Search results for: national health systems

Authors: Oluwaseun Adeleke, Samuel O. Ikani, Fidelis Edet, Anthony Nwala, Mopelola Raji, Simeon Christian Chukwu

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Background: The DISC project collaborated with partners to implement demand creation and service delivery interventions, including the MoT (Moment of Truth) innovation, in over 500 health facilities across 15 states. This has increased the voluntary conversion rate to self-injection among women who opt for injectable contraception. While some facilities recorded an increasing trend in key performance indicators, few others persistently performed sub-optimally due to provider and system-related barriers. Methodology: Twenty-two facilities performing sub-optimally were selected purposively from three Nigerian states. Low productivity was appraised using low reporting rates and poor SI conversion rates as indicators. Interviews were conducted with health providers across these health facilities using a rapid diagnosis tool. The project also conducted a data quality assessment that evaluated the veracity of data elements reported across the three major sources of family planning data in the facility. Findings: The inability and sometimes refusal of providers to support clients to self-inject effectively was associated with the misunderstanding of its value to their work experience. It was also observed that providers still held a strong influence over clients’ method choices. Furthermore, providers held biases and misconceptions about DMPA-SC that restricted the access of obese clients and new acceptors to services – a clear departure from the recommendations of the national guidelines. Additionally, quality of care standards was compromised because job aids were not used to inform service delivery. Facilities performing sub-optimally often under-reported DMPA-SC utilization data, and there were multiple uncoordinated responsibilities for recording and reporting. Additionally, data validation meetings were not regularly convened, and these meetings were ineffective in authenticating data received from health facilities. Other reasons for sub-optimal performance included poor documentation and tracking of stock inventory resulting in commodity stockouts, low client flow because of poor positioning of health facilities, and ineffective messaging. Some facilities lacked adequate human and material resources to provide services effectively and received very few supportive supervision visits. Supportive supervision visits and Data Quality Audits have been useful to address the aforementioned performance barriers. The project has deployed digital DMPA-SC self-injection checklists that have been aligned with nationally approved templates. During visits, each provider and community mobilizer is accorded special attention by the supervisor until he/she can perform procedures in line with best practice (protocol). Conclusion: This narrative provides a summary of a range of factors that identify health facilities performing sub-optimally in their provision of DMPA-SC services. Findings from this assessment will be useful during project design to inform effective strategies. As the project enters its final stages of implementation, it is transitioning high-impact activities to state institutions in the quest to sustain the quality of service beyond the tenure of the project. The project has flagged activities, as well as created protocols and tools aimed at placing state-level stakeholders at the forefront of improving productivity in health facilities.

Keywords: family planning, contraception, DMPA-SC, self-care, self-injection, barriers, opportunities, performance

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Authors: Jacolien Barnard, Corlia Van Heerden

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Effective and accessible consensual dispute resolution and in particular alternative dispute resolution, are central to consumer protection legislation. In this regard, the Consumer Protection Act 68 of 2008 (CPA) of South Africa is no exception. Due to the nature of consumer disputes, alternative dispute resolution (in theory) is an effective vehicle for the adjudication of disputes in a timely manner avoiding overburdening of the courts. The CPA sets down as one of its core purposes the provision of ‘an accessible, consistent, harmonized, effective and efficient system of redress for consumers’ (section 3(1)(h) of the CPA). Section 69 of the Act provides for the enforcement of consumer rights and provides for the National Consumer Commission to be the Central Authority which streamlines, adjudicates and channels disputes to the appropriate forums which include Alternative Dispute Resolution Agents (ADR-agents). The purpose of this paper is to analyze the regulation of these enforcement and redress mechanisms with particular focus on the Central Authority as well as the ADR-agents and their crucial role in successful and efficient adjudication of disputes in South Africa. The South African position will be discussed comparatively with the European Union (EU) position. In this regard, the European Union (EU) Directive on Alternative Dispute Resolution for Consumer Disputes (2013/11/EU) will be discussed (The ADR Directive). The aim of the ADR Directive is to solve contractual disputes between consumers and traders (suppliers or businesses) regardless of whether the agreement was concluded offline or online or whether or not the trader is situated in another member state (Recitals 4-6). The ADR Directive provides for a set of quality requirements that an ADR body or entity tasked with resolving consumer disputes should adhere to in member states which include regulatory mechanisms for control. Transparency, effectiveness, fairness, liberty and legality are all requirements for a successful ADR body and discussed within this chapter III of the Directive. Chapters III and IV govern the importance of information and co-operation. This includes information between ADR bodies and the European Commission (EC) but also between ADR bodies or entities and national authorities enforcing legal acts on consumer protection and traders. (In South Africa the National Consumer Tribunal, Provincial Consumer Protectors and Industry ombuds come to mind). All of which have a responsibility to keep consumers informed. Ultimately the papers aims to provide recommendations as to the successfulness of the current South African position in light of the comparative position in Europe and the highlight the importance of proper regulation of these redress and enforcement institutions.

Keywords: alternative dispute resolution, consumer protection law, enforcement, redress

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Authors: Seyed Saeid Tabaee, Mohammad Afshari, Bahador Ziaeemehr, Omid Bahar

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Nowadays, using modern structural systems with specific capabilities, like Diagrid, is emerging around the world. In this paper, a new resisting system, a combination of both Diagrid axial behavior and proper seismic performance of regular moment frames in tall buildings, named 'Hybrid Diagrid' is presented. The scaled specimen of the suggested hybrid system was built and tested using IIEES shaking table. The natural frequency and structural response of the analytical model were updated with the real experimental results. In order to compare its performance with the traditional Diagrid and moment frame systems, time history analysis was carried out. Extensive analysis shows the efficient seismic responses and economical behavior of Hybrid Diagrid structure with respect to the other two systems.

