Search results for: rural healthcare
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3312

Search results for: rural healthcare

882 Inter-Generational Benefits of Improving Access to Justice for Women: Evidence from Peru

Authors: Iva Trako, Maris Micaela Sviatschi, Guadalupe Kavanaugh

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Domestic violence is a major concern in developing countries, with important social, economic and health consequences. However, institutions do not usually address the problems facing women or ethnic and religious minorities. For example, the police do very little to stop domestic violence in rural areas of developing countries. This paper exploits the introduction of women’s justice centers (WJCs) in Peru to provide causal estimates on the effects of improving access to justice for women and children. These centers offer a new integrated public service model for women by including medical, psychological and legal support in cases of violence against women. Our empirical approach uses a difference in difference estimation exploiting variation over time and space in the opening of WJC together with province-by-year fixed effects. Exploiting administrative data from health providers and district attorney offices, we find that after the opening of these centers, there are important improvements on women's welfare: a large reduction in femicides and female hospitalizations for assault. Moreover, using geo-coded household surveys we find evidence that the existence of these services reduces domestic violence, improves women's health, increases women's threat points and, therefore, lead to household decisions that are more aligned with their interests. Using administrative data on the universe of schools, we find large gains on human capital for their children: affected children are more likely to enroll, attend school and have better grades in national exams, instead of working for the family. In sum, the evidence in this paper shows that providing access to justice for women can be a powerful tool to reduce domestic violence and increase education of children, suggesting a positive inter-generational benefit.

Keywords: access to justice, domestic violence, education, household bargaining

Procedia PDF Downloads 184
881 Attraction and Retention of Newly Graduated Medical Doctors to Deprived Regions in Ghana: A Qualitative Case Study

Authors: Lily Yarney, Emmanuel M. Y. Seidu, Thomas Chireh Kuusaanu, Belinda Adzimah-Yeboah

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Healthcare delivery is labor-intensive; the role of the health worker is, therefore, indispensable in maintaining and improving individual and population health. In Ghana, doctor-patient ratio is 1:10,450, with a disproportionate tilt in favor of the relatively resource rich southern part of the country. The Upper West Region located in Northern Ghana, is among the poorest regions in the country. The study was aimed at finding out the reasons why medical doctors are unwilling to accept postings to the Upper West Region where their services are needed most despite some efforts to attract, motivate and retain them. Current initiatives by the Ministry of Health and its partners to attract and retain doctors in the region were also examined. Qualitative methodology was employed with an in-depth interview guide to collect data. Sixteen respondents comprising medical doctors, health managers, and other health-related partners purposively selected took part in the study. Data were recorded, transcribed, coded, and categorized into themes in tandem with the objectives of the study. The study found that medical doctors are unwilling to take up appointments in the Upper West Region because of limited opportunities for career and continuing professional development, poor financial inducement, and weak leadership, among other important contextual social and cultural factors. Critical success factors to surmount these challenges include concessions and sponsorship for medical specialization training for doctors and clear implementable national and local policies on postings.

Keywords: attraction, retention, medical doctors, deprived regions, Ghana

Procedia PDF Downloads 110
880 Assessing Adoption Trends of Mukau (Melia volkensii (Gürke)) Enterprises in Eastern and Coastal Regions of Kenya

Authors: Lydia Murugi Mugendi

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The promotion of tree growing as a lucrative enterprise is the focus of this paper as management practices have shifted focus from protection of natural forest resources to community/government partnerships with the aim of resource conservation, management and increase of on-farm tree growing. Using KEFRI as (the source) of information pertaining Melia volkensii (the medium or message) being transferred, this paper investigates the current perception towards forestry and the behavioural attitudes of recipients of forest intervention activities. The two objectives explored in this paper are to find out the level of adoption of Mukau in Kitui, Kibwezi and Samburu/Taru and secondly, to find out the characteristics of the adoption process between Kitui, Kibwezi and Samburu/Taru. The methodologies used during data collection were participatory rural appraisal tools in conjunction with the social survey questionnaires. Simple random sampling and snowball sampling were used to identify respondents within the three target sites and analysis was done using SPSS. Results of the study of indicating that adoption rates of the Mukau in Samburu/Taru, where forestry-related activities were introduced within the past one decade had significantly increase despite initial resistance. The other areas, which had benefited from numerous decades of intense forestry extension projects and activities, indicated a decline in re-adoption rates of Mukau as an enterprise. This study has brought out the reality of adoption trends and state of Mukau population within the three counties while providing a glimpse towards the communities’ perception in regards to adoption of forestry and other environmental innovations. The outcome of the study is to provide a guideline for extension/ dissemination officers in KEFRI and related stakeholders to promote seamless cohesive interaction between the recipient communities of the proposed interventions.

Keywords: adoption, innovation, enterprise, extension, DOI Theory

Procedia PDF Downloads 113
879 Online Multilingual Dictionary Using Hamburg Notation for Avatar-Based Indian Sign Language Generation System

Authors: Sugandhi, Parteek Kumar, Sanmeet Kaur

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Sign Language (SL) is used by deaf and other people who cannot speak but can hear or have a problem with spoken languages due to some disability. It is a visual gesture language that makes use of either one hand or both hands, arms, face, body to convey meanings and thoughts. SL automation system is an effective way which provides an interface to communicate with normal people using a computer. In this paper, an avatar based dictionary has been proposed for text to Indian Sign Language (ISL) generation system. This research work will also depict a literature review on SL corpus available for various SL s over the years. For ISL generation system, a written form of SL is required and there are certain techniques available for writing the SL. The system uses Hamburg sign language Notation System (HamNoSys) and Signing Gesture Mark-up Language (SiGML) for ISL generation. It is developed in PHP using Web Graphics Library (WebGL) technology for 3D avatar animation. A multilingual ISL dictionary is developed using HamNoSys for both English and Hindi Language. This dictionary will be used as a database to associate signs with words or phrases of a spoken language. It provides an interface for admin panel to manage the dictionary, i.e., modification, addition, or deletion of a word. Through this interface, HamNoSys can be developed and stored in a database and these notations can be converted into its corresponding SiGML file manually. The system takes natural language input sentence in English and Hindi language and generate 3D sign animation using an avatar. SL generation systems have potential applications in many domains such as healthcare sector, media, educational institutes, commercial sectors, transportation services etc. This research work will help the researchers to understand various techniques used for writing SL and generation of Sign Language systems.

