Search results for: financial report

Authors: Hala S. Mekawy

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Affordable housing delivery for low and lower middle income families is a prominent problem in many developing countries; governments alone are unable to address this challenge due to diverse financial and regulatory constraints, and the private sector's contribution is rare and assists only middle-income households even when institutional and legal reforms are conducted to persuade it to go down market. Also, the market-enabling policy measures advocated by the World Bank since the early nineties have been strongly criticized and proven to be inappropriate to developing country contexts, where it is highly unlikely that the formal private sector can reach low income population. In addition to governments and private developers, affordable housing delivery systems involve an intricate network of relationships between diverse ranges of actors. Collaboration between them was proven to be vital, and hence, an approach towards partnership schemes for affordable housing delivery has emerged. The basic premise of this paper is that addressing housing affordability challenges in Egypt demands direct public support, as markets and market actors alone would never succeed in delivering decent affordable housing to low and lower middle income groups. It argues that this support would ideally be through local level partnership schemes, with a leading decentralized local government role, and partners being identified according to specific local conditions. It attempts to identify major attributes that would ensure the fulfilment of the goals of such schemes in the Egyptian context. This is based upon evidence from diversified worldwide experiences, in addition to the main outcomes of a questionnaire that was conducted to specialists and chief actors in the field.

Keywords: affordable housing, partnership schemes, housing, urban environments

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Authors: Timilehin Martins Oyinloye, Won Byong Yoon

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Simulation technology is being adopted in many industries, with research focusing on the development of new ways in which technology becomes embedded within production, services, and society in general. 3D printing (3DP) technology is fast developing in the food industry. However, the limited processability of high-performance material restricts the robustness of the process in some cases. Significantly, the printability of materials becomes the foundation for extrusion-based 3DP, with residual stress being a major challenge in the printing of complex geometry. In many situations, the trial-a-error method is being used to determine the optimum printing condition, which results in time and resource wastage. In this report, the analysis of 3 moisture levels for surimi paste was investigated for an optimum 3DP material and printing conditions by probing its rheology, flow characteristics in the nozzle, and post-deposition process using the finite element method (FEM) model. Rheological tests revealed that surimi pastes with 82% moisture are suitable for 3DP. According to the FEM model, decreasing the nozzle diameter from 1.2 mm to 0.6 mm, increased the die swell from 9.8% to 14.1%. The die swell ratio increased due to an increase in the pressure gradient (1.15107 Pa to 7.80107 Pa) at the nozzle exit. The nozzle diameter influenced the fluid properties, i.e., the shear rate, velocity, and pressure in the flow field, as well as the residual stress and the deformation of the printed sample, according to FEM simulation. The post-printing stability of the model was investigated using the additive layer manufacturing (ALM) model. The ALM simulation revealed that the residual stress and total deformation of the sample were dependent on the nozzle diameter. A small nozzle diameter (0.6 mm) resulted in a greater total deformation (0.023), particularly at the top part of the model, which eventually resulted in the sample collapsing. As the nozzle diameter increased, the accuracy of the model improved until the optimum nozzle size (1.0 mm). Validation with 3D-printed surimi products confirmed that the nozzle diameter was a key parameter affecting the geometry accuracy of 3DP of surimi paste.

Keywords: 3D printing, deformation analysis, die swell, numerical simulation, surimi paste

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Authors: Syaza Isma, Timothy Higgins

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In Malaysia, increased take-up rates of tertiary student borrowing, and reliance on retirement savings to fund children's education show the importance of public higher education financing schemes (PTPTN). PTPTN has been operating for 2 decades now; however, there are some critical issues and challenges that include low loan recovery and loan default that suggest a detailed consideration of student loan/financing scheme alternatives is crucial. In addition, the decline in funding level per student following introduction of the new PTPTN full and partial loan scheme has raised ongoing concerns over the sustainability of the scheme to provide continuous financial assistance to students in tertiary education. This research seeks to assess these issues that put greater efficiency in an effort to ensure equitable access to student funding for current and future generations. We explore the extent of repayment hardship under the current loan arrangements that presumably led to low recovery from the borrowers, particularly low-income graduates. The concept of manageable debt exists in the design of income-contingent repayment schemes, as practiced in Australia, New Zealand, UK, Hungary, USA (in limited form), the Netherlands, and South Korea. Can Income Contingent Loans (ICL) offer the best practice for an education financing scheme, and address the issue of repayment hardship and concurrently, can a properly designed ICL scheme provide a solution to the current issues and challenges facing Malaysia student financing? We examine the different potential ICL models using deterministic and stochastic approach to simulate income of graduates.

Keywords: deterministic, income contingent loan, repayment burden, simulation, stochastic

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Authors: Nattaporn Khanoonkon, Rangrong Yoksan, Amod A. Ogale

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Polyethylene (PE) is one of the most petroleum-based thermoplastic materials used in many applications including packaging due to its cheap, light-weight, chemically inert and capable to be converted into various shapes and sizes of products. Although PE is a commercially potential material, its non-biodegradability caused environmental problems. At present, bio-based polymers become more interesting owing to its bio-degradability, non-toxicity, and renewability as well as being eco-friendly. Thermoplastic starch (TPS) is a bio-based and biodegradable plastic produced from the plasticization of starch under applying heat and shear force. In many researches, TPS was blended with petroleum-based polymers including PE in order to reduce the cost and the use of those polymers. However, the phase separation between hydrophobic PE and hydrophilic TPS limited the amount of TPS incorporated. The immiscibility of two different polarity polymers can be diminished by adding compatibilizer. PE-based compatibilizers, e.g. polyethylene-grafted-maleic anhydride, polyethylene-co-vinyl alcohol, etc. have been applied for the PE/TPS blend system in order to improve their miscibility. Until now, there is no report about the utilization of starch-based compatibilizer for PE/TPS blend system. The aims of the present research were therefore to synthesize a new starch-based compatibilizer, i.e. stearic acid-grafted starch (SA-g-starch) and to study the effect of SA-g-starch on chemical interaction, morphological properties, tensile properties and water vapor as well as oxygen barrier properties of the PE/TPS blend films. PE/TPS blends without and with incorporating SA-g-starch with a content of 1, 3 and 5 part(s) per hundred parts of starch (phr) were prepared using a twin screw extruder and then blown into films using a film blowing machine. Incorporating 1 phr and 3 phr of SA-g-starch could improve miscibility of the two polymers as confirmed from the reduction of TPS phase size and the good dispersion of TPS phase in PE matrix. In addition, the blend containing SA-g-starch with contents of 1 phr and 3 phr exhibited higher tensile strength and extensibility, as well as lower water vapor and oxygen permeabilities than the naked blend. The above results suggested that SA-g-starch could be potentially applied as a compatibilizer for the PE/TPS blend system.