Keywords: hybrid diagrid system, moment frame, shaking table, tall buildings, time history analysis

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Authors: Felix Lankester, Alicia Davis, Safari Kinung'hi, Catherine Bunga, Shayo Alkara, Imam Mzimbiri, Jonathan Yoder, Sarah Cleaveland, Guy H. Palmer

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Achieving the London Declaration goal of a 90% reduction in neglected tropical diseases (NTDs) by 2030 requires cost-effective strategies that attain high and comprehensive coverage. The first objective of this trial was to assess the impact on cost and coverage of employing a novel integrative One Health approach linking two NTD control programs: mass drug administration (MDA) for soil-transmitted helminths in humans (STH) and mass dog rabies vaccination (MDRV). The second objective was to compare the coverage achieved by the MDA, a community-wide deworming intervention, with that of the existing national primary school-based deworming program (NSDP), with particular focus on the proportion of primary school-age children reached and their school enrolment status. Our approach was unconventional because, in line with the One Health approach to disease control, it coupled the responsibilities and resources of the Ministries responsible for human and animal health into one program with the shared aim of preventing multiple NTDs. The trial was carried out in hard-to-reach pastoral communities comprising 24 villages of the Ngorongoro District, Tanzania, randomly allocated to either Arm A (MDA and MDRV), Arm B (MDA only) or Arm C (MDRV only). Objective one: The percentage of people in each target village that received treatment through MDA in Arms A and B was 63% and 65%, respectively (χ2 = 1, p = 0.32). The percentage of dogs vaccinated in Arm A and C was 70% and 81%, respectively (χ2 =9, p = 0.003). It took 33% less time for a single person and a dog to attend the integrated delivery than two separate events. Cost per dose (including delivery) was lower under the integrated strategy, with delivery of deworming and rabies vaccination reduced by $0.13 (54%) and $0.85 (19%) per dose, respectively. Despite a slight reduction in the proportion of village dogs vaccinated in the integrated event, both the integrated and non-integrated strategies achieved the target threshold of 70% required to eliminate rabies. Objective two: The percentages of primary school age children enrolled in school that was reached by this trial (73%) and the existing NSDP (80%) were not significantly different (F = 0.9, p = 0.36). However, of the primary school age children treated in this trial, 46% were not enrolled in school. Furthermore, 86% of the people treated would have been outside the reach of the NSDP because they were not primary school age or were primary school age children not enrolled in school. The comparable reach, the substantial reductions in cost per dose delivered and the decrease in participants’ time support this integrated One Health approach to control multiple NTDs. Further, the recorded level of non-enrolment at primary school suggests that, in remote areas, school-based delivery strategies could miss a large fraction of school-age children and that programs that focus delivery solely at the level of the primary school will miss a substantial proportion of both primary school age children as well as other individuals from the community. We have shown that these populations can be effectively reached through extramural programs.

Keywords: canine mediated human rabies, integrated health interventions, mass drug administration, neglected tropical disease, One Health, soil-transmitted helminths

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Authors: Gregory Vigneaux

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The capacity to anticipate future events across varying time scales is integral to the effective operation of both emergency management and emergency services organizations. This paper provides fresh insight into anticipation by first offering a novel conceptualization of organizations in both fields by twisting together socio-technical systems and autopoietic theory. The result of this intertwining of theory is a view of emergency management and emergency services organizations as self-reproducing systems driven by socio-technical processes contingent upon both inflows and outflows across a boundary produced by the system’s own activity. Flowing from this perspective is an approach to anticipation that extends from a system’s intent of continuing to reproduce its identity over a dynamic landscape. This discussion takes a pragmatic turn through Maturana and Verden-Zöller’s domains of structural change, classifying anticipated events and connecting them with types of responses involving inflows, outflows, and socio-technical processes.

Keywords: risk, anticipation, organizations, planning, transformation, identity

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Authors: Zainal Abidin Akasah, Maizam Alias, Azuin Ramli

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The safety and health performances aspects of a building are the most challenging aspect of facility management. It requires a deep understanding by the building managers on the factors that contribute to health and safety performances. This study attempted to develop an explanatory architectural safety performance model for stratified low-cost housing in Malaysia. The proposed Building Safety and Health Performance (BSHP) model was tested empirically through a survey on 308 construction practitioners using Partial Least Squares (PLS) and Structural Equation Modelling (SEM) tool. Statistical analysis results supports the conclusion that architecture, building services, external environment, management approaches and maintenance management have positive influence on safety and health performance of stratified low-cost housing in Malaysia. The findings provide valuable insights for construction industry to introduce BSHP model in the future where the model could be used as a guideline for training purposes of managers and better planning and implementation of building management.

Keywords: building management, stratified low-cost housing, safety, health model

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Authors: Carmela Perta

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Following the example of both International and European legislation, on 15 December 1999 the national law 482/99 Regulations regarding the protection of historic language minorities was approved, providing a national framework for the preservation and renaissance of minority languages «The Italian Republic sustains the language and culture of people speaking Albanian, Catalan, German, Greek, Slovene, Croatian, French, Francoprovençal, Friulan, Ladin, Occitan and Sard». The legislation made it possible to use these languages in education, in public offices, in local government, in the judicial system, in mass media, and allowed for the reinstatement of place and personal names. However, several practical problems have emerged, particularly those concerning the variety that should be used in education, in official documents and in other formal domains, i.e. the local variety, the standard of reference (if there is any), or an over regional koinè. In minority settings, it might seem eminently sensible to use the ready made standard of reference, accepting the Ausbausprache, rather than the language as practice, that is the local variety. However, this process seems to be pointless, as is demonstrated by the results of a fieldwork that was carried out in a small town in the South of Italy where members speak Faetar, the local variety of Francoprovençal. Here the language is largely used by the community members in all domains, moreover a deep sense of loyalty towards the variety they use and a manifested minority identity can be observed analysing the speakers’ attitudes. However, these positive attitudes are towards the vehicle for their distinctive history and culture, and not for an “external” standard, a system which local authorities and planners are trying to introduce in the community. In other words, according to the speakers' reactions, there is little point in struggling to maintain a language, if what is conserved is not the group’s language but another.

