Search results for: quality of experience (QoE)
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 13885

Search results for: quality of experience (QoE)

10495 Interpretations of Disaster: A Comparative Study on Disaster Film Cycles

Authors: Chi-Ying Yu

Abstract:

In real life, the occurrence of disasters is always dreadful and heartbreaking, yet paradoxically, disaster film is a genre that has been popular at periodic intervals in motion picture history. This study attempts to compare the disaster film cycles of the 1970s, 1990s, and the early 21st century. Two research questions are addressed: First, how this genre has responded to the existing conditions of society in different periods in terms of the disaster proposition? Second, how this genre reflects a certain eternal substance of the human mind in light of its lasting appeal? Through cinematic textual analysis and literature review, this study finds that the emergence of disaster films in the 1970s reflected the turmoil in international relations and domestic politics situation in contemporary American society, and cinema screens showed such disaster stories as shipwrecks, air accidents, and skyscraper blazes due to human negligence. The 1990s saw the fervor of millennial apocalypse legends, and the awakening of environmental consciousness, which, together with the rapid advances in digital technology, once again gave rise to a frenzy of disaster films, with natural disasters and threats from aliens as the major themes of disasters. Since the beginning of the 21st century, the 911 Incident and natural disasters around the world have generated a consciousness of imminent crisis. Cinematic images simulated actual disasters, while aesthetic techniques focused on creating a kind of ‘empathetic’ experience in their exploration of the essence of the disaster experience. At the same time, post-apocalypse films that focus on post-disaster reconstruction have become an even more popular theme. Taking the approach of Jungian/post-Jungian film study, this study also reviews and interprets the commonly exhibited subliminal feelings in the disaster films of the three different periods. The imagination of disaster seems to serve as an underlying state of the human mind.

Keywords: disaster film, Jungian/post-Jungian film studies, stimulation, sublime

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10494 Method for Improving Antidepressants Adherence in Patients with Depressive Disorder: Systemic Review and Meta-Analysis

Authors: Juntip Kanjanasilp, Ratree Sawangjit, Kanokporn Meelap, Kwanchanok Kruthakool

Abstract:

Depression is a common mental health disorder. Antidepressants are effective pharmacological treatments, but most patients have low medication adherence. This study aims to systematic review and meta-analysis what method increase the antidepressants adherence efficiently and improve clinical outcome. Systematic review of articles of randomized controlled trials obtained by a computerized literature search of The Cochrane, Library, Pubmed, Embase, PsycINFO, CINAHL, Education search, Web of Science and ThaiLIS (28 December 2017). Twenty-three studies were included and assessed the quality of research by ROB 2.0. The results reported that printing media improved in number of people who had medication adherence statistical significantly (p= 0.018), but education, phone call, and program utilization were no different (p=0.172, p=0.127, p=0.659). There was no significant difference in pharmacist’s group, health care team’s group and physician’s group (p=0.329, p=0.070, p=0.040). Times of intervention at 1 month and 6 months improved medication adherence significantly (p= 0.0001, p=0.013). There was significantly improved adherence in single intervention (p=0.027) but no different in multiple interventions (p=0.154). When we analyzed medication adherence with the mean score, no improved adherence was found, not relevant with who gives the intervention and times to intervention. However, the multiple interventions group was statistically significant improved medication adherence (p=0.040). Phone call and the physician’s group were statistically significant improved clinical outcomes in number of improved patients (0.025 and 0.020, respectively). But in the pharmacist’s group and physician’s group were not found difference in the mean score of clinical outcomes (p=0.993, p=0.120, respectively). Times to intervention and number of intervention were not significant difference than usual care. The overall intervention can increase antidepressant adherence, especially the printing media, and the appropriate timing of the intervention is at least 6 months. For effective treatment, the provider should have experience and expert in caring for patients with depressive disorders, such as a psychiatrist. Medical personnel should have knowledge in caring for these patients also.

Keywords: depression, medication adherence, clinical outcomes, systematic review, meta-analysis

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10493 Study of Ambient Air Quality on Building's Roof of Dhaka City

Authors: Koninika Tanzim

Abstract:

The gaseous pollutants, SO2, NO2, CO and O3 affect the environment of Dhaka City. These pollutants are mainly released from stationary sources, like, fossil-fueled, power plants, industrial units and brickfields around the city. Suspended particulate matters including PM10 and PM2.5 are also contributing to air pollution in Dhaka City. SO2, NO2 and O3 are determined by using UV and visible spectrophotometry. The sensor type devised has been used for the determination of CO in ambient air. Lead in the suspended particulate matter was determined by using atomic absorption spectrometry. The samples were collected at ground level and on the roof of a seven-storied building. For all the criteria pollutants, the concentration at the roof was found to the lower than that at the ground level. The average concentration of PM10 and PM2.5 were found to the 241.5 and 81.1 mg/m3 at the ground level. On the roof of a 7 storied building was however 49.99 mg/m3 and 25.88 mg/m3 for PM10 and PM2.5 respectively. The concentration of Pb varied from 0.011 to 0.04 mg/m3 at the ground level. The values for Pb at the roof level were significantly lower. The values for SO2, NO2, CO and O3 were found to be higher than the USEPA values.

Keywords: gaseous air pollutant, PM, lead, gravimetry, spectrophotometry, atomic absorption, ambient air quality

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10492 Evaluation of Age-Friendly Nursing Service System: KKU (AFNS:KKU) Model for the Excellence

Authors: Roongtiwa Chobchuen, Siriporn Mongkholthawornchai, Boonsong Hatawaikarn, Uriwan Chaichangreet, Kobkaew Thongtid, Pusda Pukdeekumjorn, Panita Limpawattana

Abstract:

Background: Age-friendly nursing service system in Srinagarind Hospital has been developed continuously based on the value and cultural background of Thailand which corporates with the modified WHO’s Age friendly Primary Care Service System. It consists of 3 issues; 1) development of staff training, 2) age-friendly service and 3) appropriate physical environment. Objective: To evaluate the efficacy of Age-friendly Nursing Service System: KKU (AFNS:KKU) model and to evaluate factors associated with nursing perception with AFN:KKU. Study design: Descriptive study Setting: 31 wards that served older patients in Srinagarind Hospital Populations: Nursing staff from 11 departments (31 wards) Instrument: Age-friendly nursing care scale as perceived by hospitalized older person Procedure and statistical analysis: All participants were asked questions using age-friendly nursing care scale as perceived by hospitalized older person questionnaires. Descriptive statistics and multiple logistic regression analyses were used to analyse the outcomes. Results: There were 337 participants recruited in this study. The majority of them were women (92%) with the mean ages of 29 years and 77.45% were nurse practitioners. They had average nursing experiences of 5 years. The average scores of age-friendly nursing care scale were high and highest in the area of attitude and communication. Age, sex, educational level, duration of work among, and having experience in aging training were not associated with nursing perception where type of department was an independent factor. Nurses from department of Surgery and Orthopedic, Eye and ENT, special ward and Obstetrics and Gynecological had significant greater perception than nurses from Internal Medicine Department (p < 0.05). Conclusion: Nurses had high scores in all dimensions of age-friendly concept. The result indicates that nurses have good attitude to aging care which can lead to improve quality of care. Organization should support other domains of ageing care to achieve greater effectiveness in geriatric care.

