Search results for: healthcare policy

Authors: Amanda Noble

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The process of exiting/escaping situations of sex trafficking can be arduous and fraught with numerous barriers. In this paper the results of a national Canadian study on escaping situations of sex trafficking is discussed. Surveys and focus groups were conducted with 201 stakeholders in 8 cities, including 50 survivors of sex trafficking, service providers, health care providers and police. The results show that survivors are both vulnerable to being exploited and experience barriers to exiting as a result of structural factors such as colonialism, poverty, and discrimination based on race and gender. Survivors also face numerous barriers within various systems such as child welfare and the legal system. In addition, survivors contend with multiple psychological and psychosocial factors when exiting including the trauma bond, complex trauma and mental health concerns, substance use, isolation, and adjusting to ‘mainstream’ life. In light of these factors, the service needs of survivors escaping sex trafficking are discussed, and promising practices, such as trauma-informed practice and working from a stages of change model are outlined. This paper is useful for service providers that work with survivors, policy makers, or anyone who has ever wondered why survivors that are not being physically detained don’t ‘just leave’ or escape their exploitative situations.

Keywords: Barriers, Exiting, Promising Practices, Sex Trafficking

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Authors: Tzu-Jung Tseng, Pei-Hsuen Han, Tsung-Hsueh Lu

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Background: Ensuring patients with ST-elevation myocardial infarction (STEMI) access to hospitals that could perform percutaneous coronary intervention (PCI) in time is an important concern of healthcare managers. One commonly used the method to assess the coverage of population access to PCI hospital is the use GIS-estimated linear distance (crow's fly distance) between the district centroid and the nearest PCI hospital. If the distance is within a given distance (such as 20 km), the entire population of that district is considered to have appropriate access to PCI. The premise of using district centroid to estimate the coverage of population resident in that district is that the people live in the district are evenly distributed. In reality, the population density is not evenly distributed within the administrative district, especially in rural districts. Fortunately, the Taiwan government released basic statistical area (on average 450 population within the area) recently, which provide us an opportunity to estimate the coverage of population access to PCI services more accurate. Objectives: We aimed in this study to compare the population covered by a give PCI hospital according to traditional administrative district versus basic statistical area. We further examined if the differences between two geographic units used would be larger in a rural area than in urban area. Method: We selected two hospitals in Tainan City for this analysis. Hospital A is in urban area, hospital B is in rural area. The population in each traditional administrative district and basic statistical area are obtained from Taiwan National Geographic Information System, Ministry of Internal Affairs. Results: Estimated population live within 20 km of hospital A and B was 1,515,846 and 323,472 according to traditional administrative district and was 1,506,325 and 428,556 according to basic statistical area. Conclusion: In urban area, the estimated access population to PCI services was similar between two geographic units. However, in rural areas, the access population would be overestimated.

Keywords: accessibility, basic statistical area, modifiable areal unit problem (MAUP), percutaneous coronary intervention (PCI)

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Authors: Ru-Yu Lien, Shih-Hsin Hung, Shu-Fen Lu, Ju-Jen Shie, Wen-Ju Yang, Yuann-Meei Tzeng, Chien-Ying Wang

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Background: The quality of care in intensive care units (ICUs) is crucial, especially for terminally ill patients. Shared decision-making (SDM) with families is essential to ensure appropriate care and reduce suffering. Aim: This study explores the effectiveness of an end-of-life decision support Patient Decision Aid (PDA) in an ICU setting. Methods: This study employed a cross-sectional research design conducted in an ICU from August 2020 to June 2023. Participants included family members of end-of-life patients aged 20 or older. A total of 319 participants. Family members of end-of-life patients received the PDA, and data were collected after they made medical decisions. Data collection involved providing family members with a PDA during family meetings. A post-PDA questionnaire with 17 questions assessed PDA effectiveness and anxiety levels. Statistical analysis was performed using SPSS 22.0. Results: The PDA significantly reduced anxiety levels among family members (p < 0.001). It helped them organize their thoughts, prepare for discussions with doctors, and understand critical decision factors. Most importantly, it influenced decision outcomes, with a shift towards palliative care and withdrawal of life-sustaining treatment. Conclusion: This study highlights the importance of family-centered end-of-life care in ICUs. PDAs promote informed decision-making, reduce conflicts, and enhance patient and family involvement. These tools align patient values and goals with medical recommendations, ultimately leading to decisions that prioritize comfort and quality of life. Implementing PDAs in healthcare systems can ensure that patients' care aligns with their values.