Keywords: blend, compatibilizer, polyethylene, thermoplastic starch

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Authors: Sukhila Krishnan, Smita Mohanty, Sanjay K. Nayak

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Polylactide (PLA) and thermoplastic starch (TPS) are the most promising bio-based materials presently available on the market. Polylactic acid is one of the versatile biodegradable polyester showing wide range of applications in various fields and starch is a biopolymer which is renewable, cheap as well as extensively available. The usual increase in the cost of petroleum-based commodities in the next decades opens bright future for these materials. Their biodegradability and compostability was an added advantage in applications that are difficult to recycle. Currently, thermoplastic starch (TPS) has been used as a substitute for synthetic plastic in several commercial products. But, TPS shows some limitations mainly due to its brittle and hydrophilic nature, which has to be resolved to widen its application.The objective of the work we report here was to initiate chemical modifications on TPS and to build up a process to control its chemical structure using a solution process which can reduce its water sensitive properties and then blended it with PLA to improve compatibility between PLA and TPS. The method involves in cleavage of starch amylose and amylopectin chain backbone to plasticize with glycerol and water in batch mixer and then the prepared TPS was reacted in solution with diisocyanates i.e, 4,4'-Methylenediphenyl Diisocyanate (MDI).This diisocyanate was used before with great success for the chemical modification of TPS surface. The method utilized here will form an urethane-linkages between reactive isocyanate groups (–NCO) and hydroxyl groups (-OH) of starch as well as of glycerol. New polymer synthesised shows a reduced crystallinity, less hydrophilic and enhanced compatibility with other polymers. The TPS was prepared by Haake Rheomix 600 batch mixer with roller rotors operating at 50 rpm. The produced material is then refluxed for 5hrs with MDI in toluene with constant stirring. Finally, the modified TPS was melt blended with PLA in different compositions. Blends obtained shows an improved mechanical properties. These materials produced are characterized by Fourier Transform Infrared Spectra (FTIR), DSC, X-Ray diffraction and mechanical tests.

Keywords: polylactic acid, thermoplastic starch, Methylenediphenyl Diisocyanate, Polylactide (PLA)

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Authors: Jan Bohata, Stanislav Zvanovec, Matej Komanec, Jakub Jaros, David Hruby

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Even though there is a rapid development in new optical networks, still optical communication infrastructures remain composed of thousands of kilometers of aging optical cables. Many of them are located in a harsh environment which contributes to an increased attenuation or induced birefringence of the fibers leading to the increase of polarization mode dispersion (PMD). In this paper, we report experimental results from environmental optical cable tests and characterization in the climate chamber. We focused on the evaluation of optical network reliability in a harsh environment. For this purpose, a special thermal chamber was adopted, targeting to the large temperature changes between -60 °C and 160 C° with defined humidity. Single mode optical cable 230 meters long, having six tubes and a total number of 72 single mode optical fibers was spliced together forming one fiber link, which was afterward tested in the climate chamber. The main emphasis was put to the polarization mode dispersion (PMD) changes, which were evaluated by three different PMD measuring methods (general interferometry technique, scrambled state-of-polarization analysis and polarization optical time domain reflectometer) in order to fully validate obtained results. Moreover, attenuation and chromatic dispersion (CD), as well as the PMD, were monitored using 17 km long single mode optical cable. Results imply a strong PMD dependence on thermal changes, imposing the exceeding 200 % of its value during the exposure to extreme temperatures and experienced more than 20 dB insertion losses in the optical system. The derived statistic is provided in the paper together with an evaluation of such as optical system reliability, which could be a crucial tool for the optical network designers. The environmental tests are further taken in context to our previously published results from long-term monitoring of fundamental parameters within an optical cable placed in a harsh environment in a special outdoor testbed. Finally, we provide a correlation between short-term and long-term monitoring campaigns and statistics, which are necessary for optical network safety and reliability.

Keywords: optical fiber, polarization mode dispersion, harsh environment, aging

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Authors: Savin Phoeun

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Long time civil war, economic, infrastructure, social, and political structure were destroyed and everything starts from zero. Transport and communication are the key feature of the national economic growth, especially inland transport and other mode take a complementary role which supported by government and international organization both direct and indirect to private sector and small and medium size enterprises. The objectives of this study are to study the general characteristics, capacity and competitive KPIs of Cambodian Inland Transport Operators. Questionnaire and interview were formed from capacity and competitiveness key performance indicators to take apart in survey to Inland Transport Companies in Phnom Penh capital city of Cambodia. And descriptive statistics was applied to identify the data. The result of this study divided into three distinct sectors: 1). Management ability of transport operators – capital management, financial and qualification are in similar level which can compete between local competitors (moderated level). 2). Ability in operation: customer service providing is better but seemed in high cost operation because mostly they are in family size. 3). Local Cambodian Inland Transport Service Providers are able to compete with each other because they are in similar operation level while Thai competitors mostly higher than. The suggestion and recommendation from the result that inland transport companies should access to new technology, improve strategic management, build partnership (join/corporate) to be bigger size of capital and company in order to attract truthfulness from customers and customize the services to satisfy. Inland Service Providers should change characteristic from only cost competitive to cost saving and service enhancement.

Keywords: assessment, competitiveness, inland transport, operator

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Authors: Anna Siegler

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Bullying among peers is not uncommon; however, adults can notice only a fragment of the cases of harassment during everyday life. The systemic approaches of bullying investigation put the whole school community in the focus of attention and propose that the solution should emerge from the culture of the school. Bystanders are essential in the prevention and intervention processes as an active agent rather than passive. For combating exclusion, stigmatization and harassment, it is important that the bystanders have to realize they have the power to take action. To prevent the escalation of violence, victims must believe that students and teachers will help them and their environment is able to provide safety. The study based on scientific narrative psychological approach, and focuses on the examination of the different perspectives of students, how peers are mentalizing with each other in case of bullying. The data collection contained responses of students (N = 138) from three schools in Hungary, and from three different area of the country (Budapest, Martfű and Barcs). The test battery include Bullying Prevalence Questionnaire, Interpersonal Reactivity Index and an instruction to get narratives about bullying, which effectiveness was tested during a pilot test. The obtained results are in line with the findings of previous bullying research: the victims are mentalizing less with their peers and experience greater personal distress when they are in identity threatening situations, thus focusing on their own difficulties rather than social signals. This isolation is an adaptive response in short-term although it seems to lead to a deficit in social skills later in life and makes it difficult for students to become socially integrated to society. In addition the results also show that students use more mental state attribution when they report verbal bullying than in case of physical abuse. Those who witness physical harassment also witness concrete answers to the problem from teachers, in contrast verbal abuse often stays without consequences. According to the results students mentalizing more in these stories because they have less normative explanation to what happened. To expanding bullying literature, this research helps to find ways to reduce school violence through community development.

