Search results for: rural hospitals

Authors: Dennis Otieno, Lilian Kirimi Nicholas Odhiambo, Hillary Bii

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Kenya is considered to be a middle level income country and usuaaly does not meet household food security needs especially in North and South eastern parts. Approximately half of the population is living under the poverty line (www, CIA 1, 2012). Agriculture is the largest sector in the country, employing 80% of the population. These are thereby directly dependent on the sufficiency of outputs received. This makes efficient, easy-accessible and cheap agricultural practices an important matter in order to improve food security. Maize is the prime staple food commodity in Kenya and represents a substantial share of people’s nutritional intake. This study is the result of questionnaire based interviews, Key informant and focus group discussion involving 220 small scale maize farmers Kenyan. The study was located to two separated areas; Lower Kuja, Bunyala, Nandi, Lower Nzoia, Perkerra, Mwea Bura, Hola and Galana Kulalu in Kenya. The questionnaire captured the farmers’ use and perceived importance of the use irrigation services and irrigated maize production. Viability was evaluated using the four indices which were all positive with NPV giving positive cash flows in less than 21 years at most for one season output. The mean willingness to pay was found to be KES 3082 and willingness to pay increased with increase in irrigation premiums. The economic value of water was found to be greater than the willingness to pay implying that irrigated maize production is sustainable. Farmers stated that viability was influenced by high output levels, good produce quality, crop of choice, availability of sufficient water and enforcement the last two factors had a positive influence while the other had negative effect on the viability of irrigated maize. A regression was made over the correlation between the willingness to pay for irrigated maize production using scheme and plot level factors. Farmers that already use other inputs such as animal manure, hired labor and chemical fertilizer should also have a demand for improved seeds according to Liebig's law of minimum and expansion path theory. The regression showed that premiums, and high yields have a positive effect on willingness to pay while produce quality, efficient fertilizer use, and crop season have a negative effect.

Keywords: maize, food security, profits, sustainability, willingness to pay

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Authors: Safar Ghaedrahmati, Leila Soltani

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Population centralization in urban area and metropolitans, especially in developing countries such as Iran increase metropolitan's problems. For few decades, the population of cities in developing countries, including Iran had a higher growth rate than the total growth rate of countries’ population. While in developed countries, the development of the big cities began decades ago and generally allowed for controlled and planned urban expansion, the opposite is the case in developing countries, where rapid urbanization process is characterized by an unplanned existing urban expansion. The developing metropolitan cities have enormous difficulties in coping both with the natural population growth and the urban physical expansion. Iranian cities are usually the heart of economic and cultural changes that have occurred after the Islamic revolution in 1979. These cities are increasingly having impacts via political–economical arrangement and chiefly by urban management structures. Structural features have led to the population growth of cities and urbanization (in number, population and physical frame) and the main problems in them. On the other hand, the lack of birth control policies and the deceptive attractions of cities, particularly big cities, and the birth rate has shot up, something which has occurred mainly in rural regions and small cities. The population of Iran has increased rapidly since 1956. The 1956 and 1966 decennial censuses counted the population of Iran at 18.9 million and 25.7 million, respectively, with a 3.1% annual growth rate during the 1956–1966 period. The 1976 and 1986 decennial censuses counted Iran’s population at 33.7 and 49.4 million, respectively, a 2.7% and 3.9% annual growth rate during the 1966–1976 and 1976–1986 periods. The 1996 count put Iran’s population at 60 million, a 1.96% annual growth rate from 1986–1996 and the 2006 count put Iran population at 72 million. A recent major policy of urban economic and industrial decentralization is a persistent program of the government. The policy has been identified as a result of the massive growth of Tehran in the recent years, up to 9 million by 2010. Part of the growth of the capitally resulted from the lack of economic opportunities elsewhere and in order to redress the developing primacy of Tehran and the domestic pressures which it is undergoing, the policy of decentralization is to be implemented as quickly as possible. Type of research is applied and method of data collection is documentary and methods of analysis are; population analysis with urban system analysis and urban distribution system

Keywords: population centralization, cities of Iran, urban centralization, urban system

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Authors: Temple Probyne Abali

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Port Harcourt, Rivers State in the Niger Delta region of Nigeria is bedeviled by the phenomenon of climatechange, posing threat to food security and livelihood. This study examined a 4 decadel (1980-2020) trend of climate change as well as its socio-economic impact on food security in the region. Furthermore, to achieve sustainable food security and livelihood amidst the phenomenon, the study adopted the World Bank Assisted Third National Fadama Development Programme approach. The data source for climate change involved secondary data from Nigeria Meteorological Agency (NIMET). Consequently, the results for climate change over the 4decade period were displayed in tables, charts and maps for the expected changes. Data sources on socio-economic impact of food security and livelihood were acquired through questionnairedesign. A purposive random sampling technique was used in selecting 5 coastal communities inthe region known for viable economic potentials for agricultural development and the resultswere analyzed using Analysis of Variance (ANOVA). The Participatory Rural Appraisal (PRA) technique of the World Bank for needs assessment wasadopted in selecting 5 agricultural sub-project proposals/activities based on groups’ commoneconomic interest from a total of 1,000 farmers each drawn from the 5 communities of differentage groups including men, women, youths and the vulnerable. Based on the farmers’ sub-projectinterests, the various groups’ Strength, Weakness, Opportunities and Threats (SWOT), Problem Listing Matrix, Skill Gap Analysis as well as EIAson their sub-project proposals/activities were analyzed with substantialMonitoring and Evaluation (M & E), using the Specific, Measurable, Attribute, Reliable and Time bound (SMART)approach. Based on the findings from the PRA technique, the farmers recorded considerableincreaseinincomeofover200%withinthe5yearprojectplan(2008-2013).Thestudyrecommends capacity building and advisory services on this PRA innovation. By so doing, there would be a sustainable increase in agricultural production and assured food security in an environmental friendly manner, in line with the United Nation’s Sustainable Development Goals(SDGs).

Keywords: climate change, food security, fadama, world bank, agriculture, sdgs

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Authors: Jerzy Bański

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Central and Eastern European agriculture is characterized by large spatial variations in the structure of agricultural land and the structure of crops on arable land. In general, field crops predominate among the land used for agriculture. In the southern part of the study area, permanent crops have a relatively large share, which is due to favorable climatic conditions. Clear differences between the north and south of the region concern the structure of crop cultivation. In the north, the cultivation of cereals, mainly wheat, definitely prevails. In the south of the region, on the other hand, the structure of crops is more diverse, as more industrial crops are grown in addition to cereals. The primary cognitive objective of the study is to diagnose and identify the directions of changes in the structure of agricultural land use in the CEE region. Particular attention was paid to the spatial differentiation of this structure and its importance in its formation of various conditions. The analysis included the basic elements of the structure of agricultural land use and the structure of crops on arable land. The decrease in the area of arable land is characteristic of the entire region and is the result of the territorial growth of cities, the development of communications infrastructure (rail and road), and the increase in the rationality of crop production involving, among other things, the exclusion from the cultivation of land with the lowest agro-ecological values and their afforestation. It can be summarized that the directions of changes in the basic categories of agricultural land are related to agro-ecological conditions, which indicates an increase in the rationality of crop production. In countries with lower-quality of agricultural production space, the share of grassland generally increased, while in countries with favorable conditions -mainly soil- the share of arable land increased. As for the structure of field crops, the direction of its changes seems to be mainly due to economic and social reasons. Ownership changes shaping an unfavorable agrarian structure (fragmentation and fragmentation of arable fields) and the process of aging of the rural population resulted in the abandonment of resource- and labor-intensive crops. As a result, the importance of growing fruits and vegetables, and potatoes has declined. The structure of vegetable crops has been greatly influenced by the accession of Central and Eastern European countries to the European Union. This is primarily the increase in the importance of oil crops (rapeseed and sunflower) related to biofuel production. In the case of cereal crops, the main direction of change was the increase in the share of wheat at the expense of other cereal species.