Keywords: maintenance, minority languages, endangered languages, francoprovençal

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Authors: Seraphina Bakta

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In many societies in Africa, it is a taboo to speak, let alone to practice or in any way to engage in matters relating to sexual and reproductive health. For instance, girls using contraceptives may be labeled prostitutes, and married women using family planning methods may be divorced on account that they are disobedient to their husbands as they do not want to bear children. As such, sexual and reproductive health as a right is still very far from reality to many men and women. To a large extent, the objections are mainly backed up in culture, which is deeply rooted in many African traditions. While such culture have both the good and bad side, the African Charter on Human and Peoples Rights has identified the bad ones as’ harmful cultural practices. This paper argues that, while cultural norms may hinder the realization of human rights, adopting a human rights based approach to address harmful cultural practices is likely, the best approach to realizing women’s rights to sexual and reproductive health rights in Africa.

Keywords: rights, culture, health, women

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Authors: Kriangkrai Maneerat, Chutima Prommak

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Indoor wireless localization systems have played an important role to enhance context-aware services. Determining the position of mobile objects in complex indoor environments, such as those in multi-floor buildings, is very challenging problems. This paper presents an effective floor estimation algorithm, which can accurately determine the floor where mobile objects located. The proposed algorithm is based on the confidence interval of the summation of online Received Signal Strength (RSS) obtained from the IEEE 802.15.4 Wireless Sensor Networks (WSN). We compare the performance of the proposed algorithm with those of other floor estimation algorithms in literature by conducting a real implementation of WSN in our facility. The experimental results and analysis showed that the proposed floor estimation algorithm outperformed the other algorithms and provided highest percentage of floor accuracy up to 100% with 95-percent confidence interval.

Keywords: floor estimation algorithm, floor determination, multi-floor building, indoor wireless systems

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Authors: Nuri Caglayan, H. Kursat Celik

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There are many factors that influence the health and productivity of the animals in livestock production fields, including temperature, humidity, carbon dioxide (CO2), ammonia (NH3), hydrogen sulfide (H2S), physical activity and particulate matter. High NH3 concentrations reduce feed consumption and cause daily weight gain. At high concentrations, H2S causes respiratory problems and CO2 displace oxygen, which can cause suffocation or asphyxiation. Good air quality in livestock facilities can have an impact on the health and well-being of animals and humans. Air quality assessment basically depends on strictly given limits without taking into account specific local conditions between harmful gases and other meteorological factors. The stated limitations may be eliminated. using controlling systems based on neural networks and fuzzy logic. This paper describes a fuzzy logic based ventilation algorithm, which can calculate different fan speeds under pre-defined boundary conditions, for removing harmful gases from the production environment. In the paper, a fuzzy logic model has been developed based on a Mamedani’s fuzzy method. The model has been built on MATLAB software. As the result, optimum fan speeds under pre-defined boundary conditions have been presented.

Keywords: air quality, fuzzy logic model, livestock housing, fan speed

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Authors: Protima Chakraborty

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The sustainability of conventional agriculture in Bangladesh is under threat from the continuous degradation of land and water resources, and from declining yields due to indiscriminate use of agrochemicals. NASL (Northern Agro Services Limited) is pursuing efforts to promote ecological agriculture with emphasis on better use of organic fertilizer resources and the reduction of external inputs. This paper examines the sustainability of two production systems in terms of their environmental soundness, economic viability and social acceptability based on empirical data collected through making demonstration land cultivation, a household survey, soil sample analysis, observations and discussions with key informants. Twelve indicators were selected to evaluate sustainability. Significant differences were found between the two systems in crop diversification, soil fertility management, pests and diseases management, and use of agrochemicals & Organic Compost. However, significant variations were found in other indicators such as land-use pattern, crop yield and stability, risk and uncertainties, and food security. Although crop yield and financial return were found to be slightly higher in the ecological system, the economic return and value addition per unit of land show the positive difference of using compost rather than chemical fertilizer. The findings suggest that ecological agriculture has a tendency towards becoming ecologically, economically and socially more sound than conventional agriculture, as it requires considerably fewer agro-chemicals, adds more organic matter to the soil, provides balanced food, and requires higher local inputs without markedly compromising output and financial benefits. Broad-policy measures, including the creation of mass awareness of adverse health effects of agrochemical-based products, are outlined for the promotion of ecological agriculture.

Keywords: Bangladesh, compost, conventional agriculture, organic fertilizer, environmental sustainability, economic viability, social acceptability

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Authors: P. L. D. N. M. de Silva, S. G. Edirisinghe, R. Weerasuriya

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High peak-to-average power ratio (PAPR) is a concern of orthogonal frequency division multiplexing (OFDM) based visible light communication (VLC) systems. Discrete Fourier Transform spread (DFT-s) OFDM is an alternative single carrier modulation scheme which would address this concern. Employing channel coding techniques is another mechanism to reduce the PAPR. Previous research has been conducted to study the impact of these techniques separately. However, to the best of the knowledge of the authors, no study has been done so far to identify the improvement which can be harnessed by hybridizing these two techniques for VLC systems. Therefore, this is a novel study area under this research. In addition, channel coding techniques such as Polar codes and Turbo codes have been tested in the VLC domain. However, other efficient techniques such as Hamming coding and Convolutional coding have not been studied too. Therefore, the authors present the impact of the hybrid of DFT-s OFDM and Channel coding (Hamming coding and Convolutional coding) on PAPR in VLC systems using Matlab simulations.

