Search results for: crisis interventions

Authors: Theodore Panton

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As cities in the United States experience critical housing shortages, mass timber presents the opportunity to address this crisis in housing supply while taking advantage of the carbon-positive benefits of sustainably forested wood fiber. Mass timber, however, currently has a low level of adoption in residential multifamily structures due to the risk-averse nature of change within the construction financing, Architecture / Engineering / Contracting (AEC) communities, as well as various agency approval challenges. This study demonstrates how mass timber can be used within the cost and feasibility parameters of a typical multistory residential structure and ultimately address the need for dense urban housing. This study will utilize The Garden District, a mixed-use market-rate housing project in Woodinville, Washington, as a case study to illuminate the potential of mass timber in this application. The Garden District is currently in final stages of permit approval and will commence construction in 2023. It will be the tallest dowel-laminated timber (DLT) residential structure in the United States when completed. This case study includes economic, technical, and design reference points to demonstrate the relevance of the use of this system and its ability to deliver “triple bottom line” results. In terms of results, the study establishes scalable and repeatable approaches to project design and delivery of mass timber in multifamily residential uses and includes economic data, technical solutions, and a summary of end-user advantages. This study discusses the third party tested systems for satisfying acoustical requirements within dwelling units, a key to resolving the use of mass timber within multistory residential use. Lastly, the study will also compare the mass timber solution with a comparable cold formed steel (CFS) system with a similar program, which indicates a net carbon savings of over three million tons over the life cycle of the building.

Keywords: DLT, dowell laminated timber, mass timber, market rate multifamily

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Authors: Ali Liaghat, Navid Tavanpour, Nima Tavanpour

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An increase in population and prevalence of urbanity have led plan makers and decision makers put effort into sustainable development of cities at national and local levels. One of the important issues in urban development is compliance with safety issues in cities. Despite natural disasters and unexpected events such as floods, earthquakes, hurricanes, fires, etc., urban development should be regarded as an axiom, or else any form of construction and development is not safe, because it will greatly harm economic growth and development and pose an obstacle to achieving sustainable development, plus a loss to lives and finances of people. Therefore, in line with urban development, it is necessary to identify particular environmental and local issues as determinants and pay attention to them at the top of everything, in that we can call it a good action and factor in urban sustainable developments. Physical structure of each city represents how it has developed or its development shaped and what incidents, changes, natural disasters it has undergone over time. Since any form of development plan should be in accordance with the previous situations of cities, disregarding it, unfortunately, can escalate into uncontrolled urban development, non-resistant and unstable construction against earthquake or invasion of river areas, destruction of agricultural lands or vegetation, periodic floods over time. It has been viewed as serious threats to developing cities, and typically caused destruction of bed and other urban facilities as well as damages to lives and finances. In addition, uncontrolled development has caused cities to look ugly in terms of urban façade, and off and on such unplanned measures caused the country to face countless losses, and it not only vitiates expenses incurred, but it will also impose additional costs of reconstruction, i.e. it is unsustainable development. Thus, in this paper, in addition to a discussion about necessity for a profound attitude toward this subject and making long-term plans, programs for organizing river and its surrounding area, creating open and green urban spaces, retrofitting and flood preventing are presented for sustainable safety and development of cities along with a critique of successful countries.

Keywords: flood, sustainable development, urbanisation, urban management

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Authors: Roya Morad, W. Eirik Heintz

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The identity of a neighborhood is inevitably shaped by the architecture and the people of that place. Conventionally the streets within each neighborhood served as a semi-public-private extension of the private living spaces. The street as a design element formed a hybrid condition that was neither totally public nor private, and it encouraged social interactions. Thus through creating a sense of community, one of the most basic human needs of belonging was achieved. Similar to major global cities, Tehran has undergone serious urbanization. Developing into a capital city of high rises has resulted in an increase in urban density. Although allocating more residential units in each neighborhood was a critical response to the population boom and the limited land area of the city, it also created a crisis in terms of social communication and place attachment. District 10 in Tehran is a neighborhood that has undergone the most urban transformation among the other 22 districts in the capital and currently has the highest population density. This paper will explore how the active streets in district 10 have changed into their current condition of high rises with a lack of meaningful social interactions amongst its inhabitants. A residential building can be thought of as a large group of people. One would think that as the number of people increases, the opportunities for social communications would increase as well. However, according to the survey, there is an indirect relationship between the two. As the number of people of a residential building increases, the quality of each acquaintance reduces, and the depth of relationships between people tends to decrease. This comes from the anonymity of being part of a crowd and the lack of social spaces characterized by most high-rise apartment buildings. Without a sense of community, the attachment to a neighborhood is decreased. This paper further explores how the neighborhood participates to fulfill ones need for social interaction and focuses on the qualitative aspects of alternative spaces that can redevelop the sense of place attachment within the community.

Keywords: high density, place attachment, social communication, street life, urban transformation

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Authors: Eric Lai, Sarah Lorger, David Eisinger, Richard Waugh

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Introduction: Percutaneous embolization of varicoceles has shown similar outcomes to surgery. However, there are advantages of radiological intervention as patients are not exposed to general anaesthesia, experience a quicker recovery and face a lower risk of major complications. Radiological interventions are also preferable after a failed surgical approach. We evaluate clinical outcomes of percutaneous embolization at a tertiary hospital in Sydney, Australia. Methods: Retrospective case series without a control group from a single site (Royal Prince Alfred Hospital, Sydney, Australia). A data search was performed on the interventional radiology database with the word “varicocele” between February 2017 and March 2022. 62 patients were identified. Each patient file was reviewed and included in the study if they met the inclusion criteria. Results: A total of 56 patients were included. 6 patients were excluded as they did not receive intervention after the initial diagnostic venography. Technical success was 100%. Complications were seen in 3 patients (5.3%). The complications included post-procedural pain and fever, venous perforation with no clinical adverse outcome, and a mild allergic reaction to contrast. Recurrence occurred in 3 patients (5.6%), all of whom received a successful second procedure. DISCUSSION: This study demonstrates comparable rates of technical success, complication rate and recurrence to other studies in the literature. When compared to surgical outcomes, the results were also similar. The main limitation is multiple patients lack long-term follow-up beyond 1 year, resulting in potential underestimation of the recurrence rate. Conclusion: Percutaneous embolization of varicocele is a safe alternative to surgical intervention.

