Search results for: hospital policy

Authors: Tippawan Nasawan

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The objective of this study is to find the replenishment policy in Assembly-to-Order manufacturing (ATO) which some of the major components have lead-time longer than customer lead-time. The variety of products, independent component demand, and long component lead-time are the difficulty that has resulted in the overstock problem. In addition, the ordering cost is trivial when compared to the cost of material of the major component. A conceptual design of the Decision Supporting System (DSS) has introduced to assist the replenishment policy. Component replenishment by using the variable which calls Available to Promise (ATP) for making the decision is one of the keys. The Poisson distribution is adopted to realize demand patterns in order to calculate Safety Stock (SS) at the specified Customer Service Level (CSL). When distribution cannot identify, nonparametric will be applied instead. The test result after comparing the ending inventory between the new policy and the old policy, the overstock has significantly reduced by 46.9 percent or about 469,891.51 US-Dollars for the cost of the major component (material cost only). Besides, the number of the major component inventory is also reduced by about 41 percent which helps to mitigate the chance of damage and keeping stock.

Keywords: Assembly-to-Order, Decision Supporting System, Component replenishment , Poisson distribution

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Authors: Jitender Sodhi, Shweta Talati, A. K. Gupta, Pankaj Arora

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Background:Equipment donation to hospitals in resource-limited settings can significantly benefit services in these settings albeit requires important ethical, practical and financial issues to be considered before accepting donations. Objective: To understand the decision making process leading to acceptance/ rejection/ deferment of equipment donation from the perspective of a public sector teaching tertiary care hospital. Design: Retrospective, record based study. Setting: 2000-bedded public sector teaching tertiary care hospital in North India. Methods: A total of 30 cases of equipment donation from March 2010-October 2013, were analysed for their decision process leading to acceptance/rejection/deferment.Each case was studied retrospectively and data pertaining to the agenda and decision taken was collected. Results: A total of 30 cases of equipment donation received from March 2010- October 2013 were screened, out of which 17 (56.6%) were for diagnostic purpose and 13 (43.3%) for therapeutic purpose. Out of 30 cases, 16 (53.3%) were accepted and 8 (26.6%) were rejected. The remaining 6 cases included 3 (10%) which required further clarification and other 3 (10%) which were out of the domain of committee. Conclusion: This study highlights the importance of equipment donation in resource limited settings and considerations involved while making decisions for acceptance/rejections/defermentof such donations.

Keywords: equipment donation, teaching hospital, decision-making, North India

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Authors: Fatihin Khoirul, Muhammad Muqorrobin Ist

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Bojonegoro Regency is one of the districts that use the concept Agropolitan as the Territorial Development Policy. Three sub-district designated as Area Development District of Agropolitan are Kapas, Dander, and Kalitidu or commonly called KADEKA. Current policy has been shown results, but there was an inequality of results in some areas. One of them occurred in the Ngringinrejo village with the main commodities is Starfruit and Wedi village with the main commodities is Salak fruit. Therefore, a comparative study is used to search for causal factors of inequality result of the policy by using the 5 aspects compared, namely: (1) Management Development Agropolitan; (2) Physical Condition agropolitan Region; (3) Implementing Agency at the Village Level; (4) Village Government Support; and (5) Community support. Based on the discussion of qualitative analysis, it was found that five aspects have their respective roles in creating inequality of outcomes that occur in both villages. But beyond that, there are conditions where the two villages experienced the same condition that is when the initial implementation of the policy. The condition is referred to as 'the phenomenon of price trap.' The condition is caused by lower commodity prices, causing the village government's commitment in implementing policies too low, followed by public awareness in support of the policy is also low, so care for commodities is also low, and the quality is too low lead and eventually back causing low price. However, the difference is that the village Ngringinrejo able to get out of this condition with 'the new culture of administration' at the end of 2013. While the conditions in the village of Wedi compounded by not respected request assistance by the irrigation district.

Keywords: comparative policy analysis, qualitative comparative, inequallity, price trap, new culture of administration

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Authors: Maria Thaemar Tana

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The paper examines the policy and practice of Japan’s human security. Specifically, it asks the question: How does Japan’s shift towards a more proactive defence posture affect the place of human security in its foreign policy agenda? Corollary to this, how is Japan sustaining its human security policy? The objective of this research is to understand how Japan, chiefly through the Ministry of Foreign Affairs (MOFA) and JICA (Japan International Cooperation Agency), sustains the concept of human security as a policy framework. In addition, the paper also aims to show how and why Japan continues to include the concept in its overall foreign policy agenda. In light of the recent developments in Japan’s security policy, which essentially result from the changing security environment, human security appears to be gradually losing relevance. The paper, however, argues that despite the strategic challenges Japan faced and is facing, as well as the apparent decline of its economic diplomacy, human security remains to be an area of critical importance for Japanese foreign policy. In fact, as Japan becomes more proactive in its international affairs, the strategic value of human security also increases. Human security was initially envisioned to help Japan compensate for its weaknesses in the areas of traditional security, but as Japan moves closer to a more activist foreign policy, the soft policy of human security complements its hard security policies. Using the framework of neoclassical realism (NCR), the paper recognizes that policy-making is essentially a convergence of incentives and constraints at the international and domestic levels. The theory posits that there is no perfect 'transmission belt' linking material power on the one hand, and actual foreign policy on the other. State behavior is influenced by both international- and domestic-level variables, but while systemic pressures and incentives determine the general direction of foreign policy, they are not strong enough to affect the exact details of state conduct. Internal factors such as leaders’ perceptions, domestic institutions, and domestic norms, serve as intervening variables between the international system and foreign policy. Thus, applied to this study, Japan’s sustained utilization of human security as a foreign policy instrument (dependent variable) is essentially a result of systemic pressures (indirectly) (independent variables) and domestic processes (directly) (intervening variables). Two cases of Japan’s human security practice in two regions are examined in two time periods: Iraq in the Middle East (2001-2010) and South Sudan in Africa (2011-2017). The cases show that despite the different motives behind Japan’s decision to participate in these international peacekeepings ad peace-building operations, human security continues to be incorporated in both rhetoric and practice, thus demonstrating that it was and remains to be an important diplomatic tool. Different variables at the international and domestic levels will be examined to understand how the interaction among them results in changes and continuities in Japan’s human security policy.

