Search results for: coverage

Authors: Natalie A. Sterk, Bernard van Vuuren, Petrie Marais, Bongani Mthombeni

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Injuries to the internal structures of the thorax and abdomen remain a leading cause of death among soldiers. Body armour is a standard issue piece of military equipment designed to protect the vital organs against ballistic and stab threats. When configured for maximum protection, the excessive weight and size of the armour may limit soldier mobility and increase physical fatigue and discomfort. Providing soldiers with more armour than necessary may, therefore, hinder their ability to react rapidly in life-threatening situations. The capability to determine the optimal trade-off between the amount of essential anatomical coverage and hindrance on soldier performance may significantly enhance the design of armour systems. The current study aimed to develop and pilot a methodology for relating internal anatomical structures with actual armour plate coverage in real-time using low-dose diagnostic X-ray scanning. Several pilot scanning sessions were held at Lodox Systems (Pty) Ltd head-office in South Africa. Testing involved using the Lodox eXero-dr to scan dummy trunk rigs at various degrees and heights of measurement; as well as human participants, wearing correctly fitted body armour while positioned in supine, prone shooting, seated and kneeling shooting postures. The verification of sizing and metrics obtained from the Lodox eXero-dr were then confirmed through a verification board with known dimensions. Results indicated that the low-dose diagnostic X-ray has the capability to clearly identify the vital internal structures of the aortic arch, heart, and lungs in relation to the position of the external armour plates. Further testing is still required in order to fully and accurately identify the inferior liver boundary, inferior vena cava, and spleen. The scans produced in the supine, prone, and seated postures provided superior image quality over the kneeling posture. The X-ray-source and-detector distance from the object must be standardised to control for possible magnification changes and for comparison purposes. To account for this, specific scanning heights and angles were identified to allow for parallel scanning of relevant areas. The low-dose diagnostic X-ray provides a non-invasive, safe, and rapid technique for relating vital internal structures with external structures. This capability can be used for the re-evaluation of anatomical coverage required for essential protection while optimising armour design and fit for soldier performance.

Keywords: body armour, low-dose diagnostic X-ray, scanning, vital organ coverage

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Authors: Natsuki Tsuda, Kiyotaka Obunai, Kazuya Okubo, Hideyuki Tashiro, Yoshinori Yamaji, Hideyuki Kato

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The objective of this study is to investigate the effect of belt stiffness on the performance of the CVT unit, such as the required pulley thrust force and the ratio coverage. The CVT unit consists of the V-grooved pulleys and the rubber CVT belt. The width of the driving pulley groove was controlled by the stepper motor, while that of the driven pulley was controlled by the hydraulic pressure. The generated mechanical power on the motor was transmitted from the driving axis to the driven axis through the CVT unit. The rotational speed and the transmitting torque of both axes were measured by the tachometers and the torque meters attached with these axes, respectively. The transmitted, mechanical power was absorbed by the magnetic powder brake. The thrust force acting on both pulleys and the force between both shafts were measured by the load cell. The back face profile of the rubber CVT belt along with width direction was measured by the 2-dimensional laser displacement meter. This paper found that when the stiffness of the rubber CVT belt in the belt width direction was reduced, the thrust force required for shifting was reduced. Moreover, when the stiffness of the rubber CVT belt in the belt width direction was reduced, the ratio coverage of the CVT unit was reduced. Due to the decrement of stiffness in belt width direction, the excessive concave deformation of belt in pulley groove was confirmed. Because of this excessive concave deformation, apparent wrapping radius of belt would have been reduced. Proposed model could be effectively estimated the difference of ratio coverage due to concave deformation. The proposed model could also be utilized for designing the rubber CVT belt with optimal bending stiffness in width direction.

Keywords: CVT, countinuously variable transmission, rubber, belt stiffness, transmission

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Authors: Sakulsri Srisaracam

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Social media has become an important source of information for the public and the media profession. Some social issues raised on social media are picked up by journalists to report on other platforms. This relationship between social media and mainstream media can sometimes drive public debate or stimulate social movements. The question to examine is in what situations can social media conversations raise awareness and stimulate change on public issues. This study addresses the communication patterns of social media conversations driving covert issues into mainstream media and leading to social advocacy movements. In methodological terms, the study findings are based on a content analysis of Facebook, Twitter, news websites and television media reports on three different case studies – saving Bryde’s whale, protests against a government proposal to downsize the Office of Knowledge Management and Development in Thailand, and a dengue fever campaign. These case studies were chosen because they represent issues that most members of the public do not pay much attention to but social media conversations stimulated public debate and calls to action. This study found: 1) Collective social media conversations can stimulate public debate and encourage change at three levels – awareness, public debate, and action of policy and social change. The level depends on the communication patterns of online users and media coverage. 2) Patterns of communication have to be designed to combine social media conversations, online opinion leaders, mainstream media coverage and call to both online and offline action to motivate social change. Thus, this result suggests that social media is a powerful platform for collective communication and setting the agenda on public issues for mainstream media. However, for social change to succeed, social media should be used to mobilize online movements to move offline too.

Keywords: public issues, mainstream media, social media, social movement

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Authors: Janya Sainui

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As a rapid growth of digital videos and data communications, video summarization that provides a shorter version of the video for fast video browsing and retrieval is necessary. Key frame extraction is one of the mechanisms to generate video summary. In general, the extracted key frames should both represent the entire video content and contain minimum redundancy. However, most of the existing approaches heuristically select key frames; hence, the selected key frames may not be the most different frames and/or not cover the entire content of a video. In this paper, we propose a method of video summarization which provides the reasonable objective functions for selecting key frames. In particular, we apply a statistical dependency measure called quadratic mutual informaion as our objective functions for maximizing the coverage of the entire video content as well as minimizing the redundancy among selected key frames. The proposed key frame extraction algorithm finds key frames as an optimization problem. Through experiments, we demonstrate the success of the proposed video summarization approach that produces video summary with better coverage of the entire video content while less redundancy among key frames comparing to the state-of-the-art approaches.

