Search results for: schedule risk management

Authors: Kirsty Biggs, Peter Larsen-Disney

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Background: The UK cervical screening programme significantly reduces cancer mortality through the early detection of abnormal cells. Despite this, over a quarter of eligible women choose not to attend their appointment. Objective: To qualitatively explore patients’ barriers to attending cervical smear appointments and identify key trends of cervical screening behaviour, knowledge, and attitudes in primary and secondary care. Methods: A cross-sectional study was conducted to evaluate smear services in Brighton and Hove using questionnaires in general practice and colposcopy. 226 patients participated in the voluntary questionnaire between 10/11/2017 and 02/02/2018. 118 patients were recruited from general practice surgeries and 108 from the colposcopy department. Women were asked about their smear knowledge, self-perceived risks factors, prior experiences and reasons for non-attendance. Demographic data was also collected. Results: Approximately a third of women did not engage in smear testing services. This was consistent across primary and secondary care groups. Over 90% were aware of the role of the screening process in relation to cervical cancer; however, over two thirds believed the smear was also a tool to screen for other pathologies. The most commonly cited reasons for non-attendance were negative emotions or previous experiences. Inconvenient appointment times were also commonly described. In a comparison of attenders versus non-attenders previous negative experiences (p < 0.01) and number of identified risk factors (p = 0.02) were statistically significant with non-attenders describing more prior negative smears and identifying more risk factors. Smear knowledge, risk perception and perceived importance of screening were not significant. Negative previous experiences were described in relation to poor bedside manner, pain, embarrassment and staff competency. Conclusions: In contrary to the literature, our white Caucasian cohort experienced significant barriers to accessing smear services. Women’s prior negative experiences are overriding their perceived importance to attend the screening programme; therefore, efforts need to focus on improving clinical experiences through auditing tools, training and providing a supportive appointment setting. Positive changes can also be expected by improving appointment availabilities with extended hours and self-booking systems.

Keywords: barriers, cervical, Papanicolaou, screening, smear

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Authors: Tomy Prihananto, Damar Apri Sudarmadi

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Indonesia recognizes the right to privacy as a human right. Indonesia provides legal protection against data management activities because the protection of personal data is a part of human rights. This paper aims to describe the arrangement of data management and data management in Indonesia. This paper is a descriptive research with qualitative approach and collecting data from literature study. Results of this paper are comprehensive arrangement of data that have been set up as a technical requirement of data protection by encryption methods. Arrangements on encryption and protection of personal data are mutually reinforcing arrangements in the protection of personal data. Indonesia has two important and immediately enacted laws that provide protection for the privacy of information that is part of human rights.

Keywords: Indonesia, protection, personal data, privacy, human rights, encryption

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Authors: Min Ju Kim, Beom Jin Park, Deuk Jae Sung, Na Yeon Han, Kichoon Sim

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Purpose: The purpose of this study is to determine the significant magnetic resonance (MR) imaging factors of lateral pelvic lymph node (LPLN) on the assessment of survival outcomes of neoadjuvant combined chemotherapy and radiation therapy (CRT) in patients with mid/low rectal cancer. Materials and Methods: The institutional review board approved this retrospective study of 63 patients with mid/low rectal cancer who underwent MR before and after CRT and patient consent was not required. Surgery performed within 4 weeks after CRT. The location of LPLNs was divided into following four groups; 1) common iliac, 2) external iliac, 3) obturator, and 4) internal iliac lymph nodes. The short and long axis diameters, numbers, shape (ovoid vs round), signal intensity (homogenous vs heterogenous), margin (smooth vs irregular), and diffusion-weighted restriction of LPLN were analyzed on pre- and post-CRT images. For treatment response using size, lymph node groups were defined as group 1) short axis diameter ≤ 5mm on both MR, group 2) > 5mm change into ≤ 5mm after CRT, and group 3) persistent size > 5mm before and after CRT. Clinical findings were also evaluated. The disease-free survival and overall survival rate were evaluated and the risk factors for survival outcomes were analyzed using cox regression analysis. Results: Patients in the group 3 (persistent size >5mm) showed significantly lower survival rates than the group 1 and 2 (Disease-free survival rates of 36.1% and 78.8, 88.8%, p < 0.001). The size response (group 1-3), multiplicity of LPLN, the level of carcinoembryonic antigen (CEA), patient’s age, T and N stage, vessel invasion, perineural invasion were significant factors affecting disease-free survival rate or overall survival rate using univariate analysis (p < 0.05). The persistent size (group 3) and multiplicity of LPLN were independent risk factors among MR imaging features influencing disease-free survival rate (HR = 10.087, p < 0.05; HR = 4.808, p < 0.05). Perineural invasion and T stage were shown as independent histologic risk factors (HR = 16.594, p < 0.05; HR = 15.891, p < 0.05). Conclusion: The persistent size greater than 5mm and multiplicity of LPLN on both pre- and post-MR after CRT were significant MR factors affecting survival outcomes in the patients with mid/low rectal cancer.

Keywords: rectal cancer, MRI, lymph node, combined chemoradiotherapy

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Authors: Kawinphat Lertpongmanee

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The purposes of this study were (1) investigate the English language learning motivation and the attainment of their English proficiency, (2) to find out how motivation and motivational variables of the high and low proficiency subjects are related to their English proficiency. The respondents were 80 fourth-year from Faculty of Management Sciences students in Rajabhat Suansunadha University. The instruments used for data collection were questionnaires. The statistically analyzed by using the SPSS program for frequency, percentage, arithmetic mean, standard deviation (SD), t-test, one-way analysis of variance (ANOVA), and Pearson correlation coefficient. The findings of this study are summarized as there was a significant difference in overall motivation between high and low proficiency groups of subjects at .05 (p < .05), but not in overall motivational variables. Additionally, the high proficiency group had a significantly higher level of intrinsic motivation than did the low proficiency group at .05 (p < .05).