Keywords: human security, foreign policy, neoclassical realism, peace-building

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Authors: Solomon Gebremariam, Mulugeta Naizigi, Aregawi Haileselassie

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Background: Knowledge of the pattern of bacterial isolates and their antimicrobial susceptibility is crucial for guiding empirical treatment and infection prevention and control measures. Objective: The aim of this study was to analyze the pattern of bacterial isolates and their susceptibility patterns from various specimens. Methods: Retrospectively, a total of 1067 microbiological culture results that were isolated, characterized, and identified by standard microbiological methods and whose antibiotic susceptibility was determined using CLSI guidelines between 2017 and 2019 were retrieved and analyzed. Data were entered and analyzed using the Stata release 10.1 statistical package. Result: The positivity rate of culture was 26.04% (419/1609). The most common bacteria isolated were S. aureus 23.8% (94), E. coli 15.1% (60), Klebsiella pneumonia 14.1% (56), Pseudomonas aeruginosa 8.5% (34), and CONS 7.3% (29). S. aureus and CONS showed a high (58.1% - 96.2%) rate of resistance to most antibiotics tested. They were less resistant to Vancomycin which is 18.6% (13/70) and 11.8% (2/17), respectively. Similarly, the resistance of E. coli, Klebsella pneumonia, and Pseudomonas aeruginosa was high (69.4% - 100%) to most antibiotics. They were less resistant to Ciprofloxacilin, which is 41.1% (23/56), 19.2% (10/52), and 16.1% (5/31), respectively. Conclusion: This study has shown that there is a high rate of antibiotic resistance among bacterial isolates in this hospital. A combination of Vancomycin and Ciprofloxacin should be considered in the choice of antibiotics for empirical treatment of suspected infections due to S. aureus, CONS, E. coli, Klebsiella pneumonia, Pseudomonas such as in infections within hospital setup.

Keywords: antimicrobial, resistance, bacteria, hospital

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Authors: Saifurahman Fayiz

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Geo-strategically and geo-politically location of Afghanistan has endured the consideration of Indian government policy. Afghanistan has a durable and widespread economic, historical, military, and cultural relationship with India. Afghanistan has significant and durable bilateral relations with its neighbor India. India has enjoyed friendly relations with Afghanistan since 1947. After the collapse of the Taliban regime, India and Afghanistan started diplomatic relations. The relationship between the two countries was friendly and stable. The objective of this research is to study the India- Afghanistan relationship from 2001 to 2021 from different aspects. The research conducted a qualitative research method based on descriptive. The research findings propose that India should expand its soft power in Afghanistan, and India’s foreign policy in Afghanistan should be evaluated.

Keywords: relation, policy, soft power, sector

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Authors: Ramadhan Febriansyah, Sarah Novianti, Santi Agustini

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Indonesia is a big country with Moslem population. The government must fulfill all needs of the people. However, we do not have a good policy yet especially on healthy, safety and halal food. We try to offer a new solution to overcome this with ASUH (Aman, Sehat, Utuh, Halal) or in English is SHIH (Safe, Healthy, Intact, Halal) as alternative Indonesian policy on food security. This policy is Indonesian Government’s commitment to support Sustainability Development Goals program for the zero hunger (end hunger, to achieve food security and improved nutrition for Indonesian people, of course, to promote sustainable agriculture). Hopefully, it not only can increasing quality on food especially on livestock goods (meat, egg, milk) but also to guarantee the halal food. However, this policy can be an example to others country especially Moslem countries to support SDG’s programs. This research conducted means of the descriptive method; the authors find compare the secondary data obtained from journals, textbook and scientific articles in order to determine the factors that influence food safety and food security. Relevant data used and contain a description of SDG’s as well as about the system food safety and food security that SHIH (Safe, Healthy, Intact and Halal) so these ideas can be implemented.

