Search results for: socioeconomic health inequalities

Authors: Zeynep Karacor, Rahime Hulya Ozturk

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In recent years, the rise of population density and the problem of aging population took attention to the health expenditures. In Turkey, some regulations and infrastructure changes in health sector have occurred. These changes are called Health Transformation Program. The productivity of health services, patient satisfaction, quality of services are tried to be improved with this program. Some radical changes are applied in Turkish economy in this context. The aim of this paper is to present the effects of Health Transformation Program on health expenditures. In the first part of the paper, some information’s about health system and applications in Turkey are discussed. In the second part, the aims of Health Transformation Program are explained. And in the third part the effects of Health Transformation Program on health expenditures are examined.

Keywords: health transformation program, Turkey, health services, health expenditures

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Authors: Sumiti Saharan, Pallav Patankar, Lily W. Lee

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Understanding the health-seeking behaviors and attitudes of women towards maternal health in the context of gender roles and family dynamics is tremendously crucial for designing effective and impactful interventions aimed at improving maternal and child health outcomes. Further, as the digital world becomes more accessible and affordable, it is imperative to scope the potential of digital technology in enabling access to maternal health information in different socio-economic groups (SEGs). In the summer of 2017, we conducted a study with 500 women across different SEGs in urban India who were pregnant or had had a delivery in the last year. The study was undertaken to assess their maternal health information seeking behavior with a particular focus on probing their use of digital technology for health-related information. The study also measured women's decision-making autonomy in the context of maternal health, awareness of their rights to quality and respectful maternal healthcare, and agency to voice their rights. We probed the impact of key variables including education, age, and socioeconomic status on all outcome variables. In terms of health-seeking behaviors, we found that women heavily relied on medical professionals and/or their mothers and mothers-in-law for all maternal health advice. Digital adoption was found to be high across all SEGs, with around 70% of women from all populations using the internet several times a week. On the other hand, use of the internet for both accessing maternal health information and choosing maternity hospitals were both significantly dependent on SEG. The key reasons reported for not using the internet for health purposes were lack of awareness and lack of trust on content accuracy. Decisions around health practices and type of delivery were found to be jointly made by women and other family members. Almost all women reported their husbands to play a key role in all maternal health decisions and for decisions with a clear financial implication like choice of hospital for delivery, husbands were reported to be the sole decision maker by a majority of women. The agency of women was also found to be low in interactions with maternal healthcare providers with a third of respondents not comfortable with voicing their opinions and preferences to their doctors. Interestingly, we find that this relatively low agency was prominent in both lower middle class and middle-class SEGs. Recognition of the sociocultural determinants of behavior is the first step in developing actionable strategies for improving maternal health outcomes. Our study quantifies the agency and autonomy of women in urban India and the variables that impact them. Our findings emphasize the value of gender normative approaches that factor in the key role husbands play in guiding maternal health decisions. They also highlight the power of digital approaches for catalyzing access to maternal health information. These insights into the attitude and behaviors of mothers in context of their sociocultural environments—and their relationship with digital technology—can help pave the way towards designing effective, scalable maternal and child health programs in developing nations like India.

Keywords: access to healthcare information, behavior, digital health, maternal health

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Authors: Atiqa Marium

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In 2015, all 193 UN Member countries adopted the 2030 Agenda for Sustainable Development, which is an ambitious 15- year plan to address some of the most pressing issues the world faces. Goal 4 is about Quality Education which highlights the importance of inclusive and quality education for sustainable development. Sustainable Development Goal 10 focuses on reducing inequalities within and among countries. In June 2019, Federal Government in Canada released “Towards Canada’s 2030 Agenda National Strategy”, which was an important step to move the 2030 Agenda forward. In April 2019, the Ontario government announced the performance-based funding model for publically assisted colleges and universities in Ontario, which is now part of the universities’ budget 2024-2025. The literature review has shown that the funding model has been implemented by different governments to achieve objectives. However, this model has also resulted in conflicting consequences like reducing university autonomy, education quality/ academic standards, and increased equity concerns. The primary focus of this paper will be to analyze the tensions and coherence between the proposed funding model for education for sustainable development goals and targets set by Canada’s 2030 Agenda National Strategy. Considering that the literature review has provided evidence that the performance-based funding model has resulted in reducing quality of education and increased equity issues in other countries, it will be interesting to see how this proposed funding will align with the SDGs of “Quality Education” and “Reduced Inequalities”. This paper will be well-suited for Volume 4, with the theme of re-visioning institutional impact and sustainability. This paper will underscore the importance of policy coherence between federal and provincial policies for higher education institutions in Ontario for better institutional impact and helping universities in the attainment of goals set in 2030 Agenda towards education for sustainable development.

Keywords: performance-based funding model, education for sustainable development, policy coherence, sustainable development gaols

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Authors: Aemro Tazeze Terefe, Mengistu K. Aredo, Abule M. Workagegnehu, Wondimagegn M. Tesfaye

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Climate-induced shocks have been shown to reduce agricultural production and cause fluctuation in output in developing countries. When livelihoods depend on rain-fed agriculture, climate-induced shocks translate into consumption shocks. Despite the substantial improvements in household consumption, climate-induced shocks, and other factors adversely affect consumption dynamics at the household level in Ethiopia. Therefore, household consumption dynamics in the context of climate-induced shocks help to guide resilience capacity and establish appropriate interventions and programs. The research employed three-round panel data based on the Ethiopian Socioeconomic Survey with spatial rainfall data to define unique measures of rainfall variability. The linear dynamic panel model results show that the lagged value of consumption, market shocks, and rainfall variability positively affected consumption dynamics. In contrast, production shocks, temperature, and amount of rainfall had a negative relationship. Coping strategies mitigate adverse climate-induced shocks on consumption aftershocks that smooth consumption over time. Support to increase the resilience capacity of households can involve efforts to make existing livelihoods and forms of production or reductions in the vulnerability of households. Therefore, government interventions are mandatory for asset accumulation agendas that support household coping strategies and respond to shocks. In addition, the dynamic linkage between consumption and significant socioeconomic and institutional factors should be taken into account to minimize the effect of climate-induced shocks on consumption dynamics.