Keywords: convolutional coding, discrete Fourier transform spread orthogonal frequency division multiplexing, hamming coding, peak-to-average power ratio, visible light communications

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Authors: Ciza Didier

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By definition, homosexuality designates the sexual or amorous attraction towards a person of the same sex or of the same gender as one's own. The Burundi country has superficially 27834km2 with 13 millions of population. There are groups of certain people assuming that they are homosexual and that they want to claim their rights. Burundian homosexuals often organise seminars in the premises of the National Health Security Agency (NHSA) located at Kigobe quarter, in Bujumbura, this is the place where they meet to try to exchange and create their association for claim their rights. There are 2 categories of homosexuals: - gays: homosexuality between men (male sex) - lesbians: homosexuality between women (female sex) In the gay couple, there is one who behaves like a woman and often wears feminine styles while the other always remains like a man and always wears masculine styles. In the lesbian couple, there is one who behaves like a man and wears men's styles while the other remains as she is like a woman. In general, Burundian society is against homosexuality. Our society sees them as pariahs carrying a curse. According to Burundian culture and customs, homosexuality is satanic, therefore it is a great sin. In April 2011, Burundian President Pierre Nkurunziza signed a law criminalizing homosexual acts and providing for a sentence of three months to two years in prison, as well as a fine of BIF 50,000 to BIF 100,000 for any homosexual behavior. The investigation recently done shows that out of 300 people questioned, 299 were against homosexuality saying that it is against Burundian culture and 1 was for homosexuality. All Burundians are not against homosexuality. Their country must therefore take into consideration the small party of people who are for homosexuality. Homosexuals, too, need to live like others.

Keywords: homosexuality, lesbian, gay, law

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Authors: Enrico Maria la Forgia

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Since the 80ies, in specific situations, France’s Muslims have enacted political actions to reply to attacks on their identity or assimilation attempts, using their religious affiliation as a resource for the organization and expression of collective claims. Indeed, despite Islam's internal sectarian and ethnic differences, religion may be politicized when minorities’ social and cultural rights are under attack. French Civil Society organizations, in this specific case with an Islamic background (ICSO - Islamic Civil Society Organizations), play an essential role in defending Muslims’ social and cultural rights. As a matter of fact, Civil Society organized on an ethnic or religious base is a way to strengthen minoritarian communities and their role as political actors, especially in multicultural contexts. Since the first 1983’s “Marche des Beurs” (slang word referring to French citizens with foreign origins), which involved many Muslims, the development of ICSO contributed to the strenghtening of Islam in France, here meant as a Social Movement aiming to constitute a French version of Islam, defending minorities’ cultural and religious rights, and change the perception of Islam itself in national society. However, since a visible and stigmatized minority, ICSO do not relate only to protests as a strategy to achieve their goals: on several occasions, pressure on authorities through personal networks and connections, or the introduction into public debates of bargaining through the exploitation of national or international crisis, might appear as more successfully - public discourses on minorities and Islam are generally considered favorable conditions to advance requests for cultural legitimation. The proposed abstract, based on a literary review and theoretical/methodological reflection on the state of knowledge on the topic, aims to open a new branch of studies and analysis of Civil Society and Social Movements in Europe, focusing on the French Islamic community as a political actor relating on ICSO to pressure society, local, and national authorities to improve Muslims' rights. The opted methodology relies on a qualitative approach based on ethnography and face-to-face interviews addressing heads and middle-high level activists from ICSO, in an attempt to individuate the strategies enacted by ICSO for mobilizing Muslims and build relations with, on one hand, local and national authorities; into the other, with actors belonging to the Civil Society/political sphere. The theoretical framework, instead, relies on the main Social Movements Theories (resources mobilization, political opportunity structure, and contentious/non-contentious movements), aiming to individuate eventual gaps in the analysis of Islamic Social Movements and Civil Society in minoritarian contexts.

Keywords: Islam, islamophobia, civil society, social movements, sociology, qualitative methodology, Islamic activism in social movement theory, political change, Islam as social movement, religious movements, protest and politics, France, Islamic civil society

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Authors: Farrokh Taherkhani, Thomas Pinger, Max Gündel

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The total economic damage caused by corrosion in Germany is estimated to be more than 3% of the GDP per year. Additionally, corrosion and suitable corrosion protection systems are also significant factors in the consideration of life cycle costs for steel hydraulic structures. In addition to classic coating systems (for example, epoxy resin or polyurethane), zinc and its alloys offer effective and very durable corrosion protection for steels. As a protective layer, hot-dip galvanizing prevents the corrosive media from penetrating into the steel matrix and acts as a sacrificial anode, which corrodes in preference to the steel. However, hot-dip galvanizing as a corrosion protection system has not yet been approved by the relevant authority, the Federal Waterways Engineering and Research Institute (BAW) in Germany. In order to make hot-dip galvanizing usable as a corrosion protection system for steel hydraulic structures in the future, different factors must be considered. These factors are (i) corrosion protection type, (ii) resistance to mechanical stress (i.e., abrasion resistance), (iii) combinability with cathodic corrosion protection, (iv) environmental effects and (v) the crack formation and propagation during hot-dip galvanizing. In this work, hot-dip galvanizing as a corrosion protection system for steel hydraulic steel structures, as well as open questions, are discussed. This paper is based on initial long-term exposure tests with corrosion protection systems consisting of hot-dip galvanizing and duplex systems.

