Search results for: rapid access clinic
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 6297

Search results for: rapid access clinic

1917 History and Its Significance in Modern Visual Graphic: Its Niche with Respect to India

Authors: Hemang Madhusudan Anglay, Akash Gaur

Abstract:

Value of visual perception in today’s context is vulnerable. Visual Graphic broadly and conveniently expresses culture, language and science of art that satisfactorily is a mould to cast various expressions. It is one of the essential parts of communication design which relatively can be used to approach the above areas of expressions. In between the receptors and interpreters, there is an expanse of comprehension and cliché in relation to the use of Visual Graphics. There are pedagogies, commodification and honest reflections where Visual Graphic is a common area of interest. The traditional receptors amidst the dilemma of this very situation find themselves in the pool of media, medium and interactions. Followed by a very vague interpretation the entire circle of communication becomes a question of comprehension vs cliché. Residing in the same ‘eco-system’ these communities who make pedagogies and multiply its reflections sometimes with honesty and sometimes on commercial values tend to function differently. With the advent of technology, which is a virtual space allows the user to access various forms of content. This diminishes the core characteristics and creates a vacuum even though it satisfies the user. The symbolic interpretation of visual form and structure is transmitted in a culture by the means of contemporary media. Starting from a very individualistic approach, today it is beyond Print & Electronic media. The expected outcome will be a study of Ahmedabad City, situated in the Gujarat State of India. It is identity with respect to socio-cultural as well as economic changes. The methodology will include process to understand the evolution and narratives behind it that will encompass diverse community, its reflection and it will sum up the salient features of communication through combination of visual and graphic that is relevant in Indian context trading its values to global scenario.

Keywords: communication, culture, graphic, visual

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1916 An Analysis of Millennials Using Secondhand Clothing as an Ongoing Fashion Trend

Authors: Patricia Sumod

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There is a unique movement of fashion that features a trend around secondhand clothing. This is especially observed in the lifestyles of the millennials, where the concept of reusing apparel and accessories is noticeable and, therefore, slowly diminishing the high consumption of fast fashion and generating environmental awareness. This paper will focus on how this clothing trend influences and engages consumers in buying secondhand clothing and creating fashionable looks simultaneously. To further examine the millennials’ motivation towards consumption and using secondhand fashion, a concept as a trendsetter, this paper will take a closer look at their idea of concern for the environment. Considering second-hand clothing is a sustainable consumption practice, it will investigate the role of social influencers, trendsetters, and millennials in overall fashion consumption in this context. This study aims to understand how secondhand clothing and millennials differ from other consumers regarding the perception of fast-depleting natural resources, price sensitivity, vintage attachments, and psychographics. Secondly, the paper will also present the connection of emotion between millennials and secondhand clothing that may not be necessarily purchased but received. This study will reflect on the already identified influences in increased purchase behavior and an uncharted positive relationship between the consumer and the products. This behavior will further formulate into a habit by consumer segments, creating an expanded market for secondhand clothing. There is no definite indication that fast fashion will cease to exist, but slowing its rapid movement is an attempt to work toward a sustainable future. The conclusion will present possibilities for consumers to engage in C2C online interaction, thereby reinforcing a notable change in consumer behavior and attitude in contradiction to today’s extreme consumerism and willingness to be adaptable to a minimalist way of life. Fashion brands will then begin a new forecast to actively accommodate the new millennial concept of fashion that will advertise more concern than insatiability. The research will be with literature from various authors, insights provided by researchers on this new wave of consumers, and a qualitative approach with face-to-face interviews with a sample group who are in the practice of secondhand clothing consumption.

Keywords: second-hand clothing, millennials, sustainability, consumption practice, fashion environment.

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1915 The Effect of Technology and Artifical Intelligence on Legal Securities and Privacy Issues

Authors: Kerolis Samoul Zaghloul Noaman

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area law is the brand new access in the basket of worldwide law in the latter half of the 20 th Century. inside the last hundred and fifty years, courts and pupils advanced a consensus that, the custom is an vital supply of global law. Article 38(1) (b) of the statute of the international court of Justice identified global custom as a supply of global law. country practices and usages have a more role to play in formulating commonplace international regulation. This paper examines those country practices which may be certified to emerge as global standard law. due to the fact that, 1979 (after Moon Treaty) no hard law had been developed within the vicinity of space exploration. It attempts to link among country practices and custom in area exploration and development of standard global regulation in area activities. The paper makes use of doctrinal approach of felony research for inspecting the current questions of worldwide regulation. The paper explores exceptional worldwide prison files which include general meeting Resolutions, Treaty standards, working papers of UN, cases relating to commonplace global law and writing of jurists regarding area law and standard international law. it's far argued that, ideas such as common background of mankind, non-navy region, sovereign equality, nuclear weapon unfastened area and protection of outer area environment, etc. evolved nation practices a number of the worldwide community which can be certified to turn out to be international customary regulation.

Keywords: social networks privacy issues, social networks security issues, social networks privacy precautions measures, social networks security precautions measures

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1914 China's BRI and Germany's Baghdad Railroad – a Realist Analysis of Hegemonic Conflict and the Circumvention of Maritime Power

Authors: Kamen Kirov

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In the late 19th and early 20th centuries, Britain dominated global trade and finance in large part due to its maritime superiority. Germany, a land power, sought to undermine Britain’s position as the primary hegemon but ultimately could not challenge Britain’s maritime position or capabilities. This drove Germany to seek alternative strategies to weaken Britain’s position. Notably, it pushed Germany to create a reliable overland link through the Balkans to the Middle East via railroad. This article will seek to draw parallels between the German-British hegemonic conflict of the early 20th century and the Chinese-American hegemonic conflict taking place today using both secondary historical sources and current scholarly discussions of the changing international sphere. In doing so, it will provide useful insights into how China might attempt to outflank American power. The article will demonstrate that in many ways, the strategic positions and approaches of the early-20th century Germany and modern China are similar. Both countries were faced with a vastly superior foe with respect to maritime and economic power, and in both cases, their response was to undermine their rival hegemon by creating new overland infrastructure. Furthermore, in both cases, a major goal of creating new overland links was to gain further access to and control over Middle Eastern energy markets. It seems that in the modern day, China is conducting such a policy on a much grander scale than Germany did in the early 20th century—which may result in negative consequences for the US strategic position.

