Search results for: health access

Authors: Lilian A. Okeke, I. Okeke, N. Waziri, S. Balogun, P. Nguku, O. Fawole

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Background: Access to ante-natal care services promotes safe motherhood and delivery with improved maternal and neonatal outcome. We conducted this study to identify factors influencing the utilization of antenatal care (ANC) and health delivery services. Methods: We conducted a cross sectional study. Households were numbered and a one in three sample was selected using a systematic sampling method. One hundred and ninety eight women who were either pregnant or had previous deliveries were interviewed using pretested structured questionnaires to obtain information on their socio-demographic characteristics, and reasons for non-utilization of ANC and health delivery services. We performed univariate and bivariate analysis using Epi info version 3.5.3. Results: The age of respondents ranged from (17-55 years) with a median age of 29 years. One hundred and ninety two (97%) utilized antenatal care services. Ninety three (47.9%) attended ANC at second trimester. More than half (58.6%) had ≥ 4 visits to ANC. One hundred and thirty one (66.2%) had their last delivery at home by a traditional birth attendant. Factors associated with ANC and health facility delivery services utilization were: age group 45-55 (OR 0.01; 95% CI: 0.00-0.16) and > 55 years (OR 0.03; 95% CI: 0.00-0.60), wife’s educational status (OR 3.17; 95% CI: 1.66-8.30), husband’s permission (OR 11.8; 95% CI 2.19-63.62), and distance ≥ 5km (OR 0.33; 95% CI: 0.16-0.60). Conclusion: ANC services were well utilized. Most women did not book early and had their last delivery at home. Predictors of ANC use and health facility delivery were age, wife’s educational status, husband's permission and long distance from health facility. A one-day health sensitization of the benefits of ANC utilization and the dangers of delivering at home was implemented.

Keywords: ante natal care, health facility, delivery services, rural area, Plateau state

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Authors: Regina Kulugomba, Richard Blanchard, Harold Mapoma, Gregory Gamula, Stanley Mlatho

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Malawi is a country with low energy access with only 10% of people having access to electricity and 97% of people relying on charcoal and fuel wood. The over dependence on the traditional biomass has brought in a number of negative consequences on people’s health and the environment. To curb the situation, the Government of Malawi (GoM), through its national policy of 2018 and charcoal strategies of 2007, identified biogas as a suitable alternative energy source for cooking. The GoM intends to construct tubular digesters across the country and one of the most crucial factors is the availability of livestock manure. The study was conducted to assess biogas potential from livestock manure by using Quantum Geographic information system (QGIS) software. Potential methane was calculated based on the population of livestock, amount of manure produced per capita and year, total solids, biogas yield and availability coefficient. The results of the study estimated biogas potential at 687 million m3 /year. Districts identified with highest biogas potential were Lilongwe, Ntcheu, Mangochi, Neno, Mwanza, Blantyre, Chiradzulu and Mulanje. The information will help investors and the Government of Malawi to locate potential sites for biogas plants installation.

Keywords: biogas, energy, feedstock, livestock

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Authors: S. Kershaw, P. J. Barry, K. Webb

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Background: Cystic Fibrosis (CF) is a chronic lung disease where patients have chronic lung infection punctuated by acute exacerbations that require intermittent intravenous (IV) antibiotics during their lives. With time, peripheral venous access can become difficult and limited. Accessing these veins can become arduous, traumatic, painful and unworkable. A permanent intravascular access device or Port is a small device that is inserted into the central venous system that allows the delivery of medicine eliminating the need for peripheral venous access. Ports represent a convenient and efficient method when venous access is required on a permanent basis however they are also associated with significant vascular complications. Superior Vena Cava Obstruction (SVCO) is a rare but significant vascular complication of ports in this setting. Objective: We aimed to look at a single CF centre’s experience of port-related SVCO over a thirty year period. Methods: Retrospective data was extracted using patient’s notes, electronic radiological reports and local databases over a period in excess of 30 years from 1982 to 2014. Results: 13 patients were identified with SVCO as a result of their port. 11 patients had CF (9 female, 2 male), one male patient had Primary Ciliary Dyskinesia and one female patient had severe Asthma. The mean port function was 1532 days (range 110 – 4049) and the mean age at SVCO was 24 years (range 11.1 to 36.5 years). The most common symptoms were facial oedema (n=8, 61.5%) and dilated veins (n=6, 46.2%). 7 patients had their Ports removed after SVCO. 6 patients underwent attempted stenting (46.2%) and 6 did not. 4 out of the 6 who underwent stenting required/had re-intervention. 3 of the 6 patients who underwent stenting had symptom resolution, however, 4 of the 6 patients who were not stented had symptom resolution also. Symptom resolution was not guaranteed with stenting and required re-intervention in two-thirds. Conclusion: This case series represents the experience of one of the longest established CF units in the UK and represents the largest cohort ever reported in the literature.

