Access To Facilities Research Articles

An exploration of barriers to access to healthcare in Hancock County, Tennessee: A qualitative study.

Explore barriers to healthcare access in Hancock County, Tennessee using a conceptual framework for access to healthcare. We collected data from 30 participants in Hancock County during 1 week in April 2023 using a combination of network and purposive sampling. We analyzed the data using thematic analysis and the conceptual framework of healthcare access. All dimensions of the conceptual framework of healthcare access presented barriers to healthcare access for participants of the study. A lack of acceptability of local healthcare among participants manifested in a perceived lack of availability of healthcare. This resulted in participants travelling or considering it necessary to travel long distances for care, even in a life-threatening emergency, despite the local availability of a hospital with an emergency department. A lack of acceptability can create healthcare access barriers similar to a lack of availability of healthcare facilities. The research team met several times with the leader of a local community organization to discuss this research in Hancock County. These conversations helped to inform the study design and provided necessary background to conduct in-depth interviews. Members of the community organization helped identify individuals to interview and provide access to Remote Area Medical clinic patients. The research team discussed the final themes with the primary community collaborator.

Nickel‐Catalyzed Highly Selective Radical C‐C Coupling from Carboxylic Acids with Photoredox Catalysis

The selective coupling of two different radicals is a long‐standing challenge due to the process occurring statistically. Generally, the cross‐coupling selectivity is achieved by the persistent radical effect (PRE), resulting in limited radical precursors. In this paper, a highly selective cross‐coupling of alkyl radicals with acyl radicals to construct C(sp2)‐C(sp3) bonds, or with alkyl radicals to construct C(sp3)‐C(sp3) bonds have been achieved with the readily available carboxylic acids and their derivatives (NHPI ester) as coupling partners. The success originates from the use of tridentate ligand (L1) to enable radical cross‐coupling process to Ni‐mediated organometallic mechanism. This protocol offers a facile and flexible access to structurally diverse ketones (up to 90% yield), and also a new solution for the challenging double decarboxylative C(sp3)‐C(sp3) coupling. The broad utility and functional group tolerance are further illustrated by the late‐stage functionalization of natural‐occurring carboxylic acids and drugs.

Nickel-Catalyzed Highly Selective Radical C-C Coupling from Carboxylic Acids with Photoredox Catalysis.

The selective coupling of two different radicals is a long-standing challenge due to the process occurring statistically. Generally, the cross-coupling selectivity is achieved by the persistent radical effect (PRE), resulting in limited radical precursors. In this paper, a highly selective cross-coupling of alkyl radicals with acyl radicals to construct C(sp2)-C(sp3) bonds, or with alkyl radicals to construct C(sp3)-C(sp3) bonds have been achieved with the readily available carboxylic acids and their derivatives (NHPI ester) as coupling partners. The success originates from the use of tridentate ligand (L1) to enable radical cross-coupling process to Ni-mediated organometallic mechanism. This protocol offers a facile and flexible access to structurally diverse ketones (up to 90% yield), and also a new solution for the challenging double decarboxylative C(sp3)-C(sp3) coupling. The broad utility and functional group tolerance are further illustrated by the late-stage functionalization of natural-occurring carboxylic acids and drugs.

Effect of Urbanization on the Performance SMES in Anambra State Nigeria

This work evaluated the effect of urbanization on the performance SMEs in Anambra State Nigeria. Specifically the study investigated the effect of infrastructural services on performance of SMEs, social amenities on the performance of SMEs and the effect of technological development and performance of SMEs in Anambra State, Nigeria. Relevant conceptual, theoretical and empirical literatures were reviewed. The study was anchored on Self-Generated or Endogenous Urbanization Theory. This study adopted survey design. Infrastructural services, social amenities and technological development were employed as the independent variables while performance of SMEs was employed as the dependent variable. The population is unknown, as such the sample size of the study was determined with the aid of Topman’s non-parametric sample size determination formula, applied when the population frame is unknown. A sample size of 368 respondents. The data generated were analyzed using descriptive statistics, correlation analysis and multiple regression analysis. The study found that infrastructural facilities has a significant effect on the performance of SMEs; Social amenities has a significant effect on the performance and technological development has a significant effect on the performance of SMEs in Anambra State, Nigeria. The study concludes that urbanization had a significant effect on the performance of SMEs in Anambra State, Nigeria. The study recommended that government should provide availability of Infrastructural facilities in rural areas will decrease the rural – urban migration of the people that will increase on the performance of SMEs. Government in collaboration with private sector could make and implement programme for rural upliftement such as social amenities programmes, housing loans, electricity, water supply etc. So that they will not have interest to migrate to urban areas. Small business owners should stay current on technological development and try to influence government decision-making and policy on urbanization.

