Search results for: public health emergency

Authors: Grichting Anna, Al Sada Sara, Caccayam Angelica, Khan Urshi

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The Qatar Museums Authority recently announced a series of public art initiatives in Doha with the purpose of 'bringing art out of the walls of the museum' to make it accessible to the public on a daily basis and to encourage discussion and debate. While the installation of sculptures in public spaces is not new in Doha, the practice of integrating art in public spaces and architectural projects is reaching a new dimension as internationally renowned artists – such as Damien Hirst and Richard Serra - are being commissioned to install their works in the public spaces and buildings of the city of Doha as well as in more remote desert locations. This research discusses the changing presence, role and context of public art in Doha, both from a historical and cultural overview, and the different forms and media as well as the typologies of urban and public spaces in which the art is installed. It examines the process of implementing site-specific artworks, looking at questions of scale, history, social meaning and formal aesthetics. The methodologies combine theoretical research on the understanding of public art and its role and placement in public space, as well as empirical research on contemporary public art projects in Doha, based on documentation and interviews and as well as site and context analysis of the urban or architectural spaces within which the art is situated. Surveys and interviews – using social media - in different segments of the contemporary Qatari society, including all nationalities and social groups, are used to measure and qualify the impacts and effects on the population.

Keywords: public space, public art, urban design, knowledge economy

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Authors: Neda Valizadeh, Mani Mofidi, Sama Haghighi, Ali Hashemaghaee, Soudabeh Shafiee Ardestani

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Background: There are many systems and parameters to evaluate trauma patients in the emergency department. Most of these evaluations are to distinguish patients with worse conditions so that the care systems have a better prediction of condition for a better care-giving. The purpose of this study is to determine the relationship between axillary body temperature and mortality in patients hospitalized in the intensive care unit (ICU) with multiple traumas and with other clinical and para-clinical factors. Methods: All patients between 16 and 75 years old with multiple traumas who were admitted into Emergency Department then hospitalized in the ICU were included in our study. An axillary temperature in the first and the second day of admission, Glasgow cola scale (GCS), systolic blood pressure, Serum glucose levels, and white blood cell counts of all patients at the admission day were recorded and their relationship with mortality were analyzed by SPSS software with suitable statistical tests. Results: Axillary body temperatures in the first and second day were statistically lower in expired traumatic patients (p=0.001 and p<0,001 respectively). Patients with lower GCS had a significantly lower first-day temperature and a significantly higher mortality. (p=0.006 and p=0.006 respectively). Furthermore, the first-day axillary temperature was significantly lower in patients with a lower first-day systolic blood pressure (p=0.014). Conclusion: Our results showed that lower axillary body temperature in the first day is associated with higher mortality, lower GCS, and lower systolic blood pressure. Thus, this could be used as a predictor of mortality in evaluation of traumatic patients in emergency settings.

Keywords: fever, trauma, mortality, emergency

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Authors: Celestina Omoso Isiramen

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The influence of witchcraft belief on disease causation, cure and public health system in Nigeria cannot be underrated. This paper investigated the nexus between witchcraft phenomenon and health-seeking behaviour of HIV sufferers in Edo state, Nigeria. Survey methodology was adopted and stratified random sampling technique was employed in the selection of 600 sample group spread into 200 HIV sufferers, 200 spiritual healers and 200 bio-medics from the three Senatorial districts of the state. Data were collected through the use of structured questionnaire and in-dept interview and analyzed using simple percentage and frequency. Major findings were: belief in witchcraft significantly influenced the people’s perception of HIV causation and wellness and this impacted adversely on public health-care. Poverty, ignorance and dearth of retroviral drugs enhanced the people’s recourse to spiritual healers. Collaboration between spiritual healing techniques and biomedicine was recommended as panacea for curbing HIV/AIDS related morbidity and mortality. It concluded that socio-economic problems must be addressed while the importance of integrating the values of spiritual healing into biomedicine cannot be overstressed.

Keywords: biomedicine, health care, HIV/AIDS, spirituality, witchcraft

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Authors: Julius A. Ademokoya, Grace C. Ilori

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Extreme public transport difficulty for persons with disabilities (PWDs) has always been one of the challenges which these individuals experience on a daily basis in Nigeria. Private and public transport vehicles are not disability- friendly. Operators of public transport are often very intolerant of PWDs' conditions. Indeed, many Nigerians believe it is luxury for PWDs to engage in public transport. They are rarely expected to be seen in public much less going to places via public transport means. Initiatives by a few Nigerian states to develop and implement public transport policies for PWDs, therefore, were a huge relief for them and some concerned Nigerians. A few years ago, three southwest Nigerian states (Lagos, Ondo, and Ekiti) came up with some legislative welfare provisions (including transport programmes) for PWDs. This study, therefore, sought to ascertain levels of awareness and implementation of public policies among the PWDs and those expected to implement the policies. The study adopted a mixed method research. Findings across the three states showed that: (1) awareness of public policies among PWDs is low and (2) a considerable scope of the policies is not yet implemented. Recommendations are, therefore, made on how to improve on awareness and implementation of transport policies for PWDs in three south-west Nigerian states.

