Search results for: maternal and child health services
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 12971

Search results for: maternal and child health services

11171 Developing Geriatric Oral Health Network is a Public Health Necessity for Older Adults

Authors: Maryam Tabrizi, Shahrzad Aarup

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Objectives- Understanding the close association between oral health and overall health for older adults at the right time and right place, a person, focus treatment through Project ECHO telementoring. Methodology- Data from monthly ECHO telementoring sessions were provided for three years. Sessions including case presentations, overall health conditions, considering medications, organ functions limitations, including the level of cognition. Contributions- Providing the specialist level of providing care to all elderly regardless of their location and other health conditions and decreasing oral health inequity by increasing workforce via Project ECHO telementoring program worldwide. By 2030, the number of adults in the USA over the age of 65 will increase more than 60% (approx.46 million) and over 22 million (30%) of 74 million older Americans will need specialized geriatrician care. In 2025, a national shortage of medical geriatricians will be close to 27,000. Most individuals 65 and older do not receive oral health care due to lack of access, availability, or affordability. One of the main reasons is a significant shortage of Oral Health (OH) education and resources for the elderly, particularly in rural areas. Poor OH is a social stigma, a thread to quality and safety of overall health of the elderly with physical and cognitive decline. Poor OH conditions may be costly and sometimes life-threatening. Non-traumatic dental-related emergency department use in Texas alone was over $250 M in 2016. Most elderly over the age of 65 present with at least one or multiple chronic diseases such as arthritis, diabetes, heart diseases, and chronic obstructive pulmonary disease (COPD) are at higher risk to develop gum (periodontal) disease, yet they are less likely to get dental care. In addition, most older adults take both prescription and over-the-counter drugs; according to scientific studies, many of these medications cause dry mouth. Reduced saliva flow due to aging and medications may increase the risk of cavities and other oral conditions. Most dental schools have already increased geriatrics OH in their educational curriculums, but the aging population growth worldwide is faster than growing geriatrics dentists. However, without the use of advanced technology and creating a network between specialists and primary care providers, it is impossible to increase the workforce, provide equitable oral health to the elderly. Project ECHO is a guided practice model that revolutionizes health education and increases the workforce to provide best-practice specialty care and reduce health disparities. Training oral health providers for utilizing the Project ECHO model is a logical response to the shortage and increases oral health access to the elderly. Project ECHO trains general dentists & hygienists to provide specialty care services. This means more elderly can get the care they need, in the right place, at the right time, with better treatment outcomes and reduces costs.

Keywords: geriatric, oral health, project echo, chronic disease, oral health

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11170 Utilization of Long Acting Reversible Contraceptive Methods, and Associated Factors among Female College Students in Gondar Town, Northwest Ethiopia, 2018

Authors: Woledegebrieal Aregay

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Introduction: Family planning is defined as the ability of individuals and couples to anticipate and attain their desired number of children and the spacing and timing of their births. It is part of a strategy to reduce poverty, maternal, infant and child mortality; empowers women by lightening the burden of excessive childbearing. Family planning is achieved through the use of different contraceptive methods among which the most effective method is modern family planning methods like Long-Acting Reversible Contraceptive (LARCs) which are IUCD and Implant and these methods have multiple advantages over other reversible methods. Most importantly, once in place, they do not require maintenance and their duration of action is long, ranging from 3 to10 years. Methods: An institutional-based cross-sectional study was conducted in Gondar town among female college students from April-May. A simple random sampling technique was employed to recruit a total of 1166 study subjects. Descriptive variables were computed for all predictors & dependent variables. The presence of an association between covariates & LARC use was observed by two tables’ findings using the chi-square test. Bivariate logistic regression was conducted to identify all possible factors affecting LARC utilization & its crude Odds Ratio, 95% Confidence Interval (CI) & P-value was observed. A multivariable logistic regression model was developed to control possible confounding variables. Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) &P-values will be computed to identify significantly associated factors (P < 0.05) with LARC utilization. Result: Utilization of LARCs was 20.4%, the most common is Implant 86(96.5%), and followed by Intra-Uterine Contraceptive Device (IUCD) 3(3.5%). The result of the multivariate analysis revealed that the significant association of marital status of the respondent on utilization of LARC [AOR 3.965(2.051-7.665)], discussion of the respondent about LARC utilization with the husband/boyfriend [AOR 2.198(1.191-4.058)], and attitude of the respondent on implant was found to be associated [AOR 0.365(0.143-0.933)].Conclusion: The level of knowledge and attitude in this study was not satisfactory, the utilization of long-acting reversible contraceptives among college students was relatively satisfactory but if the knowledge and attitude of the participant has improved the prevalence of LARC were increased.

Keywords: utilization, long-acting reversible contraceptive, Ethiopia, Gondar

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11169 Implementing a Mobility Platform to Connect Hubs in Rural Areas

Authors: E. Neidhardt

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Mobility is not only an aspect of personal freedom, but for many people mobility is also a requirement to be able to satisfy the needs of daily life. They must buy food, get to work, or go to the doctor. Many people are dependent on public transport to satisfy their needs. Especially in rural areas with a low population density this is difficult. In these areas it is often not cost-effective to provide public transport with sufficient coverage and frequency. Therefore, the available public transport is unattractive. As a result, people use their own car, which is not desirable from a sustainable point of view. Children and some elderly people also do not have this option. Sometimes people organize themselves and volunteer transport services are created, which function similarly to the demand-oriented taxis. With a platform for demand-oriented transport, we want to make the available public transport more usable and attractive by linking scheduled transport with voluntary transport services.

