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Authors: Pia Moschall, Kathrin Sackmann

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Considering a purchasing volume of around two trillion Euros per year, which equals about 14% of the European Union’s gross domestic product, European public authorities have significant market power. Making use of this market power by prioritizing the procurement of green products and services offers a great potential to contribute to the Green New Deal. The market demand that is created by Green Public Procurement (GPP) sets incentives for European producers to design and develop Green Products and Eco-Innovations. However, most procurement still does not consider environmental criteria. The goal of the work is to encourage the adaptation of GPP in the European Union. To this end, the drivers for the adaptation were investigated over different case studies. The paper analyzes good-practice cases from European authorities from 2010 to 2020 that were provided by the European Commission. This analysis was guided by Philipp Mayring’s method of qualitative content analysis, whereby the inductively formed categories led to the identification of nine major drivers. The most important ones are ‘use of official guidelines and standards, ‘political support and requirements as well as ‘market research and involvement.’ Further, the paper discusses mutual dependencies between several drivers and how to exploit them. A supporting infrastructure was identified as a crucial factor for the successful adaption of green public procurement. In the next step, the work aims to examine on which administrative level the single drivers can be implemented most effectively. Practical implications of this research are recommendations on how to create a supporting structure on a municipal, federal and national level, including training for the responsible staff, support tools, as well as guidelines and standards for involved stakeholders.

Keywords: content analysis, green public procurement, public authorities, sustainable procurement

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Authors: Joy Ghosh, Debasmita Biswas

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The road network of any area is the most important indicator of regional planning. For proper utilization of urban road networks, the structural parameters such as connectivity and accessibility should be analyzed and evaluated. This paper aims to explain the application of GIS on urban road network connectivity and accessibility analysis with a case study of Chandannagar City. This paper has been made to analyze the road network connectivity through various connectivity measurements like the total number of nodes and links, Cyclomatic Number, Alpha Index, Beta Index, Gamma index, Eta index, Pi index, Theta Index, and Aggregated Transport Score, Road Density based on existing road network in Chandannagar city in India. Accessibility is measured through the shortest Path Matrix, associate Number, and Shimbel Index. Various urban services, such as schools, banks, Hospitals, petrol pumps, ATMs, police stations, theatres, parks, etc., are considered for the accessibility analysis for each ward. This paper also highlights the relationship between urban land use/ land cover (LULC) and urban road network and population density using various spatial and statistical measurements. The datasets were collected through a field survey of 33 wards of the Chandannagar Municipal Corporation area, and the secondary data were collected through an open street map and satellite image of LANDSAT8 OLI & TIRS from USGS. Chandannagar was actually once a French colony, and at that time, various sort of planning was applied, but now Chandannagar city continues to grow haphazardly because that city is facing some problems; the knowledge gained from this paper helps to create a more efficient and accessible road network. Therefore, it would be suggested that some wards need to improve their connectivity and accessibility for the future growth and development of Chandannagar.

Keywords: accessibility, connectivity, transport, road network

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Authors: Jimmylen Tonio, Ali Anudin, Rochelle Irene G. Lucas

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Alongside the progress of electronic-business websites, consumers have become more comfortable with online shopping. It has become customary for consumers that prior to purchasing a product or availing services, they consult online reviews info as bases in evaluating and deciding whether or not they should push thru with their procurement of the product or service. Subsequently, after purchasing, consumers tend to post their own comments of the product in the same e-business websites. Because of this, product reviews (PRS) have become an indispensable feature in online businesses equally beneficial for both business owners and consumers. This study explored the linguistic features and motivations of online product reviews on selected Philippine online shops, LAZADA and SHOPEE. Specifically, it looked into the lexical features of the PRs, the factors that motivated consumers to write the product reviews, and the difference of lexical preferences between male and female when they write the reviews. The findings revealed the following: 1. Formality of words in online product reviews primarily involves non-standard spelling, followed by abbreviated word forms, colloquial contractions and use of coined/novel words; 2. Paralinguistic features in online product reviews are dominated by the use of emoticons, capital letters and punctuations followed by the use of pictures/photos and lastly, by paralinguistic expressions; 3. The factors that motivate consumers to write product reviews varied. Online product reviewers are predominantly driven by venting negative feelings motivation, followed by helping the company, helping other consumers, positive self-enhancement, advice seeking and lastly, by social benefits; and 4. Gender affects the word frequencies of product online reviews, while negation words, personal pronouns, the formality of words, and paralinguistic features utilized by both male and female online product reviewers are not different.

Keywords: lexical choices, motivation, online shop, product reviews

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Authors: Nur A. Azmi, Suseela D. Chandran, Fadilah Puteh, Azizan Zainuddin

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Medical tourism has been associated as a global phenomenon in developed and developing countries in the 21st century. Medical tourism is defined as an activity in which individuals who travel from one country to another country to seek or receive medical healthcare. Based on the global trend, the number of medical tourists is increasing annually, especially in the Southeast Asia (SEA) region. Since the establishment of Association of Southeast Asian Nations (ASEAN) in 1967, the SEA nations have worked towards regional integration in medical tourism. The medical tourism in the SEA has become the third-largest sector that contributes towards economic development. Previous research has demonstrated several factors that affect the development of medical tourism. However, despite the already published literature on SEA's medical tourism in the last ten years there continues to be a scarcity of research on niche areas each of the SEA countries. Hence, this paper is significant in enriching the literature in the field of medical tourism particularly in showcasing the niche market of medical tourism among the SEA best players namely Singapore, Thailand, Malaysia and Indonesia. This paper also contributes in offering a comparative analysis between the said nations whether they are complementing or competing with each other in the medical tourism sector. This then, will increase the availability of information in SEA region on medical tourism. The data was collected through an in-depth interview with various stakeholders and private hospitals. The data was then analyzed using two approaches namely thematic analysis (interview data) and document analysis (secondary data). The paper concludes by arguing that the ASEAN countries have specific niche market to promote their medical tourism industry. This paper also concludes that these key nations complement each other in the industry. In addition, the medical tourism sector in SEA region offers greater prospects for market development and expansion that witnessed the emerging of new key players from other nations.