Keywords: ports, Superior Vena Cava Obstruction, cystic fibrosis, access devices

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Authors: Tom Ryan

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This paper investigates the rural mobility and accessibility challenges of a specific target group - Seniors. The target group is those over 66 years of age who are entitled to use the Public Transport (PT) Free Travel Scheme in rural Ireland. The paper explores at a high level some of the projected rural PT challenges and requirements over the next 10-15 years, noting that statistical predictions show that there will be a significant population demographic shift within the Senior's age profile. Using the PESTEL framework, the literature review explored existing research concerning mobility, accessibility challenges, and the opportunities Seniors face. Twenty-seven qualitative in-depth interviews with stakeholders within the ecosystem were undertaken. The stakeholders included: rural PT customers, Local-Link managers, NTA senior management, a Minister of State, and a European parliament policymaker. Tier 1 interviewee feedback spotlights that the PT network system does not exist for rural patients to access hospital facilities. There was no evidence from the Tier 2 research findings to show that health policymakers and transport planners are working to deliver a national solution to support patients getting access to hospital appointments. Several research interviewees discussed the theme of isolation and the perceived stigma of senior males utilising PT. The findings indicated that MaaS is potentially revolutionary in the PT arena. Finally, this paper suggests several short-, medium- and long-term recommendations based on the research findings. These recommendations are a potential springboard to ensure that rural PT is suitable for future Irish generations.

Keywords: accessibility, active ageing, car dependence, isolation, seniors health issues, behavioural changes, environmental challenges, internet of things, demand responsive, mobility as a service

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Authors: Chinasa U. Imo, Queen Chikwendu, Jonathan Ajuma, Mario Banuelos

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Background: Sociocultural norms primarily influence the health-seeking behavior of populations in rural communities. In the Nkporo community, Abia State, Nigeria, their sociocultural perception of diseases runs counter to biomedical definitions, wherein they rely heavily on traditional medicine and practices. In a state where birth asphyxia and sepsis account for the significant causes of death for neonates, malaria leads to the causes of other mortalities, followed by common preventable diseases such as diarrhea, pneumonia, acute respiratory tract infection, malnutrition, and HIV/AIDS. Most local mothers attribute their health conditions and that of their children to witchcraft attacks, the hand of God, and ancestral underlining. This influences how they see antenatal and postnatal care, choice of place of accessing care and birth delivery, response to children's illnesses, immunization, and nutrition. Method: To implement a community health improvement program, we adopted an asset-based community development model to address health's normative and social determinants. The first step was to use a qualitative approach to conduct a community health needs baseline assessment, involving focus group discussions with twenty-five (25) youths aged 18-25, semi-structured interviews with ten (10) officers-in-charge of primary health centers, eight (8) ward health committee members, and nine (9) community leaders. Secondly, we designed an intervention program. Going forward, we will proceed with implementing and evaluating this program. Result: The priority needs identified by the communities were malaria, lack of clean drinking water, and the need for behavioral change information. The study also highlighted the significant influence of youths on their peers, family, and community as caregivers and information interpreters. Based on the findings, the NGO SieDi-Hub collaborated with the Abia State Ministry of Health, the State Primary Healthcare Agency, and Empower Next Generations to design a one-year "Community Health Youth Champions Pilot Program." Twenty (20) youths in the community were trained and equipped to champion a participatory approach to bridging the gap between access and delivery of primary healthcare, to adjust sociocultural norms to improve health equity for people in Nkporo community – with limited education, lack of access to health information, and quality healthcare facilities using an innovative community-led improvement approach. Conclusion: Youths play a vital role in achieving health equity, being a vulnerable population with significant influence. To ensure effective primary healthcare, strategies must include cultural humility. The asset-based community development model offers valuable tools, and this article will share ongoing lessons from the intervention's behavioral change strategies with young people.

Keywords: asset-based community development, community health, primary health systems strengthening, youth empowerment

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Authors: Mohammad Moridzadeh, Aaron Gallant

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The paper will present the design and construction of the underground excavations of a pump station forebay and its related components including connector tunnels, access shaft, riser shaft and well shafts. The underground openings include an 8 m-diameter riser shaft, an 8-m-diameter access shaft, 34 2.4-m-diameter well shafts, a 107-m-long forebay with a cross section having a height of 11 m and width of 10 m, and a 6 m by 6 m stub connector tunnel between the access shaft and a future forebay extension. The riser shaft extends down from the existing forebay connector tunnel at elevation 247 m to the crown of the forebay at elevation 770.0 feet. The access shaft will extend from the platform at the surface down to El. 223.5 m. The pump station will have the capacity to deliver 600 million gallons per day. The project is located on an uplifted horst consisting of a mass of Precambrian metamorphic rock trending in a north-south direction. The eastern slope of the area is very steep and pronounced and is likely the result of high-angle normal faulting. Toward the west, the area is bordered by a high angle normal fault and recent alluvial, lacustrine, and colluvial deposits. An evaluation of rock mass properties, fault and discontinuities, foliation and joints, and in situ stresses was performed. The response of the rock mass was evaluated in 3DEC using Discrete Element Method (DEM) by explicitly accounting for both major and minor discontinuities within the rock mass (i.e. joints, shear zones, faults). Moreover, the stability of the entire subsurface structure including the forebay, access and riser shafts, future forebay, well shafts, and connecting tunnels and their interactions with each other were evaluated using a 3D coupled hydromechanical Finite Element Analysis (FEA).

