Search results for: health access

Authors: N. M. G. Al-Saidi, K. A. Kadhim, N. A. Rajab

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Over the past decades, computer networks and data communication system has been developing fast, so, the necessity to protect a transmitted data is a challenging issue, and data security becomes a serious problem nowadays. A secret sharing scheme is a method which allows a master key to be distributed among a finite set of participants, in such a way that only certain authorized subsets of participants to reconstruct the original master key. To create a secret sharing scheme, many mathematical structures have been used; the most widely used structure is the one that is based on graph theory (graph access structure). Subsequently, many researchers tried to find efficient schemes based on graph access structures. In this paper, we propose a novel efficient construction of a perfect secret sharing scheme for uniform access structure. The dominating set of vertices in a regular graph is used for this construction in the following way; each vertex represents a participant and each minimum independent dominating subset represents a minimal qualified subset. Some relations between dominating set, graph order and regularity are achieved, and can be used to demonstrate the possibility of using dominating set to construct a secret sharing scheme. The information rate that is used as a measure for the efficiency of such systems is calculated to show that the proposed method has some improved values.

Keywords: secret sharing scheme, dominating set, information rate, access structure, rank

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Authors: Ali A. Hammadi

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In this work, a practical study on a commissioned Giga Passive Optical Network (GPON) fiber to the home access network in Kuwait is presented. The work covers the framework of the conceptual design of the deployed Passive Optical Networks (PONs), access network, optical fiber cable network distribution, technologies, and standards. The work also describes methodologies applied by system engineers for design of Optical Network Terminals (ONTs) and Optical Line Terminals (OLTs) transceivers with respect to the distance, operating wavelengths, splitting ratios. The results have demonstrated and justified the limitation of transmission distance of a PON link in Fiber to The Premises (FTTP) to not exceed 20 km. Optical Time Domain Reflector (OTDR) test has been carried for this project to confirm compliance with International Telecommunication Union (ITU) specifications regarding the total length of the deployed optical cable, total loss in dB, and loss per km in dB/km with respect to the operating wavelengths. OTDR test results with traces for segments of implemented fiber network will be provided and discussed.

Keywords: passive optical networks (PONs), fiber to the premises (FTTx), access network, OTDR

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Authors: Maryam Tabrizi, Shahrzad Aarup

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Objectives- Understanding the close association between oral health and overall health for older adults at the right time and right place, a person, focus treatment through Project ECHO telementoring. Methodology- Data from monthly ECHO telementoring sessions were provided for three years. Sessions including case presentations, overall health conditions, considering medications, organ functions limitations, including the level of cognition. Contributions- Providing the specialist level of providing care to all elderly regardless of their location and other health conditions and decreasing oral health inequity by increasing workforce via Project ECHO telementoring program worldwide. By 2030, the number of adults in the USA over the age of 65 will increase more than 60% (approx.46 million) and over 22 million (30%) of 74 million older Americans will need specialized geriatrician care. In 2025, a national shortage of medical geriatricians will be close to 27,000. Most individuals 65 and older do not receive oral health care due to lack of access, availability, or affordability. One of the main reasons is a significant shortage of Oral Health (OH) education and resources for the elderly, particularly in rural areas. Poor OH is a social stigma, a thread to quality and safety of overall health of the elderly with physical and cognitive decline. Poor OH conditions may be costly and sometimes life-threatening. Non-traumatic dental-related emergency department use in Texas alone was over $250 M in 2016. Most elderly over the age of 65 present with at least one or multiple chronic diseases such as arthritis, diabetes, heart diseases, and chronic obstructive pulmonary disease (COPD) are at higher risk to develop gum (periodontal) disease, yet they are less likely to get dental care. In addition, most older adults take both prescription and over-the-counter drugs; according to scientific studies, many of these medications cause dry mouth. Reduced saliva flow due to aging and medications may increase the risk of cavities and other oral conditions. Most dental schools have already increased geriatrics OH in their educational curriculums, but the aging population growth worldwide is faster than growing geriatrics dentists. However, without the use of advanced technology and creating a network between specialists and primary care providers, it is impossible to increase the workforce, provide equitable oral health to the elderly. Project ECHO is a guided practice model that revolutionizes health education and increases the workforce to provide best-practice specialty care and reduce health disparities. Training oral health providers for utilizing the Project ECHO model is a logical response to the shortage and increases oral health access to the elderly. Project ECHO trains general dentists & hygienists to provide specialty care services. This means more elderly can get the care they need, in the right place, at the right time, with better treatment outcomes and reduces costs.

Keywords: geriatric, oral health, project echo, chronic disease, oral health

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Authors: Helen Coronel, Will Brewer, Peggy Bergeron, Clarissa Hall, Victoria Casson

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Simulation-based training provides the nurse practitioner (NP) student with a safe and controlled environment in which they can practice a real-life scenario. This type of learning fosters critical thinking skills essential to practice. The expectation of this study was that students would have an increase in their competency and confidence after performing the simulation. Approximately 8.4% of Americans suffer from depression. The state of Alabama is ranked 47th out of 50 for access to mental health care. As a result of this significant shortage of mental health providers, primary care providers are frequently put in the position of screening for and treating mental health conditions, such as depression. Family nurse practitioners are often utilized as primary care providers, making their ability to assess, diagnose and treat these disorders a necessary skill. The expected outcome of this simulation is an increase in confidence, competency and the empowerment of the nurse practitioner student’s ability to assess, diagnose and treat a common mood disorder they may encounter in practice. The Kirkpatrick Module was applied for this study. A non-experimental design using descriptive statistical analysis was utilized. The simulation was based on a common psychiatric mood disorder frequently observed in primary care and mental health clinics. Students were asked to watch a voiceover power point presentation prior to their on-campus simulation. The presentation included training on the assessment, diagnosis, and treatment of a patient with depression. Prior to the simulation, the students completed a pre-test, then participated in the simulation, and completed a post-test when done. Apple iPads were utilized to access a simulated health record. Major findings of the study support an increase in students’ competency and confidence when assessing, diagnosing, and treating an adult patient with depression.