Keywords: healthcare services, medical tourism, medical tourists, SEA region, comparative analysis

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Authors: Moyosooore A. Babalola, Ayodeji S. Ogunleye

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The main focus of the study was to determine the profitability of investment in the Oil Palm value chain of Osun State, Nigeria in 2015. The specific objectives were to describe the socio-economic characteristics of Oil Palm investors (producers, processors and marketers), to determine the profitability of the investment to investors in the Oil Palm value chain, and to determine the factors affecting the profitability of the investment of the oil palm investors in Osun state. A sample of 100 respondents was selected in this cross-sectional survey. Multiple stage sampling procedure was used for data collection of producers and processors while purposive sampling was used for marketers. Data collected was analyzed using the following analytical tools: descriptive statistics, budgetary analysis and regression analysis. The results of the gross margin showed that the producers and processors were more profitable than the marketers in the oil palm value chain with their benefit-cost ratios as 1.93, 1.82 and 1.11 respectively. The multiple regression analysis showed that education and years of experience were significant among marketers and producers while age and years of experience had significant influence on the gross margin of processors. Based on these findings, improvement on the level of education of oil palm investors is recommended in order to address the relatively low access to post-primary education among the oil palm investors in Osun State. In addition to this, it is important that training be made available to oil palm investors. This will improve the quality of their years of experience, ensuring that it has a positive influence on their gross margin. Low access to credit among processors and producer could be corrected by making extension services available to them. Marketers would also greatly benefit from subsidized prices on oil palm products to increase their gross margin, as the huge percentage of their total cost comes from acquiring palm oil.

Keywords: oil palm, profitability analysis, regression analysis, value chain

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Authors: Sujata Mukherjee, Arunavo Mukherjee

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Water covers 70 per cent of our planet; however, freshwater is incredibly rare, and scarce has been listed as the highest impact global risk. The problems related to freshwater scarcity multiplies with the human population having more than doubled coupled with climate change, changing water cycles leading to droughts and floods and a rise in water pollution. Businesses, governments, and local communities are constrained by water scarcity and are facing growing challenges to their growth and sustainability. Water foot printing as an indicator for water use was introduced in 2002. Business water footprint measures the total water consumed to produce the goods and services it provides. It is a combination of the water that goes into the production and manufacturing of a product or service and the water used throughout the supply chain, as well as during the use of the product. A case study approach was applied describing the efforts of Tata Steel. It is based on a series of semi-structured in-depth interviews with top executives of the company as well as observation and content analysis of internal and external documents about the company’s efforts in sustainable water management. Tata Steel draws water required for industrial use from surface water sources, primarily perennial rivers and streams, internal reservoirs and water from municipal sources. The focus of the present study was to explore Tata Steel’s engagement in sustainable water management focusing on water foot printing accounting as a tool to account for water use in the steel supply chain at its Jamshedpur plant. The findings enabled the researchers to conclude that no sources of water are adversely affected by the company’s production of steel at Jamshedpur.

Keywords: sustainability, corporate responsibility water management, risk management, business engagement

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Authors: M. C. Teng, M. C. Ke, C. Y. Yang, S. S. Ke

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There are more than one thousand times a year of felt earthquakes in Taiwan. Because earthquakes are disaster threats to urban infrastructure, they often disrupt infrastructure services. For example, the highway system is very important to transportation infrastructure; however, it is vulnerable to earthquakes and typhoons in Taiwan. When a highway system is damaged by disaster, it will create a major impact on post-disaster communications and emergency relief and affect disaster relief works. In a study case on September 18th, 2022, the Taitung Chihshang earthquake, with a magnitude of 6.8 on the Richter scale with a depth of 7 km, caused one death; 171 people were injured and had a significant urban infrastructure impact. Hualien and Taitung areas have a large number of surface ruptures, road disruptions due to the collapses, over ten cases of bridges failure or closed, partial railroad section service shutdown, building collapses, and casualties. Taitung Chihshang earthquake, the peak ground acceleration is 585 gal (cm/s²), and the seismic intensity is Level 6 Upper(6+)in Chishang, Taitung County. After the earthquakes, we conducted on-site disaster investigation works in the disaster area; the disaster investigation works included a public and private building survey, a transportation facility survey, a total of ten damaged bridges, and one railroad station damaged were investigated in this investigation. The results showed that the affected locations were mainly concentrated along the Chihshang fault and the Yuli fault in the Huatung Longitudinal Valley. We recorded and described the impact and assessed its influence region in terms of its susceptibility to and the consequences of earthquake attacks. In addition, a lesson is learned from this study regarding the key issues after the Taitung Chihshang earthquake.

