Search results for: government programs and schemes
Commenced in January 2007
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Paper Count: 6385

Search results for: government programs and schemes

85 An Anthropological Insight into Farming Practices and Cultural Life of Farmers in Sarawan Village, District Faridkot, Punjab

Authors: Amandeep Kaur

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Farming is one of the most influential traditions which started around 10000 BC and has revolutionized human civilization. It is believed that farming originated at a separate location. Thus it has a great impact on local culture, which in turn gave rise to diversified farming practices. Farming activities are influenced by the culture of a particular region or community as local people have their own knowledge and belief system about soil and crops. With the inception of the Green Revolution, 'a high tech machinery model' in Punjab, various traditional farming methods and techniques changed. The present research concentrates on the local knowledge of farmers and local farming systems from an anthropological perspective. In view of the prevailing agrarian crisis in Punjab, this research is focused on farmer’s experiences and their perception regarding farming practices. Thus an attempt has to be made to focus on the local knowledge, perception, and experience of farmers for eco-friendly and sustainable agricultural development. Farmers voices are used to understand the relationship between farming practices and socio-cultural life of farmers in Faridkot district, Punjab. The research aims to comprehend the nature of changes taking place in the socio-cultural life of people with the development of capitalism and agricultural modernization. The study is based on qualitative methods of ethnography in Sarawan village of Faridkot District. Inferences drawn from in-depth case studies collected from 60 agricultural households lead to the concept of the process of diffusion, innovation, and adoption of farming technology, a variety of crops and the dissemination of agricultural skills regarding various cultural farming practices. The data is based on random sampling; the respondents were both males and females above the age of 18 years to attain a holistic understanding across the generations. A Quasi-participant observation related to lifestyle, the standard of living, and various farming practices performed by them were done. Narratives derived from the fieldwork depicts that farmers usually oppose the restrictions imposed by the government on certain farming practices, especially ban on stubble burning. This paper presents the narratives of farmers regarding the dissemination of awareness about the use of new varieties of seeds, technology, fertilizers, pesticides, etc. The study reveals that farming systems have developed in ways reflecting the activities and choices of farmers influenced by environmental, socio-cultural, economic, and political situations. Modern farming practices have forced small farmers into debt as farmers feel pride in buying new machinery. It has also led to the loss of work culture and excessive use of drugs among youngsters. Even laborers did not want to work on the land with cultivating farmers primarily for social and political reasons. Due to lack of proper marketing of crops, there is a continuum of the wheat-rice cycle instead of crop diversification in Punjab. Change in the farming system also affects the social structure of society. Agricultural modernization has commercialized the socio-cultural relations in Punjab and is slowly urbanizing the rural landscape revolutionizing the traditional social relations to capitalistic relations.

Keywords: agricultural modernization, capitalism, farming practices, narratives

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84 The Integration of Digital Humanities into the Sociology of Knowledge Approach to Discourse Analysis

Authors: Gertraud Koch, Teresa Stumpf, Alejandra Tijerina García

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Discourse analysis research approaches belong to the central research strategies applied throughout the humanities; they focus on the countless forms and ways digital texts and images shape present-day notions of the world. Despite the constantly growing number of relevant digital, multimodal discourse resources, digital humanities (DH) methods are thus far not systematically developed and accessible for discourse analysis approaches. Specifically, the significance of multimodality and meaning plurality modelling are yet to be sufficiently addressed. In order to address this research gap, the D-WISE project aims to develop a prototypical working environment as digital support for the sociology of knowledge approach to discourse analysis and new IT-analysis approaches for the use of context-oriented embedding representations. Playing an essential role throughout our research endeavor is the constant optimization of hermeneutical methodology in the use of (semi)automated processes and their corresponding epistemological reflection. Among the discourse analyses, the sociology of knowledge approach to discourse analysis is characterised by the reconstructive and accompanying research into the formation of knowledge systems in social negotiation processes. The approach analyses how dominant understandings of a phenomenon develop, i.e., the way they are expressed and consolidated by various actors in specific arenas of discourse until a specific understanding of the phenomenon and its socially accepted structure are established. This article presents insights and initial findings from D-WISE, a joint research project running since 2021 between the Institute of Anthropological Studies in Culture and History and the Language Technology Group of the Department of Informatics at the University of Hamburg. As an interdisciplinary team, we develop central innovations with regard to the availability of relevant DH applications by building up a uniform working environment, which supports the procedure of the sociology of knowledge approach to discourse analysis within open corpora and heterogeneous, multimodal data sources for researchers in the humanities. We are hereby expanding the existing range of DH methods by developing contextualized embeddings for improved modelling of the plurality of meaning and the integrated processing of multimodal data. The alignment of this methodological and technical innovation is based on the epistemological working methods according to grounded theory as a hermeneutic methodology. In order to systematically relate, compare, and reflect the approaches of structural-IT and hermeneutic-interpretative analysis, the discourse analysis is carried out both manually and digitally. Using the example of current discourses on digitization in the healthcare sector and the associated issues regarding data protection, we have manually built an initial data corpus of which the relevant actors and discourse positions are analysed in conventional qualitative discourse analysis. At the same time, we are building an extensive digital corpus on the same topic based on the use and further development of entity-centered research tools such as topic crawlers and automated newsreaders. In addition to the text material, this consists of multimodal sources such as images, video sequences, and apps. In a blended reading process, the data material is filtered, annotated, and finally coded with the help of NLP tools such as dependency parsing, named entity recognition, co-reference resolution, entity linking, sentiment analysis, and other project-specific tools that are being adapted and developed. The coding process is carried out (semi-)automated by programs that propose coding paradigms based on the calculated entities and their relationships. Simultaneously, these can be specifically trained by manual coding in a closed reading process and specified according to the content issues. Overall, this approach enables purely qualitative, fully automated, and semi-automated analyses to be compared and reflected upon.

Keywords: entanglement of structural IT and hermeneutic-interpretative analysis, multimodality, plurality of meaning, sociology of knowledge approach to discourse analysis

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83 Magneto-Luminescent Biocompatible Complexes Based on Alloyed Quantum Dots and Superparamagnetic Iron Oxide Nanoparticles

Authors: A. Matiushkina, A. Bazhenova, I. Litvinov, E. Kornilova, A. Dubavik, A. Orlova

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Magnetic-luminescent complexes based on superparamagnetic iron oxide nanoparticles (SPIONs) and semiconductor quantum dots (QDs) have been recognized as a new class of materials that have high potential in modern medicine. These materials can serve for theranostics of oncological diseases, and also as a target agent for drug delivery. They combine the qualities characteristic of magnetic nanoparticles, that is, magneto-controllability and the ability to local heating under the influence of an external magnetic field, as well as phosphors, due to luminescence of which, for example, early tumor imaging is possible. The complexity of creating complexes is the energy transfer between particles, which quenches the luminescence of QDs in complexes with SPIONs. In this regard, a relatively new type of alloyed (CdₓZn₁₋ₓSeᵧS₁₋ᵧ)-ZnS QDs is used in our work. The presence of a sufficiently thick gradient semiconductor shell in alloyed QDs makes it possible to reduce the probability of energy transfer from QDs to SPIONs in complexes. At the same time, Forster Resonance Energy Transfer (FRET) is a perfect instrument to confirm the formation of complexes based on QDs and different-type energy acceptors. The formation of complexes in the aprotic bipolar solvent dimethyl sulfoxide is ensured by the coordination of the carboxyl group of the stabilizing QD molecule (L-cysteine) on the surface iron atoms of the SPIONs. An analysis of the photoluminescence (PL) spectra has shown that a sequential increase in the SPIONs concentration in the samples is accompanied by effective quenching of the luminescence of QDs. However, it has not confirmed the formation of complexes yet, because of a decrease in the PL intensity of QDs due to reabsorption of light by SPIONs. Therefore, a study of the PL kinetics of QDs at different SPIONs concentrations was made, which demonstrates that an increase in the SPIONs concentration is accompanied by a symbatic reduction in all characteristic PL decay times. It confirms the FRET from QDs to SPIONs, which indicates the QDs/SPIONs complex formation, rather than a spontaneous aggregation of QDs, which is usually accompanied by a sharp increase in the percentage of the QD fraction with the shortest characteristic PL decay time. The complexes have been studied by the magnetic circular dichroism (MCD) spectroscopy that allows one to estimate the response of magnetic material to the applied magnetic field and also can be useful to check SPIONs aggregation. An analysis of the MCD spectra has shown that the complexes have zero residual magnetization, which is an important factor for using in biomedical applications, and don't contain SPIONs aggregates. Cell penetration, biocompatibility, and stability of QDs/SPIONs complexes in cancer cells have been studied using HeLa cell line. We have found that the complexes penetrate in HeLa cell and don't demonstrate cytotoxic effect up to 25 nM concentration. Our results clearly demonstrate that alloyed (CdₓZn₁₋ₓSeᵧS₁₋ᵧ)-ZnS QDs can be successfully used in complexes with SPIONs reached new hybrid nanostructures, which combine bright luminescence for tumor imaging and magnetic properties for targeted drug delivery and magnetic hyperthermia of tumors. Acknowledgements: This work was supported by the Ministry of Science and Higher Education of Russian Federation, goszadanie no. 2019-1080 and was financially supported by Government of Russian Federation, Grant 08-08.

