Search results for: strategic policy

Authors: Juan Peña Aguilar, Lilia Villasana, Rodrigo Valencia, Alberto Pastrana, Martin Vivanco, Juan Peña C

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Each year a growing number of companies entering Mexico in search of the domestic market share. These activities, including stores, telephone long distance and local raw materials and energy, and particularly the financial sector, have managed to significantly increase its weight in the flows of FDI in Mexico , however, you should consider whether these trends FDI are positive for the Mexican economy and these activities increase Mexican exports in the medium term , and its share in GDP , gross fixed capital formation and employment. In general stresses that these activities, by far, have been unable to significantly generate linkages with the rest of the economy, a process that has not favored with competitiveness policies and activities aimed at these neutral or horizontal. Since the nineties foreign direct investment (FDI) has shown a remarkable dynamism, both internationally and in Latin America and in Mexico. Only in Mexico the first recipient of FDI in importance in Latin America during 1990-1995 and was displaced by Brazil since FDI increased from levels below 1 % of GDP during the eighties to around 3 % of GDP during the nineties. Its impact has been significant not only from a macroeconomic perspective , it has also allowed the generation of a new industrial production structure and organization, parallel to a significant modernization of a segment of the economy. The case of Mexico also is particularly interesting and relevant because the destination of FDI until 1993 had focused on the purchase of state assets during privatization process. This paper aims to present FDI flows in Mexico and analyze the different business strategies that have been touched and encouraged by the FDI. On the one hand, looking briefly discuss regulatory issues and source and recipient of FDI sectors. Furthermore, the paper presents in more detail the impacts and changes that generated the FDI contribution of FDI in the Mexican economy , besides the macroeconomic context and later legislative changes that resulted in the current regulations is examined around FDI in Mexico, including aspects of the Free Trade Agreement (NAFTA). It is worth noting that foreign investment can not only be considered from the perspective of the receiving economic units. Instead, these flows also reflect the strategic interests of transnational corporations (TNCs) and other companies seeking access to markets and increased competitiveness of their production networks and global distribution, among other reasons. Similarly it is important to note that foreign investment in its various forms is critically dependent on historical and temporal aspects. Thus, the same functionality can vary significantly depending on the specific characteristics of both receptor units as sources of FDI, including macroeconomic, institutional, industrial organization, and social aspects, among others.

Keywords: foreign direct investment (FDI), competitiveness, neoliberal regime, globalization, gross domestic product (GDP), NAFTA, macroeconomic

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Authors: Jingjue Bao, Ye Li, Yujie Qi

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The explosive growth of ride-hailing has reshaped residents' travel behavior and plays a crucial role in urban mobility within the built environment. Contributing to the research of the spatial variation of ride-hailing demand and its relationship to the built environment and socioeconomic factors, this study utilizes multi-source data from Haikou, China, to construct a Multi-scale Geographically Weighted Regression model (MGWR), considering spatial scale heterogeneity. The regression results showed that MGWR model was demonstrated superior interpretability and reliability with an improvement of 3.4% on R2 and from 4853 to 4787 on AIC, compared with Geographically Weighted Regression model (GWR). Furthermore, to precisely identify the surrounding environment of sampling point, DeepLabv3+ model is employed to segment street-level images. Features extracted from these images are incorporated as variables in the regression model, further enhancing its rationality and accuracy by 7.78% improvement on R2 compared with the MGWR model only considered region-level variables. By integrating multi-scale geospatial data and utilizing advanced computer vision techniques, this study provides a comprehensive understanding of the spatial dynamics between ride-hailing demand and the urban built environment. The insights gained from this research are expected to contribute significantly to urban transportation planning and policy making, as well as ride-hailing platforms, facilitating the development of more efficient and effective mobility solutions in modern cities.

Keywords: travel behavior, ride-hailing, spatial relationship, built environment, street-level image

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Authors: Amleset Haile

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Non-timber forest products (NTFPs) are harvested for both subsistence and commercial use and play a key role in the livelihoods of millions of rural people. Non-timber forest products (NTFPs) are important in rural southwest Ethiopia, Kaffa as a source of household income. market players at various levels in marketing chains are interviewed to getther information on elements of marketing system–products, product differentiation, value addition, pricing, promotion, distribution, and marketing chains. The study, therefore, was conducted in Kaffa Biosphere reserve of southwest Ethiopia with the main objective of assessing and analyzing the contribution of NTFPs to rural livelihood and to the conservation of the biosphere reserve and to identify factors influencing in the marketing of the NTFP. Five villages were selected based on their proximity gradient from Bonga town and availability of NTFP. Formal survey was carried out on rural households selected using stratified random sampling. The results indicate that Local people practice diverse livelihood activities mainly crops cultivation (cereals and cash crops) and livestock husbandry, gather forest products and off-farm/off-forest activities for surviva. NTFP trade is not a common phenomenon in southwest Ethiopia. The greatest opportunity exists for local level marketing of spices and other non timber forest products. Very little local value addition takes place within the region,and as a result local market players have little control. Policy interventions arc required to enhance the returns to local collectors, which will also contribute to sustainable management of forest resources in Kaffa biosphere reserve.

Keywords: forest management, biosphere reserve, marketing, local people

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Authors: Nalini Murugaiyah

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Indigenous students require a positive school environment where meaningful learning ought to be there to minimise myriad challenges. Therefore, Orang Asli student’s school environment should be culturally responsive and equipped with student-centred activities or provide constructively designed curriculum and pedagogy. This study sought to extend the knowledge of culturally responsive school leadership practises which relevant and responsive to Orang Asli students through th lens of a theoretical framework, Culturally Responsive School Leadership. The aim of the proposed study is to examine and understand the real-world application of leadership practices that are relevant and responsive to Orang Asli students in Malaysia. This study will also include the often-voiceless voices’ of Orang Asli students, parents, and community leaders to gain a deeper understanding of the process and experience of engaging in culturally responsive school leadership. The study will explore the differences between school leaders, teachers, parents, and community leaders in relation to culturally responsive school environment, non-Orang Asli school leaders’ and teachers’ support to the needs of Orang Asli children, children’s perspectives of teachers’ practices in the classroom align with their culture; and, the demonstration of teacher’s culturally responsive behaviour in the classroom. A basic qualitative study is the proposed research design for this study, and the data is collected through semi-structured interviews and focus group interviews. This qualitative research is designed to gain in-depth knowledge about how the principal’s leadership is culturally responsive towards the school environment, which will improve the quality of education received by the Orang Asli community in Malaysia, hence reducing the drop-out rates in Orang Asli students.