Keywords: earthquake, infrastructure, disaster investigation, lesson learned

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Authors: Chassel T. Paras, Tryxzy Q. Dela Cruz, Ma. Carmela Lousie V. Goingco, Pauline L. Tolentino, Carmela S. Dizon

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In implementing inclusive education, parental involvement is measured to be an irreplaceable contributing factor. Parental involvement is described as an indispensable aspect of the teaching-learning process and has a remarkable effect on the student's academic performance. However, there are still differences in the viewpoints, expectations, and needs of both parents and teachers that are not yet fully conveyed in their relationship; hence, the perceptions of SNED teachers are essential in their collaboration with parents. This qualitative study explored how SNED teachers perceive the roles of parental involvement in the teaching-learning process of students with special needs. To answer this question, one-on-one face-to-face semi-structured interviews with three SNED teachers in a selected public school in Angeles City, Philippines, that offer special needs education services were conducted. The gathered data are then analyzed using Interpretative Phenomenological Analysis (IPA). The results revealed four superordinate themes, which include: (1) roles of parental involvement, (2) parental involvement opportunities, (3) barriers to parental involvement, and (4) parent-teacher collaboration practices. These results indicate that SNED teachers are aware of the roles and importance of parental involvement; however, despite parent-teacher collaboration, there are still barriers that impede parental involvement. Also, SNED teachers acknowledge the big roles of parents as they serve as main figures in the teaching-learning process of their children with special needs. Lastly, these results can be used as input in developing a school-facilitated parenting involvement framework that encompasses the contribution of SNED teachers in planning, developing, and evaluating parental involvement programs, which future researchers can also use in their studies

Keywords: parental involvement, special needs education, teaching-learning process, teachers’ perceptions, special needs education teachers, interpretative phenomenological analysis

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Authors: Luís Marques, João Rocha, Andreia Fernandes, Maria Moura, Cláudia Caseiro, Filipa Figueiredo, João Nunes

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The implementation of circularity strategies other than recycling, such as reducing the amount of raw material, as well as reusing or sharing existing products, remains marginal. The European Commission announced that the transition towards a more circular economy could lead to the net creation of about 700,000 jobs in Europe by 2030, through additional labour demand from recycling plants, repair services and other circular activities. Efforts to create new circular business models in accordance with completely circular processes, as opposed to linear ones, have increased considerably in recent years. In order to create a societal Circular Economy transition model, it is necessary to include innovative solutions, where startups play a key role. Early-stage startups based on new business models according to circular processes often face difficulties in creating enough impact. The StartUp Zero Program designs a model and approach to increase the flow of startups in the Circular Economy field, focusing on a systemic decision analysis and multi-generational approach, considering Multi-Criteria Decision Analysis to support a decision-making tool, which is also supported by the use of a combination of an Analytical Hierarchy Process and Multi-Attribute Value Theory methods. We define principles, criteria and indicators for evaluating startup prerogatives, quantifying the evaluation process in a unique result. Additionally, this entrepreneurship program spanning 16 months involved more than 2400 young people, from ages 14 to 23, in more than 200 interaction activities.

Keywords: circular economy, entrepreneurship, startups;, multi-criteria decision analysis

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Authors: Kelly Grani Yuen

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Accounting scandals and auditing frauds are perceived to be driven by aggressive companies and misrepresentation of audit reports. However, local legal systems and law enforcements may affect the services auditors provide to their ‘important’ clients. Under the civil law and common law jurisdictions, the standard setters, the government, and the regulatory bodies treat cases differently. As such, whether or not different forms of legal systems and extent of law enforcement plays an important role in auditor’s Audit Quality is a question this paper attempts to explore. The paper focuses on the investigation in Asia, where Hong Kong represents the common-law jurisdiction, while Taiwan and China represent the civil law jurisdiction. Only the ten reputable accounting firms are used in this study due to the differences in rankings and establishments of some of the small local audit firms. This will also contribute to the data collected between the years 2007-2013. By focusing on the use of multiple regression based on the dependent (Audit Quality) and independent variables (Client Importance, Law Enforcement, and Press Freedom), six different models are established. Results demonstrate that since different jurisdictions have different legal systems and market regulations, auditor’s treatment on ‘important’ clients will vary. However, with the moderators in place (law enforcement and press freedom), the relationship between client importance and audit quality may be smoothed out. With that in mind, this study contributes to local governments and standard setters’ consideration on legal reform and proper law enforcement in the market. Perhaps, with such modifications on the economic systems, collusion between companies and auditors can finally be put to a halt.

Keywords: audit quality, client importance, jurisdiction, modified audit opinions

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Authors: Ghada M. R. Koura, Mohamed N. Mohamed, Ahmed M. F. El Shiwi

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Chronic mechanical Low back dysfunction (CMLBD) is the most common problem of the working-age population in modern industrial sociaty; it causes a substantial economic burden due to the wide use of medical services and absence from work. Aim of work: the aim of this study was to investigate the effect of positional release technique on patients with chronic mechanical low back pain. Materials and Methods: Thirty two patients from both sexes were diagnosed with CMLBP, aged 20 to 45 years and were divided randomly into two equal groups; sixteen patients each; group A (control group) received therapeutic exercises that include (Stretch and Strength exercises for back and abdominal muscles). Group B (experimental group) received therapeutic exercises with positional release technique; treatment was applied 3 days/week for 4 weeks. Pain was measured by Visual Analogue Scale, Lumbar range of motion was measured by Inclinometer and Functional disability was measured by Oswestry disability scale. Measurements were taken at two intervals pre-treatment and post-treatment. Results: Data obtained was analyzed via paired and unpaired t-Test. There were statistical differences between the 2 groups, where the experimental group showed greater improvement than control group. Conclusion: Positional release technique is considered as an effective treatment for reducing pain, functional disability and increasing lumbar range of motion in individuals with chronic mechanical low back pain.

