Poor Supply Research Articles

Three-dimensional model construction of a frost-free air source heat pump evaporator and its performance analysis

This study aims to design an efficient frost-free air source heat pump evaporator for use in cold regions. The challenges of low performance, slow heat transfer, and poor energy supply efficiency associated with air source heat pump evaporators are addressed. This study analyzed the benefits of combining solar energy and air source heat pumps for heat supply. A three-dimensional model of the evaporator was constructed in ANSYS software, and optimal operating parameters were determined through variable experiments. The experimental results showed that when other factors were controlled constant, the glass cover size increased from 1.7 m to 2.9 m, and the maximum value of heat absorption of the evaporator increased from 2155 W to 2418 W and then decreased to 2340 W. When the wind speed and wind pressure increased from 150Pa to 300Pa, the maximum value of heat absorption of the evaporator increased from 1620 W to 2110 W. In summary, the maximum value of heat absorption of the evaporator was increased from 1,620 W to 2,110 W when the size of the glass cover was 2.5 m*2.5 m*2.5 m. When the wind speed and pressure were 300Pa, the heat absorption efficiency of the evaporator was the highest. This finding not only provides a new idea for the performance optimization of air source heat pump evaporator, but also opens up new possibilities for energy efficiency improvement in cold regions, reflecting the innovative and application value of this study.

Perception of undergraduate students of Nigeria’s premier university on the use of emergency remote teaching during Covid-19

This study reports preliminary findings on undergraduate students’ perception of the Emergency Remote Teaching (ERT) at the University of Ibadan, Nigeria, during Covid-19. Proportional to size sampling was used in obtaining the sample size of 366, while respondents were selected using convenience sampling. Data collection was through a structured questionnaire containing both open and closed ended questions and data was collected on the factors - attitude, affect, motivation; perceived behavioural control (accessibility, self-efficacy, ease of use,); and cognitive engagement. Findings showed that students’ positive attitude towards face-to-face learning was significantly higher than towards ERT and correlation analysis showed a relationship between preference for face-to-face learning and struggling with ERT. Also, the average difference in students’ motivation for learning before and after commencement of ERT was not statistically significant. Students reported more frequent use of educational technologies after ERT commenced than before and the difference was statistically significant. Increase was reported in all the self-efficacy and cognitive engagement constructs. Positive changes reported were mainly acquisition of additional hobbies as well as business, social and technology skills. Challenges to online learning included poor power supply, cost of data subscription, network disruptions and distractions from family and friends.

Microprocessor Design Using COPRAS Method

Introduction: A microprocessor is a computer and An important part of the structure, Without it, on your computer, Nothing can be done. it is a programmable device, It does some arithmetic on the input and logical operations and the desired output creates. In simple words, Microprocessor is on a chip It is a digital device Instructions from memory. Get them and decode them can run and give results. Fundamentals of Microprocessor. In a microprocessor machine language Take some steps that activate them, to the processor That's what it should do says Microprocessor instruction Three basics when implementing Doing things: Its addition, Subtraction, multiplication, division, and some logic functions Arithmetic and Logic Unit (ALU) makes use of. New Microprocessors are floating point Functions in numbers are doing In microprocessors The data in is from one location Can be moved to another location. It is a Program Counter (PC). Contains the registry, which Based on the value of the system address of the next instruction Stores, the microprocessor from place to place Jumps and makes decisions.Research significance: For microprocessor design, this Description Various semiconductors In device fabrication processes Made using some, Consequently in a chip carrier A drop in binding occurs. This chip carrier is then printed. Solder on the circuit board (PCB). done or in the socket is inserted. New microprocessor or microcontroller unit, To make the process flow logically Some general steps can be followed. These few steps make it even easier for small manageable tasks can be separated. A new microprocessor General steps for designing. A must-have in the new app is the determination of skills. required Data path to handle capabilities Set up. Machine code Instructional Design (ISA) Define. data path Create the necessary logic to control.Methodology: An analysis of the COPRAS method in this complex proportionality assessment (COPRAS) system in 1994 showed that the index values used to assess the Gavaskar, Kalkaska, and sarka introduced at this time increased and decreased. Alternatives: Poor life recycled products market, poor consumer perception of recycled products, poor supplier commitment, the poor success of curbside pickup. Evaluation Option: Finance Team, Engagement / Support, Infrastructure Team, Knowledge Team, Environment Team.Alternative: CISC is Intel 386, Intel 486, Pentium, EPIC is IA-64, DEC Alpha 21164. Evaluation preference: Feature size (micron), Supply voltage (V), Die size (mm2), DRAM bits/chip (m).Results: from the result, it is seen that CISC Intel 386 is got the first rank whereas DEC Alpha 21164 is having the lowest rank.