Organocatalytic skeletal reorganization for enantioselective synthesis of S-stereogenic sulfinamides

The enantioselective synthesis of S-stereogenic sulfinamides has garnered considerable attention due to their structural and physicochemical properties. However, catalytic asymmetric synthesis of sulfinamides still remains daunting challenges, impeding their broad application in drug discovery and development. Here, we present an approach for the synthesis of S-stereogenic sulfinamides through peptide-mimic phosphonium salt-catalyzed asymmetric skeletal reorganization of simple prochiral and/or racemic sulfoximines. This methodology allows for the facile access to a diverse array of substituted sulfinamides with excellent enantioselectivities, accommodating various substituent patterns through desymmetrization or parallel kinetic resolution process. Mechanistic experiments, coupled with density functional theory calculations, clarify a stepwise pathway involving ring-opening and ring-closing processes, with the ring-opening step identified as crucial for achieving stereoselective control. Given the prevalence of S-stereogenic centers in pharmaceuticals, we anticipate that this protocol will enhance the efficient and precise synthesis of relevant chiral molecules and their analogs, thereby contributing to advancements in drug discovery.

Facile access to benzofuran-based bis-stilbene for organic laser dyes

A concise and efficient synthetic protocol for the synthesis of furan-based bis-stilbene derivatives (BPBFCz1) was described, which is a very promising organic laser dye. Starting with 4,4’-diethynylbiphenyl, BPBFCz1 was prepared with a total yield of 40% through a three-step classical reaction of Sonogashira Coupling, intramolecular cyclization of 2-alkynyl phenol, and Buchwald Hartwig cross-coupling. The crystal structure of BPBFCz1 was presented for the first time. The synthesis strategy was applied to the synthesis of other three materials with similar structure and the yields of 28.6–36.6% were obtained.

How Does Physical Exercise Improve the Subjective Well-Being of the Chinese Adult Population? A Moderated Mediation Model.

Based on the 2017 data from the China General Social Survey (CGSS), the conditional process analysis method was used to explore the relationship between physical exercise and subjective well-being, as well as the mediating effect of social capital and the moderating effect of Internet use. This study found that the effect of physical exercise on subjective well-being includes both direct effects and indirect effects. Physical exercise directly and positively affects SWB and partially affects SWB through social networks as a mediating variable. Additionally, Internet use can moderate the direct effect of physical exercise on SWB and the mediating effect of social networks on the relationship between the two. As the frequency of Internet use increases, the link between physical exercise and social capital weakens, resulting in a decreased promotion effect on SWB. The results of this study further reveal the internal mechanism linking physical exercise and the improvement of SWB, which is of great significance for enhancing the accessibility of physical exercise facilities and promoting a healthy online lifestyle, ultimately leading to improved well-being among residents.

