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Authors: Giselly Barros Rodrigues, Carlos Leite de Souza

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In recent years, there has been a great discussion about urbanism, the right to the city, the search for the public space and the occupation and appropriation of people in the spaces of the city. This movement happens all over the world and also in the great Brazilian metropolises. The more human-friendly city - the desirable construction of urbanity - as well as the encouragement of walking or bicycling to the detriment of cars is one of the major issues addressed by urban planners and challenges in the process of reviewing regulatory frameworks. The fact is that even if there are public spaces or space for public use in private areas - it is essential that there be, besides a project focused on the people and the use of space, a good management not to generate excess of control and consequently the segregation between different ethnicities, classes or creed. With the insertion of the Strategic Master Plan of Sao Paulo (2014), there is great incentive for them to implement - in the private spaces - of mixed uses and active facades (Services and commerce in the basement of buildings), these incentives will generate a city for people in the medium and long term. This research seeks to discuss the extent to which these spaces are democratic, what their perceptions are in relation to the space of public use in private areas and why this perception may be the one that was originally idealized. For this study, we carried out bibliographic reviews where applied research were carried out in three case studies listed in Sao Paulo. Questionnaires were also applied to the actors who gave answers regarding their perceptions and how they were approached in the places analyzed. After analyzing the material, it was verified that in the three case studies analyzed, sitting on the floor is prohibited. In the two places in Paulista Avenue (Cetenco Plaza and Square of Mall Cidade Sao Paulo) there was no problem whatsoever in relation to the clothes or attitudes of the actors in the streets of Paulista Avenue in Sao Paulo city. Different from what happened in the Itaim neighborhood (Brascan Century Plaza), with more conservative characteristics, where the actors were heavily watched by security and observed by others due to their clothes and attitudes in that area. The city of Sao Paulo is slowly changing, people are increasingly looking for places of quality in public use in their daily lives. The Strategic Master Plan of Sao Paulo (2014) and the Legislation approved in 2016 envision a city more humane and people-oriented in the future. It is up to the private sector, the public, and society to work together so that this glimpse becomes an abundant reality in every city, generating quality of life and urbanity for all.

Keywords: urbanity, space for public use, appropriation of space, segregation

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Authors: Qiyao Han, Xianhai Meng

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Urban infrastructures refer to the fundamental facilities and systems that serve cities. Due to the global climate change and human activities in recent years, many urban areas around the world are facing enormous challenges from natural and man-made disasters, like flood, earthquake and terrorist attack. For this reason, urban resilience to disasters has attracted increasing attention from researchers and practitioners. Given the complexity of infrastructure systems and the uncertainty of disasters, this paper suggests that studies of resilience could focus on urban functional sustainability (in social, economic and environmental dimensions) supported by infrastructure systems under disturbance. It is supposed that urban infrastructure systems with high resilience should be able to reconfigure themselves without significant declines in critical functions (services), such as primary productivity, hydrological cycles, social relations and economic prosperity. Despite that some methods have been developed to integrate the resilience and sustainability of individual infrastructure components, more work is needed to enable system-level integration. This research presents a conceptual analysis framework for integrating resilience and sustainability based on fractal theory. It is believed that the ability of an ecological system to maintain structure and function in face of disturbance and to reorganize following disturbance-driven change is largely dependent on its self-similar and hierarchical fractal structure, in which cross-scale resilience is produced by the replication of ecosystem processes dominating at different levels. Urban infrastructure systems are analogous to ecological systems because they are interconnected, complex and adaptive, are comprised of interconnected components, and exhibit characteristic scaling properties. Therefore, analyzing resilience of ecological system provides a better understanding about the dynamics and interactions of infrastructure systems. This paper discusses fractal characteristics of ecosystem resilience, reviews literature related to system-level infrastructure resilience, identifies resilience criteria associated with sustainability dimensions, and develops a conceptual analysis framework. Exploration of the relevance of identified criteria to fractal characteristics reveals that there is a great potential to analyze infrastructure systems based on fractal. In the conceptual analysis framework, it is proposed that in order to be resilient, urban infrastructure system needs to be capable of “maintaining” and “reorganizing” multi-scale critical functions under disasters. Finally, the paper identifies areas where further research efforts are needed.

Keywords: fractal, urban infrastructure, sustainability, system-level resilience

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Authors: Maria Ahmad, Michael Page, Danë Goodsman

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‘Educational’ debriefing – a construct distinct from clinical debriefing – is used following simulated scenarios and is central to learning and development in fields ranging from aviation to emergency medicine. However, little research into educational debriefing in prehospital medicine exists. This qualitative study explored the facilitation and effects of prehospital educational debriefing and identified obstacles to debriefing, using the London’s Air Ambulance Pre-Hospital Care Course (PHCC) as a model. Method: Ethnographic observations of moulages and debriefs were conducted over two consecutive days of the PHCC in October 2019. Detailed contemporaneous field notes were made and analysed thematically. Subsequently, seven one-to-one, semi-structured interviews were conducted with four PHCC debrief facilitators and three course participants to explore their experiences of prehospital educational debriefing. Interview data were manually transcribed and analysed thematically. Results: Four overarching themes were identified: the approach to the facilitation of debriefs, effects of debriefing, facilitator development, and obstacles to debriefing. The unpredictable debriefing environment was seen as both hindering and paradoxically benefitting educational debriefing. Despite using varied debriefing structures, facilitators emphasised similar key debriefing components, including exploring participants’ reasoning and sharing experiences to improve learning and prevent future errors. Debriefing was associated with three principal effects: releasing emotion; learning and improving, particularly participant compound learning as they progressed through scenarios; and the application of learning to clinical practice. Facilitator training and feedback were central to facilitator learning and development. Several obstacles to debriefing were identified, including mismatch of participant and facilitator agendas, performance pressure, and time. Interestingly, when used appropriately in the educational environment, these obstacles may paradoxically enhance learning. Conclusions: Educational debriefing in prehospital medicine is complex. It requires the establishment of a safe learning environment, an understanding of participant agendas, and facilitator experience to maximise participant learning. Aspects unique to prehospital educational debriefing were identified, notably the unpredictable debriefing environment, interdisciplinary working, and the paradoxical benefit of educational obstacles for learning. This research also highlights aspects of educational debriefing not extensively detailed in the literature, such as compound participant learning, display of ‘professional honesty’ by facilitators, and facilitator learning, which require further exploration. Future research should also explore educational debriefing in other prehospital services.

Keywords: debriefing, prehospital medicine, prehospital medical education, pre-hospital care course

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Authors: Umukoro Omonigho Simon, Ashaolu David ‘Diya, Aroyewun-Olaleye Temitope Folashade

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The VELMA Action to Reduce Cybercrime (ARC) is an initiative, the first of its kind in Nigeria, designed to identify, rehabilitate and empower repentant cybercrime offenders popularly known as ‘yahoo boys’ in Nigerian parlance. Velma ARC provides social inclusion boot camps with the goal of rehabilitating cybercriminals via psychotherapeutic interventions, improving their IT skills, and empowering them to make constructive contributions to society. This report highlights the psychological interventions provided for participants of the maiden edition of the Velma ARC boot camp and presents the outcomes of these interventions. The boot camp was set up in a hotel premises which was booked solely for the 1 month event. The participants were selected and invited via the Velma online recruitment portal based on an objective double-blind selection process from a pool of potential participants who signified interest via the registration portal. The participants were first taken through psychological profiling (personality, symptomology and psychopathology) before the individual and group sessions began. They were profiled using the Minnesota Multiphasic Personality Inventory -2- Restructured Form (MMPI-2-RF), the latest version of its series. Individual psychotherapy sessions were conducted for all participants based on what was interpreted on their profiles. Focus group discussion was held later to discuss a movie titled ‘catch me if you can’ directed by Steven Spielberg, featuring Leonardo De Caprio and Tom Hanks. The movie was based on the true life story of Frank Abagnale, who was a notorious scammer and con artist in his youthful years. Emergent themes from the movie were discussed as psycho-educative parameters for the participants. The overall evaluation of outcomes from the VELMA ARC rehabilitation boot camp stemmed from a disaggregated assessment of observed changes which are summarized in the final report of the clinical psychologist and was detailed enough to infer genuine repentance and positive change in attitude towards cybercrime among the participants. Follow up services were incorporated to validate initial observations. This gives credence to the potency of the psycho-educative intervention provided during the Velma ARC boot camp. It was recommended that support and collaborations from the government and other agencies/individuals would assist the VELMA foundation in expanding the scope and quality of the Velma ARC initiative as an additional requirement for cybercrime offenders following incarceration.