Keywords: age-friendly, nursing service system, excellence model, geriatric care

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10491 “Presently”: A Personal Trainer App to Self-Train and Improve Presentation Skills

Authors: Shyam Mehraaj, Samanthi E. R. Siriwardana, Shehara A. K. G. H., Wanigasinghe N. T., Wandana R. A. K., Wedage C. V.

Abstract:

A presentation is a critical tool for conveying not just spoken information but also a wide spectrum of human emotions. The single most effective thing to make the presentation successful is to practice it beforehand. Preparing for a presentation has been shown to be essential for improving emotional control, intonation and prosody, pronunciation, and vocabulary, as well as the quality of the presentation slides. As a result, practicing has become one of the most critical parts of giving a good presentation. In this research, the main focus is to analyze the audio, video, and slides of the presentation uploaded by the presenters. This proposed solution is based on the Natural Language Processing and Computer Vision techniques to cater to the requirement for the presenter to do a presentation beforehand using a mobile responsive web application. The proposed system will assist in practicing the presentation beforehand by identifying the presenters’ emotions, body language, tonality, prosody, pronunciations and vocabulary, and presentation slides quality. Overall, the system will give a rating and feedback to the presenter about the performance so that the presenters’ can improve their presentation skills.

Keywords: presentation, self-evaluation, natural learning processing, computer vision

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10490 A 'German Europe' Emerged from the Euro Crisis: A Study through the Portuguese Quality Press

Authors: Ana Luísa Mouro

Abstract:

When the financial crisis exploded in 2008 in the United States, unleashed by the collapse of Lehman Brothers, and contaminated the economies of the European periphery, Germany appeared as the anchor of the stability of all European institutions and countries in difficulty. The solutions provided by the German government have triggered a deep political debate about the key position Germany has conquered at the heart of Europe - a new “German question” has been created. Some say Germany has achieved by peaceful means what was not able to get through military conquest - the domination of Europe – and many fear Germany’s economic power. This debate about the new role of Germany in Europe has received special attention in the European media and Portugal has not been the exception. The present study has been based on the survey, selection and critical analysis of news reporting, opinion articles, interviews and editorials, published in the weekly Expresso and in the daily Público, between 2008 and 2015 (year of the 25th anniversary of Germany’s unification). The findings of this study will show the paradox of German power and its relevance for Europe’s future.

Keywords: Euro crises, German Europe, intercultural hermeneutics, Portuguese quality press

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10489 Adopting a Comparative Cultural Studies Approach to Teaching Writing in the Global Classroom

Authors: Madhura Bandyopadhyay

Abstract:

Teaching writing within multicultural and multiethnic communities poses many unique challenges not the least of which is that of intercultural communication. When the writing is in English, pedagogical imperatives often encounter the universalizing tendencies of standardization of both language use and structural parameters which are often at odds with maintaining local practices which preserve cultural pluralism. English often becomes the contact zone within which individual identities of students play out against the standardization imperatives of the larger world. Writing classes can serve as places which become instruments of assimilation of ethnic minorities to a larger globalizing or nationalistic agenda. Hence, for those outside of the standard practices of writing English, adaptability towards a mastery of those practices valued as standard become the focus of teaching taking away from diversity of local English use and other modes of critical thinking. In a very multicultural and multiethnic context such as the US or Singapore, these dynamics become very important. This paper will argue that multiethnic writing classrooms can greatly benefit from taking up a cultural studies approach whereby the students’ lived environments and experiences are analyzed as cultural texts to produce writing. Such an approach eliminates limitations of using both literary texts as foci of discussion as in traditional approaches to teaching writing and the current trend in teaching composition without using texts at all. By bringing in students’ lived experiences into the classroom and analyzing them as cultural compositions stressing the ability to communicate across cultures, cultural competency is valued rather than adaptability while privileging pluralistic experiences as valuable even as universal shared experience are found. Specifically, while teaching writing in English in a multicultural classroom, a cultural studies approach makes both teacher and student aware of the diversity of the English language as it exists in our global context in the students’ experience while making space for diversity in critical thinking, structure and organization of writing effective in an intercultural context.

Keywords: English, multicultural, teaching, writing

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10488 Audit Committee Financial Expertise and Financial Reporting Timeliness in Emerging Market: The Role of Audit Committee Chair

Authors: Saeed Rabea Baatwah, Zalailah Salleh, Norsiah Ahmad

Abstract:

This study examines whether audit committee chair with financial expertise enhances the audit committee role in financial reporting quality in emerging market. We investigate this influence by employing the direct effect and moderating effect of audit committee chair with financial expertise on financial reporting timeliness. By using Omani data and the panel data method for two proxies for financial reporting timeliness, we find that audit committee chair with financial expertise enhances the timeliness of financial reporting through making the disclosure of annual reports timely. Further, we report evidence showing that both accounting and non-accounting financial expertise on the audit committee have a positive and significant influence on the timeliness of financial reporting. We also document that the association between financial expertise and the timeliness of financial reporting is more pronounced when the chair of the audit committee has financial expertise. This study is among the first to comprehensively prove that audit committee chair with financial expertise contributes to the quality of financial reporting in emerging market.