Keywords: advanced practice, nurse practitioner, simulation, primary care, depression

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Authors: El Hadji Mamadou Sonko, Ndiogou Sankhare, Maïmouna Lo, Jean Birane Gning, Cheikh Diop

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In Senegal, access to water, hygiene, and sanitation in small island towns is a particular problem, which is still poorly understood by the public authorities and development aid actors. The main objective of this study carried out in the Municipality of Foundiougne is to contribute to the knowledge of the problems related to the supply of drinking water, access to sanitation, and hygiene in small island towns in Senegal. The methodology adopted consisted of a literature review and quantitative surveys of a sample of 100 households in the Municipality. Semi-structured interviews using interview guides and informal interviews were also conducted with mechanical and manual emptiers, municipal authorities, public toilet managers, and neighbourhood leaders. Direct observation with photography was also used. The results show that, with regard to access to drinking water, 35% of households have unimproved water services, 46% have a limited level of service, and 19% have a basic level of service. Regarding sanitation, 77% of households are considered to have access to basic sanitation services, compared to 23% with limited sanitation services. However, these figures hide the dysfunctions of the sanitation system. Indeed, manual emptying is practiced exclusively by 4% of households, while 17% of households combine it with mechanical emptying. In addition, domestic wastewater is mainly evacuated outside the sanitation facilities, and all the sludge extracted from the pits is discharged directly into the environment without treatment. As a matter of fact, the surveys showed that 52% of households do not have access to a basic level of hygiene-related to handwashing when leaving the toilet. These results show that there is real work to be done at the level of small urban centres if we want to achieve MDG 6.

Keywords: Foundiougne, Senegal, small island, small town, water-sanitation, hygiene

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Authors: Jocelyne Uwibambe, Ange Thaina Ndizeye, Dinah Ishimwe, Emmanuel Mugabo Byakagaba

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Background: In low- and middle-income countries (LMICs), the use of modern contraceptive methods among women, including adolescents, is still low despite the desire to avoid pregnancy. In addition, countries have set a minimum age for marriage, which is 21 years for most countries, including Rwanda. The Rwandan culture, to a certain extent, and religion, to a greater extent, however, limit the freedom of young women to use contraceptive services because it is wrongly perceived as an encouragement for premarital sexual intercourse. In the end, what doesn’t change is that denying access to contraceptives to either male or female adolescents does not translate into preventing them from sexual activities, hence leading to an ever-increasing number of unwanted pregnancies, possible STIs, HIV, Human Papilloma Virus, and subsequent unsafe abortion followed by avoidable expensive complications. The purpose of this study is to evaluate the perception of healthcare providers regarding contraceptive use among adolescents. Methodology: This was a qualitative study. Interviews were done with different healthcare providers, including doctors, nurses, midwives, and pharmacists, through focused group discussions and in-depth interviews, then the audio was transcribed, translated and thematic coding was done. Results: This study explored the perceptions of healthcare workers regarding the provision of modern contraception to adolescents in Rwanda. The findings revealed that while healthcare providers had a good understanding of family planning and contraception, they were hesitant to provide contraception to adolescents. Sociocultural beliefs played a significant role in shaping their attitudes, as many healthcare workers believed that providing contraception to adolescents would encourage promiscuous behavior and go against cultural norms. Religious beliefs also influenced their reluctance, with some healthcare providers considering premarital sex and contraception as sinful. Lack of knowledge among parents and adolescents themselves was identified as a contributing factor to unwanted pregnancies, as inaccurate information from peers and social media influenced risky sexual behavior. Conditional policies, such as the requirement for parental consent, further hindered adolescents' access to contraception. The study suggested several solutions, including comprehensive sexual and reproductive health education, involving multiple stakeholders, ensuring easy access to contraception, and involving adolescents in policymaking. Overall, this research highlights the need for addressing sociocultural beliefs, improving healthcare providers' knowledge, and revisiting policies to ensure adolescents' reproductive health rights are met in Rwanda. Conclusion: The study highlights the importance of enhancing healthcare provider training, expanding access to modern contraception, implementing community-based interventions, and strengthening policy and programmatic support for adolescent contraception. Addressing these challenges is crucial for improving the provision of family planning services to adolescents in Rwanda and achieving the Sustainable Development Goals related to sexual and reproductive health. Collaborative efforts involving various stakeholders and organizations can contribute to overcoming these barriers and promoting the well-being of adolescents in Rwanda.