Keywords: Velma-ARC, cybercrime offenders, rehabilitation, Nigeria

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Authors: Najma Najam, Rukhsana Kausar, Rabia Hussain Kanwal, Saira Batool, Anum Javed

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In Pakistan, elderly population though increasing but it has been neglected by the researchers and policy makers which resulted in compromised quality of life of the ageing population. Two regions, Punjab and Gilgit-Baltistan (GB) were selected for comparison as Lahore and Multan (Punjab) are highly urbanized, large cities whereas Gilgit and Skardu are remote and mountain bounded valleys in GB. This study focuses on psychological and emotional functioning of elderly and a series of measures translated and adapted in Urdu language was used to assess quality of life, psychological and mental well-being, actual and perceived social support, attachment patterns, forgiveness, affects, geriatric depression, and emotional disturbance patterns (depression, anxiety, and stress) in elderly. A gender-equated sample of 201 elderly participants, 93 from GB (60 from Gilgit, 33 from Skardu) and 108 from Punjab (61 from Lahore, 47 from Multan) with over 60 years age was collected from the multiethnic community of Punjab and GB through purposive convenient sampling technique. Findings revealed that elderly from Multan have better psychological and emotional functioning, higher levels of social support, tendency to forgive, better mental wellbeing and quality of life and lower levels of stress, anxiety, depression, negative affect and attachment avoidance and anxiety related to partner as compared to the elderly from Lahore. Furthermore, both elderly male of Gilgit & Skardu have adequate mental well-being including subjective well-being and psychological functioning which showed positive aspects of mental health but elderly female are more attached to their home and neighbourhood which shows their social and environmental mastery. Gilgiti elderly male reported more degree of positive affect such as enthusiasm, active, alertness, excitement and strong whereas among elderly from Skardu shows more negative affect i.e. aversive mood states, irritability, hostility, and general distress. The need of psychosocial therapy and family counseling for the elderly in urban areas has been identified, which can facilitate in reducing or preventing the depressive and stressful tendencies. The findings are expected to have implications for improving quality of life of the elderly, designing interventions, support system and rehabilitation services to help them. However, findings may attract attention of policy makers and researchers as currently this is the most neglected population in Pakistan.

Keywords: psychological, emotional, aging, elderly, quality of life

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Authors: Petra Hofmann, Dana Koniel, Jussi Luukkanen, Walter Nieminen, Lea Hannola, Ilkka Donoghue

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The Covid-19 pandemic forced people to isolate and become physically less connected. The pandemic hasnot only reshaped people’s behaviours and needs but also accelerated digital transformation (DT). DT of cities has become an imperative with the outlook of converting them into smart cities in the future. Embedding digital infrastructure and smart city initiatives as part of the normal design, construction, and operation of cities provides a unique opportunity to improve connection between people. Internet of Things (IoT) is an emerging technology and one of the drivers in DT. It has disrupted many industries by introducing different services and business models, and IoT solutions are being applied in multiple fields, including smart cities. As IoT and data are fundamentally linked together, IoT solutions can only create value if the data generated by the IoT devices is analysed properly. Extracting relevant conclusions and actionable insights by using established techniques, data analytics contributes significantly to the growth and success of IoT applications and investments. Companies must grasp DT and be prepared to redesign their offerings and business models to remain competitive in today’s marketplace. As there are many IoT solutions available today, the amount of data is tremendous. The challenge for companies is to understand what solutions to focus on and how to prioritise and which data to differentiate from the competition. This paper explains how IoT and data analytics can impact competitive advantage and how companies should approach IoT and data analytics to translate them into concrete offerings and solutions in the smart city context. The study was carried out as a qualitative, literature-based research. A case study is provided to validate the preservation of company’s competitive advantage through smart city solutions. The results of the researchcontribution provide insights into the different factors and considerations related to creating competitive advantage through IoT and data analytics deployment in the smart city context. Furthermore, this paper proposes a framework that merges the factors and considerations with examples of offerings and solutions in smart cities. The data collected through IoT devices, and the intelligent use of it, can create a competitive advantage to companies operating in smart city business. Companies should take into consideration the five forces of competition that shape industries and pay attention to the technological, organisational, and external contexts which define factors for consideration of competitive advantages in the field of IoT and data analytics. Companies that can utilise these key assets in their businesses will most likely conquer the markets and have a strong foothold in the smart city business.

Keywords: internet of things, data analytics, smart cities, competitive advantage

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Authors: Yeliz Cakir Kocak, Hafize Ozturk Can, Sibel Icke, Ummahan Yucel, Esin Ceber Turfan

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Introduction: Midwifery organization in Turkey became official in 1954 with the foundation of Midwifery Association. Today there are two Professional organizations representing midwives: ‘Midwifery Association’ and ‘Association for Education, Research and Development in Midwifery (AERDM)’. In recent years, conjuction with the increase in the numbers of midwives, professional consciousness and professional organization conscious is increasing. The undergraduates of Midwifery Department of Ege University İzmir Ataturk School of Health have come together for their professions when they’re stil students, so they founded ‘Midwifery Community of Ege University (MCEU) (EGEBET in Turkish)’ in counseling within structors and the confirmation of the university in 2013. Objective: The aim of this presentation is to reveal the activities and grades of an undergraduate community in-three-years, founded by the undergraduates in order to raise awareness in pregraduate Professional organization. Thus it is aimed to be aware towards postgraduate Professional organization, and to reflect Professional unity and solidarity, alongside personal development to midwifery services by maintaining Professional development. In-the-presentation it is aimed to explain what dimension the organization of midwifery students in Turkey is, and to be a stimulus so that ICM can be more active on undergraduate communities. Findings: MCEU’s an activity that has launched in the scope of Social Responsibility Lecture instructed in curricula of second grade in the Midwifery Department. The community have performed lots activities to reach their objectives between the years of 2013-2016. MCEU have had 65 members in a very-soon period. Today the community that goes on its activities on social network in order to abolish the distances and reach more midwifery students’ve 444 members. MCEU aiming to make all the students of the Midwifery Department a member of this association also accepts the applications of national and international midwifery students. More over the community has published two student periodical magazine and carries out activities on Midwifery Day each year. Conclusion: In conjuction with the national introduction of MCEU in the student congress in 2013, it has received consultancy from the members of MCEU as a sample model in the student organization of midwifery department of other universities in Turkey, and stil remains receiving. Furthermore a student community has been founded under the roof of association with the demand of community’s members. Also academician has a responsibility to give direction to the future and shape the future. Therefore, it is thought that the study can be an instance for all branches of science students and academics. Acknowledgment: We thank to founder members of MCEU and all the other students remaining to perform activities because of their contributions to Professional organization.