Keywords: audit committee, chair with financial expertise, timeliness of financial reporting, Oman

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10487 Solving LWE by Pregressive Pumps and Its Optimization

Authors: Leizhang Wang, Baocang Wang

Abstract:

General Sieve Kernel (G6K) is considered as currently the fastest algorithm for the shortest vector problem (SVP) and record holder of open SVP challenge. We study the lattice basis quality improvement effects of the Workout proposed in G6K, which is composed of a series of pumps to solve SVP. Firstly, we use a low-dimensional pump output basis to propose a predictor to predict the quality of high-dimensional Pumps output basis. Both theoretical analysis and experimental tests are performed to illustrate that it is more computationally expensive to solve the LWE problems by using a G6K default SVP solving strategy (Workout) than these lattice reduction algorithms (e.g. BKZ 2.0, Progressive BKZ, Pump, and Jump BKZ) with sieving as their SVP oracle. Secondly, the default Workout in G6K is optimized to achieve a stronger reduction and lower computational cost. Thirdly, we combine the optimized Workout and the Pump output basis quality predictor to further reduce the computational cost by optimizing LWE instances selection strategy. In fact, we can solve the TU LWE challenge (n = 65, q = 4225, = 0:005) 13.6 times faster than the G6K default Workout. Fourthly, we consider a combined two-stage (Preprocessing by BKZ- and a big Pump) LWE solving strategy. Both stages use dimension for free technology to give new theoretical security estimations of several LWE-based cryptographic schemes. The security estimations show that the securities of these schemes with the conservative Newhope’s core-SVP model are somewhat overestimated. In addition, in the case of LAC scheme, LWE instances selection strategy can be optimized to further improve the LWE-solving efficiency even by 15% and 57%. Finally, some experiments are implemented to examine the effects of our strategies on the Normal Form LWE problems, and the results demonstrate that the combined strategy is four times faster than that of Newhope.

Keywords: LWE, G6K, pump estimator, LWE instances selection strategy, dimension for free

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10486 Development of a Risk Disclosure Index and Examination of Its Determinants: An Empirical Study in Indian Context

Authors: M. V. Shivaani, P. K. Jain, Surendra S. Yadav

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Worldwide regulators, practitioners and researchers view risk-disclosure as one of the most important steps that will promote corporate accountability and transparency. Recognizing this growing significance of risk disclosures, the paper first develops a risk disclosure index. Covering 69 risk items/themes, this index is developed by employing thematic content analysis and encompasses three attributes of disclosure: namely, nature (qualitative or quantitative), time horizon (backward-looking or forward-looking) and tone (no impact, positive impact or negative impact). As the focus of study is on substantive rather than symbolic disclosure, content analysis has been carried out manually. The study is based on non-financial companies of Nifty500 index and covers a ten year period from April 1, 2005 to March 31, 2015, thus yielding 3,872 annual reports for analysis. The analysis reveals that (on an average) only about 14% of risk items (i.e. about 10 out 69 risk items studied) are being disclosed by Indian companies. Risk items that are frequently disclosed are mostly macroeconomic in nature and their disclosures tend to be qualitative, forward-looking and conveying both positive and negative aspects of the concerned risk. The second objective of the paper is to gauge the factors that affect the level of disclosures in annual reports. Given the panel nature of data, and possible endogeneity amongst variables, Diff-GMM regression has been applied. The results indicate that age and size of firms have a significant positive impact on disclosure quality, whereas growth rate does not have a significant impact. Further, post-recession period (2009-2015) has witnessed significant improvement in quality of disclosures. In terms of corporate governance variables, board size, board independence, CEO duality, presence of CRO and constitution of risk management committee appear to be significant factors in determining the quality of risk disclosures. It is noteworthy that the study contributes to literature by putting forth a variant to existing disclosure indices that not only captures the quantity but also the quality of disclosures (in terms of semantic attributes). Also, the study is a first of its kind attempt in a prominent emerging market i.e. India. Therefore, this study is expected to facilitate regulators in mandating and regulating risk disclosures and companies in their endeavor to reduce information asymmetry.

Keywords: risk disclosure, voluntary disclosures, corporate governance, Diff-GMM

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10485 Stakeholder Engagement to Address Urban Health Systems Gaps for Migrants

Authors: A. Chandra, M. Arthur, L. Mize, A. Pomeroy-Stevens

Abstract:

Background: Lower and middle-income countries (LMICs) in Asia face rapid urbanization resulting in both economic opportunities (the urban advantage) and emerging health challenges. Urban health risks are magnified in informal settlements and include infectious disease outbreaks, inadequate access to health services, and poor air quality. Over the coming years, urban spaces in Asia will face accelerating public health risks related to migration, climate change, and environmental health. These challenges are complex and require multi-sectoral and multi-stakeholder solutions. The Building Health Cities (BHC) program is funded by the United States Agency for International Development (USAID) to work with smart city initiatives in the Asia region. BHC approaches urban health challenges by addressing policies, planning, and services through a health equity lens, with a particular focus on informal settlements and migrant communities. The program works to develop data-driven decision-making, build inclusivity through stakeholder engagement, and facilitate the uptake of appropriate technology. Methodology: The BHC program has partnered with the smart city initiatives of Indore in India, Makassar in Indonesia, and Da Nang in Vietnam. Implementing partners support municipalities to improve health delivery and equity using two key approaches: political economy analysis and participatory systems mapping. Political economy analyses evaluate barriers to collective action, including corruption, security, accountability, and incentives. Systems mapping evaluates community health challenges using a cross-sectoral approach, analyzing the impact of economic, environmental, transport, security, health system, and built environment factors. The mapping exercise draws on the experience and expertise of a diverse cohort of stakeholders, including government officials, municipal service providers, and civil society organizations. Results: Systems mapping and political economy analyses identified significant barriers for health care in migrant populations. In Makassar, migrants are unable to obtain the necessary card that entitles them to subsidized health services. This finding is being used to engage with municipal governments to mitigate the barriers that limit migrant enrollment in the public social health insurance scheme. In Indore, the project identified poor drainage of storm and wastewater in migrant settlements as a cause of poor health. Unsafe and inadequate infrastructure placed residents of these settlements at risk for both waterborne diseases and injuries. The program also evaluated the capacity of urban primary health centers serving migrant communities, identifying challenges related to their hours of service and shortages of health workers. In Da Nang, the systems mapping process has only recently begun, with the formal partnership launched in December 2019. Conclusion: This paper explores lessons learned from BHC’s systems mapping, political economy analyses, and stakeholder engagement approaches. The paper shares progress related to the health of migrants in informal settlements. Case studies feature barriers identified and mitigating steps, including governance actions, taken by local stakeholders in partner cities. The paper includes an update on ongoing progress from Indore and Makassar and experience from the first six months of program implementation from Da Nang.

Keywords: informal settlements, migration, stakeholder engagement mapping, urban health

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10484 Pallet Tracking and Cost Optimization of the Flow of Goods in Logistics Operations by Serial Shipping Container Code

Authors: Dominika Crnjac Milic, Martina Martinovic, Vladimir Simovic

Abstract:

The case study method in this paper shows the implementation of Information Technology (IT) and the Serial Shipping Container Code (SSCC) in a Croatian company that deals with logistics operations and provides logistics services in the cold chain segment. This company is aware of the sensitivity of the goods entrusted to them by the user of the service, as well as of the importance of speed and accuracy in providing logistics services. To that end, it has implemented and used the latest IT to ensure the highest standard of high-quality logistics services to its customers. Looking for efficiency and optimization of supply chain management, while maintaining a high level of quality of the products that are sold, today's users of outsourced logistics services are open to the implementation of new IT products that ultimately deliver savings. By analysing the positive results and the difficulties that arise when using this technology, we aim to provide an insight into the potential of this approach of the logistics service provider.