Keywords: shared decision-making, patient decision aid, end-of-life care, intensive care unit, family-centered care

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Authors: Dimitrios Akrivos, Alexandros K. Antoniou

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This paper looks at the crucial role of the British news media in the construction of extreme pornography as a social problem, suggesting that this paved the way for the subsequent criminalization of such material through the introduction of the Criminal Justice and Immigration Act 2008. Focusing on the high-profile case of Graham Coutts, it examines the British national press’ reaction to Jane Longhurst’s murder through a qualitative content analysis of 251 relevant news articles. Specifically, the paper documents the key arguments expressed in the corresponding claims-making process. It considers the different ways in which the consequent ‘trial by media’ presented this exceptional case as the ‘tip of the iceberg’ and eventually translated into policy. The analysis sheds light on the attempts to ‘piggyback’ the issue of extreme pornography on child sexual abuse images as well as the textual and visual mechanisms used to establish an ‘us versus them’ dichotomy in the pertinent media discourse. Finally, the paper assesses the severity of the actual risk posed by extreme pornography, concluding that its criminalization should not merely be dismissed as the outcome of an institutionalized media panic.

Keywords: criminalization, extreme pornography, social problem, trial by media

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Authors: Silvia Baralla, Raffaella Zucaro, Romina Lorenzetti

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Water management needs to cope with economic, societal, and environmental changes. This could be guaranteed through 'shifting from government to governance'. In the last decades, it was applied in Europe through and within important legislative pillars (Water Framework Directive and Common Agricultural Policy) and their measures focused on resilience and adaptation to climate change, with particular attention to the creation of synergies among policies and all the actors involved at different levels. Within the climate change context, the agricultural sector can play, through sustainable water management, a leading role for climate-resilient growth and environmental integrity. A recent analysis on the water management governance of different countries identified some common gaps dealing with administrative, policy, information, capacity building, funding, objective, and accountability. The ability of a country to fill these gaps is an essential requirement to make some of the changes requested by Europe, in particular the improvement of the agro-ecosystem resilience to the effect of climatic change, supporting green and digital transitions, and sustainable water use. This research aims to contribute in sharing examples of water governances and related advantages useful to fill the highlighted gaps. Italy has developed a strong and exhaustive model of water governance in order to react with strategic and synergic actions since it is one of the European countries most threatened by climate change and its extreme events (drought, floods). In particular, the Italian water governance model was able to overcome several gaps, specifically as concerns the water use in agriculture, adopting strategies as a systemic/integrated approach, the stakeholder engagement, capacity building, the improvement of planning and monitoring ability, and an adaptive/resilient strategy for funding activities. They were carried out, putting in place regulatory, structural, and management actions. Regulatory actions include both the institution of technical committees grouping together water decision-makers and the elaboration of operative manuals and guidelines by means of a participative and cross-cutting approach. Structural actions deal with the funding of interventions within European and national funds according to the principles of coherence and complementarity. Finally, management actions regard the introduction of operational tools to support decision-makers in order to improve planning and monitoring ability. In particular, two cross-functional and interoperable web databases were introduced: SIGRIAN (National Information System for Water Resources Management in Agriculture) and DANIA (National Database of Investments for Irrigation and the Environment). Their interconnection allows to support sustainable investments, taking into account the compliance about irrigation volumes quantified in SIGRIAN, ensuring a high level of attention on water saving, and monitoring the efficiency of funding. Main positive results from the Italian water governance model deal with a synergic and coordinated work at the national, regional, and local level among institutions, the transparency on water use in agriculture, a deeper understanding from the stakeholder side of the importance of their roles and of their own potential benefits and the capacity to guarantee continuity to this model, through a sensitization process and the combined use of management operational tools.

Keywords: agricultural sustainability, governance model, water management, water policies

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Authors: Qintao Shen, Lei Luo, Jun Ma, Jie Yu, Qingbo Wu, Yongqi Ma, Zhengji Liu

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Control Flow Integrity (CFI) is one of the most promising technique to defend Code-Reuse Attacks (CRAs). Traditional CFI Systems and recent Context-Sensitive CFI use coarse control flow graphs (CFGs) to analyze whether the control flow hijack occurs, left vast space for attackers at indirect call-sites. Coarse CFGs make it difficult to decide which target to execute at indirect control-flow transfers, and weaken the existing CFI systems actually. It is an unsolved problem to extract CFGs precisely and perfectly from binaries now. In this paper, we present an algorithm to get a more precise CFG from binaries. Parameters are analyzed at indirect call-sites and functions firstly. By comparing counts of parameters prepared before call-sites and consumed by functions, targets of indirect calls are reduced. Then the control flow would be more constrained at indirect call-sites in runtime. Combined with CCFI, we implement our policy. Experimental results on some popular programs show that our approach is efficient. Further analysis show that it can mitigate COOP and other advanced attacks.

