Search results for: Greek public hospital sector

Authors: Inuwa Danladi Bawa

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One of the challenges of African states in the development of education in the past and the present is the problem of literacy. Literacy in the first language is seen as a strong base for the development of second language; they are mostly the language of education. Language development is an offshoot of language planning; so the need to develop literacy in both first and second language affects language education and predicts the extent of achievement of the entire education sector. The need to balance literacy acquisition in first language for good conditioning the acquisition of second language is paramount. Likely constraints that includes; non-standardization, underdeveloped and undeveloped first languages are among many. Solutions to some of these include the development of materials and use of the stages and levels of literacy acquisition. This is with believed that a child writes well in second language if he has literacy in the first language.

Keywords: first language, second language, literacy, english language, linguistics

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Authors: Klara Strecker

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During times of globalization, socioeconomic systems have become connected across the world through global supply chains. As a result, consumption and production locations have increasingly become spatially decoupled. This decoupling leads to complex entanglements of systems and sustainability challenges across distances -entanglements which can be conceptualized as telecouplings. Through telecouplings, people and environments across the world have become closely connected, bringing challenges as well as opportunities. Some argue that telecoupling dynamics started taking shape during times of colonization when resources were first traded across the world. An example of such a telecoupling is that of the rose. Every third rose sold in Europe is grown in Kenya and enters the European market through the Dutch flower auction system. Many Kenyan farms are Dutch-owned, closely entangling Kenya and the Netherlands through the trade of roses. Furthermore, the globalization of the flower industry and the resulting shift of production away from the Netherlands and towards Kenya has led to significant changes in the Dutch horticulture sector. However, the sustainability effects of this rose telecoupling is limited neither to the horticulture sector nor to the Netherlands and Kenya. Alongside the flow of roses between these countries come complex financial, knowledge-based, and regulatory flows. The rose telecoupling also creates spillover effects to other countries, such as Ethiopia, and other industries, such as Kenyan tourism. Therefore, telecoupling dynamics create complex entanglements that cut across sectors, environments, communities, and countries, which makes effectively governing and managing telecouplings and their sustainability implications challenging. Indeed, sustainability can no longer be studied in spatial and temporal isolation. This paper aims to map the rose telecoupling’s complex environmental and social interactions to identify points of tension guiding sustainability-targeted interventions. Mapping these interactions will provide a more holistic understanding of the sustainability challenges involved in the Dutch-Kenyan rose trade. This interdisciplinary telecoupling approach reframes and integrates interdisciplinary knowledge about the rose trade between the Netherlands, Kenya, and beyond.

Keywords: Dutch-Kenyan rose trade, globalization, socio-ecological system, sustainability, telecoupling

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Authors: Naziema B. Jappie

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Internationalization is very complex and multifaceted and has implications for the entire university sector, and the larger community which it serves. Higher education strategic plans require sustainability on all levels of academic engagement and internationalization contributes to the sustainability because of the global competition but, at the same time, ensures diversity on campuses. Universities all over the world are increasingly recognizing the challenges of globalization and the pressures towards internationalization. The past 25 years of internationalization has faded away, and new challenges have emerged. Although internationalization remains a central strategic objective for all universities, for many leaders and education practitioners it has remained a confused concept. It has various interpretations, and it intersects with numerous other national agendas in higher education domain; it often builds upon narrow notions limited to one of its facets –attracting international student fees for financial sustainability or for ensuring a diverse campus culture. It is essential to have clear institutional views, but it is imperative that everyone reflects on the values and beliefs that underpin the internationalization of higher education and have a global focus. This paper draws together the international experience locally and globally to explore the emerging patterns of strategy and practice in internationalizing higher education. This will highlight some critical notions of how the concepts of internationalization and globalization in the context of higher education is understood by those who lead universities and what new challenges are being created as universities seek to become more international. Institutions cannot simply have bullet points in the strategic plan about recruitment of international students; there has to be a complete commitment to an international strategy of inclusivity. This paper will further examine the leadership styles that ensure transformation together with the goals set out for internationalization. The interviews with the senior leadership are in-depth semi-structured recorded interviews of approximately one-hour to learn about their institutional experiences, promotion, and enhancement of the value of internationalisation to the tertiary education sector and initiating discussions around adding the international relations dimension to the curriculum. This paper will address the issues relevant to the cross-border delivery of higher education. To ensure anonymity throughout this study, the interviewees are identified only by their institutions.

Keywords: challenges, globalization, higher education, internationalization, strategic focus

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Authors: Chandra Shekhar Majumder, Orin Sultana Jamie

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Background: Dacryocystorhinostomy (DCR) has been a widely accepted surgical intervention for nasolacrimal duct obstructions. Some previous studies demonstrated the potential benefits of the peroperative application of agents like Mitomycin-C (MMC) with DCR to improve surgical outcomes. Relevant studies are rare in Bangladesh, and there are controversies about the dose, duration of MMC, and outcome. Therefore, the present study aimed to investigate the comparative efficacy of DCR with and without MMC in a tertiary hospital in Bangladesh. Objective: The study aims to determine the outcome of a dacryocystorhinostomy with preoperative local use of mitomycin–C. Methods: An analytical study was conducted in the Department of Ophthalmology, Sir Salimullah Medical College & Mitford Hospital, Dhaka, from January 2023 to September 2023. Seventy patients who were admitted for DCR operation were included according to the inclusion and exclusion criteria. Patients were divided into two groups: those who underwent DCR with peroperative administration of 0.2 mg/ml Mitomycin-C for 5 minutes (Group I) and those who underwent DCR alone (Group II). All patients were subjected to detailed history taking, clinical examination, and relevant investigations. All patients underwent DCR according to standard guidelines and ensured the highest peroperative and postoperative care. Then, patients were followed up at 7th POD, 1-month POD, 3 months POD, and 6 months POD to observe the success rate between the two groups by assessing tearing condition, irrigation, height of tear meniscus, and FDDT- test. Data was recorded using a pre-structured questionnaire, and collected data were analyzed using SPSS 23. Results: The mean age of the study patients was 42.17±6.7 (SD) years and 42.29±7.1 (SD) years in Groups I and II, respectively, with no significant difference (p=0.945). At the 6th month’s follow-up, group I patients were observed with 94.3% frequency of symptom-free, 85.6% patency of lacrimal drainage system, 68.6% had tear meniscus <0.1mm and 88.6% had positive Fluorescence Dye Disappearance Test (FDDT test). In group II, 91.4% were symptom-free, 68.6% showed patency, 57.1% had a height of tear meniscus < 0.1 mm, and 85.6% had FDDT test positive. But no statistically significant difference was observed (p<.05). Conclusion: The use of Mitomycin-C preoperatively during DCR offers better postoperative outcomes, particularly in maintaining patency and achieving symptom resolution with more FDDT test positive and improvement of tear meniscus in the MMC group than the control group. However, this study didn’t demonstrate a statistically significant difference between the two groups. Further research with larger sample sizes and longer follow-up periods would be beneficial to corroborate these findings.