Keywords: English language proficiency, faculty of management sciences, motivation factors, proficiency subjects

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Authors: Sandra D. Prewitt

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Introduction—The purpose of the extant study was to explore the relationship between religiosity and suicidal ideation. Through this exploration, further knowledge was sought relevant to gaining a better understanding regarding the higher suicide rate continuing to be experienced by young adults. Endeavoring to discover why the suicide rate continues to increase for the subject population, depression and anxiety emerged as major contributory risk factors. Although religiosity has been shown to be related to the reduced risk of suicidal behavior, the curative value of religion relevant to suicide prevention and treatment has not been sufficiently recognized. Considering the enormity of the current suicide problem, pursuits relevant to discovering effective tools enabling impactful prevention and treatment strategies remain essential to reducing suicide deaths. Methodology—The subject study was conducted utilizing a systematic literature review (SLR) which required the researcher to perform searches of appropriate databases, toward the goal of acquiring advanced knowledge based upon existing studies relevant to the subject matter under consideration. Major Findings—Depression and anxiety have been identified as two potential pathways leading to increased suicidal behavior. On the contrary, religiosity emerged as an important protective factor associated with less depression and therefore, fewer instances of suicidal thoughts. The protective nature of religion has been shown to extend to young adults without regard to the presence of identified potential suicidal behavior pathways.

Keywords: anxiety, depression, religion, suicide

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Authors: Mohamad Reza Asariha

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Crises are an integral part of social life, and their diversity is increasing day by day. Every aspect of life for humans involves a crisis, and these crises are becoming more varied over time. In times of crisis, the media has a special responsibility to inform the public and raise awareness of the situation. The public can be calmed by the media and inspired to take positive action or vice versa; the media can terrorize the public and cause mayhem. Media are regarded as one of the most significant forms of communication in the information age. Media plays an important role in different stages of crises. Before a crisis occurs, they can prevent the spread of the crisis and reduce its losses by warning about the consequences. At the time of the crisis, they can minimize the crisis by creating a scientific and rational atmosphere, or as mediators between the crisis agents and the interest groups, they can minimize the political clashes and be effective in attracting and participating the audience in crisis management. There is widespread access to the media, so it has a significant role in moderating and changing public opinion.

Keywords: media, crisis, crisis communication, crisis management, emergency situations

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Authors: Naila Awan, Shahrukh Inam

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This study was conducted to highlight the role of basic health units in district Swabi, which provides primary health services to the people of district Swabi having four tehsils. Tehsil Swabi was selected purposively for the study. Three villages were purposively selected from district Swabi. A sum of 110 respondents was randomly selected for interview i.e., 27 from Botakaa, 39 from Gulatee, and 44 from Darra Cham, using proportion allocation sampling technique. A pretested and well-designed interview schedule was used to collect as per the objective and Chi square test was applied to find an association between the quality of medicines and health improvement. The output of the test shows that the government was doing its best and providing enough facilities to the individuals at the healthcare units, and they were utilizing them. These resources were easily accessible to the people of the community. Medicines provided by the government were of good quality and quantity. There were also school health sessions and community health sessions (SHS/CHS) to deliver useful information and awareness regarding health problems and diseases were conducted. The staff of the BHU was present at work time and was performing their duties. The respondents seemed satisfied with their behavior and the duty of the staff. However, there were no emergency resources existing at the BHU after the working hours of the medical staff. It is recommended that government should provide appropriate quantity and quality of medicines to the basic health units so that these healthcare units don’t have to face any shortages regarding medicines at the end of the month. In addition, laboratory and blood testing facilities need to be provided in the basic health units, and also the infrastructure should be made suitable, satisfactory, and more functional.

Keywords: community health session, basic health units, outpatient department, tuberculosis

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Authors: M. R. Mogarekar, Shraddha V. More, Pankaj Kumar

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Gastroenteritis, the third leading killer of children in India today is responsible for 13% of all deaths in children <5 years of age and kills an estimated 300,000 children in India each year. We decided to investigate parameters which can help in early disease detection and prompt treatment. Serum paraoxonase is calcium dependent esterase which is widely distributed among tissues such as liver, kidney, and intestine and is located in the chromosomal region 7q21.3 22.1. Studies show the presence of excessive reactive oxygen metabolites and antioxidant imbalance in the gastrointestinal tract leading to oxidative stress in gastroenteritis. To our knowledge, this is the first ever study done. The objective of present study is to investigate the role of paraoxonase 1 (PON 1) status i.e arylesterase and lactonase activities and Q192R polymorphism and conjugated dienes, in gastroenteritis of paediatric population. The study and control group consists of 40 paediatric patients with and without gastroenteritis. Paraoxonase arylesterase and lactonase activities were assessed and phenotyping was determined. Conjugated dienes were also assessed. PON 1 arylesterase activities in cases (61.494±13.220) and controls (70.942±15.385) and lactonase activities in cases (15.702±1.036) and controls (17.434±1.176) were significantly decreased (p<0.05). There is no significant difference of phenotypic distribution in cases and controls. Conjugated dienes were found significantly increased in patients (0.086±0.024) than the control group (0.064±0.019) (p<0.05). Paraoxonase 1 activities (arylesterase and lactonase) and conjugated dienes may be useful in risk assessment and management in gastroenteritis in paediatric population.

