptly. The long-standing tradition of girls marrying very young, especially in rural areas, and often too much older men, causes a slew of STIs. Stigma and HIV have a cyclical relationship; people who experience stigma and discrimination are marginalized and made more vulnerable to HIV/STDs, while those living with HIV are more vulnerable to stigma and discrimination. As urban pressures have grown, so have slums - and they have fast become ideal breeding grounds for STDs. In developed countries, strict laws have been enacted requiring people suffering from STDs to seek immediate treatment as well as contact the health department. Unfortunately, because of the stigma associated with the disease, patients in India are reluctant to reveal the source of infection. With various schemes, India is attempting to promote sex education and awareness. For example, the Ministry of Health and Family Welfare developed the National Adolescent Health Programme (also known as the Rashtriya Kishor Swasthya Karyakram) in partnership with the United Nations Population Fund (UNFPA). Whereas, National AIDS Control Organisation was set up so that every person living with HIV has access to quality care and is treated with dignity and breaking all taboos. It becomes clear that research and healthcare policies will not be effective in assisting patients with STDs unless these "nonscientific" elements are taken into account.

Keywords: sexually transmitted diseases, sexually transmitted infections, taboo, stigma, HIV/STDs, sex education and awareness, treatment, quality care, medications, healthcare policies

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Authors: Rahim Ada, Ahmet Tamkoç

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The research was conducted in the “Randomized Complete Block Design” with three replications in research field of Agricultural Faculty, Selcuk University, Konya, Turkey. In study, a total of 9 Cephalaria syriaca promised lines (9, 37, 38, 42, Beyaz 4, 5 Beyaz, 13 Beyaz, 27 Beyaz, Başaklar 2), which were taken from Sivas population, and 1 population were evaluated in two growing seasons (2012-13 and 2013-14). According to the results, the highest plant height, first branch height, first head height, number of branches per plant, number of head per plant, head diameter,1000 seed weight, seed yield, oil content and oil yield were obtained respectively from Başaklar 2 (68.37 cm), Başaklar 2 (37.80 cm), Başaklar 2 (54.83 cm), 37 (7.73 number/plant), 42 (18.03 number/plant), 9 (10.30 mm), Başaklar 2 (19.33 g), 27 Beyaz (1254.2 kg ha-1), Başaklar 2 (28.77%), and 27 Beyaz (357.9 kg ha-1).

Keywords: Cephalaria syriaca, yield, oil, population

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Authors: Kelsey Kimball

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Generalized anxiety disorder (GAD) is a common mental health illness affecting approximately 10% of the perinatal population. Research examining cognitive behavioral therapy in this population has only recently become more prevalent though exploring this subject is long overdue. This research examines the impact of cognitive behavioral therapy (CBT) on GAD during the perinatal period. The aim of this project was to identify the most effective way to manage GAD during the perinatal period to provide clinicians with evidence-based methods of caring for this population’s mental health. The research was conducted using several databases to identify ten primary research articles involving anxiety management. A critique and a systematic review of the literature was done. The results of the systematic literature review suggested that CBT had a significant positive impact on perinatal anxiety. Three main themes were derived from the literature: CBT for managing GAD in the general population, CBT for managing GAD in the perinatal population, and CBT’s effect on worry and problematic behaviors in both populations. Nurse practitioners are central in improving access to and treatment of perinatal anxiety disorders.

Keywords: anxiety, cognitive behavioral therapy, nurse practitioner, perinatal

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Authors: Mediha B. Sılaydın Aydın, Emine D. Kahraman

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One of the important impacts of climate change is the sea level rise. Turkey is a peninsula, so the coastal areas of the country are threatened by the problem of sea level rise. Therefore, the urbanized coastal areas are highly vulnerable to climate change. At the aim of enhancing spatial resilience of urbanized areas, this question arises: What should be the priority intervention subject in the urban planning process for a given city. To answer this question, by focusing on the problem of sea level rise, this study aims to determine spatial vulnerability typologies and levels of Turkey coastal cities based on morphological, physical and social characteristics. As a method, spatial vulnerability of coastal cities is determined by two steps as level and type. Firstly, physical structure, morphological structure and social structure were examined in determining spatial vulnerability levels. By determining these levels, most vulnerable areas were revealed as a priority in adaptation studies. Secondly, all parameters are also used to determine spatial typologies. Typologies are determined for coastal cities in order to use as a base for urban planning studies. Adaptation to climate change is crucial for developing countries like Turkey so, this methodology and created typologies could be a guide for urban planners as spatial directors and an example for other developing countries in the context of adaptation to climate change. The results demonstrate that the urban settlements located on the coasts of the Marmara Sea, the Aegean Sea and the Mediterranean respectively, are more vulnerable than the cities located on the Black Sea’s coasts to sea level rise.