Keywords: bullying, mentalization, narrative, school culture

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Authors: Snehal D. Ganjave, Hardik Dodia, Avinash V. Sunder, Swati Madhu, Pramod P. Wangikar

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Batch cultivation of recombinant bacteria in shake flasks results in low cell density due to nutrient depletion. Previous protocols on high cell density cultivation in shake flasks have relied mainly on controlled release mechanisms and extended cultivation protocols. In the present work, we report an optimized fed-batch process for high cell density cultivation of recombinant E. coli BL21(DE3) for protein production. A cybernetic model-based, multi-objective optimization strategy was implemented to obtain the optimum operating variables to achieve maximum biomass and minimized substrate feed rate. A syringe pump was used to feed a mixture of glycerol and yeast extract into the shake flask. Preliminary experiments were conducted with online monitoring of dissolved oxygen (DO) and offline measurements of biomass and glycerol to estimate the model parameters. Multi-objective optimization was performed to obtain the pareto front surface. The selected optimized recipe was tested for a range of proteins that show different extent soluble expression in E. coli. These included eYFP and LkADH, which are largely expressed in soluble fractions, CbFDH and GcanADH , which are partially soluble, and human PDGF, which forms inclusion bodies. The biomass concentrations achieved in 24 h were in the range 19.9-21.5 g/L, while the model predicted value was 19.44 g/L. The process was successfully reproduced in a standard laboratory shake flask without online monitoring of DO and pH. The optimized fed-batch process showed significant improvement in both the biomass and protein production of the tested recombinant proteins compared to batch cultivation. The proposed process will have significant implications in the routine cultivation of E. coli for various applications.

Keywords: cybernetic model, E. coli, high cell density cultivation, multi-objective optimization

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Authors: Yahia A. M. AlKhoudary

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This Study presents the outcome of an investigation to evaluate the importance of autonomous learning as a means of motivation. However, very little research done in this field. Thus, the aims of this study are to ascertain the needs of the learners and to investigate their attitudes and motivation towards the mode of learning. Various suggestions made on how to improve learners’ participation in the learning process. A survey conducted on a sample group of 60 Omani College students. Self-report questionnaires and retrospective interviews conducted to find out their material-type preferences in a self-access learning context. Achieving autonomous learning system, which learners is one of the Ministry of Education goals in the Sultanate of Oman. As a result, this study presents the outcome of an investigation to evaluate the students’ performance in English as a Foreign Language (EFL). It focuses on the effect of autonomous learning that encourages students to learn English, a research conducted at Buraimi city, the Sultanate of Oman. The procedure of this investigation based on four dimensions: (1) sixty students are selected and divided into two groups, (2) pre and posttest projects are given to them, and (3) questionnaires are administered to both students who are involved in the experiment and 50 teachers (25 males and 25 females) to collect accurate data, (4) an interview with students and teachers to find out their attitude towards autonomous learning. Analysis of participants’ responses indicated that autonomous learning motivates students to learn English independently and increase the intrinsic rather than extrinsic motivation to improve their English language as a long-life active learning. The findings of this study show that autonomous learning approach is the best remedy to empower the students’ skills and overcome all relevant difficulties. They also show that secondary school teachers can fully rely on this learning approach that encourages language learners to monitor their progress, increase both learners and teachers’ motivation and ameliorate students’ behavior in the classroom. This approach is also an ongoing process, which takes time, patience and support to be lifelong learning.

Keywords: Omani, autonomous learning system, English as a Foreign Language (EFL), learning approach

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Authors: Narash Narasimman, Calvin Leong Jia Jun, Raksha Karthik, Paul Englert

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Background: Project Grit, a 12-week youth resilience program implemented by Impart and Spartans Boxing Club, aimed to help at-risk adolescents develop resilience through psychoeducation and mental health techniques for dealing with everyday stressors and adversity. The programme consists of two parts-1.5 hours of group therapy followed by 1 hour of boxing. Due to the novelty of the study, 6 male participants, aged 13 to 18, were recruited to participate in the study. Aim: This case study aims to examine the effectiveness of Project Grit in building resilience among at-risk adolescents. Methods: A case study design was employed to capture the complexity and uniqueness of the intervention, without oversimplifying or generalizing it. A 15-year-old male participant with a history of behavioural challenges, delinquency and gang involvement was selected for the study. Teacher, parent and child versions of the Strengths and Difficulties Questionnaire (SDQ) were administered to the facilitators, parents and participants respectively before and after the programme. Relevant themes from the qualitative interviews will be discussed. Results: Scores from all raters revealed improvements in most domains of the SDQ. Total difficulties scores across all raters improved from “very high” to “close to average”. High interrater reliability was observed (κ= .81). The participant reported learning methods to effectively deal with his everyday concerns using healthy coping strategies, developing a supportive social network, and building on his self efficacy. Themes from the subject’s report concurred with the improvement in SDQ scores. Conclusions: The findings suggest that Project Grit is a promising intervention for promoting resilience among at-risk adolescents. The teleological behaviourism framework and the combination of sports engagement and future orientation may be particularly effective in fostering resilience among this population. Further studies need to be conducted with a larger sample size to further validate the effectiveness of Project Grit.