Keywords: avatar, dictionary, HamNoSys, hearing impaired, Indian sign language (ISL), sign language

Procedia PDF Downloads 230
878 Communities And Local Food Systems In The Post Pandemic World: Lessons For Kerala

Authors: Salimah Hasnah, Namratha Radhakrishnan

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Communities play a vital role in mobilizing people and resources for the benefit of all. Since time immemorial, communities have been spear heading different activities ranging from disaster management, palliative care, local economic development and many more with laudable success. Urban agriculture is one such activity where communities can prove to make a real difference. Farming activities in cities across different developed countries have proved to have favorable outcomes in the form of increased food security, neighborhood revitalization, health benefits and local economic growth. However, urban agriculture in the developing nations have never been prioritized as an important planning tool to cater to the basic needs of the public. Urban agricultural practices are being carried out in a fragmented fashion without a formal backing. The urban dwellers rely heavily on their far-off rural counterparts for daily food requirements. With the onset of the pandemic and the recurring lockdowns, the significance of geographic proximity and its impact on the availability of food to the public are gradually being realized around the globe. This warrants a need for localized food systems by shortening the distance between production and consumption of food. The significance of communities in realizing these urban farming benefits is explored in this paper. A case-study approach is adopted to understand how different communities have overcome barriers to urban farming in cities. The applicability of these practices is validated against the state of Kerala in India wherein different community centered approaches have been successful in the past. The existing barriers are assessed and way forward to achieve a self-sufficient localized food systems is formulated with the key lessons from the case studies. These recommendations will be helpful to successfully establish and sustain farming activities in urban areas by leveraging the power of communities.

Keywords: community-centric, COVID-19, drivers and barriers, local food system, urban agriculture

Procedia PDF Downloads 137
877 Comparison of Blockchain Ecosystem for Identity Management

Authors: K. S. Suganya, R. Nedunchezhian

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In recent years, blockchain technology has been found to be the most significant discovery in this digital era, after the discovery of the Internet and Cloud Computing. Blockchain is a simple, distributed public ledger that contains all the user’s transaction details in a block. The global copy of the block is then shared among all its peer-peer network users after validation by the Blockchain miners. Once a block is validated and accepted, it cannot be altered by any users making it a trust-free transaction. It also resolves the problem of double-spending by using traditional cryptographic methods. Since the advent of bitcoin, blockchain has been the backbone for all its transactions. But in recent years, it has found its roots and uses in many fields like Smart Contracts, Smart City management, healthcare, etc. Identity management against digital identity theft has become a major concern among financial and other organizations. To solve this digital identity theft, blockchain technology can be employed with existing identity management systems, which maintain a distributed public ledger containing details of an individual’s identity containing information such as Digital birth certificates, Citizenship number, Bank details, voter details, driving license in the form of blocks verified on the blockchain becomes time-stamped, unforgeable and publicly visible for any legitimate users. The main challenge in using blockchain technology to prevent digital identity theft is ensuring the pseudo-anonymity and privacy of the users. This survey paper will exert to study the blockchain concepts, consensus protocols, and various blockchain-based Digital Identity Management systems with their research scope. This paper also discusses the role of Blockchain in COVID-19 pandemic management by self-sovereign identity and supply chain management.

Keywords: blockchain, consensus protocols, bitcoin, identity theft, digital identity management, pandemic, COVID-19, self-sovereign identity

Procedia PDF Downloads 130
876 Psychological Resilience Factors Associated with Climate Change Adaptations by Subsistence Farmers in a Rural Community, South Africa

Authors: Kgopa Bontle, Tholen Sodi

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Climate change poses a major threat to the well-being of both people and the environment, with subsistence farmers most affected as they rely on local supply systems that are sensitive to climate variation. This study documented psychological resilience factors associated with climate change adaptations by subsistence farmers in Maruleng Municipality, Limpopo Province. A qualitative study was conducted to examine the notions of climate change by subsistence farmers, the psychological resilience factors, the strategies to cope with climate change, adaptation methods, and the development of subsistence farmers’ psychological resilience factors model. Data were collected through direct interactions with participants using a grounded theory research design. An open-ended interview was used to collect data with a sample of 15 participants selected through theoretical sampling in Maruleng Municipality. The participants were both Sepedi and Xitsonga speaking from 2 villages, mostly unemployed, pensioners and dependent on social grants. The study included both males and females who were predominately the elderly. The research findings indicate that farmers have limited knowledge of what climate change is and what causes it. Furthermore, the research reflects that although their responses were non-scientific but sensible enough to know what they were dealing with. They mentioned extreme weather, which includes hot days and less rainfall and changes in seasons, as some of the impacts brought by climate change. The results also indicated that participants have learned to adapt through several adaptation strategies, including mulching, changes in irrigation time slots and being innovative. The resilience factors that emerged from the study were a passion for farming, hope, enthusiasm, courage, acceptance/tolerance, livelihood and belief systems. Looking at the socio-economic factors of the current study setting argumentation leads to the conclusion that it is important that government should assist the subsistence farmers as it was observed from the participants that they felt neglected by the government and policymakers as they are small scale farmers and are not included like commercial farmers.

Keywords: climate change, psychological resilience factors, human adaptation, subsistence farmers

Procedia PDF Downloads 122
875 Evidence of Natural Selection Footprints among Some African Chicken Breeds and Village Ecotypes

Authors: Ahmed Elbeltagy, Francesca Bertolini, Damarius Fleming, Angelica Van Goor, Chris Ashwell, Carl Schmidt, Donald Kugonza, Susan Lamont, Max Rothschild

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The major factor in shaping genomic variation of the African indigenous rural chicken is likely natural selection drives the development genetic footprints in the chicken genomes. To investigate such a hypothesis of a selection footprint, a total of 292 birds were randomly sampled from three indigenous ecotypes from East Africa (Uganda, Rwanda) and North Africa (Egypt) and two registered Egyptian breeds (Fayoumi and Dandarawi), and from the synthetic Kuroiler breed. Samples were genotyped using the Affymetrix 600K Axiom® Array. A total of 526,652 SNPs were utilized in the downstream analysis after quality control measures. The intra-population runs of homozygosity (ROH) that were consensuses in > 50% of individuals of an ecotype or > 75% of a breed were studied. To identify inter-population differentiation due to genetic structure, FST was calculated for North- vs. East- African populations in addition to population-pairwise combinations for overlapping windows (500Kb with an overlap of 250Kb). A total of 28,563 ROH were determined and were classified into three length categories. ROH and Fst detected sweeps were identified on several autosomes. Several genes in these regions are likely to be related to adaptation to local environmental stresses that include high altitude, diseases resistance, poor nutrition, oxidative and heat stresses and were linked to gene ontology terms (GO) related to immune response, oxygen consumption and heme binding, carbohydrate metabolism, oxidation-reduction, and behavior. Results indicated a possible effect of natural selection forces on shaping genomic structure for adaptation to local environmental stresses.