Keywords: climate change, coastal cities, vulnerability, urban land use planning

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Authors: Hakim Bachiri, Mohammed Znari, Moulay Abdeljalil Ait Baamranne

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Population characteristics of Atlas Barbary sheep (Ammotragus lervia lervia) were investigated 20 years following the 1999 introduction of 10 individuals into the fenced nature reserve of Amassine, High Atlas range, Morocco, for promoting wildlife watching and tourism. Population age-sex structure and density were determined in late winter-early spring during four consecutive years (2016-2019) by direct observation before the dispersal of the herd. In this latter case, the line transect distance sampling was successfully applied. Population size increased from 37 to 62 animals during the four-year study period; the maximal population size being 82 individuals recorded in 2006. An estimated population density ranged from 0.25 to 0.41 Barbary sheep/ha during the study period. The adult sex ratio varied from 91 to 67 per 100 females. The apparent birth rate was 14 to 73/100 females. Juveniles and subadults comprised 27-43% of the population, adult males 26-31% and adult females 29-45%. The survival rate from birth to 1 year of age approximated 35%, for adult males was estimated to average 69%/year. The obtained results would be helpful for developing sustainable population management and habitat restoration plan and assessing the feasibility of potential reintroduction/restocking in other areas of the Atlas range.

Keywords: atlas mountains, barbary sheep, demography, management

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Authors: T. M. Samuel, O. O. Aremu, I. O. Ismaila, L. I. Onu, B. O. Adetifa, S. E. Adegbite, O. O. Olokoshe

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The imperative of anthropometry in designing to fit cannot be overemphasized. Of essence is the variability of measurements among population for which data is collected. In this paper anthropometric data were collected for the design of gari-frying facility such that work system would be designed to fit the gari-frying population in the Southwestern states of Nigeria comprising Lagos, Ogun, Oyo, Osun, Ondo, and Ekiti. Twenty-seven body dimensions were measured among 120 gari-frying processors. Statistical analysis was performed using SPSS package to determine the mean, standard deviation, minimum value, maximum value and percentiles (2nd, 5th, 25th, 50th, 75th, 95th, and 98th) of the different anthropometric parameters. One sample t-test was conducted to determine the variation within the population. The 50th percentiles of some of the anthropometric parameters were compared with those from other populations in literature. The correlation between the worker’s age and the body anthropometry was also investigated.The mean weight, height, shoulder height (sitting), eye height (standing) and eye height (sitting) are 63.37 kg, 1.57 m, 0.55 m, 1.45 m, and 0.67 m respectively.Result also shows a high correlation with other populations and a statistically significant difference in variability of data within the population in all the body dimensions measured. With a mean age of 42.36 years, results shows that age will be a wrong indicator for estimating the anthropometry for the population.

Keywords: anthropometry, cassava processing, design to fit, gari-frying, workstation design

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Authors: Erick R. Bandala, Kebret Kebede, Nicole Johnson, Rebecca Murray, Destiny Green, John Mejia, Polioptro Martinez-Austria

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Summertemperature data from Clark County was collected and used to estimate two different heat-related indexes: the heat index (HI) and excess heat factor (EHF). These two indexes were used jointly with data of health-related deaths in Clark County to assess the effect of extreme heat on the exposed population. The trends of the heat indexes were then analyzed for the 2007-2016 decadeandthe correlation between heat wave episodes and the number of heat-related deaths in the area was estimated. The HI showed that this value has increased significantly in June, July, and August over the last ten years. The same trend was found for the EHF, which showed a clear increase in the severity and number of these events per year. The number of heat wave episodes increased from 1.4 per year during the 1980-2016 period to 1.66 per yearduring the 2007-2016 period. However, a different trend was found for heat-wave-event duration, which decreasedfrom an average of 20.4 days during the trans-decadal period (1980-2016) to 18.1 days during the most recent decade(2007-2016). The number of heat-related deaths was also found to increase from 2007 to 2016, with 2016 with the highest number of heat-related deaths. Both HI and the number of deaths showeda normal-like distribution for June, July, and August, with the peak values reached in late July and early August. The average maximum HI values better correlated with the number of deaths registered in Clark County than the EHF, probably because HI uses the maximum temperature and humidity in its estimation,whereas EHF uses the average medium temperature. However, it is worth testing the EHF of the study zone because it was reported to fit properly in the case of heat-related morbidity. For the overall period, 437 heat-related deaths were registered in Clark County, with 20% of the deaths occurring in June, 52% occurring in July, 18% occurring in August,and the remaining 10% occurring in the other months of the year. The most vulnerable subpopulation was people over 50 years old, for which 76% of the heat-related deaths were registered.Most of the cases were associated with heart disease preconditions. The second most vulnerable subpopulation was young adults (20-50), which accounted for 23% of the heat-related deaths. These deathswere associated with alcoholic/illegal drug intoxication.