Keywords: alloyed quantum dots, magnetic circular dichroism, magneto-luminescent complexes, superparamagnetic iron oxide nanoparticles

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82 Regulatory Governance as a De-Parliamentarization Process: A Contextual Approach to Global Constitutionalism and Its Effects on New Arab Legislatures

Authors: Abderrahim El Maslouhi

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The paper aims to analyze an often-overlooked dimension of global constitutionalism, which is the rise of the regulatory state and its impact on parliamentary dynamics in transition regimes. In contrast to Majone’s technocratic vision of convergence towards a single regulatory system based on competence and efficiency, national transpositions of regulatory governance and, in general, the relationship to global standards primarily depend upon a number of distinctive parameters. These include policy formation process, speed of change, depth of parliamentary tradition and greater or lesser vulnerability to the normative conditionality of donors, interstate groupings and transnational regulatory bodies. Based on a comparison between three post-Arab Spring countries -Morocco, Tunisia, and Egypt, whose constitutions have undergone substantive review in the period 2011-2014- and some European Union state members, the paper intends, first, to assess the degree of permeability to global constitutionalism in different contexts. A noteworthy divide emerges from this comparison. Whereas European constitutions still seem impervious to the lexicon of global constitutionalism, the influence of the latter is obvious in the recently drafted constitutions in Morocco, Tunisia, and Egypt. This is evidenced by their reference to notions such as ‘governance’, ‘regulators’, ‘accountability’, ‘transparency’, ‘civil society’, and ‘participatory democracy’. Second, the study will provide a contextual account of internal and external rationales underlying the constitutionalization of regulatory governance in the cases examined. Unlike European constitutionalism, where parliamentarism and the tradition of representative government function as a structural mechanism that moderates the de-parliamentarization effect induced by global constitutionalism, Arab constitutional transitions have led to a paradoxical situation; contrary to the public demands for further parliamentarization, the 2011 constitution-makers have opted for a de-parliamentarization pattern. This is particularly reflected in the procedures established by constitutions and regular legislation, to handle the interaction between lawmakers and regulatory bodies. Once the ‘constitutional’ and ‘independent’ nature of these agencies is formally endorsed, the birth of these ‘fourth power’ entities, which are neither elected nor directly responsible to elected officials, will raise the question of their accountability. Third, the paper shows that, even in the three selected countries, the de-parliamentarization intensity is significantly variable. By contrast to the radical stance of the Moroccan and Egyptian constituents who have shown greater concern to shield regulatory bodies from legislatures’ scrutiny, the Tunisian case indicates a certain tendency to provide lawmakers with some essential control instruments (e. g. exclusive appointment power, adversarial discussion of regulators’ annual reports, dismissal power, later held unconstitutional). In sum, the comparison reveals that the transposition of the regulatory state model and, more generally, sensitivity to the legal implications of global conditionality essentially relies on the evolution of real-world power relations at both national and international levels.

Keywords: Arab legislatures, de-parliamentarization, global constitutionalism, normative conditionality, regulatory state

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81 Academia as Creator of Emerging, Innovative Communities of Practice and Learning

Authors: Francisco Julio Batle Lorente

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The present paper aims at presenting a new category of role for academia: proactive creator/promoter of communities of practice in emerging areas of innovation. It is based in research among practitioners in three different areas: social entrepreneurship, alumni engaged in entrepreneurship and innovation, and digital nomads. The concept of CoP is related to an intentionally created space to share experiences and collectively reflect on the cases arising from practice. Such an endeavour is not contemplated in the literature on academic roles in an explicit way. The goal of the paper is providing a framework for this function and throw some light on the perception and priorities of members of emerging communities (78 alumni, 154 social entrepreneurs, and 231 digital nomads) regarding community, learning, engagement, and networking, areas in which the university can help and, by doing so, contributing to signal the emerging area and creating new opportunities for the academia. The research methodology was based in Survey research. It is a specific type of field study that involves the collection of data from a sample of elements drawn from a well-defined population through the use of a questionnaire. It was considered that survey research might be valuable to the present project and help outline the utility of various study designs and future projects with the emerging communities that are the object of the investigation. Open questions were used for different topics, as well as critical incident technique. It was used a standard technique for survey sampling and questionnaire design. Finally, it was defined a procedure for pretesting questionnaires and for data collection. The questionnaire was channelled by means of google forms. The results indicate that the members of emerging, innovative CoPs and learning such the ones that were selected for this investigation lack cohesion, inspiration, networking, opportunities for creation of social capital, opportunities for collaboration beyond their existing and close network. The opportunity that arises for the academia from proactively helping articulate CoP (and Communities of learning) are related to key elements of any CoP/ CoL: community construction approaches, technological infrastructure, benefits, participation issues and urgent challenges, trust, networking, technical ability/training/development and collaboration. Beyond training, other three areas (networking, collaboration and urgent challenges) were the ones in which the contribution of universities to the communities were considered more interesting and workable to practitioners. The analysis of the responses for the open questions related to perception of the universities offer options for terra incognita to be explored for universities (signalling new areas, establishing broader collaborations with research, government, media and corporations, attracting investment). Based on the findings from this research, there is some evidence that CoPs can offer a formal and informal method of professional and interprofessional development for member of any emerging and innovative community and can decrease social and professional isolation. The opportunity that it offers to academia can increase the entrepreneurial and engaged university identity. It also moves to academia into a realm of civic confrontation of present and future challenges in a more proactive way.

Keywords: social innovation, new roles of academia, community of learning, community of practice

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80 Generating Biogas from Municipal Kitchen Waste: An Experience from Gaibandha, Bangladesh

Authors: Taif Rocky, Uttam Saha, Mahobul Islam

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With a rapid urbanisation in Bangladesh, waste management remains one of the core challenges. Turning municipal waste into biogas for mass usage is a solution that Bangladesh needs to adopt urgently. Practical Action with its commitment to challenging poverty with technological justice has piloted such idea in Gaibandha. The initiative received immense success and drew the attention of policy makers and practitioners. We believe, biogas from waste can highly contribute to meet the growing demand for energy in the country at present and in the future. Practical Action has field based experience in promoting small scale and innovative technologies. We have proven track record in integrated solid waste management. We further utilized this experience to promote waste to biogas at end users’ level. In 2011, we have piloted a project on waste to biogas in Gaibandha, a northern secondary town of Bangladesh. With resource and support from UNICEF and with our own innovative funds we have established a complete chain of utilizing waste to the renewable energy source and organic fertilizer. Biogas is produced from municipal solid waste, which is properly collected, transported and segregated by private entrepreneurs. The project has two major focuses, diversification of biogas end use and establishing a public-private partnership business model. The project benefits include Recycling of Wastes, Improved institutional (municipal) capacity, Livelihood from improved services and Direct Income from the project. Project risks include Change of municipal leadership, Traditional mindset, Access to decision making, Land availability. We have observed several outcomes from the initiative. Up scaling such an initiative will certainly contribute for sustainable cleaner and healthier urban environment and urban poverty reduction. - It reduces the unsafe disposal of wastes which improve the cleanliness and environment of the town. -Make drainage system effective reducing the adverse impact of water logging or flooding. -Improve public health from better management of wastes. -Promotes usage of biogas replacing the use of firewood/coal which creates smoke and indoor air pollution in kitchens which have long term impact on health of women and children. -Reduce the greenhouse gas emission from the anaerobic recycling of wastes and contributes to sustainable urban environment. -Promote the concept of agroecology from the uses of bio slurry/compost which contributes to food security. -Creates green jobs from waste value chain which impacts on poverty alleviation of urban extreme poor. -Improve municipal governance from inclusive waste services and functional partnership with private sectors. -Contribute to the implementation of 3R (Reduce, Reuse, Recycle) Strategy and Employment Creation of extreme poor to achieve the target set in Vision 2021 by Government of Bangladesh.

Keywords: kitchen waste, secondary town, biogas, segregation

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79 Lessons Learnt from Industry: Achieving Net Gain Outcomes for Biodiversity

Authors: Julia Baker

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Development plays a major role in stopping biodiversity loss. But the ‘silo species’ protection of legislation (where certain species are protected while many are not) means that development can be ‘legally compliant’ and result in biodiversity loss. ‘Net Gain’ (NG) policies can help overcome this by making it an absolute requirement that development causes no overall loss of biodiversity and brings a benefit. However, offsetting biodiversity losses in one location with gains elsewhere is controversial because people suspect ‘offsetting’ to be an easy way for developers to buy their way out of conservation requirements. Yet the good practice principles (GPP) of offsetting provide several advantages over existing legislation for protecting biodiversity from development. This presentation describes the learning from implementing NG approaches based on GPP. It regards major upgrades of the UK’s transport networks, which involved removing vegetation in order to construct and safely operate new infrastructure. While low-lying habitats were retained, trees and other habitats disrupting the running or safety of transport networks could not. Consequently, achieving NG within the transport corridor was not possible and offsetting was required. The first ‘lessons learnt’ were on obtaining a commitment from business leaders to go beyond legislative requirements and deliver NG, and on the institutional change necessary to embed GPP within daily operations. These issues can only be addressed when the challenges that biodiversity poses for business are overcome. These challenges included: biodiversity cannot be measured easily unlike other sustainability factors like carbon and water that have metrics for target-setting and measuring progress; and, the mindset that biodiversity costs money and does not generate cash in return, which is the opposite of carbon or waste for example, where people can see how ‘sustainability’ actions save money. The challenges were overcome by presenting the GPP of NG as a cost-efficient solution to specific, critical risks facing the business that also boost industry recognition, and by using government-issued NG metrics to develop business-specific toolkits charting their NG progress whilst ensuring that NG decision-making was based on rich ecological data. An institutional change was best achieved by supporting, mentoring and training sustainability/environmental managers for these ‘frontline’ staff to embed GPP within the business. The second learning was from implementing the GPP where business partnered with local governments, wildlife groups and land owners to support their priorities for nature conservation, and where these partners had a say in decisions about where and how best to achieve NG. From this inclusive approach, offsetting contributed towards conservation priorities when all collaborated to manage trade-offs between: -Delivering ecologically equivalent offsets or compensating for losses of one type of biodiversity by providing another. -Achieving NG locally to the development whilst contributing towards national conservation priorities through landscape-level planning. -Not just protecting the extent and condition of existing biodiversity but ‘doing more’. -The multi-sector collaborations identified practical, workable solutions to ‘in perpetuity’. But key was strengthening linkages between biodiversity measures implemented for development and conservation work undertaken by local organizations so that developers support NG initiatives that really count.