Keywords: belt and road Initiative, hegemonic conflict, maritime power, realism

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1913 Adaptation Mechanism and Planning Response to Resiliency Shrinking of Small Towns Based on Complex Adaptive System by Taking Wuhan as an Example

Authors: Yanqun Li, Hong Geng

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The rapid urbanization process taking big cities as the main body leads to the unequal configuration of urban and rural areas in the aspects of land supply, industrial division of labor, service supply and space allocation, and induces the shrinking characterization of service energy, industrial system and population vitality in small towns. As an important spatial unit in the spectrum of urbanization that serves, connects and couples urban and rural areas, the shrinking phenomenon faced by small towns has an important influence on the healthy development of urbanization. Based on the census of small towns in Wuhan metropolitan area, we have found that the shrinking of small towns is a passive contraction of elastic tension under the squeeze in cities. Once affected by the external forces such as policy regulation, planning guidance, and population return, small towns will achieve expansion and growth. Based on the theory of complex adaptive systems, this paper comprehensively constructs the development index evaluation system of small towns from five aspects of population, economy, space, society and ecology, measures the shrinking level of small towns, further analyzes the shrinking characteristics of small towns, and identifies whether the shrinking is elastic or not. And then this paper measures the resilience ability index of small town contract from the above-mentioned five aspects. Finally, this paper proposes an adaptive mechanism of urban-rural interaction evolution under fine division of labor to response the passive shrinking in small towns of Wuhan. Based on the above, the paper creatively puts forward the planning response measures of the small towns on the aspects of spatial layout, function orientation and service support, which can provide reference for other regions.

Keywords: complex adaptive systems, resiliency shrinking, adaptation mechanism, planning response

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1912 Maternal Care Practices on Nutritional Status of Pre School Children in Dass Local Government Area of Bauchi State, Nigeria

Authors: Adebusoye Michael, Okunola Olayinka, Owolabi Abdulateef, Jacob Anayo

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Introduction: Child undernutrition remains one of Africa’s most fundamental challenges for improved human development because the time and capacities of caregivers are limited; far too many children are unable to access effectively amenities they need for a healthy life. Methods and procedures: This cross-sectional, descriptive study evaluated the maternal care practices on nutritional status of pre-school children, 150 mothers were selected by systematic random sampling in Dass L.G.A., Bauchi-State, Nigeria. Information on relevant parameters were collected by questionaire, analysed by various indices of descriptive statistics using SPSS version 16.0.Spearman’s rank correlation was used to test for associations between the variables. Results: Thirty-five (23.3%) of the respondents were aged 21-25 years. Thirty-three (28.0%) had secondary education, while forty-nine (32.7%) were full housewives. Majority 79(52.7) earned NI,000- N10,000 monthly versus 10(6.7%) who earned N11,000- N20,000.113(75.3%) married while 7(4.7%) of respondents were separated. Sixty-one (40.7%) practiced exclusive breastfeeding within six months. Only seventy-one (47.3%) initiated breastfeeding between 7 and 13 months. Five (3.3%) of children were mildly underweight while nine (6.0%) were severely stunted. Conclusion: The outcome suggested that working time of mothers is a major determinant on their child nutritional status. However, there is a significant relationship on the working time of mothers, income level and educational level of mothers to the nutritional status of their children (P<0.05). Recommendation: Good policy programmes should aim at eradicating poverty, better child care practices that would reduce malnutrition among under-five children.

Keywords: maternal care, nutritional status, preschool children, Dass L.G.A.

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1911 Examining the Factors Impeding the Preservation of African Architectural Heritage

Authors: Okafor Calistus Chibuzor

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Preserving African architectural heritage is a multifaceted endeavor that intersects with socio-cultural, economic, and environmental factors. Despite growing recognition of the importance of safeguarding these invaluable cultural assets, numerous challenges persist, hindering effective preservation efforts across the continent. This paper investigates the underlying factors impeding the preservation of African architectural heritage, aiming to provide insights for addressing this critical issue. The study begins with an exploration of the historical background and significance of African architectural heritage, highlighting its rich diversity and cultural significance. The study acknowledges that there is an urgent need to address the threats facing these heritage sites, including urbanization, rapid development, lack of funding, inadequate legal protection, and insufficient public awareness. The primary aim of this research is to identify and analyze the key factors contributing to the deterioration and loss of African architectural heritage, with the objective of formulating strategies to mitigate these challenges. A mixed-use research methodology combining archival research, field surveys, stakeholder interviews, and case studies is employed to gather comprehensive data and insights. The findings reveal a complex interplay of socio-economic, political, and institutional factors shaping the preservation landscape in Africa, including issues related to funding, governance, community engagement, and capacity building. The paper concludes by highlighting the urgent need for coordinated efforts among government agencies, heritage organizations, local communities, and international stakeholders to address the identified challenges and develop sustainable preservation strategies. Recommendations are provided for enhancing legal frameworks, promoting community involvement, fostering public awareness, and mobilizing resources to safeguard Africa's rich architectural heritage for future generations.

Keywords: African architectural heritage, preservation challenges, preservation strategies, factors

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1910 Ultra-Reliable Low Latency V2X Communication for Express Way Using Multiuser Scheduling Algorithm

Authors: Vaishali D. Khairnar

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The main aim is to provide lower-latency and highly reliable communication facilities for vehicles in the automobile industry; vehicle-to-everything (V2X) communication basically intends to increase expressway road security and its effectiveness. The Ultra-Reliable Low-Latency Communications (URLLC) algorithm and cellular networks are applied in combination with Mobile Broadband (MBB). This is particularly used in express way safety-based driving applications. Expressway vehicle drivers (humans) will communicate in V2X systems using the sixth-generation (6G) communication systems which have very high-speed mobility features. As a result, we need to determine how to ensure reliable and consistent wireless communication links and improve the quality to increase channel gain, which is becoming a challenge that needs to be addressed. To overcome this challenge, we proposed a unique multi-user scheduling algorithm for ultra-massive multiple-input multiple-output (MIMO) systems using 6G. In wideband wireless network access in case of high traffic and also in medium traffic conditions, moreover offering quality-of-service (QoS) to distinct service groups with synchronized contemporaneous traffic on the highway like the Mumbai-Pune expressway becomes a critical problem. Opportunist MAC (OMAC) is a way of proposing communication across a wireless communication link that can change in space and time and might overcome the above-mentioned challenge. Therefore, a multi-user scheduling algorithm is proposed for MIMO systems using a cross-layered MAC protocol to achieve URLLC and high reliability in V2X communication.

