Search results for: sustainable quality of life

Authors: Corbel Camille, Le Cerf Flora, Capriz Françoise, Vaillant-Ciszewicz Anne-Julie, Breaud Jean, Guerin Olivier, Corveleyn Xavier

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Background: The medical environment can generate stressful and anxiety-provoking situations for patients, particularly during painful care procedures for the older population. These stressful environments have deleterious effects on the quality of care and can even put the patient at risk and set the care team up for failure. The search for a solution is, therefore, imperative. The development of new technologies, such as virtual reality (VR), seems to be an answer to this problem. Objectives: The objective of this study is to compare the effects of virtual reality on pain and anxiety when caring for older hospitalized people with the effects of usual care. More precisely, different individual factors (age, cognitive level, individual preferences, etc.) and different virtual reality universes (personalized or non-personalized) are studied to understand the role of these factors in reducing pain and anxiety during care procedures. The aim of this study is to improve the quality of life of patients and caregivers in their work environment. Method: This mono-centered, randomized, controlled study was conducted from September 2023 to September 2024 on 120 participants recruited from the geriatric departments of the Cimiez Hospital, Nice, France. Participants are randomized into three groups: a control group, a personalized VR group and a non-personalized VR group. Each participant is followed during a painful care session. Data are collected before, during and after the care, using measures of pain (Algoplus and numerical scale) and anxiety (Hospital anxiety scale and numerical scale). Physiological assessments with an oximeter are also performed to collect both heart and respiratory rate measurements. The implementation of the care will be assessed among healthcare providers to evaluate its effects on the difficulty and fatigue associated with the care. Additionally, a questionnaire (System Usability Scale) will be administered at the conclusion of the study to determine the willingness of healthcare providers to integrate VR into their daily care practices. Result: The preliminary results indicate significant effects on anxiety (p=.001) and pain (p=<.001) following the VR intervention during care, as compared to the control group. Conclusion: The preliminary results suggest that VRI appears to be a suitable and effective method for reducing anxiety and pain among older hospitalized individuals compared with standard care. Finally, the experiences of healthcare professionals involved will also be considered to assess the impact of these interventions on working conditions and patient support.

Keywords: anxiety, care, pain, older adults, virtual reality

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Authors: Mohammed Elghazy, Ahmed El Refai, Usama Ebead, Antonio Nanni

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Rehabilitating corrosion-damaged reinforced concrete (RC) structures has been accomplished using various techniques such as steel plating, external post-tensioning, and external bonding of fiber reinforced polymer (FRP) composites. This paper reports on the use of an innovative technique to strengthen corrosion-damaged RC structures using fabric-reinforced cementitious matrix (FRCM) composites. FRCM consists of dry-fiber fabric embedded in cement-based matrix. Twelve large-scale RC beams were constructed and tested in flexural monotonic and fatigue loads. Prior to testing, ten specimens were subjected to accelerated corrosion process for 140 days leading to an average mass loss in the tensile steel bars of 18.8 %. Corrosion was restricted to the main reinforcement located in the middle third of the beam span. Eight corroded specimens were repaired and strengthened while two virgin and two corroded-unrepaired/unstrengthened beams were used as benchmarks for comparison purpose. The test parameters included the FRCM materials (Carbon-FRCM, PBO-FRCM), the number of FRCM plies, the strengthening scheme, and the type of loading (monotonic and fatigue). The effects of the pervious parameters on the flexural response, the mode of failure, and the fatigue life were reported. Test results showed that corrosion reduced the yield and ultimate strength of the beams. The corroded-unrepaired specimen failed to meet the provisions of the ACI-318 code for crack width criteria. The use of FRCM significantly increased the ultimate strength of the corroded specimen by 21% and 65% more than that of the corroded-unrepaired specimen. Corrosion significantly decreased the fatigue life of the corroded-unrepaired beam by 77% of that of the virgin beam. The fatigue life of the FRCM repaired-corroded beams increased to 1.5 to 3.8 times that of the corroded-unrepaired beam but was lower than that of the virgin specimen. The specimens repaired with U-wrapped PBO-FRCM strips showed higher fatigue life than those repaired with the end-anchored bottom strips having similar number of PBO-FRCM-layers. PBO-FRCM was more effective than Carbon-FRCM in restoring the fatigue life of the corroded specimens.

Keywords: corrosion, concrete, fabric-reinforced cementitious matrix (FRCM), fatigue, flexure, repair

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Authors: M. Shah Alamgir, Jun Furuya, Shintaro Kobayashi, M. Abdus Salam

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Farmers’ environmental and economic situations are very diverse. In order to develop effective policies and technologies to improve farmers’ life standard, it is important to understand which factors induce the diversity of agricultural income. Analyze both primary and secondary data, this study applied descriptive, inferential statistical tools, and econometric techniques. From the study, farmers of Sylhet Division produce potato as one of the main cash crop with other seasonal crops. The total costs of potato production per hectare varied in different districts of Sylhet division in addition seed and hired labor cost has the biggest share of the full cost. To grasp the diversity of income, the study decomposes the variance of net income into different factors of potato production. Through this decomposition, seed cost is the important factors of income variability and it is the most important sector to induce total cost disparity for potato production. The result shows that 73% of net income variation is explained by gross income. It implies that potato yield or potato price (quality) or both vary widely among farmers. This finding is important of policymaking and technology development of agricultural farming in Bangladesh.

Keywords: agricultural income, seed, hired labor, technology development

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Authors: Mimi Roy, Sriroop Chaudhuri

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Sustainable water supply is among the basic needs for human development, especially in the rural areas of the developing nations where safe water supply and basic sanitation infrastructure is direly needed. In light of the above, we propose a simple methodology to develop a composite water sustainability index (WSI) to assess the collective performance of the existing rural water supply services (RWSS) in India over time. The WSI will be computed by summarizing the details of all the different varieties of water supply schemes presently available in India comprising of 40 liters per capita per day (lpcd), 55 lpcd, and piped water supply (PWS) per household. The WSI will be computed annually, between 2010 and 2016, to elucidate changes in holistic RWSS performances. Results will be integrated within a robust geospatial framework to identify the ‘hotspots’ (states/districts) which have persistent issues over adequate RWSS coverage and warrant spatially-optimized policy reforms in future to address sustainable human development. Dataset will be obtained from the National Rural Drinking Water Program (NRDWP), operating under the aegis of the Ministry of Drinking Water and Sanitation (MoDWS), at state/district/block levels to offer the authorities a cross-sectional view of RWSS at different levels of administrative hierarchy. Due to simplistic design, complemented by spatio-temporal cartograms, similar approaches can also be adopted in other parts of the world where RWSS need a thorough appraisal.

