Search results for: health services

Authors: Wendy Maddison

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This paper describes an Action Research project which was undertaken to inform professional practice in order to develop a newly created Centre for Student Success in the specific context of transnational medical and nursing education in the Middle East. The objectives were to enhance the academic performance, persistence, integration and personal and professional development of a multinational study body, in particular in relation to preclinical medical students, and to establish a comfortable, friendly and student-driven environment within an Irish medical university recently established in Bahrain. Expatriating a new part of itself into a corner of the world and within a context which could be perceived as the antithesis of itself, in particular in terms of traditional cultural and organisational values, the university has had to innovate in the range of services, programmes and other offerings which engages and supports the academic success of medical and nursing students as they “encounter the world in the classroom” in the context of an Arab Islamic culture but within a European institution of transnational education, engaging with a global learning environment locally. The outcomes of the project resulted in the development of a specific student success ‘signature’ for this particular transnational higher education context.

Keywords: transnational higher education, medical education, action research, student success, Middle Eastern context, student persistence in the global-local, student support mechanisms

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Authors: Hayani Anastasia, Junus Widjaja, Anis Nur Widayati

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In Indonesia, schistosomiasis is caused by Schistosoma japonicum with Oncomelania hupensis lindoensis as the intermediate host. Schistosomiasis can infect humans and all species of mammals. In order to achieve schistosomiasis elimination by 2020, schistosomiasis control, including environmental management, has been carried out by multi-sector. A cross-sectional study was conducted in 2018 to evaluate the multi-sectoral schistosomiasis control program. Data were collected by depth interviews of stakeholders, stool surveys, snail surveys, observation, and document reviews. About 53.6% of control programs in the schistosomiasis control roadmap were not achieved. The number of foci area found in 2018 are not significantly different compared to before the control programs. Moreover, the prevalence of schistosomiasis in the human was 0-5.1% and in mammals was the range from 0 to 10%. In order to overcome the problems, a policy about schistosomiasis as a priority program in ministries and agencies other than the Ministry of Health is needed. Innovative health promotion with interactive media also needs to be applied. Also, the schistosomiasis work team needs to be more active with the Agency of Regional Development as the leading sector.

Keywords: evaluation, Indonesia, multi-sector, schistosomiasis

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Authors: Gulnaz Erkomaishvili

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Introduction: There are some of the biggest technological shifts happening in the modern world. The introduction of digital technologies, information, and communication services has given rise to unprecedented global socio-political and economic changes. The role of digital technologies in increasing productivity and national competitiveness is increasing. Today, it is used in almost every area of the economy. E-commerce, organizational process in computerized management, and digital infrastructure's pace of growth is remarkably high and is a key instrument of economic development. Methodology: Different research methods are applied in the presented paper; statistical, analysis, synthesis, induction, deduction, comparison ones. Works by local and foreign scientists, Ministry of Economy and Sustainable Development, as well as various organizations' studies and reports were used as a theoretical basis for research and variety of laws, government decrees and orders, and the publications of the National Statistics Office of Georgia were used as an informational basis. Conclusions: The paper deals with the processes and challenges in Georgia in the digital economy. Access to current resources in Georgia and current processes are described. Digital technology for the development of the required environmental conditions is described, how the Internet and communications are available for the population in the regions of Georgia. The pros and cons of the digital economy development and its impact on the country's economy are analyzed. The main difficulties of implementation of the digital economy in Georgia, government involvement, and future action plans are presented.

Keywords: digital economy, digital technologies, internet, communications, economic policy

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Authors: R. Setino, I. M. Ambe, J. A Badenhorst-Weiss

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The South African government supply chain management system is not adequately implemented in State Owned Enterprises (SOEs). There are weaknesses in the SOEs SCM enablers, strategies and policies. In addition, top management of SOEs still do not see SCM as strategic enough to deserve their attention, and therefore, there is very little support from top management, thus making it even difficult for SCM practitioners to execute their day to day functions, let alone delivering the letter and spirit of the relevant legislations. Supply chain strategies lack buy in from the top, and as a result senior SCM practitioners has not been involved in the corporate strategy. This has resulted in supply chain and corporate strategies being misaligned. Due to service delivery backlog, high level of corruption and continuous strikes across the country for better services it is inevitable that government leaders be more strategic about how South Africa can use SCM as a tool to improve service delivery. Consequently, there is a need to close the gap between the strategic level dealt by top management and the application of operational SCM concepts: the use of SCM concepts and, therefore, supply chain strategies – should be aligned with the corporate and business strategies in order to ensure the achievement of top level business objectives. This paper aims to explore supply chain practices in State Owned Enterprises (SOEs). The paper based on a conceptual review provides the status, trends and development and suggests a framework for aligning supply chain strategies and organizational strategies in an SOE environment.

Keywords: alignment, strategies, state owned enterprises, supply chain management, South Africa

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Authors: Ana Nascimento

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For several reasons and in different countries worldwide, there is an increasing difficulty of the States to finance higher education. However, most societies consider education as a public good, so it should be a State obligation to provide this service to citizens. In Portugal, over the last decades, state has diminished its contribution to public higher education and the public higher education institutions started to look for alternative incoming sources, namely charging student’s taxes and fees, provision of services to companies, production of applied research, search for sponsors, configuring new forms of fundraising. This financial policy can raise some concerns to the scientific and pedagogical autonomy of these institutions as well as concerns in access and equity in higher education. For these reasons and in the scope of a PhD research in the area of Economy of Education, a survey is taking place in all public higher education institutions in the Great Lisbon area that intends to analyze and discuss the policy measures in each institution in the search for external financing. The research aims to understand what these measures are and what implications they might have in the institution’s autonomy as well as in higher education access by students from less favored backgrounds. The research uses a qualitative approach, namely through semi-structured interviews to presidents, directors and rectors of each institution, totalizing 50 interviews. In this paper are discussed some of the results from the interviews made so far that present the subjects opinion about higher education finance, the right to education, the search for fundraising and the possible consequences to the institution’s autonomy as well as some literature on the state of the art.