Keywords: ultra-reliable low latency communications, vehicle-to-everything communication, multiple-input multiple-output systems, multi-user scheduling algorithm

Procedia PDF Downloads 90
1909 Special Single Mode Fiber Tests of Polarization Mode Dispersion Changes in a Harsh Environment

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

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

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

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1908 Fate of Sustainability and Land Use Array in Urbanized Cities

Authors: Muhammad Yahaya Ubale

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Substantial rate of urbanization as well as economic growth is the tasks and prospects of sustainability. Objectives of the paper are: to ascertain the fate of sustainability in urbanized cities and; to identify the challenges of land use array in urbanized cities. Methodology engaged in this paper employed the use of secondary data where articles, conference proceedings, seminar papers and literature materials were effectively used. The paper established the fact that while one thinks globally, it is reciprocal to act locally if at all sustainability should be achieved. The speed and scale of urbanization must be equal to natural and cost-effective deliberations. It also discovered a podium that allows a city to work together as an ideal conglomerate, engaging all city departments as a source of services, engaging residents, businesses, and contractors. It also revealed that city should act as a leader and partner within an urban region, engaging senior government officials, utilities, rural settlements, private sector stakeholders, NGOs, and academia. Cities should assimilate infrastructure system design and management to enhance efficiency of resource flows in an urban area. They should also coordinate spatial development; integrate urban forms and urban flows, combine land use, urban design, urban density, and other spatial attributes with infrastructural development. Finally, by 2050, urbanized cities alone could be consuming 140 billion tons of minerals, ores, fossil fuels and biomass annually (three times its current rate of consumption), sustainability can be accomplished through land use control, limited access to finite resources, facilities, utilities and services as well as property right and user charge.

Keywords: sustainability, land use array, urbanized cities, fate of sustainability and perseverance

Procedia PDF Downloads 273
1907 Design and Development of an Autonomous Beach Cleaning Vehicle

Authors: Mahdi Allaoua Seklab, Süleyman BaşTürk

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In the quest to enhance coastal environmental health, this study introduces a fully autonomous beach cleaning machine, a breakthrough in leveraging green energy and advanced artificial intelligence for ecological preservation. Designed to operate independently, the machine is propelled by a solar-powered system, underscoring a commitment to sustainability and the use of renewable energy in autonomous robotics. The vehicle's autonomous navigation is achieved through a sophisticated integration of LIDAR and a camera system, utilizing an SSD MobileNet V2 object detection model for accurate and real-time trash identification. The SSD framework, renowned for its efficiency in detecting objects in various scenarios, is coupled with the lightweight and precise highly MobileNet V2 architecture, making it particularly suited for the computational constraints of on-board processing in mobile robotics. Training of the SSD MobileNet V2 model was conducted on Google Colab, harnessing cloud-based GPU resources to facilitate a rapid and cost-effective learning process. The model was refined with an extensive dataset of annotated beach debris, optimizing the parameters using the Adam optimizer and a cross-entropy loss function to achieve high-precision trash detection. This capability allows the machine to intelligently categorize and target waste, leading to more effective cleaning operations. This paper details the design and functionality of the beach cleaning machine, emphasizing its autonomous operational capabilities and the novel application of AI in environmental robotics. The results showcase the potential of such technology to fill existing gaps in beach maintenance, offering a scalable and eco-friendly solution to the growing problem of coastal pollution. The deployment of this machine represents a significant advancement in the field, setting a new standard for the integration of autonomous systems in the service of environmental stewardship.

Keywords: autonomous beach cleaning machine, renewable energy systems, coastal management, environmental robotics

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1906 Relationship between Mental Health and Food Access among Healthcare College Students in a Snowy Area in Japan

Authors: Yuki Irie, Shota Ogawa, Hitomi Kosugi, Hiromitsu Shinozaki

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Background: Dropout from higher educational institutions is a major problem both for students and institutions, and poor mental health is one of the risk factors. Medical college students are at higher risk of poor mental health than general students because of their hard academic schedules. On the other hand, food insecurity has negative impacts on mental health. The healthcare college of the project site is located heavily snowy area. The students without own vehicles may be at higher risk of food insecurity, especially in the winter season. Therefore, they have many risks to mental health. The aim of the study is to clarify the relationship between mental health and its risk factors to promote students’ mental well-being. Method: A cross-sectional design was used to investigate the relationship between mental health status and lifestyle, including diet and food security among the students (n=421, 147 male, 274 females; 20.7 ± 2.8 years old). Participants were required to answer 3 questionnaires which consisted of diet, lifestyle, food security, and mental health. The survey was conducted during the snowy season from Dec. 2022 to Jan. 2023. Results: Mean mental score was 6.7±4.6 (max. score 27, a higher score means worse mental health). Significant risk factors in mental health were breakfast habit (p=0.02), subjective dietary habit (p=0.00), subjective health (p=0.00), exercise habit (p=0.02), food insecurity in the winter season (p=0.01), and vitamin A intakes (p=0.03). Conclusions: Nutrients intakes are not associated with mental health except vitamin A; however, some other lifestyle factors are significantly associated with mental health. Nutrition doesn’t lead to poor mental health directly; however, the promotion of a healthy lifestyle and improved food security in winter may be effective in better mental health.

