Search results for: healthcare communication

Authors: Osama Elgadi, Martin Birkett, Wai Ming Cheung

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This paper investigates the barriers behind the underutilisation of six sigma in Libyan manufacturing companies (LMCs). A mixed-method methodology is proposed, starting by conducting interviews to collect qualitative data followed by the development of a questionnaire to obtain quantitative data. The focus of this paper is on discussing the findings of the interview stage and how these can be used to further develop the questionnaire stage. The interview results showed that only four key barriers were highlighted as being encountered by LMCs. With a difference in terms of their significance, these factors were identified, and placed in descending order according to their importance, namely: “Lack of top management commitment”, “Lack of training”, “Lack of knowledge about six sigma”, and “Culture effect”. The findings also showed that some barriers which, were found in previous studies of six sigma implementation were not considered as barriers to LMCs but can, in fact, be considered as success factors or enablers for six sigma adoption. These factors were identified as: “sufficiency of time and financial resources”; “customers unsatisfied”; “good communication between all departments in the company”; “we are certain about its results and benefits to our company and unhappy with the current quality system”. These results suggest that LMCs face fewer barriers to adopting six sigma than many well-established global companies operating in other countries and could take advantage of these successful factors by developing and implementing a six sigma framework to improve their product quality and competitiveness.

Keywords: six sigma, barriers, Libyan manufacturing companies, interview

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Authors: Karissa Graham, Andrew Campbell-Lloyd

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The deep inferior epigastric artery perforator flap (DIEP) is used to reconstruct large volumes of tissue. The DIEP flap is based on the deep inferior epigastric artery (DIEA) and vein. Accurate knowledge of the anatomy of these vessels allows for efficient dissection of the flap, minimal damage to surrounding tissue, and a well vascularized flap. A 54 year old lady was assessed for bilateral delayed autologous reconstruction with DIEP free flaps. The right DIEA was consistent with the described anatomy. The left DIEA had a vessel branching shortly after leaving the external iliac artery and before entering the muscle. This independent branch entered the muscle and had a long intramuscular course to the largest perforator. The main DIEA vessel demonstrated a type II branching pattern but had perforators that were too small to have a viable DIEP flap. There were no communicating arterial branches between the independent vessel and DIEA, however, there was one venous communication between them. A muscle sparing transverse rectus abdominis muscle flap was raised using the main periumbilical perforator from the independent vessel. Our case report demonstrated an unreported anatomical variant of the DIEA. A few anatomical variants have been described in the literature, including a unilateral absent DIEA and peritoneal-cutaneous perforators that had no connection to the DIEA. Doing a pre-operative CTA helps to identify these rare anatomical variations, which leads to safer, more efficient, and effective operating.

Keywords: aberrant anatomy, CT angiography, DIEP anatomy, free flap

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Authors: Sean Yao Zu Kong, Khong Yik Chew

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Introduction: We described a case report of the successful use of advanced surgical techniques in a patient with recurrent breast cancer who underwent a wide resection including the hemi-sternum, clavicle, multiple ribs, and a lobe of the lung due to tumor involvement. This extensive resection exposed critical structures, requiring a creative approach to reconstruction. To address this complex chest wall reconstruction, a free fibula flap and a 4-zone rectus abdominis musculocutaneous flap were successfully utilized. The use of a free vascularized bone flap allowed for rapid osteointegration and resistance against osteoradionecrosis after adjuvant radiation, while a four-zone tram flap allowed for reconstruction of both the chest wall and breast mound. Although limited recipient vessels made free flaps challenging, the free fibula flap served as both a bony reconstruction and vascular conduit, supercharged with the distal peroneal artery and veins of the peroneal artery from the fibula graft. Our approach highlights the potential of advanced surgical techniques to improve outcomes in complex cases of chest wall reconstruction in patients with recurrent breast cancer, which is becoming increasingly relevant as breast cancer incidence rates increases. Case presentation: This report describes a successful reconstruction of a patient with recurrent breast cancer who required extensive resection, including the anterior chest wall, clavicle, and sternoclavicular joint. Challenges arose due to the loss of accessory muscles and the non-rigid rib cage, which could lead to compromised ventilation and instability. A free fibula osteocutaneous flap and a four-zone TRAM flap with vascular supercharging were utilized to achieve long-term stability and function. The patient has since fully recovered, and during the review, both flaps remained viable, and chest mound reconstruction was satisfactory. A planned nipple/areolar reconstruction was offered pending the patient’s decision after adjuvant radiotherapy. Conclusion: In conclusion, this case report highlights the successful use of innovative surgical techniques in addressing a complex case of recurrent breast cancer requiring extensive resection and radical reconstruction. Our approach, utilized a combination of a free fibula flap and a 4-zone rectus abdominis musculocutaneous flap, demonstrates the potential for advanced techniques in chest wall reconstruction to minimize complications and ensure long-term stability and function. As the incidence of breast cancer continues to rise, it is crucial that healthcare professionals explore and utilize innovative techniques to improve patient outcomes and quality of life.

Keywords: free fibula flap, rectus abdominis musculocutaneous flap, post-adjuvant radiotherapy, reconstructive surgery, malignancy

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Authors: Claude Alavoine, Ferkan Kaplanseren

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Negotiation is a specific form of interaction based on communication in which the parties enter into deliberately, each with clear but different interests or goals and a mutual dependency towards a decision due to be taken at the end of the confrontation. Consequently, negotiation is a complex activity involving many different disciplines from the strategic aspects and the decision making process to the evaluation of alternatives or outcomes and the exchange of information. While gender differences can be considered as one of the most researched topic within negotiation studies, empirical works and theory present many conflicting evidences and results about the role of gender in the process or the outcome. Furthermore, little interest has been shown over gender differences in the definition of what is negotiation, its essence or fundamental elements. Or, as differences exist in practices, it might be essential to study if the starting point of these discrepancies does not come from different considerations about what is negotiation and what will encourage the participants in their strategic decisions. Some recent and promising experiments made with diverse groups show that male and female participants in a common and shared situation barely consider the same way the concepts of power, trust or stakes which are largely considered as the usual driving forces of any negotiation. Furthermore, results from Human Resource self-assessment tests display and confirm considerable differences between individuals regarding essential behavioral dimensions like capacity to improvise and to achieve, aptitude to conciliate or to compete and orientation towards power and group domination which are also part of negotiation skills. Our intention in this paper is to confront these dimensions with negotiation’s usual driving forces in order to build up new paths for further research.