Keywords: awareness, disability rights, implementation persons with disability, transport policies

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Authors: Charles P. Mukumba, Kahilu K. Shakantu

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Achieving the Sustainable Development Goals [SDGs] is a key to achieving transformational results that support Zambia’s development. Public procurement is an integral to the government’s mission to deliver goods and services, in a timely and economic manner beyond the value of money spent. This study explores the link between sustainable public procurement and the SDG targets in Zambia. And to validate the established links with the public sector procurement in Zambia. The study employed qualitative research using semi-structured interviews with 18 public procurement officials. The collected data was analysed using thematic analysis. The findings indicate that public procurement plays a fundamental role in achieving the sustainable development goals [SDGs] by helping to deliver core public services that support SDGs and also by systematising and co-delivering added value along the way. The study further established the importance of sustainable public procurement within the context of development. The interviews were limited to mainstream public sector procurement entities in Lusaka, Zambia. Sustainable public procurement actions have the potential to impact SDG goals. Promoting sustainable public procurement will enhance sustainable development and significantly improve supply chain that would benefit the economy, society and environment. Findings will inform policy-makers how to strategically design sustainable public procurement policy by attuning it to procuring entities objectives and priorities in order to contribute to the attainment of SDGs.

Keywords: sustainable public procurement, sustainable development goals, target, Zambia

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Authors: Asmaa Sokrat, Aykut Karaman

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Public and private spaces are major components of the morphology of the city. This research aims to study the interactions between public and private domains in terms of urban space in Casablanca. The research focuses on a general vision of a socio-spatial issue. It plans to identify the public, private, and transition (semi-public, semi-private) spaces as the constituent of the urban space. Moreover, the study investigates the link between public and private spaces with the social dimensions. Additionally, the research argues that the public space is a place of social interaction; as a reflection, this interaction is the intersection between urban space and social connectedness. Besides, social interaction can be the key to distinguishing between the public and private spheres. The methodological approach of the research is based on the literature review and field study. The article is targeting a case study on the old Medina of Casablanca, from daily use of the public and private spaces, the urban tissue, and the urban space types. In conclusion, the research exhibits that a public space could influence the privacy of the residents of a local urban area; thus, this privacy is inverted on the social interaction. This social interaction is the link between the urban space and social connectedness. Hence, this equation affects the typology of the private space.

Keywords: public sphere, private sphere, social connectedness, old Medina of Casablanca

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Authors: Zhi Liu, Hui Jiang, Jin Li, Kunhao Chen, Langfang Zhang

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Fast acquisition of the seismic information and accurate assessment of the earthquake disaster is the key problem for emergency rescue after a destructive earthquake. In order to meet the requirements of the earthquake emergency response and rescue for the cities and counties, a quasi real-time comprehensive evaluation system for earthquake disaster is developed. Based on monitoring data of Micro-Electro-Mechanical Systems (MEMS) strong motion network, structure database of a county area and the real-time disaster information by the mobile terminal after an earthquake, fragility analysis method and dynamic correction algorithm are synthetically obtained in the developed system. Real-time evaluation of the seismic disaster in the county region is finally realized to provide scientific basis for seismic emergency command, rescue and assistant decision.

Keywords: quasi real-time, earthquake disaster data collection, MEMS accelerometer, dynamic correction, comprehensive evaluation

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Authors: Biback Das

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New Public Management, a phenomenal tool, which is used to enforcing in public administration in different country’s to enhance the capacities. Since the 1980s, New Public Management (NPM) is primarily focusing to modernize the public sector. From the initial period, many developed countries such as UK, New Zealand, Australia, and the USA are applied in their administration to modernize. Almost 1990s, it has been applied in many developing countries. This study can describe the real situations of NPM based administration. Bangladesh Government has taken many projects to reform the public sector under NPM. Even many Development Agencies like UN, UNDP, World Bank, Asian Development Bank and so on, along with many developed countries also invested and prescribed to take NPM based reform that can to restructure the public sector so that it can maximize the efforts to provide the better service. This study examines using many factors that effects work on Public Administration in Bangladesh and also assessing its endeavor to adopt in it. Although Government has taken such initiatives to implement NPM originated reform, it’s not effectively been implemented to bring positive change about as per NPM objectives. This study mainly examines some initiatives in Bangladesh that have the influence of NPM as well as some drawbacks that can’t help the satisfaction of these initiatives. This article help to identify the efforts of many development agencies providing a fund to enhance the NPM based projects with their specific conditions that are prescribed by them helping to get fund. Therefore, to establish effective public management or to follow NPM model, Bangladesh need having an institutional framework, sound rule of law, proper structure, effective civil service system, appropriate checks, and balances to restructure the public sector help along with donor agencies ad implement in it. Bangladesh Government has applied its recent days to enhance the capabilities in its Public Administration. Moreover, this study mainly identifies how the designing strategies, program formulating, its implementation in various sector such as education, health sector etc. and how to reduce the backdrop the during problem by smooth functioning. This paper is also assessing the influence of many projects like PPP (Public-Private and Partnership) to work along with private organizations for smooth service delivery. Accordingly, this paper briefly reviews how it applies in a global context following the taken many initiatives and the consequences of Bangladesh context.

