Search

This article traces the origin, sustenance and implications of a persistent rumour that is responsible for low measles mumps and rubella (MMR) vaccination uptake in the Somali diaspora in a number of countries across the globe. The rumour stipulates that the MMR vaccine – the silent shot – causes autism spectrum disorder (ASD). Although the association between MMR and ASD is non-causal, and various public health initiatives have promoted health information campaigns, the rumour continues to circulate in the Somali diaspora in many countries, including Sweden. This paper shows that there are valid reasons for this. The findings from this paper draw on a systematic scoping review and qualitative interview data from Sweden. The results show that the Somali community experiences higher than average rates of ASD compared to the general population. Moreover, ASD does not exist in the Somali language or their home country, is considered a Western disease that only affects Somali children in the diaspora, and is a highly stigmatised disease. Also, the Somali diaspora has had negative experiences with ASD diagnosis and care. The rumour has been sustained by the absence of an answer to their ASD fear and through active diaspora networks on social media. The network that surrounds the rumour has arguably further helped to create an epistemic community for a community whose concerns have been silenced. [ABSTRACT FROM AUTHOR]

The prevalent transition from ancient city walls to individualized forms of gated communities and fences elicited this study. This paper examined residents` perceptions and the characteristics of perimeter fencing in a traditional Yoruba settlement. It obtained primary data through the administration of questionnaires among residents of neighbourhoods within the study area. Physical observation aided in the identification of all residential neighbourhoods, which were stratified into three distinct and homogenous zones. One out of every four neighbourhoods in each homogenous zone was purposively selected. A total of 2055 buildings were identified within the selected neighbourhoods. Using systematic sampling, a total of 206 residents in separate dwelling units were selected for the survey. Residents perceived perimeter fencing as a feature for land boundary delineation, crime prevention, ownership and control, as well as privacy. Residential areas with a predominant rate of crime, a feeling of insecurity and disputes on land ownership were likely to witness increased use of perimeter fencing. The study recommends that local planning authorities should develop standards and regulations for perimeter fencing with consideration for the unique socio-cultural context. Improved methods of land allocation and subdivision should be implemented within traditional settlements. [ABSTRACT FROM AUTHOR]

Purpose: Being on dialysis is a traumatic situation particularly during adolescence. Therefore, adolescents must have self-care support according to their special needs. The goal of this study was to describe the adolescents´ self-care practices when they are on dialysis. This paper reports only the adolescents´ selfcare practices based on the health care team guidelines but adjusted to their beliefs and habits. Methods: The methodology of the study was interpretive phenomenology. In-depth interviews were conducted with 15 adolescents; Smith´s IPA procedure was used for data analysis. Results: Being on dialysis meant to the adolescents living in a different and broken world. Self-care practices included: 1) coexisting with the dialysis slavery or being attached to a machine day or night, 2) struggling with the maddening thirst experience, 3) Deciding what, when and how much food to eat, 4) taking care of an alien that helps to survive, 5) taking the medicines when feeling in need of them. Conclusion: The adolescents tried to care for themselves adjusting their care activities to the health team´s recommendations. However, they also adjusted those practices to their beliefs and habits, which allows them to live with dialysis in a less traumatic way. [ABSTRACT FROM AUTHOR]

Attribute-level sentiment element extraction aims to obtain the word pair < opinion target, opinion word > from texts, which mainly obtain fine-grained evaluation information in the attribute level. Due to the information fragmentation and semantic sparseness of product reviews, it is difficult to capture more comprehensive local information from unstructured texts, which leads to the incorrect extraction of some word pairs. Aimed at the problem, this paper proposes a framework for Attribute-Level Sentiment Element Extraction (ALSEE) towards product reviews. Firstly, a small amount of sample data is selected by random sampling, and multiple features (including part of speech, word distance, dependency relationship and semantic role) which are labelled. The labelled data are used as the training set. Then, the Condition Random Field (CRF) model is applied to extract opinion targets (OT) and opinion words (OW). The self-training strategy is used to achieve the semi-supervised learning of CRF model through iterative training. Finally, target-opinion word pairs with modifying relationship are obtained by dependency parsing. Compared with the existing methods, the proposed framework can effectively extract attribute-level sentiment elements though experimental results. [ABSTRACT FROM AUTHOR]

This paper reports on the design of a study to examine the policy landscape relevant to sugar-sweetened beverage taxation in seven sub-Saharan African countries. The study responds to the need for strong policy to address the rising burden of non-communicable diseases in the region. Sugar-sweetened beverage taxation has been widely recommended as a key component of a comprehensive policy approach to NCD prevention. However, it has proved a contentious policy intervention, with industry strongly opposing the introduction of such taxes. The aim was to identify opportunities to strengthen sugar-sweetened beverage taxation-related policy for the prevention of nutrition-related NCDs in a subset of Eastern and Southern African countries: Kenya, Tanzania, Botswana, Rwanda, Namibia, Zambia, Uganda. The study was conducted as a collaboration by researchers from nine institutions; including the seven study countries, South Africa, and Australia. The research protocol was collabora-tively developed, drawing on theories of the policy process to examine the existing availability of evidence, policy context, and stakeholder interests and influence. This paper describes the development of a method for a policy landscape analysis to strengthen policies relevant to NCD prevention, and specifically sugar-sweetened beverage taxation. This takes the form of a prospective policy analysis, based on systematic documentary analysis supplemented by consultations with policy actors, that is feasible in low-resource settings. Data were collected from policy documents, government and industry reports, survey documentation, webpages, and academic literature. Consultations were conducted to verify the completeness of the policy-relevant data collection. We analysed the frames and beliefs regarding the policy 'problems', the existing policy context and understandings of sugar-sweetened beverage taxation as a potential policy intervention, and the political context across relevant sectors, including industry interests and influence in the policy process. This study design will provide insights to inform public health action to support sugar-sweetened beverage taxation in the region. [ABSTRACT FROM AUTHOR]

Globally Financial inclusion provides an opportunity to promote equal access to resources for all. One of the crucial catalysts for microenterprises development is access to the financial market. However, the growth of many microenterprises has been truncated in Ghana due to limited access to financial opportunities. Despite this challenge, little is known about the drivers of financial inclusion in Wa Municipality of the Upper West Region of Ghana. This paper examines the drivers of financial inclusion of microentrepreneurs in the Wa Municipality of the Upper West Region of Ghana. Using a close ended questionnaire, this study employed an exploratory survey design to collect data from 200 engaged in trading, manufacturing, and services. The respondents were sampled using a simple random sampling technique. Given that the outcome variable is binary, the study used a binary probit regression model for the data analysis. The results predicted that religion, awareness of loan services, business registration, and preparation of financial statements drive financial inclusion in Wa Municipality. From the results, the study recommends that financial service providers should consider social networks, entrepreneurial practice, gender and religion as sensitive drivers of financial inclusion. In addition, financial education should be intensified as knowledge of the available financial products is a key driver of financial inclusion in the Municipality. While this study has contributed to the body of literature on financial inclusion in Ghana, further research is necessary to identify consumer financial needs to meet clients' expectations. [ABSTRACT FROM AUTHOR]