Keywords: adolescent, health care providers, contraception, reproductive health

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Authors: Aneal Khan, Elleine Allapitan, Desmond Koo, Katherine-Ann Piedalue, Shaneel Pathak, Utkarsh Subnis

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Background: Disease management of metabolic, genetic disorders is long-term and can be cumbersome to patients and caregivers. Patient-Reported Outcome Measures (PROMs) have been a useful tool in capturing patient perspectives to help enhance treatment compliance and engagement with health care providers, reduce utilization of emergency services, and increase satisfaction with their treatment choices. Currently, however, PROMs are collected during infrequent and decontextualized clinic visits, which makes translation of patient experiences challenging over time. The GRIT study aims to evaluate a digital health journal application called Zamplo that provides a personalized health diary to record self-reported health outcomes accurately and efficiently in patients with metabolic, genetic disorders. Methods: This is a randomized controlled trial (RCT) (1:1) that assesses the efficacy of Zamplo to increase patient activation (primary outcome), improve healthcare satisfaction and confidence to manage medications (secondary outcomes), and reduce costs to the healthcare system (exploratory). Using standardized online surveys, assessments will be collected at baseline, 1 month, 3 months, 6 months, and 12 months. Outcomes will be compared between patients who were given access to the application versus those with no access. Results: Seventy-seven patients were recruited as of November 30, 2021. Recruitment for the study commenced in November 2020 with a target of n=150 patients. The accrual rate was 50% from those eligible and invited for the study, with the majority of patients having Fabry disease (n=48) and the remaining having Pompe disease and mitochondrial disease. Real-time clinical responses, such as pain, are being measured and correlated to disease-modifying therapies, supportive treatments like pain medications, and lifestyle interventions. Engagement with the application, along with compliance metrics of surveys and journal entries, are being analyzed. An interim analysis of the engagement data along with preliminary findings from this pilot RCT, and qualitative patient feedback will be presented. Conclusions: The digital self-care journal provides a unique approach to disease management, allowing patients direct access to their progress and actively participating in their care. Findings from the study can help serve the virtual care needs of patients with metabolic, genetic disorders in North America and the world over.

Keywords: eHealth, mobile health, rare disease, patient outcomes, quality of life (QoL), pain, Fabry disease, Pompe disease

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Authors: Dilang Thouk Tharjiath

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This study seeks to examine determinants of access to finance: the case of micro and small enterprises in bonga town. It identifies the sector as the key to unlocking the economic potentials of the country. For the achievement of the objective of the study simple random and stratified sampling has been used to select 179 respondents, primary and secondary data were used, primary data were collected through face to face interview and preparing questionnaire and secondary data were collected through reviewing firms record and reports, quantitative research approach were used and the data obtained were analyzed using descriptive research design. Access to finance is one of the key obstacles of MSE’s not only when starting the business project but also when operating. Identifying the major determinants of access to finance is therefore quite crucial. Based on descriptive result the financiers specially formal financiers tend to grant credit easily for enterprises which are located near to town, having operators with higher educational level, experienced and with a positive attitudes towards or fulfill their lending procedures, and a firm having collateralized asset, prepare business plan, maintain accounting practice ,large and old enough. Finally the study recommended that As Educational level of entrepreneurs has significant effect on access to credit from bank and the managers or owners education level is low in Bonga town the concerned bodies of both the government and non-governmental institutions in collaboration with Bonga town MSE development office are recommended to create awareness and facilitate the provision of additional training for those with lower educational level.

Keywords: credit, entrepreneur, enterprise, manager

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Authors: John Narh

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There is high rate of deforestation in Ghana due to agricultural expansion, illegal mining and illegal logging. While it is attempting to address the illegalities, Ghana has also initiated a reforestation program known as the Modified Taungya System (MTS). Within the MTS framework, farmers are allocated degraded forestland and provided with tree seedlings to practice agroforestry until the trees form canopy. Yet, the political, ecological and economic models that inform the selection of tree species, the motivations of participating farmers as well as the factors that accounts for differential access to the land and performance of farmers engaged in the program lie underexplored. Using a sequential explanatory mixed methods approach in five forest-fringe communities in the Eastern Region of Ghana, the study reveals that economic factors and Ghana’s commitment to international conventions on the environment underpin the selection of tree species for the MTS program. Social network and access to remittances play critical roles in having access to, and enhances poor farmers’ chances in the program respectively. Farmers are more motivated by the access to degraded forestland to cultivate food crops than having a share in the trees that they plant. As such, in communities where participating farmers are not informed about their benefit in the tree that they plant, the program is largely unsuccessful.

Keywords: translocality, deforestation, forest management, social network

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Authors: Tanvi P. Medshinge, Prasad Vaidya, Monisha E. Royan

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In India, cooling loads in residential sector is a major contributor to its total energy consumption. Due to the increasing cooling need, the market penetration of air-conditioners is further expected to rise. Natural Ventilation (NV), however, possesses great potential to save significant energy consumption especially for residential buildings in moderate climates. As multifamily residential apartment buildings are designed by repetitive use of prototype designs, deriving individual NV based design prototype solutions for a combination of different wind incidence angles and orientations would provide significant opportunity to address the rise in cooling loads by residential sector. This paper presents the results of NV performance of a selected prototype apartment design with a cluster of four units in Pune, India, and an attempt to improve the NV performance through design modifications. The water table apparatus, a physical modelling tool, is used to study the flow patterns and simulate wind-induced NV performance. Quantification of NV performance is done by post processing images captured from video recordings in terms of percentage of area with good and poor access to ventilation. NV performance of the existing design for eight wind incidence angles showed that of the cluster of four units, the windward units showed good access to ventilation for all rooms, and the leeward units had lower access to ventilation with the bedrooms in the leeward units having the least access. The results showed improved performance in all the units for all wind incidence angles to more than 80% good access to ventilation. Some units showed an additional improvement to more than 90% good access to ventilation. This process of design and performance evaluation improved some individual units from 0% to 100% for good access to ventilation. The results demonstrate the ease of use and the power of the water table apparatus for performance-based design to simulate wind induced NV.  