Keywords: paraoxonase 1 polymorphism, arylesterase, lactonase, conjugated dienes, p-nitrophenylacetate, DHC

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Authors: Dora Martins, Susana Silva, Cândida Silva

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Human Resources Management (HRM) has been recognized by academics and practitioners as an important element in organizations. Therefore, this paper explores the best practices of HRM and seeks to understand the level of participation in the development of these practices by human resources managers in the hospitality industry and compare it with other industries. Thus, the study compared the HRM practices of companies in the hospitality sector with HRM practices of companies in other sectors, and identifies the main differences between their HRM practices. The results show that the most frequent HRM practices in all companies, independently of its sector of activity, are hiring and training. When comparing hospitality sector with other sectors of activity, some differences were noticed, namely in the adoption of the practices of communication and information sharing, and of recruitment and selection. According to these results, the paper discusses the major theoretical and practical implications. Suggestions for future research are also presented.

Keywords: exploratory study, human resources management practices, human resources manager, hospitality companies, Portuguese companies

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Authors: Neerja Ahlawat

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In Indian society, women have always been an active part of the production process. Be it agriculture, dairy, or other home-based industries, Indian women have been competent and enterprising engaged in multiple economic activities. In recent times, women across the country have started establishing business enterprise and managing and working very hard. Despite their skills and capabilities, however, women are faced with varied problems and challenges. Women entrepreneurs in Haryana face a double challenge – a gender bias against women denies them the education and the opportunities available to their male counterparts and the lack of such learning and skills development inhibits any entrepreneurial ambitions. In many parts of the state, women venturing out of the household domain face much opposition and criticism. The present paper highlights the various problems and challenges faced by the women entrepreneurs while running the enterprises in the present competitive world in Haryana. An attempt has been made to investigate women entrepreneurs about the specific issues such as working capital, distribution channel, sales promotion, electricity, human resources and competition with other industries. The present empirical study was carried out in Rohtak city of Haryana using Interview schedule and Case study method. The study revealed the nature of problems women entrepreneurs face while dealing with issues of labour, market, and bureaucracy. The study categorically pointed out the difficulties women are confronted with while keeping a balance between domestic responsibilities and workplace challenges. The study concluded that women entrepreneurs are redefining their identities and priorities in the male dominant society.

Keywords: entrepreneur, gender bias, capital, human resource

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Authors: Rabeab Khunpukdee, Aranya Sukchoui, Nonluk Somgit, Chitima Bunnaul

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Endotracheal displacement is a major risk of life threatening among critically ill patients. Standard nursing protocol is needed to minimize this risk and to improve clinical outcomes. To evaluate the effectiveness of the endothacheal care nursing guideline. The incidence rates of endochacheal displacement, oxygen deficiency after extubation, re-intubation, and nurse’s satisfaction on the utilization of the endotracheal care nursing guideline. An evidence-based nursing practice framework was used to develop the endotracheal care nursing guideline. The guideline valid content was review by a 3 panel of experts. The index of item objective (IOC) of the guideline was 0.93. The guideline was implemented in 130 patients (guideline group) and 19 registered nurses at a medicine ward, Had Yai hospital, Thailand. Patient’s outcomes were evaluated by comparison with those 155 patients who received the routine nursing care (routine care group). Descriptive statistics, frequency, percentage, mean, standard deviation and Mann Whitney U-test was analyzed using the computer program. All significantly and better outcomes were found in the guideline group compared to the routine care group. The guideline group has less incidence rates of endotracheal displacement (1.54 % vs 9.03 %, p < 0.05), and none of the guideline group had oxygen deficiency after extubation (0 % vs 83.33%) compared to the routine care group. All of the 2 patients in the guideline group, compared to 6 of 14 patients in the routine care group were re-intubation. The overall rate of re-intubation in the total group (n = 130 vs 155) was seen less in the guideline group than the routine care group (1.54 % vs 3.87). Overall, nurses satisfaction was at high-level (89.50%) on the utilization of the guideline.

Keywords: endotracheal care, nursing guideline, re-intubation, satisfaction

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Authors: Sana Masmoudi Mardassi, Yosra Makni Fourati

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Regulators highlight the importance of the Audit Committee (AC) as a key internal corporate governance mechanism. One of the most important roles of this committee is to oversee the financial reporting process. The purpose of this paper is to examine the link between the characteristics of an audit committee and the financial reporting quality by investigating whether the characteristics of audit committees are associated with improved financial reporting quality, especially the Real Earnings Management. In the current study, a panel data from 80 nonfinancial companies listed on the Amsterdam Stock Exchange during the period between 2010 and 2017 were used. To measure audit committee characteristics, four proxies have been used, specifically, audit committee independence, financial expertise, gender diversity and AC meetings. For this research, a linear regression model was used to identify the influence of a set of board characteristics of the audit committee on real earnings management after controlling for firm audit committee size, leverage, size, loss, growth and board size. This research provides empirical evidence of the association between audit committee independence, financial expertise, gender diversity and meetings and Real Earnings Management (REM) as a proxy of financial reporting quality. The study finds that independence and AC Gender diversity are strongly related to financial reporting quality. In fact, these two characteristics constrain REM. The results also suggest that AC- financial expertise reduces to some extent, the likelihood of engaging in REM. These conclusions provide support then to the audit committee requirement under the Dutch Corporate Governance Code rules regarding gender diversity and AC meetings.