Keywords: heat, health, hazards, workforce

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Authors: Medjadj Tarek, Ghribi Hayet

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This study aims to develop a flood sensitivity assessment tool using machine learning (ML) techniques and geographic information system (GIS). The importance of this study is integrating the geographic information systems (GIS) and machine learning (ML) techniques for mapping flood risks, which help decision-makers to identify the most vulnerable areas and take the necessary precautions to face this type of natural disaster. To reach this goal, we will study the case of the city of M'sila, which is among the areas most vulnerable to floods. This study drew a map of flood-prone areas based on the methodology where we have made a comparison between 3 machine learning algorithms: the xGboost model, the Random Forest algorithm and the K Nearest Neighbour algorithm. Each of them gave an accuracy respectively of 97.92 - 95 - 93.75. In the process of mapping flood-prone areas, the first model was relied upon, which gave the greatest accuracy (xGboost).

Keywords: Geographic information systems (GIS), machine learning (ML), emergency mapping, flood disaster management

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Authors: Xu Du, Aparna S. Varde

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In this research, we propose to conduct diagnostic and predictive analysis about the key factors and consequences of urban population relocation. To achieve this goal, urban simulation models extract the urban development trends as land use change patterns from a variety of data sources. The results are treated as part of urban big data with other information such as population change and economic conditions. Multiple data mining methods are deployed on this data to analyze nonlinear relationships between parameters. The result determines the driving force of population relocation with respect to urban sprawl and urban sustainability and their related parameters. Experiments so far reveal that data mining methods discover useful knowledge from the multicity urban data. This work sets the stage for developing a comprehensive urban simulation model for catering to specific questions by targeted users. It contributes towards achieving sustainability as a whole.

Keywords: data mining, environmental modeling, sustainability, urban planning

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Authors: S. Begum, T. Biswas, M. A. Islam

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The present research investigates the distribution and contamination of heavy metals in core sediments collected from three locations of the Sundarbans mangrove forest. In this research, quality of the analysis is evaluated by analyzing certified reference materials IAEA-SL-1 (lake sediment), IAEA-Soil-7, and NIST-1633b (coal fly ash). Total concentrations of 28 heavy metals (Na, Al, K, Ca, Sc, Ti, V, Cr, Mn, Fe, Co, Zn, Ga, As, Sb, Cs, La, Ce, Sm, Eu, Tb, Dy, Ho, Yb, Hf, Ta, Th, and U) have determined in core sediments of the Sundarbans mangrove by neutron activation analysis (NAA) technique. When compared with upper continental crustal (UCC) values, it is observed that mean concentrations of K, Ti, Zn, Cs, La, Ce, Sm, Hf, and Th show elevated values in the research area is high. In this research, the assessments of metal contamination levels using different environmental contamination indices (EF, Igeo, CF) indicate that Ti, Sb, Cs, REEs, and Th have minor enrichment of the sediments of the Sundarbans. The modified degree of contamination (mCd) of studied samples of the Sundarbans ecosystem show low contamination. The pollution load index (PLI) values for the cores suggested that sampling points are moderately polluted. The possible sources of the deterioration of the sediment quality can be attributed to the different chemical carrying cargo accidents, port activities, ship breaking, agricultural and aquaculture run-off of the area. Pearson correlation matrix (PCM) established relationships among elements. The PCM indicates that most of the metal's distributions have been controlled by the same factors such as Fe-oxy-hydroxides and clay minerals, and also they have a similar origin. The poor correlations of Ca with most of the elements in the sediment cores indicate that calcium carbonate has a less significant role in this mangrove sediment. Finally, the data from this research will be used as a benchmark for future research and help to quantify levels of metal pollutions, as well as to manage future ecological risks of the vulnerable mangrove ecosystem, the Sundarbans.

Keywords: contamination, core sediment, trace element, sundarbans, vulnerable

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Authors: Lakmali Anthony, Madeline Gillies

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Background: Colorectal cancer (CRC) is usually managed with surgical resection. Many of the outcomes traditionally used to define successful operative management, such as resection margin, do not adequately reflect patients’ experience. Patient-reported outcomes (PRO), such as Health-Related Quality of life (HRQoL), provide a means by which the impact of surgery for cancer can be reported in a patient-centered way. HRQoL has previously been shown to be impacted by psychosocial, behavioral and disease-specific characteristics. This exploratory cross-sectional study aims to; (1) describe postoperative HRQoL in patients who underwent primary resection in a regional Australian hospital; (2) describe the prevalence of anxiety, depression and clinically significant fear of cancer recurrence (FCR) in this population; and (3) identify demographic, psychosocial, disease and treatment factors associated with poorer self-reported HRQoL. Methods: Consecutive patients who had resection of colorectal cancer in a single regional Australian hospital between 2015 and 2022 were eligible. Participants were asked to complete a survey instrument designed to assess HRQoL, as well as validated instruments that assess several other psychosocial PROs hypothesized to be associated with HRQoL; emotional distress, fear of cancer recurrence, social support, dispositional optimism, body image and spirituality. Demographic and disease-specific data were also collected via medical record review. Results: Forty-six patients completed the survey. Clinically significant levels of fear of recurrence as well as emotional distress, were present in this group. Many domains of HRQoL were significantly worse than an Australian reference population for CRC. Demographic and disease factors associated with poor HRQoL included smoking and ongoing adjuvant systemic therapy. The primary operation was not associated with HRQoL; however, the operative approach (laparoscopic vs. open) was associated with HRQoL for these patients. All psychosocial factors measured were associated with HRQoL, including cancer worry, emotional distress, body image and dispositional optimism. Conclusion: HRQoL is an important outcome in surgery for both research and clinical practice. This study provides an overview of the quality of life in a regional Australian population of postoperative colorectal cancer patients and the factors that affect it. Understanding HRQoL and awareness of patients particularly vulnerable to poor outcomes should be used to aid the informed consent and shared decision-making process between surgeon and patient.