Keywords: rural water supply services, piped water supply, sustainability, composite index, spatial, drinking water

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Authors: Siddhartha Dhungana

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This article primarily explores dimensions in English language teacher's professionalism so that a teacher could reflect and make a strategic professional devotion to implement effective educational programs for the present and the future. The paper substantially incorporates the eastern Hindu practices, especially life values from the Bhagavad Gita, as a basis of teacher’s professional enrichment. Basically, it applies three categorical practices, i.e., Karma Yoga, Jnana Yoga, and Bhakti Yoga, in teachers’ professionality to illustrate, ignite further ahead and sharpen academic journey, professional journey, and professional devotion reflecting common practices. In this journey, a teacher comes to a stage of professional essence as s/he surpasses Karma Yoga, Jnana Yoga, and Bhakti Yoga with their basic quality formation. To illustrate their essence-making process, the three narrative stories for each category mentioned above are analyzed. The data collected from a research participant who has a high level of professional success and who inspires all English Language teachers in Nepal to develop stories for narrative analysis. The narrative analysis is based on eastern themes that are supported by Vygotsky's concept of developmental psychology. Moreover, the structural analysis is based on Gary Barkhuizen's narrative analysis.

Keywords: Karma Yoga, Jnana Yoga, Bhakti Yoga, Vygotsky's concepts, narrative analysis

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Authors: Cesar Augusto Hoil Rosas, José Luis Vázquez Burgos, José Juan Carbajal Hernandez

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White fish (Chirostoma estor estor) is an endemic species that habits in the Patzcuaro Lake, located in Michoacan, Mexico; being an important source of gastronomic and cultural wealth of the area. Actually, it have undergone an immense depopulation of individuals, due to the high fishing, contamination and eutrophication of the lake water, resulting in the possible extinction of this important species. This work proposes a new computational model for monitoring and assessment of critical environmental parameters of the white fish ecosystem. According to an Analytical Hierarchy Process, a mathematical model is built assigning weights to each environmental parameter depending on their water quality importance on the ecosystem. Then, a development of an advanced system for the monitoring, analysis and control of water quality is built using the virtual environment of LabVIEW. As results, we have obtained a global score that indicates the condition level of the water quality in the Chirostoma estor ecosystem (excellent, good, regular and poor), allowing to provide an effective decision making about the environmental parameters that affect the proper culture of the white fish such as temperature, pH and dissolved oxygen. In situ evaluations show regular conditions for a success reproduction and growth rates of this species where the water quality tends to have regular levels. This system emerges as a suitable tool for the water management, where future laws for white fish fishery regulations will result in the reduction of the mortality rate in the early stages of development of the species, which represent the most critical phase. This can guarantees better population sizes than those currently obtained in the aquiculture crop. The main benefit will be seen as a contribution to maintain the cultural and gastronomic wealth of the area and for its inhabitants, since white fish is an important food and economical income of the region, but the species is endangered.

Keywords: Chirostoma estor estor, computational system, lab view, white fish

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Authors: Duran Fiack, Jeremy Cumberbatch, Michael Sutherland, Nadine Zerphey

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Civic leaders have increasingly relied upon local climate adaptation plans to identify vulnerabilities, prioritize goals, and implement actions in order to prepare cities for the present and projected effects of global climate change. The concept of sustainability is central to these efforts, as climate adaptation discussions are often framed within the context of economic resilience, environmental protection, and the distribution of climate change impacts across various socioeconomic groups. For urban centers, the climate change issue presents unique challenges for each of these dimensions; however, its potential impacts on marginalized populations are extensive. This study draws from the ‘just sustainabilities’ framework to perform a qualitative analysis of climate adaptation plans prepared by 22 of the 100 largest U.S. cities and examine whether, and to what extent, such initiatives prioritize social equity improvements. Past research has found that the integration of sustainability in urban policy and planning often produces outcomes that favor environmental and economic objectives over social equity improvements. We find that social equity is a particularly prominent theme in local-level climate adaptation efforts, relative to environmental quality and economic development. The findings contribute to the literature on climate adaptation and sustainability within the urban context and offer practical insight for local-level stakeholders concerning potential obstacles and opportunities for the integration of social equity initiatives into climate adaptation planning. Given the likelihood that climate changes will continue to impose unique challenges for marginalized communities in urban areas, advancing our understanding of how social equity concerns are integrated into adaptation efforts is likely to become an increasingly critical area of inquiry.

Keywords: climate adaptation plan, climate change, social equity, sustainability

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Authors: Mercy Chepkirui, Reuben Omondi, Paul Orina, Albert Getabu, Lewis Sitoki, Jonathan Munguti

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Globally, the decline in capture fisheries as a result of the growing population and increasing awareness of the nutritional benefits of white meat has led to the development of aquaculture. This is anticipated to meet the increasing call for more food for the human population, which is likely to increase further by 2050. Statistics showed that more than 50% of the global future fish diet will come from aquaculture. Aquaculture began commercializing some decades ago; this is accredited to technological advancement from traditional to modern cultural systems, including cage farming. Cage farming technology has been rapidly growing since its inception in Lake Victoria, Kenya. Currently, over 6,000 cages have been set up in Kenyan waters, and this offers an excellent opportunity for recognition of Kenya’s government tactic to eliminate food insecurity and malnutrition, create employment and promote a Blue Economy. However, being an open farming enterprise is likely to emit large bulk of waste hence altering the ecosystem integrity of the lake. This is through increased chlorophyll-a pigments, alteration of the plankton community, macroinvertebrates, fish genetic pollution, transmission of fish diseases and pathogens. Cage farming further increases the nutrient loads leading to the production of harmful algal blooms, thus negatively affecting aquatic and human life. Despite the ecological transformation, cage farming provides a platform for the achievement of the Sustainable Development Goals of 2030, especially the achievement of food security and nutrition. Therefore, there is a need for Integrated Multitrophic Aquaculture as part of Blue Transformation for ecosystem monitoring.

