Search results for: Greek public hospital sector

Authors: Tasha L. Golden

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Girls in the U.S. juvenile justice system are most often arrested for truancy, drug use, or running from home, all of which are symptoms of abuse. In fact, some have called this 'The Sexual Abuse to Prison Pipeline.' Such abuse has consequences for girls' health, education, employment, and parenting, often resulting in significant health disparities. Yet when arrested, girls rarely encounter services designed to meet their unique needs. Instead, they are expected to cope with a system that was historically designed for males. In fact, even literature advocating for increased gender equity frequently fails to include girls’ voices and firsthand accounts. In response to these combined injustices, public health researchers launched a trauma-informed creative writing intervention in a southern juvenile detention facility. The program was designed to improve the health of detained girls, while also establishing innovative methods of both data collection and social justice advocacy. Girls’ poems and letters were collected and coded, adding rich qualitative data to traditional survey responses. In addition, as part of the intervention, these poems are regularly published by international literary publisher Sarabande Books—and distributed to judges, city leaders, attorneys, state representatives, and more. By utilizing a creative medium, girls generated substantial civic engagement with their concerns—thus expanding their influence and improving policy advocacy efforts. Researchers hypothesized that having access to their communities and policy makers would provide its own health benefits for incarcerated girls: cultivating self-esteem, locus of control, and a sense of leadership. This paper discusses the establishment of this intervention, examines findings from its evaluation, and includes several girls’ poems as exemplars. Grounded in social science regarding expressive writing, stigma, muted group theory, and health promotion, the paper theorizes about the application of arts-based advocacy efforts to other social justice endeavors.

Keywords: advocacy, public health, social justice, women’s health

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Authors: Chuang-Chun Chiou

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Ageing population is a global trend; therefore the need of care service has been increasing dramatically. There are three basic forms of service delivered to the elderly: institution, community, and home. Particularly, the institutional service can be seen as an extension of medical service. The nursing home or so-called care home which is equipped with professional staff and facilities can provide a variety of service including rehabilitation service, short-term care, and long term care. Similar to hospital and other health care service, care home service do need to provide quality and cost-effective service to satisfy the dwellers. The main purpose of this paper is to show how lean thinking and service innovation can be applied to care home operation. The issues and key factors of implementing lean practice are discussed.

Keywords: lean, service improvement, SERVQUAL, care home service

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Authors: Kieren Wilson, Gulnaz Majeed

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NHS constitution gives rights to the patient with suspected cancer to be seen by a cancer specialist within 2 weeks of referral. Guys and St Thomas Hospital (GSTT) is one of the largest cancer centres in London. NICE guidelines have provided guidance for health professionals to refer patients appropriately to RAC. In GSTT suspected gynae cancer referrals are mostly by NHS e-Referral Service with some fax, emails as well as paper referrals. The objective of this study was to evaluate compliance with 2-week referral pathway with emphasis on one stop diagnostic service with supporting efficient pathways. A prospective evaluation over 3 months (1 Jan 2017 to 31 Mar 2017) was undertaken. There were 26 clinics, 761 patients were booked in the clinics with a DNA rate of 13% (n=101) hence 606 patients were seen. Majority of referrals were for post menopausal bleeding (PMB) 25% (n=194) followed by cervical, vaginal, vulval reasons 23% (n=179) (abnormal cytology excluded as patients directly referred to colposcopy unit in GSTT), ovarian 7% (n=54) and endometrial 5% (n=41). Women with new or previous established diagnosis of cancer were 24, cervical (n=17), vulva (n=6) and vagina (n=1). Multifocal preinvasive disease vulva (VIN), vagina (VAIN) and cervix (CIN) was confirmed in twenty-six patients 4% (high prevalence in HIV patients). Majority of cervical referrals: PCB (n=14), cervical erosion (n=7), polyps (n=9) and cervical cyst were benign. However, two women with PMB had cervical cancer. Only 2 out of 13 referrals with vaginal concerns had VAIN. One case with non-cervical glandular cytology was confirmed to have endometrial cancer. One stop service based on the diagnostic support of ultrasound, colposcopy and hysteroscopy was achieved in 54% (n=359). Patients were discharged to GP, benign gynaecology, endometriosis, combined vulval/dermatology clinic or gynae oncology. 33% (n=202) required a second visit, 12% (n=70) third visit, 3% (n=19) fourth visit, 1% (n=4) fifth visit and 1% (n=6) sixth visit. Main reasons for follow ups were the unavailability of diagnostic slots, patient choice, need for interpreters, the discussion following gynae MDM review for triage to benign gynae, delay in availability of diagnostic results like histology/MRI/CT. Recommendations following this study are multi disciplinary review of pathways with the availability of additional diagnostic procedure slots to aim for one stop service. Furthermore, establishment of virtual and telephone consultations to reduce follow ups.

Keywords: multifocal disease, post menopausal bleeding, preinvasive disease, rapid access clinic

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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: Kyonghoon Kim, Wonyoung Park, Taeil Park

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In 1994, Korea experienced a national tragedy of Seongsu Bridge collapse. The accident was severe enough to alert governmental officers to the problem of existing management policy for national infrastructures. As a result, government legislated the ‘Guidelines for the safety inspection and test of infrastructure’ which have been utilized as the primary tool to make decision for the maintenance and rehabilitation of infrastructure for last twenty years. Although it is clear that the guideline established a basics how to evaluate and manage the condition of infrastructures in systematic manner, it is equally clear that the guideline needs improvements in order to obtain reasonable investment decisions for budget allocation. Because its inspection and evaluation procedures mainly focused on the structural condition of infrastructures, it was hard to make decision when the infrastructures were in same level of structural condition. In addition, it did not properly reflect various aspects of infrastructures such as performance, public demand, capacity, etc., which were more valuable to public. Regardless of the importance, these factors were commonly neglected in governmental decision-making process, because there factors were somewhat subjective and difficult to quantify in rational manner. Thus, this study proposes a framework to properly evaluate the serviceability indicators using AHP and Fuzzy approach. The framework is expected to assist governmental agency in establishing effective investment strategies for budget planning.