Keywords: steel hydraulic structure, hot-dip galvanizing, corrosion, corrosion resistance, zinc coating, organic coating, duplex sytems

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Authors: Kusmayadi Ita Nursita, Sundoro Ali

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Cleft lip and palate are one of the most common congenital abnormalities in the face. It could happen to anyone, but mostly affect Asian population including Indonesia. Factors that influence the occurrence of cleft lip and palate vary from genetic to environmental factors. Children with cleft lip and palate will often have various problems such as airway disorders, eating disorders, speech and language developmental disorders, hearing disorders and psycho-social disorders, one of which is caused by appearance disorders. During his life, the child will experience multidisciplinary surgery and non-surgical treatment and can be accompanied by a psychological and financial burden on himself and his family. In Indonesia, there are no detailed scientific data on the prevalence and characteristic of cleft lip and palate patients. It was mainly caused by the absence of a national level organization, differences in geographical location, and the absence of national guidelines. This study aimed to describe the characteristic and prevalence of cleft lip and palate patients in Bandung Cleft Lip and Palate Center from 1 January 2016 to 31 December 2017. A total of 560 patients were included in the study. The highest percentage of cases are left unilateral cleft lip and palate with higher number of female patient and labioplasty as the most often surgical procedure to be conducted in Bandung Cleft Lip and Palate Center. In order to improve quality of life in patients with cleft lip and palate, early recognition and early treatment based on actual comprehensive data should be conducted. The data from Bandung Cleft Lip and Palate Center as one of the largest center of cleft lip and palate in West Java Indonesia hopefully could provide a big step of further comprehensive data collection in Indonesia and for the better overall management of cleft lip and palate in the future.

Keywords: cleft lip, cleft palate, characteristic, prevalence

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Authors: Zemenu Yohannes

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Introduction: The pandemic overstretched the weak health systems in developing countries, including Ethiopia. This study aims to assess and explore the effect of COVID-19 on antenatal care (ANC) provision. Methods: A concurrent mixed methods study was applied. An interrupted time series design was applied for the quantitative study, and in-depth interviews were implemented for the qualitative research to explore maternity care providers' perceptions of ANC provision during COVID-19. We used routine monthly collected data from the health management information system (HMIS) in fifteen hospitals in the Sidama region, Ethiopia, from March 2019 to February 2020 (12 months) before COVID-19 and from March to August 2020 (6 months) during COVID-19. We imported data into STATA V.17 for analysis. ANC provision's mean monthly incidence rate ratio (IRR) was calculated using Poisson regression with a 95% confidence interval. The qualitative data were analysed using thematic analysis. Findings from quantitative and qualitative elements were integrated with a contiguous approach. Results: Our findings indicate the rate of ANC provision significantly decreased in the first six months of COVID-19. This study has three identified main themes: barriers to ANC provision, inadequate COVID-19 prevention approach, and delay in providing ANC. Conclusion and recommendation: Based on our findings, the pandemic affected ANC provision in the study area. The health bureau and stakeholders should take a novel and sustainable approach to prevent future pandemics. The health bureau and hospital administrators should establish a task force that relies on financial self-reliance to close gaps in future pandemics of medical supply shortages. Pregnant women should receive their care promptly from maternity care providers. In order to foster contact and avoid discrimination the future pandemics, hospital administrators should set up a platform for community members and maternity care providers.

Keywords: ANC provision, COVID-19, mixed methods study, Ethiopia

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Authors: Woo Young Jung, Min Ho Kwon, Bu Seog Ju

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A failure of the non-structural component can cause significant damages in critical facilities such as nuclear power plants and hospitals. Historically, it was reported that the damage from the leakage of sprinkler systems, resulted in the shutdown of hospitals for several weeks by the 1971 San Fernando and 1994 North Ridge earthquakes. In most cases, water leakages were observed at the cross joints, sprinkler heads, and T-joint connections in piping systems during and after the seismic events. Hence, the primary objective of this study was to understand the seismic performance of T-joint connections and to develop an analytical Finite Element (FE) model for the T-joint systems of 2-inch fire protection piping system in hospitals subjected to seismic ground motions. In order to evaluate the FE models of the piping systems using OpenSees, two types of materials were used: 1) Steel 02 materials and 2) Pinching 4 materials. Results of the current study revealed that the nonlinear moment-rotation FE models for the threaded T-joint reconciled well with the experimental results in both FE material models. However, the system-level fragility determined from multiple nonlinear time history analyses at the threaded T-joint was slightly different. The system-level fragility at the T-joint, determined by Pinching 4 material was more conservative than that of using Steel 02 material in the piping system.

Keywords: fragility, t-joint, piping, leakage, sprinkler

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Authors: Marcin Stasiulewicz, Sebastian Filipkowski, Aneta Panuszko

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Background: The hallmark of neurodegenerative diseases, including Alzheimer's and Parkinson's diseases, is an aggregation of the abnormal forms of peptides and proteins. Water is essential to functioning biomolecules, and it is one of the key factors influencing protein folding and misfolding. However, the hydration studies of proteins are complicated due to the complexity of protein systems. The use of model compounds can facilitate the interpretation of results involving larger systems. Objectives: The goal of the research was to characterize the properties of the hydration water surrounding the two three-residue K peptide fragments INS (Isoleucine - Asparagine - Serine) and NSR (Asparagine - Serine - Arginine). Methods: Fourier-transform infrared spectra of aqueous solutions of the tripeptides were recorded on Nicolet 8700 spectrometer (Thermo Electron Co.) Measurements were carried out at 25°C for varying molality of solute. To remove oscillation couplings from water spectra and, consequently, obtain narrow O-D semi-heavy water bands (HDO), the isotopic dilution method of HDO in H₂O was used. The difference spectra method allowed us to isolate the tripeptide-affected HDO spectrum. Results: The structural and energetic properties of water affected by the tripeptides were compared to the properties of pure water. The shift of the values of the gravity center of bands (related to the mean energy of water hydrogen bonds) towards lower values with respect to the ones corresponding to pure water suggests that the energy of hydrogen bonds between water molecules surrounding tripeptides is higher than in pure water. A comparison of the values of the mean oxygen-oxygen distances in water affected by tripeptides and pure water indicates that water-water hydrogen bonds are shorter in the presence of these tripeptides. The analysis of differences in oxygen-oxygen distance distributions between the tripeptide-affected water and pure water indicates that around the tripeptides, the contribution of water molecules with the mean energy of hydrogen bonds decreases, and simultaneously the contribution of strong hydrogen bonds increases. Conclusions: It was found that hydrogen bonds between water molecules in the hydration sphere of tripeptides are shorter and stronger than in pure water. It means that in the presence of the tested tripeptides, the structure of water is strengthened compared to pure water. Moreover, it has been shown that in the vicinity of the Asparagine - Serine - Arginine, water forms stronger and shorter hydrogen bonds. Acknowledgments: This work was funded by the National Science Centre, Poland (grant 2017/26/D/NZ1/00497).