Keywords: food safety, food security, food sovereignty, halal SDG's

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Authors: Thanduxolo Nomngcoyiya, Simon M. Kang’ethe

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The paper aimed to critically analyse gaps pertaining to the cultural policy environments governing traditional male circumcision in the Eastern Cape as exemplified by an empirical case study. The original study which this paper is derived from utilized qualitative paradigm; and encompassed 28 participants. It used in-depth one-on-one interviews complemented by focus group discussions and key informants as a method of data collection. It also adopted interview guide as a data collection instrument. The original study was cross-sectional in nature, and the data was audio recorded and transcribed later during the data analysis and coding process. The study data analysis was content thematic analysis and identified the following key major findings on the culture of male circumcision policy: Lack of clarity on culture of male circumcision policy operations; Myths surrounding procedures on culture of male circumcision; Divergent views on cultural policies between government and male circumcision custodians; Unclear cultural policies on selection criteria of practitioners; and Lack of policy enforcement and implementation on transgressors of culture of male circumcision. It recommended: a stringent selection criteria of practitioners; a need to carry out death-free male circumcision; a need for male circumcision stakeholders to work with other culture and tradition-friendly stakeholders.

Keywords: human rights, policy enforcement, traditional male circumcision, traditional surgeons and nurses

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Authors: R. A. Abdel Rahman, A. E. Abdel Wahab, E. A. Goghneimy, H. F. Mohamed, E. M. Salama

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Infectious diseases are a major cause of death worldwide. The treatment of infections continues to be problematic in modern time because of the severe side effects of some drugs and the growing resistance to antimicrobial agents. Hence, the search for newer, safer and more potent antimicrobials is a pressing need. Herbal medicines have received much attention as a source of new antibacterial drugs since they are considered time-tested and comparatively safe both for human use and the environment. In the present study, the antimicrobial activity of marjoram (Origanum majorana L.) essential oil on some gram positive and gram negative reference bacteria, as well as some hospital resistant microbes, was tested. Marjoram oil was extracted and the oil chemical constituents were identified using GC/MS analysis. Staphylococcus aureas ATCC 6923, Pseudomonus auregonosa ATCC 9027, Bacillus subtilis ATCC 6633, E. coli ATCC 8736 and two hospital resistant microbes isolates 16 and 21 were used. The two isolates were identified by biochemical tests and 16s rRNA as proteus spp. and Enterococcus facielus. The effect of different concentrations of essential oils on bacterial growth was tested using agar disk diffusion assay method to determine the minimum inhibitory concentrations and using micro dilution method to determine the minimum bactericidal concentrations. Marjoram oil was found to be effective against both reference and hospital resistance strains. Hospital strains were more resistant to marjoram oil than reference strains. P. auregonosa growth was completely inhibited at a low concentration of oil (4µl/ml). The other reference strains showed sensitivity to marjoram oil at concentrations ranged from 5 to 7µl/ml. The two hospital strains showed sensitivity at media containing 10 and 15µl/ml oil. The major components of oil were terpineol, cis-beta (23.5%), 1,6 – octadien –3-ol,3,7-dimethyl, 2 aminobenzoate (10.9%), alpha terpieol (8.6%) and linalool (6.3%). Scanning electron microscope (SEM) and transmission electron microscope (TEM) analysis were used to determine the difference between treated and untreated hospital strains. SEM results showed that treated cells were smaller in size than control cells. TEM data showed that cell lysis has occurred to treated cells. Treated cells have ruptured cell wall and appeared empty of cytoplasm compared to control cells which shown to be intact with normal volume of cytoplasm. The results indicated that marjoram oil has a positive antimicrobial effect on hospital resistance microbes. Natural crude extracts can be perfect resources for new antimicrobial drugs.

Keywords: antimicrobial activity, essential oil, hospital resistance microbes, marjoram

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Authors: Mirim Kim, Won-Oak Oh

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Purpose: The purpose of this study was to identify hospitalized children's fall risk factors, fall prevention status and fall prevention strategies recognized by nurses and caregivers of hospitalized children and present an ecological model for fall preventive management in hospitalized children. Method: The participants of this study were 14 nurses working in medical institutions and having more than one year of child care experience and 14 adult caregivers of children under 6 years of age receiving inpatient treatment at a medical institution. One to one interview was attempted to identify their perception of fall preventive management. Transcribed data were analyzed through latent content analysis method. Results: Fall risk factors in hospitalized children were 'unpredictable behavior', 'instability', 'lack of awareness about danger', 'lack of awareness about falls', 'lack of child control ability', 'lack of awareness about the importance of fall prevention', 'lack of sensitivity to children', 'untidy environment around children', 'lack of personalized facilities for children', 'unsafe facility', 'lack of partnership between healthcare provider and caregiver', 'lack of human resources', 'inadequate fall prevention policy', 'lack of promotion about fall prevention', 'a performanceism oriented culture'. Fall preventive management status of hospitalized children were 'absence of fall prevention capability', 'efforts not to fall', 'blocking fall risk situation', 'limit the scope of children's activity when there is no caregiver', 'encourage caregivers' fall prevention activities', 'creating a safe environment surrounding hospitalized children', 'special management for fall high risk children', 'mutual cooperation between healthcare providers and caregivers', 'implementation of fall prevention policy', 'providing guide signs about fall risk'. Fall preventive management strategies of hospitalized children were 'restrain dangerous behavior', 'inspiring awareness about fall', 'providing fall preventive education considering the child's eye level', 'efforts to become an active subject of fall prevention activities', 'providing customed fall prevention education', 'open communication between healthcare providers and caregivers', 'infrastructure and personnel management to create safe hospital environment', 'expansion fall prevention campaign', 'development and application of a valid fall assessment instrument', 'conversion of awareness about safety'. Conclusion: In this study, the ecological model of fall preventive management for hospitalized children reflects various factors that directly or indirectly affect the fall prevention of hospitalized children. Therefore, these results can be considered as useful baseline data for developing systematic fall prevention programs and hospital policies to prevent fall accident in hospitalized children. Funding: This study was funded by the National Research Foundation of South Korea (grant number NRF-2016R1A2B1015455).