Keywords: African Chicken, runs of homozygosity, FST, selection footprints

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874 Agricultural Investment in Ethiopia: The Case of Oromia Region

Authors: Misganaw Ayele Gelaw

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This abstract presents an overview of agricultural investment in Ethiopia, with a focus on the Oromia Region. Ethiopia is a developing country that heavily relies on agriculture as a major contributor to its economic growth and employment. The Oromia Region, located in the central part of the country, is the largest region in Ethiopia and plays a significant role in the agricultural sector. The study aims to explore the current state of agricultural investment in the Oromia Region, focusing on the opportunities, challenges, and potential benefits that arise from such investments. It also highlights the key agricultural investment strategies and policies implemented by the Ethiopian government to attract domestic and foreign investors. To achieve these objectives, a comprehensive literature review and analysis of relevant reports, publications, and government policies will be conducted. The study will also incorporate qualitative and quantitative data collection methods, such as interviews, surveys, and statistical analysis, to provide a well-rounded understanding of agricultural investment dynamics in the Oromia Region. The findings of this study are expected to shed light on the impact of agricultural investments on local farmers, rural development, food security, income generation, and overall economic growth in the Oromia Region. It will also identify the key risk factors and potential mitigations associated with agricultural investment, offering recommendations to policymakers, investors, and stakeholders to improve the effectiveness and sustainability of investment efforts in the region. This abstract highlights the importance of agricultural investment in the Oromia Region and Ethiopia as a whole, as it strives to enhance productivity, increase farmers' income, and contribute to the country's long-term development goals. By understanding the challenges and opportunities associated with agricultural investment, policymakers and investors can develop targeted strategies to ensure inclusive and sustainable growth in the agricultural sector, leading to improved livelihoods and economic prosperity in the Oromia Region.

Keywords: agriculture, investment, agriculture policy, economy

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873 Social Media Impact on Professional and Profile Level of Dental Students in Saudi Arabia

Authors: Aliyaa Zaidan, Rayan Bahabri

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The twenty-first century revealed an accelerating change and intensifying complexity of communication technology. Online social networking engines have gained astounding recognition worldwide. The influence of those social media platforms on dentistry and dental students is not well established. Therefore, this study aimed to evaluate the impact of using social media on professional and profile level among dental students in Saudi Arabia. A cross-sectional study developed via online questionnaire concerning on social media usage and its effect on professional and profile level of dental students and dental interns from several universities in Saudi Arabia. A total of 296 dental students and dental interns in Saudi Arabia responded to the questionnaire. Ninety-eight percent of the participants usually use the social media on a regular basis. Most social media sites used among the participants were Snapchat, Instagram, and YouTube by 85%, 81%, 77% respectively. Forty-one percent of the participants agreed that using social media in the dental field is a necessity nowadays. Thirty-eight percent of participants agreed that using social media is an easy way to gain a reliable knowledge, while 43% agreed that social media will improve the quality of healthcare. Furthermore, 65% of the students deemed using social media for academic purposes will improve their performance. Fifty-five percent of the respondents often use social media tools to obtain information about subject or procedures related to the dental field. Regarding profile reputation of dental students, 40% of the respondents agreed that their profile information published on social networking websites, could be used by others to judge their level of professionalism. Male and female dental students both agreed that their reputation would be adversely affected by 37%,63%, respectively, if their social networking activity were viewed by members of the public. The discrepancy among student levels reveals that social media profile positively influence the acceptance to postgraduate programs (P= 0.01).

Keywords: dental students, professional, reputation, social media

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872 Anti-Diabetic Effect of High Purity Epigallocatechin Gallate from Green Tea

Authors: Hye Jin Choi, Mirim Jin, Jeong June Choi

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Green tea, which is one of the most popular of tea, contains various ingredients that help health. Epigallocatechin gallate (EGCG) is one of the main active polyphenolic compound possessing diverse biologically beneficial effects such as anti-oxidation, anti-cancer founding in green tea. This study was performed to investigate the anti-diabetic effect of high-purity EGCG ( > 98%) in a spontaneous diabetic mellitus animal model, db/db mouse. Four-week-old male db/db mice, which was induced to diabetic mellitus by the high-fat diet, were orally administered with high-purity EGCG (10, 50 and 100 mg/kg) for 4 weeks. Daily weight and diet efficiency were examined, and blood glucose level was assessed once a week. After 4 weeks of EGCG administration, fasting blood glucose level was measured. Then, the mice were sacrificed and total abdominal fat was sampled to examine the change in fat weight. Plasma was separated from the blood and the levels of aspartate amino-transferase (ALT) and alanine amino-transferase (AST) were investigated. As results, blood glucose and body weight were significantly decreased by EGCG treatment compared to the control group. Also, the amount of abdominal fat was down-regulated by EGCG. However, ALT and AST levels, which are indicators of liver function, were similar to those of control group. Taken together, our study suggests that high purity EGCG is capable of treating diabetes mellitus based in db / db mice with safety and has a potent to develop a therapeutics for metabolic disorders. This work was supported by Korea Institute of Planning and Evaluation for Technology in Food, Agriculture, Forestry (IPET) through High Value-added Food Technology Development Program, funded by Ministry of Agriculture, Food and Rural Affairs (MAFRA) (317034-03-2-HD030)

Keywords: anti-diabetic effect, db/db mouse, diabetes mellitus, green tea, epigallocatechin gallate

Procedia PDF Downloads 187
871 Smart Water Cities for a Sustainable Future: Defining, Necessity, and Policy Pathways for Canada's Urban Water Resilience

Authors: Sima Saadi, Carolyn Johns

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The concept of a "Smart Water City" is emerging as a framework to address critical urban water challenges, integrating technology, data, and sustainable management practices to enhance water quality, conservation, and accessibility. This paper explores the definition of a Smart Water City, examines the pressing need for such cities in Canada, and proposes policy pathways for their development. Smart Water Cities utilize advanced monitoring systems, data analytics, and integrated water resources management to optimize water usage, anticipate and mitigate environmental impacts, and engage citizens in sustainable practices. Global examples from regions such as Europe, Asia, and Australia illustrate how Smart Water City models can transform urban water systems by enhancing resilience, improving resource efficiency, and driving economic development through job creation in environmental technology sectors. For Canada, adopting Smart Water City principles could address pressing challenges, including climate-induced water stress, aging infrastructure, and the need for equitable water access across diverse urban and rural communities. Building on Canada's existing water policies and technological expertise, it propose strategic investments in digital water infrastructure, data-driven governance, and community partnerships. Through case studies, this paper offers insights into how Canadian cities could benefit from cross-sector collaboration, policy development, and funding for smart water technology. By aligning national policy with smart urban water solutions, Canada has the potential to lead globally in sustainable water management, ensuring long-term water security and environmental stewardship for its cities and communities.

