Search results for: COBIT 2019

Authors: Nada Alqadri, Omaima Nasir

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Natural compounds are an important source of potential inhibitors; they have a lot of pharma potential with less adverse effects. The effective antiviral activities of natural products have been proved in different studies. The outbreak of COVID-19 in Wuhan, Hubei, in December 2019, coronavirus has had a significant impact on people's health and lives. Based on previous studies, natural products can be introduced as preventive and therapeutic agents in the fight against COVID-19; considering that no food or supplement has been authorized to prevent COVID-19, individuals continue to search for and consume specific herbs, foods, and commercial supplements for this purpose. This study will be aimed to estimate the uses of herbal and natural products during the COVID-19 infection to determine their usage reasons and evaluate their potential side effects. An online cross-sectional survey of different participants will be conducted and will be a focus on respondents’ chronic disease histories, socio-dmographic characteristics, and frequency and trends of using these products. Descriptive and univariate analyses will be performed to determine prevalence and associations between various products used and respondents’ socio-demographic data. Relationships will be tested using Pearson’s chi-square test or an exact probability test. Our main findings will give evidence of beneficial uses of natural products and herbal medicine as prophylactic and will be a vigorous approach to stop or at least slow down COVID-19 infection and transmission. This will be of great interest of public health, and the results of our study will lend health officials better control on the current pandemic.

Keywords: COVID-19, herbs, natural products, saudi arabia

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Authors: Mohammad Akbar Paiman, Yasmin Nadeem Parpio, Naureen Akbarali, Khwaja Mir Islam Saeed, Murad Moosa Khan

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Background: Gender-based violence (GBV) is widely considered a significant public health problem that is associated with acute morbidity and mortality. GBV is commonly understood as a physical, sexual, and mental assault from intimate partners, sexual violence by non-partners, sexual assault of girls, and acts like trafficking women for sex. Objective: This study aimed to determine the factors associated with injuries and trauma among victims of GBV in Afghanistan. Method: We conducted a record-based analysis of the data collected by the Gender Department of the Family Protection Centre nationally between November 2013 and October 2019. Cross-tabulation between different variables such as age, sex, marital status, and type of violence and associations between different types of violence, age, gender, and geographical location was determined using the logistic regression model. Results: During the study period, there were a total of 58,160 GBV in Afghanistan. Most of the victims were women 98% with over three-quarters being adults 78%. Most of the victims were married 76%, followed by single 14%, widowed 5%, and engaged 5%. Over three-quarters of the violence, 73% was observed in the victim’s house while nearly one-quarter of the violence 24 % occurred in the perpetrator’s house. Conclusions: GBV is a significant public health problem in Afghanistan that needs to be addressed at multiple levels including policy, state, and community as well as by raising public awareness and education and a strong code of conduct against GBV by all stakeholders.

Keywords: gender-based violence, physical and psychological violence, injuries, Afghanistan

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Authors: Janis Zarins, Kristaps Blums, Oskars Radzins, Renars Deksnis, Atis Svare, Santa Salaka

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Wide tumor resection remains the first choice method for tumors of the oral cavity. Nevertheless, remained tissue defect impacts patients functional and aesthetical outcome, which could be improved using microvascular tissue transfers. Mandibular reconstruction is challenging due to the complexity of composite tissue defects and occlusal relationships for normal eating, chewing, and pain free jaw motions. Individual 3-D virtual planning would provide better symmetry and functional outcome. The main goal of preoperative planning is to develop a customized surgical approach with patient specific cutting guides of the mandible, osteotomy guides of the fibula, pre-bended osteosynthesis plates to perform more precise reconstruction, to decrease the surgery time and reach the best outcome. Our study is based on the analysis of 32 patients operated on between 2019 to 2021. All patients underwent mandible reconstruction with vascularized fibula flaps. Patients characteristics, surgery profile, survival, functional outcome, and quality of life was evaluated. Preoperative planning provided a significant decrease of surgery time and the best arrangement of bone closely similar as before the surgery. In cases of bone asymmetry, deformity and malposition, a new mandible was created using 3D planning to restore the appearance of lower jaw anatomy and functionality.

Keywords: mandibular, 3D planning, cutting guides, fibula flap, reconstruction

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Authors: Arnold Sanda Layuk

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Fraud in the disclosure of financial statements by management shows that agency conflict is an important issue in the company. The conflict has consequences for the agency costs that must be borne and has an impact on the firm's performance. The effect of agency costs on firm performance is investigated in this study, as well as whether several variables such as corporate governance mechanisms can positively moderate the agency cost and firm performance relationship. The agency cost is measured by the asset utilization ratio and discretionary expenditure ratio. The firm's performance is represented by the return on equity. Data was collected from the manufacturing companies listed on the Indonesia Stock Exchange from 2015 to 2019, then regressed on the panel data using the panel corrected standard error model (PCSE). According to the findings, agency costs are negatively related to firm performance, which supports previous empirical research findings. It also found that the agency cost and firm performance relationship is significantly moderated by board size and ownership concentration as the representatives of corporate governance mechanisms. It suggests that corporate governance can become tools to reduce agency costs and increase firm performance as well. The empirical evidence adds to previous research on agency conflict, particularly in emerging markets. These findings are expected to supplement previous research and provide additional information to shareholders in order to control opportunistic management decisions that affect their investments and discretionary operational expenses.