Keywords: new public management, capacity building, conditionalities, service delivery, public-private-partnership

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Authors: Gokul Pathak, Dilip Kumar Yadav

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Background: Unsafe/unprotected and early sexual relations are highly responsible for the problems of unwanted pregnancy, child birth and other adverse consequences. Emergency contraception (EC) refers to methods that women can use to prevent pregnancy after unprotected sexual intercourse, method failure or incorrect use. Aim and Objective: The objective of this research study was to assess the level of knowledge, attitude and behavior on emergency contraception among youth students of Lekhnath Municipality. Methodology: This institution based descriptive study was carried out in August-October 2012 on Lekhnath Municipality, Nepal. Multistage simple random sampling procedure with pretested semi structured questionnaire following self administered technique was used to collect information. Collected data was coded and entered in the EpiData 3.1 ® and exported to Statistical Package for Social Science (SPSS®) version 20.0 for analysis. Chi-square test and Spearman correlation was applied wherever required. Results: A total of 641 students (87.6 %), youth students participated in this study which incorporates 354 male and 287 female youth students, of them 54.3% were from Higher Secondary level and 45.7% were from Undergraduate level. The awareness of EC among respondents was found only 64.7%. 25.8% respondents were found to have fair knowledge level where as 74.2% had poor knowledge level. Level of knowledge was significantly associated with age, educational level, faculty and educational status of mother. The study showed 82.4% respondent’s favorable attitude towards use of EC. 21.1% respondents were found to be sexually active (29.7% male and 10.5% female) and only 28.1% of sexually active respondents had ever used any method of EC. Conclusion: Knowledge about EC was found quiet low among youth. There was significant lack of knowledge about exact time limit of using devices of EC. Similarly several misconceptions regarding EC were found very high among youth. Health education initiatives should target students as they are more likely to be sexually active.

Keywords: emergency contraception, youth, unsafe/unprotected sexual intercourse, knowledge, attitude and behavior

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Authors: Marshal D. Kafle, Jun H. Kim, Hyun W. Been, Kyoung M. Min

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Fluid viscous damping systems are well suited for many air vehicles subjected to shock and vibration. These damping system work with the principle of viscous fluid throttling through the orifice to create huge pressure difference between compression and rebound chamber and obtain the required damping force. One application of such systems is its use in aircraft door system to counteract the door’s velocity and safely stop it. In exigency situations like crash or emergency landing where the door doesn’t open easily, possibly due to unusually tilting of fuselage or some obstacles or intrusion of debris obstruction to move the parts of the door, such system can be combined with other systems to provide needed force to forcefully open the door and also securely stop it simultaneously within the required time i.e.less than 8seconds. In the present study, a hydraulic system called snubber along with other systems like actuator, gas bottle assembly which together known as emergency power assist system (EPAS) is designed, built and experimentally studied to check the magnitude of angular velocity, damping force and time required to effectively open the door. Whenever needed, the gas pressure from the bottle is released to actuate the actuator and at the same time pull the snubber’s piston to operate the emergency opening of the door. Such EPAS installed in the suspension arm of the aircraft door is studied explicitly changing parameters like orifice size, oil level, oil viscosity and bypass valve gap and its spring of the snubber at varying temperature to generate the optimum design case. Comparative analysis of the EPAS at several cases is done and conclusions are made. It is found that during emergency condition, the systemopening time and angular velocity, when snubber with 0.3mm piston and shaft orifice and bypass valve gap of 0.5 mm with its original spring is used,shows significant improvement over the old ones.

Keywords: aircraft door damper, bypass valve, emergency power assist system, hydraulic damper, oil viscosity

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Authors: Yousef Abu Nahleh, Alhasan Hakami, Arun Kumar, Fugen Daver

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This study considers the problem of calculating safety stocks in disaster situations inventory systems that face demand uncertainties. Safety stocks are essential to make the supply chain, which is controlled by forecasts of customer needs, in response to demand uncertainties and to reach predefined goal service levels. To solve the problem of uncertainties due to the disaster situations affecting the industry sector, the concept of Emergency Safety Stock (ESS) was proposed. While there exists a huge body of literature on determining safety stock levels, this literature does not address the problem arising due to the disaster and dealing with the situations. In this paper, the problem of improving the Order Quantity Model to deal with uncertainty of demand due to disasters is managed by incorporating a new idea called ESS which is based on the probability of disaster occurrence and uses probability matrix calculated from the historical data.

Keywords: Emergency Safety Stocks, safety stocks, Order Quantity Model, supply chain

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Authors: Pablo J. Valverde, Jaime E. Fernandez

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This paper shows under which conditions public corruption can emerge. The theoretical model includes variables such as the public employee wage (w), a control corruption parameter (c), and the group size of interactions (GS) between clusters of public officers and contractors. The system behavior is analyzed using phase diagrams based on combinations of such parameters (c, w, GS). Numerical simulations are implemented in order to contrast analytic results based on Nash equilibria of the theoretical model. Major findings include the functional relationship between wages and network topology, which attempts to reduce the emergence of corrupt behavior.

Keywords: public corruption, game theory, complex systems, Nash equilibrium.