Keywords: climate shock, Ethiopia, fixed-effect model, food security

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Authors: Siran Offman, Hermes Pacule, Teofilo Nhamuhuco

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Marine invertebrates are very important for the livelihood of coastal communities, particularly in Pemba City. The study was conducted From June 2011 to March 2012. The aim of this study is to determine the socioeconomic impact of collecting marine invertebrates in communities and Chuiba Maringanha. Data were collected biweekly during the spring tide ebb in the intertidal zone, and through structured surveys, the confrontation of data was done through direct observation in the neighborhoods. In total 40 collectors was surveyed and it was found that activity of collecting marine invertebrates is practiced by women 57.2% and men 42.5%. Their ages ranged from 9 to 45 years, and the range was 25-32 dominant with 30.5% and collection practice 5-7 times per week they spend about 4-6 hours a day. The collection methods are direct harvesting by hand aided by knives, sharp irons, and transport use pots, buckets, basins, shawls. Were identified in total 8 marketable species namely: Octopus vulgaris 8.6 Kg, Cyprea Tigers 7 units, Cypraea annulus 48 kg, 40 kg holuturias, Cyprea bully, Atrina vexilium 10 kg, Modiulus philiphinarum and lambis lambis. The species with the greatest economic value are sea cucumber (3 Usd/ kg) and Octopus vulgaris ( 2.5 Usd/ kg) more commercialized. The socio-economic impacts on communities of collectors the average income of collectors varies from 0.5 to 5 Usd/ day and the money are intended to purchase food and agricultural instruments. The other socioeconomics impacts are illiteracy with 36% dropout, and 28% have never studied 87% of unemployed collectors, a high number of family members, weak economic power, poor housing made the basis of local materials and relies on community wells to access water, and most do not have electric power.

Keywords: socio-economic, impacts, collecting marine invertebrates, communities

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Authors: Zena F. Mushtaq, Iqbal M. Abbas

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Background: Diabetes mellitus during pregnancy is one of the major medical and social problems with increasing prevalence in last decades and may lead to more vulnerable to dental problems and increased risk for periodontal diseases. Objectives: To assess oral hygiene behaviors among pregnant women with diabetes who attended primary health care centers and find out the relationship between oral hygiene behaviors and studied variables. Methodology: A cross sectional design was conducted from 7 July to 30 September 2014 on non probability (convenient sample) of 150 pregnant women with diabetes was selected from twelve Primary Health Care Centers at Baghdad city. Questionnaire format is tool for data collection which had designed and consisted of three main parts including: socio demographic, reproductive characteristics and items of oral hygiene behaviors among pregnant women with diabetes. Reliability of the questionnaire was determined through internal consistency of correlation coefficient (R= 0.940) and validity of content was determined through reviewing it by (12) experts in different specialties and was determined through pilot study. Descriptive and inferential statistics were used to analyze collected data. Result: Result of study revealed that (35.3%) of study sample was (35-39) years old with mean and SD is (X & SD = 33.57 ± 5.54) years, and (34.7%) of the study sample was graduated from primary school and less, half of the study sample was government employment and self employed, (42.7%) of the study sample had moderate socioeconomic status, the highest percentage (70.0%) of the study sample was nonsmokers, The result indicates that oral hygiene behaviors have moderate mean score in all items. There are no statistical significant association between oral hygiene domain and studied variables. Conclusions: All items related to health behavior concerning oral hygiene is in moderate mean of score, which may expose pregnant women with diabetes to high risk of periodontal diseases. Recommendations: Dental care provider should perform a dental examination at least every three months for each pregnant woman with diabetes, explanation of the effect of DM on periodontal health, oral hygiene instruction, oral prophylaxis, professional cleaning and treatment of periodontal diseases(scaling and root planing) when needed.

Keywords: diabetes, health behavior, pregnant women, oral hygiene

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Authors: Hurgesa Hundera, Samuel Shibeshibikeko, Tarike Daba, Tesfaye Ganamo

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The study aimed at examining the ongoing adaptation strategies used by smallholder farmers in response to climate variability in Boset district. It also assessed the socioeconomic factors that influence the choice of adaptation strategies of smallholder farmers to climate variability risk. For attaining the objectives of the study, both primary and secondary sources of data were employed. The primary data were obtained through a household questionnaire, key informant interviews, focus group discussions, and observations, while secondary data were acquired through desk review. Questionnaires were distributed and filled by 328 respondents, and they were identified through systematic random sampling technique. Descriptive statistics and binary logistic regression model were applied in this study as the main analytical methods. The findings of the study reveal that the sample households have utilized multiple adaptation strategies in response to climate variability, such as cropping early mature crops, planting drought resistant crops, growing mixed crops on the same farm lands, and others. The results of the binary logistic model revealed that education, sex, age, family size, off farm income, farm experience, access to climate information, access to farm input, and farm size were significant and key factors determining farmers’ choice of adaptation strategies to climate variability in the study area. To enable effective adaptation measures, Ministry of Agriculture and Natural Resource, with its regional bureaus and offices and concerned non–governmental organizations, should consider climate variability in their planning and budgeting in all levels of decision making.