Keywords: coupled hydromechanical analysis, discontinuities, discrete element, finite element, pump station

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Authors: Usman Ahmed Adam, Umar Ibrahim, Ezra S. Gbaje

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This study is posed to explore the practice of Public Access Computers (PACs) in academic libraries in Kaduna State, Nigeria. The study aimed to determine the computers and other tools available, their services and challenges of the practices. Three questions were framed to identify number of public computers and tools available, their services and problems faced during the practice. The study used qualitative research design along with semi-constructed interview and observation as tools for data collection. Descriptive analysis was employed to analyze the data. The sample size of the study comprises 52 librarian and IT staff from the seven academic institutions in Kaduna State. The findings revealed that, PACs were provided for access to the Internet, digital resources, library catalogue and training services. The study further explored that, despite the limit number of the computers, users were not allowed to enjoy many services. The study recommends that libraries in Kaduna state should provide more public computers to be able to cover the population of their users; libraries should allow users to use the computers without limitations and restrictions.

Keywords: academic libraries, computers in library, digital libraries, public computers

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Authors: Michelle Jennett, Jana Dengler, Maytal Perlman

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Background: Cervical spinal cord injury (SCI) is a devastating event that results in upper limb paralysis, loss of independence, and disability. People living with cervical SCI have identified improvement of upper limb function as a top priority. Nerve and tendon transfer surgery has successfully restored upper limb function in cervical SCI but is not universally used or available to all eligible individuals. This exploratory mixed-methods study used an implementation science approach to better understand these factors that influence access to upper limb reconstruction in the Canadian context and design an intervention to increase access to care. Methods: Data from the Canadian Institute for Health Information’s Discharge Abstracts Database (CIHI-DAD) and the National Ambulatory Care Reporting System (NACRS) were used to determine the annual rate of nerve transfer and tendon transfer surgeries performed in cervical SCI in Canada over the last 15 years. Semi-structured interviews informed by the consolidated framework for implementation research (CFIR) were used to explore Ontario healthcare provider knowledge and practices around upper limb reconstruction. An inductive, iterative constant comparative process involving descriptive and interpretive analyses was used to identify themes that emerged from the data. Results: Healthcare providers (n = 10 upper extremity surgeons, n = 10 SCI physiatrists, n = 12 physical and occupational therapists working with individuals with SCI) were interviewed about their knowledge and perceptions of upper limb reconstruction and their current practices and discussions around upper limb reconstruction. Data analysis is currently underway and will be presented. Regional variation in rates of upper limb reconstruction and trends over time are also currently being analyzed. Conclusions: Utilization of nerve and tendon transfer surgery to improve upper limb reconstruction in Canada remains low. There are a complex array of interrelated individual-, provider- and system-level barriers that prevent individuals with cervical SCI from accessing upper limb reconstruction. In order to offer equitable access to care, a multi-modal approach addressing current barriers is required.

Keywords: cervical spinal cord injury, nerve and tendon transfer surgery, spinal cord injury, upper extremity reconstruction

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Authors: Faisel Eltuhami Alzaalik, Omar Imhemed Alramli, Ahmed Mohamed Elaieb

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The IEEE 802.11 defines two modes of MAC, distributed coordination function (DCF) and point coordination function (PCF) mode. The first sub-layer of the MAC is the distributed coordination function (DCF). A contention algorithm is used via DCF to provide access to all traffic. The point coordination function (PCF) is the second sub-layer used to provide contention-free service. PCF is upper DCF and it uses features of DCF to establish guarantee access of its users. Some papers and researches that have been published in this technology were reviewed in this paper, as well as talking briefly about the distributed coordination function (DCF) technology. The simulation of the PCF function have been applied by using a simulation program called network simulator (NS2) and have been found out the throughput of a transmitter system by using this function.

Keywords: DCF, PCF, throughput, NS2

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Authors: Naomi Nathan

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Introduction Digitalization of medical education can revolutionize how medical students learn and interact with the medical curriculum across contexts. With the increasing availability of the internet and mobile connectivity in LMICs, online medical education platforms and digital learning tools are becoming more widely available, providing new opportunities for learners to access high-quality medical education and training. However, the adoption and integration of digital technologies in medical education in LMICs is a complex process influenced by various factors, including learners' perceptions and attitudes toward digital learning. In Ethiopia, the adoption of digital platforms for medical education has been slow, with traditional face-to-face teaching methods still being the norm. However, as access to technology improves and more universities adopt digital platforms, it is crucial to understand how medical students perceive this shift. Methodology This study investigated medical students' perception of the digitalization of medical education in relation to their access to the Lecturio Digital Medical Education Platform through a capacity-building project. 740 medical students from over 20 medical universities participated in the study. The students were surveyed using a questionnaire that included their attitudes toward the digitalization of medical education, their frequency of use of the digital platform, and their perceived benefits and challenges. Results The study results showed that most medical students had a positive attitude toward digitalizing medical education. The most commonly cited benefit was the convenience and flexibility of accessing course material/curriculum online. Many students also reported that they found the platform more interactive and engaging, leading to a more meaningful learning experience. The study also identified several challenges medical students faced when using the platform. The most commonly reported challenge was the need for more reliable internet access, which made it difficult for students to access content consistently. Overall, the results of this study suggest that medical students in Ethiopia have a positive perception of the digitalization of medical education. Over 97% of students continuously expressed a need for access to the Lecturio platform throughout their studies. Conclusion Significant challenges still need to be addressed to fully realize the Lecturio digital platform's benefits. Universities, relevant ministries, and various stakeholders must work together to address these challenges to ensure that medical students fully participate in and benefit from digitalized medical education - sustainably and effectively.