Keywords: mental health, winter, lifestyle, students

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1905 Learned Helplessness and Agricultural Investment among Poor Farmers: An Experimental Study in Rural Uganda

Authors: Floris Burgers, Arjan Verschoor

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Poor farmers in developing countries typically do not have the resources or access to institutions to protect themselves against all kinds of income shocks, which makes their farm income highly sensitive to weather and crop price fluctuations, and various other intervening forces. Consequently, the relationship between farming effort and farming outcomes can be noisy, potentially resulting in a situation in which farmers perceive little personal control over the outcomes of their farming efforts. This perceived lack of control can result in learned helplessness in some farmers, who would then be less motivated to invest in their farm. This paper presents the results of a household survey and controlled field experiment conducted in ten villages in a farming area in eastern Uganda with a view to examining the link between learned helplessness and agricultural investment. The results show that (I) farmers with a more pessimistic attributional style for negative life events invest less in their farm, (II) an experience of uncontrollability over income in a priming task increases investment in the farm in a subsequent task if losses in the priming task are small, and decreases investment in the subsequent task if losses are moderate or big, and (III) the relationship between the number of income shocks experienced in the past two years and investment in the farm is more negative among farmers with a more pessimistic attributional style. These results are in line with the reformulated learned helplessness theory underlying this research, which leads this paper to conclude that learned helplessness can cause agricultural underinvestment in a developing country context, potentially contributing to a poverty trap.

Keywords: agricultural investment, attributional style, farmers, learned helplessness, poverty, income shocks

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1904 Postgraduate Supervision Relationship: Practices, Challenges, and Strategies of Stakeholders in the Côte d’Ivoire University System

Authors: Akuélé Radha Kondo, Kathrin Heitz-Tokpa, Bassirou Bonfoh, Francis Akindes

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Postgraduate supervision contributes significantly to a student’s academic career, a supervisor’s promotion, and a university’s reputation. Despite this, the length of graduation in the Côte d’Ivoire University system is beyond the normal duration, two years for a master's and three years for a PhD. The paper analyses supervision practices regarding the challenges and strategies mobilised by students, supervisors, and administration staff to manage various relationships. Using a qualitative research design, this study was conducted at three public universities in Côte d’Ivoire. Data were generated from thirty-two postgraduate students, seventeen supervisors, and four administration staff through semi-structured interviews. Data were analysed using content analysis and presented thematically. Findings revealed delegated supervision and co-supervision, two types of supervision relationship practices. Students pointed out that feedback is often delayed from their supervisors in delegation supervision. However, they acknowledged receiving input and scientific guidance. All students believed that their role is to be proactive, not to wait to receive everything from the supervisor, and need to be more autonomous and hardworking. They developed strategies related to these qualities. Supervisors were considered to guide, give advice, control, motivate, provide critical feedback, and validate the work. The administration was rather absent in monitoring supervision delays. Major challenges were related to the supervision relationships and access to the research funds. The study showed that more engagement of the main supervisor, administration monitoring, and secured funding would reduce the time and increase the completion rate.

Keywords: Côte d’Ivoire, postgraduate supervision, practices, strategies

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1903 Total Organic Carbon, Porosity and Permeability Correlation: A Tool for Carbon Dioxide Storage Potential Evaluation in Irati Formation of the Parana Basin, Brazil

Authors: Richardson M. Abraham-A., Colombo Celso Gaeta Tassinari

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The correlation between Total Organic Carbon (TOC) and flow units have been carried out to predict and compare the carbon dioxide (CO2) storage potential of the shale and carbonate rocks in Irati Formation of the Parana Basin. The equations for permeability (K), reservoir quality index (RQI) and flow zone indicator (FZI) are redefined and engaged to evaluate the flow units in both potential reservoir rocks. Shales show higher values of TOC compared to carbonates, as such,  porosity (Ф) is most likely to be higher in shales compared to carbonates. The increase in Ф corresponds to the increase in K (in both rocks). Nonetheless, at lower values of Ф, K is higher in carbonates compared to shales. This shows that at lower values of TOC in carbonates, Ф is low, yet, K is likely to be high compared to shale. In the same vein, at higher values of TOC in shales, Ф is high, yet, K is expected to be low compared to carbonates.  Overall, the flow unit factors (RQI and FZI) are better in the carbonates compared to the shales. Moreso, within the study location,  there are some portions where the thicknesses of the carbonate units are higher compared to the shale units. Most parts of the carbonate strata in the study location are fractured in situ, hence,  this could provide easy access for the storage of CO2. Therefore, based on these points and the disparities between the flow units in the evaluated rock types, the carbonate units are expected to show better potentials for the storage of CO2. The shale units may be considered as potential cap rocks or seals.

Keywords: total organic content, flow units, carbon dioxide storage, geologic structures

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1902 Synthesis, Characterization and Bioactivity of Methotrexate Conjugated Fluorescent Carbon Nanoparticles in vitro Model System Using Human Lung Carcinoma Cell Lines

Authors: Abdul Matin, Muhammad Ajmal, Uzma Yunus, Noaman-ul Haq, Hafiz M. Shohaib, Ambreen G. Muazzam

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Carbon nanoparticles (CNPs) have unique properties that are useful for the diagnosis and treatment of cancer due to their precise properties like small size (ideal for delivery within the body) stability in solvent and tunable surface chemistry for targeted delivery. Here, highly fluorescent, monodispersed and water-soluble CNPs were synthesized directly from a suitable carbohydrate source (glucose and sucrose) by one-step acid assisted ultrasonic treatment at 35 KHz for 4 hours. This method is green, simple, rapid and economical and can be used for large scale production and applications. The average particle sizes of CNPs are less than 10nm and they emit bright and colorful green-blue fluorescence under the irradiation of UV-light at 365nm. The CNPs were characterized by scanning electron microscopy, fluorescent spectrophotometry, Fourier transform infrared spectrophotometry, ultraviolet-visible spectrophotometry and TGA analysis. Fluorescent CNPs were used as fluorescent probe and nano-carriers for anticancer drug. Functionalized CNPs (with ethylene diamine) were attached with anticancer drug-Methotrexate. In vitro bioactivity and biocompatibility of CNPs-drug conjugates was evaluated by LDH assay and Sulforhodamine B assay using human lung carcinoma cell lines (H157). Our results reveled that CNPs showed biocompatibility and CNPs-anticancer drug conjugates have shown potent cytotoxic effects and high antitumor activities in lung cancer cell lines. CNPs are proved to be excellent substitute for conventional drug delivery cargo systems and anticancer therapeutics in vitro. Our future studies will be more focused on using the same nanoparticles in vivo model system.