Keywords: video summarization, key frame extraction, dependency measure, quadratic mutual information

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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: Vahid Bairami Rad

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Wireless communications offer organizations and users many benefits such as portability and flexibility, increased productivity, and lower installation costs. Wireless networks serve as the transport mechanism between devices and among devices and the traditional wired networks (enterprise networks and the internet). Wireless networks are many and diverse but are frequently categorized into three groups based on their coverage range: WWAN, WLAN, and WPAN. WWAN, representing wireless wide area networks, includes wide coverage area technologies such as 2G cellular, Cellular Digital Packet Data (CDPD), Global System for Mobile Communications (GSM), and Mobitex. WLAN, representing wireless local area networks, includes 802.11, Hyper lan, and several others. WPAN, represents wireless personal area network technologies such as Bluetooth and Infrared. The security services are provided largely by the WEP (Wired Equivalent Privacy) protocol to protect link-level data during wireless transmission between clients and access points. That is, WEP does not provide end-to-end security but only for the wireless portion of the connection.

Keywords: wireless lan, wired equivalent privacy, wireless network security, wlan security

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Authors: Anantha S. Babbili

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This paper analyzes the current media practices dominant in global journalistic practices within the framework of world press theories of Libertarian, Authoritarian, Communist, and Social Responsibility to evaluate their efficacy in addressing their role in the coverage of the coronavirus, also known as COVID-19. The global media flows, determinants of news coverage, and international awareness and the Western view of the world will be critically analyzed within the context of the prevalent news values that underpin free press and media coverage of the world. While evaluating the global discourse paramount to a sustained and dispassionate understanding of world events, this paper proposes an ethical framework that brings clarity devoid of sensationalism, partisanship, right-wing and left-wing interpretations to a breaking and dangerous development of a pandemic. As the world struggles to contain the coronavirus pandemic with death climbing close to 6,000 from late January to mid-March, 2020, the populations of the developed as well as the developing nations are beset with news media renditions of the crisis that are contradictory, confusing and evoking anxiety, fear and hysteria. How are we to understand differing news standards and news values? What lessons do we as journalism and mass media educators, researchers, and academics learn in order to construct a better news model and structure of media practice that addresses science, health, and media literacy among media practitioners, journalists, and news consumers? As traditional media struggles to cover the pandemic to its audience and consumers, social media from which an increasing number of consumers get their news have exerted their influence both in a positive way and in a negative manner. Even as the world struggles to grasp the full significance of the pandemic, the World Health Organization (WHO) has been feverishly battling an additional challenge related to the pandemic in what it termed an 'infodemic'—'an overabundance of information, some accurate and some not, that makes it hard for people to find trustworthy sources and reliable guidance when they need it.' There is, indeed, a need for journalism and news coverage in times of pandemics that reflect social responsibility and ethos of public service journalism. Social media and high-tech information corporations, collectively termed GAMAF—Google, Apple, Microsoft, Amazon, and Facebook – can team up with reliable traditional media—newspapers, magazines, book publishers, radio and television corporates—to ease public emotions and be helpful in times of a pandemic outbreak. GAMAF can, conceivably, weed out sensational and non-credible sources of coronavirus information, exotic cures offered for sale on a quick fix, and demonetize videos that exploit peoples’ vulnerabilities at the lowest ebb. Credible news of utility delivered in a sustained, calm, and reliable manner serves people in a meaningful and helpful way. The world’s consumers of news and information, indeed, deserve a healthy and trustworthy news media – at least in the time of pandemic COVID-19. Towards this end, the paper will propose a practical model for news media and journalistic coverage during times of a pandemic.

Keywords: COVID-19, international news flow, social media, social responsibility

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Authors: Temenuzhka Spasova, Nadya Yanakieva

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Snow modulates the hydrological cycle and influences the functioning of ecosystems and is a significant resource for many populations whose water is harvested from cold regions. Snow observations are important for validating climate models. The accumulation and rapid melt of snow are two of the most dynamical seasonal environmental changes on the Earth’s surface. The actuality of this research is related to the modern tendencies of the remote sensing application in the solution of problems of different nature in the ecological monitoring of the environment. The subject of the study is the dynamic during the different seasons on Livingstone Island, South Shetland Islands in Antarctica and on Svalbard in Arctic. The objects were analyzed and mapped according to the Еuropean Space Agency data (ESA), acquired by sensors Sentinel-1 SAR (Synthetic Aperture Radar), Sentinel 2 MSI and GIS. Results have been obtained for changes in snow coverage during the summer-winter transition and its dynamics in the two hemispheres. The data used is of high time-spatial resolution, which is an advantage when looking at the snow cover. The MSI images are with different spatial resolution at the Earth surface range. The changes of the environmental objects are shown with the SAR images and different processing approaches. The results clearly show that snow and snow melting can be best registered by using SAR data via hh- horizontal polarization. The effect of the researcher on aerospace data and technology enables us to obtain different digital models, structuring and analyzing results excluding the subjective factor. Because of the large extent of terrestrial snow coverage and the difficulties in obtaining ground measurements over cold regions, remote sensing and GIS represent an important tool for studying snow areas and properties from regional to global scales.

Keywords: climate changes, GIS, remote sensing, SAR images, snow coverage

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Authors: Samuel O. Oduyela

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Over the last ten years, many studies have examined the media coverage of terrorism across the world. Nevertheless, most of these studies have been inclined to the western narrative, more so in relation to the international media. This study departs from that partiality to explore the Nigerian press and its coverage of the Boko Haram. The study intends to illustrate how the Nigerian press has reported its homegrown terrorism within its borders. On 14 April 2014, the Shekau-led Boko Haram kidnapped over 200 female students from Chibok in the Borno State. This study analyses a structured sample of news stories, feature articles, editorial comments, and opinions from the Nation newspaper. The study examined the representation of the Chibok girls kidnaps by concentrating on four main viewpoints. The news framing of the Chibok girls’ kidnap under Presidents Goodluck Jonathan (2014) and Mohammadu Buhari (2016-2018), the sourcing model present in the news reporting of the kidnap and the challenges Nation reporters face in reporting Boko Haram. The study adopted the use of qualitative news framing analysis to provide further insights into significant developments established from the examination of news contents. The study found that the news reportage mainly focused on the government response to Chibok girls kidnap, international press and Boko Haram. Boko Haram was also framed, as a political conspiracy, as prevailing, and as instilling fear. Political, and economic influence appeared to be a significant determinant of the reportage. The study found that the Nation newspaper's portrayal of the crisis under President Jonathan differed significantly from under President Buhari. While the newspaper framed the action of President Jonathan as lacklustre, dismissive, and confusing, it was less critical of President Buhari's government's handling of the crisis. The Nation newspaper failed to promote or explore non-violent approaches. News reports of the kidnap, thus, were presented mainly from a political and ethnoreligious perspective. The study also raised questions of what roles should journalists play in covering conflicts? Should they merely report comments on and interpret it, or should they be actors in the resolution or, more importantly, the prevention of conflicts? The study underlined the need for the independence of the media, more training for journalists to advance a more nuanced and conflict-sensitive news coverage in the Nigerian context.