Keywords: digital medical education, EdTech, LMICs, e-learning

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Authors: Vassiliki Drosou, Theoni Oikonomou

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EU-SOLARIS will form a new legal entity to explore and implement improved rules and procedures for Research Infrastructures (RI) for Concentrated Solar Thermal (CST) and solar chemistry technologies, in order to optimize RI development and R&D coordination. It is expected to be the first of its kind, where industrial needs and private funding will play a significant role. The success of EU-SOLARIS initiative will be the establishment of a new governance body, aided by sustainable financial models. EU-SOLARIS is expected to be an important tool, which will provide the most complete, high quality scientific infrastructure portfolio at international level and to facilitate researchers' access to highly specialised research infrastructure through a single access point. This will be accomplished by linking scientific communities, industry and universities involved in the CST sector. The access to be offered by EU-SOLARIS will guarantee the direct contact of experienced scientists with newcomers and interested students. The set of RIs participating in EU-SOLARIS will offer access to state of the art infrastructures, high-quality services, and will enable users to conduct high quality research. Access to these facilities will contribute to the enhancement of the European research area by: -Opening installations to European and non-European scientists, coming from both academia and industry, thus improving co-operation. -Improving scientific critical mass in domains where knowledge is now widely dispersed. -Generating strong Europe-wide R&D project consortia, increasing the competitiveness of each member alone. EU-SOLARIS will be created in the framework of a European project, co-funded by the 7th Framework Programme of the European Union –whose initiative is to foster, contribute and promote the scientific and technological development of the CST and solar chemistry technologies. Primary objective of EU-SOLARIS is to contribute to the improvement of the state of the art of these technologies with the aim of preserving and reinforcing the European leadership in this field, in which EU-SOLARIS is expected to be a valuable instrument. EU-SOLARIS scope, activities, objectives, current status and vision will be given in the article. Moreover, the rules, processes and criteria regulating the access to the research infrastructures included in EU-SOLARIS will be presented.

Keywords: concentrated solar thermal (CST) technology, renewable energy sources, research infrastructures, solar chemistry

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Authors: Amaraporn Puraya, Roongtiva Boonpracom, Somsak Thojampa, Sirikanok Klankhajhon, Kittisak Kumpeera

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The objective of this qualitative research was to study the elderly health care process by community participation. Data were collected by quality research methods, including secondary data study, observation, in-depth interviews, and focus group discussions and analyzed by content analysis, reflection and review of information. The research results pointed out that the important elderly health care process by community participation consisted of 2 parts, namely the community participation development process in elderly health care and the outcomes from the participation development process. The community participation development process consisted of 4 steps as follows: 1) Building the leadership team, an important social capital of the community, which started from searching for both formal and informal leaders by giving the opportunity for public participation and creating clear agreements defining roles, duties and responsibilities; 2) investigating the problems and the needs of the community, 3) designing the elderly health care activities under the concept of self-care potential development of the elderly through participation in community forums and meetings to exchange knowledge with common goals, plans and operation and 4) the development process of sustainable health care agreement at the local level, starting from opening communication channels to create awareness and participation in various activities at both individual and group levels as well as pushing activities/projects into the community development plan consistent with the local administration policy. The outcomes from the participation development process were as follows. 1) There was the integration of the elderly for doing the elderly health care activities/projects in the community managed by the elderly themselves. 2) The service system was changed from the passive to the proactive one, focusing on health promotion rather than treating diseases or illnesses. 3) The registered nurses / the public health officers can provide care for the elderly with chronic illnesses through the implementation of activities/projects of elderly health care so that the elderly can access the services more. 4) The local government organization became the main mechanism in driving the elderly health care process by community participation.

Keywords: elderly health care process, community participation, elderly, Thailand

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Authors: Lida Moghaddam-Banaem, Mahmood Tavoosi, Soheila Khalili

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Objective: The main objective of this study was designing a breast cancer health literacy questionnaire and assess its psychometric properties. Methods: A comprehensive literature review was performed to develop a primary questionnaire consisting of five domains. Qualitative and quantitative content validity were assessed by relevant experts, and after some modifications, the content validity index (CVI) and content validity ratio (CVR) were calculated. Qualitative and quantitative face validity were evaluated by a number of patients, and the impact score for each item was calculated. 225 women with breast cancer were asked to fill out the questionnaire and construct validity was determined by using exploratory factor analysis. The reliability was tested by Cronbach's alpha coefficient. Results: A 36-item questionnaire with five domains of reading, having access, understanding, assessing/judgment, and decision making/behavior was designed. 2 items were omitted in the qualitative content validity process. All items achieved optimum values in CVI, CVR and impact scores. Content and face validity of the questionnaire were confirmed too. According to the exploratory factor analysis, the five-factor solution accounted for 64.98 percent of the observed variance. Conclusion: Due to the obtained satisfactory validity and reliability, this tool can be used to assess health literacy in women with breast cancer. Health policy makers can use these findings for improving health-related behaviors in breast cancer patients.