Keywords: carbon nanoparticles, carbon nanoparticles-methotrexate conjugates, human lung carcinoma cell lines, lactate dehydrogenase, methotrexate

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1901 Comparative Ethnography and Urban Health: A Multisite Study on Obesogenic Cities

Authors: Carlos Rios Llamas

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Urban health challenges, like the obesity epidemic, need to be studied from a dialogue between different disciplines and geographical conditions. Public health uses quantitative analysis and local samples, but qualitative data and multisite analysis would help to better understand how obesity has become a health problem. In the last decades, obesity rates have increased in most of the countries, especially in the Western World. Concerned about the problem, the American Medical Association has recently voted obesity as a disease. Suddenly, a ‘war on obesity’ attracted scientists from different disciplines to explore various ways to control and even reverse the trends. Medical sciences have taken the advance with quantitative methodologies focused on individual behaviors. Only a few scientist have extended their studies to the environment where obesity is produced as social risk, and less of them have taken into consideration the political and cultural aspects. This paper presents a multisite ethnography in South Bronx, USA, La Courneuve, France, and Lomas del Sur, Mexico, where obesity rates are as relevant as urban degradation. The comparative ethnography offers a possibility to unveil the mechanisms producing health risks from the urban tissue. The analysis considers three main categories: 1) built environment and access to food and physical activity, 2) biocultural construction of the healthy body, 3) urban inequalities related to health and body size. Major findings from a comparative ethnography on obesogenic environments, refer to the anthropological values related to food and body image, as well as the multidimensional oppression expressed in fat people who live in stigmatized urban zones. At the end, obesity, like many other diseases, is the result of political and cultural constructions structured in urbanization processes.

Keywords: comparative ethnography, urban health, obesogenic cities, biopolitics

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1900 Customer’s Choice of a Bank: An Empirical Enquiry from the Banked Ghanaian

Authors: Emmanuel Larbi Offei, Felix Agyei-Sasu, Maura Naa Densua Ashong

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Ghana has 26 universal banks and several banking and non-banking financial institutions operating in the country. The growing number of banks has heightened competition among banks to attract and retain customers more customers to ensure sustainability. Hence the need to identify and understand factors that influences customers’ choice of banks cannot be overemphasised. This study investigates the determinants of bank selection criteria by banking customers in Ghana. Four banks were purposively sampled for this study namely Barclays, Standard Chartered, Sahel Sahara and Unibank. Convenience sampling was then used to select 114 bank customers in Accra and interviewed. Questionnaires were used to collect data that were analysed in tables and charts with the use of STATA software. The findings of the study revealed that quick/prompt services and complaint handling, safety of funds, networked branches, easy access to functional Automated Teller Machines (ATMs) and low/moderate service charges were the major determinants of customers’ choice of banks. The results further show that 89.5 percent of all deposits are held in either current or savings accounts. About 22.1 percent of the respondents indicated that they have plans of changing their banks in the near future because they are not satisfied with their banks. A gender analysis of the choice criteria showed differences between the choice criteria of the male as compared to the female. The study recommends that banks in Ghana should focus on products and policies that will not compromise on the safety of funds of their customers. Again, banks must address customer complaints and dissatisfactions as promptly as possible by taking pragmatic steps to address administrative bureaucracies and infrastructural challenges that prolong the duration of banking transactions.

Keywords: Ghana, banks, determinants, customers’ choice, competition

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1899 The Numerical and Experimental Analysis of Compressed Composite Plate in Asymmetrical Arrangement of Layers

Authors: Katarzyna Falkowicz

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The work focused on the original concept of a thin-walled plate element with a cut-out, for use as a spring or load-bearing element. The subject of the study were rectangular plates with a cut-out with variable geometrical parameters and with a variable angle of fiber arrangement, made of a carbon-epoxy composite with high strength properties in an asymmetrical arrangement, subjected to uniform compression. The influence of geometrical parameters of the cut-out and the angle of fiber arrangement on the value of critical load of the structure and buckling form was investigated. Uniform thin plates are relatively cheap to manufacture, however due to their low bending stiffness; they can carry relatively small loads. The lowest form of loss of plate stability, which is the bending form, leads to its rapid destruction due to high deflection increases, with a slight increase in compressive load - low rigidity of the structure. However, the stiffness characteristics of the structure change significantly when the work of plate is forcing according to the higher flexural-torsional form of buckling. The plate is able to carry a much higher compressive load while maintaining much stiffer work characteristics in the post-critical range. The calculations carried out earlier show that plates with forced higher form of buckling are characterized by stable, progressive paths of post-critical equilibrium, enabling their use as elastic elements. The characteristics of such elements can be designed in a wide range by changing the geometrical parameters of the cut-out, i.e. height and width as well as by changing the angle of fiber arrangement The commercial ABAQUS program using the finite element method was used to develop the discrete model and perform numerical calculations. The obtained results are of significant practical importance in the design of structures with elastic elements, allowing to achieve the required maintenance characteristics of the device.

Keywords: buckling mode, numerical method, unsymmetrical laminates, thin-walled elastic elements

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1898 Addressing Primary Care Clinician Burnout in a Value Based Care Setting During the COVID-19 Pandemic

Authors: Robert E. Kenney, Efrain Antunez, Samuel Nodal, Ameer Malik, Richard B. Aguilar

Abstract:

