Search results for: mother’s satisfaction with midwife

Authors: Biback Das

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New Public Management, a phenomenal tool, which is used to enforcing in public administration in different country’s to enhance the capacities. Since the 1980s, New Public Management (NPM) is primarily focusing to modernize the public sector. From the initial period, many developed countries such as UK, New Zealand, Australia, and the USA are applied in their administration to modernize. Almost 1990s, it has been applied in many developing countries. This study can describe the real situations of NPM based administration. Bangladesh Government has taken many projects to reform the public sector under NPM. Even many Development Agencies like UN, UNDP, World Bank, Asian Development Bank and so on, along with many developed countries also invested and prescribed to take NPM based reform that can to restructure the public sector so that it can maximize the efforts to provide the better service. This study examines using many factors that effects work on Public Administration in Bangladesh and also assessing its endeavor to adopt in it. Although Government has taken such initiatives to implement NPM originated reform, it’s not effectively been implemented to bring positive change about as per NPM objectives. This study mainly examines some initiatives in Bangladesh that have the influence of NPM as well as some drawbacks that can’t help the satisfaction of these initiatives. This article help to identify the efforts of many development agencies providing a fund to enhance the NPM based projects with their specific conditions that are prescribed by them helping to get fund. Therefore, to establish effective public management or to follow NPM model, Bangladesh need having an institutional framework, sound rule of law, proper structure, effective civil service system, appropriate checks, and balances to restructure the public sector help along with donor agencies ad implement in it. Bangladesh Government has applied its recent days to enhance the capabilities in its Public Administration. Moreover, this study mainly identifies how the designing strategies, program formulating, its implementation in various sector such as education, health sector etc. and how to reduce the backdrop the during problem by smooth functioning. This paper is also assessing the influence of many projects like PPP (Public-Private and Partnership) to work along with private organizations for smooth service delivery. Accordingly, this paper briefly reviews how it applies in a global context following the taken many initiatives and the consequences of Bangladesh context.

Keywords: new public management, capacity building, conditionalities, service delivery, public-private-partnership

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Authors: Chan Hui-Ya, Ding Shin-Tan

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Background and Aim: The discharge planning is considered helpful to reduce the hospital length of stay and readmission rate, and then increased satisfaction with healthcare for patients and professionals. In order to decrease the waiting time of long-term care and boost the care quality of patients after discharge from the hospital, the Ministry of Health and Welfare department in Taiwan initiates a program “discharge planning connects with long-term care 2.0 services” in 2017. The purpose of this study is to investigate the outcome of the pilot of this program in a medical center. Methods: By purpose sampling, the study chose five wards in a medical center as pilot units. The researchers compared the beds of service, the numbers of cases which were transferred to the long-term care center and transferred rates per month between the pilot units and the other units, and analyze the basic data, the long-term care service needs and the approval service items of cases transfer to the long-term care center in pilot units. Results: From June to September 2017, a total of 92 referrals were made, and 51 patients were enrolled into the pilot program. There is a significant difference of transferring rate between the pilot units and the other units (χ = 702.6683, p < 0.001). Only 20 cases (39.2% success rate) were approved to accept the parts of service items of long-term care in the pilot units. The most approval item was respite care service (n = 13; 65%), while it was third at needs ranking of service lists during linking services process. Among the reasons of patients who cancelled the request, 38.71% reasons were related to the services which could not match the patients’ needs and expectation. Conclusion: The results indicate there is a requirement to modify the long-term care services to fit the needs of cases. The researchers suggest estimating the potential cases by screening data from hospital informatics systems and to hire more case manager according the service time of potential cases. Meanwhile, the strategies shortened the assessment scale and authorized hospital case managers to approve some items of long-term care should be considered.

Keywords: discharge planning, long-term care, case manager, patient care

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Authors: Sukhvinder Kaur, Ashok Agarwal

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Background: For the first time in 2009, India was able to generate estimates of HIV incidence (the number of new HIV infections per year). Analysis of epidemic projections helped in revealing that the number of new annual HIV infections in India had declined by more than 50% during the last decade (GOI Ministry of Health and Family Welfare, 2010). Then, National AIDS Control Organisation (NACO) planned to scale up its efforts in generating projections through epidemiological analysis and modelling by taking recent available sources of evidence such as HIV Sentinel Surveillance (HSS), India Census data and other critical data sets. Recently, NACO generated current round of HIV estimates-2012 through globally recommended tool “Spectrum Software” and came out with the estimates for adult HIV prevalence, annual new infections, number of people living with HIV, AIDS-related deaths and treatment needs. State level prevalence and incidence projections produced were used to project consequences of the epidemic in spectrum. In presence of HIV estimates generated at state level in India by NACO, USIAD funded PIPPSE project under the leadership of NACO undertook the estimations and projections to district level using same Spectrum software. In 2011, adult HIV prevalence in one of the high prevalent States, Maharashtra was 0.42% ahead of the national average of 0.27%. Considering the heterogeneity of HIV epidemic between districts, two districts of Maharashtra – Thane and Mumbai were selected to estimate and project the number of People-Living-with-HIV/AIDS (PLHIV), HIV-prevalence among adults and annual new HIV infections till 2017. Methodology: Inputs in spectrum included demographic data from Census of India since 1980 and sample registration system, programmatic data on ‘Alive and on ART (adult and children)’,‘Mother-Baby pairs under PPTCT’ and ‘High Risk Group (HRG)-size mapping estimates’, surveillance data from various rounds of HSS, National Family Health Survey–III, Integrated Biological and Behavioural Assessment and Behavioural Sentinel Surveillance. Major Findings: Assuming current programmatic interventions in these districts, an estimated decrease of 12% points in Thane and 31% points in Mumbai among new infections in HRGs and migrants is observed from 2011 by 2017. Conclusions: Project also validated decrease in HIV new infection among one of the high risk groups-FSWs using program cohort data since 2012 to 2016. Though there is a decrease in HIV prevalence and new infections in Thane and Mumbai, further decrease is possible if appropriate programme response, strategies and interventions are envisaged for specific target groups based on this evidence. Moreover, evidence need to be validated by other estimation/modelling techniques; and evidence can be generated for other districts of the state, where HIV prevalence is high and reliable data sources are available, to understand the epidemic within the local context.

Keywords: HIV sentinel surveillance, high risk groups, projections, new infections

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Authors: Paulina Clara Appiah, Kofi Issah, Timothy Letsa, Kennedy Nartey, Amanua Chinbuah, Adoma Dwomo-Fokuo, Jacqeline G. Asibey