Keywords: audit committee, financial expertise, independence, real earnings management

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Authors: Ali Reza Ghanbarnezhad Ghazvini, Seyyed Hamid Reza Mosayyebi

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In recent years, an earthquake has occurred approximately every five years in certain regions of Iran. To mitigate the impact of these seismic events, it is crucial to identify and thoroughly assess the vulnerability of buildings and infrastructure, ensuring their safety through principled reinforcement. By adopting new methods of risk assessment, we can effectively reduce the potential risks associated with future earthquakes. In our research, we have observed that the coefficient of behavior in the fourth chapter is 1.65 for the initial structure and 1.72 for the Superframe structure. This indicates that the Superframe structure can enhance the strength of the main structural members by approximately 10% through the utilization of super beams. Furthermore, based on the comparative analysis between the two structures conducted in this study, we have successfully designed a stronger structure with minimal changes in the coefficient of behavior. Additionally, this design has allowed for greater energy dissipation during seismic events, further enhancing the structure's resilience to earthquakes. By comprehensively examining and reinforcing the vulnerability of buildings and infrastructure, along with implementing advanced risk assessment techniques, we can significantly reduce casualties and damages caused by earthquakes in Iran. The findings of this study offer valuable insights for civil engineering professionals in the field of structural engineering, aiding them in designing safer and more resilient structures.

Keywords: modal pushover analysis, response modification factor, high-strength concrete, concrete shear walls, high-rise building

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Authors: Anum Atiq, Haya Fatimah

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Lucid dream is a dream where one is aware that one is dreaming, and they also might be able to influence their dreaming states. Logically, since lucidity cues towards high awareness, it should be negatively associated with proneness to psychosis. However, this association is scarcely studied. Furthermore, although gender differences and similarities in psychopathology have been thoroughly studied, there is room for research in the influence of masculinity and femininity, regardless of one’s sex, on proneness to psychosis. The aim of this study is twofold: 1) We investigated if dream lucidity was negatively associated with psychosis proneness; and 2) We explored the influence of masculinity and femininity on psychosis proneness, over and above the sex. Data were collected by convenience sampling from the undergraduate students enrolled at the University of Management and Technology, Lahore. The sample consisted of 53 students among the age range of 18-26 (men=24, women=29). Masculinity and femininity were measured using the masculinity and femininity subscales of the Personality Attributes Questionnaire. Dream lucidity was measured with The Lucidity and Consciousness in Dreams Scale; and the reality testing sub scale of The Inventory of Personality Organization was used to measure proneness to psychosis. Pearson correlation analysis revealed that psychosis proneness was significantly and negatively correlated with dream lucidity-insight and negative emotion in dreams, but not with other aspects of dream lucidity. Furthermore, masculinity, in both men and women, was positively related with lucid dreaming, and negatively with psychosis proneness. Following this, linear regression analysis showed that psychosis proneness was negatively predicted by masculinity even after controlling for gender. Lucid dreamer and masculinity both have characteristic of independence, emotional control and internal locus of control. Therefore, masculinity makes lucid dreaming less risk of psychosis in both genders.

Keywords: lucid dreaming, psychosis, gender, masculinity and femininity

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Authors: Torsten Mielitz, Dietmar Schulz, York C. Roth

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Market forecasts show a significant increase in the demand for aircraft within the next two decades and production rates will be adapted accordingly. Improvements and optimizations in the industrial system are becoming more important to cope with future challenges in manufacturing and assembly. Highest quality standards have to be met for aerospace parts, whereas cost effective production in industrial systems and methodologies are also a key driver. A look at other industries like e.g., automotive shows well established processes to streamline existing manufacturing systems. In this paper, the implementation of 'PULL' principles in an existing manufacturing process chain for a large scale composite part is presented. A nonlinear extrapolation based on 'Little's Law' showed a risk of a significant increase of parts needed in the process chain to meet future demand. A project has been set up to mitigate the risk whereas the methodology has been changed from a traditional milestone approach in the beginning towards an agile way of working in the end in order to facilitate immediate benefits in the shop-floor. Finally, delivery rates could be increased avoiding more semi-finished parts in the process chain (work in progress & inventory) by the successful implementation of the 'PULL' philosophy in the shop-floor between the work stations. Lessons learned during the running project as well as implementation and operations phases are discussed in order to share best practices.

Keywords: aerospace composite part manufacturing, PULL principles, shop-floor implementation, lessons learned

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Authors: Ali M. Subyani

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The increase in the greenhouse gas emission has had a severe impact on global climate change and is bound to affect the weather patterns worldwide. This climate change impacts are among the future significant effects on any society. Rainfall levels are drastically increasing with flash floods in some places and long periods of droughts in others, especially in arid regions. These extreme events are causes of interactions concerning environmental, socio-economic and cultural life and their implementation. This paper presents the detailed features of dry and wet spell durations and rainfall intensity series available (1971-2012) on daily basis for the Jeddah area, Western, Saudi Arabia. It also presents significant articles for combating the climate change impacts on this area. Results show trend changes in dry and wet spell durations and rainfall amount on daily, monthly and annual time series. Three rain seasons were proposed in this investigation: high rain, low rain, and dry seasons. It shows that the overall average dry spell durations is about 80 continuous days while the average wet spell durations is 1.39 days with an average rainfall intensity of 8.2 mm/day. Annual and seasonal autorun analyses confirm that the rainy seasons are tending to have more intense rainfall while the seasons are becoming drier. This study would help decision makers in future for water resources management and flood risk analysis.