Physician burnout has gained much attention during the COVID pandemic. After-hours workload, HCC coding, HEDIS metrics, and clinical documentation negatively impact career satisfaction. These and other influences have increased the rate of physicians leaving the workforce. In addition, roughly 1% of the entire physician workforce will be retiring earlier than expected based on pre-pandemic trends. The two Medical Specialties with the highest rates of burnout are Family Medicine and Primary Care. With a predicted shortage of primary care physicians looming, the need to address physician burnout is crucial. Commonly reported issues leading to clinician burnout are clerical documentation requirements, increased time working on Electronic Health Records (EHR) after hours, and a decrease in work-life balance. Clinicians experiencing burnout with physical and emotional exhaustion are at an increased likelihood of providing lower quality and less efficient patient care. This may include a lack of suitable clinical documentation, medication reconciliation, clinical assessment, and treatment plans. While the annual baseline turnover rates of physicians hover around 6-7%, the COVID pandemic profoundly disrupted the delivery of healthcare. A report found that 43% of physicians switched jobs during the initial two years of the COVID pandemic (2020 and 2021), tripling the expected average annual rate to 21.5 %/yr. During this same time, an average of 4% and 1.5% of physicians retired or left the workforce for a non-clinical career, respectively. The report notes that 35.2% made career changes for a better work-life balance and another 35% reported the reason as being unhappy with their administration’s response to the pandemic. A physician-led primary care-focused health organization, Cano Health (CH), based out of Florida, sought to preemptively address this problem by implementing several supportive measures. Working with >120 clinics and >280 PCPs from Miami to Tampa and Orlando, managing nearly 120,000 Medicare Advantage lives, CH implemented a number of changes to assist with the clinician’s workload. Supportive services such as after hour and home visits by APRNs, in-clinic care managers, and patient educators were implemented. In 2021, assistive Artificial Intelligence Software (AIS) was integrated into the EHR platform. This AIS converts free text within PDF files into a usable (copy-paste) format facilitating documentation. The software also systematically and chronologically organizes clinical data, including labs, medical records, consultations, diagnostic images, medications, etc., into an easy-to-use organ system or chronic disease state format. This reduced the excess time and documentation burden required to meet payor and CMS guidelines. A clinician Documentation Support team was employed to improve the billing/coding performance. The effects of these newly designed workflow interventions were measured via analysis of clinician turnover from CH’s hiring and termination reporting software. CH’s annualized average clinician turnover rate in 2020 and 2021 were 17.7% and 12.6%, respectively. This represents a 30% relative reduction in turnover rate compared to the reported national average of 21.5%. Retirement rates during both years were 0.1%, demonstrating a relative reduction of >95% compared to the national average (4%). This model successfully promoted the retention of clinicians in a Value-Based Care setting.

Keywords: clinician burnout, COVID-19, value-based care, burnout, clinician retirement

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1897 Virtual Team Management in Companies and Organizations

Authors: Asghar Zamani, Mostafa Falahmorad

Abstract:

Virtualization is established to combine and use the unique capabilities of employees to increase productivity and agility to provide services regardless of location. Adapting to fast and continuous change and getting maximum access to human resources are reasons why virtualization is happening. The distance problem is solved by information. Flexibility is the most important feature of virtualization, and information will be the main focus of virtualized companies. In this research, we used the Covid-19 opportunity window to assess the productivity of the companies that had been going through more virtualized management before the Covid-19 in comparison with those that just started planning on developing infrastructures on virtual management after the crises of pandemic occurred. The research process includes financial (profitability and customer satisfaction) and behavioral (organizational culture and reluctance to change) metrics assessment. In addition to financial and CRM KPIs, a questionnaire is devised to assess how manager and employees’ attitude has been changing towards the migration to virtualization. The sample companies and questions are selected by asking from experts in the IT industry of Iran. In this article, the conclusion is that companies open to virtualization based on accurate strategic planning or willing to pay to train their employees for virtualization before the pandemic are more agile in adapting to change and moving forward in recession. The prospective companies in this research, not only could compensate for the short period loss from the first shock of the Covid-19, but they could also foresee new needs of their customer sooner than other competitors, resulting in the need to employ new staff for executing the emerging demands. Findings were aligned with the literature review. Results can be a wake-up call for business owners especially in developing countries to be more resilient toward modern management styles instead of continuing with traditional ones.

Keywords: virtual management, virtual organization, competitive advantage, KPI, profit

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1896 Understanding the Notion between Resiliency and Recovery through a Spatial-Temporal Analysis of Section 404 Wetland Alteration Permits before and after Hurricane Ike

Authors: Md Y. Reja, Samuel D. Brody, Wesley E. Highfield, Galen D. Newman

Abstract:

Historically, wetlands in the United States have been lost due to agriculture, anthropogenic activities, and rapid urbanization along the coast. Such losses of wetlands have resulted in high flooding risk for coastal communities over the period of time. In addition, alteration of wetlands via the Section 404 Clean Water Act permits can increase the flooding risk to future hurricane events, as the cumulative impact of this program is poorly understood and under-accounted. Further, recovery after hurricane events is acting as an encouragement for new development and reconstruction activities by converting wetlands under the wetland alteration permitting program. This study investigates the degree to which hurricane recovery activities in coastal communities are undermining the ability of these places to absorb the impacts of future storm events. Specifically, this work explores how and to what extent wetlands are being affected by the federal permitting program post-Hurricane Ike in 2008. Wetland alteration patterns are examined across three counties (Harris, Galveston, and Chambers County) along the Texas Gulf Coast over a 10-year time period, from 2004-2013 (five years before and after Hurricane Ike) by conducting descriptive spatial analyses. Results indicate that after Hurricane Ike, the number of permits substantially increased in Harris and Chambers County. The vast majority of individual and nationwide type permits were issued within the 100-year floodplain, storm surge zones, and areas damaged by Ike flooding, suggesting that recovery after the hurricane is compromising the ecological resiliency on which coastal communities depend. The authors expect that the findings of this study can increase awareness to policy makers and hazard mitigation planners regarding how to manage wetlands during a long-term recovery process to maintain their natural functions for future flood mitigation.

Keywords: ecological resiliency, Hurricane Ike, recovery, Section 404 Permitting, wetland alteration

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1895 Linking the Built Environment, Activities and Well-Being: Examining the Stories among Older Adults during Ageing-in-Place

Authors: Wenquan Gan, Peiyu Zhao, Xinyu Zhao

Abstract:

Under the background of the rapid development of China’s ageing population, ageing-in-place has become a primary strategy to cope with this problem promoted by the Chinese government. However, most older adults currently living in old residential communities are insufficient to support their ageing-in-place. Therefore, exploring how to retrofit existing communities towards ageing-friendly standards to support older adults is essential for healthy ageing. To better cope with this issue, this study aims to shed light on the inter-relationship among the built environment, daily activities, and well-being of older adults in urban China. Using mixed research methods including GPS tracking, structured observation, and in-depth interview to examine: (a) what specific places or facilities are most commonly used by the elderly in the ageing-in-place process; (b) what specific built environment characteristics attract older adults in these frequently used places; (c) how has the use of these spaces impacted the well-being of older adults. Specifically, structured observation and GPS are used to record and map the older residents’ behaviour and movement in Suzhou, China, a city with a highly aged population and suitable as a research case. Subsequently, a follow-up interview is conducted to explore what impact of activities and the built environment on their well-being. Results showed that for the elderly with good functional ability, the facilities promoted by the Chinese government to support ageing-in-place, such as community nursing homes for the aged, day-care centre, and activity centres for the aged, are rarely used by older adults. Additionally, older adults have their preferred activities and built environment characteristics that contribute to their well-being. Our findings indicate that a complex interrelationship between the built environment and activities can influence the well-being of the elderly. Further investigations are needed to understand how to support healthy ageing-in-place, especially in addition to providing permanent elder-ly-care facilities, but to attend to the design interventions that can enhance these particularly built environment characteristics to facilitate a healthy lifestyle in later life.