Keywords: smart water city, urban water resilience, water management technology, sustainable water infrastructure, canada water policy, smart city initiatives

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870 Analysis of Extreme Case of Urban Heat Island Effect and Correlation with Global Warming

Authors: Kartikey Gupta

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Global warming and environmental degradation are at their peak today, with the years after 2000A.D. giving way to 15 hottest years in terms of average temperatures. In India, much of the standard temperature measuring equipment are located in ‘developed’ urban areas, hence showing us an incomplete picture in terms of the climate across many rural areas, which comprises most of the landmass. This study showcases data studied by the author since 3 years at Vatsalya’s Children’s village, in outskirts of Jaipur, Rajasthan, India; in the midst of semi-arid topography, where consistently huge temperature differences of up to 15.8 degrees Celsius from local Jaipur weather only 30 kilometers away, are stunning yet scary at the same time, encouraging analysis of where the natural climatic pattern is heading due to rapid unrestricted urbanization. Record-breaking data presented in this project enforces the need to discuss causes and recovery techniques. This research further explores how and to what extent we are causing phenomenal disturbances in the natural meteorological pattern by urban growth. Detailed data observations using a standardized ambient weather station at study site and comparing it with closest airport weather data, evaluating the patterns and differences, show striking differences in temperatures, wind patterns and even rainfall quantity, especially during high-pressure zone days. Winter-time lows dip to 8 degrees below freezing with heavy frost and ice, while only 30 kms away minimum figures barely touch single-digit temperatures. Human activity is having an unprecedented effect on climatic patterns in record-breaking trends, which is a warning of what may follow in the next 15-25 years for the next generation living in cities, and a serious exploration into possible solutions is a must.

Keywords: climate change, meteorology, urban heat island, urbanization

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869 Health as an Agenda in Indian Politics: A Study of Election Manifestos in 16th General Elections

Authors: Kiran Bala

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Health, education and employment opportunities available for a common citizen reflect the development status of a country. Health of an individual affects the growth of a country in every aspect. According to a study by WHO, India is estimated to lose more than $237 billion of its GDP over the period 2006-15 on account of premature death and morbidity from Non-communicable diseases alone. Each year 37 million people fall below poverty line due to high expenditure on health services they have to incur. Falling sick puts a double burden on them in terms of loss of income and expenditure on health care which pushes them further into debt and poverty. Adding to the gravity of situation, public spending on health in India has itself declined after liberalization from 1.3% of GDP in 1990 to 0.9% in 1999. The Approach Paper of the Government of India to the Twelfth Five Year Plan indicated that health expenditure alone as a per cent of GDP was about 1.4 per cent (B.E.) in 2011-12. It also mentioned that if one included expenditure on rural water supply and sanitation, the figure would be about 1.8 per cent. Given the abysmally low level of priority accorded to health in Indian economic policy, it becomes rather important to study the representation of health in the Indian public sphere. To this end, this study examines the prioritization of health in the public policy agenda of the national/regional political parties as evidenced in their election manifestos at a time when the nation is poised to go for the General Elections. The paper also focuses attention on the prioritization of health in the public perception as evidenced in their reasons for their preferences for a particular party or individual contestant. To arrive at the reasons for the priority level accorded by the political actors and the citizens, the study uses Focus groups of health policy makers, media persons, medical practitioners and voters. Collected data will be analysed in the theoretical framework of spiral of silence and agenda setting theory.

Keywords: health, election manifestos, public perception, policies

Procedia PDF Downloads 353
868 Land Lots and Shannon-Winner Index in Sarpolzahab Agro Ecosystems-Western Iran

Authors: Ashkan Asgari, Korous Khoshbakht, Saeid Soufizadeh

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Various factors including land lots can affect biodiversity indices in Agricultural systems. Field study conducted to evaluate factors affecting crop diversity in Sarpolzahab in 2012. Required data were collected through direct observation of farms and filling questionnaires. Total numbers of 140 questionnaires were filled, SAS Software was used to analyse data and Ecological Methodology Program was applied to calculate Shannon-Winner index, subsequently. Results of study indicated that average number of land lots for each farmer was 2.78 and various from 2.2 in Rikhak Olia Village to 4.31 in Golam Kaboud Olia Village which shows small size of land lots due to separating larger lots by children of deceased farmers. The correlation between number of land lots and species biodiversity (0.308**) was significant and Shannon-Winner index was (0.262**). Therefore, according to the mentioned results one can assume that increase in number of land lots results in improving of the target index. Multiple land lots allow farmers to cultivate various crops which results in increasing biodiversity of crops in agro ecosystem. Subsequently, this increase will facilitate economic sustainability of the farmers and distribution of work force in the region throughout the year. The correlation of seasonal workers with biodiversity of crop species (0.256**) and Shannon-Winner (0.286**) was statistically significant and increasing number of seasonal work forces had resulted in improving crop biodiversity and decreasing dominant species or single crop farming systems. Vegetable farms which have a significant diversity, require a significant number of work forces which describes correlation between number of workers and diversity of species.

Keywords: agricultural systems, biodiversity indices, Shannon-Winner index, sustainability, rural

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867 Botswana and Nation-Building Theory

Authors: Rowland Brucken

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This paper argues that nation-building theories that prioritize democratic governance best explain the successful post-independence development of Botswana. Three main competing schools of thought exist regarding the sequencing of policies that should occur to re-build weakened or failed states. The first posits that economic development should receive foremost attention, while democratization and a binding sense of nationalism can wait. A second group of experts identified constructing a sense of nationalism among a populace is necessary first, so that the state receives popular legitimacy and obedience that are prerequisites for development. Botswana, though, transitioned into a multi-party democracy and prosperous open economy due to the utilization of traditional democratic structures, enlightened and accountable leadership, and an educated technocratic civil service. With these political foundations already in place when the discovery of diamonds occurred, the resulting revenues were spent wisely on projects that grew the economy, improved basic living standards, and attracted foreign investment. Thus democratization preceded, and therefore provided an accountable basis for, economic development that might otherwise have been squandered by greedy and isolated elites to the detriment of the greater population. Botswana was one of the poorest nations in the world at the time of its independence in 1966, with little infrastructure, a dependence on apartheid South Africa for trade, and a largely subsistence economy. Over the next thirty years, though, its economy grew the fastest of any nation in the world. The transparent and judicious use of diamond returns is only a partial explanation, as the government also pursued economic diversification, mass education, and rural development in response to public needs. As nation-building has become a project undertaken by nations and multilateral agencies such as the United Nations and the North Atlantic Treaty Organization, Botswana may provide best practices that others should follow in attempting to reconstruct economically and politically unstable states.