Keywords: biodiversity offsetting, development, nature conservation planning, net gain

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78 Cultural Cognition and Voting: Understanding Values and Perceived Risks in the Colombian Population

Authors: Andrea N. Alarcon, Julian D. Castro, Gloria C. Rojas, Paola A. Vaca, Santiago Ortiz, Gustavo Martinez, Pablo D. Lemoine

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Recently, electoral results across many countries have shown to be inconsistent with rational decision theory, which states that individuals make decisions based on maximizing benefits and reducing risks. An alternative explanation has emerged: Fear and rage-driven vote have been proved to be highly effective for political persuasion and mobilization. This phenomenon has been evident in the 2016 elections in the United States, 2006 elections in Mexico, 1998 elections in Venezuela, and 2004 elections in Bolivia. In Colombia, it has occurred recently in the 2016 plebiscite for peace and 2018 presidential elections. The aim of this study is to explain this phenomenon using cultural cognition theory, referring to the psychological predisposition individuals have to believe that its own and its peer´s behavior is correct and, therefore, beneficial to the entire society. Cultural cognition refers to the tendency of individuals to fit perceived risks, and factual beliefs into group shared values; the Cultural Cognition Worldview Scales (CCWS) measures cultural perceptions through two different dimensions: Individualism-communitarianism and hierarchy-egalitarianism. The former refers to attitudes towards social dominance based on conspicuous and static characteristics (sex, ethnicity or social class), while the latter refers to attitudes towards a social ordering in which it is expected from individuals to guarantee their own wellbeing without society´s or government´s intervention. A probabilistic national sample was obtained from different polls from the consulting and public opinion company Centro Nacional de Consultoría. Sociodemographic data was obtained along with CCWS scores, a subjective measure of left-right ideological placement and vote intention for 2019 Mayor´s elections were also included in the questionnaires. Finally, the question “In your opinion, what is the greatest risk Colombia is facing right now?” was included to identify perceived risk in the population. Preliminary results show that Colombians are highly distributed among hierarchical communitarians and egalitarian individualists (30.9% and 31.7%, respectively), and to a less extent among hierarchical individualists and egalitarian communitarians (19% and 18.4%, respectively). Males tended to be more hierarchical (p < .000) and communitarian (p=.009) than females. ANOVA´s revealed statistically significant differences between groups (quadrants) for the level of schooling, left-right ideological orientation, and stratum (p < .000 for all), and proportion differences revealed statistically significant differences for groups of age (p < .001). Differences and distributions for vote intention and perceived risks are still being processed and results are yet to be analyzed. Results show that Colombians are differentially distributed among quadrants in regard to sociodemographic data and left-right ideological orientation. These preliminary results indicate that this study may shed some light on why Colombians vote the way they do, and future qualitative data will show the fears emerging from the identified values in the CCWS and the relation this has with vote intention.

Keywords: communitarianism, cultural cognition, egalitarianism, hierarchy, individualism, perceived risks

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77 The Importance of School Culture in Supporting Student Mental Health Following the COVID-19 Pandemic: Insights from a Qualitative Study

Authors: Rhiannon Barker, Gregory Hartwell, Matt Egan, Karen Lock

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Background: Evidence suggests that mental health (MH) issues in children and young people (CYP) in the UK are on the rise. Of particular concern is data that indicates that the pandemic, together with the impact of school closures, have accentuated already pronounced inequalities; children from families on low incomes or from black and minority ethnic groups are reportedly more likely to have been adversely impacted. This study aimed to help identify specific support which may facilitate the building of a positive school climate and protect student mental health, particularly in the wake of school closures following the pandemic. It has important implications for integrated working between schools and statutory health services. Methods: The research comprised of three parts; scoping, case studies, and a stakeholder workshop to explore and consolidate results. The scoping phase included a literature review alongside interviews with a range of stakeholders from government, academia, and the third sector. Case studies were then conducted in two London state schools. Results: Our research identified how student MH was being impacted by a range of factors located at different system levels, both internal to the school and in the wider community. School climate, relating both to a shared system of beliefs and values, as well as broader factors including style of leadership, teaching, discipline, safety, and relationships -all played a role in the experience of school life and, consequently, the MH of both students and staff. Participants highlighted the importance of a whole school approach and ensuring that support for student MH was not separated from academic achievement, as well as the importance of identifying and applying universal measuring systems to establish levels of MH need. Our findings suggest that a school’s climate is influenced by the style and strength of its leadership, while this school climate - together with mechanisms put in place to respond to MH needs (both statutory and non-statutory) - plays a key role in supporting student MH. Implications: Schools in England have a responsibility to decide on the nature of MH support provided for their students, and there is no requirement for them to report centrally on the form this provision takes. The reality on the ground, as our study suggests, is that MH provision varies significantly between schools, particularly in relation to ‘lower’ levels of need which are not covered by statutory requirements. A valid concern may be that in the huge raft of possible options schools have to support CYP wellbeing, too much is left to chance. Work to support schools in rebuilding their cultures post-lockdowns must include the means to identify and promote appropriate tools and techniques to facilitate regular measurement of student MH. This will help establish both the scale of the problem and monitor the effectiveness of the response. A strong vision from a school’s leadership team that emphasises the importance of student wellbeing, running alongside (but not overshadowed by) academic attainment, should help shape a school climate to promote beneficial MH outcomes. The sector should also be provided with support to improve the consistency and efficacy of MH provision in schools across the country.

Keywords: mental health, schools, young people, whole-school culture

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76 Rural-To-Urban Migrants' Experiences with Primary Care in Four Types of Medical Institutions in Guangzhou, China

Authors: Jiazhi Zeng, Leiyu Shi, Xia Zou, Wen Chen, Li Ling

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Background: China is facing the unprecedented challenge of rapidly increasing rural-to-urban migration. Due to the household registration system, migrants are in a vulnerable state when they attempt to access to primary care services. A strong primary care system can reduce health inequities and mitigate socioeconomic disparities in healthcare utilization. Literature indicated that migrants were more reliant on the primary care system than local residents. Although the Chinese government has attached great importance to creating an efficient health system, primary care services are still underutilized. The referral system between primary care institutions and hospitals has not yet been completely established in China. The general populations often go directly to hospitals instead of primary care institutions for their primary care. Primary care institutions generally consist of community health centers (CHCs) and community health stations (CHSs) in urban areas, and township health centers (THCs) and rural health stations (THSs) in rural areas. In addition, primary care services are also provided by the outpatient department of municipal hospitals and tertiary hospitals. A better understanding of migrants’ experiences with primary care in the above-mentioned medical institutions is critical for improving the performance of primary care institutions and providing indications of the attributes that require further attention. The purpose of this pioneering study is to explore rural-to-urban migrants’ experiences in primary care, compare their primary care experiences in four types of medical institutions in Guangzhou, China, and suggest implications for targeted interventions to improve primary care for the migrants. Methods: This was a cross-sectional study conducted with 736 rural-to-urban migrants in Guangzhou, China, in 2014. A multistage sampling method was employed. A validated Chinese version of Primary Care Assessment Tool - Adult Short Version (PCAT-AS) was used to collect information on migrants’ primary care experiences. The PCAT-AS consists of 10 domains. Analysis of covariance was conducted for comparison on PCAT domain scores and total scores among migrants accessing four types of medical institutions. Multiple linear regression models were used to explore factors associated with PCAT total scores. Results: After controlling for socio-demographic characteristics, migrant characteristics, health status and health insurance status, migrants accessing primary care in tertiary hospitals had the highest PCAT total scores when compared with those accessing primary care THCs/ RHSs (25.49 vs. 24.18, P=0.007) and CHCs/ CHSs(25.49 vs. 24.24, P=0.006). There was no statistical significant difference for PCAT total scores between migrants accessing primary care in CHCs/CHSs and those in municipal hospitals (24.24 vs. 25.02, P=0.436). Factors positively associated with higher PCAT total scores also included insurance covering parts of healthcare payment (P < 0.001). Conclusions: This study highlights the need for improvement in primary care provided by primary care institutions for rural-to-urban migrants. Migrants receiving primary care from THCs, RHSs, CHSs and CHSs reported worse primary care experiences than those receiving primary care from tertiary hospitals. Relevant policies related to medical insurance should be implemented for providing affordable healthcare services for migrants accessing primary care. Further research exploring the specific reasons for poorer PCAT scores of primary care institutions users will be needed.

Keywords: China, PCAT, primary care, rural-to-urban migrants

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75 The Mediating Effects of Student Satisfaction on the Relationship Between Organisational Image, Service Quality and Students’ Loyalty in Higher Education Institutions in Kano State, Nigeria

Authors: Ado Ismail Sabo

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Statement of the Problem: The global trend in tertiary education institutions today is changing and moving towards engagement, promotion and marketing. The reason is to upscale reputation and impact positioning. More prominently, existing rivalry today seeks to draw-in the best and brightest students. A university or college is no longer just an institution of higher learning, but one adapting additional business nomenclature. Therefore, huge financial resources are invested by educational institutions to polish their image and improve their global and national ranking. In Nigeria, which boasts of a vast population of over 180 million people, some of whose patronage can bolster its education sector; standard of education continues to decline. Today, some Nigerian tertiary education institutions are shadows of their pasts, in terms of academic excellence. Quality has been relinquished because of the unquenchable quest by government officials, some civil servants, school heads and educators to amass wealth. It is very difficult to gain student satisfaction and their loyalty. Some of the student’s loyalties factor towards public higher educational institutions might be confusing. It is difficult to understand the extent to which students are satisfy on many needs. Some students might feel satisfy with the academic lecturers only, whereas others may want everything, and others will never satisfy. Due to these problems, this research aims to uncover the crucial factors influencing student loyalty and to examine if students’ satisfaction might impact mediate the relationship between service quality, organisational image and students’ loyalty towards public higher education institutions in Kano State, Nigeria. The significance of the current study is underscored by the paucity of similar research in the subject area and public tertiary education in a developing country like Nigeria as shown in existing literature. Methodology: The current study was undertaken by quantitative research methodology. Sample of 600 valid responses were obtained within the study population comprising six selected public higher education institutions in Kano State, Nigeria. These include: North West University Kano, Bayero University Kano, School of Management Studies Kano, School of Technology Kano, Sa’adatu Rimi College Kano and Federal College of Education (FCE) Kano. Four main hypotheses were formulated and tested using structural equation modeling techniques with Analysis of Moment Structure (AMOS Version 22.0). Results: Analysis of the data provided support for the main issue of this study, and the following findings are established: “Student Satisfaction mediates the relationship between Service Quality and Student Loyalty”, “Student Satisfaction mediates the relationship between Organizational Image and Student Loyalty” respectively. The findings of this study contributed to the theoretical implication which proposed a structural model that examined the relationships among overall Organizational image, service quality, student satisfaction and student loyalty. Conclusion: In addition, the findings offered a better insight to the managerial (higher institution of learning service providers) by focusing on portraying the image of service quality with student satisfaction in improving the quality of student loyalty.