Individual and health care provider factors influencing stroke self-management behavior: A cross-sectional study

Background This study aimed to examine individual- and health service provider-related factors that influence the self-management behavior of patients with stroke. Methods This cross-sectional study investigated a cohort of 110 ischemic stroke patients in the neurology outpatient department of Universitas Airlangga Hospital from February 2023 to May 2023. Data were obtained using the following three distinct questionnaires: the general demographic questionnaire, health care provider questionnaire, and modified stroke self-management behavior questionnaire. Results Chi-square test results indicated a significant correlation between age (p = 0.023) and information availability (p = 0.000) with self-management behavior in patients with stroke. However, no significant correlations were observed between gender (p = 1.107), residence (p = 0.859), availability of access (p = 0.093), availability of health facilities (p = 0.065), and collaboration among health workers (p = 0.641) with self-management behavior in patients with stroke. Ordinal logistic regression analysis results indicated that age significantly influenced self-management behavior in patients with stroke (p = 0.034; OR = 2.49). Discussion The presence of reliable information within the hospital setting is expectedly complemented by a strong level of literacy among patients with stroke, thereby facilitating the enhancement of their self-management practices.

Metal-Free Synthesis of C-3-Alkoxycarbonylated 2H-Indazoles Using Alkyl Carbazates

AbstractA simple, efficient, and environmentally benign method for the direct C-3-alkoxycarbonylation of 2H-indazoles using alkyl carbazates has been developed under metal-free conditions at room temperature. This current protocol represents a facile access to C-3-carboxylic ester derived 2H-indazoles with wide functional group tolerance in good to excellent yields. The mechanistic studies suggest that the reaction proceeds through a radical pathway.

Current Status and Barriers of Exercise in Individuals with Spinal Cord Injuries in Korea: A Survey.

This study investigated exercise participation, health status, and barriers to exercise in 109 individuals with spinal cord injury (SCI) using a self-report questionnaire. The responses of the exercise and non-exercise groups were statistically analyzed using t-tests or Fisher's exact test. Significant differences were observed in the cause of injury and the American Spinal Injury Association Impairment Scale between the groups. The non-exercise group had a higher incidence of traumatic and complete injuries. Demographic factors such as gender, age, income level, and marital status did not significantly influence exercise participation. The exercise group reported lower pain scores, less inconvenience from complications, and higher activity and participation scores. However, less than half of the individuals with SCI met the recommended exercise intensity, and community facility usage was low. Barriers to exercise participation included severe disabilities, lack of time, insufficient exercise information, and lack of facility accessibility. To enhance exercise among individuals with SCI, it is essential to develop and extend exercise programs tailored to individual physical factors and a comprehensive understanding of barriers. Prioritizing community-based data management, alongside developing social systems and health policies, is crucial to overcome barriers to exercise participation for individuals with SCI.

Association between Child Mortality and Healthcare Facility Level Factors: Evidence from Nationally Representative Survey

Child mortality is an important indicator of child health and overall national development. Under-five mortality is unacceptably high in Low- and Middle-Income Countries (LMICs) including Bangladesh. Increased availability and access to the healthcare services can play a significant role to reduce under-five mortality. The aim of this study was to explore the associations of several forms of child mortality with health facility level factors. Data were extracted from the 2017-18 Bangladesh Demographic and Health Survey data and 2017 Bangladesh Health Facility Survey data. Three outcome variables were considered: neonatal mortality, infant mortality, and under-five mortality in this study. Health facility level factors were considered as major explanatory variables. They were the availability of the child healthcare services at the nearest healthcare facility, readiness of the nearest healthcare facility to provide child healthcare services and the average distance of the nearest healthcare facility providing child healthcare services. Multilevel mixed-effect logistic regression model was used to determine the associations between the outcome variables and explanatory variables adjusted for covariates. We reported under-five, infant and neonatal mortality were 40, 37, and 30 per 1000 live births, respectively. The likelihood of neonatal and infant mortality was found to be declined for one-unit increase on the availability and readiness of the mothers’ homes nearest healthcare facilities to provide child healthcare services. On contrary, for every kilometre increased distance between mothers’ homes and their nearest healthcare facility was found to be associated with increased in the likelihoods of neonatal, infant and under-five mortality. The availability of health facilities providing child healthcare services close to residence and their improved management, infrastructure, and readiness to provide child healthcare services play a significant role in reducing under-five mortality in Bangladesh. Policies and programs should prioritize to increase the availability and accessibility of health facilities that provide child healthcare services.

A short guide to addressing accessibility at scientific conferences.