Keywords: indigenous leadership, equity, inclusion, policy

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Authors: A. Llopis Alvarez, D. Muller-Eie

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Participatory GIS (geographic information systems) are designed for community mapping exercises in order to produce spatial representations of local knowledge. Ideally, participatory GIS caters to public participation through the use of spatial data in order to increase community-led policy-and decision-making. Having defined a spatial object, such as a neighborhood, subjective mapping involves attaining a description of the spatial, physical, social and psychological characteristics of that spatial object. This paper highlights an emerging appreciation of the subjective component, particularly in spatial analyses. The beliefs, feelings, and behaviors associated with an urban area reflect its sense of place for an individual or a group. It is important therefore to understand what types of beliefs, emotions, and behavioral patterns are relevant to particular resident, groups and urban scales. In this sense, resident’s emotional attachment to their urban areas motivates civic engagement and facilitates awareness of its strengths and its problems. Similarly, subjective perceptions act in complex ways to influence the formation and maintenance of social identity and quality of life. This paper reports on findings from a case study of immigrant population in Norwegian cities, their residential conditions and their relationship to quality of urban life. Cognitive mapping methodologies are used in this study to understand local perceptions of urban qualities. Thus, measures to alleviate disadvantages and improve quality of urban life are more likely to be effective when they are informed by an understanding of a place as constructed by those who live in it, meaning their subjective perceptions about it.

Keywords: mapping methodologies, participatory GIS, perceptual maps, public participation, spatial analysis, subjective perceptions

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Authors: Suzhou Wei, Isobel Cunningham, Laura Bradley McCauley

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Social enterprises play a significant role in resolving social issues in the modern world. In contrast to traditional commercial businesses, their main goal is to address social concerns rather than primarily maximize profits. This phenomenon in entrepreneurship is presenting new opportunities and different operating models and resulting in modified approaches to measure success beyond traditional market share and margins. This paper explores social enterprises to clarify their roles and approaches in addressing grand challenges related to social issues. In doing so, it analyses the key differences between traditional business and social enterprises, such as their operating model and value proposition, to understand their contributions to society. The research presented in this paper responds to calls for research to better understand social enterprises and entrepreneurship but also to explore the dynamics between profit-driven and socially-oriented entities to deliver mutual benefits. This paper, which examines the features of commercial business, suggests their primary focus is profit generation, economic growth and innovation. Beyond the chase of profit, it highlights the critical role of innovation typical of successful businesses. This, in turn, promotes economic growth, creates job opportunities and makes a major positive impact on people's lives. In contrast, the motivations upon which social enterprises are founded relate to a commitment to address social problems rather than maximizing profits. These entities combine entrepreneurial principles with commitments to deliver social impact and grand challenge changes, creating a distinctive category within the broader enterprise and entrepreneurship landscape. The motivations for establishing a social enterprise are diverse, such as encompassing personal fulfillment, a genuine desire to contribute to society and a focus on achieving impactful accomplishments. The paper also discusses the collaboration between commercial businesses and social enterprises, which is viewed as a strategic approach to addressing grand challenges more comprehensively and effectively. Finally, this paper highlights the evolving and diverse expectations placed on all businesses to actively contribute to society beyond profit-making. We conclude that there is an unrealized and underdeveloped potential for collaboration between commercial businesses and social enterprises to produce greater and long-lasting social impacts. Overall, the aim of this research is to encourage more investigation of the complex relationship between economic and social objectives and contributions through a better understanding of how and why businesses might address social issues. Ultimately, the paper positions itself as a tool for understanding the evolving landscape of business engagement with social issues and advocates for collaborative efforts to achieve sustainable and impactful outcomes.

Keywords: business, social enterprises, collaboration, social issues, motivations

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Authors: Mohammad Talha, Abdullah Sallehhuddin Abdullah Salim, Abdul Aziz Abdul Jalil, Norzarina Md Yatim

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The significant contribution of institutional investors across the globe in socially responsible investment (SRI) is well-documented in the literature. Nevertheless, how the SRI behavior of pressure-resistant, pressure-sensitive and pressure-indeterminate institutional investors remain unexplored extensively. This study examines the moderating effect of institutional investors towards socially responsible investment behavior in the context of emerging economies. This study involved 229 institutional investors in Malaysia. A total of 1,145 questionnaires were distributed. Out of these, 308 (130 pressure sensitive institutional investors and 178 pressure resistant institutional investors), representing a usable rate of 26.9 per cent, were found fit for data analysis. Utilizing multi-group analysis via AMOS, this study found evidence for the presence of moderating effect by a type of institutional investor topology in socially responsible investment behavior. At intentional level, it established that type of institutional investor was a significant moderator in the relationship between subjective norms, and caring ethical climate with intention among pressure-resistant institutional investors, as well as between perceived behavioral controls with intention among pressure-sensitive institutional investors. At the behavioral level, the results evidenced that there was only a significant moderating effect between intention and socially responsible investment behavior among pressure-resistant institutional investors. The outcomes are expected to benefit policy makers, regulators, and market participants in order to leap forward SRI growth in developing economies. Nevertheless, the outcomes are limited to a few factors, and it is believed that future studies shall address those limitations.

Keywords: socially responsible investment, behavior, pressure sensitive investors, pressure insensitive investors, Institutional Investment Malaysia

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Authors: Jerzy Banski

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Small towns represent a key element of settlement structure and serve a number of important functions associated with the servicing of rural areas that surround them. It is in light of this that scientific studies have paid considerable attention to the functional structure of centers of this kind, as well as the relationships with both surrounding rural areas and other urban centers. But a preliminary to such research has typically involved attempts at classifying the urban centers themselves, with this also assisting with the planning and shaping of development policy on different spatial scales. The purpose of the work is to test out the methods underpinning three different classifications of small urban centers, as well as to offer a preliminary interpretation of the outcomes obtained. Research took in 722 settlement units in Poland, granted town rights and populated by fewer than 20,000 inhabitants. A morphologically-based classification making reference to the database of topographic objects as regards land cover within the administrative boundaries of towns and cities was carried out, and it proved possible to distinguish the categories of “housing-estate”, industrial and R&R towns, as well as towns characterized by dichotomy. Equally, a functional/morphological approach taken with the same database allowed for the identification – via an alternative method – of three main categories of small towns (i.e., the monofunctional, multifunctional or oligo functional), which could then be described in far greater detail. A third, multi-criterion classification made simultaneous reference to the conditioning of a structural, a location-related, and an administrative hierarchy-related nature, allowing for distinctions to be drawn between small towns in 9 different categories. The results obtained allow for multifaceted analysis and interpretation of the geographical differentiation characterizing the distribution of Poland’s urban centers across space in the country.