Keywords: current situation, midwifery, organization, student

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Authors: Saradiya Mukherjee

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Background: Indian Muslims, compared to their counterparts in other religions, generally do not fare well on many yardsticks related to socio-economic progress and the same is true with maternal health care utilization. Due to low age at marriage a major percentage of child birth is ascribed to young (15-24 years) Muslim mothers in, which pose serious concerns on the maternal health care of Young Married Muslim women (YMMW). A thorough search of past literature on Muslim women’s health and health care reveals that studies in India have mainly focused on religious differences in fertility levels and contraceptive use while the research on the determinants of maternal health care utilization among Muslim women are lacking in India. Data and Methods: Retrieving data from the National Family Health Survey -3 (2005-06) this study attempts to assess the level of utilization and factors effecting three key maternal health indicators (full ANC, safe delivery and PNC) among YMMW (15-24 years) in India. The key socio-economic and demographic variables taken as independent or predictor variables in the study was guided by existing literature particularly for India. Bi-variate analysis and chi square test was applied and variables which were found to be significant were further included in binary logistic regression. Results: The findings of the study reveal abysmally low levels of utilization for all three indicators i.e. full ANC, safe delivery and PNC of maternal health care included in the study. Mother’s education, mass media exposure, women’s autonomy, birth order, economic status wanted status of child and region of residence were found to be significant variables effecting maternal health care utilization among YMMW. Multivariate analysis reveals that no mass media exposure, lower autonomy, education, poor economic background, higher birth order and unintended pregnancy are some of the reasons behind low maternal health care utilization. Conclusion: Considering the low level of safe maternal health care utilization and its proximate determinants among YMMW the study suggests educating Muslim girls, promoting family planning use, involving media and collaboration between religious leader and health care system could be some important policy level interventions to address the unmet need of maternity services among YMMW.

Keywords: young Muslim women, religion, socio-economic condition, antenatal care, delivery, post natal care

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Authors: Abdelmanie Suleimat, Nagham Abu Shaqra, Sawsan Majali, Issam Adawi, Heba Abo Shindi, Anas Al Mohtaseb

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The Government of Jordan recognizes that maternal mortality constitutes a grave public health problem. Over the past two decades, there has been significant progress in improving the quality of maternal health services, resulting in improved maternal and child health outcomes. Despite these efforts, measurement and analysis of maternal mortality remained a challenge, with significant discrepancies from previous national surveys that inhibited accuracy. In response with support from USAID, the Jordan Maternal Mortality Surveillance Response (JMMSR) System was established to collect, analyze, and equip policymakers with data for decision-making guided by interdisciplinary multi-levelled advisory groups aiming to eliminate preventable maternal deaths, A 2016 Public Health Bylaw required the notification of deaths among women of reproductive age. The JMMSR system was launched in 2018 and continues annually, analyzing data received from health facilities, to guide policy to prevent avoidable deaths. To date, there have been four annual national maternal mortality reports (2018-2021). Data is collected, reviewed by advisory groups, and then consolidated in an annual report to inform and guide the Ministry of Health (MOH); JMMSR collects the necessary information to calculate an accurate maternal mortality ratio and assists in identifying leading causes and contributing factors for each maternal death. Based on this data, national response plans are created. A monitoring and evaluation plan was designed to define, track, and improve implementation through indicators. Over the past four years, one of these indicators, ‘percent of facilities notifying respective health directorates of all deaths of women of reproductive age,’ increased annually from 82.16%, 92.95%, and 92.50% to 97.02%, respectively. The Government of Jordan demonstrated commitment to the JMMSR system by designating the MOH to primarily host the system and lead the development and dissemination of policies and procedures to standardize implementation. The data was translated into practical and evidence-based recommendations. The successful impact of results deepened the understanding of maternal mortality in Jordan, which convinced the MOH to amend the Bylaw now mandating electronic reporting of all births and neonatal deaths from health facilities to empower the JMMSR system, by developing a stillbirths and neonatal mortality surveillance and response system.

Keywords: maternal health, maternal mortality, preventable maternal deaths, maternal morbidity

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Authors: Shyam lamsal

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Introduction: Karnali Academy of Health Sciences (KAHS) has been established in 2011, by an Act of parliament of Nepal, in Jumla, to provide health services in easy way in backward areas, to produce skilled health professionals & conduct research. The backward areas mentioned in act of KAHS are Humla, Jumla, Kalikot, Dolpa, Mugu districts of Karnali zone, Jajarkot district of Bheri zone & Bajura, Baghang & Achham districts of Seti zone in Nepal occupying around 25 % of the total national geography. Backward area of Nepal is specific to having worst health indicators with life expectancy (47 years), HDI (0.35), Literacy rate (58%), global acute malnutrition (13%), crude birth rate (33.6), crude death rate (9.6), Total fertility rate (4.2), infant mortality rate (61.5 per 1000 live births), under five mortality rate (59 per 1000 live births) and maternal mortality ratio (400 per 1000 live births). History of health facilities in backward region: All the nine districts of this region have a district hospital with very few grass root level health manpower. Government of Nepal regularly deploys one or two medical officers to each district who generally are not regular to their care. Jumla district itself was having one medical officer before the establishment of KAHS. Development activities: Establishment of 100 bedded specialty teaching hospital with 10 medical officers and five specialists, accredited its own nursing school for running diploma nursing programme, started “Karnali health survey” which covers 55 thousand households of backward region, started community care and school health camps, planning phase completed for 300 bedded teaching hospital construction. Future Plan: Expansion of the teaching hospital to 300 beds within 3 years, start health assistant and bachelor midwifery course in 2015 AD, start bachelor in laboratory and bachelor in public health course in 2016 AD and start MBBS course in 2018 AD. Deploy the medical officers and family physicians to all the district hospitals within 3 years. KAHS provides reservation up to 45% students from backward region with the commitment to stay for at least five years of their service period. Conclusion: This institution may be the example for the rest of the world in providing nursing care, education in remote areas as well as the best model for nursing manpower retention in remote areas of developing countries.

Keywords: backward area, nursing school

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Authors: I. Gupta, N. Setia

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Introduction. Buyer conduct is a progression of practices or examples that buyers pursue before making a buy. It begins when the shopper ends up mindful of a need or wish for an item, at that point finishes up with the buying exchange. Business visionaries can't generally simply shake hands with their intended interest group people and become more acquainted with them. Research is often necessary, so every organization primarily involves doing continuous research to understand and satisfy consumer needs pattern. Aims and Objectives: The aim of the present study is to examine the different behaviors of the consumer, including pre-purchase, purchase, and post-purchase behavior. Materials and Methods: In order to get results, face to face interview held with 80 people which comprise a larger part of female individuals having upper as well as middle-class status. The prime source of data collection was primary. However, the study has also used the theoretical contribution of many researchers in their respective field. Results: Majority of the respondents were females (70%) from the age group of 20-50. The collected data was analyzed through hypothesis testing statistical techniques such as correlation analysis, single regression analysis, and ANOVA which has rejected the null hypothesis that there is no relation between researching the consumer behavior at different stages and organizational performance. The real finding of this study is that simply focusing on the buying part isn't enough to gain profits and fame, however, understanding the pre, buy and post-buy behavior of consumer performs a huge role in organization success. The outcomes demonstrated that the organization, which deals with the three phases of research of purchasing conduct is able to establish a great brand image as compare to their competitors. Alongside, enterprises can observe customer conduct in a considerably more proficient manner. Conclusion: The analyses of consumer behavior presented in this study is an attempt to understand the factors affecting consumer purchasing behavior. This study has revealed that those corporations are more successful, which work on understanding buying behavior instead to just focus on the selling products. As a result, organizations perform good and grow rapidly because consumers are the one who can make or break the company. The interviews that were conducted face to face, clearly revealed that those organizations become at top-notch whom consumers are satisfied, not just with product but also with services of the company. The study is not targeting the particular class of audience; however, it brings out benefits to the masses, in particular to business organizations.