Keywords: autonomy, finance, higher education, public goods

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Authors: Leyli Khavari, Javad Yousefian

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The aim of this study was to investigate the effect of physical biorhythm cycle on health-related fitness factors. For this purpose, 120 athlete and non-athlete male and female students were selected randomly and based on the level of physical activity divided into athletic and non-athletic groups. The exact date of birth and also when the subjects were in the positive, negative and critical physical biorhythm cycle was determined by calculation software biorhythm. The physical fitness factors tests, including Queens College Step Test, AAHPERD sit-ups; Wells stretch test and hand dynamometer. Students in three stages in positive, negative and critical physical cycle were tested. Data processing using SPSS software and statistical tests ANOVA with repeated measures and student t test was used for dependent. The results of this study showed that changes in physical fitness and physical biorhythm were not affected by changes in the 23-day physical cycle.

Keywords: AAHPERD test, biorhythm, physical cycle, Queens College Step Test

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Authors: Ahmed M. Jihad

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The paper presents the concept of sustainable development, and the role of geographic techniques in the design, planning and presentation of maps of smart cities with geographical vision, and the identification of programs and tools, and models of maps of Arab cities, is the problem of research in how to apply, process and experience these programs? What is the role of geographic techniques in planning and mapping the optimal place for these cities? The paper proposes an addition to the designs of Iraqi cities, as it can be developed in the future to serve as a model for interactive smart cities by developing its services. The importance of this paper stems from the concept of sustainable development dynamic which has become a method of development imposed by the present era in rapid development to achieve social balance and specialized programs in draw paper argues that ensuring sustainable development is achieved through the use of information technology. The paper will follow the theoretical presentation of the importance of the concept of development, design tools and programs. The paper follows the method of analysis of modern systems (System Analysis Approach) through the latest programs will provide results can be said that the new Iraqi cities can be developed with smart technologies, like some of the Arab and European cities that were newly created through the introduction of international investment, and therefore Plans can be made to select the best programs in manufacturing and producing maps and smart cities in the future.

Keywords: geographic techniques, planning the cities, smart cities, sustainable development

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Authors: Umar Shehu Umar

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Contract farming is a viable strategy agribusinesses rely on to strengthen vertical coordination. However, low contract compliance remains a significant setback to agribusinesses' contract performance. The present study aims to understand what drives smallholder farmers’ contract compliance behaviour. Qualitative information was collected through Focus Group Discussions to enrich the design of the survey questionnaire administered on a sample of 300 randomly selected farmers contracted by the Dangote Tomato Processing Plant (DTPP) in four regions of northern Nigeria. Novel transaction level data of tomato sales covering one season were collected in addition to socio-economic information of the sampled farmers. Binary logistic model results revealed that open fresh market tomato prices and payment delays negatively affect farmers' compliance behaviour while quantity harvested, education level and input provision correlated positively with compliance. The study suggests that contract compliance will increase if contracting firms devise a reliable and timely payment plan (e.g., digital payment), continue input and service provisions (e.g., improved seeds, extension services) and incentives (e.g., loyalty rewards, bonuses) in the contract.

Keywords: contract farming, compliance, farmers and processors., smallholder

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Authors: Ivy Jumao-As, Randy Lupango, Clifford Villaflores, Marites Khanser

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Alongside inadequate implementation of ecotourism standards and other pressing issues on sustainable development is the lack of business plans and formal business structures of various ecotourism sites in the Central Visayas, Philippines, and other parts of the country. Addressing these issues plays a key role to boost ecotourism which is a sustainability tool to the country’s economic development. A three-phase research is designed to investigate the green business practices of selected ecotourism sites in the region in order to propose a business model for ecotourism destinations in the region and outside. This paper reports the initial phase of the study which described the sites’ profile as well as operators of the following selected destinations: Cebu City Protected Landscape and Olango Island Wildlife Bird Sanctuary in Cebu, Rajah Sikatuna Protected Landscape in Bohol. Interview, Self-Administered Questionnaire with key informants and Data Mining were employed in the data collection. Findings highlighted similarities and differences in terms of eco-tourism products, type and number of visitors, manpower composition, cultural and natural resources, complementary services and products, awards and accreditation, peak and off peak seasons, among others. Recommendations based from common issues initially identified in this study are also highlighted.