Keywords: dacryocystorhinostomy, mitomycin-c, dacryocystitis, nasolacrimal duct obstruction

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Authors: Hamid Reza Tabatabaiefar, Bita Mansoury, Mohammad Javad Khadivi Zand

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The current energy and climate change impacts of the residential building sector in Australia are significant. Thus, the Australian Government has introduced more stringent regulations to improve building energy efficiency. In 2006, the Australian residential building sector consumed about 11% (around 440 Petajoule) of the total primary energy, resulting in total greenhouse gas emissions of 9.65 million tonnes CO2-eq. The gas and electricity consumption of residential dwellings contributed to 30% and 52% respectively, of the total primary energy utilised by this sector. Around 40 percent of total energy consumption of Australian buildings goes to heating and cooling due to the low thermal performance of the buildings. Thermal performance of buildings determines the amount of energy used for heating and cooling of the buildings which profoundly influences energy efficiency. Employing sustainable design principles and effective use of construction materials can play a crucial role in improving thermal performance of new and existing buildings. Even though awareness has been raised, the design phase of refurbishment projects is often problematic. One of the issues concerning the refurbishment of residential buildings is mostly the consumer market, where most work consists of moderate refurbishment jobs, often without assistance of an architect and partly without a building permit. There is an individual and often fragmental approach that results in lack of efficiency. Most importantly, the decisions taken in the early stages of the design determine the final result; however, the assessment of the environmental performance only happens at the end of the design process, as a reflection of the design outcome. Finally, studies have identified the lack of knowledge, experience and best-practice examples as barriers in refurbishment projects. In the context of sustainable development and the need to reduce energy demand, refurbishing the ageing residential building constitutes a necessary action. Not only it does provide huge potential for energy savings, but it is also economically and socially relevant. Although the advantages have been identified, the guidelines come in the form of general suggestions that fail to address the diversity of each project. As a result, it has been recognised that there is a strong need to develop guidelines for optimised retrofitting of existing residential buildings in order to improve their energy performance. The current study investigates the effectiveness of different energy retrofitting techniques and examines the impact of employing those methods on energy consumption of residential brick veneer buildings in Victoria (Australia). Proposing different remedial solutions for improving the energy performance of residential brick veneer buildings, in the simulation stage, annual energy usage analyses have been carried out to determine heating and cooling energy consumptions of the buildings for different proposed retrofitting techniques. Then, the results of employing different retrofitting methods have been examined and compared in order to identify the most efficient and cost-effective remedial solution for improving the energy performance of those buildings with respect to the climate condition in Victoria and construction materials of the studied benchmark building.

Keywords: brick veneer residential buildings, building energy efficiency, climate change impacts, cost effective remedial solution, energy performance, sustainable design principles

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Authors: Joseph Paul Chunga

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The investment universe is awash with a myriad of financial choices that investors have to opt for, which principally culminates into a duality between aggressive or conservative approaches. Howbeit, it is pertinent to emphasize that the investment vehicles with an aggressive approach tend to take on more risk than the latter group in an effort to generate higher future returns for their respective investors. This study examines the conditionality effect that such partiality in financing has on the High-Tech and Public Utility companies listed on the Shenzhen Stock Exchange (SSE). Specifically, it examines the significance of the relationship between capitalization ratios of Total Debt Ratio (TDR), Degree of Financial Leverage (DFL) and profitability ratios of Earnings per Share (EPS) and Returns on Equity (ROE) on the Financial Risk of the two industries. We employ a modified version of the Panel Regression Model used by Rahman (2017) to estimate the relationship. The study finds that there is a significant positive relationship between the capitalization ratios on the financial risk of Public Utility companies more than High-Tech companies and a substantial negative relationship between the profitability ratios and the financial risk of the former than the latter companies. This then spells an important insight for prospective investors with regards to the volatility of earnings of such companies.

Keywords: financial leverage, debt financing, conservative firms, aggressive firms

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Authors: Chao Li, Lei Zhou, Ruiqi Ren, Dan Li, Yali Wang, Daxin Ni, Zijian Feng, Qun Li

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Background: In 2016, yellow fever had been first ever discovered in China, soon after the yellow fever epidemic occurred in Angola. After the discovery, China had promptly made the national protocol of control and prevention and strengthened the surveillance on passenger and vector. In this study, a descriptive analysis was conducted to summarize China’s experiences of response towards this import epidemic, in the hope of providing experiences on prevention and control of yellow fever and other similar imported infectious diseases in the future. Methods: The imported cases were discovered and reported by General Administration of Quality Supervision, Inspection and Quarantine (AQSIQ) and several hospitals. Each clinically diagnosed yellow fever case was confirmed by real-time reverse transcriptase polymerase chain reaction (RT–PCR). The data of the imported yellow fever cases were collected by local Centers for Disease Control and Prevention (CDC) through field investigations soon after they received the reports. Results: A total of 11 imported cases from Angola were reported in China, during Angola’s yellow fever outbreak. Six cases were discovered by the AQSIQ, among which two with mild symptom were initiative declarations at the time of entry. Except for one death, the remaining 10 cases all had recovered after timely and proper treatment. All cases are Chinese, and lived in Luanda, the capital of Angola. 73% were retailers (8/11) from Fuqing city in Fujian province, and the other three were labors send by companies. 10 cases had experiences of medical treatment in Luanda after onset, among which 8 cases visited the same local Chinese medicine hospital (China Railway four Bureau Hospital). Among the 11 cases, only one case had an effective vaccination. The result of emergency surveillance for mosquito density showed that only 14 containers of water were found positive around places of three cases, and the Breteau Index is 15. Conclusions: Effective response was taken to control and prevent the outbreak of yellow fever in China after discovering the imported cases. However, though the similar origin of Chinese in Angola has provided an easy access for disease detection, information sharing, health education and vaccination on yellow fever; these conveniences were overlooked during previous disease prevention methods. Besides, only one case having effective vaccination revealed the inadequate capacity of immunization service in China. These findings will provide suggestions to improve China’s capacity to deal with not only yellow fever but also other similar imported diseases in China.