Keywords: logistics operations, serial shipping container code, information technology, cost optimization

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10483 Free Fibular Flaps in Management of Sternal Dehiscence

Authors: H. N. Alyaseen, S. E. Alalawi, T. Cordoba, É. Delisle, C. Cordoba, A. Odobescu

Abstract:

Sternal dehiscence is defined as the persistent separation of sternal bones that are often complicated with mediastinitis. Etiologies that lead to sternal dehiscence vary, with cardiovascular and thoracic surgeries being the most common. Early diagnosis in susceptible patients is crucial to the management of such cases, as they are associated with high mortality rates. A recent meta-analysis of more than four hundred thousand patients concluded that deep sternal wound infections were the leading cause of mortality and morbidity in patients undergoing cardiac procedures. Long-term complications associated with sternal dehiscence include increased hospitalizations, cardiac infarctions, and renal and respiratory failures. Numerous osteosynthesis methods have been described in the literature. Surgical materials offer enough rigidity to support the sternum and can be flexible enough to allow physiological breathing movements of the chest; however, these materials fall short when managing patients with extensive bone loss, osteopenia, or general poor bone quality, for such cases, flaps offer a better closure system. Early utilization of flaps yields better survival rates compared to delayed closure or to patients treated with sternal rewiring and closed drainage. The utilization of pectoralis major flaps, rectus abdominus, and latissimus muscle flaps have all been described in the literature as great alternatives. Flap selection depends on a variety of factors, mainly the size of the sternal defect, infection, and the availability of local tissues. Free fibular flaps are commonly harvested flaps utilized in reconstruction around the body. In cases regarding sternal reconstruction with free fibular flaps, the literature exclusively discussed the flap applied vertically to the chest wall. We present a different technique applying the free fibular triple barrel flap oriented in a transverse manner, in parallel to the ribs. In our experience, this method could have enhanced results and improved prognosis as it contributes to the normal circumferential shape of the chest wall.

Keywords: sternal dehiscence, management, free fibular flaps, novel surgical techniques

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10482 Effects of Smoking on the Indoor Air Quality and COVID-19

Authors: Sonam Sandal, Susan Verghese P.

Abstract:

The phrase "environmental tobacco smoke" (ETS) refers to exposure to tobacco smoke that isn't from your own smoking but instead is caused by being in close proximity to someone else's cigar, cigarette, or pipe smoke. Environmental cigarette smoke is one of the main contributors to indoor air pollution (IAP), which is exceedingly harmful to human health and results in millions of deaths each year, according to the World Health Organization. Sidestream smoke (SS), which is discharged from a cigarette's burning end in between puffs, is the primary cause of ETS. The bulk of the ETS residue is composed of gases that are produced while smoking through the cigarette paper, mainstream smoke (MS) ingested, and side stream smoke emitted while inhaling a puff from the burning end. Each of these mixtures—SS, ETS, and MS—is an aerosol composed of an IAP-causing vapor phase and a particle phase. Therefore, indoor air-cleaning equipment designed to remove particles will not significantly alter nicotine exposure but will alter the concentrations of other dangerous substances, including particulate matter (PM), PM 2.5, and PM 10. In conclusion, indoor airborne contaminants pose serious risks to human health. ETS degrades the air quality, and when someone breathes this bad air, it weakens their lungs and makes them more susceptible to COVID-19.

Keywords: pm 10, covid-19, indoor air pollution, cigarette smoke., pm 2.5

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10481 Ethiopian Textile and Apparel Industry: Study of the Information Technology Effects in the Sector to Improve Their Integrity Performance

Authors: Merertu Wakuma Rundassa

Abstract:

Global competition and rapidly changing customer requirements are forcing major changes in the production styles and configuration of manufacturing organizations. Increasingly, traditional centralized and sequential manufacturing planning, scheduling, and control mechanisms are being found insufficiently flexible to respond to changing production styles and highly dynamic variations in product requirements. The traditional approaches limit the expandability and reconfiguration capabilities of the manufacturing systems. Thus many business houses face increasing pressure to lower production cost, improve production quality and increase responsiveness to customers. In a textile and apparel manufacturing, globalization has led to increase in competition and quality awareness and these industries have changed tremendously in the last few years. So, to sustain competitive advantage, companies must re-examine and fine-tune their business processes to deliver high quality goods at very low costs and it has become very important for the textile and apparel industries to integrate themselves with information technology to survive. IT can create competitive advantages for companies to improve coordination and communication among trading partners, increase the availability of information for intermediaries and customers and provide added value at various stages along the entire chain. Ethiopia is in the process of realizing its potential as the future sourcing location for the global textile and garments industry. With a population of over 90 million people and the fastest growing non-oil economy in Africa, Ethiopia today represents limitless opportunities for international investors. For the textile and garments industry Ethiopia promises a low cost production location with natural resources such as cotton to enable the setup of vertically integrated textile and garment operation. However; due to lack of integration of their business activities textile and apparel industry of Ethiopia faced a problem in that it can‘t be competent in the global market. On the other hand the textile and apparel industries of other countries have changed tremendously in the last few years and globalization has led to increase in competition and quality awareness. So the aim of this paper is to study the trend of Ethiopian Textile and Apparel Industry on the application of different IT system to integrate them in the global market.

Keywords: information technology, business integrity, textile and apparel industries, Ethiopia

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10480 Effects of Plant Growth Promoting Rhizobacteria on the Yield and Nutritive Quality of Tomato Fruits

Authors: Narjes Dashti, Nida Ali, Magdy Montasser, Vineetha Cherian

Abstract:

The influence of two PGPR strains, Pseudomonas aeruginosa and Stenotrophomonas rhizophilia, on fruit yields, pomological traits and chemical contents of tomato (Solanum lycopersicum) fruits were studied. The study was conducted separately on two different cultivar varieties of tomato, namely Supermarmande and UC82B. The results indicated that the presence of the PGPR almost doubled the average yield per plant. There was a significant improvement in the pomological qualities of the PGPR treated tomato fruits compared to the corresponding healthy treatments especially in traits such as the average fruit weight, height, and fruit volume. The chemical analysis of tomato fruits revealed that the presence of the PGPRs increased the total protein, lycopene, alkalinity and phenol content of the tomato fruits compared to the healthy controls. They had no influence on the reduced sugar, total soluble solids or the titerable acid content of fruits. However their presence reduced the amount of ascorbic acid in tomato fruits compared to the healthy controls.

