Infrastructure, WASH Practices, and Health: a study of rural communities in São Tomé e Príncipe

Introdução: Melhorar os comportamentos de higiene e o saneamento (WASH) é uma maneira económica de reduzir os problemas que as doenças da pobreza e das doenças tropicais trazem, especialmente em comunidades pobres. Em setembro de 2016, um surto de infeções de pele foi acompanhado pela Organização Mundial da Saúde e os questionários aplicados evidenciaram que as questões de higiene em São Tomé e Príncipe merecem mais atenção, principalmente nas comunidades rurais da ilha. Assim, este estudo teve como objetivo caracterizar o comportamento de WASH e as infraestruturas relacionadas com três comunidades rurais, a fim de identificar áreas com maiores necessidades, explorando como os comportamentos em termos de WASH e outros fatores relacionam com alguns problemas de saúde relatados no último mês. Material e Métodos: Este estudo transversal ocorreu entre fevereiro e abril de 2019, no distrito de Lobata, em São Tomé e Príncipe, tendo-se recolhido uma amostra aleatória de dimensão n=162. Para a seleção aleatória usou-se a aplicação Random UX. Os dados foram recolhidos através de um questionário digitalizado no programa Qualtrics e aplicado a residentes adultos em três comunidades rurais: C - Canavial (n=56), P - Plancas (n=49) e I - Ilheu (n=57). Após uma análise exploratória de dados e testes de hipóteses (paramétricos e não-paramétricos), utilizaram-se modelos Log-lineares e de regressão logística simples e múltipla. Resultados: Encontramos diferenças significativas no uso de fontes naturais de água e na melhoria dos locais de lavagem de roupas entre as três comunidades. Relativamente as latrinas nota-se que faltam nas três comunidades. Canavial e Plancas parecem ter practices menos adequadas. Apenas 8.0% dos participantes no estudo relataram que têm acesso a caso de banho, com diferenças significativas por comunidade (8.9% C; 0.0% P e 14.0% I, p=0.015). Em termos de acesso a uma latrina há diferenças muito significativas entre as três comunidades (7.1% C; 22.3% P e 40.4% I, p<0.001). Em termos de água canalizada, as percentagens são também reduzidas (5.4% C; 0.0% P e 19.3% I, p=0.001). Também identificamos associações entre o uso de fontes naturais de água para beber e outros usos, e o uso de fontes naturais de água para limpar roupas e mais problemas de saúde no mês anterior à recolha de dados. O uso de recipientes fechados para o armazenamento de água foi associado a menos problemas de saúde, sendo um possível fator de proteção de reduzido custo que pode ser útil para intervir nessas comunidades. Conclusões: Neste estudo registou-se a falta de casas de banho, latrinas e água apropriadas em todas as comunidades e registam-se práticas menos adequadas de WASH, principalmente, em Canavial e Plancas. São necessárias mais pesquisas sobre a qualidade das fontes naturais de água, para entender melhor os riscos que esse tipo de armazenamento de água pode trazer a estas comunidades.Improving hygiene and sanitation (WASH) behaviors is an cost effective and sustainable way to reduce the problems that diseases of poverty and tropical diseases bring, especially in poor communities. In September 2016, an outbreak of necrotizing fasciitis was reported and monitored by the World Health Organization and subsequent inquiries suggested hygiene issues in Sao Tome and Principe that merit further attention, especially in the rural communities of the island. Thus, the aim of the study is to characterize the WASH behavior and related infrastructure of the three rural communities in order to identify areas of greatest need, exploring how WASH behaviors and other factors relate to some reported health problems. Materials and Methods: This cross-sectional study took place between February and April 2019, in the Lobata district of São Tomé and Príncipe, and a random sample size n = 162 was collected. For random selection the Random UX application was used. Data were collected through a digitized Qualtrics questionnaire and applied to adult residents in three rural communities: C - Canavial (n = 56), P - Plancas (n = 49) and I - Ilheu (n = 57). After an exploratory data analysis and hypothesis tests (parametric and non-parametric), a log-linear analysis and simple and multiple logistic regression models were developed and run. Results: We found significant differences in the use of natural sources of water and improved washing facilities between the three communities. Furthermore, a serious lack of appropriate latrines in all communities and sub-optimal WASH practices in Canavial and Plancas. Only 8.0% of study participants reported having access to bathrooms, with significant differences by community (8.9% C; 0.0% P and 14.0% I, p = 0.015). there were significant differences between the three communities in terms of latrine access (7.1% C; 22.3% P and 40.4% I, p <0.001). Regarding indoor plumbing, the percentages are also low (5.4% C; 0.0% P and 19.3% I, p = 0.001). We also identified associations between the use of natural sources of water (for both drinking and other uses) and the use of natural water sources to clean clothes with more health problems in the month prior to data collection. Finally, the use of closed bottles for water storage has been associated with fewer health problems, a possible low-cost protection factor that may be useful for intervening in these communities. Conclusions: In this study, a lack of adequate bathrooms, latrines and sources of clean water in all communities was identified, as well as less than adequate WASH practices, mainly in Canavial and Plancas. Further research on the quality of natural water sources is needed to better understand the risks that such types of water storage may bring to these communities