Keywords: aquaculture, ecosystem, blue economy, food security

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Authors: Tyrus C. Torres, Michael Harris

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In a coastal town of Ecuador, the role of women is commonly defined as an ama de casa, a woman who works in the house, raises children, and contributes to the community. This project, under the guidance of Dr. Michael Harris from the Florida Atlantic University, seeks to understand how the role of an ama de casa provides a secure environment for men and women, coexists with economic and environmental constraints that explain the origins of how this environment has been formed. The coastal community aspects of familia (family), trabajo (work), relación (relationships), machismo (masculinity), feminista (femininity), and the culture of Ecuador define the ways of life in a coastal setting. This ethnographic research project included the following methodologies: environment mapping, conducting interviews, surveys, participant observation, direct and indirect observations, and integration into daily life. Immersion into the daily life and building relationships with the local people allowed the documentation of intricacies of both the cultural and social spheres. The findings of this research offer insight on how culture, economics, and environment can form female and male agency. Our investigation shows that occupations such as fishermen, laborers, ama de casas, and even students utilize occupational routes to create social agency in the face of economic and environmental constraints in Ecuador.

Keywords: Ecuador, ethnography, gender division of labor, gender roles

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Authors: Sana Abusin

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Food security in Qatar is a research priority of Qatar University (2021-2025) and all national strategies, including the Qatar National Vision 2030 and food security strategy (2018-2023). Achieving food security requires three actions: 1) transforming surplus food to those who are insecure; 2) reducing food loss and waste by recycling food into valuable resources such as compost (“green fertilizer”) that can be used in growing food; and, finally, 3) establishing strong enforcement agencies to protect consumers from outdated food and promote healthy food. Currently, these objectives are approached separately and not in a sustainable fashion. Food security in Qatar is a research priority of Qatar University (2021-2025) and all national strategies, including the Qatar National Vision 2030 and food security strategy (2018-2023). The study aims to develop an innovative mobile application that supports a sustainable solution to food insecurity and food waste in Qatar. The application will provide a common solution for many different users. For producers, it will facilitate easy disposal of excess food. For charities, it will notify them about surplus food ready for redistribution. The application will also benefit the second layer of end-users in the form of food recycling companies, who will receive information about available food waste that is unable to be consumed. We will use self-exoplanetary diagrams and digital pictures to show all the steps to the final stage. The aim is to motivate the young generation toward innovation and creation, and to encourage public-private collaboration in this sector.

Keywords: food security, innovative technology, sustainability, food waste, Qatar

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Authors: Tak Mau Simon Chan, Ying Chuen Lance Chan

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Homelessness has been a popular and controversial debate in Hong Kong, a city which is densely populated and well-known for very expensive housing. The constitution of the homeless as threats to the community and environmental hygiene is ambiguous and debatable in the Hong Kong context. The lack of an intervention model is the critical research gap thus far, aside from the tangible services delivered. The life story approach (LSA), with its unique humanistic orientation, has been well applied in recent decades to depict the needs of various target groups, but not the homeless. It is argued that the life story approach (LSA), which has been employed by health professionals in the landscape of dementia, and health and social care settings, can be used as a reference in the local Chinese context through indigenization. This study, therefore, captures the viewpoints of service providers and users by constructing an indigenous intervention model that refers to the LSA in serving the chronically homeless. By informing 13 social workers and 27 homeless individuals in 8 focus groups whilst 12 homeless individuals have participated in individual in-depth interviews, a framework of LSA in homeless people is proposed. Through thematic analysis, three main themes of their life stories was generated, namely, the family, negative experiences and identity transformation. The three domains solidified framework that not only can be applied to the homeless, but also other disadvantaged groups in the Chinese context. Based on the three domains of family, negative experiences and identity transformation, the model is applied in the daily practices of social workers who help the homeless. The domain of family encompasses familial relationships from the past to the present to the speculated future with ten sub-themes. The domain of negative experiences includes seven sub-themes, with reference to the deviant behavior committed. The last domain, identity transformation, incorporates the awareness and redefining of one’s identity and there are a total of seven sub-themes. The first two domains are important components of personal histories while the third is more of an unknown, exploratory and yet to-be-redefined territory which has a more positive and constructive orientation towards developing one’s identity and life meaning. The longitudinal temporal dimension of moving from the past – present - future enriches the meaning making process, facilitates the integration of life experiences and maintains a more hopeful dialogue. The model is tested and its effectiveness is measured by using qualitative and quantitative methods to affirm the extent that it is relevant to the local context. First, it contributes to providing a clear guideline for social workers who can use the approach as a reference source. Secondly, the framework acts as a new intervention means to address problem saturated stories and the intangible needs of the homeless. Thirdly, the model extends the application to beyond health related issues. Last but not least, the model is highly relevant to the local indigenous context.

Keywords: homeless, indigenous intervention, life story approach, social work practice

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Authors: Ribut Alam Malau, Durri Andriani, C. B. Supartomo

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Universitas Terbuka (UT) as a higher education institution implements open and distance education is responsible to provide higher education to all Indonesian citizen wherever they live, including those reside in cultural diversity aras. Operate from Jakarta Head Office and 37 regional centers (ROs), UT is accustomed to the challenge. UT-Kupang and UT-Ambon which oversee East Nusa Tenggara and Maluku have successfully provided quality educational services for students. The two ROs have provided educational facilities which could assist the students to cope with their study in spite of the diversity situations. In order to analyze the effectiveness of the facilities provided, questionnaires focusing on tutorial services were sent to 90 students in the two ROs asking them to assess the facilities which best fulfills students’ needs in terms of their culture diversity. The results showed that UT-Kupang and UT-Ambon have successful in providing education for students in their areas as reflected in more than 80% of respondents aware of the facilities concerning tutorial service except for tutorial mechanism where only 34,5% of respondents aware of. However, despite lower rate of awareness in tutorial mechanism, majority of respondent 90.8% of respondents registered in tutorials and 95.4% will register in tutorials next semester. The majority of respondents showed appreciation for the ROs efforts to provide tutorials on weekdays which could accommodate their beliefs. In addition, conducting tutorials in all islands also perceived highly since students did not have to commute between islands. Efforts done by UT-Kupang and UT-Ambon have proven to be appreciated by students.