Keywords: amyloids, K-peptide, hydration, FTIR spectroscopy

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Authors: Stela Doncheva

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Postpartum distress, encompassing depressive symptoms, obsessions, and anxiety, remains a subject of significant scientific interest due to its prevalence among individuals giving birth. This critical and transformative period presents a multitude of factors that impact women's health. On the one hand, variables such as social support, satisfaction in romantic relationships, shared newborn care, and birth satisfaction directly affect the mental well-being of new mothers. On the other hand, the interplay of hormonal changes, personality characteristics, emotional difficulties, and the profound life adjustments experienced by mothers can profoundly influence their self-esteem and overall physical and emotional well-being. This paper extensively explores the factors of alexithymia, social support, partners' support, and birth satisfaction to gain deeper insights into their impact on postpartum distress. Utilizing a qualitative survey consisting of six self-reflective questionnaires, this study collects valuable data regarding the individual postpartum experiences of Bulgarian mothers. The primary objective is to enrich our understanding of the complex factors involved in the development of postpartum distress during this crucial period. The results shed light on the intricate nature of the problem and highlight the significant influence of bio-psycho-social elements. By contributing to the existing knowledge in the field, this research provides valuable implications for the development of interventions and support systems tailored to the unique needs of mothers in the postpartum period. Ultimately, this study aims to improve the overall well-being of new mothers and promote optimal maternal health during the postpartum journey.

Keywords: maternal mental health, postpartum distress, postpartum depression, postnatal mothers

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Authors: Al Huuskonen, Clio Lake, K. M. Naude, Polina Petlitsyna, Sorsha Henning, Julia Wimmers-Klick

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This project presents the outcomes of a community-based participatory action initiative aimed at advocating for equitable healthcare and human rights for trans, two-spirit, and gender-diverse individuals, building upon the University of British Columbia (UBC) Trans Coalition's ongoing efforts. Participatory Action Research (PAR) was chosen as the research method with the goal of improving trans rights on the UBC campus, particularly regarding equitable access to healthcare. PAR involves active community contribution throughout the research process, which in this case was done by way of liaising with student resource groups and advocacy leaders. The goals of this project were as follows: a) identify gaps in gender-affirming healthcare for UBC students by consulting the community and collaborating with UBC services, b) develop an information package outlining provincial and university-based health insurance for gender-affirming care (including hormone therapy and surgeries), FAQs, and resources for UBC's trans students, c) make this package available to UBC students and other national transgender advocacy organizations. The initiative successfully expanded the UBC AMS Student Health and Dental Plan to include gender-affirming procedural coverage, developed a care access guide for students, and advocated for improved health records inclusivity, mechanisms for trans students to report negative care experiences, and increased access to gender-affirming primary care through the on-campus health clinic. Collaboration with other universities' pride organizations and Trans Care BC yielded positive outcomes through broader coalition building and resource sharing. Ongoing efforts are underway to update provincial policies, particularly through expanding coverage under fair pharma care and addressing the compounding effects of the primary care crisis for trans individuals. The project's tangible results include improved trans rights on campus, especially in terms of healthcare access. Expanding healthcare coverage through student care benefits thousands of students, making the ability to undergo important affirming procedures more affordable. Providing students with information on extended coverage options and communication with their doctors further removes barriers to care and positively impacts student wellbeing. This initiative demonstrates the effectiveness of community-based participatory action in advancing equitable healthcare for trans and gender-diverse individuals and serves as a model for other institutions and organizations striving to promote inclusivity and advocate for marginalized populations' rights.

Keywords: equitable healthcare, trans and gender-diverse individuals, inclusivity, participatory action research project

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Authors: Ngo Thi Thanh Mai, Nguyen Thu Ha, Frances Crawford

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The demand for developing international social work field education is on the rise. Global foreign universities have considered international collaboration and cross-cultural perspective as an essential part of their social work training curriculum. International placement program at Faculty of Social Work (FSW), Hanoi National University of Education (HNUE) has met the need of international social work students, as well as the institutions involved in achieving social work professional social work knowledge in the Vietnamese context. This program has also lead to a long-term collaboration between HNUE and several global institutions in developing social work education, research and practice skill. This paper focuses on the benefits and challenges of students who involved in the global placement programme at Faculty of Social Work (FSW), Hanoi National University of Education (HNUE) and content of international field education provided to the international students based on the experience of the authors. Study results indicated that the participants have opportunity them to explore a new culture and social work system abroad especially in the Vietnamese context. However, there are still difficulties that international students have to face during different phases of the exchange process such as language and communication barriers, cultural value differences, insufficient support and supervision during placement. Basing on these results, the authors intend to propose some recommendations to enhance the programme activities such as pre-departure orientation, support and supervision during placement, cultural exchange and follow-up activities.