Keywords: surgery, colorectal, cancer, PRO, HRQoL

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Authors: Md. Royhanur Islam, Thomas Cansse, Md. Sahidul Islam, Atiqur Rahman Sunny

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The geographical location of Bangladesh makes it one of the most vulnerable countries to climate change. Climate-induced phenomena mainly affect the south-central region of Bangladesh (Laxmipur district) where they have begun to occur more frequently. The aim of the study was to identify the hydro-climatic factors that lead to weather-related disasters in the coastal areas and analyse the consequences of these factors on coastal livelihoods, with possible adaptation options using participatory rural appraisal (PRA) tools. The present study showed several disasters such as land erosion, depressions and cyclones, coastal flooding, storm surge, and precipitation. The frequency of these disasters is of a noticeable rate. Surveys have also discovered that land erosion is ongoing. Tidal water is being introduced directly into the mainland, and as a result of the salt intrusion, production capacity is declining. The coastal belt is an important area for fishing activities, but due to changed fishing times and a lack of Alternative Income Generating Activities (AIGAs), people have been forced to search for alternative livelihood options by taking both short-term and long-term adaptation options. Therefore, in order to increase awareness and minimize the losses, vulnerable communities must be fully incorporated into disaster response strategies. The government as well as national and international donor organizations should come forward and resolve the present situation of these vulnerable groups since otherwise, they will have to endure endless and miserable suffering due to the effects of climate change ahead in their lives.

Keywords: adaptation, community, fishery development, livelihood

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Authors: Justin A. Udie, Subhes C. Bhatthacharyya, Leticia Ozawa-Meida

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The impact of climate change is severe in the Niger Delta and critical oil and gas infrastructures are vulnerable. This is partly due to lack of specific impact assessment framework to assess impact indices on both existing and new infrastructures. The purpose of this paper is to develop a framework for the assessment of climate change impact on critical oil and gas infrastructure in the region. Comparative and documentary methods as well as analysis of frameworks were used to develop a flexible, integrated and conceptual four dimensional framework underpinning; 1. Scoping – the theoretical identification of inherent climate burdens, review of exposure, adaptive capacities and delineation of critical infrastructure; 2. Vulnerability assessment – presents a systematic procedure for the assessment of infrastructure vulnerability. It provides real time re-scoping, practical need for data collection, analysis and review. Physical examination of systems is encouraged to complement the scoped data and ascertain the level of exposure to relevant climate risks in the area; 3. New infrastructure – consider infrastructures that are still at developmental level. It seeks to suggest the inclusion of flexible adaptive capacities in original design of infrastructures in line with climate threats and projections; 4. The Mainstreaming Climate Impact Assessment into government’s environmental decision making approach. Though this framework is designed specifically for the estimation of exposure, adaptive capacities and criticality of vulnerable oil and gas infrastructures in the Niger Delta to climate burdens; it is recommended for researchers and experts as a first-hand generic and practicable tool which can be used for the assessment of other infrastructures perceived as critical and vulnerable. The paper does not provide further tools that synch into the methodological approach but presents pointers upon which a pragmatic methodology can be developed.

Keywords: adaptation, assessment, conceptual, climate, change, framework, vulnerability

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Authors: Mohsin Ali Baloch, Saira Baloch

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Objective: The aim of this study was to evaluate the levels of serum lipid profiles in Urban and Rural Population of Sindh, to indicate the existing risk of cardiovascular diseases. Material and Methods: Study was conducted at Liaquat University of Medical & Health Sciences, in the cities of Jamshoro and Hyderabad of Sindh. Blood samples from 300 healthy individuals were collected in fasting condition, out them 100 were from rural population, 100 were urban while 100 were used as control group. The biochemistry of these samples was obtained by the analysis of total Cholesterol, high density lipoprotein Cholesterol (HDL), low-density lipoprotein Cholesterol (LDL) and Triglycerides using kit method on Analyzer Clinical Chemistry. Results and Conclusion: Serum levels of total cholesterol, Triglycerides, and LDL cholesterol were significantly raised in the rural and urban males, whereas HDL cholesterol was decreased as compared to the Healthy controls that indicated significant risk of CVD. Urban population was with more risk of CVD and male gender in both groups was at more risk. The worst lipid profile in gender wise distribution was observed in male gender of urban population with highest Total Cholesterol/HDL Ratio while female gender also shown moderate risk of CVD with highest LDL/HDL Ratio.