Keywords: student loyalty, service quality, student satisfaction, organizational image

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74 Early Initiation of Breastfeeding and Its Determinants among Non-Caesarean Deliveries at Primary and Secondary Health Facilities: A Case Observational Study

Authors: Farhana Karim, Abdullah N. S. Khan, Mohiuddin A. K. Chowdhury, Nabila Zaka, Alexander Manu, Shams El Arifeen, Sk Masum Billah

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Breastfeeding, an integral part of newborn care, can reduce 55-87% of all-cause neonatal mortality and morbidity. Early initiation of breastfeeding within 1 hour of birth can avert 22% of newborn mortality. Only 45% of world’s newborns and 42% of newborns in South-Asia are put to the breast within one hour of birth. In Bangladesh, only a half of the mothers practice early initiation of breastfeeding which is less likely to be practiced if the baby is born in a health facility. This study aims to generate strong evidence for early initiation of breastfeeding practices in the government health facilities and to explore the associated factors influencing the practice. The study was conducted in selected health facilities in three neighbouring districts of Northern Bangladesh. Total 249 normal vaginal delivery cases were observed for 24 hours since the time of birth. The outcome variable was initiation of breastfeeding within 1 hour while the explanatory variables included type of health facility, privacy, presence of support person, stage of labour at admission, need for augmentation of labour, complications during delivery, need for episiotomy, spontaneous cry of the newborn, skin-to-skin contact with mother, post-natal contact with the service provider, receiving a post-natal examination and counselling on breastfeeding during postnatal contact. The simple descriptive statistics were employed to see the distribution of samples according to socio-demographic characteristics. Kruskal-Wallis test was carried out for testing the equality of medians among two or more categories of each variable and P-value is reported. A series of simple logistic regressions were conducted with all the potential explanatory variables to identify the determining factors for breastfeeding within 1 hour in a health facility. Finally, multiple logistic regression was conducted including the variables found significant at bi-variate analyses. Almost 90% participants initiated breastfeeding at the health facility and median time to initiate breastfeeding was 38 minutes. However, delivering in a sub-district hospital significantly delayed the breastfeeding initiation in comparison to delivering in a district hospital. Maintenance of adequate privacy and presence of separate staff for taking care of newborn significantly reduced the time in early breastfeeding initiation. Initiation time was found longer if the mother had an augmented labour, obstetric complications, and the newborn needed resuscitation. However, the initiation time was significantly early if the baby was put skin-to-skin on mother’s abdomen and received a postnatal examination by a provider. After controlling for the potential confounders, the odds of initiating breastfeeding within one hour of birth is higher if mother gives birth in a district hospital (AOR 3.0: 95% CI 1.5, 6.2), privacy is well-maintained (AOR 2.3: 95% CI 1.1, 4.5), babies cry spontaneously (AOR 7.7: 95% CI 3.3, 17.8), babies are put to skin-to-skin contact with mother (AOR 4.6: 95% CI 1.9, 11.2) and if the baby is examined by a provider in the facility (AOR 4.4: 95% CI 1.4, 14.2). The evidence generated by this study will hopefully direct the policymakers to identify and prioritize the scopes for creating and supporting early initiation of breastfeeding in the health facilities.

Keywords: Bangladesh, early initiation of breastfeeding, health facility, normal vaginal delivery, skin to skin contact

Procedia PDF Downloads 122
73 Assessment of Rooftop Rainwater Harvesting in Gomti Nagar, Lucknow

Authors: Rajkumar Ghosh

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Water scarcity is a pressing issue in urban areas, even in smart cities where efficient resource management is a priority. This scarcity is mainly caused by factors such as lifestyle changes, excessive groundwater extraction, over-usage of water, rapid urbanization, and uncontrolled population growth. In the specific case of Gomti Nagar, Lucknow, Uttar Pradesh, India, the depletion of groundwater resources is particularly severe, leading to a water imbalance and posing a significant challenge for the region's sustainable development. The aim of this study is to address the water shortage in the Gomti Nagar region by focusing on the implementation of artificial groundwater recharge methods. Specifically, the research aims to investigate the effectiveness of rainwater collection through rooftop rainwater harvesting systems (RTRWHs) as a sustainable approach to reduce aquifer depletion and bridge the gap between groundwater recharge and extraction. The research methodology for this study involves the utilization of RTRWHs as the main method for collecting rainwater. This approach is considered effective in managing and conserving water resources in a sustainable manner. The focus is on implementing RTRWHs in residential and commercial buildings to maximize the collection of rainwater and its subsequent utilization for various purposes in the Gomti Nagar region. The study reveals that the installation of RTRWHs in the Gomti Nagar region has a positive impact on addressing the water scarcity issue. Currently, RTRWHs cover only a small percentage (0.04%) of the total rainfall collected in the region. However, when RTRWHs are installed in all buildings, their influence on increasing water availability and reducing aquifer depletion will be significantly greater. The study also highlights the significant water imbalance of 24519 ML/yr in the region, emphasizing the urgent need for sustainable water management practices. This research contributes to the theoretical understanding of sustainable water management systems in smart cities. By highlighting the effectiveness of RTRWHs in reducing aquifer depletion, it emphasizes the importance of implementing such systems in urban areas. The findings of this study can serve as a basis for policymakers, urban planners, and developers to prioritize and incentivize the installation of RTRWHs as a potential solution to the water shortage crisis. The data for this study were collected through various sources such as government reports, surveys, and existing groundwater abstraction patterns. The collected data were then analysed to assess the current water situation, groundwater depletion rate, and the potential impact of implementing RTRWHs. Statistical analysis and modelling techniques were employed to quantify the water imbalance and evaluate the effectiveness of RTRWHs. The findings of this study demonstrate that the implementation of RTRWHs can effectively mitigate the water scarcity crisis in Gomti Nagar. By reducing aquifer depletion and bridging the gap between groundwater recharge and extraction, RTRWHs offer a sustainable solution to the region's water scarcity challenges. The study highlights the need for widespread adoption of RTRWHs in all buildings and emphasizes the importance of integrating such systems into the urban planning and development process. By doing so, smart cities like Gomti Nagar can achieve efficient water management, ensuring a better future with improved water availability for its residents.

Keywords: rooftop rainwater harvesting, rainwater, water management, aquifer

Procedia PDF Downloads 61
72 Ecological Planning Method of Reclamation Area Based on Ecological Management of Spartina Alterniflora: A Case Study of Xihu Harbor in Xiangshan County

Authors: Dong Yue, Hua Chen

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The study region Xihu Harbor in Xiangshan County, Ningbo City is located in the central coast of Zhejiang Province. Concerning the wave dispating issue, Ningbo government firstly introduced Spartina alterniflora in 1980s. In the 1990s, S. alterniflora spread so rapidly thus a ‘grassland’ in the sea has been created nowadays. It has become the most important invasive plant of China’s coastal tidal flats. Although S. alterniflora had some ecological and economic functions, it has also brought series of hazards. It has ecological hazards on many aspects, including biomass and biodiversity, hydrodynamic force and sedimentation process, nutrient cycling of tidal flat, succession sequence of soil and plants and so on. On engineering, it courses problems of poor drainage and channel blocking. On economy, the hazard mainly reflected in the threat on aquaculture industry. The purpose of this study is to explore an ecological, feasible and economical way to manage Spartina alterniflora and use the land formed by it, taking Xihu Harbor in Xiangshan County as a case. Comparison method, mathematical modeling, qualitative and quantitative analysis are utilized to proceed the study. Main outcomes are as follows. By comparing a series of S. alterniflora managing methods which include the combination of mechanical cutting and hydraulic reclamation, waterlogging, herbicide and biological substitution from three standpoints – ecology, engineering and economy. It is inferred that the combination of mechanical cutting and hydraulic reclamation is among the top rank of S. alternifora managing methods. The combination of mechanical cutting and hydraulic reclamation means using large-scale mechanical equipment like large screw seagoing dredger to excavate the S. alterniflora with root and mud together. Then the mix of mud and grass was blown off nearby coastal tidal zone transported by pipelines, which can cushion the silt of tidal zone to form a land. However, as man-made land by coast, the reclamation area’s ecological sensitivity is quite high and will face high possibility of flood threat. Therefore, the reclamation area has many reasonability requirements, including ones on location, specific scope, water surface rate, direction of main watercourse, site of water-gate, the ratio of ecological land to urban construction land. These requirements all became important basis when the planning was being made. The water system planning, green space system planning, road structure and land use all need to accommodate the ecological requests. Besides, the profits from the formed land is the managing project’s source of funding, so how to utilize land efficiently is another considered point in the planning. It is concluded that by aiming at managing a large area of S. alterniflora, the combination of mechanical cutting and hydraulic reclamation is an ecological, feasible and economical method. The planning of reclamation area should fully respect the natural environment and possible disasters. Then the planning which makes land use efficient, reasonable, ecological will promote the development of the area’s city construction.