Keywords: negotiation, gender, trust, power, stakes, strategies

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Authors: Mariia Zhuldybina, Ahmed Moulay, Mirko Torres, Mike Rozel, Ngoc-Duc Trinh, Chloé Bois

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To reduce the global waste of perishable goods, a solution for monitoring and traceability of their environmental conditions is needed. Temperature is the most controllable environmental parameter determining the kinetics of physical, chemical, and microbial spoilage in food products. To store the time-temperature information, time-temperature indicator (TTI) is a promising solution. Printed electronics (PE) has shown a great potential to produce customized electronic devices using flexible substrates and inks with different functionalities. We propose to fabricate a hybrid printed TTI using environmentally friendly materials. The real-time TTI profile can be stored and transmitted to the smartphone via Near Field Communication (NFC). To ensure environmental performance, Canadian Green Electronics NSERC Network is developing green materials for the ink formulation with different functionalities. In terms of substrate, paper-based electronics has gained the great interest for utilization in a wide area of electronic systems because of their low costs in setup and methodology, as well as their eco-friendly fabrication technologies. The main objective is to deliver a prototype of TTI using small-scale printed techniques under typical printing conditions. All sub-components of the smart labels, including a memristor, a battery, an antenna compatible with NFC protocol, and a circuit compatible with integration performed by an offsite supplier will be fully printed with flexography or flat-bed screen printing.

Keywords: NFC, printed electronics, time-temperature indicator, hybrid electronics

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Authors: Liya Abraham

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Eritrea is located along the Red Sea, north of the Horn of Africa, between Djibouti and Sudan and has a population of about 3.2 million as of 2010. It has six administrative regions; Anseba, Debub, Debubawi K’eyih Bahri, Gash-Barka, Ma'akel, and Semenawi K’eyih Bahri. Eritrea has got its independence in 1991 after 30 years war of liberation. The country is blessed with various medicinal flora and fauna, and marine and terrestrial biodiversity. Traditional Medicine (TM) has been an integral part of the Eritrean culture for centuries. So far, more than 19 TM modalities have been recognized, and are broadly categorized as; herbal, procedure-based and spiritual. Despite the availability of modern medicine to the majority of the population, TM is still widely practiced. The rationale behind widespread use is accessibility, affordability and cultural acceptability. Hence, TM is of great contribution to the Eritrean health care system. As a matter of fact, harnessing the potential contribution of effective and safe TM in order to attain Universal Health Coverage (UHC) has been emphasized in the WHO TM strategy 2014-2023. The Eritrean TM, however, was operating without regulation and reliable scientific justification behind its safety and efficacy. Thus, the Ministry of Health (MoH), in recognition of the role of TM in primary healthcare and safeguard public health, established a regulatory body for TM so-called as Traditional Medicine Unit (TMU) in 2012. The mission of the unit is to ensure rational TM use through an integrated health service delivery system and contribute to the country’s economic and social development. The unit has established its national TM policy in 2017. The activities of the unit are guided by the National TM Advisory Committee (TMAC), responsible for the provision of technical assistance and advisory role. Moreover, the Legal Framework and Code of Ethics and Practice which provide a legal basis for the regulation of TM have also been drafted. In recognition of the importance of TM research and development, the unit launched a nationwide TM survey in 2017 and had surveyed two zones (Gash-Barka and Debub). The findings of the survey were subjected to a research dissemination workshop and publication in international journals. Furthermore, TM-related adverse events reporting tool (Green Form) aiming to guide regulatory interventions and researches have been established by the unit, and ever since reports are flowing. The unit has also been offering training to THPs, pharmacy students and health care professionals regarding TM and its regulatory activities. In addition, as part of the establishment of the national medicinal plants' database and herbal monograph, more than 329 and 30 medicinal plants, have been compiled respectively. In conclusion, TM is still widely accepted and practiced in Eritrea. The TMU ever since its establishment is endeavoring to ensure the safety and efficacy of the TM, and its integration in the mainstream health service delivery system.

Keywords: efficacy, regulation, safety, traditional medicine, traditional medicine unit, universal health coverage

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Authors: Mohammed Murtuza Soofi

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Purpose: Marketers and Researchers alike have simultaneously, yet in mutually exclusive instances, promote the use of humour by brands in their communication and gendering of brands, as both enhance brand equity and can generate positive attitudinal responses from customers. However, the gendering of brands comes with associated gendered stereotypical expectations. The current paper consolidates the long standing literature on gender role/stereotype theory and brand gender theories establishing a theoretical framework for understanding how gender-based stereotypes about humour can influence consumers’ attitudinal responses towards brands. Design/methodology/approach: Using parallel constrain satisfaction theory as domain theory to explain the highhandedness of stereotypes and gender stereotype theories (particularly around feminine use of humour), we explain why gender based stereotypes could constrain brand behaviors, and in turn, feminine brands get penalised for using witty, aggressive and self-enhancing humor. Findings: Extension of gender stereotypes to anthropomorphised brands will lead consumers to judge the use of negative humour by a feminine brand as less appropriate, which will trigger the causal chain of reduced sense of communal appropriateness and brand warmth which will result in a negative attitude towards the brand. Originality/value: Brand gendering being susceptible to gender based stereotypes, has very little attention in the literature and hence use of negative humour (stereotypical male behaviour), has never been studied in the context of gendered brands. It also helps understand to what extent stereotypes will impact attitudinal responses to the brand. Our work can help understand when heavily gendered brands can optimise the use of humour and when they can avoid it.

