Service Continuity Research Articles

Murder in a time of crisis: a qualitative exploration of the 2020 homicide spike through offender interviews

ABSTRACT This study investigates how the COVID-19 pandemic and the civil unrest following George Floyd’s murder influenced the 2020 homicide surge, focusing on individuals already at high risk for violence. Based on life history interviews with 18 people convicted of homicide in Minnesota, the research explores how the disruptions of 2020 intensified pre-existing vulnerabilities, accelerating pathways to lethal violence. Participants reported that the breakdown of social order, loss of routine, and economic instability created conditions that rapidly escalated violence within their lives and communities. This qualitative analysis complements existing quantitative research by offering a detailed account of the micro-level experiences behind the homicide spike, revealing how large-scale societal disruptions can shape individual trajectories toward serious violence. Findings underscore the need for policies that address structural inequalities and ensure continuity of social supports and mental health services during periods of widespread upheaval to prevent future escalations in violence.

Dropout from Maternity Continuum of Care and Associated Factors Among Mothers Who Gave Birth After War in Adigrat Town, Tigray, Northern Ethiopia 2024

<i>Background: </i>Maternity continuum of care is the continuity of maternal health care services given to mothers during antenatal period, child birth and post natal period. It is one of the strategic programs meant to lower the death rates of mothers, newborns, and children. In spite of this, a large number of moms discontinue their participation in maternal continuum care. Dropout from the maternity continuum of care is prevalent public health issue in underdeveloped nations, such as Ethiopia. <i>Methods: </i>Community based quantitative cross-sectional study was carried out among 357 mothers who gave birth in the 12 months in Adigrat town. Systematic sampling method was used to obtain study participants. Data was collected using pretested, semi- structured and face to face interviewer administered questioner. Bivariable and multivariable logistic regression model was fitted. Variables having p-value less than 0.2 in bivariable analysis was entered to multivariable logistic regression model. In multivariable logistic regression adjusted odds ratio with 95% confidence interval was used to determine strength and direction of the association between dependent and independent variables. <i>Results:</i> The overall magnitude of drop out from the maternity continuum of care was 237 (66.4%) [95%CI (61.3-70.9)], 60.6% drop out from ANC visit, 5.6% drop out from skill birth attendant and 58.9% drop out from PNC. Mothers never heard on maternal health care service (AOR=4.179 (1.107, 15.783), service out of health facility (AOR =5.136 (1.988, 13.267) noabortionhistory (AOR=1.424 (1.113, 12.133), unplannedpregnancy (AOR=5.478 (1.902, 15.777), less than 4 ANC visit (AOR= 5.583 (2.598, 11. 997) and mothers attitude (AOR=15.049 (2.489, 32.997) were statically significant factors associated with drop out from maternity continuum of care. <i>Conclusion and discussion: </i>This study showed that magnitude of drop out from maternity continuum of care was high as compared to WHO recommendations. As a result concerned stakeholders and policy makers should initiate more than four ANC visit, create awareness on harmful traditional practice, bad pregnancy history, support mothers to use family planning to prevent unplanned pregnancy, and work on attitude change of the community.

Disruptions and adaptations of an urban nutrition intervention delivering essential services for women and children during a major health system crisis in Dhaka, Bangladesh

AbstractSystematic crises may disrupt well‐designed nutrition interventions. Continuing services requires understanding the intervention paths that have been disrupted and adapting as crises permit. Alive & Thrive developed an intervention to integrate nutrition services into urban antenatal care services in Dhaka, which started at the onset of COVID‐19 and encountered extraordinary disruption of services. We investigated the disruptions and adaptations that occurred to continue the delivery of services for women and children and elucidated how the intervention team made those adaptations. We examined the intervention components planned and those implemented annotating the disruptions and adaptations. Subsequently, we detailed the intervention paths (capacity building, supportive supervision, demand generation, counselling services, and reporting, data management and performance review). We sorted out processes at the system, organizational, service delivery and individual levels on how the intervention team made the adaptations. Disruptions included decreased client load and demand for services, attrition of providers and intervention staff, key intervention activities becoming unfeasible and clients and providers facing challenges affecting utilization and provision of services. Adaptations included incorporating new guidance for the continuity of services, managing workforce turnover and incorporating remote modalities for all intervention components. The intervention adapted to continue by incorporating hybrid modalities including both original activities that were feasible and adapted activities. Amidst health system crises, the adapted intervention was successfully delivered. This knowledge of how to identify disruptions and adapt interventions during major crises is critical as Bangladesh and other countries face new threats (conflict, climate, economic downturns, inequities and epidemics).

