Search results for: women's rights movement
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5880

Search results for: women's rights movement

3960 Approaching Sexual Violence Against People with Disabilities in Colombia from a Qualitative Perspective

Authors: Mariana Calderón, Rocío Murad, Natalia Acevedo, Laura León, Juliana Fonseca, Maria de los Angeles Balaguera Villa

Abstract:

Recently, different countries and international organizations have put on their agenda the elimination of violence against people with disabilities. This research aims to evaluate the social dimensions of sexual violence against people with disabilities, particularly those with psychosocial and cognitive, in Colombia. Results reveal that 55% of people with disabilities that are survivors of sexual violence are younger than 29 years and 20,4 are people with cognitive and psychosocial disabilities. Colombian regions with better social positions presented more cases of sexual violence against people with disabilities. There were found access barriers for health, education and employment among this population, and there was also found poor data quality. Despite Colombia having an important normative framework aimed at preventing and attending to gender-based violence, it does not take into account people with disabilities specific needs. Additionally, it was found an insufficient implementation and appropriation of these norms, negative attitudes, and in general, a lack of service adaptation according to the needs, identities and circumstances of people with disabilities. Furthermore, among the factors that are exposing people with disabilities to sexual violence, it was found that family members tend to be the main aggressors, there are deep gaps in the sex education received by people with disabilities, imaginaries and perceptions about their sexuality are both hypersexualizing and presenting them as asexual. On the other hand, among protective factors, there were found body self-knowledge and conscience, acknowledgment of their sexuality and their sexual and reproductive rights and access to sex ed. Although during the last few years, there has occurred a positive change toward social inclusion of people with disabilities, specifically through their role in the political agenda and the recognition of their rights. More work is needed in order to guarantee their sexual and reproductive rights, particularly for persons with psychosocial and cognitive disabilities. This research results showed the importance of transforming persisting negative imaginaries about their sexuality and also enforcing and promoting their autonomy. In this sense, it is important to acknowledge gaps and barriers faced by them and create strategies to encourage their social inclusion through education, employment, and skill development. Nevertheless, it is necessary to keep contributing new evidence of the social determinants of health that are influencing the occurrence of sexual violence. This research understands sexual violence against people with disabilities in a multidimensional manner and offers the following recommendations: 1- To foment public sensitization and understanding of disabilities. 2- To increase parents, caregivers and officers’ commitment to the prevention and reduction of sexual violence. 3- To focus on the needs, identities and circumstances of people with disabilities.

Keywords: disabilities, sexual and reproductive rights, sexual violence, prevention

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3959 The Impact of Geophagia on the Iron Status of Black South African Women

Authors: A van Onselen, C. M. Walsh, F. J. Veldman, C. Brand

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Objectives: To determine the nutritional status and risk factors associated with women practicing geophagia in QwaQwa, South Africa. Materials and Methods: An observational epidemiological study design was adopted which included an exposed (geophagia) and non-exposed (control) group. A food frequency questionnaire, anthropometric measurements and blood sampling were applied to determine nutritional status of participants. Logistic regression analysis was performed in order to identify factors that were likely to be associated with the practice of geophagia. Results: The mean total energy intake for the geophagia group (G) and control group(C) were 10324.31 ± 2755.00 kJ and 10763.94 ± 2556.30 kJ respectively. Both groups fell within the overweight category according to the mean body mass index (BMI) of each group (G= 25.59 kg/m2; C= 25.14 kg/m2). The mean serum iron levels of the geophagia group (6.929 μmol/l) were significantly lower than that of the control group (13.75 μmol/l) (p = 0.000). Serum transferrin (G=3.23g/l; C=2.7054g/l) and serum transferrin saturation (G=8.05%; C=18.74%) levels also differed significantly between groups (p=0.00). Factors that were associated with the practice of geophagia included haemoglobin (Odds ratio (OR):14.50), serum-iron (OR: 9.80), serum-ferritin (OR: 3.75), serum-transferrin (OR: 6.92) and transferrin saturation (OR: 14.50). A significant negative association (p=0.014) was found between women who were wage-earners and those who were not wage-earners and the practice of geophagia (OR: 0.143; CI: 0.027; 0.755). These findings seem to indicate that a permanent income may decrease the likelihood of practising geophagia. Key findings: Geophagia was confirmed to be a risk factor for iron deficiency in this community. The significantly strong association between geophagia and iron deficiency emphasizes the importance of identifying the practice of geophagia in women, especially during their child bearing years. Further research to establish whether the practice of geophagia is a cause of iron-deficiency, or whether it is the consequence thereof, would give a clearer view on how to recognise and treat the condition.

Keywords: geophagia, iron deficiency anaemia, dietary intake, anthropometry

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3958 Collaborative Implementation of Master Plans in Afghanistan's Context Considering Land Readjustment as Case Study

Authors: Ahmad Javid Habib, Tetsuo Kidokoro

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There is an increasing demand for developing urban land to provide better living conditions for all citizens in Afghanistan. Most of the development will involve the acquisition of land. And the current land acquisition method practiced by central government is expropriation, which is a cash-based transaction method that imposes heavy fiscal burden on local municipalities and central government, and it does not protect ownership rights and social equity of landowners besides it relocates the urban poor to remote areas with limited access to jobs and public services. The questionnaire analysis, backed by observations of different case studies in countries where land readjustment is used as a collaborative land development tool indicates that the method plays a key role in valuing landowners’ rights, giving other community members and stakeholders the opportunity to collaboratively implement urban development projects. The practice of the method is reducing the heavy fiscal burden on the local and central governments and is a better option to deal with the current development challenges in Afghanistan.

Keywords: collaboration, land readjustment, master plan, expropriation

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3957 Genetic Determinants of Ovarian Response to Gonadotropin Stimulation in Women Undergoing Assisted Reproductive Treatment

Authors: D. Tohlob, E. Abo Hashem, N. Ghareeb, M. Ghanem, R. Elfarahaty, S. A. Roberts, P. Pemberton, L. Mohiyiddeen, W. G. Newman

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Gonadotropin stimulation is used in females undergoing assisted reproductive treatment for ovulation induction, but ovarian response is variable and unpredictable in these women. More effective protocols and individualization of treatment are needed to increase the success rate of IVF/ICSI cycles. We genotyped seven variants reported in previous studies to be associated with ovarian response (number of ova retrieved and total gonadotropin dose) in women undergoing IVF treatment including FSHR variants Asn 680 Ser (c.2039 A > G), Thr 307 Ala (c. 919 > A), -29 G > A, HRG c.610 C > T gene, BMP15 -9 C > G, AMH Ile 49 Ser (c.146 G > T), and AMHR -489A˃G in 118 Egyptian females attending Mansoura Integrated Fertility Center in Egypt, these females were undergoing their first cycle of controlled ovarian hyper stimulation for IVF/ICSI treatment. They were analyzed by TaqMan allelic discrimination assay in Manchester Center of Genomic Medicine. We found no evidence of any significant difference (p value < 0.05) in the number of eggs retrieved or the gonadotropin dose used between individuals in all genotypes except for HRG c.610 C > T gene polymorphism where regression analysis gives a p value of 0.04 with a fewer eggs number in TT genotyped females. These results indicate that these variants do not provide sufficient clinically relevant data to individualize the treatment protocols.