SPC with positive autocorrelation is well known to result in frequent false alarms if the autocorrelation is ignored. The autocorrelation is a nuisance and not a feature that merits modeling and understanding. This paper proposes exhaustive systematic sampling, which is similar to Bayesian thinning except no observations are dropped, to create a pooled variance estimator that can be used in Shewhart control charts with competitive performance. The expected value and variance are derived using quadratic forms that is nonparametric in the sense no distribution or time series model is assumed. Practical guidance for choosing the systematic sampling interval is offered to choose a value large enough to be approximately unbiased and not too big to inflate variance. The proposed control charts are compared to time series residual control charts in a simulation study that validates using the empirical reference distribution control limits to preserve stated in-control false alarm probability and demonstrates similar performance. [ABSTRACT FROM AUTHOR]

Climate change is an important driver of migration, but little research exists on whether migrant communities in the U.S. identify climate change-related factors as reasons for migrating. In 2021, we conducted a multidisciplinary, collaborative project to better understand the nexus of climate change and immigrant health in the Atlanta area. This paper presents one arm of this collaboration that explored both the role of climate change in decisions to immigrate to Georgia and the ways that climate change intersects with other possible drivers of migration. First generation migrants from Latin America were recruited primarily through CPACS Cosmo Health Center and were invited to participate in an intake survey and an in-depth interview. Results were analyzed using descriptive statistics and thematic analysis. Findings suggest that while participants may not have explicitly identified climate change as a primary reason for migration, in both surveys and in-depth interviews, participants reported multiple and intersecting social, economic, political, and environmental factors that are directly or indirectly influenced by climate change and that are involved in their decisions to migrate. The narratives that emerged from in-depth interviews further contextualised survey data and elucidated the complex nexus of climate change, migration, and health. [ABSTRACT FROM AUTHOR]

Approximately 280 million people around the world suffer from depression, and the rates are higher among women than men. For women living in informal settlements in lower – and middle-income countries (LMICs) the prevalence and associated burden of depressive symptoms may be particularly high. The purpose of this paper was to explore factors associated with possible major depressive disorder (MDD) in a probability sample of women living in Mathare informal settlement in Nairobi, Kenya and to identify potential points for intervention and/or support. Quantitative surveys were conducted with 552 women aged 18–75. Possible MDD was measured using the Patient Health Questionnaire and regressed on individual, household/familial-, and community/interpersonal-level factors. Findings highlight the potential importance of factors such as physical health, economic stress, access to water and sanitation, household and family dynamics, and neighbourhood/village differences in possible MDD among women living in informal settlements. We identify potential points for research, intervention and policy including: providing appropriate tangible assistance or interventions to reduce economic stress/strain; expanding access to water and sanitation and, in doing so, reducing potential burdens to physical health; providing and expanding healthcare to include mental healthcare; and investigating family dynamics and bolstering support for families, particularly for those experiencing conflict. [ABSTRACT FROM AUTHOR]

Global health practitioners and policymakers have become increasingly vocal about the complex challenges of identifying and quantifying the causes of death of the world's poorest people. To address this cause-of-death uncertainty and to minimise longstanding sensitivities about full autopsies, the Bill and Melinda Gates Foundation have been one of the foremost advocates of minimally invasive autopsy technology (MIA). MIA involves using biopsy needles to collect samples from key organs and body fluids; as such, it is touted as potentially more acceptable and less invasive than a complete autopsy, which requires opening the cadaver. In addition, MIA is considered a good means of collecting accurate bodily samples and can provide the crucial information needed to address cause-of-death uncertainty. In this paper, we employ qualitative data to demonstrate that while MIA technology has been introduced as a solution to the enduring cause-of-death uncertainty, the development and deployment of technologies such as these always constitute interventions in complex social and moral worlds; in this respect, they are both the solutions to and the causes of new kinds of uncertainties. We deconstruct the ways in which those new dimensions of uncertainty operate at different levels in the global health context. [ABSTRACT FROM AUTHOR]

The probability of a single access point (AP) failure is very small. In addition, APs communicate with each other; therefore, it is considered that these failures have little impact on the wireless network. Only when a large number of APs are abnormal offline, do we consider that the wireless network is faulty and needs to be recovered immediately. Network breakdown, network congestion, and AP management software shutdown may cause numerous APs in aborted status. In this article, we utilize DBSCAN algorithm to detect abnormal Wi-Fi APs. Compared with other research works, our proposed unsupervised method can distinguish between normal and abnormal offline APs. This study proposes a new date dimension to calculate the number of online APs together with the time dimension, and it provides new insights to set up thresholds of online APs automatically. Experimental results show that this 3-D model based on date and time is more accurate than the traditional 2-D model only based on time. With regard to the sampling method of random forest, this paper carries out repetitive random sampling to form small sample sets and finally to obtain the mean feature plane, which can reduce the interference of abnormal points to our algorithm. [ABSTRACT FROM AUTHOR]

Young mothers often encounter stigma and discrimination, affecting their lives and that of their children. This paper explores stigma management strategies and their effectiveness for young mothers in rural Nigeria. Ten key informants and 24 young mothers were recruited from Ife-East in South-Western Nigeria. Data from semi-structured interviews showed that societal disapproval of pregnant teenagers and young mothers were common experiences. Women used a range of strategies to actively cope with stigma including: belief in predestination, avoidance, concealment, and cohabitation. These strategies could be seen as tools to mitigate negative stereotypes and discrimination. However, they also had the unintended consequences of compounding many young women’s difficult circumstances and exposing them to adverse outcomes, including gender-based violence, repeat pregnancies, poor mental health, and low uptake of services. The results show the need for policy frameworks to actively combat stigma by addressing the negative framing of early pregnancy and motherhood and promoting supportive environments for young mothers. Health professionals need to be trained to offer de-stigmatising services to encourage young mothers to seek help and reduce pre-existing inequities in access to services, and policies need to include measures that address the rights of young mothers and protect them from violence and abuse. [ABSTRACT FROM AUTHOR]

The UN’s Zero Tolerance Policy, which bans all relationships between UN staff and locals, portrays all relationships as exploitative, fails to account for nuances in these relationships and does not acknowledge the agency of local women or communities. This study uses community-based qualitative data from eastern DRC that shares narratives on a wide variety of consensual relationships between peacekeepers and local women. Our paper uses a data-driven approach, including a post-colonial feminist lens, and ideas of structural agency to provide an expanded definition of agency that invites readers to re-examine their views of women in conflict settings. Finally, we provide clear recommendations for the UN and other international non-governmental agencies on policies related to sexual exploitation and abuse. [ABSTRACT FROM AUTHOR]