Keywords: climate change, daily rainfall, dry and wet spill, Jeddah, Saudi Arabia

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Authors: Sharmin Sultana, Palash Chandra Banik, Shirin Jahan Mumu, Liaquat Ali

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Santals are one of the oldest indigenous groups of South Asia who, according to anthropological evidence, are thought to be the origins of the Bengali race. The aim of the study was to explore, according to our best knowledge for the first time, the prevalence and determinants of hypertension in this relatively isolated and marginalized indigenous group who still live mostly in a traditional style. Under a cross-sectional analytical design, the study was conducted on the adult (age≥18 years) Santals (n=389, M/F 184/205, age in years, 38±15.3) of a village located in a remote rural area of northern Bangladesh. Subjects were selected by purposive sampling, and data were collected by interviewer-administered pretested questionnaire. Blood pressure was measured by following the WHO guideline of JNC-7 has been used to classify the blood pressure. The prevalence of hypertension was 4.9% among the respondents. Females had a much higher prevalence (5.4%) of hypertension compared to males (4.3%). Among the risk indicators of hypertension, more than half (50.9%) of the study population took extra salt in their meals, whereas 10.5% of respondents used extra salt occasionally, which is an important risk factor for high blood pressure. High waist circumference was found in 19% of the study subjects in terms of central obesity. Older age group (p=0.003, OR=1.1, 95%CI-1.02-1.10), respondents who completed more than primary school (p=0.038, OR=7.1, CI-1.11, 44.6), overweight and obesity (p=0.004, OR=17.1, CI-2.5, 118.1), were the major determinant for hypertension as found from the binary logistic model. None of the respondents received any medication, neither they visit any doctor ever for their hypertension control. The prevalence of hypertension was found to be low but not ignorable. Pre-hypertension in the case of systolic blood pressure needs attention among Santal indigenous population.

Keywords: hypertension, indigenous group, Santals, Bangladesh

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Authors: Zaiton Osman, Phang Ing, Azaze Azizi Abd Adis, Izyanti Awg Razli, Mohd Rizwan Abd Majid, Rosle Mohidin

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This study is conducted to investigate the level of financial literacy among students taking Financial Management and Banking in Universiti Malaysia Sabah, Malaysia. Students are asked to answer basic financial literacy questions in their first class before study commence and the similar questions were given in their final week of study (after 14 weeks of study duration). The comparison on their level of financial literacy will be examined. This study is expected to yields the following findings; firstly, comparison of the level of financial literacy 'before and after' courses in finance being introduced can be revealed. Secondly, it will provide suggestion on improving the standard of teaching and learning in financial management and banking courses and lastly it will help in identifying financial courses that are important in improving the level of financial literacy among students in Malaysia.

Keywords: financial literacy, university students, personal financial planning, business and management engineering

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Authors: Wilfred Fritz

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The accreditation process of engineering degree programmes is based on various reports evaluated by the relevant governing bodies of the institution of higher education. One of the aforementioned reports for the accreditation process is a self-assessment report which is to be completed by the applying institution. This paper seeks to emphasise the importance of analysis of internal quality management systems and self-examination processes in the engineering accreditation processes. A description of how the programme fulfils the criteria should be given. Relevant stakeholders all need to contribute in the writing and structuring of the self-assessment report. The last step is to gather evidence in the form of supporting documentation. In conclusion, the paper also identifies learning outcomes in a case study in seeking accreditation from an international relevant professional body.

Keywords: accreditation, governing bodies, self-assessment report, quality management

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Authors: Mohammed Sani Abdulai

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Ghana’s Public Financial Management reforms have been going on for some two decades now (1997/98 to 2017/18). Given this long period of reforms, Ghana in 2019 is putting together both a Public Financial Management (PFM) strategy and a Ghana Integrated Financial Management Information System (GIFMIS) strategy for the next 5-years (2020-2024). The primary aim of these dual strategies is assisting the country in moving beyond reforms to consolidation and sustainability. In this paper we, first, examined the evolution of Ghana’s PFM reforms. We, secondly, reviewed the legal and institutional reforms undertaken to strengthen the country’s key PFM institutions. Thirdly, we summarized the strengths and weaknesses identified by the 2018 Public Expenditure and Financial Accountability (PEFA) assessment of Ghana’s PFM system relating to its macro-fiscal framework, budget preparation and approval, budget execution, accounting and fiscal reporting as well as external scrutiny and audit. We, finally, considered what the country should be doing to achieve its intended goal of PFM consolidation and sustainability. Using a qualitative method of review and analysis of existing documents, we, through this paper, brought to the fore the lessons that could be learnt by other developing countries from Ghana’s PFM reforms experiences. These lessons included the need to: (a) undergird any PFM reform with a comprehensive PFM reform strategy; (b) undertake a legal and institutional reforms of the key PFM institutions; (c) assess the strengths and weaknesses of those reforms using PFM performance evaluation tools such as PEFA framework; and (d) move beyond reforms to consolidation and sustainability.