Keywords: fluid dynamics, prototype design, natural ventilation, simulations, water table apparatus, wind incidence angles

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Authors: Elkington Sibusiso Mnguni

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Although South Africa has made good progress in providing basic water and sanitation services to its citizens, there is still a large section of the population that has no access to these services. This paper reviews the performance of the government’s municipal infrastructure grant programme in providing basic water and sanitation services which are part of the constitutional requirements to the citizens. The method used to gather data and information was a desk top study which sought to review the progress made in rolling out the programme. The successes and challenges were highlighted and possible solutions were identified that can accelerate the elimination of the remaining backlogs and improve the level of service to the citizens. Currently, approximately 6.5 million citizens are without access to basic water services and approximately 10 million are without access to basic sanitation services.

Keywords: grant, municipal infrastructure, sanitation, services, water

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Authors: Fulufhelo Oscar Makananise

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Digital technologies have played a significant role in bridging the information gap between the haves and the have nots in society. In developing countries such as South Africa, historically marginalised groups such as women in rural communities have an opportunity to use digital technologies to network among themselves as well as interact with their government, thereby enhancing prospects for poverty eradication, political participation, community development and democracy. However, the extent to which these goals can be achieved in a developing context through harnessing digital technologies is not quite clear, particularly given the fact that access to these technologies is not evenly distributed and the fact that women’s access to digital technologies is hampered by factors that go beyond the question of infrastructure. Informed by the technological dependency theory, this paper is about how female youth in rural South Africa are deploying digital media tools for socio-economic empowerment. In particular, the study investigated the extent to which female youth in Limpopo province, South Africa access and use digital media platforms and gadgets and the extent to which those technologies are breaking down barriers that stand in the way of female youth empowerment. Data were gathered using a self-administered questionnaire disseminated to selected 100 female youth in Limpopo Province, South Africa. The data were analysed using SPSS version 9, and the results were analysed using descriptive statistics. The paper argues that wider and constant access to digital media by female youth in rural areas is indicative of the great potential for empowering female youth in rural areas through harnessing digital media. The study established that the majority of female youth had access to digital media technologies and used them to share valuable information among themselves. The study further established that female youth are active users of digital media in South Africa, which is the significant driver for socio-economic empowerment.

Keywords: digital technologies, empowerment, female youth, South Africa, survey, technological dependency

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Authors: Tzu-Jung Tseng, Pei-Hsuen Han, Tsung-Hsueh Lu

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Background: Ensuring patients with ST-elevation myocardial infarction (STEMI) access to hospitals that could perform percutaneous coronary intervention (PCI) in time is an important concern of healthcare managers. One commonly used the method to assess the coverage of population access to PCI hospital is the use GIS-estimated linear distance (crow's fly distance) between the district centroid and the nearest PCI hospital. If the distance is within a given distance (such as 20 km), the entire population of that district is considered to have appropriate access to PCI. The premise of using district centroid to estimate the coverage of population resident in that district is that the people live in the district are evenly distributed. In reality, the population density is not evenly distributed within the administrative district, especially in rural districts. Fortunately, the Taiwan government released basic statistical area (on average 450 population within the area) recently, which provide us an opportunity to estimate the coverage of population access to PCI services more accurate. Objectives: We aimed in this study to compare the population covered by a give PCI hospital according to traditional administrative district versus basic statistical area. We further examined if the differences between two geographic units used would be larger in a rural area than in urban area. Method: We selected two hospitals in Tainan City for this analysis. Hospital A is in urban area, hospital B is in rural area. The population in each traditional administrative district and basic statistical area are obtained from Taiwan National Geographic Information System, Ministry of Internal Affairs. Results: Estimated population live within 20 km of hospital A and B was 1,515,846 and 323,472 according to traditional administrative district and was 1,506,325 and 428,556 according to basic statistical area. Conclusion: In urban area, the estimated access population to PCI services was similar between two geographic units. However, in rural areas, the access population would be overestimated.

Keywords: accessibility, basic statistical area, modifiable areal unit problem (MAUP), percutaneous coronary intervention (PCI)

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Authors: Rohan M. Dalal, Elena Pirondini, Shanu Somvanshi

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Introduction: The current state of reproductive health outcomes in lower-income countries is poor, with inadequate knowledge and culture among adolescent boys. Moreover, boys have traditionally not been a priority target. To explore the opportunity to educate adolescent boys in the developing world regarding accurate reproductive health information, the purpose of this study is to investigate how adolescent boys in the developing world engage and use technology, utilizing cell phones. This electronic survey and video interview study were conducted to determine the feasibility of a mobile phone platform for an educational video game specifically designed for boys that will improve health knowledge, influence behavior, and change health outcomes, namely teen pregnancies. Methods: With the assistance of Plan India, a subsidiary of Plan International, informed consent was obtained from parents of adolescent males who participated in an electronic survey and video interviews via Microsoft Teams. An electronic survey was created with 27 questions, including topics of mobile phone usage, gaming preferences, and sexual and reproductive health, with a sample size of 181 adolescents, ages 11-25, near New Delhi, India. The interview questions were written to explore more in-depth topics after the completion of the electronic survey. Eight boys, aged 15, were interviewed for 40 minutes about gaming and usage of mobile phones as well as sexual and reproductive health. Data/Results. 154 boys and 27 girls completed the survey. They rated their English fluency as relatively high. 97% of boys (149/154) had access to mobile phones. The majority of phones were smartphones (97%, 143/148). 48% (71/149) of boys borrowed cell phones. The most popular phone platform was Samsung (22%, 33/148). 36% (54/148) of adolescent males looked at their phones 1-10 times per day for 1-2 hours. 55% (81/149) of the boys had parental restrictions. 51% (76/148) had 32 GB of storage on their phone. 78% (117/150) of the boys had wifi access. 80% (120/150) of respondents reported ease in downloading apps. 97% (145/150) of male adolescents had social media, including WhatsApp, Facebook, and YouTube. 58% (87/150) played video games. Favorite video games included Free Fire, PubG, and other shooting games. In the video interviews, the boys revealed what made games fun and engaging, including customized avatars, progression to higher levels, realistic interactive platforms, shooting/guns, the ability to perform multiple actions, and a variety of worlds/settings/adventures. Ideas to improve engagement in sexual and reproductive health classes included open discussions in the community, enhanced access to information, and posting on social media. Conclusion: This study involving an electronic survey and video interviews provides an initial foray into understanding mobile phone usage among adolescent males and understanding sexual and reproductive health education in New Delhi, India. The data gathered from this study support using mobile phone platforms, and this will be used to create a serious video game to educate adolescent males about sexual and reproductive health in an attempt to lower the rate of unwanted pregnancies in the world.