Keywords: controlled ovarian hyperstimulation, gene variants, ovarian response, assisted reproduction

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3956 Determinants of Repeated Abortion among Women of Reproductive Age Attending Health Facilities in Northern Ethiopia: A Case-Control Study

Authors: Henok Yebyo Henok, Araya Abrha Araya, Alemayehu Bayray Alemayehu, Gelila Goba Gelila

Abstract:

Background: Every year, an estimated 19–20 million unsafe abortions take place, almost all in developing countries, leading to 68,000 deaths and millions more injured many permanently. Many women throughout the world, experience more than one abortion in their lifetimes. Repeat abortion is an indicator of the larger problem of unintended pregnancy. This study aimed to identify determinants of repeat abortion in Tigray Region, Ethiopia. Methods: Unmatched case-control study was conducted in hospitals in Tigray Region, Northern Ethiopia, from November 2014 to June 2015. The sample included 105 cases and 204 controls, recruited from among women seeking abortion care at public hospitals. Clients having two or more abortions (“repeat abortion”) were taken as cases, and those who had a total of one abortion were taken as controls (“single abortion”). Cases were selected consecutive based on proportional to size allocation while systematic sampling was employed for controls. Data were analyzed using SPSS version 20.0. Binary and multiple variable logistic regression analyses were calculated with 95% CI. Results: Mean age of cases was 24 years (±6.85) and 22 years (±6.25) for controls. 79.0% of cases had their sexual debut in less than 18 years of age compared to 57% of controls. 42.2% of controls and 23.8% of cases cited rape as the reason for having an abortion. Study participants who did not understand their fertility cycle and when they were most likely to conceive after menstruation (adjusted odds ratio [AOR]=2.0, 95% confidence interval [CI]: 1.1-3.7), having a previous abortion using medication(AOR=3.3, CI: 1.83, 6.11), having multiple sexual partners in the preceding 12 months (AOR=4.4, CI: 2.39,8.45), perceiving that the abortion procedure is not painful (AOR=2.3, CI: 1.31,4.26), initiating sexual intercourse before the age of 18 years (AOR=2.7, CI: 1.49, 5.23) and disclosure to a third-party about terminating the pregnancy (AOR=2.1, CI: 1.2,3.83) were independent predictors of repeat abortion. Conclusion: This study identified several factors correlated with women having repeat abortions. It may be helpful for the Government of Ethiopia to encourage women to delay sexual debut and decrease their number of sexual partners, including by promoting discussion within families about sexuality, to decrease the occurrence of repeated abortion.

Keywords: abortion, Ethiopia, repeated abortion, single abortion

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3955 Access the Knowledge, Awareness, and Factors Associated With Hypertension Among the Residents of Modeca District of Tiko, South West Region of Cameroon, in the Middle of a Separatist Violence Since 2017

Authors: Franck Kem Acho

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The trends of diseases have been changed from the last few years, now the burden of non-communicable diseases is increasing day by day. In all the non-communicable diseases, Hypertension is one of the leading causes of premature death and morbidity worldwide. This disease is a silent killer, it mostly affects the people with no obvious symptoms. Not only the heart it also increases the risk of brain, kidney and other diseases, now a days it is a serious medical problem. Over a billion people near about 1 in 4 men and 1 in 5 women having hypertension. In this case study men and women of ages between 30-80 years with Hypertension were identified in community remote area with their Health status being checked and monitored for one week and Health Education was provided for the importance of regular Health checkup alongside the continuous taking of medications.

Keywords: hypertension, health status, health check up, health education

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3954 A Study of the Disorders of Sexual Functioning in Women with Type 2 Diabetes Mellitus in a Tertiary Care Hospital in India

Authors: Mehak Nagpal, T. S. Sathyanarayan Rao

Abstract:

Background: Sexual functioning is a neglected aspect of health in women with diabetes, though it contributes greatly towards quality of life and feeling of wellbeing. Also women with DM are at higher risk than men of developing sexual dysfunction and depression. Materials and Methods: Cross-sectional comparison study. Sample size: 100 previously diagnosed type 2DM patients attending Outpatient Diabetic Clinic at Medicine department JSS Hospital Mysore; aged 20-65 years and 60 normal healthy female subjects for Control group. Data was collected with ethical approval over a period of 2 years. Tools Used: 1) Hamilton Depression Rating Scale (HAMD – 17 item) 2) Female Sexual Functioning Index (FSFI) 3) Arizona Sexual Experience Scale (ASEX-F) for female-for screening. 4) The Appraisal of Diabetes Scale (ADS). Results: Statistically significant differences were observed in prevalence rate and severity of depression between diabetic group (45% vs 11% syndromal depression) and controls. Depression scores correlated significantly with glycaemic control, adherence to treatment, BMI and the cognitive appraisal of diabetes. There was significantly greater impairment in the sexual functioning of women with type 2 diabetes mellitus as compared to controls; both prevalence (62% vs 38.3%) and severity (p value < 0.01). Arousal (74.2% vs 53.3%), Desire (76.3% vs 50%) and Satisfaction (76.7% vs 63.7%) were most affected and 64.5% were affected in 2 or more domains. A negative illness appraisal on ADS correlated significantly with poor glycaemic control, higher rates of depression and also more severe female sexual dysfunction (p value < 0.05). Conclusion: Diabetes specific factors that correlated significantly with FSD in this study included the psychological appraisal of diabetes, duration of diabetes, presence of complications and BMI.

Keywords: depression, female sexual dysfunction, India, type 2 diabetes mellitus

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3953 Maternity Care Model during Natural Disaster or Humanitarian Emegerncy Setting in Rural Pakistan