Keywords: public financial management, public expenditure and financial accountability, reforms, consolidation, sustainability

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Authors: Luis Reynaldo Mota-Santiago, Angélica Lozano

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Determining appropriate measures to face earthquakesarea challenge for practitioners. In the literature, some analyses consider disaster scenarios, disregarding some important field characteristics. Sometimes, software that allows estimating the number of victims and infrastructure damages is used. Other times historical information of previous events is used, or the scenarios’informationis assumed to be available even if it isnot usual in practice. Humanitarian operations start immediately after an earthquake strikes, and the first hours in relief efforts are important; local efforts are critical to assess the situation and deliver relief supplies to the victims. A preparation action is prepositioning stockpiles, most of them at central warehouses placed away from damage-prone areas, which requires large size facilities and budget. Usually, decisions in the first 12 hours (standard relief time (SRT)) after the disaster are the location of temporary depots and the design of distribution paths. The motivation for this research was the delay in the reaction time of the early relief efforts generating the late arrival of aid to some areas after the Mexico City 7.1 magnitude earthquake in 2017. Hence, a preparation approach for planning the immediate response to earthquake disasters is proposed, intended for local governments, considering their capabilities for planning and for responding during the SRT, in order to reduce the start-up time of immediate response operations in urban areas. The first steps are the generation and analysis of disaster scenarios, which allow estimatethe relief demand before and in the early hours after an earthquake. The scenarios can be based on historical data and/or the seismic hazard analysis of an Atlas of Natural Hazards and Risk as a way to address the limited or null available information.The following steps include the decision processes for: a) locating local depots (places to prepositioning stockpiles)and aid-giving facilities at closer places as possible to risk areas; and b) designing the vehicle paths for aid distribution (from local depots to the aid-giving facilities), which can be used at the beginning of the response actions. This approach allows speeding up the delivery of aid in the early moments of the emergency, which could reduce the suffering of the victims allowing additional time to integrate a broader and more streamlined response (according to new information)from national and international organizations into these efforts. The proposed approachis applied to two case studies in Mexico City. These areas were affectedby the 2017’s earthquake, having limited aid response. The approach generates disaster scenarios in an easy way and plans a faster early response with a short quantity of stockpiles which can be managed in the early hours of the emergency by local governments. Considering long-term storage, the estimated quantities of stockpiles require a limited budget to maintain and a small storage space. These stockpiles are useful also to address a different kind of emergencies in the area.

Keywords: disaster logistics, early response, generation of disaster scenarios, preparation phase

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Authors: Petr Gurný

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One of the most important tasks in the risk management is the correct determination of probability of default (PD) of particular financial subjects. In this paper a possibility of determination of financial institution’s PD according to the credit-scoring models is discussed. The paper is divided into the two parts. The first part is devoted to the estimation of the three different models (based on the linear discriminant analysis, logit regression and probit regression) from the sample of almost three hundred US commercial banks. Afterwards these models are compared and verified on the control sample with the view to choose the best one. The second part of the paper is aimed at the application of the chosen model on the portfolio of three key Czech banks to estimate their present financial stability. However, it is not less important to be able to estimate the evolution of PD in the future. For this reason, the second task in this paper is to estimate the probability distribution of the future PD for the Czech banks. So, there are sampled randomly the values of particular indicators and estimated the PDs’ distribution, while it’s assumed that the indicators are distributed according to the multidimensional subordinated Lévy model (Variance Gamma model and Normal Inverse Gaussian model, particularly). Although the obtained results show that all banks are relatively healthy, there is still high chance that “a financial crisis” will occur, at least in terms of probability. This is indicated by estimation of the various quantiles in the estimated distributions. Finally, it should be noted that the applicability of the estimated model (with respect to the used data) is limited to the recessionary phase of the financial market.

Keywords: credit-scoring models, multidimensional subordinated Lévy model, probability of default

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Authors: Darshana Rathod, Kirtikumar Rathod, Kamlesh Kumari, Abhilasha Motghare

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Background and Aims: Hypospadias is one of the common congenital anomalies in males. Various modalities are used for pain management, including caudal, penile, pudendal, ring blocks, and systemic analgesics. There has yet to be a consensus regarding the most effective and safe analgesic method for controlling pain in these children. We planned this study to determine our institute's pain management practices for hypospadias surgeries. Material and Methods: This retrospective cohort study reviewed 150 children with hypospadias undergoing surgery from January 2020 to December 2023. Data regarding the mode of pain management, postoperative opioid requirement, PACU discharge, and complications was collected from the records. Results: For postoperative pain, 33 (22%) children received caudal block, 60 (40%) penile block, and 57 (38%) were managed by intravenous analgesics. A significant difference was found in the three groups, with the IV analgesic group requiring significantly higher opioid boluses in PACU [43 (75.4%) required two boluses (p < 0.05)]. The difference in PACU discharge time among the three groups was statistically significant (p< 0.05), with IV analgesics groups having the highest (55 mins [47, 60]), the Caudal group at 35mins (30, 40), and the dorsal penile block group at 35mins (25, 40). There was no significant difference in complications like edema, meatal stenosis, urethra-cutaneous fistula, or wound dehiscence among all three groups. Conclusion: Intravenous analgesics and regional blocks like caudal and penile blocks are the common pain management modalities in our institute. The regional blocks are effective in managing pain in the postoperative period and are not significantly associated with complications.