Keywords: contex-sensitive, CFI, binary analysis, code reuse attack

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Authors: Mir Afzal Tajik

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The 'Strengthening Teacher Education in Pakistan' (STEP) is an innovative programme jointly funded by the Government of Canada and the Aga Khan Foundation Canada and implemented by the Aga Khan University - Institute for Educational Development (AKU-IED) in partnership with the local governments, education departments and communities in the provinces of Balochistan, Sindh and Gilgit-Baltistan in Pakistan. One of the key components of the programme is the professional development of teachers, headteachers and teacher educators through a variety of teacher education programmes including a two-year Masters of Education (MEd) Programme offered by AKU-IED. A number of teachers, headteachers and teacher educators from these provinces have been developed through the MEd Programme. This paper discusses a qualitative research study conducted to explore the nature, relevance, rigor and richness of the experiences of the MEd graduates, and how these experiences have fostered their own professional development and their ability to bring about positive changes in their schools. The findings of the study provide useful insights into the graduates’ self-actualization, the transformation of their professional beliefs and practices, the difference they have made in their schools, and the challenges they face. The study also provides recommendations for policy and practice related to teacher education programmes.

Keywords: STEP, teacher education, Pakistan, Canada, Aga Khan foundation

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Authors: Elena Kovalevich, Irina Tomasheva

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The research relevance is caused by the importance of studying features of cross-cultural communication in the system of intensive language contacts, on the one hand, and on the other – by the need of control over the language situation as cross-cultural contacts often reflect emotionally intense reality, destructive for national culture and language and also for health and mentality of the individual. The objective consists in systematization of requirements imposed by the globalized society on ethics, aesthetics and emotive component of cross-cultural communication under conditions of language hybridization of modern Russian-speaking society. Problems connected with establishing the criteria differentiating eco-friendly and eco-unfriendly communication; identifying the specifics of the eco-unfriendly communication containing language hybrids; justifying the negative impact of language hybridization on ethics and esthetics of cross-cultural communication are considered, taking into account the category of emotivity. The study makes a contribution to the development of key problems of modern linguistics connected with exploration of basics in the theory of language personality, ecology of language, emotive linguistics. The results can be used by specialists in the fields of sociolinguistics, cross-cultural communication, the national language policy.

Keywords: cross-cultural communication, eco-linguistics, ethics and aesthetics, emotivity, language hybrids

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Authors: Umar Ubandawaki

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Political participation involves voluntary and deliberate efforts by the members of a political system to determine the kinds of political institution and individuals that will govern them and equally influence the mobilization and allocation of the available societal resources. Over the years, youths in Nigeria participated actively in political party rallies and voting to elect their leaders and representatives in governance. This paper examines categories and nature of participation in politics as well as factors that derived youths into politics in Sokoto State. Through the use of qualitative and quantitative data generated from focus group discussions, interviews and questionnaire, the paper find out that youth, in Sokoto State, have been induced in participatory activities that encourage political thuggery and manipulation of electoral outcomes. Moreover, they are neglected in the mobilization and allocation of the available resources of the society i.e they are denied dividends of good governance. The paper recommends that youths should be engaged into positive participatory activities for ensuring inclusiveness and promotion of good governance in Nigeria. It is hoped that this will enlighten youth and policy implementers on the constructive strategies in controlling youth’s participation in politics in Nigeria.

Keywords: democracy, governance, inclusivenes, participation and politic

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Authors: Yusuf A. Bako, Olubunmi O. Kolawole

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This study sought to establish the effect of recruitment and selection on the employee performance in hospitality industries. The success of any organization in this modern business environment depends on the caliber of the manpower that steer the affairs of the organization. History has shown that recruitment and selection as a function of human resources management practices have a pivotal role in determining the level of employee performance in an organization. The hospitality industries have been faced with challenges of performance due to unconventional selection and placement practices in terms of poor policy in selecting candidate, inconsistency in selection process, sidetracking employment test and interview, godfatherism and regional selection process etc. The overall objective of the study was to determine how recruitment and selection affect employee performance in hospitality industry in Ogun State, Nigeria. This study adopts descriptive and inferential research design while population was drawn from leading hotels in Ogun State, Nigeria. The samples size was 100 employees and questionnaire was used to collect data while Cronbach alpha was used to test the instrument. The result of the study reveals that correlation between employee performance and recruitment and selection were highly significant.

Keywords: employee performance, human resources management, practices, recruitment, selection

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Authors: Charintorn Suwannawong, Tananpon Yavilas, Sopida Boonaneksap, Chotika Viriyarattanasak, Chairath Tangduangdee

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With increasing aging population and health conscious consumers, the demand for health promoting products such as functional foods, dietary supplements, and nutraceutical products has continuously increased in Thailand. Nevertheless, the strategic framework for regulatory functional food developments in Thailand is still unclear. The objective of this study was to survey stakeholders’ perspectives on three scopes, consisting of 1) the current status 2) obstacles, and 3) future trend for the development and production of functional foods in Thailand. A survey was conducted by interviewing ten experts from governmental organization, industrial sector and academic institute. The obtained results show that there is no established definition for functional foods in Thailand. There is a variety of raw materials that are capable to be potential ingredients for functional food production in Thailand and exported to global market. However, the scaling up technology into a commercial production is limited. Moreover, there is a need to establish the infrastructures, such as testing laboratory, and regulatory standards for quality control and ensuring product safety. This information is useful for government in the development of the strategic framework and policy statement on improvement of functional food industry in Thailand.