Keywords: yellow fever, first import, China, suggestion

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Authors: Michael Vieth, Aric Schadler, Hubert Ballard, J. A. Bauer, Pratibha Thakkar

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Introduction: Congenital diaphragmatic hernia (CDH) is a condition characterized by the herniation of abdominal contents into the thoracic cavity requiring postnatal surgical repair. Previous literature suggests improved CDH outcomes at high-volume regional referral centers compared to low-volume centers. The purpose of this study was to examine CDH outcomes at Kentucky Children’s Hospital (KCH), a low-volume center, compared to the Congenital Diaphragmatic Hernia Study Group (CDHSG). Methods: A retrospective chart review was performed at KCH from 2007-2019 for neonates with CDH, and then subdivided into two cohorts: those requiring ECMO therapy and those not requiring ECMO therapy. Basic demographic data and measures of mortality and morbidity including ventilator days and length of stay were compared to the CDHSG. Measures of morbidity for the ECMO cohort including duration of ECMO, clinical bleeding, intracranial hemorrhage, sepsis, need for continuous renal replacement therapy (CRRT), need for sildenafil at discharge, timing of surgical repair, and total ventilator days were collected. Statistical analysis was performed using IBM SPSS Statistics version 28. One-sample t-tests and one-sample Wilcoxon Signed Rank test were utilized as appropriate.Results: There were a total of 27 neonatal patients with CDH at KCH from 2007-2019; 9 of the 27 required ECMO therapy. The birth weight and gestational age were similar between KCH and the CDHSG (2.99 kg vs 2.92 kg, p =0.655; 37.0 weeks vs 37.4 weeks, p =0.51). About half of the patients were inborn in both cohorts (52% vs 56%, p =0.676). KCH cohort had significantly more Caucasian patients (96% vs 55%, p=<0.001). Unadjusted mortality was similar in both groups (KCH 70% vs CDHSG 72%, p =0.857). Using ECMO utilization (KCH 78% vs CDHSG 52%, p =0.118) and need for surgical repair (KCH 95% vs CDHSG 85%, p =0.060) as proxy for severity, both groups’ mortality were comparable. No significant difference was noted for pulmonary outcomes such as average ventilator days (KCH 43.2 vs. CDHSG 17.3, p =0.078) and home oxygen dependency (KCH 44% vs. CDHSG 24%, p =0.108). Average length of hospital stay for patients treated at KCH was similar to CDHSG (64.4 vs 49.2, p=1.000). Conclusion: Our study demonstrates that outcome in CDH patients is independent of center’s case volume status. Management of CDH with a standardized approach in a low-volume center can yield similar outcomes. This data supports the treatment of patients with CDH at low-volume centers as opposed to transferring to higher-volume centers.

Keywords: ECMO, case volume, congenital diaphragmatic hernia, congenital diaphragmatic hernia study group, neonate

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Authors: Santos Andressa M. N.

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The research brings reflections on the importance of Instagram for the clothing trade, aiming to analyze the use of this social network as a sales tool by small companies in the fashion/clothing sector in Boqueirão-PI. Thus, field research was carried out, with the application of questionnaires, to raise and analyze data related to the topic. Thus, it is believed that Instagram positively influences the dissemination, visibility, reach and profitability of companies in Boqueirão do Piauí. The survey had a low number of companies due to the lack of availability of the owners during the COVID-19 pandemic.

Keywords: Instagram, sales, fashion, marketing

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Authors: Mabrouka Immhemd Al-Werfalli

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How are political alienation and corruption related? What is the nature of relationship linking corruption and political alienation? When citizens withdraw their loyalty from their political regime and leaders, they highlight their alienation from them. The link between corruption and political alienation is that the individual would intentionally involve in corruption particularly when a state of lawlessness prevails. This paper represents a challenge- how to gauge a link between political alienation culture of corruption and corruption. It aims to highlight the political alienation related factors that determine the levels of corruption in Libya. One of the most prominent reasons for the Libyan uprising in February 2011 was the pervasiveness of corruption. Corruption in Libya remained a significant problem despite a robust anti-corruption discourse and harsh legislation undertaken by the previous regime. The long-standing political corruption in Libya has offered ample opportunity for the evolution of a structure of negative values and morals. This has formed what is termed as a ‘culture of corruption’, which has induced people to accept and justify corrupt behavior. The paper is a part of a study concerns the phenomenon of political alienation in Libya which was based on a survey conducted in 2001 in the city of Benghazi. The finding shows that abuse of power, embezzlement and misuse of public funds for personal enrichment was thought to be rife within public bodies, institutions, companies, factories, banks and enterprises owned entirely or partially by the state.

Keywords: Libya, abuse of power, anti-corruption, corruption, culture of corruption, embezzlement, participation in corruption, political alienation

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Authors: Mohammed Alnuwairan, Mahmoud Abdelrahman

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Based on the sustainability concept, this paper explores the current situation of construction and demolition waste (C&D) in the Kingdom of Saudi Arabia (KSA) from the source of production to final destinations. The issues that hindered the investment of recycling C&D in the context will be studied in order to identify the challenges and opportunities to improve this sector and put forward a strategic framework to reduce, reuse, recycle and minimize the disposal of this type of waste. The research, which is exploratory in nature, identified four types of organizations that were appropriate case studies. These organizations were drawn from the municipalities, city council, recyclers and manufacturers. Secondary data collection, direct observation, and elite interviewing methods were used in the case studies to facilitate comparisons with existing literature to explore opportunities to improve sustainability practices in the buildings sector. Implementation of C&D waste management and recycling in KSA is in the early stages. Resistance of virgin building material manufacturers, free usage of landfill, culture, surpluses of natural raw material, availability of land and the cost of recycling this material compared with virgin material hinders the adoption of recycled buildings martial. Although the metal material is collected and recycled but it has the lowest percentage of C&D waste in Saudi. The findings indicate that government and industry need to collaborate more closely in order to successfully implement best practices. Economic and environmental benefits can be achieved, particularly through improvements to infrastructure and legislation. Feasible solution framework and recommendations for managing C&D waste under current situation are provided. The findings can be used to extend this framework and to enable it to be applicable in other context with emerging economies similar to that found in KSA. No study of this type has been previously carried out in KSA. The findings should prove useful in creating a future research agenda for C&D waste in KSA and, possibly, other emerging countries within a similar context.