Keywords: chronic mechanical low back pain, traditional physical therapy program, positional release technique, randomized controlled trial

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Authors: Jessy Abouarab

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For more than half a century, international norms related to refugee security and protection have proliferated, yet their role in alleviating war’s negative impacts on human life remains limited. The impact of refugee-security processes often manifests asymmetrically within populations. Many issues and people get silenced due to narrow security policies that focus either on abstract threat containment and refugee control or refugee protection and humanitarian aid. (In)security practices are gendered and experienced. Examining the case study of Syrian refugees in Lebanon, this study explores the gendered impact of refugee security mechanisms on local realities. A transnational feminist approach will be used to position this research in relation to existing studies in the field of security and the refugee-protection regime, highlighting the social, cultural, legal, and political barriers to gender equality in the areas of violence, rights, and social inclusion. Through Photovoice methodology, the Syrian refugees’ (in)securities in Lebanon were given visibility by enabling local volunteers to record and reflect their realities through pictures, at the same time voice the participants’ anxieties and recommendations to reach normative policy change. This Participatory Action Research approach helped participants observe the structural barriers and lack of culturally inclusive refugee services that hinder security, increase discrimination, stigma, and poverty. The findings have implications for a shift of the refugee protection mechanisms to a community-based approach in ways that extend beyond narrow security policies that hinder women empowerment and raise vulnerabilities such as gendered exploitation, abuse, and neglect.

Keywords: gender, (in)security, Lebanon, refugee, Syrian refugees, women

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Authors: Lusia Ndahafa Nghitotelwa

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India is a home to many languages, cultures, traditions, castes and religions. This diversity, when observed in education, appears to be challenging and difficult to manage with respect to including everyone in the educational system. But in order to achieve this, attempts to understand the complexity of the issue and find some solutions for including everyone in education has been made in India since independence, regardless of the students’ background. Despite that, the challenge is still topical. Plenty of students are left out of the system due to the lack of awareness and appropriate management of these diversities. Therefore, the present paper makes an attempt to study the awareness and management of diversity in Indian schools. Existing studies on diversity in Indian schools, along with how measures and which measures have been taken to accommodate and retain everyone in school, have been looked at, and a thorough critical analysis of findings has been narrated. It was found that a lot of efforts have been conjugated to include and educate children of all castes, religions, and linguistic backgrounds. Furthermore, the awareness of inclusive education among teachers and society members is moderate, but teachers lack the necessary skills and knowledge on how to deal with students with special educational needs in regular classes. Also, the management is aware of inclusive education, but the management does not include teachers in decision-making. Moreover, it was found that the poor management of inclusion services and retention of special needs students in Indian schools results in their poor effective integration into the workforce. Finally, the management was found to have stringent admission criteria, which has the effect of hindering some students from entering the educational system. Based on the results of the study, it is clear that the implementation of inclusive education is still a challenge in India. However, there are promising results in tackling the issue. All children should be given an opportunity to learn together with other children in order to broaden their interest and challenge their potential.

Keywords: awareness, management, inclusive education, students

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Authors: Made Kurnia Widiastuti Giri, Nyoman Kanca, Arie Swastini, Bambang Purwanto

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Aim: Waria transgenders are a phenomenon whose existence is undeniable. The sexual behaviours of waria transgenders belong to the groups of high-risk STDs infections, especially HIV/AIDS. The present study was aimed at finding out the general idea of the existence of waria transgenders in Singaraja, their sexual transactions, their sexual behaviours, and at exploring the factors affecting their sexual behaviours along with their participation in regular reproduction health control. Methods: The subjects of the present research were male-to-female transgenders living in the town of Singaraja. The research applied a qualitative approach. Data collection in this research was conducted through in-depth interview and observation. Results: The results of the study exposed 1) the existence of waria transgender community in Singaraja observed from their active participation in social events such as taking the roles of counsellors in the campaign of prevention and control of HIV/AIDS with the Local Commission of AIDS Control and other foundations; 2) the sexual services provided by waria transgenders which were performed in squeeze method, oral and anal sex which could be categorized as HIV/AIDS high-risk sexual behaviours, while the consistency in doing safe sex among the trangenders in Singaraja showed that most of the waria transgenders (80%) were aware of the urgency of using condoms during sexual intercourse; and 3) the low participation of the waria transgenders in Singaraja in regular reproduction health check up at the local Centre of Public Health Service was caused by their negative perception about being examined by female doctors. Conclucions: Waria in singaraja categorized as HIV/AIDS high-risk sexual behaviours but they do have consistency in doing safe sex by using condoms. They have a negative psychological perception about being examined by female doctors.

Keywords: waria transgenders, sexual behaviours, reproduction health, hiv/aids

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Authors: Tulika Bhattacharyya, Suhita C. Chatterjee

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West Bengal, one of the most rapidly ageing states in India, has inadequate structure for elder care. Therefore, there is an urgent need to improve elder care which involves focusing on different care settings where the elderly exists, like - Homes, Hospitals and Long-Term Care facilities (e.g. - Old Age Homes, Hospices). The study explores various elder care settings, with the intention to develop an understanding about them, and thereby generate comprehensive information about the entire spectrum of elder care in Kolkata. Empirical data are collected from the elderly and their caregivers in different settings. The tools for data collection are narratives, in-depth interviews and focus group discussions, along with field observations. Mixed method design is adopted to analyze the complexities of elder care in different set ups. The major challenges of elder care in private Homes are: architecturally inadequate housing conditions, paucity of financial support and scarcity of skilled caregivers. While the key factors preventing the Hospital and Long-Term Care Facilities from providing elder care services are inadequate policies and set governmental standards for elder care for the hospitalized elderly in various departments of the Hospital and the elderly residing in different kinds of Long Term Care Facilities. The limitations in each care setting results in considerable neglect and abuse of the elderly. The major challenges in elder care in West Bengal are lack of continuum between different care settings/ peripheral location of private Homes within public health framework and inadequate state Palliative policy- including narcotic regulations. The study suggests remedial measures to improve the capacity to deliver elder care in different settings.