Keywords: social work education, social work, international placement, field placement, Vietnam

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Authors: Chawarat Rotejanaprasert, Andrew Lawson

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Early detection of unusual health events depends on the ability to detect rapidly any substantial changes in disease, thus facilitating timely public health interventions. To assist public health practitioners to make decisions, statistical methods are adopted to assess unusual events in real time. We introduce a surveillance Kullback-Leibler (SKL) measure for timely detection of disease outbreaks for small area health data. The detection methods are compared with the surveillance conditional predictive ordinate (SCPO) within the framework of Bayesian hierarchical Poisson modeling and applied to a case study of a group of respiratory system diseases observed weekly in South Carolina counties. Properties of the proposed surveillance techniques including timeliness and detection precision are investigated using a simulation study.

Keywords: Bayesian, spatial, temporal, surveillance, prospective

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Authors: S. Cheng, C. Catallo

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Introduction: Canada's healthcare and social services systems are failing high risk, vulnerable older adults. Care for vulnerable older Canadians (65 and older) is not optimal in Canada. It does not address the care needs of vulnerable, high risk adults using a holistic approach. Given the growing aging population, and the care needs for seniors with complex conditions is one of the highest in Canada's health care system, there is a sense of urgency to optimize care. Integration of health and social services is an emerging trend in Canada when compared to European countries. There is no common and universal understanding of healthcare and social services integration within the country. Consequently, a clear understanding and definition of integrated health and social services are absent in Canada. Objectives: A study was undertaken to develop a case definition for integrated health and social care initiatives that serve older adults, which was then tested against three Canadian integrated initiatives. Methodology: A limited literature review was undertaken to identify common characteristics of integrated health and social care initiatives that serve older adults, and comprised both scientific and grey literature, in order to develop a case definition. Three Canadian integrated initiatives that are located in the province of Ontario, were identified using an online search and a screening process. They were surveyed to determine if the literature-based integration definition applied to them. Results: The literature showed that there were 24 common healthcare and social services integration characteristics that could be categorized into ten themes: 1) patient-care approach; 2) program goals; 3) measurement; 4) service and care quality; 5) accountability and responsibility; 6) information sharing; 7) Decision-making and problem-solving; 8) culture; 9) leadership; and 10) staff and professional interaction. The three initiatives showed agreement on all the integration characteristics except for those characteristics associated with healthcare and social care professional interaction, collaborative leadership and shared culture. This disagreement may be due to several reasons, including the existing governance divide between the healthcare and social services sectors within the province of Ontario that has created a ripple effect in how professions in the two different sectors interact. In addition, the three initiatives may be at maturing levels of integration, which may explain disagreement on the characteristics associated with leadership and culture. Conclusions: The development of a case definition for healthcare and social services integration that incorporates common integration characteristics can act as a useful instrument in identifying integrated healthcare and social services, particularly given the emerging and evolutionary state of this phenomenon within Canada.

Keywords: Canada, case definition, healthcare and social services integration, integration, seniors health, services delivery

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Authors: Tesfahiwot Abay Weldearegay

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Ethiopian Federal ministry of health, in collaboration with different partners, provides financial support from sustainable development grants and global fund budget sources to Regional health science colleges through the regional health bureau to improve the quality of training and avail professionals based on the regional health bureau demand from the year of 2012 to 2019EC. It was mainly focused on health extension workers (HEW) Level III&IV, Health Information technicians (HIT), Emergency Medical technicians (EMT), laboratory technicians, Pharmacy technicians, Anesthesia Level V, Radiography, midwifery, Environmental health and biomedical equipment technician. Laboratory technician, Radiography and Pharmacy technician, was retooling program. The study aims at assessing the Utilization and outcome of budgets transferred through regional health bureau to regional health science colleges. The study used both quantitative and qualitative approaches to develop sufficient data to explain the utilization of the budget, and outcomes obtained from the transferred budget and to identify the gaps. The data for the study were obtained through structured questionnaires and interviews was conducted to increase the reliability of the data. Nationally, students enrolled in different disciplines at RHSC through budget support for RHB to improve the quality of training were 87 840 students and the total Budget transferred, according to MOU was 895,752,038 Ethiopian birr. Among the students enrolled nationally in different disciplines at RHSC through budget support only 72% of students have graduated from different disciplines. In Hareri and Addis Ababa, all enrolled students were graduated (100%). At the same time, Oromia 69%, Amara 77%, SNNP 58% students graduated, respectively. The demand of the regional health bureau and the enrollment capacity of health science colleges increased from year to year. The financial support added great value to the HSCs to cop with problems related to student fees, skill lab materials and renovation.

Keywords: emergency medical technician, radiography, Biomedical, health extension