Keywords: infrastructure, evaluation, serviceability, fuzzy

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Authors: Paul Holmes, Mike N. G.

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Foundation-year doctors face increased stress, pressure and uncertainty when starting new rotations throughout their first years of work. This research questionnaire resulted in an induction cheat sheet and induction video that enhanced the Junior doctor's understanding of how to work effectively within the plastic surgery department at NHS Tayside. The objectives and goals were to improve the transition between cohorts of junior doctors in ward 26 at Ninewells Hospital. Before this quality improvement project, the induction pack was 74 pages long and over eight years old. With the support of consultant Mike Ng a new up-to-date induction was created. This involved a questionnaire and cheat sheet being developed. The questionnaire covered clerking, venipuncture, ward pharmacy, theatres, admissions, specialties on the ward, the cardiac arrest trolley, clinical emergencies, discharges and escalation. This audit has three completed cycles between August 2022 and August 2023. The cheat sheet developed a concise two-page A4 document designed for doctors to be able to reference easily and understand the essentials. The document format is a table containing ward layout; specialty; location; physician associate, shift patterns; ward rounds; handover location and time; hours coverage; senior escalation; nights; daytime duties, meetings/MDTs/board meetings, important bleeps and codes; department guidelines; boarders; referrals and patient stream; pharmacy; absences; rota coordinator; annual leave; top tips. The induction video is a 10-minute in-depth explanation of all aspects of the ward. The video explores in more depth the contents of the cheat sheet. This alternative visual format familiarizes the junior doctor with all aspects of the ward. These were provided to all foundation year 1 and 2 doctors on ward 26 at Ninewells Hospital at NHS Tayside Scotland. This work has since been adopted by the General Surgery Department, which extends to six further wards and has improved the effective handing over of the junior doctor’s role between cohorts. There is potential to further expand the cheat sheet to other departments as the concise document takes around 30 minutes to complete by a doctor who is currently on that ward. The time spent filling out the form provides vital information to the incoming junior doctors, which has a significant possibility to improve patient care.

Keywords: induction, junior doctor, handover, plastic surgery

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Authors: Emilio Galdeano-Gómez, Ángeles Godoy-Durán, Juan C. Pérez-Mesa, Laura Piedra-Muñoz

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Eco-efficiency is receiving ever-increasing interest as an indicator of sustainability, as it links environmental and economic performances in productive activities. In agriculture, these indicators and their determinants prove relevant due to the close relationships in this activity between the use of natural resources, which is generally limited, and the provision of basic goods to society. In this context, various analyses have focused on eco-efficiency by considering individual family farms as the basic production unit. However, not only must the measure of efficiency be taken into account, but also the existence of a series of factors which constitute socio-economic, political-institutional, and environmental determinants. Said factors have been studied to a lesser extent in the literature. The present work analyzes eco-efficiency at a micro level, focusing on small-scale family farms as the main decision-making units in horticulture in southeast Spain, a sector which represents about 30% of the fresh vegetables produced in the country and about 20% of those consumed in Europe. The objectives of this study are a) to obtain a series of eco-efficiency indicators by estimating several pressure ratios and economic value added in farming, b) to analyze the influence of specific social, economic and environmental variables on the aforementioned eco-efficiency indicators. The present work applies the method of Data Envelopment Analysis (DEA), which calculates different combinations of environmental pressures (water usage, phytosanitary contamination, waste management, etc.) and aggregate economic value. In a second stage, an analysis is conducted on the influence of the socio-economic and environmental characteristics of family farms on the eco-efficiency indicators, as endogeneous variables, through the use of truncated regression and bootstrapping techniques, following Simar-Wilson methodology. The results reveal considerable inefficiency in aspects such as waste management, while there is relatively little inefficiency in water usage and nitrogen balance. On the other hand, characteristics, such as product specialization, the adoption of quality certifications and belonging to a cooperative do have a positive impact on eco-efficiency. These results are deemed to be of interest to agri-food systems structured on small-scale producers, and they may prove useful to policy-makers as regards managing public environmental programs in agriculture.

Keywords: data envelopment analysis, eco-efficiency, family farms, horticulture, socioeconomic features

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Authors: Iman Nazari, Behrouz Shaabani, Ali Ramouz

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Regarding to the dramatic rise of cancer prevalence of cancers in Iran and also base on the investigations around environmental factors which causes cancer, The air and water pollution is in high level in Iran’s capital city this issue motivated us to start an investigation on concentration of heavy metals and nitrate in Tehran’s Tap water, additionally we investigated the effects of this contaminations on public health, it is clear that heavy metals and also nitrate are causes cancers directly and indirectly, we divided the city to four districts: (1) North, (2) East, (3) West, (4) South and totally collected over 30 samples from noted districts, we obvious difference in concentrations, after a study we founded the reasons of this difference, the old distribution system, non-standard sewage disposal system, travel up from contaminated rains, releasing industrial wastes waters without any pretreatment, the most important one is the old distribution system, Tehran is an old city hence distribution system is old too we know that the old water pipes were built from alloys which containing several of this harmful heavy metals, releasing of this heavy metals from pipes to the tap water is one of the most Important reasons, as the result we presented the concentrations by districts and the alternatives to decreasing the level of this contaminations.