Keywords: agriculture, land use, Central and Eastern Europe, crops, arable land

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Authors: Freya Harding, Anne Gatuguta, Chi Eziefula

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Introduction Research shows the quality of experiences of pregnancy, birth, and postpartum impacts the health and well-being of the mother and baby. This is recognised by the WHO in their recommendations ‘Intrapartum care for a positive childbirth experience’. The COVID-19 pandemic saw the transformation of the NHS Maternity services to prevent the transmission of COVID-19. Physical and social isolation may have affected women’s experiences of pregnancy, birth and postpartum; especially those of healthcare. Examples of such changes made to the NHS include both the reduction in volume of face-to-face consultations and restrictions to visitor time in hospitals. One notable detriment due to these changes was the absence of a partner during certain stages of birth. The aim of this study was to explore women’s experiences of pregnancy, birth, and postnatal period during the COVID-19 pandemic in the UK. Methods We collected qualitative data from women who had given birth during the COVID-19 pandemic. In-depth, semi-structured interviews were conducted with twelve participants recruited from mother and baby groups in Southeast England. Data were audio-recorded, transcribed verbatim, and analysed thematically using both inductive and deductive approaches. Ethics permission was granted from Brighton and Sussex Medical School (ER/BSMS9A83/1). Results Interviews were conducted with 12 women who gave birth between May 2020 and February 2021. Ages of the participants ranged between 28 and 42 years, most of which were white British, with one being Asian British. All participants were heterosexual and either married or co-habiting with their partner. Five participants worked in the NHS, and all participants had professional occupations. Women felt inadequately supported both socially and medically. An appropriate sense of control over their own birthing experience was lacking. Safety mechanisms, such as in-person visits from the midwife, had no suitable alternatives in place. Serious health issues were able to “slip through the net.” Mental health conditions in some of those interviewed worsened or developed. Similarly, reduced support from partners during birth and during the immediate postpartum period at the hospital, coupled with reduced ward staffing, resulted in some traumatic experiences; particularly for women who had undergone caesarean section. However, some unexpected positive effects were reported; one example being that partners were able to spend more time with their baby due to furlough schemes and working from home. Similarly, emergency care was not felt to have been compromised. Overall, six themes emerged: (1) Self-reported traumatic experiences, (2) Challenges of caring for a baby with reduced medical and social support, (3) Unexpected benefits to the parenting experience, (4) The effects of a sudden change in medical management (5) Poor communication from healthcare professionals (6) Social change; with subthemes of support accessing medical care, the workplace, family and friends, and antenatal & baby groups. Conclusions The results indicate that the healthcare system was unable to adequately deliver maternity care to facilitate positive pregnancy, birth, and postnatal experiences during the heights of the pandemic. The poor quality of such experiences has been linked an increased risk of long-term health complications in both the mother and child.

Keywords: pregnancy, birth, postpartum, postnatal, COVID-19, maternity, social support, qualitative, pandemic

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Authors: Outokesh Fatemeh, Jourabchi Keivan, Talebi Maryam, Nikbakht Fatemeh

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Mayamei is a small town in Iran that is located between Shahrud and Sabzevar cities, on the Silk Road. It enjoys a history of approximately 1000 years. An alley entitled ‘Aghayan’ exists in this town that comprises residential buildings of a famous family. Bathhouse, mosque, telegraph center, cistern are all related to this alley. This architectural complex belongs to Sadat Mousavi, who is one of the Mayamei's major grandees and religious household. The alley after construction has been inherited from generation to generation within the family masters. The purpose of this study, which was conducted on Aghayan alley and its associated complex, was to elucidate Iranian vernacular domestic architecture of Qajar era in small towns and villages. We searched for large, medium, and small architectural patterns in the contemplated complex, and tried to elaborate their evolution from past to the present. The other objective of this project was finding a correlation between changes in the lifestyle of the alley’s inhabitants with the form of the building's architecture. Our investigation methods included: literature review especially in regard to historical travelogues, peer site visiting, mapping, interviewing of the elderly people of the Mousavi family (the owners), and examining the available documents especially the 4 meters’ scroll-type testament of 150 years ago. For the analysis of the aforementioned data, an effort was made to discover (1) the patterns of placing of different buildings in respect of the others, (2) finding the relation between function of the buildings with their relative location in the complex, as was considered in the original design, and (3) possible changes of functions of the buildings during the time. In such an investigation, special attention was paid to the chronological changes of lifestyles of the residents. In addition, we tried to take all different activities of the residents into account including their daily life activities, religious ceremonies, etc. By combining such methods, we were able to obtain a picture of the buildings in their original (construction) state, along with a knowledge of the temporal evolution of the architecture. An interesting finding is that the Aghayan complex seems to be a big structure of the horizontal type apartments, which are placed next to each other. The houses made in this way are connected to the adjacent neighbors both by the bifacial rooms and from the roofs.

Keywords: Iran, Qajar period, vernacular domestic architecture, life style, residential complex

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Authors: Sonia Bedhiaf-Romdhani

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The sheep (Ovis aries) was domesticated, approximately 11,000 years ago (YBP), in the Fertile Crescent from Asian Mouflon (Ovis Orientalis). The Northern African (NA) sheep is 7,000 years old, represents a remarkable diversity of sheep populations reared under traditional and low input farming systems (LIFS) over millennia. The majority of small ruminants in developing countries are encountered in low input production systems and the resilience of local communities in rural areas is often linked to the wellbeing of small ruminants. Regardless of the rich biodiversity encountered in sheep ecotypes there are four main sheep breeds in the country with 61,6 and 35.4 percents of Barbarine (fat tail breed) and Queue Fine de l’Ouest (thin tail breed), respectively. Phoenicians introduced the Barbarine sheep from the steppes of Central Asia in the Carthaginian period, 3000 years ago. The Queue Fine de l’Ouest is a thin-tailed meat breed heavily concentrated in the Western and the central semi-arid regions. The Noire de Thibar breed, involving mutton-fine wool producing animals, has been on the verge of extinction, it’s a composite black coated sheep breed found in the northern sub-humid region because of its higher nutritional requirements and non-tolerance of the prevailing harsher condition. The D'Man breed, originated from Morocco, is mainly located in the southern oases of the extreme arid ecosystem. A genetic investigation of Tunisian sheep breeds using a genome-wide scan of approximately 50,000 SNPs was performed. Genetic analysis of relationship between breeds highlighted the genetic differentiation of Noire de Thibar breed from the other local breeds, reflecting the effect of past events of introgression of European gene pool. The Queue Fine de l’Ouest breed showed a genetic heterogeneity and was close to Barbarine. The D'Man breed shared a considerable gene flow with the thin-tailed Queue Fine de l'Ouest breed. Native small ruminants breeds, are capable to be efficiently productive if essential ingredients and coherent breeding schemes are implemented and followed. Assessing the status of genetic variability of native sheep breeds could provide important clues for research and policy makers to devise better strategies for the conservation and management of genetic resources.

Keywords: sheep, farming systems, diversity, SNPs.

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Authors: Hesam Gholami

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Elevated suspended sediment loads in riverine systems resulting from accelerated erosion due to human activities are a serious threat to the sustainable management of watersheds and ecosystem services therein worldwide. Therefore, mitigation of deleterious sediment effects as a distributed or non-point pollution source in the catchments requires reliable provenance information. Sediment tracing or sediment fingerprinting, as a combined process consisting of sampling, laboratory measurements, different statistical tests, and the application of mixing or unmixing models, is a useful technique for discriminating the sources of sediments. From 1996 to the present, different aspects of this technique, such as grouping the sources (spatial and individual sources), discriminating the potential sources by different statistical techniques, and modification of mixing and unmixing models, have been introduced and modified by many researchers worldwide, and have been applied to identify the provenance of fine materials in agricultural, rural, mountainous, and coastal catchments, and in large catchments with numerous lakes and reservoirs. In the last two decades, efforts exploring the uncertainties associated with sediment fingerprinting results have attracted increasing attention. The frameworks used to quantify the uncertainty associated with fingerprinting estimates can be divided into three groups comprising Monte Carlo simulation, Bayesian approaches and generalized likelihood uncertainty estimation (GLUE). Given the above background, the primary goal of this study was to apply geochemical fingerprinting within the GLUE framework in the estimation of sub-basin spatial sediment source contributions in the arid Mehran River catchment in southern Iran, which drains into the Persian Gulf. The accuracy of GLUE predictions generated using four different sets of statistical tests for discriminating three sub-basin spatial sources was evaluated using 10 virtual sediments (VS) samples with known source contributions using the root mean square error (RMSE) and mean absolute error (MAE). Based on the results, the contributions modeled by GLUE for the western, central and eastern sub-basins are 1-42% (overall mean 20%), 0.5-30% (overall mean 12%) and 55-84% (overall mean 68%), respectively. According to the mean absolute fit (MAF; ≥ 95% for all target sediment samples) and goodness-of-fit (GOF; ≥ 99% for all samples), our suggested modeling approach is an accurate technique to quantify the source of sediments in the catchments. Overall, the estimated source proportions can help watershed engineers plan the targeting of conservation programs for soil and water resources.