Keywords: small towns, classification, local planning, Poland

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Authors: Sidi Ahmed Berrabah

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English as a Medium of Instruction (EMI) is expanding rapidly in the world. A growing volume of research has been dedicated to investigating its introduction, with findings that describe a complex picture and suggest that the practicality and effectiveness of EMI are still the subjects of debate. However, considerably less attention has been given to understanding EMI in a context where its introduction has been discussed but not yet put into practice. One such context is Algeria, where discourses about a potential introduction of EMI have been going on for some time. It is likely that the first courses where EMI is introduced are Business degree programmes. This study aims to examine the current discourses and attitudes towards the potential implementation of EMI and the language practices in Business degree programmes in three Algerian universities. The research is conducted in three different universities in three different regions in Algeria with the aim of including both ‘centre’ and ‘periphery’ Algerian universities. In order to achieve the previous aims, a mixed research paradigm is used. Questionnaires, semi structured interviews, and classroom observations are used to gather data from three participant cohorts: university students of Business, lecturers of Business, and lecturers of English for specific purposes. The findings showed that students and lecturers of Business are found in favour of the introduction of English instead of French or standard Arabic as a medium of instruction. The reason is that English is seen as having internationalisation and instrumental benefits, while French was too closely linked to the colonial history of the country. The favourable attitudes towards EMI, however, seem to contrast with the daily classroom practices at the departments of Business studies, where students and lecturers make practical choices of using their language repertoire based on their linguistic background and skills. Classrooms in the three Algerian universities featured fluid and translanguaging practices that cannot be reduced to a monolingual EMI policy.

Keywords: EMI, Algerian universities, business degree programmes, translanguaging

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Authors: Tadele Tesfay Teame, Tsegaye Abrehame, Hágen István Zsombor

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Liquidity is one of the main concerns for banks, and thus achieving the optimum level of liquidity is critical. The main objective of this study is to discover the driving force of selected private commercial banks’ liquidity. In order to achieve the objective explanatory research design and quantitative research approach were used. Data has been collected from a secondary source of the sampled Ethiopian private commercial banks’ financial statements, the National Bank of Ethiopia, and the Minister of Finance, the sample covering the period from 2011 to 2022. Bank-specific and macroeconomic variables were analyzed by using the balanced panel fixed effect regression model. Bank’s liquidity ratio is measured by the total liquid asset to total deposits. The findings of the study revealed that bank size, capital adequacy, loan growth rate, and non-performing loan had a statistically significant impact on private commercial banks’ liquidity, and annual inflation rate and interest rate margin had a statistically significant impact on the liquidity of Ethiopian private commercial banks measured by L1 (bank liquidity). Thus, banks in Ethiopia should not only be concerned about internal structures and policies/procedures, but they must consider both the internal environment and the macroeconomic environment together in developing their strategies to efficiently manage their liquidity position and private commercial banks to maintain their financial proficiency shall have bank liquidity management policy by assimilating both bank-specific and macro-economic variables.

Keywords: liquidity, Ethiopian private commercial banks, liquidity ratio, panel data regression analysis

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Authors: Aayushi Lyngwa, Bimal Kishore Sahoo

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The study discusses the relationship between cognitive ability and the level of education attained by the tribal street entrepreneurs on their financial literacy. It is driven by the objective of examining the effect of cognitive ability on financial ability on the one hand and determining the effect of the same on financial literacy on the other. A field experiment was conducted on 203 tribal street vendors in the north-eastern Indian state of Mizoram. This experiment's calculations are conditioned by providing each question scores like math score (cognitive ability), financial score and debt score (financial ability). After that, categories for each of the variables, like math category (math score), financial category (financial score) and debt category (debt score), are generated to run the regression model. Since the dependent variable is ordinal, an ordered logit regression model was applied. The study shows that street vendors' cognitive and financial abilities are highly correlated. It, therefore, confirms that cognitive ability positively affects the financial literacy of street vendors through the increase in attainment of educational levels. It is also found that concerning the type of street vendors, regular street vendors are more likely to have better cognitive abilities than temporary street vendors. Additionally, street vendors with more cognitive and financial abilities gained better monthly profits and performed habits of bookkeeping. The study attempts to draw a particular focus on a set-up which is economically and socially marginalized in the Indian economy. Its finding contributes to understanding financial literacy in an understudied area and provides policy implications through inclusive financial systems solutions in an economy limited to tribal street vendors.

Keywords: financial literacy, education, street entrepreneurs, tribals, cognitive ability, financial ability, ordered logit regression.

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Authors: Leila Kharrat, Younes Boujelbene

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In recent decades, solid waste management (SWM) has become a global concern because rapid population growth and overexploitation of non-renewable resources have generated enormous amounts of waste far exceeding carrying capacity; too, it poses serious threats to the environment and health. However, it is still difficult to combat the growing amount of solid waste before assessing the condition of people. Therefore, this study was conducted to assess the knowledge, attitudes, perception, and practices on the separation of solid waste in Sfax City. Nowadays, GDS is essential for sustainable development, hence the need for intensive research. Respondents from seven different districts in the city of Sfax were analyzed through a questionnaire survey with 342 households. This paper presents a qualitative exploratory study on the behavior of the citizens in the field of waste separation. The objective knows the antecedents of waste separation and the representation that individuals have about sorting waste on a specific territory which presents some characteristics regarding waste management in Sfax city. Source separation is not widely practiced and people usually sweep their places throwing waste components into the streets or neighboring plots. The results also indicate that participation in solid waste separation activities depends on the level of awareness of separating activities in the area, household income and educational level. It is, therefore, argued that increasing quality of municipal service is the best means of promoting positive attitudes to solid waste separation activities. One of the effective strategies identified by households that can be initiated by policymakers to increase the rate of participation in separation activities and eventually encourage them to participate in recycling activities is to provide a financial incentive in all residential areas in Sfax city.