Keywords: cardiovascular diseases, lipid profiles, urban and rural population, LDL/HDL Ratio

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Authors: Sabyasachi Behera, Shiv Kumar, Pramod Gautam, Anisur Rahman, Pawan Pathak, Rahul Bhadouria

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Background: The increasing proportion of population especially urban poor and vulnerable groups or groups with specific needs, with health indicators worse than their rural counterparts in India face various issues related with availability and quality of health care. The reasons are myriad, starting from information and awareness of the community, especially, in a scenario wherein the needs and challenges of floating and migrant urban populations remain poorly understood. Weak linkages between health care facilities and slum dwellers and vulnerable populations hinder the improvement of health services for urban poor. Method: To address this issue, TCIHC program is helping health department of Indore city of Madhya Pradesh to establish a referral mechanism with a dual approach: at both community and facility level. The former is based on the premise of ‘building social capital’, i.e. norms and networks within a community facilitating collective action, helps improve the demand and supply of health services at appropriate levels of care (Minus 2: Accredited Social Health Activist and Community Health Groups; Minus 1: Urban Health Nutrition Days; Zero: Urban Primary Health Center; Plus 1: secondary facility with BEmONC services; Plus 2: secondary facilities with CEmONC services; Plus 3: tertiary level facility) for the urban poor. The latter focuses on encouraging the provision of all services at various levels of service delivery points and stakeholders to function in a coordinated manner to ensure better health service availability and coverage in underserved slum areas. Results: This initiative has enhanced the utilization of community based, primary and secondary level services through defined referral pathways that are clearly known to a community dweller. Conclusion: An ideal referral mechanism should begin with referral at the community level wherein services of a frontline health care provider are accessed by them at their door-step, causing no delay in both understanding and decision on the health issues faced by them.

Keywords: levels of care, linkages, referral mechanism, service delivery

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Authors: Viktorija Voidogaitė

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Catholic education is based on the belief that every human being is created in the image and likeness of God. It is also influenced by the idea that the Kingdom of Heaven belongs to the humble and vulnerable. These principles emphasize the importance of serving the most vulnerable members of the Church community and promoting inclusivity without discrimination. This perspective emphasizes the need to protect the weakest members with compassion. However, realizing such an ideal in practice proves challenging, as the shortcomings and errors prevalent in any society often stem from the actions of Christians within that society. The evolution of these connections is observed throughout the historical development of Catholic education. In some European countries, Catholic education has become elitist, with limited room for inclusivity. This creates a conspicuous gap between the principles of the Evangelical community and elite Catholic schools and gymnasiums. Some schools appear to be most inclined to educate only those students who best align with their profile, leaving those needing assistance on the margins. As we advance into the third decade of the 21st century, there emerges a fundamental consideration: whether individuals who can assist the underprivileged and the infirm are being emphasized. Yet, it remains an open question whether these individuals will also possess the willingness and capability to construct a community or society that is inclusive and accessible to all.

Keywords: inclusion, Catholic education, inclusive education, becoming

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Authors: Surya Prasad Sharma, Suyash Katdare, Syed Ainul Hussain

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Human-induced factors contributed to the population decline of crocodylians in India which became evident by the mid-20th century when authorities forewarned the extinction risk for the crocodile and proposed regulation in the crocodile trade. The proposed action led to the enactment of national and international wildlife regulations to prohibit the trade-in of crocodile skins and parts. Subsequently, conservation translocation programs were initiated to restore the species in the wild through a 'head-start' approach. In India, the crocodile conservation program, which began in the early 1970s, has been one of India's longest-running conservation initiatives. The gharial (Gavialis gangeticus) population has benefitted, and the gharial number increased rapidly owing to these efforts. The immediate risk of extinction was averted as the gharial has recovered due to decades-long cumulative conservation efforts, the consideration of the genetic for monitoring the recovery of the recovered populations is still lacking. Hence, we assessed the genetic diversity of the Girwa gharial population in India using six polymorphic nuclear microsatellites loci and mitochondrial control region. The number of alleles per loci ranged between 2 to 5, and the allelic richness (Ar) was 2.67 ± 0.49, and the observed (Ho) and expected (He) heterozygosities were 0.42 ± 0.08 and 0.42 ± 0.09, respectively. The M-ratio yielded a value of (0.41 ± 0.16) lower than critical M, suggesting a genetic bottleneck in the Girwa population. We observed more mitochondrial control region haplotypes in the Girwa population than previously reported in the largest gharial population in the Chambal River. Overall, our study indicates that genetic diversity remains low despite the recovery in the Girwa population. Hence, we recommend a range-wide genetic assessment of gharial populations using high-throughput techniques to identify the source population and plan future translocation programs.