Continuity in public transport provision during the Covid-19 pandemic – responding to organisational and health challenges facing workers

PurposeThis paper explores and analyses the major challenges faced by both customer-facing and office-based public transport employees during the early stages of the Covid-19 pandemic and the responses of their employers to their concerns.Design/methodology/approachQualitative semi-structured interviews and focus groups were carried out, involving 39 employees and directors representing a wide range of professionals working in the transport sector in three European countries, Poland, Ireland and the UK. Data were analysed through thematic analysis and the emerging issues explored.FindingsMajor employee challenges included: access to resources for safe working; worker mental health and well-being; and the effects of changing working practices, particularly flexible working, on their wider household circumstances and work–life balance (especially combining childcare responsibilities with work). First, physical health safety measures (such as PPE) were put in place for all workers, although sometimes with delays. Second, concerning practical support for mental health and well-being at work, the findings highlight that their employers’ practical support was considered limited by some customer-facing participants. In contrast, participants working from home were offered considerably greater employer support for their well-being, including increased and regular communication regarding work and non-work-related topics to tackle isolation and lack of social interactions. Third, work–life balance, and especially childcare were significant issues for those working from home. To improve organisational resilience, employer support for workers needs to better reflect employees’ job role, work setting and location, as well as their household demands such as childcare.Practical implicationsThe lessons learned from this study contribute to future employer responses and practices and their organisational resilience, both in times of major crises and also for improving mental-health and childcare support in normal times.Originality/valueThe study considers the role of employee perspectives on organisational resilience and service continuity in public transport during a crisis and in three countries. Importantly, the data were gathered contemporaneously during the early stages of the pandemic, and so are not influenced by retrospective rationalisation or uncertain recollections.

Self-adjusting resilient control plane for virtual software-defined optical networks

Optical networks must promptly respond to failures and efficiently handle dynamic traffic in order to fulfill their role as a critical infrastructure. Leveraging network softwarization and virtualization, virtual software-defined networks offer sufficient flexibility towards this goal by sharing the physical infrastructure among multiple tenants whose traffic must traverse the network hypervisor. In a resilient optical control plane each switch must be assigned to a primary and backup hypervisor instance through short control paths, which challenge will be addressed in this paper. First, we propose an intelligent greedy hypervisor placement heuristic which maximizes acceptance ratio for current, and preparedness for future requests. Secondly, we introduce a graph neural network model that can be seamlessly integrated with either our integer linear program or heuristic method to yield high-quality placements in significantly less time compared to our prior solutions. This enhancement renders our approach applicable to larger networks, significantly expanding its practical utility. Finally, we propose a self-adjusting hypervisor migration strategy, which continuously adapts the placement to the dynamically changing virtual network requests, thus, ensuring service continuity by avoiding frequent control plane reconfigurations. Through simulations we show that our hypervisor placement and migration strategies provide a balanced control load while they can handle a wide variety of changes.

Healthcare performance for patients with heart failure in Iran: addressing the tip of the iceberg.

Chronic diseases, such as heart failure with reduced ejection fraction (HFrEF), remain significant factors in the healthcare burden in Iran. Healthcare systems must have comprehensive data on the current usage, costs, and quality of care to tackle these challenges and formulate strategic plans effectively. The study included 209 patients with a mean age of 58 years (SD = 16.5) who met the inclusion criteria of having an ejection fraction of less than 40% and a confirmed diagnosis of HFrEF. This study used nationally representative data to assess the healthcare usage, costs, and quality of HFrEF management in Iran. The most used services were medication dispensing (76%) and outpatient visits (53%), while rehabilitation (3%) and homecare (2%) were used less frequently. The annual per-patient direct medical cost was $1,464, with $308 (21%) paid out-of-pocket (OOP). Hospitalization accounted for most of the total cost (68%), and pharmacy expenses comprised the largest portion of OOP payments (46%). Echocardiography was performed for 91.1% of patients upon admission. Only 71.6% of patients had arrangements for a cardiology visit within seven days following hospital discharge. Additionally, only 67.5% of patients received prescriptions for angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, and 85% were prescribed beta-blockers. Patients with heart failure in Iran face challenges in accessing adequate cardiac care, including a lack of care continuity and advanced cardiac services. The study provided an essential benchmark for future healthcare reform.