Keywords: ecotourism, ecotourism sites, green business, sustainability

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Authors: Yael Rieder, Yael Gilboa, S. O. Adva, Efrat Halevi, Ronnie Tepper

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Background: Operation of ultrasound equipment is a core skill for many clinical specialties. As part of the training program at -Simultech- a simulation center for Ob\Gyn at the Meir Medical Center, Israel, teaching how to operate ultrasound equipment requires dealing with misunderstandings of spatial and 3D orientation, failure of the operator to hold a transducer correctly, and limited ability to evaluate the data on the screen. We have developed a platform intended to endow physicians and sonographers with clinical and operational skills of obstetric ultrasound. Simultech's simulations are focused on medical knowledge, risk management, technology operations and physician-patient communication. The simulations encompass extreme work conditions. Setup: Between eight and ten of the eight hundred and fifty physicians and sonographers of the Clalit health services from seven hospitals and eight community centers across Israel, participate in individual Ob/Gyn training sessions each week. These include Ob/Gyn specialists, experts, interns, and sonographers. Innovative teaching and training methodologies: The six-hour training program includes: (1) An educational computer program that challenges trainees to deal with medical questions based upon ultrasound pictures and films. (2) Sophisticated hands-on simulators that challenge the trainees to practice correct grip of the transducer, elucidate pathology, and practice daily tasks such as biometric measurements and analysis of sonographic data. (3) Participation in a video-taped simulation which focuses on physician-patient communications. In the simulation, the physician is required to diagnose the clinical condition of a hired actress based on the data she provides and by evaluating the assigned ultrasound films accordingly. Giving ‘bad news’ to the patient may put the physician in a stressful situation that must be properly managed. (4) Feedback at the end of each phase is provided by a designated trainer, not a physician, who is specially qualified by Ob\Gyn senior specialists. (5) A group exercise in which the trainer presents a medico-legal case in order to encourage the participants to use their own experience and knowledge to conduct a productive ‘brainstorming’ session. Medical cases are presented and analyzed by the participants together with the trainer's feedback. Findings: (1) The training methods and content that Simultech provides allows trainees to review their medical and communications skills. (2) Simultech training sessions expose physicians to both basic and new, up-to-date cases, refreshing and expanding the trainee's knowledge. (3) Practicing on advanced simulators enables trainees to understand the sonographic space and to implement the basic principles of ultrasound. (4) Communications simulations were found to be beneficial for trainees who were unaware of their interpersonal skills. The trainer feedback, supported by the recorded simulation, allows the trainee to draw conclusions about his performance. Conclusion: Simultech was found to contribute to physicians at all levels of clinical expertise who deal with ultrasound. A break in daily routine together with attendance at a neutral educational center can vastly improve performance and outlook.

Keywords: medical training, simulations, ultrasound, Simultech

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Authors: Bassem Nassar, Wessam Hussein, Medhat Mokhtar

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The crucial concern of satellite operations is to ensure the health and safety of satellites. The worst case in this perspective is probably the loss of a mission but the more common interruption of satellite functionality can result in compromised mission objectives. All the data acquiring from the spacecraft are known as Telemetry (TM), which contains the wealth information related to the health of all its subsystems. Each single item of information is contained in a telemetry parameter, which represents a time-variant property (i.e. a status or a measurement) to be checked. As a consequence, there is a continuous improvement of TM monitoring systems in order to reduce the time required to respond to changes in a satellite's state of health. A fast conception of the current state of the satellite is thus very important in order to respond to occurring failures. Statistical multivariate latent techniques are one of the vital learning tools that are used to tackle the aforementioned problem coherently. Information extraction from such rich data sources using advanced statistical methodologies is a challenging task due to the massive volume of data. To solve this problem, in this paper, we present a proposed unsupervised learning algorithm based on Principle Component Analysis (PCA) technique. The algorithm is particularly applied on an actual remote sensing spacecraft. Data from the Attitude Determination and Control System (ADCS) was acquired under two operation conditions: normal and faulty states. The models were built and tested under these conditions and the results shows that the algorithm could successfully differentiate between these operations conditions. Furthermore, the algorithm provides competent information in prediction as well as adding more insight and physical interpretation to the ADCS operation.

Keywords: space telemetry monitoring, multivariate analysis, PCA algorithm, space operations

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Authors: Ogbuagu Josephat Okechukwu, Okeke Abuchi Princewill, Arinze Rosemary Uche, Tabugbo Ifeyinwa Blessing, Ogbuagu Adaora Stellamaris

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Phthalates or Phthalate esters (PAEs), categorized as an endocrine disruptor and persistent organic pollutants, are known for their environmental contamination and toxicological effects. In this study, the concentration of selected phthalates was determined across the sampling site to investigate their occurrence and the ecological and health risk assessment they pose to the environment. Water and sediment samples were collected following standard procedures. Solid phase and ultrasonic methods were used to extract seven different PAEs, which were analyzed by Gas Chromatography with Mass Detector (GCMS). The analytical average recovery was found to be within the range of 83.4% ± 2.3%. The results showed that PAEs were detected in six out of seven samples with a high percentage of detection rate in water. Di-n-butyl phthalate (DPB) and disobutyl phthalates (DiBP) showed a greater detection rate compared to other PAE monomers. The concentration of PEs was found to be higher in sediment samples compared to water samples due to the fact that sediments serve as a sink for most persistent organic pollutants. The concentrations of PAEs in water samples and sediments ranged from 0.00 to 0.23 mg/kg and 0.00 to 0.028 mg/l, respectively. Ecological risk assessment using the risk quotient method (RQ) reveals that the estimated environmental risk caused by phthalates lies within the moderate level as RQ ranges from 0.1 to 1.0, whereas the health risk assessment caused by phthalates on estimating the average daily dose reveals that the ingestion of phthalates was found to be approaching permissible limit which can cause serious carcinogenic occurrence in the human system with time due to excess accumulation.