Keywords: water quality, heavy metals, drinking water, environmental toxinology

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Authors: Latif Karimi, Yasuhide Mochida

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The purpose of this paper is to study Modern Methods of Construction (MMC); specifically, the prefabrication technology and check the applicability, suitability, and benefits of this construction technique over conventional methods for building new houses in Afghanistan. Construction industry and house building sector are a key contributor to Afghanistan’s economy. However, this sector is challenged with lack of innovation and severe impacts that it has on the environment due to huge amount of construction waste from building, demolition and or renovation activities. This paper studies the prefabrication technology, a popular MMC that is becoming more common, improving in quality and being available in a variety of budgets. Several feasibility studies worldwide have revealed that this method is the way forward in improving construction industry performance as it has been proven to reduce construction time, construction wastes and improve the environmental performance of the construction processes. In addition, this study emphasizes on 'sustainability' in-house building, since it is a common challenge in housing construction projects on a global scale. This challenge becomes more severe in the case of under-developed countries, like Afghanistan. Because, most of the houses are being built in the absence of a serious quality control mechanism and dismissive to basic requirements of sustainable houses; well-being, cost-effectiveness, minimization - prevention of wastes production during construction and use, and severe environmental impacts in view of a life cycle assessment. Methodology: A literature review and study of the conventional practices of building houses in urban areas of Afghanistan. A survey is also being completed to study the potentials and challenges of using prefabrication technology for building modern houses in the cities across the country. A residential housing project is selected for case study to determine the drawbacks of current construction methods vs. prefabrication technique for building a new house. Originality: There are little previous research available about MMC considering its specific impacts on sustainability related to house building practices. This study will be specifically of interest to a broad range of people, including planners, construction managers, builders, and house owners.

Keywords: modern methods of construction (MMC), prefabrication, prefab houses, sustainable construction, modern houses

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Authors: Zeynep İnan Ocak, Gülsün Tanyeli

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One of the most important architectural types of Islamic architecture is madrasah used as educational institutions, hospital or observatory. This type of buildings has one or two storeys, central open or closed courtyards, four iwans and students cells located among the iwans. The main characteristic of the designs featured in the portals. The Islamic art features and adornments are seen well on these buildings made of stone. The earliest examples date to late 12th century in Anatolia after the Battle of Manzikert. Under the Seljuks rule over the one thousand facilities were built in 12th and 13th centuries and there are one hundred thirty five madrasah in total list. But today no all of them are conserved only forty percent are remained. The Seljuks madrasah located in many Anatolian were registered as immovable cultural property in several times by Turkish Culture and Tourism Ministry. The first Turkish buildings inscribed on the World Heritage List are the Great Mosque and Hospital of Divriği in 1985. Also the nominated site named as Anatolian Seljuks Madrasah is in the tentative list of UNESCO World Heritage in 2014. The property is composed some of notable madrasah such as İnce Minareli Madrasah and Karatay Madrasah in Konya; Çifte Madrasah and Sahibiye Madrasah in Kayseri; Buruciye Madrasah, Çifte Minareli Madrasah and Gök Madrasah in Sivas; Çifte Minareli Madrasah and Yakutiye Madrasah in Erzurum; Cacabey Madrasah in Kirşehir. Certainly the advantage of tourism is important for conducting the preservation of heritage. It offers much kind of cultural heritage products by means of visiting monuments. In spite of advantage of tourism, it can be the negative effects of tourism on sites and places of cultural significance. While assisting and guiding the conservation works of madrasah, it should be get reference to international charters and other doctrinal texts about the relation between heritage and tourism. Thereby the monuments will be conserved in good condition promoting by tourism. It should be plan a project about the correlation of visitors and heritage to focus on theme of Seljuks architecture. This study aims to set out the principles about the conservation of madrasah as world heritage taking advantages of tourism. The madrasah as a heritage should be evaluated not only a monument but also cultural route. So the cultural route for madrasah is determined by means of a journey through space and time, how the heritage of the different Anatolian cities. Also the cultural route is created visiting both the madrasah and the other medieval structures. In this study, the route, the principles, relation of tourism are represented considering the conservation of Seljuks madrasah.

Keywords: architectural heritage, cultural routes, Seljuks madrasah, Anatolia

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Authors: Carolina Cuéllar, Paz González

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Research has shown that school leadership has a significant indirect effect on students’ achievements. In Chile, evidence has also revealed that this impact is stronger in vulnerable schools. With the aim of strengthening school leadership, public policy has taken up the challenge of enhancing capabilities of novice principals through the implementation of induction programs, which include a mentoring component, entrusting the task of delivering these programs to universities. The importance of using mentoring or coaching models in the preparation of novice school leaders has been emphasized in the international literature. Thus, it can be affirmed that building leadership capacity through partnership is crucial to facilitate cognitive and affective support required in the initial phase of the principal career, gain role clarification and socialization in context, stimulate reflective leadership practice, among others. In Chile, mentoring is a recent phenomenon in the field of school leadership and it is even more new in the preparation of new principals who work in public schools. This study, funded by the Chilean Ministry of Education, sought to explore the challenges and lessons arising from the design and implementation of mentoring processes which are part of the induction programs, according to the perception of the different actors involved: ministerial agents, university coordinators, mentors and novice principals. The investigation used a qualitative design, based on a study of three cases (three induction programs). The sources of information were 46 semi-structured interviews, applied in two moments (at the beginning and end of mentoring). Content analysis technique was employed. Data focused on the uniqueness of each case and the commonalities within the cases. Five main challenges and lessons emerged in the design and implementation of mentoring within the induction programs for new principals from Chilean public schools. They comprised the need of (i) developing a shared conceptual framework on mentoring among the institutions and actors involved, which helps align the expectations for the mentoring component within the induction programs, along with assisting in establishing a theory of action of mentoring that is relevant to the public school context; (ii) recognizing trough actions and decisions at different levels that the role of a mentor differs from the role of a principal, which challenge the idea that an effective principal will always be an effective mentor; iii) improving mentors’ selection and preparation processes trough the definition of common guiding criteria to ensure that a mentor takes responsibility for developing critical judgment of novice principals, which implies not limiting the mentor’s actions to assist in the compliance of prescriptive practices and standards; (iv) generating common evaluative models with goals, instruments and indicators consistent with the characteristics of mentoring processes, which helps to assess expected results and impact; and (v) including the design of a mentoring structure as an outcome of the induction programs, which helps sustain mentoring within schools as a collective professional development practice. Results showcased interwoven elements that entail continuous negotiations at different levels. Taking action will contribute to policy efforts aimed at professionalizing the leadership role in public schools.