Keywords: ecological management, ecological planning method, reclamation area, Spartina alternifora, Xihu harbor

Procedia PDF Downloads 288
71 Accurate Energy Assessment Technique for Mine-Water District Heat Network

Authors: B. Philip, J. Littlewood, R. Radford, N. Evans, T. Whyman, D. P. Jones

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UK buildings and energy infrastructures are heavily dependent on natural gas, a large proportion of which is used for domestic space heating. However, approximately half of the gas consumed in the UK is imported. Improving energy security and reducing carbon emissions are major government drivers for reducing gas dependency. In order to do so there needs to be a wholesale shift in the energy provision to householders without impacting on thermal comfort levels, convenience or cost of supply to the end user. Heat pumps are seen as a potential alternative in modern well insulated homes, however, can the same be said of older homes? A large proportion of housing stock in Britain was built prior to 1919. The age of the buildings bears testimony to the quality of construction; however, their thermal performance falls far below the minimum currently set by UK building standards. In recent years significant sums of money have been invested to improve energy efficiency and combat fuel poverty in some of the most deprived areas of Wales. Increasing energy efficiency of older properties remains a significant challenge, which cannot be achieved through insulation and air-tightness interventions alone, particularly when alterations to historically important architectural features of the building are not permitted. This paper investigates the energy demand of pre-1919 dwellings in a former Welsh mining village, the feasibility of meeting that demand using water from the disused mine workings to supply a district heat network and potential barriers to success of the scheme. The use of renewable solar energy generation and storage technologies, both thermal and electrical, to reduce the load and offset increased electricity demand, are considered. A wholistic surveying approach to provide a more accurate assessment of total household heat demand is proposed. Several surveying techniques, including condition surveys, air permeability, heat loss calculations, and thermography were employed to provide a clear picture of energy demand. Additional insulation can bring unforeseen consequences which are detrimental to the fabric of the building, potentially leading to accelerated dilapidation of the asset being ‘protected’. Increasing ventilation should be considered in parallel, to compensate for the associated reduction in uncontrolled infiltration. The effectiveness of thermal performance improvements are demonstrated and the detrimental effects of incorrect material choice and poor installation are highlighted. The findings show estimated heat demand to be in close correlation to household energy bills. Major areas of heat loss were identified such that improvements to building thermal performance could be targeted. The findings demonstrate that the use of heat pumps in older buildings is viable, provided sufficient improvement to thermal performance is possible. Addition of passive solar thermal and photovoltaic generation can help reduce the load and running cost for the householder. The results were used to predict future heat demand following energy efficiency improvements, thereby informing the size of heat pumps required.

Keywords: heat demand, heat pump, renewable energy, retrofit

Procedia PDF Downloads 75
70 Coastal Cliff Protection in Beit Yanai, Israel: Examination of Alternatives and Public Preference Analysis

Authors: Tzipi Eshet

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The primary objectives of this work are the examination of public preferences and attributed importance to different characteristics of coastal cliff protection alternatives, and drawing conclusions about the applicable alternative in Beit-Yanai beach. Erosion of coastal cliffs is a natural phenomenon that occurs in many places in the world. This creates problems along the coastlines, which are densely populated areas with highly developed economic activity. In recent years, various aspects of the aeolianite cliffs along the Israeli coast have been studied extensively. There is a consensus among researchers regarding a general trend of cliff retreat. This affects civilian infrastructure, wildlife habitats and heritage values, as well as Increases the risk to human life. The Israeli government, committed to the integrated coastal zones management approach, decided on a policy and guidelines to deal with cliff erosion, which includes establishing physical protection on land and in the sea, sand nourishment and runoff drainage. Physical protection solutions to reduce the rate of retreat of the cliffs are considerably important both for planning authorities and visitors to the beach. Direct costs of different protection alternatives, as well as external costs and benefits, may vary, thus affecting consumer preferences. Planning and execution of sustainable coastal cliff protection alternatives must take into account the different characteristics and their impact on aspects of economics, environment and leisure. The rocky shore of Beit-Yanai Beach was chosen as a case study to examine the nature of the influence of various protective solutions on consumer preferences. This beach is located in the center of Israel's coastline, and acts as a focus of attraction for recreation, land and sea sports, and educational activities as well. If no action will be taken, cliff retreat will continue. A survey was conducted to reveal the importance of coastal protection alternatives characteristics and the visual preferences to visitors at beach Beit-Yanai and residents living on the cliff (N=287). Preferences and willingness-to-pay were explored using Contingent-Ranking and Choice-Experiments techniques. Results show that visitors’ and residents’ willingness-to-pay for coastal cliff protection alternatives is affected both by financial and environmental aspects, as well as leisure. They prefer coastal cliff protection alternatives that are not visible and do not need constant maintenance, do not affect the quality of seawater or the habitats of wildlife and do not lower the security level of the swimmers. No significant difference was found comparing willingness-to-pay among local and non-local users. Additionally, they mostly prefer a protection solution which is integrated in the coastal landscape and maintains the natural appearance of the beach. Of the possible protection alternatives proposed for the protection of the cliff in Beit Yanai beach are two techniques that meet public preferences: rock revetments and submerged detached breakwaters. Results indicate that the visiting public prefer the implementation of these protection alternatives and will be willing to pay for them. Future actions to reduce retreat rate in Beit-Yanai have to consider implications on the economic, environmental and social conditions, along with weighting public interest against the interest of the individual.

Keywords: contingent-ranking, choice-experiments, coastal cliff protection, erosion of coastal cliffs, environment

Procedia PDF Downloads 267
69 Simulation-based Decision Making on Intra-hospital Patient Referral in a Collaborative Medical Alliance

Authors: Yuguang Gao, Mingtao Deng

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The integration of independently operating hospitals into a unified healthcare service system has become a strategic imperative in the pursuit of hospitals’ high-quality development. Central to the concept of group governance over such transformation, exemplified by a collaborative medical alliance, is the delineation of shared value, vision, and goals. Given the inherent disparity in capabilities among hospitals within the alliance, particularly in the treatment of different diseases characterized by Disease Related Groups (DRG) in terms of effectiveness, efficiency and resource utilization, this study aims to address the centralized decision-making of intra-hospital patient referral within the medical alliance to enhance the overall production and quality of service provided. We first introduce the notion of production utility, where a higher production utility for a hospital implies better performance in treating patients diagnosed with that specific DRG group of diseases. Then, a Discrete-Event Simulation (DES) framework is established for patient referral among hospitals, where patient flow modeling incorporates a queueing system with fixed capacities for each hospital. The simulation study begins with a two-member alliance. The pivotal strategy examined is a "whether-to-refer" decision triggered when the bed usage rate surpasses a predefined threshold for either hospital. Then, the decision encompasses referring patients to the other hospital based on DRG groups’ production utility differentials as well as bed availability. The objective is to maximize the total production utility of the alliance while minimizing patients’ average length of stay and turnover rate. Thus the parameter under scrutiny is the bed usage rate threshold, influencing the efficacy of the referral strategy. Extending the study to a three-member alliance, which could readily be generalized to multi-member alliances, we maintain the core setup while introducing an additional “which-to-refer" decision that involves referring patients with specific DRG groups to the member hospital according to their respective production utility rankings. The overarching goal remains consistent, for which the bed usage rate threshold is once again a focal point for analysis. For the two-member alliance scenario, our simulation results indicate that the optimal bed usage rate threshold hinges on the discrepancy in the number of beds between member hospitals, the distribution of DRG groups among incoming patients, and variations in production utilities across hospitals. Transitioning to the three-member alliance, we observe similar dependencies on these parameters. Additionally, it becomes evident that an imbalanced distribution of DRG diagnoses and further disparity in production utilities among member hospitals may lead to an increase in the turnover rate. In general, it was found that the intra-hospital referral mechanism enhances the overall production utility of the medical alliance compared to individual hospitals without partnership. Patients’ average length of stay is also reduced, showcasing the positive impact of the collaborative approach. However, the turnover rate exhibits variability based on parameter setups, particularly when patients are redirected within the alliance. In conclusion, the re-structuring of diagnostic disease groups within the medical alliance proves instrumental in improving overall healthcare service outcomes, providing a compelling rationale for the government's promotion of patient referrals within collaborative medical alliances.

Keywords: collaborative medical alliance, disease related group, patient referral, simulation

Procedia PDF Downloads 25
68 A Scoping Review of Technology-Facilitated Gender-Based Violence: Findings from Asia

Authors: Vaiddehi Bansal, Laura Hinson, Mayumi Rezwan, Erin Leasure, Mithila Iyer, Connor Roth, Poulomi Pal, Kareem Kysia

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As digital usage becomes increasingly ubiquitous worldwide, technology-facilitated gender-based violence (GBV) has garnered increasing attention in the recent years, especially during the COVID-19 pandemic. This form of violence is defined as “action by one or more people that harms others based on their sexual or gender identity or by enforcing harmful gender norms. This action is carried out using the internet and/or mobile technology that harms others based on their sexual or gender identity or by enforcing harmful gender norms”.Common forms of technology-facilitated GBV include cyberstalking, cyberbullying, sexual harassment, image-based abuse, doxing, hacking, gendertrolling, hate speech, and impersonation. Most literature on this pervasive yet complex issue has emerged from high-income countries, and few studies comprehensively summarize its prevalence, manifestations, and implications. This rigorous scoping review examines the evidence base of this phenomenon in low and middle-income countries across Asia, summarizing trends and gaps to inform actionable recommendations. The research team developed search terms to conduct a comprehensive search of peer-reviewed and grey literature. Query results were eligible for inclusion if they were published in English between 2006-2021 and with an explicit emphasis on technology-facilitated violence, gender, and the countries of interest in the Asia region. Title, abstracts, and full-texts were independently screened by two reviewers based on inclusion criteria, and data was extracted through deductive coding. Of 2,042 articles screened, 97 met inclusion criteria. The review revealed a gap in the evidence-base in Central Asia and the Pacific Islands. Findings across South and Southeast Asia indicate that technology-facilitated GBV comprises various forms of abuse, violence, and harassment that are largely shaped by country-specific societal norms and technological landscapes. The literature confirms that women, girls, and sexual minorities, especially those with intersecting marginalized identities, are often more vulnerable to experiencing online violence. Cultural norms and patriarchal structures tend to stigmatize survivors, limiting their ability to seek social and legal support. Survivors are also less likely to report their experience due to barriers such as lack of awareness of reporting mechanisms, the perception that digital platforms will not address their complaints, and cumbersome reporting systems. The COVID-19 pandemic has further exacerbated perpetration and strained support mechanisms. Prevalence varies by the form of violence but is difficult to estimate accurately due to underreporting and disjointed, outdated, or non-existent legal definitions. Addressing technology-facilitated GBV in Asia requires collective action from multiple actors, including government authorities, technology companies, digital and feminist movements, NGOs, and researchers.