Keywords: caudal block, hypospadias, pain management, penile block

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Authors: Mei-Fang Wu, Shu-Li Wang, Tsung-Yueh Lu, Feng-Tsung Cheng

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Strengthening core competitiveness is the main goal of enterprises in a fierce competitive environment. Accurate cost information is a great help for managers in dealing with operation strategies. This paper establishes a profitability management mechanism that applies the Activity-Based Benefit approach (ABBA) to solve the profitability for each customer from the market. ABBA provides financial and non-financial information for the operation, but also indicates what resources have expired in the operational process. The customer profit management model shows the level of profitability of each customer for the company. The empirical data were gathered from a case company operating in the leather industry in Taiwan. The research findings indicate that 30% of customers create little profit for the company as a result of asking for over 5% of sales discounts. Those customers ask for sales discount because of color differences of leather products. This paper provides a customer’s profitability evaluation mechanism to help enterprises to greatly improve operating effectiveness and promote operational activity efficiency and overall operation profitability.

Keywords: activity-based benefit approach, customer profit analysis, leather industry, profitability management mechanism

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Authors: Sahar El Shair, Laura Greco, William Reay, Murray Cairns

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Background: Rheumatoid arthritis (RA) is a chronic, systematic, inflammatory, autoimmune disease that involves damages to joints and erosions to the associated bones and cartilage, resulting in reduced physical function and disability. RA is a multifactorial disorder influenced by heterogenous genetic and environmental factors. Whilst different medications have proven successful in reducing inflammation associated with RA, they often come with significant side effects and limited efficacy. To address this, the novel pharmagenic enrichment score (PES) algorithm was tested in self-reported RA patients from the UK Biobank (UKBB), which is a cohort of predominantly European ancestry, and identified individuals with a high genetic risk in clinically actionable biological pathways to identify novel opportunities for precision interventions and drug repurposing to treat RA. Methods and materials: Genetic association data for rheumatoid arthritis was derived from publicly available genome-wide association studies (GWAS) summary statistics (N=97173). The PES framework exploits competitive gene set enrichment to identify pathways that are associated with RA to explore novel treatment opportunities. This data is then integrated into WebGestalt, Drug Interaction database (DGIdb) and DrugBank databases to identify existing compounds with existing use or potential for repurposed use. The PES for each of these candidates was then profiled in individuals with RA in the UKBB (Ncases = 3,719, Ncontrols = 333,160). Results A total of 209 pathways with known drug targets after multiple testing correction were identified. Several pathways, including interferon gamma signaling and TID pathway (which relates to a chaperone that modulates interferon signaling), were significantly associated with self-reported RA in the UKBB when adjusting for age, sex, assessment centre month and location, RA polygenic risk and 10 principal components. These pathways have a major role in RA pathogenesis, including autoimmune attacks against certain citrullinated proteins, synovial inflammation, and bone loss. Encouragingly, many also relate to the mechanism of action of existing RA medications. The analyses also revealed statistically significant association between RA polygenic scores and self-reported RA with individual PES scorings, highlighting the potential utility of the PES algorithm in uncovering additional genetic insights that could aid in the identification of individuals at risk for RA and provide opportunities for more targeted interventions. Conclusions In this study, pharmacologically annotated genetic risk was explored through the PES framework to overcome inter-individual heterogeneity and enable precision drug repurposing in RA. The results showed a statistically significant association between RA polygenic scores and self-reported RA and individual PES scorings for 3,719 RA patients. Interestingly, several enriched PES pathways were targeted by already approved RA drugs. In addition, the analysis revealed genetically supported drug repurposing opportunities for future treatment of RA with a relatively safe profile.

Keywords: rheumatoid arthritis, precision medicine, drug repurposing, system biology, bioinformatics

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Authors: S. P. Chintan, A. M. Khoja, M. Modi, R. K. Chopra, S. Garde, D. Jain, O. Kajale

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Pulmonary Hypertension is a rare but debilitating disease that affects individuals of all ages and walks of life. As recent as 15 years ago, a patient diagnosed with PH was given an average survival rate of 2.8 years. Recent advances in treatment options have allowed patients to improve quality o and quantity of life. Initial screening for PH is through echocardiography with final diagnosis confirmed through right heart catheterization. PH is now considered to have five major classifications with subgroups among each. The mild to moderate PH is common in chronic lung diseases like Chronic obstructive pulmonary diseases and Interstitial lung disease. But very severe PH is noted in few cases. In COPD patients, PH is associated with an increased risk of severe exacerbations and a reduced life expectancy. Similarly, in patients with ILD, the presence of PH correlates with a poor prognosis. Early diagnosis is essential to slow disease progression. We report here five cases of severe PH (Out of Proportion) of which four cases were of COPD and another one of IPF (UIP pattern). There echocardiography showed gross RA/RV dilatation, interventricular septum bulging to the left and mPAP of more than 100 mmHg in all the five cases. These patients were put on LTOT, pulmonary rehabilitation, combination pharmacotherapy of vasodilators and diuretics in continuation to the treatment of underlying disease. As these patients have grave prognosis close monitoring and follow up is required. Physicians associated with respiratory care and treating chronic lung disease should have knowledge in the diagnosis and management of patients with PH.

Keywords: COPD, pulmonary hypertension, chronic lung disease, India

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Authors: Nadhir Al-Ansari, Ammar A. Ali, Sven Knutsson

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Iraq is located in the Middle East. It covers an area of 433,970 square kilometres populated by about 32 million inhabitants. Iraq greatly relies in its water resources on the Tigris and Euphrates Rivers. Recently, Iraq is suffering from water shortage problems. This is due to external and internal factors. The former includes global warming and water resources policies of neighbouring countries while the latter includes mismanagement of its water resources. The supply and demand are predicted to be 43 and 66.8 Billion Cubic Meters (BCM) respectively in 2015, while in 2025 it will be 17.61 and 77 BCM respectively. In addition, future prediction suggests that Tigris and Euphrates Rivers will be completely dry in 2040. To overcome this problem, prudent water management policies are to be adopted. This includes Strategic Water Management Vision, development of irrigation techniques, reduction of water losses, use of non-conventional water resources and research and development planning.