For the existing image matching algorithms, some inherent shortcomings, such as high mismatch rate and low computational efficiency, give rise to a bad influence on the performance of Visual Simultaneous Localization and Mapping (VSLAM). In this paper, a Grid-Based Motion Statistics for Fast and Random Sample Consensus (GMS-RANSAC) method combining with Multi-Probe Location Sensitive Hash (LSH)-based Adaptive and Generic Corner Detection Based on the Accelerated Segment Test and Oriented FAST and Rotated BRIEF (AGAST-ORB) algorithm is proposed to improve the real time and accuracy of image matching. To this end, the AGAST algorithm and the multi-probe LSH algorithm are firstly integrated into the traditional ORB algorithm to obtain the initial matching set. Specifically, the image feature points are extracted by the AGAST algorithm and then the main direction of feature points is given according to the intensity centroid method to guarantee the rotary invariant of feature points. Based on the extracted feature points, the multi-probe LSH algorithm, benefiting from its high time efficiency, is used to generate the initial matching pairs. In what follows, a GMS-RANSAC algorithm, which is improved by adding a directional similarity constraint model and the traditional RANSAC algorithm, is performed to improve the accuracy of eliminating result further. Finally, the performance test is implemented via a Mikolajczyk standard data set and it is verified that the proposed algorithm has higher matching precision and matching efficiency than traditional image matching algorithms. [ABSTRACT FROM AUTHOR]

Classical continuous goodness-of-fit (GOF) testing is employed for examining whether the data come from an assumed parametric model. In many cases, GOF tests assume a uniform null distribution and examine extreme values of the order statistics of the samples. Many of these statistics can be expressed by a function of the order statistics and the p-values amount to a joint probability statement based on the uniform order statistics. In this paper, we utilize Steck's recursion method and propose two high precision computing algorithms to compute the p-values for these GOF statistics. The numerical difficulties in implementing Steck's method are discussed and compared with solutions provided in high precision libraries. [ABSTRACT FROM AUTHOR]

Background: While research on trans People of Color's experiences has been increasing in recent years, this intersectional work has often not included a focus on the specificities of multiracial and multiethnic trans experiences. Aims: This study explores shifts in racial identity by multiracial/multiethnic trans people as they transition gender and the ways Whiteness and nationalist ideology shape their racialized gender experiences. Methods: This paper is based on six in-depth, semi-structured interviewswith self-identifiedmultiracial, multiethnic, andmulti-heritage trans people in the USA. Data collection centered participants' experiences of self-identification and interactionswith others (e.g., family, acquaintances, and strangers). Results: As participants transitioned gender and were acknowledged by others in their gender identity, shifts in their embodiment were used by others to ascribe a new racialized gender. This often resulted in participants reflecting on their sense of self and racialized gender identities in new ways. Discussion: Multiracial and multiethnic transgender people's experiences in transitioning race confirm the importance of intersectional analysis, reveal the intersectional fluidity of social categories, explicate how social understandings of one category (e.g., race) influence another category (e.g., gender), demonstrate that the meanings associated with racialized gender are based in relations of power, and show that, in transgender studies particularly, we must attend to the ways that the concept of transition implicates not only gender, but also other categories such as race and nationality. [ABSTRACT FROM AUTHOR]

Ranked set sampling (RSS) design as a cost-effective sampling is a powerful tool in situations where measuring the variable of interest is costly and time-consuming; however, ranking information about sampling units can be obtained easily through inexpensive and easy to measure characteristics at little or no cost. In this paper, we study RSS data for analysis of an ordinal population. First, we compare the problem of non-representative extreme samples under RSS and commonly-used simple random sampling. Using RSS data with tie information, we propose non-parametric and maximum likelihood estimators for population parameters. Through extensive numerical studies, we investigate the effect of various factors including ranking ability, tie generating mechanisms, the number of categories and population setting on the performance of the estimators. Finally, we apply the proposed methods to the bone disorder data to estimate the proportions of patients with osteopenia and osteoporosis status. [ABSTRACT FROM AUTHOR]

Communication tower (CT) and its accessory equipment (AE) such as radio frequency equipment (RFE) and antenna, are essential in providing highspeed and stable mobile network services. It is necessary to routinely monitor the security and stability of CT and AE for seamless communication. There is limited research on fine segmentation of communication base station objects. This paper proposes a method for accurately segmenting the point cloud of the CT and AE from Terrestrial Laser Scanning (TLS) data. At first, the CT point cloud is accurately segmented based on region growing and Random Sample Consensus (RANSAC). Then, the point cloud of pole-shaped apart is extended to a certain distance to obtain the buffer point cloud containing AE. Normal Differential (ND) clustering is employed to obtain several groups of clusters containing planes, and calculate each plane's filling rate and size. Finally, the cluster type (such as antenna, RFE, or other) is distinguished. The experimental results demonstrate that the point-based average F1-score of CTs is 98. 70%, the point-based and object-based average F1-scores of antennas are 96. 09% and 97. 93%, and the corresponding values for the RFE are 89. 89% and 90. 00%, respectively, indicating the optimal performance of the proposed method. [ABSTRACT FROM AUTHOR]

Although white stork Ciconia ciconia counts go back to the XIX century, making the species a model in population investigations, substantial gaps remain in the knowledge of its large-scale population dynamics. In particular, incomplete past estimates from the core breeding areas leave the long-term changes uncertain. In this paper, we provide the earliest estimation of population size and spatial distribution of the white stork in its main stronghold (Poland) to reconstruct the species long-term trends. Based on original survey data collected during the 2nd (1958, incomplete in Poland) and 3rd (1974, successful) International White Stork Census (IWSC) we compared stork numbers in a random sample of villages surveyed on both occasions. We applied linear models to estimate the population growth rate between 1958 and 1974 and to assess spatial variation in population change across the country. Finally, we collated worldwide stork numbers obtained from all IWSCs and discuss the long-term population trends in light of new data. The stork population in Poland in 1958 was estimated at 46,100 breeding pairs and the nationwide density at 14.7 pairs/100 km2. A strong decline (by 30.2%, 1.88% per year) was noted between 1958 and 1974 across Poland with prominent spatial variation reflecting differences in local densities. The strongest declines in absolute terms affected the most abundant populations in Eastern Poland. Our data show that in the mid-20th century, the stork population in Poland was close to the current level, but it experienced a massive decline during the 1960s–1980s. This decline was consistent with trends in the worldwide and regional European populations, contrary to earlier statements indicating limited, if any, changes in the core European area. Overall, our data expand knowledge on the long-term dynamics in the white stork numbers and show that even massive changes may easily go undetected if based on non-solid data. [ABSTRACT FROM AUTHOR]

This paper was analyzed the impact of off-farm activities on food security status of rural households in the Dibatie district of the Bebishangul Gumuz region. The study was used in a simple random sampling technique to select respondent households with proportionate sample size based on the number of households exist in sampled kebele administrations. The primary data were collected using a structured questionnaire and key informants' interview. Both descriptive statistics and econometric model (an endogenous switching probit) were used to analyze this data at household levels. This model accounts for selection bias resulting from unobserved factors that potentially affect both household's participation and food security outcomes and also the model shows the counterfactual case of food security outcomes. Food security index is used to measure the food security status of sample households based on average kCal/day/adult equivalent. The result of this study revealed that about 59.4% of the households were food secure and 40.6% of households were food insecure. And also, about 55.4% of the households were off-farm participants and 44.6% of households were off-farm non-participants. Moreover, computing switch_probit command, the impacts of participant household have higher probability of food security status as compared with the counterfactual case of non-participants. In addition, the model result shows that variables such as household size, distance to the nearest market, age of household head, education level of household head, special skill, utilization of formal credit, access to electricity and frequency of extension contact were found to have a significant influence on off-farm participation. Finally, the study suggesting that the interventions designed to promote farmers participating in off-farm activities that are made to increase food security status at the household level in the study area. This is because there could be increased productivity effects in this off-farm economy, better agricultural linkages and indeed, stronger structural transformation of the rural economy. [ABSTRACT FROM AUTHOR]