Keywords: archipelago, cultural diversity, ODL, service quality, Universitas Terbuka

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Authors: E. Lacasa, J. L. Santolaya, I. Millán

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The progress toward sustainability implies maintaining and preferably improving both, human and ecosystem well-being, according to a triple bottom line that includes the environmental, economic and social dimensions. The life cycle assessment (LCA) is a method applicable to all production sectors that aims to quantify the environmental pressures and the benefits related to goods and services, as well as the trade-offs and the scope for improving areas of the production process. While using LCA to measure the environmental dimension of sustainability is widespread, similar approaches for the economic and the social dimensions still have limited application worldwide and there is a need for consistent and robust methods and indicators. This paper focuses on the milk production process and presents the analysis of the flows exchanged by an industrial installation through accounting all the energy and material inputs and the associated emissions and waste outputs at this stage of its life cycle. The functional unit is one litre of milk produced. Different metrics and indicators are used to assess the three dimensions of sustainability. Metrics considered useful to assess the production activities are the total water and energy consumptions and the milk production volume of each cow. The global warming, the value added and the working hours are indicators used to measure each sustainability dimension. The study is performed with two types of feeding of the cows, which includes a change in percentages of components as well. Nutritional composition of the milk obtained is almost kept. It is observed that environmental and social improvements involve high economic costs.

Keywords: milk production, sustainability, indicators, life cycle assessment

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Authors: G. M. Cappucci, C. Losi, P. Neri, M. Pini, A. M. Ferrari

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Waste treatment and many production processes cause significant emissions of odors, thus typically leading to intense debate. The introduction of odorimetric units and their units of measurement, i.e., U.O. / m3, with the European regulation UE 13725 of 2003 designates the dynamic olfactometry as the official method for odorimetric analysis. Italy has filled the pre-existing legislative gap on the regulation of odorous emissions only recently, by introducing the Legislative Decree n°183 in 2017. The concentration of the odor to which a perceptive response occurs to 50% of the panel corresponds to the odorimetric unit of the sample under examination (1 U.O. / m3) and is equal to the threshold of perceptibility of the substance (O.T.). In particular, the treatment of Municipal Solid Waste (MSW) by Mechanical-Biological Treatment (MBT) plants produces odorous emissions, typically generated by aerobic procedures, potentially leading to significant environmental burdens. The quantification of odorous emissions represents a challenge within a LCA study since primary data are often missing. The aim of this study is to present the preliminary findings of an ongoing study whose aim is to identify and quantify odor emissions from the Tre Monti MBT plant, located in Imola (Bologna, Italy). Particularly, the issues faced with odor emissions in the present work are: i) the identification of the components of the gaseous mixture, whose total quantification in terms of odorimetric units is known, ii) the distribution of the total odorimetric units among the single substances identified and iii) the quantification of the mass emitted for each substance. The environmental analysis was carried out on the basis of the amount of emitted substance. The calculation method IMPact Assessment of Chemical Toxics (IMPACT) 2002+ has been modified since the original one does not take into account indoor emissions. Characterization factors were obtained by adopting a preliminary method in order to calculate indoor human effects. The impact and damage assessments were performed without the identification of new categories, thus in accordance with the categories of the selected calculation method. The results show that the damage associated to odorous emissions is the 0.24% of the total damage, and the most affected damage category is Human Health, mainly as a consequence of ammonia emission (86.06%). In conclusion, this preliminary approach allowed identifying and quantifying the substances responsible for the odour impact, in order to attribute them the relative damage on human health as well as ecosystem quality.

Keywords: life cycle assessment, municipal solid waste, odorous emissions, waste treatment

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Authors: Mailin Misson, Bo Jin, Sheng Dai, Hu Zhang

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Advances in biotechnology have witnessed a growing interest in enzyme applications for the development of green and sustainable bio processes. While known as powerful bio catalysts, enzymes are no longer of economic value when extended to large commercialization. Alternatively, immobilization technology allows enzyme recovery and continuous reuse which subsequently compensates high operating costs. Employment of enzymes on nano structured materials has been recognized as a promising approach to enhance enzyme catalytic performances. High porosity, inter connectivity and self-assembling behaviors endow nano fibers as exciting candidate for enzyme carrier in bio reactor systems. In this study, nano fibers were successfully fabricated via electro spinning system by optimizing the polymer concentration (10-30 %, w/v), applied voltage (10-30 kV) and discharge distance (11-26 cm). Microscopic images have confirmed the quality as homogeneous and good fiber alignment. The nano fibers surface was modified using strong oxidizing agent to facilitate bio molecule binding. Bovine serum albumin and β-galactosidase enzyme were employed as model bio catalysts and immobilized onto the oxidized surfaces through covalent binding. Maximum enzyme adsorption capacity of the modified nano fibers was 3000 mg/g, 3-fold higher than the unmodified counterpart (1000 mg/g). The highest immobilization yield was 80% and reached the saturation point at 2 mg/ml of enzyme concentration. The results indicate a significant increase of activity retention by the enzyme-bound modified nano fibers (80%) as compared to the nascent one (60%), signifying excellent enzyme-nano carrier bio compatibility. The immobilized enzyme was further used for the bio conversion of dairy wastes into value-added products. This study demonstrates great potential of acid-modified electrospun polystyrene nano fibers as enzyme carriers.

Keywords: immobilization, enzyme, nanocarrier, nanofibers

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Authors: Naila Awan, Shahrukh Inam

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This study was conducted to highlight the role of basic health units in district Swabi, which provides primary health services to the people of district Swabi having four tehsils. Tehsil Swabi was selected purposively for the study. Three villages were purposively selected from district Swabi. A sum of 110 respondents was randomly selected for interview i.e., 27 from Botakaa, 39 from Gulatee, and 44 from Darra Cham, using proportion allocation sampling technique. A pretested and well-designed interview schedule was used to collect as per the objective and Chi square test was applied to find an association between the quality of medicines and health improvement. The output of the test shows that the government was doing its best and providing enough facilities to the individuals at the healthcare units, and they were utilizing them. These resources were easily accessible to the people of the community. Medicines provided by the government were of good quality and quantity. There were also school health sessions and community health sessions (SHS/CHS) to deliver useful information and awareness regarding health problems and diseases were conducted. The staff of the BHU was present at work time and was performing their duties. The respondents seemed satisfied with their behavior and the duty of the staff. However, there were no emergency resources existing at the BHU after the working hours of the medical staff. It is recommended that government should provide appropriate quantity and quality of medicines to the basic health units so that these healthcare units don’t have to face any shortages regarding medicines at the end of the month. In addition, laboratory and blood testing facilities need to be provided in the basic health units, and also the infrastructure should be made suitable, satisfactory, and more functional.