Keywords: conservation translocation, recovery, crocodile, bottleneck

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Authors: Firman Riyudha, Endrik Mifta Shaiful

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The spread of drug users is one kind of behavioral epidemiology that becomes a threat to every country in the world. This problem caused various crisis simultaneously, including financial or economic crisis, social, health, until human crisis. Most drug users are teenagers at school age. A new deterministic model would be constructed to determine the dynamics of the spread of drug users by considering level of education in a susceptible population. Based on the analytical model, two equilibria points were obtained; there were E₀ (zero user) and E₁ (endemic equilibrium). Existence of equilibrium and local stability of equilibria depended on the Basic Reproduction Ratio (R₀). This parameter was defined as the expected rate of secondary prevalence and primary prevalence in virgin population along spreading primary prevalence. The zero-victim equilibrium would be locally asymptotically stable if R₀ < 1 while if R₀ > 1 the endemic equilibrium would be locally asymptotically stable. The result showed that R₀ was proportional to the rate of interaction of each susceptible population based on educational level with the users' population. It is concluded that there was a need to be given a control in interaction, so that drug users population could be minimized. Numerical simulations were also provided to support analytical results.

Keywords: drugs users, level education, mathematical model, stability

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Authors: Mohammed Saleem Tariq

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The enthusiasm for gluten avoidance in a growing market is met by improvements in sensitive detection methods for analysing gluten content. Paradoxically, manufacturers employ no such systems in the production process but continue to market their product as gluten free, a significant risk posed to an undetermined coeliac population. The paper resonates with an immunological response that causes gastrointestinal scarring and villous atrophy with the conventional description of personal injury. The current developing regime in the UK however, it is discussed, has avoided creating specific rules to provide an adequate level of protection for this type of vulnerable ‘characteristic’. Due to the struggle involved with identifying an appropriate cause of action, this paper analyses whether a claim brought in misrepresentation, negligence and/or under the Consumer Protect Act 1987 could be sustained. A necessary comparison is then made with the approach adopted by the Americans with Disability Act 1990 which recognises this chronic disease as a disability. The ongoing failure to introduce a level of protection which matches that afforded to those who fall into any one of the ‘protected characteristics’ under the Equality Act 2010, is inconceivable given the outstanding level of legal vulnerability.

Keywords: coeliac, litigation, misrepresentation, negligence

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Authors: Maria Vargas Hernandez, Jose Rojas Suarez, Carmelo Dueñas Castell, Sandra Contreras, Camilo Bello, Diana Borre, Walter Anichiarico, Harold Vasquez, Eduard Perez, Jose Santacruz

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In the last two decades, there have been outbreaks of emerging infectious diseases, with an impact on both the general population and the obstetric population. These infections, which affect the general population, pose a high risk for adverse maternal and perinatal outcomes, taking into account that physiological and immunological changes that occur during pregnancy can increase their risk or severity. Among these, the pandemics of viral infections, Influenza A/H1N1 and SARS-CoV-2/COVID-19, stand out. In 2009, Influenza A/H1N1 infection (H1N1 2009pdm) affected approximately 3,110 obstetric patients, with data reported from 29 countries, including 1,625 (52.3%) cases that were hospitalized, 378 (23.3%) admissions to ICU and 130 (8%) deaths; and since the end of 2019, the Severe Acute Respiratory Syndrome - 2 (SARS-CoV-2) has been identified, causing the COVID-19 pandemic, with global mortality that is around 2-4% for the general population, and higher mortality in patients requiring admission to the intensive care unit. Its impact on the obstetric population is still unknown. Objectives: To evaluate the impact on maternal and perinatal outcomes of COVID-19 infection in reference to influenza A/H1N1 infection in the obstetric population. Methodology: Systematic review of the literature and meta-analysis. Results: Mortality from maternal infection with influenza A/H1N1 appears to be higher (8%) than mortality due to maternal infection with COVID-19 (3%). The rates of ICU admission, hospitalization, the requirement for invasive mechanical ventilation, and fetal death also appear to be higher in the maternal population with A/H1N1 infection, in reference to the maternal population with COVID-19 infection. Within perinatal outcomes, the admission to the neonatal ICU appears to be higher in the infants born to mothers with COVID-19 infection (28% vs. 15% for COVID-19 and A/H1N1, respectively). Conclusion: A/H1N1 infection in the obstetric population seems to be associated with a higher proportion of adverse outcomes in relation to COVID-19 infection. The actual impact of maternal influenza A/H1N1 infection on perinatal outcomes is unknown. More COVID-19 studies are needed to understand the impact of maternal infection on perinatal outcomes in this population.

Keywords: A/H1N1, COVID-19, maternal outcomes, perinatal outcomes

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Authors: Akiko Kondo, Akio Kondo

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We are facing serious problems related to a long-term depopulation and an aging society with a falling birth rate in Japan. In this situation, we are suffering from a shortfall in human resources as well as a shortage of workforce in rural regions. In addition, we are struggling with a protracted economic slump and excess concentration of population in the Tokyo Metropolitan area. It is an urgent national issue to consider how to live in this country and what kind of structure of society and administration policy is needed. It is necessary to clarify people’s desire for their way of living and social assistance to be provided. The aim of this study is to clarify the characteristics of regional issues and the degree of their seriousness in local municipalities of Japan. We conducted a questionnaire survey about regional agenda in all local municipalities in Japan. We obtained responses concerning the degree of seriousness of regional issues and degree of importance of policies. Based on the data gathered from the survey, it is apparent that many local municipalities are facing an aging population and declining population. We constructed a model to analyze factors for declining population. Using the model, it was clarified that a population’s age structure, job opportunities, and income level affect the decline of population. In addition, we showed the way of the evaluation of the state of a local municipality.