Keywords: consumer behavior, pre purchase, post purchase, consumer satisfaction

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Authors: Chukwuka Justus Iwegbu

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Background: A major concern facing the world is providing senior citizens, individuals with disabilities, and other vulnerable groups with high-quality care. This issue is more serious in Nigeria's North Eastern area, where the burden of disease and disability is heavy, and access to care is constrained. This study aims to fill this gap by exploring the roles, challenges and support needs of caregivers, care home management, funding and administration in challenged communities in North Eastern Nigeria. The study will also provide a comprehensive understanding of the current situation and identify opportunities for improving the quality of care and support for caregivers and care recipients in these communities. Methods: A mixed-methods design, including both quantitative and qualitative data collection methods, will be used, and it will be guided by the stress process model of caregiving. The qualitative stage approach will comprise a survey, In-depth interviews, observations, and focus group discussion and the quantitative analysis will be used in order to comprehend the variations between caregiver's roles and care home management. A review of relevant documents, such as care home policies and funding reports, would be used to gather quantitative data on the administrative and financial aspects of care. The data collected will be analyzed using both descriptive statistics and thematic analysis. A sample size of around 200-300 participants, including caregivers, care recipients, care home managers and administrators, policymakers and health care providers, would be recruited. Findings: The study revealed that caregivers in challenged communities in North Eastern Nigeria face significant challenges, including lack of training and support, limited access to funding and resources, and high levels of burnout. Care home management and administration were also found to be inadequate, with a lack of clear policies and procedures and limited oversight and accountability. Conclusion: There is a need for increased investment in training and support for caregivers, as well as a need for improved care home management and administration in challenged communities in North Eastern Nigeria. It also highlights the importance of involving community members in decision-making and planning processes related to care homes and services. The study would contribute to the existing body of knowledge by providing a detailed understanding of the challenges faced by caregivers, care home managers and administrators.

Keywords: caregivers, care home management, funding, administration, challenge communities, North Eastern Nigeria

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Authors: Masilonyane Mokhele

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Across the world, different planning models of the so-called airport-led developments are becoming bandwagons hailed as key to the future of cities. However, in the existing knowledge, there is paucity of empirically informed description and explanation of the economic fundamentals driving the forces of attraction of airports. This void is arguably a result of the absence of an appropriate theoretical framework to guide the analyses. Given this paucity, the aim of the paper is to contribute towards a theoretical framework that could be used to describe and explain forces that drive the location and mix of airport-centric developments. Towards achieving this aim, the objectives of the paper are: one, to establish the type of economic activities that are located on and around O.R. Tambo International Airport (ORTIA), and analyse the reasons for locating there; two, to establish changes that have occurred over time in the form of the airport-centric development of ORTIA; three, to identify the propulsive economic qualities of ORTIA; four, to analyse the spatial, economic and structural linkages within the airport-centric development of ORTIA, between the airport-centric development and the airport, as well as the airport-centric development’s linkages with their metropolitan area and other regional, national and international airport-centric developments and locations. To address the objectives above, the study adopted a case study approach, centred on ORTIA in South Africa: Africa’s busiest airport in terms of passengers and airfreight handled. Using a lens of location theory, a survey was adopted as a main research method, wherein telephonic interviews were conducted with a representative number of firms on and around ORTIA. Other data collection methods encompassed in-depth qualitative interviews (to augment the information obtained through the survey) and analysis of secondary information, particularly as regards establishing changes that have occurred in the form of ORTIA and surrounds. From the empirical findings, ORTIA was discovered to have propulsive economic qualities that act as significant forces of attraction in the clustering of firms. Together with its airport-centric development, ORTIA was discovered to have growth pole properties because of the linkages that occur within the study area, and the linkages that exist between the airport-centric firms and the airport. It was noted that the transport-oriented firms (typified by couriers and freight carriers) act as anchors in some fellow airport-centric firms making use of elements of urbanisation economies, particularly as regards the use of the airport for airfreight services. The empirical findings presented in the paper (in conjunction with results from other airport-centric development case studies) could be used as contribution towards extending theory that describes and explains forces that drive the location and mix of airport-centric developments.

Keywords: airports, airport-centric development, O. R. Tambo international airport, South Africa

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Authors: Ergham Al Bachir

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This study adopts strategic leadership (Upper Echelons) as the core theory and contextual leadership theory as the research lens. This research asks how the external context impacts strategic leadership effectiveness to achieve the outcomes in pluralistic organizations (PO). The study explores how the context influences the selection of CEOs, top management teams (TMT), and their leadership effectiveness. POs are characterized by the multiple objectives of their top management teams, divergent objectives, multiple strategies, and multiple governing authorities. The research question is explored by means of a qualitative multiple-case study focusing on healthcare, real estate, and financial services organizations. The data sources are semi-structured interviews, documents, and direct observations. The data analysis strategy is inductive and deploys thematic analysis and cross-case synthesis. The findings differentiate between national and international CEOs' delegation of authority and relationship with the Board of Directors. The findings identify the elements of the dynamic context that influence TMT and PO outcomes. The emergent hybrid strategic and contextual leadership framework shows how the different contextual factors influence strategic direction, PO context, selection of CEOs and TMT, and the outcomes in four pluralistic organizations. The study offers seven theoretical contributions to Upper Echelons, strategic leadership, and contextual leadership research. (1) The integration of two theories revealed how CEO’s impact on the organization is complementary to the contextual impact. (2) Conducting this study in the Middle East contributes to strategic leadership and contextual leadership research. (3) The demonstration of the significant contextual effects on the selection of CEOs. (4 and 5) Two contributions revealed new links between the context, the Board role, internal versus external CEOs, and national versus international CEOs. (6 and 7) This study offered two definitions: what accounts for CEO leadership effectiveness and organizational outcomes. Two methodological contributions were also identified: (1) Previous strategic leadership and Upper Echelons research are mainly quantitative, while this study adopts qualitative multiple-case research with face-to-face interviews. (2) The extrication of the CEO from the TMT advanced the data analysis in strategic leadership research. Four contributions are offered to practice: (1) The CEO's leadership effectiveness inside and outside the organization. (2) Rapid turnover of predecessor CEOs signifies the need for a strategic and contextual approach to CEOs' succession. (3) TMT composition and education impact on TMT-CEO and TMT-TMT interface. (4) Multilevel strategic contextual leadership development framework.

Keywords: strategic leadership, contextual leadership, upper echelons, pluralistic organizations, cross-cultural leadership

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Authors: Riofrio Jonathan, Fernandez Guillermo

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Renewable energy represented around 80% of the energy matrix for power generation in Ecuador during 2020, so the deployment of current public policies is focused on taking advantage of the high presence of renewable sources to carry out several electrification projects. These projects are part of the portfolio sent to the United Nations Framework on Climate Change (UNFCCC) as a commitment to reduce greenhouse gas emissions (GHG) in the established national determined contribution (NDC). In this sense, the Ecuadorian Organic Energy Efficiency Law (LOEE) published in 2019 promotes E-mobility as one of the main milestones. In fact, it states that the new vehicles for urban and interurban usage must be E-buses since 2025. As a result, and for a successful implementation of this technological change in a national context, it is important to deploy land surveys focused on technical and geographical areas to keep the quality of services in both the electricity and transport sectors. Therefore, this research presents a technological and energy comparison between a conventional diesel bus and its equivalent E-bus. Both vehicles fulfill all the technical requirements to ride in the study-case city, which is Ambato in the province of Tungurahua-Ecuador. In addition, the analysis includes the development of a model for the energy estimation of both technologies that are especially applied in a highland city such as Ambato. The altimetry of the most important bus routes in the city varies from 2557 to 3200 m.a.s.l., respectively, for the lowest and highest points. These operation conditions provide a grade of novelty to this paper. Complementary, the technical specifications of diesel buses are defined following the common features of buses registered in Ambato. On the other hand, the specifications for E-buses come from the most common units introduced in Latin America because there is not enough evidence in similar cities at the moment. The achieved results will be good input data for decision-makers since electric demand forecast, energy savings, costs, and greenhouse gases emissions are computed. Indeed, GHG is important because it allows reporting the transparency framework that it is part of the Paris Agreement. Finally, the presented results correspond to stage I of the called project “Analysis and Prospective of Electromobility in Ecuador and Energy Mix towards 2030” supported by Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ).