Keywords: varicocele, interventional radiology, urology, radiology

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Authors: E. Von Cheong, Carol Sinnott, Darren Dahly, Patricia M. Kearney

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Introduction and Aim: Adverse childhood experiences (ACEs) are all too common and have been linked to poorer health and wellbeing across the life course. While the prevention of ACEs is a worthy goal, it is important that we also try to lessen the impact of ACEs for those who do experience them. This study aims to investigate associations between adverse childhood experiences (ACEs) and later-life depressive symptoms; and to explore whether perceived social support (PSS) moderates these. Method: We analysed baseline data from the Mitchelstown (Ireland) 2010-11 cohort involving 2047 men and women aged 50–69 years. Self-reported assessments included ACEs (Centre for Disease Control ACE questionnaire), PSS (Oslo Social Support Scale), and depressive symptoms (CES-D). The primary exposure was self-report of at least one ACE. We also investigated the effects of ACE exposure by the subtypes abuse, neglect, and household dysfunction. Associations between each of these exposures and depressive symptoms were estimated using logistic regression, adjusted for socio-demographic factors that were selected using the Directed Acyclic Graph (DAG) approach. We also tested whether the estimated associations varied across levels of PSS (poor, moderate, and good). Results: 23.7% of participants reported at least one ACE (95% CI: 21.9% to 25.6%). ACE exposures (overall or subtype) were associated with a higher odds of depressive symptoms, but only among individuals with poor PSS. For example, exposure to any ACE (vs. none) was associated with 3 times the odds of depressive symptoms (Adjusted OR 2.97; 95% CI 1.63 to 5.40) among individuals reporting poor PSS, while among those reporting moderate PSS, the adjusted OR was 1.18 (95% CI 0.72 to 1.94). Discussion: ACEs are common among older adults in Ireland and are associated with higher odds of later-life depressive symptoms among those also reporting poor PSS. Interventions that enhance perception of social support following ACE exposure may help reduce the burden of depression in older populations.

Keywords: adverse childhood experiences, depression, later-life, perceived social support

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Authors: Chitsanzo Isaac

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Across the world, the ongoing Covid-19 pandemic has challenged urban systems and policy frameworks, highlighting societal vulnerabilities and systemic inequities among many communities. Measures of confinement and social distancing to contain the Covid-19 virus have fragmented the physical and social fabric of cities. This has caused urban dwellers to reassess how they engage with their urban surroundings and maintain social ties. Urbanists have presented strategies that would allow communities to survive and even thrive, in extraordinary times of crisis like the pandemic. Tactical Urbanism, particularly the 15-Minute City, has gained popularity. It is considered a resilient approach in the global north, however, it’s transferability to the global south has been called into question. To this end, this paper poses the question: to what extent is the 15-Minute City framework integral sustainable design, and are there processes that make it adoptable by cities in the global south? This paper explores four issues using secondary quantitative data analysis and convergence analysis in the Paris and Blantyre urban regions. First, it questions how the 15-Minute City has been defined and measured, and how it impacts urban dwellers. Second, it examines the extent to which the 15-minute city performs under the lens of frameworks such as Wilber’s integral theory and Fleming’s integral sustainable design theory. Thirdly this work examines the processes that can be transferred to developing cities which foster community resilience through the perspectives of experience, behaviors, cultures, and systems. Finally, it reviews the principal ways in which a multi-perspective reality can be the basis for resilient community design and sustainable urban development. This work will shed a light on the importance of a multi-perspective reality as a means of achieving sustainable urban design goals in developing urban areas.

Keywords: 15-minute city, developing cities, global south, community resilience, integral sustainable design, systems thinking, complexity, tactical urbanism

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Authors: Adeyinka Adeniran, Omowunmi Bakare, Esther Oluwole, Florence Chieme, Temitope Durojaiye, Modupe Akinyinka, Omobola Ojo, Babatunde Olujobi, Marcus Ilesanmi, Akintunde Ogunsakin

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Introduction: Globally, COVID-19 has greatly impacted the human race physically, socially, mentally, and economically. However, healthcare workers seemed to bear the greatest impact. The study, therefore, sought to assess the impact of COVID-19 on the primary healthcare workers in Ekiti, South-west Nigeria. Methods: The study was a cross-sectional descriptive study using a quantitative data collection method of 716 primary healthcare workers in Ekiti state. Respondents were selected using an online convenience sampling method via their social media platforms. Data was collected, collated, and analyzed using SPSS version 25 software and presented as frequency tables, mean and standard deviation. Bivariate and multivariate analyses were conducted using a t-test, and the level of statistical significance was set at p<0.05. Results: Less than half (47.1%) of respondents were between 41-50 age group and a mean age of 44.4+6.4SD. A majority (89.4%) were female, and almost all (96.2%) were married. More than (90%) had ever heard of Coronavirus, and (85.8%) had to spend more money on activities of daily living such as transportation (90.1%), groceries (80.6%), assisting relations (95.8%) and sanitary measures (disinfection) at home (95.0%). COVID-19 had a huge negative impact on about (89.7%) of healthcare workers, with a mean score of 22+4.8. Conclusion: COVID-19 negatively impacted the daily living and professional duties of primary healthcare workers, which reflected their psychological, physical, social, and economic well-being. Disease outbreaks are unlikely to disappear in the near future. Hence, global proactive interventions and homegrown measures should be adopted to protect healthcare workers and save lives.