Keywords: agency cost, corporate governance, asset utilization ratio, firm performance

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Authors: Sana El Adlani, Yassir Ait Ben Kaddour, Abdelhafid Benksim, Abderraouf Soummani, Mohamed Cherkaoui

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Background: Infertility in all countries of the word is on an increase, it’s why the World Health Organization included an investigation into young people's fertility. In this sense, it’s important to increase efforts to improve the knowledge about fertility for the young population. The aim of this study is to describe the difference between knowledge and attitude of medical and non-medical Moroccan young people. Materials and Methods: 100 medical Moroccan students (group 1) participated in the study, between 18 and 30 years, by a simple random sampling method, during 2020 and using a previously validated questionnaire. The answers were confronted to the result of our same study among 355 non-medical Moroccan young people (group 2) in 2019. Statistical analyses were performed using Statistical Package for the Social Sciences (version 10). Result: Medical students had a significantly higher level of knowledge about infertility than non-medical young people. However, both groups were aware of the impact of lifestyle on infertility. The knowledge state of the first group about infertility management was higher than the second group. Moreover, all non-medical Moroccan young people believed that it is easier to conceive if the couples had already their first baby, whereas, among medical students, only 53% had confirmed this belief. The results showed that 65% of medical students had proposed to try fertility treatments more than one time if treatment fails. Besides, the first advice of the second group was polygamy and adoption. Conclusion: Following the result of our study, the investigation of young people is the measure to optimize reproductive health. So, it’s crucial that the government increase efforts to improve the knowledge about infertility not only for medical universities but for all scholar programs.

Keywords: attitude, infertility, knowledge, medical, non-medical, young people

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Authors: Pranab Kumar Goswami

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According to WHO, over 1000 million people worldwide are employed in small-scale industries. The ‘garment’ industry’ is one such industry in developing countries. These garment SMEs are mostly run by private establishments in the unorganized sector to avoid legal obligations of OSH provisions. The OSH standards are very poor and even basic health and safety provisions are not provided in such units. The study has been conducted in India among workers employed in the ‘garment’ industry with the objectives to analyze the types and extent of occupational health hazards of the garment workers and to assess the relationship of sociodemographic and occupational factors with various health hazards. The survey method, the tabular method followed by applying simple statistical technique, has been taken into account to analyze the data collected from three SME garment industries in Delhi (India-Asia). The study was conducted in Delhi from August-2019 to October-2020. A random sampling of 70 workers from three factories has been chosen for this study. The study shows that most of the workers were males (82%) and were in the 18-50 age group (78%), with none below 18 years of age. It was found that 26% of the workers were illiterate and most of them belonged to poor socioeconomic status. The study revealed that the nature of the hazards in garment industries in India is mostly physical and mechanical. We found that musculoskeletal problems (54%) were the commonest health problem. The body areas commonly affected were neck, low back, hand, wrist, finger, and shoulder. If garment workers’ health is affected by occupational hazards, it will impact on national health and economic growth of developing countries. Health is a joint responsibility of both government and employing authority.

Keywords: garment, MSD, health hazard, social factor

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Authors: Abbas Sedighinejad, Hossein Khoshrang, Mohammad Haghighi, Ali Ashraf, Mostafa Saeedinia, Gelareh Biazar, Zahra Atrkarroushan, Mahdi Ajdadi

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Background: Coronavirus disease 2019 (COVID-19) as an alarming attack broke out in China and spread rapidly worldwide. Objectives: Based on a theory indicating the correlation between some viral diseases and blood types, we investigated the relationship between blood groups and coronavirus infection risk in Guilan Province, Iran. Methods: Retrospectively, all the files of the admitted patients with suspected COVID-19, in peak conditions of the disease between March 1 and May 30, 2020, were reviewed using the Census method. The required data, including epidemiological and clinical information and outcomes, were obtained from electronic records. Results: A total of 249 cases were analyzed, of whom 109 were collected from governmental centers, and the rest were collected from private hospitals. The most common co-morbidity was diabetes with 71 (37.6%) cases and the main symptom at the admission time was dyspnea with 170 (24.5%) cases. Of the total patients, 155 (62.2%) were discharged, and the rest died. The most common blood group among our patients was O Rh-positive with 91 (36.5%) cases. No meaningful correlation was found between outcomes and blood groups in terms of ABO types (P = 0.89) or Rh factor (P = 0.456). The Rh-positive proportion was significantly higher in the COVID-19 cases than in the general population (P = 0.038). Conclusions: We found that the Rh-positive proportion was significantly higher in the COVID-19 cases than in the healthy individuals. However, no correlation was observed between the groups regarding ABO typing.