Keywords: community health session, basic health units, outpatient department, tuberculosis

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Authors: Y. Karbhari, A. Benamraoui, A. Fahmi Sheikh Hassan

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The study applies role theory to investigate the quality of the compliance review in Malaysia, which is perceived to have the most advanced Islamic banking governance framework in the Islamic world. Drawing from the questionnaire survey and semi-structured interviews, our study reveals the existence of a well-established structure for compliance reviews which is found to be regulatory driven and contingent upon the level of commercial activity of individual Islamic bank’s. However, the compliance review process was found to be ceremonial and inadequately undertaken by some SBs with greater prominence placed on its advisory role. In particular, the study provides evidence of a lack of understanding on accounting issues when undertaking the compliance review. Problems in communication between SBs, board of directors and management were also reported to exist. Our findings raise concern over the quality and thus the credibility of the religious compliance assurance communicated in Islamic Banks annual reports.

Keywords: Islamic banks, religious compliance, Sharia board assurance, role theory

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Authors: Esra Yaldız, Dicle Aydın

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Sustainability is a term that provides deciding about the future considering environment and investigates the harmony and balance between protection and usage of the resource. The main objective of sustainability is creating residential areas is nature compatible or providing continuance thereby adapting existing residential area to nature. In this context, historical and traditional areas must have utilized according to sustainability. Traditional housing texture are identified as a traditional architectural product has been designed based on this term. General characteristics of traditional housing within the context of sustainable architecture are their specific dynamics and components and their harmonisation of environment and nature. Owing to the fact that traditional housing texture harmonizes natural conditions of the region, topography, climate and their context, construction materials are provided from environment and traditional techniques and their forms are used and due to construction materials has natural insulation traditional housing create healthy and comfortable living environment, traditional housing is rather significant in terms of sustainable architecture. The basis of this study comprise the routers in traditional housing design in accordance with the principles of sustainability. These are, accommodating topography, climate, and geography, accessibility, structuring at the scale of human, utilization of green zones, unique to the region used construction materials, the form of construction, building envelope and space organization of dwelling. In this context, the purpose of this study is that vernacular architecture approaches of traditional housing textures which are in Central Anatolia Region Located in Anatolia are utilized with regard to sustainability.

Keywords: Anatolia, sustainability, traditional housing texture, vernacular architecture

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Authors: Furkan Ozkan, M. Selcuk Arslan, Hatice Mercan

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Electric vehicles are becoming increasingly popular asa sustainable alternative to traditional combustion engine vehicles. However, to fully realize the potential of EVs in reducing environmental impact and energy consumption, efficient control strategies are essential. This study explores the application of green wave control using model predictive control for electric vehicles, coupled with energy consumption modeling using neural networks. The use of MPC allows for real-time optimization of the vehicles’ energy consumption while considering dynamic traffic conditions. By leveraging neural networks for energy consumption modeling, the EV's performance can be further enhanced through accurate predictions and adaptive control. The integration of these advanced control and modeling techniques aims to maximize energy efficiency and range while navigating urban traffic scenarios. The findings of this research offer valuable insights into the potential of green wave control for electric vehicles and demonstrate the significance of integrating MPC and neural network modeling for optimizing energy consumption. This work contributes to the advancement of sustainable transportation systems and the widespread adoption of electric vehicles. To evaluate the effectiveness of the green wave control strategy in real-world urban environments, extensive simulations were conducted using a high-fidelity vehicle model and realistic traffic scenarios. The results indicate that the integration of model predictive control and energy consumption modeling with neural networks had a significant impact on the energy efficiency and range of electric vehicles. Through the use of MPC, the electric vehicle was able to adapt its speed and acceleration profile in realtime to optimize energy consumption while maintaining travel time objectives. The neural network-based energy consumption modeling provided accurate predictions, enabling the vehicle to anticipate and respond to variations in traffic flow, further enhancing energy efficiency and range. Furthermore, the study revealed that the green wave control strategy not only reduced energy consumption but also improved the overall driving experience by minimizing abrupt acceleration and deceleration, leading to a smoother and more comfortable ride for passengers. These results demonstrate the potential for green wave control to revolutionize urban transportation by enhancing the performance of electric vehicles and contributing to a more sustainable and efficient mobility ecosystem.

Keywords: electric vehicles, energy efficiency, green wave control, model predictive control, neural networks

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Authors: Yuan-Hao Lee, Chia-Wei Lee, Ming-Fang Lin, Tzu-Huei Wu, Chih-Hsiang Ko, Wing P. Chan

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Computed tomography (CT) scan of the head is a good method for investigating cranial lesions. However, radiation-induced oxidative stress can be accumulated in the eyes and promote carcinogenesis and cataract. In this regard, we aimed to protect the eyes with barium sulfate shield(s) during CT scans and investigate the resultant image quality and radiation dose to the eye. Patients who underwent health examinations were selectively enrolled in this study in compliance with the protocol approved by the Ethics Committee of the Joint Institutional Review Board at Taipei Medical University. Participants’ brains were scanned with a water-based marker simultaneously by a multislice CT scanner (SOMATON Definition Flash) under a fixed tube current-time setting or automatic tube current modulation (TCM). The lens dose was measured by Gafchromic films, whose dose response curve was previously fitted using thermoluminescent dosimeters, with or without barium sulfate or bismuth-antimony shield laid above. For the assessment of image quality CT images at slice planes that exhibit the interested regions on the zygomatic, orbital and nasal bones of the head phantom as well as the water-based marker were used for calculating the signal-to-noise and contrast-to-noise ratios. The application of barium sulfate and bismuth-antimony shields decreased 24% and 47% of the lens dose on average, respectively. Under topogram-based TCM, the dose saving power of bismuth-antimony shield was mitigated whereas that of barium sulfate shield was enhanced. On the other hand, the signal-to-noise and contrast-to-noise ratios of DSCT images were decreased separately by barium sulfate and bismuth-antimony shield, resulting in an overall reduction of the CNR. In contrast, the integration of topogram-based TCM elevated signal difference between the ROIs on the zygomatic bones and eyeballs while preferentially decreasing the signal-to-noise ratios upon the use of barium sulfate shield. The results of this study indicate that the balance between eye exposure and image quality can be optimized by combining eye shields with topogram-based TCM on the multislice scanner. Eye shielding could change the photon attenuation characteristics of tissues that are close to the shield. The application of both shields on eye protection hence is not recommended for seeking intraorbital lesions.