Keywords: PGPR, tomato, fruit quality

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10479 Physical Properties Characterization of Shallow Aquifer and Groundwater Quality Using Geophysical Method Based on Electrical Resistivity Tomography in Arid Region, Northeastern Area of Tunisia: A Study Case of Smar Aquifer

Authors: Nesrine Frifita

Abstract:

In recent years, serious interest in underground sources has led to more intensive studies of depth, thickness, geometry and properties of aquifers. Geophysical method is the common technique used in discovering the subsurface. However, determining the exact location of groundwater in subsurface layers is one of problems that needs to be resolved. While the biggest problem is the quality of the groundwater which suffers from pollution risk especially with water shortage in arid regions under a remarkable climate change. The present study was conducted using electrical resistivity tomography at Jeffara coastal area in Southeast Tunisia to image the potential shallow aquifer and studying their physical properties. The purpose of this study is to understand the characteristics and depth of the Smar aquifer. Therefore, it can be used as a reference in groundwater drilling in order to guide the farmers and to improve the living of the inhabitants of nearby cities. The use of the Winner-Schlumberger array for data acquisition is suitable to obtain a deeper profile in areas with homogeneous layers. For that, six electrical resistivity profiles were carried out in Smar watershed using 72 electrodes with 4 and 5 m spacing. The resistivity measurements were carefully interpreted by a least-square inversion technique using the RES2DINV program. Findings show that the Smar aquifer has about 31 m thickness and it extends to 36.5 m depth in the downstream area of Oued Smar. The defined depth and geometry of Smar aquifer indicate that the sedimentary cover thins toward the coast, and the Smar shallow aquifer becomes deeper toward the West. While the resistivity values show a significant contrast even reaching < 1 Ωm in ERT1, this resistivity value can be related to the saline water that foretells a risk of pollution and bad groundwater quality. The ERT1 geoelectrical model defines an unsaturated zone, while under ERT3 site, the geoelectrical model presents a saturated zone, which reflect a low resistivity values indicate the locally surface water coming from the nearby Office of the National Sanitation Utility (ONAS) that can be a source of recharge of the studied shallow aquifer and more deteriorate the groundwater quality in this region.

Keywords: electrical resistivity tomography, groundwater, recharge, smar aquifer, southeastern tunisia

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10478 Performance Evaluation of a Very High-Resolution Satellite Telescope

Authors: Walid A. Attia, Taher M. Bazan, Fawzy Eltohamy, Mahmoud Fathy

Abstract:

System performance evaluation is an essential stage in the design of high-resolution satellite telescopes prior to the development process. In this paper, a system performance evaluation of a very high-resolution satellite telescope is investigated. The evaluated system has a Korsch optical scheme design. This design has been discussed in another paper with respect to three-mirror anastigmat (TMA) scheme design and the former configuration showed better results. The investigated system is based on the Korsch optical design integrated with a time-delay and integration charge coupled device (TDI-CCD) sensor to achieve a ground sampling distance (GSD) of 25 cm. The key performance metrics considered are the spatial resolution, the signal to noise ratio (SNR) and the total modulation transfer function (MTF) of the system. In addition, the national image interpretability rating scale (NIIRS) metric is assessed to predict the image quality according to the modified general image quality equation (GIQE). Based on the orbital, optical and detector parameters, the estimated GSD is found to be 25 cm. The SNR has been analyzed at different illumination conditions of target albedos, sun and sensor angles. The system MTF has been computed including diffraction, aberration, optical manufacturing, smear and detector sampling as the main contributors for evaluation the MTF. Finally, the system performance evaluation results show that the computed MTF value is found to be around 0.08 at the Nyquist frequency, the SNR value was found to be 130 at albedo 0.2 with a nadir viewing angles and the predicted NIIRS is in the order of 6.5 which implies a very good system image quality.

Keywords: modulation transfer function, national image interpretability rating scale, signal to noise ratio, satellite telescope performance evaluation

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10477 Seawater Desalination for Production of Highly Pure Water Using a Hydrophobic PTFE Membrane and Direct Contact Membrane Distillation (DCMD)

Authors: Ahmad Kayvani Fard, Yehia Manawi

Abstract:

Qatar’s primary source of fresh water is through seawater desalination. Amongst the major processes that are commercially available on the market, the most common large scale techniques are Multi-Stage Flash distillation (MSF), Multi Effect distillation (MED), and Reverse Osmosis (RO). Although commonly used, these three processes are highly expensive down to high energy input requirements and high operating costs allied with maintenance and stress induced on the systems in harsh alkaline media. Beside that cost, environmental footprint of these desalination techniques are significant; from damaging marine eco-system, to huge land use, to discharge of tons of GHG and huge carbon footprint. Other less energy consuming techniques based on membrane separation are being sought to reduce both the carbon footprint and operating costs is membrane distillation (MD). Emerged in 1960s, MD is an alternative technology for water desalination attracting more attention since 1980s. MD process involves the evaporation of a hot feed, typically below boiling point of brine at standard conditions, by creating a water vapor pressure difference across the porous, hydrophobic membrane. Main advantages of MD compared to other commercially available technologies (MSF and MED) and specially RO are reduction of membrane and module stress due to absence of trans-membrane pressure, less impact of contaminant fouling on distillate due to transfer of only water vapor, utilization of low grade or waste heat from oil and gas industries to heat up the feed up to required temperature difference across the membrane, superior water quality, and relatively lower capital and operating cost. To achieve the objective of this study, state of the art flat-sheet cross-flow DCMD bench scale unit was designed, commissioned, and tested. The objective of this study is to analyze the characteristics and morphology of the membrane suitable for DCMD through SEM imaging and contact angle measurement and to study the water quality of distillate produced by DCMD bench scale unit. Comparison with available literature data is undertaken where appropriate and laboratory data is used to compare a DCMD distillate quality with that of other desalination techniques and standards. Membrane SEM analysis showed that the PTFE membrane used for the study has contact angle of 127º with highly porous surface supported with less porous and bigger pore size PP membrane. Study on the effect of feed solution (salinity) and temperature on water quality of distillate produced from ICP and IC analysis showed that with any salinity and different feed temperature (up to 70ºC) the electric conductivity of distillate is less than 5 μS/cm with 99.99% salt rejection and proved to be feasible and effective process capable of consistently producing high quality distillate from very high feed salinity solution (i.e. 100000 mg/L TDS) even with substantial quality difference compared to other desalination methods such as RO and MSF.