Keywords: elder care settings, family caregiver, home care, geriatric hospital care, long term care facility

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Authors: Abigail Vallance

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Current research shows a correlation between declining mental health in the United States and the effect of COVID-19 on young adults and adolescents. Anxiety and depression are the two most common psychiatric illnesses, which are also the leading impediments to academic success. Spending six hours a day or more using computers is associated with higher risks of depression, with this time constraint pervasive even in present-day academia. Along with many hours on the computer, common issues COVID-19 had on students’ academic performance during online school included technical difficulties, poor support services, and difficulty adapting to online learning. Given the volume of requirements with unrealistic deadlines, and despite experiencing COVID-19, students showed an increase in their levels of anxiety. Besides the prevalent effect of COVID-19 on mental health, many studies show a correlation between mental health, COVID-19, academia, and sports performance. Academic research showed that negative self-talk, in relation to one’s self-efficacy, correlated with negative academic performance. Research showed that students who reported negative self-efficacy when test-taking led to negative test results. Furthermore, in sports performance, negative effects were found when athletes engage in negative self-talk. Overall, motivational self-talk, by oneself and through teammates and coaches, correlated with better performance than regular self-talk in sports. In relation to sports performance, the COVID-19 pandemic canceled complete sports seasons for millions of adolescents across the country. Many student-athletes use their sport to release emotions and escape from their mental health, but this was taken away. The purpose of this study is to address the current increase in mental health diagnoses in adolescents, including suicide rates after the COVID-19 pandemic began in 2020.This literature analysis is actively being studied.

Keywords: self-talk, COVID-19, mental health, adolescents

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Authors: Panos Xenos, Milton Nektarios, John Yfantopoulos

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Background: Policy makers, professional organizations and payers have introduced a variety of initiatives and reforms for the health systems worldwide, aimed at improving hospital efficiency. Their efforts are concentrated in two main categories: to constrain increasing healthcare costs and to enhance quality of services provided. Research Objectives: This study examines the efficiency of 112 Greek public hospitals for the year 2009, evaluates the importance of bootstrapping techniques and investigates the effect of contextual factors on hospital efficiency. Furthermore, the effect of qualitative evidence, on hospital efficiency is explored using data from 28 large hospitals. Methods: We applied Data Envelopment Analysis, augmented by bootstrapping techniques, to estimate efficiency scores. In order to measure the effect of environmental factors on hospital efficiency we used Tobit regression analysis. The significance of our models is evaluated using statistical tests to compare distributions. Results: The Kolmogorov-Smirnov test between the original and the bootstrap-corrected efficiency indicates that their distributions are significantly different (p-value<0.01). The environmental factors, that seem to influence efficiency, are Occupancy Rating and the ratio between Outpatient Visits and Inpatient Days. Results indicate that the inclusion of the quality variable in DEA modelling generates statistically significant variations in efficiency scores (p-value<0.05). Conclusions: The inclusion of quality variables and the use of bootstrap resampling in efficiency analysis impose a statistically significant effect on the distribution of efficiency scores. As a policy conclusion we highlight the importance of these methods on hospital efficiency analysis and, by implication, on healthcare resource allocation.

Keywords: hospitals, efficiency, quality, data envelopment analysis, Greek public hospital sector

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Authors: Leila Zarei

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The primary objective of the 2014 Survey of The Capacity Assessment of Kish Island in Visa Exchange and its Effect of Tourism Development was to obtain more comprehensive statistical information relating to foreign tourists who aimed to renew their visa in Kish Island. Kish Island the pearl of Persian Gulf is well known as a destination for visa exchange to many alien who work and live in the country located around Persian Gulf. Foreign visitors fly to Kish with aim of visa exchange and after passing through official procedures they return back to their country of resident. The present thesis studied the subject of capacity and potential of Kish Island in visa exchange. In accordance with it a survey had been conducted in English written form of a questionnaire which was researcher's made composed of 120 questions which covers diverse aspects of the field of this study (airport, public transportation, accommodate and medical centers and travel agencies). The data collected were obtained at the airport, hotels and other places from the international tourists and covered the following items: a) the profile of the tourists (sex, age, occupation, purpose of visit, etc.) b) The Rating of services and Prices. The target population was all international tourists who master English and non Iranian. Main findings: 56% of tourists interviewed were males and 44% were females. The age of arrived tourist was 30 – 39 years with the highest percentage of 47%. The highest percentage frequencies of income belong to the 1000- 2500 Dhrs. (26%). In addition, that 50 percentage of the population was married and rest was single. Concerning the religion, 26 percent of the travelers were Muslim and 65% Christian and the rest from the other branches which all these populations reach Kish via air. The majority (56%) of visa exchangers hold diploma.

Keywords: Kish Island, tourism development, visa exchange, Iran

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Authors: Vesna Šućur-Janjetović, Andrea Rakanović Radonjić

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Department of Social Work of the Faculty of Political Sciences, University of Banja Luka is the only School of Social Work in the Republic of Srpska (entity of Bosnia and Herzegovina). This Department has been implementing students’ practice as mandatory module since it was established in year 2000. As of 2006, the University of Banja Luka initiated the transformation of the education system in accordance with the Bologna Agreement. The Department of Social Work adopted a new Curriculum that anticipated 120 hours of Students’ practice. After ten years, a new process of changing and improving the Curriculum has been initiated, and research was conducted, in order to meet both the needs of practice and academic standards in the field of social work education. From 2006-2016 students were evaluating their practice experience under the mentor’s supervision. These evaluations were subject to the evaluation process of current Curriculum, including students practice module. Additional research was designed in order to assess the opinions of certified mentors on specific aspects of students’ practice, the needs of practice and possibilities for improving the education for social workers. Special research instruments were designed for the purpose of this research. All mentors were graduated social works working in all fields where social work services are provided (social welfare sector, health, education, non-government sector etc.). The third dimension of the research was a qualitative analysis of curriculums of Schools of Social Work in the region of Southeast Europe. This paper represents the results of the research, conclusions and consequences that led towards the improvement of Students’ practice and Curriculum of the Department of Social Work. The new Model anticipates 300 hours of Students’ practice, divided in three years of study, with different and specific learning outcomes.