Keywords: adaptation strategies, boset district, climate variability, smallholder farmers

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Authors: Narendra Kumar

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This study uses data from the ‘National Family Health Survey (NFHS-3) 2005-06’ to investigate the predictors of infant and child mortality among low economic households in East and Northeast region. The cross tabulation, life table survival estimates and Cox proportional hazard model techniques have been used to estimate the predictors of infant and child mortality. The life table survival estimates for infant and child mortality shows that infant mortality in female child is lower in comparison to male child but with child mortality, the rates are higher for female in comparison to male child and the Cox proportional hazard model also give highly significant in female in comparison to male child. The infant and child mortality rates among poor households highest in the Central region followed by North and Northeast region and the lowest in South region in comparison to all regions of India. Education of respondent has been found a significant characteristics in both analyzes, further birth interval, respondent occupation, caste/tribe and place of delivery has substantial impact on infant and child mortality among low economic households in East and Northeast region. Finally these findings specified that an increase in parents’ education, improve health care services and improve socioeconomic conditions of low economic households which should in turn raise infant and child survival and should decrease child mortality among low economic households in India.

Keywords: infant, child, mortality, socio-economic, India

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Authors: Hassan Al Salman

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We consider a nonlinear parabolic cross diffusion model arising in applied mathematics. A fully practical piecewise linear finite element approximation of the model is studied. By using entropy-type inequalities and compactness arguments, existence of a global weak solution is proved. Providing further regularity of the solution of the model, some uniqueness results and error estimates are established. Finally, some numerical experiments are performed.

Keywords: cross diffusion model, entropy-type inequality, finite element approximation, numerical analysis

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Authors: Abdulwahab Alalyani, Mahbub Rashid

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Public green space promotes community health including daily activities, but these resources may not be available enough or may not equitably be distributed. This paper measures and compares the availability of public green spaces (PGS) among low, middle, and high-income neighborhoods in the Riyadh city. Additionally, it compares the total availability of PGS to WHO standard and Dubai availability of PGS per person. All PGS were mapped using geographical information systems, and total area availability of PGS compared to WHO and Dubai standards. To evaluate the significant differences in PGS availability across low, medium, and high-income Riyadh neighborhoods, we used a One-way ANOVA analysis of covariance to test the differences. As a result, by comparing PGS of Riyadh neighborhoods to WHO and Dubai-availability, it was found that Riyadh PGS were lower than the minimum standard of WHO and as well as Dubai. Riyadh has only 1.13 m² per capita of PGS. The second finding, the availability of PGS, was significantly different among Riyadh neighborhoods based on socioeconomic status. The future development of PGS should be focused on increasing PGS availability and should be given priority to those low-income and unhealthy communities.

Keywords: spatial equity, green space, quality of life, built environment

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Authors: Aileen Editha

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The legal recognition of property rights over human genes is a divisive topic to which there is no resolution. As a frequently discussed topic, scholars and practitioners often highlight the inadequacies of a proprietary regime. However, little has been said in regard to the nature of human genetic materials (HGMs). This paper proposes approaching the issue of property over HGMs from an alternative perspective that looks at the personal and social value and valuation of HGMs. This paper will highlight how the unique and unresolved status of HGMs is incompatible with the main tenets of property and, consequently, contributes to legal ambiguity and uncertainty in the regulation of property rights over human genes. HGMs are perceived as part of nature and a free-for-all while also being within an individual’s private sphere. Additionally, it is also considered to occupy a unique “not-private-nor-public” status. This limbo-like position clashes with property’s fundamental characteristic that relies heavily on a clear public/private dichotomy. Moreover, as property is intrinsically linked to the legal recognition of one’s personhood, this irresolution benefits some while disadvantages others. In particular, it demands the publicization of once-private genes for the “common good” but subsequently encourages privatization (through labor) of these now-public genes. This results in the gain of some (already privileged) individuals while enabling the disenfranchisement of members of minority groups, such as Indigenous communities. This paper will discuss real and intellectual property rights over human genes, such as the right to income or patent rights, in Canada and the US. This paper advocates for a sui generis approach to governing rights and interests over human genes that would not rely on having a strict public/private dichotomy. Not only would this improve legal certainty and clarity, but it would also alleviate—or, at the very least, minimize—the role that the current law plays in further entrenching existing systemic inequalities. Despite the specificity of this topic, this paper argues that there are broader lessons to be learned. This issue is an insightful case study on the interconnection of various principles in law, society, and property, and what must be done when discordance between one or more of those principles has detrimental societal outcomes. Ultimately, it must be remembered that property is an adaptable and malleable instrument that can be developed to ensure it contributes to equity and flourishing.

Keywords: property rights, human genetic materials, critical legal scholarship, systemic inequalities

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Authors: Syed Toqueer, Omer Younus

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Terrorism, today, has emerged as a global menace with Pakistan being the most adversely affected state. Therefore, the motive behind this study is to empirically establish the linkage of terrorism with socio-economic (uneven income distribution, poverty and unemployment) and political nexuses so that a policy recommendation can be put forth to better approach this issue in Pakistan. For this purpose, the study employs two competing models, namely, the distributed lag model and OLS, so that findings of the model may be consolidated comprehensively, over the reference period of 1984-2012. The findings of both models are indicative of the fact that uneven income distribution of Pakistan is rather a contributing factor towards terrorism when measured through GDP per capita. This supports the hypothesis that immiserizing modernization theory is applicable for the state of Pakistan where the underprivileged are marginalized. Results also suggest that other socio-economic variables (poverty, unemployment and consumer confidence) can condense the brutality of terrorism once these conditions are catered to and improved. The rational of opportunity cost is at the base of this argument. Poor conditions of employment and poverty reduces the opportunity cost for individuals to be recruited by terrorist organizations as economic returns are considerably low and thus increasing the supply of volunteers and subsequently increasing the intensity of terrorism. The argument of political freedom as a means of lowering terrorism stands true. The more the people are politically repressed the more alternative and illegal means they will find to make their voice heard. Also, the argument that politically transitioning economy faces more terrorism is found applicable for Pakistan. Finally, the study contributes to an ongoing debate on which of the two set of factors are more significant with relation to terrorism by suggesting that socio-economic factors are found to be the primary causes of terrorism for Pakistan.