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Background: The Every Newborn Action Plan provides evidence–based interventions to end preventable deaths in high burden countries. Brong Ahafo Region is one of ten regions in Ghana with less than half of its district hospitals having sick newborn units. Facility-based neonatal care is not prioritized and under-funded, and there is also inadequate knowledge and competence to manage the sick. The aim of this intervention was to make available in–patient care for sick newborns in all 19 district hospitals through the strengthening of facility-based systems. Methods: With the development and dissemination of the National Newborn Strategy and Action Plan 2014-2018, the country was able to attract PATH which provided the region with basic resuscitation equipment, supported hospital providers’ capacity building in Helping Babies Breathe, Essential Care of Every Baby, Infection Prevention and Management and held a symposia on managing the sick newborn. Newborn advocacy was promoted through newborn champions at the facility and community levels. Hospital management was then able to mobilize resources from communities, corporate organizations and from internally generated funds; created or expanded sick newborn care units and provided essential medicines and equipment. Kangaroo Mother Care was initiated in 6 hospitals. Pediatric specialist outreach services initiated comprised telephone consultations, teaching ward rounds and participating in perinatal death audits meetings. Newborn data capture and management was improved through the provision and training on the use of standard registers provided from the national level. Results: From February 2015 to November 2017, hospitals with sick newborn units increased from 7 to 19 (37%-100%). 180 pieces each of newborn ventilation bags and masks size 0, 1 and penguin suction bulbs were distributed to the hospitals, in addition to 20 newborn mannequin sets and 90 small clinical reminder posters. 802 providers (96.9%) were trained in resuscitation, of which 96% were successfully followed up in 6 weeks, 91% in 6 months and 80% in 12 months post-training. 53 clinicians (65%) were trained and mentored to manage sick newborns. 56 specialist teaching ward rounds were conducted. Data completeness improved from 92.6% - 99.9%. Availability of essential medicines improved from 11% to 100%. Number of hospital cots increased from 116 to 248 (214%). Cot occupancy rate increased from 57.4% to 92.5%. Hospitals with phototherapy equipment increased from 0 to 12 (63%). Hospitals with incubators increased from 1 to 12 (5%-63%). Newborn deaths among admissions reduced from 6.3% to 5.4%. Conclusion: Access to in-patient care increased significantly. Newborn advocacy successfully mobilized resources required for strengthening facility –based systems.

Keywords: facility-based systems, Ghana, in-patient care, newborn advocacy

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Authors: Samart Homthong, Wutthipong Moungnoi

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Critical success factors (CSFs) and the criteria to measure project success have received much attention over the decades and are among the most widely researched topics in the context of project management. However, although there have been extensive studies on the subject by different researchers, to date, there has been little agreement on the CSFs. The aim of this study is to identify the CSFs that influence the performance of construction projects, and determine their relative importance for different objectives across five stages in the project life cycle. A considerable literature review was conducted that resulted in the identification of 179 individual factors. These factors were then grouped into nine major categories. A questionnaire survey was used to collect data from three groups of respondents: client representatives, consultants, and contractors. Out of 164 questionnaires distributed, 93 were returned, yielding a response rate of 56.7%. Using the mean score, relative importance index, and weighted average method, the top 10 critical factors for each category were identified. The agreement of survey respondents on those categorised factors were analysed using Spearman’s rank correlation. A one-way analysis of variance was then performed to determine whether the mean scores among the various groups of respondents were statistically significant. The findings indicate the most CSFs in each category in procurement phase are: proper procurement programming of materials (time), stability in the price of materials (cost), and determining quality in the construction (quality). They are then followed by safety equipment acquisition and maintenance (health and safety), budgeting allowed in a contractual arrangement for implementing environmental management activities (environment), completeness of drawing documents (productivity), accurate measurement and pricing of bill of quantities (risk management), adequate communication among the project team (human resource), and adequate cost control measures (client satisfaction). An understanding of CSFs would help all interested parties in the construction industry to improve project performance. Furthermore, the results of this study would help construction professionals and practitioners take proactive measures for effective project management.

Keywords: critical success factors, procurement phase, project life cycle, project performance

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Authors: Monika Haanpää

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Well-functioning workplaces are often characterized by good co-operation, adequate flow of information, open interaction between workers and a supportive work environment. The workplace is a mosaic of human personalities and the influx of people, who speak different languages and who are from different cultural backgrounds, may bring about new challenges and enrich this environment. However, this influx of people could also pose a problem as the adaptation of immigrant people to new terms of work may depend heavily on the level of language skills, the stage of culture shock, professional identity, and personality. Migration is not a rare phenomenon in Finland anymore; nobody is surprised to see people from different countries and different backgrounds in the schools, on the streets or in shops. However, this does not mean that immigration is an easy process for people coming from other countries. The experience of workers, with diverse language and backgrounds, has rarely been researched, particularly from the superior's point of view. In addition, the vast majority of researchers have paid more attention to multicultural kindergartens in terms of immigrant children and their families. Hence, there is a need to show the problem which exists in the recruitment of the increasing number of workers who come from different countries. Opinions about kindergartens, as multicultural workplaces, have been gathered through interviews with immigrant workers responsible for education. In addition, a questionnaire for native Finnish workers and superiors in kindergartens was carried out. The collected material has been analyzed qualitatively, focusing on topics such as: the kindergarten as a multicultural workplace, factors influencing career success of workers with diverse language and cultural backgrounds, the social relations in the multicultural workplaces and teachers’ changing professional identity. The results of the research provided a novel aspect of the multicultural workplace and emphasized a dependency of immigrant workers’ on language skills in Finnish; affecting professional success. In addition, they showed the good relations between other native Finnish co-workers and superiors. The results also illustrate why writing skills in Finnish are so important in kindergartens. Part of the investigation also questions some results of the research i.e. which is more important in the kindergarten as a multicultural workplace: personality, good professional skills or good language skills.

Keywords: kindergarten, multicultural workplace, social relations at work, work satisfaction

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Authors: Benrithung Murry

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This paper highlights the biosocial determinants of health-seeking behavior in tribal population groups of northeast India, focusing on maternal and child health. The northeastern region of India is a conglomeration of several ethnic groups, most of which are scheduled as tribal groups. A total of 750 ever-married women in reproductive ages (15-49 years) were interviewed from three tribal groups of Nagaland, India using pre-tested and modified maternal health schedule. Data pertaining to reproductive performance of the mothers and their children health status were collected from 12 villages of Dimapur district, Nagaland, India. The sample for study comprises 212 Angami women, 267 Ao women, and 271 Sumi women, all of which belonging to tribal populations of Northeast India. Sex ratios of 15-49 years in these three populations are 1018.18, 1086.69, and 1106.92, respectively. 90% of the populations in the study are nuclear families, with about 10% of households falling below the poverty line as per the cutoffs for India. Female literacy level in these population groups is higher than the national average of 65.46%; however, about 30% of all married women are not engaged in any sort of earnings. Total fertility rates of these populations are alarming (Total Fertility Rate ≥ 6) and far from replacement fertility level, while infant mortality rates are found to be much lower than the national average of 34 per 1000. The perception and practice of maternal health in this region is unimpressive despite the availability of medical amenities. Only 3 % of mothers in the study have reported 4 times antenatal checkups during last two pregnancies. Other mothers have reported 1 to 3 times of antenatal checkups, but about 25% of them never visited a doctor during the entire pregnancy period. About 15% of mothers never took tetanus injection, while 40% of mothers never took iron folic supplements during pregnancy. Almost half of all women and their husbands do not use birth control measures even for the spacing of children, which has an immense impact on prenatal mortality mainly due to deliberate abortions: the percentage of prenatal mortality among Angami, Ao and Sumi populations is 44.88, 31.88 and 54.98, respectively per 1000 live births. The steep decline in fertility levels in most countries is a consequence of the increasing use of modern methods of contraception. However, among users of birth control measures in these populations, it is seen that most couples use it only after they have the desired number of children, thus its use having no substantial influence in reducing fertility. It is also seen that the majority of the children were only partially vaccinated. With many child deliveries being done at home, many newborns are not administered with polio at birth. Two-third of all children do not have complete basic immunization against polio, diphtheria, tetanus, pertussis, bacillus, and hepatitis besides others. Certain adherence to traditional beliefs and customs apart from the socio-economic factors is believed to have been operating in these populations, which determines their health-seeking behavior. While a more in-depth study combining biological, socio-cultural, economic, and genetic factors is suggested, there is an urgent need for intervention in these populations to combat with the poor maternal and child health status.