Keywords: adolescent males, India, mobile phone, sexual and reproductive health

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Authors: Shoohira Aftab, Hammad Afzal

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Information integration is a well known procedure to provide consolidated view on sets of heterogeneous information sources. It not only provides better statistical analysis of information but also facilitates users to query without any knowledge on the underlying heterogeneous information sources The problem of providing a consolidated view of information can be handled using Semantic data (information stored in such a way that is understandable by machines and integrate-able without manual human intervention). However, integrating information using semantic web technology without any access management enforced, will results in increase of privacy and confidentiality concerns. In this research we have designed and developed a framework that would allow information from heterogeneous formats to be consolidated, thus resolving the issue of interoperability. We have also devised an access control system for defining explicit privacy constraints. We designed and applied our framework on both semantic and non-semantic data from heterogeneous resources. Our approach is validated using scenario based testing.

Keywords: information integration, semantic data, interoperability, security, access control system

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Authors: Islam Elsayed Hussein Ali, Stefan M. Wagner

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Smartphone and tablet computers, as well as other ultra portable devices, have already gained enough critical mass to be considered mainstream devices, being present in the daily lives of millions of higher education students. Many universities throughout the world have already adopted or are planning to adopt mobile technologies in many of their courses as a better way to connect students with the subjects they are studying. These new mobile platforms allow students to access content anywhere/anytime to immerse himself/herself into that content (alone or interacting with teachers or colleagues via web communication forms) and to interact with that content in ways that were not previously possible. This paper plans to provide a thorough overview of the possibilities and consequences of m-learning in higher education environments as a gateway to ubiquitous learning – perhaps the ultimate form of learner engagement, since it allows the student to learn, access and interact with important content in any way or at any time or place he might want so the objective of the study is to examine how the usage of mobile phones for m-learning differs between heavy and light mobile phone users at TU Braunschweig. Heavy mobile phone users are hypothesized to have access to/subscribe to one type of mobile content than light mobile phone users, to have less frequent access to, subscribe to or purchase mobile content within the last year than light mobile phone users, and to pay less money for mobile learning, its content and mobile games than light mobile phone users.

Keywords: mobile learning, technologies, applications, higher education

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Authors: Ali Motevalli, Shahin Nayyeri Amiri

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Cross-Hole Sonic Logging (CSL) is a common type of Non-Destructive Testing (NDT) method, which is currently used to check the integrity of placed drilled shafts. CSL evaluates the integrity of the concrete inside the cage and between the access tubes based on propagation of ultrasonic waves between two or more access tubes. A number of access tubes are installed inside the reinforcing cage prior to concrete placement as guides for sensors. The access tubes can be PVC or steel galvanized based on ASTM6760. The type of the CSL tubes can affect the axial strength of the drilled shaft. The objective of this study is to compare the amount of axial load capacity of drilled shafts due to using a different type of CSL tubes inside the caging. To achieve this, three (3) large-scale drilled shaft samples were built and tested using a hydraulic actuator at the Florida International University’s (FIU) Titan America Structures and Construction Testing (TASCT) laboratory. During the static load test, load-displacement curves were recorded by the data acquisition system (MegaDAC). Three drilled shaft samples were built to evaluate the effect of the type of the CSL tube on the axial load capacity in drilled shaft foundations.

Keywords: drilled shaft foundations, axial load capacity, cage, PVC, galvanized tube, CSL tube

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Authors: Sethu Lekshmi, Shahanas, Prettha P.

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All existing protocols in wireless networks are mainly based on Carrier Sense Multiple Access with Collision avoidance. By applying collision detection in wireless networks, the time spent on collision can be reduced and thus improves system throughput. However in a real WLAN scenario due to the use of nonlinear modulation techniques only receiver can decided whether a packet loss take place, even there are multiple transmissions. In this proposed method, the receiver or Access Point detects the collision when multiple data packets are transmitted from different wireless stations. Whenever the receiver detects a collision, it transmits a jamming signal to all the transmitting stations so that they can immediately stop their on-going transmissions. We also provide preferential access to all collided packet to reduce unfairness and to increase system throughput by reducing contention. However, this preferential access will not block the channel for the long time. Here, an in-band transmission is considered in which both the data frames and control frames are transmitted in the same channel. We also provide a simple mathematical model for the proposed protocol and give the simulation result of WLAN scenario under various capture thresholds.