Keywords: phthalates, endocrine disruptor, risk assessment, ecological risk, health risk

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Authors: Ossai Paulinus Edwin

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Cash Management is a broad area having to do with the collection, concentration, and disbursement of cash including measuring the level of liquidity and managing the cash balance and short-Term Investments. Cash Management involves the efficient collection and disbursement of cash and cash equivalents. It also includes management of marketable securities because, in modern Terminology, money comprises marketable securities and actual cash in hand or in a bank. This cash management is concerned with management of cash inflow and cash outflow of a business especially as it concerns a developing nation like Nigeria. The paper throws light on the impact of cashless policy in Nigeria as it was introduced by the Central Bank of Nigeria (CBN) in December 2011 and was kick-started in Lagos in January 2012. Survey research was adopted with the questionnaires as data collection instrument. Responses show that cashless policy if adopted generally shall increase employment opportunities, reduce cash related robbery thereby reducing risk of carrying cash; it shall also reduce cash related corruption and attract more foreign investors to the country. It is expected that the introduction of cashless policy in Nigeria is a step in the right direction as it shall bring about modernization of Nigeria payment system, reduction in the cost of banking services, reduction in high security and safety risk and also curb banking related corruptions.

Keywords: cashless economy, cash management, cashless policy, e-banking, Nigeria

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Authors: Nurullah Ekmekci, Omer Akkaya, Vural Cagliyan

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Increased use of the Internet has resulted in the emergence of a new retail types called online shopping or electronic retail (e-retail). The rapid growth of the Internet has enabled customers to search information about the product and buy these products or services from e-retailers. Although this new form of shopping has grown in a remarkable way because of offering easiness to people, it is not an easy task to capture the success by distinguishing from competitors in this environment which millions of players takes place. For the success, e-retailers should determine the factors which the customers take notice while they are buying from e-retailers. This paper aims to identify the factors that provide preferability for the online shopping websites and the importance levels of these factors. These main criteria which have taken notice are Customer Service Performance (CSP), Website Performance (WSP), Criteria Related to Product (CRP), Ease of Payment (EP), Security/Privacy (SP), Ease of Return (ER), Delivery Service Performance (DSP) and Order Fulfillment Performance (OFP). It has benefited from Analytic Hierarchy Process to determine the priority of the criteria. Based on analysis, Security/Privacy (SP) criteria seems to be most important criterion with 22 % weight. Companies should attach importance to the security and privacy for making their online website more preferable among the online shoppers.

Keywords: AHP (analytical hierarchy process), multi-criteria decision making, online shopping, shopping

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Authors: Ali A. Alshatwi, Vaiyapuri S. Periasamy, Jegan Athinarayanan

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Engineered nanoparticles’ usage rapidly increased in various applications in the last decade due to their unusual properties. However, there is an ever increasing concern to understand their toxicological effect in human health. Particularly, metal and metal oxide nanoparticles have been used in various sectors including biomedical, food and agriculture. But their impact on human health is yet to be fully understood. In this present investigation, we assessed the toxic effect of engineered nanoparticles (ENPs) including Ag, MgO and Co3O4 nanoparticles (NPs) on human mesenchymal stem cells (hMSC) adopting cell viability and cellular morphological changes as tools The results suggested that silver NPs are more toxic than MgO and Co3O4NPs. The ENPs induced cytotoxicity and nuclear morphological changes in hMSC depending on dose. The cell viability decreases with increase in concentration of ENPs. The cellular morphology studies revealed that ENPs damaged the cells. These preliminary findings have implications for the use of these nanoparticles in food industry with systematic regulations.

Keywords: cobalt oxide, human mesenchymal stem cells, MgO, silver

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Authors: Habtamu Fufa, Yemane Berhane

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Child under nutrition has long-term consequences for intellectual ability, economic productivity, reproductive performance and susceptibility to metabolic and cardiovascular disease. The unacceptably high prevalence of malnutrition in young children of the region has not changed much over the last decades, which could make the achievement of the corresponding Millennium Development Goals very unlikely. Despite the well-documented problems of child malnutrition in Sub-Saharan Africa, there is few systematic review of evidences on determinants of child malnutrition in the region. The current available evidence on determinants of child under nutrition in Sub-Saharan Africa is systematically reviewed. The method used in searching relevant literature was using bio medical databases PUBMED, Google scholar and the website of the World Health Organization on nutrition using the following key words: "Determinants “, "Child Malnutrition", and "Sub- Saharan Africa". The search was limited to articles published in and after 1995 up to date. In all the reviewed articles, the data were analyzed using multivariate regression analysis and or odds ratios for significance of determinants in child malnutrition. Synthesis of 40 published articles from various countries of the region is done and noted that household economic status, maternal education, disease, breastfeeding practices, age and sex of a child, birth interval and residential areas were found to be determinants of child under nutrition. Poverty remains the main factor of malnutrition in Sub-Saharan Africa and poor education of parents aggravates the malnutrition through perpetuation of poor nutrition practices. Male children under five years are the most affected ones. Understanding of these determinants of poor nutritional attainment would provide insights in designing interventions for reducing the high levels of child malnutrition in this region. Large-scale multi-sectoral community-based interventions are urgently needed for a sustainable improvement of child nutritional & health status in Sub-Saharan Africa.