Keywords: resilience, project grit, adolescents, at-risk, boxing, future orientation

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Authors: Mehran Asadi, Afrand Agah

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In data mining, partitioning is used as a fundamental tool for classification. With the help of partitioning, we study the structure of data, which allows us to envision decision rules, which can be applied to classification trees. In this research, we used online social network dataset and all of its attributes (e.g., Node features, labels, etc.) to determine what constitutes an above average chance of being a divergent node. We used the R statistical computing language to conduct the analyses in this report. The data were found on the UC Irvine Machine Learning Repository. This research introduces the basic concepts of classification in online social networks. In this work, we utilize overfitting and describe different approaches for evaluation and performance comparison of different classification methods. In classification, the main objective is to categorize different items and assign them into different groups based on their properties and similarities. In data mining, recursive partitioning is being utilized to probe the structure of a data set, which allow us to envision decision rules and apply them to classify data into several groups. Estimating densities is hard, especially in high dimensions, with limited data. Of course, we do not know the densities, but we could estimate them using classical techniques. First, we calculated the correlation matrix of the dataset to see if any predictors are highly correlated with one another. By calculating the correlation coefficients for the predictor variables, we see that density is strongly correlated with transitivity. We initialized a data frame to easily compare the quality of the result classification methods and utilized decision trees (with k-fold cross validation to prune the tree). The method performed on this dataset is decision trees. Decision tree is a non-parametric classification method, which uses a set of rules to predict that each observation belongs to the most commonly occurring class label of the training data. Our method aggregates many decision trees to create an optimized model that is not susceptible to overfitting. When using a decision tree, however, it is important to use cross-validation to prune the tree in order to narrow it down to the most important variables.

Keywords: online social networks, data mining, social cloud computing, interaction and collaboration

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Authors: Shalini Arora, Sri Sivakumar

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The deep removal of high molecular weight sulphur compounds (e.g., 4,6, dimethyl dibenzothiophene) is challenging due to their steric hindrance. Hydrogenation desulfurization (HYD) pathway is the main pathway to remove these sulfur compounds, and it is mainly governed by the number of type 2 sites. The formation of type 2 sites can be enhanced by modulating the pore structure and the interaction between the active metal and support. To this end, we report the enhanced HDS catalytic activity of ultrasmall NiMo supported on amorphous alumina (A-Al₂O₃) catalysts by one pot colloidal synthesis method followed by calcination and sulfidation. The amorphous alumina (A-Al₂O₃) was chosen as the support due to its lower surface energy, better physicochemical properties, and enhanced acidic sites (due to the dominance of tetra and penta coordinated [Al] sites) than crystalline alumina phase. At 20% metal oxide composition, NiMo supported on A-Al₂O₃ catalyst showed 1.4 and 1.2 times more reaction rate constant and turn over frequency (TOF) respectively than the conventional catalyst (wet impregnated NiMo catalysts) for HDS reaction of dibenzothiophene reactant molecule. A-Al₂O₃ supported catalysts represented enhanced type 2 sites formation (because this catalystpossesses higher sulfidation degree (80%) and NiMoS sites (19.3 x 10¹⁷ sites/mg) with desired optimum stacking degree (2.5) than wet impregnated catalyst at same metal oxide composition 20%) along with higher active metal dispersion, Mo edge site fraction. The experimental observations were also supported by DFT simulations. Lower heat of adsorption (< 4.2 ev for MoS2 interaction and < 3.15 ev for Ni doped MoS2 interaction) values for A-Al₂O₃ confirmed the presence of weaker metal-support interaction in A-Al₂O₃ in contrast to crystalline ℽ-Al₂O3. The weak metal-support interaction for prepared catalysts clearly suggests the higher formation of type 2 sites which leads to higher catalytic activity for HDS reaction.

Keywords: amorphous alumina, colloidal, desulfurization, metal-support interaction

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Authors: T. S. Serniabat, M. N. N. Khan, M. F. M. Zain

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As climate change and environmental pressures are now well established as major international issues, to which governments, businesses and consumers have to respond through more environmentally friendly and aware practices, products and policies; the need to develop alternative sustainable construction materials, reduce greenhouse gas emissions, save energy, look to renewable energy sources and recycled materials, and reduce waste are just some of the pressures impacting significantly on the construction industry. The utilization of waste materials (slag, fly ash, glass beads, plastic and so on) in concrete manufacturing is significant due to engineering, financial, environmental and ecological importance. Thus, utilization of waste materials in concrete production is very much helpful to reach the goal of the sustainable construction. Therefore, this study intends to use glass beads in concrete production. The paper reports on the performance of 9 different concrete mixes containing different ratios of glass crushed to 5 mm - 20 mm maximum size and glass marble of 20 mm size as coarse aggregate .Ordinary Portland cement type 1 and fine sand less than 0.5 mm were used to produce standard concrete cylinders. Compressive strength tests were carried out on concrete specimens at various ages. Test results indicated that the mix having the balanced ratio of glass beads and round marbles possess maximum compressive strength which is 3888.68 psi, as glass beads perform better in bond formation but have lower strength, on the other hand marbles are strong in themselves but not good in bonding. These mixes were prepared following a specific W/C and aggregate ratio; more strength can be expected to achieve from different W/C, aggregate ratios, adding admixtures like strength increasing agents, ASR inhibitor agents etc.

Keywords: waste glass, recycling, environmentally friendly, glass aggregate, strength development

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Authors: M. Gil, R. Montalvo

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Business Intelligence (BI) has become a major source of competitive advantages for firms around the world. BI has been defined as the process of data visualization and reporting for understanding what happened and what is happening. Moreover, BI has been studied for its predictive capabilities in the context of trade and financial transactions. The current literature has identified that BI permits managers to identify market trends, understand customer relations, and predict demand for their products and services. This last capability of BI has been of special concern to academics. Specifically, due to its power to build predictive models adaptable to specific time horizons and geographical regions. However, the current literature of BI focuses on predicting specific markets and industries because the impact of such predictive models was relevant to specific industries or organizations. Currently, the existing literature has not developed a predictive model of BI that takes into consideration the whole economy of a geographical area. This paper seeks to create a predictive model of BI that would show the bigger picture of a geographical area. This paper uses a data set from the Secretary of Economic Development of the state of Jalisco, Mexico. Such data set includes data from all the commercial transactions that occurred in the state in the last years. By analyzing such data set, it will be possible to generate a BI model that predicts supply and demand from specific industries around the state of Jalisco. This research has at least three contributions. Firstly, a methodological contribution to the BI literature by generating the predictive supply and demand model. Secondly, a theoretical contribution to BI current understanding. The model presented in this paper incorporates the whole picture of the economic field instead of focusing on a specific industry. Lastly, a practical contribution might be relevant to local governments that seek to improve their economic performance by implementing BI in their policy planning.