Keywords: induction programs, mentoring, novice principals, school leadership preparation

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Authors: Abdulrahman Algaeed

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The Ophthalmic Ultrasound is the easiest method of early diagnosing Retinoblastoma after clinical examination. It can be done with ease without sedation. King Khaled Eye Specialist Hospital is a tertiary care center where Retinoblastoma patients are often seen and treated there. The first modality to rule out the disease is Ophthalmic Ultrasound. Classic Retinoblastoma is easily diagnosed by using the conventional 10MHz Ophthalmic Ultrasound probe in the regular clinic setup. Retinal lesion with multiple, very highly reflective surfaces within lesion typical of Calcium deposits. The use of Standardized A-scan is very useful where internal reflectivity is classified as very highly reflective. Color Doppler is extremely useful as well to show the blood flow within lesion/s. In conclusion: Ophthalmic Ultrasound should be the first tool to be used to diagnose Retinoblastoma after clinical examination. The accuracy of the Exam is very high.

Keywords: doppler, retinoblastoma, reflectivity, ultrasound

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Authors: Meseret Habtamu, Mekuria Argaw

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Urban forests can help to improve the microclimate and air quality. Urban forests in Addis Ababa are important sinks for GHGs as the number of vehicles and the traffic constrain is steadily increasing. The objective of this study was to characterize the vegetation types in selected public parks and to estimate the carbon stock potential of urban forests by assessing carbon in the above, below ground biomass, in the litter and soil. Species which vegetation samples were taken using a systematic transect sampling within value DBH ≥ 5cm were recorded to measure the above, the below ground biomass and the amount of C stored. Allometric models (Y= 34.4703 - 8.0671(DBH) + 0.6589(DBH2) were used to calculate the above ground and Below ground biomass (BGB) = AGB × 0.2 and sampling of soil and litter was based on quadrates. There were 5038 trees recorded from the selected study sites with DBH ≥ 5cm. Most of the Parks had large number of indigenous species, but the numbers of exotic trees are much larger than the indigenous trees. The mean above ground and below ground biomass is 305.7 ± 168.3 and 61.1± 33.7 respectively and the mean carbon in the above ground and below ground biomass is 143.3±74.2 and 28.1 ± 14.4 respectively. The mean CO2 in the above ground and below ground biomass is 525.9 ± 272.2 and 103.1 ± 52.9 respectively. The mean carbon in dead litter and soil carbon were 10.5 ± 2.4 and 69.2t ha-1 respectively. Urban trees reduce atmospheric carbon dioxide (CO2) through sequestration which is important for climate change mitigation, they are also important for recreational, medicinal value and aesthetic and biodiversity conservation.

Keywords: biodiversity, carbon sequestration, climate change, urban forests

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Authors: Krishna Prasad Sharma

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Nepal’s financial sector has become deeper and wider, and the number and types of financial intermediaries have grown rapidly over the past two decades. However, access to financial services remains limited for many people in many parts of rural Nepal. While financial institutions have been expanding rapidly in an urban area in recent years, the access to the rural poor is excessively inadequate due to financial illiteracy and limited numbers of financial institutions that confined only to the district headquarters. Based on the focus group discussion, semi-structured interview of key people and literature review, this paper aims to examine the supply of and demand for financial services in Nepal and the constraints to increasing access to them, and offers way forward for making the financial sector work for all of Nepal’s people, especially the rural poor. While Nepal’s government has tried to increase access to formal financial services for small businesses and low-income households through directed lending programs for small businesses and low-income households, created specialized wholesale and retail institutions, and lowered market entry requirements, formal financial services are declining, and financial intermediation is stagnating. Supply and demand indicators show that, despite government efforts, formal financial institutions do not serve the needs of most of the Nepalese population. While access to and use of formal financial services are limited, in general, the problem is acute for small businesses and low-income households. Indeed, both access and use are closely correlated with business loan size and household income. This study concludes that banks and microfinance institutions with the use of mobile phones can connect hundreds of millions of unbanked and low-income people, especially rural poor to financial services at low costs. While there are many challenges ahead in expanding the service to rural areas, the mobile financial services will be beneficial that makes payments faster and cheaper, more convenient and accessible to a greater number of senders and recipients in rural areas. In rural areas, clients will benefit from money transfer and other mobile and online services.