Keywords: curriculum, Republic of Srpska, social work education, students’ practice

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Authors: Athulya Jayakumar, M. Manjula

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Though there has been a shift in the understanding of homosexuality from being a sin, crime or pathology in the medical and legal perspectives, the acceptance of homosexuality still remains very scanty in the Indian subcontinent. The present case study is a 24-year-old female who has completed a diploma in polytechnic engineering and residing in the state of Kerala. She initially presented with her husband with complaints of lack of sexual desire and non-cooperation from the index client. After an initial few sessions, the client revealed, in an individual session, about her homosexual orientation which was unknown to her family. She has had multiple short-term relations with females and never had any heterosexual orientation/interest. During her adolescence, she was wondering if she could change herself into a male. However, currently, she accepts her gender. She never wanted a heterosexual marriage; but, had to succumb to the pressure of mother, as a result of a series of unexpected incidents at home and had to agree for the marriage, also with a hope that she may change herself into a bi-sexual. The client was able to bond with the husband emotionally but the multiple attempts at sexual intercourse, at the insistence of the husband, had always been non-pleasurable and induced a sense of disgust. Currently, for several months, there has not been any sexual activity. Also, she actively avoids any chance to have a warm communication with him so that she can avoid chances of him approaching her in a sexual manner. The case study is an attempt to highlight the culture and the struggles of a homosexual individual who comes to therapy for wanting to be a ‘normal wife’ despite having knowledge of legal rights and scenario. There is a scarcity of Indian literature that has systematically investigated issues related to homosexuality. Data on prevalence, emotional problems faced and clinical services available are sparse though it is crucial for increasing understanding of sexual behaviour, orientation and difficulties faced in India.

Keywords: case study, culture, cognitive behavior therapy, female homosexuality

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Authors: Laid Fekih

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Background: Depression affects people in all communities across the world and in all aspects of their lives. Its spread varies from one country to another, can happen at any age and get rid of it is not easy. There is no clear policy in Algeria's higher education institutions to detect and treat these disorders or pay particular attention to those at risk. Identifying the prevalence of depression among Algerian students, its correlation with different variables, and studying gender differences in the light of a range of variables is necessary to develop an appropriate plan to raise the level of hope and love of life among students. Method: Random samples of 1500 University of Tlemcen students (967 girls and 533 boys), aged 19 to 24 years completed a self-administered questionnaire that included Beck's Depression Inventory ®-II (BDI®-II), (School Health Promotion: The Mood part), Other questions included in this survey focused on demographic characteristics including gender, age and year of study, academic performance (Annual Average Score (0-20) AAS), were examined. Results: The rate of depression (moderate, severe and extreme) varied from 03% to 13% among university students in Tlemcen University. There was no difference in the rates of depression in male and female students, which means that male and female students do have similar rates of depression. The rate of depression in the first-year of the study shows a higher score relative to students of other years. Depression has a negative relationship with academic performance, which means that depressed students have many difficulties in academic tasks at university. Conclusion: Depression among university students is an important center of interest in the world, not only because of the ease with which they can be followed, or the difficulties encountered during their studies and their technical courses but for the link between the level of depression and the quality of care of mental health services, especially if many students with mood and emotional problems don't meet the criteria for psychotherapy.

Keywords: depression, epidemiology, university students, academic performance

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Authors: Lauren M. Cook, Tove A. Larsen

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Due to their potential to provide numerous ecosystem services, green roofs have been proposed as a solution to mitigate a growing list of environmental challenges, like urban flooding and urban heat island effect. Because of their cooling effect, green roofs placed below rooftop photovoltaic (PV) panels also have the potential to increase PV panel efficiency. Sedums, a type of succulent plant, are commonly used on green roofs because they are drought and heat tolerant. However, other plant species, such as grasses or plants with reflective properties, have been shown to reduce more runoff and cool the rooftop more than succulent species due to high evapotranspiration (ET) and reflectivity, respectively. The goal of this study is to evaluate whether vegetation with high ET or reflectivity can influence multiple co-benefits of the green roof. Four small scale green roofs in Zurich are used as an experiment to evaluate differences in (1) the timing and amount of runoff discharged from the roof, (2) the air temperature above the green roof, and (3) the temperature and efficiency of solar panels placed above the green roof. One grass species, Silene vulgaris, and one silvery species, Stachys byzantia, are compared to a baseline of Sedum album and black roof. Initial results from August to November 2019 show that the grass species has retained more cumulative runoff and led to a lower canopy temperature than the other species. Although the results are not yet statistically significant, they may suggest that plants with higher ET will have a greater effect on canopy temperature than plants with high reflectivity. Future work will confirm this hypothesis and evaluate whether it holds true for solar panel temperature and efficiency.

Keywords: co-benefit estimation, green cities, green roofs, solar panels

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Authors: Fabiane Alves Farias Guimarães, Rodrigo Otávio Moretti-Pires, Ana Lúcia Schaefer Ferreira de Mello

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Introduction: Considering the last changes in Brazilian Health and Higher Educational Systems, the production of scientific knowledge regarding dental education and training has been increasing. The National Curriculum Guidelines for undergraduate courses in Dentistry established in 2002 the principles and procedures to perform a more generalist dental professional profile. Objectives: To perform a systematic review of the Brazilian scientific literature about dental education and training. Methods: The systematic review was conducted considering the Lilacs - Latin American Literature in Health Sciences and SciELO - Scientific Electronic Library Online data bases, using the combination of key words dentistry, education, teaching or training. It was select original research articles, published between 2010 and 2013, in Portuguese. Results: Based on the selection criteria, it was found 23 articles. In order to organize the outcomes, the analysis was separated in three themes: Ethical aspects of education (3 articles), integrating dental service with training (10 articles) and Dental education and the Brazilian curriculum guidelines (10 articles). Most of the studies were published between 2011 and 2012 (35% each) and were held in public universities. The studied populations included dental students, teachers, universities directors, health managers and dentists. The qualitative methodological approach was predominant. Conclusion: It was possible to identify a transience time in Brazilian undergraduate courses in Dentistry after curricular changes. The produced literature shows some advances, as the incorporation of ethical values on dental education and the inclusion of new practices environments for students by integrating education and training in diversified dental services scenarios.

