Search results for: Greek public hospital sector

Authors: Zhao Jiashen, Serene Goh, Jerry Goo, Anthony Li, Lim Woan Wui, Paul Drakeford, Chen Qing Yan

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Introduction: Emergency laparotomy (EL) is one of the most common surgeries done in Singapore to treat acute abdominal pathologies. A significant proportion of these surgeries are performed in the geriatric population (65 years and older), who tend to have the highest postoperative morbidity, mortality, and highest utilization of intensive care resources. Frailty, the state of vulnerability to adverse outcomes from an accumulation of physiological deficits, has been shown to be associated with poorer outcomes after surgery and remains a strong driver of healthcare utilization and costs. To date, there is little understanding of the impact it has on emergency laparotomy outcomes. The objective of this study is to examine the impact of frailty on postoperative morbidity, mortality, and length of stay after EL. Methods: A retrospective study was conducted in two tertiary centres in Singapore, Tan Tock Seng Hospital and Khoo Teck Puat Hospital the period from January to December 2019. Patients aged 65 years and above who underwent emergency laparotomy for intestinal obstruction, perforated viscus, bowel ischaemia, adhesiolysis, gastrointestinal bleed, or another suspected acute abdomen were included. Laparotomies performed for trauma, cholecystectomy, appendectomy, vascular surgery, and non-GI surgery were excluded. The Clinical Frailty Score (CFS) developed by the Canadian Study of Health and Aging (CSHA) was used. A score of 1 to 4 was defined as non-frail and 5 to 7 as frail. We compared the clinical outcomes of elderly patients in the frail and non-frail groups. Results: There were 233 elderly patients who underwent EL during the study period. Up to 26.2% of patients were frail. Patients who were frail (CFS 5-9) tend to be older, 79 ± 7 vs 79 ± 5 years of age, p <0.01. Gender distribution was equal in both groups. Indication for emergency laparotomies, time from diagnosis to surgery, and presence of consultant surgeons and anaesthetists in the operating theatre were comparable (p>0.05). Patients in the frail group were more likely to receive postoperative geriatric assessment than in the non-frail group, 49.2% vs. 27.9% (p<0.01). The postoperative complications were comparable (p>0.05). The length of stay in the critical care unit was longer for the frail patients, 2 (IQR 1-6.5) versus 1 (IQR 0-4) days, p<0.01. Frailty was found to be an independent predictor of 90-day mortality but not age, OR 2.9 (1.1-7.4), p=0.03. Conclusion: Up to one-fourth of the elderly who underwent EL were frail. Patients who were frail were associated with a longer length of stay in the critical care unit and a 90-day mortality rate of more than three times that of their non-frail counterparts. PPOSSUM was a better predictor of 90-day mortality in the non-frail group than in the frail group. As frailty scoring was a significant predictor of 90-day mortality, its integration into acute surgical units to facilitate shared decision-making and discharge planning should be considered.

Keywords: frailty elderly, emergency, laparotomy

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Authors: Funmilayo L. Amao, Amos O. Amao

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It has been observed that majority of the people are living in poor housing quality or totally homeless in urban center despite all governmental policies to provide housing to the public. On the supply side, various government policies in the past have been formulated towards overcoming the huge shortage through several Housing Reform Programmes. Despite these past efforts, housing continues to be a mirage to ordinary Nigerian. Currently, there are various mass housing delivery programmes such as the affordable housing scheme that utilize the Public Private Partnership effort and several Private Finance Initiative models could only provide for about 3% of the required stock. This suggests the need for a holistic solution in approaching the problem. The aim of this research is to find out the problems hindering the delivery of housing in Nigeria and its effects on housing affordability. The specific objectives are to identify the causes of housing delivery problems, to examine different housing policies over years and to suggest a way out for sustainable housing delivery. This paper also reviews the past and current housing delivery programmes in Nigeria and analyses the demand and supply side issues. It identifies the various housing delivery mechanisms in current practice. The objective of this paper, therefore, is to give you an insight into the delivery option for the sustainability of housing in Nigeria, given the existing delivery structures and the framework specified in the New National Housing Policy. The secondary data were obtained from books, journals and seminar papers. The conclusion is that we cannot copy models from other nations, but should rather evolve workable models based on our socio-cultural background to address the huge housing shortage in Nigeria. Recommendations are made in this regard.

Keywords: housing, sustainability, housing delivery, housing policy, housing affordability

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Authors: Mdluli Fezile, Schmidt Stefan, Thamaga-Chitja Joyce

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In view of the frequently reported foodborne disease outbreaks caused by contaminated fresh produce, consumers have a preference for foods that meet requisite hygiene standards to reduce the risk of foodborne illnesses. Producing good quality fresh produce then becomes critical in improving market access and food security, especially for small-scale farmers. Questions of hygiene and subsequent microbiological quality in the rural small-scale farming sector of South Africa are even more crucial, given the policy drive to develop small-scale farming as a measure for reinforcement of household food security and reduction of poverty. Farming practices and methods, throughout the fresh produce value chain, influence the quality of the final product, which in turn determines its success in the market. This study’s aim was to therefore determine the extent to which training on organic farming methods, including modules such as Importance of Production Hygiene, influenced the hygienic farming practices employed by eTholeni small-scale organic farmers in uMbumbulu, KwaZulu-Natal- South Africa. Questionnaires were administered to 73 uncertified organic farmers and analysis showed that a total of 33 farmers were trained and supplied the local Agri-Hub while 40 had not received training. The questionnaire probed respondents’ attitudes, knowledge of hygiene and composting practices. Data analysis included descriptive statistics such as the Chi-square test and a logistic regression model. Descriptive analysis indicated that a majority of the farmers (60%) were female, most of which (73%) were above the age of 40. The logistic regression indicated that factors such as farmer training and prior experience in the farming sector had a significant influence on hygiene practices both at 5% significance levels. These results emphasize the importance of training, education and farming experience in implementing good hygiene practices in small-scale farming. It is therefore recommended that South African policies should advocate for small-scale farmer training, not only for subsistence purposes, but also with an aim of supplying produce markets with high fresh produce.