ANALISIS KETERSEDIAAN DAN KEBUTUHAN AIR BAKU DISTRIK BONGGO KABUPATEN SARMI

The development of an area will cause the demand for water to continue to increase along with thepopulation growth rate. The fulfillment of food needs and the activities of the population are always closely relatedto the need for water. The demands are unavoidable but must be predicted and planned for optimal utilization.The tendency that often occurs is the imbalance between water availability and water demand. To achieve abalance between water demand and availability in the future, efforts are needed to assess the components of rawwater availability and demand as clean water sources. The source of clean water for the people of Bonggo District, Sarmi Regency, comes from borehole pumps,shallow wells (pumps), and rainwater. The analysis results on the need for domestic and non-domestic clean waterin the Bonggo District in 2023 show a total requirement of 210.38 liters/day or 0.0024 m3/second. The need forclean water is expected to increase by 2043, with the total requirement for domestic and non-domestic clean waterreaching 285,820 liters/day or 0.0033 m3/second. The availability and need for clean water sourced from rawwater that can be utilized as clean water comes from pump bore wells as a suitable raw water source. In terms ofquantity, it is available 24 hours a day and throughout the year. The investigation results of the pump bore wellraw water source meet the clean water quality requirements according to Government Regulation No. 82 of 2001,Level II. This is supported by groundwater, obtained through the analysis of geological conditions, land cover,morphology, and river flow, which have a high to very high groundwater potential score, located in the northernpart of Bonggo District. Economically, in terms of quantity, rainwater can be used as clean water due to its sufficientavailability, with high rainfall (104,775 mm/year) and year-round service (continuity), and in terms of quality, theresults of rainwater quality tests meet the clean water standards according to quality standards.

Towards integration of care in Portugal: Expansion of a new management model for the NHS

Abstract Introduction In 1999, the first Local Health Unit (LHU) was created in the Northern region of Portugal to improve management, share resources and integrate care. The LHU integrated a National Health Service (NHS) hospital and primary healthcare (PHC) services located within the same geographic area and became responsible for public health activities and the provision of care. Over the next few years, 7 LHUs were created, the last one in 2012. In 2024, the government expanded this model to the entire territory, creating 39 LHUs. This research analyses the objectives, characteristics and expected outcomes of the scale-up of LHUs. Methods This study utilised a mixed methods approach based on the 6 Ps - Problem, People (policy stakeholders), Process (policy development), Price tag (Resource allocation), Paper (policies, laws, regulations), Programmes (policy implementation); and the political, social and economic setting of the Policy Circle Framework. Findings A 2015 assessment revealed that LHUs did not differ from non-LHUs in terms of access, waiting times, clinical excellency, patient safety or patient centeredness. The degree of integration of care in LHUs seemed lower compared with non-LHUs. However, there was no systematic evaluation of the creation of the first LHU. Despite this, the government announced the intention to expand LHUs to the entire national territory, which culminated with the creation of 39 LHUs in 2024 to deliver integrated care, with an emphasis on the proximity and continuity of health services and promotion. Conclusions Despite the existing knowledge gap on the impacts of LHUs in health outcomes and management efficiency, LHUs can provide opportunities to advance integrated and patient-centred care and develop strategies for managing scarce resources, including the health workforce. Nevertheless, the integration of hospitals and PHC can threaten the centrality of primary health care both in terms of delivery of care and resource allocation.