Keywords: Teaching, Dental Students, Human resources in dentistry

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Authors: Antonia Hoffmann, Andrea Stübner

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Resource scarcity and rising material prices are forcing companies to rethink their business models. The conventional linear system of economic growth and rising social needs further exacerbates the problem of resource scarcity. Therefore, it is necessary to separate economic growth from resource consumption. This can be achieved through the circular economy (CE), which focuses on sustainable product life cycles. However, companies face challenges in implementing CE into their businesses. Small and medium-sized enterprises are particularly affected by these problems, as they have a limited resource base. Collaboration and social interaction between different actors can help to overcome these obstacles. Based on a self-generated sample of 1,023 German small and medium-sized enterprises, we use a questionnaire to investigate the influence of social capital and its three dimensions - structural, relational, and cognitive capital - on the implementation of CE and the mediating effect of dynamic capabilities in explaining these relationships. Using regression analyses and structural equation modeling, we find that social capital is positively associated with CE implementation and dynamic capabilities partially mediate this relationship. Interestingly, our findings suggest that not all social capital dimensions are equally important for CE implementation. We theoretically and empirically explore the network forms of social capital and extend the CE literature by suggesting that dynamic capabilities help organizations leverage social capital to drive the implementation of CE practices. The findings of this study allow us to suggest several implications for managers and institutions. From a practical perspective, our study contributes to building circular production and service capabilities in small and medium-sized enterprises. Various CE activities can transform products and services to contribute to a better and more responsible world.

Keywords: circular economy, dynamic capabilities, SMEs, social capital

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Authors: Matthew John F. Sino Cruz, Sarah Jane M. Ferrer, Janice C. Francisco

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COVID-19 pandemic has affected more than 114 countries all over the world since it was considered a global health concern in 2020. Different sectors, including education, have shifted to remote/distant setups to follow the guidelines set to prevent the spread of the disease. One of the higher education institutes which shifted to remote setup is the Pangasinan State University (PSU). In order to continue providing quality instructions to the students, PSU designed Flexible Learning Model to still provide services to its stakeholders amidst the pandemic. The model covers the redesigning of delivering instructions in remote setup and the technology needed to support these adjustments. The primary goal of this study is to determine the insights of the PSU – Bayambang students towards the remote setup implemented during the pandemic and how they perceived the initiatives employed in relation to their experiences in flexible learning. In this study, the topic modelling approach was implemented using Latent Dirichlet Allocation. The dataset used in the study. The results show that the most common concern of the students includes time and resource management, poor internet connection issues, and difficulty coping with the flexible learning modality. Furthermore, the findings of the study can be used as one of the bases for the administration to review and improve the policies and initiatives implemented during the pandemic in relation to remote service delivery. In addition, further studies can be conducted to determine the overall sentiment of the other stakeholders in the policies implemented at the University.

Keywords: COVID-19, topic modelling, students’ sentiment, flexible learning, Latent Dirichlet allocation

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Authors: Tope Olubodun

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Background: Family planning practices help individuals and couples avoid unwanted pregnancies, regulate intervals between pregnancies, and determine the number of children in the family. Family planning is an effective intervention for promoting maternal health, but its acceptability and utilization are impeded by many factors in Southwest Nigeria. Aim: This study was conducted to assess women’s knowledge and practice of family planning in two rural communities in Ogun State, Southwest Nigeria, and to determine factors associated with the utilization of family planning among these women. Methods: This was a cross-sectional study conducted among 561 women of reproductive age selected by multistage sampling. The data collection was done using interviewer-administered questionnaires. Data obtained were analyzed using IBM SPSS Statistics version 20. Frequencies were generated, and chi-square test was used to explore associations. The level of significance was set at 0.05. Result: The majority of the respondents were aware of family planning 410 (73.1%). The method most commonly known was male condom 348 (62.0%), then pills 276 (49.2%) and injectables 231(41.3%). The commonest sources of information on family planning were health workers 158 (26.8%), outreaches 162 (27.5%) and TV/radio 136 (23.1%). Respondents that had used family planning, however, only constituted forty–five percent. The methods commonly used were injectables 104 (39.2%) and pills 85 (32.1%). Reasons for choosing not to use family planning include the desire for more children 78 (26.3%), because spouse does not support family planning 56 (18.9%), fear of unbearable side effects 44 (14.9%), and poor knowledge of the methods of family planning as well as where the services can be obtained 39 (13.2%). There is a statistically significant association between age, ethnicity, education, occupation, average monthly income, and use of family planning. Conclusion: Campaigns that promote male involvement in family planning, use of family planning for child spacing, and dispelling of fears is recommended to improve the practice of family planning among such a group of women.