Keywords: solid waste management, waste separation, public policy, econometric modelling

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Authors: Pornwipa Daoduong, Jairak Loysongkroa, Napaphan Viriyautsahakul, Wachira Pengjuntr

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Obesity is on of serious health problem in many countries including Thailand where the prevalence of childhood obesity has increased from 8.8 % in 2014 to 9.5 % in 2015 and 12.9 % in 2016. The Ministry of Public Health’s objective is to reduce prevalence of childhood Obesity to 10% or lower in 2017, by implementing the measure in relation to nutrition, physical activity (PA) and environment in 6,405 targeted school with proportion of school children with obesity is higher than 10 %. Smart Kids Coacher (SKC)” is a new innovative intervention created by Department of Health and consists of 252 regional and provincial officers. The SKC aims to train the super trainers about food and nutrition.PA and emotional control through implementing three learning activities including 1) Food for Fun is about Nutrition flag, Nutrition label, food portion and Nutrition surveillance; 2) Fun for Fit includes intermediated- and advanced level workouts within 60 minutes such as kangaroo dance, Chair stretching; and 3) Control emotional is about to prevent probability of access to unhealthy food, to ensure for having meal in appropriate time, and to recruit peers and family member to increase awareness among target groups. Apart from providing SKC lesson for 3,828 officers at district level, a number of students (2,176) as role model are selected through implementing “Smart Kids Leader: (SKL)”.Consequently. The SKC lowers proportion of childhood obesity from 17% in 2012 to 12.9% in 2016. Further, the SKC coverage should be expanded to other setting. Policy maker should be aware of the important of reduction of the prevalence of childhood obesity, and it’s related risk. Network and Collaboration between stakeholders are essential as well as an improvement of holistic intervention and knowledge “NuPETHS” for kids in the future.

Keywords: childhood obesity, model, obesity, smart kids coacher

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Authors: Belaynesh Tsegay Beyene, Teklay Gebrecherkos, Atsebaha Gebrekidan Kahsay, Mahmud Abdulkader

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Background: Hepatitis B and C viruses are of important health and socioeconomic problem of the globe with remarkable diseases and deaths in Sub-Saharan African countries. The burden of hepatitis is unknown in the prison settings of Tigrai. Therefore, we aimed to describe the seroprevalence and associated factors of hepatitis B and C viruses among prisoners of Tigrai, Ethiopia. Methods: A cross-sectional study was carried out from February 2020 to May 2020 at the prison facilities of Tigrai. Demographics and associated factors were collected from 315 prisoners prospectively. Five milliliter of blood was collected and tested using rapid tests kits of HBsAg (Zhejiang orient Gene Biotech Co., Ltd., China) and HCV antibodies (Volkan Kozmetik Sanayi Ve Ticaret Ltd. STI, Turkey). Positive samples were confirmed using enzyme-linked immunosorbent assay (ELISA) (Beijing Wantai Biological Pharmacy Enterprise Co. Ltd). Data were analyzed using Statistical Package for Social Sciences (SPSS) version 20 and p < 0.05 was considered statistically significant. Results: The overall seroprevalence of HBV and HCV were 25 (7.9%) and 1(0.3%), respectively. The majority of hepatitis B viral infections were identified from the age groups of 18-25 years (10.7%) and unmarried prisoners (11.8%). Prisoners greater than 100 per cell [AOR =3.95, 95% CI= (1.15, 13.6, p =0.029)] and having history of alcohol consumption [AOR =3.01, 95% CI= (1.17, 7.74, p =0.022)] were significantly associated with HBV infections. Conclusions: The seroprevalence of HBV among prisoners was nearly high or borderline (7.9%) with a very low HCV prevalence (0.3%). HBV was most prevalent among young adults, large number of prisoners per cell and those who had history of alcohol consumption. This study recommends that there should be prison-focused intervention including regular health education by emphasis on the mode of transmission and introducing HBV screening policy for prisoners especially when they enter to the prison.

Keywords: seroprevalence, HBV, HCV, prisoners, Tigrai

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Authors: Rachael Sullivan, Joshua Berman

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The number of satellites orbiting earth are in the thousands now. Commercial launches are increasing, and civilians are venturing into the outer reaches of the atmosphere. As the space industry continues to grow and evolve, so too will the demand on resources, the disparities amongst socio-economic groups, and space company governance standards. Outside of just ensuring that space operations are compliant with government regulations, export controls, and international sanctions, companies should also keep in mind the impact their operations will have on society and the environment. Those looking to expand their operations into outer space should remain mindful of both the opportunities and challenges that they could encounter along the way. From commercial launches promoting civilian space travel—like the recent launches from Blue Origin, Virgin Galactic, and Space X—to regulatory and policy shifts, the commercial landscape beyond the Earth's atmosphere is evolving. But practices will also have to become sustainable. Through a review and analysis of space industry trends, international government regulations, and empirical data, this research explores how Environmental, Social, and Governance (ESG) reporting and investing will manifest within a fast-changing space industry.Institutions, regulators, investors, and employees are increasingly relying on ESG. Those working in the space industry will be no exception. Companies (or investors) that are already engaging or plan to engage in space operations should consider 1) environmental standards and objectives when tackling space debris and space mining, 2) social standards and objectives when considering how such practices may impact access and opportunities for different socioeconomic groups to the benefits of space exploration, and 3) how decision-making and governing boards will function ethically, equitably, and sustainably as we chart new paths and encounter novel challenges in outer space.

Keywords: climate, environment, ESG, law, outer space, regulation

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Authors: Samah Jawad Jabari

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Water is the most important and valuable resource not only for human life but also for all living things on the planet. The water supply utilities should fulfill the water requirement quantitatively and qualitatively. Drinking water systems are exposed to both natural (hurricanes and flood) and manmade hazards (risks) that are common in Palestine. Non-Revenue Water (NRW) is a manmade risk which remains a major concern in Palestine, as the NRW levels are estimated to be at a high level. In this research, Hebron city water distribution network was taken as a case study to estimate and audit the NRW levels. The research also investigated the state of the existing water distribution system in the study area by investigating the water losses and obtained more information on NRW prevention and management practices. Data and information have been collected from the Palestinian Water Authority (PWA) and Hebron Municipality (HM) archive. In addition to that, a questionnaire has been designed and administered by the researcher in order to collect the necessary data for water auditing. The questionnaire also assessed the views of stakeholder in PWA and HM (staff) on the current status of the NRW in the Hebron water distribution system. The important result obtained by this research shows that NRW in Hebron city was high and in excess of 30%. The main factors that contribute to NRW were the inaccuracies in billing volumes, unauthorized consumption, and the method of estimating consumptions through faulty meters. Policy for NRW reduction is available in Palestine; however, it is clear that the number of qualified staff available to carry out the activities related to leak detection is low, and that there is a lack of appropriate technologies to reduce water losses and undertake sufficient system maintenance, which needs to be improved to enhance the performance of the network and decrease the level of NRW losses.