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Authors: Duygu Çelgin

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Until the new Occupational Health and Safety Law of Turkey, most of the workers were excluded from the mandatory occupational health and safety services. This new law, made the OHS services mandatory for all workers from all sectors including both public and private. However, in the application some problems and disadvantageous cases are occurred and the government also considered these cases. In this study, the new OHS law of Turkey and the regulations prepared according to the law are studied with the literature search.

Keywords: occupational health and safety in Turkey, OHS servicing in Turkey, safety experts, OHS support

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Authors: Anthony Barker, Roland Jiang

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Dupuytren’s contractures are a debilitating condition affecting the palmar fascia of the hand reducing its function. This case series looks at the minimally-invasive technique of Xiaflex injections and the outcome in a public health setting. 15 patients undertook collagenase injection (Xiaflex, C. histolyticum) injection over the period from September 2015 to May 2017 at Fairfield Hospital, NSW. Their reported outcome post injection and in follow-up was recorded as well as their satisfaction and likelihood to request the procedure in the future. Other treatment modalities include percutaneous needle aponeurotomy, limited palmar fasciotomy, and palmar fasciectomy. A literature review of cost-effectiveness was performed to compare Xiaflex suitability for waitlist reduction in a public setting given average waiting times in the public setting extend past 365 days.

Keywords: Dupuytrens Disease, xiaflex, collagenase, plastic surgery

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Authors: Majid Bayatian, Mohammadreza Ashouri

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Releasing hazardous chemicals is one of the major problems for office buildings in the chemical industry and, therefore, environmental risks are inherent to these environments. The adverse health effects of the airborne concentration of benzene have been a matter of significant concern, especially in oil refineries. The chronic and acute adverse health effects caused by benzene exposure have attracted wide attention. Acute exposure to benzene through inhalation could cause headaches, dizziness, drowsiness, and irritation of the skin. Chronic exposures have reported causing aplastic anemia and leukemia at the occupational settings. Association between chronic occupational exposure to benzene and the development of aplastic anemia and leukemia were documented by several epidemiological studies. Numerous research works have investigated benzene emissions and determined benzene concentration at different locations of the refinery plant and stated considerable health risks. The high cost of industrial control measures requires justification through lifetime health risk assessment of exposed workers and the public. In the present study, a Computational Fluid Dynamics (CFD) model has been proposed to assess the exposure risk of office building around a refinery due to its release of benzene. For simulation, GAMBIT, FLUENT, and CFD Post software were used as pre-processor, processor, and post-processor, and the model was validated based on comparison with experimental results of benzene concentration and wind speed. Model validation results showed that the model is highly validated, and this model can be used for health risk assessment. The simulation and risk assessment results showed that benzene could be dispersion to an office building nearby, and the exposure risk has been unacceptable. According to the results of this study, a validated CFD model, could be very useful for decision-makers for control measures and possibly support them for emergency planning of probable accidents. Also, this model can be used to assess exposure to various types of accidents as well as other pollutants such as toluene, xylene, and ethylbenzene in different atmospheric conditions.

Keywords: health risk assessment, office building, Benzene, numerical simulation, CFD

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Authors: Victor Kang, Sirene Bellahnid, Amy Al-Simaani

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Efficient documentation and completion of clerical tasks are pillars of efficient patient-centered care in acute settings such as the emergency department (ED). Medical scribes aid physicians with documentation, navigation of electronic health records, results gathering, and communication coordination with other healthcare teams. However, the use of medical scribes is not widespread, with some hospitals even continuing to discontinue their programs. One reason for this could be the lack of studies that have outlined concrete improvements in efficiency and patient and provider satisfaction in emergency departments before and after incorporating scribes. Methods: We conducted a review of the literature concerning the implementation of a medical scribe program and emergency department performance. For this review, a narrative synthesis accompanied by textual commentaries was chosen to present the selected papers. PubMed was searched exclusively. Initially, no date limits were set, but seeing as the electronic medical record was officially implemented in Canada in 2013, studies published after this date were preferred as they provided insight into the interplay between its implementation and scribes on quality improvement. Results: Throughput, efficiency, and cost-effectiveness were the most commonly used parameters in evaluating scribes in the Emergency Department. Important throughput metrics, specifically door-to-doctor and disposition time, were significantly decreased in emergency departments that utilized scribes. Of note, this was shown to be the case in community hospitals, where the burden of documentation and clerical tasks would fall directly upon the attending physician. Academic centers differ in that they rely heavily on residents and students; so the implementation of scribes has been shown to have limited effect on these metrics. However, unique to academic centers was the provider’s perception of incrased time for teaching was unique to academic centers. Consequently, providers express increased work satisfaction in relation to time spent with patients and in teaching. Patients, on the other hand, did not demonstrate a decrease in satisfaction in regards to the care that was provided, but there was no significant increase observed either. Of the studies we reviewed, one of the biggest limitations was the lack of significance in the data. While many individual studies reported that medical scribes in emergency rooms improved relative value units, patient satisfaction, provider satisfaction, and increased number of patients seen, there was no statistically significant improvement in the above criteria when compiled in a systematic review. There is also a clear publication bias; very few studies with negative results were published. To prove significance, data from more emergency rooms with scribe programs would need to be compiled which also includes emergency rooms who did not report noticeable benefits. Furthermore, most data sets focused only on scribes in academic centers. Conclusion: Ultimately, the literature suggests that while emergency room physicians who have access to medical scribes report higher satisfaction due to lower clerical burdens and can see more patients per shift, there is still variability in terms of patient and provider satisfaction. Whether or not this variability exists due to differences in training (in-house trainees versus contractors), population profile (adult versus pediatric), setting (academic versus community), or which shifts scribe work cannot be determined based on the studies that exist. Ultimately, more scribe programs need to be evaluated to determine whether these variables affect outcomes and prove whether scribes significantly improve emergency room efficiency.