Keywords: Botswana, democratization, economic development, nation-building

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866 Uncovering Geometrical Ideas in Weaving: An Ethnomathematical Approaches to School Pedagogy

Authors: Jaya Bishnu Pradhan

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Weaving mat is one of the common activities performed in different community generally in the rural part of Nepal. Mat weavers’ practice mathematical ideas and concepts implicitly in order to perform their job. This study is intended to uncover the mathematical ideas embedded in mat weaving that can help teachers and students for the teaching and learning of school geometry. The ethnographic methodology was used to uncover and describe the beliefs, values, understanding, perceptions, and attitudes of the mat weavers towards mathematical ideas and concepts in the process of mat weaving. A total of 4 mat weavers, two mathematics teachers and 12 students from grade level 6-8, who are used to participate in weaving, were selected for the study. The whole process of the mat weaving was observed in a natural setting. The classroom observation and in-depth interview were taken with the participants with the help of interview guidelines and observation checklist. The data obtained from the field were categorized according to the themes regarding mathematical ideas embedded in the weaving activities, and its possibilities in teaching learning of school geometry. In this study, the mathematical activities in different sectors of their lives, their ways of understanding the natural phenomena, and their ethnomathematical knowledge were analyzed with the notions of pluralism. From the field data, it was found that the mat weaver exhibited sophisticated geometrical ideas in the process of construction of frame of mat. They used x-test method for confirming if the mat is rectangular. Mat also provides a good opportunity to understand the space geometry. A rectangular form of mat may be rolled up when it is not in use and can be converted to a cylindrical form, which usually can be used as larder so as to reserve food grains. From the observation of the situations, this cultural experience enables students to calculate volume, curved surface area and total surface area of the cylinder. The possibilities of incorporation of these cultural activities and its pedagogical use were observed in mathematics classroom. It is argued that it is possible to use mat weaving activities in the teaching and learning of school geometry.

Keywords: ethnography, ethnomathematics, geometry, mat weaving, school pedagogy

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865 Toxicological Effects of Atmospheric Fine Particulate Matter on Human Bronchial Epithelial Cells: Metabolic Activation, Genotoxicity and Epigenetic Modifications

Authors: M. Borgie, Z. Dagher, F. Ledoux, A. Verdin, F. Cazier, H. Greige, P. Shirali, D. Courcot

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In October 2013, the International Agency for Research on Cancer (IARC) classified outdoor air pollution and fine particulate matter (PM2.5) as carcinogenic to humans. Despite the clearly relationship established by epidemiological studies between PM exposure and the onset of respiratory and cardiovascular diseases, uncertainties remain about the physiopathological mechanisms responsible for these diseases. The aim of this work was to evaluate the toxicological effects of two samples of atmospheric PM2.5 collected at urban and rural sites on human bronchial epithelial cells, BEAS-2B, especially to investigate the metabolic activation of organic compounds, the alteration of epigenetic mechanisms (i.e. microRNAs genes expression), the phosphorylation of H2AX and the telomerase activity. Our results showed a significant increase in CYP1A1, CYP1B1, and AhRR genes expression, miR-21 gene expression, H2AX phosphorylation and telomerase activity in BEAS-2B cells after their exposure to PM2.5, both in a dose and site-dependent manner. These results showed that PM2.5, especially urban PM, are able to induce the expression of metabolizing enzymes which can provide metabolic biotransformation of organic compounds into more toxic and carcinogenic metabolites, and to induce the expression of the oncomiR miR-21 which promotes cell growth and enhances tumor invasion and metastasis in lung cancer. In addition, our results have highlighted the role of PM2.5 in the activation of telomerase, which can maintain the telomeres length and subsequently preventing cell death, and have also demonstrated the ability of PM2.5 to induce DNA breaks and thus to increase the risk of mutations or chromosomal translocations that lead to genomic instability. All these factors may contribute to cell abnormalities, and thus the development of cancer.

Keywords: BEAS-2B cells, carcinogenesis, epigenetic alterations and genotoxicity, PM2.5

Procedia PDF Downloads 382
864 Exoskeleton-Enhanced Manufacturing: A Study Exploring Psychological and Physical Effects on Assembly Operators' Wellbeing

Authors: Iveta Eimontaite, Sarah R. Fletcher, Michele Surico, Alfio Minissale, Fabio F. Abba

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Industry 4.0 offers possibilities for increased production volumes and greater efficiency whilst at the same time presenting new opportunities and challenges for the human workforce. Exoskeletons have been used in healthcare and are now starting to be adopted in manufacturing. The potential benefits of reducing fatigue and physical strain are attractive prospects of the technology for industry; however, the novelty of exoskeletons and surrounding ethical issues raise concerns amongst the stakeholders. The current case study investigated the introduction of an upper body exoskeleton designed to support posture but not increase physical strength in a factory over three time points: before the exoskeleton was introduced, and one and two months post-introduction once operators had experienced working with it. The main focus was to evaluate changes in operators' workload, situation awareness, technology self-efficacy, and physical discomfort following the introduction of the exoskeleton. After using the exoskeleton over two months, operators reported a decrease in temporal demand and an increase in performance of the NASA TLX instrument. Furthermore, over the second month, operators' self-reported technology self-efficacy scores increased, but at the same time, their situation awareness decreased. Interestingly, operators' physical discomfort after using the exoskeleton for two months increased from not uncomfortable to quite uncomfortable in the shoulder, arm, and middle back regions. The results suggest that self-perceived task efficiency improved; however, increased discomfort and decreased situation awareness scores indicate that two months might not be long enough for the exoskeleton to be integrated into operators’ mental body schema. The paper will discuss further implications and suggestions for exoskeleton introduction to manufacturing environments.