Keywords: functional foods, interview, perspective, Thailand

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Authors: Sufia Maroof

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This empirical study investigated the web-translations of five Pakistani public offices (FPSC, FIA, HEC, USB, and Ministry of Finance) offering Urdu tab as an option to access information on their official websites. Triangulation of quantitative and qualitative research design informed the researcher of the semantic, lexical and syntactic caveats in these translations. The study hypothesized that majority of the Pakistani population is oblivious of the Supreme Court’s amendments in language policy concerning national and official language; hence, Urdu web-translations of the public departments have not been accessed effectively. Firstly, the researcher conducted an online survey, comprising of two sections, close ended and short answer based questions. Secondly, the researcher compiled corpus of the five selected websites in a tabular form to compare the data. Thirdly, the administrators of the departments had been contacted regarding the methods of translation and the expertise of the personnel involved. The corpus was assessed for TQA after examining the lexical, semantic, syntactical and technical alignment inaccuracies and imperfections. The study suggests the public offices to invest in their Urdu webs by either hiring expert translators or engaging expertise of a translation agency for this project to offer quality translation to public.

Keywords: machine translations, public offices, Urdu translations, websites

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Authors: A. Rana, M. Badri, D. Lopez Behar, O. Yee, H. Al Bqaei

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The building sector is one of the largest emitters of greenhouse gases. However, as operation energy demands of this sector decrease with more effective energy policies and strategies, there is an urgent need to parallel focus on the growing proportion of embodied carbons. In this regard, benchmarks on embodied carbon of buildings can provide a point of reference to compare and improve the environmental performance of buildings for the stakeholders. Therefore, embodied carbon benchmarks can serve as a useful tool to address climate change challenges. This research utilizes the method to provide a knowledge roadmap of embodied carbon benchmarks development and implementation trends. Two main databases, Web of Science and Engineering Village, are considered for the study. The mapping was conducted with the help of VosViewer tool to provide information regarding: the critical research areas; most cited authors and publications; and countries with the highest publications. It is revealed that the role of benchmarks in energy policies is an emerging trend. In addition, the research highlighted that in policies, embodied carbon benchmarks are gaining importance at the material, whole building, and building portfolio levels. This research reveals direction for improvement and future research and of relevance to building industry professionals, policymakers, and researchers.

Keywords: buildings embodied carbon benchmark, methods, policy

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Authors: Nitu Marilena Cristina

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Decentralization of the education system is an educational policy option necessary from the perspective of democratizing internal life and streamlining service administration public. The experience of recent years has shown that decisions taken at central level do not to take into account all situations and especially all the specific needs and interests of the various institutions and individuals. A democratic society implies that the decision-making process is brought closer to the place of application, allowing citizens to take part in the decision-making that affects them directly or indirectly. Essentially decentralization of pre-university education is the transfer of authority, responsibility and resources in decision-making and general management, and financially to the educational units and the local community. This creates a frame of an effective collaboration between school and community. Modern theories on the leadership of education advocate the adoption of decentralization measures and participatory strategies. Numerous countries confronted with the educational impasse has appealed to these strategies. Reforming projects have begun application diversified and nuanced social decentralization models according to the specific social and educational situation. Analysis of legal provisions and measures adopted in the framework of the reform process indicates that, at least formally, decentralization is the solution chosen.

Keywords: decentralization, educational, management, reforming

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Authors: Jorge Urrutia-Mosquera, Luz Flórez-Calderón, Yasna Cortés

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We assessed the state of progress in terms of urban sustainability indicators and studied the impact of current land use conditions and the level of spatial accessibility to basic urban amenities on travel patterns and sustainable mobility in Santiago de Chile. We determined the spatial impact of urban facilities on sustainable travel patterns through the statistical analysis, data visualisation, and weighted regression models. The results show a need to diversify land use in more than 60% of the communes, although in 85% of the communes, accessibility to public spaces is guaranteed. The findings also suggest improving access to early education facilities, as only 26% of the communes meet the sustainability standard, negatively impacting travel in sustainable modes. It is also observed that the level of access to urban facilities generates spatial heterogeneity in the city, which negatively affects travel patterns in terms of time over 60 minutes and modes of travel in private vehicles. The results obtained allow us to identify opportunities for public policy intervention to promote and adopt sustainable mobility.