Keywords: fall down, safety culture, hospitalized children, risk factors

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Authors: Gifty Kumadey, Albert Tchey Agbenyegah

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This study explores the role of stakeholders in developing a sustainable supply chain policy framework in Ghana's pharmaceutical industry. It employs a qualitative research design to analyze policy documents, academic articles, and reports, shedding light on stakeholder involvement. The findings highlight the contributions of government agencies, regulatory bodies, pharmaceutical companies, suppliers, and civil society organizations. Key policies such as green procurement, waste management, and recycling initiatives are identified. However, challenges such as limited transparency, supplier engagement, and regulatory complexity impede implementation. The study recommends strengthening collaboration and promoting transparency to overcome these challenges. The findings provide valuable insights for policymakers, industry stakeholders, and researchers seeking to advance sustainable supply chain practices in Ghana's pharmaceutical industry.

Keywords: stakeholders, sustainable supply chain, policy framework, pharmaceutical industry

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Authors: Lauren Freed

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This research proposal outlines an examination of homeschool oversight in the Massachusetts educational system amid the backdrop of ideological differences between various parties with contributing interests. This mixed methodology study will follow an interpretive policy research approach, involving the use of existing data, surveys, and focus groups. The aim is to capture distinct sets of meanings, values, feelings, and beliefs by principal stakeholders, while exploring the ways in which they/each interact with, interpret, and implement homeschool guidelines set forth by the Massachusetts Supreme Judicial Court Decision Care and Protection of Charles (1987). This analysis will identify and contextualize the attitudes, administrative choices, financial implications, and educational impacts that result from the process and practice of enacting current homeschool oversight policy in Massachusetts. The following question will guide this study: How do districts, homeschooling parents, and Massachusetts Department of Elementary and Secondary Education (DESE) regulate, fund, collect, interpret, implement and report Massachusetts homeschool oversight policy? The resulting analysis will produce a unique and original baseline snapshot of qualitative and quantifiable point-in-time data based on the registered homeschool population in the state of Massachusetts.

Keywords: alternative education, homeschooling, home education, home schooling policy

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Authors: Alina Gilmanova

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China’s dependency on coal for energy is causing pollution in China and abroad. To supply the increasing energy demand and being under the pressure from international society to reduce the emissions, China was pushed to develop renewable energy. The increasing subsidies in Renewable energy sources (RES) led not only to the price-cutting but also affecting the international trade in green technology sector. In order to evaluate the role of RES in foreign policy of China, I am going to give an (i) overview of RES development in China and examine the cooperation between China and (ii) developed, (ii) developing and emerging countries. The conclusive remarks are intended to address the question of how the present Chinese renewable energy development is impacting its foreign policy and international society.

Keywords: renewable energy, China, foreign affairs, brics, cooperation

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Authors: Katie Hudson

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A growing body of scholarship is dedicated to the concept of imperial nationalism, denoting a nostalgia for empire amongst former imperial powers and a yearning to recapture the grandeur of the imperial ‘golden age.’ Much research within this field has focused on Brexit, arguing that Britain’s imperialist identity has spawned Euroscepticism. However, the interaction between imperial nationalism and foreign policy remains underdeveloped and thus far has failed to consider cases outside of the UK. Using maximum variation sampling across post-2000 Britain, Spain and the Netherlands, this comparative analysis aims to explore the discursive invocation of empire in foreign policy framing, under which circumstances and in what ways imperial nationalism emerges. Preliminary findings demonstrate that empire is most often cited when there is a perceived threat to the sovereignty of the nation and that all cases frame foreign policy options according to their acute concerns with regaining the prestige associated with empire. This is present to a lesser extent in Spain, whose earlier period of decolonisation affected the extent to which imperialism has permeated their national psyche. This, therefore, provides an alternative lens through which we can view both Euroscepticism and international relations, conditioned by an imperial legacy.

Keywords: empire, nationalism, foreign policy, IR

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Authors: Kim H. K. Choy, Oliva H. K. Chu, W. Y. Keung, B. Lim, Winnie P. Y. Tang

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Background: The prevalence of workplace obesity is rising worldwide; therefore, the workplace is an ideal venue to implement weight control intervention. This pilot randomized controlled trial aimed to develop, implement, and evaluate a nutritional wellness program for obese health care providers working in a hospital. Methods: This hospital-based nutritional wellness program was an 8-week pilot randomized controlled trial for obese health care providers. The primary outcomes were body weight and body mass index (BMI). The secondary outcomes were serum fasting glucose, fasting cholesterol, triglyceride, high-density (HDL) and low-density (LDL) lipoprotein, body fat percentage, and body mass. Participants were randomly assigned to the intervention (n = 20) or control (n = 22) group. Participants in both groups received individual nutrition counselling and nutrition pamphlets, whereas only participants in the intervention group were given mobile phone text messages. Results: 42 participants completed the study. In comparison with the control group, the intervention group showed approximately 0.98 kg weight reduction after two months. Participants in intervention group also demonstrated clinically significant improvement in BMI, serum cholesterol level, and HDL level. There was no improvement of body fat percentage and body mass for both intervention and control groups. Conclusion: The nutritional wellness program for obese health care providers was feasible in hospital settings. Health care providers demonstrated short-term weight loss, decrease in serum fasting cholesterol level, and HDL level after completing the program.