Keywords: computed tomography, barium sulfate shield, dose saving, image quality

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Authors: Thilivhali E. Rasimphi, David Tinarwo

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Access to energy is crucial in poverty alleviation, economic growth, education, and agricultural improvement. The best renewable energy source is one which is locally available, affordable, and can easily be used and managed by local communities. The usage of renewable energy technology has the potential to alleviate many of the current problems facing rural areas. To address energy poverty, biogas technology has become an important part of resolving such. This study, therefore, examines the performance of digesters in Gawula village; it also identifies the contributing factors to the adoption and use of the technology. Data was collected using an open-ended questionnaire from biogas users. To evaluate the performance of the digesters, a data envelopment analysis (DEA) non-parametric technique was used, and to identify key factors affecting adoption, a logit model was applied. The reviewed critical barriers to biogas development in the area seem to be a poor institutional framework, poor infrastructure, a lack of technical support, user training on maintenance and operation, and as such, the implemented plants have failed to make the desired impact. Thus most digesters were abandoned. To create awareness amongst rural communities, government involvement is key, and there is a need for national programs. Biogas technology does what few other renewable energy technologies do, which is to integrate waste management and energy. This creates a substantial opportunity for biogas generation and penetration. That is, a promising pathway towards achieving sustainable development through biogas technology.

Keywords: domestic biogas technology, economic, sustainable, social, rural development

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Authors: M. Bukowski, K. Kreissl

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Social and environmental pressures in our times bear threats that often cross-border in scale, such as climate change, poverty-driven migration, demographic change as well as socio-economic developments. One of the hot topics is prevailing in many societies across Europe and worldwide, concerns 'affordable housing' and poverty-driven international and domestic migration (including displacements through gentrification processes), focusing here on the urban and regional context. The right to adequate housing and shelter is one of the recognized in the Universal Declaration of Human rights and International Covenant on Economic, Social and Cultural Rights, and as such considered as a human right of the second generation. The decreasing supply of affordable housing, especially in urban areas, has reached dimensions that have led to an increasing 'housing crisis'. This crisis, which has even reached middle-income homes, has an even more devastating impact on low income and poor households raising poverty levels. Therefore, the understanding of the connection between housing and poverty is vital to integrate and support the different stakeholders in order to tackle poverty. When it comes to issues of inequalities and poverty within the SDG framework, multi-faceted stakeholders with different claims, distribution of resources and interactions with other development goals (spill-over and trade-offs) account for a highly complex context. To contribute to a sustainable and fair society and hence to support the UN Sustainable Development Goals, the University of Salzburg participates in the Austrian-wide universities' network 'UniNEtZ'. Our joint target is to develop an options report for the Austrian Government regarding the seventeen SDGs, so far hosted by 18 Austrian universities. In this vein, the University of Salzburg; i.e., the Centre for Ethics and Poverty Research, the departments of Geography and Geology and the Department of Sociology and Political Science are focusing on the SDG 1 (No Poverty) and SDG 10 (Reduced Inequalities). Our target and research focus is to assess and evaluate the status of SDG 1 and 10 in Austria, to find possible solutions and to support stakeholders' integration. We aim at generating and deducing appropriate options as scientific support, from interdisciplinary research studies to 'Sustainability Developing Goals and their Targets' in action. For this reason, and to deal with the complexity of the Agenda 2030, we have developed a special Model for Inequalities and Poverty Assessment (IPAM). Through the example of 'affordable housing' we provide insight into the situation focusing on sustainable outcomes, including ethical and justice perceptions. The IPAM has proven to be a helpful tool in detecting the different imponderables on the Agenda 2030, assessing the situation, showing gaps and options for ethical SDG actions combining different SDG targets. Supported by expert and expert group interviews, this assessment allows different stakeholders to overview a complex and dynamic SDG challenge (here housing) which is necessary to be involved in an action finding process.

Keywords: affordable housing, inequality, poverty, sustainable development goals

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Authors: Nur Atirah Hasmi, Nadia Nisha Musa, Hasnun Nita Ismail, Zulfadli Mahfodz

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The effect of water quality parameters on the abundance of aquatic insects has been studied in Batu Berangkai, Dipang, Kuala Woh and Lata Kinjang Rivers, Perak, northern peninsular Malaysia. The focuses are to compare the abundance of aquatic insects in each sampling areas and to investigate the physical and chemical factors (water temperature, depth of water, canopy, water velocity, pH value, and dissolved oxygen) on the abundance of aquatic insects. The samples and data were collected by using aquatic net and multi-probe parameter. Physical parameters; water velocity, water temperature, depth, canopy cover, and two chemical parameters; pH value and dissolved oxygen have been measured in situ and recorded. A total of 631 individuals classified into 6 orders and 18 families of aquatic insects were identified from four sampling sites. The largest percentage of samples collected is from order Plecoptera 35.8%, followed by Ephemeroptera 32.6%, Trichoptera 17.0%, Hemiptera 8.1%, Coleoptera 4.8%, and the least is Odonata 1.7%. The aquatic insects collected from Dipang River have the highest abundance of 273 individuals from 6 orders and 13 families and the least insects trapped at Lata Kinjang which only have 64 individuals from 5 orders and 6 families. There is significant association between different sampling areas and abundance of aquatic insects (p<0.05). High abundance of aquatic insects was found in higher water temperature, low water velocity, deeper water, low pH, high amount of dissolved oxygen, and the area that is not covered by canopy.