Keywords: gender-based violence, technology, online sexual harassment, image-based abuse

Procedia PDF Downloads 98
67 Environmental Risk of Pharmaceuticals, Drugs of Abuse and Stimulant Caffeine in Marine Water: A Case Study in the North-Western of Spain

Authors: Raquel Dafouz Neus Cáceres, Javier Fernandez-Rubio, Belinda Huerta José Luis Rodríguez-Gil, Nicola Mastroianni, Miren López de Alda, Damià Barceló, Yolanda Valcárcel

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The region of Galicia, found in north-western (NW) Spain, is a national and world leader in shellfish, especially mussel production, and recognized for its fishing industry. Few studies have evaluated the presence of emerging contaminants in NW Spain, with those published mainly concerning the continental aquatic environment. The objective of this study was to identify the environmental risk posed by the presence of pharmaceuticals and drugs of abuse in this important coastal region. The presence of sixteen pharmaceuticals (benzodiazepines, anxiolytics, and caffeine), and 19 drugs of abuse (cocainics, amphetamine-like compounds, opiates and opioids, lysergic compounds, and cannabinoids) was assessed in 23 sites located in the Rías (Coastal inlets) of Muros, Arousa, and Pontevedra (NW Spain). Twenty-two of these locations were affected by waste-water treatment plant (WWTP) effluents, and one represented the effluent of one of these WWTPs. Venlafaxine was the pharmaceutical compound detected at higher concentration in the three Rías, with a maximum value of 291 ng/L at the site Porto do Son (Ría de Muros). Total concentration in the three Rías was 819,26 ng/L. Next, citalopram and lorazepam were the most prevalent compounds detected. Metabolite of cocaine benzoylecgonine was the drug of abuse with the highest concentration, measured at 972 ng/L in the Ría of Noia WWTP (no dilution). This compound was also detected at 142 ng/L in the site La Isla de Aros, Ría of Pontevedra. Total concentration for the three Rías was 1210 ng/L. Ephedrine was also detected at high level in the three Rías, with a total concentration of 579,28 ng/L. The results obtained for caffeine show maximum and average concentrations of 857 ng/L Isla de Arosa, Ría de Pontevedra the highest measured in seawater in Spain. A preliminary hazard assessment was carried out by comparing these measured environmental concentrations (MEC) to predicted no-effect concentrations (PNECs) for aquatic organisms. Six out of the 22 seawater samples resulted in a Hazard Quotient (HQ) from chronic exposure higher than 1 with the highest being 17.14, indicating a high probability of adverse effects in the aquatic environment. In addition, the risk was assessed on the basis of persistence, bioaccumulation, and toxicity (PBT). This work was financially supported by the Spanish Ministry of Economy and Competitiveness through the Carlos III Health Institute and the program 'Proyectos de Investigacion en Salud 2015-2017' FIS (PI14/00516), the European Regional Development Fund (ERDF), the Catalan Government (Consolidated Research Groups '2014 SGR 418 - Water and Soil Quality Unit' and 2014 SGR 291 - ICRA), and the European Union’s Seventh Framework Programme for research, technological development and demonstration under grant agreement no. 603437. The poster entitled 'Environmental Risk of Pharmaceuticals, Drugs of Abuse and Stimulant Caffeine in Marine Water: A Case Study in the North-Western of Spain'.

Keywords: drug of abuse, pharmaceuticals, caffeine, environmental risk, seawater

Procedia PDF Downloads 195
66 Analyzing the Effectiveness of Elderly Design and the Impact on Sustainable Built Environment

Authors: Tristance Kee

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With an unprecedented increase in elderly population around the world, the severe lack of quality housing and health-and-safety provisions to serve this cohort cannot be ignored any longer. Many elderly citizens, especially singletons, live in unsafe housing conditions with poorly executed planning and design. Some suffer from deteriorating mobility, sight and general alertness and their sub-standard living conditions further hinder their daily existence. This research explains how concepts such as Universal Design and Co-Design operate in a high density city such as Hong Kong, China where innovative design can become an alternative solution where government and the private sector fail to provide quality elderly friendly facilities to promote a sustainable urban development. Unlike other elderly research which focuses more on housing policies, nursing care and theories, this research takes a more progressive approach by providing an in-depth impact assessment on how innovative design can be practical solutions for creating a more sustainable built environment. The research objectives are to: 1) explain the relationship between innovative design for elderly and a healthier and sustainable environment; 2) evaluate the impact of human ergonomics with the use of universal design; and 3) explain how innovation can enhance the sustainability of a city in improving citizen’s sight, sound, walkability and safety within the ageing population. The research adopts both qualitative and quantitative methodologies to examine ways to improve elderly population’s relationship to our built environment. In particular, the research utilizes collected data from questionnaire survey and focus group discussions to obtain inputs from various stakeholders, including designers, operators and managers related to public housing, community facilities and overall urban development. In addition to feedbacks from end-users and stakeholders, a thorough analysis on existing elderly housing facilities and Universal Design provisions are examined to evaluate their adequacy. To echo the theme of this conference on Innovation and Sustainable Development, this research examines the effectiveness of innovative design in a risk-benefit factor assessment. To test the hypothesis that innovation can cater for a sustainable development, the research evaluated the health improvement of a sample size of 150 elderly in a period of eight months. Their health performances, including mobility, speech and memory are monitored and recorded on a regular basis to assess if the use of innovation does trigger impact on improving health and home safety for an elderly cohort. This study was supported by district community centers under the auspices of Home Affairs Bureau to provide respondents for questionnaire survey, a standardized evaluation mechanism, and professional health care staff for evaluating the performance impact. The research findings will be integrated to formulate design solutions such as innovative home products to improve elderly daily experience and safety with a particular focus on the enhancement on sight, sound and mobility safety. Some policy recommendations and architectural planning recommendations related to Universal Design will also be incorporated into the research output for future planning of elderly housing and amenity provisions.

Keywords: elderly population, innovative design, sustainable built environment, universal design

Procedia PDF Downloads 203
65 Income Generation and Employment Opportunity of the Entrepreneurs and Farmers Through Production, Processing, and Marketing of Medicinal Plants in Bangladesh

Authors: Md. Nuru Miah, A. F. M. Akhter Uddin

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Medicinal plants are grown naturally in a tropical environment in Bangladesh and used as drug and therapeutic agents in the health care system. According to Bangladesh Agricultural Research Institute (BARI), there are 722 species of medicinal plants in the country. Of them, 255 plants are utilized by the manufacturers of Ayurvedic and Unani medicines. Medicinal plants like Aloevera, Ashwagonda, shotomul,Tulsi, Vuikumra, Misridana are extensively cultivated in some selected areas as well; where Aloevera scored the highest position in production. In the early 1980, Ayurvedic and Unani companies procured 80 percent of medicinal plants from natural forests, and the rest 20 percent was imported. Now the scenario has changed; 80 percent is imported, and the rest 20 percent is collected from local products(Source: Astudy on sectorbased need assessment of Business promotion council-Herbal products and medicinal plants, page-4). Uttara Development Program Society, a leading Non- Government development organization in Bangladesh, has been implementing a value chain development project under promoting Agricultural commercialization and Enterprises of Pally Karma Sahayak Foundation (PKSF) funded by the International Fund for Agricultural Development (IFAD) in Natore Sadar Upazila from April 2017 to sustainably develop the technological interventions for products and market development. The ultimate goal of the project is to increase income, generate employment and develop this sector as a sustainable business enterprise. Altogether 10,000 farmers (Nursery owners, growers, input supplier, processors, whole sellers, and retailers) are engaged in different activities of the project. The entrepreneurs engaged in medicinal plant cultivation did not know and follow environmental and good agricultural practices. They used to adopt traditional methodology in production and processing. Locally the farmers didn’t have any positive initiative to expand their business as well as developvalue added products. A lot of diversified products could be possible to develop and marketed with the introduction of post-harvest processing technology and market linkage with the local and global buyer. Training is imparted to the nursery owners and herbal growers on production technologies, sowing method, use of organic fertilizers/compost/pesticides, harvesting procedures, and storage facilities. Different types of herbal tea like Rosella, Moringa, Tulshi, and Basak are being produced and packed locally with a good scope of its marketing in different cities of the country. The project has been able to achieve a significant impact in the development of production technologies, but still, there is room for further improvement in processing, packaging, and marketing level. The core intervention of the current project to develop some entrepreneurs for branding, packaging, promotion, and marketing while considering environment friendly practices. The present strategies will strengthen the knowledge and skills of the entrepreneurs for the production and marketing of their products, maintaining worldwide accepted compliance system for easy access to the global market.

Keywords: aloe vera, herbs and shrubs, market, interventions

Procedia PDF Downloads 61
64 Heritage, Cultural Events and Promises for Better Future: Media Strategies for Attracting Tourism during the Arab Spring Uprisings

Authors: Eli Avraham

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The Arab Spring was widely covered in the global media and the number of Western tourists traveling to the area began to fall. The goal of this study was to analyze which media strategies marketers in Middle Eastern countries chose to employ in their attempts to repair the negative image of the area in the wake of the Arab Spring. Several studies were published concerning image-restoration strategies of destinations during crises around the globe; however, these strategies were not part of an overarching theory, conceptual framework or model from the fields of crisis communication and image repair. The conceptual framework used in the current study was the ‘multi-step model for altering place image’, which offers three types of strategies: source, message and audience. Three research questions were used: 1.What public relations crisis techniques and advertising campaign components were used? 2. What media policies and relationships with the international media were adopted by Arab officials? 3. Which marketing initiatives (such as cultural and sports events) were promoted? This study is based on qualitative content analysis of four types of data: 1) advertising components (slogans, visuals and text); (2) press interviews with Middle Eastern officials and marketers; (3) official media policy adopted by government decision-maker (e.g. boycotting or arresting newspeople); and (4) marketing initiatives (e.g. organizing heritage festivals and cultural events). The data was located in three channels from December 2010, when the events started, to September 31, 2013: (1) Internet and video-sharing websites: YouTube and Middle Eastern countries' national tourism board websites; (2) News reports from two international media outlets, The New York Times and Ha’aretz; these are considered quality newspapers that focus on foreign news and tend to criticize institutions; (3) Global tourism news websites: eTurbo news and ‘Cities and countries branding’. Using the ‘multi-step model for altering place image,’ the analysis reveals that Middle Eastern marketers and officials used three kinds of strategies to repair their countries' negative image: 1. Source (cooperation and media relations; complying, threatening and blocking the media; and finding alternatives to the traditional media) 2. Message (ignoring, limiting, narrowing or reducing the scale of the crisis; acknowledging the negative effect of an event’s coverage and assuring a better future; promotion of multiple facets, exhibitions and softening the ‘hard’ image; hosting spotlight sporting and cultural events; spinning liabilities into assets; geographic dissociation from the Middle East region; ridicule the existing stereotype) and 3. Audience (changing the target audience by addressing others; emphasizing similarities and relevance to specific target audience). It appears that dealing with their image problems will continue to be a challenge for officials and marketers of Middle Eastern countries until the region stabilizes and its regional conflicts are resolved.