Keywords: financial inclusion, financial enabling environment, microfinance, branchless banking, rural poor

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Authors: Emmanuel Dele Balogun

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This paper analyzes, using descriptive statistics and econometrics data which span the period 1981 to 2014 to gauge the effects of trade policy incentives on economic growth in Nigeria. It argues that the provided incentives penalize economic growth during pre-trade liberalization eras, but stimulated a rapid increase in total factor productivity during the post-liberalization period of 2000 to 2014. The trend analysis shows that Nigeria maintained high tariff walls in economic regulation eras which became low in post liberalization era. The protections were in favor of infant industries, which were mainly appendages of multinationals but against imports of competing food and finished consumer products. The trade openness index confirms the undue exposure of Nigeria’s economy to the vagaries of international market shocks; while banking sector recapitalization and new listing of telecommunications companies deepened the financial markets in post-liberalization era. The structure of economic incentives was biased in favor of construction, trade and services, but against the real sector despite protectionist policies. Total Factor Productivity (TFP) estimates show that the Nigerian economy suffered stagnation in pre-liberalization eras, but experienced rapid growth rates in post-liberalization eras. The regression results relating trade policy incentives to TFP growth rate yielded a significant but negative intercept suggesting that a non-interventionist policy could be detrimental to economic progress, while protective tariff which limits imports of competing products could spur productivity gains in domestic import substitutes beyond factor growth with market liberalization. The main constraint to the effectiveness of trade policy incentives is the failure of benefiting industries to leverage on the domestic factor endowments of the nation. This paper concludes that there is the need to review the current economic transformation strategies urgently with a view to provide policymakers with a better understanding of the most viable options that could make for rapid success.

Keywords: economic growth, macroeconomic incentives, total factor productivity, trade policies

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Authors: Katja Mikhailovich, Barbara Pamphilon

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Farmer training in Papua New Guinea has focused mainly on technology transfer approaches. This has primarily benefited men and often excluded women whose literacy, low education and role in subsistence crops has precluded participation in formal training. The paper discusses an approach that uses both a brokerage model of agricultural extension to link smallholders with private sector agencies and an innovative family team’s approach that aims to support the economic empowerment of women in families and encourages sustainable and gender equitable farming and business practices.

Keywords: women, economic development, agriculture, training

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Authors: Philippa Anne French

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This paper presents a case study of 3000acres, a for-purpose organisation established in 2013 to improve the health of Melbournians by enabling them to grow more of their own food. Over the past four years, the organisation has encountered a number of barriers, both obvious and less obvious, which discourage communities from beginning their own food-growing projects. These include soil contamination, planning policies, public perception and access to land. 3000acres has been working to remove these barriers if possible, or otherwise to find ways around them. Strategies have included the use of removable planter boxes on temporarily vacant land, separating the site soil from above-ground garden beds, writing planning exemptions, developing relationships with land management authorities and recording both the quantitative and qualitative products of food gardens in Melbourne. While creating change in policy and legal requirements will be a gradual process, discernable progress has been made in the attitudes of land management authorities and the establishment of new food gardens is becoming easier. Over the past four years, 3000acres has supported the establishment of 14 food gardens in and around Melbourne, including public community gardens, fenced community gardens and urban farms supplying food to a food relief organisation.

Keywords: case study, community gardens, land access, land contamination, urban agriculture

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Authors: Oliver Fuo

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One of the central features of post-apartheid constitutional reform was the establishment of local government as a distinct sphere of government in the Constitution of the Republic of South Africa, 1996. Local government, constituted by about 279 wall-to-wall municipalities, have legislative and executive powers vested in democratically elected municipal councils to govern areas within their jurisdiction subject only to limits imposed by the Constitution. In addition, unlike the past where municipalities merely played a service delivery role, they are now mandated to realise an expanded developmental mandate – pursue social justice and sustainable development; contribute, together with national and provincial government, to the realisation of socio-economic rights entrenched in the Bill of Rights; and facilitate public participation in local governance. In order to finance their developmental programmes, municipalities receive equitable allocations from national government and have legal powers to generate additional finances by charging rates on property and imposing surcharges on services provided. In addition to its general obligation to foster public participation in local governance, the law requires municipalities to facilitate public participation in their budgeting processes. This requirement is generally consistent with recent trends in local government democratic reforms which call for inclusive budget planning and implementation whereby citizens, civil society and NGOs participate in the allocation of resources. This trend is best captured in the concept of participatory budgeting. This paper specifically analyses the legal and policy framework for participatory budgeting at the local government level in South Africa. Using Borbet South Africa (Pty) Ltd and Others v Nelson Mandela Bay Municipality 2014 (5) SA 256 (ECP) as an example, this paper argues that the legal framework for participatory budgeting creates an illusory right for citizens to participate in municipal budgeting processes. This challenge is further compounded by the barrenness of the jurisprudence of courts that interpret the obligation of municipalities in this regard. It is submitted that the wording of s 27(4) of the Municipal Finance Management Act (MFMA) 53 of 2003 - which expressly stipulates that non-compliance by a municipality with a provision relating to the budget process or a provision in any legislation relating to the approval of a budget-related policy, does not affect the validity of an annual or adjustments budget – is problematic as it seems to trivialise the obligation to facilitate public participation in budgeting processes. It is submitted that where this provision is abused by municipal officials, this could lead to the sidelining of the real interests of communities in local budgets. This research is based on a critical and integrated review of primary and secondary sources of law.

Keywords: courts and jurisprudence, local government law, participatory budgeting, South Africa

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Authors: Rasim M. Alguliyev, Alovsat G. Aliyev

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In the paper information on economic development trends in developed countries are analyzed. The current status of information society and economy of the country is reviewed and some recommendations are given for future development. The problems of Information Society and establishment of its innovative economy are studied. In this turn, development trends information economy in developed countries are analyzed.