Keywords: boko haram, chibok girls kidnap, conflict in nigeria, media framing

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Authors: Miriam I. Lautenschläger, Max H. Scheiwe, Kay A. Weidenmann, Frank Henning, Peter Elsner

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Due to increasing environmental awareness jute fibers are more often used in fiber reinforced composites. In the Sheet Molding Compound (SMC) process, the mold cavity is filled via material flow allowing more complex component design. But, the difficulty of using jute fibers in this process is the decreased capacity of fiber movement in the mold. A comparative flow study with jute nonwoven reinforced SMC was conducted examining the influence of the fiber volume content, the grammage of the jute nonwoven textile and a mechanical modification of the nonwoven textile on the flowability. The nonwoven textile reinforcement was selected to support homogeneous fiber distribution. Trials were performed using two SMC paste formulations differing only in filler type. Platy-shaped kaolin with a mean particle size of 0.8 μm and ashlar calcium carbonate with a mean particle size of 2.7 μm were selected as fillers. Ensuring comparability of the two SMC paste formulations the filler content was determined to reach equal initial viscosity for both systems. The calcium carbonate filled paste was set as reference. The flow study was conducted using a jute nonwoven textile with 300 g/m² as reference. The manufactured SMC sheets were stacked and centrally placed in a square mold. The mold coverage was varied between 25 and 90% keeping the weight of the stack for comparison constant. Comparing the influence of the two fillers kaolin yielded better results regarding a homogeneous fiber distribution. A mold coverage of about 68% was already sufficient to homogeneously fill the mold cavity whereas for calcium carbonate filled system about 79% mold coverage was necessary. The flow study revealed a strong influence of the fiber volume content on the flowability. A fiber volume content of 12 vol.-% and 25 vol.-% were compared for both SMC formulations. The lower fiber volume content strongly supported fiber transport whereas 25 vol.-% showed insignificant influence. The results indicate a limiting fiber volume content for the flowability. The influence of the nonwoven textile grammage was determined using nonwoven jute material with 500 g/m² and a fiber volume content of 20 vol.-%. The 500 g/m² reinforcement material showed inferior results with regard to fiber movement. A mold coverage of about 90 % was required to prevent the destruction of the nonwoven structure. Below this mold coverage the 500 g/m² nonwoven material was ripped and torn apart. Low mold coverages led to damage of the textile reinforcement. Due to the ripped nonwoven structure the textile was modified with cuts in order to facilitate fiber movement in the mold. Parallel cuts of about 20 mm length and 20 mm distance to each other were applied to the textile and stacked with varying orientations prior to molding. Stacks with unidirectional orientated cuts over stacks with cuts in various directions e.g. (0°, 45°, 90°, -45°) were investigated. The mechanical modification supported tearing of the textile without achieving benefit for the flowability.

Keywords: filler, flowability, jute fiber, nonwoven, sheet molding compound

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Authors: Li Yongyi

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In order to explore the distribution of geological disasters within the expressway area of Shaanxi Province, the Analytic Hierarchy Process theory is applied based on the geographic information system technology platform, and the ground elevation, rainfall, vegetation coverage and other indicators are selected for analysis, and the expressway area is sensitive Sexual evaluation. The results show that the highway area disasters in Shaanxi Province are mainly distributed in the southern mountainous areas and are dominated by landslides; the disaster area ratio basically increases with the increase in ground elevation, surface slope, surface undulation, rainfall, and vegetation coverage. The increase in the distance from the river shows a decreasing trend; after grading the disaster sensitivity within 5km of the expressway, the extremely sensitive area, the highly sensitive area, the medium sensitive area, the low sensitive area, and the extremely low sensitive area respectively account for 8.17%、15.80%、22.99%、26.22%、26.82%. Highly sensitive road areas are mainly distributed in southern Shaanxi.

Keywords: highway engineering, sensitivity, analytic hierarchy process, geological hazard, road area

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Authors: L. Marcos Domínguez, Nils Rage, Ongun B. Kazanci, Bjarne W. Olesen

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Thermally Activated Building Systems (TABS) have proven to be an energy-efficient solution to provide buildings with an optimal indoor thermal environment. This solution uses the structure of the building to store heat, reduce the peak loads, and decrease the primary energy demand. TABS require the heated or cooled surfaces to be as exposed as possible to the indoor space, but exposing the bare concrete surfaces has a diminishing effect on the acoustic qualities of the spaces in a building. Acoustic solutions capable of providing optimal acoustic comfort and allowing the heat exchange between the TABS and the room are desirable. In this study, the effects of free-hanging units on the cooling performance of TABS and the occupants’ thermal comfort was measured in a full-scale TABS laboratory. Investigations demonstrate that the use of free-hanging sound absorbers are compatible with the performance of TABS and the occupant’s thermal comfort, but an appropriate acoustic design is needed to find the most suitable solution for each case. The results show a reduction of 11% of the cooling performance of the TABS when 43% of the ceiling area is covered with free-hanging horizontal sound absorbers, of 23% for 60% ceiling coverage ratio and of 36% for 80% coverage. Measurements in actual buildings showed an increase of the room operative temperature of 0.3 K when 50% of the ceiling surface is covered with horizontal panels and of 0.8 to 1 K for a 70% coverage ratio. According to numerical simulations using a new TRNSYS Type, the use of comfort ventilation has a considerable influence on the thermal conditions in the room; if the ventilation is removed, then the operative temperature increases by 1.8 K for a 60%-covered ceiling.