This paper considers the estimation of parameters for the Poisson regression model in the presence of high, but imperfect multicollinearity. To mitigate this problem, we suggest using the Poisson Liu Regression Estimator (PLRE) and propose some new approaches to estimate this shrinkage parameter. The small sample statistical properties of these estimators are systematically scrutinized using Monte Carlo simulations. To evaluate the performance of these estimators, we assess the Mean Square Errors (MSE) and the Mean Absolute Percentage Errors (MAPE). The simulation results clearly illustrate the benefit of the methods of estimating these types of shrinkage parameters in finite samples. Finally, we illustrate the empirical relevance of our newly proposed methods using an empirically relevant application. Thus, in summary, via simulations of empirically relevant parameter values, and by a standard empirical application, it is clearly demonstrated that our technique exhibits more precise estimators, compared to traditional techniques – at least when multicollinearity exist among the regressors. [ABSTRACT FROM AUTHOR]

In low- and middle-income countries, there is scarcity of validated and reliable measurement tools for health facility management, and many interventions to improve primary health care (PHC) facilities are designed without adequate evidence base on what management practices are critical. This article developed and validated a scorecard to measure management practices at primary health care facilities under the performance-based financing (PBF) scheme in Nigeria. Relevant management practice domains and indicators for PHC facilities were determined based on literature review and a prior qualitative study conducted in Nigeria. The domains and indicators were tested for face validity via experts review and organized into an interviewer-administered scorecard. A stratified random sampling of PHC facilities in three States in Nigeria was conducted to assess the reliability and construct validity of the scorecard. Inter-rater reliability using inter-class correlation (ICC) (1, k) was assessed with one-way ANOVA. Exploratory factor analysis (EFA) was conducted to assess the construct validity, and an updated factor structure were developed. 32 indicators and 6 management practice domains were initially described. Ordinal responses were derived for each indicator. Data on the scorecard were obtained from 111 PHC facilities. The ICC of mean ratings for each team of judges was 0.94. The EFA identified 6 domains (Stakeholder engagement and communication; Community-level activities; Update of plan and target; Performance management; Staff attention to planning, target, and performance; and Drugs and financial management) and reduced the number of indicators to 17. The average communality of selected items was 0.45, and item per factor ratio was 17:6. Despite a few areas for further refinement, this paper presents a reliable and valid scorecard for measuring management practices in PHC facilities. The scorecard can be applied for routine supervisory visits to PHC facilities, and can help accumulate knowledge on facility management, how it affects performance, and how it may be strengthened. [ABSTRACT FROM AUTHOR]

Purpose: Healthiness is constructed, in Western culture, as a moral ideal or supervalue. This paper will interrogate the assumption that health and the pursuit of healthiness is always and unquestionably positive, by exploring how discourses of health and freedom interact to reinforce the current inequalities and detract from social transformation. Method: Twenty young South African adults were interviewed about their understandings and experiences of health. These discussions were analysed using Foucauldian discourse analysis. Results: Participants constructed healthiness as facilitating the experience of freedom, while at the same time being dependent on a personal orientation towards freedom (as opposed to merely submitting to dominant health authorities). Freedom discourses also played a role in connecting health to neoliberal discourses idealizing economic productivity and hard work. Participants were able to construct a self that is active, productive, valuable, hopeful, and self-assured when talking about health using discourses of freedom. However, these discourses also functioned to moralise and idealise healthiness, which contributed to blaming poor health on its sufferers. Conclusion: Health/freedom discourses can further reinforce the neoliberal value of individual responsibility by constructing self-improvement and self-work as the solution to ill-health, thereby contributing to victim-blaming and weakening support for public health interventions. [ABSTRACT FROM AUTHOR]

Background: Improving maternal health is a major development goal, with ambitious targets set for high-mortality countries like Bangladesh. Following a steep decline in the maternal mortality ratio over the past decade in Bangladesh, progress has plateaued at 196/100,000 live births. A voucher scheme was initiated in 2007 to reduce financial, geographical and institutional barriers to access for the poorest. Objective: The current paper reports the effect of vouchers on the use of continuum of maternal care. Methods: Cross-sectional surveys were carried out in the Chattogram and Sylhet divisions of Bangladesh in 2017 among 2400 women with children aged 0–23 months. Using Cluster analysis utilisation groups for antenatal care, facility delivery and postnatal care were formed. Clusters were regressed on voucher receipt to identify the underlying relationship between voucher receipt and utilisation of care while controlling for possible confounders. Results: Four clusters with varying levels of utilisation were identified. A significantly higher proportion of voucher-recipients belonged to the high-utilisation cluster compared to non-voucher recipients (43.5% vs. 15.4%). For the poor voucher recipients, the probability of belonging to the high-utilisation cluster was higher compared to poor non-voucher recipients (33.3% vs. 6.8%) and the probability of being in the low-utilisation cluster was lower than poor non-voucher recipients (13.3% vs. 55.4%). Conclusion: The voucher programme enhanced uptake of the complete continuum of maternal care and the benefits extended to the most vulnerable women. However, a lack of continued transition through the continuum of maternal care was identified. This insight can assist in designing effective interventions to prevent intermittent or interrupted care-seeking. Programmes that improve access to quality healthcare in pregnancy, childbirth and the postnatal period can have wide-ranging benefits. A coherent continuum-based approach to understanding maternal care-seeking behaviour is thus expected to have a greater impact on maternal, newborn and child health outcomes. [ABSTRACT FROM AUTHOR]

The article presents a clarification of the paper "An Analysis of Data Quality: Professional Panels, Student Subject Pools, and Amazon's Mechanical Turk," by Jeremy Kees et al. in the 2017 issue, by discussing the issues related to cheating, speeding and other concerns which may appear with the use of Mechanical Turk (MTurk) research methodology. Topics addressed include the similarity of MTurk crowdsourcing with traditional methods, the indication of poor data quality and limitation of sampling method. The mean completion of the survey using MTurk is assessed.