Keywords: exoskeleton, manufacturing, mental workload, physical discomfort, situation awareness, technology self-efficacy

Procedia PDF Downloads 132
863 Determinants of Cessation of Exclusive Breastfeeding in Ankesha Guagusa Woreda, Awi Zone, Northwest Ethiopia: A Cross-Sectional Study

Authors: Tebikew Yeneabat, Tefera Belachew, Muluneh Haile

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Background: Exclusive breast-feeding (EBF) is the practice of feeding only breast milk (including expressed breast milk) during the first six months and no other liquids and solid foods except medications. The time to cessation of exclusive breast-feeding, however, is different in different countries depending on different factors. Studies showed the risk of diarrhea morbidity and mortality is higher among none exclusive breast-feeding infants, common during starting other foods. However, there is no study that evaluated the time to cessation of exclusive breast-feeding in the study area. The aim of this study was to show time to cessation of EBF and its predictors among mothers of index infants less than twelve months old. Methods: We conducted a community-based cross-sectional study from February 13 to March 3, 2012 using both quantitative and qualitative methods. This study included a total of 592 mothers of index infant using multi-stage sampling method. Data were collected by using interviewer administered structured questionnaire. Bivariate and multivariate Cox regression analyses were performed. Results: Cessation of exclusive breast-feeding occurred in 392 (69.63%) cases. Among these, 224 (57.1%) happened before six months, while 145 (37.0%) and 23 (5.9%) occurred at six months and after six months of age of the index infant respectively. The median time for infants to stay on exclusive breast-feeding was 6.36 months in rural and 5.13 months in urban, and this difference was statistically significant on a Log rank (Cox-mantel) test. Maternal and paternal occupation, place of residence, postnatal counseling on exclusive breast-feeding, mode of delivery, and birth order of the index infant were significant predictors of cessation of exclusive breast-feeding. Conclusion: Providing postnatal care counseling on EBF, routine follow-up and support of those mothers having infants stressing for working mothers can bring about implementation of national strategy on infant and young child feeding.

Keywords: exclusive breastfeeding, cessation, median duration, Ankesha Guagusa Woreda

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862 Prevalence of SARS-CoV-2 Infection and Associated Risk Factors in Selected Health Facilities of Tigray, Ethiopia: Cross-Sectional Study Design, 2023

Authors: Weldegerima Gebremedhin Hagos

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Background: The Coronavirus disease of 2019 (COVID-19) is a catastrophic emerging global health threat caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). COVID-19 has a wide range of complications and sequels. It is devastating in developing countries, causing serious health and socioeconomic crises as a result of the increasingly overburdened healthcare system. Ethiopia reported the first case of SARS-CoV-2 on 13th March 2020, with community transmission ensuing by mid-May. The aim of this study was conducted to determine the prevalence of SARS-CoV-2 infection in Tigray, Ethiopia. Methods: Facility-based correctional study designs were used on a total of 380 study participants from March 2023 up to May 2023 in two general hospitals and one comprehensive specialized hospital in Tigray, Ethiopia. A pre-structured questionnaire was used to assess information regarding the socio-demographic, clinical data and other risk factors. A nasal swap was taken by trained health professionals, and the laboratory analysis was done by RT-PCR (quant studio 7-flex, applied biosystems) in Tigrai Health Research Institute and Mekelle University Medical Microbiology Research Laboratory. Result: The mean age of the study participants was 31 (SD+/-3.5) years, with 65% being male and 35% female. The overall seropositivity of sars-cov-2 among the study participants was 5.5%. The prevalence was higher in males (6.2%) than females which were (4.7%). Sars-cov-2 infection was significantly associated with a history of lack of vaccination (p-value 0.002). There was no significant association between seropositivity and demographic factors (P > 0.05). Conclusion: The seroprevalence of SARS-CoV-2 among the study participants is high. Those study participants with a previous history of vaccination have a low probability of developing COVID-19 infection. A low SARS-CoV-2 infection rate was recorded in those who frequently use masks.

Keywords: prevalence, SARS-CoV-2, infection, risk factors

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861 Health Information Technology in Developing Countries: A Structured Literature Review with Reference to the Case of Libya

Authors: Haythem A. Nakkas, Philip J. Scott, Jim S. Briggs

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This paper reports a structured literature review of the application of Health Information Technology in developing countries, defined as the World Bank categories Low-income countries, Lower-middle-income, and Upper-middle-income countries. The aim was to identify and classify the various applications of health information technology to assess its current state in developing countries and explore potential areas of research. We offer specific analysis and application of HIT in Libya as one of the developing countries. Method: A structured literature review was conducted using the following online databases: IEEE, Science Direct, PubMed, and Google Scholar. Publication dates were set for 2000-2013. For the PubMed search, publications in English, French, and Arabic were specified. Using a content analysis approach, 159 papers were analyzed and a total number of 26 factors were identified that affect the adoption of health information technology. Results: Of the 2681 retrieved articles, 159 met the inclusion criteria which were carefully analyzed and classified. Conclusion: The implementation of health information technology across developing countries is varied. Whilst it was initially expected financial constraints would have severely limited health information technology implementation, some developing countries like India have nevertheless dominated the literature and taken the lead in conducting scientific research. Comparing the number of studies to the number of countries in each category, we found that Low-income countries and Lower-middle-income had more studies carried out than Upper-middle-income countries. However, whilst IT has been used in various sectors of the economy, the healthcare sector in developing countries is still failing to benefit fully from the potential advantages that IT can offer.

Keywords: developing countries, developed countries, factors, failure, health information technology, implementation, libya, success

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860 Revised Risk Priority Number in Failure Mode and Effects Analysis Model from the Perspective of Healthcare System

Authors: Fatemeh Rezaei, Mohammad H. Yarmohammadian, Masoud Ferdosi, Abbas Haghshnas

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Background: Failure Modes and Effect Analysis is now having known as the main methods of risk assessment and the accreditation requirements for many organizations. The Risk Priority Number (RPN) approach is generally preferred, especially for its easiness of use. Indeed it does not require statistical data, but it is based on subjective evaluations given by the experts about the Occurrence (O i), the Severity (Si) and the Detectability (D i) of each cause of failure. Methods: This study is a quantitative – qualitative research. In terms of qualitative dimension, method of focus groups with inductive approach is used. To evaluate the results of the qualitative study, quantitative assessment was conducted to calculate RPN score. Results; We have studied patient’s journey process in surgery ward and the most important phase of the process determined Transport of the patient from the holding area to the operating room. Failures of the phase with the highest priority determined by defining inclusion criteria included severity (clinical effect, claim consequence, waste of time and financial loss), occurrence (time- unit occurrence and degree of exposure to risk) and preventability (degree of preventability and defensive barriers) and quantifying risks priority criteria in the context of RPN index. Ability of improved RPN reassess by root cause (RCA) analysis showed some variations. Conclusions: Finally, It could be concluded that understandable criteria should have been developed according to personnel specialized language and communication field. Therefore, participation of both technical and clinical groups is necessary to modify and apply these models.