Keywords: case study, health behavior, mother and child, northeast india

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Authors: Shyamani Hettiarachchi, Thilini Lokubalasuriya, Shakeela Saleem, Dinusha Nonis, Isuru Dharmaratne, Lakshika Udugama

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Introduction: Late identification of language difficulties in children could result in long-term negative consequences for communication, literacy and self-esteem. This highlights the need for early identification and intervention for speech, language and communication difficulties. Speech and language therapy is a relatively new profession in Sri Lanka and at present, there are no formal standardized screening tools to assess language skills in Sinhala-speaking children. The development and validation of a short, accurate screening tool to enable the identification of children with syntactic difficulties in Sinhala is a current need. Aims: 1) To develop test items for a Sinhala Syntactic Structures (S3 Short Form) test on children aged between 3;0 to 5;0 years 2) To validate the test of Sinhala Syntactic Structures (S3 Short Form) on children aged between 3; 0 to 5; 0 years Methods: The Sinhala Syntactic Structures (S3 Short Form) was devised based on the Renfrew Action Picture Test. As Sinhala contains post-positions in contrast to English, the principles of the Renfrew Action Picture Test were followed to gain an information score and a grammar score but the test devised reflected the linguistic-specificity and complexity of Sinhala and the pictures were in keeping with the culture of the country. This included the dative case marker ‘to give something to her’ (/ejɑ:ʈə/ meaning ‘to her’), the instrumental case marker ‘to get something from’ (/ejɑ:gən/ meaning ‘from him’ or /gɑhən/ meaning ‘from the tree’), possessive noun (/ɑmmɑge:/ meaning ‘mother’s’ or /gɑhe:/ meaning ‘of the tree’ or /male:/ meaning ‘of the flower’) and plural markers (/bɑllɑ:/ bɑllo:/ meaning ‘dog/dogs’, /mɑlə/mɑl/ meaning ‘flower/flowers’, /gɑsə/gɑs/ meaning ‘tree/trees’ and /wɑlɑ:kulə/wɑlɑ:kulu/ meaning ‘cloud/clouds’). The picture targets included socio-culturally appropriate scenes of the Sri Lankan New Year celebration, elephant procession and the Buddhist ‘Wesak’ ceremony. The test was piloted with a group of 60 participants and necessary changes made. In phase 1, the test was administered to 100 Sinhala-speaking children aged between 3; 0 and 5; 0 years in one district. In this presentation on phase 2, the test was administered to another 100 Sinhala-speaking children aged between 3; 0 to 5; 0 in three districts. In phase 2, the selection of the test items was assessed via measures of content validity, test-retest reliability and inter-rater reliability. The age of acquisition of each syntactic structure was determined using content and grammar scores which were statistically analysed using t-tests and one-way ANOVAs. Results: High percentage agreement was found on test-retest reliability on content validity and Pearson correlation measures and on inter-rater reliability. As predicted, there was a statistically significant influence of age on the production of syntactic structures at p<0.05. Conclusions: As the target test items included generated the information and the syntactic structures expected, the test could be used as a quick syntactic screening tool with preschool children.

Keywords: Sinhala, screening, syntax, language

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Authors: Shailendra Kumar, Lokesh Kashyap, Puneet Khanna, Nishant Patel, Rakesh Kumar, Arshad Ayub, Kelika Prakash, Yudhyavir Singh, Krithikabrindha V.

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Introduction: Spinal anesthesia is considered a standard anesthesia technique for caesarean delivery. The incidence of spinal hypotension during caesarean delivery is 70 -80%. Spinal hypotension may cause cerebral hypoperfusion in the mother, but physiologically cerebral autoregulatory mechanisms accordingly prevent cerebral hypoxia. Cerebral blood flow remains constant in the 50-150 mmHg of Cerebral Perfusion Pressure (CPP) range. Near-infrared spectroscopy (NIRS) is a non-invasive technology that is used to detect Cerebral Desaturation Events (CDEs) immediately compared to other conventional intraoperative monitoring techniques. Objective: The primary aim of the study is to correlate the change in cerebral oxygen saturation using NIRS with respect to a fall in mean blood pressure after spinal anaesthesia and to find out the effects of spinal hypotension on neonatal APGAR score, neonatal acid-base variations, and presence of Postoperative Delirium (POD). Methodology: NIRS sensors were attached to the forehead of all the patients, and their baseline readings of cerebral oxygenation on the right and left frontal regions and mean blood pressure were noted. Subarachnoid block was given with hyperbaric 0.5% bupivacaine plus fentanyl, the dose being determined by the individual anaesthesiologist. Co-loading of IV crystalloid solutions was given to the patient. Blood pressure reading and cerebral saturation were recorded every 1 minute till 30min. Hypotension was a fall in MAP less than 20% of the baseline values. Patients going for hypotension were treated with an IV Bolus of phenylephrine/ephedrine. Umbilical cord blood samples were taken for blood gas analysis, and neonatal APGAR was noted by a neonatologist. Study design: A prospective observational study conducted in a population of Thirty ASA 2 and 3 parturients scheduled for lower segment caesarean section (LSCS). Results: Mean fall in regional cerebral saturation is 28.48 ± 14.7% with respect to the mean fall in blood pressure 38.92 ± 8.44 mm Hg. The correlation coefficient between fall in saturation and fall in mean blood pressure is 0.057, and p-value {0.7} after subarachnoid block. A fall in regional cerebral saturation occurred 2±1 min before a fall in mean blood pressure. Twenty-nine out of thirty patients required vasopressors during hypotension. The first dose of vasopressor requirement is needed at 6.02±2 min after the block. The mean APGAR score was 7.86 and 9.74 at 1 and 5 min of birth, respectively, and the mean umbilical arterial pH of 7.3±0.1. According to DRS-98 (Delirium Rating Scale), the mean delirium rating score on postoperative day 1 and day 2 were 0.1 and 0.7, respectively. Discussion: There was a fall in regional cerebral oxygen saturation, which started before with respect to a significant fall in mean blood pressure readings but was statistically not significant. Maximal fall in blood pressure requiring vasopressors occurs within 10 min of SAB. Neonatal APGAR scores and acid-base variations were in the normal range with maternal hypotension, and there was no incidence of postoperative delirium in patients with post-spinal hypotension.

Keywords: cerebral oxygenation, LSCS, NIRS, spinal hypotension

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Authors: Saman Kumara, Duminda Guruge, Krishani Jayasinghe

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Introduction: Nutrition strongly influences good health and development in early life. This study, based on a health promotion approach, used a community-based intervention to improve child nutrition. The approach provides the community with control of interventions, thereby building its capacity and empowering individuals and communities. The aim of this research was to reduce stunting, low birth weight and underweight in communities from Anuradhapura District in Sri Lanka, by identifying and addressing the underlying determinants of under-nutrition and strengthening families and communities to address them. Methods: A health promotion intervention was designed and implemented-based on a logical framework developed in collaboration with members of targeted community. Community members’ implements action, so they fully own the process. Members of the community identify and address the most crucial determinants of health including child health and development and monitor the initial results of their action and modify action to optimize outcomes as well as future goals. Group Discussion, group activities, awareness programs, cluster meetings, community tools and sharing success stories were major activities to address determinants. Continuous data collection was planned at different levels. Priority was given to strengthening the ability of families and groups or communities to collect meaningful data and analyze these themselves. Results: Enthusiasm and interest of the mother, happiness of the child/ family, dietary habits, money management, tobacco and alcohol use of fathers, media influences, illnesses in the child or others, hygiene and sanitary practices, community sensitiveness and domestic violence were the major perceived determinants elicited from the study. There were around 1000 well-functioning mothers groups in this district. ‘Happiness calendar’, ‘brain calendar’, ‘money tool’ and ‘stimulation books’ were created by the community members, to address determinants and measure the process. Evaluation of the process has shown positive early results, such as improvement of feeding habits among mothers, innovative ways of providing early stimulation and responsive care, greater involvement of fathers in childcare and responsive feeding. There is a positive movement of communities around child well-being through interactive play areas. Family functioning and community functioning improved. Use of alcohol and tobacco declined. Community money management improved. Underweight was reduced by 40%. Stunting and low birth weight among under-fives also declined within one year. Conclusion: The health promotion intervention was effective in changing the determinants of under-nutrition in early childhood. Addressing the underlying determinants of under-nutrition in early childhood can be recommended for similar contexts.