Keywords: sediment source tracing, generalized likelihood uncertainty estimation, virtual sediment mixtures, Iran

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Authors: Yael Rieder, Yael Gilboa, S. O. Adva, Efrat Halevi, Ronnie Tepper

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Background: Operation of ultrasound equipment is a core skill for many clinical specialties. As part of the training program at -Simultech- a simulation center for Ob\Gyn at the Meir Medical Center, Israel, teaching how to operate ultrasound equipment requires dealing with misunderstandings of spatial and 3D orientation, failure of the operator to hold a transducer correctly, and limited ability to evaluate the data on the screen. We have developed a platform intended to endow physicians and sonographers with clinical and operational skills of obstetric ultrasound. Simultech's simulations are focused on medical knowledge, risk management, technology operations and physician-patient communication. The simulations encompass extreme work conditions. Setup: Between eight and ten of the eight hundred and fifty physicians and sonographers of the Clalit health services from seven hospitals and eight community centers across Israel, participate in individual Ob/Gyn training sessions each week. These include Ob/Gyn specialists, experts, interns, and sonographers. Innovative teaching and training methodologies: The six-hour training program includes: (1) An educational computer program that challenges trainees to deal with medical questions based upon ultrasound pictures and films. (2) Sophisticated hands-on simulators that challenge the trainees to practice correct grip of the transducer, elucidate pathology, and practice daily tasks such as biometric measurements and analysis of sonographic data. (3) Participation in a video-taped simulation which focuses on physician-patient communications. In the simulation, the physician is required to diagnose the clinical condition of a hired actress based on the data she provides and by evaluating the assigned ultrasound films accordingly. Giving ‘bad news’ to the patient may put the physician in a stressful situation that must be properly managed. (4) Feedback at the end of each phase is provided by a designated trainer, not a physician, who is specially qualified by Ob\Gyn senior specialists. (5) A group exercise in which the trainer presents a medico-legal case in order to encourage the participants to use their own experience and knowledge to conduct a productive ‘brainstorming’ session. Medical cases are presented and analyzed by the participants together with the trainer's feedback. Findings: (1) The training methods and content that Simultech provides allows trainees to review their medical and communications skills. (2) Simultech training sessions expose physicians to both basic and new, up-to-date cases, refreshing and expanding the trainee's knowledge. (3) Practicing on advanced simulators enables trainees to understand the sonographic space and to implement the basic principles of ultrasound. (4) Communications simulations were found to be beneficial for trainees who were unaware of their interpersonal skills. The trainer feedback, supported by the recorded simulation, allows the trainee to draw conclusions about his performance. Conclusion: Simultech was found to contribute to physicians at all levels of clinical expertise who deal with ultrasound. A break in daily routine together with attendance at a neutral educational center can vastly improve performance and outlook.

Keywords: medical training, simulations, ultrasound, Simultech

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Authors: Lei Zhou, Chao Li, Ruiqi Ren, Dan Li, Yali Wang, Daxin Ni, Zijian Feng, Qun Li

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Background: Since the first human infection with avian influenza A(H7N9) case was reported in China on 31 March 2013, five epidemics have been observed in China through February 2013 and September 2017. Though the overall mortality rate of H7N9 has remained as high as around 40% throughout the five epidemics, the specific mortality rate in Mainland China varied by provinces. We conducted a descriptive analysis of mortality rates of H7N9 cases to explore the various severity features of the disease and then to provide clues of further analyses of potential factors associated with the severity of the disease. Methods: The data for analysis originated from the National Notifiable Infectious Disease Report and Surveillance System (NNIDRSS). The surveillance system and identification procedure for H7N9 infection have not changed in China since 2013. The definition of a confirmed H7N9 case is as same as previous reports. Mortality rates of H7N9 cases are described and compared by time and location of reporting, age and sex, and genetic features of H7N9 virus strains. Results: The overall mortality rate, the male and female specific overall rates of H7N9 is 39.6% (608/1533), 40.3% (432/1072) and 38.2% (176/461), respectively. There was no significant difference between the mortality rates of male and female. The age-specific mortality rates are significantly varied by age groups (χ²=38.16, p < 0.001). The mortality of H7N9 cases in the age group between 20 and 60 (33.17%) and age group of over 60 (51.16%) is much higher than that in the age group of under 20 (5.00%). Considering the time of reporting, the mortality rates of cases which were reported in the first (40.57%) and fourth (42.51%) quarters of each year are significantly higher than the mortality of cases which were reported in the second (36.02%) and third (27.27%) quarters (χ²=75.18, p < 0.001). The geographic specific mortality rates vary too. The mortality rates of H7N9 cases reported from the Northeast China (66.67%) and Westeast China (56.52%) are significantly higher than that of H7N9 cases reported from the remained area of mainland China. The mortality rate of H7N9 cases reported from the Central China is the lowest (34.38%). The mortality rates of H7N9 cases reported from rural (37.76%) and urban (38.96%) areas are similar. The mortality rate of H7N9 cases infected with the highly pathogenic avian influenza A(H7N9) virus (48.15%) is higher than the rate of H7N9 cases infected with the low pathogenic avian influenza A(H7N9) virus (37.57%), but the difference is not statistically significant. Preliminary analyses showed that age and some clinical complications such as respiratory failure, heart failure, and septic shock could be potential risk factors associated with the death of H7N9 cases. Conclusions: The mortality rates of H7N9 cases varied by age, sex, time of reporting and geographical location in mainland China. Further in-depth analyses and field investigations of the factors associated with the severity of H7N9 cases need to be considered.

Keywords: H7N9 virus, Avian Influenza, mortality, China

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Authors: Blessings Masuku

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This study positions itself within the nascent of street food vending that plays a crucial role in addressing urban household food security across the urban landscape of South Africa. The study aimed to understand how various forms of infrastructure systems (i.e., energy, water and sanitation, housing, and transport, among others) intersect with food and urban informality and how vendors and households’ choices and decisions made around food are influenced by infrastructure assemblages. This study noted that most of the literature studies on food security have mainly focused on the rural agricultural sector, with limited attention to urban food security, notably the role of informality practices in addressing urban food insecurity at the household level. This study pays close attention to how informal informality practices such as street food vending can be used as a catalyst to address urban poverty and household food security and steer local economies for sustainable livelihoods of the urban poor who live in the periphery of the city in Johannesburg. This study deconstructs the infrastructure needs of street food vendors, and the aim was to understand how such infrastructure needs intersect with food and policy that governs urban informality practices. The study argues that the decisions and choices of informality actors in the city of Johannesburg are chiefly determined by the assemblages of infrastructure, including regulatory frameworks that govern the informal sector in the city of Johannesburg. A qualitative approach that includes surveys (open-ended questions), archival research (i., e policy and other key document reviews), and key interviews mainly with city officials and informality actors. A thematic analysis was used to analyze the data collected. This study contributes to greater debates on urban studies and burgeoning literature on urban food security in many ways that include Firstly, the pivotal role that the informal food sector, notably street food vending, plays within the urban economy to address urban poverty and household food security, therefore questioning the conservative perspectives that view the informal sector as a hindrance to a ‘modern city’ and an annoyance to ‘modern’ urban spaces. Secondly, this study contributes to the livelihood and coping strategies of the urban poor who, despite harsh and restrictive regulatory frameworks, devise various agentive ways to generate incomes and address urban poverty and food insecurities.

Keywords: urban food security, street food vending, informal food sector, infrastructure systems, livelihood strategies, policy framework and governance

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Authors: Nino Damenia

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E-commerce opens a new horizon for business development, which is why the presence of e-commerce is a necessary condition for the formation, growth, and development of the country's economy. Worldwide, e-commerce turnover is growing at a high rate every year, as the electronic environment provides great opportunities for product promotion. E-commerce in Georgia is developing at a fast pace, but it is still a relatively young direction in the country's economy. Movement restrictions and other public health measures caused by the COVID-19 pandemic have reduced economic activity in most economic sectors and countries, significantly affecting production, distribution, and consumption. The pandemic has accelerated digital transformation. Digital solutions enable people and businesses to continue part of their economic and social activities remotely. This has also led to the growth of e-commerce. According to the data of the National Statistics Service of Georgia, the share of online trade is higher in cities (27.4%) than in rural areas (9.1%). The COVID-19 pandemic has forced local businesses to expand their digital offerings. The size of the local market increased 3.2 times in 2020 to 138 million GEL. And in 2018-2020, the share of local e-commerce increased from 11% to 23%. In Georgia, the state is actively engaged in the promotion of activities based on information technologies. Many measures have been taken for this purpose, but compared to other countries, this process is slow in Georgia. The purpose of the study is to determine development prospects for the economy of Georgia based on the analysis of electronic commerce. Research was conducted around the issues using Georgian and foreign scientists' articles, works, reports of international organizations, collections of scientific conferences, and scientific electronic databases. The empirical base of the research is the data and annual reports of the National Statistical Service of Georgia, internet resources of world statistical materials, and others. While working on the article, a questionnaire was developed, based on which an electronic survey of certain types of respondents was conducted. The conducted research was related to determining how intensively Georgian citizens use online shopping, including which age category uses electronic commerce, for what purposes, and how satisfied they are. Various theoretical and methodological research tools, as well as analysis, synthesis, comparison, and other types of methods, are used to achieve the set goal in the research process. The research results and recommendations will contribute to the development of e-commerce in Georgia and economic growth based on it.