Although encouraging progress to address issues of accessibility at scientific conferences has been made in recent years, further efforts are required to enact the comprehensive solutions necessary to accommodate the diverse needs of disabled scientists. This Opinion provides an easy-to-follow guide to ensuring that scientific conferences are accessible to disabled scientists and is aimed at conference organizers and funders in the field of cell biology. In this piece, I, a person who identifies as a disabled scientist, advocate for collective action within the cell biology community to promote the routine inclusion of accessibility officers on conference organizing panels and the use of accessibility checklists as part of applications for conference funding in order to build inclusive practices into conference planning and organization. I propose a move away from requiring personal disclosures of disability needs on a person-to-person basis towards community-agreed guidelines that ensure accessibility for scientists with a wide variety of needs. To that end, I detail a list of practical, cost-effective adjustments to standard conference activities that can enhance accessibility. Moreover, I suggest several long-term, high-impact changes - including guaranteeing the availability of wheelchair-accessible facilities and making hybrid meeting formats standard - aimed at enabling conference participation for all scientists.

Birth preparedness and pregnancy complication readiness and associated factors among pregnant women in Ethiopia: A multilevel analysis.

Maternal and child deaths occur during pregnancy and delivery. Timely information on signs of pregnancy complications and ways to plan for normal birth is a strategy to reduce maternal and child deaths. The purpose of this study was to assess birth preparedness, and pregnancy complications readiness and identify associated factors in Ethiopia. A cross-sectional study design was used. A total of 1635 weighted samples of pregnant women were included for analysis from the 2016 Ethiopian demographic and health survey data set. Multilevel mixed-effect logistic regression was used to estimate the effects of potential variables on birth preparedness and complication readiness. STATA version 15 software was used for data processing and analysis. A variable with a p-value < 0.05 with a 95% confidence interval was considered a significant factor. Pregnant women were informed about convulsions (8.02%), fever (35.95%), abdominal pain (28.92%), leaking fluid from the vagina (28.21%), and blurred vision (17.98%). Pregnant women prepared for supplies needed for birth (38.70%), transportation (20.04%), money (18.97%), people's support for birth (5.03%), and blood donors (3.11%). Only 56% and 44.91% of pregnant women had good birth preparedness and were informed about pregnancy complications respectively. Educational status, antenatal care visits, and region were significant factors associated with birth preparedness and complication readiness. Distance to health facility and residency were significantly associated with birth and complication readiness, respectively. Birth preparedness and complication readiness among pregnant women were low in Ethiopia. Empowering women with education, installing safe roads, building accessible health facilities, and emphasizing pregnancy complications and birth preparedness plans during antenatal care visits are important interventions to enhance birth preparedness and pregnancy complication readiness.

A bizarre synthesized cascaded optimized predictor (BizSCOP) model for enhancing security in cloud systems

Due to growing network data dissemination in cloud, the elasticity, pay as you go options, globally accessible facilities, and security of networks have become increasingly important in today's world. Cloud service providers, including AWS, Azure, GCP, and others, facilitate worldwide expansion within minutes by offering decentralized communication network functions, hence providing security to cloud is still remains a challenging task. This paper aims to introduce and evaluate the Biz-SCOP model, a novel intrusion detection system developed for cloud security. The research addresses the pressing need for effective intrusion detection in cloud environments by combining hybrid optimization techniques and advanced deep learning methodologies. The study employs prominent intrusion datasets, including CSE-CIC-IDS 2018, CIC-IDS 2017, and a cloud intrusion dataset, to assess the proposed model's performance. The study's design involves implementing the Biz-SCOP model using Matlab 2019 software on a Windows 10 OS platform, utilizing 8 GB RAM and an Intel core i3 processor. The hybrid optimization approach, termed HyPSM, is employed for feature selection, enhancing the model's efficiency. Additionally, an intelligent deep learning model, C2AE, is introduced to discern friendly and hostile communication, contributing to accurate intrusion detection. Key findings indicate that the Biz-SCOP model outperforms existing intrusion detection systems, achieving notable accuracy (99.8%), precision (99.7%), F1-score (99.8%), and GEO (99.9%). The model excels in identifying various attack types, as demonstrated by robust ROC analysis. Interpretations and conclusions emphasize the significance of hybrid optimization and advanced deep learning techniques in enhancing intrusion detection system performance. The proposed model exhibits lower computational load, reduced false positives, ease of implementation, and improved accuracy, positioning it as a promising solution for cloud security.