Keywords: birth-weight, community, determinants, stunting, underweight

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Authors: E. Knisel, H. Rupprich, A. Heissel

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Health Literacy is defined as the degree to which people have the capacity to obtain and understand information to make health decisions. Illustrated are three levels of health literacy: (1) Functional literacy refers to the transmission of information about e. g. physical activity and nutrition; (2) interactive literacy implies the development of personal and social skills to adopt health-related behaviour and (3) critical health literacy indicates advanced cognitive skills connected with personal empowerment to critically analyse health information, to define self-determined goals and taking action in various situations accordingly. The achievement of the third level refers to self-determination and autonomy which should be outcomes of exercise programs for overweight children as health-related behaviour change will occur and persist if it is autonomously motivated. Method: We adopted a quasi-experimental design with group (autonomy supportive coaching, control) and session (pre-test, intervention, post-test, and follow-up-test). Overweight and obese children and adolescents at the age of 8-14 years (N=40) received a 6-month (20 sessions) exercise program with autonomy supportive coaching implemented by the coaches and sandwiched between pre-test and post-test. All participants (N=92) completed the German version of the Basic Needs Satisfaction Scale Sport and Exercise. Additionally, we assessed the engagement in the exercise program by the MVPA (Moderate-to-Vigorous Physical Activity) and by the adherence and drop-out-rate. Results: Participants in the intervention group perceived their autonomy as moderate in the post-test and the follow-up-test. However, the psychological intervention failed to develop a high autonomy, as both groups show moderate perceived autonomy from the pre-test to the post-test. Participants in the intervention group were higher engaged in MVPA in the exercise program and they attend the program more regularly. Discussion: Young overweight and obese children and adolescents can acquire autonomy using autonomy supporting coaching. However, research identifying the extent they achieve critical health literacy is required to implement an autonomy-supportive coaching style into exercise programs for this target group.

Keywords: autonomy support, coaching, health literacy, health promotion

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Authors: Giorgi Gaganidze, Eter Kharaishvili

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The atypical crisis has created new challenges in the education system. Globally, including in Georgia, traditional methods of managing the education system have appeared particularly vulnerable. In addition, new opportunities for the introduction of innovative management of learning processes have emerged. The aim of the research is to identify the main challenges in the field of education management in the distance learning process in Georgia and to develop recommendations on the opportunities for the introduction of innovative management. The paper substantiates the relevance of the research, in particular, it notes that in Georgia, as in many countries, distance learning in higher education institutions became particularly crucial during the Covid-19 pandemic. What is more, theoretical and practical aspects of distance learning are less proven, and a number of problems have been identified in the field of education management in Georgia. The article justifies the need to study the challenges of distance learning for the formation of a sustainable education management system. Within the bibliographic research, there are grouped the opinions of researchers on the modern problems of distance learning and education management in the article. Based on scientific papers, the expectations formed about distance learning are studied, and the main focus is on the existing problems of education management during the atypical crisis. The article discusses the forms and opportunities of distance learning in different countries, evaluates different approaches and challenges to distance learning, and justifies the role of education management in effective distance learning. The paper uses various theoretical-methodological tools of research, including desk research on the research topic; Data selection-grouping, problem identification is carried out by analysis, synthesis, sampling, induction, and other methods;SWOT analysis is used to assess the strengths, weaknesses, opportunities, and threats of distance education and management; The level of student satisfaction with distance learning is determined through the Population-based / Census-based approach; The results of the research are processed by SPSS program. Quantitative research and semi-structured interviews with relevant focus groups were conducted to identify working directions for innovative management of distance learning and education. Research has shown that the demand for distance education is growing in Georgia, but the need to introduce innovative education management remains a particular challenge. Conclusions have been made on the introduction of innovative education management, and the relevant recommendations have been developed.

Keywords: distance learning, management challenges, education management, innovative management

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Authors: Elvis Munyoka

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While the number of African refugees settling in Australia has significantly increased since the mid-1990s, the marginalisation and exclusion of young people from refugee backgrounds in employment remain a critical challenge. Unemployment or underemployment can negatively impact refugees in multiple areas, such as income, housing, life satisfaction, and social status. Higher rates of unemployment among refugees are linked in part to the intersection of pre-migration and daily challenges like trauma, racism, gender identity, and English language competency, all of which generate multiple employability disadvantages. However, the intersection of gender, race, social class, and age in impacting African refugee youth’s access to employment has received less attention. Using a qualitative case study approach, the presentation will explore how gender, race, social class, and age influence African refugee youth graduates’ access to employment in South Australia. The intersectionality theory and capability approach to social justice is used to explore intersecting factors impacting African refugee youth’s access to employment in South Australia. Participants were 16 African refugee graduates aged 18-30 living in South Australia who took part in the study for one year. Based on the trends in the data, the results suggest that long-term unemployment and underemployment, coupled with ongoing racism and marginalisation, have the potential to make refugees more vulnerable to several mental disorders such as depression, hopelessness, and suicidal thoughts. The analysis also reveals that resettlement challenges may limit refugees’ ability to recover from pre-migration trauma. The impact of resettlement challenges on refugee mental health highlights the need for comprehensive policy interventions to address the barriers refugees face in finding employment in resettlement communities. With African refugees constituting such an important part of Australian society, they should have equal access to meaningful employment, as decent work promotes good mental health, successful resettlement, hope, and self-sufficiency.

Keywords: African refugees, employment, mental health, Australia, underemployment

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Authors: Guoqing Wang, Yanhua Zhao, Lina Zhang, Jingbin Bai, Ruican Zhu

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Friction stir welding with bobbin tool is a simple technique compared to conventional FSW since the backing fixture is no longer needed and assembling labor is reduced. It gets adopted more and more in the aerospace industry as a result. However, a post-weld problem, the left keyhole, has to be fixed by forced repair welding. To close the keyhole, the conventional fusion repair could be an option if the joint properties are not deteriorated; friction push plug welding, a forced repair, could be another except that a rigid support unit is demanded at the back of the weldment. Therefore, neither of the above ways is satisfaction in welding a large enclosed structure, like rocket propellant tank. Although friction pulls plug welding does not need a backing plate, the wide applications are still held back because of the disadvantages in respects of unappropriated tensile stress, (i.e. excessive stress causing neck shrinkage of plug that will bring about back defects while insufficient stress causing lack of heat input that will bring about face defects), complicated welding parameters (including rotation speed, transverse speed, friction force, welding pressure and upset)，short welding time (approx. 0.5 sec.), narrow windows and poor stability of process. In this research, an updated technique called inertia friction pull plug welding, and its equipment was developed. The influencing rules of technological parameters on joint properties of inertia friction pull plug welding were observed. The microstructure characteristics were analyzed. Based on the elementary performance data acquired, the conclusion is made that the uniform energy provided by an inertia flywheel will be a guarantee to a stable welding process. Meanwhile, due to the abandon of backing plate, the inertia friction pull plug welding is considered as a promising technique in repairing keyhole of bobbin tool FSW and point type defects of aluminium base material.