Keywords: non-revenue water, water auditing, leak detection, water meters

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Authors: Pampita Chakraborty, Sukumar Mukherjee

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The study was done to determine the microbiological profile and changing pattern of the pathogens causing UTI in the ICU patients. All the patients admitted to the ICU with urinary catheter insertion for more than 48hours were included in the study. Urine samples were collected in a sterile container with aseptic precaution using disposable syringe and was processed as per standards. Antimicrobial susceptibility test was done by Disc Diffusion method as per CLSI guidelines. A total of 100 urine samples were collected from ICU patients, out of which 30% showed significant bacterial growth and 7% showed growth of candida spp. Prevalence of UTI was more in female (73%) than male (27.%). Gram-negative bacilli 26(86.67%) were more common in our study followed by gram-positive cocci 4(13.33%). The most common uropathogens isolated were Escherichia coli 14 (46.67%), followed by Klebsiella spp 7(23.33%), Staphylococcus aureus 4(13.33%), Acinetobacter spp 3(10%), Enterococcus faecalis 1(3.33%) and Pseudomonas aeruginosa 1(3.33%). Most of the Gram-negative bacilli were sensitive to amikacin (80%) and nitrofurantoin (80%), where as all gram-positive organisms were sensitive to Vancomycin. A large number ESBL producers were also observed in this study. The study finding showed that E.coli is the predominant pathogen and has increasing resistance pattern to the commonly used antibiotics. The study proposes that the adherence to antibiotic policy is the key ingredients for successful outcome in ICU patients and also emphasizes that repeated evaluation of microbial characteristics and continuous surveillance of resistant bacteria is required for selection of appropriate antibiotic therapy.

Keywords: antimicrobial sensitivity, intensive care unit, nosocomial infection, urinary tract infection

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Authors: Koteswara Rao Pagolu, Raghava Rao Tamanam

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In India, genetic disease is a disregarded service element in the community health- protection system. This study aims to gauge the accessibility of services for treating genetic disorders and also to evaluate the practices on deterrence and management services in the district health system. A cross-sectional survey of selected health amenities in the government health sector was conducted from 15 primary health centers (PHC’s), 4 community health centers (CHC’s), 1 district government hospital (DGH) and 3 referral hospitals (RH’s). From these, the existing manpower like 130 medical officers (MO’s), 254 supporting staff, 409 nursing staff (NS) and 45 lab technicians (LT’s) was examined. From the side of private health institutions, 25 corporate hospitals (CH’s), 3 medical colleges (MC’s) and 25 diagnostic laboratories (DL’s) were selected for the survey and from these, 316 MO’s, 995 NS and 254 LT’s were also reviewed. The findings show that adequate staff was in place at more than 70% of health centers, but none of the staff have obtained any operative training on genetic disease management. The largest part of the DH’s had rudimentary infrastructural and diagnostic facilities. However, the greater part of the CHC’s and PHC’s had inadequate diagnostic facilities related to genetic disease management. Biochemical, molecular, and cytogenetic services were not available at PHC’s and CHC’s. DH’s, RH’s, and all selected medical colleges were found to have offered the basic Biochemical genetics units during the survey. The district health care infrastructure in India has a shortage of basic services to be provided for the genetic disorder. With some policy resolutions and facility strengthening, it is possible to provide advanced services for a genetic disorder in the district health system.

Keywords: district health system, genetic disorder, infrastructural amenities, management practices

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Authors: Mohsen Shati, Seyede Salehe Mortazavi, Seyed Kazem Malakouti, Hamidreza Khanke Fazlollah Ahmadi

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Taking unnecessary or excessive medication or using drugs with no indication (polypharmacy) by people of all ages, especially the elderly, is associated with increased adverse drug reactions (ADR), medical errors, hospitalization and escalating the costs. It may be facilitated or impeded by the healthcare system. In this study, we are going to describe the role of the health system in the practice of polypharmacy in Iranian elderly. In this Inductive qualitative content analysis using Graneheim and Lundman methods, purposeful sample selection until saturation has been made. Participants have been selected from doctors, pharmacists, policy-makers and the elderly. A total of 25 persons (9 men and 16 women) have participated in this study. Data analysis after incorporating codes with similar characteristics revealed 14 subcategories and six main categories of the referral system, physicians’ accessibility, health data management, drug market, laws enforcement, and social protection. Some of the conditions of the healthcare system have given rise to polypharmacy in the elderly. In the absence of a comprehensive specialty and subspecialty referral system, patients may go to any physician office so may well be confused about numerous doctors' prescriptions. Electronic records not being prepared for the patients, failure to comply with laws, lack of robust enforcement for the existing laws and close surveillance are among the contributing factors. Inadequate insurance and supportive services are also evident. Age-specific care providing has not yet been institutionalized, while, inadequate specialist workforce playing a major role. So, one may not ignore the health system as contributing factor in designing effective interventions to fix the problem.

Keywords: elderly, polypharmacy, health system, qualitative study

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Authors: Thomas J. Bell III

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This paper explores the value of assimilating certification training within a traditional course curriculum. This innovative approach is believed to increase stakeholder value within the Computer Information System program at Texas Wesleyan University. Stakeholder value is obtained from increased job marketability and critical thinking skills that create employment-ready graduates. This paper views value as first developing the capability to earn an industry-recognized certification, which provides the student with more job placement compatibility while allowing the use of critical thinking skills in a liberal arts business program. Graduates with industry-based credentials are often given preference in the hiring process, particularly in the information technology sector. And without a pioneering curriculum that better prepares students for an ever-changing employment market, its educational value is dubiously questioned. Since certifications are trending in the hiring process, academic programs should explore the viability of incorporating certification training into teaching pedagogy and courses curriculum. This study will examine the use of the balanced scorecard across four performance dimensions (financial, customer, internal process, and innovation) to measure the stakeholder value of certification training within a traditional course curriculum. The balanced scorecard as a strategic management tool may provide insight for leveraging resource prioritization and decisions needed to achieve various curriculum objectives and long-term value while meeting multiple stakeholders' needs, such as students, universities, faculty, and administrators. The research methodology will consist of quantitative analysis that includes (1) surveying over one-hundred students in the CIS program to learn what factor(s) contributed to their certification exam success or failure, (2) interviewing representatives from the Texas Workforce Commission to identify the employment needs and trends in the North Texas (Dallas/Fort Worth) area, (3) reviewing notable Workforce Innovation and Opportunity Act publications on training trends across several local business sectors, and (4) analyzing control variables to identify specific correlations between industry alignment and job placement to determine if a correlation exists. These findings may provide helpful insight into impactful pedagogical teaching techniques and curriculum that positively contribute to certification credentialing success. And should these industry-certified students land industry-related jobs that correlate with their certification credential value, arguably, stakeholder value has been realized.