Keywords: demand-oriented, HubChain, living lab, public transport

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11168 Transformation of Health Communication Literacy in Information Technology during Pandemic in 2019-2022

Authors: K. Y. S. Putri, Heri Fathurahman, Yuki Surisita, Widi Sagita, Kiki Dwi Arviani

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Society needs the assistance of academics in understanding and being skilled in health communication literacy. Information technology runs very fast while health communication literacy skills in getting health communication information during the pandemic are not as fast as the development of information technology. The research question is whether there is an influence of health communication on information technology in health information during the pandemic in Indonesia. The purpose of the study is to find out the influence of health communication on information technology in health information during the pandemic in Indonesia. The concepts of health communication literacy and information technology are used this study. Previous research is in support of this study. Quantitative research methods by disseminating questionnaires in this study. The validity and reliability test of this study is positive, so it can proceed to the next statistical analysis. Descriptive results of variable health communication literacy are of positive value in all dimensions. All dimensions of information technology are of positive value. Statistical tests of the influence of health communication literacy on information technology are of great value. Discussion of both variables in the influence of health communication literacy and high-value information technology because health communication literacy has a high effect in information technology. Respondents to this study have high information technology skills. So that health communication literacy in obtaining health information during the 2019-2022 pandemic is needed. Research advice is that academics are still very much needed by the community in the development of society during the pandemic.

Keywords: health information, health information needs, literacy health communication, information technology

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11167 The Influence of Contextual Factors on Long-Term Contraceptive Use in East Java

Authors: Ni'mal Baroya, Andrei Ramani, Irma Prasetyowati

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The access to reproduction health services, including with safe and effective contraception were human rights regardless of social stratum and residence. In addition to individual factors, family and contextual factors were also believed to be the cause in the use of contraceptive methods. This study aimed to assess the determinants of long-term contraceptive methods (LTCM) by considering all the factors at either the individual level or contextual level. Thereby, this study could provide basic information for program development of prevalence enhancement of MKJP in East Java. The research, which used cross-sectional design, utilized Riskesdas 2013 data, particularly in East Java Province for further analysis about multilevel modeling of MKJP application. The sample of this study consisted of 20.601 married women who were not in pregnant that were drawn by using probability sampling following the sampling technique of Riskesdas 2013. Variables in this study were including the independent variables at the individual level that consisted of education, age, occupation, access to family planning services (KB), economic status and residence. As independent variables in district level were the Human Development Index (HDI, henceforth as IPM) in each districts of East Java Province, the ratio of field officers, the ratio of midwives, the ratio of community health centers and the ratio of doctors. As for the dependent variable was the use of Long-Term Contraceptive Method (LTCM or MKJP). The data were analyzed by using chi-square test and Pearson product moment correlation. The multivariable analysis was using multilevel logistic regression with 95% of Confidence Interval (CI) at the significance level of p < 0.05 and 80% of strength test. The results showed a low CPR LTCM was concentrated in districts in Madura Island and the north coast. The women which were 25 to 35 or more than 35 years old, at least high school education, working, and middle-class social status were more likely to use LTCM or MKJP. The IPM and low PLKB ratio had implications for poor CPR LTCM / MKJP.

Keywords: multilevel, long-term contraceptive methods, east java, contextual factor

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11166 Searching k-Nearest Neighbors to be Appropriate under Gaming Environments

Authors: Jae Moon Lee

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In general, algorithms to find continuous k-nearest neighbors have been researched on the location based services, monitoring periodically the moving objects such as vehicles and mobile phone. Those researches assume the environment that the number of query points is much less than that of moving objects and the query points are not moved but fixed. In gaming environments, this problem is when computing the next movement considering the neighbors such as flocking, crowd and robot simulations. In this case, every moving object becomes a query point so that the number of query point is same to that of moving objects and the query points are also moving. In this paper, we analyze the performance of the existing algorithms focused on location based services how they operate under gaming environments.

Keywords: flocking behavior, heterogeneous agents, similarity, simulation

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11165 A Cloud-Based Mobile Auditing Tools for Muslim-Friendly Hospitality Services

Authors: Mohd Iskandar Illyas Tan, Zuhra Junaida Mohamad Husny, Farawahida Mohd Yusof

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The potentials of Muslim-friendly hospitality services bring huge opportunities to operators (hoteliers, tourist guides, and travel agents), especially among the Muslim countries. In order to provide guidelines that facilitate the operations among these operators, standards and manuals have been developing by the authorities. Among the challenges is the applicability and complexity of the standard to be adopted in the real world. Mobile digital technology can be implemented to overcome those challenges. A prototype has been developed to help operators and authorities to assess their readiness in complying with MS2610:2015. This study analyzes the of mobile digital technology characteristics that are suitable for the user in conducting sharia’ compliant hospitality audit. A focus group study was conducted in the state of Penang, Malaysia that involves operators (hoteliers, tourist guide, and travel agents) as well as agencies (Islamic Tourism Center, Penang Islamic Affairs Department, Malaysian Standard) that involved directly in the implementation of the certification. Both groups were given the 3 weeks to test and provide feedback on the usability of the mobile applications in order to conduct an audit on their readiness towards the Muslim-friendly hospitality services standard developed by the Malaysian Standard. The feedbacks were analyzed and the overall results show that three criteria (ease of use, completeness and fast to complete) show the highest responses among both groups for the mobile application. This study provides the evidence that the mobile application development has huge potentials to be implemented by the Muslim-friendly hospitality services operator and agencies.

Keywords: hospitality, innovation, audit, compliance, mobile application

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11164 Breaking Barriers: Utilizing Innovation to Improve Educational Outcomes for Students with Disabilities

Authors: Emily Purdom, Rachel Robinson

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As the number of students worldwide requiring speech-language therapy, occupational therapy and mental health services during their school day increases, innovation is becoming progressively more important to meet the demand. Telepractice can be used to reach a greater number of students requiring specialized therapy while maintaining the highest quality of care. It can be provided in a way that is not only effective but ultimately more convenient for student, teacher and therapist without the added burden of travel. Teletherapy eradicates many hurdles to traditional on-site service delivery and helps to solve the pervasive shortage of certified professionals. Because location is no longer a barrier to specialized education plans for students with disabilities when teletherapy is conducted, there are many advantages that can be deployed. Increased frequency of engagement is possible along with students receiving specialized care from a clinician that may not be in their direct area. Educational teams, including parents, can work together more easily and engage in face-to-face, student-centered collaboration through videoconference. Practical strategies will be provided for connecting students with qualified therapists without the typical in-person dynamic. In most cases, better therapy outcomes are going to be achieved when treatment is most convenient for the student and educator. This workshop will promote discussion in the field of education to increase advocacy for remote service delivery. It will serve as a resource for those wanting to expand their knowledge of options for students with special needs afforded through innovation.