Keywords: acoustic comfort, concrete core activation, full-scale measurements, thermally activated building systems, TRNSys

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Authors: A. Cittadino, P. Gantes, C. Coviella, M. Casset, A. Sanchez Caro

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Three currently active landfills receive the waste from Buenos Aires city and the Great Buenos Aires suburbs. One of the first landfills to receive solid waste from this area was located in Villa Dominico, some 7 km south from Buenos Aires City. With an area of some 750 ha, including riparian habitats, divided into 14 cells, it received solid wastes from June 1979 through February 2004. In December 2010, a biological monitoring program was set up by CEAMSE and Universidad Nacional de Lujan, still operational to date. The aim of the monitoring program is to assess the state of several biological groups within the landfill and to follow their dynamics overtime in order to identify if any, early signs of damage the landfill activities might have over the biota present. Bird and rodent populations, aquatic and terrestrial invertebrates’ populations, cells vegetation coverage, and surrounding areas vegetation coverage and main composition are followed by quarterly samplings. Bird species richness and abundance were estimated by observation over walk transects on each environment. A total of 74 different species of birds were identified. Species richness and diversity were high for both riparian surrounding areas and within the landfill. Several grassland -typical of the 'Pampa'- bird species were found within the landfill, as well as some migratory and endangered bird species. Sherman and Tomahawk traps are set overnight for small mammal sampling. Rodent populations are just above detection limits, and the few specimens captured belong mainly to species common to rural areas, instead of city-dwelling species. The two marsupial species present in the region were captured on occasions. Aquatic macroinvertebrates were sampled on a watercourse upstream and downstream the outlet of the landfill’s wastewater treatment plant and are used to follow water quality using biological indices. Water quality ranged between weak and severe pollution; benthic invertebrates sampled before and after the landfill, show no significant differences in water quality using the IBMWP index. Insect biota from yellow sticky cards and pitfall traps showed over 90 different morphospecies, with Shannon diversity index running from 1.9 to 3.9, strongly affected by the season. An easy-to-perform non-expert demandant method was used to assess vegetation coverage. Two scales of determination are utilized: field observation (1 m resolution), and Google Earth images (that allow for a better than 5 m resolution). Over the eight year period of the study, vegetation coverage over the landfill cells run from a low 83% to 100% on different cells, with an average between 95 to 99% for the entire landfill depending on seasonality. Surrounding area vegetation showed almost 100% coverage during the entire period, with an average density from 2 to 6 species per sq meter and no signs of leachate damaged vegetation.

Keywords: biological indicators, biota monitoring, landfill species diversity, waste management

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Authors: Alisha Fisher

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Sex trafficking is a worldwide crisis that requires trauma-informed and survivor-centered media attention to accurate disseminate information. Much of the previous literature on sex trafficking tends to focus on the frequency of incidents, intervention, and support strategies for survivors, with few of them looking to how the media is conducting their reporting on sex trafficking cases to the public. Utilizing data of reports from the media of cases of sex trafficking in the two Canadian provinces with the highest cases of sex trafficking, Ontario and Nova Scotia, the authors sought to analyze the similarities and differences of how sex trafficking cases were being reported. A total of twenty articles were examined, with ten based within the province of Ontario and the remaining ten from the province of Nova Scotia. The authors coded in two processes, first, who the article was about, and second, the framing and content inclusion. The results suggest that there is high usage and reliance of voices and images of authority, with male people of color being shown as the perpetrators and white women being shown as the survivors. These findings can aid in the expansion of trauma-informed, survivor-centered media literacy of reports of sex trafficking to provide accurate insights and further developing robust methods to intersectional approaches to reporting cases of sex trafficking.

Keywords: sex trafficking, media coverage, Canada sex trafficking, content analysis

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Authors: Richard Ssempala, Francis Kintu, Christine K. Tashobya

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Funding for health remains a key constraint facing many developing countries, Uganda inclusive. Uganda’s health sector budget to the national budgetary allocation has stagnated between 8.2% to 10% over the years. Using data collected from different government documents, we sought to establish the implications of the budget allocation over the period (FY2010/11-2018/19) on health services delivery in Uganda to inform policymakers specifically Members of Parliament who are critical in making sectorial allocation on the steps they can adapt to change the terrain of health financing in Uganda. Findings revealed that the contribution of public funding to the health sector is low (15.7%) with private sources (42.6%) and donors contributing much more, with the bulk of private funds, are out of pocket. The study further revealed that low budget allocation had been manifested in inadequate and poorly motivated health workers, essential drug stock-outs that ultimately contribute to poor access to services, catastrophic health expenditures, and high morbidity rates. We recommend for a substantial and sustained increase in the government health budget, optimizing the available resources by addressing wastages, prioritizing health promotion, prevention and finally, institutionalizing the National Health Insurance Scheme.

Keywords: budget allocations, universal health coverage, health service delivery, Uganda

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Authors: Selma Sbit, Mohamed Bechir Dadi, Belgacem Chibani Rhaimi

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Incorporating Home eNodeB (HeNB) in cellular networks, e.g. Long Term Evolution Advanced (LTE-A), is beneficial for extending coverage and enhancing capacity at low price especially within the non-line-of sight (NLOS) environments such as homes. HeNB or femtocell is a small low powered base station which provides radio coverage to the mobile users in an indoor environment. This deployment results in a heterogeneous network where the available spectrum becomes shared between two layers. Therefore, a problem of Inter Cell Interference (ICI) appears. This issue is the main challenge in LTE-A. To deal with this challenge, various techniques based on frequency, time and power control are proposed. This paper deals with the impact of carrier aggregation and higher order MIMO (Multiple Input Multiple Output) schemes on the LTE-Advanced performance. Simulation results show the advantages of these schemes on the system capacity (4.10⁹ b/s/Hz when bandwidth B=100 MHz and when applying MIMO 8x8 for SINR=30 dB), maximum theoretical peak data rate (more than 4 Gbps for B=100 MHz and when MIMO 8x8 is used) and spectral efficiency (15 b/s/Hz and 30b/s/Hz when MIMO 4x4 and MIMO 8x8 are applying respectively for SINR=30 dB).