Keywords: construction and demolition waste, recycling, reuse, sustainability

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

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Public Sector Undertakings (PSUs), being government-owned organizations have commitments for the economic and social wellbeing of the society; this commitment needs to be reflected in their risk-taking, decision-making and governance structures. Therefore, the primary objective of the study is to suggest measures that may lead to improvement in performance of PSUs. To achieve this objective two normative frameworks (one relating to risk levels and other relating to governance structure) are being put forth. The risk index is based on nine risks, such as, solvency risk, liquidity risk, accounting risk, etc. and each of the risks have been scored on a scale of 1 to 5. The governance index is based on eleven variables, such as, board independence, diversity, risk management committee, etc. Each of them are scored on a scale of 1 to five. The sample consists of 39 PSUs that featured in Nifty 500 index and, the study covers a 10 year period from April 1, 2005 to March, 31, 2015. Return on assets (ROA) and return on equity (ROE) have been used as proxies of firm performance. The control variables used in the model include, age of firm, growth rate of firm and size of firm. A dummy variable has also been used to factor in the effects of recession. Given the panel nature of data and possibility of endogeneity, dynamic panel data- generalized method of moments (Diff-GMM) regression has been used. It is worth noting that the corporate governance index is positively related to both ROA and ROE, indicating that with the improvement in governance structure, PSUs tend to perform better. Considering the components of CGI, it may be suggested that (i). PSUs ensure adequate representation of women on Board, (ii). appoint a Chief Risk Officer, and (iii). constitute a risk management committee. The results also indicate that there is a negative association between risk index and returns. These results not only validate the framework used to develop the risk index but also provide a yardstick to PSUs benchmark their risk-taking if they want to maximize their ROA and ROE. While constructing the CGI, certain non-compliances were observed, even in terms of mandatory requirements, such as, proportion of independent directors. Such infringements call for stringent penal provisions and better monitoring of PSUs. Further, if the Securities and Exchange Board of India (SEBI) and Ministry of Corporate Affairs (MCA) bring about such reforms in the PSUs and make mandatory the adherence to the normative frameworks put forth in the study, PSUs may have more effective and efficient decision-making, lower risks and hassle free management; all these ultimately leading to better ROA and ROE.

Keywords: PSU, risk governance, diff-GMM, firm performance, the risk index

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Authors: Surinder Deswal, Vineet Verma

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Air Quality Index (AQI) is used as a tool to indicate the level of severity and disseminate the information on air pollution to enable the public to understand the health and environmental impacts of air pollutant concentration levels. The annual and seasonal variation of criteria air pollutants concentration based on the National Ambient Air Quality Monitoring Programme has been conducted for a period of nine years (2006-2014) using the AQI system. AQI was calculated using IND-AQI methodology and Maximum Operator Concept is applied. An attempt has been made to quantify the variations in AQI on an annual and seasonal basis over a period of nine years. Further, year-wise frequency of occurrence of AQI in each category for all the five stations is analysed, which presents in depth analysis of trends over the period of study. The best air quality was observed in the Noida residential area, followed by Noida industrial area during the study period; whereas, Bulandshahar industrial area and Faridabad residential area were observed to have the worst air quality. A shift in the worst air quality from winter to summer season has also been observed during the study period. Further, the level of Respirable Suspended Particulate Matter was found to be above permissible limit at all the stations. The present study helps in enhancing public awareness and calls for the need of immediate measures to be taken to counter-effect the cause of the increasing level of air pollution.

Keywords: air quality index, annual trends, criteria pollutants, seasonal variation

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Authors: Wei-Hwa Chiang, Wei-Ting Hsu, Yuan-Chi Liu, Cheng-Che Tsai

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A sustainable built environment aims for minimizing both regional and global environmental impact while maintaining a healthy living for individuals. Sustainability of performing venues has rarely been discussed when compared with residential, office, and other popular building types. Life-cycle carbon emission due to the high standard requirements in acoustics, stage engineering, HVAC, and building structure need to be carefully examined. This can be complicated by social-economic and cultural concerns in addition to technical excellence. This paper reported case-based study and statistics of performing venues regarding urban connectivity and spatial layouts in enhancing facility usage and promoting cultural vitality. Interviews conducted for a major venue at Taipei indicated high linkage with surrounding leisure activity and the need for quality pedestrian and additional spaces open to the general public. Statistics of venues with various size and function suggested the possibility and strategies limit the size and height of reception and foyer spaces, and to maximize their use when there are no performances. Design strategies are identified to increase visual contact or facility sharing between the artists and the audience or the general public in reducing facility size and promoting potential involvement in cultural activities.

Keywords: sustainability, performing venue, design, operation

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Authors: Adebisi David Alade

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In pre-colonial West Africa, the deadliness of the climate vis-a- vis malaria and other tropical diseases to Europeans turned the region into the “white man’s grave.” Thus, immediately after the partition of Africa in 1885, civilisatrice and mise en valeur not only became a pretext for the establishment of colonial rule; from a medical point of view, the control and possible eradication of disease in the continent emerged as one of the first concerns of the European colonizers. Though geared toward making Africa exploitable, historical evidence suggests that some colonial Water, Sanitation and Hygiene (WASH) policies and projects reduced certain tropical diseases in some West African communities. Exploring some of these disease control interventions by way of historical revisionism, this paper challenges the orthodox interpretation of colonial sanitation and public health measures in West Africa. This paper critiques the deployment of race and class as analytical tools for the study of colonial WASH projects, an exercise which often reduces the complexity and ambiguity of colonialism to the binary of colonizer and the colonized. Since West Africa presently ranks high among regions with Neglected Tropical Diseases (NTDs), it is imperative to decentre colonial racism and economic exploitation in African history in order to give room for Africans to see themselves in other ways. Far from resolving the problem of NTDs by fiat in the region, this study seeks to highlight important blind spots in African colonial history in an attempt to prevent post-colonial African leaders from throwing away the baby with the bath water. As scholars researching colonial sanitation and public health in the continent rarely examine its complex meaning and content, this paper submits that the outright demonization of colonial rule across space and time continues to build ideological wall between the present and the past which not only inhibit fruitful borrowing from colonial administration of West Africa, but also prevents a wide understanding of the challenges of WASH policies and projects in most West African states.

Keywords: colonial rule, disease control, neglected tropical diseases, WASH

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Authors: Thizwilondi Madzaga, Jabu Tsakani Mabunda, Takalani Tshitangano

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Hypertension is a global public health problem. In most cases, hypertension individuals are not aware of their condition, and they only detected it accidentally during public awareness programmes. The aim of the study was to determine the prevalence, awareness and control of hypertension among University of Venda academic staff. UNIVEN is situated in Thohoyandou, South Africa. A cross-sectional study was conducted to determine the prevalence, awareness and control of hypertension among University of Venda academic staff. Slovin’s formula was used to randomly select 179 academic staff (male=104 and female=75). WHO stepwise Questionnaire version 23.0 was used to get information on demographic information. Blood pressure was measured twice after five minutes rest using electronic blood pressure monitor. In this study, hypertension referred to self-reported to be on hypertension medication or having blood pressure equal or exceeding 140 over 90 mmHg. Statistical Package of Social Sciences version 23.0 was used to analyse data. Prevalence of hypertension was 20% and 46% prehypertension. Only 34% had a normal blood pressure. About 34% were not sure of their current blood pressure status (within 12 months). About 10% of the total respondents had been previously diagnosed with hypertension and half of them who were hypertensive were not aware that they had it. Among those who were aware that they are hypertensive, about 90% were on treatment whereas 10% had stopped taking treatment. About 13% of those who were on treatment had controlled blood pressure. There is a need for health education programmes to increase hypertension awareness.