FROM SERVICE TO SUPERIORITY: UNVEILING THE IMPACT OF ARTIFICIAL INTELLIGENCE ON CUSTOMER EXPERIENCE IN GIANT HYPERMARKETS, KLANG VALLEY, MALAYSIA

The integration of Artificial Intelligence (AI) in retail has redefined customer experience, offering new opportunities for personalisation, service quality enhancement, and continuous service delivery. This study investigates the impact of AI on customers’ experience at Giant Hypermarkets in Klang Valley, Malaysia, focusing on four key areas: personalisation, service quality, hassle-free service, and customer service. Using quantitative methods, data were gathered from 365 respondents to assess the influence of AI-driven services on customer experience. The findings reveal that hassle-free service significantly enhances customer experience, while personalisation, service quality, and customer service show no significant impact. These results suggest that while AI is effective in streamlining operations and reducing customer effort, it may fall short in providing the emotional engagement needed to enhance the overall customer experience. This study highlights the importance of balancing AI efficiency with human interaction, particularly in relational services. This research offers valuable insights for retailers, academics, and small business owners, emphasizing the need to adopt AI technologies that focus on customer convenience and experience while maintaining a personal touch. This study clearly highlights the implications for the retail industry, demonstrating that AI can significantly enhance customer experience, but its strategic integration is crucial to address both operational efficiency and emotional engagement.<p> </p><p><strong> Article visualizations:</strong></p><p><img src="/-counters-/soc/0735/a.php" alt="Hit counter" /></p>

Strategic Vigilance in Sports Clubs: Insights and Practices

Objectives: This study explores the reality of strategic vigilance practices in sports clubs in Oman. Methods: A questionnaire was administered to a random sample of 162 participants which included members of boards of directors, club managers, sports activity directors, coaches, and players in Oman. Result: Institutions show significant gaps in competitor analysis and communication with authorities, leading to a shortage of technological expertise that negatively impacts service promotion. Sports institutions prioritize continuous service development to retain existing clients and attract new ones. Conclusions: The study revealed a need to promote a culture of strategic vigilance among all employees in sports institutions in Oman. It emphasizes the necessity of engaging marketing specialists to address weaknesses within the institutions and contribute to the development of marketing vigilance

Navigating urban congestion: A Comprehensive strategy based on an efficient smart IoT wireless communication for PV powered smart traffic management system.

Egypt faces extreme traffic congestion in its cities, which results in long travel times, large lines of parked cars, and increased safety hazards. Our study suggests a multi-modal approach that combines critical infrastructure improvements with cutting-edge technologies to address the ubiquitous problem of traffic congestion. Assuring vehicles owners of their timely arrival, cutting down on fuel usage, and improving communication using deep learning approach and optimization algorithm within the potential of IoT enabled 5G framework are the main goals. The traffic management system incorporates detection cameras, Raspberry Pi 3 microcontroller, an Android application, cloud connectivity, and traditional traffic lights that are powered using PV modules and batteries to secure the traffic controllers operation in case of grid outage and assure service continuity. The model examines the difficulties associated with Internet of Things (IoT) communication, highlighting possible interference from device-to-device (D2D) devices and cellular user equipment. This all-encompassing strategy aims to reduce fuel consumption, increase road safety and improve traffic efficiency. The model predicts a significant increase in Egypt's urban mobility by utilizing the possibilities of IoT and 5G technologies, which would improve Egypt's towns' livability and efficiency. The goal of this paper is to modernize Egypt's traffic management system and bring it into compliance with global guidelines for intelligent transportation networks.