DermaClose: A Case Series in the Management of Large Soft Tissue Defects in Diabetic Foot Infection

Abstract: Diabetic foot infection poses a complex problem due to several interrelated issues, including rapidly spreading infection, poor vascular supply, and reduced healing ability. Management may require multiple operative procedures and prolonged treatment with a high risk of morbidity, such as amputation, and mortality. Debridement of infection commonly creates large wounds and soft tissue defects, with limited soft tissue reconstructive options due to adverse local and systemic factors. In this setting, treatment often consists of protracted periods of secondary wound healing by granulation, de-tensioning the tissues by removing bone, and minor or major amputation. Flaps and grafts may be considered but often carry unacceptable rates of failure. We present 3 cases in which DermaClose, an automated wound management system, was employed by a joint Orthopedic and Plastic Surgery team with excellent results and rapid closure of large soft tissue defects. Level of Evidence: Level IV.

Experience of caregivers on the continuum of care and prevention of malnutrition among children with cholera in Ethiopia: a phenomenology study

IntroductionMalnutrition is a public health problem in low- and middle-income countries among children. Although illnesses such as diarrhea are common immediate drivers of childhood malnutrition, their consequences could be averted through optimal sick child feeding and care to ensure the continuum of care. This study aimed to explore the lived experiences of mothers/caregivers on continuum of care to prevent malnutrition among children with cholera in Ethiopia.MethodsA phenomenology study design was applied to explore experiences of mothers/caregivers in the Bale and Guji zones of the Oromia region, southeast Ethiopia, from November to December 2022 using an unstructured interview guide. The saturation of ideas was used to stop the in-depth interview. Translated data were cleaned and imported into ATLAS.ti7 software for analysis. Using an open coding system, the data were coded into a meaningful context. Deeper immersion into data with repeated reading, creating themes, subthemes, and family/category were carried out. In coding and categorization, multiple coders were involved. The finding was presented using well-spoken verbatim/quotes as illustrations and in narratives.ResultsIn this qualitative study, ten participants were taken to explore their lived experience on the continuum of care for children with acute malnutrition and cholera. The study found that poverty, expensive cost of living, and poor utilization of diversified food were challenges. Moreover, health facilities did not provide any services to mothers whose child was admitted for malnutrition treatment. Children five years and above were excluded from both therapeutic food and screening for malnutrition program. Interruptions of supplies, low attention given to child feeding, inadequate knowledge, and lack of time to prepare diversified food were the main findings.ConclusionPoverty, poor feeding habits, supplies interruption and non-inclusion of malnourished children five and above in screening for malnutrition and in the therapeutic feeding program is missed opportunities that lead to decreased early detection and treatment of malnutrition among children with cholera. Moreover, mothers/caregivers did not receive any service from health facilities when their child was admitted for treatment of malnutrition. This situation forces them to stop treatment before their child recovers from malnutrition, which has a negative impact on the continuum of care and prevention of malnutrition. Therefore, we strongly recommend strengthening emergency nutrition within the country’s health system and revising the food and nutrition policy to incorporate emergency nutrition, with a particular focus on children under the age of fifteen. Additionally, it is important that the study’s recommendations underscore the significance of a multi-sectoral approach that involves collaboration among the health sector, government agencies, and non-governmental organizations. Moreover, adaptive agricultural products be made easily accessible to the community which is crucial in effective preventing and reducing malnutrition in children in the study and similar settings.