Keywords: e-commerce, information technology, pandemic, digital transformation

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Authors: Ma Chu Jui

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Culture plays a pivotal role in shaping societal responses to change and fostering adaptability. In the realm of healthcare provision, hospitals serve as dynamic settings molded by the cultural consciousness of healthcare professionals. This intricate interplay extends to their expectations of leadership, communication styles, and attitudes towards patient care. Recognizing the cultural inclinations of healthcare professionals becomes imperative in navigating this complex landscape. This study will utilize Hofstede's Value Survey Module 2013 (VSM 2013) as a comprehensive analytical tool. The targeted participants for this research are in-service nursing professionals with a tenure of at least three months, specifically employed in the nursing department of an Eastern hospital. This quantitative approach seeks to quantify diverse cultural tendencies among the targeted nursing professionals, elucidating not only abstract cultural concepts but also revealing their cultural inclinations across different dimensions. The study anticipates gathering between 400 to 500 responses, ensuring a robust dataset for a comprehensive analysis. The focused approach on nursing professionals within the Eastern hospital setting enhances the relevance and specificity of the cultural insights obtained. The research aims to contribute valuable knowledge to the understanding of cultural tendencies among in-service nursing personnel in the nursing department of this specific Eastern hospital. The VSM 2013 will be initially distributed to this specific group to collect responses, aiming to calculate scores on each of Hofstede's six cultural dimensions—Power Distance Index (PDI), Individualism vs. Collectivism (IDV), Uncertainty Avoidance Index (UAI), Masculinity vs. Femininity (MAS), Long-Term Orientation vs. Short-Term Normative Orientation (LTO), and Indulgence vs. Restraint (IVR). the study unveils a significant correlation between different cultural dimensions and healthcare professionals' tendencies in understanding leadership expectations through PDI, grasping behavioral patterns via IDV, acknowledging risk acceptance through UAI, and understanding their long-term and short-term behaviors through LTO. These tendencies extend to communication styles and attitudes towards patient care. These findings provide valuable insights into the nuanced interconnections between cultural factors and healthcare practices. Through a detailed analysis of the varying levels of these cultural dimensions, we gain a comprehensive understanding of the predominant inclinations among the majority of healthcare professionals. This nuanced perspective adds depth to our comprehension of how cultural values shape their approach to leadership, communication, and patient care, contributing to a more holistic understanding of the healthcare landscape. A profound comprehension of the cultural paradigms embraced by healthcare professionals holds transformative potential. Beyond a mere understanding, it acts as a catalyst for elevating the caliber of healthcare services. This heightened awareness fosters cohesive collaboration among healthcare teams, paving the way for the establishment of a unified healthcare ethos. By cultivating shared values, our study envisions a healthcare environment characterized by enhanced quality, improved teamwork, and ultimately, a more favorable and patient-centric healthcare landscape. In essence, our research underscores the critical role of cultural awareness in shaping the future of healthcare delivery.

Keywords: hofstede's cultural, cultural dimensions, cultural values in healthcare, cultural awareness in nursing

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Authors: Sarkawt M. Hama, Paul S. Monks, Rebecca L. Cordell

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Within the Joaquin project, ultrafine particles (UFP) are continuously measured at one urban background site in Leicester. The main aims are to examine the temporal and seasonal variations in UFP number concentration and size distribution in an urban environment, and to try to assess the added value of continuous UFP measurements. In addition, relations of UFP with more commonly monitored pollutants such as black carbon (BC), nitrogen oxides (NOX), particulate matter (PM2.5), and the lung deposited surface area(LDSA) were evaluated. The effects of meteorological conditions, particularly wind speed and direction, and also temperature on the observed distribution of ultrafine particles will be detailed. The study presents the results from an experimental investigation into the particle number concentration size distribution of UFP, BC, and NOX with measurements taken at the Automatic Urban and Rural Network (AURN) monitoring site in Leicester. The monitoring was performed as part of the EU project JOAQUIN (Joint Air Quality Initiative) supported by the INTERREG IVB NWE program. The total number concentrations (TNC) were measured by a water-based condensation particle counter (W-CPC) (TSI model 3783), the particle number concentrations (PNC) and size distributions were measured by an ultrafine particle monitor (UFP TSI model 3031), the BC by MAAP (Thermo-5012), the NOX by NO-NO2-NOx monitor (Thermos Scientific 42i), and a Nanoparticle Surface Area Monitor (NSAM, TSI 3550) was used to measure the LDSA (reported as μm2 cm−3) corresponding to the alveolar region of the lung between November 2013 and November 2015. The average concentrations of particle number concentrations were observed in summer with lower absolute values of PNC than in winter might be related mainly to particles directly emitted by traffic and to the more favorable conditions of atmospheric dispersion. Results showed a traffic-related diurnal variation of UFP, BC, NOX and LDSA with clear morning and evening rush hour peaks on weekdays, only an evening peak at the weekends. Correlation coefficients were calculated between UFP and other pollutants (BC and NOX). The highest correlation between them was found in winter months. Overall, the results support the notion that local traffic emissions were a major contributor of the atmospheric particles pollution and a clear seasonal pattern was found, with higher values during the cold season.

Keywords: size distribution, traffic emissions, UFP, urban area

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Authors: Gunjan Razdan, Priyanka Sreenath, Jagannath Behera, S. K. Mishra, Sunil Mehra

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Uttar Pradesh is one of the poor performing states with high Malnutrition and Anaemia among adolescent girls resulting in high MMR, IMR and low birth weight rate. The rate of anaemia among adolescent girls has doubled in the past decade. Adolescents gain around 15-20% of their optimum height, 25-50% of the ideal adult weight and 45% of the skeletal mass by the age of 19. Poor intake of energy, protein and other nutrients is one of the factors for malnutrition and anaemia. METHODS: The cross-sectional survey using a mixed method (quantitative and qualitative) was adopted in this study. The respondents (adolescents, parents and frontline health workers) were selected randomly from 30 villages and surveyed through a semi-structured questionnaire for qualitative information and FGDs and IDIs for qualitative information. A 24 hours dietary recall method was adopted to estimate their dietary practices. A total of 1069 adolescent girls, 1067 boys, 1774 parents and 69 frontline functionaries were covered under the study. Percentages and mean were calculated for quantitative variable, and content analysis was carried out for qualitative data. RESULTS: Over 80 % of parents provided assertions that they understood the term balanced diet and strongly felt that their children were having balanced diet. However, only negligible 1.5 % of parents could correctly recount essential eight food groups and 22% could tell about four groups which was the minimum response expected to say respondents had fair knowledge on a balanced diet. Only 10 percent of parents could tell that balanced diet helps in physical and mental growth and only 2% said it has a protective role. Besides, qualitative data shows that the perception regarding balanced diet is having costly food items like nuts and fruits. The dietary intake of adolescents is very low despite the increased iron needs associated with physical growth and puberty.The consumption of green leafy vegetables (less than 35 %) and citrus fruits (less than 50%) was found to be low. CONCLUSIONS: The assertions on an understanding of term balanced diet are contradictory to the actual knowledge and practices. Knowledge on essential food groups and nutrients is crucial to inculcate healthy eating practices among adolescents. This calls for comprehensive communication efforts to improve the knowledge and dietary practices among adolescents.