Keywords: membrane distillation, waste heat, seawater desalination, membrane, freshwater, direct contact membrane distillation

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10476 Negative Perceptions of Ageing Predicts Greater Dysfunctional Sleep Related Cognition Among Adults Aged 60+

Authors: Serena Salvi

Abstract:

Ageistic stereotypes and practices have become a normal and therefore pervasive phenomenon in various aspects of everyday life. Over the past years, renewed awareness towards self-directed age stereotyping in older adults has given rise to a line of research focused on the potential role of attitudes towards ageing on seniors’ health and functioning. This set of studies has showed how a negative internalisation of ageistic stereotypes would discourage older adults in seeking medical advice, in addition to be associated to negative subjective health evaluation. An important dimension of mental health that is often affected in older adults is represented by sleep quality. Self-reported sleep quality among older adults has shown to be often unreliable when compared to their objective sleep measures. Investigations focused on self-reported sleep quality among older adults have suggested how this portion of the population would tend to accept disrupted sleep if believed to be up to standard for their age. On the other hand, unrealistic expectations, and dysfunctional beliefs towards sleep in ageing, might prompt older adults to report sleep disruption even in the absence of objective disrupted sleep. Objective of this study is to examine an association between personal attitudes towards ageing in adults aged 60+ and dysfunctional sleep related cognition. More in detail, this study aims to investigate a potential association between personal attitudes towards ageing, sleep locus of control and dysfunctional beliefs towards sleep among this portion of the population. Data in this study were statistically analysed in SPSS software. Participants were recruited through the online participants recruitment system Prolific. Inclusion of attention check questions throughout the questionnaire and consistency of responses were looked at. Prior to the commencement of this study, Ethical Approval was granted (ref. 39396). Descriptive statistics were used to determine the frequency, mean, and SDs of the variables. Pearson coefficient was used for interval variables, independent T-test for comparing means between two independent groups, analysis of variance (ANOVA) test for comparing the means in several independent groups, and hierarchical linear regression models for predicting criterion variables based on predictor variables. In this study self-perceptions of ageing were assessed using APQ-B’s subscales, while dysfunctional sleep related cognition was operationalised using the SLOC and the DBAS16 scales. Of the final subscales taken in consideration in the brief version of the APQ questionnaire, Emotional Representations (ER), Control Positive (PC) and Control and Consequences Negative (NC) have shown to be of particularly relevance for the remits of this study. Regression analysis show how an increase in the APQ-B subscale Emotional Representations (ER) predicts an increase in dysfunctional beliefs and attitudes towards sleep in this sample, after controlling for subjective sleep quality, level of depression and chronological age. A second regression analysis showed that APQ-B subscales Control Positive (PC) and Control and Consequences Negative (NC) were significant predictors in the change of variance of SLOC, after controlling for subjective sleep quality, level of depression and dysfunctional beliefs about sleep.

Keywords: sleep-related cognition, perceptions of aging, older adults, sleep quality

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10475 Cable De-Commissioning of Legacy Accelerators at CERN

Authors: Adya Uluwita, Fernando Pedrosa, Georgi Georgiev, Christian Bernard, Raoul Masterson

Abstract:

CERN is an international organisation funded by 23 countries that provide the particle physics community with excellence in particle accelerators and other related facilities. Founded in 1954, CERN has a wide range of accelerators that allow groundbreaking science to be conducted. Accelerators bring particles to high levels of energy and make them collide with each other or with fixed targets, creating specific conditions that are of high interest to physicists. A chain of accelerators is used to ramp up the energy of particles and eventually inject them into the largest and most recent one: the Large Hadron Collider (LHC). Among this chain of machines is, for instance the Proton Synchrotron, which was started in 1959 and is still in operation. These machines, called "injectors”, keep evolving over time, as well as the related infrastructure. Massive decommissioning of obsolete cables started in 2015 at CERN in the frame of the so-called "injectors de-cabling project phase 1". Its goal was to replace aging cables and remove unused ones, freeing space for new cables necessary for upgrades and consolidation campaigns. To proceed with the de-cabling, a project co-ordination team was assembled. The start of this project led to the investigation of legacy cables throughout the organisation. The identification of cables stacked over half a century proved to be arduous. Phase 1 of the injectors de-cabling was implemented for 3 years with success after overcoming some difficulties. Phase 2, started 3 years later, focused on improving safety and structure with the introduction of a quality assurance procedure. This paper discusses the implementation of this quality assurance procedure throughout phase 2 of the project and the transition between the two phases. Over hundreds of kilometres of cable were removed in the injectors complex at CERN from 2015 to 2023.

Keywords: CERN, de-cabling, injectors, quality assurance procedure

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10474 Biodiesel Production from Yellow Oleander Seed Oil

Authors: S. Rashmi, Devashish Das, N. Spoorthi, H. V. Manasa

Abstract:

Energy is essential and plays an important role for overall development of a nation. The global economy literally runs on energy. The use of fossil fuels as energy is now widely accepted as unsustainable due to depleting resources and also due to the accumulation of greenhouse gases in the environment, renewable and carbon neutral biodiesel are necessary for environment and economic sustainability. Unfortunately biodiesel produced from oil crop, waste cooking oil and animal fats are not able to replace fossil fuel. Fossil fuels remain the dominant source of primary energy, accounting for 84% of the overall increase in demand. Today biodiesel has come to mean a very specific chemical modification of natural oils. Objectives: To produce biodiesel from yellow oleander seed oil, to test the yield of biodiesel using different types of catalyst (KOH & NaOH). Methodology: Oil is extracted from dried yellow oleander seeds using Soxhlet extractor and oil expeller (bulk). The FFA content of the oil is checked and depending on the FFA value either two steps or single step process is followed to produce biodiesel. Two step processes includes esterfication and transesterification, single step includes only transesterification. The properties of biodiesel are checked. Engine test is done for biodiesel produced. Result: It is concluded that biodiesel quality parameters such as yield(85% & 90%), flash point(1710C & 1760C),fire point(1950C & 1980C), viscosity(4.9991 and 5.21 mm2/s) for the biodiesel from seed oil of Thevetiaperuviana produced by using KOH & NaOH respectively. Thus the seed oil of Thevetiaperuviana is a viable feedstock for good quality fuel.The outcomes of our project are a substitute for conventional fuel, to reduce petro diesel requirement,improved performance in terms of emissions. Future prospects: Optimization of biodiesel production using response surface method.