Keywords: emergency medicine, medical scribe, scribe, documentation

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Authors: Sunny Ewankhiwimen Aigbomian

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Time, is a scarce resource and in everything we do, time is required to accomplish any given task. The need for this presentation is predicated on the way majority of Nigerian especially in the public sector operators see “Time Management”. Time as resources cannot be regained if lost or managed badly. As a significant aspect of human life it should be handled with diligence and utmost seriousness if the public sector is to function as a coordinated entity. In our homes, private life and offices, we schedule different things to ensure that some things do not go the unexpected. When it comes to service delivery on the part of government, it ought to be more serious because government is all about effect and efficient service delivery and “Time” is a significant variable necessary to successful accomplishment. The need for Nigerian government to re-examine time management in her public sector with a view of repositioning the sector to be able to compete well with other public sectors in the world. The peculiarity of Time management in Public Sector in Nigerian context as examined and some useful recommendations of immerse assistance proffered.

Keywords: Nigeria, public sector, time management, task

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Authors: Nazif Fuat Turkmen

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Domestic violence is the most common form of violence that risks the health and psychological well-being of victims and its witnesses. Psychology as a scientific field has made contributions in research, exploration, assessment, intervention, and prevention of domestic violence. The present study will be exploring the level of recognition of Turkish Cypriots on domestic violence and their understanding about it in general terms. While discussing the level of awareness of Turkish Cypriots on domestic violence and the effects of this level of awareness on the general well-being of the members of the society, the most common types of domestic violence as well as how Turkish Cypriots recognize and interpret these different types will be explored. The participants consisted of 224 Turkish Cypriots; 48.4% (n= 109) were female, 51.1% (n=115) were male. For the purpose of the study, a 28-item questionnaire was prepared and used for data collection. According to the results, there is a strong relationship between the education level of the respondents and their awareness on domestic violence. The study shows that cultural approaches on child rearing effect people’s recognition of violence in general and awareness on domestic violence in particular.

Keywords: culture, domestic violence, health psychology, public health, Turkish Cypriots, violence

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Authors: Sathvika Reddy, Devi Revathi

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Background: In India, deliberate self-harm (DSH) with poisoning agents carries a significant impact on morbidity and mortality. Changes in the patterns of poisoning vary across various geographical locations. It is important to know the patterns in a given region in order to facilitate rapid clinical diagnosis, appropriate treatment to reduce associated morbidity and mortality. Aim and Objective: To study the patterns, treatment outcomes of acute poisoning in patients admitted to emergency wards in a tertiary care hospital and to provide poison information services. Materials and Methods: This study was conducted at M.S Ramaiah Memorial and Teaching Hospital from November 2016 to March 2017. The patient’s data was obtained from patient case sheet, interaction with health care professionals, interviewing patients and their caretakers (if possible), and were documented in a suitably designed form. Results: The study involved 131 patients with a mean age of 27.76 ± 15.5 years. Majority of the patients were in the age group 21-30 years, literates (n=53) dwelling in urban (n=113) areas belonging to upper middle class (n=50). Analgesics and antipyretics were commonly utilized in intentional drug overdosage (n=49). Envenomation constituted n=21(16.03%). Furthermore, a significant relationship was observed between marital status and self-poisoning (n=64) (P < 0.001) which commonly occurred through oral ingestion. The outcomes were correlated with the GCS and PSS system and n=85 recovered, n=17 were discharged against medical advice, and n=4 died, and n=4 were lost to follow up respectively. The poison information queries include drug overdose (n=29) and management related queries (n=22) provided majorly by residents (n=45) to update knowledge (n=11) and for better patient care (n=40). Conclusion: The trend in poisoning is dynamic. Medications were identified as the main cause of poisoning in urban areas of India. Educational programs with more emphasis on preventive measures are necessary to create awareness among the general public.

Keywords: poisoning, suicides, clinical pharmacist, envenomation, poison information services

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Authors: Emy Nayana Pinto, Denise Bomtempo Birche De Carvalho