Reconstruction of palaeoenvironmental conditions that led to the formation of Eocene sub-bituminous coal seams in the Hungarian Paleogene Basin

Although in the second half of the Eocene, thick sub-bituminous coal seams were deposited in the Hungarian Paleogene Basin, it is not known under what climatic conditions these strata were formed. To investigate this, the paleoenvironmental conditions were reconstructed for the upper Lutetian-middle Priabonian period. The reconstruction of paleoclimatic conditions was based on the Coexistence Approach, for which the climatic data of the extant relatives of 15 fossil plant genera provided the basis of the analysis. Most (87%) of the extant relatives of the studied fossil plant genera can be found most frequently in tropical climate regions. Plotting the reconstructed average mean annual temperature (23.4 ± 3.9 °C) and precipitation (2375 mm ± 964 mm) values to the Whittaker Plot and Peltier's plots it was found that the region had a tropical monsoon climate during the upper Lutetian- middle Priabonian period. At the same time, there was a great difference between the precipitation sums of the wettest and driest months (409 ± 178 mm and 59 ± 56 mm), indicating a tropical monsoon-like climate with strong chemical weathering conditions. Currently, in climatically similar regions, tropical rainforest and tropical moist deciduous forest vegetation grow under tropical rainforest and tropical monsoon climates, and lateritic soils are formed. Furthermore, relatively rich mangrove plant associations flourish along the coasts of these regions, indicating that a part of the peat may have been deposited in mangroves. The contemporary lateritic soils, which later became the protoliths of bauxites, provided a poor nutrient supply for coastal vegetation, likely due to peat accumulation.

Research on identification method of transformer winding material based on vibration characteristic

At present, there are shoddy transformers in the market, of which the windings are replaced by aluminum and copper clad aluminum. The commissioning of these transformers may cause poor power supply performance and excessive winding heating. The existing detection methods of windings are complex, time-consuming to operate and destructive. Therefore, a winding material identification method based on vibration characteristics is proposed. Firstly, the vibration accelerations of transformer cores and windings with different winding materials are theoretically derived. Furthermore, through the coupling simulation of magnetic field and structure field of distribution transformers, the calculated vibration characteristics of copper, aluminum, and copper clad aluminum are verified. Finally, by comparing the time domain, the frequency domain and time-frequency domain of acceleration signals, preliminary identification of winding materials is conducted, which lays a theoretical foundation for establishing a precise identification model for winding materials in the future. This work provides guarantee for the safe operation of the distribution network.

Performance Evaluation of Intelligent Agricultural Supply Chain Based on Structural Equation Model

To solve the problems of unstable chain and poor supply chain (SC) function in the China’s agriculture industry, the relevant study is carried out on the function evaluation of the sustainable agricultural SC by structural equation modelling (SEM) under the background of digital technology. Primarily, the analysis is implemented on the research status of the sustainable SC and SC function. Then, starting with the relationship among big data (BD) application, information sharing, and sustainable SC function of agricultural production, a function evaluation model is implemented for the sustainable SC of SEM-based agricultural production. Next, a questionnaire is designed for the research on the impact of BD applications on the function of the sustainable agricultural SC. Ultimately, the statistical analysis of the obtained data reveals the correlation between the interaction and influence among the BD application, information sharing, and sustainable SC function of agricultural production. The results show that the BD application dimension, information sharing dimension, and all sub-dimensions have is beneficial to the function of the agricultural sustainable SC. The application of multidimensional cloud technology in BD has no obvious relationship with the dimensionality and level of information sharing, and the relationship between other corresponding dimensions shows a significant positive impact. A referenceable method is provided for the practice of sustainable SC management of agricultural production.

Analysis of factors and solutions to poor supply chain quality in a manufacturing organisation