Keywords: aquatic insect, physicochemical parameter, river, water quality

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Authors: Hwasuk Jung, Seoi Lee, Dongchoon Ryou, Pyungjong Yoo, Seokmo Lee

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The Nakdong River being used as drinking water sources for Pusan metropolitan city has the vulnerability of water management due to the fact that industrial areas are located in the upper Nakdong River. Most citizens of Busan think that the water quality of Nakdong River is not good, so they boil or use home filter to drink tap water, which causes unnecessary individual costs to Busan citizens. We need to diversify water intake to reduce the cost and to change the weak water source. Under this background, this study was carried out for the environmental accounting of Namgang dam water treatment system compared to Nakdong River water treatment system by using emergy analysis method to help making reasonable decision. Emergy analysis method evaluates quantitatively both natural environment and human economic activities as an equal unit of measure. The emergy transformity of Namgang dam’s water was 1.16 times larger than that of Nakdong River’s water. Namgang Dam’s water shows larger emergy transformity than that of Nakdong River’s water due to its good water quality. The emergy used in making 1 m3 tap water from Namgang dam water treatment system was 1.26 times larger than that of Nakdong River water treatment system. Namgang dam water treatment system shows larger emergy input than that of Nakdong river water treatment system due to its construction cost of new pipeline for intaking Namgang daw water. If the Won used in making 1 m3 tap water from Nakdong river water treatment system is 1, Namgang dam water treatment system used 1.66. If the Em-won used in making 1 m3 tap water from Nakdong river water treatment system is 1, Namgang dam water treatment system used 1.26. The cost-benefit ratio of Em-won was smaller than that of Won. When we use emergy analysis, which considers the benefit of a natural environment such as good water quality of Namgang dam, Namgang dam water treatment system could be a good alternative for diversifying intake source.

Keywords: emergy, emergy transformity, Em-won, water treatment system

Procedia PDF Downloads 285

Authors: Sujan Mahamud

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Purpose: A major challenge in radiotherapy treatment is to deliver precise dose of radiation to the tumor with minimum dose to the healthy normal tissues. Recently, gel dosimetry has emerged as a powerful tool to measure three-dimensional (3D) dose distribution for complex delivery verification and quality assurance. These dosimeters act both as a phantom and detector, thus confirming the versatility of dosimetry technique. The aim of the study is to know the application of Gel Dosimeters in Radiotherapy and find out the comparison with 1D and 2D dimensional dosimeters. Methods and Materials: The study is carried out from Gel Dosimeter literatures. Secondary data and images have been collected from different sources such as different guidelines, books, and internet, etc. Result: Analyzing, verifying, and comparing data from treatment planning system (TPS) is determined that gel dosimeter is a very excellent powerful tool to measure three-dimensional (3D) dose distribution. The TPS calculated data were in very good agreement with the dose distribution measured by the ferrous gel. The overall uncertainty in the ferrous-gel dose determination was considerably reduced using an optimized MRI acquisition protocol and a new MRI scanner. The method developed for comparing measuring gel data with calculated treatment plans, the gel dosimetry method, was proven to be a useful for radiation treatment planning verification. In 1D and 2D Film, the depth dose and lateral for RMSD are 1.8% and 2%, and max (Di-Dj) are 2.5% and 8%. Other side 2D+ ( 3D) Film Gel and Plan Gel for RMSDstruct and RMSDstoch are 2.3% & 3.6% and 1% & 1% and system deviation are -0.6% and 2.5%. The study is investigated that the result fined 2D+ (3D) Film Dosimeter is better than the 1D and 2D Dosimeter. Discussion: Gel Dosimeters is quality control and quality assurance tool which will used the future clinical application.

Keywords: gel dosimeters, phantom, rmsd, QC, detector

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Authors: Sitira Williams, Georgina Cherry, Andrea Wright, Kevin Wells, Taran Rai, Richard Brown, Travis Street, Alasdair Cook

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Social media sources (50) were identified, keywords defined by veterinarians and organised into 6 topics known to be indicative of feline pruritus: body areas, behaviors, symptoms, diagnosis, and treatments. These were augmented using academic literature, a cat owner survey, synonyms, and Google Trends. The content was collected using a social intelligence solution, with keywords tagged and filtered. Data were aggregated and de-duplicated. SL content matching body areas, behaviors and symptoms were reviewed manually, and posts were marked relevant if: posted by a pet owner, identifying an itchy cat and not duplicated. A sub-set of 493 posts published from 2009-2022 was used for reflexive thematic analysis in NVIVO (Burlington, MA) to identify themes. Five themes were identified: allergy, pruritus, additional behaviors, unusual or undesirable behaviors, diagnosis, and treatment. Most (258) posts reported the cat was excessively licking, itching, and scratching. The majority were indoor cats and were less playful and friendly when itchy. Half of these posts did not indicate a known cause of pruritus. Bald spots and scabs (123) were reported, often causing swelling and fur loss, and 56 reported bumps, lumps, and dry patches. Other impacts on the cat’s quality of life were ear mites, cat self-trauma and stress. Seven posts reported their cats’ symptoms caused them ongoing anxiety and depression. Cats with food allergies to poultry (often chicken and beef) causing bald spots featured in 23 posts. Veterinarians advised switching to a raw food diet and/or changing their bowls. Some cats got worse after switching, leaving owners’ needs unmet. Allergic reactions to flea bites causing excessive itching, red spots, scabs, and fur loss were reported in 13 posts. Some (3) posts indicated allergic reactions to medication. Cats with seasonal and skin allergies, causing sneezing, scratching, headshaking, watery eyes, and nasal discharge, were reported 17 times. Eighty-five posts identified additional behaviors. Of these, 13 reported their cat’s burst pimple or insect bite. Common behaviors were headshaking, rubbing, pawing at their ears, and aggressively chewing. In some cases, bites or pimples triggered previously unseen itchiness, making the cat irritable. Twenty-four reported their cat had anxiety: overgrooming, itching, losing fur, hiding, freaking out, breathing quickly, sleeplessness, hissing and vocalising. Most reported these cats as having itchy skin, fleas, and bumps. Cats were commonly diagnosed with an ear infection, ringworm, acne, or kidney disease. Acne was diagnosed in cats with an allergy flare-up or overgrooming. Ear infections were diagnosed in itchy cats with mites or other parasites. Of the treatments mentioned, steroids were most frequently used, then anti-parasitics, including flea treatments and oral medication (steroids, antibiotics). Forty-six posts reported distress following poor outcomes after medication or additional vet consultations. SL provides veterinarians with unique insights. Verbatim comments highlight the detrimental effects of pruritus on pets and owner quality of life. This study demonstrates the need for veterinarians to communicate management and treatment options more effectively to relieve owner frustrations. Data analysis could be scaled up using machine learning for topic modeling.