Keywords: child malnutrition, determinants, Sub-Saharan Africa, health status

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Authors: Muhammad Awais Kiani, Abdul Basit Kiani, Maryam Kiani

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Synergizing Sales and Marketing for Electronics Engineering with Web Development, explores the dynamic relationship between sales, marketing, and web development within the electronics engineering industry. This study is important for the power of digital platforms to connect with customers. Which increases brand visibility and drives sales. It highlights the need for collaboration between sales and marketing teams, as well as the integration of web development strategies to create seamless user experiences and effective lead generation. Furthermore, It also emphasizes the role of data analytics and customer insights in optimizing sales and marketing efforts in the ever-evolving landscape of electronics engineering. Sales and marketing play a crucial role in driving business growth, and in today's digital landscape, web development has become an integral part of these strategies. Web development enables businesses to create visually appealing and user-friendly websites that effectively showcase their products or services. It allows for the integration of e-commerce functionalities, enabling seamless online transactions. Furthermore, web development helps businesses optimize their online presence through search engine optimization (SEO) techniques, social media integration, and content management systems. This abstract highlights the symbiotic relationship between sales marketing in the electronics industry and web development, emphasizing the importance of a strong online presence in achieving business success.

Keywords: electronics industry, web development, sales, marketing

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Authors: Dieudonne Uwizeye, Reuben Muhayiteto

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Teenage pregnancy is a challenging problem for sustainable development due to restrictions it poses to socioeconomic opportunities for young mothers, their children and families. Being unable to take appropriate economic and social responsibilities, teen mothers get trapped into poverty and become economic burden to their family and country. Besides, teenage pregnancy is also a health problem because children born to very young mothers are vulnerable with greater risk of illnesses and deaths, and teenage mothers are more likely to be exposed to greater risk of maternal mortality and to other health and psychological problems. In Kigali city, in Rwanda, teenage pregnancy rate is currently high and its increase in recent years is worrisome. However, only individual factors influencing the teenage pregnancy tend to be the basis of interventions. It is important to understand the important socioeconomic factors at the household level that are associated with teenage pregnancy to help government, parents, and other stakeholders to appropriately address the problem with sustainable measures. This study analyzed secondary data from the Fifth Rwanda Demographic and Health Survey (RDHS-V 2014-2015) conducted by the National Institute of Statistics of Rwanda (NISR). The aim was to examine household socio-economic factors that are associated with incidence of teenage pregnancies in Kigali city. In addition to descriptive analysis, Pearson’s Chi Square and Binary Logistic Regression were used in the analysis. Findings indicate that marital status and age of household head, number of members in a household, number of rooms used for sleeping, educational level of the household head and household's wealth are significantly associated with teenage pregnancy in Rwanda ( p< 0.05). It was found that teenagers living with parents, those having parents with higher education and those from richer families are less likely to become pregnant. Age of household head was pinpointed as factor to teenage pregnancy, with teenage-headed households being more vulnerable. The findings also revealed that household composition correlates with the probability of teenage pregnancy (p < 0.05) with teenagers from households with less number of members being more vulnerable. Regarding the size of the house, the study suggested that the more rooms available in households, the less incidences of teenage pregnancy are likely to be observed (p < 0.05). However, teenage pregnancy was not significantly associated with physical violence among parents (p = 0.65) and sex of household heads (p = 0.52), except in teen-headed households of which female are predominantly heads. The study concludes that teenage pregnancy remains a serious social, economic and health problem in Rwanda. The study informs government officials, parents and other stakeholders to take interventions and preventive measures through community sex education, policies and strategies to foster effective parental guidance, care and control of young girls through meeting their necessary social and financial needs within households.

Keywords: household socio-economic factors, Rwanda, Rwanda demographic and health survey, teenage pregnancy

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Authors: Hajar Hajmohammadi, Paul Pfeffer, Anna De Simoni, Jim Cole, Chris Griffiths, Sally Hull, Benjamin Heydecker

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Background: There is strong interest in the relationship between short-term air pollution exposure and human health. Most studies in this field focus on serious health effects such as death or hospital admission, but air pollution exposure affects many people with less severe impacts, such as exacerbations of respiratory conditions. A lack of quantitative analysis and inconsistent findings suggest improved methodology is needed to understand these effectsmore fully. Method: We developed a time series regression model to quantify the relationship between daily NOₓ concentration and Asthma exacerbations requiring oral steroids from primary care settings. Explanatory variables include daily NOₓ concentration measurements extracted from 8 available background and roadside monitoring stations in east London and daily ambient temperature extracted for London City Airport, located in east London. Lags of NOx concentrations up to 21 days (3 weeks) were used in the model. The dependent variable was the daily number of oral steroid courses prescribed for GP registered patients with asthma in east London. A mixed distribution model was then fitted to the significant lags of the regression model. Result: Results of the time series modelling showed a significant relationship between NOₓconcentrations on each day and the number of oral steroid courses prescribed in the following three weeks. In addition, the model using only roadside stations performs better than the model with a mixture of roadside and background stations.