Background: Understanding the magnitude of inequalities and drivers for reducing gender-related health inequalities is crucial in developing countries. This is particularly the case for Liberia with its very high level of gender-related inequalities in health and health outcomes. Objective: This paper assesses the magnitude of gender health inequalities and the relative contribution of different factors to health inequality in Liberia. Methods: Data came from the Liberian Household Income Expenditure Survey 2014. A two stage sampling methodology was used and 4,104 households were randomly selected and interviewed. The main variable of interest is dichotomised, good versus poor self-assessed health. Gender-related health inequality is assessed using the Oaxaca–Blinder decomposition for non-linear models. The decomposition reveals the magnitude of inequality and contributions of different factors. Results: We found large gender disparities (0.054, p < 0.01) characterised by women disadvantages in health status. In addition, the gender health disparities are mostly pronounced in rural areas. About 54% of the gender inequalities in health status were explained by the differences in endowments. Equalizing access to information, wealth and utilization of mosquito nets would reduce the gender gaps by 44, 5 and 4%, respectively. Conclusions: Addressing gender health inequalities inter alia requires access to health information (i.e. electronic and print media), gender responsive interventions that improve wealth in key sectors (i.e. education, employment, social protection, housing, and other appropriate infrastructure). In addition, the government, private sector and civil society should ensure that the health sector provides access to quality mosquito nets and improved health services including preventive care in order to reduce disease burden. [ABSTRACT FROM AUTHOR]

In recent years, the coefficient of variation (CV) chart is receiving increasing attention in quality control. A number of studies demonstrated that adaptive charts could detect process shifts faster than traditional charts. This paper proposes an EWMA chart with variable sampling interval (VSI) to monitor the CV. Formulas for computing the performance measures of the VSI EWMA-γ² chart are derived using Markov chain, where γ² denotes the CV squared. Comparative studies show that the VSI EWMA-γ2 chart signifi- cantly outperforms other competing charts. An example using real manufacturing data shows that the VSI EWMA-γ² chart performs well in applications. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate the effects of Virtual reality training on dynamic balance of children with spastic hemiplegic cerebral palsy (SHCP). 20 girls with SHCP (mean age =9.4; SD =1.48) were selected from special schools and divided into the experimental and control groups. Commercially available Kinect dance game (Microsoft Inc., Redmond, WA, U.S.A.) 'Just Dance 3' and Modified star excursion balance test (SEBT) were used for video game based training and dynamic balance tests, respectively. MANCOVA and ANCOVA Tests were performed at p < 0.05 to analyze the data. Based on MANCOVA test results, there was a significant difference between groups at least in one of the dynamic balance variables (anterior, posterolateral, and posteromedial) after controlling for pretest (F (3, 13) = 41.81, p <.005). Results of ANCOVA test showed a significant difference between the dynamic balance variables in the anterior (F = 52.80, p = 0.001), posterolateral (F = 117.86, p = 0.001), and posteromedial (F = 23.84, p = 0.001) directions in children with cerebral palsy. This paper proposes that video game based training can successfully guide children with cerebral palsy to improve their balance ability. This virtual system is therefore an interesting tool in the therapies related to the children with cerebral palsy. [ABSTRACT FROM AUTHOR]

To estimate the effects of an interactive web-based support system via mobile phone on preference-based patient participation in patients with hypertension treated in primary care (compared with standard hypertensive care only). A parallel group, non-blinded, randomized controlled trial, conducted October 2018–February 2021. Besides standard hypertensive care, the intervention group received eight weeks of support via mobile phone to facilitate self-monitoring and self-management, tentatively providing for augmented patient engagement. 31 primary healthcare centers in Sweden. 949 patients treated for hypertension. The effects on preference-based patient participation, that is, the match between a patient's preferences for and experiences of patient participation in their health and healthcare. This was measured with the 4Ps (Patient Preferences for Patient Participation) tool at baseline, after 8 weeks, and at 12 months. Data were registered electronically and analyzed with multilevel ordinal regression. At baseline, 43–51% had a complete match between their preferences for and experiences of patient participation. There was an indication of a positive effect by a higher match for 'managing treatment myself' at 8-weeks in the intervention group. Such preference-based participation in their health and healthcare was reversed at 12 months, and no further effects of the intervention on preference-based patient participation persisted after 12 months. The interactive web-based support system via mobile phone had a wavering effect on preference-based patient participation. There is a prevailing need to better understand how person-centered patient participation can be facilitated in primary care. Although patient participation is essential when having a long-term condition, interventions optimizing individuals' engagement have not been fully identified. About half of the patients with hypertension in this study did not experience participation in the manner and extent they preferred. A web-based support system via mobile phone improved some aspects of patient participation in the short- but not long term. Strategies to better identify patients' preferences for patient participation are needed, to evaluate and improve the outcome of care. [ABSTRACT FROM AUTHOR]

Disability encompasses the limitations on an individual’s basic physical activities, and the consequent social oppressions such individual faces in society. In this regard, the limitation on the use of some parts of the genitals in a patriarchal system is considered a form of disability. This paper describes the perceptions of and the coping mechanisms employed by affected couples dealing with the consequences of female genital mutilation (FGM) as a form of sexual disability. Cultural Libertarianism was employed as a theoretical framework. The paper presents the results of a descriptive cross-sectional study conducted in Akure, Ondo State, Nigeria, with 10 male and 12 female respondents purposively selected through a snowball sampling for in-depth interviews. The findings present the justifications provided for the practice of FGM, and victims’ perceptions of how it affects their sexual relations. Furthermore, it highlights coping strategies employed by affected women and their spouses. The study shows that the disabling consequence of FGM is largely sexual in nature, leading to traumatic experiences and negative beliefs about sex, and requiring a myriad of coping strategies employed by the disabled women, and their spouses, which may have its own implications for marital and sexual bliss. [ABSTRACT FROM PUBLISHER]

This study was conducted to identify farmers' breeding objectives and trait preferences for indigenous cattle in north-west Ethiopia. Multistage purposive and random sampling techniques were used to select study districts, and smallholder farmers. The required data were collected through structured questionnaires from 320 households, personal observations, and focus group discussions. The chisquare (Χ2) test, least squares mean, and ranking index were statistical methods used for data analysis. The least squares mean analysis showed a difference (p < 0.001) and the mean herd size was 10.9 heads. Based on ranking index results, milk production (0.35) and draught power (0.25) were the main cattle production purpose/objectives of farmers. The chi-square (Χ2) test results of mating practices showed a significant difference (p < 0.001) and 63.8% of farmers used controlled mating. According to the ranking index result, large body size (0.35), colour (0.26), and good traction (0.18) were considered the most important traits in selecting a breeding bull. High milk yield (0.4), colour (0.19), large body size (0.16), and calf growth (0.13) were the preferred traits/criterias for cow selection. Prioritizing farmer trait preference and breeding objectives in this study was critical for the design and implementation of breeding programmes. [ABSTRACT FROM AUTHOR]

Objective: Patient education based on the patient's individual needs and circumstances is known to be associated with positive changes in clinical outcomes in chronic obstructive pulmonary disease (COPD). We aimed to assess the levels of patients' subjective needs for information about COPD before and after their general practitioners had taken part in a COPD education. Design: A secondary analysis of a cluster randomized controlled trial Setting: 22 PHCCs in Stockholm, Sweden Subjects: Randomly selected primary care patients with COPD in GOLD stages 2 and 3 (n=293) Outcome measures: Scores in the Lung Information Needs Questionnaire (LINQ) at baseline and 18months, spirometry results, and self-reported, descriptive patient data. Results: GPs' improved skills in COPD did not affect patients' self-management skills over time. In general, patients' information needs remained great in issues concerning diet, exercise and self-management. However, 43% of the patients reported reduced and 57% increased or unchanged information needs, over time. Reduced information needs were mainly associated with a high level of information needs at baseline (OR = 3.17 [95% CI 1.93-5.23], p<.01) and establishing contact with a physiotherapist (OR = 2.26 [95% CI 1.05-4.86], p=.038). Patients in a mild or stable phase of COPD with no recent exacerbations reported greater needs than those with unstable, deteriorated COPD. Conclusion: Patients' information needs are substantial in most areas of self-management of COPD, and seem to covary with the patient's current clinical status. Care providers should thus continuously be vigilant about offering all patients with COPD support and education. [ABSTRACT FROM AUTHOR]