Keywords: business intelligence, predictive model, supply and demand, Mexico

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Authors: Naim Izet Kajtazi

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Context: Increased intracranial pressure and associated symptoms such as headache, papilledema, motor or sensory deficits, seizures, and conscious disturbance are well-known in acute CVT. However, visual loss is not commonly associated with this disease, except in the case of secondary IIH associated with it. Process: We report a case of a 40-year-old male with Behçet’s disease and cerebral venous thrombosis, and other multiple comorbidities admitted with a four-day history of increasing headache and rapidly progressive visual loss bilaterally. The neurological examination was positive for bilateral papilledema of grade 3 with light perception on the left eye and counting fingers on the right eye. Brain imaging showed old findings of cerebral venous thrombosis without any intraparenchymal lesions to suggest a flare-up of Behçet’s disease. The lumbar puncture, followed by the lumbar drain insertion, gave no benefit in headache or vision. However, he completely lost sight. The right optic nerve sheath fenestration did not result in vision improvement. The acute spinal shock complicated the lumbar drain removal due to epidural hematoma. An urgent lumbar laminectomy with hematoma evacuation undertook. Intra-operatively, the neurosurgeon noted suspicious abnormal vessels at conus medullaris with the possibility of an arteriovenous malformation. Outcome: In a few days following the spinal surgery, the patient vision started to improve. Further improvement was achieved after plasma exchange sessions followed by cyclophosphamide. In the recent follow-up in the clinic, he reported better vision, drove, and completed his Ph.D. studies. Relevance: Visual loss in patients with Behçet’s disease should always be anticipated and taken reasonable care of, ensuring that they receive well-combined immunosuppression with anticoagulation and agents to reduce intracranial pressure. This patient’s story is significant for a high disease burden and complicated hospital course by acute spinal shock due to spinal lumbar drain removal with a possible underlying spinal arteriovenous malformation.

Keywords: Behcet disease, optic neuritis, IIH, CVT

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Authors: Farshad Kalantari

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Tourism industry has gained a progressive trend within the past years, which affect the cultural exchange among different nations. It is obvious that each country has its own culture, heritage and history, which can be manifested in the population lifestyle and pattern of living. the lifestyle can be considered as an indicator for health status, as the culture may affect way of living, which known as lifestyle and its components, including dietary pattern, physical activity status and other social behaviours. As a result, it seems that each culture can transfer the lifestyle to other societies by international communications. Moreover, different regions and countries may benefit from natural resources, which can be a leading cause for tourist attraction, in the other words, natural resources and culture, can affect the tourist turnover in a region, and as a result, it can be hypothesised that it may affect the exchange of lifestyle including dietary pattern and physical activity. In the positive way, this can make a region to health pole for other nationalities to gain benefit from that culture in order to improve their quality of life and health status. In this paper has aimed to assess the effect of culture and heritage on tourism rate and the effect of natural resources along with cultural lifestyle on public health and international exchange between other regions. It was hypothesised that by using culture in a positive manner, positive aspect of lifestyle, including ancient physical activity patter, can be transfer and exchange with other regions, which can improve health status as a result. Moreover, it was focused on how to design and recruit strategies to improve the way of gaining benefits from resources and lifestyle in order to improve tourism industry and its rate, which may bring beneficial outcomes, including financial, cultural and health outcomes.

Keywords: toursim, health, culture, sport, lifestyle

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Authors: A. S. Strait, J. A. Bryk-Lucy, L. M. Ritchie

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Thrush is a common disease of ungulates primarily affecting the frog and sulci, caused by the anaerobic bacteria Fusobacterium necrophorum. Thrush accounts for approximately 45.0% of hoof disorders in horses. Prevention and treatment of thrush are essential to prevent horses from developing severe infections and becoming lame. Proper knowledge of hoof care and thrush treatments is crucial to avoid financial costs, unsoundness and lost training time. Research on the effectiveness of numerous commercial and homemade thrush treatments is limited in the equine industry. The objective of this study was to compare the effectiveness of three common thrush treatments for horses: weekly application of Thrush Buster, daily dilute bleach solution spray, or Metronidazole pastes every other day. Cases of thrush diagnosed by a veterinarian or veterinarian-trained researcher were given a score, from 0 to 4, based on the severity of the thrush in each hoof (n=59) and randomly assigned a treatment. Cases were rescored each week of the three-week treatment, and the final and initial scores were compared to determine effectiveness. The thrush treatments were compared with Thrush Buster as the reference at a significance level of α=.05. Binomial Logistic Regression Modeling was performed, finding that the odds of a hoof treated with Metronidazole to be thrush-free was 6.1 times greater than a hoof treated with Thrush Buster (p=0.001), while the odds of a hoof that was treated with bleach to be thrush-free was only 0.97 times greater than a hoof treated with Thrush Buster (p=0.970), after adjustment for treatment week. Of the three treatments utilized in this study, Metronidazole paste applied to the affected areas every other day was the most effective treatment for thrush in horses. There are many other thrush remedies available, and further research is warranted to determine the efficacy of additional treatment options.

Keywords: fusobacterium necrophorum, thrush, equine, horse, lameness

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Authors: Iftikhar Ahmad, Youssef Elkezza

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Sarir oilfield is in North Africa. It has facilities for oil and gas production. The assets of the Sarir oilfield can be divided into five following categories, namely: (i) well bore and wellheads; (ii) vessels such as separators, desalters, and gas processing facilities; (iii) pipelines including all flow lines, trunk lines, and shipping lines; (iv) storage tanks; (v) other assets such as turbines and compressors, etc. The nature of the petroleum industry recognizes the potential human, environmental and financial consequences that can result from failing to maintain the integrity of wellheads, vessels, tanks, pipelines, and other assets. The importance of effective asset integrity management increases as the industry infrastructure continues to age. The primary objective of assets integrity management (AIM) is to maintain assets in a fit-for-service condition while extending their remaining life in the most reliable, safe, and cost-effective manner. Corrosion management is one of the important aspects of successful asset integrity management. It covers corrosion mitigation, monitoring, inspection, and risk evaluation. External corrosion on pipelines, well bores, buried assets, and bottoms of tanks is controlled with a combination of coatings by cathodic protection, while the external corrosion on surface equipment, wellheads, and storage tanks is controlled by coatings. The periodic cleaning of the pipeline by pigging helps in the prevention of internal corrosion. Further, internal corrosion of pipelines is prevented by chemical treatment and controlled operations. This paper describes the integrity management system used in the Sarir oil field for its oil and gas production facilities based on standard practices of corrosion mitigation and inspection.