PUBLIC ADMINISTRATION POLICY IN THE HEALTHCARE SECTOR UNDER MARTIAL LAW

The article analyzes the main directions of public administration in the field of health care of Ukraine during martial law. The main focus is on the adaptation of the legislative framework and the modernization of management approaches, which allow to ensure the effective functioning of the health care system in crisis situations. The issue of creating mobile medical teams and hospitals, which are the main tool for providing medical care in front-line and de-occupied areas, was considered. The contribution of international organizations to the support of the Ukrainian medical system in terms of supplying medical equipment, medicines and providing financial assistance is analyzed. The key normative legal acts, which were adopted from 2022 and contributed to the adaptation of the medical system to new challenges, were studied. Features of the functioning of the Resolution of the Cabinet of Ministers No. 302, No. 683, No. 1078 and others are given. Particular attention is paid to the digitization of health care, the implementation of electronic medical records in order to ensure the prompt provision of medical services. The problems of medical institutions in the front-line zones, including the destruction of more than 700 hospitals, and ways to solve the logistical problems of the supply of medicines were considered. A conclusion was made regarding the further development of public administration in the field of health care based on the integration of international and national resources, improvement of digital technologies and modernization of medical infrastructure. Ensuring adequate funding of the health care system, which includes the health insurance program, emergency and specialized medical care, is revealed, which is a priority in the 2023 budget. The article examines the influence of international humanitarian organizations on the support of the Ukrainian health care system in the conditions of military operations. The basis for the development of long-term strategies for the recovery of medical facilities after destruction and their equipment with modern technologies is proposed. Aspects of integration of digital solutions to ensure the continuity of medical services in the most difficult conditions have been studied.

Latency‐Sensitive Service Function Chains Intelligent Migration in Satellite Communication Driven by Deep Reinforcement Learning

ABSTRACTSatellite communication technology solves the problem that the traditional wired network infrastructure is difficult to achieve global communication coverage. However, factors such as satellite orbits introduce frequent changes to the network topology, and challenges like satellite failures and communication link interruptions are prevalent. In the face of these issues, service function chain (SFC) migration becomes a crucial method for swiftly adjusting SFCs during faults, maintaining service continuity and availability. This article proposes a latency‐sensitive SFC migration algorithm tailored to satellite networks. The algorithm first models the satellite network as a multi‐domain virtual network, capturing the constraints faced during SFC migration. Subsequently, a deep reinforcement learning algorithm integrated attention mechanism is designed to more accurately capture and understand the complex network environment and dynamic satellite network topology and derive optimal SFC migration strategies for superior performance. Finally, through experimentation and evaluation of the deep reinforcement learning‐driven latency‐sensitive service function chain intelligent migration algorithm (LS‐SFCM) in satellite communication, this study validates the effectiveness and superior performance of the algorithm in latency‐sensitive scenarios. It provides a new avenue for enhancing the service quality and efficiency of satellite communication networks.

Transitional Infrastructures Extending Access to Safe Water in Informal Settlements: A Cross-Sectional Study in Nairobi, Kenya.

There is a pressing need for transitional water infrastructures in rapidly growing cities where conventional infrastructures lag behind human settlement expansion. In Kenya, sectoral innovations have addressed local socioeconomic challenges, but empirical evidence on their efficacy (combining quantitative indicators of safety and continuity) is lacking. We addressed this gap by comparing different water infrastructures in their ability to provide constant access to safe water in informal settlements in Nairobi, Kenya. We conducted a cross-sectional survey including 1,147 households in two informal settlements. Water infrastructures were categorized based on their distribution system: 1) piped to premises; 2) piped to a neighboring compound; 3) public tap/dispenser; and 4) street vendor. We tested associations between these systems with two outcomes: constant water availability and diarrhea (stratified by age group). We used adjusted odds ratios (AORs) to test associations between distribution systems and the selected outcomes, while accounting for confounders. Obtaining water from public taps/dispensers or street vendors was associated with service continuity (AOR = 1.45, 95% confidence interval [CI]: 1.06-1.99; AOR = 11.16, 95% CI: 2.45-50.82). Piped sources were associated with service disruption, especially when obtained from a neighboring compound (AOR = 0.45, 95% CI: 0.28-0.70). Public taps/dispensers were the only system consistently associated with lower odds of diarrhea, notably in children under the age of 5 years (AOR = 0.47, 95% CI: 0.29-0.79). Hence, in cities with a high prevalence of informal settlements and limited financial resources, public taps and dispensers hold promise as transitional water infrastructures.