Keywords: small-scale farmers, leafy salad vegetables, organic produce, food safety, hygienic practices, food security

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Authors: Jonathan Sahu, Jill Aylott

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Individuals with Autism, Intellectual and Developmental disabilities (AIDD) are one of the most vulnerable groups in society, hampered not only by their own limitations to understand and interact with the wider society, but also societal limitations in perception and understanding. Communication to express their needs and wishes is fundamental to enable such individuals to live and prosper in society. This research project was designed as an organisational case study, in a large secondary health care hospital within the National Health Service (NHS), to assess the quality of care provided to people with AIDD and to review the role of advocacy to reduce health inequalities in these individuals. Methods: The research methodology adopted was as an “insider researcher”. Data collection included both quantitative and qualitative data i.e. a mixed method approach. A semi-structured interview schedule was designed and used to obtain qualitative and quantitative primary data from a wide range of interdisciplinary frontline health care workers to assess their understanding and awareness of systems, processes and evidence based practice to offer a quality service to people with AIDD. Secondary data were obtained from sources within the organisation, in keeping with “Case Study” as a primary method, and organisational performance data were then compared against national benchmarking standards. Further data sources were accessed to help evaluate the effectiveness of different types of advocacy that were present in the organisation. This was gauged by measures of user and carer experience in the form of retrospective survey analysis, incidents and complaints. Results: Secondary data demonstrate near compliance of the Organisation with the current national benchmarking standard (Monitor Compliance Framework). However, primary data demonstrate poor knowledge of the Mental Capacity Act 2005, poor knowledge of organisational systems, processes and evidence based practice applied for people with AIDD. In addition there was poor knowledge and awareness of frontline health care workers of advocacy and advocacy schemes for this group. Conclusions: A significant amount of work needs to be undertaken to improve the quality of care delivered to individuals with AIDD. An operational strategy promoting the widespread dissemination of information may not be the best approach to deliver quality care and optimal patient experience and patient advocacy. In addition, a more robust set of standards, with appropriate metrics, needs to be developed to assess organisational performance which will stand the test of professional and public scrutiny.

Keywords: advocacy, autism, health inequalities, intellectual developmental disabilities, quality of care

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Authors: Liberto Pombal, Christian Dieter Jaekel

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The objective of this work is to establish theoretical and numerical conditions for Solving Extended Linear Complementarity Problems (XLCP), with emphasis on the Horizontal Linear Complementarity Problem (HLCP). Two new strategies for solving complementarity problems are presented, using differentiable and penalized functions, which resulted in a natural formalization for the Linear Horizontal case. The computational results of all suggested strategies are also discussed in depth in this paper. The implication in practice allows solving and optimizing, in an innovative way, the (forestry) problems of the value chain of the industrial wood sector in Angola.

Keywords: complementarity, box constrained, optimality conditions, wood and environment

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Authors: Mohammed Alhawiti

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This paper investigates the insight of educational practitioners concerning challenges that seriously obstruct the comprehension of ICT-related goals of educational institutes. ICT education is a broad area encircling a variety of discipline; both those traditionally classified as IT such as information systems, engineering etc., as well as recent areas, which cross over a variety of educational fields. The results are from a local survey among national representative samples of institutes across GCC countries. The research entails a brief synopsis of the design of this project, a review of key indicators regarding ICT (Information and Communication Technologies) in various institutions, key obstacles and an investigation of the co-variation between challenges and related factors at the country-level.

Keywords: information, communication technology, GCC countries, education sector

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Authors: Nita Mitra, Pranab Chanda

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In this paper, the issue of attitude-behavior consistency has been addressed in the context of climate change. Scientists (about 98 percent) opine that human behavior has a significant role in climate change. Such climate changes are harmful for human life. Thus, it is natural to conclude that only change of human behavior can avoid harmful consequences. Government and Non-Government Organizations are taking steps to bring in the desired changes in behavior. However, it seems that although the efforts are achieving changes in the attitudes to some degree, those steps are failing to materialize the corresponding behavioral changes. This has been a great concern for environmentalists. Psychologists have noticed the problem as a particular case of the general psychological problem of making attitude and behavior consistent with each other. The present study is in continuation of a previous work of the same author based upon descriptive research on the status of attitude and behavior of the people of a foot-hill region of the Himalayas in India regarding climate change. The observations confirm the mismatch of attitude and behavior of the people of the region with respect to climate change. While doing so an attitude-behavior mismatch has been noticed with respect to the acceptance of psychological findings by the public. People have been found to be interested in Psychology as an important subject, but they are reluctant to take the observations of psychologists seriously. A comparative study in this regard has been made with similar studies done elsewhere. Finally, an attempt has been made to perceive observations in the framework of observational learning due to Bandura's and behavior change due to Lewin.

Keywords: acceptance of psychological variables, attitude-behavior consistency, behavior change, climate change, observational learning

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Authors: Sophia Yakhlef

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In spring 2020, the spread of coronavirus disease 2019 (COVID-19) reached the epidemiological criteria to be declared a global pandemic. Global action was taken in order to stop the spread of the virus, such as, for example, restrictions regarding spending time outside of your home and, in several countries, periods of mandatory quarantine. Sweden's method of handling the pandemic has stood out among other European nations, and the tactic of relying on citizens' sense of civic solidarity, rather than enforcing legal restrictions preventing people from spending time outside, has been highly criticised in international news media. This situation has entailed a moral dilemma concerning the proper conduct of behaviour in everyday situations in Sweden, which is also reflected in public news media and social media. This media study focuses on Swedish social media debates and attitudes concerning moral dilemmas of handling this sense of civic solidarity. Comments on social media forums expressing outrage and anger regarding, amongst others, the actions of public media figures (such as celebrities, journalists, and bloggers) are analyzed. Drawing on a social psychological perspective on emotions, the study identifies ambiguities of moral disagreements and moral panics as ways of expressing that a moral norm has been violated. The findings suggest that social media is used in order to handle such ambiguities and make sense of the loosely defined norms of civic solidarity.