Keywords: brand femininity, brand gender, gender stereotypes, humour

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Authors: Laila Al-Balushi, Suad Al-Kharosui

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Due to the increasing number of breast cancer cases in Oman and the impact of the novel coronavirus disease 2019 (COVID-19 on bed situation in the hospital, a policy of early discharge (ED) with drain after breast cancer surgery was initiated at one of the tertiary hospitals in Oman. The uniqueness of this policy is no home visit follow-up, conducted after discharge and the main mode of communication was Instagram media. This policy then was evaluated by conducting a quasi-experimental study using a questionnaire with ten open and closed-ended questions, five questions to explore patient experience using a five-point Likert scale. A total of 41 female patients responded to the questionnaire. Almost 96% of the participants stated being well informed about drain care pre- and post-surgery at home. 9% of the participants developed early sign of infection and was managed at out-patient clinics. Participants with bilateral drains expressed more pain than those with single drain. 90% stated satisfied being discharged with breast drain whereas 10% preferred to stay in the hospital until the drains were removed. This study found that the policy of ED with a drain after BC surgery is practical and well-accepted by most patients. The role of breast nurse and presence of family and institutional support enhanced the success of the policy implementation. To optimize patient care, conducting a training program by breast nurse for nurses at local health centres about care management of patients with drain could improve care and enhance patient satisfaction.

Keywords: breast cancer, surgery, early discharge, surgical drain

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Authors: Abu Zafor Sadek

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Pharmaceuticals were one of the least impacted business sectors during the corona pandemic as they are the center point of Covid-19 fight. Emergency use authorization, unproven indication of some commonly used drugs, self-medication, research and production capacity of an individual country, capacity of producing vaccine by many countries, Active Pharmaceutical Ingredients (APIs) related uncertainty, information gap among manufacturer, practitioners and user, export restriction, duration of lock-down, lack of harmony in transportation, disruption in the regulatory approval process, sudden increased demand of hospital items and protective equipment, panic buying, difficulties in in-person product promotion, e-prescription, geo-politics and associated issues added a new dimension to this industry. Although the industry maintains a reasonable growth throughout Covid-19 days; however, it has been characterized by both long- and short-term effects. Short-term effects have already been visible to so many countries, especially those who are import-dependent and have limited research capacity. On the other hand, it will take a few more time to see the long-term effects. Nevertheless, supply chain disruption, changes in strategic planning, new communication model, squeezing of job opportunity, rapid digitalization are the major short-term effects, whereas long-term effects include a shift towards self-sufficiency, growth pattern changes of certain products, special attention towards clinical studies, automation in operations, the increased arena of ethical issues etc. Therefore, this qualitative and exploratory study identifies the post-covid-19 landscape of the global pharmaceutical industry.

Keywords: covid-19, pharmaceutical, businees, landscape

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Authors: Sadullah Rahmani

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Legends, stories, beliefs and traditions in every nation represent the collective dreams, secrets and aspirations of a nation and on the other hand, the foundation of their collective memory; What generally forms the foundation of the culture of any nation has undergone changes and transformations due to the passage of time and changes in political, religious and social conditions. Afghanistan is one of the richest countries in terms of cultural diversity. This country is home to people of different languages, ethnicities and religions. The purpose of this article is to analyze the contrasts and cultural commonalities between two ethnic groups in Afghanistan, namely the Hazara and Uzbek peoples. This research was done with qualitative method and structured interview tool. The method of data analysis is content analysis. In order to explain the intercultural sensitivities of the two groups, Milton Bennett's intercultural sensitivities measures have been used. Based on the theory of intercultural sensitivities, the development of communication is an important factor in reducing intercultural sensitivities. In this research, 8 people from the Hazara and Uzbek tribes were interviewed. Various factors such as customs and manners, music, language, art, lifestyle, etc. have been examined in the article. These factors can contribute to cultural differences and commonalities between the Hazara and Uzbek peoples. The results of this research show that according to Bennett's theory, there are less cultural sensitivities between the Hazara and Uzbek peoples of Afghanistan, especially in matters of marriage, language, economic poverty, being discriminated against, and work relationships; But cultural sensitivities are more in many other cases such as education, religion and the formation of cultural communities.

Keywords: Keywords: Uzbek, language, culture, religion, Hazara.

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Authors: Alexander Suuk Laar, Emmanuel Bekyieriya, Sylvester Isang, Benjamin Baguune

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Introduction: In Ghana, despite the implementation of strategies and initiatives to ensure universal access to reproductive health and family planning (FP) services for the past two decades, interventions have not adequately addressed the access and utilization needs of women of reproductive age, especially in rural Ghana. To improve access and use of reproductive and maternal health services in Ghana, a free maternal care exemption policy under the universal health coverage of the National Health Insurance Scheme was implemented in 2005. Despite the importance of FP, this service was left out of the benefit package of the policy. Low or no use of FP services is often associated with poor health among women. However, to date, there has been limited research on perspectives of women for not making FP services as part of the benefit package of the free maternal health services. This qualitative study explored perceptions of women on the comprehensiveness of the free maternal health benefit package and the effects on utilisation of services in the rural Upper West region of Ghana to improve services. Methods: This exploratory qualitative study used focus group discussions with pregnant and lactating women in three rural districts in the Upper West region of Ghana. Six focus groups were held with both pregnant women and lactating mothers at the time of the interview. Three focus group discussions were organised with the same category of women in each district. We used a purposive sampling procedure to select the participants from the districts. The interviews with the written consent of the participants lasted between 60 minutes and 120 minutes. Interviews were audio-recorded and transcribed verbatim. Data were analysed using Braun and Clarke thematic framework guidelines. Results: This research presents an in-depth account of women's perceptions on the effects associated with the uptake of FP services and its exclusion from the benefit package of the free maternal health policy. Our study found that participants did not support the exclusion of FP services in the benefit package. Participants mentioned factors hampering their access to and use of FP and contraceptive services to include the cost of services, distance and cost of transport to health facilities, lack of knowledge about FP services, socio-cultural norms and negative attitude of healthcare professionals. Participants are of the view that making FP services part of the benefit package could have addressed the cost aspect of services which act as the main barrier to improve the use of services by poor rural women. Conclusion: Women of reproductive age face cost barriers that limit their access to and use of FP and contraception services in the rural Upper West region of Ghana and need health policymakers to revise the free maternal health package to include FP services. It is essential for policymakers to begin considering revising the free maternal health policy benefit package to include FP services to help address the cost barrier for rural poor women to use services.