Keywords: air pollution, time series modeling, public health, road transport

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Authors: Hanadi Mubarak Al-Mubaraki, Michael Busler

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Innovation is the powerful tools for economic growth and diversification, which lead to smart growth. The objective of this paper is to identify the opportunities and challenges of innovation programs discuss and analyse the implementation of the innovation program in the United States (US) and United Kingdom (UK). To achieve the objectives, the research used a mixed methods approach, quantitative (survey), and qualitative (multi-case study) to examine innovation best practices in developed countries. In addition, the selection of 4 interview case studies of innovation organisations based on the best practices and successful implementation worldwide. The research findings indicated the two challenges such as 1) innovation required business ecosystem support to deliver innovation outcomes such as new product and new services, and 2) foster the climate of innovation &entrepreneurship for economic growth and diversification. Although the two opportunities such as 1) sustainability of the innovation events which lead smart growth, and 2) establish the for fostering the artificial intelligence hub entrepreneurship networking at multi-levels. The research adds value to academicians and practitioners such as government, funded organizations, institutions, and policymakers. The authors aim to conduct future research a comparative study of innovation case studies between developed and developing countries for policy implications worldwide. The Originality of This study contributes to current literature about the innovation best practice in developed and developing countries.

Keywords: economic development, technology transfer, entrepreneurship, innovation program

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Authors: Dhananjoy Dutta

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Field studies in lower Gangetic plains of India reveal that over-abstraction of groundwater for irrigation to paddy leads to a substantial depletion of groundwater over the decades, resulting in negative effects on lowering of the water table, drying up of surface water sources and aquifer pollution with leached-out arsenic. The aggravating arsenic toxicity in drinking water is manifested in health problems and ‘arsenicosis’ of people. A social conflict arises between farmers, who intend to grow paddy for livelihoods, and the groundwater authority, which enacts the ‘Regulation Laws’ by putting a check on the excessive installation of private tube-wells for irrigation. Hence, considering the challenges of resource sustainability, health issues, and food security, the study calls for a paradigm shift in policy from further groundwater development to sustainable water resources management and evaluates some strategies integrating supply and demand side management for mitigating the problems.

Keywords: groundwater, irrigation, paddy farming, water table depletion, arsenic pollution, gangetic plains

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Authors: Moyera Sanganeria

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In the highly competitive landscape of contemporary sports, sportspersons worldwide encounter formidable challenges, often practicing for extensive hours while contending with limited social and physical resources. A growing number of sportspersons globally are sharing their struggles with depression, anxiety, and stress arising from the complex journey and identity associated with being a sportsperson. This qualitative study aims to investigate the challenges faced by sportspersons in individual versus team sports and explore potential gender-based variations in coping strategies. It attempts to do so by recognizing the imperative to comprehend the root causes and coping mechanisms for these stressors. By employing purposive sampling, MMA and Kabaddi players from training academies across Mumbai were selected for the study. Twelve participants were interviewed through semi-structured interviews guided by an interview guide. Reflective thematic analysis was employed to discern diverse stressors and coping strategies. Key stressors encountered by young Indian sportspersons encompass injuries, socio-economic challenges, financial constraints, escalating competition, and performance anxiety. Notably, individuals engaged in team sports tended to adopt emotion-focused coping mechanisms, while those in individual sports leaned more towards problem-focused coping strategies in response to these stressors. There were no prominent gender differences found in coping strategies employed by sportspersons. This study underscores the critical issue of declining mental health among sportspersons in India, emphasizing the necessity for a structured and customized mental health intervention strategy tailored to the unique needs of this population.

Keywords: stressors, coping strategies, sports psychology, sportspersons, mental health

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Authors: Harriet Bothwell, Lowri Evans, Kevin Jones

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Background: The University of Bristol provides all medical students the opportunity to undertake student selected components (SSCs) at multiple stages of the undergraduate programme. SSCs enable students to explore areas of interest that are not necessarily covered by the curriculum. Students are required to produce a written report and most use SSCs as an opportunity to undertake an audit or small research project. In 2013 Swindon Academy, based at the Great Western Hospital, offered eight students the opportunity of a global health SSC which included a two week trip to rural hospital in Uganda. This SSC has since expanded and in 2017 a total of 20 students had the opportunity to undertake small research projects at two hospitals in rural Uganda. 'Tomorrows Doctors' highlights the importance of understanding healthcare from a 'global perspective' and student feedback from previous SSCs suggests that self-assessed knowledge of global health increases as a result of this SSC. Through the most recent version of this SSC students had the opportunity to undertake projects in a wide range of specialties including paediatrics, palliative care, surgery and medical education. Methods: An anonymous online questionnaire was made available to students following the SSC. There was a response rate of 80% representing 16 out of the 20 students. This questionnaire surveyed students’ satisfaction and experience of the SSC including the level of academic, project and spiritual support provided as well as perceived challenges in completing the project and barriers to healthcare delivery in the low resource setting. This survey had multiple open questions allowing the collection of qualitative data. Further qualitative data was collected from the students’ project report. The suggested format included a reflection and all students completed these. All qualitative data underwent thematic analysis. Results: All respondents rated the overall experience of the SSC as 'good' or 'excellent'. Preliminary data suggest that students’ confidence in their knowledge of global health, diagnosis of tropical diseases and management of tropical diseases improved after completing this SSC. Thematic analysis of students' reflection is ongoing but suggests that students gain far more than improved knowledge of tropical diseases. Students reflect positively on having the opportunity to research in a low resource setting and feel that by completing these projects they will be 'useful' to the hospital. Several students reflect the stark contrast to healthcare delivery in the UK and recognise the 'privilege' of having a healthcare system that is free at the point of access. Some students noted the different approaches that clinicians in Uganda had to train in 'taking ownership' of their own learning. Conclusions: Students completing this SSC report increased knowledge of global health and tropical medicine. However, their reflections reveal much broader learning outcomes and demonstrate considerable insight in multiple topics including conducting research in the low resource setting, training and healthcare inequality.