Keywords: COVID-19 crisis, moral disagreements, moral panic, social media, social norms, social psychology, Sweden

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Authors: Sharmila Parmanand

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This paper examines dominant media representations of prostitution in the Philippines and interrogates sex workers’ interactions with the media establishment. This analysis of how sex workers are constituted in media, often as both innocent victims and immoral actors, contributes to an understanding of public discourse on sex work in the Philippines, where decriminalisation has recently been proposed and sex workers are currently classified as potential victims under anti-trafficking laws but also as criminals under the penal code. The first part is an analysis of media coverage of two prominent themes on prostitution: first, raid and rescue operations conducted by law enforcement; and second, prostitution on military bases and tourism hotspots. As a result of pressure from activists and international donors, these two themes often define the policy conversations on sex work in the Philippines. The discourses in written and televised news reports and documentaries from established local and international media sources that address these themes are explored through content analysis. Conclusions are drawn based on specific terms commonly used to refer to sex workers, how sex workers are seen as performing their cultural roles as mothers and wives, how sex work is depicted, associations made between sex work and public health, representations of clients and managers and ‘rescuers’ such as the police, anti-trafficking organisations, and faith-based groups, and which actors are presumed to be issue experts. Images of how prostitution is used as a metaphor for relations between the Philippines and foreign nations are also deconstructed, along with common tropes about developing world female subjects. In general, sex workers are simultaneously portrayed as bad mothers who endanger their family’s morality but also as long-suffering victims who endure exploitation for the sake of their children. They are also depicted as unclean, drug-addicted threats to public health. Their managers and clients are portrayed as cold, abusive, and sometimes violent, and their rescuers as moral and altruistic agents who are essential for sex workers’ rehabilitation and restoration as virtuous citizens. The second part explores sex workers’ own perceptions of their interactions with media, through interviews with members of the Philippine Sex Workers Collective, a loose organisation of sex workers around the Philippines. They reveal that they are often excluded by media practitioners and that they do not feel that they have space for meaningful self-revelation about their work when they do engage with journalists, who seem to have an overt agenda of depicting them as either victims or women of loose morals. In their assessment, media narratives do not necessarily reflect their lived experiences, and in some cases, coverage of rescues and raid operations endangers their privacy and instrumentalises their suffering. Media representations of sex workers may produce subject positions such as ‘victims’ or ‘criminals’ and legitimize specific interventions while foreclosing other ways of thinking. Further, in light of media’s power to reflect and shape public consciousness, it is a valuable academic and political project to examine whether sex workers are able to assert agency in determining how they are represented.

Keywords: discourse analysis, news media, sex work, trafficking

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Authors: Maryam Ziaee, Himanshu Shee, Amrik Sohal

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Big Data Analytics (BDA) in supply chain management has recently drawn the attention of academics and practitioners. Big data refers to a massive amount of data from different sources, in different formats, generated at high speed through transactions in business environments and supply chain networks. Traditional statistical tools and techniques find it difficult to analyse this massive data. BDA can assist organisations to capture, store, and analyse data specifically in the field of supply chain. Currently, there is a paucity of research on BDA in the pharmaceutical supply chain context. In this research, the Australian pharmaceutical supply chain was selected as the case study. This industry is highly significant since the right medicine must reach the right patients, at the right time, in right quantity, in good condition, and at the right price to save lives. However, drug shortages remain a substantial problem for hospitals across Australia with implications on patient care, staff resourcing, and expenditure. Furthermore, a massive volume and variety of data is generated at fast speed from multiple sources in pharmaceutical supply chain, which needs to be captured and analysed to benefit operational decisions at every stage of supply chain processes. As the pharmaceutical industry lags behind other industries in using BDA, it raises the question of whether the use of BDA can improve transparency among pharmaceutical supply chain by enabling the partners to make informed-decisions across their operational activities. This presentation explores the impacts of BDA on supply chain management. An exploratory qualitative approach was adopted to analyse data collected through interviews. This study also explores the BDA potential in the whole pharmaceutical supply chain rather than focusing on a single entity. Twenty semi-structured interviews were undertaken with top managers in fifteen organisations (five pharmaceutical manufacturers, five wholesalers/distributors, and five public hospital pharmacies) to investigate their views on the use of BDA. The findings revealed that BDA can enable pharmaceutical entities to have improved visibility over the whole supply chain and also the market; it enables entities, especially manufacturers, to monitor consumption and the demand rate in real-time and make accurate demand forecasts which reduce drug shortages. Timely and precise decision-making can allow the entities to source and manage their stocks more effectively. This can likely address the drug demand at hospitals and respond to unanticipated issues such as drug shortages. Earlier studies explore BDA in the context of clinical healthcare; however, this presentation investigates the benefits of BDA in the Australian pharmaceutical supply chain. Furthermore, this research enhances managers’ insight into the potentials of BDA at every stage of supply chain processes and helps to improve decision-making in their supply chain operations. The findings will turn the rhetoric of data-driven decision into a reality where the managers may opt for analytics for improved decision-making in the supply chain processes.

Keywords: big data analytics, data-driven decision, pharmaceutical industry, supply chain management

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Authors: M. Ndaw, G. Mendy, S. Ouya

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Risk management in banking sector is a key issue linked to financial system stability and its importance has been elevated by technological developments and emergence of new financial instruments. In this paper, we improve the model previously defined for quantifying internal control impact on banking risks by automatizing the residual criticality estimation step of FMECA. For this, we defined three equations and a maturity coefficient to obtain a mathematical model which is tested on all banking processes and type of risks. The new model allows an optimal assessment of residual criticality and improves the correlation rate that has become 98%.