Keywords: weight management, weight control, health care providers, hospital

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Authors: Mohammad Saraj Sharifzai, Keisuke Kitagawa, Mohammad Kamil Halimee, Javid Habib, Daishi Sakaguchi

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The overall goal of this paper is to examine the suitability and potential of the policies addressing the sustainability and affordability of housing for returnees, and to determine the impact of this policy on housing delivery for Afghan refugees. Housing is a central component of the settlement experience of refugees. A positive housing situation can facilitate many aspects of integration. Unaffordable, and unsafe housing, however, can cause disruptions in the entire settlement process. This paper aims to identify a suite of built forms for housing that is both affordable and environmentally sustainable for Afghan refugees. The result was the development of a framework that enables the assessment of the overall performance of various types of housing development in all zones of the country. There is very little evidence that the present approach of housing provision to the vagaries of market forces has provided affordable housing, especially for Afghan refugees. There is a need to incorporate social housing into the policy to assist people who cannot afford to have their own houses.

Keywords: Afghan refugees, housing policy, affordability, social housing, housing provision, environmental sustainability principles, resettlement

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Authors: Md Mizanur Rahman, M. Aslam Alam, Muhammad Abu Yusuf

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The abundance of Jellyfish across the coasts of the Bay of Bengal is increasing sharply due to marine pollution, increased sea acidification and climate change. Jellyfish draws our attention to address the local and global stressors. This also indicates that something wrong is happening in this bay behind the scenes. This study aimed to investigate how the policy framework governing the sea can be reformed. To do so, this study evaluated the existing policy, regulatory and institutional framework. Empirical data were collected from the middle coastal zone of Bangladesh. The secondary literature on policy, legal documents, and institutional arrangements were reviewed. The causes of poor coordination among different public sectors and non-compliance of laws were identified. The key findings show that despite the existing of Department of Environment, poor coordination with other departments, and lack of logistics and technical staffs have resulted in severe marine pollution and degradation of coastal and marine living resources. The existing policies had no monitoring and evaluation mechanisms. Non-compliance of the existing laws has been fueling the problems. This study provides an integrated policy and a guideline for updating the legal and institutional mechanism to manage coastal and marine living resources sustainably in Bangladesh to achieve Sustainable Development Goal 14.

Keywords: legal, institutional, framework, jellyfish

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Authors: J. Niyitegeka, G. Nshimirimana, A. Silverstein, J. Odhiambo, Y. Lin, T. Nkurunziza, R. Riviello, S. Rulisa, P. Banguti, H. Magge, M. Macharia, J. P. Dushime, R. Habimana, B. Hedt-Gauthier

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In low-resource settings, women needing an emergency cesarean section experiences various delays in both reaching and receiving care that is often linked to poor neonatal outcomes. In this study, we quantified different measures of delays and assessed the association between these delays and neonatal outcomes at three rural district hospitals in Rwanda. This retrospective study included 441 neonates and their mothers who underwent emergency cesarean sections in 2015 at Butaro, Kirehe and Rwinkwavu District Hospitals. Four possible delays were measured: Time from start of labor to district hospital admission, travel time from a health center to the district hospital, time from admission to surgical incision, and time from the decision for the emergency cesarean section to surgical incision. Neonatal outcomes were categorized as unfavorable (APGAR < 7 or death) and favorable (APGAR ≥ 7). We assessed the relationship between each type of delay and neonatal outcomes using multivariate logistic regression. In our study, 38.7% (108 out of 279) of neonates’ mothers labored for 12 to 24 hours before hospital admission and 44.7% (159 of 356) of mothers were transferred from health centers that required 30 to 60 minutes of travel time to reach the district hospital. 48.1% (178 of 370) of caesarean sections started within five hours after admission and 85.2% (288 of 338) started more than thirty minutes after the decision for the emergency cesarean section was made. Neonatal outcomes were significantly worse among mothers with more than 90 minutes of travel time from the health center to the district hospital compared to health centers attached to the hospital (OR = 5.12, p = 0.02). Neonatal outcomes were also significantly different depending on decision to incision intervals; neonates with cesarean deliveries starting more than thirty minutes after decision had better outcomes than those started immediately (OR = 0.32, p = 0.04). Interventions that decrease barriers to access to maternal health care services can improve neonatal outcome after emergency cesarean section. Triaging could explain the inverse relationship between time from decision to incision and neonatal outcome; this must be studied more in the future.