Keywords: global health, medical education, student feedback, undergraduate

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Authors: Marilou P. Angeles

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Seniors are a growing number of population all over the world, and they are getting sick with illnesses like diabetes, high blood, and high cholesterol. It is necessary to see the relationship of their physical illness and its effect on their quality of life. Having chronic illnesses also can affect the mood of the elderly; becoming cranky, lonely, not eating, etc. Therefore, there is a need to study the relationship of the quality of life of the elderly and the level of depression. Depression for elderly is known as late onset depression or vascular depression since it is tied to the vascular illnesses they are experiencing, although this is not homogeneous. There is heterogeneity in seniors. The purpose of the study is to determine how keep the satisfaction in life i.e., quality of life of seniors, as long as possible. This study was made in 4 barangays in Longos, Potrero, Tonsuya and Catmon, in Malabon, Metro Manila, Philippines. These Filipino seniors are availing of free medicines for their diabetes, high blood, and high cholesterol ailments in the barangay health centers, given freely by the Department of Health. Two instruments were used; quality of life (CASP-19) and patient health questionnaire(PHQ-19). The quality of life questionnaire was based on the theory of Abraham Maslow, human: beings are motivated to action by needs, starting from the lowest, physiological to the highest self-transcendence. Severity of depression is determined by PHQ-9, and according to the unified model of depression by Aaron Beck and Kurt B. Bredemeier, depression happens when a person cannot cope with life has not able to satisfy his needs as a person. The Pearson R correlation was used to determine the significance of the relationship between quality of life and depression. Finding is there is negative relationship between quality of life and depression. It means that a high value of quality of life lowers or minimizes depression. CASP-19 found that the Filipino elderly were in control, independent, enjoying their lives even if they are poor, and this is shown by the significant results. Self-transcendence, a need to give back to others, is important for Filipino elderly. Although the seniors have difficulty with money and they were affected by their illnesses, they are full of optimism, they are ignoring their physical pain because they are focusing on helping their loved ones (i.e., self-transcendence), their children and grandchildrenothers, and if problems come, they are resilient accepting of the challenges, because they have strong faith in God. They are also having pleasures interacting with their friends and neighbors who, like them, have the same health problems. And these two coping strategies for the elderlies allow them to live a meaningful life, a life high in quality. Thus, where there is high quality of life, there is none or minimal depression. Recommendation for future study is finding the relationship of spirituality to quality of life of seniors.

Keywords: CASP-19, depression, quality of life, PHQ-9, senior citizen

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Authors: Arowosafe Folusade Catherine, Arowosafe Olubunmi, Aina Samson

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In many countries, tourism has been portrayed as a contributor to small-scale enterprises, contributing to improved standards of living, a catalyst for community development, and poverty alleviation. This study assessed the willingness of the host communities to provide homestay accommodation and also identified the homestay facilities available to host visitors to the community. A random sampling method was used to administer 150 copies of the questionnaire to the residents in Idanre. Data collected were subjected to descriptive and inferential statistical analysis, and results were presented using frequency and percentage tables. Results: Findings revealed that the majority of the residents were above 60 years (47.3%), with 33% of them aware of the concept of homestay accommodation, and 32% had primary education. The majority were self-employed (43.3%), earning less than ₦30,000 per month; it also revealed that 80.7% of the residents owned at least one house and had adequate water supply facility (100%) and electricity (99.3%). Some constraints observed revealed that safety for the host family (mean 4.81) was ranked high as a possible deterrent to providing homestay accommodation to strangers. Results revealed a correlation between the resident’s awareness and willingness to provide homestay accommodation services (r.0.05, p<0.05). This study recommends that sensitization programs to create awareness of the potential benefits of homestay accommodation in the host communities of Idanre Hills should be carried out by the relevant stakeholders.

Keywords: accommodation, benefits, homestay, Idanre Hills

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Authors: Kelsey Kimball

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Generalized anxiety disorder (GAD) is a common mental health illness affecting approximately 10% of the perinatal population. Research examining cognitive behavioral therapy in this population has only recently become more prevalent though exploring this subject is long overdue. This research examines the impact of cognitive behavioral therapy (CBT) on GAD during the perinatal period. The aim of this project was to identify the most effective way to manage GAD during the perinatal period to provide clinicians with evidence-based methods of caring for this population’s mental health. The research was conducted using several databases to identify ten primary research articles involving anxiety management. A critique and a systematic review of the literature was done. The results of the systematic literature review suggested that CBT had a significant positive impact on perinatal anxiety. Three main themes were derived from the literature: CBT for managing GAD in the general population, CBT for managing GAD in the perinatal population, and CBT’s effect on worry and problematic behaviors in both populations. Nurse practitioners are central in improving access to and treatment of perinatal anxiety disorders.