Keywords: failure mode, effects analysis, risk priority number(RPN), health system, risk assessment

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859 Demonstration Operation of Distributed Power Generation System Based on Carbonized Biomass Gasification

Authors: Kunio Yoshikawa, Ding Lu

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Small-scale, distributed and low-cost biomass power generation technologies are highly required in the modern society. There are big needs for these technologies in the disaster areas of developed countries and un-electrified rural areas of developing countries. This work aims to present a technical feasibility of the portable ultra-small power generation system based on the gasification of carbonized wood pellets/briquettes. Our project is designed for enabling independent energy production from various kinds of biomass resources in the open-field. The whole process mainly consists of two processes: biomass and waste pretreatment; gasification and power generation. The first process includes carbonization, densification (briquetting or pelletization), and the second includes updraft fixed bed gasification of carbonized pellets/briquettes, syngas purification, and power generation employing an internal combustion gas engine. A combined pretreatment processes including carbonization without external energy and densification were adopted to deal with various biomass. Carbonized pellets showed a better gasification performance than carbonized briquettes and their mixture. The 100-hour continuous operation results indicated that pelletization/briquetting of carbonized fuel realized the stable operation of an updraft gasifier if there were no blocking issues caused by the accumulation of tar. The cold gas efficiency and the carbon conversion during carbonized wood pellets gasification was about 49.2% and 70.5% with the air equivalence ratio value of around 0.32, and the corresponding overall efficiency of the gas engine was 20.3% during the stable stage. Moreover, the maximum output power was 21 kW at the air flow rate of 40 Nm³·h⁻¹. Therefore, the comprehensive system covering biomass carbonization, densification, gasification, syngas purification, and engine system is feasible for portable, ultra-small power generation. This work has been supported by Innovative Science and Technology Initiative for Security (Ministry of Defence, Japan).

Keywords: biomass carbonization, densification, distributed power generation, gasification

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858 Strategic Policy Formulation to Ensure the Atlantic Forest Regeneration

Authors: Ramon F. B. da Silva, Mateus Batistella, Emilio Moran

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Although the existence of two Forest Transition (FT) pathways, the economic development and the forest scarcity, there are many contexts that shape the model of FT observed in each particular region. This means that local conditions, such as relief, soil quality, historic land use/cover, public policies, the engagement of society in compliance with legal regulations, and the action of enforcement agencies, represent dimensions which combined, creates contexts that enable forest regeneration. From this perspective we can understand the regeneration process of native vegetation cover in the Paraíba Valley (Forest Atlantic biome), ongoing since the 1960s. This research analyzed public information, land use/cover maps, environmental public policies, and interviewed 17 stakeholders from the Federal and State agencies, municipal environmental and agricultural departments, civil society, farmers, aiming comprehend the contexts behind the forest regeneration in the Paraíba Valley, Sao Paulo State, Brazil. The first policy to protect forest vegetation was the Forest Code n0 4771 of 1965, but this legislation did not promote the increase of forest, just the control of deforestation, not enough to the Atlantic Forest biome that reached its highest pick of degradation in 1985 (8% of Atlantic Forest remnants). We concluded that the Brazilian environmental legislation acted in a strategic way to promote the increase of forest cover (102% of regeneration between 1985 and 2011) from 1993 when the Federal Decree n0 750 declared the initial and advanced stages of secondary succession protected against any kind of exploitation or degradation ensuring the forest regeneration process. The strategic policy formulation was also observed in the Sao Paulo State law n0 6171 of 1988 that prohibited the use of fire to manage agricultural landscape, triggering a process of forest regeneration in formerly pasture areas.

Keywords: forest transition, land abandonment, law enforcement, rural economic crisis

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857 Problems and Prospects of Agricultural Biotechnology in Nigeria’s Developing Economy

Authors: Samson Abayomi Olasoju, Olufemi Adekunle, Titilope Edun, Johnson Owoseni

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Science offers opportunities for revolutionizing human activities, enriched by input from scientific research and technology. Biotechnology is a major force for development in developing countries such as Nigeria. It is found to contribute to solving human problems like water and food insecurity that impede national development and threaten peace wherever it is applied. This review identified the problems of agricultural biotechnology in Nigeria. On the part of rural farmers, there is a lack of adequate knowledge or awareness of biotechnology despite the fact that they constitute the bulk of Nigerian farmers. On part of the government, the problems include: lack of adequate implementation of government policy on bio-safety and genetically modified products, inadequate funding of education as well as research and development of products related to biotechnology. Other problems include: inadequate infrastructures (including laboratory), poor funding and lack of national strategies needed for development and running of agricultural biotechnology. In spite of all the challenges associated with agricultural biotechnology, its prospects still remain great if Nigeria is to meet with the food needs of the country’s ever increasing population. The introduction of genetically engineered products will lead to the high productivity needed for commercialization and food security. Insect, virus and other related diseases resistant crops and livestock are another viable area of contribution of biotechnology to agricultural production. In conclusion, agricultural biotechnology will not only ensure food security, but, in addition, will ensure that the local farmers utilize appropriate technology needed for large production, leading to the prosperity of the farmers and national economic growth, provided government plays its role of adequate funding and good policy implementation.

Keywords: biosafety, biotechnology, food security, genetic engineering, genetic modification

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856 Self-Reported Health Status and Its Consistency: Evidence from India

Authors: Dona Ghosh, Zakir Husain

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In India, the increase in share of aged has generated many social and economic issues, of which health concerns is a major challenge that society must confront in coming years. Self-reported health (SRH) is a popular health measure in this regard but has been questioned in recent years due to its heavy dependence on the socioeconomic status. So, the validity of SRH, as a measure of health status during old age, is needed to be verified. This paper emphasizes on the self-reported health and related inconsistent responses among elderly in India. The objective of the study is bifurcated into two parts: firstly, to identify the socioeconomic determinants of subjective health status and its change over time; and secondly, to analyse the role of the socioeconomic components in providing inconsistent responses regarding the health status of elderly. Inconsistency in response can rise in two ways: positive response bias (if an individual has a health problem but reports his/her health as good) and negative response bias (if bad health is reported even if there is no health problem). However, in the present study, we focus only on the negative response bias of elderly individuals. To measure the inconsistencies in responses, self-reported health is compared with two types of physical health conditions – existence of chronicle ailment and physical immobility. Using NSS dataset of 60th and 71st rounds, the study found that subjective health has worsened over time in both rural and urban areas. Findings suggest that inconsistency in responses, related to chronic ailment, vary across social classes, living environments, geographical regions, age groups and education levels. On the contrary, variation in inconsistent responses regarding physical mobility is quite rare and difficult to explain by socioeconomic characteristics because most of the indicators are found to be insignificant in this regard. The findings indicate that in case of chronicle ailment, inconsistency between objective and subjective health status largely depends on socioeconomic conditions but the importance of such factors disappears for physical immobility.