Keywords: Covid-19, health workforce, primary health care, health systems, depression

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Authors: Riyona Chetty, Raisuyah Bhagwan, Nalini Govender

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Background: A myriad of physical, psychosocial, and environmental sequelae are associated with limb loss. However, there is a paucity of empirical South African data, which focuses on these sequelae, how they interface with the amputee’s quality of life as well as the challenges they experience following amputation. Objective: This study sought to explore the biopsychosocial effects of amputation and how amputation affected the quality of life of transtibial amputees. Setting: Participants were recruited from a medical facility, under the KwaZulu-Natal Department of Health in South Africa. Methods: A qualitative approach guided this study. Data was collected using one-on-one interviews with 14 unilateral transtibial amputees. Data was analysed thematically. Results: Five broad themes emerged from the inquiry, which captured amputees’ experiences of phantom limb pain, body image disturbances, and their challenges related to adapting to daily activities. Participants also expressed the salience of familial support as well as the importance of psychological interventions to cope. Conclusion: The findings suggested that support networks and professional psychological intervention are imperative in facilitating successful adjustment to the amputation experience. Raising awareness of limb loss in both, rural and urban settings may help reduce the stigma attached to it. Contribution: Quality of life comprises several domains, namely physical, psychological, environmental, and social albeit limited local and international data exists regarding the environmental and social effects. This study brought to the fore the positive and negative effects of amputation in each domain, as well as various strategies that facilitate successful adjustment to amputation.

Keywords: amputation, quality of life, biopsychosocial, phantom limb pain, body image, support

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Authors: P. J. Kagosi, M. Mndolwa, E. Japhate

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The study was conducted to communities adjacent MNR, Lushoto district, Tanzania. The MNR is one of the nine nature reserves in the Eastern Arc Mountains of Tanzania with an area of 8,700ha with high biological diversity. However, biodiversity in MNR have been threatened by increasing human activities for livelihood in 1970s. The AF systems in the study area was practised since 1980s however, no study was conducted on AF impacts. This paper presents the influence of AF on livelihood of communities adjacent MNR and biodiversity conservation. Qualitative and quantitative data were collected using socio-economic survey and botanical surveys. Data were analysed using Statistical Packages for Social Sciences and content analysis. The study found that in 1970s free livestock grazing caused considerable surface runoff, soil erosion and reduction of crop production. Since 1980s, the study area received various interventions based on the land conservations and improved livelihood through practising AF systems. It was further found that the AF farming improved crop productivity, reduced soil erosion, increased firewood (80.2%) and other forest products availability and AF encouraged community members practicing indoor livestock keeping.The dominant agroforestry tree found in the study area is grevillea reported by 74.1% of respondents planting an average of 40 trees. The study found that the AF reduced pressure to MNR as forest products and fodders were obtained from community's farms in turn, currently water flow from MNR has been increased. Thus AF products support livelihood needs and conserve biodiversity. The study recommends continuity education on new AF technology packages.

Keywords: impact of agroforestry, biodiversity management, communities’ livelihoods, Magamba nature reserve

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Authors: Caiwei Chen, Jianhao Li, Jiasong Zhu

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The reform and opening-up stimulated economic and technological take-off in China while resulting in massive urbanization and motorization. Wujiaochang area was set as a secondary business district in Shanghai to meet the growing demand, with the reconstruction of Wujiaochang Plaza in 2005 being a milestone of this intended urban renewal. Wujiaochang is now an economically dynamic area providing much larger traffic and transit capacity transportation-wise. However, this rebuilding has completely changed the face of the district. It is, therefore, appropriate to evaluate its impact on neighborhoods and communities while assessing the overall sustainability of such an operation. In this study, via an online questionnaire survey among local residents and daily visitors, we assess the perceptions and the estimated impact of Wujiaochang Plaza's reconstruction. We then confront these results to the 62 answers from local residents to a questionnaire collected on paper. The analysis of our data, along with observation and other forms of information -such as maps analysis or online applications (Dianping)- demonstrate major improvement in economic sustainability but also significant losses in environmental sustainability, especially in terms of active transportation. As for the social viewpoint, local residents' opinions tend to be rather positive, especially regarding traffic safety and access to consumption, despite the lack of connectivity and radical changes induced by Wujiaochang massive transformations. In general, our investigation exposes the overall positive outcomes of Wujiaochang Plaza reconstruction but also unveils major drawbacks, especially in terms of soft mobility and traffic fluidity. We gather that our approach could be of tremendous help for future major urban interventions, as such approaches in municipal regeneration are widely implemented in Chinese cities and yet still need to be thoroughly assessed in terms of sustainability.

Keywords: China's reform and opening-up, economical revitalization, neighborhood identity, sustainability assessment, urban renewal

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Authors: Haris Karnezi, Kevin Tierney

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Cognitive Behaviour Drama is a research-based intervention model that brought together the science of psychology with the art form of drama to create an unobtrusive and exciting approach that would provide children on the higher end of the autism spectrum the motivation to explore the rules of social interaction and develop competencies associated with communicative success. The method involves engaging the participants in exciting fictional scenarios and encouraging them to seek various solutions on a number of problems that will lead them to an understanding of causal relationships and how a different course of action may lead to a different outcome. The sessions are structured to offer opportunities to the participants to practice target behaviours and understand the functions they serve. The study involved six separate interventions and employed both single case and group designs. Overall 8 children aged between 6 to 13 years, diagnosed with ASD participated in the study. Outcomes were measured using theory of mind tests, executive functioning tests, behavioural observations, pre and post intervention standardised social competence questionnaires for parents and teachers. Collectively, the results indicated positive changes in the self esteem and behaviour of all eight participants. In particular, improvements in the ability to solve theory of mind tasks were noted in the younger group; and qualitative improvements in social communication, in terms of verbal (content) and non verbal expression (body posture, vocal expression, fluency, eye contact, reduction of ritualistic mannerisms) were noted in the older group. The need for reliable impact measures to assess the effectiveness of the model in generating global changes in the participants’ behaviour outside the therapeutic context was identified.

Keywords: autism, drama, intervention, social skills

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Authors: K. Vrinda

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Coastal ecosystems across the world are facing a lot of challenges due to natural phenomena as well as from uncontrolled human interventions. Here, Alappad, a coastal island situated in Kerala, India is undergoing significant damage and is gradually losing its environmental and social sustainability. The area is blessed with very rare and precious black mineral sand deposits. Sand mining for these minerals started in 1911 and is still continuing. But, unfortunately all the problems that Alappad faces now, have its root on mining of this mineral sand. The land area is continuously diminishing due to sea erosion. The mining has also caused displacement of people and environmental degradation. Marine life also is getting affected by mining on beach and pollution. The inhabitants are fishermen who are largely dependent on the eco-system for a living. So loss of environmental sustainability subsequently affects social sustainability too. Now the damage has reached a point beyond which our actions may not be able to make any impact. This was one of the most affected areas of the 2004 tsunami and the environmental degradation has further increased the vulnerability. So this study focuses on understanding the concerns related to the resource utilization, environment and the indigenous community staying there, and on formulating suitable strategies to restore the sustainability of the area. An extensive study was conducted on site, to find out the physical, social, and economical characteristics of the area. A focus group discussion with the inhabitants shed light on different issues they face in their day-to-day life. The analysis of all these data, led to the formation of a new development vision for the area which focuses on environmental restoration and socio-economic development while allowing controlled exploitation of resources. A participatory approach is formulated which enables these three aspects through community based programs.