Background: With about 55% of operating costs in manufacturing organisations coming from costs of supply chains, coupled with a 6% increase in supply chain costs incurred by a manufacturing organisation during the financial year 2021–2022, supply chain managers need to ascertain factors contributing to high supply operating cost and ascertain suitable strategies to lower supply chain management cost.Objectives: The purpose of this study is to unveil the factors and the solutions to poor supply chain quality in a steel product manufacturing organisation.Method: A qualitative approach conducted via an interview guide was used in this study. Perceptions of key supply chain stakeholders within a steel product manufacturing organisation formed the basis of the exploring factors contributing to poor supply chain quality and the solutions thereof. The Pareto chart was created to ascertain the critical factors that contribute to poor supply chain quality.Results: The study revealed that inventory stock-out, management decisions, process deviations, longer lead times, suppliers and unreliable enterprise resource planning (ERP) system issues contributed to poor supply chain quality.Conclusion: Supply chain managers should make use of strategies such as safety and consignment stock policy, just-in-time (JIT) system, supplier evaluation exercise for supplier selection, localisation of the sourcing of raw materials, customised ERP systems, job rotation and dashboards, with a view to improve visibility and efficiency of supply chain processes.Contribution: The study serves as a knowledge advisor to supply chain managers, on the critical factors contributing to poor supply chain quality, and the solutions thereof.

Usage of electronic information resources by undergraduates in Western Delta University, Oghara, Delta State

This study investigated the usage of electronic information resources by undergraduates in Western Delta University. In carrying out this study, three research questions were generated. Descriptive survey design was utilized for the study. Two hundred undergraduates in 200 and 300 level who used the library during the period of the study formed the population for the study. The simple random sampling was adopted in selecting the undergraduates as they made use of the Library. The instruments used for this study was a questionnaire entitled: “Usage of Electronic Information Resources” The data obtained were analysed, using frequency and percentage. Findings revealed that undergraduates of Western Delta University make use of electronic books, followed by electronic journals and that the purpose of utilizing electronic information resources was for research and assignment purposes. slow Internet connectivity and poor power supply were some of the identified problems militating against the effective use of electronic information resources in WDU library. The study has provided information that will be useful to the library in the provision electronic resources to the undergraduates. It was recommended that the University management should ensure that there is alternative power supply in the library and Internet connectivity should be improved on increasing the size of the bandwidth.

A logit model approach to the examination of parents’ willingness to contribute towards the cost of senior high school education: The case of parents in Tamale, Ghana

The Free Senior High School policy introduced in Ghana has helped to enhance access resulting in significant increases in enrolment and other improvements such as early reporting at schools by students, sufficient provision of schoolbooks, distribution of school outfits and improved feeding menu. There are also challenges ranging from inadequate and delayed funding to poor and insufficient supplies, with most facilities being either absent or in poor shape, mainly because of heavy financial burden the policy puts on government. These resulted in calls on government by stakeholders and other watchers of the sector for a review of the policy that will allow parents to make some contributions towards their wards' senior high school education. This study sought to examine the willingness of parents to contribute towards the senior high school education of their wards amidst the current Free Senior High School policy in Ghana; to help make a research-based input into the discussion using a logit model approach; and to also create a basis for comparison in future studies. Responses from some 467 parents of students in Senior and Junior High Schools in the Tamale township; purposively and randomly selected were analysed. Respondents were made up of more females than males who were predominantly either employed or self-employed with about 69% having a formal education of a sort. The study observed that majority of respondents expressed their willingness to contribute towards their wards’ senior high school education; largely towards the feeding component of the cost, and that a review that will cover the forementioned will not be out of place since it is anticipated, and parents are willing to contribute in that direction. It was also observed that the logit model was an appropriate statistical approach in performing the analysis of the study data with a categorical and dichotomous response variable. A mean willingness to contribute amount was also estimated as GH₵450.70. The study recommends a review that will allow parents whose wards have boarding status to at least pay for the boarding component including feeding.

COVID-19 vaccine wastage in Africa: A case of Nigeria.

The World Health Organization has launched campaigns to boost immunisation rates to 70 percent globally by the middle of 2022. However, despite the global success of about 64% COVID-19 vaccination coverage, there is a big gap in Nigeria. To date, only 13.8% of the population has received the recommended dose. This demonstrates a significant disparity between the vaccinated and the unvaccinated. Amidst the wide gap in vaccination, COVID-19 vaccine wastage still occurs in Nigeria. At the end of 2021, it was estimated that over a million doses of the COVID-19 vaccine had been wasted. It is anticipated that there will be more COVID-19 vaccine wastage in Nigeria, because of the combined factors that threaten vaccination uptake including vaccine accessibility, lack of appropriate storage facilities, poor electricity supply, insecurity challenges, and inadequate health promotion. This results in concomitant financial and opportunity losses. In this paper, we discuss COVID-19 vaccine wastage in Nigeria including causes, and solutions that can be applied to mitigate this wastage.