Keywords: terrorism, socioeconomic conditions, political freedom, distributed lag model, ordinary least square

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Authors: Chiara Magliacane

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This project aims to analyse the relationship between the post-conflict Northern Irish environment and youth trauma in deprived areas. Using an anthropological perspective and methodology, the study investigates the possible contribution that a socio-cultural perspective can give to the current research on the field, with a special focus on the role of transgenerational trauma. The recognition of the role that socio-economic determinants have on health is usually a challenge for social researchers. In post-conflict Northern Ireland, the overall lack of research about connections between the social context and youth trauma opens the way to the present project. Anthropological studies on social implications of mental disorders have achieved impressive results in many societies; they show how conditions of sufferance and poverty are not intrinsically given, but are the products of historical processes and events. The continuum of violence and the politics of victimhood sustains a culture of silence and fear in deprived areas; this implies the need of investigating the structural and symbolic violence that lies behind the diffusion of mental suffering. The project refers to these concepts from Medical Anthropology and looks at connections between trauma and social, political and economic structures. Accordingly, the study considers factors such as poverty, unemployment, social inequality and gender and class perspectives. At the same time, the project problematises categories such as youth and trauma. 'Trauma' is currently debated within the social sciences since the 'invention' of the Post-Traumatic Stress Disorder (PTSD) in 1980. Current critics made to its clinical conception show how trauma has been mainly analysed as a memory of the past. On the contrary, medical anthropological research focuses on wider perspectives on society and its structures; this is a new and original approach to the study of youth trauma considering that, to author’s best knowledge, there is no research of this kind regarding Northern Ireland. Methods: Qualitative interviews, participant observation. Expected Impact: Local Northern Ireland organizations, i.e. specific charities that provide mental health support. Ongoing and present connections will ensure they will hear about this research.

Keywords: health and social inequalities, Northern Ireland, structural violence, youth

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Authors: Jeffrey Siphiwe Mkhize

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Twelve years of schooling for most South African children, particularly those children from disadvantaged past, are confronted with numerous and diverse challenges. These challenges range from infrastructural limitations, language of teaching, poor resources and varying family backgrounds. Likewise, schools are categorized to signify schools’ geographic location, poverty lines, societal class and type of students that the school are likely to enroll. Such categorization perpetuates particular lines of identities that are indirectly reinforced by the same system that seeks to redress. South African universities prefer point systems to determine students’ suitability to gain access to their programmes. Once students are admitted based on the qualifying points there is an assumed equity in the manner in which they receive tuition. They are assumed as equal; noting the widened access to South African universities as means to redress past inequalities. Given the challenges, inequalities, it is necessary to view higher education as a site for knowledge construction that is accessible to all students. Epistemological access is key to all students irrespective of their socio-economic status. This paper seeks to contribute to the discourse of student engagement using lecturer-student relationship as a lens to understand this phenomenon. Data were generated using South African Survey of Student Engagement, focus group interviews, semi-structured one-on-one-interviews as well as document analysis. The focus was on students registered for the first year of a Bachelor of Education degree as well as lecturers that teach high risk modules in this qualification at the same level. The findings suggest that lecturers are challenged by overcrowded classrooms and over-enrolled modules; this challenge hampers their good intentions to become more efficient and innovative in their teaching. Students lack confidence in approaching lecturers for assistance. Collaborative learning has stronger results and students believe in self-support to deal with their challenges based on their individual strengths. Collaborative learning is key to student academic performance.

Keywords: collaborative learning, consultations, student engagement, student performance

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Authors: Sireen Irsheid

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Despite concerted efforts to improve education attainment with progress in recent years, student achievement and attainment remain among the most significant challenges for school districts across the United States. Many scholars have argued that students who do not complete high school do not drop out of school voluntarily but are ‘pushed out’ of schools through multiple mechanisms related to structural and socioeconomic barriers, behavioral health challenges, pedagogical practices, and administrative procedures. Extant literature has shown that living in historically disadvantaged neighborhoods or attending under-resourced schools exacerbates student-level risk factors for grade retention and school pushout. Most efforts to respond to the school pushout phenomenon have focused on individual characteristics of students, with relatively little attention to addressing these multiple system-level characteristics related to perpetuating inequities. This study is built on a growing body of social justice-oriented research concerned with the systemic influences that shape the experiences and mental health challenges of young people. Specifically, this study examined how young people who have been experiencing education inequities make meaning and navigate the structural factors related to neighborhood and school disinvestment and access to resources and supports, and their risk for school pushout. Furthermore, schools as political, cultural, and ideologically reproductive spaces often serve as sites of resistance and can support students who are impacted by educational inequity. Study findings provide education, neighborhood, school psychology, social work practice, and policy considerations.