Keywords: anemia, knowledge, malnutrition, perceptions

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Authors: Linneth Nkateko Mabila, Patrick Hulisani Demana, Tebogo Maria Mothiba

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Background: Sustaining adherence to antiretroviral therapy (ART) over the long term by people, especially children living with Human-Immunodeficiency Virus (HIV), requires accurate and consistent monitoring, and this is a particular challenge for countries in sub-Saharan Africa. However, the regularity and punctuality in monthly antiretroviral treatment collections indicate medication adherence to a certain extent since it has been revealed to be a significant determinant of the outcome of ART. Aim: This study assessed and described the pattern of monthly antiretroviral treatment collections among a cohort of virally unsuppressed HIV-positive children initiated and managed on ART in the rural public clinics of Mopani District, Limpopo, and explored the nurses' perceptions and views of the findings. Methods: A facility-based mixed-methods study was conducted to assess the honoring of scheduled monthly treatment collection practices by a cohort of HIV-positive children under 15 years initiated and managed on ART by Nurse Initiated Management of Antiretroviral Treatment (NIMART)-trained professional nurses (PNs) from 01 January 2015 to 31 December 2015 in public PHC clinics of Mopani District Municipality. This was followed by the exploration of the nurses' perceptions and views regarding this issue to share their experiences and knowledge acquired through managing these children on ART. Results: From a total of 7105 analysable visits, only 44% (3134) were honored as scheduled, with 40% (2828) of children presenting to the clinics after the scheduled appointment date – they missed their appointments, and 11% (768) of treatment collections that took place before the scheduled appointment date. This finding was further confirmed by 90% (97) of the nurses, who reported that they have children who miss scheduled appointments in their public clinics. The primary reasons for children missing appointments were related to caregivers' forgetfulness and conflict between the school schedule and the dates of clinic visits. Conclusion: We confirmed a high prevalence of non-adherence to scheduled monthly ART collections and the existence of health system, social, and caregiver-related factors that threaten treatment adherence and proper clinical outcomes. These findings suggest an urgent need for intervention since non-adherence to ARV therapy can be life-threatening to the child and poses the danger of reduced life expectancy.

Keywords: antiretroviral therapy (art), nimart, virally unsuppressed children, missed appointments

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Authors: Vanessa Casadella, Mourad Chouki, Agnès Ceccarelli, Sofiane Tahi

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Mentoring is positioned in an interpersonal and intergenerational perspective, serving the transmission of interpersonal skills and organizational culture. It echoes orientation, project, self-actualization, guidance, transmission, and filiation. It is available using a formal or informal approach. The formal dimension refers to a privileged relationship between a senior and a junior. Informal mentoring is unplanned and emerges naturally between two people who choose each other. However, it remains more difficult to understand. To study the link between formal and informal mentoring and to define the notion of “social” mentoring, we conducted a qualitative study of an exploratory nature with around ten SSE organizations located in the southeast region of Tunisia. The wealth of this territory has pushed residents to found SSE organizations with a view to creating jobs but also to preserving traditions and preserving nature. These organizations developed spontaneously to solve various local problems, such as the revitalization of deserted rural areas, environmental degradation, and the reskilling and professional reintegration of people marginalized in the labor market. This research, based on semi-structured interviews in order to obtain exhaustive and sensitive data, involves an interview guide with few questions mobilized to let the respondents, leaders of the different structures, express themselves freely. The guide includes questions on activities, methods of sharing knowledge, and difficulties in understanding between stakeholders. The interviews, lasting 30 to 60 minutes, were recorded using a dictaphone and then transcribed in full. The results are as follows: 1. We see two iterative mentoring loops. A first loop can be considered a type of formal mentoring. It highlights the support organized (in the form of training) by social enterprises with the aim of developing the autonomy, know-how, and interpersonal skills of members. A second loop concerns informal mentoring. This is non-formalized support provided by members or with other members of the entourage. This informal mentoring is mainly based on the observation of good practices and learning by doing. 2. We notice an intersection between the two loops. If the first loop is not done, the second will not take place. The knowledge acquired in the first loop is used to feed the second. 3. We note a form of reluctance on the part of some members to share their knowledge for reasons of competition. Ultimately, we retain the notion of “social” mentoring as a hybridization of formal and informal mentoring while dimensioning the “social” perspective by emphasizing the reciprocal character, solidarity, confidence, and trust between the mentor and the mentee.

Keywords: social innovation, social mentoring, social and solidarity economy, informal mentoring

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Authors: May Bazzi, Shafik Tokmaj, Younes Saberi, Mats Geijer, Tony Jurkiewicz, Patrik Sund, Anna Bjällmark

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Mobile radiography, employing portable X-ray equipment, has become a routine procedure within hospital settings, with chest X-rays in intensive care units standing out as the most prevalent mobile X-ray examinations. This approach is not limited to hospitals alone, as it extends its benefits to imaging patients in various settings, particularly those too frail to be transported, such as elderly care residents in nursing homes. Moreover, the utility of mobile X-ray isn't confined solely to traditional healthcare recipients; it has proven to be a valuable resource for vulnerable populations, including the homeless, drug users, asylum seekers, and patients with multiple co-morbidities. Mobile X-rays reduce patient stress, minimize costly hospitalizations, and offer cost-effective imaging. While studies confirm its reliability, further research is needed, especially regarding image quality. Recent advancements in lightweight equipment with enhanced battery and detector technology provide the potential for nearly handheld radiography. The main aim of this study was to evaluate a new lightweight mobile X-ray system with two different detectors and compare the image quality with a modern stationary system. Methods: A total of 74 images of the chest (chest anterior-posterior (AP) views and chest lateral views) and pelvic/hip region (AP pelvis views, hip AP views, and hip cross-table lateral views) were acquired on a whole-body phantom (Kyotokagaku, Japan), utilizing varying image parameters. These images were obtained using a stationary system - 18 images (Mediel, Sweden), a mobile X-ray system with a second-generation detector - 28 images (FDR D-EVO II; Fujifilm, Japan) and a mobile X-ray system with a third-generation detector - 28 images (FDR D-EVO III; Fujifilm, Japan). Image quality was assessed by visual grading analysis (VGA), which is a method to measure image quality by assessing the visibility and accurate reproduction of anatomical structures within the images. A total of 33 image criteria were used in the analysis. A panel of two experienced radiologists, two experienced radiographers, and two final-term radiographer students evaluated the image quality on a 5-grade ordinal scale using the software Viewdex 3.0 (Viewer for Digital Evaluation of X-ray images, Sweden). Data were analyzed using visual grading characteristics analysis. The dose was measured by the dose-area product (DAP) reported by the respective systems. Results: The mobile X-ray equipment (both detectors) showed significantly better image quality than the stationary equipment for the pelvis, hip AP and hip cross-table lateral images with AUCVGA-values ranging from 0.64-0.92, while chest images showed mixed results. The number of images rated as having sufficient quality for diagnostic use was significantly higher for mobile X-ray generation 2 and 3 compared with the stationary X-ray system. The DAP values were higher for the stationary compared to the mobile system. Conclusions: The new lightweight radiographic equipment had an image quality at least as good as a fixed system at a lower radiation dose. Future studies should focus on clinical images and consider radiographers' viewpoints for a comprehensive assessment.

Keywords: mobile x-ray, visual grading analysis, radiographer, radiation dose

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Authors: Ahmedou Moulaye Idriss, Yahya Tfeil

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Medical imaging technology has become an indispensable tool in many branches of the biomedical, health area, and research and is vitally important for the training of professionals in these fields. It is not only about the tools, technologies, and knowledge provided but also about the community that this training project proposes. In order to be able to raise the level of anatomy teaching in the medical school of Nouakchott in Mauritania, it is necessary and even urgent to facilitate access to modern technology for African countries. The role of technology as a key driver of justifiable development has long been recognized. Anatomy is an essential discipline for the training of medical students; it is a key element for the training of medical specialists. The quality and results of the work of a young surgeon depend on his better knowledge of anatomical structures. The teaching of anatomy is difficult as the discipline is being neglected by medical students in many academic institutions. However, anatomy remains a vital part of any medical education program. When anatomy is presented in various planes medical students approve of difficulties in understanding. They do not increase their ability to visualize and mentally manipulate 3D structures. They are sometimes not able to correctly identify neighbouring or associated structures. This is the case when they have to make the identification of structures related to the caudate lobe when the liver is moved to different positions. In recent decades, some modern educational tools using digital sources tend to replace old methods. One of the main reasons for this change is the lack of cadavers in laboratories with poorly qualified staff. The emergence of increasingly sophisticated mathematical models, image processing, and visualization tools in biomedical imaging research have enabled sophisticated three-dimensional (3D) representations of anatomical structures. In this paper, we report our current experience in the Faculty of Medicine in Nouakchott Mauritania. One of our main aims is to create a local learning community in the fields of anatomy. The main technological platform used in this project is called 3D Slicer. 3D Slicer platform is an open-source application available for free for viewing, analysis, and interaction with biomedical imaging data. Using the 3D Slicer platform, we created from real medical images anatomical atlases of parts of the human body, including head, thorax, abdomen, liver, and pelvis, upper and lower limbs. Data were collected from several local hospitals and also from the website. We used MRI and CT-Scan imaging data from children and adults. Many different anatomy atlases exist, both in print and digital forms. Anatomy Atlas displays three-dimensional anatomical models, image cross-sections of labelled structures and source radiological imaging, and a text-based hierarchy of structures. Open and free online anatomical atlases developed by our anatomy laboratory team will be available to our students. This will allow pedagogical autonomy and remedy the shortcomings by responding more fully to the objectives of sustainable local development of quality education and good health at the national level. To make this work a reality, our team produced several atlases available in our faculty in the form of research projects.