Keywords: ABO blood group, COVID 19, association, personal protection

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Authors: Ankush Verma, Rohit Bishist

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The present investigation was carried out at different locations of Shimla and Kinnaur district and nutrient analysis was done in the laboratory of Department of Silviculture and Agroforestry, Dr. Y.S. Parmar University of Horticulture and Forestry, Nauni, Distt. Solan, Himachal Pradesh during 2019-2020 with the objectives to study the seasonal variation in the nutritive value of different Quercus species and to study the farmers’ preference rating of fodder tress species. From each location leaf samples were collected at 3 months interval from each Quercus spp. The findings of the present study revealed that the nutritional traits of leaves of different Quercus species varied among different seasons throughout the year. The dry matter (61.12 to 64.99%), ether extract (4.07 to 4.42%), crude fibre (34.38 to 37.85%), neutral detergent fibre (57.70 to 61.54%), acid detergent fibre (44.64 to 48.51%), total ash (3.57 to 3.91%), acid insoluble ash (44.64 to 48.51%) and calcium (1.31 to 1.53%) increased with the maturity in the leaves of different Quercus species. While, crude protein (9.10 to 10.61%), nitrogen free extract (44.73 to 47.41%), organic matter (96.09 to 96.43%), and phosphorus (0.16 to 0.31%) decreased with the advancing maturity in the leaves of different Quercus species. Maximum mean values for dry matter (65.05%), ether extract (4.45%), crude fibre (40.82%), neutral detergent fibre (61.48%), acid detergent fibre (48.44%), and organic matter (96.67%) among different Quercus species were recorded in Quercus ilex, while, Maximum mean values for crude protein (10.54%), nitrogen free extract (50.53%), total ash (4.05%), acid insoluble ash (0.59%), calcium (1.61%) and phosphorus (0.40%) were recorded in Quercus leucotrichophora.

Keywords: nutritional evaluation, fodder species, crude protein, carbohydrates

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Authors: Ilma Ulfatul Janah, Ibnu Rizky Briwantara, Muhammad Afif

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The agricultural sector is one of the sectors that contribute to national development. The benefit of the agricultural sector can be felt directly by the majority of Indonesian people. Indonesia is one of the agricultural countries and most of the people working in the agricultural sector. Hence, the agricultural sector’s become the second sector which has contributed greatly to the growth of Gross Domestic Product (GDP) after the manufacture sector. Based on the National Medium Term Development Plan (RPJMN) from 2015 to 2019, one of the targets to be achieved by the Indonesian government is rice’s self-sufficient. Rice is the main food commodities which as most people in Indonesia, and it is making Indonesian government attempt self-sufficient in rice. Indonesia as an agricultural country becomes one of the countries that have a lower percentage of food security than other ASEAN countries. Rice self-sufficiency can be created through agricultural productivity and the availability of a market for the output. There are some problems still to be faced by the farmers such as farmer exchange rate is low. The low exchange rate of farmers showed that the level of the welfare’s Indonesian farmers is still low. The aims of this paper are to resolve problems related to food security and improve the welfare of the national rice farmers. The method by using materials obtained from the analysis of secondary data with the descriptive approach and conceptual framework. Integrated Farmers barn raising rice production is integrated and managed by the government coupled with the implementation of technology in the form of systems connected and accessible to farmers, namely 'SIBUNGTAN'.

Keywords: agriculture, self-sufficiency, technology, productivity

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Authors: Okpanachi Linus Odiji, Chris Ogwu Attah

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Election is no doubt widely assumed as one of the most suitable means of resolving political quagmires even though it has never been bereft of conflict which can manifest before, during, or after polls. What, however, advances democracy and promotes electoral integrity is the existence and effectiveness of institutional frameworks for electoral conflict management. Electoral conflicts are no doubt unique in the sense that they represent the struggles of people over the control of public resources. In most cases, the stakes involved are high and emotional that they do not only undermine inter-group relationship but also threaten national security. The need, therefore, for an effectively functional conflict management apparatus becomes imperative. While at the State level, there exist numerous governmental initiatives at various electoral stages aimed at managing conflicts, this paper examines the activities of the mass media, which is another prominent stakeholder in the electoral process. Even though media influence has increased tremendously in the last decade, researchers are yet to agree on its utility in the management of conflicts. Guided by the social responsibility theory of media reporting and drawing data from observed trends in Kogi state, the paper, which context analyses the 2019 gubernatorial election coverage in the state, observes both conflict escalation and de-escalation roles in the media. To mitigate conflict reporting misrepresentation, therefore, a common approach to conflict reporting should be designed and ordered by the National Broadcasting Commission as well as the Nigerian Press Council. This should be garnished with the training of journalists on conflict reporting and development of a standard conflict reporting procedure.

Keywords: conflict management, electoral conflict, mass media, media reporting

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Authors: Anthony Townsend, Robyn Fasser

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While complete objectivity is a desirable scientific position from which to conduct a care and contact evaluation (CCE), it is precisely the recognition that we are inherently incapable of operating objectively that is the foundation of ethical practice and skilled assessment. Drawing upon recent research from Daniel Kahneman (2021) on the differences between noise and bias, as well as different inherent biases collectively termed “The Elephant in the Brain” by Kevin Simler and Robin Hanson (2019) from Oxford University, this presentation addresses both the various ways in which our judgments, perceptions and even procedures can be distorted and contaminated while conducting a CCE, but also considers the value of second order cybernetics and the psychodynamic concept of ‘ambivalence’ as a conceptual basis to inform our assessment methodologies to limit such errors or at least better identify them. Both a conceptual framework for ambivalence, our higher-order capacity to allow for the convergence and consideration of multiple emotional experiences and cognitive perceptions to inform our reasoning, and a practical methodology for assessment relying on data triangulation, Bayesian inference and hypothesis testing is presented as a means of promoting ethical practice for health care professionals conducting CCEs. An emphasis on widening awareness and perspective, limiting ‘splitting’, is demonstrated both in how this form of emotional processing plays out in alienating dynamics in families as well as the assessment thereof. In addressing this concept, this presentation aims to illuminate the value of ambivalence as foundational to ethical practice for assessors.