Keywords: education policy, mental health, school prison nexus, school pushout, structural trauma

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Authors: Danielle A. Walker, Kyle L. Johnson, Patrick J. Fox, Jacen S. Moore

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The HIV Continuum of Care has become a universal model to provide context for the process of HIV testing, linkage to care, treatment, and viral suppression. HIV testing is the first step in moving toward community viral suppression. Countries with a lower socioeconomic status experience the lowest rates of testing and access to care. The Democratic Republic of the Congo is located in the heart of sub-Saharan Africa, where testing and access to care are low and women experience higher HIV prevalence compared to men. In the Democratic Republic of the Congo there is only a 21.6% HIV testing rate among women. Because a critical gap exists between a woman’s risk of contracting HIV and the decision to be tested, this study was conducted to obtain a better understanding of the relationship between factors that could influence HIV testing among women. The datasets analyzed were from the 2013-14 Democratic Republic of the Congo Demographic and Health Survey Program. The data was subset for women with an age range of 18-49 years. All missing cases were removed and one variable was recoded. The total sample size analyzed was 14,982 women. The results showed that there did not seem to be a difference in HIV testing by mean age. Out of 11 religious categories (Catholic, Protestant, Armee de salut, Kimbanguiste, Other Christians, Muslim, Bundu dia kongo, Vuvamu, Animist, no religion, and other), those who identified as Other Christians had the highest testing rate of 25.9% and those identified as Vuvamu had a 0% testing rate (p<0.001). There was a significant difference in testing by religion. Only 0.7% of women surveyed identified as having no religious affiliation. This suggests partnerships with key community and religious leaders could be a tool to increase testing. Over 60% of women who had never been tested for HIV did not know where to be tested. This highlights the need to educate communities on where testing facilities can be located. Almost 80% of women who believed HIV could be transmitted by supernatural means and/or witchcraft had never been tested before (p=0.08). Cultural beliefs could influence risk perception and testing decisions. Consequently, misconceptions need to be considered when implementing HIV testing and prevention programs. Location by province, years of education, and wealth index were also analyzed to control for socioeconomic status. Kinshasa had the highest testing rate of 54.2% of women living there, and both Equateur and Kasai-Occidental had less than a 10% testing rate (p<0.001). As the education level increased up to 12 years, testing increased (p<0.001). Women within the highest quintile of the wealth index had a 56.1% testing rate, and women within the lowest quintile had a 6.5% testing rate (p<0.001). This study concludes that further research is needed to identify culturally competent methods to increase HIV education programs, build partnerships with key community leaders, and improve knowledge on access to care.

Keywords: Democratic Republic of the Congo, cultural beliefs, education, HIV testing

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Authors: Liu Canqi, Zeng Junsheng

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This study identifies two typical bottlenecks that occur when a vehicle cannot change lanes: car following and car stopping. The ideas of traffic field and traffic mass are presented in this work. When there are other vehicles in front of the target vehicle within a particular distance, a force is created that affects the target vehicle's driving speed. The characteristics of the driver and the vehicle collectively determine the traffic mass; the driving speed of the vehicle and external variables have no bearing on this. From a physical level, this study examines the vehicle's bottleneck when following a car, identifies the outside factors that have an impact on how it drives, takes into account that the vehicle will transform kinetic energy into potential energy during deceleration, and builds a calculation model for traffic mass. The energy-time conversion coefficient is created from an economic standpoint utilizing the social average wage level and the average cost of motor fuel. Vissim simulation program measures the vehicle's deceleration distance and delays under the Wiedemann car-following model. The difference between the measured value of deceleration delay acquired by simulation and the theoretical value calculated by the model is compared using the conversion calculation model of traffic mass and deceleration delay. The experimental data demonstrate that the model is reliable since the error rate between the theoretical calculation value of the deceleration delay obtained by the model and the measured value of simulation results is less than 10%. The article's conclusion is that the traffic field has an impact on moving cars on the road and that physical and socioeconomic factors should be taken into account while studying vehicle-following behavior. The deceleration delay value of a vehicle's driving and traffic mass have a socioeconomic relationship that can be utilized to calculate the energy-time conversion coefficient when dealing with the bottleneck of cars stopping and starting.

Keywords: traffic field, social economics, traffic mass, bottleneck, deceleration delay

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Authors: Nqobizwe Mvelo Ngema

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The right to equality has been accepted as one of the principles of jus cogens since the Second World War and it is protected in numerous international and regional human rights instruments. The convention on the elimination of all forms of discrimination against women (CEDAW) is a comprehensive document that serves as the international Bill of Rights for women and it prohibits polygamy. This paper examines whether the most unusual customary practice of polyandry would serve as a solution in elevating the status of women to be on par with that of man that are polygamists or not. This paper concludes by arguing that polyandry cannot solve the problem of inequalities that are confronted by women because even in polyandrous societies there is male domination that is detrimental to the equality rights of women.

Keywords: human rights, polygamy, polyandry, polygyny

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Authors: Tomoaki Hashimoto

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Recently, optimal control problems subject to probabilistic constraints have attracted much attention in many research field. Although probabilistic constraints are generally intractable in optimization problems, several methods haven been proposed to deal with probabilistic constraints. In most methods, probabilistic constraints are transformed to deterministic constraints that are tractable in optimization problems. This paper examines a method for transforming probabilistic constraints into deterministic constraints for a class of probabilistic constrained optimal control problems.

Keywords: optimal control, stochastic systems, discrete-time systems, probabilistic constraints

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Authors: W. C. Lucas, S. Titus, M. E. M. Young

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Gymnastics is the umbrella term that represents seven different and unique disciplines of gymnastics. Men and women of all ages and abilities practice this sport, and participation in gymnastics can develop both gross and fine motor skills, strength, flexibility, coordination and balance. There are various social factors, such as a family’s socioeconomic status or accessibility to sports facilities that may play a role in affecting levels of participation. The aim of this study is to investigate the social factors that have an influence on gymnastics participation in the Western Cape. To this end, a qualitative approach is adopted to collect data. This study also adopts the ecological systems theory as the theoretical framework, and is used to analyze and interpret current social factors that directly or indirectly influence participation in gymnastics. The study’s objectives were to ascertain which social factors hinder participation, and which social factors promote participation, thus, coaches, parents and gymnasts participated in focus group discussions. Key informant interviews took place with experts in the field of gymnastics in the Western Cape. A thematic analysis was conducted on transcriptions from the focus group discussions and key informant interviews. Social factors investigated in this study occurred in the chronosystem, macrosystem, exosystem, mesosystem, and microsystem, and had both a direct and indirect influence on the gymnast’s continued participation. These systems are defined as the environment of the individual, in which they grow and develop. The research findings of this paper are used to draw conclusions and make specific recommendations for practice and further research. The information gathered in this study can assist all stakeholders within the field of gymnastics, such as parents, judges, coaches, gymnasts, and the supporting community which surround the participating gymnast.