Keywords: defect repairing, equipment, inertia friction pull plug welding, technological parameters

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Authors: Kristin Prentice, Carri Hand

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As the Canadian population ages and chronic health conditions continue to escalate, older adults will require various types of housing, such as long term care or retirement homes. Moving to a new home may require a change in leisure activities and social networks, which could be challenging to maintain identity and create a sense of home. Leisure has been known to help older adults maintain or increase their quality of life and life satisfaction and may help older adults in moving to new homes. Sense of home and identity within older adults' transitions to new homes are concepts that may also relate to leisure engagement. Literature is scant regarding the role of leisure in older adults moving to new homes and how the sense of home and identity inter-relate. This study aims to explore how leisure may play a role in older adults' transitioning to new homes, including how sense of home and identity inter-relate. An ethnographic approach will be used to understand the culture of older adults transitioning to new homes. This study will involve older adults who have recently relocated to a mid-sized city in Ontario, Canada. The study will focus on the older adult’s interactions with and connections to their home environment through leisure. Data collection will take place via video-conferencing and will include a narrative interview and two other interviews to discuss an activity diary of leisure engagement pre and post move and mental maps to capture spaces where participants engaged in leisure. Participants will be encouraged to share photographs of leisure engagement taken inside and outside their home to help understand the social spaces the participants refer to in their activity diaries and mental maps. Older adults attempt to adjust to their new homes by maintaining their identity, developing a sense of home through creating attachment to place, and maintaining social networks, all of which have been linked to engaging in leisure. This research will provide insight into the role of leisure in this transition process and the extent that the home and community can contribute to aiding their transition to the new home. This research will contribute to existing literature on the inter-relationships of leisure, sense of home, and identity and how they relate to older adults moving to new homes. This research also has potential for influencing policy and practice for meeting the housing needs of older adults.

Keywords: leisure, older adults, transition, identity

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Authors: Elvis Munyoka

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While the number of African refugees settling in Australia has significantly increased since the mid-1990s, the marginalisation and exclusion of young people from refugee backgrounds in employment remain a critical challenge. Unemployment or underemployment can negatively impact refugees in multiple areas, such as income, housing, life satisfaction, and social status. Higher rates of unemployment among refugees are linked in part to the intersection of pre-migration and daily challenges like trauma, racism, gender identity, and English language competency, all of which generate multiple employability disadvantages. However, the intersection of gender, race, social class, and age in impacting African refugee youth’s access to employment has received less attention. Using a qualitative case study approach, the paper will explore how gender, race, social class, and age influence African refugee youth graduates’ access to employment in South Australia. The intersectionality theory and capability approach to social justice is used to explore intersecting factors impacting African refugee youth’s access to employment in South Australia. Participants were 16 African refugee graduates aged 18-30 living in South Australia who took part in the study for one year. Based on the trends in the data, the results suggest that long-term unemployment and underemployment, coupled with ongoing racism and marginalisation, have the potential to make refugees more vulnerable to several mental disorders such as depression, hopelessness, and suicidal thoughts. The analysis also reveals that resettlement challenges may limit refugees’ ability to recover from pre-migration trauma. The impact of resettlement challenges on refugee mental health highlights the need for comprehensive policy interventions to address the barriers refugees face in finding employment in resettlement communities. With African refugees constituting such an important part of Australian society, they should have equal access to meaningful employment, as decent work promotes good mental health, successful resettlement, hope, and self-sufficiency.

Keywords: African refugee youth, mental health, employment, resettlement, racism

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

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

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

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Authors: Lorraine Joyce Chua, Sheena Fatima Ragas, Flora Mae Tantay, Carolyn Marie Sunio

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The Philippines is one of the countries most affected by weather-related disasters. The occurrence of natural disasters in this country increases due to environmental degradation making environment preservation a growing trend in the society including the corporate world. Most organizations implemented green practices in order to lower expenses unaware that some of these practices were already a part of a new trend in human resource management known as Green Human Resource Management (GHRM). GHRM is when business organizations implement HR policies programs processes and techniques that bring environmental impact and sustainability practices on the organization. In relation to this, the study hypothesizes that implementing GHRM practices in the workplace will spillover to an employees lifestyle and such lifestyle may moderate the impact of GHRM practices to his job performance. Private industries located in the Philippines National Capital Region (NCR) were purposively selected for the purpose of this study. They must be ISO14001 certified or are currently aiming for such certification. The employee respondents were randomly selected and were asked to answer a reliable and valid researcher-made questionnaire. Structural equation modeling (SEM) supported the hypothesis that GHRM practices may spillover to employees lifestyle stimulating such individual to start a green lifestyle which moderates the impact of GHRM to his job performance. It can also be implied that GHRM practices help shape employees to become environmentally aware and responsible which may help them in preserving the environment. The findings of this study may encourage Human Resource practitioners to implement GHRM practices in the workplace in order to take part in sustaining the environment while maintaining or improving employees job performance and keeping them motivated. This study can serve as a basis for future research regarding the importance of strengthening the GHRM implementation here in the Philippines. Future studies may focus more on the impact of GHRM to other factors, such as job loyalty and job satisfaction of the employees belonging to specific industries which would greatly contribute to the GHRM community in the Philippines.

Keywords: GHRM practices, Green Human Resource Management, Green Lifestyle, ISO14001, job performance, Philippines

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Authors: Rogaleva Liudmila, Malkin Valery

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Physical culture lessons are considered not only to be a means of physical development of students, but a matter of their personal development. Physical culture lessons can enable to develop such qualities of students as activity and initiation, readiness to cooperate, self-confidence, ability to define and reach targets, readiness to overcome difficulties and assess their abilities (and disadvantages) properly in any precise situation as well to be responsible for their own decision. The solution of this problem is possible under the circumstance if the students aware themselves as the subject of the activity that are able to develop their possibilities. The research was aimed to learn the matters that enable female teenagers of senior forms to become strong personalities attending physical culture lessons. There were two stages of the research. At the first stage we define the interests and demands of the girls. According the results of research we changed the programme of physical culture lessons. We took into consideration values of youth subculture: youth music, preferences to sport-dancing physical activities, demand of self-determination, revealing their individualities, needs of cooperative work. At the second stage we worked out motivating technology of course. This technology was aimed to create sush conditions under which students could show themselves as the subjects of activity and self-development. The active participation sport-dance festivals during 2-3 years creates the conditions for their self-realization. 78% students of the experimental groups considered their main motives to were: the interest, developing of their abilities, the satisfaction of the achievements of targets. Control groups 67% of the students claimed the success school good marks. The girls said that due to festivals they became self-confident (94%), responsible (86%), ability to cooperate (73%), aspiration for reaching the target (68%), self-exactingness (57 %). The main factors that provide successful performance were called: efforts to reach the target (87%), mutual support and mutual understanding (77%). The research on values showed that in the experimental groups we can find increase of importance of such values as: social initiative (active life) 83%, friends (75%), self-control (73%), effectiveness in deeds (58%).