Keywords: information economy, ICT sector, ICT infrastructure, innovation, innovation system hi-tech products, antimonopoly policy

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Authors: Teten Masduki

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Indonesia is a unitary state which has a wide range of cultures, local languages, religions, ethnicity, race, traditions, and beliefs held by people who are scattered in several islands Indonesia. But with such diversity has the potential to cause various problems in society. Because one of the characteristics of diversity is the difference. Unresolved differences could develop into conflicts or contradictions in society. Pancasila as the philosophy and ideology of the nation was stated in the opening of the 1945 Constitution as an alternative solution to the conflict that occurred in Indonesia. Because the ideology of Pancasila role as a nation and also as an integral tool that upholds humanity, justice, unity, harmony, and balance on the belt by the five precepts. If the values contained in Pancasila can be applied and lived by the public of Indonesia, it will be the creation of a just, peaceful and peace. However, the lack of public awareness in implementing pancsila can lead to conflict within the community itself, such as the existence of separatist movements in Papua who gathered in the Organisasi Papua Merdeka (OPM) with the active movement that has a lot of casualties. This paper raised the topic of which offer solutions revitalization (reviving) the values of Pancasila as an alternative solution to the conflict in Indonesia is based on a case study of separatist movements in Papua. This paper will also discuss the implementation of strategic steps in the implementation of solutions which are summarized in the conclusions of this paper.

Keywords: Pancasila, separatism, revitalization, democracy

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Authors: Louay Safi

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The notion of secular society that evolved over the last two centuries was initially intended to free the public sphere from religious imposition, before it assumed the form a comprehensive ideology whose aim is to prevent any overt religious expression from the public space. The negative view of religious expression, and the desire by political elites to purge the public space from all forms of religious expressions were first experienced in the Middle East in the last decades of the twentieth century in relation to Islam, before it manifests itself in the twentieth century Europe. Arab regimes were encouraged by European democracies to marginalize all forms of religious expressions in the public as part of the secularization process that was deemed necessary for modernization and progress. The prohibition of Islamic symbols and outlawing the headscarf was first undertaken to Middle Eastern republics, such as Turkey in 1930s and Syria in 1970s, before it is implemented recently in France. Secularization has been perceived by European powers as the central aspect of social and political liberalization, and was given priority over democratization and human rights, so much so that European elites were willing to entrust the task of nurturing liberal democracy to Arab autocrats and dictators. Not only did the strategy of empowering autocratic regimes to effect liberal democratic culture failed, but it contributed to the rise of Islamist extremism and produced failed states in Syria and Iraq that undermine both national and global peace and stability. The paper adopts the distinction made by John Rawls between political and comprehensive liberalism to argue that the modernization via secularization in Muslim societies is counterproductive and has subverted early successful efforts at democratization and reform in the Middle East. Using case studies that illustrate the role of the secularization strategy in Syria, Iran, and Egypt in undermining democratic and reformist movements in those countries, the paper calls for adopting a different approach rooted in liberal and democratic values rather than cultural practices and lifestyle. The paper shows that Islamic values as articulated by reform movements support a democratic and pluralist political order, and emphasizes the need to legitimize and support social forces that advocate democracy and human rights. Such an alternative strategy allows for internal competition among social groups for popular support, and therefore enhances the chances that those with inclusive and forward-looking political principles and policies would create a democratic and pluralist political order more conducive to meaningful national and global cooperation, and respectful of human dignity.

Keywords: democracy, Islamic values, political liberalism, secularization

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Authors: Simplejit Kaur Dhanoa, Manmohan Singh

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This study was done with the primary objective to evaluate the motor and mental developmental delays among children having neonatal Jaundice. A total sample of 300 neonates were collected; out of them, 150 were preterm neonates, and 150 were full term neonates from the hospital setting and follow up study was done with the help of the Developmental Assessment scale of the Indian Infant. The registered samples were assessed up to 2.6 years with a gap of 6 months. The outcomes of this study reveal that developmental delays were present among children who had preterm neonatal jaundice as compare to full term normal babies. Further, It was reported that both motor and mental development is affected due to neonatal hyperbilirubinemia in addition to preterm birth.

Keywords: hyperbinirubinemia, preterm neonates, developmental delays, preterm

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Authors: Ana María Rojas Chaparro, Cristian Camilo Sarmiento Chaves

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Given the growing importance of logistics as a discipline for efficient management of materials flow and information, the adoption of tools that permit to create facilities in making decisions based on a global perspective of the system studied has been essential. The article shows how from a concepts-based model is possible to organize and represent in appropriate way the reality, showing accurate and timely information, features that make this kind of models an ideal component to support an information system, recognizing that information as relevant to establish particularities that allow get a better performance about the evaluated sector.