Keywords: developing child, ecological systems theory, facilities, federation, gymnastics, influence, participation, social factors, socioeconomic status, sport

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Authors: Estifanos H. Zeru

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Introduction: Epidemiological research is important to draw need-based rational public health policy. However, research on child and adolescent mental health in low and middle income countries, where socioeconomic, political, cultural, biological and other mental health hazards are in abundance, is almost nonexistent. To the author's knowledge, there is no published research in this field in Eritrea, whose child and adolescent population constitutes 53% of its total population. Study Aims and Objectives: The objective of this study was to determine the prevalence and patterns of DSM-IV psychiatric disorders and identify their socio-demographic correlates among children and adolescents in Mendefera, Eritrea. The study aims to provide local information to public health policymakers to guide policy in service development. Methodology: In a cross-sectional two stage procedure, both the Parent and Child versions of the SDQ were used to screen 314 children and adolescents aged 4-17 years, recruited by a multi-stage random sampling method. All parents/adult guardians also completed a socio-demographic questionnaire. All children and adolescents who screened positive for any of the SDQ abnormality sub-classes were selected for the second stage interview, which was conducted using the K-SADS-PL 2009 Working Draft version to generate specific DSM-IV diagnoses. All data gathered was entered into CSPro version 6.2 and was then transported in to and analyzed using SPSS version 20 for windows. Results: Prevalence of DSM-IV psychiatric disorders was found to be 13.1%. Adolescents 11-17 years old and males had higher prevalence than children 4-10 years old and females, respectively. Behavioral disorders were the commonest disorders (9.9%), followed by affective disorders (3.2%) and anxiety disorders (2.5). Chronic medical illness in the child, poor academic performance, difficulties with teachers in school, psychopathology in a family member and parental conflict were found to be independently associated with these disorders. Conclusion: Prevalence of child and adolescent psychiatric disorders in Eritrea is high. Promotion, prevention, treatment, and rehabilitation for child and adolescent mental health services need to be made widely available in the country. The socio-demographic correlates identified by this study can be targeted for intervention. The need for further research is emphasized.

Keywords: adolescents, children, correlates, DSM-IV psychiatric disorders, Eritrea, K-SAD-PL 2009, prevalence and correlates, SDQ

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Authors: Xiangmei Li

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Domestic violence (DV) victims are at a greater risk of suffering mental health problems; however, not all victims experience the same degree of depression. Women respond differently to gender inequalities based on their gender ideologies. This study explored the moderating role of gender ideology in the relation between exposure to DV and depression. Data were drawn from a sub-sample of women aged 18-60 from the Third WaveSurvey on the Social Status of Women in China (N = 10,701). The survey adopted astratified three-stage sampling design to select a representative sample of respondents from the country. Regression models were used to examine the moderating effects of gender ideology on the relation between DV and depression. Women who reported DV experience had more severe depressive symptoms after controlling for confounding social–demographic factors (β = 0.592, 95% CI: 0.489 – 0.695). Women's gender ideology moderated the association between DV severity and depression (β = -0.049, 95% CI: -0.085 – -0.013), despite being subjected to the same levels of victimization. The experience of domestic violence is a useful indicator for routine screening for depression in clinic and community settings. Interventions that aim to decrease depression caused by DV are more likely to be effective if they promote more egalitarian gender ideology to counter the mindset that a woman's role is confined to the home and a family suffers if the wife participates in the labor force.

Keywords: domestic violence against wives, depression, gender ideology, moderation

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Authors: Tamirat Solomon, Aberash Yohannis, Efrem Gulfo

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The plantation of trees, which harmonizes the agroecology of the environment, has been implemented in Ethiopia with great concern for a noticeably degraded environment. This study was designed to evaluate the effectiveness of green legacy, species selection and, the rate of survival, and the management status in the study areas. A systematic sampling method was employed to collect the required data from 144 quadrants measuring a 15m radius with an interval of 40m apart. Additionally, 244 sample households were selected for the socioeconomic study in addition to secondary data collected from office recordings. The data collected was analyzed using multivariate analysis, considering exposure and outcome variables. The findings of this study indicated that four exotic tree species, namely; A. salgina, C. fistula, A. indica, and G. robusta, were commonly selected tree species for degraded land restoration in the study areas. Among the seedlings planted at the four study sites, a total of 79.9% survived, and A. salgina was the dominant and best performed species, A. indica was the least survived species in the entire study area. The age of the seedling before planting significantly (p = 0.05) affected the survival potential of most seedlings of species, and the majority (82%) of local communities expressed their positive attitudes and willingness to manage the restoration works in the study areas. It was recommended to consider the inclusion of native species in the restoration effort and evaluate the co-existence of native flora with exotic and its competition for nutrients, water, and light in addition to the invading potentials in the ecosystem. In general, before embarking on degraded land restoration, species selection, adequate preparation of seedlings, and species diversity composition that exactly fit the socioeconomic and ecological demands of the areas must get the attention for the success of the restoration.