South Asians are the largest and fastest-growing racialized group in Canada, yet there are limited data on various aspects of health and well-being within this population. This includes the South Asian older adults' ethnoculturally informed perceptions of ageing. The study aimed to understand how social and cultural forces impact the meaning assigned to healthy ageing amongst older South Asians in Canada. We recruited with purposeful and snowball sampling strategies in Southern Ontario. We conducted in-depth focus group and individual interviews (n = 19) in five South Asian languages, employing a multilingual and cross-cultural qualitative approach. In our analysis, we identified three central themes: (a) taking care of body (b) taking care of mind and heart and (c) healthy ageing through the integration of mind and body. Our study demonstrates that older immigrants are a diverse and heterogeneous population and that their conception of healthy ageing is strongly influenced by their country of origin. This study also demonstrates how racialized foreign-born older adults might provide distinctive perspectives on the ageing process and on social theories of ageing due to their simultaneous immersion in and belonging to global majority and global minority cultures. This research also adds to the limited body of literature on the theories of ageing, despite migration trends, still has a white-centric lens. [ABSTRACT FROM AUTHOR]

Purpose: China employed a unique volunteerism system where health care providers outside of Hubei Province, the epicentre, travelled to reverse the devastation wrought by coronavirus disease 2019 (COVID-19) at its global onset. The aim is to study the unique circumstances of Chinese volunteerism in the context of continuing pandemic threats, specifically exploring the experiences of 20 Chinese nurse and physician volunteers fighting COVID-19 during the outbreak. Methods: Interviews were done through video calling. Results: Using content analysis with a hermeneutic perspective, emerging patterns showed the ways in which China's particular manifestation of volunteerism teaches us how to engage global threats of this nature. The overarching lesson, For the Good of the People, was manifested in several dynamic and overlapping themes: 1) Reaching for Professional Standards Even in Crisis; 2) Constantly Caring Through Failures and Successes; and 3) Holding Fast to the Common Good. The devastation was met by the resilience of volunteers, who overcame profound challenges managing patient care. Conclusions: Volunteerism required sacrifice and tremendous support in the form of training and administrative direction, family support, and peer collaboration. Volunteers' physical and psychosocial wellbeing was a priority. Recognizing the representative themes can help societies plan for continuing and future events. [ABSTRACT FROM AUTHOR]

Background: The incidence and prevalence of COVID-19 continues to escalate globally, with the consequence to quality of life, the economies of nations and various sectors of society. While there is substantial research on the impact and experiences of the COVID-19 pandemic, little remains known about the perceptions and lived experiences of families living with people diagnosed with COVID-19, particularly within the South African context. Purpose: To explore the perceptions and lived experiences of family members living with people diagnosed with COVID-19 in South Africa. Methods: A descriptive phenomenological design was used. Data were collected from 15 participants who were family members of people diagnosed with COVID-19 in South Africa. Purposive snowball sampling was used to identify and recruit participants, and data were collected at community level in KwaZulu-Natal, Western Cape and Gauteng, South Africa. Individual in-depth interviews were used to collect the data, and an audio tape was used to record all interviews. Data were transcribed verbatim and analysed using a phenomenological data analysis processes. Ethical approval to conduct the study was obtained from the University of KwaZulu-Natal Research Ethics Committee--reference number: BREC00003228/ 2021. Results: Four super-ordinate themes emerged in relation to the perceptions and lived experiences of family members living with people diagnosed with COVID-19 in South Africa. The superordinate themes were: (1) sources of information about COVID-19, (2) pandemic perceptions and experiences, (3) impact of diagnosis and related burden and (4) aftermath of living with a family member diagnosed with COVID-19. Discussion and conclusion: Family members' perceptions and lived experiences of COVID-19 are largely influenced by media, moreover, the impact of diagnosis has consequences for the physical, mental and emotional well-being of family members. Diagnosis disrupts family dynamics by depleting financial resources due to the caregiver burden experienced. The findings thus imply that provision of psychosocial support is imperative for families living with persons diagnosed with COVID-19. [ABSTRACT FROM AUTHOR]

Purpose: Pharmacists can enhance mHealth delivery by promoting the awareness and use of health apps, while pharmacy students and early career pharmacists allow broader perspective for further development. This study aimed to explore the experiences and attitudes of pharmacy students and pharmacists, on the use, advantages and possible improvement of available mHealth platforms in Serbia. Methods: One-on-one interviews were conducted online in two phases, during March and April 2020 (n = 40) and during March 2021 (n = 20), using a published, validated interview guide which was adapted for this study. Interviews were transcribed ad verbatim, coded and thematically analysed. Results: Although participants recognized room for optimization, most apps had satisfactory user experience. Participants used health apps as a source of updated information and tools in education and work, but also for self-development. During working hours, participants mostly used medication-related apps, however, it was shown that they use different health apps in order to provide the best possible care to patients. Conclusions: Greater insight into usage, expectations, benefits and challenges of mHealth in pharmacy was obtained and can lead into better informed design of health apps to encourage students and pharmacists, both as professionals and individuals, on the path of their continuous improvement. [ABSTRACT FROM AUTHOR]

Purpose: The COVID-19 pandemic restrictions have had a major impact on the organization of health services in Europe. Co-parents' experiences of not being allowed to fully participate during pregnancy, childbirth, and the postpartum period is poorly understood. We investigated how the non-birthing partner experienced becoming a parent during the pandemic. Methods: We applied a qualitative design. We recruited the participants from all part of the country by using snowball sampling. 18 individual interviews were conducted by using videotelephony software program/telephone. The transcripts were analysed using a six-step model for thematic analysis. Results: The non-birthing participants were not considered by the healthcare system to be equal partners in terms of their involvement in the process of becoming parents. Three themes were constructed from the interview analysis- deprivation of the opportunity of "doing their part" of the job; participation by proxy to enhance togetherness; and choosing between obedience or opposition to the restrictions. Conclusion: The non-birthing co-parents felt deprived of doing what they considered to be their most important job--namely, to support and comfort their partners during pregnancy and childbirth. The healthcare system's decision to exclude co-parents from being physically present thus requires further reflection and discussion. [ABSTRACT FROM AUTHOR]

