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One of the targets of sustainable development goal (SDG) 2030 is to reduce maternal mortality ratio to 70 per 100,000 live births and ensure pregnant women attend at least four antenatal visits. In urban Pakistan, it is expected that more women utilize antenatal care (ANC) because urban areas have more resources, higher education and wealthier people. Despite these facilities, the lack of utilization of antenatal care among pregnant women is abysmal—the latest estimate by Pakistan Demographic and Health Survey (PDHS) places the figure at 63%. Therefore, the paper attempts to identify the factors that affect the utilization of ANC in urban areas by using the PDHS 2017–2018.

The study used cross-tabs to determine the socioeconomic characteristics of women, and used the marginal effects from the probit model to evaluate the significance and relationship between socioeconomic determinants and antenatal visits. Finally, the study used Adam Wagstaff's decomposition analysis to identify the magnitude and main determinants of inequality.

The marginal effects show that socioeconomic variables such as education, province of residence, birth of a first child, age, education and consulting a doctor predicted the probability of 4+ antenatal visits. The decomposition analysis shows that women who consulted a doctor, belonged to non-poor class, were more educated and older contributed significantly to the inequality of antenatal care utilization in urban areas.

The study calls for increasing the number of doctors, promoting education, increasing awareness related to pregnancy complications and reducing wealth inequality. Moreover, the study also calls for increasing global intervention by implementing programs similar to ending preventable maternal mortality (EPPM) to increase antenatal coverage.

The distinctiveness of the study can be found in the fact that no study has been conducted that analyses the inequality related to the usage of ANC in urban areas of Pakistan.

The peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-06-2022-0390

Quality Control and/or Assurance and similar phrases are in common use but can have different meanings, depending on the type of product involved and on economic considerations. It is proposed that, from the soldering point of view, component design and solderability must be as good as possible and must be regularly checked. There must be adequate control over every aspect of the soldering process, and inspection of the completed assembly must be meaningful with realistic accept/reject levels decided upon at the outset. Having established a complete production scheme incorporating quality checking, it is proposed that no alterations should be made without full consultation and collaboration with all the personnel concerned.

The 1997-98 financial crisis has had a profound effect on how East Asian economies the role of the IMF and its strategic interests relative to those of the United States in the international financial regime. It has prompted them to create a regional mechanism for financial and monetary cooperation, ranging from deeper policy dialogue and surveillance, to a system of financial cooperation, and common exchange rate arrangements. This paper analyses the economic and strategic motivations behind this and outlines recent developments in financial cooperation in East Asia to provide possible directions for the future.

A network of bilateral swap arrangements under the Chiang Mai Initiative(CMI) needs stronger policy dialogue and surveillance to develop into a regional financing facility, a sort of East Asian IMF. The facility plays a role as an regional lender of last resort, providing short-term funds to a member country facing a temporary liquidity shortage and for market intervention to stabilize foreign exchange rate. East Asian countries need to achieve regional exchange rate stability. In the long run, the region may develop a common currency arrangement, but it cannot be expected in the very near future because there is no convergence of macroeconomic conditions, economic structure and systems. A realistic approach would be for East Asian developing countries to adopt a currency basket system to minimize the impact of dollar/yen exchange rate volatility on their economies. Strong political will and a vision for regional integration will be required to introduce it.

How does the human brain absorb information and turn it into skills of its own in psychotherapy? In an attempt to answer this question, the authors will review the intricacies of processing channels in psychotherapy and propose the term transprocessing (as in transduction and processing combined) for the underlying mechanisms. Through transprocessing the brain processes multimodal memories and creates reparative solutions in the course of psychotherapy. Transprocessing is proposed as a stage-sequenced mechanism of deconstruction of engrained patterns of response. Through psychotherapy, emotional-cognitive reintegration and its consolidation is accomplished. This process is mediated by cellular and neural plasticity changes.

To utilize LGBTQ affirmative theory to inform clinical work which affords queer youth with disabilities agency and authorship in their negotiations of sexuality.

The authors use a case study to explore the use of queer affirmative theory and peer consultation to guide and evaluate an ongoing clinical case of a young gay man with cerebral palsy as he negotiates his developing sexuality amid powerful messages from media, pornography, friends, and parental influence.

This paper finds that a queer affirmative therapy model which explores themes of intersectionality, and utilizes nuanced views of sexual identity, sexual behavior, and gender identity are useful to practitioners to encourage agency and authorship for queer disabled people in their negotiations of ability, sexuality, identity, and behavior.

This paper provides an alternative approach to nurturing queer identity by (1) creating refuge for emerging sexualities; (2) allowing for difficult dialogues where ability, sexuality, and gender can be pragmatically discussed, performed, and negotiated; (3) tolerating the discomfort of these difficult dialogues and pushing through to nurturing the unique queerness that evolves out of these conversations; and finally (4) encouraging transformation of all participants including client and practitioners. The practitioners discuss their own transformation through the co-created dialog with each other and with the client.