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In the present study, the harmful use of illicit drugs is seen as a public health problem and as one of the expressions of the social question, since its consequences fall mainly on the poorer classes of the population. This perspective is a counterpoint to the dominant paradigm on illicit drug policy at the global level, whose centrality lies within the criminal justice arena. The 'drug problem' is internationally combated through fragmented approaches that focus its actions on banning and criminalizing users. In this sense, the research seeks to answer the following key questions: What are the influences of the prohibitionism in the recommendations of the United Nations (UN), the World Health Organization (WHO), and the formulation of drug policies in member countries? What are the actors that have been provoking the prospect of breaking with the prohibitionist paradigm? What is the WHO contribution to the rupture with the prohibitionist paradigm and the displacement of the drug problem in the field of public health? The general objective of this work is to seek evidence from the perspective of rupture with the prohibitionist paradigm in the field of drugs policies at the global and regional level, through analysis of documents of the World Health Organization (WHO), between the years of 2001 to 2016. The research was carried out in bibliographical and documentary sources. The bibliographic sources contributed to the approach with the object and the theoretical basis of the research. The documentary sources served to answer the research questions and evidence the existence of the perspective of change in drug policy. Twenty-two documents of the UN system were consulted, of which fifteen had the contribution of the World Health Organization (WHO). In addition to the documents that directly relate to the subject of the research, documents from various agencies, programs, and offices, such as the Joint United Nations Program on HIV/AIDS (UNAIDS) and the United Nations Office on Drugs and Crime (UNODC), which also has drugs as the central or transversal theme of its performance. The results showed that from the 2000s it was possible to find in the literature review and in the documentary analysis evidence of the critique of the prohibitionist paradigm parallel to the construction of a new perspective for drug policy at the global level and the displacement of criminal justice approaches for the scope of public health, with the adoption of alternative and pragmatic interventions based on human rights, scientific evidence and the reduction of social damages and health by the misuse of illicit drugs.

Keywords: illicit drugs, international organizations, prohibitionism, public health, World Health Organization

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Authors: Kimberly Tasha Jiayi Tang, Changqing Lin, Zhe Wang, Tze-Wai Wong, Md. Shakhaoat Hossain, Jian Yu, Alexis Lau

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Hong Kong has practiced a risk-based Air Quality Health Index (AQHI) system that sums hospitalization risks associated with short-term exposure to air pollu-tants. As an air pollution risk communication tool, it informs the public about the current air quality, anchoring around the World Health Organization's (WHO) 2005 Air Quality Guidelines (AQGs). Given the WHO's recent update in 2021, assessing how Hong Kong’s air quality risk communication can be en-hanced using these updated guidelines is essential. Hong Kong’s AQHI is lim-ited by solely focusing on short-term health risks, which could lead the public to underestimate cumulative health impacts. Therefore, we propose the intro-duction of a composite AQHI that reports both long-term and short-term health risks. Additionally, the WHO interim targets will be considered as anchor points for various health risk categories. Furthermore, with the increasing ozone levels in Hong Kong and Southern China due to improved NOx mitigation measures, it has been a challenging task in balancing health protection against climate mitigation. However, our findings present a promising outlook. Despite the rise in ozone levels, the combined health risks in Hong Kong and Guang-dong have seen a decline, largely due to reductions in NO2 and PM concentra-tions, both having significant health implications. By shifting from a concentra-tion-based approach to a health risk-based system like the AQHI, our study highlights the prospective of harmonizing health protection and climate mitiga-tion goals. This health-focused framework suggests that rigorous NOx controls can effective-ly serve both objectives in parallel.

Keywords: air quality management, air quality health index, health risk management, air pollution

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Authors: Laura Cochrane

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The United States Centers for Disease Control and Prevention has established three categories of biological agents based on their ease of spread and the severity of the disease they cause. Category A biological agents are the highest priority because of their high degree of morbidity and mortality, ease of dissemination, the potential to cause social disruption and panic, special requirements for public health preparedness, and past use as a biological weapon. Despite the threat of Category A biological agents, opportunities for medical intervention exist. This work summarizes public information, consolidated and reviewed across the situational usefulness and disease awareness to offer discussion to three specific Category A agents: anthrax (Bacillus anthracis), botulism (Clostridium botulinum toxin), and smallpox (variola major), and provides an overview on the management of medical countermeasures available to treat these three (3) different types of pathogens. The medical countermeasures are discussed in the setting of pre-exposure prophylaxis, post-exposure prophylaxis, and therapeutic treatments to provide a framework for requirements in public health preparedness.

Keywords: anthrax, botulism, smallpox, medical countermeasures

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Authors: Marine Kobalava, Eter Narimanishvili, Nino Grigolaia

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The paper analyzes the contemporary problems of public relations in Georgia. The approaches to public attitudes towards the relationship with the population of the country are studied on a global scale, the importance of forming the concept of public relations in Georgia in terms of globalization is justified. The basic components of public relations are characterized by the RACE system, namely analyzing research, action, communication, evaluation. The main challenges of public relations are identified in the research process; taking into consideration the scope of globalization, the influence of social, economic, and political changes in Georgia on PR development are identified. The article discusses the public relations as the strategic management function that facilitates communication with the society, recognition of public interests, and their prediction. In addition, the feminization of the sector is considered to be the most important achievement of public relations in the modern world. The conclusion is that the feminization indicator of the field is an unconditional increase in the employment rates of women. In the paper, the problems of globalization and public relations in the industrial countries are studied, the directions of improvement of public relations with the background of peculiarities of different countries and globalization process are proposed. Public relations under globalization are assessed in accordance with the theory of benefits and requirements, and the requirements are classified according to informational, self-identification, integration, social interaction, and other types of signs. In the article, conclusions on the current challenges of public relations in Georgia are made, and the recommendations for their solution, taking into consideration globalization processes in the world, are proposed.