Keywords: education technology, innovation, student support services, telepractice

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11163 Understanding Health Behavior Using Social Network Analysis

Authors: Namrata Mishra

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Health of a person plays a vital role in the collective health of his community and hence the well-being of the society as a whole. But, in today’s fast paced technology driven world, health issues are increasingly being associated with human behaviors – their lifestyle. Social networks have tremendous impact on the health behavior of individuals. Many researchers have used social network analysis to understand human behavior that implicates their social and economic environments. It would be interesting to use a similar analysis to understand human behaviors that have health implications. This paper focuses on concepts of those behavioural analyses that have health implications using social networks analysis and provides possible algorithmic approaches. The results of these approaches can be used by the governing authorities for rolling out health plans, benefits and take preventive measures, while the pharmaceutical companies can target specific markets, helping health insurance companies to better model their insurance plans.

Keywords: breadth first search, directed graph, health behaviors, social network analysis

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11162 The Impact of Quality Management System Establishment over the Performance of Public Administration Services in Kosovo

Authors: Ilir Rexhepi, Naim Ismajli

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Quality and quality management are key factors of success nowadays. Public sector and quality management in this sector contains many challenges and difficulties, most notably in a new country like Kosovo. This study analyses the process of implementation of quality management system in public administration institutions in this country. The main objective is to show how to set up a quality management system and how does the quality management system setup affect the overall public administration services in Kosovo. This study shows how the efficiency and effectiveness of public institution services/performance is rapidly improving through the establishment and functionalization of Quality Management System. The specific impact of established QMC within the organization has resulted with the identification of mission related processes within the entire system including input identification, the person in charge and the way of conversion to the output of each activity though the interference with other service processes within the system. By giving detailed analyses of all steps of implementation of the Quality Management System, its effect and consequences towards the overall public institution service performance, we try to go one step further, by showing it as a very good example or tool of other public institutions for improving their service performance. Interviews with employees, middle and high level managers including the quality manager and general secretaries are also part of analyses in this paper.

Keywords: quality, quality management system, efficiency, public administration institutions

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11161 Service Interactions Coordination Using a Declarative Approach: Focuses on Deontic Rule from Semantics of Business Vocabulary and Rules Models

Authors: Nurulhuda A. Manaf, Nor Najihah Zainal Abidin, Nur Amalina Jamaludin

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Coordinating service interactions are a vital part of developing distributed applications that are built up as networks of autonomous participants, e.g., software components, web services, online resources, involve a collaboration between a diverse number of participant services on different providers. The complexity in coordinating service interactions reflects how important the techniques and approaches require for designing and coordinating the interaction between participant services to ensure the overall goal of a collaboration between participant services is achieved. The objective of this research is to develop capability of steering a complex service interaction towards a desired outcome. Therefore, an efficient technique for modelling, generating, and verifying the coordination of service interactions is developed. The developed model describes service interactions using service choreographies approach and focusing on a declarative approach, advocating an Object Management Group (OMG) standard, Semantics of Business Vocabulary and Rules (SBVR). This model, namely, SBVR model for service choreographies focuses on a declarative deontic rule expressing both obligation and prohibition, which can be more useful in working with coordinating service interactions. The generated SBVR model is then be formulated and be transformed into Alloy model using Alloy Analyzer for verifying the generated SBVR model. The transformation of SBVR into Alloy allows to automatically generate the corresponding coordination of service interactions (service choreography), hence producing an immediate instance of execution that satisfies the constraints of the specification and verifies whether a specific request can be realised in the given choreography in the generated choreography.

Keywords: service choreography, service coordination, behavioural modelling, complex interactions, declarative specification, verification, model transformation, semantics of business vocabulary and rules, SBVR

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11160 Conceptual Study on 4PL and Activities in Turkey

Authors: Berna Kalkan, Kenan Aydin

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Companies give importance customer satisfaction to compete the developing and changing market. This is possible when customer reaches the right product, right quality, place, time and cost. In this regard, the extension of logistics services has played active role on formation and development of the different logistics services concept. The concept of logistics services has played important role involved in the healing of economic indicators today. Companies can use logistics providers, thus have competitive advantage and low cost, reducing time, tobe flexibility. In recent years, Fourth Party Logistics (4PL) has emerged as a new concept that includes relationship between suppliers and firms in outsourcing. 4PL provider is an integrator that offers comprehensive supply chain solutions with the technology, resources and capabilities that it possesses. Also, 4PL has attracted as a popular research topic attention in the recent past. In this paper, logistics outsourcing and 4PL concepts are analyzed and a literature review on 4PL activities is given. Also, the previous studies in literature and the approaches that are used in previous studies in literature is presented by analysing on 4PL activities. In this context, a field study will be applied to 4PL providers and service buyer in Turkey. If necessary, results related to this study will be shared in scientific areas.