Keywords: academic staff, awareness, control, hypertension, prevalence

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Authors: Abdullah S. Alghamdi, Khaled Alghamdi, Richard O. Jenkins, Parvez I. Haris

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Background: Unhealthy diet is one of the modifiable risk factors for developing type 2 diabetes mellitus (T2DM). Improvement in diet can be beneficial for countering diabetes. For example, HbA1c, an important biomarker for diabetes, can be reduced by 1.1% through only alteration in diet. Ramadan fasting has been reported to provide positive health benefits. However, optimal benefits are not achieved, often due to poor dietary habits and lifestyle. There is a need to better understand the dietary habits of people fasting during Ramadan, so that necessary improvements can be made to develop this form of fasting as a non-pharmacological strategy for management and prevention of T2DM. Aim: This study aimed to assess the dietary patterns of Saudi adult patients with T2DM over three different periods (before, during, and after Ramadan) and relate this to HbA1c levels. Methods: This study recruited 82 Saudi with T2DM, who chose to fast during Ramadan, from the Endocrine and Diabetic Centre of Al Iman General Hospital, Riyadh, Saudi Arabia. Ethical approvals for the study were obtained from De Montfort University and Saudi Ministry of Health. Dietary patterns were assessed by a self-administered questionnaire in each period. This assessment included the diet type and frequency. Blood samples were collected in each period for determination of HbA1c. Results: The number of meals per day for the participants significantly decreased during Ramadan (P < 0.001). The consumption of fruit and vegetables significantly increased during Ramadan (P = 0.017). However, the consumption of sugary drinks significantly increased during and after Ramadan (P = 0.005). Approximately 60% of the patients indicated that they ate sugary foods at least once per week. The consumption of bread and rice was reported to be at least two times per week. The consumption of rice significantly reduced during Ramadan (P = 0.002). The mean HbA1c significantly varied between periods (P = 0.001), with lowest level during Ramadan compared to before and after Ramadan. The increase in the consumption of fruits and vegetables had a medium effect size on the reduction in HbA1c during Ramadan. There was a variance of 7.7% in the mean difference in HbA1c levels between groups (who changed their fruit and vegetable consumption) which can be accounted for by the increase in the consumption of fruits and vegetables. Likewise, 9.3% of the variance in the mean HbA1c difference between the groups was accounted for by a decrease in the consumption of rice. Conclusion: The increase in the frequency of fruit and vegetables intake, and especially the reduction in the frequency of rice consumption, during Ramadan produce beneficial effects in reducing HbA1c level. Therefore, further improving the dietary habits of patients with T2DM, such as reducing their sugary drinks intake, may help them to obtain greater benefits from Ramadan fasting in the management of their diabetes. It is recommended that dietary guidance is provided to the public to maximise health benefits through Ramadan fasting.

Keywords: Diabetes, Diet, Fasting, HbA1c, Ramadan

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Authors: Elda Maraj, Shkelqim Kuka

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Coronary heart disease causes many deaths in the world. Unfortunately, this problem will continue to increase in the future. In this paper, a fuzzy logic model to predict coronary heart disease is presented. This model has been developed with seven input variables and one output variable that was implemented for 30 patients in Albania. Here fuzzy logic toolbox of MATLAB is used. Fuzzy model inputs are considered as cholesterol, blood pressure, physical activity, age, BMI, smoking, and diabetes, whereas the output is the disease classification. The fuzzy sets and membership functions are chosen in an appropriate manner. Centroid method is used for defuzzification. The database is taken from University Hospital Center "Mother Teresa" in Tirana, Albania.

Keywords: coronary heart disease, fuzzy logic toolbox, membership function, prediction model

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Authors: P. H. G. J. Pushpakumara, Andrew Dawson

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Introduction: Deliberate self harm (DSH) is a major public health problem globally. Suicide rates of Sri Lanka are being among the highest national rates in the world, since 1950. Previous DSH is the most important independent predictor of repetition. The estimated 1 year non-fatal repeat self-harm rate was 16.3%. Asian countries had considerably lower rate, 10.0%. Objectives: To calculate incidence of deliberate self-poisoning (DSP) and suicides, repetition rate of DSP in Kurunegala District (KD). To determine the pattern of repeated DSP in KD. Methods: Study had two components. In the first component, demographic and event related details of, DSP admission in 46 hospitals and suicides in 28 police stations of KD were collected for 3 years from January 2011. Demographic details of cohort of DSP patients admitted to above hospitals in 2011 were linked with hospital admissions and police records of next two years period from the index admission. Records were screened for links with high sensitivity using the computer then did manual matching which would have been much more specific. In the second component, randomly selected DSP patients (n=438), who admitted to main referral centre which receives 60% of DSP cases of the district, were interviewed to assess life-time repetition. Results: There were 16,993 DSP admissions and 1078 suicides for the three year period. Suicide incidences in KD were, 21.6, 20.7 and 24.3 per 100,000 population in 2011, 2012 and 2013. Average male to female ratio for suicide incidences was 5.5. DSP incidences were 205.4, 248.3 and 202.5 per 100,000 population. Male incidences were slightly greater than the female incidences, male: female ratio was 1.1:1. Highest age standardized male and female incidence was reported in 20-24 years age group, 769.6/100,000, and 15-19 years age group 1304.0/100,000. Male to female ratio of the incidence increased with the age. There were 318 (179 male and 139 female) patients attempted DSH within two years. Female repetitive patients were ounger compared to the males, p < 0.0001, median age: males 28 and females 19 years. 290 (91.2%) had only one repetitive attempt, 24 (7.5%) had two, 3 (0.9%) had three and one (0.3%) had four in that period. One year repetition rate was 5.6 and two year repetition rate was 7.9%. Average intervals between indexed events and first repetitive DSP events were 246.8 (SD:223.4) and 238.5 (SD:207.0) days among males and females. One fifth of first repetitive events occurred within first two weeks in both males and females. Around 50% of males and females had the second event within 28 weeks. Within the first year of the indexed event, around 70% had the second event. First repetitive event was fatal for 28 (8.8%) individuals. Ages of those who died, mean 49.7 years (SD:15.3), were significantly higher compared to those who had non-fatal outcome, p<0.0001. 9.5% had life time history of DSH attempts. Conclusions: Both, DSP and suicide incidences were very high in KD. However, repetition rates were lesser compared regional values. Prevention of repetition alone may not produce significant impact on prevention of DSH.