Keywords: yellow oleander seeds, biodiesel, quality parameters, renewable sources

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10473 Assessing the Disability-Free Life Expectancy and Decomposition of Its Difference: A Gender Perspective on India over the Decade 2001-2011

Authors: Kajori Banerjee, Laxmi Kant Dwivedi

Abstract:

“Health transition” is defined to be “a process through which high levels of mortality, morbidity and disability are reduced to low levels by influencing cultural, social and behavioural factors”. Life expectancy in India has been on the rise and parallel the burden of disease and disability has also risen noticeably. Borrowing data from Indian Census (2001, 2011), this study identifies the gender-wise burden of disability by calculating disability free life expectancy (DFLE) and life lived with disability (LWD). Sullivan’s method of calculating DFLE using proportion of disabled is used for this purpose. The change in person years lived with disability in the decade 2001-11 is further decomposed using Arriaga’s method into mortality and disability effects (ME and DE) to check the magnitude and direction of contribution of mortality and disability. Nationally, along with DFLE, LWD has amplified too. Despite having the highest life expectancy and DFLE, LWD in Kerala, was highest for both sexes in 2001. But in 2011, the LWD was highest among the males of Orissa and females of Rajasthan. For the overall population, DE is positive for the prime working age groups of 20-40years indicating that there has been an increase in the disability proportion holding mortality constant for 2001-2011. Females exhibit higher positive DE implying greater loss of healthy years due to disability than males. The findings call for an immediate attention to the causes of rising disability burden among the working population, especially females, as this might heavily effect the availability of quality labour force and its relative economic output in the Indian labour market. This also hints at the degrading quality of the elongated life and needs to be given the required attention to enhance the quality of life lead in the Nation.

Keywords: disability-free life expectancy, disability effect, life expectancy, mortality effect

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10472 Integrated Risk Management in The Supply Chain of Essential Medicines in Zambia

Authors: Mario M. J. Musonda

Abstract:

Access to health care is a human right, which includes having timely access to affordable and quality essential medicines at the right place and in sufficient quantity. However, inefficient public sector supply chain management contributes to constant shortages of essential medicines at health facilities. Literature review involved a desktop study of published research studies and reports on risk management, supply chain management of essential medicines and their integration to increase the efficiency of the latter. The research was conducted on a sample population of offices under Ministry of Health Headquarters, Lusaka Provincial and District Offices, selected health facilities in Lusaka, Medical Stores Limited, Zambia Medicines Regulatory Authority and Cooperating Partners. Individuals involved in study were selected judgmentally by their functions under selection and quantification, regulation, procurement, storage, distribution, quality assurance, and dispensing of essential medicines. Structured interviews and discussions were held with selected experts and self-administered questionnaires were distributed. Collected and analysed data of 35 returned and usable questionnaires from the 50 distributed. The highest prioritised risks were; inadequate and inconsistent fund disbursements, weak information management systems, weak quality management systems and insufficient resources (HR and infrastructure) among others. The results for this research can be used to increase the efficiency of the public sector supply chain of essential medicines and other pharmaceuticals. The results of the study showed that there is need to implement effective risk management systems by participating institutions and organisations to increase the efficiency of the entire supply chain in order to avoid and/or reduce shortages of essential medicines at health facilities.

Keywords: essential medicine, risk assessment, risk management, supply chain, supply chain risk management

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10471 Assessing the Physical Conditions of Motorcycle Taxi Stands and Comfort Conditions of the Drivers in the Central Business District of Bangkok

Authors: Nissa Phloimontri

Abstract:

This research explores the current physical conditions of motorcycle taxi stands located near the BTS stations in the central business district (CBD) and the comfort conditions of motorcycle taxi drivers. The criteria set up for physical stand survey and assessment are the integration of multimodal access design guidelines. After the survey, stands that share similar characteristics are classified into a series of typologies. Based on the environmental comfort model, questionnaires and in-depth interviews are conducted to evaluate the comfort levels of drivers including physical, functional, and psychological comfort. The results indicate that there are a number of motorcycle taxi stands that are not up to standard and are not conducive to the work-related activities of drivers. The study concludes by recommending public policy for integrated paratransit stops that support the multimodal transportation and seamless mobility concepts within the specific context of Bangkok as well as promote the quality of work life of motorcycle taxi drivers.

Keywords: motorcycle taxi, paratransit stops, environmental comfort, quality of work life

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10470 Dimensions of Public Spaces: Feelings through Human Senses

Authors: Piyush Hajela

Abstract:

The significance of public spaces is on a rise in Indian cities as a strong interaction space across cultures and community. It is a pertinent gathering space for people across age and gender, where the face keeps changing with time. A public space is directly related to the social dimension, people, comfort, safety, and security, that, it proposes to provide, as inherent qualities. The presence of these and other dimensions of space, together with related equitable environments, impart certain quality to a public space. The higher the optimum contents of these dimensions, the better the quality of public space. Public is represented by PEOPLE through society and community, and space is created by dimensions. Society contains children, women and the elderly, community is composed of social, and religious groups. These behave differently in a different setting and call for varied quality of spaces, created and generated. Public spaces are spread across a city and have more or less established their existence and prominence in a social set up. While few of them are created others are discovered by the people themselves in their constant search for desirable interactive public spaces. These are the most sought after gathering spaces that have the quality of promoting social interaction, providing free accessibility, provide desirable scale etc. The emergence of public space dates back to the times when people started forming communities, display cultures and traditions publicly, gathered for religious observations and celebrations, and address the society. Traditional cities and societies in India were feudal and orthodox in their nature and yet had public spaces. When the gathering of people at one point in a city became more frequent the point became more accessible and occupied. Baras (large courts, Chowks (public squares) and Maidans (large grounds) became well-known gathering spaces in the towns and cities. As the population grew such points grew in number, each becoming a public space in itself and with a different and definite social character. The author aims at studying the various dimensions of public spaces with which a public space has power to hold people for a significant period of time. The human senses here are note referred to as taste, sight, hearing, touch or smell, but how human senses collectively respond to when stationed in a given public space. The collectives may reflect in dimensions like comfort, safety, environment, freedom etc. Various levels of similar other responses would be studied through interviews, observations and other scientific methods for both qualitative and quantitative analysis.