Keywords: Arab spring, cultural events, image repair, Middle East, tourism marketing

Procedia PDF Downloads 259
63 Economic Impacts of Sanctuary and Immigration and Customs Enforcement Policies Inclusive and Exclusive Institutions

Authors: Alexander David Natanson

Abstract:

This paper focuses on the effect of Sanctuary and Immigration and Customs Enforcement (ICE) policies on local economies. "Sanctuary cities" refers to municipal jurisdictions that limit their cooperation with the federal government's efforts to enforce immigration. Using county-level data from the American Community Survey and ICE data on economic indicators from 2006 to 2018, this study isolates the effects of local immigration policies on U.S. counties. The investigation is accomplished by simultaneously studying the policies' effects in counties where immigrants' families are persecuted via collaboration with Immigration and Customs Enforcement (ICE), in contrast to counties that provide protections. The analysis includes a difference-in-difference & two-way fixed effect model. Results are robust to nearest-neighbor matching, after the random assignment of treatment, after running estimations using different cutoffs for immigration policies, and with a regression discontinuity model comparing bordering counties with opposite policies. Results are also robust after restricting the data to a single-year policy adoption, using the Sun and Abraham estimator, and with event-study estimation to deal with the staggered treatment issue. In addition, the study reverses the estimation to understand what drives the decision to choose policies to detect the presence of reverse causality biases in the estimated policy impact on economic factors. The evidence demonstrates that providing protections to undocumented immigrants increases economic activity. The estimates show gains in per capita income ranging from 3.1 to 7.2, median wages between 1.7 to 2.6, and GDP between 2.4 to 4.1 percent. Regarding labor, sanctuary counties saw increases in total employment between 2.3 to 4 percent, and the unemployment rate declined from 12 to 17 percent. The data further shows that ICE policies have no statistically significant effects on income, median wages, or GDP but adverse effects on total employment, with declines from 1 to 2 percent, mostly in rural counties, and an increase in unemployment of around 7 percent in urban counties. In addition, results show a decline in the foreign-born population in ICE counties but no changes in sanctuary counties. The study also finds similar results for sanctuary counties when separating the data between urban, rural, educational attainment, gender, ethnic groups, economic quintiles, and the number of business establishments. The takeaway from this study is that institutional inclusion creates the dynamic nature of an economy, as inclusion allows for economic expansion due to the extension of fundamental freedoms to newcomers. Inclusive policies show positive effects on economic outcomes with no evident increase in population. To make sense of these results, the hypothesis and theoretical model propose that inclusive immigration policies play an essential role in conditioning the effect of immigration by decreasing uncertainties and constraints for immigrants' interaction in their communities, decreasing the cost from fear of deportation or the constant fear of criminalization and optimize their human capital.

Keywords: inclusive and exclusive institutions, post matching, fixed effect, time trend, regression discontinuity, difference-in-difference, randomization inference and sun, Abraham estimator

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62 Temporal Delays along the Neurosurgical Care Continuum for Traumatic Brain Injury Patients in Mulago Hospital in Kampala Uganda

Authors: Silvia D. Vaca, Benjamin J. Kuo, Joao Ricardo N. Vissoci, Catherine A. Staton, Linda W. Xu, Michael Muhumuza, Hussein Ssenyonjo, John Mukasa, Joel Kiryabwire, Henry E. Rice, Gerald A. Grant, Michael M. Haglund

Abstract:

Background: While delays to care exist in resource rich settings, greater delays are seen along the care continuum in low- and middle-income countries (LMICs) largely due to limited healthcare capacity to address the disproportional rates of traumatic brain injury (TBI) in Sub Saharan Africa (SSA). While many LMICs have government subsidized systems to offset surgical costs, the burden of securing funds by the patients for medications, supplies, and CT diagnostics poses a significant challenge to timely surgical interventions. In Kampala Uganda, the challenge of obtaining timely CT scans is twofold. First, due to a lack of a functional CT scanner at the tertiary hospital, patients need to arrange their own transportation to the nearby private facility for CT scans. Second, self-financing for the private CT scans ranges from $80 - $130, which is near the average monthly income in Kampala. These bottlenecks contribute significantly to the care continuum delays and are associated with poor TBI outcomes. Objective: The objectives of this study are to 1) describe the temporal delays through a modified three delays model that fits the context of neurosurgical interventions for TBI patients in Kampala and 2) investigate the association between delays and mortality. Methods: Prospective data were collected for 563 TBI patients presenting to a tertiary hospital in Kampala from 1 June – 30 November 2016. Four time intervals were constructed along five time points: injury, hospital arrival, neurosurgical evaluation, CT results, and definitive surgery. Time interval differences among mild, moderate and severe TBI and their association with mortality were analyzed. Results: The mortality rate of all TBI patients presenting to MNRH was 9.6%, which ranged from 4.7% for mild and moderate TBI patients receiving surgery to 81.8% for severe TBI patients who failed to receive surgery. The duration from injury to surgery varied considerably across TBI severity with the largest gap seen between mild TBI (174 hours) and severe TBI (69 hours) patients. Further analysis revealed care continuum differences for interval 3 (neurosurgical evaluation to CT result) and 4 (CT result to surgery) between severe TBI patients (7 hours for interval 3 and 24 hours for interval 4) and mild TBI patients (19 hours for interval 3, and 96 hours for interval 4). These post-arrival delays were associated with mortality for mild (p=0.05) and moderate TBI (p=0.03) patients. Conclusions: To our knowledge, this is the first analysis using a modified ‘three delays’ framework to analyze the care continuum of TBI patients in Uganda from injury to surgery. We found significant associations between delays and mortality for mild and moderate TBI patients. As it currently stands, poorer outcomes were observed for these mild and moderate TBI patients who were managed non-operatively or failed to receive surgery while surgical services were shunted to more severely ill patients. While well intentioned, high mortality rates were still observed for the severe TBI patients managed surgically. These results suggest the need for future research to optimize triage practices, understand delay contributors, and improve pre-hospital logistical referral systems.

Keywords: care continuum, global neurosurgery, Kampala Uganda, LMIC, Mulago, prospective registry, traumatic brain injury

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61 Mean Nutrient Intake and Nutrient Adequacy Ratio in India: Occurrence of Hidden Hunger in Indians

Authors: Abha Gupta, Deepak K. Mishra

Abstract:

The focus of food security studies in India has been on the adequacy of calories and its linkage with poverty level. India currently being undergoing a massive demographic and epidemiological transition has demonstrated a decline in average physical activity with improved mechanization and urbanization. Food consumption pattern is also changing with decreasing intake of coarse cereals and a marginal increase in the consumption of fruits, vegetables and meat products resulting into a nutrition transition in the country. However, deficiency of essential micronutrients such as vitamins and minerals is rampant despite their growing importance in fighting back with lifestyle and other modern diseases. The calorie driven studies can hardly tackle the complex problem of malnutrition. This paper fills these research lacuna and analyses mean intake of different major and micro-nutrients among different socio-economic groups and adequacy of these nutrients from recommended dietary allowance. For the purpose, a cross-sectional survey covering 304 households selected through proportional stratified random sampling was conducted in six villages of Aligarh district of the state of Uttar Pradesh, India. Data on quantity consumed of 74 food items grouped into 10 food categories with a recall period of seven days was collected from the households and converted into energy, protein, fat, carbohydrate, calcium, iron, thiamine, riboflavin, niacin and vitamin C using standard guidelines of National Institute of Nutrition. These converted nutrients were compared with recommended norms given by National Nutrition Monitoring Bureau. Per capita nutrient adequacy was calculated by dividing mean nutrient intake by the household size and then by comparing it with recommended norm. Findings demonstrate that source of both macro and micro-nutrients are mainly cereals followed by milk, edible oil and sugar items. Share of meat in providing essential nutrients is very low due to vegetarian diet. Vegetables, pulses, nuts, fruits and dry fruits are a poor source for most of the nutrients. Further analysis evinces that intake of most of the nutrients is higher than the recommended norm. Riboflavin is the only vitamin whose intake is less than the standard norm. Poor group, labour, small farmers, Muslims, scheduled caste demonstrate comparatively lower intake of all nutrients than their counterpart groups, though, they get enough macro and micro-nutrients significantly higher than the norm. One of the major reasons for higher intake of most of the nutrients across all socio-economic groups is higher consumption of monotonous diet based on cereals and milk. Most of the nutrients get their major share from cereals particularly wheat and milk intake. It can be concluded from the analysis that although there is adequate intake of most of the nutrients in the diet of rural population yet their source is mainly cereals and milk products depicting a monotonous diet. Hence, more efforts are needed to diversify the diet by giving more focus to the production of other food items particularly fruits, vegetables and pulse products. Awareness among the population, more accessibility and incorporating food items other than cereals in government social safety programmes are other measures to improve food security in India.