Keywords: anatomy, education, medical imaging, three dimensional

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Authors: Adam J. Bowen

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Abstract— Should robots have rights or legal protections. Often debates concerning whether robots and AI should be afforded rights focus on conditions of personhood and the possibility of future advanced forms of AI satisfying particular intrinsic cognitive and moral attributes of rights-holding persons. Such discussions raise compelling questions about machine consciousness, autonomy, and value alignment with human interests. Although these are important theoretical concerns, especially from a future design perspective, they provide limited guidance for addressing the moral and legal standing of current and near-term AI that operate well below the cognitive and moral agency of human persons. Robots and AI are already being pressed into service in a wide range of roles, especially in healthcare and biomedical contexts. The design and large-scale implementation of robots in the context of core societal institutions like healthcare systems continues to rapidly develop. For example, we bring them into our homes, hospitals, and other care facilities to assist in care for the sick, disabled, elderly, children, or otherwise vulnerable persons. We enlist surgical robotic systems in precision tasks, albeit still human-in-the-loop technology controlled by surgeons. We also entrust them with social roles involving companionship and even assisting in intimate caregiving tasks (e.g., bathing, feeding, turning, medicine administration, monitoring, transporting). There have been advances to enable severely disabled persons to use robots to feed themselves or pilot robot avatars to work in service industries. As the applications for near-term AI increase and the roles of robots in restructuring our biomedical practices expand, we face pressing questions about the normative implications of human-robot interactions and collaborations in our collective worldmaking, as well as the moral and legal status of robots. This paper argues that robots operating in public and private spaces be afforded some protections as either moral patients or legal agents to establish prohibitions on robot abuse, misuse, and mistreatment. We already implement robots and embed them in our practices and institutions, which generates a host of human-to-machine and machine-to-machine relationships. As we interact with machines, whether in service contexts, medical assistance, or home health companions, these robots are first encountered in relationship to us and our respective roles in the encounter (e.g., surgeon, physical or occupational therapist, recipient of care, patient’s family, healthcare professional, stakeholder). This proposal aims to outline a framework for establishing limiting factors and determining the extent of moral or legal protections for robots. In doing so, it advocates for a relational approach that emphasizes the priority of mapping the complex contextually sensitive roles played and the relations in which humans and robots stand to guide policy determinations by relevant institutions and authorities. The relational approach must also be technically informed by the intended uses of the biomedical technologies in question, Design History Files, extensive risk assessments and hazard analyses, as well as use case social impact assessments.

Keywords: biomedical robots, robot ethics, robot laws, human-robot interaction

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Authors: Abdullah Nurus Salam Khan, Farhana Karim, Mohiuddin Ahsanul Kabir Chowdhury, S. Masum Billah, Nabila Zaka, Alexander Manu, Shams El Arifeen

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Globally, pre-eclampsia (PE) and ante-partum haemorrhage (APH) are two major causes of maternal mortality. Prompt identification and management of these conditions depend on competency of the birth attendants. Since these conditions are infrequent to be observed, clinical vignette based assessment could identify the extent of health worker’s competence in managing emergency obstetric care (EmOC). During June-August 2016, competence of 39 medical officers (MO) and 95 nurses working in obstetric ward of 15 government health facilities (3 district hospital, 12 sub-district hospital) was measured using clinical vignettes on PE and APH. The vignettes resulted in three outcome measures: total vignette scores, scores for diagnosis component, and scores for management component. T-test was conducted to compare mean vignette scores and linear regression was conducted to measure the strength and association of vignette scores with different cadres of health workers, facility’s readiness for EmOC and average annual utilization of normal deliveries after adjusting for type of health facility, health workers’ work experience, training status on managing maternal complication. For each of the seven component of EmOC items (administration of injectable antibiotics, oxytocic and anticonvulsant; manual removal of retained placenta, retained products of conception; blood transfusion and caesarean delivery), if any was practised in the facility within last 6 months, a point was added and cumulative EmOC readiness score (range: 0-7) was generated for each facility. The yearly utilization of delivery cases were identified by taking the average of all normal deliveries conducted during three years (2013-2015) preceding the survey. About 31% of MO and all nurses were female. Mean ( ± sd) age of the nurses were higher than the MO (40.0 ± 6.9 vs. 32.2 ± 6.1 years) and also longer mean( ± sd) working experience (8.9 ± 7.9 vs. 1.9 ± 3.9 years). About 80% health workers received any training on managing maternal complication, however, only 7% received any refresher’s training within last 12 months. The overall vignette score was 8.8 (range: 0-19), which was significantly higher among MO than nurses (10.7 vs. 8.1, p < 0.001) and the score was not associated with health facility types, training status and years of experience of the providers. Vignette score for management component (range: 0-9) increased with higher annual average number of deliveries in their respective working facility (adjusted β-coefficient 0.16, CI 0.03-0.28, p=0.01) and increased with each unit increase in EmOC readiness score (adjusted β-coefficient 0.44, CI 0.04-0.8, p=0.03). The diagnosis component of vignette score was not associated with any of the factors except it was higher among the MO than the nurses (adjusted β-coefficient 1.2, CI 0.13-2.18, p=0.03). Lack of competence in diagnosing and managing obstetric complication by the nurses than the MO is of concern especially when majority of normal deliveries are conducted by the nurses. Better EmOC preparedness of the facility and higher utilization of normal deliveries resulted in higher vignette score for the management component; implying the impact of experiential learning through higher case management. Focus should be given on improving the facility readiness for EmOC and providing the health workers periodic refresher’s training to make them more competent in managing obstetric cases.

Keywords: Bangladesh, emergency obstetric care, clinical vignette, competence of health workers

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Authors: Luis Guilherme Resende Santos, Ido Nevat, Leslie Norford

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The Urban Heat Island (UHI) is characterized by increased air temperatures in urban areas compared to undeveloped rural surrounding environments. With urbanization and densification, the intensity of UHI increases, bringing negative impacts on livability, health and economy. In order to reduce those effects, it is required to take into consideration design factors when planning future developments. Given design constraints such as population size and availability of area for development, non-trivial decisions regarding the buildings’ dimensions and their spatial distribution are required. We develop a framework for optimization of urban design in order to jointly minimize UHI intensity and buildings’ energy consumption. First, the design constraints are defined according to spatial and population limits in order to establish realistic boundaries that would be applicable in real life decisions. Second, the tools Urban Weather Generator (UWG) and EnergyPlus are used to generate outputs of UHI intensity and total buildings’ energy consumption, respectively. Those outputs are changed based on a set of variable inputs related to urban morphology aspects, such as building height, urban canyon width and population density. Lastly, an optimization problem is cast where the utility function quantifies the performance of each design candidate (e.g. minimizing a linear combination of UHI and energy consumption), and a set of constraints to be met is set. Solving this optimization problem is difficult, since there is no simple analytic form which represents the UWG and EnergyPlus models. We therefore cannot use any direct optimization techniques, but instead, develop an indirect “black box” optimization algorithm. To this end we develop a solution that is based on stochastic optimization method, known as the Cross Entropy method (CEM). The CEM translates the deterministic optimization problem into an associated stochastic optimization problem which is simple to solve analytically. We illustrate our model on a typical residential area in Singapore. Due to fast growth in population and built area and land availability generated by land reclamation, urban planning decisions are of the most importance for the country. Furthermore, the hot and humid climate in the country raises the concern for the impact of UHI. The problem presented is highly relevant to early urban design stages and the objective of such framework is to guide decision makers and assist them to include and evaluate urban microclimate and energy aspects in the process of urban planning.