Keywords: capacity, carrier aggregation, LTE-Advanced, MIMO (Multiple Input Multiple Output), peak data rate, spectral efficiency

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Authors: Pawasuth Saengdee, Chamras Promptmas, Ting Zeng, Silke Leimkühler, Ulla Wollenberger

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Sulfite has been used as a versatile preservative to limit the microbial growth and to control the taste in some food and beverage. However, it has been reported to cause a wide spectrum of severe adverse reactions. Therefore, it is important to determine the amount of sulfite in food and beverage to ensure consumer safety. An efficient electrocatalytic biosensor for sulfite detection was developed by immobilizing of human sulfite oxidase (hSO) on 3-aminoproplytriethoxysilane (APTES) modified indium tin oxide (ITO) electrode. Cyclic voltammetry was employed to investigate the electrochemical characteristics of the hSO modified ITO electrode for various pretreatment and binding conditions. Amperometry was also utilized to demonstrate the current responses of the sulfite sensor toward sodium sulfite in an aqueous solution at a potential of 0 V (vs. Ag/AgCl 1 M KCl). The proposed sulfite sensor has a linear range between 0.5 to 2 mM with a correlation coefficient 0.972. Then, the additional polymer layer of PVA was introduced to extend the linear range of sulfite sensor and protect the enzyme. The linear range of sulfite sensor with 5% coverage increases from 2.8 to 20 mM at a correlation coefficient of 0.983. In addition, the stability of sulfite sensor with 5% PVA coverage increases until 14 days when kept in 0.5 mM Tris-buffer, pH 7.0 at 4 8C. Therefore, this sensor could be applied for the detection of sulfite in the real sample, especially in food and beverage.

Keywords: sulfite oxidase, bioelectrocatalytsis, indium tin oxide, direct electrochemistry, sulfite sensor

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Authors: Gatut Priyowidodo, I. I. Indrayani

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The relations between Indonesia and Malaysia are always full of colors. Indonesia is always known as old brother of Malaysia since it has similar history, religion also socio culturally. Some decades show that the declination of relationship the both countries. Another time, as ASEAN members the two countries devotes their nationalities to purify their collective identities as Eastern. The objective of the research is to extricate the construction of Kompas online and Utusan online toward news coverage of the borders dispute between Indonesia-Malaysia in 2010. This research is proposed to examine central issues which reported by Kompas online and Utusan online consistently. As a media industry, Kompas coverage dominates circulation nationally. Kompas.com was the pioneer of online news in Indonesia and born in reformation era. Utusan is prominent media industry in Malaysia that conducted by UMNO as the ruling party in Malaysia for some periods. The method used in this research is framing method by Robert N. Entman’s which consists of four steps identification: defining problem, diagnosing causes, moral judgment and a treatment recommendation. This research found that Kompas news covered the border dispute must be negotiated as recognition of Indonesia dignity. In contrary, Utusan’s spectacle focused on the Indonesia demonstrans anarchism during the dispute.

Keywords: online media, media construction, the border dispute, Indonesia-Malaysia’s bilateral relations

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Authors: Gang Li, Ghulam Mubashar Hassan, Arcady Dyskin, Cara MacNish

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Digital image correlation (DIC) is a contactless full-field displacement and strain reconstruction technique commonly used in the field of experimental mechanics. Comparing with physical measuring devices, such as strain gauges, which only provide very restricted coverage and are expensive to deploy widely, the DIC technique provides the result with full-field coverage and relative high accuracy using an inexpensive and simple experimental setup. It is very important to study the natural patterns effect on the DIC technique because the preparation of the artificial patterns is time consuming and hectic process. The objective of this research is to study the effect of using images having natural pattern on the performance of DIC. A systematical simulation method is used to build simulated deformed images used in DIC. A parameter (subset size) used in DIC can have an effect on the processing and accuracy of DIC and even cause DIC to failure. Regarding to the picture parameters (correlation coefficient), the higher similarity of two subset can lead the DIC process to fail and make the result more inaccurate. The pictures with good and bad quality for DIC methods have been presented and more importantly, it is a systematic way to evaluate the quality of the picture with natural patterns before they install the measurement devices.

Keywords: Digital Image Correlation (DIC), deformation simulation, natural pattern, subset size

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Authors: Fouzia Khanam, Tridib Chowdhury, Belal Hossain, Sajedur Rahman, Mahfuzar Rahman

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Introduction: Over the last decades, the world has achieved a noticeable success in preventing malaria. Nevertheless, malaria, a vector-borne infectious disease, remains a major public health burden globally as well as in Bangladesh. To achieve the goal of eliminating malaria, BRAC, a leading organization of Bangladesh in collaboration with government, is distributing free LLIN to the 13 endemic districts of the country. The study was conducted with the aim of assessing the gap between coverage, access, and utilization of LLIN among the people of the 13 malaria endemic districts of Bangladesh. Methods: This baseline study employed a community cross-sectional design triangulated with qualitative methods to measure households’ ownership, access and use of 13 endemic districts. A multistage cluster random sampling was employed for the quantitative part and for qualitative part a purposive sampling strategy was done. Thus present analysis included 2640 households encompassing a total of 14475 populations. Data were collected using a pre-tested structured questionnaire through one on one face-to-face interview with respondents. All analyses were performed using STATA (Version 13.0). For the qualitative part participant observation, in-depth interview, focus group discussion, key informant interview and informal interview was done to gather the contextual data. Findings: According to our study, 99.8% of households possessed at least one-bed net in both study areas. 77.4% households possessed at least two LLIN and 43.2% households had access to LLIN for all the members. So the gap between coverage and access is 34%. 91.8% people in the 13 districts and 95.1% in Chittagong Hill Tracts areas reported having had slept under a bed net the night before interviewed. And despite the relatively low access, in 77.8% of households, all the members were used the LLIN the previous night. This higher utilization compared to access might be due to the increased awareness among the community people regarding LLIN uses. However, among those people with sufficient access to LLIN, 6% of them still did not use the LLIN which reflects the behavioral failure that needs to be addressed. The major reasons for not using LLIN, identified by both qualitative and quantitative findings, were insufficient access, sleeping or living outside the home, migration, perceived low efficacy of LLIN, fear of physical side effects or feeling uncomfortable. Conclusion: Given that LLIN access and use was a bit short of the targets, it conveys important messages to the malaria control program. Targeting specific population segments and groups for achieving expected LLIN coverage is very crucial. And also, addressing behavior failure by well-designed behavioral change interventions is mandatory.