Keywords: risk, control, banking, FMECA, criticality

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Authors: Yu-Yu Wang, Shih-Hua Hsieh, Ru-Shian Hsieh

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Wishes and choices being respected, and the right to be supported rather than coerced, have been internationally recognized as the human rights of persons with mental illness. In Taiwan, ‘coerced hospitalization’ has become difficult since the revision of the mental health legislation in 2007. Despite trend towards human rights, the real problem families face when their family members are in mental health crisis is the lack of alternative services. This study aims to explore: 1) When is hospitalization seen as the only solution by family members? 2) What are the barriers for arranging hospitalization, and how are they managed? 3) What have family carers learned, in their experiences of caring for their family members with mental illness? To answer these questions, qualitative approach was adopted, and focus group interviews were taken to collect data. This study includes 24 family carers. The main findings of this research include: First, hospital is the last resort for carers in helplessness. Family carers tend to do everything they could to provide care at home for their family members with mental illness. Carers seek hospitalization only when a patient’s behavior is too violent, weird, and/or abnormal, and beyond their ability to manage. Hospitalization, nevertheless, is never an easy choice. Obstacles emanate from the attitudes of the medical doctors, the restricted areas of ambulance service, and insufficient information from the carers’ part. On the other hand, with some professionals’ proactive assistance, access to medical care while in crisis becomes possible. Some family carers obtained help from the medical doctor, nurse, therapist and social workers. Some experienced good help from policemen, taxi drivers, and security guards at the hospital. The difficulty in accessing medical care prompts carers to work harder on assisting their family members with mental illness to stay in stable states. Carers found different ways of helping the ‘person’ to get along with the ‘illness’ and have better quality of life. Taking back ‘the right to control’ in utilizing medication, from passiveness to negotiating with medical doctors and seeking alternative therapies, are seen in many carers’ efforts. Besides, trying to maintain regular activities in daily life and play normal family roles are also experienced as important. Furthermore, talking with the patient as a person is also important. The authors conclude that in order to protect the human rights of persons with mental illness, it is crucial to make the medical care system more flexible and to make the services more humane: sufficient information should be provided and communicated, and efforts should be made to maintain the person’s social roles and to support the family.

Keywords: family carers, independent living, mental health crisis, persons with mental illness

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Authors: Holly D. Shan, Monique L. Bautista Neughebauer

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Sunscreen usage is emphasized in public health strategy as it reduces the risk of sunburns and skin cancers. This study aims to explore factors that influence sun protective behavior and outcomes. Data was received from the National Health Interview Survey (NHIS) 2020. Adults were asked how often they wore sunscreen when outside on a sunny day. Consistent use (“always”) of sunscreen, the incidence of sunburn within a year, and ever having a diagnosis of skin melanoma were compared by gender, race, and the diagnosis of anxiety, depression, and dementia. Individuals identifying as a mixed race were excluded. Statistical analysis was adjusted for large-scale surveys using STATA VSN 7.0, and a two-sided p<0.05 was considered significant. Of the 37,352 participants (53.18% females, 75.01% white, 10.49% black, 0.76% Indian Americans,5.60% Asian), 13.11% had a diagnosis of anxiety, 14.78% depression, and 0.84% dementia. Females wore sunscreen more often than males (24.72% vs. 10.91%, p<0.001). White individuals wore sunscreen most frequently; black individuals the least (17.37% vs. 6.49%, p<0.001). White individuals had the highest rate of sunburn (25.61%, p<0.001) and a history of skin melanoma (3.38%, p<0.001). Participants with anxiety, depression, and dementia all had statistically significantly decreased sunscreen use and increased frequency of sunburn compared to the general population. Only those with dementia had an increased incidence of skin melanoma (2.85% vs. 1.22%, p=0.009). Dermatologists and public health professionals should consider gender, race, and psychiatric comorbidities when counseling patients on sun protection.

Keywords: sun protective behavior, psychiatric disorder, melanoma, sunburn

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Authors: L. Agneni, F. Carta, C. Micheletta, V. Tersigni

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The development of a qualitative method to profile jobseekers is needed to improve the quality of the Public Employment Services (PES) in Italy. This is why the National Agency for Active Labour Market Policies (ANPAL) decided to introduce a Qualitative Profiling Service in the context of the activities carried out by local employment offices’ operators. The qualitative profiling service provides information and data regarding the jobseeker’s personal transition status, through a semi-structured questionnaire administered to PES clients during the guidance interview. The questionnaire responses allow PES staff to identify, for each client, proper activities and policy measures to support jobseekers in their reintegration into the labour market. Data and information gathered by the qualitative profiling tool are the following: frequency, modalities and motivations for clients to apply to local employment offices; clients’ expectations and skills; difficulties that they have faced during the previous working experiences; strategies, actions undertaken and activated channels for job search. These data are used to assess jobseekers’ personal and career characteristics and to measure their employability level (qualitative profiling index), in order to develop and deliver tailor-made action programmes for each client. This paper illustrates the use of the above-mentioned qualitative profiling service on the national territory and provides an overview of the main findings of the survey: concerning the difficulties that unemployed people face in finding a job and their perception of different aspects related to the transition in the labour market. The survey involved over 10.000 jobseekers registered with the PES. Most of them are beneficiaries of the “citizens' income”, a specific active labour policy and social inclusion measure. Furthermore, data analysis allows classifying jobseekers into a specific group of clients with similar features and behaviours, on the basis of socio-demographic variables, customers' expectations, needs and required skills for the profession for which they seek employment. Finally, the survey collects PES staff opinions and comments concerning clients’ difficulties in finding a new job and also their strengths. This is a starting point for PESs’ operators to define adequate strategies to facilitate jobseekers’ access or reintegration into the labour market.

Keywords: labour market transition, public employment services, qualitative profiling, vocational guidance