Keywords: benefit package, free maternal policy, women, Ghana, rural Upper West Region, Universal Health Coverage.

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Authors: A. Swetha

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This study aims to prioritize and explore critical risks in construction project assessment, employing the Weighted Average Index method and Principal Component Analysis (PCA). Through extensive literature review and expert interviews, project assessment risk factors were identified across Budget and Cost Management Risk, Schedule and Time Management Risk, Scope and Planning Risk, Safety and Regulatory Compliance Risk, Resource Management Risk, Communication and Stakeholder Management Risk, and Environmental and Sustainability Risk domains. A questionnaire was distributed to stakeholders involved in construction activities in Hyderabad, India, with 180 completed responses analyzed using the Weighted Average Index method to prioritize risk factors. Subsequently, PCA was used to understand relationships between these factors and uncover underlying patterns. Results highlighted dependencies on critical resources, inadequate risk assessment, cash flow constraints, and safety concerns as top priorities, while factors like currency exchange rate fluctuations and delayed information dissemination ranked lower but remained significant. These insights offer valuable guidance for stakeholders to mitigate risks effectively and enhance project outcomes. By adopting systematic risk assessment and management approaches, construction projects in Hyderabad and beyond can navigate challenges more efficiently, ensuring long-term viability and resilience.

Keywords: construction project assessment risk factor, risk prioritization, weighted average index, principal component analysis, project risk factors

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Authors: Isaac Alonge Olusola

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One of the major peculiarities of man is the ability to communicate and interact with language. The original Yoruba society, before the advent of the Europeans, was purely oral. That is the major means of inter- personal communication was through speaking. The abolition of slave trade by Britain marked the beginning of development of Yoruba alphabet and introduction of writing around 1800. However, most of the writing was Christian religion-focused. Later, the introduction of British colonial rule led to the introduction of writing that dwelt on political and economic emancipation. On October 1, 1960, Nigeria was granted independence by the British colonial masters and self-rule started in Nigeria. Unfortunately, the military and civilian administrations brought about political and economic oppression instead of comfort. The discomfort brought about by Nigerian political and military rulers turned the Yoruba poets to activists, reactionaries and critics. This paper will give a brief preamble on the history of Nigeria and how she got her political independence from the British in 1960. It will thereafter go further to mention some political and economic hardship brought about by Nigerian leaders. Using literary theories called semiotics and structuralism, the reactions and criticisms of some Yoruba poets will be mentioned and analyzed vis-à-vis the counter reactions of the governments in power. Moreover, the paper will bring about a conclusion on how to create a conducive atmosphere for the Yoruba poets to operate in Nigeria. Finally, suggestions will be offered on how the Nigerian government and Yoruba poets can co-exist positively to bring about a better standard of living to Nigerians and also promote good governance

Keywords: Yoruba, Yoruba language, Yoruba poets, political leaders

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Authors: Baker Ssekitto, Ambrose Mbogo

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The study reveals that indeed agriculture employs over 70% of Uganda’s population, of which majority are youth and women. The study further reveals that over 70% of the farmers are smallholder farmers based in rural areas, whose operations are greatly affected by; climate change, weak digital skills, limited access to productivity knowledge along value chains, limited access to quality farm inputs, weak logistics systems, limited access to quality extension services, weak business intelligence, limited access to quality markets among others. It finds that the emerging 4th industrial revolution powered by artificial intelligence, 5G and data science will provide possibilities of addressing some of these challenges. Furthermore, the study finds that despite rapid development of ICT4Agric Innovation, their uptake is constrained by a number of factors including; limited awareness of these innovations, low internet and smart phone penetration especially in rural areas, lack of appropriate digital skills, inappropriate programmes implementation models which are project and donor driven, limited articulation of value addition to various stakeholders among others. Majority of farmers and other value chain actors lacked knowledge and skills to harness the power of ICTs, especially their application of ICTs in monitoring and evaluation on quality of service in the extension system and farm level processes.

Keywords: artificial intelligence, productivity, ICT4agriculture, value chain, logistics

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Authors: Aisha M. Memon, Arabella Bhutto, Zahid A. Memon, Adnan Pitafi

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This study aims to identify the existing and non-existing elements in the entrepreneurial ecosystem which include finance, institutions, laws and regulations, human capital, culture, and markets, to measure the level of effectiveness of existing elements and to develop recommendations for improving the ecosystem to facilitate the women entrepreneurs in Jamshoro, Pakistan. The nature of this study is qualitative. Data were drawn from 25 in-depth, semi-structured interviews and a focus group discussion with women entrepreneurs in rural Jamshoro, Pakistan. The findings show the lack of awareness and knowledge among women entrepreneurs about available financial resources, lack of knowledge about laws, an absence of familial and societal support for women in accessing the entrepreneurial ecosystem, the absence of business and innovation enablers in rural areas, communication gaps, and unskilled human capital. The study found that institutions like non-for-profit organizations are playing an active role in the growth of women entrepreneurs. The existing entrepreneurial ecosystem in Jamshoro can be improved through culturally sensitive coordinated approach, interventions aimed at increasing awareness about the resources, promoting an understanding about the laws and regulations, making business enablers more effective, establishing public-private partnerships, and providing the women entrepreneurs easy access to market and financial resources.

Keywords: entrepreneurship, entrepreneurship ecosystem, Pakistan, women entrepreneurs

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Authors: Meaghan Bowman

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Microblogging has become increasingly popular for commenting on current events, spreading gossip, and encouraging individualism--which favors its low-context communication channel. These social media (SM) platforms allow users to express opinions while interacting with a wide range of populations. Hashtags allow immediate identification of like-minded individuals worldwide on a vast array of topics. The output of the analytic tool, Linguistic Inquiry and Word Count (LIWC)--a program that associates psychological meaning with the frequency of use of specific words--may suggest the nature of individuals’ internal states and general sentiments. When applied to groupings of SM posts unified by a hashtag, such information can be helpful to community leaders during periods in which the forming of public opinion happens in parallel with the unfolding of political, economic, or social events. This is especially true when outcomes stand to impact the well-being of the group. Here, we applied the online tools, Google Translate and the University of Texas’s LIWC, to a 90-posting sample from a corpus of Colombian Spanish microblogs. On translated disjoint sets, identified by hashtag as being authored by advocates of voting “No,” advocates voting “Yes,” and entities refraining from hashtag use, we observed the value of LIWC’s Tone feature as distinguishing among the categories and the word “peace,” as carrying particular significance, due to its frequency of use in the data.