Authors: Humaira Maheen, Elizabeth Hoban, Catherine Bennette

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Background: Globally, role of Community Health Workers (CHW) as front line disaster health work force is underutilized. Developing countries which are at risk of natural disasters or humanitarian emergencies should lay down effective strategies especially to ensure adequate access to maternity care during crisis situation by using CHW as they are local, trained, and most of them possess a good relationship with the community. The Minimum Initial Service Package (MISP) is a set of universal guidelines that addresses women’s reproductive health needs during the first phase of an emergency. According to the MISP, pregnant women should have access to a skilled birth attendant and adequate transportation arrangements so they can access a maternity care facility. Pakistan is one of the few countries which has been severely affected by a number of natural disaster as well as humanitarian emergencies in last decade. Pakistan has a young and structured National Disaster Management System in place, where District Authorities play a vital role in disaster management. The District Health Department develops the contingency health plan for an emergency situation and implements it under the existing district health human resources (health workers and medical staff at the health facility) and infrastructure (health care facilities). Methods: A mixed methods study was conducted in rural villages of Sindh adjacent to the river Indus, and included in-depth interviews with 15 women who gave birth during the floods, structured interviews with 668 women who were pregnant during 2010-2014, and in-depth interviews with 25 community health workers (CHW) and 30 key informants. Results: Women said that giving birth in the relief camps during the floods was one of the most challenging times of their life. The district health department didn’t make transportation arrangement for labouring women from relief camp to the nearest health care facility. As a result 91.2% women gave birth in temporary shelters with the help of a traditional birth attendant (Dai) with no clean physical space available to birth. Of the 332 women who were pregnant at the time of the floods, 26 had adverse birth outcomes; 10 had miscarriages, 14 had stillbirths and there were four neonatal deaths. Conclusion: The district health department was not able to provide access to adequate maternity care during according to the international standard during the floods in 2011. We propose a model where CHWs will be used as frontline maternity care providers during any emergency or disaster situations in Pakistan. A separate "birthing station" should be mandatory in all district relief camps, managed by CHWs. Community midwives (CMW) would and the Lady Health Workers (LHW) would provide antenatal and postnatal care alongside, vaccination for pregnant women, neonates and children under five. There must be an ambulance facility for emergency obstetric cases and all district health facilities should have at least two medical staff identified and trained for emergency obstetric management. The District Health Department must provide clean birthing kits and regular and emergency contraceptives in the relief camps. Methods: A mixed methods study was conducted in rural villages of Sindh adjacent to the river Indus, and included in-depth interviews with 15 women who gave birth during the floods, structured interviews with 668 women who were pregnant during 2010-2014, and in-depth interviews with 25 community health workers (CHW) and 30 key informants. Results: Women said that giving birth in the relief camps during the floods was one of the most challenging times of their life. Nearly 91.2% women gave birth in temporary shelters with the help of a traditional birth attendant (Dai) with no clean physical space available to birth, and the health camp was mostly accessed by men and always overcrowded. There was no obstetric trained medical staff in the health camps or transportation provided to take women with complications to the nearest health facility. The rate of adverse outcome following disaster was 22.2% (95% CI: 8.62% – 42.2%) amongst 27 women who did not evacuate as compare to 7.91% (95% CI: 5.03% – 11.8%) among 278 women who lived in relief camp study participants. There were 27 women who evacuated on pre-flood warning and had 0% rate of adverse outcome. Conclusion: We propose a model where CHWs will be used as frontline maternity care providers during any emergency or disaster situations in Pakistan. A separate "birthing station" should be mandatory in all district relief camps, managed by CHWs. Community midwives (CMW) would and the Lady Health Workers (LHW) would provide antenatal and postnatal care alongside, vaccination for pregnant women, neonates and children under five. There must be an ambulance facility for emergency obstetric cases and all district health facilities should have at least two medical staff identified and trained for emergency obstetric management. The District Health Department must provide clean birthing kits and regular and emergency contraceptives in the relief camps.

Keywords: natural disaster, maternity care model, rural, Pakistan, community health workers

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3952 Modern Hybrid of Older Black Female Stereotypes in Hollywood Film

Authors: Frederick W. Gooding, Jr., Mark Beeman

Abstract:

Nearly a century ago, the groundbreaking 1915 film ‘The Birth of a Nation’ popularized the way Hollywood made movies with its avant-garde, feature-length style. The movie's subjugating and demeaning depictions of African American women (and men) reflected popular racist beliefs held during the time of slavery and the early Jim Crow era. Although much has changed concerning race relations in the past century, American sociologist Patricia Hill Collins theorizes that the disparaging images of African American women originating in the era of plantation slavery are adaptable and endure as controlling images today. In this context, a comparative analysis of the successful contemporary film, ‘Bringing Down the House’ starring Queen Latifah is relevant as this 2004 film was designed to purposely defy and ridicule classic stereotypes of African American women. However, the film is still tied to the controlling images from the past, although in a modern hybrid form. Scholars of race and film have noted that the pervasive filmic imagery of the African American woman as the loyal mammy stereotype faded from the screen in the post-civil rights era in favor of more sexualized characters (i.e., the Jezebel trope). Analyzing scenes and dialogue through the lens of sociological and critical race theory, the troubling persistence of African American controlling images in film stubbornly emerge in a movie like ‘Bringing Down the House.’ Thus, these controlling images, like racism itself, can adapt to new social and economic conditions. Although the classic controlling images appeared in the first feature length film focusing on race relations a century ago, ‘The Birth of a Nation,’ this black and white rendition of the mammy figure was later updated in 1939 with the classic hit, ‘Gone with the Wind’ in living color. These popular controlling images have loomed quite large in the minds of international audiences, as ‘Gone with the Wind’ is still shown in American theaters currently, and experts at the British Film Institute in 2004 rated ‘Gone with the Wind’ as the number one movie of all time in UK movie history based upon the total number of actual viewings. Critical analysis of character patterns demonstrate that images that appear superficially benign contribute to a broader and quite persistent pattern of marginalization within the aggregate. This approach allows experts and viewers alike to detect more subtle and sophisticated strands of racial discrimination that are ‘hidden in plain sight’ despite numerous changes in the Hollywood industry that appear to be more voluminous and diverse than three or four decades ago. In contrast to white characters, non-white or minority characters are likely to be subtly compromised or marginalized relative to white characters if and when seen within mainstream movies, rather than be subjected to obvious and offensive racist tropes. The hybrid form of both the older Jezebel and Mammy stereotypes exhibited by lead actress Queen Latifah in ‘Bringing Down the House’ represents a more suave and sophisticated merging of past imagery ideas deemed problematic in the past as well as the present.

Keywords: African Americans, Hollywood film, hybrid, stereotypes

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3951 The Effects of Seat Heights and Obesity on Lower-Limb Joint Kinematics during Sit-To-Stand Movement

Authors: Seungwon Baek, Haeseok Jeong, Haehyun Lee, Woojin Park

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The main purpose of this study was to compare obese people to the non-obese in terms of joint kinematics in lower-limb body. The height of chairs was also considered as a design factor. Obese people had a difficulty in sit-to-stand (STS) tasks compared to the non-obese people. High chair heights can make STS task easy and it helps the obese to be more comfortable with STS task in particular. Subjects were instructed to wear inertial measurement unit (IMU) sensors. They perform STS task using chairs of different heights. Joint kinematics and subjective ratings of discomfort were measured. Knee angles of the obese group were greater than that of the non-obese group in normal type. No significant difference in joint kinematics was found in high chair. Interaction effect was found between obesity and height of chair. The results verified the previous research that had suggested a biomechanical model of STS movement. The results can be applied to occupational design for the obese.