Keywords: fourth party logistics, literature review, outsourcing, supply chain management

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11159 Towards Developing A Rural South African Child Into An Engineering Graduates With Conceptual And Critical Thinking Skills

Authors: Betty Kibirige

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Students entering the University of Zululand (UNIZULU) Science Faculty mostly come with skills that allow them to prepare for exams and pass them in order to satisfy requirements for entry into a tertiary Institution. Some students hail from deep rural schools with limited facilities, while others come from well-resourced schools. Personal experience has shown that it may take a student the whole time at a tertiary institution following the same skills as those acquired in high school as a sure means of entering the next level in their development, namely a postgraduate program. While it is apparent that at this point in human history, it is totally impossible to teach all the possible content in any one subject, many academics approach teaching and learning from the traditional point of view. It therefore became apparent to explore ways of developing a graduate that will be able to approach life with skills that allows them to navigate knowledge by applying conceptual and critical thinking skills. Recently, the Science Faculty at the University of Zululand introduced two Engineering programs. In an endeavour to approach the development of the Engineering graduate in this institution to be able to tackle problem-solving in the present-day excessive information availability, it became necessary to study and review approaches used by various academics in order to settle for a possible best approach to the challenge at hand. This paper focuses on the development of a deep rural child in a graduate with conceptual and critical thinking skills as major attributes possessed upon graduation. For this purpose, various approaches were studied. A combination of these approaches was repackaged to form an approach that may appear novel to UNIZULU and the rural child, especially for the Engineering discipline. The approach was checked by offering quiz questions to students participating in an engineering module, observing test scores in the targeted module and make comparative studies. Test results are discussed in the article. It was concluded that students’ graduate attributes could be tailored subconsciously to indeed include conceptual and critical thinking skills, but through more than one approach depending mainly on the student's high school background.

Keywords: graduate attributes, conceptual skills, critical thinking skills, traditional approach

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11158 Barriers That Special Education Teachers Faced When Working with Students with Intellectual Disabilities in an Inclusion Schools

Authors: Faris Algahtani

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Every child has a right to education. This is one of the laws in the constitution and it empowers every child to access knowledge but it does not, however, allocate special interest to the rights of education for children with disabilities. It also does not address the challenges that teachers of such children face while trying to educate them. This study was conducted at government schools of Saudi Arabia. As the teaching profession is the most valuable profession and deserves to have its challenges tackled. This paper explores the challenges that teachers face as they try to teach students who have intellectual disabilities (ID). It looks at the daily challenges of a teacher who has to teach both children with disabilities and those without. The literature review shed light on the various aspects of mainstream education from the classroom to the outside environment to the teachers involved in mainstream education. The study employed qualitative methods in which Focus Group Discussions were utilized and Twenty (N=20) special education teachers were randomly sampled from primary schools through 6 groups of teachers from 6 different schools were interviewed through semi-structured interviews with the aim of drawing collective perceptions rather than personal perceptions about the challenges. The study found that most teachers had similar perceptions about the challenges that teachers face as they educate students with intellectual disabilities. The study recommends that The Ministry of Education should consider increasing the availability of special needs courses, workshops and conference for special education teachers.

Keywords: intellectual disabilities, inclusion, mainstream schools, disabilities, special education teachers

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11157 Teaching Children with Autism Spectrum Disorder Using Virtual Reality: Exploratory Study

Authors: Abdiwahab Guled

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Autism spectrum disorder (ASD) is a neurodevelopmental disorder that emanates from a broad range of conditions, which affect the communication skills, social skills. It causes restrictive and repetitive behaviors to individuals. The number of children with ASD is an increasing prevalence around the world. Virtual reality (VR) is an assistive technology, which puts the learner in an immersive learning environment. It allows the learner to interact with that environment in a seemingly real or physical way using special electronic equipment, such as headsets. This exploratory study examines the potential benefits that VR may provide to improving the communication skills of children with ASD. Educating a child with ASD is challenging because access to services, resources, and support for autistic children is inadequate. Therefore, this study intends to investigate the challenges of teaching children with ASD and how VR might help teachers to improve the communication skills of these children with ASD. Online research and literature review were used as a method to gather previously published studies to identify the research gap and provide the groundwork for future studies. Results show that VR offers potential benefits to improving the communication skills of children with ASD but there is a gap in our understanding of the functionalities of all the features of VR technology and how we can utilize it to improve the communication skills of children with ASD. Communication is a broad subject and it is impossible for one study to evidently define the speech challenges of autistic children and provide an irrefutable solution. Therefore, this study proposes further research to dissect how can VR be used to improve the different communication challenges that impede the everyday functioning of autistic children.

Keywords: Autism spectrum disorder (ASD), autistic, Asperger, Disorder-Not Otherwise Specified (PDD-NOS), virtual reality (VR).

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11156 Using Indigenous Games to Demystify Probability Theorem in Ghanaian Classrooms: Mathematical Analysis of Ampe

Authors: Peter Akayuure, Michael Johnson Nabie

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Similar to many colonized nations in the world, one indelible mark left by colonial masters after Ghana’s independence in 1957 has been the fact that many contexts used to teach statistics and probability concepts are often alien and do not resonate with the social domain of our indigenous Ghanaian child. This has seriously limited the understanding, discoveries, and applications of mathematics for national developments. With the recent curriculum demands of making the Ghanaian child mathematically literate, this qualitative study involved video recordings and mathematical analysis of play sessions of an indigenous girl game called Ampe with the aim to demystify the concepts in probability theorem, which is applied in mathematics related fields of study. The mathematical analysis shows that the game of Ampe, which is widely played by school girls in Ghana, is suitable for learning concepts of the probability theorems. It was also revealed that as a girl game, the use of Ampe provides good lessons to educators, textbook writers, and teachers to rethink about the selection of mathematics tasks and learning contexts that are sensitive to gender. As we undertake to transform teacher education and student learning, the use of indigenous games should be critically revisited.