Keywords: Colombia peace referendum, FARC, hashtags, linguistics, microblogging, social media

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Authors: Trina Isabel D. Santiago, Juan Raphael M. Perez, Maria Angelica O. Soriano, Teresita B. Suing, Jumee F. Tayaban

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To achieve universal healthcare for everyone, the World Health Organization has emphasized the importance of National Medicines Policies for increased accessibility and utilization of high-quality and affordable medications. In the Philippines, significant challenges have been identified surrounding the sustainability of essential medicines, resulting in limited access such as high cost and dominance and market dominance and monopoly of multinational companies (MNCs) in the Philippine pharmaceutical industry. These identified challenges have been addressed by several initiatives, such as the Philippine National Drug Policy and Generics Act of 1988 (Republic Act 6675), to attempt to reduce drug prices. Despite these efforts, the concerns with drug accessibility and affordability continue to persist; hence, Republic Act 9502 was enacted. This paper attempts to review RA 9502 in the pursuit of making medicines more affordable for Filipinos, analyze and critique the problems and challenges associated with the law, and provide recommendations to address identified problems and challenges. A literature search and review, as well as an analysis of the law, has been done to evaluate the policy. RA 9502 recognizes the importance of market competition in drug price reduction and quality medicine accessibility. Contentious issues prior to enactment of the law include 1) parallel importation, pointing out that the drug price will depend on the global market price, 2) contrasting approaches in the drafting of the law as the House version focused on medicine price control while the Senate version prioritized market competition, and 3) MNCs opposing the amendments with concerns on discrimination, constitutional violations, and noncompliance with international treaty obligations. There are also criticisms and challenges with the implementation of the law in terms of content or modeling, interpretation and implementation, and other external factors or hindrances. The law has been criticized for its narrow scope as it only covers specific essential medicines with no cooperation with the national health insurance program. Moreover, the law has sections taking advantage of the TRIPS flexibilities, which disallow smaller countries to reap the benefits of flexibilities. The sanctions and penalties have an insignificant role in implementation as they only ask for a small portion of the income of MNCs. Proposed recommendations for policy improvement include aligning existing legislation through strengthened price regulation and expanded law coverage, strengthening penalties to promote law adherence, and promoting research and development to encourage and support local initiatives. Through these comprehensive recommendations, the issues surrounding the policy can be addressed, and the goal of enhancing the affordability and accessibility of medicines in the country can be achieved.

Keywords: drug accessibility, drug affordability, price regulation, Republic Act 9502

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Authors: Hassan Sadeghi Naeini, Mozhgan Sabzehparvar, Mahdiye Jafarnezhad, Neda Brumandi, Mohammad Parsa Sabzehparvar

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This study aims to discover the relationship between the factors of aesthetics, user experience, and social sustainability concerning the design of street furniture and the impact of these factors on the emotional arousal of citizens to encourage and make them prefer to use street furniture. The method used in this research included extracting indicators related to each of the factors of aesthetics, user experience, and social sustainability from the articles and then selecting indicators related to the purpose of the research in consultation with industrial design experts and architects. Finally, 9 variables for aesthetics, 7 variables for user experience, and 5 variables for evaluating social sustainability were selected. To identify the effect of each of these factors on street furniture and to recognize their relationship with each other. A 10-scale prioritization questionnaire, from 1, the least amount of importance, to 10, the most amount of importance, was answered by architects and industrial designers on the “Pors Line” online platform for three consecutive weeks, and a total of 82 people answered the questionnaire. The results showed that by using aesthetic factors in the design of street furniture and having a positive impact on users’ experience of using the product, we could expect the occurrence of behavioral factors, such as creating constructive interaction and product acceptance so that the satisfaction of the user in the use of street furniture and optimal interaction in the urban environment is formed, followed by that, the requirements of social sustainability will be met.

Keywords: visual aesthetic, user experience, social sustainability, street furniture

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Authors: Rayah Asiri, Anna Robinson-Barella, Adam Todd, Andy Husband

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Introduction: A high prevalence of diabetes and diabetes-related complications in ethnic minority communities is of significant concern. Several studies have indicated low adherence rates to antidiabetic medications in ethnic minorities. Poor adherence to antidiabetic medications leads to a higher risk of complications and mortality. This review aims to explore the barriers to and facilitators of adherence to antidiabetic medication among ethnic minority groups in high-income countries. Methods: A comprehensive search of MEDLINE, Embase, CINAHL, and PsycINFO databases for qualitative studies exploring the barriers to or facilitators of adherence to antidiabetic medication in ethnic minority groups were conducted from database inception to March 2022 (PROSPERO CRD42022320681). A quality assessment of the studies was conducted using the Critical Appraisal Skills Programme (CASP) tool. Key concepts and themes from relevant studies were synthesised using a meta-ethnographic approach. Result: A total of 18 studies were included in the review, and three major themes were developed: 1) cultural underpinnings, 2) communication and building relationships, and 3) managing diabetes during holidays. Conclusion: Multiple barriers and facilitators of adherence to antidiabetic medication among ethnic minority people in high-income countries have been identified. A medication adherence intervention focusing on identified barriers to adherence to antidiabetic medication in ethnic minorities may help in improving diabetes outcomes in these groups.