Keywords: certification exam teaching pedagogy, exam preparation, testing techniques, exam study tips, passing certification exams, embedding industry certification and curriculum alignment, balanced scorecard performance evaluation

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Authors: Pui Hong Chung, Wing Chi Ho, Jun Li, Cyrus Leung, Ek Yeoh

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Background: Cigarette smoking is associated with poor tuberculosis (TB) outcomes in terms of progression of active TB, relapse of TB and TB-related mortality, but the association with latent tuberculosis infection (LTBI) is unclear. The systematic review conducted aimed at studying the association between active smoking and LTBI, and likelihood of dose-response relationship. Methods: Two independent reviewers searched three electronic databases comprising PudMed, Medline by EBSCOHOST, ExcerptaMedica Database (EMBASE), from inception up to 31st Dec 2015 for studies reporting data on current smoking and the LTBI with tuberculin skin test (TST) or interferon-γ release assays (IGRAs) results, comparing the odds ratios (ORs) of outcome measure of TST or IGRAs among current smokers with 95% confidence intervals (CI). Results: Seven studies were identified, including six cross-sectional studies and one longitudinal cohort study. The outcome measures from three studies were in TST, three studies in IGRAs and one for both tests. For TST, OR ranging from 1.39 to 3.40 (95% CI) with all studies shown positive association between cigarette smoking and LTBI. For IGRAs, OR ranging from 0.47 to 1.89 (95% CI) with one study shown the negative association that might be related to impaired interferon-gamma production in immunosuppressive persons. One identified study demonstrated positive dose-response relationship in TST result. Conclusions: Cigarette smoking is likely to be a risk factor of LTBI. There is the important implication for TB and tobacco control program to halt TB by empowering public health policy. Further study is also needed to provide more evidence of the dose-response model/relationship.

Keywords: latent tuberculosis infection, systematic review, active smoking, model

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Authors: D. Varadaradjou, H. Kebir, J. Mespoulet, D. Tingaud, S. Bouvier, P. Deconick, K. Ameyama, G. Dirras

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The development of new architecture metallic alloys with controlled microstructures is one of the strategic ways for designing materials with high innovation potential and, particularly, with improved mechanical properties as required for structural materials. Indeed, unlike conventional counterparts, metallic materials having so-called harmonic structure displays strength and ductility synergy. The latter occurs due to a unique microstructure design: a coarse grain structure surrounded by a 3D continuous network of ultra-fine grain known as “core” and “shell,” respectively. In the present study, pure harmonic-structured (HS) Nickel samples were processed via controlled mechanical milling and followed by spark plasma sintering (SPS). The present work aims at characterizing the mechanical properties of HS pure Nickel under room temperature dynamic loading through a Split Hopkinson Pressure Bar (SHPB) test and the underlying microstructure evolution. A stopper ring was used to maintain the strain at a fixed value of about 20%. Five samples (named B1 to B5) were impacted using different striker bar velocities from 14 m/s to 28 m/s, yielding strain rate in the range 4000-7000 s-1. Results were considered until a 10% deformation value, which is the deformation threshold for the constant strain rate assumption. The non-deformed (INIT – post-SPS process) and post-SHPB microstructure (B1 to B5) were investigated by EBSD. It was observed that while the strain rate is increased, the average grain size within the core decreases. An in-depth analysis of grains and grain boundaries was made to highlight the thermal (such as dynamic recrystallization) or mechanical (such as grains fragmentation by dislocation) contribution within the “core” and “shell.” One of the most widely used methods for determining the dynamic behavior of materials is the SHPB technique developed by Kolsky. A 3D simulation of the SHPB test was created through ABAQUS in dynamic explicit. This 3D simulation allows taking into account all modes of vibration. An inverse approach was used to identify the material parameters from the equation of Johnson-Cook (JC) by minimizing the difference between the numerical and experimental data. The JC’s parameters were identified using B1 and B5 samples configurations. Predictively, identified parameters of JC’s equation shows good result for the other sample configuration. Furthermore, mean rise of temperature within the harmonic Nickel sample can be obtained through ABAQUS and show an elevation of about 35°C for all fives samples. At this temperature, a thermal mechanism cannot be activated. Therefore, grains fragmentation within the core is mainly due to mechanical phenomena for a fixed final strain of 20%.

Keywords: 3D simulation, fragmentation, harmonic structure, high strain rate, Johnson-cook model, microstructure

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Authors: Dalia Hanna, Alexander Ferworn

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This research provides detailed proposed training modules for the public safety teams and, specifically, SAR teams responsible for search and rescue operations related to finding lost persons with dementia. Finding a lost person alive is the goal of this training. Time matters if a lost person is to be found alive. Finding lost people living with dementia is quite challenging, as they are unaware they are lost and will not seek help. Even a small contribution to SAR operations could contribute to saving a life. SAR operations will always require expert professional and human volunteers. However, we can reduce their time, save lives, and reduce costs by providing practical training that is based on real-life scenarios. The content for the proposed training is based on the research work done by the researcher in this area. This research has demonstrated that, based on utilizing drones, the algorithmic approach could support a successful search outcome. Understanding the behavior of the lost person, learning where they may be found, predicting their survivability, and automating the search are all contributions of this work, founded in theory and demonstrated in practice. In crisis management, human behavior constitutes a vital aspect in responding to the crisis; the speed and efficiency of the response often get affected by the difficulty of the context of the operation. Therefore, training in this area plays a significant role in preparing the crisis manager to manage the emotional aspects that lead to decision-making in these critical situations. Since it is crucial to gain high-level strategic choices and the ability to apply crisis management procedures, simulation exercises become central in training crisis managers to gain the needed skills to respond critically to these events. The training will enhance the responders’ ability to make decisions and anticipate possible consequences of their actions through flexible and revolutionary reasoning in responding to the crisis efficiently and quickly. As adult learners, search and rescue teams will be approaching training and learning by taking responsibility of the learning process, appreciate flexible learning and as contributors to the teaching and learning happening during that training. These are all characteristics of adult learning theories. The learner self-reflects, gathers information, collaborates with others and is self-directed. One of the learning strategies associated with adult learning is effective elaboration. It helps learners to remember information in the long term and use it in situations where it might be appropriate. It is also a strategy that can be taught easily and used with learners of different ages. Designers must design reflective activities to improve the student’s intrapersonal awareness.