Keywords: Ampe, mathematical analysis, probability theorem, Ghanaian girl game

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11155 Self-Management among the Ethnic Groups with Type 2 Diabetes Mellitus in Thailand

Authors: Siwarak Kitchanapaibul, Warren Gillibrand, Rob Burton

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The prevalence of diabetes mellitus has been rising all over the world. Self-management is required for diabetes mellitus patients. The objective of this study is to explore the self-management among the ethnic groups with type 2 diabetes mellitus in Thailand, an upper middle-income country which is located in South East Asia. The ethnic groups in Thailand are a minority group which has limited education and a different culture, language, costume and lifestyle from Thai people. The qualitative exploratory study was used in this study. In-depth interviews with semi-structured open questions were conducted by 20 participants from purposive sampling. These participants were the ethnic groups who have type 2 diabetes mellitus, received the services from a region hospital, understood Thai and were willing to participate. Content analysis was adopted for the study. The results showed that all of the participants controlled their diet before the appointment day and never miss their appointment. Only 3 participants did their exercise while 2 participants stated that they occasionally forgot to take medicine. 10 participants use the herbs for reducing the sugar level. 12 participants drank a lot of water after a lapse in the diet because they believed that water could dilute the sugar. The findings identified 5 themes; ‘controlling diet before appointment day’; ‘drinking water after a lapse in diet’; ‘medication being a vital importance’; ‘exercise is unimportant’; and ‘taking herbs for sugar reduction’. The results of this study are important to the health professionals to understand the self-management of Ethnic groups and use the data to create the appropriate intervention for promoting health among the ethnic groups with type 2 diabetes mellitus in Thailand. The findings will lead to the revision of health policy and the procedure for promoting health in this special ethnic groups.

Keywords: self-management, diabetes, ethnic groups, Thailand

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11154 Body, Sex and Culture: Gender Dissidences through Cinema

Authors: Piedad Lucia Bolivar Goez, Daniel Ignacio Garzon Luna, Maria Camila Balcero Angel, Sara Carolina Martinez Roman, Daniela Natalia Polo Rivas, Sandra Liliana Rocha Guitierrez

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This article provides a critical analysis on the conception of disorders of sexual development (DSDs) within the bioethics framework. By means of analytical thought, the objective is to approach topics such as the rediscovery of the body, the reinvention of sexuality and link them to the liability that health personnel have to inform people about the options they have to decide over their health and body. The medicalization of sexed bodies in both psychosocial and anatomo-morpho-physiological dimensions from a legal standpoint were analyzed. Its also explored the gender stereotypes established by society and the role of laws in guaranteeing the right of autonomy that takes on greater relevance in DSD. Through this analysis, it was concluded that despite intersexuality having been analyzed by Colombia’s Constitutional Court, that it is stated as a fair entity, the stigmatization by society has not allowed these individuals to belong to an egalitarian context in which everyone has the same opportunities of access to the goods and services that they need. This leads individuals to hide their identity and expression of genre in order to be accepted in a set of contexts. Thus creating a vulnerability that the health system must be able to identify and in which it is necessary to intervene at a biopsychosocial level, in order to guarantee the protection of the individual within an unquestionable frame of equality and solidarity.

Keywords: disorders of sex development, gender identity, sexuality, transgender persons

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11153 Proposed Terminal Device for End-to-End Secure SMS in Cellular Networks

Authors: Neetesh Saxena, Narendra S. Chaudhari

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Nowadays, SMS is a very popular mobile service and even the poor, illiterate people and those living in rural areas use SMS service very efficiently. Although many mobile operators have already started 3G and 4G services, 2G services are still being used by the people in many countries. In 2G (GSM), only encryption provided is between the MS and the BTS, there is no end-to-end encryption available. Sometimes we all need to send some confidential message to other person containing bank account number, some password, financial details, etc. Normally, a message is sent in plain text only to the recipient and it is not an acceptable standard for transmitting such important and confidential information. Authors propose an end-to-end encryption approach by proposing a terminal for sending/receiving a secure message. An asymmetric key exchange algorithm is used in order to transmit secret shared key securely to the recipient. The proposed approach with terminal device provides authentication, confidentiality, integrity and non-repudiation.

Keywords: AES, DES, Diffie-Hellman, ECDH, A5, SMS

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11152 An Analysis of Teacher Knowledge of Recognizing and Addressing the Needs of Traumatized Students

Authors: Tiffany Hollis

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Childhood trauma is well documented in mental health research, yet has received little attention in urban schools. Child trauma affects brain development and impacts cognitive, emotional, and behavioral functioning. When educators understand that some of the behaviors that appear to be aggressive in nature might be the result of a hidden diagnosis of trauma, learning can take place, and the child can thrive in the classroom setting. Traumatized children, however, do not fit neatly into any single ‘box.’ Although many children enter school each day carrying with them the experience of exposure to violence in the home, the symptoms of their trauma can be multifaceted and complex, requiring individualized therapeutic attention. The purpose of this study was to examine how prepared educators are to address the unique challenges facing children who experience trauma. Given the vast number of traumatized children in our society, it is evident that our education system must investigate ways to create an optimal learning environment that accounts for trauma, addresses its impact on cognitive and behavioral development, and facilitates mental and emotional health and well-being. The researcher describes the knowledge, attitudes, dispositions, and skills relating to trauma-informed knowledge of induction level teachers in a diverse middle school. The data for this study were collected through interviews with teachers, who are in the induction phase (the first three years of their teaching career). The study findings paint a clear picture of how ill-prepared educators are to address the needs of students who have experienced trauma and the implications for the development of a professional development workshop or series of workshops that train teachers how to recognize and address and respond to the needs of students. The study shows how teachers often lack skills to meet the needs of students who have experienced trauma. Traumatized children regularly carry a heavy weight on their shoulders. Children who have experienced trauma may feel that the world is filled with unresponsive, threatening adults, and peers. Despite this, supportive interventions can provide traumatized children with places to go that are safe, stimulating, and even fun. Schools offer an environment that potentially meets these requirements by creating safe spaces where students can feel at ease and have fun while also learning via stimulating educational activities. This study highlights the lack of preparedness of educators to address the academic, behavioral, and cognitive needs of students who have experienced trauma. These findings provide implications for the creation of a professional development workshop that addresses how to recognize and address the needs of students who have experienced some type of trauma. They also provide implications for future research with a focus on specific interventions that enable the creation of optimal learning environments where students who have experienced trauma and all students can succeed, regardless of their life experiences.