The Impact of School Environment on Student Health Behaviors: Insights from Qualitative Interviews

The relationship between the school environment and student health behaviors is increasingly pertinent amidst rising health concerns among youths. This qualitative study, conducted across diverse socioeconomic backgrounds in Vietnam, explores the multifaceted influences of school settings on the health behaviors of students. Data were collected through semi-structured interviews and focus group discussions involving students, teachers, parents, and administrators from three schools, each representing urban, suburban, and rural settings. The study identified key factors within schools' physical and social environments that significantly impact health behaviors. These include the availability and condition of physical facilities, the nutritional quality of food offered, peer influences, teacher engagement in health education, and the availability of mental health resources. Socioeconomic factors and cultural attitudes towards health and education also emerged as significant determinants. The findings suggest that improvements in physical resources, enhanced teacher training in health education, standardized healthy food offerings, and greater availability of mental health services are critical for fostering healthier behaviors among students. This study underscores the need for holistic policy interventions tailored to diverse educational settings to promote overall student health.

Architectural and Urban Changes in a Residential Environment—Implications for Design Science

Current spatial changes involving broad urban landscapes affect people’s perceptions of their surroundings, sense of place, and attachment to a place, constituting a disruption to these. As a result, on a social scale, they translate into people’s well-being. The following study of the impact of large-scale architectural and urban developments on the place of residence is based on the assumption that physical space determines the quality of life in the living place and the changes in the process condition residents to adapt to their new surroundings—based on the three pillars of place, people, and process (3Ps). The article consists of two parts. The first is theoretical, which conceptualises spatial change based on the theory of human dependence on place. The second part–an empirical study—discusses the transformation of the post-industrial area of Bicocca (Milan), which, 40 years after the intervention, has led to conclusions and recommendations for urban planning. The results demonstrate the different sensitivities of the urban areas to the process of functional–spatial change, the essence of the accessibility of public space, public facilities, and transport infrastructure. The planning process can positively influence social adaptation to spatial change mitigation. Residential areas may be subject to additional protection procedures. The study is relevant to a sustainable planning process in the inevitable transformation of urban areas. The interdisciplinary nature of the issue prompts the integration of research findings and knowledge transfer in the socio-technological subsystem (STS).

Primary extranodal lymphoma: a report of six cases in a private cancer centre in Nigeria

Primary extra-nodal lymphoma (PENL) refers to lymphomas which present with disease in any organ or tissue other than lymph nodes or spleen. Symptoms at initial presentation are mainly from extra nodal involvement and after routine staging procedures, the extra nodal involvement remains the clinically dominant site of disease with little or no nodal disease [1, 2]. About 25–40% of lymphomas arise at extra nodal sites and with clinical presentation similar to solid tumors [3, 4] creating ambiguity in diagnosis and delays in treatment especially in resource poor settings. We report six cases of PENL seen at a private cancer centre in Lagos, Nigeria between 2021 and 2022. The age range was 32–95 years with five females and one male. Two patients were HIV positive. Five patients had initial symptoms of vague abdominal pain with one patient investigated multiple times for peptic ulcer disease. One patient presented with pathological fracture of left femur. Another patient had previously been diagnosed with an inoperable cholangiocarcinoma. All patients had non-Hodgkin’s lymphoma, DLBCL being most common (83.37%). Four patients started chemotherapy. All treated patients showed good outcomes with complete or good partial response highlighting the importance of accurate diagnosis. Initial histological diagnosis in most of the cases did not suggest lymphoma until immunohistochemistry (IHC) results were received. Cancer care in Nigeria is fraught with difficulties obtaining accurate diagnosis due in part to the limited availability of IHC and molecular testing facilities required to characterize the malignant cells leading to delays in treatment and poorer prognosis [6–8].