Keywords: high altitude cities, energy planning, NDC, e-buses, e-mobility

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Authors: B. M. M. D. Mendis, L. I. Rajapaksa, P. S. K. Gunathunga, R. C. Fernando, M. Jayalath

Abstract:

Background / introduction: During the year 2011, 8511 males received services from the sexual health clinics island wide. At present there is only limited information on the risk behaviours of male attendees. Information on risk behaviours related to STI /HIV transmission is helpful in planning suitable prevention interventions. Aim(s)/objectives: The objectives were to determines the sexual partners (other than the marital partner and regular partners) responsible for transmitting STI( Sexually transmitted infections)/ HIV and to understand the practice of safer sex. Methods: Study was a clinic based prospective study conducted for a one year period using an interviewer administered questionnaire. Results: 983 attendees were interviewed. . Mean age was 34.02 years. 75% of the sample had completed GCE O/L (ordinary level examination). Skilled labourers, drivers and forces/police comprised 40% of the sample. 50% admitted sex with a casual female, 12% with a casual male, and 13% with CSW (commercial sex workers) while MSW (male sex workers) exposures were minimal. It was identified that younger males had more contacts with males, and regular female partners while more older males with CSW. Anal sex among males was reported by 11.5%. 20.5% used alcohol frequently and 5.9% used drugs and 1.4% injected. Common STI were genital herpes (7.9%), Non gonococcal urethritis (6.2%) and gonorrhoea (6.2%). Among those who had contacts with FSW 6.7% gonorrhoea (GC), 8.2% non gonococcal urethritis (NGU), 7.5% genital herpes and 0.7% HIV. Non regular partner exposures 3.7% had gonorrhoea, 8.3% NGU, 6.6% genital herpes and 0.8% HIV. Among MSM contacts 10.6% had GC, 4.5% NGU, 5.3% genital herpes, 5.3% secondary syphilis and 0.8% HIV. Only 9.0% used condoms correctly. Friends, doctors, newspapers, internet, and forces were important sources of information on condoms. Non use of condoms were due to worry about satisfaction (24.6%) and faith in the partner (25.6%). Discussion/conclusion: Casual partners for unsafe sex is a concern. MSM and CSW are remained as an important source of infection. Early Syphilis and gonorrhoea infections were mostly seen among MSM exposures. The findings indicate that the male population in the sample had satisfactory education. However, still the unsafe sexual contacts are common. . Newspapers, internet were more important sources of information on condoms. Low condom use remains another concern.. More males contracted STI through casual partners. Therefore strategies used for prevention need to be revisited also emphasizing on general population where casual partners represent. . Increasing awareness of men and women through mass media and primary health care teams may be important strategies that can be used to keep the HIV epidemic in a low level.

Keywords: STI, HIV, Males, safe sex practices

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Authors: Rinat Gabbay-Benziv, Merav Ben-Natan, Ariel Roguin, Benyamine Abbou, Anna Ofir, Adi Klein, Dikla Dahan-Shriki, Mordechai Hallak, Boris Kessel, Mickey Dudkiewicz

Abstract:

Introduction: Over recent decades, technology has become integral to healthcare, with electronic health records and advanced medical equipment now standard. However, this reliance has made healthcare systems increasingly vulnerable to ransomware attacks. On October 13, 2021, Hillel Yaffe Medical Center experienced a severe ransomware attack that disrupted all IT systems, including electronic health records, laboratory services, and staff communications. The attack, carried out by the group DeepBlueMagic, utilized advanced encryption to lock the hospital's systems and demanded a ransom. This incident caused significant operational and patient care challenges, particularly impacting the obstetrics department. Objective: The objective is to describe the challenges facing the obstetric division following a cyberattack and discuss ways of preparing for and overcoming another one. Methods: A retrospective descriptive study was conducted in a mid-sized medical center. Division activities, including the number of deliveries, cesarean sections, emergency room visits, admissions, maternal-fetal medicine department occupancy, and ambulatory encounters, from 2 weeks before the attack to 8 weeks following it (a total of 11 weeks), were compared with the retrospective period in 2019 (pre-COVID-19). In addition, we present the challenges and adaptation measures taken at the division and hospital levels leading up to the resumption of full division activity. Results: On the day of the cyberattack, critical decisions were made. The media announced the event, calling on patients not to come to our hospital. Also, all elective activities other than cesarean deliveries were stopped. The number of deliveries, admissions, and both emergency room and ambulatory clinic visits decreased by 5%–10% overall for 11 weeks, reflecting the decrease in division activity. Nevertheless, in all stations, there were sufficient activities and adaptation measures to ensure patient safety, decision-making, and workflow of patients were accounted for. Conclusions: The risk of ransomware cyberattacks is growing. Healthcare systems at all levels should recognize this threat and have protocols for dealing with them once they occur.

Keywords: ransomware attack, healthcare cybersecurity, obstetrics challenges, IT system disruption

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Authors: Yali Liu, Maria Avello Iturriagagoitia

Abstract:

Background: Fitness applications (apps) are one of the most popular mobile health (mHealth) apps. These apps can help prevent/control health issues such as obesity, which is one of the most serious public health challenges in the developed world in recent decades. Compared with the traditional intervention like face-to-face treatment, it is cheaper and more convenient to use fitness apps to interfere with physical activities and healthy behaviors. Nevertheless, fitness applications apps tend to have high abandonment rates and low levels of user engagement. Therefore, maintaining the endurance of users' usage is challenging. In fact, previous research shows a variety of strategies -goal-setting, self-monitoring, coaching, etc.- for promoting fitness and health behavior change. These strategies can influence the users’ perseverance and self-monitoring of the program as well as favoring their adherence to routines that involve a long-term behavioral change. However, commercial fitness apps rarely incorporate these strategies into their design, thus leading to a lack of engagement with the apps. Most of today’s mobile services and brands engage their users proactively via push notifications. Push notifications. These notifications are visual or auditory alerts to inform mobile users about a wide range of topics that entails an effective and personal mean of communication between the app and the user. One of the research purposes of this article is to implement the application of behavior change strategies through push notifications. Proposes: This study aims to better understand the influence that effective use of push notifications combined with the behavioral change strategies will have on users’ engagement with the fitness app. And the secondary objectives are 1) to discuss the sociodemographic differences in utilization of push notifications of fitness apps; 2) to determine the impact of each strategy in customer engagement. Methods: The study uses a combination of the Consumer Engagement Theory and UTAUT2 based model to conduct an online survey among current users of fitness apps. The questionnaire assessed attitudes to each behavioral change strategy, and sociodemographic variables. Findings: Results show the positive effect of push notifications in the generation of consumer engagement and the different impacts of each strategy among different groups of population in customer engagement. Conclusions: Fitness apps with behavior change strategies have a positive impact on increasing users’ usage time and customer engagement. Theoretical experts can participate in designing fitness applications, along with technical designers.

Keywords: behavioral change, customer engagement, fitness app, push notification, UTAUT2

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Authors: Nora Alomar, Bianca Alexandra Stefa, Saleh Bazi

Abstract:

This research uncovers the determinants that drive millennial consumers to adhere to product return of fast-fashion products purchases via e-commerce and what effects it has on consumer experience and satisfaction. Online consumption has skyrocketed, with e-commerce being the only, most reliable, and safe method of shopping during and post Covid-19. It has been noted customers are demanding a wide variety of product characteristics and a generous optimal return policy. The authors have selected to examine millennial consumers as they are digital natives and have an affinity for researching, reading product reviews, and shopping online, with a great spending power due to a higher disposable income in comparison to other generations. A multi-study approach is adopted, where study one (interviews, sample of 20 respondents) investigates the factors that drive product return, and study two (PLS-SEM, sample of 250 respondents) looks into the relationships of product return management against behavioral outcomes by having the generated factors (from study one) as moderators. Five themes are generated from study one (return policies, product characteristics, delivery lead time, seasonality, product trial & overspending). The authors identify that two out of the five factors (seasonality, product trial & overspending) have not been highlighted by the literature. The paper examines 11 hypotheses, where 10 are supported. Findings highlight the quality of the product return management influences the overall millennial customer experience and satisfaction. Findings also indicate that product return management was identified to have a significant negative effect on customer experience. Additionally, seasonality has a significant but negative moderation, which means increasing seasonality decreases the relationship between product return management and customer experience and satisfaction. Results highlight that return policies have a significant negative influence on the relationship between returning a product and customer experience and satisfaction. Moreover, product characteristics are also identified to have a significant negative influence on the relationship between returning a product and customer experience and satisfaction. This study further examines the influence of the factors on direct e-commerce websites and third-party e-commerce websites. Findings showcase a strong statistical significance for the increased rate of return of fast-fashion products on third-party websites. This paper aids practitioners in taking strategic decisions related to return management, to improve the quality of logistical services and, in turn, increase profitability.