Keywords: plantation forest, degraded land, forest restoration, plantation survival, species selection

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Authors: Suteera Pradubwong, Pattama Surit, Sumalee Pongpagatip, Tharinee Pethchara, Bowornsilp Chowchuen

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Background: Cleft lip and palate (CLP) is a congenital anomaly of the lip and palate that is caused by several factors. It was found in approximately one per 500 to 550 live births depending on nationality and socioeconomic status. The Tawanchai Center and out-patients surgical room of Srinagarind Hospital are responsible for providing care to patients with CLP (starting from birth to adolescent) and their caregivers. From the observations and interviews with nurses working in these units, they reported that both patients and their caregivers confronted many problems which affected their physical and mental health. Based on the Soukup’s model (2000), the researchers used evidence triggers from clinical practice (practice triggers) and related literature (knowledge triggers) to investigate the problems. Objective: The purpose of this study was to investigate the problems of care for patients with CLP in the Tawanchai Center and out-patient surgical room of Srinagarind Hospital. Material and Method: The descriptive method was used in this study. For practice triggers, the researchers obtained the data from medical records of ten patients with CLP and from interviewing two patients with CLP, eight caregivers, two nurses, and two assistant workers. Instruments for the interview consisted of a demographic data form and a semi-structured questionnaire. For knowledge triggers, the researchers used a literature search. The data from both practice and knowledge triggers were collected between February and May 2016. The quantitative data were analyzed through frequency and percentage distributions, and the qualitative data were analyzed through a content analysis. Results: The problems of care gained from practice and knowledge triggers were consistent and were identified as holistic issues, including 1) insufficient feeding, 2) risks of respiratory tract infections and physical disorders, 3) psychological problems, such as anxiety, stress, and distress, 4) socioeconomic problems, such as stigmatization, isolation, and loss of income, 5)spiritual problems, such as low self-esteem and low quality of life, 6) school absence and learning limitation, 7) lack of knowledge about CLP and its treatments, 8) misunderstanding towards roles among the multidisciplinary team, 9) no available services, and 10) shortage of healthcare professionals, especially speech-language pathologists (SLPs). Conclusion: From evidence-triggers, the problems of care affect the patients and their caregivers holistically. Integrated long-term care by the multidisciplinary team is needed for children with CLP starting from birth to adolescent. Nurses should provide effective care to these patients and their caregivers by using a holistic approach and working collaboratively with other healthcare providers in the multidisciplinary team.

Keywords: evidence-triggers, cleft lip, cleft palate, problems of care

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Authors: Yung-Feng Yen, Yun-Ju Lai

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Background: Animal studies have shown that alcohol exposure may cause immunosuppression and increase the susceptibility to tuberculosis (TB) infection. However, the temporality of alcohol consumption with subsequent TB development remains unclear. This nationwide population-based cohort study aimed to investigate the impact of alcohol exposure on TB development in Taiwanese adults. Methods: We included 46 196 adult participants from three rounds (2001, 2005, 2009) of the Taiwan National Health Interview Survey. Alcohol consumption was classified into heavy, regular, social, or never alcohol use. Heavy alcohol consumption was defined as intoxication at least once/week. Alcohol consumption and other covariates were collected by in-person interviews at baseline. Incident cases of active TB were identified from the National Health Insurance database. Multivariate logistic regression was used to estimate the association between alcohol consumption and active TB, with adjustment for age, sex, smoking, socioeconomic status, and other covariates. Results: A total of 279 new cases of active TB occurred during the study follow-up period. Heavy (adjusted odds ratio [AOR], 5.21; 95% confident interval [CI], 2.41-11.26) and regular alcohol use (AOR, 1.73; 95% CI, 1.26-2.38) were associated with higher risks of incident TB after adjusting for the subject demographics and comorbidities. Moreover, a strong dose-response effect was observed between increasing alcohol consumption and incident TB (AOR, 2.26; 95% CI, 1.59-3.21; P <.001). Conclusion: Heavy and regular alcohol consumption were associated with higher risks of active TB. Future TB control programs should consider strategies to lower the overall level of alcohol consumption to reduce the TB disease burden.

Keywords: alcohol consumption, tuberculosis, risk factor, cohort study

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Authors: Anna Mirczak

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Introduction: In connection with the aging of the population and the increase in the number of people with chronic illnesses, the priority objective for public health has become not only lengthening life, but also improving quality of life in older persons, as well as maintenance of their relative independence and active participation in social life. The most important determinant of a person’s quality of life is health. According to the literature, older people with chronic illness who live in rural settings are at greater risk for poor outcomes than their urban counterparts. Furthermore research characterizes the rural elderly as having a higher incidence of sickness, dysfunction, disability, restricted mobility, and acute and chronic conditions than their urban citizens. It is dictated by the overlapping certain specific socio-economic factors typical for rural areas which include: social and geography exclusion, limited access to health care centers, and low socioeconomic status. Aim of the study: The objective of this study was to recognize health status and needs of older people living in selected rural areas in Poland and evaluate the impacts of working in the farm on their health status. Material and methods: The study was performed personally, using interviews based on the structural questionnaires, during the period from March 2011 to October 2012. The group of respondents consisted 203 people aged 65 years and over living in selected rural areas in Poland. The analysis of collected research material was performed using the statistical package SPSS 19 for Windows. The level of significance for the tested the hypotheses assumed value of 0.05. Results: The mean age of participants was 75,5 years (SD=5,7) range from 65 to 94 years. Most of the interviewees had children (89.2%) and grandchildren (83.7) and lived mainly with family members (75.9%) mostly in double (46.8%) and triple (20.8%) household. The majority of respondents (71,9%) were physical working on the farm. At the time of interview, each of the respondents reported that they had been diagnosed with at least one chronic diseases by their GP. The most common were: hypertension (67,5%), osteoarthritis (44,8%), atherosclerosis (43,3%), cataract (40,4%), arrhythmia (28,6%), diabetes mellitus (19,7%) and stomach or duodenum ulcer diseases (17,2%).The number of diseases occurring of the sample was dependent on gender and age. Significant associations were observed between working on the farm and frequency of occurrence cardiovascular diseases, the gastrointestinal tract dysfunction and sensory disorders. Conclusions: The most common causes of disability among older citizens were: chronic diseases, malnutrition and complaints about access to health services (especially to cardiologist and an ophthalmologist). Health care access and health status are a particular concern in rural areas where the population is older, has lower education and income levels, and is more likely to be living in medically underserved areas than is the case in urban areas.