Keywords: medication adherence, diabetes, ethnic minority, barriers, facilitators

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Authors: Samaneh Abedini, Diana Urajnik, Nicole Naccarato

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A high prevalence of mental health problems was observed in marginalized youth living in underserved regions of Ontario during the COVID-19 pandemic. To address this issue, a growing number of community-based traditional mental health services are offering digital mental health resources due to their accessibility, affordability, and scalability. The feasibility of providing these resources in underserved regions has been examined by researchers rather than by representatives of effective services within a mental health system. Indeed, digitalized mental health contents are not routinely embedded within local mental health organizations' services in Northern Ontario, where they can make a substantial impact. To date, many technology-based mental health initiatives have not been effectively implemented in this region. The obstacles associated with implementing digitalized mental health resources in Northern Ontario may be unique to that region. Thus, specific context-based considerations might need to be applied for developing and implementing digital resources by regional mental health organizations in Northern Ontario. The target population was child-serving organizations situated in northeastern Ontario, specifically within Greater Sudbury and the Sudbury District. A sample of six organizations were selected with representation from the mental health, social, and healthcare sectors. The project supervisor was in a unique position to access the organizations by virtue of existing relationships with the practice and lay communities at large. Thus, recruitment was conducted through professional outreach in partnership with the Center for Rural and Northern Health Research (CRaNHR). Semi-structured interviews were conducted with 1-2 key personnel (e.g., administrator, clinician) from participating organizations. Audio recordings from the semi-structured interviews were transcribed verbatim and thematically analyzed supported by NVivo. Thematic analysis of the data resulted in a total of 13 excerpts which were categorized into two major themes including 1) digital mental health services as a valuable resource for organizations both during and after the pandemic, and 2) barriers and facilitators to a successful implementation of digital mental health resources in northern Ontario. Four secondary themes were identified: 1) perceived barriers to implementation of digital mental health resources to the offered services by mental health agencies; 2) acceptability and feasibility of digital health sources for people living in northern Ontario; 3) data security, safety, and risk; and 4) connecting with clients. The employees of mental health organizations in northern Ontario considered digital mental health resources as generally acceptable to youth. However, they raised several concerns that may affect their implementation into routine practice and service delivery. The implementation of digital systems should be simple and straightforward and should enhance rather than hinder clinical workflows for staff. A clear plan for implementing technological services is also required for the successful adoption of digital systems. For successful adoption and implementation of digital systems, staff views must be considered.

Keywords: COVID-19 pandemic, digital mental health resources, Ontario, underserved

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Authors: Tanya Greathosue, Adrianna Taylor, Lori Darnel, Eileen Starr, Susie Ryder, Julie Clockston, Dawn Matera Bassett, Jess Retrum

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The United States has an identified need to improve the social work mental and behavioral health workforce shortage with a focus on culturally diverse and responsive mental and behavioral health practitioners to adequately serve its rapidly growing multicultural communities. The U.S. is experiencing rapid demographic changes. Ensuring that mental and behavioral health services are effective and accessible for diverse communities is essential for improving overall health outcomes. In response to this need, we developed a training program focused on interdisciplinary collaboration, evidence-based practices, and culturally responsive services. The success of the training program, funded by the Health Resource Service Administration (HRSA) Behavioral Health Workforce Education and Training (BHWET), has provided the foundation for stage two of our programming. In addition to HRSA/BHWET, we are receiving funding from Colorado Access, a state workforce development initiative, and Kaiser Permanente, a healthcare provider network in the United States. We have moved beyond improved learner outcomes to increasing recruitment of historically excluded, disproportionately mistreated learners, mentorship of students to improve retention, and successful, culturally responsive, diverse workforce development. These authors will utilize a pretest-posttest comparison group design and trend analysis to evaluate the success of the training program. Comparison groups will be matched based on age, gender identification, race, income, as well as prior experience in the field, and time in the degree program. This article describes our culturally responsive training program. Our goals are to increase the recruitment and retention of historically excluded, disproportionately mistreated learners. We achieve this by integrating cultural humility and sensitivity training into educational curricula for our scholars who participate in cohort classroom and seminar learning. Additionally, we provide our community partners who serve as internship sites with ongoing continuing education on how to promote and develop inclusive and supportive work environments for our learners. This work will be of value to mental and behavioral health care practitioners who serve historically excluded and mistreated populations. Participants will learn about culturally informed best practices to increase recruitment and retention of culturally diverse learners. Additionally, participants will hear how to create a culturally responsive training program that encourages an inclusive community for their learners through cohort learning, mentoring, community networking, and critical accountability.

Keywords: culturally diverse mental health practitioners, recruitment, mentorship, workforce development, underserved clinics, professional development

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Authors: Chiao-Chen Chang, Yang-Chieh Chin

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The mobile phone has no longer confined to communication, from the aspect of smartphones, consumers are only willing to pay for the product which the added value has corresponded with their appetites, such as multiple application, upgrade of the camera, and the appearance of the phone and so on. Moreover, as the maturity stage of smartphone industry today, the strategy which manufactures used to gain competitive advantages through hardware as well as software differentiation, is no longer valid. Thus, this research aims to initiate from brand image, to examine exactly whether consumers’ buying intention focus on smartphone brand or operating system, at the same time, perceived value and customer satisfaction will be added between brand image and continuous usage intention to investigate the impact of these two facets toward continuous usage intention. This study verifies the correlation, fitness, and relationship between the variables that lies within the conceptual framework. The result of using structural equation modeling shows that brand image has a positive impact on continuous usage intention. Firms can affect consumer perceived value and customer satisfaction through the creation of the brand image. It also shows that the brand image of smartphone and brand image of the operating system have a positive impact on customer perceived value and customer satisfaction. Furthermore, perceived value also has a positive impact on satisfaction, and so is the relation within satisfaction and perceived value to the continuous usage intention. Last but not least, the brand image of the smartphone has a more remarkable impact on customers than the brand image of the operating system. In addition, this study extends the results to management practice and suggests manufactures to provide fine product design and hardware.