ANALYSIS OF MULTIDIMENSIONAL POVERTY AMONG RURAL FARMING HOUSEHOLDS IN TARABA STATE, NIGERIA

The study analyzed the training needs of extension agents on information and communication technologies (ICTs) in Kaduna State Agricultural Development Programme (KADP), Nigeria. Seventy-five extension agents were randomly selected for the study. Data were collected using structured questionnaires and analyzed using frequencies, percentages, mean and multinomial regression. The results revealed that the majority of the extension agents had a great need for training in the use of ICT facilities such as multimedia (85%), remote sensing equipment (83.3), internet (83.3%), video camera (81.7%), audio recorder/player (76.7%), computer (73.3%) and audio-visual aids (66.7%). majority (83%) of the respondents had participated in one extension programme or the other while 20 % of the extension agents have never participated into any agricultural extension programme. Factors that influence the training needs of extension agents included training (-0.349 and 0.312), education level (-0.322 and 0.205), job experience (0.142) and age (-0.528) of the extension agents. The major constraints associated with the use of ICT tools by extension agents include lack of skills and knowledge, poor finance, the problem of internet coverage and connectivity, high cost of ICT tools, poor power supply and unavailability of ICT tools. The establishment of ICT units equipped with modern ICT facilities for extension services in all the KADA zones should be carried out. Training courses on the application ICT facilities in extension services should be planned and conducted for all extension agents in KADP for effective extension service delivery.

ASSESSMENT OF TRAINING NEEDS AMONG AGRICULTURAL EXTENSION AGENTS ON INFORMATION AND COMMUNICATION TECHNOLOGIES IN KADUNA STATE AGRICULTURAL DEVELOPMENT PROGRAMME, NIGERIA

The study analyzed the training needs of extension agents on information and communication technologies (ICTs) in Kaduna State Agricultural Development Programme (KADP), Nigeria. Seventy-five extension agents were randomly selected for the study. Data were collected using structured questionnaires and analyzed using frequencies, percentages, mean and multinomial regression. The results revealed that the majority of the extension agents had a great need for training in the use of ICT facilities such as multimedia (85%), remote sensing equipment (83.3), internet (83.3%), video camera (81.7%), audio recorder/player (76.7%), computer (73.3%) and audio-visual aids (66.7%). majority (83%) of the respondents had participated in one extension programme or the other while 20 % of the extension agents have never participated into any agricultural extension programme. Factors that influence the training needs of extension agents included training (-0.349 and 0.312), education level (-0.322 and 0.205), job experience (0.142) and age (-0.528) of the extension agents. The major constraints associated with the use of ICT tools by extension agents include lack of skills and knowledge, poor finance, the problem of internet coverage and connectivity, high cost of ICT tools, poor power supply and unavailability of ICT tools. The establishment of ICT units equipped with modern ICT facilities for extension services in all the KADA zones should be carried out. Training courses on the application ICT facilities in extension services should be planned and conducted for all extension agents in KADP for effective extension service delivery.

The Relationship Between Environmental Sanitation and the Incidence of Diarrhea in the Working Area of Puskesmas Sentosa Baru

In 2021, there was an increase in the incidence of diarrhea by 1,225 patients, starting from early January to December 2021. This study aims to determine the relationship between Environmental Sanitation and the incidence of diarrhea in the Puskesmas work area. This study used the cross-sectional method. The population of this study is people who live in the working area of Sentosa Baru Health Center. Sample selection using the Lameshow 1997 formula so that 96 samples were obtained. Statistical tests using chi-square with the help of computer software. The research site in the working area of Sentosa Baru Health Center was carried out in May-August 2022. Based on environmental sanitation, respondents who met the requirements for healthy latrines (16.7%) and did not meet the requirements (83.3%), good Clean Water Supply Facilities (11.5%) and poor Water Supply (88.5%), good Garbage Can Facilities (7.3%) and poor Garbage Can Facilities (92.7%), while Wastewater Management Facilities that met the requirements were as many (19.8%) and did not meet the requirements as much (80.2%). Research shows that there is a relationship between Environmental Sanitation including Healthy Latrines Provision Facilities (p-value = 0.00), there is a relationship between Clean Water Facilities and diarrhea events (p-value = 0.010), there is no relationship between Garbage Can Facilities and diarrhea events (p-value = 0.070), and there is a relationship between Wastewater Management Facilities and diarrhea events (p-value = 0.015).