Keywords: customer experience, customer satisfaction, e-commerce, fast-fashion, product returns

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Authors: Bisemiire Anthony,

Abstract:

PESH Poultry is a business project proposed specifically to solve unemployment and income-related problems affecting the youths in the Busia district. The project is intended to transform the life of the youth in terms of economic, social and behavioral, as well as the domestic well-being of the community at large. PESH Poultry is a start-up poultry farm that will be engaged in the keeping of poultry birds, broilers and layers for the production of quality and affordable poultry meat and eggs respectively and other poultry derivatives targeting consumers in eastern Uganda, for example, hotels, restaurants, households and bakeries. We intend to use a semi-intensive system of farming, where water and some food are provided in a separate nighttime shelter for the birds; our location will be in Lumino, Busia district. The poultry project will be established and owned by Bisemiire Anthony, Nandera Patience, Naula Justine, Bwire Benjamin and other investors. The farm will be managed and directed by Nandera Patience, who has five years of work experience and business administration knowledge. We will sell poultry products, including poultry eggs, chicken meat, feathers and poultry manure. We also offer consultancy services for poultry farming. Our eggs and chicken meat are hygienic, rich in protein and high quality. We produce processes and packages to meet the standard organization of Uganda and international standards. The business project shall comprise five (5) workers on the key management team who will share various roles and responsibilities in the identified business functions such as marketing, finance and other related poultry farming activities. PESH Poultry seeks 30 million Ugandan shillings in long-term financing to cover start-up costs, equipment, building expenses and working capital. Funding for the launch of the business will be provided primarily by equity from the investors. The business will reach positive cash flow in its first year of operation, allowing for the expected repayment of its loan obligations. Revenue will top UGX 11,750,000, and net income will reach about UGX115 950,000 in the 1st year of operation. The payback period for our project is 2 years and 3 months. The farm plans on starting with 1000 layer birds and 1000 broiler birds, 20 workers in the first year of operation.

Keywords: chicken, pullets, turkey, ducks

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Authors: Patience Manjengwa-Hungwe, Carmen White

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Background: Odyssean malaria refers to malaria acquired by infected mosquito bites from malaria endemic to non-endemic regions by mechanical modes of transport, such as airplanes, water vessels, trains and vehicles. Odyssean Malaria is rare and is characterised by absence of travel history to malaria endemic areas. As not anticipated in non-endemic areas, late diagnosis and treatment lead to a high case fatality rate. On 26 September 2014, the Outbreak Response Unit at the National Institute of Communicable Diseases was notified of a suspected death from Odyssean Malaria in Johannesburg, Gauteng Province, a non-endemic area. The main objective of this investigation was to identify the etiological agent's mode and source of transmission. Methods: Epidemiological surveys were conducted with the deceased’s family and clinical details were obtained from doctors who treated the victim in Southrand, Johannesburg. Blood samples were collected prior to death and sent to the National Health Laboratory Services, Johannesburg laboratory for a full blood count, urea electrolytes, creatinine, and C-reactive protein. Environmental assessments and entomological investigations, including collection of mosquito and larvae, were conducted at the deceased’s home and surrounding areas and sent to the laboratory for analysis. Results: Epidemiological surveys revealed no travel history, no mechanical transmission through blood transfusion and no previous possible exposure of the victim to malaria mosquitoes. Laboratory findings indicated that the platelet count was low. A further smear revealed that the malaria parasite was present and malaria antigen for P. falciparum was positive. Entomological findings revealed that none of the six adult or larval mosquitoes collected on site were malaria vectors. Dumping sites found at the back of the house were identified as possible sites where mosquitoes from endemic places could possibly breed. Conclusion: Given that there was no travel history or the possibility of mechanical transmission (blood transfusion or needle), the research team concluded that it is highly probable that the infection was acquired through an infective Anopheles mosquito inadvertently translocated from a Malaria endemic area by mechanical modes of transport. We recommend that clinicians in non-endemic malaria areas be aware of this type of malaria and test for malaria in patients showing malaria-like symptoms.

Keywords: Odyssean Malaria, vector Bourne, malaria, epidemiological surveys

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Authors: Kollie B. Dogba, Willis Oluoch-Kosura, Chepchumba Chumo

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In Liberia, many of the agricultural households cultivate cassava for either sustenance purposes, or to generate farm income. Many of the concentrated cassava farmers reside in Nimba, a north-eastern County that borders two other economies: the Republics of Cote D’Ivoire and Guinea. With a high demand for cassava output and products in emerging Asian markets coupled with an objective of the Liberia agriculture policies to increase the competitiveness of valued agriculture crops; there is a need to examine the level of resource-use efficiency for many agriculture crops. However, there is a scarcity of information on the efficiency of many agriculture crops, including cassava. Hence the study applying an output-oriented method seeks to assess the economic efficiency of cassava farmers in Nimba County, Liberia. A multi-stage sampling technique was employed to generate a sample for the study. From 216 cassava farmers, data related to on-farm attributes, socio-economic and institutional factors were collected. The stochastic frontier models, using the Translog functional forms, of production and revenue, were used to determine the level of revenue efficiency and its determinants. The result showed that most of the cassava farmers are male (60%). Many of the farmers are either married, engaged or living together with a spouse (83%), with a mean household size of nine persons. Farmland is prevalently obtained by inheritance (95%), average farm size is 1.34 hectares, and most cassava farmers did not access agriculture credits (76%) and extension services (91%). The mean cassava output per hectare is 1,506.02 kg, which estimates average revenue of L$23,551.16 (Liberian dollars). Empirical results showed that the revenue efficiency of cassava farmers varies from 0.1% to 73.5%; with the mean revenue efficiency of 12.9%. This indicates that on average, there is a vast potential of 87.1% to increase the economic efficiency of cassava farmers in Nimba by improving technical and allocative efficiencies. For the significant determinants of revenue efficiency, age and group membership had negative effects on revenue efficiency of cassava production; while farming experience, access to extension, formal education, and average wage rate have positive effects. The study recommends the setting-up and incentivizing of farmer field schools for cassava farmers to primarily share their farming experiences with others and to learn robust cultivation techniques of sustainable agriculture. Also, farm managers and farmers should consider a fix wage rate in labor contracts for all stages of cassava farming.

Keywords: economic efficiency, frontier production and revenue functions, Nimba County, Liberia, output-oriented approach, revenue efficiency, sustainable agriculture

Procedia PDF Downloads 127

Authors: Bollu Mounica

Abstract:

Background: Nowadays drug related problems were seen very commonly within the health care practice. These could result in the medication errors, adverse events, drug interactions and harm to patients. Pharmacist has an identified role in minimizing and preventing such type of problems. Objectives: To detect the incidence of drug related problems for the hospitalized patient, and to analyze the clinical pharmacist interventions performed during the review of prescription orders of the general medicine, psychiatry, surgery, pediatrics, gynaecology units of a large tertiary care teaching hospital. Methods: It was a retrospective, observational and interventional study. The analysis took place daily with the following parameters: dose, rate of administration, presentation and/or dosage form, presence of inappropriate/unnecessary drugs, necessity of additional medication, more proper alternative therapies, presence of relevant drug interactions, inconsistencies in prescription orders, physical-chemical incompatibilities/solution stability. From this evaluation, the drug therapy problems were classified, as well as the resulting clinical interventions. For a period starting November 2012 until December 2014, the inpatient medication charts and orders were identified and rectified by ward and practicing clinical pharmacists within the inpatient pharmacy services in a tertiary care teaching hospital on routine daily activities. Data was collected and evaluated. The causes of this problem were identified. Results: A total of 360 patients were followed. Male (71.66%) predominance was noted over females (28.33%). Drug related problems were more commonly seen in patients aged in between 31-60. Most of the DRP observed in the study resulted from the dispensing errors (26.11%), improper drug selection (17.22%), followed by untreated indications (14.4%) Majority of the clinical pharmacist recommendations were on need for proper dispensing (26.11%), and drug change (18.05%). Minor significance of DRPs were noted high (41.11 %), whereas (35.27 %) were moderate and (23.61 %) were major. The acceptance rate of intervening clinical pharmacist recommendation and change in drug therapy was found to be high (86.66%). Conclusion: Our study showed that the prescriptions reviewed had some drug therapy problem and the pharmacist interventions have promoted positive changes needed in the prescriptions. In this context, routine participation of clinical pharmacists in clinical medical rounds facilitates the identification of DRPs and may prevent their occurrence.