Keywords: training, OER, dementia, drones, search and rescue, adult learning, UDL, instructional design

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Authors: Michaela Kaineder, Beate Bartlmae, Stefan Gaebler, Miriam Gutleder, Marlene Wuerfl

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Digital tools and e-participation processes have seen a steady increase in popularity in recent years. While online trends come with the premise of new opportunities and easier participatory possibilities, there are still manifold challenges that smart city initiators and developers need to face. In this paper, innovative quality criteria of citizen participation processes was suggested by defining meaningful and measurable evaluation categories. Considering various developments, including the global megatrend of connectivity, a need for a fundamental examination of the basic structure of citizen participation processes was identified. To this end, the application of methods and tools through different points in the policy cycle is required. In order to provide an overview of the current challenges and problems in the field of participation, this paper analyzes those issues by carrying out a literature review that also focuses on disparities in the civic sector that might hinder residents in their desire for engagement. Additionally, a case study was chosen to demonstrate the potential that e-participation tools offer to planning experts and public authorities when integrating citizen’s creativity and experience at a large scale. This online co-creation process finally leads to offline events – such as local co-design workshops - with professional planners. The findings of this paper subsequently suggest a combination of e-participation and analogue forms to merge the benefits of both worlds, resulting in a broader audience and higher quality for participation processes.

Keywords: citizen participation, disparities, e-participation, integrated urban development, sustainable development goals, sustainable urban development

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Authors: Philasande Runeli, Lynn Jonas

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Empowerment suggests participation is working collaboratively towards shared objectives, obtaining resources and critically analysing one’s social and political differences are all necessary steps in the empowering process. The aim of leadership empowerment is to give a team the resources and encouragement they need to work more productively together. This study explores potential ways to increase local empowerment and participation in blue tourism activities in an urban coastal context in South Africa. Blue tourism, which refers to the application of sustainability practices to tourism activities in coastal and marine settings, has the potential to significantly improve socioeconomic conditions in coastal communities. However, people's engagement in these activities remain restricted. The study uses a constructivist research paradigm and employs a qualitative method, conducting semi-structured interviews with community members from three different communities gaining in-depth perspectives from them. The study's goal is to identify impediments and potential for community participation in blue tourism, as well as offering practical solutions for promoting long-term and inclusive participation. Initial key findings highlight critical barriers to participation, emphasising the importance of skills development, policy alignment with local needs, and public-private partnerships as key components of community empowerment. This study offers policymakers and stakeholders recommendations for promoting inclusive blue tourism initiatives. The recommended initiatives emphasise the significance of skills development, infrastructure investment, and sustainable tourism models in ensuring economic empowerment and environmental conservation in urban coastal communities in developing states.

Keywords: blue tourism, community empowerment and participation, sustainable tourism models, inclusive participation

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Authors: Giada Feletti, Daniela Tedesco, Paolo Trucco

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The present study aims to develop a dashboard of Key Performance Indicators (KPI) to enhance information and predictive capabilities in Emergency Medical Services (EMS) systems, supporting both operational and strategic decisions of different actors. The employed research methodology consists of the first phase of revision of the technical-scientific literature concerning the indicators currently used for the performance measurement of EMS systems. From this literature analysis, it emerged that current studies focus on two distinct perspectives: the ambulance service, a fundamental component of pre-hospital health treatment, and the patient care in the Emergency Department (ED). The perspective proposed by this study is to consider an integrated view of the ambulance service process and the ED process, both essential to ensure high quality of care and patient safety. Thus, the proposal focuses on the entire healthcare service process and, as such, allows considering the interconnection between the two EMS processes, the pre-hospital and hospital ones, connected by the assignment of the patient to a specific ED. In this way, it is possible to optimize the entire patient management. Therefore, attention is paid to the dependency of decisions that in current EMS management models tend to be neglected or underestimated. In particular, the integration of the two processes enables the evaluation of the advantage of an ED selection decision having visibility on EDs’ saturation status and therefore considering the distance, the available resources and the expected waiting times. Starting from a critical review of the KPIs proposed in the extant literature, the design of the dashboard was carried out: the high number of analyzed KPIs was reduced by eliminating the ones firstly not in line with the aim of the study and then the ones supporting a similar functionality. The KPIs finally selected were tested on a realistic dataset, which draws us to exclude additional indicators due to the unavailability of data required for their computation. The final dashboard, which was discussed and validated by experts in the field, includes a variety of KPIs able to support operational and planning decisions, early warning, and citizens’ awareness of EDs accessibility in real-time. By associating each KPI to the EMS phase it refers to, it was also possible to design a well-balanced dashboard covering both efficiency and effective performance of the entire EMS process. Indeed, just the initial phases related to the interconnection between ambulance service and patient’s care are covered by traditional KPIs compared to the subsequent phases taking place in the hospital ED. This could be taken into consideration for the potential future development of the dashboard. Moreover, the research could proceed by building a multi-layer dashboard composed of the first level with a minimal set of KPIs to measure the basic performance of the EMS system at an aggregate level and further levels with KPIs that can bring additional and more detailed information.

Keywords: dashboard, decision support, emergency medical services, key performance indicators

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Authors: Muhammad Siddique, Volodymyr Lugovskyy

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This paper explores how nations might mitigate the unfavorable impacts of oil price volatility on economic growth by switching to renewable energy sources. The impacts of uncertain factor prices on economic activity are examined by looking at the Realized Volatility (RV) of oil prices rather than the more traditional method of looking at oil price shocks. The United States of America (USA), China (C), India (I), United Kingdom (UK), Germany (G), Malaysia (M), and Pakistan (P) are all included to round out the traditional literature's examination of selected nations, which focuses on oil-importing and exporting economies. Granger Causality Tests (GCT), Impulse Response Functions (IRF), and Variance Decompositions (VD) demonstrate that in a Vector Auto-Regressive (VAR) scenario, the negative impacts of oil price volatility extend beyond what can be explained by oil price shocks alone for all of the nations in the sample. Different nations have different levels of vulnerability to changes in oil prices and other factors that may play a role in a sectoral composition and the energy mix. The conventional method, which only takes into account whether a country is a net oil importer or exporter, is inadequate. The potential economic advantages of initiatives to decouple the macroeconomy from volatile commodities markets are shown through simulations of volatility shocks in alternative energy mixes (with greater proportions of renewables). It is determined that in developing countries like Pakistan, increasing the use of renewable energy sources might lessen an economy's sensitivity to changes in oil prices; nonetheless, a country-specific study is required to identify particular policy actions. In sum, the research provides an innovative justification for mitigating economic growth's dependence on stable oil prices in our sample countries.