Analisis Konflik Dan Dampak Keterbelakangan Dalam Akses Jaringan Internet Dan Listrik Di Desa Terate Yang Terikat Dengan PTPN XII Kotta Blater

Terate village, which is located near the PTPN XII Kotta Blater plantation company, is facing serious problems related to poor internet networks and electricity supplies. The aim of this research is to study the dynamics of conflict, how retarded access impacts people's lives. The analysis is based on Ralf Dahrendorf's conflict theory to understand inequality of access. This study will look at what caused conflict during the construction of internet and electricity network infrastructure in Terate Village, with special emphasis on the role of the economic power of PTPN XII Kotta Blater in causing conflict. In addition, we will investigate how limited access affects education, economic growth and social life in Terate Village. This research will use approaches such as interviews and surveys with the community to gain a better understanding of the dynamics of conflict in Terate Village. In addition, this research is expected to provide insight into the complexity of conflict and also provide recommendations with the aim of improving equality of access and quality of life.

Measures that may assist non-performing municipalities in improving their performance

Background: Municipalities’ non-performance in terms of service delivery is often considered to be a significant concern that affects the community. Municipalities constitute the most important sphere of government as they operate at grassroot level and are mandated to provide essential services to communities. A lack of governance, poor financial management reporting, poor supply chain and asset management processes are some impediments that affect the service delivery.Aim: This study aimed to identify performance enhancing measures that non-performing municipalities in South Africa could apply.Setting: The article focused on all 44 district municipalities and identified the best performing ones from the period 2017 to 2020 financial years before examining measures that assisted well-performing municipalities.Method: A sequential exploratory research design was used in the study. The municipal performance measures were identified from the literature, confirmed, and validated through the content analysis of performing municipalities’ annual reports. The performance of these municipalities was based on the audit outcomes from the Auditor General South Africa (AGSA).Results: Forty-two measures were recommended to enhance non-performing municipalities’ performance.Conclusion: The overall view of all district municipalities and the identification of measures to focus on may assist municipalities in reflecting and implementing the suggested measures.Contribution: Most of the available literature focuses on metropolitan municipalities and tends to focus on corporate governance. This study examined change drivers in district municipalities and focuses on governance, financial management, supply chain management, and asset management. Areas for improvement were flagged and improvement measurements were put in place to enhance performance.

Explaining the challenges of resources management and its underlying factors in COVID-19 era in Iran: a qualitative study

BackgroundIdentifying factors affecting health costs can contribute to formulating the best policies for controlling and managing health costs. To this end, the present study aimed to analyze resource wastage and identify the factors underlying it in COVID-19 management in Iran’s health sector.MethodThis qualitative content analysis study was conducted in Iran’s health sector. The participants were 23 senior, middle, and operational managers in the health sector. The data were collected through semistructured interviews with the managers. The participants were selected using purposive, quota, and snowball sampling techniques. The interviews continued until the data were saturated. The collected data were analyzed using MAXQDA software (version 10).ResultsFollowing the data analysis, the factors affecting the wastage of health resources were divided into 4 themes and 13 main themes. Vaccines, diagnostic kits, medicines, and human resources were the main factors underlying resource wastage. The identified main themes were open and unused vials, nonuse of distributed vaccines and their expiration, excess supply and decreased demand for vaccines, expiration of diagnostic and laboratory kits and their quantitative and qualitative defects, and the large number of tests. Inefficiency and the expiration of COVID-19 drugs, poor drug supply and consumption chain management, inaccuracy in inventory control and expiration dates, disorganization and inconsistency in the distribution of healthcare staff, low productivity of the staff, and failure to match the staff’s skills with assigned tasks in selected centers were identified as the most important causes of resource wastage.ConclusionGiven the limited health funds and the increased healthcare costs, effective preparation and planning and making reasonable decisions for unexpected events can minimize unnecessary costs and resource wastage, which requires some revisions in attitudes toward COVID-19 management in the healthcare sector.