Keywords: assets integrity management, corrosion prevention in oilfield assets, corrosion management in oilfield, corrosion prevention, inspection activities

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Authors: Bing Lu, Shuang Li, Hongyuan Zhou

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The steel–concrete hybrid structure has been extensively employed in high–rise buildings and super high–rise buildings. The light gauge steel–concrete hybrid structure, including light gauge steel structure and concrete hybrid structure, is a new–type steel–concrete hybrid structure, which possesses some advantages of light gauge steel structure and concrete hybrid structure. The seismic behavior and loss assessment of three high–rise buildings with three different concrete hybrid structures were investigated through finite element software, respectively. The three concrete hybrid structures are reinforced concrete column–steel beam (RC‒S) hybrid structure, concrete–filled steel tube column–steel beam (CFST‒S) hybrid structure, and tubed concrete column–steel beam (TC‒S) hybrid structure. The nonlinear time-history analysis of three high–rise buildings under 80 earthquakes was carried out. After simulation, it indicated that the seismic performances of three high–rise buildings were superior. Under extremely rare earthquakes, the maximum inter–storey drifts of three high–rise buildings are significantly lower than 1/50. The inter–storey drift and floor acceleration of high–rise building with CFST‒S hybrid structure were bigger than those of high–rise buildings with RC‒S hybrid structure, and smaller than those of high–rise building with TC‒S hybrid structure. Then, based on the time–history analysis results, the post-earthquake repair cost ratio and repair time of three high–rise buildings were predicted through an economic performance analysis method proposed in FEMA‒P58 report. Under frequent earthquakes, basic earthquakes and rare earthquakes, the repair cost ratio and repair time of three high-rise buildings were less than 5% and 15 days, respectively. Under extremely rare earthquakes, the repair cost ratio and repair time of high-rise buildings with TC‒S hybrid structure were the most among three high rise buildings. Due to the advantages of CFST-S hybrid structure, it could be extensively employed in high-rise buildings subjected to earthquake excitations.

Keywords: seismic behavior, loss assessment, light gauge steel–concrete hybrid structure, high–rise building, time–history analysis

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Authors: Omolola A. Tajelawi, Hari L. Garbharran

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Revenue leakages are one of the major challenges manufacturers face in production processes, as most of the input materials that should emanate as products from the lines are lost as waste. Rather than generating income from material input which is meant to end-up as products, losses are further incurred as costs in order to manage waste generated. In addition, due to the lack of a clear view of the flow of resources on the lines from input to output stage, acquiring information on the true cost of waste generated have become a challenge. This has therefore given birth to the conceptualization and implementation of waste minimization strategies by several manufacturing industries. This paper reviews the principles and applications of three environmental management accounting tools namely Activity-based Costing (ABC), Life-Cycle Assessment (LCA) and Material Flow Cost Accounting (MFCA) in the manufacturing industry and their effectiveness in curbing revenue leakages. The paper unveils the strengths and limitations of each of the tools; beaming a searchlight on the tool that could allow for optimal resource utilization, transparency in production process as well as improved cost efficiency. Findings from this review reveal that MFCA may offer superior advantages with regards to the provision of more detailed information (both in physical and monetary terms) on the flow of material inputs throughout the production process compared to the other environmental accounting tools. This paper therefore makes a case for the adoption of MFCA as a viable technique for the identification and reduction of waste in production processes, and also for effective decision making by production managers, financial advisors and other relevant stakeholders.

Keywords: MFCA, environmental management accounting, resource efficiency, waste reduction, revenue losses

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Authors: Chueh Chang, Chia-jung Hsieh, Fu-yu Yu, Yu-Hwa Lin

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Background:The majority of women diagnosed with breast cancer undergo treatment involving surgery and radiotherapy or chemotherapy, or both. With these major advances in breast cancer management, many patients still have to deal with short or long-term side effects and psychological distress related to the disease and treatment, which have a substantial impact on their quality of life. The Laughing Qigong Program (LQP) is an interactive laughter program that combines the physical and physiological benefits of laughter with the mental benefits of Chinese qigong. Purpose: In order to improve the quality of life for breast cancer women in the community as well as echoing the WHO 2004 “Promoting Mental Health” for every one. This study focused on how to promote the positive mental health for women of breast cancer through the “laughter program” in Taiwan. During the presentation, how to practice Laughing Qigong will be demonstrated. Method: Using nonequivalent pretest-posttest design, ix-one breast cancer patients were volunteered to enroll in this study from the Taiwan Breast Cancer Alliance (TBCA). Thirty patients were assigned to the experimental group and the other 31 patients were assigned to the control group. The women who were assigned to the experimental group received laughter program one hour per session, once a week, totally 12 sessions. All subjects were tested before and after the intervention on the following: Self-Esteem scale (RSE), Face Scale (FS), Anxiety and pain experience were measured as psychological markers; saliva cortisol (CS) as an immunological marker; blood pressure (BP), heart rate (HR),and heart rate variability (HRV) as physiological markers of the body’s response to stress. Results: After comparing the experimental and control groups, the results revealed that those breast cancer women with “laughing program” their sense of humor were improved, less uncomfortable on self report physical conditions, more positive attitudes toward stress management by using laughter, and had emotional improvement according to the face scale.

Keywords: mental health promotion, breast cancer, laughing Qigong, women

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Authors: Vicent Lwanga

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Background: Elderly Widows Orphans Family Support, a Community Based Organization operating in Kapchorwa with the main focus of reducing economic and social vulnerability among children affected by HIV/AIDS. The survey on reducing vulnerability targeted HIV/AIDS affected households, which included 111 adults and 185 children. The broad objective of the study was to determine how the needs of the children affected by HIV/AIDS could be appropriately met by specifically examining the situation of children affected by HIV/AIDS and establishing their needs. Methodology: The survey applied a structured questionnaire. Parents whose consent for the interview of the children had been obtained then communicated to the selected child/children. If the child consented, an arrangement for the interview was made as regards the time and place of the interview. Lessons: Adult respondents included 22.2% males and 77.8% females. Child respondents were males, 49.5%, and females 50.5%. The majority of the households are from lower economic strata. 74.1% and 63.0% of males and females, respectively, indicated that their illness had affected their income-earning activities; some of the adults have lost their jobs due to AIDS. A fair number of the children are engaged in economic activity: some of those still in school worked after school for wages and looked after their siblings. The income earned was spent mostly on household needs and school fees — one-fifth of children linked parents` inability to do more of what they desired to their ill-health. Elderly Widows Orphans Family Support secured sponsors to educate 22 girls and 16 boys in the community. Income-generating projects like piggery and skill training are given to orphans. The specific vulnerability of HIV/AIDS orphan's needs is responded to now more than ever. Community organisations interventions such as financial support to orphans introduced to moderate the impact of the disease on orphans and families.