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Authors: Hsiao-Lin Fang

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Every life is precious, and comprehensive care should be provided to individuals who are in the final stages of their lives. Hospice-shared care aims to provide optimal symptom control and palliative care to terminal (cancer) patients through the implementation of shared care, and to support patients and their families in making various physical and psychological adjustments in the face of death. This report examines a 10-year-boy diagnosed with Out-of-Hospital Cardiac Arrest (OHCA). The individual fainted when swimming at school and underwent 31 minutes of cardiopulmonary resuscitation (CPR). While receiving treatment at the hospital, the individual received extracorporeal membrane oxygenation(ECMO) due to unstable hemodynamics. Urgent cardiac catheterization found: Suspect acute fulminant myocarditis or underlying cardiomyopathy with acute decompensation, After the active rescue by the medical team, hemodynamics still showed only mean pressure value. With respect to the patient, interdepartmental hospice-shared care was implemented and a do-not-resuscitate (DNR) order was signed after family discussions were conducted. Assistance and instructions were provided as part of the comfort care process. A farewell gathering attended by the patient’s relatives, friends, teachers, and classmates was organized in an intensive care unit (ICU) in order to look back on the patient’s life and the beautiful memories that were created, as well as to alleviate the sorrow felt by family members, including the patient’s father and sister. For example, the patient was presented with drawings and accompanied to a garden to pick flowers. In this manner, the patient was able to say goodbye before death. Finally, the patient’s grandmother and father participated in the clinical hospice care and post-mortem care processes. A hospice-shared care clinician conducted regular follow-ups and provided care to the family of the deceased, supporting family members through the sorrowful period. Birth, old age, sickness, and death are the natural phases of human life. In recent years, growing attention has been paid to human-centered hospice care. Hospice care is individual holistic care provided by a professional team and it involves the provision of comprehensive care to a terminal patient. Hospice care aims to satisfy the physical, psychological, mental, and social needs of patients and their families. It does not involve the cessation of treatment but rather avoids the exacerbation or extension of the suffering endured by patients, thereby preserving the dignity and quality of life during the end-of-life period. Patients enjoy the company of others as they complete the last phase of their lives, and their families also receive guidance on how they can move on with their own lives after the patient’s death.

Keywords: hospice-shared care, extracorporeal membrane oxygenation (ECMO), hospice-shared care, child patient

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Authors: Erva Akin

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– The use of copyrighted material for machine learning purposes is a challenging issue in the field of artificial intelligence (AI). While machine learning algorithms require large amounts of data to train and improve their accuracy and creativity, the use of copyrighted material without permission from the authors may infringe on their intellectual property rights. In order to overcome copyright legal hurdle against the data sharing, access and re-use of data, the use of copyrighted material for machine learning purposes may be considered permissible under certain circumstances. For example, if the copyright holder has given permission to use the data through a licensing agreement, then the use for machine learning purposes may be lawful. It is also argued that copying for non-expressive purposes that do not involve conveying expressive elements to the public, such as automated data extraction, should not be seen as infringing. The focus of such ‘copy-reliant technologies’ is on understanding language rules, styles, and syntax and no creative ideas are being used. However, the non-expressive use defense is within the framework of the fair use doctrine, which allows the use of copyrighted material for research or educational purposes. The questions arise because the fair use doctrine is not available in EU law, instead, the InfoSoc Directive provides for a rigid system of exclusive rights with a list of exceptions and limitations. One could only argue that non-expressive uses of copyrighted material for machine learning purposes do not constitute a ‘reproduction’ in the first place. Nevertheless, the use of machine learning with copyrighted material is difficult because EU copyright law applies to the mere use of the works. Two solutions can be proposed to address the problem of copyright clearance for AI training data. The first is to introduce a broad exception for text and data mining, either mandatorily or for commercial and scientific purposes, or to permit the reproduction of works for non-expressive purposes. The second is that copyright laws should permit the reproduction of works for non-expressive purposes, which opens the door to discussions regarding the transposition of the fair use principle from the US into EU law. Both solutions aim to provide more space for AI developers to operate and encourage greater freedom, which could lead to more rapid innovation in the field. The Data Governance Act presents a significant opportunity to advance these debates. Finally, issues concerning the balance of general public interests and legitimate private interests in machine learning training data must be addressed. In my opinion, it is crucial that robot-creation output should fall into the public domain. Machines depend on human creativity, innovation, and expression. To encourage technological advancement and innovation, freedom of expression and business operation must be prioritised.

Keywords: artificial intelligence, copyright, data governance, machine learning

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Authors: Carmela Cucuzzella, Jean-Pierre Chupin

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Eco-architecture today is being assessed and judged increasingly on the basis of its environmental performance and its dedication to urgent stakes of sustainability. Architects have responded to environmental imperatives in novel ways since the 1960s. In the last two decades, however, different forms of eco-architecture practices have emerged that seem to be as dedicated to the issues of sustainability, as to their ability to 'communicate' their ecological features. The hypothesis is that some contemporary eco-architecture has been developing a characteristic 'explanatory discourse', of which it is possible to identify in buildings around the world. Some eco-architecture practices do not simply demonstrate their alignment with pressing ecological issues, rather, these buildings seem to be also driven by the urgent need to explain their ‘greenness’. The design aims specifically to teach visitors of the eco-qualities. These types of architectural practices are referred to in this paper as eco-didactic. The aim of this paper is to identify and assess this distinctive form of environmental architecture practice that aims to teach. These buildings constitute an entirely new form of design practice that places eco-messages squarely in the public realm. These eco-messages appear to have a variety of purposes: (i) to raise awareness of unsustainable quotidian habits, (ii) to become means of behavioral change, (iii) to publicly announce their responsibility through the designed eco-features, or (iv) to engage the patrons of the building into some form of sustainable interaction. To do this, a comprehensive review of Canadian eco-architecture is conducted since 1998. Their potential eco-didactic aspects are analysed through a lens of three vectors: (1) cognitive visitor experience: between the desire to inform and the poetics of form (are parts of the design dedicated to inform the visitors of the environmental aspects?); (2) formal architectural qualities: between the visibility and the invisibility of environmental features (are these eco-features clearly visible by the visitors?); and (3) communicative method for delivering eco-message: this transmission of knowledge is accomplished somewhere between consensus and dissensus as a method for disseminating the eco-message (do visitors question the eco-features or are they accepted by visitors as features that are environmental?). These architectural forms distinguish themselves in their crossing of disciplines, specifically, architecture, environmental design, and art. They also differ from other architectural practices in terms of how they aim to mobilize different publics within various urban landscapes The diversity of such buildings, from how and what they aim to communicate, to the audience they wish to engage, are all key parameters to better understand their means of knowledge transfer. Cases from the major cities across Canada are analysed, aiming to illustrate this increasing worldwide phenomenon.