Keywords: health literacy, breast cancer, questionnaire, psychometric properties

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Authors: Shah S. M. A., Aftab U.

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It is imperative in today’s world to get a real time information about different emergency situation occurred in the environment. Helicopters are mostly used to access places which are hard to access in emergencies like earthquake, floods, bridge failure or in any other disasters conditions. Use of helicopters are considered more costly to properly collect the data. Therefore a new technique has been introduced in this research to promptly collect data using drones. The drone designed in this research is based on trial and error experimental work with objective to construct an economical drone. Locally available material have been used for this purpose. And a mobile camera were also attached to prepare video during the flight. It was found that within very limited resources the result were quite successful.

Keywords: UAV, real time, camera, disasters

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Authors: Ana Cristina A. P. Carvalho, Solange Teles Da Silva

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In April, 174 countries signed the Paris Agreement, a multilateral agreement on climate change which deals with greenhouse gas emissions, mitigation, adaptation, finance, access to information, transparency, among other subjects related to the environment. Since then, Parties shall cooperate in taking measures, as appropriate, to enhance climate change education, training, public awareness, public participation and public access to information, recognizing the importance of these steps with respect to enhancing actions under this Agreement. This paper aims to analyze the consequences of this new rule in terms of the implementation of the Agreement, collecting data from Brazilian and Canadian legislations in order to identify if these countries have rules complying with the Treaty, the steps that have been already taken and if they could be used as examples for other countries. The analysis will take into consideration the different kinds of climate change information, means of transparency, reliability of the data and how to spread the information. The methodology comprehends a comparative legal research based on both the Paris Agreement and domestic laws of Brazil and Canada, as well as on doctrine and Court decisions. The findings can contribute to the implementation of the Paris Agreement through compliance with this Treaty at countries’ domestic and policy level.

Keywords: climate change information, domestic legislation, Paris Agreement, public policy

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Authors: S. Vadivukkarasi, K. Karthi, M. Karthick, C. Dinesh, S. Santhosh, A. Yogaraj

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The appointment system was designed to minimize patient’s idle time overlooking patients waiting time in hospitals. This is no longer valid in today’s consumer oriented society. Long waiting times for treatment in the outpatient department followed by short consultations has long been a complaint. Nowadays, customers use waiting time as a decisive factor in choosing a service provider. Queuing theory constitutes a very powerful tool because queuing models require relatively little data and are simple and fast to use. Because of this simplicity and speed, modelers can be used to quickly evaluate and compare various alternatives for providing service. The application of queuing models in the analysis of health care systems is increasingly accepted by health care decision makers. Timely access to care is a key component of high-quality health care. However, patient delays are prevalent throughout health care systems, resulting in dissatisfaction and adverse clinical consequences for patients as well as potentially higher costs and wasted capacity for providers. Arguably, the most critical delays for health care are the ones associated with health care emergencies. The allocation of resources can be divided into three general areas: bed management, staff management, and room facility management. Effective and efficient patient flow is indicated by high patient throughput, low patient waiting times, a short length of stay at the hospital and overtime, while simultaneously maintaining adequate staff utilization rates and low patient’s idle times.

Keywords: appointment system, patient scheduling, bed management, queueing calculation, system analysis

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Authors: Hammad Khalid

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In this paper, a strategy for computerized arranging of Fiber to the Home (FTTH) get to systems is proposed. We presented an efficient methodology for arranging access organize framework. The GIS information and a lot of calculations were utilized to make the arranging procedure increasingly programmed. The technique clarifies various strides of the arranging process. Considering various situations, various designs can be produced by utilizing the technique. It was likewise conceivable to produce the designs in an extremely brief temporal contrast with the conventional arranging. A contextual investigation is considered to delineate the utilization and abilities of the arranging technique. The technique, be that as it may, doesn't completely robotize the arranging however, make the arranging procedure fundamentally quick. The outcomes and dialog are displayed and end is given at last.

Keywords: FTTH, GIS, robotize, plan

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Authors: Nikunj Agarwal, M. P. Sebastian

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Cloud computing can reduce the start-up expenses of implementing EHR (Electronic Health Records). However, many of the healthcare institutions are yet to implement cloud computing due to the associated privacy and security issues. In this paper, we analyze the challenges and opportunities of implementing cloud computing in healthcare. We also analyze data of over 5000 US hospitals that use Telemedicine applications. This analysis helps to understand the importance of smart phones over the desktop systems in different departments of the healthcare institutions. The wide usage of smartphones and cloud computing allows ubiquitous and affordable access to the health data by authorized persons, including patients and doctors. Cloud computing will prove to be beneficial to a majority of the departments in healthcare. Through this analysis, we attempt to understand the different healthcare departments that may benefit significantly from the implementation of cloud computing.