Keywords: aids, children, needs, vulnerability

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Authors: P. H. Tee, S. M. Zamri, K. M. Kasim, S. K. Tiew

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This study evaluates the management of osteoporosis in a tertiary care government hospital in Malaysia. As the number of admitted patients having osteoporotic fractures is on the rise, osteoporotic medications are an increasing financial burden to government hospitals because they account for half of the orthopedic budget and expenditure. Comprehensive knowledge among practitioners is important to detect early and avoid this preventable disease and its serious complications. The purpose of this study is to evaluate the awareness, knowledge, and practices in managing osteoporosis among practitioners in Hospital Tengku Ampuan Rahimah (HTAR), Klang. A questionnaire from an overseas study in managing osteoporosis among primary care physicians is adapted to Malaysia’s Clinical Practice Guideline of Osteoporosis 2012 (revised 2015) and international guidelines were distributed to all orthopedic practitioners in HTAR Klang (including surgeons, orthopedic medical officers), endocrinologists, rheumatologists and geriatricians. The participants were evaluated on their expertise in the diagnosis, prevention, treatment decision and medications for osteoporosis. Collected data were analyzed for all descriptive and statistical analyses as appropriate. All 45 participants responded to the questionnaire. Participants scored highest on expertise in prevention, followed by diagnosis, treatment decision and lastly, medication. Most practitioners stated that own-initiated continuing professional education from articles and books was the most effective way to update their knowledge, followed by attendance in conferences on osteoporosis. This study confirms the importance of comprehensive training and education regarding osteoporosis among tertiary care physicians and surgeons, predominantly in pharmacotherapy, to deliver wholesome care for osteoporotic patients.

Keywords: awareness, knowledge, osteoporosis, practices

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Authors: Imran Mehboob Shaikh, Kamaruzaman Noordin

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Musharakah Mutanaqisah or Diminishing Partnership is a derivative of Musharakah contract, which is used by Islamic banks for housing finance facility. Most of the banks offer housing finance based on the concept of Musharakah Mutanaqisah, apart from few which still offer housing finance using BBA, Tawarruq (commodity Murabahah) and Istisna. This research attempts to compare the practice of DP housing finance offered in Malaysia. This paper will further look into challenges in Musharakah Mutanaqisah practice and its sustainability as a mortgage product. In practice there are certain issues related to Musharakah Mutanaqisah also known as Musharakah al Muntaiah bi tamlik, widely accepted and mostly used for housing finance by the Islamic banks. In Malaysia, it is in transforming stage from Bay bithamman Ajil, which is mostly used for housing finance in ASEAN region i.e., Malaysia, Indonesia and Brunei. In order to conduct this study, a discussion was carried out with few researchers who had worked on the topic previously and some Islamic bank officers attached to a full-fledged Islamic bank in Malaysia. Apart from that previous literature on Musharakah Mutanaqisah was also reviewed and various books, as well as online data, was considered for this study, and websites of different Islamic banks with information for Diminishing partnership, home financing were retrieved. This paper will highlight issues surrounding Diminishing Partnership contract and its conformity to Maqasid al Shariah (objectives of Shariah). Diminishing Partnership is widely accepted in different parts of the world and is mostly used for housing finance. The future prospect of DP is believed to be affirmative. As the product is a better substitute for BBA and most of the Islamic banks around the world have utilized their housing portfolio using the contract but at the same time, there are certain issues that need to be overcome. Even though Islamic banks are striving to sustain and compete the conventional banks but securing the customers from Gharar and other issues should be the primary objective of Islamic financial institutions.

Keywords: BBA, home financing, musharakah mutanaqisah, tawarruq

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Authors: R. Cooper, M. Kurien

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Background: Coeliac Disease affects around 1 in 100 people. Untreated, it can result in serious morbidity such as malabsorption and cancers. The only treatment is to adhere to a gluten free diet (GFD). International guidelines recommend that people with the coeliac disease receive follow-up healthcare annually to detect complications early and support their adherence to a GFD. However, there is a finite amount of healthcare in the UK, and as such, not all patients receive follow-up care as recommended by the guidelines. Furthermore, there is an increasing number of patients being diagnosed with coeliac disease. Given the potential severe morbidity that non-adherence to a GFD could result in, alongside reports that the rate of non- GFD adherence could be as high as 91%, it is imperative that action is taken. One potential solution to this would be to provide follow-up care digitally through utilising technology. This abstract reports on a rapid review undertaken to explore the existing evidence in this area. Methods: In June 2020, 11 bibliographic databases were searched to find any pertinent studies. The inclusion criteria required the study to be written in the English language and report on the use of digital healthcare interventions for people with Coeliac Disease. Results: A small amount of evidence (n=8) was found which met our inclusion criteria and pertained to the provision of CD follow-up digitally. These studies focussed either on educating and supporting patients to adhere to a GFD or providing consultation remotely with a focus on detecting complications early. These studies showed that there is potential for digital healthcare interventions to positively impact people with coeliac disease. However, it is suggested that the effectiveness of these interventions may depend on local circumstances, individual knowledge of CD and general attitudes. Conclusion: The above studies suggest that providing follow-up care digitally may offer a potential solution; however, the evidence about how this should be done and in what circumstances this will work for individuals is scarce. In the light of the COVID-19 pandemic, the introduction of digital healthcare interventions appears to be highly topical, and as such, this review may benefit from being refreshed in the future.