Keywords: building energy consumption, stochastic optimization, urban design, urban heat island, urban weather generator

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Authors: Olayemi Bakre

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The majoritant of the South African rural populace are directly or indirectly engaged in agricultural practices for a livelihood. However, impediments such as the climate change and inadequacy of governmental support has undermined the once thriving subsistence farming communities of South Africa. Furthermore, the poor leadership in hydrology, coupled with lack of depths in skills to facilitate the understanding and acceptance of groundwater from national level to local governance has made it near impossible for subsistence farmers to optimally benefit from the groundwater beneath their feet. The 2012 drought experienced in South Africa paralysed the farming activities across several subsistence farming communities across the KwaZulu-Natal Province. To revamp subsistence farming, a variety of interventions and strategies such as the Resource Poor Farmers (RPF) and Water Allocation Reforms (WAR) have been launched by the Department of Water and Sanitation (DWS) as an agendum to galvanising the defunct subsistence farming communities of KwaZulu-Natal as well as other subsistence farming communities across South Africa. Despite the enormous resources expended on the subsistence farming communities whom often fall under the Historically Disadvantaged Individuals (HDI); indicators such as the unsustainable farming practices, poor crop yield, pitiable living condition as well as the poor standard of living, are evidential to the claim that these afore cited interventions and a host of other similar strategies indicates that these initiatives have not yield the desired result. Thus, this paper seeks to suggest practicable interventions aimed at salvaging the vulnerability of subsistence farmers within the province understudy. The study pursued a qualitative approach as the view of experts on ground water and similarly related fields from the DWS were solicited as an agendum to obtaining in-depth perspective into the current study. Some of the core challenges undermining the sustainability and growth of subsistence farming in the area of study were - inadequacy of experts (engineers, scientist, researchers) in ground water; water shortages; lack of political will as well as lack of coordination among stakeholders. As an agendum to optimising the ground water usage for subsistence farming, this paper advocates the strengthening of geohydrological skills, development of technical training capacity, interactive participation among stakeholders as well as the initiation of Participatory Action Research as an agenda to optimising the available ground water in KwaZulu-Natal which is intended to orchestrate a sustainable and viable subsistence farming practice within the province.

Keywords: subsistence farming, ground water optimisation, resource poor farmers, and water allocation reforms, hydrology

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Authors: Lamia Bouzgarrou, Amira Omrane, Naima Bouatay, Chaima Harrathi, Samia Machroughl, Ahmed Mhalla

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Background and Aims: Professionals of health care sector are exposed to psychosocial constraints like stress, harassment, violence, which can lead to many mental health problems such as, depression, addictive behavior, and burn-out. Moreover, it’s well established that caregivers affected to intensive care units are more likely to experience such constraints and mental health problems. For these caregivers, the mental health state may affect care quality and patient’s safety. This study aims either to identify occupational psychosocial constraints and their mental health consequences among paramedical and medical caregivers affected to intensive units in Tunisian public hospital. Methods: An exhaustive three months cross-sectional study conducted among medical and paramedical staffs of intensive care units in three Tunisian university hospitals. After informed consent collection, we evaluated work-related stress, workplace harassment, depression, anxious troubles, addictive behavior, and self-esteems through an anonymous self-completed inquiry form. Five validated questionnaires and scales were included in this form: Karasek's Job Content Questionnaire, Negative Acts Questionnaire, Rosenberg, Beck depression inventory and Hamilton Anxiety scale. Results: We included 129 intensive unit caregivers; with a mean age of 36.1 ± 1.1 years and a sex ratio of 0.58. Among these caregivers, 30% were specialist or under-specialization doctors. The average seniority in the intensive care was 6.1 ± 1.2 (extremes=1 to 40 years). Atypical working schedules were noted among 36.7% of the subjects with an imposed choice in 52.4% of cases. During the last 12 months preceding the survey, 51.7% of care workers were absent from work because of a health problem with stops exceeding 15 days in 11.7%. Job strain was objective among 15% of caregivers and 38.33% of them were victims of moral harassment. A low or very low self-esteem was noted among 40% of respondents. Moreover, active smoking was reported by 20% subjects, alcohol consumption by 13.3% and psychotropic substance use by 1.7% of them. According to Beck inventory and Hamilton Anxiety scale, we concluded that 61.7% of intensive care providers were depressed, with 'severe' depression in 13.3% of cases and 49.9% of them present anxious disorders. Multivariate analysis objective that, job strain was correlated with young age (p=0.005) and shorter work seniority (p=0.001). Workplace and moral harassment was more prevalent among females (p=0.009), under-specialization doctor (p=0.021), those affected to atypical schedules (p=0.008). Concerning depression, it was more prevalent among staff in job strain situation (p = 0.004), among smokers caregivers (p = 0.048), and those with no leisure activity (p < 0.001). Anxious disorders were positively correlated to chronic diseases history (p = 0.001) and work-bullying exposure (p = 0.004). Conclusions: Our findings reflected a high frequency of caregivers who are under stress at work and those who are victims of moral harassment. These health professionals were at increased risk for developing psychiatric illness such depressive and anxious disorders and addictive behavior. Our results suggest the necessity of preventive strategies of occupational psychosocial constraints in order to preserve professional’s mental health and maximize patient safety and quality of care.

Keywords: health care sector, intensive care units, mental health, psychosocial constraints

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Authors: Fangjing Zhou, Wen Chen, Brian J. Hall, Yu Wang, Carl Latkin, Li Ling, Joseph D. Tucker

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Background: Economic and social reforms designed to open China to the world has been successful, but also appear to have rapidly laid the foundation for the reemergence of STIs since 1980s. Changes in sexual behaviors, relationships, and norms among Chinese contributed to the STIs epidemic. As the massive population moved during the last 30 years, early coital debut, multiple sexual partnerships, and unprotected sex have increased within the general population. Our objectives were to assess associations between residences location, sexual risk behaviors and sexually transmitted infections (STIs) among adults living in Guangzhou, China. Methods: Stratified cluster sampling followed a two-step process was used to select populations aged 18-59 years in Guangzhou, China. Spatial methods including Geographic Information Systems (GIS) were utilized to identify 1400 coordinates with latitude and longitude. Face-to-face household interviews were conducted to collect self-report data on sexual risk behaviors and diagnosed STIs. Kulldorff’s spatial scan statistic was implemented to identify and detect spatial distribution and clusters of sexual risk behaviors and STIs. The presence and location of statistically significant clusters were mapped in the study areas using ArcGIS software. Results: In this study, 1215 of 1400 households attempted surveys, with 368 refusals, resulting in a sample of 751 completed surveys. The prevalence of self-reported sexual risk behaviors was between 5.1% and 50.0%. The self-reported lifetime prevalence of diagnosed STIs was 7.06%. Anal intercourse clustered in an area located along the border within the rural-urban continuum (p=0.001). High rate clusters for alcohol or other drugs using before sex (p=0.008) and migrants who lived in Guangzhou less than one year (p=0.007) overlapped this cluster. Excess cases for sex without a condom (p=0.031) overlapped the cluster for college students (p<0.001). Conclusions: Short-term migrants and college students reported greater sexual risk behaviors. Programs to increase safer sex within these communities to reduce the risk of STIs are warranted in Guangzhou. Spatial analysis identified geographical clusters of sexual risk behaviors, which is critical for optimizing surveillance and targeting control measures for these locations in the future.

Keywords: cluster analysis, migrant, sexual risk behaviors, spatial distribution

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Authors: Jay Raval

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Sports and physical fitness have been a vital component of our civilization. It is such a power which, motivates and inspires every individual, communities and even countries to be aware of the physical and mental health. All though, sports play vital role in the overall development of the nation, but in the developing countries such as India, this culture of sports is yet to be motivated. However, in India lack of sporting culture has held back the growth of a similar industry in the past, despite the growing awareness and interest in various different sports besides cricket. Hence, due to a lack of sporting culture, corporate investments in India’s sports have traditionally been limited to only non-profit corporate social responsibility activities and initiatives. From past couple of years, India has come up with new initiatives such as Indian Premier League (Cricket), Hockey India League, Indian Badminton League, Pro Kabaddi League, and Indian Super League (Football) which help to boost Indian sports culture and thereby increase economy of the country. Out of 29 states of India, among all of those competitive states, Gujarat is showing very rapid increase in sports participation. Khel Mahakumbh, the competition conducted for the last six years has been a giant step in this direction and covers rural and urban areas of Gujarat. The objective of the research is to address the overall development of the sports system. Sports system includes infrastructure, coaches, resources, and participants. The current existing system is not disabled friendly. This research paper highlights adequate steps in order to improve and sort out pressing issues in the sports system. Education system is highly academic-centric with a definite trend towards reducing school sports and extra-curricular sports in the Gujarat state. Constituents of this research work make an attempt to evaluate the framework of the Olympic Charter, the Sports Authority of India, the Indian Olympics Association and the National Sports Federations. It explores the areas that need to be revamped, rejuvenated and reoriented to function in an open, democratic, equitable, transparent and accountable manner. Research is based on mixed method approach. It is used for the data collection which includes the personal interviews, document analysis and the use of news article. Quality assurance is also tested by conducting the trustworthiness of the paper. Mixed method helps to strengthen the analysis part and give strong base for the discussion during the analysis.