Keywords: Africa, emergency obstetric care, rural health delivery, maternal and child health

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Authors: Walaa Diab, Baher Atlam, Nadia El Nimer

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Egypt faces many obvious economic challenges, and it is so clear that a real economic transformation is needed to address those problems, especially after the recent decisions of floating the Egyptian pound and the gradual subsidy cuts that are trying to meet the needed conditions to get the IMF support of (a £12bn loan) for its economic reform program. Following the post-2008 revival of the interest in the fiscal policy and its vital role in speeding up or slowing down the economic growth. Here comes the value of this paper as it seeks to analyze the macroeconomic effects of fiscal policy in Egypt by applying A Bayesian SVAR Approach. The study uses the Bayesian method because it includes the prior information and no relevant information is omitted and so it is well suited for rational, evidence-based decision-making. Since the study aims to define the effects of fiscal policy shocks in Egypt to help the decision-makers in determining the proper means to correct the structural problems in the Egyptian economy, it has to study the period of 1990s economic reform, but unfortunately; the available data is on an annual frequency. Thus, it uses annual time series to study the period 1991: 2005 And quarterly data over the period 2006–2016. It uses a set of six main variables includes government expenditure and net tax revenues as fiscal policy arms affecting real GDP, unemployment, inflation and the interest rate. The study also tries to assess the 'crowding out' effects by considering the effects of government spending and government revenue shocks on the composition of GDP, namely, on private consumption and private investment. Last but not least the study provides its policy implications regarding the needed role of fiscal policy in Egypt in the upcoming economic reform building on the results it concludes from the previous reform program.

Keywords: fiscal policy, government spending, structural vector autoregression, taxation

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Authors: Mohamed F. Othman

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Manchester, Britain has become the destination of immigrants from different parts of the world. As a result, it is currently home to over 150 different ethnic languages. The present study investigates minority language policy and planning at the micro-level of the city. In order to get an in-depth investigation of such a policy, it was decided to cover it from two angles: the first is the policy making process. This was aimed at getting insights on how decisions regarding the provision of government services in minority languages are taken and what criteria are employed. The second angle is the service provider; i.e. the different departments in Manchester City Council (MCC), the NHS, the courts, and police, etc., to obtain information on the actual provisions of services. Data was collected through semi-structured interviews with different personnel representing different departments in MCC, solicitors, interpreters, etc.; through the internet, e.g. the websites of MCC, NHS, courts, and police, etc.; and via personal observation of provisions of community languages in government services. The results show that Manchester’s language policy is formulated around two concepts that work simultaneously: one is concerned with providing services in community languages in order to help minorities manage their life until they acquire English, and the other with helping the integration of minorities through encouraging them to learn English. In this regard, different government services are provided in community languages, though to varying degrees, depending on the numerical strength of each individual language. Thus, it is concluded that there is awareness in MCC and other government agencies working in Manchester of the linguistic diversity of the city and there are serious attempts to meet this diversity in their services. It is worth mentioning here that providing such services in minority languages are not meant to support linguistic diversity, but rather to maintain the legal right to equal opportunities among the residents of Manchester and to avoid any misunderstanding that may result due to the language barrier, especially in such areas as hospitals, courts, and police. There is actually no explicitly-mentioned language policy regarding minorities in Manchester; rather, there is an implied or covert policy resulting from factors that are not explicitly documented. That is, there are guidelines from the central government, which emphasize the principle of equal opportunities; then the implementation of such guidelines requires providing services in the different ethnic languages.

Keywords: community language, covert language policy, micro-language policy and planning, minority language

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Authors: Mehtab Alam, Mudiarasan Kuppusamy

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Image branding is the prominent and well-guided phenomena of managing tourism destinations. It examines the image of cities forming as brand identity. Transformation of cities into tourist destinations is obligatory for the current management practices to be used for foreign policy. The research considers the features of perception, destination accommodation, destination quality, traveler revisit, destination information system, and behavioral image for tourism destination management. Using the quantitative and qualitative research methodology, the objective is to examine and investigate the opportunities for destination branding. It investigates the features and management of tourism destinations in Abbottabad city of Pakistan through SPSS and NVivo 12 software. The prospective outlook of the results and coding reflects the significant contribution of integrated destination management for image branding, where Abbottabad has the potential to become a destination city. The positive impact of branding integrates tourism management as it is fulfilling travelers’ requirements to influence the choice of destination for innovative foreign policy.

Keywords: image branding, destination management, tourism, foreign policy, innovative

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Authors: Bec Strating

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This paper examines the ways that domestic politics and pressure–generated through lobbying, public diplomacy campaigns and other tools of soft power-contributes to the formation of short-term and long-term national interests, priorities and strategies of states in their international relations. It primarily addresses the conceptual problems regarding the kinds of influence that lobby groups wield in foreign policy and how this influence might be assessed. Scholarly attention has been paid to influential foreign policy lobbies and interest groups, particularly in the areas of US foreign policy. Less attention has been paid to how lobby groups might influence the foreign policy of a middle power such as Australia. This paper examines some of the methodological complexities in developing and conducting a research project that can measure the nature and influence of lobbies on foreign affairs priorities and activities. This paper will use Australian foreign policy in the context of its historical bilateral relationship with Indonesia as a case study for considering the broader issues of domestic influences on foreign policy. Specifically, this paper will use the so-called ‘pro-Jakarta lobby’ as an example of an interest group. The term ‘pro-Jakarta lobby’ is used in media commentary and scholarship to describe an amorphous collection of individuals who have sought to influence Australian foreign policy in favour of Indonesia. The term was originally applied to a group of Indonesian experts at the Australian National University in the 1980s but expanded to include journalists, think tanks and key diplomats. The concept of the ‘pro-Jakarta lobby’ was developed largely through criticisms of Australia’s support for Indonesia’s sovereignty of East Timor and West Papua. Pro-Independence supporters were integral for creating the ‘lobby’ in their rhetoric and criticisms about the influence on Australian foreign policy. In these critical narratives, the ‘pro-Jakarta lobby’ supported a realist approach to relations with Indonesia during the years of President Suharto’s regime, which saw appeasement of Indonesia as paramount to values of democracy and human rights. The lobby was viewed as integral in embedding a form of ‘foreign policy exceptionalism’ towards Indonesia in Australian policy-making circles. However, little critical and scholarly attention has been paid to nature, aims, strategies and activities of the ‘pro-Jakarta lobby.' This paper engages with methodological issues of foreign policy analysis: what was the ‘pro-Jakarta lobby’? Why was it considered more successful than other activist groups in shaping policy? And how can its influence on Australia’s approach to Indonesia be tested in relation to other contingent factors shaping policy? In addressing these questions, this case study will assist in addressing a broader scholarly concern about the capacities of collectives or individuals in shaping and directing the foreign policies of states.