Keywords: system, information, conceptual model, logistics

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Authors: Mekroud Amel

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Introduction The rate of use by the elderly of emergency departments, operating rooms and intensive care units has increased worldwide. Emergency surgery is a context where evaluation is often insufficient, with incomplete information gathering. The aim of this work is to shed light on the frequent use of emergency surgeries by the elderly and their characteristics, as well as on the lack of geriatric assessment scores in the emergency room. Material : Prospective, observational and descriptive, monocentric study. Patients aged 65 and over, admitted for emergency surgery in the operating room, were counted. Emergency operating room including visceral surgery, urology, traumatology and neurosurgery. Parameters studied: Patient characteristics, degree of autonomy, type of surgical pathology, operative management times, preoperative evaluation, postoperative outcome Results : 192 patients were identified over 12 months, from 09.01.2017 to 08.31.2018 Age from 65 to 101 years, 79.81 years +/- 8.38. With predominance of the age group between [65-75 years] 41.1% Female predominance, Sexratio = 0.81 Elderly subjects with total motor autonomy are in the majority at 57.8% Subjects without pathological ATCD represent 12.5% of cases Those who are on only one type of medication or without any treatment are at 36.9% Discussion : The emergency operative care of the elderly patient for a surgical or traumatological pathology is characterized by many specificities linked first to the emergency context, where the evaluation is often insufficient, besides the fact that the elderly patient has particularities requiring reception in centers with experience in the care of this category of patient, or, failing that, a center which uses the minimum of geriatric evaluation scores which are simplified for the emergency departments. In our hospital, we have not yet made this evaluation routine in the emergency room and this delay in the introduction of these scores can be directly attributed to the covid 19 pandemic. Besides the standard preoperative assessment, only 43.2% of patients were assessed in the preoperative period by an anesthesiologist. Traumatological emergencies come first 68.2% followed by visceral emergencies 19.2% (including proctological, urological emergencies), neurosurgical emergencies 7.8% and finally peripheral emergency surgery all acts combined 4.7%. Hospital stay at 9.6 +/- 16.8 days, average operability time of 4.5 +/- 3 days. Death rate at 7.29% Conclusion This work has demonstrated the major impact of emergency surgery, which remains curable for the most part, on the elderly patient despite total motor and cognitive autonomy preoperatively. The improvement of the preoperative evaluation, the reduction of the operating time and enhanced recovery after surgery, with personalized protocols, are the only guarantee for the resumption of preoperative autonomy in these patients.

Keywords: emergency surgery, elderly patients, preoperative geriatric scores, curable emergency surgical pathologies

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Authors: Tzipi Eshet

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The primary objectives of this work are the examination of public preferences and attributed importance to different characteristics of coastal cliff protection alternatives, and drawing conclusions about the applicable alternative in Beit-Yanai beach. Erosion of coastal cliffs is a natural phenomenon that occurs in many places in the world. This creates problems along the coastlines, which are densely populated areas with highly developed economic activity. In recent years, various aspects of the aeolianite cliffs along the Israeli coast have been studied extensively. There is a consensus among researchers regarding a general trend of cliff retreat. This affects civilian infrastructure, wildlife habitats and heritage values, as well as Increases the risk to human life. The Israeli government, committed to the integrated coastal zones management approach, decided on a policy and guidelines to deal with cliff erosion, which includes establishing physical protection on land and in the sea, sand nourishment and runoff drainage. Physical protection solutions to reduce the rate of retreat of the cliffs are considerably important both for planning authorities and visitors to the beach. Direct costs of different protection alternatives, as well as external costs and benefits, may vary, thus affecting consumer preferences. Planning and execution of sustainable coastal cliff protection alternatives must take into account the different characteristics and their impact on aspects of economics, environment and leisure. The rocky shore of Beit-Yanai Beach was chosen as a case study to examine the nature of the influence of various protective solutions on consumer preferences. This beach is located in the center of Israel's coastline, and acts as a focus of attraction for recreation, land and sea sports, and educational activities as well. If no action will be taken, cliff retreat will continue. A survey was conducted to reveal the importance of coastal protection alternatives characteristics and the visual preferences to visitors at beach Beit-Yanai and residents living on the cliff (N=287). Preferences and willingness-to-pay were explored using Contingent-Ranking and Choice-Experiments techniques. Results show that visitors’ and residents’ willingness-to-pay for coastal cliff protection alternatives is affected both by financial and environmental aspects, as well as leisure. They prefer coastal cliff protection alternatives that are not visible and do not need constant maintenance, do not affect the quality of seawater or the habitats of wildlife and do not lower the security level of the swimmers. No significant difference was found comparing willingness-to-pay among local and non-local users. Additionally, they mostly prefer a protection solution which is integrated in the coastal landscape and maintains the natural appearance of the beach. Of the possible protection alternatives proposed for the protection of the cliff in Beit Yanai beach are two techniques that meet public preferences: rock revetments and submerged detached breakwaters. Results indicate that the visiting public prefer the implementation of these protection alternatives and will be willing to pay for them. Future actions to reduce retreat rate in Beit-Yanai have to consider implications on the economic, environmental and social conditions, along with weighting public interest against the interest of the individual.

Keywords: contingent-ranking, choice-experiments, coastal cliff protection, erosion of coastal cliffs, environment

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Authors: Rabiaal Adawiyah Shazali, Corina Joseph

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The disclosure of Intellectual Capital (IC) information is getting more vital in today’s era of a knowledge-based economy. Companies are advised by accounting bodies to enhance IC disclosure which complements the conventional financial disclosures. There are no accounting standards for Intellectual Capital Disclosure (ICD), therefore the disclosure is entirely voluntary. Hence, this study aims to investigate the extent of ICD and to examine the relationship between corporate governance and ICD in Malaysia. This study employed content analysis of 100 annual reports by the top 100 public listed companies in Malaysia during 2012. The uniqueness of this study lies on its underpinning theory used where it applies the institutional isomorphism theory to support the effect of the attributes of corporate governance towards ICD. In order to achieve the stated objective, multiple regression analysis were employed to conduct this study. From the descriptive statistics, it was concluded that public listed companies in Malaysia have increased their awareness towards the importance of ICD. Furthermore, results from the multiple regression analysis confirmed that corporate governance affects the company’s ICD where the frequency of audit committee meetings and the board size has positively influenced the level of ICD in companies. Findings from this study would provide an incentive for companies in Malaysia to enhance the disclosure of IC. In addition, this study would assist Bursa Malaysia and other regulatory bodies to come up with a proper guideline for the disclosure of IC.