This study aims to integrate design methods and additive manufacturing with the use of a thermoplastic elastomer certified for medical use and reverse engineering towards a new concept of a customized buttress model with optimized features for the reconstruction of the osteo-dural opening after endoscopic endonasal transtuberculum-transplanum approach.

Additive manufacturing allows making of cost-effective and useable devices with tailored properties for biomedical applications. The endoscopic endonasal approach to the suprasellar area enables the management of different intradural tumours, and the craniectomy at the skull base is generally wide and irregular. Defining an optimal strategy for osteodural defect closure at the preoperative stage represents a significant challenge.

Using the results obtained from a computed tomography analysis, skull base defects were designed to plan the surgical approach. Several concepts of customized buttress models were first built up, initially focusing on thin, flexible edges characterized by different thicknesses. Finite element analyses and design optimization allowed us to achieve the optimal design solution with improved compliance/flexibility for easy intranasal manoeuvrability, maintaining an adequate mechanical stability. As the thickness of the edges decreased, an increase of strain energy values was found (i.e. 1.2 mJ – Model A, 1.7 mJ – Model B, 2.3 mJ – Model C, 4.3 mJ – Model D). However, a further optimization (Model E) led to a significant increase of the compliance (strain energy of 14.1 mJ).

The results obtained from clinical evaluations demonstrated the feasibility of the proposed technical solutions, improving surgery effectiveness.

A high proportion of people with learning disabilities receive psychotropic medications such as antipsychotics, antidepressants, antianxiety drugs including benzodiazepines, buspirone and beta blockers, mood stabilisers such as lithium and some antiepileptic medications, psychostimulants, opioid antagonists and also vitamins and diets. Many receive these for behaviour problems for which these medications have not been indicated. Apart from a few exceptions of recent good quality randomised controlled trials (RCTs) of risperidone on the management of behaviour problems among children and adults with learning disabilities with and without autism, most of the evidence for the effectiveness of medication for the management of behaviour problems comes from non‐controlled or non‐randomised observational studies. The lack of evidence does not automatically mean that there is evidence that these medications are not effective. Current guidelines suggest that a thorough assessment of the cause and effect of the behaviour problems should be carried out before prescribing medications. A formulation should document the assessment and rationale for use of medications. Non‐medication based interventions should always be considered along with medication and where appropriate behavioural and psychological interventions should be employed either instead of or along with the medication. People with learning disabilities and their carers should be involved in the decision‐making process all along. Where necessary other relevant professionals should also be involved. At the outset the time, method and people involved with the follow‐up assessment should be determined. Follow up should involve an objective assessment of target behaviours but, more importantly, an assessment of the quality of life of the person and their carers. At each follow up a reformulation should be carried out along with consideration of non‐medication based management and the possibility of withdrawing medication. Important issues such as capacity, consent and legal issues should always be borne in mind. Medications should be used with some caution because of their adverse effects.

This paper aims to examine the impact of intra-industry trade on business cycle synchronization within the Economic Community of West African States (ECOWAS). ECOWAS region is characterized by limited intracommunity trade and a low level of foreign direct investment.

First, this research uses the two-digit level harmonized system classification to measure intra-industry trade, which is straightforward to interpret and compute, making it suitable for countries with low trade intensity. Second, it uses the system generalized method of moments (system-GMM) to examine the dynamic relationship between variables and address endogeneity concerns.

The results obtained from the system-GMM estimation reveal a positive and significant correlation between intra-industry trade intensity and business cycle synchronization, as well as an inhibiting effect of economic freedom on the relationship between intra-industry trade and business cycle synchronization. These results highlight the need to implement policies aimed at reducing tariff barriers, improving financial integration and intensifying production.

This research analyze the link between intra-industry trade and business cycle synchronization within the ECOWAS. It also analyze the role of economic freedom on the link between intra-industry trade and business cycle synchronization.

By age 77 a plurality of women in wealthy Western societies are widows. Comparing older (aged 70+) married women to widows in the American Time Use Survey (ATUS) 2003–2018 and linking the data to the Current Population Survey allow inferring the short- and longer-term effects of a demographic shock – husband's death – and measuring the paths of adjustment of time use to it. Widows differ from otherwise similar married women, especially from married women with working husbands, by cutting back on home production, mainly food preparation and housework, mostly by engaging in less of it each day, not doing it less frequently. The ratio of time to money expenditures on one item – food – is higher among married older couples than among widows. Widows are alone for 2/3 of the time they had spent with their spouses, with a small increase in time with friends and relatives shortly after becoming widowed. Older French, Italian, German, and Dutch women exhibit similar differences in time use; European widows also feel less time stress than married women. Following older women in 18 European countries before and after a partner's death shows that becoming widowed reduces their feelings of time pressure.