Keywords: physical development, sports authority of India, sports policy, women empowerment

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Authors: Krithika Lakshmi Sathiya Moorthy

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Introduction: Young people’s attitude towards Intimate partner violence (IPV) is likely to influence their indulgence in or abstinence from IPV in future. We aimed to assess the knowledge and attitudes of college students in a south Indian city regarding IPV, its associated factors and redressal mechanisms. Methods: A convenient sample of 247 students, pursuing medicine and engineering, participated in this analytical cross sectional study. They responded to a self-administered questionnaire developed and pretested for this study. The questionnaire comprises statements from a third person’s perspective and vignettes to reduce social desirability bias. Clearance was obtained from the Institute Ethical Committee of Velammal Medical College Hospital and Research Institute, Madurai, India. Data were entered in Epidata Entry v3.1, Odense, Denmark and analysed using SPSS v20.0. Results: Among 247 students, 116 (47%) were males and 59 (24.9%) hailed from rural areas. About 18% (43) of students believed that IPV was a problem only among females. Almost half of the students had witnessed IPV; at home between their parents (9.7%), other family members (13.4%), in their neighbourhood (13%) or public places (15%). Only 118 (47.8%) were aware that a law was in place in India to address IPV. The perceived risk factors for IPV were alcoholic spouse (78.9%), low income families (53.8%), personality traits (52.2%) and dowry system (51%). A sizeable number of students (38.4%) believed that some amount of physical violence was allowable in a marital relationship while 57.6% even considered IPV as an expression of love. Males as compared to females were more in agreement with negative gender stereotypes such as husband can– ‘threaten wife to ensure welfare of family’ (55% vs. 34%, p < 0.001), ‘spy on wife to check fidelity’ (41% vs. 27%, p < 0.001), ‘financially deprive housewife to punish’ (13% vs. 3.8%, p=0.001) and agreed with the statement that it is ‘duty of wife to comply with demands for sex from the husband’ (9.5% vs 4.6%, p=0.3). About 32% males and 25.6% females foresaw themselves as perpetrators of IPV in future. Conclusion: Knowledge about IPV and the associated risk factors among the study population was satisfactory. However, there was widespread acceptance of negative societal gender stereotypes, more so among males and some degrees of IPV were acceptable between married couples. The study advocates the need to halt the propagation of negative gender stereotypes in the impressionable young minds and the necessity to spread the awareness that no degree of IPV is acceptable. This knowledge is also required to plan the content and choose the appropriate media to effectively communicate the awareness about IPV among young persons.

Keywords: attitude, India, intimate partner violence, knowledge, students

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Authors: Nairy Kechichian

Abstract:

The original Leclerc Bridge is a covered wooden bridge that is considered a Quebec heritage structure with an index of 60, making it a very important provincial bridge from a historical point of view. It was constructed in 1927 and is in the rural area of Abitibi-Temiscamingue. It is a “town Québécois” type of structure, which is generally rare but common for covered bridges in Abitibi-Temiscamingue. This type of structure is composed of two trusses on both sides formed with diagonals, internal bracings, uprights and top and bottom chords to allow the transmission of loads. This structure is mostly known for its solidity, lightweightness, and ease of construction. It is a single-span bridge with a length of 25.3 meters and allows the passage of one vehicle at a time with a 4.22-meter driving lane. The structure is composed of 2 trusses located at each end of the deck, two gabion foundations at both ends, uprights and top and bottom chords. WSP (Williams Sale Partnership) Canada inc. was mandated by the Transport Minister of Quebec in 2019 to increase the capacity of the bridge from 5 tons to 30.6 tons and rehabilitate it, as it has deteriorated quite significantly over the years. The bridge was damaged due to material deterioration over time, exposure to humidity, high load effects and insect infestation. To allow the passage of 3 axle trucks, as well as to keep the integrity of this heritage structure, the final design chosen to rehabilitate the bridge involved adding a new deck independent from the roof structure of the bridge. Essentially, new steel beams support the deck loads and the desired vehicle loads. The roof of the bridge is linked to the steel deck for lateral support, but it is isolated from the wooden deck. The roof is preserved for aesthetic reasons and remains intact as it is a heritage piece. Due to strict traffic management obstacles, an efficient construction method was put into place, which consisted of building a temporary bridge and moving the existing roof onto it to allow the circulation of vehicles on one side of the temporary bridge while providing a working space for the repairs of the roof on the other side to take place simultaneously. In parallel, this method allowed the demolition and reconstruction of the existing foundation, building a new steel deck, and transporting back the roof on the new bridge. One of the main criteria for the rehabilitation of the wooden bridge was to preserve, as much as possible, the existing patrimonial architectural design of the bridge. The project was completed successfully by the end of 2021.

Keywords: covered bridge, wood-steel, short span, town Québécois structure

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Authors: Anusha Vaddiraj Pallapu

Abstract:

Across the globe, there is a steady increase in people residing in urban areas. Due to this increase in urban population, urban health is affecting. The major issues identified like overcrowding, air pollution, unhealthy diet, inadequate infrastructure, poor solid waste management systems and insufficient access to health facilities, these issues are gradually clearly observed in health statistics of diseases and deaths rapidly increase in urban areas. Therefore, the present study aims to assess the health statistics and infrastructure services at urban areas to know the cause and effect between Infrastructure, its management and diseases (water borne). Most of the Indian cities have the municipal boundaries, which authorized by their respective municipal corporations and development authorities. Generally, cities have various zones under which municipal wards exist. The paper focuses on the city Ahmedabad, at Gujarat state. Ahmedabad Municipal Corporation (AMC) is divided into six zones namely Central zone, West zone, New-West zone, East zone, North zone, and South zone. Each zone includes various wards within it. Incidence of diseases in Ahmadabad which are linked to infrastructure was identified such as water-borne diseases. Later on, the occurrence of water-borne diseases at urban area was examined at each zone level. The study methodology follows four steps i.e. 1) Pre-Field literature study: Study on Sewerage system in urban areas and its best practices and public health status globally and Indian scenario; 2) Field study: Data collection and interviews of stakeholders regarding heal status and issues at each zone and ward level; 3) Post field: Data analysis with qualitative description of each ward of zones, followed by correlation coefficient analysis between sewerage coverage, diseases and density of each ward using geographic information system mapping (GIS); 4) Identification of reasons: Affected health on each of zone and wards followed by correlation analysis on each reason. The results reveal that the health conditions in Ahmedabad municipal zones or boundaries are effected due to the slums created by the migrated people from various rural and urban areas. It is also observed that due to increase in population water supply and sewerage management is affecting. The overall effect on infrastructure is creating the health diseases which detailed in the paper using geographical information system in Indian city.

Keywords: infrastructure, municipal wards, GIS, water supply, sewerage, medical facilities, water borne diseases

Procedia PDF Downloads 190

Authors: Maryam Al Mheiri, Khaled Al Awadi

Abstract:

Urban population is continuously increasing worldwide and the speed at which cities urbanize creates major challenges, particularly in terms of creating sustainable urban environments. Rapid urbanization often leads to negative environmental impacts and changes in the urban microclimates. Moreover, when rapid urbanization is paired with limited landscape elements, the effects on human health due to the increased pollution, and thermal comfort due to Urban Heat Island effects are increased. Urban Heat Island (UHI) describes the increase of urban temperatures in urban areas in comparison to its rural surroundings, and, as we discuss in this paper, it impacts on pedestrian comfort, reducing the number of walking trips and public space use. It is thus very necessary to investigate the quality of outdoor built environments in order to improve the quality of life incites. The main objective of this paper is to address the morphology of Emirati neighborhoods, setting a quantitative baseline by which to assess and compare spatial characteristics and microclimate performance of existing typologies in Abu Dhabi. This morphological mapping and analysis will help to understand the built landscape of Emirati neighborhoods in this city, whose form has changed and evolved across different periods. This will eventually help to model the use of different design strategies, such as landscaping, to mitigate UHI effects and enhance outdoor urban comfort. Further, the impact of different native plants types and native species in reducing UHI effects and enhancing outdoor urban comfort, allowing for the assessment of the impact of increasing landscaped areas in these neighborhoods. This study uses ENVI-met, an analytical, three-dimensional, high-resolution microclimate modeling software. This micro-scale urban climate model will be used to evaluate existing conditions and generate scenarios in different residential areas, with different vegetation surfaces and landscaping, and examine their impact on surface temperatures during summer and autumn. In parallel to these simulations, field measurement will be included to calibrate the Envi-met model. This research therefore takes an experimental approach, using simulation software, and a case study strategy for the evaluation of a sample of residential neighborhoods. A comparison of the results of these scenarios constitute a first step towards making recommendations about what constitutes sustainable landscapes for Abu Dhabi neighborhoods.

Keywords: landscape, microclimate, native plants, sustainable neighborhoods, thermal comfort, urban heat island

Procedia PDF Downloads 292