Keywords: drug related problems, clinical pharmacist, drug prescriptions, drug related problems, intervention

Procedia PDF Downloads 304

Authors: Zhaozhang Sun

Abstract:

Health communication is essential in promoting healthy lifestyles, preventing unhealthy behaviours, managing disease conditions, and eventually reducing health disparities. Nowadays, social media provides unprecedented opportunities for enhancing health communication for both healthcare providers and people with health conditions, including self-management of chronic conditions such as diabetes. Meanwhile, a special group of active social media users have started playing a pivotal role in providing health ‘solutions’. Such individuals are often referred to as ‘influencers’ because of their ‘central’ position in the online communication system and the persuasive effect their actions and advice may have on audiences' health-related knowledge, attitudes, confidence and behaviours. Work on social media influencers (SMIs) has gained much attention in a specific research field of “influencer marketing”, which mainly focuses on emphasising the use of SMIs to promote or endorse brands’ products and services in the business. Yet to date, a lack of well-studied and empirical evidence has been conducted to guide the exploration of health-related social media influencers. The failure to investigate health-related SMIs can significantly limit the effectiveness of communicating health on social media. Therefore, this article presents a study to identify key diabetes-related SMIs in the UK and the potential implications of information provided by identified social media influencers on their audiences’ diabetes-related knowledge, attitudes and behaviours to bridge the research gap that exists in linking work on influencers in marketing to health communication. The multidisciplinary theories and methods in social media, communication, marketing and diabetes have been adopted, seeking to provide a more practical and promising approach to investigate the potential of social media influencers in health communication. Twitter was chosen as the social media platform to initially identify health influencers and the Twitter API academic was used to extract all the qualitative data. Health-related Influencer Identification Model was developed based on social network analysis, analytic hierarchy process and other screening criteria. Meanwhile, a two-section English-version online questionnaire has been developed to explore the potential implications of social media influencers’ (SMI’s) diabetes-related narratives on the health-related knowledge, attitudes and behaviours (KAB) of their audience. The paper is organised as follows: first, the theoretical and research background of health communication and social media influencers was discussed. Second, the methodology was described by illustrating the model for the identification of health-related SMIs and the development process of the SMIKAB instrument, followed by the results and discussions. The limitations and contributions of this study were highlighted in the summary.

Keywords: health communication, Interdisciplinary research, social media influencers, diabetes management

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Authors: Ilona Pavlovska, Aneka Klavina, Agris Auce, Ivars Vanadzins, Alise Silova, Laura Komarovska, Linda Paegle, Baiba Silamikele, Linda Dobkevica

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Freshwater sapropel is a common material formed by complex biological transformations of Holocene sediments in the water basement of the lakes in Latvia that has the potential to be used as medical mud. Sapropel forms over a long period in shallow waters by slowly decomposing organic sediment and has different compositions depending on the location of the source, surroundings, the water regime, etc. Official geological survey of Latvia lakes, from Latvian lake database (ezeri.lv), used in the selection of the area of the exploration. The multifunctional effect of sapropel on the whole organism explained by its complex chemical and biological structure. This unique, organic substance and its ability to maintain heat for a long time ensures deep tissue warming and has a positive effect on the treatment of various joint and skin diseases. Sapropel is a valuable resource with multiple areas of application. Investigation of sapropel sediments and survey of the five sites selected according to the criteria performed in the current study. Also, our study includes sampling at different depths and their initial treatment, evaluation of external signs, and study of physical-chemical parameters, as well as analysis of biochemical parameters and evaluation of microbiological indicators. The main selection criteria were sapropel deposits depth, hydrological regime, the history of agriculture next to the lake, and the potential exposure to industrial waste. One hundred and five sapropel samples obtained from five lakes (Audzelu, Dunakla, Ivusku, Zielu, and Mazars Kivdalova) during the wintertime. The main goal of the study is to carry out detailed and systematic research on the medical properties of sapropel to be obtained in Latvia, to promote its scientifically based use in balneology, to develop new medical procedures and services, and to promote the development of new exportable products. Latvian freshwater sapropel could be used as raw material for getting sapropel extract and use it as a remedy. All mentioned above brings us to the main question for sapropel usage in medicine, balneology, and pharmacy “how to develop quality criteria for raw sapropel and its extracts. The research was co-financed by the project "Analysis of characteristics of medical sapropel and its usage for medical purposes and elaboration of industrial extraction methods" No.1.1.1.1/16/A/165.

Keywords: balneology, extracts, freshwater sapropel, Latvian lakes, medical mud, sapropel

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Authors: Ingrid Van Der Heijden, Naeemah Abrahams, Jane Harries

Abstract:

Background: Commonly, womanhood is defined as the qualities considered to be natural to or characteristic of a woman. However, womanhood is not a static concept; it is contextual and negotiable. For women with disabilities, gender roles or ‘qualities’ of womanhood are often overstated or contradicted because of assumptions of weakness, passivity, asexuality and infertility. Currently, little is known about how disability stigma intersects with notions of womanhood to make women with disabilities vulnerable to violence, or how women navigate this intersection to prevent or protect themselves from violence. Objective: To describe how the stigmatized constructions of womanhood and disability promote women with physical disabilities’ exposure to or protection from violence. Methods: Qualitative data for this paper comes from a doctoral study involving women with disabilities living in Cape Town, South Africa. It presents data from repeat in-depth interviews with 30 women with a range of physical impairments. Women attending protective workshops, rehabilitative centers and residential care facilities for people living with disabilities were invited to participate. Consent procedures and interviews were conducted by the first author (who is herself a woman living with a physical disability), and a female research assistant/translator who is a qualified occupational therapist. Reasonable accommodation is central to the methodology and the study as a whole. Findings: Descriptive and thematic analyses reveal how stigma and local constructions around womanhood, as well as women’s self-image and physical limitations, promotes women’s exposure to psychological, physical and sexual violence. It reveals how disabled women feel they are presumed incapable of living up to expectations of a ‘proper’ woman. This plays out as psychological violence, with women reporting that they feel ‘devalued,' ‘rejected’ and deprived of lasting intimate relationships. Furthermore, forms of psychological violence perpetuate physical and sexual violence. Women also discuss using strategies to prevent violence; by refusing to date, avoiding certain places or avoiding isolation, creating awareness, hiding their physical impairments, and exaggerating their ‘femininity.' Implications: Service providers need to be made aware of women’s violence experiences, and provide a range of accessible psychological and mental health services to women living with disabilities, as well as raising awareness around disability, and violence prevention, among caregivers, men, and women. Violence awareness and prevention interventions need to involve disability experts, researchers and people with disabilities.