Keywords: physical culture, subject, personal development, self-determination

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Authors: Zahidul Islam

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This study investigates the effectiveness of resourcing in post-disaster housing reconstruction with reference to Cyclones Sidr and Aila in Bangladesh. Through evaluating three key theories- Build Back Better approach, Balance Scorecard approach and Dynamic Competency theories, the synthesis of literature, and empirical fieldwork, this research develops a dynamic theoretical framework that moves the trajectory of post-disaster housing reconstruction towards the reconstruction of more resilient houses. The ultimate goal of any post-disaster housing reconstruction project is to provide quality houses and to achieve high levels of satisfaction for beneficiaries. However, post-disaster reconstruction projects often fail in their stated objectives; only 10-20% housing needs are met, with most houses constructed on a temporary rather than permanent basis. A number of scholars have argued that access to resources can significantly increase the capacity and capability of disaster victims to rebuild their lives, including the construction of new homes. This study draws on structured interviews of 285 villagers affected by cyclones to investigate the effectiveness of resourcing in rebuilding houses after Cyclone Sidr in 2007 and Cyclone Aila in 2009. Furthermore, semi-structured interviews were conducted with 20 key stakeholders in UNDP, Oxfam, government officials, and national and international NGOs. The results of this study show that recovery rate of cyclone resilient houses that can withstand cyclone is very low and majority of the population are still vulnerable. Furthermore, hierarchical regression of survey data and thematic analyses of qualitative data indicate that access to resources, level of education, quality of building materials and income generating activities of the respondents are critical for effective post-disaster recovery. Conversely, resource availability, lack of coordination among participant organisations, corruption and lack of access to appropriate land constituted significant obstacles to livelihood recovery. Finally, this study makes significant theoretical contributions to theories of post-disaster recovery by introducing new variables and measures for evaluating the quality and effectiveness of post-disaster housing.

Keywords: disaster, resourcing, housing, resilience

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Authors: Lineo Dzansi

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South African government has been mandated by the Constitution (Act 108 of 1996) to deliver basic services to all who live in it. However, service delivery has always been marred with much criticism and citizens’ dissatisfaction regarding the quality of services rendered to them. This is evidenced by public protests that are common in South Africa lately which they are mostly alleged to link with failure by the government through various municipalities to meet citizens’ service delivery expectations. Municipalities render services through people. People management plays a crucial role in influencing employee and organisational performance and it thus needs to be conducted in a fair and just manner. Literature confirms that there is a relationship between organisational justice perceptions and employee behaviour, and that positive or negative justice perceptions can have an influence on employee attitudes, commitment to their jobs and organisation. The nature of the attachments formed by individuals to their employing organisations depends on the manner in which the organisation treats them. This implies that Municipal employees’ commitment could be linked to fair or unfair perceptions of Human Resource Management practices within their organisations. Unfortunately, the political nature of municipal environment could be a fertile ground for appointments of people based on political affiliation as a reward for political patronage rather than on merit. This paper seeks to investigate the relationship between municipal employees’ perceptions of fairness of Human Resource Management practices and employee commitment from the organisational justice point of view. Research on organisational justice has shown that employees’ organisational justice perceptions link directly with job satisfaction and employee organisational commitment. Quantitative research methods were employed to collect and analyse data from selected managerial and non-managerial municipal employees within selected municipalities in Free State Province of South Africa. Employee commitment has positive relationships with HRM practices at the .05 and .01 levels of significance – indicating that the higher the levels of HRM practices in municipal employees the higher the organisational commitment of employees. Therefore, it is concluded that organisational commitment of municipal employees (EOC) is positively related to their perceptions of fairness of HRM practices (PHF) of municipalities. In other words, fair HRM practices of municipalities promote organisational commitment in municipal employees.

Keywords: organisational Justice, HRM practices, employee organisational commitment, employee attitudes

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Authors: Hasan Taştan, Ayşen Ciravoğlu

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The rapid growth of the human population and the environmental degradation associated with increased consumption of resources raises concerns on sustainability. Social sustainability constitutes one of the three dimensions of sustainability together with environmental and economic dimensions. Even though there is not an agreement on what social sustainability consists of, it is a well known fact that it necessitates user participation. The fore, this study aims to observe and analyze the role of user participation on social sustainability. In this paper, the links between user participation and indicators of social sustainability have been searched. In order to achieve this, first of all a literature review on social sustainability has been done; accordingly, the information obtained from researches has been used in the evaluation of the projects conducted in the developing countries considering user participation. These examples are taken as role models with pros and cons for the development of the checklist for the evaluation of the case studies. Furthermore, a case study over the post earthquake residential settlements in Turkey have been conducted. The case study projects are selected considering different building scales (differing number of residential units), scale of the problem (post-earthquake settlements, rehabilitation of shanty dwellings) and the variety of users (differing socio-economic dimensions). Decisionmaking, design, building and usage processes of the selected projects and actors of these processes have been investigated in the context of social sustainability. The cases include: New Gourna Village by Hassan Fathy, Quinta Monroy dwelling units conducted in Chile by Alejandro Aravena and Beyköy and Beriköy projects in Turkey aiming to solve the problem of housing which have appeared after the earthquake happened in 1999 have been investigated. Results of the study possible links between social sustainability indicators and user participation and links between user participation and the peculiarities of place. Results are compared and discussed in order to find possible solutions to form social sustainability through user participation. Results show that social sustainability issues depend on communities' characteristics, socio-economic conditions and user profile but user participation has positive effects on some social sustainability indicators like user satisfaction, a sense of belonging and social stability.

Keywords: housing projects, residential areas, social sustainability, user participation

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Authors: K. S. Rao, Ankesh Kumar

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The search for alternative energy sources to petroleum has increased these days because of increase in need and depletion of petroleum reserves. Therefore the importance of oil shales as an economically viable substitute has increased many folds in last 20 years. The technologies like hydro-fracturing have opened the field of oil extraction from these unconventional rocks. Oil shale is a compact laminated rock of sedimentary origin containing organic matter known as kerogen which yields oil when distilled. Oil shales are formed from the contemporaneous deposition of fine grained mineral debris and organic degradation products derived from the breakdown of biota. Conditions required for the formation of oil shales include abundant organic productivity, early development of anaerobic conditions, and a lack of destructive organisms. These rocks are not gown through the high temperature and high pressure conditions in Mother Nature. The most common approach for oil extraction is drastically breaking the bond of the organics which involves retorting process. The two approaches for retorting are surface retorting and in-situ processing. The most environmental friendly approach for extraction is In-situ processing. The three steps involved in this process are fracturing, injection to achieve communication, and fluid migration at the underground location. Upon heating (retorting) oil shale at temperatures in the range of 300 to 400°C, the kerogen decomposes into oil, gas and residual carbon in a process referred to as pyrolysis. Therefore it is very important to understand the physico-mechenical behavior of such rocks, to improve the technology for in-situ extraction. It is clear from the past research and the physical observations that these rocks will behave as an anisotropic rock so it is very important to understand the mechanical behavior under high pressure at different orientation angles for the economical use of these resources. By knowing the engineering behavior under above conditions will allow us to simulate the deep ground retorting conditions numerically and experimentally. Many researchers have investigate the effect of organic content on the engineering behavior of oil shale but the coupled effect of organic and inorganic matrix is yet to be analyzed. The favourable characteristics of Assam coal for conversion to liquid fuels have been known for a long time. Studies have indicated that these coals and carbonaceous shale constitute the principal source rocks that have generated the hydrocarbons produced from the region. Rock cores of the representative samples are collected by performing on site drilling, as coring in laboratory is very difficult due to its highly anisotropic nature. Different tests are performed to understand the petrology of these samples, further the chemical analyses are also done to exactly quantify the organic content in these rocks. The mechanical properties of these rocks are investigated by considering different anisotropic angles. Now the results obtained from petrology and chemical analysis are correlated with the mechanical properties. These properties and correlations will further help in increasing the producibility of these rocks. It is well established that the organic content is negatively correlated to tensile strength, compressive strength and modulus of elasticity.