An ethnobotanical study of wild edible plants used by the Tibetan in the Rongjia River Valley, Tibet, China

BackgroundWild edible plants (WEPs) play a crucial role in communities with limited communication with the outside world, where unstable factors, such as poor food supply and insufficient access to timely nutritional supplementation, are common, as in the Himalayan region. To document the traditional knowledge of WEPs and explore their significance for communities with minimal global economic exchange, an ethnobotanical study was conducted in the town of Rongjia, which lies in a narrow valley near Mount Everest, Tibet, China.MethodsThis ethnobotanical study was conducted in three villages in the Rongjia River Valley between August 2021 and June 2023. Semi-structured interviews and participatory observations were used to collect information on WEPs. The fieldwork was performed with the assistance of local guides. Voucher specimens were collected from each documented plant species for taxonomic identification. We used the use report (UR) and relative frequency of citations (RFC) to evaluate the comprehensive utilization value of WEPs.ResultsWe interviewed 161 informants who provided us with 2499 use reports. We collected 50 WEPs belonging to 28 families and 42 genera used by the Tibetan people in the Rongjia River Valley. WEPs are used in vegetables, fruits, seasonings, healthcare foods, substitute grains, and beverages. Wild vegetables were the most commonly used, followed by wild fruits. Leaves were the most commonly consumed part of the plant. The three most important WEPs ordered by RFC values were Rosa sericea var. glandulosa Osmaston (RFC = 0.76), Zanthoxylum bungeanum Maxim. (RFC = 0.75), and Urtica hyperborea Jacquem. ex Wedd. (RFC = 0.71). Other than that, we also document some of WEPs used in the past. Arisaema erubescens Schott, Pinellia ternata (Thunb.) Makino, and Satyrium nepalense var. ciliatum (Lindl.) Hook. f. used to serve as important substitute grains, are no longer in use, however, they remain vivid in the memories of older people.ConclusionsWEPs included wild vegetables, fruits, seasonings, healthcare food, and substitute grains for Tibetan people in the Rongjia River Valley. Some WEPs have become important cultural symbols for older people, which can help in understanding the relationship between plants and local people in the past. In addition, WEPs can increase the resilience of local people living in remote areas when facing sudden destabilizing events in future. This is the significance of WEPs for communities with minimal global economic exchange. Therefore, we suggest that future studies focus more on WEPs in communities with limited communication with the world to improve their resilience.

Consulting a midwife when not pregnant: what happened in France after the 2009 reform?

Abstract Background While access to gynecologists in France has become very difficult for most women, demography of midwives is dynamic (+ 10.5% between 2013 and 2018), especially in ambulatory positions. In the same time, in 2009, a healthcare reform in France extended the skills of midwives. While they have been historically associated to care for pregnancy and childbirth, midwifes have been authorized from then to intervene for the gynecological follow-up of non-pregnant women. This paper explores how this reform affects the probability of women to consult a midwife when not pregnant, and the heterogeneity of this effect according to women's characteristics. Data and Methods Using longitudinal administrative data on the healthcare consumption of French women, we reconstruct pregnancy periods and control for a rather large number of individual characteristics (age, health status, outpatient care expenses, rate of extra fees born, region, index of a taxonomy of the French living areas, etc.). We use a generalized estimating equations (GEE) probit regression model to study the change in the probability of non-pregnant women aged 15 to 55 to consult a midwife between 2007 and 2017. Results We find that the probability of consulting a midwife for reasons other than pregnancy increases after the 2009 reform, particularly since 2012, and increasingly so. This increase is particularly important for women having a recent pregnancy, suggesting that midwives are their own “sales representatives”. The increase is also especially high in rural areas and deprived periurban areas. It can be related to the very poor healthcare supply in these two types of areas that are both characterized by a low supply of care, particularly for healthcare specialists. Key messages • The 2009 reform broadening the scope of midwives’ skills is illustrated in practice through an increase in the use of midwives outside pregnancy by all women and this concerns all types of territories. • the increase appears rather slow, given the significant rationing of gynecological care in many areas due to financial barriers and lack of professionals.