Keywords: oil price volatility, renewable energy, economic growth, developed and developing economies

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Authors: Nonso Ochinanwata, Patrick Oseloka Ezepue

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This paper explores challenges and prospects in Nigerian higher education. The paper develops an integrated business model that aimed to innovate Nigeria higher education system. A survey and semi-structured interview among Nigerian higher education academics, students and graduates are used to explore the challenges and prospects. The study provides a comparison between lecturers, students and graduates opinions to evaluate challenges and prospects in Nigerian higher institutions. The study found to achieve efficient and effectiveness innovation in Nigerian higher education, there is a need for higher institutions to collaborate with industry professionals and other stakeholders such as company management, and government policy makers in designing higher education institutions curricula. The study found that the curriculum design and delivery need to blend theoretical understanding and real-life experience from industry, and with social cultural influences related to Nigerian environment. This will enable lecturers to organise their teaching and assessments such that students can learn around theoretical and practical study themes. The curriculum design and delivery need to link the core ideas to challenging problems in society, nationally and globally. Hence, this approach will support business start-ups and social entrepreneurship which resolve key societal problems. The study suggests that higher education executives, directors, deans, head of departments, and even individual academics need to emulate innovative business managers to create value-adding products and services from innovative research and academic work.

Keywords: higher education, curriculum innovation, business model innovation, teaching and research excellence, economic development

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Authors: Saheed Shittu, Lolwa Alansari, Fahed Nattouf, Tawa Olukade, Naji Abdallah, Tamara Alshdafat, Sarra Amdouni

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Cesarean sections (CS), a highly regarded surgical intervention for improving fetal-maternal outcomes and serving as an integral part of emergency obstetric services, are not without complications. Although CS has many advantages, it poses significant risks to both mother and child and increases healthcare expenditures in the long run. The escalating global prevalence of CS, coupled with variations in rates among immigrant populations, has prompted an inquiry into the correlation between CS rates and the nationalities of women undergoing deliveries at Al-Wakra Hospital (AWH), Qatar's second-largest public maternity hospital. This inquiry is motivated by the notable CS rate of 36%, deemed high in comparison to the 34% recorded across other Hamad Medical Corporation (HMC) maternity divisions This is Qatar's first comprehensive investigation of Caesarean section rates and nationalities. A retrospective cross-sectional study was conducted, and data for all births delivered in 2019 were retrieved from the hospital's electronic medical records. The CS rate, the crude rate, and adjusted risks of Caesarean delivery for mothers from each nationality were determined. The common indications for CS were analysed based on nationality. The association between nationality and Caesarean rates was examined using binomial logistic regression analysis considering Qatari women as a standard reference group. The correlation between the CS rate in the country of nationality and the observed CS rate in Qatar was also examined using Pearson's correlation. This study included 4,816 births from 69 different nationalities. CS was performed in 1767 women, equating to 36.5%. The nationalities with the highest CS rates were Egyptian (49.6%), Lebanese (45.5%), Filipino and Indian (both 42.2%). Qatari women recorded a CS rate of 33.4%. The major indication for elective CS was previous multiple CS (39.9%) and one prior CS, where the patient declined vaginal birth after the cesarean (VBAC) option (26.8%). A distinct pattern was noticed: elective CS was predominantly performed on Arab women, whereas emergency CS was common among women of Asian and Sub-Saharan African nationalities. Moreover, a significant correlation was found between the CS rates in Qatar and the women's countries of origin. Also, a high CS rate was linked to instances of previous CS. As a result of these insights, strategic interventions were successfully implemented at the facility to mitigate unwarranted CS, resulting in a notable reduction in CS rate from 36.5% in 2019 to 34% in 2022. This proves the efficacy of the meticulously researched approach. The focus has now shifted to reducing primary CS rates and facilitating well-informed decisions regarding childbirth methods.

Keywords: maternal nationality, caesarean section rate variation, migrants, high-income country

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Authors: Ines Cherif, Ghassen Kharroubi, Leila Bouabid, Adel Gharbi, Aicha Boukthir, Margaret Mccarron, Nissaf Ben Alaya, Afif Ben Salah, Jihene Bettaieb

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Healthcare workers' flu vaccination prevents influenza disease among both patients and caregivers. We aimed in this study to assess influenza vaccine (IV) coverage in 2018-2019 among Tunisian physicians and to determine factors associated with IV receipt. A cross sectional study was carried out in Tunisian primary and secondary health care facilities in the 2018-2019 influenza season. Physicians with direct patient contact were recruited according to a self-weighted multistage sampling. Data were collected through a face to face questionnaire containing questions on knowledge, attitudes, and practices regarding IV. Bivariate analysis was used in order to determine factors associated with IV receipt. A total of 167 physicians were included in the study with a mean age of 48.2 ± 7.7 years and a sex-ratio (M: F) of 0.37. Among participants, 15.1% (95% CI: [9.7%-20.3%]) were vaccinated against influenza in the 2018-2019 influenza season. Bivariate analysis revealed that previous flu immunization in the four years preceding the 2018-2019 influenza season (OR=32.3; p < 10-3), belief that vaccinating healthcare workers may reduce work absenteeism (OR=4.7, p=0.028), belief that flu vaccine should be mandatory to healthcare workers (OR=3.3, p=0.01) and high confidence towards IV efficacy in preventing influenza among caregivers (OR= 4.5, p=0.01) were associated with a higher IV receipt in 2018-2019 among physicians. Less than one fifth of Tunisian physicians were vaccinated against influenza in 2018-2019. Higher vaccine uptake was related to a higher belief in vaccine efficacy in preventing influenza disease among both patients and caregivers. This underscores the need for periodic educational campaigns to raise physicians' awareness about IV efficacy. The switch to an IV mandatory policy should also be considered.

Keywords: influenza vaccine, physicians, Tunisia, vaccination uptake

Procedia PDF Downloads 137