Keywords: eco-architecture, public awareness, community engagement, didacticism, communication

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Authors: S. Anastasiou, C. Nathanailides

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The purpose of this study is to examine the possible link between employee and customer satisfaction. The service provided by employees, help to build a good relationship with customers and can help at increasing their loyalty. Published data for job satisfaction and indicators of customer services were gathered from relevant published works which included data from five different countries. The reviewed data indicate a significant correlation between indicators of customer and employee satisfaction in the Banking sector. There was a significant correlation between the two parameters (Pearson correlation R2=0.52 P<0.05) The reviewed data provide evidence that there is some practical evidence which links these two parameters.

Keywords: job satisfaction, job performance, customer’ service, banks, human resources management

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Authors: Muhammad Farhan Saeed, Waheed Aslam Khan, Muhammad Nadeem, Iftikhar Ahmad, Zakir Ali

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Milk is an important and fundamental nutrition source of human diet. In Pakistan, the milk used by the consumer is of low quality and is often contaminated due to the lack of quality controls. Mycotoxins produced from molds which contaminate the agriculture commodities of animal feed. Mycotoxins are poisons which affect the animals when they consume contaminated feeds. Aflatoxin AFM1 is naturally occurring form of mycotoxins in milk which is carcinogenic. To assess public awareness regarding milk Aflatoxin contamination, a population-based survey using a questionnaire was carried out from general public and from farmers of both rural and urban areas. It was revealed from the data that people of rural area were more satisfied about quality of available milk but the awareness level about milk contamination was found lower in both areas. Total 297 samples of milk were collected from rural (n=156) and urban (n=141) areas of district Vehari during June-July 2015. Milk samples were collected from three different point sources; farmer, milkman and milkshop. These point sources had three types of dairy milk including cow milk, buffalo milk and mixed milk. After performing ELISA test 18 samples with positive ELISA results were maintain per source for further analysis for aflatoxin M1 (AFM1) by High Performance Liquid Chromatography (HPLC). Higher percentages of samples were found exceeding the permissible limit for urban area. In rural area about 15% samples and from urban area about 35% samples were exceeded the permissible limit of AFM1 with 0.05µg/kg set by European Union. From urban areas about 55% of buffalo, 33% of cows and 17% of mixed milk samples were exceeded the permissible AFM1 level as compared with 17%, 11% and 17% for milk samples from rural areas respectively. Samples from urban areas 33%, 44% and 28% were exceeded the permissible AFM1 level for farmer, milkman and of milk shop respectively as compared with 28% and 17% of farmer and milkman’s samples from rural areas respectively. The presence of AFM1 in milk samples demands the implementation of strict regulations and also urges the need for continuous monitoring of milk and milk products in order to minimize the health hazards. Regulations regarding aflatoxins contamination and adulteration should be strictly imposed to prevent health problems related to milk quality. Permissible limits for aflatoxin should be enforced strongly in Pakistan so that economic loss due to aflatoxin contamination can be reduced.

Keywords: Vehari, aflatoxins AFM1, milk, HPLC

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Authors: Dessy Arumsari, Ais Assana Athqiya, Mulyaminingrum

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Healthcare in remote areas is one of the major concerns in Indonesia. Building hospitals in a nation of 18.000 islands with a larger-than-life bureaucracy and problems with corruption, a critical shortage of qualified medical professionals and well-heeled patients resigned to traveling abroad for health care is a hard feat to accomplish. To assuring that all populations have access to appropriate and cost-effective care, a new solution to tackle this problem is with the presence of RV Car Clinic. This car has a concept such as a walking hospital that provides health facilities inside it. All of the health professionals who work in RV Car Clinic will do the rotation for a year in order to the equitable distribution of health workers. We need to advocate the policy makers to help realize RV Car Clinic in remote areas. Health services can be disseminated by the present of RV Car Clinic. Summarily, the local communities can get cost effectively because RV Car Clinic will come to their place and serve the health services.

Keywords: health policy, health professional, remote areas, RV Car Clinic

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Authors: Kirsten Hoeper, Maike Kriependorf

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This paper firstly discusses the initial situation and problems. Afterward, it defines professional bureaucracies and shows their impact for the OR-work. The OR-center and its actors are shown. Finally, the paper provides the empiric design for detecting the target systems of the different work groups within the OR, the quality criteria in qualitative research and empirical results. It is shown that different groups have different targets in their daily work and that helps for a better understanding. More precisely, by detecting the target systems of these experts, we can ‘bridge’ the different points of view to create a common basis for the work in the OR. One of the aims was to find bridges to overcome separating factors. This paper describes the situation in Germany focusing the Hannover Medical School. It can be assumed that the results can be transferred to other countries using the DRG-System (Diagnosis Related Groups).

Keywords: hospital, OR, professional bureaucracies, target systems

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Authors: Sujeet Kumar

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Education has greater importance particularly in terms of increasing human capital and economic competitiveness. It plays a crucial role in terms of cognitive and skill development. Its plays a vital role in process of socialization, fostering social justice, and enhancing social cohesion. Policy related to education has been always a priority for developed countries, which is later adopted by developing countries also. The government of India has also brought change in education polices in line with recognizing change at national and supranational level. However, quality education is still not become an open door for every child in India and several reports are produced year to year about level of school education in India. This paper is concerned with schooling in India. Particularly, it focuses on two government and two private schools in Bihar, but reference has made to schools in Delhi especially around slum communities. The paper presents brief historical context and an overview of current school systems in India. Later, it focuses on analysis of current development in policy in reference with field observation, which is anchored around choice, diversity, market – orientation and gap between different groups of pupils. There is greater degree of difference observed at private and government school levels in terms of quality of teachers, method of teaching and overall environment of learning. The paper concludes that the recent policy development in education particularly Sarva Siksha Abhiyaan (SAA) and Right to Education Act (2009) has required renovating new approach to bridge the gap through broader consultation at grassroots and participatory approach with different stakeholders.