Previous research has widely recognized the challenges uniformed police officers face in their working lives. However, little is known about the overall lifestyles of police officers, including what they do in private life. We interviewed 17 officers and used reflexive thematic analysis to explore their experiences. The study sheds light on how uniformed police officers navigate the intersection between their private and professional lives, as well as how their professional role impacts their day-to-day doings and private life roles. The key findings relate to how the demands of their professional role impact their private life, such as the profession becoming a way of life. Furthermore, they highlight the challenges of avoiding certain environments where they might be recognized as police officers. It also entails balancing energy levels in work and private life, as well as how their profession's unpredictability affects their daily routines and roles. The findings also show how their personal choices in private life are frequently influenced by their professional role. The study's findings have theoretical as well as practical implications, contributing to a better understanding of uniformed police officers' challenges and resources for a sustainable and healthy lifestyle. [ABSTRACT FROM AUTHOR]

Unintended pregnancy is a common global public health problem associated with significant health risks and social costs with 85 M occurring in 2012. Innumerable health surveys have shown increased contraceptive use and access, despite not meeting demand leading to unmet need for contraception. This paper scrutinizes inequity in unmet need among married women of reproductive age using PMA2020/Kenya survey data. Cross-sectional design with multi-stage cluster random sampling technique involving random selection of nine Counties, 120 enumeration areas and 42 households was adopted. Face-to-face interviews using digital platform was done in seven survey rounds from 2014 to 2018 generating 35,185 interviews. Strongly balanced panel data with 2,154 respondents per wave was analyzed using Stata® Ver 14.2. Unmet need was high amongst pubescents (23.2%), higher parity (22.6%), rural residency (22.6%), informal education (36.0%) and poorest (24.8%). Concentration index was negative (−0.11, SE = 0.01), implying poor households have unmet need unlike rich households. Unadjusted and adjusted odds ratio was estimated to rise by 0.44 (95%CL = 0.35–0.57, p-value < 0.05) and 0.69 times (95%CL = 0.34–1.42, p-value > 0.05) with increased poverty levels. Creating contraceptive uptake demand must reciprocate unfailing supply of inexpensive methods targeting adolescents, higher parity, less educated and poorest. Consider involving spouses when discussing contraceptive methods, associated side effects and individual health concerns. [ABSTRACT FROM AUTHOR]

In recent decades, bold steps taken by the government of Nepal to liberalise its abortion law and increase the affordability and accessibility of safe abortion and family planning have contributed to significant improvements in maternal mortality and other sexual and reproductive health (SRH) outcomes. The Trump administration's Global Gag Rule (GGR) – which prohibits foreign non-governmental organisations (NGOs) from receiving US global health assistance unless they certify that they will not use funding from any source to engage in service delivery, counselling, referral, or advocacy related to abortion – threatens this progress. This paper examines the impact of the GGR on civil society, NGOs, and SRH service delivery in Nepal. We conducted 205 semi-structured in-depth interviews in 2 phases (August–September 2018, and June–September 2019), and across 22 districts. Interview participants included NGO programme managers, government employees, facility managers and service providers in the NGO and private sectors, and service providers in public sector facilities. This large, two-phased study complements existing anecdotal research by capturing impacts of the GGR as they evolved over the course of a year, and by surfacing pathways through which this policy affects SRH outcomes. We found that low policy awareness and a considerable chilling effect cut across levels of the Nepali health system and exacerbated impacts caused by routine implementation of the GGR, undermining the ecology of SRH service delivery in Nepal as well as national sovereignty. [ABSTRACT FROM AUTHOR]

Background: Worldwide, there is an increased reliance on casual staff in the health sector. Recent policy attention in South Africa has focused on the interrelated challenges of agency nursing and moonlighting in the health sector. Objective: This paper examines the potential health system consequences of agency nursing and moonlighting among South African nurses. Methods: During 2010, a cluster random sample of 80 hospitals was selected in four South African provinces. On the survey day, all nurses providing clinical care completed a self-administered questionnaire after giving informed consent. The questionnaire obtained information on socio-demographics, involvement in agency nursing and moonlighting, and self-reported indicators of potential health system consequences of agency nursing and moonlighting. A weighted analysis was done using STATA® 13. Results: In the survey, 40.7% of nurses reported moonlighting or working for an agency in the preceding year. Of all participants, 51.5% reported feeling too tired to work, 11.5% paid less attention to nursing work on duty, and 10.9% took sick leave when not actually sick in the preceding year. Among the moonlighters, 11.9% had taken vacation leave to do agency work or moonlighting, and 9.8% reported conflicting schedules between their primary and secondary jobs. In the bivariate analysis, moonlighting nurses were significantly more likely than non-moonlighters to take sick leave when not sick (p=0.011) and to pay less attention to nursing work on duty (p=0.035). However, in a multiple logistic regression analysis, the differences between moonlighters and non-moonlighters did not remain statistically significant after adjusting for other sociodemographic variables. Conclusion: Although moonlighting did not emerge as a statistically significant predictor, the reported health system consequences are serious. A combination of strong nursing leadership, effective management, and consultation with and buy-in from front-line nurses is needed to counteract the potential negative health system consequences of agency nursing and moonlighting. [ABSTRACT FROM AUTHOR]

Background: Staff retention and turnover have risen in prominence in the global discourse on the health workforce. Moonlighting, having a second job in addition to a primary job, has not featured in debates on turnover. Objective: This paper examines whether moonlighting is a determinant of South African nurses' intention to leave their primary jobs. Design: During 2010, a one-stage cluster random sample of 80 hospitals was selected in four South African provinces. On the survey day, all nurses working in critical care, theatre, emergency, maternity, and general medical and surgical wards completed a self-administered questionnaire after giving informed consent. In addition to demographic information and information on moonlighting, the questionnaire obtained information on the participants' intention to leave their primary jobs in the 12 months following the survey. A weighted analysis of the survey data was done using STATA® 13. Results: Survey participants (n=3,784) were predominantly middle-aged with a mean age of 41.5 (SD±10.4) years. Almost one-third of survey participants (30.9%) indicated that they planned to leave their jobs within 12 months. Intention to leave was higher among the moonlighters (39.5%) compared to non-moonlighters (27.9%; p<0.001). Predictors of intention to leave in a multiple logistic regression were moonlighting in the preceding year, nursing category, sector of primary employment, period working at the primary job, and number of children. The odds of intention to leave was 1.40 (95% CI: 1.16-1.69) times higher for moonlighters than for non-moonlighters. The odds ratio of intention to leave was 0.53 (95% CI: 0.42-0.66) for nursing assistants compared to professional nurses and 2.09 (95% CI: 1.49-2.94) for nurses working for a commercial nursing agency compared to those working in the public sector. Conclusions: Moonlighting is a predictor of intention to leave. Both individual and organisational strategies are needed to manage moonlighting and to enhance retention among South African nurses. [ABSTRACT FROM AUTHOR]

This paper aims to develop a multiple deferred state sampling plan for a time-truncated life test if the lifetime of the item follows exponentiated half logistic distribution. The optimal parameters of the proposed plan, such as the number of successive lots required for making the decision whether to accept or reject the current lot, sample size, the rejection and acceptance numbers are obtained using two points approach. The implementation of the proposed plan is illustrated with examples. Tables are constructed for various combinations of consumer's and producer's risks. Comparison is also made with existing sampling plans under exponentiated half logistic distribution. [ABSTRACT FROM AUTHOR]