Keywords: coeliac disease, follow-up, gluten free diet, digital healthcare interventions

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Authors: Mahfouz Saeed

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Cu₂(ZnSn)(S)₄ (CTZS) offers potential advantages over CuInGaSe₂ (CIGS) as solar thin film because to its higher band gap. Preparing such photovoltaic materials by electrochemical techniques is particularly attractive due to the lower processing cost and the high throughput of such techniques. Several recent publications report CTZS electroplating; however, the electrochemical process still facing serious challenges such as a sulfur atomic ration which is about 50% of the total alloy. We introduce in this work an improved electrolyte composition which enables the direct electrodeposition of CTZS from a single bath. The electrolyte is significantly more dilute in comparison to common baths described in the literature. The bath composition we introduce is: 0.0032 M CuSO₄, 0.0021 M ZnSO₄, 0.0303 M SnCl₂, 0.0038 M Na₂S₂O₃, and 0.3 mM Na₂S₂O3. PHydrion is applied to buffer the electrolyte to pH=2, and 0.7 M LiCl is applied as supporting electrolyte. Electrochemical process was carried at a rotating disk electrode which provides quantitative characterization of the flow (room temperature). Comprehensive electrochemical behavior study at different electrode rotation rates are provided. The effects of agitation on atomic composition of the deposit and its adhesion to the molybdenum back contact are discussed. The post treatment annealing was conducted under sulfur atmosphere with no need for metals addition from the gas phase during annealing. The potential which produced the desired atomic ratio of CTZS at -0.82 V/NHE. Smooth deposit, with uniform composition across the sample surface and depth was obtained at 500 rpm rotation speed. Final sulfur atomic ratio was adjusted to 50.2% in order to have the desired atomic ration. The final composition was investigated using Energy-dispersive X-ray spectroscopy technique (EDS). XRD technique used to analyze CTZS crystallography and thickness. Complete and functional CTZS PV devices were fabricated by depositing all the required layers in the correct order and the desired optical properties. Acknowledgments: Case Western Reserve University for the technical help and for using their instruments.

Keywords: photovoltaic, CTZS, thin film, electrochemical

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Authors: Sugeng Rianto, P.W. Arinto Yudi, Soemarno Muhammad Nurhuda

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A computation of a 3D compressible fluid flow for virtual environment with haptic interaction can be a non-trivial issue. This is especially how to reach good performances and balancing between visualization, tactile feedback interaction, and computations. In this paper, we describe our approach of computation methods based on parallel programming on a GPU. The 3D fluid flow solvers have been developed for smoke dispersion simulation by using combinations of the cubic interpolated propagation (CIP) based fluid flow solvers and the advantages of the parallelism and programmability of the GPU. The fluid flow solver is generated in the GPU-CPU message passing scheme to get rapid development of haptic feedback modes for fluid dynamic data. A rapid solution in fluid flow solvers is developed by applying cubic interpolated propagation (CIP) fluid flow solvers. From this scheme, multiphase fluid flow equations can be solved simultaneously. To get more acceleration in the computation, the Navier-Stoke Equations (NSEs) is packed into channels of texel, where computation models are performed on pixels that can be considered to be a grid of cells. Therefore, despite of the complexity of the obstacle geometry, processing on multiple vertices and pixels can be done simultaneously in parallel. The data are also shared in global memory for CPU to control the haptic in providing kinaesthetic interaction and felling. The results show that GPU based parallel computation approaches provide effective simulation of compressible fluid flow model for real-time interaction in 3D computer graphic for PC platform. This report has shown the feasibility of a new approach of solving the compressible fluid flow equations on the GPU. The experimental tests proved that the compressible fluid flowing on various obstacles with haptic interactions on the few model obstacles can be effectively and efficiently simulated on the reasonable frame rate with a realistic visualization. These results confirm that good performances and balancing between visualization, tactile feedback interaction, and computations can be applied successfully.

Keywords: CIP, compressible fluid, GPU programming, parallel computation, real-time visualisation

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Authors: K. M. Pratap Shankar, Dattatreya Rao, Sai Prasad

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Background: Skin diseases are among the most common health problems worldwide and are associated with a considerable burden. Eczema is such a skin ailment which cause psychological, social and financial burden on the patient and their families. Management of eczema with antibiotics, antihistamines, steroids etc., are available but even after their use relapses, recurrences and other complications are very common. Aim: The aim of this study was to assess the efficacy of leech application in the management of vicarcikā (Eczema) with Histopathological study. Methods: For the present study 10 patients having the classical symptoms of Vicarcikā, were randomly selected as per the inclusion and exclusion criteria from O.P.D. & I.P.D. sections of Śalya department, S.V. Āyurvedic Hospital, Tirupati. Minimum 4 sittings of Leech application was carried out with seven days interval. Total duration of treatment was 6 weeks. Biopsy samples were collected from the lesion site before and after treatment. Histopathological examination was done by the pathologist. Results: In eczema (dermatitis) the leech application therapy gives excellent response by reducing the inflammatory component, hyperkeratosis, spongiosis, irregular acanthosis and by evoking a granulation tissue response in the dermis and in most of the cases with complete recovery from the lesion. Most of the cases in the study were chronic dermatitis and sebhoric keratosis, almost all local/focal pigmented lesions is totally relieved by leech therapy especially in cases of sebhoric keratosis. Conclusion: In the present study it was found that, leech application evokes significant changes at histological level specifically in reduction of inflammatory component, hyperkeratosis, spongiosis and irregular acanthosis. It was also found that there was a considerable formation of granulation tissue, which helps in formation of healthy new tissues.

Keywords: acanthosis, eczema, hyperkeratosis, leech application, spongiosis

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Authors: Lily Yarney, Emmanuel M. Y. Seidu, Thomas Chireh Kuusaanu, Belinda Adzimah-Yeboah

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Healthcare delivery is labor-intensive; the role of the health worker is, therefore, indispensable in maintaining and improving individual and population health. In Ghana, doctor-patient ratio is 1:10,450, with a disproportionate tilt in favor of the relatively resource rich southern part of the country. The Upper West Region located in Northern Ghana, is among the poorest regions in the country. The study was aimed at finding out the reasons why medical doctors are unwilling to accept postings to the Upper West Region where their services are needed most despite some efforts to attract, motivate and retain them. Current initiatives by the Ministry of Health and its partners to attract and retain doctors in the region were also examined. Qualitative methodology was employed with an in-depth interview guide to collect data. Sixteen respondents comprising medical doctors, health managers, and other health-related partners purposively selected took part in the study. Data were recorded, transcribed, coded, and categorized into themes in tandem with the objectives of the study. The study found that medical doctors are unwilling to take up appointments in the Upper West Region because of limited opportunities for career and continuing professional development, poor financial inducement, and weak leadership, among other important contextual social and cultural factors. Critical success factors to surmount these challenges include concessions and sponsorship for medical specialization training for doctors and clear implementable national and local policies on postings.

Keywords: attraction, retention, medical doctors, deprived regions, Ghana

Procedia PDF Downloads 111