Keywords: long lasting insecticide net, malaria, malaria control programme, World Health Organisation

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Authors: Endalamaw Ewnu Kassa, Ade Kurniawan, Ya-Fen Wu, Sajal Biring

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Perovskite-based gas sensors represent a highly promising materials within the realm of gas sensing technology, with a particular focus on detecting ammonia (NH3) due to its potential hazards. Our work conducted thorough comparison of various solvents, including dimethylformamide (DMF), DMF-dimethyl sulfoxide (DMSO), dimethylacetamide (DMAC), and DMAC-DMSO, for the preparation of our perovskite solution (MAPbI3). Significantly, we achieved an exceptional response at 10 ppm of ammonia gas by employing a binary solvent mixture of DMAC-DMSO. In contrast to prior reports that relied on single solvents for MAPbI3 precursor preparation, our approach using mixed solvents demonstrated a marked improvement in gas sensing performance. We attained enhanced surface coverage, a reduction in pinhole occurrences, and precise control over grain size in our perovskite films through the careful selection and mixtures of appropriate solvents. This study shows a promising potential of employing binary and multi-solvent mixture strategies as a means to propel advancements in gas sensor technology, opening up new opportunities for practical applications in environmental monitoring and industrial safety.

Keywords: sensors, binary solvents, ammonia, sensitivity, grain size, pinholes, surface coverage

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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: Ran Goldblatt, Nicholas Jones, Jennifer Mannix, Brad Bottoms

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Accurate, complete, and up-to-date geospatial information is the foundation of successful disaster management. When the 2010 Haiti Earthquake struck, accurate and timely information on the distribution of critical infrastructure was essential for the disaster response community for effective search and rescue operations. Existing geospatial datasets such as Google Maps did not have comprehensive coverage of these features. In the days following the earthquake, many organizations released high-resolution satellite imagery, catalyzing a worldwide effort to map Haiti and support the recovery operations. Of these organizations, OpenStreetMap (OSM), a collaborative project to create a free editable map of the world, used the imagery to support volunteers to digitize roads, buildings, and other features, creating the most detailed map of Haiti in existence in just a few weeks. However, large portions of the island are still not fully covered by OSM. There is an increasing need for a tool to automatically identify which areas in Haiti, as well as in other countries vulnerable to disasters, that are not fully mapped. The objective of this project is to leverage different types of remote sensing measurements, together with machine learning approaches, in order to identify geographical areas where OSM coverage of building footprints is incomplete. Several remote sensing measures and derived products were assessed as potential predictors of OSM building footprints coverage, including: intensity of light emitted at night (based on VIIRS measurements), spectral indices derived from Sentinel-2 satellite (normalized difference vegetation index (NDVI), normalized difference built-up index (NDBI), soil-adjusted vegetation index (SAVI), urban index (UI)), surface texture (based on Sentinel-1 SAR measurements)), elevation and slope. Additional remote sensing derived products, such as Hansen Global Forest Change, DLR`s Global Urban Footprint (GUF), and World Settlement Footprint (WSF), were also evaluated as predictors, as well as OSM street and road network (including junctions). Using a supervised classification with a random forest classifier resulted in the prediction of 89% of the variation of OSM building footprint area in a given cell. These predictions allowed for the identification of cells that are predicted to be covered but are actually not mapped yet. With these results, this methodology could be adapted to any location to assist with preparing for future disastrous events and assure that essential geospatial information is available to support the response and recovery efforts during and following major disasters.

Keywords: disaster management, Haiti, machine learning, OpenStreetMap, remote sensing

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Authors: Karolina Wieczorek, Zofia Przypaśniak

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Climate change is a rapidly growing threat to global health, and part of the responsibility to combat it lies within the healthcare sector itself, including adequate education of future medical professionals. To mitigate the consequences, the General Medical Council (GMC) has equipped medical schools with a list of outcomes regarding sustainability teaching. Students are expected to analyze the impact of the healthcare sector’s emissions on climate change. The delivery of the related teaching content is, however, often inadequate and insufficient time is devoted for exploration of the topics. Teaching curricula lack in-depth exploration of the learning objectives. This study aims to assess the extent and characteristics of climate change and sustainability subjects teaching in the curriculum of a chosen UK medical school (Barts and The London School of Medicine and Dentistry). It compares the data to the national average scores from the Climate Change and Sustainability Teaching (C.A.S.T.) in Medical Education Audit to draw conclusions about teaching on a regional level. This is a single-center audit of the timetabled sessions of teaching in the medical course. The study looked at the academic year 2020/2021 which included a review of all non-elective, core curriculum teaching materials including tutorials, lectures, written resources, and assignments in all five years of the undergraduate and graduate degrees, focusing only on mandatory teaching attended by all students (excluding elective modules). The topics covered were crosschecked with GMC Outcomes for graduates: “Educating for Sustainable Healthcare – Priority Learning Outcomes” as gold standard to look for coverage of the outcomes and gaps in teaching. Quantitative data was collected in form of time allocated for teaching as proxy of time spent per individual outcomes. The data was collected independently by two students (KW and ZP) who have received prior training and assessed two separate data sets to increase interrater reliability. In terms of coverage of learning outcomes, 12 out of 13 were taught (with the national average being 9.7). The school ranked sixth in the UK for time spent per topic and second in terms of overall coverage, meaning the school has a broad range of topics taught with some being explored in more detail than others. For the first outcome 4 out of 4 objectives covered (average 3.5) with 47 minutes spent per outcome (average 84 min), for the second objective 5 out of 5 covered (average 3.5) with 46 minutes spent (average 20), for the third 3 out of 4 (average 2.5) with 10 mins pent (average 19 min). A disproportionately large amount of time is spent delivering teaching regarding air pollution (respiratory illnesses), which resulted in the topic of sustainability in other specialties being excluded from teaching (musculoskeletal, ophthalmology, pediatrics, renal). Conclusions: Currently, there is no coherent strategy on national teaching of climate change topics and as a result an unstandardized amount of time spent on teaching and coverage of objectives can be observed.