Keywords: society, interaction, people, accessibility, comfort, enclosure

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10469 Evaluation to Assess the Impact of Newcastle Infant Partnership Approach

Authors: Samantha Burns, Melissa Brown, Judith Rankin

Abstract:

Background: As a specialised intervention, NEWPIP provides a service which supports both parents and their babies from conception to two years, who are experiencing issues which may affect the quality of their relationship and development of the infant. This evaluation of the NEWPIP approach was undertaken in response to the need for rich, in-depth data to understand the lived experiences of the parents who experienced the service to improve the service. NEWPIP is currently one of 34 specialised parent–infant relationship teams across England. This evaluation contributes to increasing understanding of the impact and effectiveness of this specialised service to inform future practice. Aim: The aim of this evaluation was to explore the perspectives and experiences of parents or caregivers (service users), to assess the impact of the NEWPIP service on the parents themselves and the relationship with their baby. Methods: The exploratory nature of the aim and focus on service users’ experience and perspectives provided scope for a qualitative approach for this evaluation. This consisted of 10 semi-structured interviews with parents who had received the service within the last two years. Recruitment involved both purposive and convenience sampling. The interviews took place between February 2021 – March 2021, lasting between 30-90 minutes and were guided by open-ended questions from a topic guide. The interviews adopted a narrative approach to enable the parents to share their lived experiences. The researchers transcribed the interviews and analysed the data thematically by using a coding method which is grounded in the data. Results: The analysis and findings from the data gathered illuminated an approach which supports parents to build a better bond with their baby and provides a safe space for parents to heal through their relationships. While the parents shared their experiences, the interviews were intended to receive feedback, so questions were asked about what could be improved and what recommendations could be offered to Children North East. Guided by the voice of the parents, this evaluation provides recommendations to support the future of the NEWPIP approach. Conclusions: The NEWPIP approach appears to successfully provide early and flexible support for new parents, increasing a parent’s confidence in their ability to not only cope but thrive as a new parent.

Keywords: maternal health, mental health, parent infant relationship, therapy

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10468 Corporate Codes of Ethics and Earnings Discretion: International Evidence

Authors: Chu Chen, Giorgio Gotti, Tony Kang, Michael Wolfe

Abstract:

This study examines the role of codes of ethics in reducing the extent to which managers’ act opportunistically in reporting earnings. Corporate codes of ethics, by clarifying the boundaries of ethical corporate behaviors and making relevant social norms more salient, have the potential to deter managers from engaging in opportunistic financial reporting practices. In a sample of international companies, we find that the quality of corporate codes of ethics is associated with higher earnings quality, i.e., lower discretionary accruals. Our results are confirmed for a subsample of firms more likely to be engaging in opportunistic reporting behavior, i.e., firms that just meet or beat analysts’ forecasts. Further, codes of ethics play a greater role in reducing earnings management for firms in countries with weaker investor protection mechanisms. Our results suggest that corporate codes of ethics can be a viable alternative to country-level investor protection mechanisms in curbing aggressive reporting behaviors.

Keywords: corporate ethics policy, code of ethics, business ethics, earnings discretion, accruals

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10467 Analysis of Total Acid in Arabica Coffee Beans after Fermentation with Ohmic Technology

Authors: Reta

Abstract:

Coffee is widely consumed not only because of its typical taste, but coffee has antioxidant properties because of its polyphenols, and it stimulates brain's performance. The main problem with the consumption of coffee is its content of caffeine. Caffeine, when consumed in excess, can increase muscle tension, stimulate the heart, and increase the secretion of gastric acid. In this research, we applied ohmic-based fermentation technology, which is specially designed to mimic the stomach. We used Arabica coffee, which although cheaper than Luwak coffee, has high acidity, which needs to be reduced. Hence, we applied the ohmic technology, varied the time and temperature of the process and measured the total acidity of the coffee to determine optimum fermentation conditions. Results revealed total acidity of the coffee varied with fermentation conditions; 0.32% at 400C and 12 hr, and 0.52% at 400C and 6 hr. The longer the fermentation, the lower was the acidity. The acidity of the mongoose-fermented (natural fermentation) beans was 2.34%, which is substantially higher than the acidity of the ohmic samples. Ohmic-based fermentation technology, therefore, offers improvements in coffee quality, and this is discussed to highlight the potential of ohmic technology in coffee processing.

Keywords: ohmic technology, fermentation, coffee quality, Arabica coffee

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10466 An Action Toolkit for Health Care Services Driving Disability Inclusion in Universal Health Coverage

Authors: Jill Hanass-Hancock, Bradley Carpenter, Samantha Willan, Kristin Dunkle

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Access to quality health care for persons with disabilities is the litmus test in our strive toward universal health coverage. Persons with disabilities experience a variety of health disparities related to increased health risks, greater socioeconomic challenges, and persistent ableism in the provision of health care. In low- and middle-income countries, the support needed to address the diverse needs of persons with disabilities and close the gaps in inclusive and accessible health care can appear overwhelming to staff with little knowledge and tools available. An action-orientated disability inclusion toolkit for health facilities was developed through consensus-building consultations and field testing in South Africa. The co-creation of the toolkit followed a bottom-up approach with healthcare staff and persons with disabilities in two developmental cycles. In cycle one, a disability facility assessment tool was developed to increase awareness of disability accessibility and service delivery gaps in primary healthcare services in a simple and action-orientated way. In cycle two, an intervention menu was created, enabling staff to respond to identified gaps and improve accessibility and inclusion. Each cycle followed five distinct steps of development: a review of needs and existing tools, design of the draft tool, consensus discussion to adapt the tool, pilot-testing and adaptation of the tool, and identification of the next steps. The continued consultations, adaptations, and field-testing allowed the team to discuss and test several adaptations while co-creating a meaningful and feasible toolkit with healthcare staff and persons with disabilities. This approach led to a simplified tool design with ‘key elements’ needed to achieve universal health coverage: universal design of health facilities, reasonable accommodation, health care worker training, and care pathway linkages. The toolkit was adapted for paper or digital data entry, produces automated, instant facility reports, and has easy-to-use training guides and online modules. The cyclic approach enabled the team to respond to emerging needs. The pilot testing of the facility assessment tool revealed that healthcare workers took significant actions to change their facilities after an assessment. However, staff needed information on how to improve disability accessibility and inclusion, where to acquire accredited training, and how to improve disability data collection, referrals, and follow-up. Hence, intervention options were needed for each ‘key element’. In consultation with representatives from the health and disability sectors, tangible and feasible solutions/interventions were identified. This process included the development of immediate/low-cost and long-term solutions. The approach gained buy-in from both sectors, who called for including the toolkit in the standard quality assessments for South Africa’s health care services. Furthermore, the process identified tangible solutions for each ‘key element’ and highlighted where research and development are urgently needed. The cyclic and consultative approach enabled the development of a feasible facility assessment tool and a complementary intervention menu, moving facilities toward universal health coverage for and persons with disabilities in low- or better-resourced contexts while identifying gaps in the availability of interventions.

Keywords: public health, disability, accessibility, inclusive health care, universal health coverage

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