Keywords: older adults, built environment, spatial behavior, community activity, healthy ageing

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1894 Lighting Consumption Analysis in Retail Industry: Comparative Study

Authors: Elena C. Tamaş, Grațiela M. Țârlea, Gianni Flamaropol, Dragoș Hera

Abstract:

This article is referring to a comparative study regarding the electrical energy consumption for lighting on diverse types of big sizes commercial buildings built in Romania after 2007, having 3, 4, 5 versus 8, 9, 10 operational years. Some buildings have installed building management systems (BMS) to monitor also the lighting performances starting with the opening days till the present days but some have chosen only local meters to implement. Firstly, for each analyzed building, the total required energy power and the energy power consumption for lighting were calculated depending on the lamps number, the unit power and the average daily running hours. All objects and installations were chosen depending on the destination/location of the lighting (exterior parking or access, interior or covering parking, building interior and building perimeter). Secondly, to all lighting objects and installations, mechanical counters were installed, and to the ones linked to BMS there were installed the digital meters as well for a better monitoring. Some efficient solutions are proposed to improve the power consumption, for example the 1/3 lighting functioning for the covered and exterior parking lighting to those buildings if can be done. This type of lighting share can be performed on each level, especially on the night shifts. Another example is to use the dimmers to reduce the light level, depending on the executed work in the respective area, and a 30% power energy saving can be achieved. Using the right BMS to monitor, the energy consumption depending on the average operational daily hours and changing the non-performant unit lights with the ones having LED technology or economical ones might increase significantly the energy performances and reduce the energy consumption of the buildings.

Keywords: commercial buildings, energy performances, lightning consumption, maintenance

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1893 Assessment of Pakistan-China Economic Corridor: An Emerging Dynamic of 21st Century

Authors: Naad-E-Ali Sulehria

Abstract:

Pakistan and china have stepped in a new phase of strengthening fraternity as the dream of economic corridor once discerned by both countries is going to take a pragmatic shape. Pak-China economic corridor an under construction program is termed to be an emerging dynamic of 21st century that anticipates a nexus between Asian continent and Indian Ocean by extending its functions to adjoining East, South, Central and Western Asian regions. The $45.6 billion worth heavily invested megaprojects by China are meant to revive energy sector and building economic infrastructure in Pakistan. Evidently, these projects are a part of ‘southern extension’ of Silk Road economic belt which is going to draw out prominent incentives for both countries particularly bolstering China to acquire influential dominance over the regional trade and beyond. In pursuit to adhere, by these progressive plans both countries have began working on their respective assignments. This article discusses the economical development programs under China’s peripheral diplomacy regarding its region-specific-approach to accumulate trade of Persian Gulf and access the landlocked Central Asian states through Pakistan in a sublimate context to break US encirclement of Asia. Pakistan’s utmost preference to utilize its strategic channel as a trade hub to become an emerging economy and surpass its arch-rival India for strategic concerns is contemplated accordingly. The needs and feasibility of the economic gateway and the dividends it can provide in the contemporary scenario are examined carefully and analysis is drawn upon the future prospects of the Pakistan-China Economic corridor once completed.

Keywords: pak-china economic corridor (PCEC), central asian republic states (CARs), new silk road economic belt, gawadar

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1892 Numerical Analysis of the Response of Thin Flexible Membranes to Free Surface Water Flow

Authors: Mahtab Makaremi Masouleh, Günter Wozniak

Abstract:

This work is part of a major research project concerning the design of a light temporary installable textile flood control structure. The motivation for this work is the great need of applying light structures for the protection of coastal areas from detrimental effects of rapid water runoff. The prime objective of the study is the numerical analysis of the interaction among free surface water flow and slender shaped pliable structures, playing a key role in safety performance of the intended system. First, the behavior of down scale membrane is examined under hydrostatic pressure by the Abaqus explicit solver, which is part of the finite element based commercially available SIMULIA software. Then the procedure to achieve a stable and convergent solution for strongly coupled media including fluids and structures is explained. A partitioned strategy is imposed to make both structures and fluids be discretized and solved with appropriate formulations and solvers. In this regard, finite element method is again selected to analyze the structural domain. Moreover, computational fluid dynamics algorithms are introduced for solutions in flow domains by means of a commercial package of Star CCM+. Likewise, SIMULIA co-simulation engine and an implicit coupling algorithm, which are available communication tools in commercial package of the Star CCM+, enable powerful transmission of data between two applied codes. This approach is discussed for two different cases and compared with available experimental records. In one case, the down scale membrane interacts with open channel flow, where the flow velocity increases with time. The second case illustrates, how the full scale flexible flood barrier behaves when a massive flotsam is accelerated towards it.