Keywords: deliberate self-harm, incidence, repetition, Sri Lanka, suicide

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Authors: Seyedeh Samaneh Hosseini Yousefi

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Space does not play role just in mentioning the place or locations. It also takes part in people attendance and social structures. Urban space is of substantial aspects of city which is a public sphere for free and unlimited appearance of citizens. Along with such appearances and regarding physical, environmental and functional conditions, different personal and social behaviors can be seen and analyzed toward people. The main principle of an urban space is including social relations and communications. In this survey, urban space has been referred to one in which physical, environmental and functional attractions cause pause and staying of people. Surveys have shown that urban designers have discussed about place more than architects or planners. With attention to mutual relations between urban space, society and civilization, proper policy making and planning are essential due to achieving an ideal urban space. The survey has been decided to analyze the effect of functional and physical structure of urban spaces on citizens' social behaviors. Hence, Valiasr crossroads, Tehran identified public space, has been selected in which analytic-descriptive method utilized. To test the accuracy of assumptions, statistical test has been accomplished by SPSS. Findings have shown that functional structure affects social behaviors, relations, integration and participation more than physical structure does.

Keywords: citizens' social behavior, functional structure, physical structure, urban space

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Authors: Waqas Abrar

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Background: Pakistan is confronted with a formidable challenge to increase uptake of modern contraceptive methods. USAID, through its flagship Maternal and Child Survival Program (MCSP), in Pakistan is determined to support provincial Departments of Health and Population Welfare to increase the country's contraceptive prevalence rates (CPR) in Sindh, Punjab and Balochistan to achieve FP2020 goals. To inform program design and planning, a Rapid Situation Assessment (RSA) of family planning was carried out in Rawalpindi and Lahore districts in Punjab and Karachi district in Sindh. Methodology: The methodology consisted of comprehensive desk review of available literature and used a qualitative approach comprising of in-depth interviews (IDIs) and focus group discussions (FGDs). FGDs were conducted with community women, men, and mothers-in-law whereas IDIs were conducted with health facility in-charges/chiefs, healthcare providers, and community health workers. Results: Some of the oft-quoted reasons captured during desk review included poor quality of care at public sector facilities, affordability and accessibility in rural communities and providers' technical incompetence. Moreover, providers had inadequate knowledge of contraceptive methods and lacked counseling techniques; thereby, leading to dissatisfied clients and hence, discontinuation of contraceptive methods. These dissatisfied clients spread the myths and misconceptions about contraceptives in their respective communities which seriously damages community-level family planning efforts. Private providers were found reluctant to insert Intrauterine Contraceptive Devices (IUCDs) due to inadequate knowledge vis-à-vis post insertion issues/side effects. FGDs and IDIs unveiled multi-faceted reasons for poor contraceptives uptake. It was found that low education and socio-economic levels lead to low contraceptives uptake and mostly uneducated women rely on condoms provided by Lady Health Workers (LHWs). Providers had little or no knowledge about postpartum family planning or lactational amenorrhea. At community level family planning counseling sessions organized by LHWs and Male Mobilizers do not sensitize community men on permissibility of contraception in Islam. Many women attributed their physical ailments to the use of contraceptives. Lack of in-service training, job-aids and Information, Education and Communications (IEC) materials at facilities seriously comprise the quality of care in effective family planning service delivery. This is further compounded by frequent stock-outs of contraceptives at public healthcare facilities, poor data quality, false reporting, lack of data verification systems and follow-up. Conclusions: Some key conclusions from this assessment included capacity building of healthcare providers on long acting reversible contraceptives (LARCs) which give women contraception for a longer period. Secondly, capacity building of healthcare providers on postpartum family planning is an enormous challenge that can be best addressed through institutionalization. Thirdly, Providers should be equipped with counseling skills and techniques including inculcation of pros and cons of all contraceptive methods. Fourthly, printed materials such as job-aids and Information, Education and Communications (IEC) materials should be disseminated among healthcare providers and clients. These concluding statements helped MCSP to make informed decisions with regard to setting broad objectives of project and were duly approved by USAID.

Keywords: capacity building, contraceptive prevalence rate, family planning, Institutionalization, Pakistan, postpartum care, postpartum family planning services

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Authors: Ntokozo Mthembu

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Access to relevant health indicates people’s likelihood of survival, including craft of indigenous healing and its related practitioners- izinyanga. However, the emergence of a dreaded novel corona virus - COVID-19 that has engulfed almost the whole world has necessitated the need to revisit the state of traditional healers in South Africa. This circumstance tended to expose the reality of social settings in various social structures and related policies including the manner coloniality reveal its ugly head when it comes treatment between western and African based therapeutic practices in this country. In attempting to gain a better understanding of such experiences, primary and secondary sources were consulted when collecting data that perusal of various literature in this instance including face-to-face interviews with traditional healers working on the street of Tshwane Municipality in South Africa. Preliminary findings revealed that the emergence of this deadly virus coincided with the moment when the government agenda was focussed on fulfilment of its promise of addressing the past inequity practices, including the transformation of medical sector. This scenario can be witnessed by the manner in which government and related agencies such as health department keeps on undermining indigenous healing practice irrespective of its historical record in terms of healing profession and fighting various diseases before times of father of medicine, Imhotep. Based on these preliminary findings, it is recommended that the government should hasten the incorporation of African knowledge systems especially medicine to offer alternatives and diverse to assess the underutilised indigenous African therapeutic approach and relevant skills that could be useful in combating ailments such as COVID 19. Perhaps, the plural medical systems should be recognized and related policies are formulated to guarantee mutual respect among citizens and the incorporation of healing practices in South African health sector, Africa and in the broader global community.

Keywords: indigenous healing practice, inyanga, COVID-19, therapeutic, urban, experience

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Authors: Isabella Maria Beil