Keywords: smartphone, brand image, perceived value, continuous usage intention

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Authors: Chia-Yi Wu, Jung-Chen Chang, Wen-Yu Hu, Ming-Been Lee

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In nearly all physical health conditions, suicide risk is increased compared to healthy people even after adjustment for age, gender, mental health, and substance use diagnoses. In order to highlight the importance of suicide risk assessment for the inpatients and early identification and engagement for inpatients’ mental health problems, a study was designed aiming at developing a comprehensive psychosomatic nursing engagement (PSNE) model with standardized operation procedures informing how nurses communicate, assess, and engage with the inpatients with emotional distress. The purpose of the study was to promote the gatekeeping role of clinical nurses in performing brief assessment and interventions to detect depression and anxiety symptoms among the inpatients, particularly in non-psychiatric wards. The study will be carried out in a 2000-bed university hospital in Northern Taiwan in 2019. We will select a ward for trial and develop feasible procedures and in-job training course for the nurses to offer mental health care, which will also be validated through professional consensus meeting. The significance of the study includes the following three points: (1) The study targets at an important but less-researched area of PSNE model in the cultural background of Taiwan, where hospital service is highly accessible, but mental health and suicide risk assessment are hardly provided by non-psychiatric healthcare personnel. (2) The issue of PSNE could be efficient and cost-effective in the identification of suicide risks at an early stage to prevent inpatient suicide or to reduce future suicide risk by early treatment of mental illnesses among the high-risk group of hospitalized patients who are more than three-times lethal to suicide. (3) Utilizing a brief tool with its established APP ('The Five-item Brief Symptom Rating Scale, BSRS-5'), we will invent the standardized procedure of PSNE and referral steps in collaboration with the medical teams across the study hospital. New technological tools nested within nursing assessment/intervention will concurrently be invented to facilitate better care quality. The major outcome measurements will include tools for early identification of common mental distress and suicide risks, i.e., the BSRS-5, revised BSRS-5, and the 9-item Concise Mental Health Checklist (CMHC-9). The main purpose of using the CMHC-9 in clinical suicide risk assessment is mainly to provide care and build-up therapeutic relationship with the client, so it will also be used to nursing training highlighting the skills of supportive care. Through early identification of the inpatients’ depressive symptoms or other mental health care needs such as insomnia, anxiety, or suicide risk, the majority of the nursing clinicians would be able to engage in critical interventions that alleviate the inpatients’ suffering from mental health problems, given a feasible nursing input.

Keywords: mental health care, clinical outcome improvement, clinical nurses, suicide prevention, psychosomatic nursing

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Authors: Aleksandra Ristic

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The world changes and becomes a global village. Globalization of the last decade has caused changes and developments in the economy and technology, which also affected communication resources and brought diversities of cultural differences, values, relationships, religions, sexual identities, economic backgrounds, mindsets, perspectives, talents, and much more. Diversity without inclusion is marginalization and exclusion. Diversity gives a competitive advantage, enriches, and gives choice and power for decision-making and solutions. On a daily basis, in the role of special educators, we facilitate children’s observations of the world by improving diversity and inclusion in the school system. The subject of the research is children with special needs, expressing and noticing the differences and similarities in the world, while this is the key to their development. The subject of the research is also six pictures, which are similar and unique and represent scenes from everyone’s life. In the methodology, we conducted a theoretical review of the importance of difference, values, equality, inclusion, and exclusion and the quantitative research approach to analyze various factors by children with special needs. We used tools such as self /peer–reflection for them to think and to speak up through their own experiences of the words: difference, values, equality, inclusion, and exclusion. After that, children with special needs observed the photos and attributed those terms to them. By interpreting the results, we deepened our understanding of the power of the child's understanding of individual differences and elements of inclusion, which is based on the experiences at home, in the school environment, and in life. The children, as individuals or establishing networking groups, define those terms and, with the solutions, contribute to making the world more included and accepted.

Keywords: diversity, equality, exclusion, inclusion, special needs, values

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Authors: Jennifer Zelmer

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The debate regarding the morality, and therefore legality, of abortion has many social, political, and medical ramifications worldwide. In a developing country like Bolivia, carrying a pregnancy to delivery is incredibly risky. Given the very high maternal mortality rate in Bolivia, greater consideration has been given to the (de)criminalization of abortion – a contributing cause of maternal death. In the spring of 2017, the Bolivian government proposed to loosen restrictions on women’s access to receiving a safe abortion, which was met with harsh criticism from 'pro-vida' (pro-life) factions. Although the current Bolivian government Movimiento al Socialismo (Movement Toward Socialism) portrays an agenda of decolonization, or to seek a 'traditionally-modern' society, nevertheless, Bolivia still has one of the highest maternal mortality rates in the Americas, because of centuries of colonial and patriarchal order. Applying a feminist critique and using the abortion debate as the central point, this paper argues that the 'traditionally-modern' society Bolivia strives towards is a paradox, and in fact only contributes to the reciprocal process of the death of 'mother tongues' and the unnecessary death of women. This claim is supported by a critical analysis of historical texts about Spanish Colonialism in Bolivia; the linguistic reality of reproductive educational strategies, and the philosophical framework which the Bolivian government and its citizens implement. This analysis is demonstrated in the current state of women’s access to reproductive healthcare in Cochabamba, Bolivia based on recent fieldwork which included audits of clinics and hospitals, interviews, and participant observation. This paper has two major findings: 1) the language used by opponents of abortion in Bolivia is not consistent with the claim of being 'pro-life' but more accurately with being 'pro-potential'; 2) when the topic of reproductive health appears in Cochabamba, Bolivia, it is often found written in the Spanish language, and does not cater to the many indigenous communities that inhabit or visit this city. Finally, this paper considers the crucial role of public health documentation to better inform the abortion debate, as well as the necessity of expanding reproductive health information to more than text-based materials in Cochabamba. This may include more culturally appropriate messages and mediums that cater to the oral tradition of the indigenous communities, who historically and currently have some of the highest fertility rates. If the objective of one who opposes abortion is to save human lives, then preventing the death of women should equally be of paramount importance. But rather, the 'pro-life' movement in Bolivia is willing to risk the lives of to-be mothers, by judicial punishment or death, for the chance of a potential baby. Until abortion is fully legal, safe, and accessible, there will always be the vestiges of colonial and patriarchal order in Bolivia which only perpetuates the needless death of women.