Keywords: Community development, Disaster resilience, Ecological restoration, Environmental sustainability, Social-environmental planning, Social Sustainability

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Authors: Timothy Akinwande, Eddie C. M. Hui

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Housing the urban poor has remained a challenge for many years across the world, especially in developing economies, despite the apparent research attention and policy interventions. It is apt to investigate the prevalent affordable housing (AH) provision challenges using unconventional approaches. It is pragmatic to thoroughly examine housing experts to provide supply-side solutions to AH challenges and investigate informal settlers to deduce solutions from AH demand viewpoints. This study being the supply-side investigation of an ongoing research, interrogated housing experts to determine significant expert solutions. Focus group discussions and in-depth interviews were conducted with housing experts in Nigeria. Through descriptive, content, and systematic thematic analyses of data, major findings are that deliberate finance models designed for the urban poor are the most significant housing finance solution in developing economies. Other findings are that adequately implemented rent control policies, deliberate PPP approaches like inclusionary housing and land-value capture, and urban renewal programmes to enlighten and tutor the urban poor on how to earn more, spend wisely, and invest in their own better housing will effectively solve AH finance challenges. Study findings are informative for the best approaches to achieve effective, affordable housing finance for the urban poor in Nigeria, which is indispensable for the achievement of sustainable development goals. This research’s originality lies in the exploration of experts’ opinions in relation to AH finance to produce an equation model of critical solutions to AH finance challenges. Study data are useful resources for future pro-poor housing studies. This study makes housing policy-oriented recommendations toward effective, affordable housing for the urban poor in developing countries.

Keywords: affordable housing, effective affordable housing, housing policy, housing research, sustainable development, urban poor

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Authors: Hui Liu, Xiaozan Wang, Jiarong Zhong, Ziming Shao

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Introduction: Related research shows that students don’t concentrate on teacher’s speaking in the classroom. The d2 attention test is a time-limited test about selective attention. The d2 attention test can be used to evaluate individual selective attention. Purpose: To use the d2 attention test tool to measure the difference between the attention level of the experimental class and the control class before and after Brain-Break and to explore the effect of Brain-Break in the classroom on students' selective attention. Methods: According to the principle of no difference in pre-test data, two classes in the fourth- grade of Shenzhen Longhua Central Primary School were selected. After 20 minutes of class in the third class in the morning and the third class in the afternoon, about 3-minute Brain-Break intervention was performed in the experimental class for 10 weeks. The normal class in the control class did not intervene. Before and after the experiment, the d2 attention test tool was used to test the attention level of the two-class students. The paired sample t-test and independent sample t-test in SPSS 23.0 was used to test the change in the attention level of the two-class classes around 10 weeks. This article only presents results with significant differences. Results: The independent sample t-test results showed that after ten-week of Brain-Break, the missed errors (E1 t = -2.165 p = 0.042), concentration performance (CP t = 1.866 p = 0.05), and the degree of omissions (Epercent t = -2.375 p = 0.029) in experimental class showed significant differences compared with control class. The students’ error level decreased and the concentration increased. Conclusions: Adding Brain-Break interventions in the classroom can effectively improve the attention level of fourth-grade primary school students to a certain extent, especially can improve the concentration of attention and decrease the error rate in the tasks. The new sport's learning model is worth promoting

Keywords: cultural class, micromotor, attention, D2 test

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Authors: Elida Cena

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Return migration is receiving increased attention as the phenomenon challenges assumptions of natural ‘homecomings’. This talk outlines preliminary findings from an ongoing PhD study which explores return migration of Albanian migrants (aged 30-50 years) and their children (aged 7-18 years). Participants (n=51) were purposively recruited from two Albanian cities with divergent social and economic conditions, and the majority had returned from Greece following the recent economic downturn in that country. Qualitative data were collected through in-depth interviews with respondents aged 13 years and above, and were augmented with focus groups and family case studies. Data collection for case studies was aided by photo elicitation, interviews and participatory techniques (drawing) were employed for children aged 7-12 years. Through a multidisciplinary perspective, findings will uncover experiences of migrants and children upon return, the quest to identify with the originating country and create a sense of belongingness. Narrative analysis reveals that the abrupt return was associated with ambivalent feelings and disillusionment about their (re)settlement for both younger and older participants. Faced with unexpected realities and lack of opportunities, particularly for the children of migrants, Albania is viewed as a ‘transit country’, a temporary solution to escape the crisis in the destination country and move to a more developed western country. Adult return migrants articulate lack of employment and insecurity for the future. Apart from school difficulties, children experience isolation and social exclusion, marked by stigmatized labelling from other peers which exacerbates their belonging. Such mobilities have had deeper effects in complicating family relationships as influenced by many disintegration factors. Feelings of alienation and being emigrant for the second time were common in participants' accounts. Findings concerning the difficulties of individuals (re)connecting with their ethnic background and the impact on their identities are discussed in relation to the literature on return migration and identification.