Keywords: evaluation, local municipality, regional analysis, regional issue

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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: Jinu Phonamontham

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Coronavirus, also referred to as COVID-19, is a virus caused by the SARS-Cov-2 virus. The pandemic has caused over 10 million cases and 500,000 deaths worldwide through the end of June 2020. In a previous study, HLA-DQA1*01:02 allele was associated with COVID-19 disease (p-value = 0.0121). Furthermore, there was a statistical significance between HLA- DQB1*06:02 and COVID-19 in the Italian population by Bonferroni’s correction (p-value = 0.0016). Nevertheless, there is no data describing the distribution of HLA alleles as a valid marker for prediction of COVID-19 in the Thai population. We want to investigate the prevalence of HLA-DQA1*01:02 and HLA-DQB1*06:02 alleles that are associated with severe COVID-19 in the Thai population. In this study, we recruited 200 healthy Thai individuals. Genomic DNA samples were isolated from EDTA blood using Genomic DNA Mini Kit. HLA genotyping was conducted using the Lifecodes HLA SSO typing kits (Immucor, West Avenue, Stamford, USA). The frequency of HLA-DQA1 alleles in Thai population, consisting of HLA-DQA1*01:01 (27.75%), HLA-DQA1*01:02 (24.50%), HLA-DQA1*03:03 (13.00%), HLA-DQA1*06:01 (10.25%) and HLA-DQA1*02:01 (6.75%). Furthermore, the distributions of HLA-DQB1 alleles were HLA-DQB1*05:02 (21.50%), HLA-DQB1*03:01 (15.75%), HLA-DQB1*05:01 (14.50%), HLA-DQB1*03:03 (11.00%) and HLA-DQB1*02:02 (8.25%). Particularly, HLA- DQA1*01:02 (29.00%) allele was the highest frequency in the NorthEast group, but there was not significant difference when compared with the other regions in Thais (p-value = 0.4202). HLA-DQB1*06:02 allele was similarly distributed in Thai population and there was no significant difference between Thais and China (3.8%) and South Korea (6.4%) and Japan (8.2%) with p-value > 0.05. Whereas, South Africa (15.7%) has a significance with Thais by p-value of 0.0013. This study supports the specific genotyping of the HLA-DQA1*01:02 and HLA-DQB1*06:02 alleles to screen severe COVID-19 in Thai and many populations.

Keywords: HLA-DQA1*01:02, HLA-DQB1*06:02, Asian, Thai population

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Authors: P. U. S. Peiris

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The butterflies are ecologically very important insects. The adults generally feed on nectar and are important as pollinators of flowering plants. However, these pollinators are under threat with their habitat loss. One reason for habitat loss is spread of invasive plants. However, there are even beneficial exotic plants which can directly support for Butterfly Conservation Action Plan of Sri Lanka by attracting butterflies for nectar. Stachytarpheta jamaicensis (L.) is an important nectar plant which attracts a diverse set of butterflies in higher number. It comprises a violet color inflorescence which last for about 37 hours where it attracted a peak of butterflies around 9.00am having around average of 15 butterflies. There were no butterflies in early and late hours where the number goes to very low values as 2 at 1.00pm. it was found that a diverse group of butterflies were attracted from around 15 species including 01 endemic species, 02 endemic subspecies and 02 vulnerable species. Therefore, this is a beneficial exotic plant that could be used in butterfly attraction and conservation however with adequate monitoring of the plant population.

Keywords: butterflies, exotic plants, pollinators, Stachytarpheta jamaicensis (L.)

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Authors: Luis F. Caballero-castro, Dirsa Feliciano, Daniela Novoa, Orlando Arroyo, Jesús D. Villalba-morales