Leveraging Digital Health Data to Transform the United Nations Systems for Palestine Refugees for the Post Pandemic Time

ABSTRACT The COVID-19 pandemic presented a grave threat to the continuity of health services that UNRWA provides to 5.9 million Palestine Refugees in the Near East. UNRWA runs 140 primary health care clinics, providing approximately nine million medical consultations a year. During the pandemic, UNRWA’s e-Health system (and other digital health tools) were crucial in maintaining health services. The e-Health system enabled the identification of at-risk patients and transformed UNRWA’s services for sustainability and efficiency. Innovations like telemedicine and two smartphone applications (e-NCD and e-MCH) enhanced service delivery and staff management. To evaluate the effectiveness of digital health integration in UNRWA’s services during and after the pandemic, the team analyzed reports, events, and e-Health data from 2019–2022. Results show that digital tools, like e-NCD and e-MCH applications, helped reduce COVID-19 among Palestine Refugees, enabling remote care and continuous access to essential health services. Digital health has now become essential in UNRWA’s post-pandemic operations. This paper offers a paradigm for future outbreak responses. By harnessing the power of digital health, UNRWA’s e-Health system served as a beacon of hope, demonstrating how innovative approaches can empower patients, enhance health care outcomes, and ensure equitable access to health care services during crisis situations and beyond.

Lessons from the Department of Veterans Affairs: A continuum of age-friendly care for older adults.

With almost 90% of Americans expressing a desire to age in place in their home, many health systems and communities are challenged to provide the right resources, at the right time, to support What Matters to older adults. In the Department of Veterans Affairs (VA), approximately 50% of Veterans enrolled in VA health care are aged 65 and older, driving an imperative to provide timely, Age-Friendly care through a broad continuum of services. VA has taken a multifaceted approach to shift Long-Term Services and Supports to promote aging in place through innovation pilots, expansion of Home and Community Based Services (HCBS) and adoption of Age-Friendly Health Systems (AFHS) practices [or "framework"]. VA is spreading geriatrics knowledge throughout the clinician and trainee workforce, improving skills and practices across all disciplines and care settings. The framework of AFHS creates a shared language to support transitions across ambulatory, hospital, emergency department, home care, and nursing home settings. Through these efforts, VA is reimagining geriatrics, providing an example of the type of care all older adults want and deserve. Since March 2020, 375 care settings across 132/139 (95%) VA parent facilities have earned AFHS recognition. By incorporating AFHS into the infrastructure of the healthcare system, clinicians are prepared to address What Matters across clinical settings and address common geriatric syndromes. Leaders in a variety of health systems can learn from VA efforts to provide a continuum of Age-Friendly programs and services that promote independence, function, well-being and aging in place.

Service specification for senior care workers with traditional Chinese medicine specialty

Abstract Senior care workers specializing in traditional Chinese medicine (TCM) healthcare have become an indispensable force in institutional care, community care, and home care. The first Chinese nursing service team aimed to improve the health of the elderly by providing continuous services for physical and mental well-being, disease prevention, physical amelioration, and overall health enhancement using TCM concepts, methods, and technologies. The primary purpose of formulating this TCM health and elderly care worker service specification was to standardize services within the TCM elderly care industry, ensuring that the elderly receive better health and elderly care services supported by technical expertise. This specification outlined the basic requirements for TCM health and elderly care workers, including standards for service content, service quality control, service evaluation, and improvement. It primarily focused on the content and requirements of TCM health and elderly care services, such as constitution identification, life care, acupoint healthcare, and TCM auxiliary nursing for elderly individuals with chronic diseases. This specification is applicable to TCM health and elderly care personnel at various levels of hospitals and healthcare institutions and is noted for its strong applicability and effectiveness.

Communication, Socialization, and Literacy for Adults With Developmental Disabilities: An Interview Study of Parents' Perspectives and Experiences.

The study highlights the significance of continuous support and services in communication, socialization, and literacy skills for adults with developmental disabilities (DDs). The aim of the study was to gather in-depth information on the individualized needs, lived experiences, and expectations of adults with DD by interviewing their parents. A total of 14 parents of adults with DD participated in one-on-one semistructured interviews. During the interviews, parents were asked to describe (a) their children's current communication, socialization, reading and writing skills; (b) the types of communication, socialization, and literacy support their children were receiving; and (c) the types of support that their children needed. Interviews were video- and audio-recorded, transcribed, and analyzed qualitatively using thematic analysis. Thematic analysis revealed three main themes and eight subthemes: (1) insufficient support and services for adults with DD (i.e., lack of competent professionals and lack of literacy support), (2) approaches that the parents attempted for their children with DD (i.e., parents' responsibilities, technologies, and pseudoscience), and (3) recommendations for ongoing support and services (i.e., novel technologies, social media, and motivation). The study highlights crucial gaps between the participating parents' desire for individualized, consistent, and innovative support and services for their adult children with DD and scarcity of resources in communication, socialization, and literacy. The dearth of evidence-based support and resources leads to easy access to pseudoscience. Future research is warranted to develop innovative, customized, and highly motivating programs in communication, socialization, and literacy for adults with DD. https://doi.org/10.23641/asha.27214407.