Keywords: education, public policy, participatory approach

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Authors: Bongs Lainjo

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The evolution and escalation of bike-sharing programs (BSP) continue unabated. Since the sixties, many countries have introduced different models and strategies of BSP. These include variations ranging from dockless models to electronic real-time monitoring systems. Reasons for using this BSP include recreation, errands, work, etc. And there is all indication that complex, and more innovative rider-friendly systems are yet to be introduced. The objective of this paper is to analyze current variables established by different operators and streamline them identifying the most compelling ones using analytics. Given the contents of available databases, there is a lack of uniformity and common standard on what is required and what is not. Two factors appear to be common: user type (registered and unregistered, and duration of each trip). This article uses historical data provided by one operator based in the greater Washington, District of Columbia, USA area. Several variables including categorical and continuous data types were screened. Eight out of 18 were considered acceptable and significantly contribute to determining a useful and reliable predictive model. Bike-sharing systems have become popular in recent years all around the world. Although this trend has resulted in many studies on public cycling systems, there have been few previous studies on the factors influencing public bicycle travel behavior. A bike-sharing system is a computer-controlled system in which individuals can borrow bikes for a fee or free for a limited period. This study has identified unprecedented useful, and pragmatic parameters required in improving BSP ridership dynamics.

Keywords: sharing program, historical data, parameters, ridership dynamics, trip duration

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Authors: Tamar Trop

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Bike sharing systems can be important elements of smart cities as they have the potential for impact on multiple levels. These systems can add a significant alternative to other modes of mass transit in cities that are continuously looking for measures to become more livable and maintain their attractiveness for citizens, businesses and tourism. Bike-sharing began in Europe in 1965, and a viable format emerged in the mid-2000s thanks to the introduction of information technology. The rate of growth in bike-sharing schemes and fleets has been very rapid since 2008 and has probably outstripped growth in every other form of urban transport. Today, public bike-sharing systems are available on five continents, including over 700 cities, operating more than 800,000 bicycles at approximately 40,000 docking stations. Since modern bike sharing systems have become prevalent only in the last decade, the existing literature analyzing these systems and their sustainability is relatively new. The purpose of the presented study is to assess the sustainability of these newly emerging transportation systems, by using the Envision™ rating system as a methodological framework and the Israeli 'Tel -O-Fun' – bike sharing project as a case study. The assessment was conducted by project team members. Envision™ is a new guidance and rating system used to assess and improve the sustainability of all types and sizes of infrastructure projects. This tool provides a holistic framework for evaluating and rating the community, environmental, and economic benefits of infrastructure projects over the course of their life cycle. This evaluation method has 60 sustainability criteria divided into five categories: Quality of life, leadership, resource allocation, natural world, and climate and risk. 'Tel -O-Fun' project was launched in Tel Aviv-Yafo on 2011 and today provides about 1,800 bikes for rent, at 180 rental stations across the city. The system is based on a complex computer terminal that is located in the docking stations. The highest-rated sustainable features that the project scored include: (a) Improving quality of life by: offering a low cost and efficient form of public transit, improving community mobility and access, enabling the flexibility of travel within a multimodal transportation system, saving commuters time and money, enhancing public health and reducing air and noise pollution; (b) improving resource allocation by: offering inexpensive and flexible last-mile connectivity, reducing space, materials and energy consumption, reducing wear and tear on public roads, and maximizing the utility of existing infrastructure, and (c) reducing of greenhouse gas emissions from transportation. Overall, 'Tel -O-Fun' project was highly scored as an environmentally sustainable and socially equitable infrastructure. The use of this practical framework for evaluation also yielded various interesting insights on the shortcoming of the system and the characteristics of good solutions. This can contribute to the improvement of the project and may assist planners and operators of bike sharing systems to develop a sustainable, efficient and reliable transportation infrastructure within smart cities.

Keywords: bike sharing, Envision™, sustainability rating system, sustainable infrastructure

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Authors: Oginni Omoniyi Israel

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The study investigated the evaluation of the implementation of public examination chief examiners’ reports in Mathematics curriculum contents in Ekiti State Senior Secondary schools, Nigeria. The study adopted descriptive research of survey design. The population for the study comprised 694 Mathematics teachers in Senior Secondary schools and 26,292 Senior Secondary School III students spread across the three senatorial districts in Ekiti State. The sample consisted of 60 Mathematics teachers and 120 students using a multi-stage sampling procedure. The instruments used in the study were: ‘Questionnaire on Teachers Implementation of Chief Examiners’ Report and Mathematics Curriculum Contents (QTICERMCC) and Questionnaire on Students Knowledge of Chief Examiners’ Report and Mathematics Curriculum Contents Implementation (SIERMCC)’. The instruments were validated by using face and content validity. The reliability of the two instruments was tested using Cronbach’s Alpha test. The coefficient of reliability of the instruments was 0.85 and 0.87, respectively. The data collected were analyzed using descriptive statistics such as frequency counts, means, percentages and standard deviation to answer the evaluation questions, while inferential statistics such as Pearson’s Product Moment Correlation Analysis were used to test the hypotheses and were tested at 0.05 level of significance. The findings of the study revealed that there was a significant relationship between awareness, availability, and accessibility of Chief Examiners’ Report in Mathematics. The findings also showed that there was a significant relationship between awareness, availability and accessibility of Mathematics curriculum. There was also a significant relationship between the implementation of the Chief Examiners’ Report in Mathematics between teachers and students. Also, the findings revealed there was no significant relationship between the teacher implementation contents of the mathematics curriculum and students' access to the Mathematics curriculum. Based on the findings, it was recommended that the examination bodies should organize an enlightenment programme annually to create awareness on the utilization of the Chief Examiners’ Report for teachers, school administrators, government and students; the Ministry of Education should ensure that school administrators use Chief Examiners’ Report as one of the classroom delivery notes to prepare their students for external examinations; State Ministry of Education should make available Mathematics curriculum contents to various schools in Ekiti State; government and school administrators should organize training and re-training for teachers on difficult contents in the Mathematics curriculum.