Keywords: finite element formulation, finite volume algorithm, fluid-structure interaction, light pliable structure, VOF multiphase model

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1891 Assessment of Environmental Quality of an Urban Setting

Authors: Namrata Khatri

Abstract:

The rapid growth of cities is transforming the urban environment and posing significant challenges for environmental quality. This study examines the urban environment of Belagavi in Karnataka, India, using geostatistical methods to assess the spatial pattern and land use distribution of the city and to evaluate the quality of the urban environment. The study is driven by the necessity to assess the environmental impact of urbanisation. Satellite data was utilised to derive information on land use and land cover. The investigation revealed that land use had changed significantly over time, with a drop in plant cover and an increase in built-up areas. High-resolution satellite data was also utilised to map the city's open areas and gardens. GIS-based research was used to assess public green space accessibility and to identify regions with inadequate waste management practises. The findings revealed that garbage collection and disposal techniques in specific areas of the city needed to be improved. Moreover, the study evaluated the city's thermal environment using Landsat 8 land surface temperature (LST) data. The investigation found that built-up regions had higher LST values than green areas, pointing to the city's urban heat island (UHI) impact. The study's conclusions have far-reaching ramifications for urban planners and politicians in Belgaum and other similar cities. The findings may be utilised to create sustainable urban planning strategies that address the environmental effect of urbanisation while also improving the quality of life for city dwellers. Satellite data and high-resolution satellite pictures were gathered for the study, and remote sensing and GIS tools were utilised to process and analyse the data. Ground truthing surveys were also carried out to confirm the accuracy of the remote sensing and GIS-based data. Overall, this study provides a complete assessment of Belgaum's environmental quality and emphasizes the potential of remote sensing and geographic information systems (GIS) approaches in environmental assessment and management.

Keywords: environmental quality, UEQ, remote sensing, GIS

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1890 Tractography Analysis and the Evolutionary Origin of Schizophrenia

Authors: Mouktafi Amine, Tahiri Asmaa

Abstract:

A substantial number of traditional medical research has been put forward to managing and treating mental disorders. At the present time, to our best knowledge, it is believed that a fundamental understanding of the underlying causes of the majority of psychological disorders needs to be explored further to inform early diagnosis, managing symptoms and treatment. The emerging field of evolutionary psychology is a promising prospect to address the origin of mental disorders, potentially leading to more effective treatments. Schizophrenia as a topical mental disorder has been linked to the evolutionary adaptation of the human brain represented in the brain connectivity and asymmetry directly linked to humans' higher brain cognition in contrast to other primates being our direct living representation of the structure and connectivity of our earliest common African ancestors. As proposed in the evolutionary psychology scientific literature, the pathophysiology of schizophrenia is expressed and directly linked to altered connectivity between the Hippocampal Formation (HF) and Dorsolateral Prefrontal Cortex (DLPFC). This research paper presents the results of the use of tractography analysis using multiple open access Diffusion Weighted Imaging (DWI) datasets of healthy subjects, schizophrenia-affected subjects and primates to illustrate the relevance of the aforementioned brain regions' connectivity and the underlying evolutionary changes in the human brain. Deterministic fiber tracking and streamline analysis were used to generate connectivity matrices from the DWI datasets overlaid to compute distances and highlight disconnectivity patterns in conjunction with other fiber tracking metrics: Fractional Anisotropy (FA), Mean Diffusivity (MD) and Radial Diffusivity (RD).

Keywords: tractography, diffusion weighted imaging, schizophrenia, evolutionary psychology

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1889 Measuring Fragmentation Index of Urban Landscape: A Case Study on Kuala Lumpur City

Authors: Shagufta Tazin Shathy, Mohammad Imam Hasan Reza

Abstract:

Fragmentation due to urbanization and agricultural expansion has become the main reason for destruction of forest area and loss of biodiversity particularly in the developing world. At present, the world is experiencing the largest wave of urban growth in human history, and it is estimated that this influx will be mainly taking place in developing world. Therefore, study on urban fragmentation is vital for a sustainable urban development. Landscape fragmentation is one of the most important conservation issues in the last few decades. Habitat fragmentation due to landscape alteration has caused habitat isolation, destruction in ecosystem pattern and processes. Thus, this research analyses the spatial and temporal extent of urban fragmentation using landscape indices in the Kuala Lumpur (KL) – the capital and most populous city in Malaysia. The objective of this study is to examine the urban fragmentation index in KL city. Fragmentation metrics used in the study are: a) Urban landscape ratio (the ratio of urban landscape area and build up area), b) Infill (development that occurred within urbanized open space), and c) Extension (development of exterior open space). After analyzing all three metrics, these are calculated for the combined urban fragmentation index (UFI). In this combined index, all three metrics are given an equal weight. Land cover/ land use maps of the year 1996 and 2005 have been developed from the Landsat TM 30 m resolution satellite image. The year 1996 is taken as a reference year to analyze the changes. The UFI calculated for the year of 1996 and2005 found that the KL city has undergone rapid landscape changes destructing forest ecosystem adversely. Increasing UFI for the year of 1996 compared to 2005 indicates that the developmental activities have been occupying open spaces and fragmenting natural lands and forest. This index can be implemented in other unplanned and rapidly urbanizing Asian cities for example Dhaka and Delhi to calculate the urban fragmentation rate. The findings from the study will help the stakeholders and urban planners for a sustainable urban management planning in this region.

Keywords: GIS, index, sustainable urban management, urbanization

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1888 Self-Government Health Policy Programs as a Form of Implementation of Public Health Tasks in Poland

Authors: T. Holecki, J. Wozniak-Holecka, K. Sobczyk

Abstract:

Development, implementation, and evaluation of the effects of health policy programs, resulting from the identified health needs and health status of residents, is the own task of all local government units in Poland. This is due to the obligation to provide access to healthcare services to all residents and the implementation of tasks in the field of health promotion based on specific legal acts. Until the end of 2016 local governments financed health policy programs only with their own funds. Currently, there are additional resources available from the public health insurance subsidising up to 80% of health policy programs costs in cities with a population under 5 thousand people and up to 40% in bigger cities. Changes in legal provisions do not translate automatically to increased involvement of local government units in the implementation of public health tasks. The main objective of the study was to assess the actual impact of the new legal regulation on financing local health policy programs on the engagement of local administration in this area of public health activity. To achieve this aim, we analyzed difference in the number of local governments developing and implementing health policy programs before and after the new law came into force. The aim of the study was also to estimate the level of expenditures incurred by self-government units and the National Health Fund to cover the costs of health policy programs. In the first stage of the project, legal acts concerning the subject of research and financial data published by the National Health Fund were analyzed. The material for the second, main stage of the study was the detailed financial data obtained from the National Health Fund and data obtained from local government units. The results present the situation in Poland in territorial terms, divided into 16 voivodships.

Keywords: health care system, health policy programs, local self-governments, public health

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