Keywords: 802.11, WLAN, capture effect, collision detection, collision resolution, receiver initiated

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Authors: Tukur Husaini Nahuche

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The parent resources play a vital role in the life of the offspring. It help give children basic necessities of life like food, clothing, and housing. In a like manner financial assets allow parents to move into neighborhood with more affluent school systems, to pay school bills, purchase expensive technologies like personal computer, save money for tutoring books, magazines, journals, Newspapers etc. Making of proper provision in the home environment conducive for learning after school hours and creation of other outdoor activities for them are what necessitate in enhancing and accelerating children’s learning opportunities. Indeed, this paper intends to discuss parental investment in education, parent income resources, parental education, occupation, and income as relatively influencing children’s access to quality education. With the hope that families would provide equal opportunities for children irrespective of their sex, intelligence, subject choice,etc.

Keywords: parental investment, children's access, quality education

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Authors: Araba A. Z. Osei-Tutu, Ebenezer Odame, Joseph Bawa, Samuel Amponsah

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Education is recognized as a fundamental human right and a catalyst for development. Despite progress in the provision of higher education on the African continent, there persist challenges with the tripartite areas of access, equity and quality. Therefore, this systematic review aimed at providing a comprehensive overview of conversations and voices of scholars on these three concepts in HE in Africa. The systematic review employed a thematic analysis approach, synthesizing findings from 38 selected sources. After a critical analysis of the sources included in the systematic review, deficits in access, quality, and equity were outlined, focusing on infrastructure, regional disparities, and privatization challenges. The review also revealed the weak enforcement of quality assurance measures. Strategies for improvement, proffered by the study, include expanding public sector HE, deregulating the educational sector, promoting open and distance learning, implementing preferential admission policies, and enhancing financial aid. This research contributes valuable insights for policymakers, educators, and stakeholders, fostering a collaborative approach to address challenges and promote holistic development in African higher education.

Keywords: access, equity, quality, higher education, Africa, systematic review, strategies

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Authors: Krishna Prasad Sharma

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Nepal’s financial sector has become deeper and wider, and the number and types of financial intermediaries have grown rapidly over the past two decades. However, access to financial services remains limited for many people in many parts of rural Nepal. While financial institutions have been expanding rapidly in an urban area in recent years, the access to the rural poor is excessively inadequate due to financial illiteracy and limited numbers of financial institutions that confined only to the district headquarters. Based on the focus group discussion, semi-structured interview of key people and literature review, this paper aims to examine the supply of and demand for financial services in Nepal and the constraints to increasing access to them, and offers way forward for making the financial sector work for all of Nepal’s people, especially the rural poor. While Nepal’s government has tried to increase access to formal financial services for small businesses and low-income households through directed lending programs for small businesses and low-income households, created specialized wholesale and retail institutions, and lowered market entry requirements, formal financial services are declining, and financial intermediation is stagnating. Supply and demand indicators show that, despite government efforts, formal financial institutions do not serve the needs of most of the Nepalese population. While access to and use of formal financial services are limited, in general, the problem is acute for small businesses and low-income households. Indeed, both access and use are closely correlated with business loan size and household income. This study concludes that banks and microfinance institutions with the use of mobile phones can connect hundreds of millions of unbanked and low-income people, especially rural poor to financial services at low costs. While there are many challenges ahead in expanding the service to rural areas, the mobile financial services will be beneficial that makes payments faster and cheaper, more convenient and accessible to a greater number of senders and recipients in rural areas. In rural areas, clients will benefit from money transfer and other mobile and online services.

Keywords: financial inclusion, financial enabling environment, microfinance, branchless banking, rural poor

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Authors: Soori Nnko, Zaina Mchome, John Dusabe, Angela Obasi

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In sub-Saharan Africa, adolescent girls living in urban and periurban settings are among the groups at increased risk of getting sexually transmitted infections. One of the challenges to improve uptake of sexual and reproductive health (SRH) services among adolescents is linked to little appreciation about their vulnerability and the knowledge on availability of the SRH services. Objective: This study assesses adolescents’ perceptions on risks for SRH problems and the availability of services to prevent against SRH problems. Methodology: The study was conducted in March 2011 in Mwanza region, Tanzania. Data collection techniques included 18 Participatory Group Discussions and 17 In-depth Interviews with adolescents and young mothers aged 15-20 years. Results: Adolescents indicated that risk places included their homes, bushes, commercial centers, roadsides as well as school settings. Risk for having unprotected sex varied depending on where you are, and the time of the day. For example, collection of firewood in the bushes or water from the wells exposed girls to men who forced or lured them to have sex. The girls reported to encounter motorcyclists who offered the ride in exchange for sex. Girls also knew myriads places to seek SRH services, including public and private clinics, drug shops and traditional healers. Despite being aware of risky environment, and places to seek the services, access to SRH services were limited due to the stigma and negative attitude of community regarding adolescents’ utilization of SRH services. Conclusion: Adolescents are exposed to various risky environments, yet due to social stigma they have difficult to access the available SRH services.