Keywords: ambivalence, forensic, psychology, noise, bias, ethics

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Authors: Laila Al-Balushi, Suad Al-Kharosui

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

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

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Authors: Xiaofang Wei

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Harmful Algal Blooms are a recurrent disturbing occurrence in Lake Erie that has caused significant negative impacts on water quality and aquatic ecosystem around Great Lakes areas in the United States. Targeting the recent HAB events in western Lake Erie, this paper utilizes satellite imagery and hydrological modeling to monitor HAB cyanobacteria blooms and analyze the impacts of agricultural activities from Maumee watershed, the biggest watershed of Lake Erie and agriculture dominant.SWAT (Soil & Water Assessment Tool) Model for Maumee watershed was established with DEM, land use data, crop data layer, soil data, and weather data, and calibrated with Maumee River gauge stations data for streamflow and nutrients. Fast Line-of-sight Atmospheric Analysis of Hypercubes (FLAASH) was applied to remove atmospheric attenuation and cyanobacteria Indices were calculated from Landsat OLI imagery to study the intensity of HAB events in the years 2015, 2017, and 2019. The agricultural practice and nutrients management within the Maumee watershed was studied and correlated with HAB cyanobacteria indices to study the relationship between HAB intensity and nutrient loadings. This study demonstrates that hydrological models and satellite imagery are effective tools in HAB monitoring and modeling in rivers and lakes.

Keywords: harmful algal bloom, landsat OLI imagery, SWAT, HAB cyanobacteria

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Authors: Yun Ma, Jiajun Lu

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President Xi Jinping has clearly stated the need to more effectively advance the process of urbanization centered on people, striving to shape cities into spaces that are healthier, safer, and more livable. However, during the development and construction of mountainous cities, numerous uncertain disruptive factors have emerged, one after another, posing severe challenges to the city's overall development. Therefore, building resilient cities and creating high-quality urban ecosystems and safety systems have become the core and crux of achieving sustainable urban development. This paper takes the central urban area of Chongqing as the research object and establishes an urban resilience assessment indicator system from four dimensions: society, economy, ecology, and infrastructure. It employs the entropy weight method and TOPSIS model to assess the urban resilience level of the central urban area of Chongqing from 2019 to 2022. The results indicate that i. the resilience level of the central urban area of Chongqing is unevenly distributed, showing a spatial pattern of "high in the middle and low around"; it also demonstrates differentiation across different dimensions; ii. due to the impact of the COVID-19 pandemic, the overall resilience level of the central urban area of Chongqing has declined significantly, with low recovery capacity and slow improvement in urban resilience. Finally, based on the four selected dimensions, this paper proposes optimization strategies for urban resilience in mountainous cities, providing a basis for Chongqing to build a safe and livable new city.

Keywords: mountainous urban areas, central urban area of Chongqing, entropy weight method, TOPSIS model, ArcGIS

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Authors: Mershack O. Tetteh, Albert P. C. Chan, Amos Darko, Gabriel Nani

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International construction joint ventures (ICJVs) have evolved as an effective approach to sustainable development, given their myriad socio-economic and environmental benefits. Yet, they are not free of barriers and risks. In many studies, it is termed as risks for convenience’s sake. While the barriers and risks continue to affect the success of ICJVs, a systematic and reliable approach for managing them has yet to be developed. This study aims to identify and classify the barriers and risks factors affecting ICJVs through a systematic literature review. Based on a critical review of 54 papers published in peer-reviewed journals from 1990 to 2019, a conceptual framework was proposed for managing the barriers and risks in ICJV operations. The review showed that the barriers can be grouped into six including inter-organizational differences, lack of expertise and confidence, lack of effective planning and strategies, lack of knowledge of ICJV’s fundamentals, conflicts among ICJV entities, and management difficulties. The risks were also categorized into six: policy and political risks, legal risks, financial risks, management risks, project and technical risks, and market risks. The developed model would help practitioners achieve more efficient resource allocation and bring new perspectives for managerial practices in ICJVs. Moreover, it is positioned to alleviate the negligence of previous studies that combined the barriers and risks factors as one checklist.