An observational study on menstrual hygiene practices among adolescents girls attending zilla parishad high school at Kommadi village in Visakhapatnam

Under RMNCH+A strategy, adolescent health program is relatively a new concept, particularly for female gender, and has been considered to be a continuum of health services up to adolescent age. The priority interventions among adolescent girls are, nutrition, Adolescent Friendly Health clinics (AFHCs), Counselling, Menstrual hygiene and preventive health checkups. Menstrual hygiene component has been taken for the present study among the adolescent girls in a Zilla Parishad High School aged 10 to 19 years. Rastriya Kishora Swastya Karyakram (RKSK) is broader one including both gender for distinct health services in India. : To study the association of various socio- economic and cultural practices influencing the usage of sanitary napkins by menstruating adolescent school girls. : Cross sectional study among menstruating adolescent girls in a Zilla Parishad High School at Kommadi village. 198 adolescent girls were randomly selected for study using semi structured questionnaire. Each menstruating girl is questioned categorically (yes/no) as per the structured questionnaire covering socio economic status, literacy of mother, awareness about ASHA etc. Appropriate statistical tests like frequencies, percentages and chi-square tests are applied to analyse and interpret the collected data.Socio-demographic factors of the target population in the community from where the adolescent girls attending zilla Parishad High school were subjected to study and found that 19(22%) adolescent girls having white ration card are using sanitary napkin. 46% of sanitary napkin users in our study are aware of using cloth available in the house during menstruation. 39 (52%) adolescent girls using sanitary napkin are aware of ASHA worker visiting their colony. One of the family members, either mother or elder sister being a member in Self Help Group in the colony is influencing the usage of sanitary napkin 46 (50.5%). Habit of Over-the-Counter drugs usage in the family has significantly (55%) influenced the adolescent school girls in using sanitary napkin. School drop-outs 51(62.9%) are also observed among sanitary napkin users during menstruation.: The usage of sanitary napkin replacing the traditional home-made cloth is highly essential for proper menstrual hygiene management among adolescent girls attending the school regularly without drop out. The role of ASHA workers and other paramedical staff in the community cannot be undermined.

Early Address Detection: A Soft Vertical Handover Approach in Proxy Mobile IPv6

Study’s Excerpt Handover technique for Proxy Mobile IPv6 (PMIPv6) networks through a proactive IP address allocation approach is introduced. It significantly reduces handover-blocking probability and latency, thereby ensuring smoother transitions between WLAN and WiMAX domains. It is proved to be superior to velocity-aware handover methods. Full Abstract This study presents an enhanced handover technique for Proxy Mobile IPv6 (PMIPv6) networks aimed at improving mobility management in heterogeneous wireless environments. The proposed scheme introduces a proactive approach where the anchor Local Mobility Anchor (LMA) obtains IP addresses for the Mobile Node (MN) before it leaves the home network, facilitating faster handovers between Wireless Local Area Network (WLAN) and Worldwide Interoperability for Microwave Access (WiMAX) domains. The performance of the proposed scheme was evaluated through both mathematical analysis and network simulation, comparing it with a velocity-aware handover approach. Three key metrics were assessed: handover completion probability, handover latency, and packet loss ratio. Mathematical modeling demonstrated the scheme’s effectiveness in reducing handover-blocking probability and latency across various MN velocities. Simulation results, conducted using NS2.35, further established these findings, showing improvements in the number of successful handovers, reduced handover delay, and decreased packet loss compared to the velocity-aware approach. The study’s outcomes indicate that the proposed scheme offers a more efficient handover mechanism, particularly beneficial for maintaining service continuity in heterogeneous network environments.