Keywords: land use, urban sustainability, travel patterns, spatial heterogeneity, GWR model, sustainable mobility

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Authors: Peng Yew Wong

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House prices in the Australian capital cities were at record levels subsequent to Global Financial Crisis (GFC) 2008 and many believed that foreign investors, especially the Chinese investors, were the main reason for the Australian capital cities’ house prices escalation. This research conducted an Australian cross border semi-structured interviews in Shanghai, China to uncover historical evidence and emerging trend supporting the existence of a significant relationship between overseas investors and residential housing markets performance in Australia subsequent to the GFC 2008. Some unique investment strategies of private investors from China which emphasised on non-capitalist factors such as early education were identified, alongside with some insights on the significant China government policies that have incentivised the cross border investments from China. It is believed that this understanding will assist policy makers to effectively manage the overheated Australian residential property market without compromising the steady flow of FREI.

Keywords: Australian housing market, residential property, foreign real estate investment, education, China investor

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Authors: Susan Diamond

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Machine Learning workloads have traditionally been run in high-performance computing (HPC) environments, where users log in to dedicated machines and utilize the attached GPUs to run training jobs on huge datasets. Training of large neural network models is very resource intensive, and even after exploiting parallelism and accelerators such as GPUs, a single training job can still take days. Consequently, the cost of hardware is a barrier to entry. Even when upfront cost is not a concern, the lead time to set up such an HPC environment takes months from acquiring hardware to set up the hardware with the right set of firmware, software installed and configured. Furthermore, scalability is hard to achieve in a rigid traditional lab environment. Therefore, it is slow to react to the dynamic change in the artificial intelligent industry. Watson Deep Learning as a service, a cloud-based deep learning platform that mitigates the long lead time and high upfront investment in hardware. It enables robust and scalable sharing of resources among the teams in an organization. It is designed for on-demand cloud environments. Providing a similar user experience in a multi-tenant cloud environment comes with its own unique challenges regarding fault tolerance, performance, and security. Watson Deep Learning as a service tackles these challenges and present a deep learning stack for the cloud environments in a secure, scalable and fault-tolerant manner. It supports a wide range of deep-learning frameworks such as Tensorflow, PyTorch, Caffe, Torch, Theano, and MXNet etc. These frameworks reduce the effort and skillset required to design, train, and use deep learning models. Deep Learning as a service is used at IBM by AI researchers in areas including machine translation, computer vision, and healthcare. 

Keywords: deep learning, machine learning, cognitive computing, model training

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Authors: Chioma J. Nwakamma, Blessing O. Oyedemi, Garuba Omosun

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This research surveys and documents information on medicinal plants and their botanical preparations used in the treatment of children’s ailments in South-Eastern Nigeria. Children under the age of 5 in developing countries suffer from diseases with high morbidity and mortality rate yearly due to inaccessible and unaffordable healthcare. Structured questionnaires were administered to herbal sellers, traditional medicine practitioners, nursing mothers, and adult dwellers to collect data on the names of plants used to treat the conditions, methods of preparation, duration of treatment, adverse effects, and the methods of administration of the plant materials. A total of 135 plants belonging to 55 families were identified for the management of children’s health in the area. Common pediatric ailments which were said to be treated with herbal remedies by the respondents included malaria, pneumonia, stomach ache, diarrhea, dysentery, measles, chickenpox/smallpox, convulsion, jaundice, pile, ringworm, scabies, eczema, stubborn cough, scurvy, catarrh, wounds, boils, insect bites, food poison, cholera, and umbilical cord complications. Percentages of respondents were; herbal sellers (48.2%), traditional medical practitioners (21.6%), nursing mothers (11.1%), and others (19.1%). The most occurring plant families were Euphorbiaceae, Fabaceae, and Apocynaceae, with 8 species of plants each followed by Annonaceae and Asteriaceae with 7 and 6 species, respectively. The recipes were made from the combination of different parts of two or more plant species, and others were made from single plant parts. Methods of extraction were mostly decoction and raw-squeezing out of the juice and infusion, while oral administration was the main route of administration.

Keywords: ethno-botanicals, children’s health, medicinal plants, South-Eastern Nigeria

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Authors: Xi Zhang, Yong Geng

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It is crucial to decouple economic growth from environmental pollution in China. This study aims to evaluate the decoupling degree between PM₂.₅ emissions and economic growth in China from a regional investment perspective. Using the panel data of 30 Chinese provinces for the period of 1998-2016, this study combines decomposition analysis with decoupling analysis to identify the roles of conventional factors and three novel investment factors in the mitigation and decoupling of PM₂.₅ emissions in China and its four sub-regions. The results show that China’s PM₂.₅ emissions were weakly decoupled to economic growth during the period of 1998-2016, as well as in China’s four sub-regions. At the national level, investment scale played the dominant role while investment structure had a marginal effect. In contrast, emission intensity was the largest driver in promoting the decoupling effect, followed by investment efficiency and energy intensity. The investment scale effect in the western region far exceeded those in other three sub-regions. At the provincial level, the investment structure of Inner Mongolia and investment scales of Xinjiang and Inner Mongolia had the greatest impacts on PM₂.₅ emission growth. Finally, several policy recommendations are raised for China to mitigate its PM₂.₅ emissions.