Keywords: educator preparation, induction educators, professional development, trauma-informed

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11151 Wildlife Communities in the Service of Extensively Managed Fishpond Systems – Advantages of a Symbiotic Relationship

Authors: Peter Palasti, Eva Kerepeczki

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Extensive fish farming is one of the most traditional forms of aquaculture in Europe, usually practiced in large pond systems with earthen beds, where the growth of fish is based on natural feed and supplementary foraging. These farms have semi-natural environmental conditions, sustaining diverse wildlife communities that have complex effects on fish production and also provide a livelihood for many wetland related taxa. Based on their characteristics, these communities could be sources of various ecosystem services (ESs), that could also enhance the value and enable the multifunctional use of these artificially constructed and maintained production zones. To identify and estimate the whole range of wildlife’s contribution we have conducted an integrated assessment in an extensively managed pond system in Biharugra, Hungary, where we studied 14 previously revealed ESs: fish and reed production, water storage, water and air quality regulation, CO2 absorption, groundwater recharge, aesthetics, recreational activities, inspiration, education, scientific research, presence of semi-natural habitats and useful/protected species. ESs were collected through structured interviews with the local experts of all major stakeholder groups, where we have also gathered information about the known forms, levels (none, low, high) and orientations (positive, negative) of the contributions of the wildlife community. After that, a quantitative analysis was carried out: we calculated the total mean value of the services being used between 2014-16, then we estimated the value and percentage of contributions. For the quantification, we mainly used biophysical indicators with the available data and empirical knowledge of the local experts. During the interviews, 12 of the previously listed services (85%) were mentioned to be related to wildlife community, consisting of 5 fully (e.g., recreation, reed production) and seven partially dependent ESs (e.g., inspiration, CO2 absorption) from our list. The orientation of the contributions was said to be positive almost every time; however, in the case of fish production, the feeding habit of some wild species (Phalacrocorax carbo, Lutra lutra) caused significant losses in fish stocks in the study period. During the biophysical assessment, we calculated the total mean value of the services and quantified the aid of wildlife community at the following services: fish and reed production, recreation, CO2 absorption, and the presence of semi-natural habitats and wild species. The combined results of our interviews and biophysical evaluations showed that the presence of wildlife community not just greatly increased the productivity of the fish farms in Biharugra (with ~53% of natural yield generated by planktonic and benthic communities) but also enhanced the multifunctionality of the system through expanding the quality and number of its services. With these abilities, extensively managed fishponds could play an important role in the future as refugia for wetland related services and species threatened by the effects of global warming.

Keywords: ecosystem services, fishpond systems, integrated assessment, wildlife community

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11150 Household Socioeconomic Factors Associated with Teenage Pregnancies in Kigali City, Rwanda

Authors: Dieudonne Uwizeye, Reuben Muhayiteto

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Teenage pregnancy is a challenging problem for sustainable development due to restrictions it poses to socioeconomic opportunities for young mothers, their children and families. Being unable to take appropriate economic and social responsibilities, teen mothers get trapped into poverty and become economic burden to their family and country. Besides, teenage pregnancy is also a health problem because children born to very young mothers are vulnerable with greater risk of illnesses and deaths, and teenage mothers are more likely to be exposed to greater risk of maternal mortality and to other health and psychological problems. In Kigali city, in Rwanda, teenage pregnancy rate is currently high and its increase in recent years is worrisome. However, only individual factors influencing the teenage pregnancy tend to be the basis of interventions. It is important to understand the important socioeconomic factors at the household level that are associated with teenage pregnancy to help government, parents, and other stakeholders to appropriately address the problem with sustainable measures. This study analyzed secondary data from the Fifth Rwanda Demographic and Health Survey (RDHS-V 2014-2015) conducted by the National Institute of Statistics of Rwanda (NISR). The aim was to examine household socio-economic factors that are associated with incidence of teenage pregnancies in Kigali city. In addition to descriptive analysis, Pearson’s Chi Square and Binary Logistic Regression were used in the analysis. Findings indicate that marital status and age of household head, number of members in a household, number of rooms used for sleeping, educational level of the household head and household's wealth are significantly associated with teenage pregnancy in Rwanda ( p< 0.05). It was found that teenagers living with parents, those having parents with higher education and those from richer families are less likely to become pregnant. Age of household head was pinpointed as factor to teenage pregnancy, with teenage-headed households being more vulnerable. The findings also revealed that household composition correlates with the probability of teenage pregnancy (p < 0.05) with teenagers from households with less number of members being more vulnerable. Regarding the size of the house, the study suggested that the more rooms available in households, the less incidences of teenage pregnancy are likely to be observed (p < 0.05). However, teenage pregnancy was not significantly associated with physical violence among parents (p = 0.65) and sex of household heads (p = 0.52), except in teen-headed households of which female are predominantly heads. The study concludes that teenage pregnancy remains a serious social, economic and health problem in Rwanda. The study informs government officials, parents and other stakeholders to take interventions and preventive measures through community sex education, policies and strategies to foster effective parental guidance, care and control of young girls through meeting their necessary social and financial needs within households.

Keywords: household socio-economic factors, Rwanda, Rwanda demographic and health survey, teenage pregnancy

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11149 The Impact of Social Enterprises on Women Empowerment in South Asia: A Systematic Review

Authors: Saba Aziz

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Social enterprises are playing a growing role in transforming the lives of individuals and communities around the world, providing innovative solutions to critical social and environmental issues such as education, job creation, and health care. Women are increasingly utilising services of these enterprises to overcome socio-economic constraints and increase their access to business and market. This article systematically reviews the available literature on the role of social enterprises on women's empowerment in South Asia. Twelve key terms were specified and researched on five databases. Some of the literature was excluded based on the lack of evidence on the involvement of social enterprises. Remaining literature was rated according to the quality; due to methodological inconsistency, the findings are presented in a descriptive form. The relevant studies review the impact of social enterprises on women’s economic, social, relational, health, personal and political aspects of empowerment. In discussion, we outline areas for further research on social enterprises activity that impacts women’s overall empowerment specifically in South Asia.