Keywords: biomechanics, electromyography, joint kinematics, obesity, sitting, sit-to-stand

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3950 Pleading the Belly: Sentencing of Convicted Pregnant Women under the Common Law

Authors: Nana Yaw Ofori Gyasi

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Under the Common Law, there was a procedure called pleading the belly which allowed a woman who had reached the advanced stage of pregnancy to receive a reprieve of her death sentence until after she had put to bed. The plea was replaced with a legislation, which provides that a pregnant woman would automatically have her death sentence commuted to life imprisonment with hard labour. This Common Law principle has been continued and enacted into law by the various countries where the Common Law is practiced. This paper takes a look at what it terms as Pregnancy Legislations in some selected Common Law countries such as United States of America, Canada, England and Wales, Ghana and India to examine the scope, procedure and effect of such legislations. The paper adopts a comparative study approach to ascertain the country with the widest scope, non-complicated procedure and far-reaching effects of the Pregnancy Legislations. It is observed that some legislations make provision for the conversion of death penalty to life imprisonment for capital offences and also prescribe non-custodial sentence for non-capital offences. There are other legislations that merely suspend the death penalty while the convict is found to be pregnant. In terms of the procedure, some of the legislations make the issue of pregnancy a question of fact to be determined by a jury and in other legislations, the trial judge makes that determination after the judge is satisfied on the question of the convict being pregnant. The effects of the Pregnancy Legislation are observed to be varying. Women who give birth in prison are highly at risk of having stillbirth. Most of the prisons do not have adequate facilities to support expectant and lactating mothers while in prison. It has also been observed that with the number of female prisoners increasing over the years, custodial sentence for convicted pregnant women has a wider societal effect. The paper identifies certain gaps left in some of the legislations which relate to the procedure to be followed after custodial sentence is suspended for a convicted pregnant woman. The time the accused person got pregnant- whether before her arrest or during trial- and the effect of the timing of the pregnancy are gaps left in some of the legislations. The paper argues that such gaps should be filled by the legislator to prevent accused persons taking undue advantage of the Pregnancy Legislations. It is further argued that if convicted pregnant women will have to spend time in prison at all for very heinous crimes, the prison facilities should be improved so that expectant and lactating mothers can comfortably care for their babies and themselves to prevent dire health consequences for such mothers and the society at a whole.

Keywords: sentence of pregnant women, custodial sentence, , pregnant women, , common law

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3949 Isolation and Antifungal Susceptibility Pattern of Candida albicans from Endocervical and High Vaginal Swabs of Pregnant Women Attending State Specialist Hospital Gombe, Nigeria

Authors: Isa Shu’aibu, A. A. Mu’inat, F. U. Maigari, M. A. Mani

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Candida albicans is the common cause of both oral and vaginal candidiasis in humans. This candidiasis leads to a wide range of physical, psychological and even physiological problems in humans particularly pregnant women. Samples of endocervical and high vaginal swab were collected from 200 women attending Gombe Specialist Hospital and inoculated on Saboraud Dextrose Agar (SDA) incorporated with chloramphenicol to get rid of the unwanted bacterial contaminants. Gram staining technique and germ tube test were employed for the identification, as Candida albicans is positive for both. Gram positive samples were 70% (n=140) and were further subjected to germ tube test. The remaining 30% (n=60) were found to be Gram negative. 90% (n=126) of the Gram positive ones isolated were also found to be positive for germ tube test; confirming the presence of Candida albicans. Antifungal susceptibility testing revealed that members of Imidazole (Ketoconazole, Miconazole) and those of Triazoles (Fluconazole and Itraconazole) were found to be more effective at concentrations of 20, 50 and 100 µg/disc compared to Griseofulvin (Fulcin) with only 26.00 mm zone of inhibition at 100 µg/disc concentration.

Keywords: Candida albicans, candidiasis, endocervical, vaginal swab, antifungal susceptibility, imidazole, triazoles

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3948 Right to Information in Egypt and the Prospects of Renegotiating a New Social Order

Authors: Farida Ibrahim

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Right to information is the public's right to know through having access to public information held by state bodies. Recognized as a cornerstone in transparent, participatory and open democracies, the right to information is increasingly perceived today as an emerging human right on the international level. While this right is conceptualized in a range of different contexts, the paper focuses on its conceptualization as a force for socio-economic change for disadvantaged groups. The paper's goal is study the instrumental capacity of this right in empowering the public to access state-held information pertinent to their socio-economic rights. In this regard, the paper views the right to information as an inclusionary tool that is capable of spurring inclusion for individuals excluded from the ambits of both: public participation and social justice. For exploring this, the paper examines the advocacy role played by civil society groups in furthering this instrumental capacity. In particular, the paper presents a focused account on the Egyptian case. While Egypt has recently adopted its constitutional provision on access to information, doubts arise on Egyptian citizens' genuine ability to access information held by state bodies. The politico-economic environment, long term culture of bureaucratic secrecy, and legal framework do not provide promising outcomes on access to public information. Within the particular context of the Egyptian case, this paper questions the extent to which civil society in Egypt is capable of instrumentally employing the political opportunity offered by the constitutional entitlement to information access for pressuring public authorities to disclose information. Through four lawsuits brought by civil society groups in Egypt, the paper argues that the right to information has instrumentally provided civil society actors with new domains of mobilization for furthering the realization of social and economic rights, and ultimately, for renegotiating a new social order lining the relationship between the Egyptian state and its citizens marginalized by socio-economic imbalances.

Keywords: civil society, Egypt, right to information, socio-economic rights

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3947 An Investigation on Orthopedic Rehabilitation by Avoiding Thermal Necrosis

Authors: R. V. Dahibhate, A. B. Deoghare, P. M. Padole

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Maintaining natural integrity of biosystem is paramount significant for orthopedic surgeon while performing surgery. Restoration is challenging task to rehabilitate trauma patient. Drilling is an inevitable procedure to fix implants. The task leads to rise in temperature at the contact site which intends to thermal necrosis. A precise monitoring can avoid thermal necrosis. To accomplish it, data acquiring instrument is integrated with the drill bit. To contemplate it, electronic feedback system is developed. It not only measures temperature without any physical contact in between measuring device and target but also visualizes the site and monitors correct movement of tool path. In the current research work an infrared thermometer data acquisition system is used which monitors variation in temperature at the drilling site and a camera captured movement of drill bit advancement. The result is presented in graphical form which represents variations in temperature, drill rotation and time. A feedback system helps in keeping drill speed in threshold limit.

Keywords: thermal necrosis, infrared thermometer, drilling tool, feedback system

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3946 Social Enterprises in India: Conceptualization and Challenges

Authors: Prajakta Khare

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There is a huge number of social enterprises operating in India, across all enterprise sizes and forms addressing diverse social issues. Some cases such as such as Aravind eye care, Narayana Hridalaya, SEWA have been studied extensively in management literature and are known cases in social entrepreneurship. But there are several smaller social enterprises in India that are not called so per se due to the lack of understanding of the concept. There is a lack of academic research on social entrepreneurship in India and the term ‘social entrepreneurship’ is not yet widely known in the country, even by people working in this field as was found by this study. The present study aims to identify the most prominent form of social enterprises in India, the profile of the entrepreneurs, challenges faced, the lessons (theory and practices) emerging from their functioning and finally the factors contributing to the enterprises’ success. This is a preliminary exploratory study using primary data from 30 social enterprises in India. The study used snow ball sampling and a qualitative analysis. Data was collected from founders of social enterprises through written structured questionnaires, open-ended interviews and field visits to enterprises. The sample covered enterprises across sectors such as environment, affordable education, children’s rights, rain water harvesting, women empowerment etc. The interview questions focused on founder’s background and motivation, qualifications, funding, challenges, founder’s understanding and perspectives on social entrepreneurship, government support, linkages with other organizations etc. apart from several others. The interviews were conducted across 3 languages - Hindi, Marathi, English and were then translated and transcribed. 50% of founders were women and 65% of the total founders were highly qualified with a MBA, PhD or MBBS. The most important challenge faced by these entrepreneurs is recruiting skilled people. When asked about their understanding of the term, founders had diverse perspectives. Also, their understandings about the term social enterprise and social entrepreneur were extremely varied. Some founders identified the terms with doing something good for the society, some thought that every business can be called a social enterprise. 35% of the founders were not aware of the term social entrepreneur/ social entrepreneurship. They said that they could identify themselves as social entrepreneurs after discussions with the researcher. The general perception in India is that ‘NGOs are corrupt’- fighting against this perception to secure funds is also another problem as pointed out by some founders. There are unique challenges that social entrepreneurs in India face, as the political, social, economic environment around them is rapidly changing; and getting adequate support from the government is a problem. The research in its subsequent stages aims to clarify existing, missing and new definitions of the term to provide deeper insights in the terminology and issues relating to Social Entrepreneurship in India.