Keywords: ageing, health status, older people, rural

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Authors: Narupon Kunbootsri, Patpiya Sirasaporn

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Low back pain is the most common of chief complaints in chronic pain. Low back pain directly affect to activities daily living and also has high socioeconomic costs. The prevalence of low back pain is high in both genders in all populations. The symptoms of low back pain including, pain at low back area, muscle spasm, tenderness points and stiff back. Trancutanous Electrical Nerve Stimulation (TENS) is one of modalities mainly use for control pain. There was indicated that TENS is wildly use in low back pain, but no scientific data about the flexibility of muscle after TENS in low back pain. Thus the aim of this study was to investigate immediate effect of TENS on flexibility and health status in patients with chronic nonspecific low back pain. Eight chronic nonspecific low back pain patients 1 male and 7 female employed in this study. Participants were diagnosed by a doctor based on history and physical examination. Each participant received treatment at physiotherapy unit. Participants completed Roland Morris Disability Questionnaire (RMDQ), numeric rating scale (NRS) and trunk flexibility before treatment. Each participant received low frequency TENS set at asymmetrical, 10 Hz, 20 minutes per point. Immediately after treatment, participants completed RNS, RMDQ and trunk flexibility again. All participants were treated by only one physiotherapist. There was a statistically significant increased in flexibility immediately after low frequency TENS [mean difference -6.37 with 95%CI were (-8.35)-(-4.39)]. There was a statistically significant decreased in numeric rating scale [mean difference 2.13 with 95%CI were 1.08-3.16]. Roland Morris Disability Questionnaire showed improvement of health status average 44.8% immediately after treatment. In conclusion, the results of the present study indicate that immediately effect after low frequency TENS can decrease pain and improve flexibility of back muscle in chronic nonspecific low back pain patients.

Keywords: low back pain, flexibility, TENS, chronic

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Authors: Rujeko Samanthia Chimukuche

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Introduction: Transboundary migration at both regional and continental levels has become the defining feature of the 21st century. The recent global migration crisis due to economic strife and war brings back to the fore an old age problem, but with fresh challenges. Migration and forced displacement are issues that require long-term solutions. In South Africa, for example, whilst much attention has been placed on xenophobic attacks and other issues at the nexus of immigrant and indigenous communities, the limited focus has been placed on the integration, specifically formal labour integration of immigrant communities and the gender inequalities that are prevalent. Despite noble efforts by South Africa, hosting several immigrants, several challenges arise in integrating the migrants into society as it is often difficult to harmonize the interests of indigenous communities and those of foreign nationals. This research study has aimed to fill in the gaps by analyzing how stringent immigration and visa regulations prevent skilled migrant women spouses from employment, which often results in several societal vices, including domestic abuse, minimum or no access to important services such as healthcare, education, social welfare among others. Methods: Using a qualitative approach, the study analyzed South Africa migration and labour policies in terms of mainstreaming the gender needs of skilled migrant women. Secondly, the study highlighted the migratory experiences and constraints of skilled Zimbabwean women migrant spouses in South Africa labour integration. The experiences of these women have shown the gender inequalities of the migratory policies. Thirdly, Zimbabwean women's opportunities and/or challenges in integration into the South African formal labour market were explored. Lastly, practical interventions to support the integration of skilled migrant women spouses into South Africa’s formal labour market were suggested. Findings: Key findings show that gender dynamics are pivotal in migration patterns and the mainstreaming of gender in migration policies. This study, therefore, contributed to the fields of gender and migration by examining ways in which gender rights of skilled migrant women spouses can be incorporated in labour integration policy making.

Keywords: accompanying spouse visa, gender-migration, labour-integration, Zimbabwean women

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Authors: K. Shaloom Mbambu, M. Pascal Tshimbalanga, K. Ruth Mutala, K. Roger Kabuya, N. Dieudonné Kabeya, Y. L. Kabeya Mukeba

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In this article, the authors examine the even more worrying situation of girls in sub-Saharan Africa. Two-girls on five are private of Global Education, which represents a real loss to the development of communities and countries. Cultural traditions, poverty, violence, early and forced marriages, early pregnancies, and many other gender inequalities were the causes of this cancer development. Namely, "it is no more efficient development tool that is educating girls." The non-schooling of girls and their lack of supervision by liberal professions have serious consequences for the life of each of them. To improve the conditions of their inferior status, girls to men introduce poverty and health risks. Raising awareness among parents and communities on the importance of girls' education, improving children's access to school, girl-boy equality with their rights, creating income, and generating activities for girls, girls, and girls learning of liberal trades to make them self-sufficient. Organizations such as the United Nations Organization can save the children. ASEAD and the AEDA group are predicting the impact of this cancer on the development of a nation's future generation must be preserved.

Keywords: young girl, Sub-Saharan Africa, higher and vocational education, development, society, environment

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Authors: Sammani Danwawu Abdullahi

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Vertex Enumeration Algorithms explore the methods and procedures of generating the vertices of general polyhedra formed by system of equations or inequalities. These problems of enumerating the extreme points (vertices) of general polyhedra are shown to be NP-Hard. This lead to exploring how to count the vertices of general polyhedra without listing them. This is also shown to be #P-Complete. Some fully polynomial randomized approximation schemes (fpras) of counting the vertices of some special classes of polyhedra associated with Down-Sets, Independent Sets, 2-Knapsack problems and 2 x n transportation problems are presented together with some discovered open problems.

Keywords: counting with uncertainties, mathematical programming, optimization, vertex enumeration

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