Keywords: barriers, construction, international construction joint venture, risks, sustainable development

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Authors: Mohamed Lotfy, Ghada Soliman

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Recognizing Arabic dot-matrix digits is a challenging problem due to the unique characteristics of dot-matrix fonts, such as irregular dot spacing and varying dot sizes. This paper presents an approach for recognizing Arabic digits printed in dot matrix format. The proposed model is based on Convolutional Neural Networks (CNN) that take the dot matrix as input and generate embeddings that are rounded to generate binary representations of the digits. The binary embeddings are then used to perform Optical Character Recognition (OCR) on the digit images. To overcome the challenge of the limited availability of dotted Arabic expiration date images, we developed a True Type Font (TTF) for generating synthetic images of Arabic dot-matrix characters. The model was trained on a synthetic dataset of 3287 images and 658 synthetic images for testing, representing realistic expiration dates from 2019 to 2027 in the format of yyyy/mm/dd. Our model achieved an accuracy of 98.94% on the expiry date recognition with Arabic dot matrix format using fewer parameters and less computational resources than traditional CNN-based models. By investigating and presenting our findings comprehensively, we aim to contribute substantially to the field of OCR and pave the way for advancements in Arabic dot-matrix character recognition. Our proposed approach is not limited to Arabic dot matrix digit recognition but can also be extended to text recognition tasks, such as text classification and sentiment analysis.

Keywords: computer vision, pattern recognition, optical character recognition, deep learning

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Authors: Sophia Yakhlef

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In spring 2020, the spread of coronavirus disease 2019 (COVID-19) reached the epidemiological criteria to be declared a global pandemic. Global action was taken in order to stop the spread of the virus, such as, for example, restrictions regarding spending time outside of your home and, in several countries, periods of mandatory quarantine. Sweden's method of handling the pandemic has stood out among other European nations, and the tactic of relying on citizens' sense of civic solidarity, rather than enforcing legal restrictions preventing people from spending time outside, has been highly criticised in international news media. This situation has entailed a moral dilemma concerning the proper conduct of behaviour in everyday situations in Sweden, which is also reflected in public news media and social media. This media study focuses on Swedish social media debates and attitudes concerning moral dilemmas of handling this sense of civic solidarity. Comments on social media forums expressing outrage and anger regarding, amongst others, the actions of public media figures (such as celebrities, journalists, and bloggers) are analyzed. Drawing on a social psychological perspective on emotions, the study identifies ambiguities of moral disagreements and moral panics as ways of expressing that a moral norm has been violated. The findings suggest that social media is used in order to handle such ambiguities and make sense of the loosely defined norms of civic solidarity.

Keywords: COVID-19 crisis, moral disagreements, moral panic, social media, social norms, social psychology, Sweden

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Authors: Sara Corvino

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The aim of this study is to explore the potential of inclusive learning and assessment strategies to foster students' engagement with historical debates surrounding the field of graphic design. The goal is to respond to the diversity of L4 Graphic Design students, at Nottingham Trent University, in a way that instead of 'lowering standards' can benefit everyone. This research tests, measures, and evaluates the impact of a specific intervention, an assessment task, to develop students' critical visual analysis skills and stimulate a deeper engagement with the subject matter. Within the action research approach, this work has followed a case study research method to understand students' views and perceptions of a specific project. The primary methods of data collection have been: anonymous electronic questionnaire and a paper-based anonymous critical incident questionnaire. NTU College of Business Law and Social Sciences Research Ethics Committee granted the Ethical approval for this research in November 2019. Other methods used to evaluate the impact of this assessment task have been Evasys's report and students' performance. In line with the constructivist paradigm, this study embraces an interpretative and contextualized analysis of the collected data within the triangulation analytical framework. The evaluation of both qualitative and quantitative data demonstrates that active learning strategies and the disruption of thinking patterns can foster greater students' engagement and can lead to meaningful learning.

Keywords: active learning, assessment for learning, graphic design, higher education, student engagement

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Authors: Karim Hajjar, Luis Lillo, Diego Martinez, Manuel Hermosilla, Nicholas Risko

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Objectives: This study examines the relationship between universal health coverage (UCH) and the burden of emergency diseases at a global level. Methods: Data on Disability-Adjusted Life Years (DALYs) from emergency conditions were extracted from the Institute for Health Metrics and Evaluation (IHME) database for the years 2015 and 2019. Data on UHC, measured using two variables, 1) coverage of essential health services and 2) proportion of population spending more than 10% of household income on out-of-pocket health care expenditure, was extracted from the World Bank Database for years preceding our outcome of interest. Linear regression was performed, analyzing the effect of the UHC variables on the DALYs of emergency diseases, controlling for other variables. Results: A total of 133 countries were included. 44.4% of the analyzed countries had coverage of essential health services index of at least 70/100, and 35.3% had at least 10% of their population spend greater than 10% of their household income on healthcare. For every point increase in the coverage of essential health services index, there was a 13-point reduction in DALYs of emergency medical diseases (95% CI -16, -11). Conversely, for every percent decrease in the population with large household expenditure on healthcare, there was a 0.48 increase in DALYs of emergency medical diseases (95% CI -5.6, 4.7). Conclusions: After adjusting for multiple variables, an increase in coverage of essential health services was significantly associated with improvement in DALYs for emergency conditions. There was, however, no association between catastrophic health expenditure and DALYs.