Keywords: social enterprise, women empowerment, systematic review, well-being, social impact, micro finance, South Asia, Pakistan

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11148 Grapevine Farmers’ Adaptation to Climate Change and its Implication to Human Health: A Case of Dodoma, Tanzania

Authors: Felix Y. Mahenge, Abiud L. Kaswamila, Davis G. Mwamfupe

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Grapevine is a drought resistant crop, although in recent years it has been observed to be affect by climate change. This compelled investigation of grapevine farmers’ adaptation strategies to climate change in Dodoma, Tanzania. A mixed research approach was adopted. Likewise, purposive and random sampling techniques were used to select individuals for the study. About 248 grapevine farmers and 64 key informants and members of focus group discussions were involved. Primary data were collected through surveys, discussions, interviews, and observations, while secondary data were collected through documentary reviews. Quantitative data were analysed through descriptive statistics by means of IBM (SPSS) software while the qualitative data were analysed through content analysis. The findings indicate that climate change has adversely affected grapevine production leading to the occurrence of grapevine pests and diseases, drought which increases costs for irrigation and uncertainties which affect grapevine markets. For the purpose of lessening grapevine production constraints due to climate change, farmers have been using several adaptation strategies. Some of the strategies include application of pesticides, use of scarers to threaten birds, irrigation, timed pruning, manure fertilisers and diversification to other farm or non-farm activities. The use of pesticides and industrial fertilizers were regarded as increasing human health risks in the study area. The researchers recommend that the Tanzania government should strengthen the agricultural extension services in the study area so that the farmers undertake adaptation strategies with the consideration of human health safety.

Keywords: grapevine farmers, adaptation, climate change, human health

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11147 A Cross-Sectional Study on the Nutritional Status of School Going Children From Urban and Rural Populations of Pakistan

Authors: Aftab Ahmed, Farhan Saeed, Muhammad Afzaal, Shinawar Waseem Ali, Ali Imran, Sadaf Munir

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Malnutrition is a globally increasing public health concern among children; it affects number of school children influencing their growth, development and academic performance. The tenet of the current cross sectional study was to assess the nutritional biomarkers of school going children of age 12-15 years resulting in stunting, underweight, overweight, bone deformities and other health disparities in nutritionally deprived urban and rural populations of Pakistan. A sample size comprising of 180 school going children was stipulated from the targeted urban and rural populations. The fallouts of investigation unveiled that both rural and urban populations were experiencing nutritional challenges however; on account of awareness paucity the rustic population was nutritionally more compromised. Hematological tests elucidated 16.7% and 7.8% cases for high glucose level, 35.6% and 27.8% cases for low hemoglobin levels, 14.4% and 15.6% cases for low calcium indices, 12.2% and 4.4% high white blood cell count (WBC), 20% and 14.4% low red blood cell count, 76.7% and 74.4% low hematocrit (HCT) values, among the rural and urban populations respectively. The above mentioned outcomes can serve as a way forward for policy and law maker institutions to curb the possible barricades in the way of healthy nutritional status in these areas

Keywords: malnutrition, hematological study, child nutrition, bone mineral density, calcium, RBC

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11146 Implementation of Enhanced Recovery after Cesarean Section at Koidu Government Hospital, Sierra Leone 2024. A Quality Improvement Project

Authors: Hailemariam Getachew, John Sandi, Isata Dumbuya, Patricia Efe.Azikiwe, Evaline Nginge, Moses Mugisha, Eseoghene Dase, Foday Mandaray, Grace Moore

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Enhanced recovery after cesarean section (ERAC) is a standardized peri- operative care program that comprises the multidisciplinary team's collective efforts working in collaboration throughout the peri-operative period with the principal goal to improve quality of surgical care, decrease surgical related complications, and increasing patient satisfaction. Objective: The main objective of this project is to improve the implementation of enhanced recovery after cesarean section at Koidu Government hospital. Identified gap: Even though the hospital is providing comprehensive maternal and child care service, there are gaps in the implementation of ERAC. According to our survey, we found that there is low (13.3%) utilization of WHO surgical safety checklist, only limited (15.9%) patients get opioid free analgesia, pain was not recorded as a vital sign, there is no standardized checklist for hand over to and from Post Anesthesia care Unit(PACU). Furthermore, there is inconsistent evidence based post-operative care and there is no local consensus protocol and guideline as well. Implementation plan: we aimed at designing standardized protocol, checklist and guideline, provide training, build staff capacity, document pain as vital sign, perform regional analgesia, and provide evidence based post-operative care, monitoring and evaluation. Result: Data from 389 cesarean mothers showed that, Utilization of the WHO surgical safety check list found to be 95%, and pain assessment and documentation was done for all surgical patients. Oral feeding, ambulation and catheter removal was performed as per the ERAC standard for all patients. Postoperative complications drastically decreased from 13.6% to 8.1%. While, the rate of readmission was kept below 1%. Furthermore, the duration of hospital stay decreased from 4.64 days to 3.12 days. Conclusion The successful implementation of ERAC protocols demonstrates through this Quality Improvement Project that, the effectiveness of the protocols in improving recovery and patient outcome following cesarean section.

Keywords: cesarean delivery, enhanced recovery, quality improvement, patient outcome

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11145 E-Governance: A Key for Improved Public Service Delivery