Keywords: abortion, feminist theory, Quechua, reproductive health education

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Authors: Eugenio Ferrer Santiago

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The growing complexities of the modern world on high-end gadgets, software applications, scams, identity theft, and Artificial Intelligence (AI) make the “uninformed” the weak and vulnerable to be victims of cybercrimes. Artificial Intelligence is not a new thing in our daily lives; the principles of database management, logical programming, and garbage in and garbage out are all connected to AI. The Philippines had in place legal safeguards against the abuse of cyberspace, but self-regulation of key industry players and self-protection by individuals are primordial to attain the success of these initiatives. Data protection, Data Privacy, and Research Ethics must work hand in hand during the policy process in the course of urban planning practice in different environments. This paper focuses on the interconnection of data protection, data privacy, and research ethics in coming up with clear-cut policies against perpetrators in the urban planning professional practice relevant in sustainable communities and smart cities. This paper shall use expository methodology under qualitative research using secondary data from related literature, interviews/blogs, and the World Wide Web resources. The claims and recommendations of this paper will help policymakers and implementers in the policy cycle. This paper shall contribute to the body of knowledge as a simple treatise and communication channel to the reading community and future researchers to validate the claims and start an intellectual discourse for better knowledge generation for the good of all in the near future.

Keywords: data privacy, data protection, urban planning, research ethics

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Authors: Maziar Asefi, Safa Salkhi Khasraghi

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Despite the great development of Islamic Architecture in its conquered lands, its active performance in a vast geographical area, faded by the advent of industrial age. Now in the Information Age with great advances in technologies and increased interconnection among many societies, every aspect of life is affected by rapid spreading phenomenon called globalization which resulted in the world with less regional and cultural boundaries. So being proudly globalized in the past and becoming inactive in today's globalized world puts Islamic Architecture in a great challenge. Indeed, its important role has changed from transmitting cultural values to the world to importing dominated values even defectively. This study aimed to determine the factors influenced this controversial situation of Islamic Architecture, especially in current age. The paper focuses on performance of Islamic architecture in relation with Globalization as an ancient process. So qualitative method in terms of logic analysis was chosen to evaluate how Islamic architecture of Iran has contributed in Globalization subject in different time periods. Several works were analyzed as case studies in three categories: religious, monumental, commercial utilities and climate element. Theoretical and practical findings indicate that there is a mutual relationship between Islamic Architecture and Globalization which is transformed from the active mode to passive mode gradually in three periods of Globalization: proto, modern and communication Globalization. The proposed solution in the response to this challenge is finding a solution that makes an equilibrium between science, art, and technology, as well as taking the global performance of architecture.

Keywords: Islamic architecture, globalisation, the relationship among art, science and technology, Iranian architecture

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Authors: Sazzad Hossain Talukder

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Survival in the competitive international market with unforeseen environmental contingencies has always been a concern of the firms that led to adopting different strategies to deal with different situations. Language strategy is considered to enhance the international performance of a firm by organizing language diversity and fostering communications within and outside the firm. Yet there is a lack of theoretical attention or model development on the role of language strategy on firm international survival. From resource dependence perspective, the adoption of language strategy and its relationship with firm survival are determined by the firm´s capability to prevent dependency concentration and/or increase relative power on the external environment. However, the impact of language strategy on firm survival is complex and multifaceted as the strategy influence firm performance indirectly through communication, coordination, learning and value creation. The evidence of various types of language strategies and different forms of firm survival also bring in complexities to understand the effects of a language strategy on the international survival of a firm. Based on language literatures and resource dependence logic, certain propositions are developed to conceptualize the relationship between language strategy and firm international survival in this conceptual paper. For the purpose of this paper, a conceptual model is proposed to examine how different kinds of language strategy foster reduction of resource dependency that lead to firm international survival in respond to local responsiveness and global integration. In this proposed model, it is theorized that language strategy has a positive relationship with the international survival of the firm, as the strategy is likely to reduce external resource dependency and increase the ability to continue independent operations both in short and long term.

Keywords: language strategy, language diversity, firm international survival, resource dependence logic

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Authors: Fan Wei, Tang Yipeng

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Knowledge sharing is of great value to organizational performance and innovation ability. However, the mainstream research has focused largely on the impact of knowledge sharing at the team level on individuals and teams. There is a lack of empirical studies on how employees interact in the exchange of knowledge and its effect on employees’ own creative performance. Based on communication accommodation theory and social exchange theory, this article explores the construction of an employee knowledge interaction mechanism under the moderating of social status and introduces the leader's creativity expectation as a moderating variable to explore its cross-level moderating effect on employee knowledge sharing and their own creative performance. An empirical test was conducted on 36 teaching and research teams in the two primary schools, and the results showed that: (1) Explicit/tacit knowledge of employees is positively correlated with acquisition of explicit/tacit knowledge; (2) Colleagues’ evaluations of employees’ social status play a moderating role between the employees’ explicit/tacit knowledge and the acquisition of explicit/tacit knowledge. (3) The leadership creativity expectation positively regulates the relationship between the employees' explicit knowledge acquisition and creative performance. This research helps to open the "black box" of the interpersonal interaction mechanism of knowledge sharing and also provides an important theoretical basis and practical guidance for organizational managers to effectively stimulate employee knowledge sharing and creative performance.

Keywords: knowledge sharing, knowledge interaction, social status, leadership creativity expectations, creative performance

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Authors: Chaomeng Liu, Li Li, Xiao Wang, Li Ren, Qinge Zhang

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Late-life depression (LLD) is a prevalent mental disorder among the elderly, frequently accompanied by significant cognitive decline, and has emerged as a worldwide public health concern. Microglia, astrocytes, and peripheral immune cells play pivotal roles in regulating inflammatory responses within the central nervous system (CNS) across diverse cerebral disorders. This review commences with the clinical research findings and accentuates the recent advancements pertaining to microglia and astrocytes in the neuroinflammation process of LLD. The reciprocal communication network between the CNS and immune system is of paramount importance in the pathogenesis of depression and cognitive decline. Stress-induced downregulation of tight and gap junction proteins in the brain results in increased blood-brain barrier permeability and impaired astrocyte function. Concurrently, activated microglia release inflammatory mediators, initiating the kynurenine metabolic pathway and exacerbating the quinolinic acid/kynurenic acid imbalance. Moreover, the balance between Th17 and Treg cells is implicated in the preservation of immune homeostasis within the cerebral milieu of individuals suffering from LLD. The ultimate objective of this review is to present future strategies for the management and treatment of LLD, informed by the most recent advancements in research, with the aim of averting or postponing the onset of AD.

Keywords: neuroinflammation, late-life depression, microglia, astrocytes, central nervous system, blood-brain barrier, Kynurenine pathway

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