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Colombia faces a critical challenge in seismic resilience due to the prevalence of informal housing, which constitutes approximately 70% of residential structures. More than 10 million Colombians (20% of the population), live in homes susceptible to collapse in the event of an earthquake. This, combined with the fact that 83% of the population is in intermediate and high seismic hazard areas, has brought serious consequences to the country. These consequences became evident during the 1999 Armenia earthquake, which affected nearly 100,000 properties and represented economic losses equivalent to 1.88% of that year's Gross Domestic Product (GDP). Despite previous efforts to reinforce informal housing through methods like externally reinforced masonry walls, alternatives related to seismic protection systems (SPDs), such as Buckling-Restrained Braces (BRB), have not yet been explored in the country. BRBs are reinforcement elements capable of withstanding both compression and tension, making them effective in enhancing the lateral stiffness of structures. In this study, the use of low-cost and easily installable BRBs for the retrofit of informal housing in Colombia was evaluated, considering the economic limitations of the communities. For this purpose, a case study was selected involving an informally constructed dwelling in the country, from which field information on its structural characteristics and construction materials was collected. Based on the gathered information, nonlinear models with and without BRBs were created, and their seismic performance was analyzed and compared through incremental static (pushover) and nonlinear dynamic analyses. In the first analysis, the capacity curve was identified, showcasing the sequence of failure events occurring from initial yielding to structural collapse. In the second case, the model underwent nonlinear dynamic analyses using a set of seismic records consistent with the country's seismic hazard. Based on the results, fragility curves were calculated to evaluate the probability of failure of the informal housings before and after the intervention with BRBs, providing essential information about their effectiveness in reducing seismic vulnerability. The results indicate that low-cost BRBs can significantly increase the capacity of informal housing to withstand earthquakes. The dynamic analysis revealed that retrofit structures experienced lower displacements and deformations, enhancing the safety of residents and the seismic performance of informally constructed houses. In other words, the use of low-cost BRBs in the retrofit of informal housing in Colombia is a promising strategy for improving structural safety in seismic-prone areas. This study emphasizes the importance of seeking affordable and practical solutions to address seismic risk in vulnerable communities in earthquake-prone regions in Colombia and serves as a model for addressing similar challenges of informal housing worldwide.

Keywords: buckling-restrained braces, fragility curves, informal housing, incremental dynamic analysis, seismic retrofit

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Authors: Sehrish Ather

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Introduction: To improve organizational achievements through the production of new knowledge, health policy and system research is the basic requirement. An aging population is always the source of the increased burden of chronic diseases, disabilities, mental illnesses, and other co-morbidities; therefore the provision of quality health care services to every group of the population should be achieved by making strong policy and system research for the betterment of health care system. Unfortunately, the whole world is lacking policies and system research for providing health care to their elderly population. Materials and Methods: A literature review of published studies on aging diseases was done, ranging from the year 2011-2018. Geriatric, population, health policy, system, and research were the key terms used for the search. Databases searched were Google Scholar, PubMed, Science Direct, Ovid, and Research Gate. Grey literature was searched from various websites, including IHME, Library of the University of Lahore, World Health Organization (Ageing and Life Course), and Personal communication with Neuro-physicians. After careful reviewing published and un-published information, it was decided to carry on with commentary. Results and discussion: Most of the published studies have highlighted the need to advocate the funders of health policy and stakeholders of healthcare system research, and it was detected as a major issue, research on policy and healthcare system to provide health care to 'geriatric population' was found as highly neglected area. Conclusion: It is concluded that physicians are more involved with the policy and system research regarding any type of diseases, but scientists and researchers of basic and social science are less likely to be involved in methods used for health policy and system research due to lack of funding and resources. Therefore ageing diseases should be considered as a priority, and comprehensive policy and system research should be initiated for diseases of the geriatric population.

Keywords: geriatric population, health care system, health policy, system research

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Authors: Daniel Fundi Murithi

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Missing data is a real bane in many surveys. To overcome the problems caused by missing data, partial deletion, and single imputation methods, among others, have been proposed. However, problems such as discarding usable data and inaccuracy in reproducing known population parameters and standard errors are associated with them. For regression and stochastic imputation, it is assumed that there is a variable with complete cases to be used as a predictor in estimating missing values in the other variable, and the relationship between the two variables is linear, which might not be realistic in practice. In this project, we estimate population total in presence of missing values in two-phase sampling. Instead of regression or stochastic models, non-parametric model based regression model is used in imputing missing values. Empirical study showed that nonparametric model-based regression imputation is better in reproducing variance of population total estimate obtained when there were no missing values compared to mean, median, regression, and stochastic imputation methods. Although regression and stochastic imputation were better than nonparametric model-based imputation in reproducing population total estimates obtained when there were no missing values in one of the sample sizes considered, nonparametric model-based imputation may be used when the relationship between outcome and predictor variables is not linear.

Keywords: finite population total, missing data, model-based imputation, two-phase sampling

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Authors: Mohamed Hamed

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Population studies, essentially deals with the size, growth, and distribution of the population in a given area. Size, growth, and distribution are determined by three major factors, which are reproduction, mortality, and migration. Of these factors, reproduction is a potent socio-demographic force in vital process of population growth. It is a major component of population growth, and has crucial role in population dynamic, because it measures the rate at which a population increased. In fact the most striking feature of human reproduction is its variation. Its levels are vary widely among nations, countries, geographic regions, ethnic. The variations of reproductive behaviour among married women have been empirically documented in a large numbers of countries. For instance, many researchers in developing and developed countries investigated the differential of reproductive behaviour among married women. Most of these studies found that reproductive behaviour is strongly influenced by the socioeconomic and biological factors.Such as education, income, employment of women, marriage pattern, age at marriage, contraceptive use, education, and employment. However, the above socioeconomic and biological factors are determined by cultural factors surrounded by married women. So, this study is going to find out the effect of culture on reproductive behaviour among married women in Sudan, a case of Shendi town.

Keywords: fertilty pattern, sudan, shendi town, factors affecting reproductive behaviour, married women

Procedia PDF Downloads 281