Keywords: foreign policy, interests groups, Australia, Indonesia

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Authors: Peri Harish Kumar, Rafique Umer Harvitkar

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Background: The emergency department mandates maximum efficacy in the utilization of the available resources. Non-urgent patient visits pose a serious concern to the treatment, patient triage, and resources available. Aims and Objectives: We conducted a retrospective case-control study of the emergency department patient list from October 2019 to November 2022. A total of 839 patients formed part of the study. Somatic complaints, vital signs, diagnostic test results, admission to the hospital, etc., were some of the criteria used for the categorization of patients. Results: The proportion of non-urgent visits varied from 7.2% to 43%, with a median of 21%. Somatic complaints were the least associated with further hospital admissions (n=28%), while diagnostic test results were the most significant indicator of further hospital admissions (n=74%). Effective triage helped minimize emergency department admissions by 36%. Conclusion: Our study shows that effective triaging, patient counselling, and round-the-clock consumable monitoring helped in the effective management of patients admitted and also significantly helped provide treatment to the patients most in need.

Keywords: urgent visits, non-urgent visits, traiging, emergency department admissions

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Authors: Shuaibu Umar Abdul

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The essence of any state as well as government is to ensure and advance the security of lives and property of its citizens. As a result, providing security in all spheres ranging from safeguarding the territorial integrity, security of lives and property of the citizens as well as economic emancipation have constitute the core objectives cum national interest of virtually all country’s foreign policy in the world. In view of this imperative above, Nigeria has enshrined in the early part of her 1999 constitution as amended, as its duty and responsibility as a state, to ensure security of lives and property of its citizens. Yet, it does not make any significant shift as it relates to the country’s fundamental security needs as exemplified by the current enormous security challenges that reduced the country’s fortune to the background in all ramifications. The study chooses realist paradigm as theoretical underpinning which emphasizes that exigency of the moment should always take priority in the pursuit of foreign policy. The study is historical, descriptive and narrative in method and character. Data for the study was sourced from secondary sources and analysed via content analysis. The study found out that it is lack of political will on the side of the government to guarantee a just and egalitarian society that will be of benefit to all citizens. This could be more appreciated when looking at the gaps between the theory in Nigerian foreign policy and the practice as exemplified by the action or inaction of the government to ensure security in the state. On this account, the study recommends that until the leaderships in Nigerian foreign policy recognized the need for political will and respect for constitutionalism to ensure security of its citizens and territory, otherwise achieving great Nigeria will remain an illusion.

Keywords: foreign policy, nation, national security, Nigeria, security

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Authors: Charles Asenime, Asaju Joel, Fagbenro Abiola, Adetoyese Oguntimehin, Agosu Rebecca

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This paper examines the fundamental principles of the National Transport Policy (NTP) and determined its role in the execution of transport projects, and the establishment of ministries, departments, and agencies. Data used for the paper are from secondary sources of commissioned reports, studies, internet sources, and government releases. Results of the analysis show that the draft NTP has been used to establish transport schemes, master plans, and transport infrastructure. The paper concludes that though, the national transport Policy is still in a draft form, its production, however, has shaped the transport system in Nigeria and has shown how transport has improved the economy through the efficient utilisation of resources, improved mobility, and lifestyle.

Keywords: principles, draft, system, resources

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Authors: Syed Ameer Haider Jafri, Mariam Amri

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Dental caries is the most prevalent dental disease of childhood. The aims and objectives of this study were to identify the most common reason for seeking dental treatment and to determine caries profile and there is a treatment need in children visiting the hospital. A total of 170 Saudi children of age 1-5 years studied. Results show the most common reason for visiting hospital was decay followed by pain. These children show mean DMFT/DMFS of 9.8/22.4 and most commonly needed treatment was one-surface restoration followed by pulp treatment.