Keywords: decoupling, economic growth, investment, PM₂.₅ emissions

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Authors: Douglas Arthur, Oluwayemisi Ekor, Ernest Obese, Andrew Kissi Agyei, Elvis Ofori Ameyaw

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bjective: Pain negatively impacts every aspect of health, and patients with pain disorders create enormous demands on healthcare systems globally, costing economies up to $635 billion annually. The study was therefore conducted at the Cape Coast Teaching Hospital (CCTH), the only Tertiary Hospital in the Central Region of Ghana and was designed to assess pain disorders in patients between 18 and 90 years attending Urology Clinic. Methods: The study employed a descriptive cross-sectional design, and 149 subjects (16-24, 25-34, 35-44, 45-54, 55-64, 65-90 years) were conveniently selected. The McGill Pain Questionnaire (MPQ), a multidimensional instrument that assesses several aspects of pain by the use of words (descriptors) that the patient chooses to express his/her pain, was used as the primary instrument for data collection. A patient profile form (PPF) was also designed to document the demographics and history of patients. Results: The prevalence of pain disorders was higher among females compared to males. The univariate and multivariate analysis showed that females were more likely to experience pain while being married correlated with a lower likelihood of pain. Again, the 45-54 age group exhibited the highest prevalence of pain disorders. Results from the MPQ showed that half of the patients experienced pain on a daily basis, 15.91% had experienced pain for 3-6 months and 37% experienced pain for more than one year. Pain intensity was described by 25% of the subjects as excruciating for their worst pain experience, followed by 21% for the distressing experience. The most frequently reported area of pain was the abdominal region (22.72%). The co-administration of NSAIDs and opioid compounds was provided for 17.46% of the patients with chronic pain. Conclusion: The treatment interventions improved the pain and associated symptoms such as nausea, improved daily activities and ability to sleep. However, attention and resources should be devoted to 45-54 age group.

Keywords: pain, opioids, distressing, excruciating

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Authors: Okorowo Cyril Agochi

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The Niger Delta Region of Nigeria is home to about 20 million people and 40 different ethnic groups. The region has an area of seventy thousand square kilometers (70,000 KM2) of wetlands, formed primarily by sediments deposition and makes up 7.5 percent of Nigeria's total landmass. The notable ecological zones in this region includes: coastal barrier islands; mangrove swamp forests; fresh water swamps; and lowland rainforests. This incredibly naturally-endowed ecosystem region, which contains one of the highest concentrations of biodiversity on the planet, in addition to supporting abundant flora and fauna, is threatened by the inhuman act known as gas flaring. Gas flaring is the combustion of natural gas that is associated with crude oil when it is pumped up from the ground. In petroleum-producing areas such as the Niger Delta region of Nigeria where insufficient investment was made in infrastructure to utilize natural gas, flaring is employed to dispose of this associated gas. This practice has impoverished the communities where it is practiced, with attendant environmental, economic and health challenges. This paper discusses the adverse environmental and health implication associated with the practice, the role of Government, Policy makers, Oil companies and the Local communities aimed at bring this inhuman practice to a prompt end.

Keywords: natural combustion, emission, environment, flaring, gas, health, Niger Delta

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Authors: Mohsen S. Sajadieha, Danyar Molavia

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In this paper, a truck scheduling problem is investigated at a two-touch cross-docking center with due dates for outbound trucks as a hard constraint. The objective is to minimize the total cost comprising penalty and delivery cost of delayed shipments. The sequence of unloading shipments is considered and is assumed that shipments are sent to shipping dock doors immediately after unloading and a First-In-First-Out (FIFO) policy is considered for loading the shipments. A mixed integer programming model is developed for the proposed model. Two meta-heuristic algorithms including genetic algorithm (GA) and variable neighborhood search (VNS) are developed to solve the problem in medium and large sized scales. The numerical results show that increase in due dates for outbound trucks has a crucial impact on the reduction of penalty costs of delayed shipments. In addition, by increase the due dates, the improvement in the objective function arises on average in comparison with the situation that the cross-dock is multi-touch and shipments are sent to shipping dock doors only after unloading the whole inbound truck.