Keywords: Iraq, Tigris River, Euphrates River, water scarcity, water resources management

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Authors: Victor Emery David Jr, Md S. Hossain

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Sewage sludge management has been a problem faced by most developing cities as in the case of Monrovia. The management of sewage sludge in Monrovia is still in its infant stage. The city is still struggling with poor sanitation, clogged pipes, shortage of septic tanks, lack of resources/human capacity, inadequate treatment facilities, open defecation, the absence of clear guidelines, etc. The rapid urban population growth of Monrovia has severely stressed Monrovia’s marginally functional urban WSS system caused by the civil conflict which led to break down in many sectors as well as infrastructure. The sewerage system which originally covered 17% of the population of Monrovia was down to serving about 7% because of bursts and blockages causing backflows in other areas. Prior to the Civil War, the average water production for Monrovia was about 68,000 m3/day but has now dropped to about 10,000 m3/day. Only small parts of Monrovia currently have direct access to the piped water supply while most areas depend on trucked water delivered to community collection points or household tanks, and/or on water from unprotected dug wells or hand pumps. There are only two functional treatment plants; The Fiamah Treatment plant and the White Plains Treatment Plant.

Keywords: Fiamah Treatment plant, management, Monrovia/Montserrado County, sewage, sludge

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Authors: Yih-Wenn Laih

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In recent times, the dependence and co-movement among international financial markets have become stronger than in the past, as evidenced by commentaries in the news media and the financial sections of newspapers. Studying the co-movement between returns in financial markets is an important issue for portfolio management and risk management. The realization of co-movement helps investors to identify the opportunities for international portfolio management in terms of asset allocation and pricing. Since the election of the new Prime Minister, Shinzo Abe, in November 2012, the yen has weakened against the US dollar from the 80 to the 120 level. The policies, known as “Abenomics,” are to encourage private investment through a more aggressive mix of monetary and fiscal policy. Given the close economic relations and competitions among Asia markets, it is interesting to discover the co-movement relations, affected by the depreciation of yen, between stock market of Japan and 5 major Asia stock markets, including China, Hong Kong, Korea, Singapore, and Taiwan. Specifically, we devote ourselves to measure the co-movement of stock markets between Japan and each one of the 5 Asia stock markets in terms of rank correlation coefficients. To compute the coefficients, return series of each stock market is first fitted by a skewed-t GARCH (generalized autoregressive conditional heteroscedasticity) model. Secondly, to measure the dependence structure between matched stock markets, we employ the symmetrized Joe-Clayton (SJC) copula to calculate the probability density function of paired skewed-t distributions. The joint probability density function is then utilized as the scoring scheme to optimize the sequence alignment by dynamic programming method. Finally, we compute the rank correlation coefficients (Kendall's  and Spearman's ) between matched stock markets based on their aligned sequences. We collect empirical data of 6 stock indexes from Taiwan Economic Journal. The data is sampled at a daily frequency covering the period from January 1, 2013 to July 31, 2015. The empirical distributions of returns indicate fatter tails than the normal distribution. Therefore, the skewed-t distribution and SJC copula are appropriate for characterizing the data. According to the computed Kendall’s τ, Korea has the strongest co-movement relation with Japan, followed by Taiwan, China, and Singapore; the weakest is Hong Kong. On the other hand, the Spearman’s ρ reveals that the strength of co-movement between markets with Japan in decreasing order are Korea, China, Taiwan, Singapore, and Hong Kong. We explore the effects of “Abenomics” on Asia stock markets by measuring the co-movement relation between Japan and five major Asia stock markets in terms of rank correlation coefficients. The matched markets are aligned by a hybrid method consisting of GARCH, copula and sequence alignment. Empirical experiments indicate that Korea has the strongest co-movement relation with Japan. The strength of China and Taiwan are better than Singapore. The Hong Kong market has the weakest co-movement relation with Japan.

Keywords: co-movement, depreciation of Yen, rank correlation, stock market

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Authors: Dalia Suša Vugec, Ana-Marija Stjepić, Darija Ivandić Vidović

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Digital transformation is one of the latest trends on the global market. In order to maintain the competitive advantage and sustainability, increasing number of organizations are conducting digital transformation processes. Those organizations are changing their business processes and creating new business models with the help of digital technologies. In that sense, one should also observe the role of business process management (BPM) and its maturity in driving digital transformation. Therefore, the goal of this paper is to investigate the role of BPM in digital transformation process within one organization. Since experiences from practice show that organizations from financial sector could be observed as leaders in digital transformation, an insurance company has been selected to participate in the study. That company has been selected due to the high level of its BPM maturity and the fact that it has previously been through a digital transformation process. In order to fulfill the goals of the paper, several interviews, as well as questionnaires, have been conducted within the selected company. The results are presented in a form of a case study. Results indicate that digital transformation process within the observed company has been successful, with special focus on the development of digital strategy, BPM and change management. The role of BPM in the digital transformation of the observed company is further discussed in the paper.

Keywords: business process management, case study, Croatia, digital transformation, insurance company

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