Authors: Ayesha Akbar

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Public service delivery has witnessed a significant improvement with the integration of information communication technology (ICT). It not only improves management structure with advanced technology for surveillance of service delivery but also provides evidence for informed decisions and policy. Pakistan’s public sector organizations have not been able to produce some good results to ensure service delivery. Notwithstanding, some of the public sector organizations in Pakistan has diffused modern technology and proved their credence by providing better service delivery standards. These good indicators provide sound basis to integrate technology in public sector organizations and shift of policy towards evidence based policy making. Rescue-1122 is a public sector organization which provides emergency services and proved to be a successful model for the provision of service delivery to save human lives and to ensure human development in Pakistan. The information about the organization has been received by employing qualitative research methodology. The information is broadly based on primary and secondary sources which includes Rescue-1122 website, official reports of organizations; UNDP (United Nation Development Program), WHO (World Health Organization) and by conducting 10 in-depth interviews with the high administrative staff of organizations who work in the Lahore offices. The information received has been incorporated with the study for the better understanding of the organization and their management procedures. Rescue-1122 represents a successful model in delivering the services in an efficient way to deal with the disaster management. The management of Rescue has strategized the policies and procedures in such a way to develop a comprehensive model with the integration of technology. This model provides efficient service delivery as well as maintains the standards of the organization. The service delivery model of rescue-1122 works on two fronts; front-office interface and the back-office interface. Back-office defines the procedures of operations and assures the compliance of the staff whereas, front-office equipped with the latest technology and good infrastructure handles the emergency calls. Both ends are integrated with satellite based vehicle tracking, wireless system, fleet monitoring system and IP camera which monitors every move of the staff to provide better services and to pinpoint the distortions in the services. The standard time of reaching to the emergency spot is 7 minutes, and during entertaining the case; driver‘s behavior, traffic volume and the technical assistance being provided to the emergency case is being monitored by front-office. Then the whole information get uploaded to the main dashboard of Lahore headquarter from the provincial offices. The latest technology is being materialized by Rescue-1122 for delivering the efficient services, investigating the flaws; if found, and to develop data to make informed decision making. The other public sector organizations of Pakistan can also develop such models to integrate technology for improving service delivery and to develop evidence for informed decisions and policy making.

Keywords: data, e-governance, evidence, policy

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11144 Understanding ICT Behaviors among Health Workers in Sub-Saharan Africa: A Cross-Sectional Study for Laboratory Persons in Uganda

Authors: M. Kasusse, M. Rosette, E. Burke, C. Mwangi, R. Batamwita, N. Tumwesigye, S. Aisu

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A cross-sectional survey to ascertain the capacity of laboratory persons in using ICTs was conducted in 15 Ugandan districts (July-August 2013). A self-administered questionnaire served as data collection tool, interview guide and observation checklist. 69 questionnaires were filled, 12 interviews conducted, 45 HC observed. SPSS statistics 17.0 and SAS 9.2 software were used for entry and analyses. 69.35% of participants find it difficult to access a computer at work. Of the 30.65% who find it easy to access a computer at work, a significant 21.05% spend 0 hours on a computer daily. 60% of the participants cannot access internet at work. Of the 40% who have internet at work, a significant 20% lack email address but 20% weekly read emails weekly and 48% daily. It is viable/feasible to pilot informatics projects as strategies to build bridges develop skills for e-health landscape in laboratory services with a bigger financial muscle.

Keywords: ICT behavior, clinical laboratory persons, Sub-Saharan Africa, Uganda

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11143 Role of Machine Learning in Internet of Things Enabled Smart Cities

Authors: Amit Prakash Singh, Shyamli Singh, Chavi Srivastav

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This paper presents the idea of Internet of Thing (IoT) for the infrastructure of smart cities. Internet of Thing has been visualized as a communication prototype that incorporates myriad of digital services. The various component of the smart cities shall be implemented using microprocessor, microcontroller, sensors for network communication and protocols. IoT enabled systems have been devised to support the smart city vision, of which aim is to exploit the currently available precocious communication technologies to support the value-added services for function of the city. Due to volume, variety, and velocity of data, it requires analysis using Big Data concept. This paper presented the various techniques used to analyze big data using machine learning.

Keywords: IoT, smart city, embedded systems, sustainable environment

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11142 Creating Moments and Memories: An Evaluation of the Starlight 'Moments' Program for Palliative Children, Adolescents and Their Families

Authors: C. Treadgold, S. Sivaraman

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The Starlight Children's Foundation (Starlight) is an Australian non-profit organisation that delivers programs, in partnership with health professionals, to support children, adolescents, and their families who are living with a serious illness. While supporting children and adolescents with life-limiting conditions has always been a feature of Starlight's work, providing a dedicated program, specifically targeting and meeting the needs of the paediatric palliative population, is a recent area of focus. Recognising the challenges in providing children’s palliative services, Starlight initiated a research and development project to better understand and meet the needs of this group. The aim was to create a program which enhances the wellbeing of children, adolescents, and their families receiving paediatric palliative care in their community through the provision of on-going, tailored, positive experiences or 'moments'. This paper will present the results of the formative evaluation of this unique program, highlighting the development processes and outcomes of the pilot. The pilot was designed using an innovation methodology, which included a number of research components. There was a strong belief that it needed to be delivered in partnership with a dedicated palliative care team, helping to ensure the best interests of the family were always represented. This resulted in Starlight collaborating with both the Victorian Paediatric Palliative Care Program (VPPCP) at the Royal Children's Hospital, Melbourne, and the Sydney Children's Hospital Network (SCHN) to pilot the 'Moments' program. As experts in 'positive disruption', with a long history of collaborating with health professionals, Starlight was well placed to deliver a program which helps children, adolescents, and their families to experience moments of joy, connection and achieve their own sense of accomplishment. Building on Starlight’s evidence-based approach and experience in creative service delivery, the program aims to use the power of 'positive disruption' to brighten the lives of this group and create important memories. The clinical and Starlight team members collaborate to ensure that the child and family are at the centre of the program. The design of each experience is specific to their needs and ensures the creation of positive memories and family connection. It aims for each moment to enhance quality of life. The partnership with the VPPCP and SCHN has allowed the program to reach families across metropolitan and regional locations. In late 2019 a formative evaluation of the pilot was conducted utilising both quantitative and qualitative methodologies to document both the delivery and outcomes of the program. Central to the evaluation was the interviews conducted with both clinical teams and families in order to gain a comprehensive understanding of the impact of and satisfaction with the program. The findings, which will be shared in this presentation, provide practical insight into the delivery of the program, the key elements for its success with families, and areas which could benefit from additional research and focus. It will use stories and case studies from the pilot to highlight the impact of the program and discuss what opportunities, challenges, and learnings emerged.

Keywords: children, families, memory making, pediatric palliative care, support

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