Keywords: public relations, globalization, RACE system, public relationship concept, feminization

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Authors: John Ahluwalia

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As an affluent first-world nation, Canada took swift and comprehensive action during the outbreak of the SARS-CoV-2 (COVID-19) pandemic compared to other countries in the same socio-economic cohort. The United States has stumbled to overcome obstacles most developed nations have faced, which has led to significantly more per capita cases and deaths. The initial outbreaks of COVID-19 occurred in the US and Canada within days of each other and posed similar potentially catastrophic threats to public health, the economy, and governmental stability. On a macro level, events that take place in the US have a direct impact on Canada. For example, both countries tend to enter and exit economic recessions at approximately the same time, they are each other’s largest trading partners, and their currencies are inexorably linked. Variables intrinsic to Canada’s national infrastructure have been instrumental in the country’s efforts to flatten the curve of COVID-19 cases and deaths. Canada’s coordinated multi-level governmental effort has allowed it to create and enforce policies related to COVID-19 at both the national and provincial levels. Canada’s policy of universal health care is another variable. Health care and public health measures are enforced on a provincial level, and it is within each province’s jurisdiction to dictate standards for public safety based on scientific evidence. Rather than introducing confusion and the possibility of competition for resources such as PPE and vaccines, Canada’s multi-level chain of government authority has provided consistent policies supporting national public health and local delivery of medical care. This paper will demonstrate that the coordinated efforts on provincial and federal levels have been the linchpin in Canada’s relative success in containing the deadly spread of the COVID-19 virus.

Keywords: COVID-19, canada, GIS, geospatial analysis

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Authors: Abdullah Alhaqbani

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Purpose: Implementing continuous improvement is a challenge that public sector organisations face in becoming successful. Many obstacles hinder public organisations from successfully implementing continuous improvement. This paper aims to highlight the key core obstacles that face public organisations to implement continuous improvement programmes. Approach: Based on the literature, this paper reviews 66 papers that were published between 2000 and 2013 and that focused on the concept of continuous improvement and improvement methodologies in the context of public sector organisations. The methodologies for continuous improvement covered in these papers include Total Quality Management, Six Sigma, process re-engineering, lean thinking and Kaizen. Findings: Of the 24 obstacles found in the literature, 11 barriers were seen as core barriers that frequently occurred in public sector organisations. The findings indicate that lack of top management commitment; organisational culture and political issues and resistance to change are significant obstacles for improvement programmes. Moreover, this review found that improvement methodologies share some core barriers to successful implementation within public organisations. These barriers as well are common in the different geographic area. For instance lack of top management commitment and training that found in the education sector in Albanian are common barriers of improvement studies in Kuwait, Saudi Arabia, Spain, UK and US. Practical implications: Understanding these core issues and barriers will help managers of public organisations to improve their strategies with respect to continuous improvement. Thus, this review highlights the core issues that prevent a successful continuous improvement journey within the public sector. Value: Identifying and understanding the common obstacles to successfully implementing continuous improvement in the public sector will help public organisations to learn how to improve in launching and successfully sustaining such programmes. However, this is not the end; rather, it is just the beginning of a longer improvement journey. Thus, it is intended that this review will identify key learning opportunities for public sector organisations in developing nations which will then be tested via further research.

Keywords: continuous improvement, total quality management, obstacles, public sector

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Authors: Taerim Kim, Shin Ahn, Chang Hwan Sohn, Dong Woo Seo, Won Young Kim

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Object: Reversible cerebral vasospasm syndrome (RCVS) remains an underrated cause of thunderclap headache which shares similar history of the ‘worst-ever’ headache with subarachnoid hemorrhage (SAH) to the emergency physicians. This study evaluated the clinical manifestations, radiological features, and outcomes of patients with RCVS so that the physicians could raise the high index of suspicion to detect RCVS in more patients with thunderclap headache before having life-threatening complications. Methods: The electric medical records of 18 patients with diagnostic criteria of RCVS at the emergency department (ED) between January 2013 and December 2014 were retrospective reviewed. Results: The mean age was 50.7 years, and 80% were women. Patients with RCVS visit an average of 4.7 physicians before receiving an accurate diagnosis and mean duration of symptom until diagnosis is 9.3 days. All patients except one experienced severe headache, from 8 to 10 pain intensity on a numerical rating scale (NRS). 44% of patients had nausea as an associated symptom, 66% of patients experienced worsening of headache while gagging, leaning forward, defecating, urinating or having sex. The most frequently affected vessels are middle cerebral arteries demonstrating the characteristic diffuse “string of beads” appearance. Four patients had SAH as a complication. Conclusion: Patients with RCVS have a unique set of clinical and imaging features. Emergency physicians should raise the high index of suspicion to detect RCVS in more patients with thunderclap headache before life-threatening complications.