Keywords: oil shale, producibility, hydro-fracturing, kerogen, petrology, mechanical behavior

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Authors: S. MacDonald, A. Manuel, R. Law, N. Bandruak, A. Dubrowski, V. Curran, J. Smith-Young, K. Simmons, A. Warren

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High fidelity human patient simulation has been used for many years by health sciences education programs to foster critical thinking, engage learners, improve confidence, improve communication, and enhance psychomotor skills. Unfortunately, there is a paucity of research on the use of high fidelity human patient simulation to foster teamwork among nursing, medicine and pharmacy undergraduate students. This study compared the impact of high fidelity and low fidelity simulation education on teamwork among nursing, medicine and pharmacy students. For the purpose of this study, two innovative teaching scenarios were developed based on the care of an adult patient experiencing acute anaphylaxis: one high fidelity using a human patient simulator and one low fidelity using case based discussions. A within subjects, pretest-posttest, repeated measures design was used with two-treatment levels and random assignment of individual subjects to teams of two or more professions. A convenience sample of twenty-four (n=24) undergraduate students participated, including: nursing (n=11), medicine (n=9), and pharmacy (n=4). The Interprofessional Teamwork Questionnaire was used to assess for changes in students’ perception of their functionality within the team, importance of interprofessional collaboration, comprehension of roles, and confidence in communication and collaboration. Student satisfaction was also assessed. Students reported significant improvements in their understanding of the importance of interprofessional teamwork and of the roles of nursing and medicine on the team after participation in both the high fidelity and the low fidelity simulation. However, only participants in the high fidelity simulation reported a significant improvement in their ability to function effectively as a member of the team. All students reported that both simulations were a meaningful learning experience and all students would recommend both experiences to other students. These findings suggest there is merit in both high fidelity and low fidelity simulation as a teaching and learning approach to foster teamwork among undergraduate nursing, medicine and pharmacy students. However, participation in high fidelity simulation may provide a more realistic opportunity to practice and function as an effective member of the interprofessional health care team.

Keywords: acute anaphylaxis, high fidelity human patient simulation, low fidelity simulation, interprofessional education

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Authors: Maria Tsouroufli, Andrea Mondokova, Subashini Suresh

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Background: The under-representation of women and consequent failure to fulfil their potential contribution to Science, Technology, Engineering, Maths, and Medicine (STEMM) subjects in the UK is an issue that the Higher Education sector is being encouraged to address. Focus: The aim of this research is to investigate the barriers, facilitators, and incentives that influence diverse groups of women who have embarked upon a related career in STEMM subjects. The project will address a number of interconnected research questions: 1. How do participants perceive the barriers, facilitators and incentives for women in terms of research, teaching and management/leadership at each stage of their development towards forging a career in STEMM? 2. How might gender intersect with ethnicity, pregnancy/maternity and academic grade in the career experiences of women in STEMM? 3. How do participants perceive the example of female role models in emulating them as a career model? 4. How do successful females in STEMM see themselves as role models and what strategies do they employ to promote their careers? 5. How does institutional culture manifest itself as a barrier or facilitator for women in STEMM subjects in the institution? Methodology and Theoretical framework: A mixed-methodology will be employed in a case study of one university. The study will draw on extant quantitative data for context and involve conducting a qualitative inquiry to discover the perceptions of staff and students around the key concepts under study (career progression, sense of belonging and tenure, role-models, personal satisfaction, perceived gender in/equality, institutional culture). The analysis will be informed by an intersectionality framework, feminist and gender theory, and organisational psychology and human resource management perspectives. Implications: Preliminary findings will be collected in 2017. Conclusions will be drawn and used to inform recruitment and retention, and the development and implementation of initiatives to enhance the experiences and outcomes of women working and studying in STEMM subjects in Higher Education.

Keywords: under-representation, women, STEMM subjects, intersectionality

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Authors: Manahil Alfuraydan, Jodie Croxall, Lisa Hurt, Mike Kerr, Sinead Brophy

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Autism Spectrum Disorder (ASD) is a developmental condition characterised by impairment in terms of social communication, social interaction, and a repetitive or restricted pattern of interest, behaviour, and activity. There is a significant delay between seeking help and a confirmed diagnosis of ASD. This may result in delay in receiving early intervention services, which are critical for positive outcomes. The long wait times also cause stress for the individuals and their families. Telehealth potentially offers a way of improving the diagnostic pathway for ASD. This review of the literature aims to examine which telehealth approaches have been used in the diagnosis and assessment of autism in children and adults, whether they are feasible and acceptable, and how they compare with face-to-face diagnosis and assessment methods. A comprehensive search of following databases- MEDLINE, CINAHL Plus with Full text, Business Sources Complete, Web of Science, Scopus, PsycINFO and trail and systematic review databases including Cochrane Library, Health Technology Assessment, Database of Abstracts and Reviews of Effectiveness and NHS Economic Evaluation was conducted, combining the terms of autism and telehealth from 2000 to 2018. A total of 10 studies were identified for inclusion in the review. This review of the literature found there to be two methods of using telehealth: (a) video conferencing to enable teams in different areas to consult with the families and to assess the child/adult in real time and (b) a video upload to a web portal that enables the clinical assessment of behaviours in the family home. The findings were positive, finding there to be high agreement in terms of the diagnosis between remote methods and face to face methods and with high levels of satisfaction among the families and clinicians. This field is in the very early stages, and so only studies with small sample size were identified, but the findings suggest that there is potential for telehealth methods to improve assessment and diagnosis of autism used in conjunction with existing methods, especially for those with clear autism traits and adults with autism. Larger randomised controlled trials of this technology are warranted.

Keywords: assessment, autism spectrum disorder, diagnosis, telehealth

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Authors: Amani A. Saleh, Maram M. Saudy, Mohamed N. AbouZeid

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Asphalt cement concrete is a very commonly used material in the construction of roads. It has many advantages, such as being easy to use as well as providing high user satisfaction in terms of comfortability and safety on the road. However, there are some problems that come with asphalt cement concrete, such as its high carbon footprint, which makes it environmentally unfriendly. In addition, pavements require frequent maintenance, which could be very costly and uneconomic. The aim of this research is to study the effect of mixing waste-based geopolymers with asphalt binders. Geopolymer mixes were prepared by combining alumino-silicate sources such as fly ash, silica fumes, and metakaolin with alkali activators. The purpose of mixing geopolymers with the asphalt binder is to enhance the rheological and microstructural properties of asphalt. This was done through two phases, where the first phase was developing an optimum mix design of the geopolymer additive itself. The following phase was testing the geopolymer-modified asphalt binder after the addition of the optimum geopolymer mix design to it. The testing of the modified binder is performed according to the Superpave testing procedures, which include the dynamic shear rheometer to measure parameters such as rutting and fatigue cracking, and the rotational viscometer to measure workability. In addition, the microstructural properties of the modified binder is studied using the environmental scanning electron microscopy test (ESEM). In the testing phase, the aim is to observe whether the addition of different geopolymer percentages to the asphalt binder will enhance the properties of the binder and yield desirable results. Furthermore, the tests on the geopolymer-modified binder were carried out at fixed time intervals, therefore, the curing time was the main parameter being tested in this research. It was observed that the addition of geopolymers to asphalt binder has shown an increased performance of asphalt binder with time. It is worth mentioning that carbon emissions are expected to be reduced since geopolymers are environmentally friendly materials that minimize carbon emissions and lead to a more sustainable environment. Additionally, the use of industrial by-products such as fly ash and silica fumes is beneficial in the sense that they are recycled into producing geopolymers instead of being accumulated in landfills and therefore wasting space.