Keywords: cloud computing, smart devices, healthcare, telemedicine

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Authors: Contimi Kenfack Mouafo, Sebastian Klick

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In the rural and remote areas of Cameroon, access to electricity is very limited since most of the population is not connected to the main utility grid. Throughout the country, efforts are underway to not only expand the utility grid to these regions but also to provide reliable off-grid access to electricity. The Cameroonian company Solahydrowatt is currently working on the design and planning of one of the first hybrid solar-hydropower plants of Cameroon in Fotetsa, in the western region of the country, to provide the population with reliable access to electricity. This paper models and proposes a design for the low-voltage network with a hybrid solar-hydropower plant in Fotetsa. The modelling takes into consideration the voltage compliance of the distribution network, the maximum load of operating equipment, and most importantly, the ability for the network to operate as an off-grid system. The resulting modelled distribution network does not only comply with the Cameroonian voltage deviation standard, but it is also capable of being operated as a stand-alone network independent of the main utility grid.

Keywords: Cameroon, rural electrification, hybrid solar-hydro, off-grid electricity supply, network simulation

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Authors: Mahadev Bhise, Nabanita Majumder

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Recent studies have found association between air pollutants and mortality, particularly how concentration of air pollutant explains under-five mortality across the countries. Thus, the present study evaluates the relationship between Carbon dioxide (CO2) emission and under-five mortality, while controlling other well-being determinant of Under-five mortality in 100 countries using panel unbalanced cross sectional data. We have used PCSE and GMM model for the period 1990-2011 to meet our objectives. Our findings suggest that, the positive relationship between lagged periods of carbon dioxide and under-five mortality; the percentage of rural population with access of improved water is negatively associated with under-five mortality, while in case of urban population with access of improved water, is positively related to under-five mortality. Access of sanitation facility, food production index, GDP per capita, and concentration of urban population have significant negative impact on under-five mortality. Further, total fertility rate is significantly associated (positive) with under-five mortality which indicates relative change in fertility is related to relative change in under-five mortality.

Keywords: arbon dioxide (CO2), under-five mortality (0q5), gross domestic product (GDP), urban population, food production, panel corrected standard errors (PCSE), generalized method of moments (GMM)

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Authors: Koyangbo Guere Monguia Michel Alex Emmanuel

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In e-government and especially recruitment, many researches have been conducted to build a trustworthy and reliable online or application system capable to process users or job applicant files. In this research (Government Recruitment Agency), cloud computing, identity management and public key encryption have been used to management domains, access control authorization mechanism and to secure data exchange between entities for reliable procedure of processing files.

Keywords: cloud computing network, identity management systems, public key encryption, access control and authorization

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Authors: Domenico Chizzoniti, Monica Moscatelli, Letizia Cattani, Piero Favino, Luca Preis

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A settlement strategy is to anticipate and respond the needs of existing and future communities through the provision of primary health care facilities in marginalized areas. Access to a health care network is important to improving healthcare coverage, often lacking, in developing countries. The study explores that a good sanitary system strategy of rural contexts brings advantages to an existing settlement: improving transport, communication, water and social facilities. The objective of this paper is to define a possible methodology to implement primary health care facilities in disadvantaged areas of emerging countries. In this research, we analyze the case study of Lauro de Freitas, a municipality in the Brazilian state of Bahia, part of the Metropolitan Region of Salvador, with an area of 57,662 km² and 194.641 inhabitants. The health localization system in Lauro de Freitas is an integrated process that involves not only geographical aspects, but also a set of factors: population density, epidemiological data, allocation of services, road networks, and more. Data were collected also using semi-structured interviews and questionnaires to the local population. Synthesized data suggest that moving away from the coast where there is the greatest concentration of population and services, a network of primary health care facilities is able to improve the living conditions of small-dispersed communities. Based on the health service needs of populations, we have developed a methodological approach that is particularly useful in rural and remote contexts in emerging countries.

Keywords: healthcare, settlement strategy, urban health, rural

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Authors: Fareena Alladin

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In the Caribbean, issues of food security, health and taste are intricately linked, seen most clearly in the increasing incidence of lifestyle diseases among children coupled with a taste for high calorie and Westernized diets. In order to fully appreciate this link, the role of nutrition environments must be examined. To this end, the present study incorporates tenets of Bourdieu’s social constructivist theory with the Community Nutrition Environment Model. The aim of this study was to examine the relationships between availability of and access to healthy/unhealthy foods within nutrition environments, namely the household and school, and the development of taste preferences for healthy/unhealthy foods among primary school children in a selected educational district in Trinidad and Tobago. A cross-sectional survey of 400 children between the ages of 9 and 11 years was conducted. Data analysis was conducted using SPSS 24. Results indicated that availability of healthy food at home was positively correlated with preference for vegetables, and negatively correlated with preference for salty snacks and fast food. The availability of unhealthy food within the home was found to be negatively correlated with preference for vegetables and positively correlated with preference for salty snacks. Access to unhealthy foods at school had a positive correlation with preference for fast food. These findings highlight the role of the food environment in shaping taste preferences, and point to the need for interrogating the centrality of food security concerns in emerging health concerns of Caribbean countries. Such interrogations are a necessary part of the development of research agendas, and policy formulation and implementation.