Keywords: family planning, rural, knowledge, practice

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Authors: Dorcas Matowe

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Inequality in health care for racial and ethnic minorities continues to be a growing concern for many Americans. Some of the barriers hindering the elimination of health disparities include lack of insurance, socioeconomic status (SES), and racism. This study will specifically focus on the association between some of these factors- health care access, which includes insurance coverage and frequency of doctor visits, race, ethnicity, and health status. The purpose of this study will be to address the following questions: is having health insurance associated with increased doctor visits? Are racial and ethnic minorities with health insurance more or less likely to see a doctor? Is the association between having health insurance moderated by being an ethnic minority? Given the current implications of the 2010 Affordable Care Act, this study will highlight the need to prioritize health care access for minorities and confront institutional racism. Critical Race Theory (CRT) will demonstrate how racism has reinforced these health disparities. This quantitative study design will analyze secondary data from the 2015 Behavioral Risk Factor Surveillance System (BRFSS) questionnaire, a telephone survey conducted annually in all 50 states and three US territories by state health departments in conjunction with the Center for Disease Control (CDC). Non-identifying health-related data is gathered annually from over 400,000 adults 18 years and above about their health status and use of preventative services. Through Structural Equation Modeling (SEM), the relationship between the predictor variables of health care access, race, and ethnicity, the criterion variable of health status, and the latent variables of emotional support and life satisfaction will be examined. It is hypothesized that there will be an interaction between certain racial and ethnic minorities who went to see a doctor, had insurance coverage, experienced racism, and the quality of their health status, emotional support, and life satisfaction.

Keywords: ethnic minorities, health disparities, health access, racism

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Authors: Isaac Kofi Mensah

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Governments around the world are adopting Information and Communication Technologies (ICTs) because of the important opportunities it provides through E-government (EG) to modernize government public administration processes and delivery of quality and efficient public services. Almost every country in the world is adopting ICT in its public sector administration (EG) to modernize and change the traditional process of government, increase citizen engagement and participation in governance, as well as the provision of timely information to citizens. This paper, therefore, seeks to present the adoption, development and implementation of EG in regions globally, as well as the ICT indicators around the world, which are making EG initiatives successful. Europe leads the world in its EG adoption and development index, followed by the Americas, Asia, Oceania and Africa. There is a gradual growth in ICT indicators in terms of the increase in Internet access and usage, increase in broadband penetration, an increase of individuals using the Internet at home and a decline in fixed telephone use, while the mobile cellular phone has been on the increase year-on-year. Though the lack of ICT infrastructure is a major challenge to EG adoption and implementation around the world, in Africa it is very pervasive, hampering the expansion of Internet access and provision of broadband, and hence is a barrier to the successful adoption, development, and implementation of EG initiatives in countries on the continent. But with the general improvement and increase in ICT indicators around the world, it provides countries in Europe, Americas, Asia, Arab States, Oceania and Africa with the huge opportunity to enhance public service delivery through the adoption of EG. Countries within these regions cannot fail their citizens who desire to enjoy an enhanced and efficient public service delivery from government and its many state institutions.

Keywords: e-government development index, e-government, indicators, information and communication technologies (ICTs)

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Authors: Meseret Gebeyehu Yehuala

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Women represent the majority of urban farmers engaged in vegetable and fruit production in Bahir Dar, Ethiopia. We examine urban agriculture in Bahir Dar city in the context of disruptions caused by the civil war and COVID-19. The Sustainable Livelihoods Framework serves as a conceptual frame to explore the vulnerability context, the structural and institutional challenges faced by women, and how this impacts their livelihoods. A total of 25 urban women farmers and 6 key informants were involved in the study through explorative and structured interviews conducted in 2021. Observations and informal conversations during repeated visits provided deeper insights. In addition, key informants employed in civil service institutions and experts were interviewed. Data were analysed by applying qualitative content analysis by using Atlas tia software. Women report that they experience a lack of access to land, insecurity of tenure, irregular technical support and input provision by agricultural extension services, and lack of access to credit and formal marketplaces. The COVID-19 pandemic restrictions aggravated this situation by delaying agricultural extension offices’ provision of necessary inputs and disrupting food handling and storage leading to the loss of perishable products. Bombing in relation to the civil war has destroyed harvests and left women in fear of returning to their fields. Women stated that vegetable and fruit production could contribute to their incomes, household food supplies, and more diversified diets. However, the city municipal office has, so far, not committed to supporting urban agriculture as a livelihood strategy.

Keywords: urban agriculture, institutional challenges, Bahir Dar, sustainable livelihood framework

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Authors: Henry Schwartz, Bogdan Iancu, Magnus Gustafsson, Johan Lilius

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The shipping sector generates significant amounts of carbon emissions on annual basis. The excess amount of carbon dioxide is harmful for both the environment and the society, and partly for that reason, there is acute interest to decrease the volume of anthropogenic carbon dioxide emissions in shipping. The usage of the existing cargo carrying capacity can be maximized, and the share of time used in actual transportation operations could be increased if the whole transportation and logistics chain was optimized with the aid of information sharing done through a centralized marketplace and an information-sharing platform. The outcome of this change would be decreased carbon dioxide emission volumes produced per each metric ton of cargo transported by a vessel. Cargo coordination is a platform under development that matches the need for waterborne transportation services with the ships that operate at a given moment in time. In this research, the transition towards adopting cargo coordination is modelled with system dynamics. The model encompasses the complex supply-demand relationships of ship operators and cargo owners. The built scenarios predict the pace at which different stakeholders start using the digitalized platform and by doing so reduce the amount of annual CO2 emissions generated. To improve the reliability of the results, various sensitivity analyses considering the pace of transition as well as the overall impact on the environment (carbon dioxide emissions per amount of cargo transported) are conducted. The results of the study can be used to support investors and politicians in decision making towards more environmentally sustainable solutions. In addition, the model provides concepts and ideas for a wider discussion considering the paths towards carbon neutral transportation.

Keywords: carbon dioxide emissions, energy efficiency, sustainable transportation, system dynamics

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