Keywords: return migration, belonging, identity, disintegration, integration

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Authors: Saha Naseri

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Introduction/Objective: Son preference, a preference for sons over daughters, is a practice deeply-rooted in gender inequality that is widespread in many societies and across different religions and cultures. In this study, we are aiming to study the effects of son preference on fertility outcomes (birth interval and current contraceptive use) in Afghanistan, where have been perceived with high rates of son preference. The objectives of the study are to examine the association between the sex of the previous child and the duration of the subsequent birth interval and to evaluate the effect of son preference on current contraceptive use. Methodology: Afghanistan Demographic and Health Survey (DHS) (2015) was used to study the impact of son preference on fertility outcomes among married women. The data collected from 28,661 on currently-married women, aged between 15 and 49 years who have at least one child, have used to conduct this quantitative study. Outcomes of interest are birth interval and current contraceptive use. Simple and multiple regression analysis have been conducted to assess the effect of son preference on these fertility outcomes. Results: The present study has highlighted that son preference somehow exists among married women in Afghanistan. It is indicated that the sex of the first birth is significantly associated with the succeeding birth interval. Having a female child as the first baby was associated with a shorter average succeeding birth interval by 1.8 months compared to a baby boy (p-value = 0.000). For the second model, the results identified that women who desire for more sons have 7% higher odds to be current contraceptive user compared to those who have no preference (p-value = 0.03). The latter results do not indicate the son preference. However, one limitation for this result was the timeliness of the questions asked since contraceptive use in the current time was asked along with a question on ‘future’ desired sex composition. Moreover, women may have just given birth and want to reach a certain time span of birth interval before planning for another child, even if it was a boy, which might have affected the results. Conclusion: Overall, this study has demonstrated that there is a positive relationship between son preference and one main fertility behaviors, birth interval. The second fertility outcome, current contraceptive use, was not a good indicator to measure son preference. Based on the finding, recommendations will be made for appropriate interventions addressing gender norms and related fertility decisions.

Keywords: Afghanistan, birth interval, contraceptive, son preference

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Authors: Nino Chikhladze, Tamar Dochviri, Nato Pitskhelauri, Maia Bitskhinashvili

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Population aging is a key social and demographic trend of the 21st century. Falls represent a prevalent geriatric syndrome that poses significant risks to the health and independence of older adults. The World Health Organization notes a lack of comprehensive data on falls in low- and middle-income countries, complicating the creation of effective prevention programs. To the authors’ best knowledge, no such studies have been conducted in Georgia. The aim of the study is to explore the epidemiology of falls in the elderly population. The hospitalization database of the National Center for Disease Control and Public Health of Georgia was used for the retrospective study. Falls-related injuries were identified using ICD-10 classifications using the class XIX (S and T codes) and class XX for the type of injury (V-Y codes). Statistical data analyses were done using SPSS software version 23.0. The total number of fall-related hospitalizations for individuals aged 65 and older from 2015 to 2021 was 29,697. The study revealed that falls accounted for an average of 63% (ranging from 59% to 66%) of all hospitalizations and 68% (ranging from 65% to 70%) of injury-related hospitalizations during this period. The 69% of all patients were women and 31%-men (Chi2=4482.1, p<0.001). The highest rate of hospitalization was in the age groups 80-84 and 75-79. The probability of fall-related hospitalization was significantly higher in women (p<0.001) compared to men in all age groups except 65-69 years. In the target age group of 65 years and older, the probability of hospitalization increased significantly with an increase in age (p<0.001). The study's results can be leveraged to create evidence-based awareness programs, design targeted multi-domain interventions addressing specific risk factors, and enhance the quality of geriatric healthcare services in Georgia.

Keywords: elderly population, falls, geriatric patients, hospitalization, injuries

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Authors: Ena Arora, Rong Fan, Aleksandr Fuks, Kolawole Felix Akinnawonu

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Introduction: Leiomyomas are benign tumors that are derived from the overgrowth of uterine smooth muscle cells. Women with symptomatic leiomyomas who desire future fertility, myomectomy should be the standard surgical treatment. Perioperative hemorrhage is a common complication in myomectomy. We performed the study to investigate blood transfusion rate in abdominal myomectomies, risk factors influencing blood loss and modalities to improve perioperative blood loss. Methods: Retrospective chart review was done for patients who underwent myomectomy from 2016 to 2022 at Queens hospital center, New York. We looked at preoperative patient demographics, clinical characteristics, intraoperative variables, and postoperative outcomes. Mann-Whitney U test were used for parametric and non-parametric continuous variable comparisons, respectively. Results: A total of 159 myomectomies were performed between 2016 and 2022, including 1 laparoscopic, 65 vaginal and 93 abdominal. 44 patients received blood transfusion during or within 72 hours of abdominal myomectomy. The blood transfusion rate was 47.3%. Blood transfusion rate was found to be twice higher than the average documented rate in literature which is 20%. Risk factors identified were black race, preoperative hematocrit<30%, preoperative blood transfusion within 72 hours, large fibroid burden, prolonged surgical time, and abdominal approach. Conclusion: Preoperative optimization with iron supplements or GnRH agonists is important for patients undergoing myomectomy. Interventions to decrease intra operative blood loss should include cell saver, tourniquet, vasopressin, misoprostol, tranexamic acid and gelatin-thrombin matrix hemostatic sealant.

Keywords: myomectomy, perioperative blood loss, cell saver, tranexamic acid

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Authors: Kinda AlSamara

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The nineteenth century was characterized by major educational reforms in the Arab World. One of the unintended outcomes of colonization in Arab countries was the initiation of women liberation as well as the introduction of modern education and its application in sensitizing people on the rights of women and their liberation. The reforms were often attributed to various undercurrents that took place at different levels within the Ottoman Empire, and particularly the arrival and influence of the Christian missionaries were supported by the American and European governments. These trends were also significantly attributed to the increase in the presence of Europeans in the region, as well as the introduction of secular ideas and approaches related to the meaning of modernity. Using literary analysis as a method, this paper examines the role of an important male figure like the political activist and writer Qāsim Amīn and the religious reformer Muḥammad ʻAbduh in starting this discourse and shows their impact on the emancipation of women movement (Taḥrīr), and how later women led the movement with their published work. This paper explores Arab Salons and the initiation of women’s literary circles. Women from wealthy families in Egypt and Syria who had studied in Europe or interacted with European counterparts began these circles. These salons acted as central locations where people could meet and hold discussions on political, social, and literary trends as they happened each day. The paper concludes with a discussion of current debates between the Islamist and the secularist branches of the movement today. While the Islamists believe that adhering to the core of Islam with some of its contested position on women is a modern ideology of liberation that fits the current culture of modern time Egypt; the secularists argue that the influence that Islam has on the women’s liberation movement in Egypt has been a threat to the natural success and progress of the movement, which was initiated in the early nineteenth century independent of the more recent trends towards religiosity in the country.