Keywords: food security, nutrition environment, taste preference, Trinidad and Tobago

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Authors: Victor Abu

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Background: Social justice ideals are considered as the foundation of nursing practice. These ideals are not always clearly integrated into nursing professional standards or curricula. This hinders concerted global nursing agendas for becoming aware of social injustice or engaging in action for social justice to improve the health of individuals and groups. Aim and objectives: The aim was to create an educational framework for empowering nursing students for social justice awareness and action. This purpose was attained by understanding the meaning of social justice, the effect of social injustice, the visibility of social justice learning, and ways of integrating social justice in nursing education and practice. Methods: Critical interpretive methodologies and constructivist grounded theory research designs guided the processes of recruiting nursing students (n = 11) and nurse educators (n = 11) at a London nursing university to participate in interviews and focus groups, which were analysed by coding systems. Findings: Firstly, social justice was described as ethical practices that enable individuals and groups to have good access to health resources. Secondly, social injustice was understood as unfair practices that caused minimal access to resources, social deprivation, and poor health. Thirdly, social justice learning was considered to be invisible in nursing education due to a lack of explicit modules, educator knowledge, and organisational support. Lastly, explicit modules, educating educators, and attracting leaders’ support were suggested as approaches for the visible integration of social justice in nursing education and practice. Discussion: This research proposes approaches for nursing awareness and action for the development of critical active nurse-learner, critical conscious nurse-educator, and servant nurse leader. The framework on Awareness for Social Justice Action (ASJA) created in this research is an approach for empowering nursing students for social justice practices. Conclusion: This research contributes to and advocates for greater nursing scholarship to raise the spotlight on social justice in the profession.

Keywords: social justice, nursing practice, nursing education, nursing curriculum, social justice awareness, social justice action, constructivist grounded theory

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Authors: Mulusew G. Jebena, David Lindstrom, Tefera Belachew, Craig Hadley, Carl Lachat, Patrick Kolsteren

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Background: The biological and psychosocial consequence of food insecurity on physical health and nutritional status has been reported. But, its effect on mental health during adolescence remains unexplored. Thus, the main aim of this analysis is to examine the mechanism by which food insecurity is linked to mental health among adolescents living in Jimma, Southwest Ethiopia. Methods: We used data from third round observation of Jimma Longitudinal Family and Youth Survey (JLFSY). A total of 1,521 adolescents included for the main analysis. Food insecurity was measured using 5-items scale and The Self Reporting Questionnaire (SRQ-20) was used to measure mental distress. Structural equation modeling analysis was done using maximum likelihood estimation method. Model diagnostics test was reported. All p values were two tailed and P value ≤ 0.05 was used to determine statistical significance. Results: The prevalence of mental distress was 20.8%, 95% CI: (18.8, 22.9). After adjusted for covariates, the final model depicts food insecurity was associated with adolescent mental distress (β=.324). This analysis showed 94.1% of the effect of food insecurity on mental distress is direct. By contrast, 5.9% of the food insecurity effect is mediated by physical health. In addition, Self-rated health (β=.356), socioeconomic status (β=-.078) parental educational (β= .170), living in urban (β= .193) and female headed household (β=.205) were associated with adolescent mental distress. Conclusions: This finding highlights the direct effect of food insecurity on adolescent mental distress. Therefore, any intervention aimed to improve mental distress of adolescents should consider strategies to improve access to sufficient, safe, and nutritious food. Beside this, prevention of underlying factors such as psychosomatic health illness and improving socio economic status is also very critical. Furthermore longitudinal relationship of the long term effect of food insecurity on mental health should be investigated.

Keywords: adolescent, Ethiopia, food insecurity, mental health

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Authors: Saeeda Batool, Ather Maqsood Ahmed

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This study investigates the impact of public healthcare facilities and socio-economic circumstances on the status of child health in Pakistan. The complete analysis is carried out in correspondence with fourth and sixth millennium development goals. Further, the health variables chosen are also inherited from targeted indicators of the mentioned goals (MDGs). Trends in the Human Opportunity Index (HOI) for both health inequalities and coverage are analyzed using the Pakistan Social and Living Standards Measurement (PLSM) data set for 2001-02 to 2012-13 at the national and provincial level. To reveal the relative importance of each circumstance in achieving the targeted values for child health, Shorrocks decomposition is applied on HOI. The annual point average growth rate of HOI is used to simulate the time period for the achievement of target set by MDGs and universal access also. The results indicate an improvement in HOI for a reduction in child mortality rates from 52.1% in 2001-02 to 67.3% in 2012-13, which confirms the availability of healthcare opportunities to a larger segment of society. Similarly, immunization against measles and other diseases such as Diphtheria, Polio, Bacillus Calmette-Guerin (BCG), and Hepatitis has also registered an improvement from 51.6% to 69.9% during the period of study at the national level. On a positive note, no gender disparity has been found for child health indicators and that health outcome is mostly affected by the parental and geographical features and availability of health infrastructure. However, the study finds that this achievement has been uneven across provinces. Pakistan is not only lagging behind in achieving its health goals, disappointingly with the current rate of health care provision, but it will take many additional years to achieve its targets.