Keywords: headache, thunderclap, subarachnoid haemorrhage, stroke

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Authors: S. Ahmet Bagci, Hayati Akman

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This study was conducted at the research laboratory and greenhouse conditions to determine the effect on germination and emergency values of long-term stored seed (7 years) and non-stored seed (control) of nine durum wheat varieties. Three replicates of 20 seeds were germinated between double layered rolled germination papers in the Petri plates. Seeds were allowed to germinate at 20±1°C in the dark for 8 days. The seeds were counted on the 8th day as per ISTA rules and calculated in percent to determine germination capacity. Seedling emergency values were determined by testing 20 seeds placed into the sands with three replications of pots. Plants were counted on the 7th day and 12th day to determined seedling emergency rate and capacity, respectively. According to results, there are significant differences among the varieties in terms of germination capacity, seedling emergency rate and capacity of long-term stored and non-stored seeds. Germination capacity values declined from 100% to 93,3% of non-stored seeds whereas they were from 96,7% to 71,7% of long-term stored seeds. Percentage of seedling emergency capacity varied from 65,0% to 93,3% for non-stored seeds, however, the percentage of it was between 11,7 and 86,7% for long-term stored seeds. Results indicate that germination and emergence values responses to long-term stored condition varied significantly among durum wheat cultivars. Research results showed that the long-term-storage resulted in significant decrease with 13.5 % for germination, 36.4 % for emergence on the seventh day and 32.4 % for emergence on the twelfth day. Germination values ranged from 93.3 to 100.0 % for control and 71.7 to 96.7 % for storage. Emergence values in seventh day varied between 51.7 % and 90.0 % for control and 75.0 % and 10.0 % for storage, however values in twelfth day were between 93.3 % and 65.0 % for control and 86.7 % and 11.7 % for storage. According to research results, germination and emergence responses to long-term storage condition varied significantly among durum wheat cultivars.

Keywords: germination, emergence, long-term-storage, durum wheat

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Authors: Pelin Sonmez

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Health services provided to refugees and asylum seekers are very important and of priority due to their physical damages during the war and conflict situation, possible diseases in migration journey and negative psychological mood. However, there are very poor international standards in regards to providing health services to these people, which in return cause each country to differ their regulations. United Nations Sustainable Development Goals that are in effect as of 2016 assure that attention should be provided to non-citizen vulnerable groups in terms of health policies and they should be included in the global development, thereby aims to decrease the problems arising from providing health services to refugees. Though, we should not forget that these are the recent and yet uncertain attempts, mostly, as a result of Syrian War's forced migration wave. As an attempt to reveal different attitudes of international actors, this study compares/analyzes health services provided to refugees and asylum seekers on the basis of Turkey-EU policy implementations. While doing so, two research data will be focused upon. In this globe, results of the focus group interviews and a field study in a specific work (from its health related section) which was done in 2017 to 5000 Syrian women living in Turkey and presented to Republic of Turkey Disaster and Emergency Management Presidency will be utilized.

Keywords: European Union, health policies, refugee, Syrian women, Turkey

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Authors: Titir Bhattacharya, Tanika Chakraborty, Prabal K. De

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Maternal and child health continue to be a significant policy focus in developing countries, including India. An emerging model in health care is the creation of public and private partnerships. Since the construction of physical infrastructure is costly, governments at various levels have tried to implement social health insurance schemes where a trust calculates insurance premiums and medical payments. Typically, qualifying families get full subsidization of the premium and get access to private hospitals, in addition to low cost public hospitals, for their tertiary care needs. We analyze one such pioneering social insurance scheme in the Indian state of Andhra Pradesh (AP). The Rajiv Aarogyasri program (RA) was introduced by the Government of AP on a pilot basis in 2007 and implemented in 2008. In this paper, we first examine the extent to which access to reproductive health care changed. For example, the RA scheme reimburses hospital deliveries leading us to expect an increase in institutional deliveries, particularly in private hospitals. Second, we expect an increase in institutional deliveries to also improve child health outcomes. Hence, we estimate if the program improved infant and child mortality. We use District Level Health Survey data to create annual birth cohorts from 2000-2015. Since AP was the only state in which such a state insurance program was implemented, the neighboring states constituted a plausible control group. Combined with the policy timing, and the year of birth, we employ a difference-indifference strategy to identify the effects of RA on the residents of AP. We perform several checks against threats to identification, including testing for pre-treatment trends between the treatment and control states. We find that the policy significantly lowered infant and child mortality in AP. We also find that deliveries in private hospitals increased, and government hospitals decreased, showing a substitution effect of the relative price change. Finally, as expected, out-of-pocket costs declined for the treatment group. However, we do not find any significant effects for usual preventive care such as vaccination, showing that benefits of insurance schemes targeted at the tertiary level may not trickle down to the primary care level.

Keywords: public health insurance, maternal and child health, public-private choice

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Authors: H. Nur Görkemli, Mehmet Fidan

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After the first acquaintance with internet in April 1993, number of internet users increased rapidly in Turkey. According to Turkish Statistical Institute’s 2013 data, internet usage in Turkey between 16-74 age group is 48,9%. Hospitals are one of the areas where internet is being intensively used like many other businesses. As a part of public relations application, websites are important tools for hospitals to reach a wide range of target audience within and outside the organization. With their websites, hospitals have opportunities to give information about their organization, strengthen their image, compete with their rivals, interact with shareholders, reflect their transparency and meet with new audiences. This study examines web sites of totally 31 hospitals which are located in Konya. Institutions are categorized as public and private hospitals and then three main research categories are determined: content, visual and technical. Main and sub categories are examined by using content analysis method. Results are interpreted in terms of public and private institutions.

Keywords: websites, hospital, health communication, internet, webpages

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