Keywords: annual report, content analysis, corporate governance, intellectual capital disclosure

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Authors: N. Gharooni-Dowrani, B. Gharooni-Dowrani

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The benefits of hilotherapy following orthogonathic surgery have been explored in recent years, demonstrating reduction in patient pain and swelling post-operatively. However, hilotherapy is not always widely accessible to all patients following orthognathic surgery. In this study, 50 patients were examined at Luton and Dunstable Hospital, half (25) of which used hilotherm masks post operatively and half of which opted for traditional ice packs in order to aid recovery. This study demonstrated that the use of hilotherapy reduced patient pain when analgesia need and use were analysed, as well as shortening inpatient stay. Although no current hilotherm masks are available without rental services in our trust, this study demonstrated the positive outcomes that they may bring, which may be worth future investment for our department.

Keywords: orthognathic surgery, orthodontics, hilotherapy, OMFS

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Authors: Sisi Xia, Dezhuan Tao

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Urban Double Reform is an effective means to improve the quality of ecological space, based on improving the living environment and urban functions and promoting the organic integration of the city and nature. This paper takes the design of Qinyang Wetland Park in Jiaozuo, Henan Province, as an example, attempting to closely link the ecological restoration of wetland with the urban culture and to extend the urban spirit of the ancient county of Qinyang while purifying the ecological water system. This design uses ecological technology to repair underwater forests and underwater turf, rapidly improving the quality of urban water without biological side effects. The ecological grass slope is used to create multiple bank forms, combining with a number of hydrophilic platforms to provide a good view of the public. Through the placement of ecological education bases, urban cultural exhibition halls, and other means, the cultural value of wetland parks will be enhanced, and the citizens will return to nature and experience the ecology and appreciate the charm of urban culture in the ecological space. Repair the ecosystem, sculpt the urban culture, let the public return to nature, experience the ecology, and experience the charm of urban culture in the ecological space.

Keywords: urban double reform, ecological space, improvement strategy, wetland park design

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Authors: Marziye Hadian, Alireza Jabbari

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Background: The World Health Organization has identified COVID-19 as a public health emergency and is urging governments to stop the virus transmission by adopting appropriate policies. In this regard, the countries have taken different approaches to cutting the chain or controlling the spread of the disease. Methods: The present study was a systematize review of publications relating to prevention strategies for covid-19 disease. The study was carried out based on the PRISMA guidelines and CASP for articles and AACODS for grey literature. Finding: The study findings showed that in order to confront the COVID-19 epidemic, in general, there are three approaches of "mitigation", "active control" and "suppression" and four strategies of "quarantine", "isolation", "social distance" as well as "lockdown" in both individual and social dimensions to deal with epidemics that the choice of each approach requires specific strategies and has different effects when it comes to controlling and inhibiting the disease. Conclusion: The only way to control the disease is to change your behavior and lifestyle. In addition to prevention strategies, use of masks, observance of personal hygiene principles such as regular hand washing and non-contact of contaminated hands with the face, as well as observance of public health principles such as control of sneezing and coughing, safe extermination of personal protective equipment, etc. have not been included in the category of prevention tools. However, it has a great impact on controlling the epidemic, especially the new coronavirus epidemic.

Keywords: novel corona virus, COVID-19, prevention tools, prevention strategies

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Authors: Seng Sing Tan

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Clamping of the umbilical cord after birth is widely practiced as a part of labor management. Further improvements were proposed to produce a smaller, lighter and more comfortable clamp while still maintaining current standards of clamping. A detachable holder was also developed to facilitate the clamping process. This pilot study on the efficacy of the mini-clamp was conducted to evaluate a tightness of the seal and a firm grip of the clamp on the umbilical cord. The study was carried out at National University Hospital, using 5 sets of placental cord. 18 samples of approximate 10 cm each were harvested. The test results showed that the mini-clamp was able to stop the flow through the cord after clamping without rupturing the cord. All slip tests passed with a load of 0.2 kg. In the pressure testing, 30kPa of saline was exerted into the umbilical veins. Although there was no physical sign of fluid leaking through the end secured by the mini-clamp, the results showed the pressure was not able to sustain the pressure set during the tests. 12 out of the 18 test samples have more than 7% of pressure drop in 30 seconds. During the pressure leak test, it was observed on several samples that when pressurized, small droplets of saline were growing on the outer surface of the cord lining membrane. It was thus hypothesized that the pressure drop was likely caused by the perfusion of the injected saline through the Wharton’s jelly and the cord lining membrane. The average pressure in the umbilical vein is roughly 2.67kPa (20 mmHg), less than 10% of 30kPa (~225mmHg), set for the pressure testing. As such, the pressure set could be over-specified, leading to undesirable outcomes. The development of the mini-clamp was an attempt to increase the comfort of newly born babies while maintaining the usability and efficacy of hospital grade umbilical cord clamp. The pressure leak in this study would be unfair to fully attribute it to the design and efficacy of the mini-clamp. Considering the unexpected leakage of saline through the umbilical membrane due to over-specified pressure exerted on the umbilical veins, improvements can definitely be made to the existing experimental setup to obtain a more accurate and conclusive outcome. If proven conclusive and effective, the mini-clamp with a detachable holder could be a smaller and potentially cheaper alternative to existing umbilical cord clamps. In addition, future clinical trials could be conducted to determine the user-friendliness of the mini-clamp and evaluate its practicality in the clinical setting by labor ward clinicians. A further potential improvement could be proposed on the sustainability factor of the mini-clamp. A biodegradable clamp would revolutionise the industry in this increasingly environmentally sustainability world.

Keywords: leak test, mini-clamp, slip test, umbilical cord

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