Keywords: dental caries, DMFT/DMFS index, prevalence, dental treatment need

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Authors: A. Abbou, V. Makis, N. Salari

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We study the condition-based maintenance (CBM) problem of a system subject to stochastic deterioration. The system is composed of three units (or modules): (i) Module 1 deterioration follows a Markov process with two operational states and one failure state. The operational states are partially observable through periodic condition monitoring. (ii) Module 2 deterioration follows a Gamma process with a known failure threshold. The deterioration level of this module is fully observable through periodic inspections. (iii) Only the operating age information is available of Module 3. The lifetime of this module has a general distribution. A CBM policy prescribes when to initiate a maintenance intervention and which modules to repair during intervention. Our objective is to determine the optimal CBM policy minimizing the long-run expected average cost of operating the system. This is achieved by formulating a Markov decision process (MDP) and developing the value iteration algorithm for solving the MDP. We provide numerical examples illustrating the cost-effectiveness of the optimal CBM policy through a comparison with heuristic policies commonly found in the literature.

Keywords: reliability, maintenance optimization, Markov decision process, heuristics

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Authors: Paraskevi Liosatou

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Climate change is considered to be of global concern being amplified by the fact that by its nature, cannot be spatially limited. This fact makes necessary the intergovernmental decision-making procedures. In the intergovernmental level, the institutions such as the United Nations Framework Convention on Climate Change and the Intergovernmental Panel on Climate Change develop efforts, methods, and practices in order to plan and suggest climate mitigation and adaptation measures. These measures are based on specific scientific findings and methods making clear the strong connection between science and policy. In particular, these scientific recommendations offer a series of practices, methods, and choices mitigating the problem by aiming at the indirect mitigation of the causes and the factors amplifying climate change. Moreover, modern production and economic context do not take into consideration the social, political, environmental and spatial dimensions of the problem. This work studies the decision-making process working in international and European level. In this context, this work considers the policy tools that have been implemented by various intergovernmental organizations. The methodology followed is based mainly on the critical study of standards and process concerning the connections and cooperation between science and policy as well as considering the skeptic debates developed. The finding of this work focuses on the links between science and policy developed by the institutional and scientific mechanisms concerning climate change mitigation. It also analyses the dimensions and the factors of the science-policy framework; in this way, it points out the causes that maintain skepticism in current scientific circles.

Keywords: climate change, climate change mitigation, climate change skepticism, IPCC, skepticism

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Authors: Drago Jakovcevic, Mihovil Andelinovic, Igor Husak

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The aim of this paper is to explore the economic circumstances in which the selective credit policy, the least used instrument of four types of instruments on disposal to central banks, should be used. The most significant example includes the use of selective credit policies in response to the emergence of the global financial crisis by the FED. Specifics of the potential use of selective credit policies as the instigator of economic growth in Croatia, a small open economy, are determined by high euroization of financial system, fixed exchange rate and long-term trend growth of external debt that is related to the need to maintain high levels of foreign reserves. In such conditions, the classic forms of selective credit policies are unsuitable for the introduction. Several alternative approaches to implement selective credit policies are examined in this paper. Also, thorough analysis of distribution of selective monetary policy loans among economic sectors in Croatia is conducted in order to minimize the risk of investing funds and maximize the return, in order to influence the GDP growth.

Keywords: global crisis, selective credit policy, small open economy, Croatia

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Authors: Esam Roshdy, Saleh AlRashdi, Turki Alharbi, Rawan Eskandarani, Zurina Cabilo

Abstract:

Introduction/ background: Consultation in the Emergency Department constitute a major part of the work flow every day. Any delay in the consultation process have a major impact on the length of stay and patient disposition and thus affect the total waiting time of patients in the ED. King Fahad medical City in Riyadh City, Saudi Arabia is considered a major Tertiary hospital where there is high flow of patients of different categories visiting the ED. The importance of decreasing consultation time and decision for final disposition of patients was recognized and interpreted in this project to find ways to improve the patient flow in the department and thus the total patient disposition and outcome. Aim / Objectives: 1. To monitor the time of consultation for patients in the Emergency department and its impact on the length of stay of patients in the ED. 2. To detect and assess the problems that lead to long consultation times in the ED, and reach a targeted time of 2 hours for final disposition of patients, according to recognized international and our institutional consultation policy, to reach the final goal of decreasing total length of stay and thus improve the patient flow in the ED. Methods: Data was collected retrospectively for a 92 charts of consultations done in the ED over 2 month’s period. The data was analyzed to get the median of Total Consultation Time. A survey was conducted among all ED staff to determine the level of knowledge about the total consultation time and the compliance to the institutional policy target of 2 hours. A second Data sample of 168 chart was collected after awareness campaign and education of all ED staff about the importance of reaching the target consultation time and compliance to the institutional policy. Results: We have found that there is room for improvement in our overall consultation time. This was found to be more frequent with certain specialties. Our surveys have showed that many ED staff are not familiar or not compliant with our consultation policy which was not clear for everyone. Post-intervention data have showed that awareness of the importance to decrease the total consultation time and compliance alone to the targeted goal have had a huge impact on overall improvement and decreasing the time of final decision and disposition of the patient and the overall patient length of stay in the ED. Conclusion: Working on improving Consultation time in the Emergency Department is a major factor in improving overall length of stay and patient flow. This improvement helps in the overall patient disposition and satisfaction. Plan: As a continuation of our project we are planning to focus on the conflict of admission cases where more than one specialty is involved in the care of patients. We are planning to collect data on the time it takes to resolve and reach final disposition of those patients, and its impact on the length of stay and our department flow and the overall patient outcome and satisfaction.

Keywords: consultation time, impact, length of stay, in the ED

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