Keywords: emergency medicine, universal healthcare, global health, health economics

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Authors: Mohammed Sani Abdulai

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Ghana’s Public Financial Management reforms have been going on for some two decades now (1997/98 to 2017/18). Given this long period of reforms, Ghana in 2019 is putting together both a Public Financial Management (PFM) strategy and a Ghana Integrated Financial Management Information System (GIFMIS) strategy for the next 5-years (2020-2024). The primary aim of these dual strategies is assisting the country in moving beyond reforms to consolidation and sustainability. In this paper we, first, examined the evolution of Ghana’s PFM reforms. We, secondly, reviewed the legal and institutional reforms undertaken to strengthen the country’s key PFM institutions. Thirdly, we summarized the strengths and weaknesses identified by the 2018 Public Expenditure and Financial Accountability (PEFA) assessment of Ghana’s PFM system relating to its macro-fiscal framework, budget preparation and approval, budget execution, accounting and fiscal reporting as well as external scrutiny and audit. We, finally, considered what the country should be doing to achieve its intended goal of PFM consolidation and sustainability. Using a qualitative method of review and analysis of existing documents, we, through this paper, brought to the fore the lessons that could be learnt by other developing countries from Ghana’s PFM reforms experiences. These lessons included the need to: (a) undergird any PFM reform with a comprehensive PFM reform strategy; (b) undertake a legal and institutional reforms of the key PFM institutions; (c) assess the strengths and weaknesses of those reforms using PFM performance evaluation tools such as PEFA framework; and (d) move beyond reforms to consolidation and sustainability.

Keywords: public financial management, public expenditure and financial accountability, reforms, consolidation, sustainability

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Authors: Tanja Salary

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This study uncovers a gap in the research and adds to the body of knowledge regarding medication errors in a juvenile justice facility. The study includes an introduction to data collected about medication errors in a juvenile justice facility and explores contributing factors that relate to those errors. The data represent electronic incident records of the medication errors that were documented from the years 2011 through 2019. In addition, this study reviews both current and historical research of empirical data about patient safety standards and quality care comparing traditional healthcare facilities to juvenile justice residential facilities. The theoretical/conceptual framework for the research study pertains to Bandura and Adams’s (1977) framework of self-efficacy theory of behavioral change and Mark Friedman’s results-based accountability theory (2005). Despite the lack of evidence in previous studies about addressing medication errors in juvenile justice facilities, this presenter will relay information that adds to the body of knowledge to note the importance of how assessing the potential relationship between medication errors. Implications for more research include recommendations for more education and training regarding increased communication among juvenile justice staff, including nurses, who administer medications to juveniles to ensure adherence to patient safety standards. There are several opportunities for future research concerning other characteristics about factors that may affect medication administration errors within the residential juvenile justice facility.

Keywords: juvenile justice, medication errors, psychotropic medications, behavioral health, juveniles, incarcerated youth, recidivism, patient safety

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Authors: Mohammed-Hareef Asunramu, Sana Hashemi, Raja Ohri, Luc Worthington, Nadia Zaman, Junkai Zhu

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Background: The 2012 Health and Social Care Act committed to a ‘parity of esteem between mental and physical health services. Although this investment, aimed to both increase the quality of services and ensure the retention of mental health staff, questions remained regarding its ability to prevent mental health problems. One possible solution is a focus on the social determinants of health which have been shown to impact mental health. Aim: To examine the relationship between the index of multiple deprivations (IMD) and the prevalence of common mental health disorders (CMD) for CCGs in NHS England between 2019 and 2020. Design and setting: Cross-sectional analysis of 189 CCGs in NHS England. Methods: A multivariate linear regression model was utilized with CMD as outcome variable and IMD, age and ethnicity as explanatory variables. Datasets were obtained from Public Health England and the latest UK Census. Results: CCG IMD was found to have a significantly positive relationship with CMD. For every 1-point increase in IMD, CMD increases by 0.25%. Ethnicity had a significantly positive relationship with CMD. For every 1% increase in the population that identifies as BME, there is a 0.03% increase in CMD. Age had a significantly negative relationship with CMD. For every 1% increase in the population aged 60+, there is a 0.11% decrease in CMD. Conclusion: This study demonstrates that addressing mental health issues may require a multi-pronged approach. Beyond budget increases, it is essential to prioritize health equity, with careful considerations towards ethnic minorities and different age brackets.

Keywords: deprivation, health inequality, mental health, social determinants

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Authors: Mahjabeen Akbar

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Dental aesthetics and its associated psychosocial influence have a significant impact on individuals. Correcting malocclusions is a key motivating factor for majority patients; however, psychosocial factors have been rarely incorporated in evaluating malocclusions. Therefore, it is necessary to study the psychosocial influence of malocclusion in patients. The study aimed to determine the psychosocial influence of dental aesthetics in dental students by the ‘Psychosocial Impact of Dental Aesthetics Questionnaire’ and self-rated Aesthetic Component of the Index of Orthodontic Treatment Need (IOTN). This was a quantitative study using a cross-sectional study design. One hundred twenty dental students (71 females and 49 males; mean age 24.5) were selected via purposive sampling from July to August 2019. Dental students with no former orthodontic treatment were requested to fill out the ‘Psychosocial Impact of Dental Aesthetics Questionnaire.’ Variables including; self-confidence/insecurity, social influence, psychological influence and self-perception of the need of an orthodontic treatment were evaluated by a sequence of statements, while dental aesthetics were evaluated by using the IOTN Aesthetic Component. To determine the significance, the Kruskal-Wallis test was utilized. The results show that all four variables measuring psychosocial impact indicated significant correlations with the perceived malocclusions with a p-value of less than 0.01. The results conclude there is a strong psychological and social influence of altered dental aesthetics on an individual. Moreover, the relationship between the IOTN-AC grading with the psychosocial wellbeing of an individual stands proven, indicating that the perception of altered dental aesthetics is as important as a factor in treatment need as the amount of malocclusion.