Keywords: cross-docking, truck scheduling, fixed due date, door assignment

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Authors: Nasiru Inuwa, Haruna Usman Modibbo, Yahya Zakari Abdullahi

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The purpose of this paper is to investigate the effects of foreign direct investment (FDI), economic growth on carbon emissions in context of WAIFEM member countries. The Im-Pesaran-Shin panel unit root test, Kao residual based test panel cointegration technique and panel Granger causality tests over the period 1980-2012 within a multivariate framework were applied. The results of cointegration test revealed a long run equilibrium relationship among CO2 emissions, economic growth and foreign direct investment. The results of Granger causality tests revealed a unidirectional causality running from economic growth to CO2 emissions for the panel of WAIFEM countries at the 5% level. Also, Granger causality runs from economic growth to foreign direct investment without feedback. However, no causality relationship between foreign direct investment and CO2 emissions for the panel of WAIFEM countries was observed. The study therefore, suggest that policy makers from WAIFEM member countries should design policies aim at attracting more foreign direct investments inflow as well the adoption of cleaner production technologies in order to reduce CO2 emissions.

Keywords: economic growth, CO2 emissions, causality, WAIFEM

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Authors: Saban Inam, Necdet Sahiner, Tayfun Cay

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Environmental factors such as rapid population growth, changing economic conditions, desertification and climate change increase demand for the acquisition and use of land. Demands on the land are increasing due to the lack of production of soils and scarcity. This causes disagreements on the land. Reducing the pressure on the land and protecting the natural resources, public investments should be directed economically and rationally. This will make it possible to achieve equivalent living conditions between the rural area and the urban area. Initiating the development from the rural area and the cadastre needs to be redefined to allow the management of the land. The planned, regular, effective agriculture and rural development policies that Turkey will implement in the process of European Union membership will also significantly shape Turkey's position in the European Union. For this reason, Turkey enjoys the most appropriate use of natural resources, which is one of the main objectives of the European Union's recent rural development policy. This study deals with the urgent need to provide cadastral data infrastructure that will form the basis for land management which is supposed to support economic and societal sustainable development in rural and urban areas.

Keywords: rural development, cadastre, land management, agricultural reform implementation project, land parcel identification system

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Authors: Kingsley Nnaemeka Ogbu, Constantine Mbajiorgu

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Vegetation has a marked effect on runoff and has become an important component in hydrologic model. The watershed Resources Management (WRM) model, a process-based, continuous, distributed parameter simulation model developed for hydrologic and soil erosion studies at the watershed scale lack a crop growth component. As such, this model assumes a constant parameter values for vegetation and hydraulic parameters throughout the duration of hydrologic simulation. Our approach is to develop a crop growth algorithm based on the original plant growth model used in the Environmental Policy Integrated Climate Model (EPIC) model. This paper describes the development of a single crop growth model which has the capability of simulating all crops using unique parameter values for each crop. Simulated crop growth processes will reflect the vegetative seasonality of the natural watershed system. An existing model was employed for evaluating vegetative resistance by hydraulic and vegetative parameters incorporated into the WRM model. The improved WRM model will have the ability to evaluate the seasonal variation of the vegetative roughness coefficient with depth of flow and further enhance the hydrologic model’s capability for accurate hydrologic studies.

Keywords: runoff, roughness coefficient, PAR, WRM model

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Authors: Elisha Kyirem

Abstract:

Undoubtedly, climate change is a major global challenge that could threaten the very foundation upon which life on earth is anchored, with its impacts on human mobility attracting the attention of policy makers and researchers. There is an increasing body of literature and case studies suggesting that migration could be a way through which the vulnerable move away from areas exposed to climate extreme events to improve their lives and that of their families. This presents migration as a way through which people voluntarily move to seek opportunities that could help reduce their exposure and avoid danger from climate events. Thus, migration is seen as a proactive adaptation strategy aimed at building resilience and improving livelihoods to enable people to adapt to future changing events. However, there has not been any mathematical equation linking migration and climate change adaptation. Drawing from literature in development studies, this paper develops an equation that seeks to link the relationship between migration and climate change adaptation. The mathematical equation establishes the linkages between migration, resilience, poverty reduction and vulnerability, and these the paper maintains, are the key variables for conceptualizing the migration-climate change adaptation nexus. The paper then tests the validity of the equation using the sustainable livelihood framework and publicly available data on migration and tourism in Ghana.

Keywords: migration, adaptation, climate change, adaptation, poverty reduction

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Authors: Odunayo S. Faluse, Roger Telfer

Abstract:

Customer relationship management is a business strategy that is centred on the idea that ‘Customer is the driving force of any business’ i.e. Customer is placed in a central position in any business. However, this belief coupled with the advancement in information technology in the past twenty years has experienced a change. In any form of business today it can be concluded that customers are the modern dictators to whom the industry always adjusts its business operations due to the increase in availability of information, intense market competition and ever growing negotiating ideas of customers in the process of buying and selling. The most vital role of any organization is to satisfy or meet customer’s needs and demands, which eventually determines customer’s long-term value to the industry. Therefore, this paper analyses and describes the application of customer relationship management operational strategies in some of the major industries in business. Both developed and up-coming companies nowadays value the quality of customer services and client’s loyalty, they also recognize the customers that are not very sensitive when it comes to changes in price and thereby realize that attracting new customers is more tasking and expensive than retaining the existing customers. However, research shows that several factors have recently amounts to the sudden rise in the execution of CRM strategies in the marketplace, such as a diverted attention of some organization towards integrating ideas in retaining existing customers rather than attracting new one, gathering data about customers through the use of internal database system and acquiring of external syndicate data, also exponential increase in technological intelligence. Apparently, with this development in business operations, CRM research in Academia remain nascent; hence this paper gives detailed critical analysis of the recent advancement in the use of CRM and key research opportunities for future development in using the implementation of CRM as a determinant factor for successful business optimization.