Understanding Strategic Planning: Why Nonprofit Organizations Struggle in the Current Era of Privatization

Several studies suggest that nonprofit organizations that compete with for-profit organizations to deliver public services struggle to obtain mission clarity and face resistance by staff and volunteers when implementing traditional for-profit business planning procedures. The purpose of this study was to extend the Austrian theory of entrepreneurism and Bourdieu\u27s social practice theory to identify particular procedural functions during the strategic planning process that played a role in the struggle of nonprofit organizations to obtain mission clarity. This study focused on nonprofit organizations that delivered residential services to disabled individuals in the state of Indiana. Data collected included 15 face-to-face interviews with the executive leadership from the study\u27s participating nonprofit organizations; qualitative survey results from 17 staff members who were asked open-ended questions about their experiences with the strategic planning process; and publicly available documents related to the strategic planning process, including internal documents, and standard business documents. All data were inductively coded and then subjected to a constant comparative method of analysis to identify key themes and concepts. A key finding identified that communication during the strategic planning process and the clarity of the role played by staff in that process had a direct effect on both mission clarity and staff resistance during the strategic planning exercise. The positive social change implications of this study include recommendations for non-profit organizations for the improvement of strategic planning processes, which may, in turn, lead to an increase in options for care and service delivery available for people receiving public service that results in a better quality of life

Distributing Real Time Data From a Multi-Node Large Scale Contact Center Using Corba

This thesis researches and evaluates the current technologies available for developing a system for propagation of Real-Time Data from a large scale Enterprise Server to large numbers of registered clients on the network. The large scale Enterprise Server being implemented is a Contact Centre Server, which can be a standalone system or part of a multi-nodal system. This paper makes three contributions to the study of scalable real-time notification services. Firstly, it defines the research of the different technologies and their implementation for distributed objects in today\u27s world of computing. Secondly, the paper explains how we have addressed key design challenges faced when implementing a Notification Service for TAO, which is our CORBA-compliant real-time Object Request Broker (ORB). The paper shows how to integrate and configure CORBA features to provide real-time event communication. Finally, the paper analyzes the results of the implementation and how it compares to existing technologies being used for the propagation of Real-Time Data

Interview with Horace Goggins

In his April 29, 1981 interview with Viola Sherrill, Horace Goggins shares the story of how he became a dentist, his involvement in the Civil Rights Movement, and how he supports his wife’s political career. This interview was conducted for inclusion into the Louise Pettus Archives and Special Collections Oral History Program.https://digitalcommons.winthrop.edu/oralhistoryprogram/1100/thumbnail.jp

PUBLIC SCHOOL CHOICE AND THE PUBLIC-PRIVATE SCHOOL DECISION

This dissertation is a compilation of three studies related to public school choice issues. Chapter 2 examines whether access to public schools of choice influences a household’s decision to choose private school for their child. I employ a multistate, individual-level data-set on students and their families — for which I have been granted access to restricted geo-code information. I supplement these data by matching students with their respective school districts using geographic information systems (GIS); I then examine whether relative measures of public school choice (PSC) in a school district influence the household’s public-private school decision. I find slight evidence that households respond to general measures of choice, though the implied effects appear to be trivial. Conditional on the presence of either PSC type of school in a district, I find more consistently significant crowd-out effects for competition measures from magnet schools, while charter school measures elicit stronger private-sector crowd-out effects, roughly three times those of the respective magnet school measures. Chapter 3 examines the statewide educational policies and student, household, and school district-level attributes that influence the demand for interdistrict and intra-district public schools of choice. In the context of a multinomial probit model, I also estimate the demand for private school as a third alternative to attending an assigned school. I find evidence to suggest that households substitute between intra-district and interdistrict schools of choice.. I also find that mobility patterns may significantly increase the probability a household opts out of district. Chapter 4 is an exploratory analysis that examines the qualities that distinguish school districts as net-losers, net-keepers, or net- gainers of students in their public schools. In particular, I examine how public schools of choice affect the net flow of students across the public sector. I find that charter schools appear to locate in districts that are net-losers of students, where students are opting into private school. I also find evidence to suggest that net-loser districts may signal better quality school districts with more diverse options available to facilitate positive student-school matches

Association of dietary behaviors, macro-nutrients and energy intake with body fat percentage, lean mass, and bone mineral density.