Keywords: educational model, crisis of terminologies, Arab awakening, nineteenth century

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Authors: Chantel Snyman, Chrizanne van Eeden, Marita Heyns

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Autism spectrum disorder (ASD) is one of the most common disabilities in schools, with up to50% of children displaying behaviors that challenge, bringing about demanding teaching circumstances. The teachers and teaching assistants of such learners often experience a negative impact on their own quality of life. Research globally and in South Africa about the teachers of ASD learners and teaching interventions, especially positive psychology approaches aimed at supporting learners with ASD, is limited. The primary research aim of this study was to investigate the feasibility as well as the effect of a strength-based intervention for teachers on the behavior of their learners with ASD and on the wellbeing and self-efficacy of teachers and assistants over time. This quantitative study used a pre-experimental group design with a pre-test-post-test method for the proposed school-based intervention. Teachers and teaching assistants completed the Difficult Behavior Self-Efficacy Scale, the Mental Health Questionnaire, and the short Behaviors That Challenge Checklist for learners with ASD. The six-week intervention on character strengths was delivered by the researcher as part of Teacher Staff Development. Results were generally significant on a practical level (based on practical effect sizes), which indicate that the intervention had a visible effect on behaviors that challenge. Research scores over time suggested a positive effect of the intervention in the well-being of participants and an overall positive effect on behaviors that challenge of ASD learners. Results showed that the character strengths intervention shows promise as a simple but effective intervention for teachers and teaching assistants, with positive effects for learners and teaching staff in the ASD classroom. It is recommended that this intervention should be repeated over a longer period of time and with a larger sample to determine its validity.

Keywords: autism spectrum disorder (ASD), behavior that challenge, character strengths, disabilities, self-efficacy, teachers, teaching assistants, well-being

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Authors: Hayfa Almutary, Noof Eid Al Shammari

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Aim: The management of depression in patients undergoing hemodialysis remains challenging. The aim of this study was to evaluate the effectiveness of a breathing training program on quality of life and depression among patients on hemodialysis. Design: A one-group pretest-posttest quasi-experimental design was used. Methods: Data were collected from hemodialysis units at three dialysis centers. Initial baseline data were collected, and a breathing training program was implemented. The breathing training program included three types of breathing exercises. The impact of the intervention on outcomes was measured using both the Kidney Disease Quality of Life Short Version and the Beck Depression Inventory-Second Edition from the same participants. The participants were asked to perform the breathing training program three times a day for 30 days. Results: The mean age of the patients was 52.1 (SD:15.0), with nearly two-thirds of them being male (63.4%). Participants who were undergoing hemodialysis for 1–4 years constituted the largest number of the sample (46.3%), and 17.1% of participants had visited a psychiatric clinic 1-3 times. The results show that the breathing training program improved overall quality of life and reduced symptoms and problems. In addition, a significant decrease in the overall depression score was observed after implementing the intervention. Conclusions: The breathing training program is a non-pharmacological intervention that has proven visible effectiveness in hemodialysis. This study demonstrated that using breathing exercises reduced depression levels and improved quality of life. The integration of this intervention in dialysis units to manage psychological issues will offer a simple, safe, easy, and inexpensive intervention. Future research should compare the effectiveness of various breathing exercises in hemodialysis patients using longitudinal studies. Impact: As a safety precaution, nurses should initially use non-pharmacological interventions, such as a breathing training program, to treat depression in those undergoing hemodialysis.

Keywords: breathing training program, depression, exercise, quality of life, hemodialysis

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Authors: Rita Alfattal, Maryam Alfarhan, Adeeb M. Algaith, Buthaina Albash, Reem M. Elshafie, Asma Alshammari, Ahmad Alahmad, Fatima Dashti, Rasha Alsafi, Hind Alsharhan

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Defects of respiratory chain complex III (CIII) result in characteristic but rare mitochondrial disorders associated with distinct neuroradiological findings. The underlying molecular defects affecting mitochondrial CIII assembly factors are few and yet to be identified. LYRM7 assembly factor is required for proper CIII assembly where it acts as a chaperone for the Rieske iron‐sulfur (UQCRFS1) protein in the mitochondrial matrix and stabilizing it. We present here the seventeenth individual with LYRM7-associated mitochondrial leukoencephalopathy harboring a previously reported rare pathogenic homozygous LYRM 7 variant, c.2T>C, (p.Met1?). Like previously reported individuals, our 4-year-old male proband presented with recurrent metabolic and lactic acidosis, encephalopathy, and myopathy. Further, he has additional, previously unreported features, including an acute stroke like episode with bilateral central blindness and optic neuropathy, recurrent hyperglycemia and hypertension associated with metabolic crisis. However, he has no signs of psychomotor regression. He has been stable clinically with residual left-sided reduced visual acuity and amblyopia, and no more metabolic crises for 2-year-period while on the mitochondrial cocktail. Although the reported brain MRI findings in other affected individuals are homogenous, it is slightly different in our index, revealing evidence of bilateral almost symmetric multifocal periventricular T2 hyperintensities with hyperintensities of the optic nerves, optic chiasm, and corona radiata but with no cavitation or cystic changes. This report describes new clinical and radiological findings of LYRM7-associated disease. The report also summarizes the clinical and molecular data of previously reported individuals describing the full phenotypic spectrum.

Keywords: LYRM7 gene defect, mitochondrial disease, , lactic acidosis, , genetic disorder

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Authors: Nirali Shukla, Neel Shah

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The World Bank Institute (WBI) is undertaking a review of government interventions aimed at facilitating sustainable investment in public private partnerships (PPPs) in various under developed countries. The study presents best practice for applying financial model to make PPPs financially viable. The lessons presented here, if properly implemented, can help countries use limited funds to attract more private investment, get more infrastructure built and, as a result, achieve greater economic growth. The four countries Brazil, Colombia, Mexico, and India in total develop an average of nearly US$50 billion in PPPs per year. There are a range of policies and institutional arrangements governments use to provide subsidies to PPPs. For example, some countries have created dedicated agencies, or ‘funds’, capitalized with money from the national budget to manage and allocate subsidies. Other countries have established well-defined policies for appropriating subsidies on an ad hoc basis through an annual budget process. In this context, subsidies are direct fiscal contributions or grants paid by the government to a project when revenues from user fees are insufficient to cover all capital and operating costs while still providing private investors with a reasonable rate of return. Without subsidies, some infrastructure projects that would provide economic or social gains, but are not financially viable, would go undeveloped. But the Financial model of BOLT (PPP) model described in this study suggests that it is most feasible option rather than going for subsidy schemes for making infrastructure projects financially viable. The major advantage for implementing this model is the government money is saved and can be used for other projects as well as the private investors are getting better rate of return than subsidized schemes.