Keywords: adolescent girls, sexual and reproductive health, AIDS, risk, opportunities, interventions, sub Saharan africa

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Authors: Gabriela Prins, Quinette Louw, Dawn Ernstzen

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Background: Access to rehabilitation services is a major challenge globally, especially in low-and-middle income countries (LMICs) where resources and infrastructure are extremely limited. Telerehabilitation (TR) has emerged in recent decades as a highly promising method to dramatically expand accessibility to rehabilitation services globally. TR provides rehabilitation care remotely using communication technologies such as video conferencing, smartphones, and internet-connected devices. This boosts accessibility to underprivileged regions and allows for greater flexibility for patients. Despite this, TR is hindered by several factors, including limited technological resources, high costs, lack of digital access, and the unavailability of healthcare systems, which are major barriers to widespread adoption among LMIC patients. These barriers have collectively hindered the potential implementation and adoption of TR services in LMICs healthcare settings. Adoption of TR will also require the buy-in of end users and limited information is known on the perspectives of the SA population. Aim: The study aimed to understand patients' perspectives regarding the use of digital technology as part of their OA rehabilitation at a public community healthcare centre in the Cape Metropole Area. Methods: A qualitative descriptive study design was used on 10 OA patients from a public community rehabilitation centre in South Africa. Data collection included semi-structured interviews and patient-reported outcome measures (PSFS, ASES-8, and EuroQol EQ-5D-5L) on functioning and quality of life. Transcribed interview data were coded in Atlas.ti. 22.2 and analyzed using thematic analysis. The results were narratively documented. Results: Four themes arose from the interviews. The themes were Telerehabilitation awareness (Use of Digital Technology Information Sources and Prior Experience with Technology /TR), Telerehabilitation Benefits (Access to healthcare providers, Access to educational information, Convenience, Time and Resource Efficiency and Facilitating Family Involvement), Telerehabilitation Implementation Considerations (Openness towards TR Implementation, Learning about TR and Technology, Therapeutic relationship, and Privacy) and Future use of Telerehabilitation (Personal Preference and TR for the next generation). The ten participants demonstrated limited awareness and exposure to TR, as well as minimal digital literacy and skills. Skepticism was shown when comparing the effectiveness of TR to in-person rehabilitation and valued physical interactions with health professionals. However, some recognized potential benefits of TR for accessibility, convenience, family involvement and improving community health in the long term. Willingness existed to try TR with sufficient training. Conclusion: With targeted efforts addressing identified barriers around awareness, technological literacy, clinician readiness and resource availability, perspectives on TR may shift positively from uncertainty towards endorsement of this expanding approach for simpler rehabilitation access in LMICs.

Keywords: digital technology, osteoarthritis, primary health care, telerehabilitation

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Authors: Mohamed Elkholy, Ahmed Elfatatry

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Cloud computing has emerged as a flexible computing paradigm that reshaped the Information Technology map. However, cloud computing brought about a number of security challenges as a result of the physical distribution of computational resources and the limited control that users have over the physical storage. This situation raises many security challenges for data integrity and confidentiality as well as authentication and access control. This work proposes a security mechanism for data integrity that allows a data owner to be aware of any modification that takes place to his data. The data integrity mechanism is integrated with an extended Kerberos authentication that ensures authorized access control. The proposed mechanism protects data confidentiality even if data are stored on an untrusted storage. The proposed mechanism has been evaluated against different types of attacks and proved its efficiency to protect cloud data storage from different malicious attacks.

Keywords: access control, data integrity, data confidentiality, Kerberos authentication, cloud security

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Authors: Chuks Odiegwu-Enwerem

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The classical notion of opinion leadership presupposes that the media is at the center of an effective and successful opinion leadership. Under this idea, an opinion leader is an active media user who consumes, understands, digests and interprets the messages for the understanding and acceptance/adoption by lower-end media users – whose access and understanding of media content are supposedly low. Because of their unique access to and presumed understanding of media functions and their content, opinion leaders are typically esteemed by those who look forward to and accept their opinions. Lazarsfeld and Katz’s two-step flow of communication theory is the basis of opinion leadership – propelled by limited access to the media. With the emergence and spread of social media and its unlimited access by all and sundry, however, the study interrogates the relevance and application of opinion leaders and, by implication, the two-step flow communication theory in Nigeria’s Northcentral region. It seeks to determine whether opinion leaders still exist in the picture and if they still exert considerable influence, especially in matters of political conversations and decision-making among the citizens of this area. It further explores whether the diffusion of social media is a reality and how the ‘low-end’ media users react to the new-found freedom of access to media, and how they are using it to inform their decisions on important matters as well as examines if they are still glued to their opinion leaders. This study explores the empirical dimensions of the two-step flow hypothesis in relation to the activities of social media to determine if a change has occurred and in what direction, using mixed methos of Survey and in-depth interviews. Our understanding and belief in some theoretical assumptions may be enhanced or challenged by the study outcome.

Keywords: Opinion Leadership, Active Media User, Two-Step-Flow, Social media, Northcentral Nigeria

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Authors: N. Dlamini, Mpumelelo G. Ndlela, Philisiwe Dlamini, Nicholus Kisyeri, Bhekizitha Sithole

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Accessing health services during the COVID-19 pandemic have exacerbated scarcity to routine medication. To ensure continuous accessibility to services, Eswatini launched Community Health Commodities Distribution (CHCD). Eligible Antiretroviral Therapy(ART) stable clients (VL<1,000) and patients on Non-Communicable Disease (NCD) medications were attended at community pick up points (PUP) based on distance between clients’ residence and the public health facility. Services provided includes ART and Pre-Exposure prophylaxis (PrEP) refills and NCD drug refills). The number of community PUP was 14% higher than health facility visits. Among all medications and commodities distributed between April and October 2020 at the PUP, 64% were HIV-related (HIV rapid test, HIVST, VL test, PrEP meds), and 36% were NCD related. The rapid roll out of CHCD during COVID-19 pandemic reduced the risk of COVID-19 transmission to clients as travel to health facilities was eliminated. It Additionally increased access to commodities during COVID-19-driven lockdown, decongested health facilities, integrated model of care, and increase service coverage. It was also noted that CHCD added different curative and HIV related services based on client specific needs and availability of the commodities.