Keywords: disability, gender, stigma, violence awareness and prevention interventions

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Authors: R. Tariq, R. Lee

Abstract:

Background: Additional demands placed on senior clinical teams with ongoing COVID-19 management has accelerated the need to harness the wider healthcare professional resources and upskill them to take on greater clinical responsibility safely. The UK NHS Long Term Plan (2019)¹ emphasises the importance of expanding Advanced Practitioners’ (APs) roles to take on more clinical diagnostic responsibilities to cope with increased demand. In acute settings, APs are often the first point of care for patients and require training to take on initial triage responsibilities efficiently and safely. Critically, their roles include determining which onward services the patients may require, and assessing whether they can be treated at home, avoiding unnecessary admissions to the hospital. Dem Dx is a Clinical Reasoning Platform (CRP) that claims to help frontline healthcare professionals independently assess and triage patients. It guides the clinician from presenting complaints through associated symptoms to a running list of differential diagnoses, media, national and institutional guidelines. The objective of this study was to compare the clinical referral rates and guidelines adherence registered by the HMR Urgent Community Care Team (UCCT)² and Dem Dx recommendations using retrospective cases. Methodology: 192 cases seen by the UCCT were anonymised and reassessed using Dem Dx clinical pathways. We compared the UCCT’s performance with Dem Dx regarding the appropriateness of onward referrals. We also compared the clinical assessment regarding adherence to NICE guidelines recorded on the clinical notes and the presence of suitable guidance in each case. The cases were audited by two medical doctors. Results: Dem Dx demonstrated appropriate referrals in 85% of cases, compared to 47% in the UCCT team (p<0.001). Of particular note, Dem Dx demonstrated an almost 65% (p<0.001) improvement in the efficacy and appropriateness of referrals in a highly experienced clinical team. The effectiveness of Dem Dx is in part attributable to the relevant NICE and local guidelines found within the platform's pathways and was found to be suitable in 86% of cases. Conclusion: This study highlights the potential of clinical decision support, as Dem Dx, to improve the quality of onward clinical referrals delivered by a multidisciplinary team in primary care. It demonstrated that it could support healthcare professionals in making appropriate referrals, especially those that may be overlooked by providing suitable clinical guidelines directly embedded into cases and clear referral pathways. Further evaluation in the clinical setting has been planned to confirm those assumptions in a prospective study.

Keywords: advanced practitioner, clinical reasoning, clinical decision-making, management, multidisciplinary team, referrals, triage

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Authors: Antti Lanki, Justiina Halonen, Juuso Punnonen, Emmi Rantavuo

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Marine oil spill response operation requires extensive vessel maneuvering and navigation skills. At-sea oil containment and recovery include both single vessel and multi-vessel operations. Towing long oil containment booms that are several hundreds of meters in length, is a challenge in itself. Boom deployment and towing in multi-vessel configurations is an added challenge that requires precise coordination and control of the vessels. Efficient communication, as a prerequisite for shared situational awareness, is needed in order to execute the response task effectively. To gain and maintain adequate maritime skills, practical training is needed. Field exercises are the most effective way of learning, but especially the related vessel operations are resource-intensive and costly. Field exercises may also be affected by environmental limitations such as high sea-state or other adverse weather conditions. In Finland, the seasonal ice-coverage also limits the training period to summer seasons only. In addition, environmental sensitiveness of the sea area restricts the use of real oil or other target substances. This paper examines, whether maritime simulator training can offer a complementary method to overcome the training challenges related to field exercises. The objective is to assess the efficiency and the learning impact of simulator training, and the specific skills that can be trained most effectively in simulators. This paper provides an overview of learning results from two oil spill response pilot courses, in which maritime navigational bridge simulators were used to train the oil spill response authorities. The simulators were equipped with an oil spill functionality module. The courses were targeted at coastal Fire and Rescue Services responsible for near shore oil spill response in Finland. The competence levels of the participants were surveyed before and after the course in order to measure potential shifts in competencies due to the simulator training. In addition to the quantitative analysis, the efficiency of the simulator training is evaluated qualitatively through feedback from the participants. The results indicate that simulator training is a valid and effective method for developing marine oil spill response competencies that complement traditional field exercises. Simulator training provides a safe environment for assessing various oil containment and recovery tactics. One of the main benefits of the simulator training was found to be the immediate feedback the spill modelling software provides on the oil spill behaviour as a reaction to response measures.

Keywords: maritime training, oil spill response, simulation, vessel manoeuvring

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Authors: Rashmi Uchil, A. H. Sequeira

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Post-liberalization era in India has seen an unprecedented growth of mergers, both domestic as well as cross-border deals. Indian organizations have slowly begun appreciating this inorganic method of growth. However, all is not well as is evidenced in the lowering value creation of organizations after mergers. Several studies have identified that organizational culture is one of the key factors that affects the success of mergers. But very few studies have been attempted in this realm in India. The current study attempts to identify the factors in the organizational culture variable that may be unique to India. It also focuses on the difference in the impact of organizational culture on merger of organizations in the manufacturing and service sectors in India. The study uses a mixed research approach. An exploratory research approach is adopted to identify the variables that constitute organizational culture specifically in the Indian scenario. A few hypotheses were developed from the identified variables and tested to arrive at the Grounded Theory. The Grounded Theory approach used in the study, attempts to integrate the variables related to organizational culture. Descriptive approach is used to validate the developed grounded theory with a new empirical data set and thus test the relationship between the organizational culture variables and the success of mergers. Empirical data is captured from merged organizations situated in major cities of India. These organizations represent significant proportions of the total number of organizations which have adopted mergers. The mix of industries included software, banking, manufacturing, pharmaceutical and financial services. Mixed sampling approach was adopted for this study. The first phase of sampling was conducted using the probability method of stratified random sampling. The study further used the non-probability method of judgmental sampling. Adequate sample size was identified for the study which represents the top, middle and junior management levels of the organizations that had adopted mergers. Validity and reliability of the research instrument was ensured with appropriate tests. Statistical tools like regression analysis, correlation analysis and factor analysis were used for data analysis. The results of the study revealed a strong relationship between organizational culture and its impact on the success of mergers. The study also revealed that the results were unique to the extent that they highlighted a marked difference in the manner of internalization of change of organizational culture after merger by the organizations in the manufacturing sector. Further, the study reveals that the organizations in the service sector internalized the changes at a slower rate. The study also portrays the industries in the manufacturing sector as more proactive and can contribute to a change in the perception of the said organizations.

Keywords: manufacturing industries, mergers, organizational culture, service industries

Procedia PDF Downloads 297

Authors: Kajal Attri

Abstract:

Introduction: Transgender people are considered third gender in India, although they still face identification issues and alienated from society. Furthermore, they face several challenges, including discrimination in employment, resources, education, and property as a result, most transgender people make a living through begging at traffic lights, trains, and buses; attending auspicious occasions such as childbirth and weddings; and engaging in sex work, which includes both home-based and street-based sex work. During COVID-19, maintaining social distance exacerbates transgender people's circumstances and prevents them from accessing health care services, sexual reassignment surgery, identity-based resources, government security, and financial stability. Nonetheless, the pandemic raised unfavorable attitudes about transgender persons, such as unsupportive family members and trouble forming emotional relationships. This study focuses on how we missed transgender people during COVID-19 to provide better facilities to cope with this situation when they are already the most vulnerable segment of the society. Methodology: The research was conducted using secondary data from published publications and grey literature obtained from four databases: Pubmed, Psychinfo, Science direct, and Google scholar. The literature included total 25 articles that met the inclusion criteria for a review. Result and Discussion: Transgender people, who are considered the most vulnerable sector of society, have already faced several obstacles as a result of the outbreak. The analysis underscores the difficulties that transgender persons faced during COVID-19, such as, They had trouble accessing the government's social security programmes during the lockdown, which provide rations and pensions since they lack the necessary identifying cards. The impact of COVID-19 leaves transgender people at heightened risk of poverty and ill health because they exist on the margins of society, those livelihood base on sex work, begging, and participation on auspicious occasions. They had a significant risk of contracting SARS-CoV2 because they lived in congested areas or did not have permanent shelter, and they were predominantly infected with HIV, cancer, and other non-communicable illnesses. The pandemic raised unfavorable attitudes about transgender persons, such as unsupportive family members and trouble forming emotional relationships. Conclusion: The study comes forward with useful suggestions based on content analysis and information to reduce the existing woes of transgenders during any pandemic like COVID-19.

Keywords: COVID-19, transgender, lockdown, transwomen, stigmatization

Procedia PDF Downloads 75