Keywords: PPP, BOLT, subsidy schemes, financial model

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Authors: Nazli Kazanoglu

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Reconciliation of work and family life has been an area of interest within the academic as well as in the political debate for more than three decades. With the dramatic changes in the extent to which women and men contribute to unpaid domestic work and paid employment, the reconciliation of work and family life issues have become more prominent than ever before. And they have begun to enjoy an increased attention of policy makers both at the EU and national levels. Over the last three decades the EU has initiated numerous equality programs and strategies and roadmaps regarding reconciliation of work and family life, though particularly because of the crisis and increasing willingness of achieving the EUs target of seventy five per cent of men and women in employment by 2020, those programs, strategies and roadmaps emphasized on eradicating womens familial burdens while entering labor market and providing them as equal opportunities as their male counterparts have. Reconciliation of work and family life policies thus bit by bit moved away from the objectives with a strong commitment to ensuring gender equality towards employment objectives. This paper is thus an endeavor to look at the nature of EU reconciliation of work and family life policies from the angle of gender equality. More precisely relying on the feminist literature, this paper rests on the assumption that reconciliation of work and family policies should provide the sufficient measures indeed with a more emphasis on endorsing gender equality rather than economic concerns and prioritizes two inter-related aspects while evaluating the gender equality of reconciliation of work and family life policies. First providing free choice to women in terms of their family and work lives and second challenge the unequal division of labor at home. In that sense, it investigates the nature of the changing uses and meanings of gender equality in reconciliation of work and family life policies in different stages of the EU social policy development particularly after the introduction of European Employment Strategy which gave a tremendous importance to reconciliation of work and family life during their collaborations with other issues on the EU agenda as well as the major rationale behind their development and implementation and locates them in terms of two inter-related parameters mentioned above.

Keywords: European Union, division of unpaid work, gender equality, rhetoric of free choice

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Authors: Insaf Sayar, Moôtez Marzougui, Abderraouf Ben Abderrahman

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Background: Physical Education and Sports (PES) plays an important role in the overall education of the student. It has physical, affective, psychological, and social repercussions. In fact, overweight children are sometimes underestimated by their lower physical performance and suffer from discriminatory attitudes by their peers and their physical education (PE) teachers. Objectives: The aim of this study was to investigate the impacts of both teacher’s pedagogy and overweight or obesity on the inclusion of obese students in physical education classes in the school setting in the Emirate of Ajman (United Arab Emirates) and to understand how physical education and sports (PES) teachers adapt their pedagogical interventions towards this category. Methods: A sample of 48 overweight or obese students and 20 teachers were approached from different schools in Ajman Emirate. Two standardized questionnaires for obese students and PSE teachers were used. Overweight and obesity were defined using age and sex-specific Body Mass Index (BMI). Results: Our results showed that the average BMI of the surveyed students is 28.58 ± 3.14 kg/m². According to the collected data, 85.42% of obese students report that they do not practice physical activity or rarely practice outside of school, and 73.42% go to school by bus or car. In addition, 66.7% of the surveyed students said that being overweight is a barrier to PES practice, and 100% of obese or overweight students do not prefer some physical activities such as running and jumping. Similarly, 75% of the surveyed teachers said that obese students are not integrated into the PES course, but only 55% of teachers reported that the obese student became an obstacle in PES sessions, while 80% of teachers reported that obese or overweight students were marginalized by their colleagues. In the same way, most of them (75%) said that obese students are exempted from PES courses. Conclusion: Overweight/obesity is prevalent among school children in the Emirate of Ajman, with a high correlation with sedentary behavior. The study confirmed an urgent need and effective teaching strategies/ pedagogies for including overweight or obese students in physical education engagement and learning.

Keywords: adolescent, mainstreaming, obesity, PES education, UAE

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Authors: Kensuke Otsuyama

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The United Nation World Conference on Disaster Risk Reduction was held in Sendai, Japan, in 2015 and priorities for actions until 2030 were adopted for the next 15 years. Although one of these priorities is to ‘build back better’, there is neither a consensus definition of better recovery, nor indicators to measure better recovery. However, the community is considered as a key driver of recovery nowadays, and participation is a key word for effective recovery. In order to understand more about participatory community recovery, the author investigated recovery from the Great East Japan Earthquake and Tsunami (GEJET) in Kesennuma, a severely affected city. The research sought to: 1) Identify the elements that contribute to better recovery at the community level, and 2) analyze the role of community volunteers for disaster risk reduction for better recovery. A Participatory Community Recovery Index (PCRI) was created as a tool to measure community recovery. The index adopts seven primary indicators and 20 tertiary indicators, including: socio-economic aspect, housing, health, environment, self-organization, transformation, and institution. The index was applied to nine districts in Kesennuma city. Secondary and primary data by questionnaire surveys with local residents’ organization leaders and interviews with crisis management department officials in city government were also obtained. The indicator results were transformed into scores among 1 to 5, and the results were shown for each district. Based on the result of PCRI, it was found that the s Local Social Welfare Council played an important role in facilitating better recovery, enhancing community volunteer involvement to allow elderly residents to initiate local volunteer work for more affected single-living elderly people. Volunteers for the elderly by the elderly played a crucial role to strengthen community bonding in Kesennuma. In this research, the potential of community volunteers and inter-linkage with DRR activities are discussed.