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The International Geosciences and Geoparks Programme (IGGP) were officially created in 2015 by the United Nations Educational, Scientific and Cultural Organization (UNESCO) to enhance the protection of the geological heritage and fill the gaps on the World Heritage Convention. According to UNESCO, a Global Geopark is an unified area where sites and landscapes of international geological significance are managed based on a concept of sustainable development. Tourism is seen as a main activity to develop new sources of revenue. Currently (November 2022), UNESCO recognized 177 Global Geoparks, of which more than 50% are in Europe, 40% in Asia, 6% in Latin America, and the remaining 4% are distributed between Africa and Anglo-Saxon America. This picture shows the existence of a much uneven geographical distribution of these areas across the planet. Currently, there are three Geoparks in Brazil; however, the first of them was accepted by the Global Geoparks Network in 2006 and, just fifteen years later, two other Brazilian Geoparks also obtained the UNESCO title. Therefore, this paper aims to provide an overview of the current geopark situation in Brazil and to identify the main challenges faced by the implementation of these areas in the country. To this end, the Brazilian history and its main characteristics regarding the development of geoparks over the years will be briefly presented. Then, the results obtained from interviews with those responsible for each of the current 29 aspiring geoparks in Brazil will be presented. Finally, the main challenges related to the implementation of Geoparks in the country will be listed. Among these challenges, the answers obtained through the interviews revealed conflicts and problems that pose hindrances both to the start of the development of a Geopark project and to its continuity and implementation. It is clear that the task of getting multiple social actors, or stakeholders, to engage with the Geopark, one of UNESCO’s guidelines, is one of its most complex aspects. Therefore, among the main challenges, stand out the difficulty of establishing solid partnerships, what directly reflects divergences between the different social actors and their goals. This difficulty in establishing partnerships happens for a number of reasons. One of them is that the investment in a Geopark project can be high and investors often expect a short-term financial return. In addition, political support from the public sector is often costly as well, since the possible results and positive influences of a Geopark in a given area will only be experienced during future mandates. These results demonstrate that the research on Geoparks goes far beyond the geological perspective linked to its origins, and is deeply embedded in political and economic issues.

Keywords: Brazil, geoparks, tourism, UNESCO

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Authors: B. Orser, A. Riding, Y. Li

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To inform government about how gender gaps in SME ( small and medium-sized enterprise) contracting might be redressed, the research question was: What are the key obstacles to, and response strategies for, increasing the engagement of women business owners among SME suppliers to the government of Canada? Thirty-five interviews with senior policymakers, supplier diversity organization executives, and expert witnesses to the Canadian House of Commons, Standing Committee on Government Operations and Estimates. Qualitative data were conducted and analysed using N’Vivo 11 software. High order response categories included: (a) SME risk mitigation strategies, (b) SME procurement program design, and (c) performance measures. Primary obstacles cited were government red tape and long and complicated requests for proposals (RFPs). The majority of 'common' complaints occur when SMEs have questions about the federal procurement process. Witness responses included use of outcome-based rather than prescriptive procurement practices, more agile procurement, simplified RFPs, making payment within 30 days a procurement priority. Risk mitigation strategies included provision of procurement officers to assess risks and opportunities for businesses and development of more agile procurement procedures and processes. Recommendations to enhance program design included: improved definitional consistency of qualifiers and selection criteria, better co-ordination across agencies; clarification about how SME suppliers benefit from federal contracting; goal setting; specification of categories that are most suitable for women-owned businesses; and, increasing primary contractor awareness about the importance of subcontract relationships. Recommendations also included third-party certification of eligible firms and the need to enhance SMEs’ financial literacy to reduce financial errors. Finally, there remains the need for clear and consistent pre-program statistics to establish baselines (by sector, issuing department) performance measures, targets based on percentage of contracts granted, value of contract, percentage of target employee (women, indigenous), and community benefits including hiring local employees. The study advances strategies to enhance federal procurement programs to facilitate socio-economic policy objectives.

Keywords: procurement, small business, policy, women

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Authors: Samet Sen, Yalcin Alver

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Before Izmir Commuter Rail System (IZBAN), most of the respondents along the railway were making their trips by city buses, minibuses or private cars. After IZBAN was put into service, some people changed their previous trip behaviors and they started travelling by IZBAN. Therefore a big travel demand in IZBAN occurred. In this study, the characteristics of passengers and their trip behaviors are found out based on the longitudinal data conducted via two wave trip surveys. Just after one year from IZBAN's opening, the first wave of the surveys was carried out among 539 passengers at six stations during morning peak hours between 07.00 am-09.30 am. The second wave was carried out among 669 passengers at the same six stations two years after the first wave during the same morning peak hours. As a result of this study, the respondents' socio-economic specifications, the distribution of trips by region, the impact of IZBAN on transport modes, the changes in travel time and travel cost and satisfaction data were obtained. These data enabled to compare two waves and explain the changes in socio-economic factors and trip behaviors. In both waves, 10 % of the respondents stopped driving their own cars and they started to take IZBAN. This is an important development in solving traffic problems. More public transportation means less traffic congestion.

Keywords: commuter rail system, comparative study, longitudinal survey, public transportation

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Authors: Hossam N. Alhawatmeh, Areen I. Albustanji

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Hemodialysis negatively affects physical and psychological health. Pain, poor sleep quality, and low self-esteem are highly prevalent among patients with end-stage renal disease (ESRD) who receive hemodialysis, significantly increasing mortality and morbidity of those patients. Mind-body interventions (MBI), such as mindfulness meditation, have been recently gaining popularity that improved pain, sleep quality, and self-esteem in different populations. However, to our best knowledge, its effects on these health problems in patients receiving hemodialysis have not been studied in Jordan. Thus, the purpose of the study was to examine the effect of mindfulness meditation on pain, sleep quality, and self-esteem in patients with ESR receiving hemodialysis in Jordan. An experimental repeated-measures, randomized, parallel control design was conducted on (n =60) end-stage renal disease patients undergoing hemodialysis between March and June 2023 in the dialysis center at a public hospital in Jordan. Participants were randomly assigned to the experimental (n =30) and control groups (n =30) using a simple random assignment method. The experimental group practiced mindfulness meditation for 30 minutes three times per week for five weeks during their hemodialysis treatments. The control group's patients continued to receive hemodialysis treatment as usual for five weeks during hemodialysis sessions. The study variables for both groups were measured at baseline (Time 0), two weeks after intervention (Time 1), and at the end of intervention (Time 3). The numerical rating scale (NRS), the Rosenberg Self-Esteem Scale (RSES-M), and the Pittsburgh Sleep Quality Index (PSQI) were used to measure pain, self-esteem, and sleep quality, respectively. SPSS version 25 was used to analyze the study data. The sample was described by frequency, mean, and standard deviation as an appropriate. The repeated measures analysis of variance (ANOVA) tests were run to test the study hypotheses. The results of repeated measures ANOVA (within-subject) revealed that mindfulness meditation significantly decrease pain by the end of the intervention in the experimental group. Additionally, mindfulness meditation improved sleep quality and self-esteem in the experimental group, and these improvements occurred significantly after two weeks of the intervention and at the end of the intervention. The results of repeated measures ANOVA (within and between-subject) revealed that the experimental group, compared to the control group, experienced lower levels of pain and higher levels of sleep quality and self-esteem over time. In conclusion, the results provided substantial evidence supporting the positive impacts of mindfulness meditation on pain, sleep quality, and self-esteem in patients with ESRD undergoing hemodialysis. These results highlight the potential of mindfulness meditation as an adjunctive therapy in the comprehensive care of this patient population. Incorporating mindfulness meditation into the treatment plan for patients receiving hemodialysis may contribute to improved well-being and overall quality of life.