Keywords: India, aging, self-reported health, inconsistent responses

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855 Cost Analysis of Neglected Tropical Disease in Nigeria: Implication for Programme Control and Elimination

Authors: Lawong Damian Bernsah

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Neglected Tropical Diseases (NTDs) are most predominant among the poor and rural populations and are endemic in 149 countries. These diseases are the most prevalent and responsible for infecting 1.4 billion people worldwide. There are 17 neglected tropical diseases recognized by WHO that constitute the fourth largest disease health and economic burden of all communicable diseases. Five of these 17 diseases are considered for the cost analysis of this paper: lymphatic filariasis, onchocerciasis, trachoma, schistosomiasis, and soil transmitted helminth infections. WHO has proposed a roadmap for eradication and elimination by 2020 and treatments have been donated through the London Declaration by pharmaceutical manufacturers. The paper estimates the cost of NTD control programme and elimination for each NTD disease and total in Nigeria. This is necessary as it forms the bases upon which programme budget and expenditure could be based. Again, given the opportunity cost the resources for NTD face it is necessary to estimate the cost so as to provide bases for comparison. Cost of NTDs control and elimination programme is estimated using the population at risk for each NTD diseases and for the total. The population at risk is gotten from the national master plan for the 2015 - 2020, while the cost per person was gotten for similar studies conducted in similar settings and ranges from US$0.1 to US$0.5 for Mass Administration of Medicine (MAM) and between US$1 to US$1.5 for each NTD disease. The combined cost for all the NTDs was estimated to be US$634.88 million for the period 2015-2020 and US$1.9 billion for each NTD disease for the same period. For the purpose of sensitivity analysis and for robustness of the analysis the cost per person was varied and all were still high. Given that health expenditure for Nigeria (% of GDP) averages 3.5% for the period 1995-2014, it is very clear that efforts have to be made to improve allocation to the health sector in general which is hoped could trickle to NTDs control and elimination. Thus, the government and the donor partners would need to step-up budgetary allocation and also to be aware of the costs of NTD control and elimination programme since they have alternative uses. Key Words: Neglected Tropical Disease, Cost Analysis, NTD Programme Control and Elimination, Cost per Person

Keywords: Neglected Tropical Disease, Cost Analysis, Neglected Tropical Disease Programme Control and Elimination, Cost per Person

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854 Screening for Diabetes in Patients with Chronic Pancreatitis: The Belfast Trust Experience

Authors: Riyas Peringattuthodiyil, Mark Taylor, Ian Wallace, Ailish Nugent, Mike Mitchell, Judith Thompson, Allison McKee, Philip C. Johnston

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Aim of Study: The purpose of the study was to screen for diabetes through HbA1c in patients with chronic pancreatitis (CP) within the Belfast Trust. Background: Patients with chronic pancreatitis are at risk of developing diabetes, earlier diagnosis with subsequent multi-disciplinary input has the potential to improve clinical outcomes. Methods: Clinical and laboratory data of patients with chronic pancreatitis were obtained through the Northern Ireland Electronic Healthcare Record (NIECR), specialist hepatobiliary, and gastrointestinal clinics. Patients were invited to have a blood test for HbA1c. Newly diagnosed patients with diabetes were then invited to attend a dedicated Belfast City Hospital (BCH) specialist chronic pancreatitis and diabetes clinic for follow up. Results: A total of 89 chronic pancreatitis patients were identified; Male54; Female:35, mean age 52 years, range 12-90 years. Aetiology of CP included alcohol 52/89 (58%), gallstones 18/89 (20%), idiopathic 10/89 11%, 2 were genetic, 1: post ECRP, 1: IgG autoimmune, 1: medication induced, 1: lipoprotein lipase deficiency 1: mumps, 1: IVDU and 1: pancreatic divisum. No patients had pancreatic carcinoma. Mean duration of CP was nine years, range 3-30 years. 15/89 (16%) of patients underwent previous pancreatic surgery/resections. Recent mean BMI was 25.1 range 14-40 kg/m². 62/89 (70%) patients had HbA1c performed. Mean HbA1c was 42 mmol/mol, range 27-97mmol/mol, 42/62 (68%) had normal HbA1c (< 42 mmol/mol) 13/62 (21%) had pre-diabetes (42-47mmol/mol) and 7/62 (11%) had diabetes (≥ 48 mmol/mol). Conclusions: Of those that participated in the screening program around one-third of patients with CP had glycaemic control in the pre and diabetic range. Potential opportunities for improving screening rates for diabetes in this cohort could include regular yearly testing at gastrointestinal and hepatobiliary clinics.

Keywords: pancreatogenic diabetes, screening, chronic pancreatitis, trust experience

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853 Psychological Wellbeing of Caregivers: Findings from a Large Cohort of Thai Adults

Authors: Vasoontara Yiengprugsawan, Sam-ang Seubsman

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As Thais live longer, caregivers will become even more important to social and healthcare systems. Commonly reported in many low and middle‐income countries in Asia, formal social welfare services to support caregivers are lacking and informal family support will be required for all levels of care. In 2005, 87,151 open‐university adults were recruited to the Thai Cohort Study, with the majority aged between 25 and 39 years, and residing nationwide. At the 4‐year follow up in 2009 (n=60569) and the 8‐year follow‐up in 2013 (n=42785), prospective cohort participants were asked if they provide care for chronically ill, disabled, or frail family members. Among Thai cohort members reporting between 2009 and 2013, approximately 56% were not caregivers in either year, 24.5% reported providing care in 2009 only, 8.6% in 2013 only, and 10.6% reported providing care at both time points. Caregivers in the cohort reported providing financial support, help with shopping, emotional support, and assist with daily activities. Kessler 6 psychological distress scale, measured in both 2009 and 2013, was used as the primary outcome of a relationship between caregiving status and mental health. Using multivariate logistic regression, our 4‐year longitudinal findings revealed that cohort members who reported providing care at both time points were 1.4 to 1.6 times more likely to report high psychological distress than non‐caregivers, after accounting for potential covariates. With increasing needs for informal care provided by family members, the future health and social welfare system will need to provide adequate support to caregivers (e.g., respite care, clinical support and information for the family, and awareness of mental health among caregivers).

Keywords: family caregivers, psychological distress, prospective cohort, longitudinal study, Thailand

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