Keywords: recovery, participation, the great East Japan earthquake and tsunami, community volunteers

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Authors: Annunziata Albano

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Intimate Partner Violence (IPV) and Non-Partner Sexual Violence (NPSV) are still the most common forms of interpersonal violence against women today, and numerous studies have shown how they can affect women's physical and psychological well-being, frequently leading to depression, posttraumatic stress disorder (PTSD), and substance abuse. The primary goal of Italian Anti-Violence Centres (AVCs) is to provide an appropriate context for women to embark on a personalised path out of violence by providing various services such as listening groups, psychological and legal support, housing support in collaboration with shelters, work orientation, and specific support in the case of minor children. However, their physical environment is frequently overlooked, partly because these centres are typically established in pre-existing buildings and have a limited budget. Several studies on healthcare design and mental health, on the other hand, emphasise the potential of the built environment to facilitate healing by providing a restorative setting that aids in coping with stress and traumatic experiences, investigating the positive role of natural features and sensorial qualities such as light, colours, sound, and smell. This research aims to collect and summarise the key evidence-based principles derived from a multidisciplinary literature review about interior design elements that can help women recover after their traumatic experience. Furthermore, the study examines multiple case studies of Italian AVCs through the lens of previously determined principles, to understand how and whether these guidelines have been applied and which outcomes can provide relevant insights for design practice, with an emphasis on sensory qualities, usually overlooked in favour of other requirements. The outlined guidelines may serve as a framework for various typologies of services provided to women who are the victims of interpersonal violence, such as women's crisis centres and shelters.

Keywords: anti-violence centres, environmental psychology, interior design, interpersonal violence, restorative environments

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Authors: Warnakulasuriya Arachichige Malisha Ann Rosary Fernando, Udalamatta Gamage Omila Chalanka Jinadasa, Bihini Pabasara Amandi Amarasinghe, Manul Thisuraka Mandalawatta, Uthpala Samarakoon, Manori Gamage

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The surge in sexually transmitted diseases (STDs) has become a critical public health crisis demanding urgent attention and action. Like many other nations, Sri Lanka is grappling with a significant increase in STDs due to a lack of education and awareness regarding their dangers. Presently, the available applications for tracking and managing STDs cover only a limited number of easily detectable infections, resulting in a significant gap in effectively controlling their spread. To address this gap and combat the rising STD rates, it is essential to leverage technology and data. Employing technology to enhance the tracking and management of STDs is vital to prevent their further propagation and to enable early intervention and treatment. This requires adopting a comprehensive approach that involves raising public awareness about the perils of STDs, improving access to affordable healthcare services for early detection and treatment, and utilizing advanced technology and data analysis. The proposed mobile application aims to cater to a broad range of users, including STD patients, recovered individuals, and those unaware of their STD status. By harnessing cutting-edge technologies like image detection, symptom-based identification, prevention methods, doctor and clinic recommendations, and virtual counselor chat, the application offers a holistic approach to STD management. In conclusion, the escalating STD rates in Sri Lanka and across the globe require immediate action. The integration of technology-driven solutions, along with comprehensive education and healthcare accessibility, is the key to curbing the spread of STDs and promoting better overall public health.

Keywords: STD, machine learning, NLP, artificial intelligence

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Authors: Nneka U. Igboeli, Maxwell O. Adibe

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Iron and folate supplementation in pregnancy are important interventions that prevent maternal anaemia and fetal anomaly. Thus, daily oral doses of iron and folic acid are recommended throughout pregnancy as part of antenatal care. However, low adherence has been a major drawback leading to low effectiveness of these programs. The effect of mobile text message reminders to pregnant women to take their routine medications on adherence was evaluated in this study. The first 100 women who consented to the study were recruited and randomized to either receive a text message reminder on adherence to routine medications or not. Adherence was assessed using the 8-item Modified Morisky Adherence Scale (8-MMAS). The folders of successfully recruited women were tagged with the a study number assigned to each of them. The womens’ phone numbers were collected and these were used to send text messages reminders on adhering to routine drugs only to women in the intervention group. The text messages were sent three times per week for a period of four weeks with an adherence reassessment at the one month follow-up antenatal visit for recruited women. At one month follow-up, the lost to follow-up were 6 (16%) women for the intervention group and 17 (34%) for the control group. The across group mean difference in adherence score was 0.07 (-0.96 – 1.10) at baseline and 0.3 (-0.31 – 0.92) after intervention, both insignificant at p > 0.05. The within group change were increases of 0.58 (0.00 – 1.16) (p = 0.05) from baseline for the intervention group and a 0.35 (-0.51 – 1.20) (p = 0.395) for the control group. Non-significant increase in adherence scores were recorded for both groups. However, the increase in adherence scores of women in the intervention group was greater and may be potentially transformed into more positive results if the study period is increased with possibly reduced study drop-outs shows great promise for more positive results.

Keywords: adherence, mobile phone, pregnant women, reminders

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Authors: Kyung-Sook Bang

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Background: The health status of school-age children has a great influence on their growth and life-long health. The purposes of this study were to identify physical and mental health status of late school-age children in Seoul, South Korea and to investigate the related factors for their health. Methods: After gaining the approval from Institutional Review Board (IRB), a cross-sectional study was conducted with elementary students in grade 4 or 5. Questionnaires were distributed to eight elementary schools located different regions of Seoul in November, 2016, and 302 participants were finally included. From all participants, informed consents from the parents, and assents from children were received. Children's socioeconomic status, family functioning, peer relations, physical health symptoms, and depression were measured with self-reported questionnaires. Data were analyzed with descriptive statistics, t-test, Pearson’s correlations, and multiple regression. Results: Children's physical health symptoms and depression were not significantly different, and only their peer relations were significantly different according to their socioeconomic status (t=-3.93, p<.001). Depression showed significant positive correlation with physical health symptoms (r=.720, p<.001) and negative correlations with family functioning (r=-.428, p<.001) and peer relations (r=-.775, p<.001). The multiple regression model, which explained 73.5% of variance, showed peer relations (r2 =.604), physical health symptoms (r2 change=.125), and family functioning (r2 change=.005) as significant predictors for depression. Only the peer relations was significant predictor for their physical health symptoms and explained 50.6% of it. Conclusions: The peer relations was the most important factor in their physical and mental health at this age, and it can be affected by their socioeconomic status. Nursing interventions for promoting social relations and family functioning are required to improve children’s physical and mental health, especially for vulnerable population.

Keywords: child, depression, health, peer relation

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