Keywords: geopolymer, rutting, superpave, fatigue cracking, sustainability, waste

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Authors: Brian Bacia, Esther Githaiga, Teresia Kabucho, Paul Moses Ndegwa, Lucy Gichohi

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Purpose: The aim of the study is to ensure an appropriate mix of evidence-based prevention strategies geared towards the reduction of new HIV infections and the incidence of Sexually transmitted Illnesses Background: In Nakuru County, more than 90% of all HIV-infected patients are adults and on a single-dose medication-one pill that contains a combination of several different HIV drugs. Nakuru town has been identified as the hardest hit by HIV/Aids in the County according to the latest statistics from the County Aids and STI group, with a prevalence rate of 5.7 percent attributed to the high population and an active urban center. Method: 2 key studies were carried out to provide evidence for the effectiveness of antiretroviral therapy (ART) when used optimally on preventing sexual transmission of HIV. Discussions based on an examination, assessments of successes in planning, program implementation, and ultimate impact of prevention and treatment were undertaken involving health managers, health workers, community health workers, and people living with HIV/AIDS between February -August 2021. Questionnaires were carried out by a trained duo on ethical procedures at 15 HIV treatment clinics targeting patients on ARVs and caregivers on ARV prevention and treatment of pediatric HIV infection. Findings: Levels of AIDS awareness are extremely high. Advances in HIV treatment have led to an enhanced understanding of the virus, improved care of patients, and control of the spread of drug-resistant HIV. There has been a tremendous increase in the number of people living with HIV having access to life-long antiretroviral drugs (ARV), mostly on generic medicines. Healthcare facilities providing treatment are stressed challenging the administration of the drugs, which require a clinical setting. Women find it difficult to take a daily pill which reduces the effectiveness of the medicine. ART adherence can be strengthened largely through the use of innovative digital technology. The case management approach is useful in resource-limited settings. The county has made tremendous progress in mother-to-child transmission reduction through enhanced early antenatal care (ANC) attendance and mapping of pregnant women Recommendations: Treatment reduces the risk of transmission to the child during pregnancy, labor, and delivery. Promote research of medicines through patients and community engagement. Reduce the risk of transmission through breastfeeding. Enhance testing strategies and strengthen health systems for sustainable HIV service delivery. Need exists for improved antenatal care and delivery by skilled birth attendants. Develop a comprehensive maternal reproductive health policy covering equitability, efficient and effective delivery of services. Put in place referral systems.

Keywords: evidence-based prevention strategies, service delivery, human management, integrated approach

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Authors: Nilam Bano, Uzma Iram

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Globally, the dilemma of undernutrition has become a notable concern for the researchers, academicians, and policymakers because of its severe consequences for many centuries. The nutritional deficiencies create hurdles for the people to achieve goals related to live a better lifestyle. Not only at micro level but also at the macro level, the consequences of undernutrition affect the economic progress of the country. The initial five years of a child’s life are considered critical for the physical growth and brain development. In this regard, children require special care and good quality food (nutrient intake) to fulfill their nutritional demand of the growing body. Having the sensitive stature and health, children specially under the age of 5 years are more vulnerable to the poor economic, housing, environmental and other social conditions. Beside confronting economic challenges and political upheavals, Pakistan is also going through from a rough patch in the context of social development. Majority of the children are facing serious health problems in the absence of required nutrition. The complexity of this issue is getting severe day by day and specially children are left behind with different type of immune problems and vitamins and mineral deficiencies. It is noted that children from the well-off background are less likely affected by the undernutrition. In order to underline this issue, the present study aims to highlight the existing nutritional inequalities among the children of under five years in Pakistan. Moreover, this study strives to decompose those factors that severely affect the existing nutritional inequality and standing in the queue to capture the consideration of concerned authorities. Pakistan Demographic and Health Survey 2012-13 was employed to assess the relevant indicators of undernutrition such as stunting, wasting, underweight and associated socioeconomic factors. The objectives were executed through the utilization of the relevant empirical techniques. Concentration indices were constructed to measure the nutritional inequalities by utilizing three measures of undernutrition; stunting, wasting and underweight. In addition to it, the decomposition analysis following the logistic regression was made to unfold the determinants that severely affect the nutritional inequalities. The negative values of concentration indices illustrate that children from the marginalized background are affected by the undernutrition more than their counterparts who belong from rich households. Furthermore, the result of decomposition analysis indicates that child age, size of a child at birth, wealth index, household size, parents’ education, mother’s health and place of residence are the most contributing factors in the prevalence of existing nutritional inequalities. Considering the result of the study, it is suggested to the policymakers to design policies in a way so that the health sector of Pakistan can stimulate in a productive manner. Increasing the number of effective health awareness programs for mothers would create a notable difference. Moreover, the education of the parents must be concerned by the policymakers as it has a significant association with the present research in terms of eradicating the nutritional inequalities among children.

Keywords: concentration index, decomposition analysis, inequalities, undernutrition, Pakistan

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Authors: Omneya Messallam, Sara S. Fouad

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The Modernist Movement initially flourished in France, Holland, Germany and the Soviet Union. Many architects and designers were inspired and followed its principles. Two of its most important architects (Gerrit Rietveld and Ludwig Mies van de Rohe) were introduced in this paper. Each did not follow the other’s principles and had their own particular rules; however, they shared the same features of the Modernist International Style, such as Anti-historicism, Abstraction, Technology, Function and Internationalism/ Universality. Key Modernist principles translated into high expectations, which sometimes did not meet the inhabitants’ aspirations of living comfortably; consequently, leading to a conflict and misunderstanding between the designer and their clients’ needs. Therefore, historical case studies (the Schroder and the Farnsworth houses) involving two Modernist pioneer architects have been chosen. This paper is an attempt to explore some of the influential factors affecting buildings design such as: needs, gender, and question concerning commonalities between both designers and their clients. The three aspects and two designers explored here have been chosen because they have been influenced the researchers to understand the impact of those factors on the design process, building’s performance, and the dweller’s satisfaction. This is a descriptive/ analytical research based on two historical comparative case studies that involve several steps such as: key evaluation questions (KEQs), observations, document analysis, etc. The methodology is based on data collation and finding validations. The research aims to state a manifest to regulate the relation between architects and their clients to reach the optimum building performance and functional interior design that suits their clients’ needs, reflects the architects’ character, and the school they belong to. At the end, through the investigation in this paper, the different needs between both the designers and the clients have been seen not only in the building itself but also it could convert the inhabitant’s life in various ways. Moreover, a successful relationship between the architect and their clients could play a significant role in the success of projects. In contrast, not every good design or celebrated building could end up with a successful relationship between the designer and their client or full-fill the inhabitant’s aspirations.

Keywords: architect’s character, building’s performance, commonalities, client’s character, gender, modernist movement, needs

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