Keywords: hemodialysis, pain, sleep quality, self-esteem, mindfulness

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Authors: Jacklyn Yek, Clara Tong, Shin Yuet Chong, Yee Yian Ong

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Background: While emergency manuals and cognitive aids (CA) have been used in high-hazard industries for decades, this has been a nascent field in healthcare. CAs can potentially offset the large cognitive load involved in crisis resource management and possibly facilitate the efficient performance of key steps in treatment. A crisis manual was developed based on local guidelines and the latest evidence-based information and introduced to a tertiary hospital setting in Singapore. Hence, the objective of this study is to evaluate the effectiveness of the crisis manual in guiding response and management of critical events. Methods: 7 surgical teams were recruited to participate in a series of simulated emergencies in high-fidelity operating room simulator over the period of April to June 2018. All teams consisted of a surgical consultant and medical officer/registrar, anesthesia consultant and medical officer/registrar; as well as a circulating, scrub and anesthetic nurse. Each team performed a simulated operation in which 1 or more of the crisis events occurred. The teams were randomly assigned to a scenario of the crisis manual and all teams were deemed to be equal in experience and knowledge. Before the simulation, teams were instructed on proper checklist use but the use of the checklist was optional. Results: 7 simulation sessions were performed, consisting of the following scenarios: Airway fire, Massive Transfusion Protocol, Malignant Hyperthermia, Eclampsia, and Difficult Airway. Out of the 7 surgical teams, 2 teams made use of the crisis manual – of which both teams had encountered a ‘Malignant Hyperthermia’ scenario. These team members reflected that the crisis manual assisted allowed them to work in a team, especially being able to involve the surgical doctors who were unfamiliar with the condition and management. A run chart plotted showed a possible upward trend, suggesting that with increasing awareness and training, staff would become more likely to initiate the use of the crisis manual. Conclusion: Despite the high volume load in this tertiary hospital, certain crises remain rare and clinicians are often caught unprepared. A crisis manual is an effective tool and easy-to-use repository that can improve patient outcome and encourage teamwork. With training, familiarity would allow clinicians to be increasingly comfortable with reaching out for the crisis manual. More simulation training would need to be conducted to determine its effectiveness.

Keywords: crisis resource management, high fidelity simulation training, medical errors, visual aids

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Authors: Tetyana Kendzerska, David T. Zhu, Michael Pugliese, Douglas Manuel, Mohsen Sadatsafavi, Marcus Povitz, Therese A. Stukel, Teresa To, Shawn D. Aaron, Sunita Mulpuru, Melanie Chin, Claire E. Kendall, Kednapa Thavorn, Rebecca Robillard, Andrea S. Gershon

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The impact of the COVID-19 pandemic on the management of ambulatory care sensitive conditions (ACSCs) remains unknown. To compare observed and expected (projected based on previous years) trends in all-cause mortality and healthcare use for ACSCs in the first year of the pandemic (March 2020 - March 2021). A population-based study using provincial health administrative data.General adult population (Ontario, Canada). Monthly all-cause mortality, and hospitalizations, emergency department (ED) and outpatient visit rates (per 100,000 people at-risk) for seven combined ACSCs (asthma, COPD, angina, congestive heart failure, hypertension, diabetes, and epilepsy) during the first year were compared with similar periods in previous years (2016-2019) by fitting monthly time series auto-regressive integrated moving-average models. Compared to previous years, all-cause mortality rates increased at the beginning of the pandemic (observed rate in March-May 2020 of 79.98 vs. projected of 71.24 [66.35-76.50]) and then returned to expected in June 2020—except among immigrants and people with mental health conditions where they remained elevated. Hospitalization and ED visit rates for ACSCs remained lower than projected throughout the first year: observed hospitalization rate of 37.29 vs. projected of 52.07 (47.84-56.68); observed ED visit rate of 92.55 vs. projected of 134.72 (124.89-145.33). ACSC outpatient visit rates decreased initially (observed rate of 4,299.57 vs. projected of 5,060.23 [4,712.64-5,433.46]) and then returned to expected in June 2020. Reductions in outpatient visits for ACSCs at the beginning of the pandemic combined with reduced hospital admissions may have been associated with temporally increased mortality—disproportionately experienced by immigrants and those with mental health conditions. The Ottawa Hospital Academic Medical Organization

Keywords: COVID-19, chronic disease, all-cause mortality, hospitalizations, emergency department visits, outpatient visits, modelling, population-based study, asthma, COPD, angina, heart failure, hypertension, diabetes, epilepsy

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Authors: Mohita Gangwar Sharma

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Different factors are compelling manufacturers to move towards the phenomenon of servitization i.e. when firms go beyond giving support to the customers in operating the equipment. The challenges that are being faced in this transition by the manufacturing firms from being a product provider to a product- service provider are multipronged. Product-Service Systems (PSS) lies in between the pure-product and pure-service continuum. Through this study, we wish to understand the dimensions of ‘PSS-quality’. We draw upon the quality literature for both the product and services and through an expert survey for a specific transportation sector using analytical hierarchical process (AHP) derive a conceptual model that can be used as a comprehensive measurement tool for PSS offerings.

Keywords: servitisation, quality, product-service system, AHP

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Authors: Robin Ratnasingham, Maher Elshakankiri

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This research report will look at how to make a smart washroom to increase public hygiene and cleanliness. The system would use IoT devices to pick up various activities in the washroom and notify the appropriate stakeholders or devices to regulate the condition of the washroom. As more people are required to physically go back to the office or school, ensuring a clean and sanitized washroom is even more important now than before. It would help prevent virus outbreaks and safeguard the organization from shutdowns or slowdowns in their business. A framework of the suggested smart washroom was introduced to help reduce the chances of a virus outbreak. Most organizations outsource renovation or implementation to an external party. Using the smart washroom framework, we looked at vendors that provide smart washroom solutions. There are IoT vendors that cannot match the framework, and there are vendors that can support the framework design. This segment is a niche market, and most of the devices are similar in their basic functions. However, all the vendors have unique characteristics to give them a competitive advantage over the rest of the IoT washroom companies. Ultimately, the organization would need to decide if they want to add IoT devices to enable smart capability or renovate the washroom to create a fluid IoT smart washroom design. The report would introduce an IoT smart washroom framework to help organizations design a cohesive preventive measure network for the daily maintenance routine. The framework is designed to help understand how to manage washroom cleanliness more efficiently and to provide guidance in achieving this goal. The leading result is eliminating potential viral outbreaks that could jeopardize the organization.

Keywords: IoT, smart washroom, public hygiene, cleanliness, virus outbreaks, safeguard

Procedia PDF Downloads 87