Background: Due to the obesity epidemic, many studies have compared nutrient intake to human body composition. However, previous studies have not used gold standard measures of body composition in a college population. Purpose: The purpose of this study is to examine how dietary behaviors, overall energy intake, and macronutrient intake are associated with the body composition factors measured in a dual-energy x-ray absorptiometry (DXA) scan. We hypothesize higher body fat percentage will be associated with higher fat and carbohydrate intake, but not total energy intake. Methodology: This was a cross-sectional study done as part of Exercise is Medicine® On Campus initiative. It was a convenience sample of subjects that had to be connected to the University of Arkansas as a student, faculty, or a staff member, and at least 18 years old. Body composition was measured using a DXA scan, which measured total body lean tissue, fat mass, and bone mineral density. Participants completed an online survey on dietary habits. 24-hour dietary recalls will be used to determine nutrient intake for each subject. Results from the recalls will be entered into Nutritionist Pro™ to obtain macronutrient levels and overall energy intake. Descriptive statistics were calculated and linear regression adjusted for sex and age compared the dependent variables of body composition by independent variables of dietary behaviors. Results: Survey: There were a total of 47 participants (n=29 women), with a mean age of 29.2 (SD 12.5, range 19.1 to 66.0). Preliminary results found average percent body fat of 33.9% (SD 8.6) for women and 21.8% (SD 7.3) for men, lean mass of 39.5 kg (6.2) for women and 59.0 kg (5.8) for men, bone mineral density of 1.2 (0.1) for women and 1.3 (0.1) for men. Eight participants (17%) drank milk at least daily and of those that consumed milk at all, 11 (26.2%) primarily consumed whole milk. Additionally, 19 (41%) participants consumed fruit at least daily. In models adjusted for age and sex, there were no differences in percent body fat (β 2.5, p=.435), lean mass (β 0.6, p=.806), or bone mineral density (β .004, p=.925) in those who consumed milk daily compared to those who consumed milk less than daily. There was no difference in percent body fat (β 2.3, p=.368) between those who consumed fruit daily compared to those who consumed less than one serving of fruit daily. Dietary Recalls and DXA: there was no association between total fat percentage and total energy intake (β 0.1, p=.124), carbohydrate intake (β=-0.1, p=.268), protein intake (β=0.1, p=.637), or fat intake (β=0.1, p=.439). The same is true for android fat percentage, gynoid fat percentage, and lean mass percentage. There was an association between total energy (Kcal) intake and bone mineral density (β=.002, p=.039). Bone mineral density was not associated with carbohydrate intake (β=0.0, p=.979), protein intake (β=-.003, p=.089), or fat intake (β=.002, p=.092). Discussion: Results from the survey indicate that there is not an association between body composition and dietary behaviors. Results from dietary recalls indicate there is no association between body composition and macronutrients, but there is an association between bone mineral density and total energy intake. Further studies for combatting the epidemic of obesity should also look at other behaviors such as exercise and lifestyle

Interview with Juanita Goggins

In her April 14, 1981 interview with Shannon Port, Juanita Goggins recalls the details of her political career. In particular, Goggins addresses the obstacles she faced during her career and what she accomplished despite of those obstacles. This interview was conducted for inclusion into the Louise Pettus Archives and Special Collections Oral History Program.https://digitalcommons.winthrop.edu/oralhistoryprogram/1101/thumbnail.jp

Simulating Autonomous Cruise Missile Swarm Behaviors in an Anti-Access Area Denial (A2AD) Environment

The increasingly sophisticated anti-access area denial (A2AD) threat imposed by the modern integrated air defense system (IADS), coupled with the decreasingly potent advantage provided by high-end stealth platforms, has prompted Air Force senior leaders to invest in radically changing the nature of air power for the year 2030 and beyond. A prominent element of this new vision is weapon swarming, which aims to address this challenge by overwhelming the IADS with huge numbers of low-cost, attritable aerial assets emboldened by autonomous capabilities. This research proposes a framework for classifying the different levels of autonomous capability along three independent dimensions—namely ability to act alone, ability to cooperate, and ability to adapt. A virtual combat model is constructed using the Advanced Framework for Simulation, Integration, and Modeling (AFSIM) in order to simulate the engagement between a friendly air strike package, featuring a manned penetrating bomber and an autonomous cruise missile swarm, and an enemy IADS acting in an A2AD role. The influence of varying levels of autonomy on the strike package’s performance is evaluated by using the autonomy framework as the basis for a designed experiment. Analyzing the experimental results reveals which dimensions and levels of autonomy are most impactful in promoting survivability and lethality for this simulated scenario