Abortion stigma is experienced not only by women but also by providers and health professionals in a wide range of legal contexts. This paper analyses interviews with providers who work in the public health system in the Metropolitan Area of Buenos Aires, Argentina. A court ruling in 2012, FAL/12, changed the interpretation of abortion's legal status, clarifying the decriminalisation of abortion in cases of rape, and also requiring public policies and procedures to speed up access to legal abortion. Between 2014 and 2017, we conducted 27 in-depth, semi-structured interviews with abortion providers in public facilities across healthcare services in the Metropolitan Area of Buenos Aires. We found the way that health providers dealt with abortion stigma evolved over the course of time, as the abortion debate moved from the margins to the heart of political debate and public policies in Argentina between 2007 and 2017. Providers' experiences changed as the social and legal context changed. FAL/12 – as a clear, legal ruling – was a landmark and turning point in the way health professionals in public health facilities conduct their activities, making it possible for them to move from providing silent and hidden abortion care, to acknowledging it with pride. [ABSTRACT FROM AUTHOR]

This study empirically investigates the multidimensional poverty index (MPI) level and vulnerability to poverty in Pakistan. This study explores MPI province-wise. The MPI consists of three equally weighted dimensions: schooling, health well-being and living standards. This investigation uses a systematic random sampling approach to gather the data from householders from 2003 to 2018. The empirical result demonstrates that 24% of the population was multidimensionally poor in 2007, 20.2% in 2011, 18% in 2014 and 16.4% in 2018, respectively. It identified major determinants of poverty as children mortality and school attendance, cooking fuel and nutrition. [ABSTRACT FROM AUTHOR]

The present study determines the impacts of different types of green intellectual capital such as green human capital, green structural capital, and green relational capital on environmental sustainability in the Sultanate of Oman. It has become a crucial aspect to analyze the effect of green intellectual capital on ecological sustainability. A simple random sample technique is used to assemble data using a structured questionnaire from 205 respondents working at Raysut Cement Company and Salalah Methanol Company in Oman. The covariance-based equation in the structural modeling perspective is used to examine data. The study's results reveal that green structure-based capital is the only dimension of green Intellectual capital that significantly affects environmental sustainability. In contrast, green human capital and relation-based capital do not substantially affect ecological sustainability. Conclusively, this study also provides ecological strategies that can be useful to enrich organizations to accomplish sustainability. [ABSTRACT FROM AUTHOR]

In this paper, a two-stage dispatching rule for the on-time delivery of an order-driven FAB is presented. Dispatching rules have a significant impact on the performance of FABs. Consequently, many such rules have been created, such as first in first out, earliest due data, operation due date, and critical ratio. Because these conventional dispatching rules make decisions only by considering the due date of each lot, they might not be suitable for dynamic order-driven FABs, for which it is very essential to monitor not only the due date of each lot but also the production rate of each step. In the first stage of the proposed two-stage dispatching rule, the production rate of each step is taken into account, and the due date of each lot is considered in the second stage. In this paper, the production rates of steps are computed by combining forward simulation and backward pegging. A simulation model, based on a wafer FAB data-set, has been developed, and simulation is conducted using commercial software SEEPLAN®. The simulation results clearly show the advantages of the proposed dispatching rule over existing rules. [ABSTRACT FROM PUBLISHER]

Due to the COVID-19 pandemic, access to medical care is restricted for nearly all non-acute conditions. Due to their status as a vulnerable social group and the inherent need for transition-related treatments, transgender people are assumed to be affected particularly severely by the restrictions caused by the COVID-19 pandemic. As an ad hoc collaboration between researchers, clinicians and 23 community organizations, we developed a web-based survey in German that was translated into 26 languages. Participants were recruited via community sources, social media channels, and snowball sampling since May 2020. The present sample is based on the data collected until August 9, 2020. We assessed demographical data, health problems, risk factors, COVID-19 data (e.g., contact history), and the influence of the COVID-19 pandemic on access to transgender health care services. To identify factors associated with the experience of restrictions, we conducted multiple logistic regression analysis. 5267 transgender people from 63 upper-middle-income and high-income countries participated in the study. Over 50% of the participants had risk factors for a severe course of a COVID-19 infection and were at a high risk of avoiding COVID-19 treatment due to the fear of mistreatment or discrimination. Access to transgender health care services was restricted for 50% of the participants. Male sex assigned at birth and a lower monthly income were significant predictors for the experience of restrictions to health care. 35.0% reported at least one mental health condition and 3.2% have attempted suicide since the beginning of the COVID-19 pandemic. Transgender people suffer under the severity of the pandemic due to the intersections between their status as a vulnerable social group, their high number of medical risk factors, and their need for ongoing medical treatment. The COVID-19 pandemic can potentiate these vulnerabilities, add new challenges for transgender people, and, therefore, can lead to devastating consequences, like severe physical or mental health issues, self-harming behavior, and suicidality. [ABSTRACT FROM AUTHOR]

The article focuses on evaluating the technical efficiency of garlic production in northwest Ethiopia. The average yield in the region was lower than its potential, indicating a need to improve farming practices. Data were collected from 359 garlic producers using random sampling. The Cobb-Douglas stochastic frontier production function was used to estimate technical efficiency, which was found to be 73%. This means that about 27% of potential garlic output was lost due to inefficiency. Factors such as land size, seed, fertilizer, insecticide, and oxen days were found to have a positive and significant impact on garlic production. On the other hand, factors like age, extension contact, distance, renting land, garlic disease shock, access to finance, and access to information were linked to technical inefficiency. The study suggests that investing in high-quality seeds, improved farming inputs, and access to information can enhance garlic output by leveraging its high efficiency level. [ABSTRACT FROM AUTHOR]

To be regularly physically active is of major importance for the health of people with metabolic risk factors. Many of these persons are insufficiently active and in need of support. This study aimed to explore barriers and facilitators perceived by health care professionals' within Swedish primary care in their work to support persons with metabolic risk factors to increase their physical activity. A qualitative design with focus group discussions was used. The data were analysed using qualitative content analysis with a manifest, inductive approach. Primary health care in five Swedish healthcare regions. Nine physiotherapists, ten physicians and five nurses participated in six digital focus group discussions including two to six participants. Barriers and facilitators to supporting persons with metabolic risk factors to increase their physical activity were found within four generic categories, where the barriers and facilitators related to each generic category: 'Patient readiness for change', 'Supporting the process of change', 'The professional role', and 'The organisation of primary care'. The findings suggests that barriers and facilitators for supporting patients with metabolic risk factors can be found at several levels within primary care, from individual patient and the health care professionals to the organisational level. In the primary care setting, this should be highlighted when implementing support to increase physical activity in people with metabolic risk factors. Health care professionals within primary care are in a position to support people with metabolic risk factors to increase their physical activity. Barriers and facilitators to support the patients should be addressed at several levels within primary care. The study highlights factors on multiple levels such as professional responsibility, organisational prioritisation and resources, and the challenge to motivate behaviour change. [ABSTRACT FROM AUTHOR]