Keywords: challenges, India, social entrepreneurship, social entrepreneurs

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3945 Assessment of Kinetic Trajectory of the Median Nerve from Wrist Ultrasound Images Using Two Dimensional Baysian Speckle Tracking Technique

Authors: Li-Kai Kuo, Shyh-Hau Wang

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The kinetic trajectory of the median nerve (MN) in the wrist has shown to be capable of being applied to assess the carpal tunnel syndrome (CTS), and was found able to be detected by high-frequency ultrasound image via motion tracking technique. Yet, previous study may not quickly perform the measurement due to the use of a single element transducer for ultrasound image scanning. Therefore, previous system is not appropriate for being applied to clinical application. In the present study, B-mode ultrasound images of the wrist corresponding to movements of fingers from flexion to extension were acquired by clinical applicable real-time scanner. The kinetic trajectories of MN were off-line estimated utilizing two dimensional Baysian speckle tracking (TDBST) technique. The experiments were carried out from ten volunteers by ultrasound scanner at 12 MHz frequency. Results verified from phantom experiments have demonstrated that TDBST technique is able to detect the movement of MN based on signals of the past and present information and then to reduce the computational complications associated with the effect of such image quality as the resolution and contrast variations. Moreover, TDBST technique tended to be more accurate than that of the normalized cross correlation tracking (NCCT) technique used in previous study to detect movements of the MN in the wrist. In response to fingers’ flexion movement, the kinetic trajectory of the MN moved toward the ulnar-palmar direction, and then toward the radial-dorsal direction corresponding to the extensional movement. TDBST technique and the employed ultrasound image scanner have verified to be feasible to sensitively detect the kinetic trajectory and displacement of the MN. It thus could be further applied to diagnose CTS clinically and to improve the measurements to assess 3D trajectory of the MN.

Keywords: baysian speckle tracking, carpal tunnel syndrome, median nerve, motion tracking

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3944 Postpartum Female Sexual Dysfunctions in Hungary: A Cross-Sectional Study

Authors: Katalin Szöllősi, László Szabó

Abstract:

Introduction and purpose: Even though female sexual dysfunctions are common among women in the postpartum period, the profile of these disturbances has not been well investigated in Hungary yet. The aim of the study was to evaluate the postpartum female sexual functions in Hungary. This research sought to investigate the possible predictor factors which can influence postpartum female sexual functions. Method and sample: This was a cross-sectional study, including patients from two maternity clinics in Budapest. 113 women were recruited into our study 3 months after their childbirth. 53 had vaginal birth, 60 had a caesarian section. Data were collected from medical reports in addition by using self-developed questions and validated questionnaires in order to measure important predictors which may be responsible for postpartum sexual dysfunctions such as mode of delivery, parity, urinary incontinence and body image. Sexual functions were evaluated by the Hungarian version of the Female Sexual Function Index (FSFI). The Hungarian version of Body Image Questionnaire-Short Form14 (BSQ-SF14) was applied for assessing body image. Results: 82,3% of the participants began to have sexual intercourse within three months postpartum. 53,98% of the participants reported sexual dysfunctions (cut-off FSFI score 26,55). According to our results mode of delivery, parity, hemorrhoids, time of intercourse, resumption was not associated with female sexual dysfunctions. We found correlation at a tendential level between urinary incontinence and sexual dysfunctions (p=0,003, R=0,26). We found a negative correlation at a tendential level between the total score of BSQ-SF14 and FSFI (p=0,03, R=-0,269). Only 32,74% of women reported discussing sexual life with health care professionals. However, 67,25% of them would have had the need to be asked about their postpartum health issues. Conclusions and recommendations: The prevalence of female sexual dysfunctions were relatively high after childbirth. We found that incontinence and body image was associated with sexual dysfunctions; other risk factors remained unknown. Despite regular contact with health care professionals, women rarely get any information about postpartum sexual health issues. The high prevalence of dysfunctions indicates the need for further investigation to address other risk factors and proper counselling of women after childbirth.

Keywords: body image, postpartum, sexual dysfunction, urinary incontinence

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3943 Development and Validation of Work Movement Task Analysis: Part 1

Authors: Mohd Zubairy Bin Shamsudin

Abstract:

Work-related Musculoskeletal Disorder (WMSDs) is one of the occupational health problems encountered by workers over the world. In Malaysia, there is increasing in trend over the years, particularly in the manufacturing sectors. Current method to observe workplace WMSDs is self-report questionnaire, observation and direct measurement. Observational method is most frequently used by the researcher and practitioner because of the simplified, quick and versatile when it applies to the worksite. However, there are some limitations identified e.g. some approach does not cover a wide spectrum of biomechanics activity and not sufficiently sensitive to assess the actual risks. This paper elucidates the development of Work Movement Task Analysis (WMTA), which is an observational tool for industrial practitioners’ especially untrained personnel to assess WMSDs risk factors and provide a basis for suitable intervention. First stage of the development protocol involved literature reviews, practitioner survey, tool validation and reliability. A total of six themes/comments were received in face validity stage. New revision of WMTA consisted of four sections of postural (neck, back, shoulder, arms, and legs) and associated risk factors; movement, load, coupling and basic environmental factors (lighting, noise, odorless, heat and slippery floor). For inter-rater reliability study shows substantial agreement among rater with K = 0.70. Meanwhile, WMTA validation shows significant association between WMTA score and self-reported pain or discomfort for the back, shoulder&arms and knee&legs with p<0.05. This tool is expected to provide new workplace ergonomic observational tool to assess WMSDs for the next stage of the case study.