Keywords: audit, climate change, sustainability, education

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Authors: Shola H. Adeosun, Lekan M. Togunwa, Kolawole Z. Amos

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This paper appraises ‘Newspaper Coverage of 2015 General Election: A study of The Punch and Guardian Newspapers’. The objectives of the study were to examine how credible newspaper reports of 2015 election were and to examine the significant role Nigeria Newspapers played in the 2015 general elections. Also this study examined the extent at which the print media contributed to the success of 2015 general election and to ascertain the extent at which print media reports serve as a tool for sensitizing the masses. The research questions that guided this research include: How credible was newspaper report of 2015 general election? To what extent did the print media contributed to the success of 2015 general elections? To what extent did the print media reports serve as a tool for sensitizing the masses? The research work was given solid theoretical foundation with the review of Agenda-setting theory, Media System Dependency Theory and Normative theories. This study was given solid theoretical foundation with the review of Agenda-setting theory, Media Dependency Theory and Normative theories. The theory was conducted using content analysis method of research and 30 publications of both The Guardian and Punch Newspaper between January 1st and March 30, 2015 forms the population for this research work. Selection of the dates and editions of Newspaper under study were done using the composite week sampling technique. All the days of the week were used for the newspapers because they (The Punch and The Guardian) are published all the days of the week. Coding sheet was the tool of data collection for the content analysis of this study. Findings of the study revealed that by the Punch newspaper and Guardian has played a significant role in eradicating election malpractices in Nigeria. It therefore concludes that media is metaphoric when we termed it to be a watchdog of the nation as well the mirror through which the nation see and recognize itself. The study also recommends that Nigerian media should strike balance between entertainment stories, crisis stories, economic stories, law story, education stories, terrorism stories, health stories, sport stories, metropolitan stories instead of portraying the country as being crime oriented.

Keywords: newspaper, coverage, general elections, impact

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Authors: Aneta Nitsch-Osuch, Beata Pawlus, Maria Pawlak

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Introduction: Recently, the number of parents who refuse to vaccinate their children or present so-called hesitant behaviors has increased in many developed countries. The study aimed to analyze the completeness and timeliness of vaccinations against hepatitis B and tuberculosis in neonates in a single maternity hospital in Warsaw (Poland). Material and Methods: We analyzed medical records of children born in the hospital between 1st January 2015 and 31st December 2016 and calculated the proportion of newborns not vaccinated on time. Results: The percentage of unvaccinated newborns was similar in the analyzed years: 7.2% in 2015 and 6.7% in 2016. Parental decisions rather than medical contraindications caused non-immunization (4.3% vs. 2.9% in 2015, and 4.7% vs. 2% in 2016). Most parents refused both vaccinations (81%-84%), whereas 7-8% refused only hep B vaccination, and 9-11% refused alone tuberculosis vaccination. The majority of hesitant parents decided to delay both vaccinations (70-80%), while 10-11% of parents chose to delay only one vaccination (hep B). In consecutive years, an increase in the percentage of parents delaying tuberculosis vaccination was reported (10 vs. 19%). Discussion: The increase in the number of newborns who are not correctly vaccinated just after birth due to their parents' decision should be considered non-gradual, both for hepatitis B and tuberculosis. It is necessary to implement effective educational and informative measures targeted at future parents to reinforce positive attitudes towards vaccinations and to dispel doubts about them among parents who are hesitant.

Keywords: hepatitis B, tuberculosis, immunization, new-borns, coverage rate

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Authors: Paul Moses Ndegwa, Teresia Kabucho, Lucy Wanjiru, Esther Wanjiru, Brian Githaiga, Jecinta Wambui

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Health outcome has improved in the country since 2013 following the adoption of the new constitution in Kenya with devolved governance with administration and health planning functions transferred to county governments. 2018-2022 development agenda prioritized universal healthcare coverage, food security, and nutrition, however, the emergence of Covid-19 and the increase of non-communicable diseases pose a challenge and constrain in an already overwhelmed health system. A study was conducted July-November 2021 to establish key challenges in achieving universal healthcare coverage within the county and best practices for improved non-communicable disease control. 14 health workers ranging from nurses, doctors, public health officers, clinical officers, and pharmaceutical technologists were purposely engaged to provide critical information through questionnaires by a trained duo observing ethical procedures on confidentiality. Data analysis. Communicable diseases are major causes of morbidity and mortality. Non-communicable diseases contribute to approximately 39% of deaths. More than 45% of the population does not have access to safe drinking water. Study noted geographic inequality with respect to distribution and use of health resources including competing non-health priorities. 56% of health workers are nurses, 13% clinical officers, 7% doctors, 9%public health workers, 2% are pharmaceutical technologists. Poor-quality data limits the validity of disease-burdened estimates and research activities. Risk factors include unsafe water, sanitation, hand washing, unsafe sex, and malnutrition. Key challenge in achieving universal healthcare coverage is the rise in the relative contribution of non-communicable diseases. Improve targeted disease control with effective and equitable resource allocation. Develop high infectious disease control mechanisms. Improvement of quality data for decision making. Strengthen electronic data-capture systems. Increase investments in the health workforce to improve health service provision and achievement of universal health coverage. Create a favorable environment to retain health workers. Fill in staffing gaps resulting in shortages of doctors (7%). Develop a multi-sectional approach to health workforce planning and management. Need to invest in mechanisms that generate contextual evidence on current and future health workforce needs. Ensure retention of qualified, skilled, and motivated health workforce. Deliver integrated people-centered health services.