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Authors: Irina Belozerova

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In the recent years, the number of crimes against peace and humanity has constantly been increasing. The development of the international community is inseparably connected to the compliance with the law which protects the rights and interests of citizens in all of their manifestations. The provisions of the law of criminal procedure are no exception. The rights of the victims of genocide, of the war crimes and the crimes against humanity, require particular attention. These crimes fall within the jurisdiction of the International Criminal Court governed by the Rome Statute of the International Criminal Court. These crimes have the following features. First, any such crime has a mass character and therefore requires specific regulation in the international criminal law and procedure and the national criminal law and procedure of different countries. Second, the victims of such crimes are usually children, women and old people; the entire national, ethnic, racial or religious groups are destroyed. These features influence the classification of victims by the age criterion. Article 68 of the Rome Statute provides for protection of the safety, physical and psychological well-being, dignity and privacy of victims and witnesses and thus determines the procedural status of these persons. However, not all the persons whose rights have been violated by the commission of these crimes acquire the status of victims. This is due to the fact that such crimes affect a huge number of persons and it is impossible to mention them all by name. It is also difficult to assess the entire damage suffered by the victims. While assessing the amount of damages it is essential to take into account physical and moral harm, as well as property damage. The procedural status of victims thus gains an exclusive character. In order to determine the full extent of the damage suffered by the victims it is necessary to collect sufficient evidence. However, it is extremely difficult to collect the evidence that would ensure the full and objective protection of the victims’ rights. While making requests for the collection of evidence, the International Criminal Court faces the problem of protection of national security information. Religious beliefs and the family life of victims are of great importance. In some Islamic countries, it is impossible to question a woman without her husband’s consent which affects the objectivity of her testimony. Finally, the number of victims is quantified by hundreds and thousands. The assessment of these elements demands time and highly qualified work. These factors justify the creation of a mechanism that would help to collect the evidence and establish the truth in the international criminal proceedings. This mechanism will help to impose a just and appropriate punishment for the persons accused of having committed a crime, since, committing the crime, criminals could not misunderstand the outcome of their criminal intent.

Keywords: crimes against humanity, evidence in international criminal proceedings, international criminal proceedings, protection of victims

Procedia PDF Downloads 232

Authors: Muhamad Ammar Bin Mohd Asri, Muhammad Hamizan Bin Yusof, Muhammad Haziq Bin Abdul Khalil, Esman Hanief Bin Khairul Anuar, Muhammad Fikri Bin Ishak, Amril Azim Bin Mohd Norrahim, Muhammad Danial Fakhri Bin Fakhruddin, Muhammad Khairul Nizam in Hosnodin, Muhammad Ezzat Hariz Bin Norhisam

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Ergonomics is the science of creating and arranging workplaces, products, and systems to increase human performance, comfort, and safety. This study researched ergonomics as a solution for preventing workplace injuries, specifically musculoskeletal disorders, among employers and employees. The method will be used in this project is a literature review which means conducting a study about ergonomics with peer-reviewed journal articles and books. It focuses on employees and employers who are in one company on other departments under the protection of Occupational Safety and Health (OSHA). These solutions include ergonomic assessments, workplace design improvements, effective training and education, and the use of ergonomic tools and equipment. Employers can build workplaces that are safer and more productive by putting these solutions in place, and employees can work comfortably and prevent accidents from bad ergonomics. Overall, the paper highlights how crucial it is to take injury prevention measures and consider ergonomics at work.

Keywords: occupational safety and health, musculoskeletal disorders, ergonomic, ergonomic risk

Procedia PDF Downloads 203

Authors: Y. Ates, A. R. Boynuegri, M. Uzunoglu, A. Karakas

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The recent interest in alternative and renewable energy systems results in increased installed capacity ratio of such systems in total energy production of the world. Specifically, wind energy conversion systems (WECS) draw significant attention among possible alternative energy options, recently. On the contrary of the positive points of penetrating WECS in all over the world in terms of environment protection, energy independence of the countries, etc., there are significant problems to be solved for the grid connection of large scale WECS. The reactive power regulation, voltage variation suppression, etc. can be presented as major issues to be considered in this regard. Thus, this paper evaluates the application of a Static VAr Compensator (SVC) unit for the reactive power regulation and operation continuity of WECS during a fault condition. The system is modeled employing the IEEE 13 node test system. Thus, it is possible to evaluate the system performance with an overall grid simulation model close to real grid systems. The overall simulation model is developed in MATLAB/Simulink/SimPowerSystems® environments and the obtained results effectively match the target of the provided study.

Keywords: IEEE 13 bus distribution system, reactive power regulation, static VAr compensator, wind energy conversion system

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Authors: Ayşin Sev, Görkem Aslan

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Sustainable tall buildings that provide comfortable, healthy and efficient indoor environments are clearly desirable as the densification of living and working space for the world’s increasing population proceeds. For environmental concerns, these buildings must also be energy efficient. One component of these tasks is the provision of indoor air quality and thermal comfort, which can be enhanced with natural ventilation by the supply of fresh air. Working spaces can only be naturally ventilated with connections to the outdoors utilizing operable windows, double facades, ventilation stacks, balconies, patios, terraces and skygardens. Large amounts of fresh air can be provided to the indoor spaces without mechanical air-conditioning systems, which are widely employed in contemporary tall buildings. This paper tends to present the concept of natural ventilation for sustainable tall office buildings in order to achieve healthy and comfortable working spaces, as well as energy efficient environments. Initially the historical evolution of ventilation strategies for tall buildings is presented, beginning with natural ventilation and continuing with the introduction of mechanical air-conditioning systems. Then the emergence of natural ventilation due to the health and environmental concerns in tall buildings is handled, and the strategies for implementing this strategy are revealed. In the next section, a number of case studies that utilize this strategy are investigated. Finally, how tall office buildings can benefit from this strategy is discussed.

Keywords: tall office building, energy efficiency, double-skin façade, stack ventilation, air conditioning

Procedia PDF Downloads 494

Authors: Manel Brichni, Abdelhak-Djamel Seriai

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Systems are increasingly complex. To reduce their complexity, an abstract view of the system can simplify its development. To overcome this problem, we propose a method to decompose systems into subsystems while reducing their coupling. These subsystems represent components. Consisting of an existing object-oriented systems, the main idea of our approach is based on modelling as graphs all entities of an oriented object source code. Such modelling is easy to handle, so we can apply restructuring algorithms based on graph metrics. The particularity of our approach consists in integrating in addition to standard metrics, such as coupling and cohesion, some graph metrics giving more precision during the components identication. To treat this problem, we relied on the ROMANTIC approach that proposed a component-based software architecture recovery from an object oriented system.

Keywords: software reengineering, software component and interfaces, metrics, graphs

Procedia PDF Downloads 483