Keywords: community health commodities distribution, pick up points, antiretroviral therapy, pre-exposure prophylaxis

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Authors: Saransh Sharma, Atharv Dekhne

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Passwords stored on central services and hashed are prone to cyberattacks and hacks. Hence, given all these nuisances, there’s a need to eliminate character-based authentication protocols, which would ultimately benefit all developers as well as end-users.To replace this conventional but antiquated protocol with a secure alternative would be Passwordless Authentication. The meta root.id system creates a public and private key, of which the user is only able to access the private key. Further, after signing the key, the user sends the information over the API to the server, which checks its validity with the public key and grants access accordingly.

Keywords: passwordless, OAuth, bitcoin, ZKP, SIN, BIP

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Authors: Marina Gold, Yves Jackson, David Parrat

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The high predominance of Latin American migrants in Geneva from countries where Chagas disease is endemic (Bolivia, Brazil, Argentina, Colombia) is increasing the incidence of chronic Chagas-related problems, especially cardiovascular complications. The precarious migratory status of what are mostly undocumented migrants complicates access to health and affects patients’ and doctors’ health perceptions regarding screening, treatment and monitoring of Chagas-related health concerns. This project results from a 3 year collaboration between the Geneva University Hospital and the NGO Mundo Sano to understand the following questions: 1) how do Latin American migrants perceive their health? 2) What do they understand from Chagas disease? 3) Are patients’ and doctors’ health perceptions similar or do they have competing agendas? This paper aims to present the results of a long-term study that interrogates health perceptions among Latin American migrants in Geneva. The first phase consisted in completing surveys at three community screening events (2016, 2017. 2018), and the results of these surveys reveal the subordination of the importance of health to that of having met economic family obligation. That is, health is important only when it becomes an impediment to economic gain. The contradictory result emerged that people are aware of the importance of health prevention in order to ensure long-term health, but they do not always have agency over their life-style habits (healthy food, regular exercise, emotional stability). The second phase of the research collected open-ended interviews with selected participants, in order to explore in more detail how Latin American migrants deal with Chagas in a different socio-political and economic context to that of endemic countries. These interviews (5 in total) reveal mixed methods of managing health: social networks, access to health care transnationally (in Geneva, Spain and back in their home country), and different valuations of health problems in each situation. The third phase consisted in observations of doctor-patient consultations and further extended interviews with patients to determine doctor/patient health perceptions around Chagas disease. This phase is ongoing, but it has yielded preliminarily observations regarding the expectations that patients’ have of doctors, and the understanding of doctors’ to patients’ complex situations. Positive and complementary health perceptions include patients’ feeling that doctors in Geneva are more understanding, more knowledgeable and less racist than those in their home country, who do not provide detailed information about Chagas or its treatment and discriminate against them for being indigenous or from poor rural areas, enabling a better communication between doctors and patients. Possible conflicting health perceptions include patients addressing their health concerns more holistically and encountering the specialist’s limitations to only treating one health concern, given time limitations and lack of competition with their colleagues (the general practitioner that referred the patient, for example). The implications of this study extend the case of Chagas disease in Geneva and is relevant for all chronic concerns and migratory contexts of precarity.

Keywords: chagas disease, health perceptions, Latin American Migrants, non-endemic countries

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Authors: Durhane Wong-Rieger, Kawaldip Sehmi, Nicola Bedlington, Nicole Boice, Tamás Bereczky

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Patient-generated health data should be seen as the expression of the experience of patients, including the outcomes reflecting the impact a treatment or service had on their physical health and wellness. We discuss how the healthcare system can reach a place where digital is a determinant of health - where data is generated by patients and is respected and which acknowledges their contribution to science. We explore the biggest barriers facing this. The International Experience Exchange with Patient Organisation’s Position Paper is based on a global patient survey conducted in Q3 2021 that received 304 responses. Results were discussed and validated by the 15 patient experts and supplemented with literature research. Results are a subset of this. Our research showed patient communities want to influence how their data is generated, shared, and used. Our study concludes that a reasonable framework is needed to protect the integrity of patient data and minimise abuse, and build trust. Results also demonstrated a need for patient communities to have more influence and control over how health data is generated, shared, and used. The results clearly highlight that the community feels there is a lack of clear policies on sharing data.

Keywords: digital health, equitable access, humanise healthcare, patient data

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Authors: Rakesh Mishra, Mukunda Upadhyay, Rajni Singh

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This paper attempts to link remittances sent by internal as well as international out-migrants and its domestic preferences of usage in three different dimension of Household level development in India and its states. Investment of remittances in these sectors reveals for mixed choices of preferential among the states from where people have out-migrated. The multivariate analysis implies that among all three indicators of human development, health (Investment in Food and Health) is the one that attracts the major investment followed by capital formation and least on Education. Usage of the remittances has been found to be varying across all the states in India as far as usage in health, capital formation and education are concerned. Orissa, Nagaland, Madhya Pradesh, Jharkhand, Gujarat, D & H Haweli are some of the states and union territory that contributes highest of its international remittances on health, while most of the usage of the internal remittances has second or third preferences of investment on the health except for Uttar Pradesh, D & H Haweli, Arunachal Pradesh and A & N Is. This paper tries to access usage of international remittances as well as internal remittances on the flow of remittances at the micro level and its implications across three basic determinants of Human Development that is Health, Capital formation and Education coupled with the preferences of usage in presence of Several Socio economic and Demographic variable.

Keywords: multivariate analysis, household development, remittances, internal and international migration

Procedia PDF Downloads 439