Keywords: socio-economic circumstances, unmet MDGs, public healthcare services, child and infant mortality

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Authors: Rajiv Kumar, Amit Sachan, Arindam Mukherjee

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Government agencies around the world, including India, are incorporating digital technologies and processes into their day-to-day operations to become more efficient. Despite low internet penetration (around 34.8% of total population) in India, Government of India has made some public services mandatory to access online (e.g. passport, tax filing).This is insisting citizens to access mandatory public services online. However, due to digital divide, all citizens do not have equal access to internet. In light of this, it is an interesting topic to explore how citizens are able to access mandatory online public services. It is important to understand how citizens are adopting these mandatory e-government services and how the adoption behavior of these mandatory e-government services is different or similar to adoption behavior of non-mandatory e-government services. The purpose of this research is to investigate the factors that influence adoption of mandatory and non-mandatory e-government services in India. A quantitative technique is employed in this study. A conceptual model has been proposed by integrating the influencing factors to adopt e-government services from previous studies. The proposed conceptual model highlights a comprehensive set of potential factors influencing the adoption of e-government services. The proposed model has been validated by keeping in view the local context of Indian society. Online and paper based survey was administered, collected data was analyzed and results have been discussed. A total of 463 valid responses were received and further the responses were analyzed. The research reveals that the influencing factors to adopt e-government services are not same for both mandatory and non-mandatory e-government services. There are some factors that influence adoption of both mandatory and non-mandatory e-government services but there are some which are relevant for either of mandatory and non-mandatory e-government services. The research findings may help government or concerned agencies in successfully implementing e-government services.

Keywords: adoption, e-government, India, mandatory, non-mandatory

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Authors: M. Moiz

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Family planning has been known and accepted as a key tool to decrease fertility, provides birth spacing and plays a vital role to attain better outcomes for maternal and child health. Pakistan initiated various family planning programs to preserve maternal and child health for six decades. However, less contraceptive use leading to high fertility and low birth spacing is ultimately a risk for increasing morbidity and mortality. As an outcome of 2012 London Summit on Family Planning where 20 countries including Pakistan made its commitment to increase contraceptive prevalence rate by 55% and provide a universal access to reproductive health to protect human rights of women and ensure safe, choice informed and affordable contraceptives throughout the country. This paper will assess some of the factors of service delivery, coverage and the role of Ministry of Health and Population Welfare Department in providing Family Planning services and how it can be improved in Pakistan. In view of Pakistan Demographic Health Survey 2017-18, there are total nine million potential users of contraceptives and one third among them never used with unmet need while every fifth pregnancy ends into abortion indicates need for Family Planning services. In order to explain this concern, a comprehensive analysis has been done on role of governance in implementing family planning policy and its limitations are discussed. Moreover, this paper highlights policy options and recommendations for improving service provision through public and private sector in creating demand for Family Planning services in Pakistan.

Keywords: contraceptive prevalence rate, family planning, maternal and child health, policy options

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Authors: Hamad Albadr

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With a rapid influence to sustain the needs for global trends that had arisen for the increasing complexities in health-care provision, the increasing number of health professionals at different levels, and the need to assure more equitable access to health care, the great variation in the levels of initial education for health care professional around the world had been assign bachelor's degree as the minimum point of entry to the health professions. This intent had affected all the health care professions including biomedical engineering. In Saudi Arabia, these challenges add more pressure to retain the global trends for associate degree graduates to upgrade their education to the bachelor's degree or called birding. This paper is to review the reality of biomedical technology programs that offered in Saudi Arabia by Technical Colleges or Community Colleges nationwide and the challenges that face these colleges to run such bridging program to achieve the Bachelor's degree in biomedical engineering and the official requirements by the Ministry of Higher Education and to maintain the international standards. The author will use strategic planning methodology for designing the biomedical engineering bridging of bachelor's program by reviewing the responsibilities of the biomedical engineers in hospitals through their job descriptions to determine the job assessment needs in advance to Developing a Curriculum (DACUM) through Instructional System Design (ISD) approach via five steps: Analysis, Design, Development, Implement, Evaluate (ADDIE).

Keywords: bachelor's degree bridging, biomedical engineering program, Saudi Arabia, Riyadh College of Technology

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Authors: Ying Wang, Jianhong Xiang, Yu Zhong

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The offset Quadrature Amplitude Modulation-based Filter Bank Multi-Carrier (FBMC) system provides superior spectral properties over Orthogonal Frequency Division Multiplexing. However, seriously affected by imaginary interference, its performances are hampered in many areas. In this paper, we propose a Precoding-Assisted Frequency Division Multiple Access (PA-FDMA) modulation scheme. By spreading FBMC symbols into the frequency domain and transmitting them with a precoding matrix, the impact of imaginary interference can be eliminated. Specifically, we first generate the coding pre-solution matrix with a nonuniform Fast Fourier Transform and pick the best columns by introducing auxiliary factors. Secondly, according to the column indexes, we obtain the precoding matrix for one symbol and impose scaling factors to ensure that the power is approximately constant throughout the transmission time. Finally, we map the precoding matrix of one symbol to multiple symbols and transmit multiple data frames, thus achieving frequency-division multiple access. Additionally, observing the interference between adjacent frames, we mitigate them by adding frequency Cyclic Prefixes (CP) and evaluating them with a signal-to-interference ratio. Note that PA-FDMA can be considered a CP-available FBMC technique because the underlying strategy is FBMC. Simulation results show that the proposed scheme has better performance compared to Single Carrier Frequency Division Multiple Access (SC-FDMA), etc.

Keywords: PA-FDMA, SC-FDMA, FBMC, non-uniform fast fourier transform

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