Predictive factors of occupational stress among nurses during the COVID-19 pandemic: a cross-sectional study in Kashan, Iran

BackgroundConsidering the severe and sudden changes in the job conditions of nurses during the covid-19 pandemic, the increase in job tensions during this critical period and its consequences on the quantity and quality of nursing care, this study aims to investigate the job stress of nurses during the covid-19 pandemic and its predictors in Iran.MethodsThis cross-sectional study was conducted on 400 nurses in ‘Kashan’, Iran, who were randomly selected using stratified sampling. Data were collected using two questionnaires on occupational stress and potential related factors. The data were analyzed in SPSS version 16.ResultsThe results showed that the occupational stress of nurses in Iran was at a medium to high level with a mean and standard deviation of 103.773 ± 15.742 (scale of 34–136). Factors such as satisfaction with physical health, quality of work life, satisfaction with the availability of facilities, sense of coherence, education level, work experience, job burnout, male gender, being native, and workplace were predictors of occupational stress and explained 23.3% of the variance in occupational stress score. The highest contribution was related to satisfaction with physical health.ConclusionConsidering the consequences of occupational stress for nurses, it is crucial for health and nursing authorities to take these factors into consideration in policy-making and planning.

Drivers of Land Abandonment in Neelakantha Municipality: Perceptions of Farmers

This study analysed the role of factors for land abandonment in Neelakantha municipality, Dhading. For this purpose, survey and causal-comparative research design are used. Similarly, Reliability and normality of the collected data was ensured by using cronbach alpha and Shapiro-Wilk test respectively. Then after, inferential statistical tools i.e. Pearson correlation and multiple regression analysis have been used to derive the result of the study. This study found that there is a significant impact of high cost of agro product, out migration, rough topography, lack of government protection from international competition, and destruction of food crops by wild animals on land abandonment. However, the impact of irrigation facility and market access on land abandonment was not statistically significant. The findings of the study suggest that the factors that contribute to land abandonment are complex and interrelated. However, the study provides some evidence that the factors that were found to be statistically significant can play a role in land abandonment.

The Integration of ICT in ELT of Pre-Service Teacher Professional Education (PPG) Students

Student teachers are expected to take advantage the use of technology for teaching process. This study aims to investigate the ICT tools used by Pre-service English Teachers who are also PPG students to achieve their learning goals in teaching English during their Teaching Practicum (PPL), how they integrate these ICT tools evaluated by TPACK and SAMR framework, and examine the obstacles. This current study was descriptive qualitative research. In this research design, the data was gathered by means of document analysis, semi-structured interview and observation. The participants were five Pre-Service Teacher Professional Education (PPG) Students majoring English Education Batch 2 academic year 2022/2023 in one of university in Yogyakarta, who represented three school levels (SMP, SMA and SMK). The data were in three distinct stages: reduction or condensation, data display, and conclusion drawing or verification. The result shows that (1) variety of ICT tools are used to achieve the learning goals, they are Google Form, Google Docs, WhatsApp, Canva, Blooket, Bamboozle, WordWall, Kahoot, Quizizz, YouTube, and GimKit. These tools are selected based on the learning needs, students’ need, students’ preferences, learning objectives, availability of facility, and possible challenges. (2) The activities that integrating ICT tools majority are in augmented level of SAMR. While the pre-services teachers’ TPACK is effectively help them in integrating ICT tool to enhance the quality of learning, but still need optimization. (3) There are three main obstacles faced by the teachers; which come from the technical problems, teachers’ TPACK, and students’ problem. Technical problems covers the lack of internet access, insufficient devices, and restrictive school rules. Teachers’ challenge on their TPACK includes the selection of suitable tools, the time management in integrating ICT tools, and the struggle to keep up with the rapid development of technology. The students face no significant problems, yet sometimes the negligence of the task arises as they become too attached with the ICT tools.