Keywords: agriculture, banking, business strategies, CRM, education, healthcare

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Authors: Rungrot Trongsakul

Abstract:

This paper was aimed to study the strategic cooperation development of Thailand in accordance with the door open policy of Myanmar, by use of DIMES Model: Diplomacy, Information, Military and Economics, Socio-Culture. This research employed qualitative method, aiming to study, analyze and synthesize the content of laws, policies, relevant research papers and documents, and relevant theories, and to study external environment and national power based on DIMES Model. The five steps of strategic development utilized in this study included (1) conceptual framework and definition; (2) environmental scanning; (3) assessing; (4) determining; and (5) drafting strategic plan. The suggested strategies were based on the concept of 'Soft Power'. Therefore, the determination of measures, action plans or projects as strategic means of public and private organizations should be based on sincere participation among people and communities living on the borders shared by both countries. Adoption of education, learning and sharing process is a key to building sustainability of the countries’ strategic cooperation, while an application of 'Soft Power' in all dimensions of the cooperation between the two countries was suggested.

Keywords: education, strategic cooperation, Thailand-Myanmar borders, sustainability

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Authors: Wen Xu

Abstract:

The expansion of Confucius institutes and Chinese as a Foreign Language (CFL) education is often considered as cultural invasion and part of much bigger, if not ambitious, Chinese central government agenda among Western public opinion. The CFL knowledge and teaching practice inherent in textbooks are also harshly critiqued as failing to align with Western educational principles. This paper takes up these concerns and attempts to articulate that Confucius’s idea of ‘education without discrimination’ appears to have become synonymous with social justice touted in contemporary Australian education and policy discourses. To do so, it capitalises on Bernstein's conceptualization of classification and pedagogic rights to articulate CFL curriculum's potential of drawing in and drawing out curriculum boundaries to achieve educational justice. In this way, the potential useful knowledge of CFL constitutes a worthwhile tool to engage in a peripheral Western country’s education issues, as well as to include disenfranchised students in the multicultural Australian society. It opens spaces for critically theorising CFL curricular justice in Australian educational contexts, and makes an original contribution to scholarly argumentation that CFL curriculum has the potential of including socially and economically disenfranchised students in schooling.

Keywords: curriculum justice, Chinese as a Foreign Language curriculum, Bernstein, equity

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Authors: Mohammad K. Rumjaun, Sana Amjed, Muhammad A. Ghazi, Safa G. Attar, Jason Raw

Abstract:

Background: National Health Service (NHS) in England is one of the leading healthcare systems in the world and it heavily relies on the recruitment of overseas doctors. 30.7% of the doctors currently serving in NHS are overseas doctors. Most of these doctors do not receive the essential induction required to work in the NHS when they first arrive and therefore, they mostly struggle to work effectively in the first few months of their new jobs as compared to UK graduates. In our hospital, the clinical need for a dedicated induction programme for the International Medical Graduates (IMGs) was identified for their initial settling period and this programme was designed to achieve this. Methods: A questionnaire was designed for the previous 7 IMGs (Group 1) in order to identify the difficulties they faced in their initial phase. Thereafter, an induction programme consisting of presentations explaining the NHS and hospital framework, communication skills practice sessions, the clinical ceiling of care and patient simulation training was implemented for 6 new IMGs (Group 2). Another survey was done and compared with the previous. Results: After this programme, group 2 required only 1 week to understand the complexity of the IT systems as compared 3 weeks in group 1. 83% of group 2 was well-supported for their on-call duties after this programme as compared to 29% and 100% of group 2 was aware of their role in the job after the induction as compared to 0%. Furthermore, group 2 was able to function independently and confidently in their roles after only 1 month as compared to an average of 3 months for group 1. After running the PDSA cycles, our results show clear evidence that this programme has tremendously benefitted the IMGs in settling in the NHS. The IMGs really appreciated this initiative and have given positive feedback. Conclusion: Leaving your home country to begin your career in a different country is not an easy transition and undoubtedly, everyone struggles. It is important to invest in a well-structured induction programme for the IMGs in the initial phase of their jobs as this will improve not only their confidence and efficacy but also patients’ safety.

Keywords: induction programme, international medical graduates, NHS, overseas doctors struggles.

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