Keywords: evaluation, implementation, public examination, chief examiners’ reports, curriculum contents

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Authors: Rakesh Kumar, Fatima Electricwala

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One of the major thrusts of the Bus Rapid Transit System is to reduce the commuter’s dependency on private vehicles and increase the shares of public transport to make urban transportation system environmentally sustainable. In this study, commuter mode choice analysis is performed that examines behavioral responses to the proposed Bus Rapid Transit System (BRTS) in Surat, with estimation of the probable shift from private mode to public mode. Further, evaluation of the BRTS scenarios, using Surat’s transportation ecological footprint was done. A multi-modal simulation model was developed in Biogeme environment to explicitly consider private users behaviors and non-linear environmental impact. The data of the different factors (variables) and its impact that might cause modal shift of private mode users to proposed BRTS were collected through home-interview survey using revealed and stated preference approach. A multi modal logit model of mode-choice was then calibrated using the collected data and validated using proposed sample. From this study, a set of perception factors, with reliable and predictable data base, to explain the variation in modal shift behaviour and their impact on Surat’s ecological environment has been identified. A case study of the proposed BRTS connecting the Surat Industrial Hub to the coastal area is provided to illustrate the approach.

Keywords: BRTS, private modes, mode choice models, ecological footprint

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Authors: Surarong Chinwong, Namthip Intarakumhang Na Rachasima, Siyaporn Kuikhiew, Dujrudee Chinwong

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Irrational use of medicines is a major problem in public health. Half of all patients take medicines incorrectly. An inappropriate use of antibiotics is one of the common types of irrational medicine use; for example, patients use antibiotic for treatment of common cold or diarrhea. Objectives: This cross-sectional study aimed to investigate the behaviors on antibiotic use, using amoxicillin and norfloxacin as examples, as well as sources of received health information. Methods: An online self-administered questionnaire was used to collect data from participants in Thailand between September and December 2015. Participants were asked about their behaviors on antibiotic use. Data were analyzed using descriptive statistics. Results: Of all 405 participants, most were female (65.3 %), aged 18-30 years (49.4 %), undergraduate or lower (69.7%), and civil servant or state enterprises (31.7 %). We found inappropriate behaviors in use of amoxicillin or norfloxacin: 1) there were 201/400 participants (50.3%) taking amoxicillin right away in case of having a common cold, such as having sore throat, running nose, and cough; 2) there were 170/405 participants (42.0%) using amoxicillin for relieving inflammatory symptoms, e.g. muscle inflammation or osteoarthritis; 3) there were 71/398 participants (17.8%) using amoxicillin as a muscle relaxant; 4) there were 135/398 participants (33.9%) using norfloxacin for treating diarrhea. Sources of health information received by the participants were from the internet (78.5%), the radio and/or television (42.2%), advertising publishing (33.3 %), and word of mouth (30.1%). Conclusion: This study showed improper behaviors in antibiotic use especially amoxicillin and norfloxacin. Health care providers including pharmacists should raise the public awareness on dangers of inappropriate antibiotic use and promote the rational use of antibiotics.

Keywords: antibiotic use, amoxicillin, norfloxacin, rational drug use

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Authors: Oscar Guerra

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Educational technologies have great potential as tools for student empowerment, particularly for members of a marginalized population such as immigrant Latino children in the American public education system. It is not merely a matter of access to the necessary technological devices; rather, it is development and implementation under a critical lens that may prompt a positive change.

Keywords: education, critical technologies, minorities, higher education

Procedia PDF Downloads 307

Authors: Anum Obaid, Iman Fatima, Wanisha Feroz, Haleema Imran, Hammad Tariq

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Unmarried women over thirty years of age as a health issue is a relatively young phenomenon, but it is rapidly growing in Pakistan; therefore, it is a public health issue. The challenges affecting nutrition and public health are some of the indispensable components that need to be met to achieve sustainable development goals (SDGs). This research intends to explain these goals in the context of nutrition and public health, especially analyzing the issues related to unmarried women above the age of thirty in Faisalabad, Pakistan. Still, this research is not feasible in Pakistan. In Pakistan alone, 10 million women over the age of 35 are unmarried, based on a recent United Nations report. The United Nations, in cooperation with the World Health Organization, has identified health as a state of being healthy, free from illness or disease, and not just a condition where there are no diseases or bodily disabilities. The current generation of women is unmarried and living a life under constant pressure from society to deliver changes like the diet these women take, and hence, their nutritional status defines their comprehensive health triangle, a mix of physical, mental, and social well-being. The research was carried out under the qualitative research paradigm, specifically through interviews with the participants who were unmarried women and married women above the age of thirty. This qualitative study explores how marriage affects the intake of nutrients, nutritional health, psychological and social well-being and their effects. The realization of well-being consisted of factors like physical health, mental and emotional health, pressure from society, social health, economic independence, and decision-making power to reveal the impact of singleness on well-being. The findings disclosed that marital status had a notable impact on the diet habits and nutritional behaviors of women in Faisalabad. Also, it was found that single women suffer from more stress and are not as positive as married women because they are lonely, as their husbands are absent from their lives. The findings established that nutritional understanding is differentially affected by marital status as a determinant of the health triangle consisting of physical, mental, and social health. Awareness of these factors is significant in designing specific goal-directed interventions that can enhance the nutritional well-being and general health status of unmarried women in Faisalabad. Hence, this study underscores the necessity of maintaining supportive environments and increasing the regard concerning the health state of single ladies beyond thirty.

Keywords: health triangle, over thirty, singleness, age barriers, unmarried women, women’s health, well-being

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Authors: Mette Kjerholt, Thora Grothe Thomsen, Connie Bøttcher Berthelsen, Bibi Hølge Hazelton

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Academic nursing is a relatively new phenomenon in Denmark. Leadership and management training in nursing does not prepare Danish nurse leaders to become leaders for nurses with academic background, and some leaders may feel estranged with including this kind of nursing staff in clinical settings. Currently there is a debate regarding what academic nurses can contribute with in clinical practice, and some managers express concern regarding whether this will lead to less focus on clinical practice and more focus on theoretical issues that may not seem so relevant in a busy everyday clinical setting. The paper will present the experiences of integrating three advanced nurse practitioners with Ph.D. degrees (ANP) in three different clinical departments at a regional hospital in Denmark with no prior experiences with such profiles among its staff.

Keywords: leadership, advanced nurse practitioners, clinical practice, academic nursing

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