Keywords: dental aesthetics, malocclusion, psychosocial influence, dental students

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Authors: Hassan Ali Abood Nassrullah, Jabbar Fadeel Mahdi, Mohammed Salih Mahdi Alkurdi, Ali Al Mousawi, Saad Ibrahim Al-Ghabban, Abdul Amir H. Kadhum, Ahmed Al-Amiery

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Background: Q fever is a zoonotic disease characterized by its clinical polymorphism and can present acutely as fever, pneumonia, hepatitis, and chronically as infective endocarditis, arthritis, osteomyelitis, or hepatitis. Objective: The aim of this study is To estimate the prevalence of cases of Q fever in hospitalized febrile patients in Imam Al Hussain Teaching Medical City in Karbala. Methods: One hundred patients with pyrexia were admitted to the medical ward from 1st August to 31st December 2019. Serological procedures fortified by Enzyme-linked Immunosorbent Assay test. Patients were considered to have acute Q fever when the specific antibodies (IgM and IgG) of phase II of Coxiella burnetii were positive. Results: The mean age of the patients was 35.05±12.93 years; females constituted 60% of them. Eighteen patients (18%) showed positive results for IgM, a lower proportion (13% n=13) had positive IgG levels, and 9% showed equivocal results. Statistical analysis revealed a significant association between positive IgM levels of the female gender and in patients consuming unpasteurized milk. One patient (female aged 60 years) died in the hospital, while all other patients were discharged well. Two female patients were pregnant, and one of them had an abortion. Conclusions: Q fever is more common in febrile patients. The study indicates that this disease should not be overlooked in the differential diagnosis of acute fever. Serological testing should be performed in all patients with acute febrile illness with an unsettling diagnosis.

Keywords: antibodies, frequency, immunoglobulin IgM, Q fever

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Authors: Solomon Gebremariam, Mulugeta Naizigi, Aregawi Haileselassie

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

Keywords: antimicrobial, resistance, bacteria, hospital

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Authors: Reza Johari Fard, Najmeh Cheraghi, Parvin Ehtesham Zadeh, Parviz Asgari

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The aim of this study was to investigate and comparison of the effectiveness of schema mode therapy and emotionally focused couples therapy in attachment styles (secure, avoidant, and anxious) in couples with marital conflict in a quasiexperimental method in a pretest, posttest, and follow up design with a control group. The statistical population of the study included all the couples with marital conflict who visited the Mehrana counseling center in 2019 in Ahvaz, Iran 45 couples were selected by voluntary sampling method and randomly divided into two experimental groups and one control group (15 pairs in each group). The participants completed the Adult Attachment Scale (Hazan and Shaver). The experimental groups underwent schema mode therapy and emotionally focused couples therapy for 12 sessions, but the control group did not receive any intervention. The data were analyzed by the statistical analysis of repeated measures in SPSS-19 software. The results showed that both schema mode therapy and emotionally focused couples therapy are effective in increasing the secure attachment style and reducing avoidant and ambivalent attachment styles in couples with marital conflict. There was no significant difference between the schema mode therapy group and the emotionally focused couple's therapy group in attachment styles. Therefore, it is recommended that therapists and family counselors use these therapies along with other therapeutic interventions to increase secure attachment styles and reduce marital conflicts.

Keywords: schema mode therapy, emotional focused couple therapy, attachment styles, marital conflict

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Authors: Alexander J. Severinsky, Allen L. Sessoms

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Atmospheric carbon dioxide (CO₂) has dominated the discussion about the causes of climate change. This is a reflection of the time horizon that has become the norm adopted by the IPCC as the planning horizon. Recently, it has become clear that a 100-year time horizon is much too long, and yet almost all mitigation efforts, including those in the near-term horizon of 30 years, are geared toward it. In this paper, we show that, for a 30-year time horizon, methane (CH₄) is the greenhouse gas whose radiative forcing exceeds that of CO₂. In our analysis, we used radiative forcing of greenhouse gases in the atmosphere since they directly affect the temperature rise on Earth. In 2019, the radiative forcing of methane was ~2.5 W/m² and that of carbon dioxide ~2.1 W/m². Under a business-as-usual (BAU) scenario until 2050, such forcing would be ~2.8 W/m² and ~3.1 W/m², respectively. There is a substantial spread in the data for anthropogenic and natural methane emissions as well as CH₄ leakages from production to consumption. We estimated the minimum and maximum effects of the reduction of these leakages. Such action may reduce the annual radiative forcing of all CH₄ emissions by between ~15% and ~30%. This translates into a reduction of the RF by 2050 from ~2.8 W/m² to ~2.5 W/m² in the case of the minimum effect and to ~2.15 W/m² in the case of the maximum. Under the BAU, we found that the RF of CO₂ would increase from ~2.1 W/m² nowadays to ~3.1 W/m² by 2050. We assumed a reduction of 50% of anthropogenic emission linearly over the next 30 years. That would reduce radiative forcing from ~3.1 W/m² to ~2.9 W/m². In the case of ‘net zero,’ the other 50% of reduction of only anthropogenic emissions would be limited to either from sources of emissions or directly from the atmosphere. The total reduction would be from ~3.1 to ~2.7, or ~0.4 W/m². To achieve the same radiative forcing as in the scenario of maximum reduction of methane leakages of ~2.15 W/m², then an additional reduction of radiative forcing of CO₂ would be approximately 2.7 -2.15=0.55 W/m². This is a much larger value than in expectations from ‘net zero’. In total, one needs to remove from the atmosphere ~660 GT to match the maximum reduction of current methane leakages and ~270 GT to achieve ‘net zero.’ This amounts to over 900 GT in total.