Keywords: anxiety, cognitive behavioral therapy, nurse practitioner, perinatal

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Authors: Klaudia Gołębiowska

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This article analyzes the actions of Poland's ruling party facing two refugee crises. These crises emerged almost one after the other within a few months. The first concerned irregular migrants from various countries, including the Middle East, seeking to cross the Polish border from the territory of Belarus. The second was caused by Russia's full-scale invasion of Ukraine. I aim to show the evolution of the discourse and law towards immigrants and refugees by the party Prawo i Sprawiedliwość (PiS, ang. Law and Justice), which has been in power in Poland since 2015. The authorities, in power since 2015, have radically changed its anti-immigrant discourse towards the exodus of civilians from Ukraine. Research questions are the following: What were the roots of the refugee crises in Poland in 2021 and 2022? What legal or illegal measures were taken in Poland to deal with the refugee crises? The methods of qualitative source analysis and process tracing. From the first days of the war in Ukraine, not only was aid organised for Ukrainians, but they were also given access to public services and education. All refugees were granted temporary international protection. At the same time, the basic physiological needs of those on the Polish-Belarusian border were ignored. Moreover, illegal pushbacks were used against those coming mainly from the Middle East, pushing them into the territory of Belarus, where they were often subjected to torture and inhumane treatment. The Polish government justified such treatment on the grounds that these people were part of a 'hybrid war' waged by Russia and Belarus using migrants. Only Ukrainians were treated as 'real' refugees in the analyzed crises at the Polish borders.

Keywords: refugee, irregular migrants, hybrid war, migrants

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Authors: Paul Narh Doku

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The relationship between parental HIV/AIDS status or death and child mental health is well known, although the role of child maltreatment as a confounder or mediator in this relationship remains uncertain. This study examined the potential path mechanism through child maltreatment mediating the link between HIV/AIDS family dysfunction trajectories and psychosocial problems. A cross-sectional survey was conducted in the Lower Manya Municipal Assembly of Ghana. A questionnaire which consisted of the Strengths and Difficulties Questionnaire (SDQ), Social and Health Assessment (SAHA), Rosenberg Self-Esteem Scale (RSES), and the Conflict Tactics Scale (CTS) was completed by 291 adolescents. Controlling for relevant sociodemographic confounders, mediation analyses using linear regression were fitted to examine whether the association between family dysfunction and psychosocial problems is mediated by child maltreatment. The results indicate that, among adolescents, child maltreatment fully mediated the association between being orphaned by AIDS and self-esteem, delinquency and risky behaviours, and peer problems. Similarly, child maltreatment fully mediated the association between living with an HIV/AIDS-infected parent and self-esteem, delinquency and risky behaviours, depression/emotional problems, and peer problems. Partial mediation was found for hyperactivity. Child maltreatment mediates the association between the family dysfunction trajectories of parental HIV/AIDS or death and psychosocial problems among adolescents. This implies that efforts to address child maltreatment among families affected by HIV/AIDS may be helpful in the prevention of psychosocial problems among these children, thus enhancing their well-being. The findings, therefore, underscore the need for comprehensive psychosocial interventions that address both the unique negative exposures of HIV/AIDS and maltreatment for children affected by HIV.

Keywords: child maltreatment, child abuse, mental health, psychosocial problems, domestic violence, HIV/AIDS, adolescents

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Authors: Daniel Francis, Mo Yassin

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Transverse patella fractures are routinely fixed using tension band wiring (TBW) using Kirschner wires and a wire in the shape of a figure of 8. The idea of the study was to compare the outcomes of the traditional technique against the more recently used cannulated screws and fiber tape in the shape of a figure of 8. We performed a retrospective cohort study of all the surgically fixed patella fractures from the year 2019 to 2022. The patients were divided into two groups TBW group and cannulated screws group. The primary outcome measure was the failure of fixation and the need for the removal of metalwork. Twenty-six patellar fractures were studied. TBW was used in 14 (53.8%), and cannulated screws were used for fixation in 12 (46.2%). There was one incident of metalwork failure in the TBW and one incident in the cannulated screws group. Five (35.7%) of patients in the TBW needed symptomatic metal work removed and One (8.3%) in the cannulated screw group. In both groups, the rate of fixation failure was low. Symptomatic implants, the most common complication observed, were higher in the TBW group in our practice. Although the small numbers in both groups, the hope of this study is to shine the light on the use of cannulated screws for patella fractures as it would reduce the need for a second operation and reduce the load on the already stretched services as well as improving the patient experience by not requiring further surgery. Although this is not a brand-new technique, it is not commonly used as there have not yet been any studies that demonstrate the lower rates of second surgery needed.

Keywords: patella, tension band wiring, randomised, new technique

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Authors: Andres Portocarrero Bonifaz, Caterina Sandra Camarena Rodriguez, Ricardo Palma Esparza, Nicolas Antonio Romero Carlos

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Reference levels for common X-rays procedures have been set in many protocols. In Peru, during quality control tests, the dose tolerance is set by these international recommendations. Nevertheless, further studies can be made to assess the national reality and relate dose levels with different parameters such as kV, mA/mAs, exposure time, type of processing (digital, digitalized or conventional), etc. In this paper three radiologic procedures were taken into account for study, general X-rays (fixed and mobile), intraoral X-rays (fixed, mobile and portable) and mammography. For this purpose, an Unfors Xi detector was used; the dose was measured at a focus - detector distance which varied depending on the procedure, and was corrected afterward to find the surface entry dose. The data used in this paper was gathered over a period of over 3 years (2015-2018). In addition, each X-ray machine was taken into consideration only once. The results hope to achieve a new standard which reflects the local practice, and address the issues of the ‘Bonn Call for Action’ in Peru. For this purpose, the 75% percentile of the dose of each radiologic procedure was calculated. In future quality control services, those machines with dose values higher than the selected threshold should be informed that they surpass the reference dose levels established in comparison other radiological centers in the country.

Keywords: general X-rays, intraoral X-rays, mammography, reference dose levels

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