Keywords: assessment, biomechanics, musculoskeletal disorders, observational tools

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3942 The Role of Women in Criminal Organizations

Authors: Rossella Marzullo

Abstract:

Family plays a central role in the Calabrian criminal organization, which draws its strength from blood ties and gender stereotypes that still impose a strong verticalization of intra-family relationships for the benefit of men. However, female figures are of great importance in the organizational structure of the 'Ndrangheta families, despite the fact that they appear to be formally suffocated by the culture of gender subordination still strongly present in the archaic world of criminal organizations. And this is so much true that over time, the women of the 'Ndrangheta have added to the function of ‘internal containment’, the increasingly explicit function of intermediaries in the ‘external’ activities of the clan. But what happens in the 'Ndrangheta if women break the bond and decide to speak? The results are shocking. When a woman starts talking to ask the institutions for help, the system ‘goes crazy’, because the woman is considered the means of consolidating and transmitting family codes: she educates, forges, holds the structure together. If a woman from the 'Ndrangheta decides to speak out and get out of the family bottlenecks of the clan, she does not exclusively destroy the family; she destroys the system. This happens because, while not playing the same roles as men within organizations, women carry out support activities as intermediaries for the circulation of communications, thus ensuring the operability of the gang in practice and on a daily basis. Crossing the border means breaking the bonds of belonging, thus questioning one's own identity and reconstructing it according to other points of reference. How much these disruptive choices are feared by the men of the 'Ndrangheta has been seen in the dramatic stories of Lea Garofalo and Maria Concetta Cacciola: the fear of the breaking of the family pact, of the earthquake that arises from within, has marked their fate of death, useful both to stop the judicial action and to recompose the organization's estate under the aegis of terror. With physical, psychological violence, underhanded torture, and moral blackmail, the men of the mafia family tried to heal the shock caused by the voices of women, relying on violence and yet another attempt to subordinate them. This proves that the 'Ndrangheta is really afraid of them. The female voices of the 'Ndrangheta, who have shaken a consolidated and considered intangible system, represent the anti-'ndrangheta par excellence; in their choices, there is an even stronger desire to break with the mafia world.

Keywords: families, gender, ‘Ndrangheta, stereotypes

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3941 Succinct Perspective on the Implications of Intellectual Property Rights and 3rd Generation Partnership Project in the Rapidly Evolving Telecommunication Industry

Authors: Arnesh Vijay

Abstract:

Ever since its early introduction in the late 1980s, the mobile industry has been rapidly evolving with each passing year. The development witnessed is not just in its ability to support diverse applications, but also its extension into diverse technological means to access and offer various services to users. Amongst the various technologies present, radio systems have clearly emerged as a strong contender, due to its fine attributes of accessibility, reachability, interactiveness, and cost efficiency. These advancements have no doubt guaranteed unprecedented ease, utility and sophistication to the cell phone users, but caused uncertainty due to the interdependence of various systems, making it extremely complicated to exactly map concepts on to 3GPP (3rd Generation Partnership Project) standards. Although the close interrelation and interdependence of intellectual property rights and mobile standard specifications have been widely acknowledged by the technical and legal community; there, however, is a requirement for clear distinction between the scope and future-proof of inventions to influence standards and its market place adoptability. For this, collaborative work is required between intellectual property professionals, researchers, standardization specialists and country specific legal experts. With the evolution into next generation mobile technology, i.e., to 5G systems, there is a need for further work to be done in this field, which has been felt now more than ever before. Based on these lines, this poster will briefly describe the importance of intellectual property rights in the European market. More specifically, will analyse the role played by intellectual property in various standardization institutes, such as 3GPP (3rd generation partnership project) and ITU (International Telecommunications Union). The main intention: to ensure the scope and purpose is well defined, and concerned parties on all four sides are well informed on the clear significance of good proposals which not only bring economic revenue to the company but those that are capable of improving the technology and offer better services to mankind. The poster will comprise different sections. The first segment begins with a background on the rapidly evolving mobile technology, with a brief insight on the industrial impact of standards and its relation to intellectual property rights. Next, section two will succinctly outline the interplay between patents and standards; explicitly discussing the ever changing and rapidly evolving relationship between the two sectors. Then the remaining sections will examine ITU and its role played in international standards development, touching upon the various standardization process and the common patent policies and related guidelines. Finally, it proposes ways to improve the collaboration amongst various sectors for a more evolved and sophisticated next generation mobile telecommunication system. The sole purpose here is to discuss methods to reduce the gap and enhance the exchange of information between the two sectors to offer advanced technologies and services to mankind.

Keywords: mobile technology, mobile standards, intellectual property rights, 3GPP

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3940 Human Machine Interface for Controlling a Robot Using Image Processing

Authors: Ambuj Kumar Gautam, V. Vasu

Abstract:

This paper introduces a head movement based Human Machine Interface (HMI) that uses the right and left movements of head to control a robot motion. Here we present an approach for making an effective technique for real-time face orientation information system, to control a robot which can be efficiently used for Electrical Powered Wheelchair (EPW). Basically this project aims at application related to HMI. The system (machine) identifies the orientation of the face movement with respect to the pixel values of image in a certain areas. Initially we take an image and divide that whole image into three parts on the basis of its number of columns. On the basis of orientation of face, maximum pixel value of approximate same range of (R, G, and B value of a pixel) lie in one of divided parts of image. This information we transfer to the microcontroller through serial communication port and control the motion of robot like forward motion, left and right turn and stop in real time by using head movements.

Keywords: electrical powered wheelchair (EPW), human machine interface (HMI), robotics, microcontroller

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3939 Influence of Flight Design on Discharging Profiles of Granular Material in Rotary Dryer

Authors: I. Benhsine, M. Hellou, F. Lominé, Y. Roques

Abstract:

During the manufacture of fertilizer, it is necessary to add water for granulation purposes. The water content is then removed or reduced using rotary dryers. They are commonly used to dry wet granular materials and they are usually fitted with lifting flights. The transport of granular materials occurs when particles cascade from the lifting flights and fall into the air stream. Each cascade consists of a lifting and a falling cycle. Lifting flights are thus of great importance for the transport of granular materials along the dryer. They also enhance the contact between solid particles and the air stream. Optimization of the drying process needs an understanding of the behavior of granular materials inside a rotary dryer. Different approaches exist to study the movement of granular materials inside the dryer. Most common of them are based on empirical formulations or on study the movement of the bulk material. In the present work, we are interested in the behavior of each particle in the cross section of the dryer using Discrete Element Method (DEM) to understand. In this paper, we focus on studying the hold-up, the cascade patterns, the falling time and the falling length of the particles leaving the flights. We will be using two segment flights. Three different profiles are used: a straight flight (180° between both segments), an angled flight (with an angle of 150°), and a right-angled flight (90°). The profile of the flight affects significantly the movement of the particles in the dryer. Changing the flight angle changes the flight capacity which leads to different discharging profile of the flight, thus affecting the hold-up in the flight. When the angle of the flight is reduced, the range of the discharge angle increases leading to a more uniformed cascade pattern in time. The falling length and the falling time of the particles also increase up to a maximum value then they start decreasing. Moreover, the results show an increase in the falling length and the falling time up to 70% and 50%, respectively, when using a right-angled flight instead of a straight one.