Keywords: methane leakages, methane radiative forcing, methane mitigation, methane net zero

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Authors: Usman A. Usman

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Undeniably, unlike the Classical side, the Keynesian perspective of the aggregate demand side indeed has a significant position in the policy, growth, and welfare of Nigeria due to government involvement and ineffective demand of the population living with poor per capita income. This study seeks to investigate the effect of Government Final Consumption Expenditure, Financial Deepening on Households, and NPISHs Final consumption expenditure using data on Nigeria from 1981 to 2019. This study employed the ADF stationarity test, Johansen Cointegration test, and Vector Error Correction Model. The results of the study revealed that the coefficient of Government final consumption expenditure has a positive effect on household consumption expenditure in the long run. There is a long-run and short-run relationship between gross fixed capital formation and household consumption expenditure. The coefficients cpsgdp (financial deepening and gross fixed capital formation posit a negative impact on household final consumption expenditure. The coefficients money supply lm2gdp, which is another proxy for financial deepening, and the coefficient FDI have a positive effect on household final consumption expenditure in the long run. Therefore, this study recommends that Gross fixed capital formation stimulates household consumption expenditure; a legal framework to support investment is a panacea to increasing hoodmold income and consumption and reducing poverty in Nigeria. Therefore, this should be a key central component of policy.

Keywords: government final consumption expenditure, household consumption expenditure, vector error correction model, cointegration

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Authors: Muksalmina

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Transportation plays an important role in people's daily activities but is often marred by traffic accidents. In Indonesia, traffic accidents are the third leading cause of death after coronary heart disease and tuberculosis, according to the World Health Organization (2013). Several roads in East Aceh District are strategic access points for economic growth in the Aceh region. There were 446 traffic accidents in 2023, which is the highest case in the last five years. This study aims to analyze black spot locations on national roads in East Aceh District and evaluate road safety deficiencies in the area. The research methodology began by selecting the locations with the highest accident rates based on data from East Aceh Police from 2019-2023. Next, Average Daily Traffic (ADT) was measured by projecting population growth data. The analysis of road safety deficiencies included measurements of road geometrics, traffic signs and markings, and traffic volumes at black spot locations. The study results showed deficiencies in lane width, shoulder width, and inadequate road safety facilities at several locations. Recommendations for improvements include increasing lane and shoulder widths and adding signs and markings to improve safety. This study is expected to serve as a reference for the government and relevant stakeholders in improving traffic safety in East Aceh District.

Keywords: black spot, traffic accident, severity index, road safety

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Authors: Frantisek Odvarka

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Based on the data from the Moravian Karst, the influence of the calcite speleothem growth by selected meteorological factors was evaluated. External temperature was determined as one of the main factors influencing speleothem growth in Moravian Karst. This factor significantly influences the CO₂ concentration in soil/epikarst, and cave atmosphere in the Moravian Karst and significantly contributes to the changes in the CO₂ partial pressure differences between soil/epikarst and cave atmosphere in Moravian Karst, which determines the drip water supersaturation with respect to the calcite and quantity of precipitated calcite in the Moravian Karst cave environment. External air temperatures and cave air temperatures were measured using a COMET S3120 data logger, which can measure temperatures in the range from -30 to +80 °C with an accuracy of ± 0.4 °C. CO₂ concentrations in the cave and soils were measured with a FT A600 CO₂H Ahlborn probe (value range 0 ppmv to 10,000 ppmv, accuracy 1 ppmv), which was connected to the data logger ALMEMO 2290-4, V5 Ahlborn. The soil temperature was measured with a FHA646E1 Ahlborn probe (temperature range -20 to 70 °C, accuracy ± 0.4 °C) connected to an ALMEMO 2290-4 V5 Ahlborn data logger. The airflow velocities into and out of the cave were monitored by a FVA395 TH4 Thermo anemometer (speed range from 0.05 to 2 m s⁻¹, accuracy ± 0.04 m s⁻¹), which was connected to the ALMEMO 2590-4 V5 Ahlborn data logger for recording. The flow was measured in the lower and upper entrance of the Imperial Cave. The data were analyzed in MS Office Excel 2019 and PHREEQC.

Keywords: speleothem growth, carbon dioxide partial pressure, Moravian Karst, external temperature

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