Keywords: multi-sectional approach, equity, people-centered, health workforce retention

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Authors: Tina Naser Torabi

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Prevalence of allergy is affected by different factors according to its base and seasonal weather changes, and it also needs various treatments.Although reasons of allergy existence are not clear but generally, allergens cause reaction between antigen and antibody because of their antigenic traits. In this state, allergens cause immune system to make mistake and identify safe material as threat, therefore function of immune system impaired because of histamine secretion. There are different reasons for allergy, but herbal reasons are on top of the list, although animal causes cannot be ignored. Important point is that allergenic compounds, cause making dedicated antibody, so in general every kind of allergy is different from the other one. Therefore, most of the plants in herbal allergenic category can cause various allergies for human beings, such as respiratory allergies, nutritional allergies, injection allergies, infection allergies, touch allergies, that each of them show different symptoms based on the reason of allergy and also each of them requires different prevention and treatment. Geographical condition is another effective factor in allergy. Seasonal changes, weather condition, herbal coverage variety play important roles in different allergies. It goes without saying that humid climate and herbal coverage variety in different seasons especially spring cause most allergies in human beings in Iran and India that are discussed in this article. These two countries are good choices for allergy prevalence because of their condition, various herbal coverage, human and animal factors. Hay fever is one of the allergies, although the reasons of its prevalence are unknown yet. It is one of the most popular allergies in Iran and India because of geographical, human, animal and herbal factors. Hay fever is on top of the list in these two countries. Significant point about these two countries is that herbal factor is the most important factor in prevalence of hay fever. Variety of herbal coverage especially in spring during herbal pollination is the main reason of hay fever prevalence in these two countries. Based on the research result of Pharmacognosy and Phytochemistry, pollination of some plants in spring is major reason of hay fever prevalence in these countries. If airborne pollens in pollination season enter the human body through air, they will cause allergic reactions in eyes, nasal mucosa, lungs, and respiratory system, and if these particles enter the body of potential person through food, they will cause allergic reactions in mouth, stomach, and other digestive systems. Occasionally, chemical materials produced by human body such as Histamine cause problems like: developing of nasal polyps, nasal blockage, sleep disturbance, risk of asthma developing, blood vasodilation, sneezing, eye tears, itching and swelling of eyes and nasal mucosa, Urticaria, decrease in blood pressure, and rarely trauma, anesthesia, anaphylaxis and finally death. This article is going to study the reasons of hay fever prevalence in Iran and India and presents prevention and treatment Method from Phytochemistry and Pharmocognocy point of view by using local natural products in these two countries.

Keywords: hay fever, India, Iran, natural treatment, phytochemistry

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Authors: Aghasadeghi MR., Bahramali G., Sadat SM., Sadeghi SA., Yousefi M., Khodaei K., Ghorbani M., Sadat Larijani M.

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Background:The emerging COVID-19 pandemic is a serious concernfor the public health worldwide. Despite the many mutations in the virus genome, it is important to find an effective vaccine against viral mutations. Therefore, in current study, we aimed at immunoinformatic evaluation of the virus proteins immunogenicity to design a preventive vaccine candidate, which could elicit humoral and cellular immune responses as well. Methods:Three antigenic regions are included;Spike, Membrane, and Nucleocapsid amino acid sequences were obtained, and possible fusion proteins were assessed andcompared by immunogenicity, structural features, and population coverage. The best fusion protein was also evaluated for MHC-I and MHC-II T-cell epitopes and the linear and conformational B-cell epitopes. Results: Among the four predicted models, the truncated Spike protein in fusion with M and N proteins is composed of 24 highly immunogenic human MHC class I and 29 MHC class II, along with 14 B-cell linear and 61 discontinues epitopes. Also, the selected protein has high antigenicity and acceptable population coverage of 82.95% in Iran and 92.51% in Europe. Conclusion: The data indicate that the truncated Spike-M-N SARS-CoV-2form which could be potential targets of neutralizing antibodies. The protein also has the ability to stimulate humoral and cellular immunity. The in silico study provided the fusion protein as a potential preventive vaccine candidate for further in vivo evaluation.

Keywords: SARS-CoV-2, immunoinformatic, protein, vaccine

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Authors: Jill Hanass-Hancock, Bradley Carpenter, Samantha Willan, Kristin Dunkle

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Access to quality health care for persons with disabilities is the litmus test in our strive toward universal health coverage. Persons with disabilities experience a variety of health disparities related to increased health risks, greater socioeconomic challenges, and persistent ableism in the provision of health care. In low- and middle-income countries, the support needed to address the diverse needs of persons with disabilities and close the gaps in inclusive and accessible health care can appear overwhelming to staff with little knowledge and tools available. An action-orientated disability inclusion toolkit for health facilities was developed through consensus-building consultations and field testing in South Africa. The co-creation of the toolkit followed a bottom-up approach with healthcare staff and persons with disabilities in two developmental cycles. In cycle one, a disability facility assessment tool was developed to increase awareness of disability accessibility and service delivery gaps in primary healthcare services in a simple and action-orientated way. In cycle two, an intervention menu was created, enabling staff to respond to identified gaps and improve accessibility and inclusion. Each cycle followed five distinct steps of development: a review of needs and existing tools, design of the draft tool, consensus discussion to adapt the tool, pilot-testing and adaptation of the tool, and identification of the next steps. The continued consultations, adaptations, and field-testing allowed the team to discuss and test several adaptations while co-creating a meaningful and feasible toolkit with healthcare staff and persons with disabilities. This approach led to a simplified tool design with ‘key elements’ needed to achieve universal health coverage: universal design of health facilities, reasonable accommodation, health care worker training, and care pathway linkages. The toolkit was adapted for paper or digital data entry, produces automated, instant facility reports, and has easy-to-use training guides and online modules. The cyclic approach enabled the team to respond to emerging needs. The pilot testing of the facility assessment tool revealed that healthcare workers took significant actions to change their facilities after an assessment. However, staff needed information on how to improve disability accessibility and inclusion, where to acquire accredited training, and how to improve disability data collection, referrals, and follow-up. Hence, intervention options were needed for each ‘key element’. In consultation with representatives from the health and disability sectors, tangible and feasible solutions/interventions were identified. This process included the development of immediate/low-cost and long-term solutions. The approach gained buy-in from both sectors, who called for including the toolkit in the standard quality assessments for South Africa’s health care services. Furthermore, the process identified tangible solutions for each ‘key element’ and highlighted where research and development are urgently needed. The cyclic and consultative approach enabled the development of a feasible facility assessment tool and a complementary intervention menu, moving facilities toward universal health coverage for and persons with disabilities in low- or better-resourced contexts while identifying gaps in the availability of interventions.

Keywords: public health, disability, accessibility, inclusive health care, universal health coverage

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