Keywords: discrete element method, granular materials, lifting flight, rotary dryer

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3938 Motherhood Factors Influencing the Business Growth of Women-Owned Sewing Businesses in Lagos, Nigeria: A Mixed Method Study

Authors: Oyedele Ogundana, Amon Simba, Kostas Galanakis, Lynn Oxborrow

Abstract:

The debate about factors influencing the business growth of women-owned businesses has been a topical issue in business management. Currently, scholars have identified the issues of access to money, market, and management as canvasing factors influencing the business growth of women-owned businesses. However, the influence of motherhood (household/family context) on business growth is inconclusive in the literature; despite that women are more family-oriented than their male counterparts. Therefore, this research study considers the influence of motherhood factor (household/family context) on the business growth of women-owned sewing businesses (WOSBs) in Lagos, Nigeria. The sewing business sector is chosen as the fashion industry (which includes sewing businesses) currently accounts for the second largest number of jobs in Sub-Saharan Africa, following agriculture. Thus, sewing businesses provide a rich ground for contributing to existing scholarly work. Research questions; (1) In what way does the motherhood factor influence the business growth of WOSBs in Lagos? (2) To what extent does the motherhood factor influence the business growth of WOSBs in Lagos? For the method design, a pragmatic approach, a mixed-methods technique and an abductive form of reasoning are adopted. The method design is chosen because it fits, better than other research perspectives, with the research questions posed in this study. For instance, using a positivist approach will not sufficiently answer research question 1, neither will an interpretive approach sufficiently answer research question 2. Therefore, the research method design is divided into 2 phases, and the results from one phase are used to inform the development of the subsequent phases (only phase 1 has been completed at the moment). The first phase uses qualitative data and analytical method to answer research question 1. While the second phase of the research uses quantitative data and analytical method to answer research question 2. For the qualitative phase, 5 WOSBs were purposefully selected and interviewed. The sampling technique is selected as it was not the intention of the researcher to make any statistical inferences, at this phase, rather the purpose was just exploratory. Therefore, the 5 sampled women comprised of 2 unmarried women, 1 married woman with no child, and 2 married women with children. A 40-60 minutes interview was conducted per participants. The interviews were audio-recorded and transcribed. Thereafter, the data were analysed using thematic analysis in order to unearth patterns and relationships. Findings for the first phase of this research reveals that motherhood (household/family context) directly influences (positively/negatively) the performance of WOSBs in Lagos. Apart from a direct influence on WOSBs, motherhood also moderates (positively/negatively) other factors–e.g., access to money, management/human resources and market/opportunities– influencing WOSBs in Lagos. To further strengthen this conclusion, a word frequency query result shows that ‘family,’ ‘husband’ and ‘children’ are among the 10 words used frequently in all the interview transcripts. This first phase contributes to existing studies by showing the various forms by which motherhood influences WOSBs. The second phase (which data are yet to be collected) would reveal the extent to which motherhood influence the business growth of WOSBs in Lagos.

Keywords: women-owned sewing businesses, business growth, motherhood, Lagos

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3937 Hysterectomy and Symbolic Damage: When the Desire for Motherhood is Reactivated in a Nun

Authors: Ndje Ndje Mireille

Abstract:

The improvement in the physical aspects of hysterectomy has tended to make us forget the psychological burden of this operation for many women. African women closely associate fertility and femininity, and they fear that their desire will diminish, that they will be less desirable after having undergone a hysterectomy. Medicine may be tempted to trivialize this surgical intervention by relying on the evolution of current surgery that leaves little or no marks. It is possible to think that the uterus is useless for a nun who has decided to freely disregard her motherhood. We used the clinical research method for this study. Through a semi-directive interview guide, we collected the verbatims of an hysterectomized catholic nun. The verbatims were transcribed and analyzed with the thematic content analysis. This analysis shows that the medical reality does not always correspond to the subjective experience of women, for whom hysterectomy can imply strong symbolic damage. The uterus is not essential to life, but it is essential to give life, and this lack can reactivate a desire for motherhood. The experience of hysterectomy is unique for each woman in relation to her history. This operation will eliminate all hope of pregnancy; it will be felt as intimate mutilation and an attack on femininity, it will bring up concerns about sexuality. Even if a woman has past the age of having children, has gone through menopause, or has freely decided not to have children, she still find it difficult to accept this procedure. The lack of uterus make a woman feel useless.

Keywords: hysterectomy, symbolic damage, desire for motherhood, feminity, nun

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3936 Maternal Health Care Mirage: A Study of Maternal Health Care Utilization for Young Married Muslim Women in India

Authors: Saradiya Mukherjee

Abstract:

Background: Indian Muslims, compared to their counterparts in other religions, generally do not fare well on many yardsticks related to socio-economic progress and the same is true with maternal health care utilization. Due to low age at marriage a major percentage of child birth is ascribed to young (15-24 years) Muslim mothers in, which pose serious concerns on the maternal health care of Young Married Muslim women (YMMW). A thorough search of past literature on Muslim women’s health and health care reveals that studies in India have mainly focused on religious differences in fertility levels and contraceptive use while the research on the determinants of maternal health care utilization among Muslim women are lacking in India. Data and Methods: Retrieving data from the National Family Health Survey -3 (2005-06) this study attempts to assess the level of utilization and factors effecting three key maternal health indicators (full ANC, safe delivery and PNC) among YMMW (15-24 years) in India. The key socio-economic and demographic variables taken as independent or predictor variables in the study was guided by existing literature particularly for India. Bi-variate analysis and chi square test was applied and variables which were found to be significant were further included in binary logistic regression. Results: The findings of the study reveal abysmally low levels of utilization for all three indicators i.e. full ANC, safe delivery and PNC of maternal health care included in the study. Mother’s education, mass media exposure, women’s autonomy, birth order, economic status wanted status of child and region of residence were found to be significant variables effecting maternal health care utilization among YMMW. Multivariate analysis reveals that no mass media exposure, lower autonomy, education, poor economic background, higher birth order and unintended pregnancy are some of the reasons behind low maternal health care utilization. Conclusion: Considering the low level of safe maternal health care utilization and its proximate determinants among YMMW the study suggests educating Muslim girls, promoting family planning use, involving media and collaboration between religious leader and health care system could be some important policy level interventions to address the unmet need of maternity services among YMMW.

Keywords: young Muslim women, religion, socio-economic condition, antenatal care, delivery, post natal care

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3935 Towards a Mandatory Frame of ADR in Divorce Cases: Key Elements from a Comparative Perspective for Belgium

Authors: Celine Jaspers

Abstract:

The Belgian legal system is slowly evolving to mandatory mediation to promote ADR. One of the reasons for this evolution is the lack of use of alternative methods in relation to their possible benefits. Especially in divorce cases, ADR can play a beneficial role in resolving disputes, since the emotional component is very much present. When children are involved, a solution provided by the parent may be more adapted to the child’s best interest than a court order. In the first part, the lack of use of voluntary ADR and the evolution toward mandatory ADR in Belgium will be indicated by sources of legislation, jurisprudence and social-scientific sources, with special attention to divorce cases. One of the reasons is lack of knowledge on ADR, despite the continuing efforts of the Belgian legislator to promote ADR. One of the last acts of ADR-promotion, was the implementation of an Act in 2018 which gives the judge the possibility to refer parties to mediation if at least one party wants to during the judicial procedure. This referral is subject to some conditions. The parties will be sent to a private mediator, recognized by the Federal Mediation Commission, to try to resolve their conflict. This means that at least one party can be mandated to try mediation (indicated as “semi-mandatory mediation”). The main goal is to establish the factors and elements that Belgium has to take into account in their further development of mandatory ADR, with consideration of the human rights perspective and the EU perspective. Furthermore it is also essential to detect some dangerous pitfalls other systems have encountered with their process design. Therefore, the second part, the comparative component, will discuss the existing framework in California, USA to establish the necessary elements, possible pitfalls and considerations the Belgian legislator can take into account when further developing the framework of mandatory ADR. The contrasting and functional method will be used to create key elements and possible pitfalls, to help Belgium improve its existing framework. The existing mandatory system in California has been in place since 1981 and is still up and running, and can thus provide valuable lessons and considerations for the Belgian system. Thirdly, the key elements from a human rights perspective and from a European Union perspective (e.g. the right to access to a judge, the right to privacy) will be discussed too, since the basic human rights and European legislation and jurisprudence play a significant part in Belgian legislation as well. The main sources for this part will be the international and European treaties, legislation, jurisprudence and soft law. In the last and concluding part, the paper will list the most important elements of a mandatory ADR-system design with special attention to the dangers of these elements (e.g. to include or exclude domestic violence cases in the mandatory ADR-framework and the consequences thereof), and with special attention for the necessary the international and European rights, prohibitions and guidelines.