Keywords: hidden hunger, India, nutrients, recommended norm

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60 Challenges for Reconstruction: A Case Study from 2015 Gorkha, Nepal Earthquake

Authors: Hari K. Adhikari, Keshab Sharma, K. C. Apil

Abstract:

The Gorkha Nepal earthquake of moment magnitude (Mw) 7.8 hit the central region of Nepal on April 25, 2015; with the epicenter about 77 km northwest of Kathmandu Valley. This paper aims to explore challenges of reconstruction in the rural earthquake-stricken areas of Nepal. The Gorkha earthquake on April 25, 2015, has significantly affected the livelihood of people and overall economy in Nepal, causing severe damage and destruction in central Nepal including nation’s capital. A larger part of the earthquake affected area is difficult to access with rugged terrain and scattered settlements, which posed unique challenges and efforts on a massive scale reconstruction and rehabilitation. 800 thousand buildings were affected leaving 8 million people homeless. Challenge of reconstruction of optimum 800 thousand houses is arduous for Nepal in the background of its turmoil political scenario and weak governance. With significant actors involved in the reconstruction process, no appreciable relief has reached to the ground, which is reflected over the frustration of affected people. The 2015 Gorkha earthquake is one of most devastating disasters in the modern history of Nepal. Best of our knowledge, there is no comprehensive study on reconstruction after disasters in modern Nepal, which integrates the necessary information to deal with challenges and opportunities of reconstructions. The study was conducted using qualitative content analysis method. Thirty engineers and ten social mobilizes working for reconstruction and more than hundreds local social workers, local party leaders, and earthquake victims were selected arbitrarily. Information was collected through semi-structured interviews and open-ended questions, focus group discussions, and field notes, with no previous assumption. Author also reviewed literature and document reviews covering academic and practitioner studies on challenges of reconstruction after earthquake in developing countries such as 2001 Gujarat earthquake, 2005 Kashmir earthquake, 2003 Bam earthquake and 2010 Haiti earthquake; which have very similar building typologies, economic, political, geographical, and geological conditions with Nepal. Secondary data was collected from reports, action plans, and reflection papers of governmental entities, non-governmental organizations, private sector businesses, and the online news. This study concludes that inaccessibility, absence of local government, weak governance, weak infrastructures, lack of preparedness, knowledge gap and manpower shortage, etc. are the key challenges of the reconstruction after 2015 earthquake in Nepal. After scrutinizing different challenges and issues, study counsels that good governance, integrated information, addressing technical issues, public participation along with short term and long term strategies to tackle with technical issues are some crucial factors for timely and quality reconstruction in context of Nepal. Sample collected for this study is relatively small sample size and may not be fully representative of the stakeholders involved in reconstruction. However, the key findings of this study are ones that need to be recognized by academics, governments, and implementation agencies, and considered in the implementation of post-disaster reconstruction program in developing countries.

Keywords: Gorkha earthquake, reconstruction, challenges, policy

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59 ESRA: An End-to-End System for Re-identification and Anonymization of Swiss Court Decisions

Authors: Joel Niklaus, Matthias Sturmer

Abstract:

The publication of judicial proceedings is a cornerstone of many democracies. It enables the court system to be made accountable by ensuring that justice is made in accordance with the laws. Equally important is privacy, as a fundamental human right (Article 12 in the Declaration of Human Rights). Therefore, it is important that the parties (especially minors, victims, or witnesses) involved in these court decisions be anonymized securely. Today, the anonymization of court decisions in Switzerland is performed either manually or semi-automatically using primitive software. While much research has been conducted on anonymization for tabular data, the literature on anonymization for unstructured text documents is thin and virtually non-existent for court decisions. In 2019, it has been shown that manual anonymization is not secure enough. In 21 of 25 attempted Swiss federal court decisions related to pharmaceutical companies, pharmaceuticals, and legal parties involved could be manually re-identified. This was achieved by linking the decisions with external databases using regular expressions. An automated re-identification system serves as an automated test for the safety of existing anonymizations and thus promotes the right to privacy. Manual anonymization is very expensive (recurring annual costs of over CHF 20M in Switzerland alone, according to an estimation). Consequently, many Swiss courts only publish a fraction of their decisions. An automated anonymization system reduces these costs substantially, further leading to more capacity for publishing court decisions much more comprehensively. For the re-identification system, topic modeling with latent dirichlet allocation is used to cluster an amount of over 500K Swiss court decisions into meaningful related categories. A comprehensive knowledge base with publicly available data (such as social media, newspapers, government documents, geographical information systems, business registers, online address books, obituary portal, web archive, etc.) is constructed to serve as an information hub for re-identifications. For the actual re-identification, a general-purpose language model is fine-tuned on the respective part of the knowledge base for each category of court decisions separately. The input to the model is the court decision to be re-identified, and the output is a probability distribution over named entities constituting possible re-identifications. For the anonymization system, named entity recognition (NER) is used to recognize the tokens that need to be anonymized. Since the focus lies on Swiss court decisions in German, a corpus for Swiss legal texts will be built for training the NER model. The recognized named entities are replaced by the category determined by the NER model and an identifier to preserve context. This work is part of an ongoing research project conducted by an interdisciplinary research consortium. Both a legal analysis and the implementation of the proposed system design ESRA will be performed within the next three years. This study introduces the system design of ESRA, an end-to-end system for re-identification and anonymization of Swiss court decisions. Firstly, the re-identification system tests the safety of existing anonymizations and thus promotes privacy. Secondly, the anonymization system substantially reduces the costs of manual anonymization of court decisions and thus introduces a more comprehensive publication practice.

Keywords: artificial intelligence, courts, legal tech, named entity recognition, natural language processing, ·privacy, topic modeling

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58 Competence of the Health Workers in Diagnosing and Managing Complicated Pregnancies: A Clinical Vignette Based Assessment in District and Sub-District Hospitals in Bangladesh

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

Abstract:

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

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

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57 Street Naming and Property Addressing Systems for New Development in Ghana: A Case Study of Nkawkaw in the Kwahu West Municipality

Authors: Jonathan Nii Laryea Ashong, Samuel Opare

Abstract:

Current sustainable cities debate focuses on the formidable problems for the Ghana’s largest urban and rural agglomerations, the majority of all urban dwellers continue to reside in far smaller urban settlements. It is estimated that by year 2030, almost all the Ghana’s population growth will likely be intense in urban areas including Nkawkaw in the Kwahu West Municipality of Ghana. Nkawkaw is situated on the road and former railway between Accra and Kumasi, and lies about halfway between these cities. It is also connected by road to Koforidua and Konongo. According to the 2013 census, Nkawkaw has a settlement population of 61,785. Many international agencies, government and private architectures’ are been asked to adequately recognize the naming of streets and property addressing system among the 170 districts across Ghana. The naming of streets and numbering of properties is to assist Metropolitan, Municipal and District Assemblies to manage the processes for establishing coherent address system nationally. Street addressing in the Nkawkaw in the Kwahu West Municipality which makes it possible to identify the location of a parcel of land, public places or dwellings on the ground based on system of names and numbers, yet agreement on how to progress towards it remains elusive. Therefore, reliable and effective development control for proper street naming and property addressing systems are required. The Intelligent Addressing (IA) technology from the UK is being used to name streets and properties in Ghana. The intelligent addressing employs the technique of unique property Reference Number and the unique street reference number which would transform national security and other service providers’ ability to respond rapidly to distress calls. Where name change is warranted following the review of existing streets names, the Physical Planning Department (PPDs) shall, in consultation with the relevant traditional authorities and community leadership (or relevant major stakeholders), select a street name in accordance with the provisions of the policy and the processes outlined for street name change for new development. In the case of existing streets with no names, the respective PPDs shall, in consultation with the relevant traditional authorities and community leadership (or relevant major stakeholders), select a street name in accordance with the requirements set out in municipality. Naming of access ways proposed for new developments shall be done at the time of developing sector layouts (subdivision maps) for the designated areas. In the case of private gated developments, the developer shall submit the names of the access ways as part of the plan and other documentation forwarded to the Municipal District Assembly for approval. The names shall be reviewed first by the PPD to avoid duplication and to ensure conformity to the required standards before submission to the Assembly’s Statutory Planning Committee for approval. The Kwahu West Municipality is supposed to be self-sustaining, providing basic services to inhabitants as a result of proper planning layouts, street naming and property addressing system that prevail in the area. The implications of these future projections are discussed.

Keywords: Nkawkaw, Kwahu west municipality, street naming, property, addressing system

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56 Top-Down, Middle-Out, Bottom-Up: A Design Approach to Transforming Prison

Authors: Roland F. Karthaus, Rachel S. O'Brien

Abstract:

Over the past decade, the authors have undertaken applied research aimed at enabling transformation within the prison service to improve conditions and outcomes for those living, working and visiting in prisons in the UK and the communities they serve. The research has taken place against a context of reducing resources and public discontent at increasing levels of violence, deteriorating conditions and persistently high levels of re-offending. Top-down governmental policies have mainly been ineffectual and in some cases counter-productive. The prison service is characterised by hierarchical organisation, and the research has applied design thinking at multiple levels to challenge and precipitate change: top-down, middle-out and bottom-up. The research employs three distinct but related approaches, system design (top-down): working at the national policy level to analyse the changing policy context, identifying opportunities and challenges; engaging with the Ministry of Justice commissioners and sector organisations to facilitate debate, introducing new evidence and provoking creative thinking, place-based design (middle-out): working with individual prison establishments as pilots to illustrate and test the potential for local empowerment, creative change, and improved architecture within place-specific contexts and organisational hierarchies, everyday design (bottom-up): working with individuals in the system to explore the potential for localised, significant, demonstrator changes; including collaborative design, capacity building and empowerment in skills, employment, communication, training, and other activities. The research spans a series of projects, through which the methodological approach has developed responsively. The projects include a place-based model for the re-purposing of Ministry of Justice land assets for the purposes of rehabilitation; an evidence-based guide to improve prison design for health and well-being; capacity-based employment, skills and self-build project as a template for future open prisons. The overarching research has enabled knowledge to be developed and disseminated through policy and academic networks. Whilst the research remains live and continuing; key findings are emerging as a basis for a new methodological approach to effecting change in the UK prison service. An interdisciplinary approach is necessary to overcome the barriers between distinct areas of the prison service. Sometimes referred to as total environments, prisons encompass entire social and physical environments which themselves are orchestrated by institutional arms of government, resulting in complex systems that cannot be meaningfully engaged through narrow disciplinary lenses. A scalar approach is necessary to connect strategic policies with individual experiences and potential, through the medium of individual prison establishments, operating as discrete entities within the system. A reflexive process is necessary to connect research with action in a responsive mode, learning to adapt as the system itself is changing. The role of individuals in the system, their latent knowledge and experience and their ability to engage and become agents of change are essential. Whilst the specific characteristics of the UK prison system are unique, the approach is internationally applicable.

Keywords: architecture, design, policy, prison, system, transformation

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