Keywords: Belgium, divorce, framework, mandatory ADR

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3934 Introduction of a Standardised Proforma to Optimise Post-Operative Analgesia after Caesarean Section

Authors: Prashant Neupane, Sumitra Kafle, Asmi Pandey, Laura Mitchell

Abstract:

Pain following caesarean section can influence recovery, patient satisfaction, breast feeding success and mother-child bonding. Since the introduction of enhanced recovery protocols, mothers are often discharged 24 hours later. We identified concerns within our hospital with mothers tolerating poorly controlled pain in order to achieve earlier discharge and subsequently suffering significant pain at home with inadequate analgesia. Methods: We conducted a prospective audit of analgesic prescribing and post-operative pain scores after caesarean section. Mothers were seen on post-operative day one, their pain score recorded on a verbal analogue score from 0-10, and their prescription chart reviewed. A follow-up phone call was then made on post-operative day 3-7 to enquire about pain scores and analgesia use at home. Following this, a standardized proforma for prescribing after the caesarean section was introduced, including the addition of dihydrocodeine that patients can take home following discharge. There were educational update sessions for anesthetists and midwifes, and then a re-audit was conducted months later. Results: Data was collected from 50 women before and after the introduction of the change. Initial audit showed that there was considerable variation in prescribing, with four women prescribed no regular analgesia at all and inconsistency in the dose of oral morphine prescribed. Women were not given any form of analgesia to take home after discharge and were advised to take regular paracetamol and ibuprofen. However, 31/50 (62%) reported that they needed additional analgesia and eight women (16%) even sought prescription for additional analgesia from elsewhere. After the introduction of the change, prescribing was more consistent with all patients prescribed regular analgesia. 46/50 patients were given dihydrocodeine on discharge. Mean pain scores on post-operative day one improved from 5.16 to 3.9, and at home improved from 6.18 to 2.58. Use of dihydrocodeine at home significantly improved patients reporting of severe pain at home from 24% to zero. Discussion: Lack of strong analgesia out of the hospital and the increased demands on activity levels means that women are frequently in more pain at home after discharge. Introduction of a standardized prescription proforma, including the use of to-take-out dihydrocodeine, was successful in improving patient pain scores and the requirement for additional analgesia, both in hospital and at home.

Keywords: analgesia, caesarean section, post-operative pain, standardised

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3933 Maternal and Child Health Care: A Study among the Rongmeis of Manipur, India

Authors: Lorho Mary Maheo, Arundhati Maibam Devi

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Background: Maternal and child health (MCH) cares are the health services provided to mothers and children. It includes the health promotion, preventive, curative and rehabilitation health care for mothers and children. Materials and method: The present study sample comprises of 208 women within the age range 15-69 years from two remote villages of Tamenglong District in Manipur. They were randomly chosen for assessing their health as well as the child’s health adopting an interview schedule method. Results: The findings of the study revealed that majority (80%) of the women have their first conception in their first year of married life. A decadal change has been observed with regard to the last pregnancy i.e., antenatal check-up, place of delivery as well as the service provider. However, irrespective of age of the women, home delivery is still preferred though very few are locally trained. Pre- and post-delivery resting period vary depending on the busy schedule of the agricultural works as the population under study is basically agriculturist. Postnatal care remains to be traditional as they are strongly associated with cultural beliefs and practices that continue to prevail in the studied community. Breast feeding practices such as colostrums given, initiation of breastfeeding, weaning was all taken into account.  Immunization of children has not reached the expected target owing to a variety of reasons. Maternal health care also includes use of birth control measures. The health status of women would invariably improve if family planning is meaningfully adopted. Only 10.1% of the women adopted the modern birth control implying its deep-rooted value attached to the children. Based on the self-assessment report on their health treatment a good number of the respondents resorted to self-medication even to the extent of buying allopathic medicine without a doctor’s prescription. One important finding from the study is the importance attributed to the traditional health care system which is easily affordable and accessible to the villagers. Conclusion: The overall condition of maternal and child care is way behind till now as no adequate/proper health services are available.

Keywords: antenatal, breastfeeding, child health, maternal, Tamenglong District

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3932 A Migration Policy Gone Wrong: A Study on How the Encampment Policy Undermines Refugees’ Potentials and Fails Local Economy: A Case of East Africa

Authors: John Bosco Ngendakurio

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The key question this paper asks is, ‘how does the refugee encampment policy undermine refugees’ potentials and fail local economy in East African countries?’ It is important to develop a full understanding of the legacies of the encampment policy for refugees’ performances economically, socially, and politically. The negative impacts of the encampment policy include the lack of participation or access to opportunities outside the refugee camps such as employment, education, and local integration, unfair imprisonments and constant alienation of refugees, mental and physical health issues, just to name a few. Evidence suggests that refugee camps in East Africa have progressively become open detention centres due to their designs, their locations, and movement restrictions imposed on refugees. Such restrictions in a region that hosts millions of refugees do not only undermine refugees’ potentials, but it also hurts the local economy- host countries miss out in many ways. Outlining the negative impacts of the encampment policy will enable governments and relevant non-governmental actors, including policymakers, to re-consider this policy with the aim to improve refugees’ participation and contributions in the broader society, promote socially cohesive practices, and help millions of refugees gain independence and reach their potentials financially, socially and politically, finally and truly giving the voice to the voiceless. The encampment policy undermines the general human security in East Africa, and it is one of the migration practices showcasing East African governments’ lack of will to protect human rights, especially within the most vulnerable population groups such as refugees.

Keywords: migration policy, immigration, refugees, encampment, migration, integration, social cohesion

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3931 New Innovation and Sustainability in a Developing Country: The Case of Cameroon

Authors: Lema Catherine Forje

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Innovation activates the system of an economy to a new level. Innovation follows a process. The first step in innovation is the idea-generation process. There is widespread appreciation that people go to great lengths, incur expenses: energy and materials to generate innovative ideas. People get inspired, create, and connect. The inspiration also enables the building of a culture of innovation. Data collection was done through a face-to-face interview with the producer of the first Cameroon beer that came out in the early 1960s, a rice producing company, a cement producing company, and 100 women following a type of dressing commonly worn by Cameroonian women (wrappa). There were a total number of one hundred and three interviewees. The implication of this study is for everybody. It sheds light on the factors that are likely to sustain an innovation. Conclusion emphasises continuous research to keep giving the innovation a face lift.

Keywords: entrepreneurship, ideas, innovation, sustainability

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