Keywords: content analysis, feline, itch, pruritus, social media, thematic analysis, veterinary dermatology

Procedia PDF Downloads 171

Authors: Jung Yoon Kim

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Introduction: Wounds inevitably cause patients to experience discomfort, distress, and consequentially reduced quality of life due to entailed pain, maceration, and foul odor. The dressing has been a universal wound care method in which wounds are covered and protected, and an optimum environment for healing is provided. This study aimed to investigate Korean nurses’ level of awareness of pain and skin tearing in wound beds and/or peri-wound skin at dressing change. Methods: A descriptive study was performed. Convenience sampling was employed, and registered nurses were recruited from attendees of continuing education program. A total of 399 participants (RN) completed the questionnaire. Data were collected from September to November 2022. Results: Many of them perceived skin tearing and wound-related pain associated with dressing changes, but most of them did not assess and record pain and skin tearing at dressing change. More than half of the respondents reported that they did not provide nursing intervention to prevent pain and skin tearing. Many of them reported that a systematic educational program for preventing pain and skin tearing at dressing changes was needed. Discussion: Many of the respondents were aware of pain and skin tearing at dressing change but did not take any further necessary measures, including nursing intervention, for the most appropriate, systematic pain and skin tearing management. Therefore, this study suggested that a systematic and comprehensive educational program for Korean healthcare professionals needs to be developed and implemented in Korea’s hospital settings.

Keywords: skin tearing, pain, dressing change, nurses

Procedia PDF Downloads 89

Authors: Carmen Axisa, Louise Nash, Patrick Kelly, Simon Willcock

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Introduction: Doctors experience high levels of burnout, stress and psychiatric morbidity. This can affect the health of the doctor and impact patient care. Study Aims: To evaluate the effectiveness of a workshop intervention to promote wellbeing for Australian Physician Trainees. Methods: A workshop was developed in consultation with specialist clinicians to promote health and wellbeing for physician trainees. The workshop objectives were to improve participant understanding about factors affecting their health and wellbeing, to outline strategies on how to improve health and wellbeing and to encourage participants to apply these strategies in their own lives. There was a focus on building resilience and developing long term healthy behaviours as part of the physician trainee daily lifestyle. Trainees had the opportunity to learn practical strategies for stress management, gain insight into their behaviour and take steps to improve their health and wellbeing. The workshop also identified resources and support systems available to trainees. The workshop duration was four and a half hours including a thirty- minute meal break where a catered meal was provided for the trainees. Workshop evaluations were conducted at the end of the workshop. Sixty-seven physician trainees from Adult Medicine and Paediatric training programs in Sydney Australia were randomised into intervention and control groups. The intervention group attended a workshop facilitated by specialist clinicians and the control group did not. Baseline and post intervention measurements were taken for both groups to evaluate the impact and effectiveness of the workshop. Forty-six participants completed all three measurements (69%). Demographic, personal and self-reported data regarding work/life patterns was collected. Outcome measures include Depression Anxiety Stress Scale (DASS), Professional Quality of Life Scale (ProQOL) and Alcohol Use Disorders Identification Test (AUDIT). Results: The workshop was well received by the physician trainees and workshop evaluations showed that the majority of trainees strongly agree or agree that the training was relevant to their needs (96%) and met their expectations (92%). All trainees strongly agree or agree that they would recommend the workshop to their medical colleagues. In comparison to the control group we observed a reduction in alcohol use, depression and burnout but an increase in stress, anxiety and secondary traumatic stress in the intervention group, at the primary endpoint measured at 6 months. However, none of these differences reached statistical significance (p > 0.05). Discussion: Although the study did not reach statistical significance, the workshop may be beneficial to physician trainees. Trainees had the opportunity to share ideas, gain insight into their own behaviour, learn practical strategies for stress management and discuss approach to work, life and self-care. The workshop discussions enabled trainees to share their experiences in a supported environment where they learned that other trainees experienced stress and burnout and they were not alone in needing to acquire successful coping mechanisms and stress management strategies. Conclusion: These findings suggest that physician trainees are a vulnerable group who may benefit from initiatives that promote wellbeing and from a more supportive work environment.

Keywords: doctors' health, physician burnout, physician resilience, wellbeing workshop

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Authors: Malgorzata Sekulowicz, Krystyna Boron-Krupinska, Paulina Morga, Blazej Cieslik

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Burnout is highly prevalent in health care employees, especially in physicians. It significantly reduces the efficiency of these employees, which can have negative consequences for both physicians and patients. Resilience and mindfulness enhancing positive emotions, leading to sustainable development and personal commitment, can have a significant impact on burnout. Therefore, the aim of this study was to determine the relationship between burnout symptoms and mindfulness and resilience among physicians. The authors conducted a cross-sectional survey study among seventy-four polish physicians. Participants filled out the following psychometric tools: the Maslach Burnout Inventory - Human Services Survey (MBI-HSS), Five Facet Mindfulness Questionnaire (FFMQ), Areas of Work-Life Survey (AWS), International Personality Item Pool (IPIP), the Resilience Assessment Scale (SPP-25) and the Mini-COPE Inventory. The relationship between burnout and resilience and mindfulness was assessed with path analysis. Analyzing the relationship between MBI-HSS components and mindfulness, a significant negative correlation of the FFMQ score with emotional exhaustion (-0.50, p < 0.05) and depersonalization (-0.43, p < 0.05) and a positive correlation with personal accomplishment (0.50, p < 0.05) was demonstrated. Analyzing resilience, a statistically significant relationship of SPP-25 with all tested components of MBI-HSS was demonstrated: emotional exhaustion (-0.54, p < 0.05), depersonalization (-0.31, p < 0.05) and personal accomplishment (0.35, p < 0.05). In the group of medical doctors, the higher the level of mindfulness and resilience, the lower the risk of burnout. Furthermore, the more frequently used active coping strategies (planning, acceptance), the lower the risk of burnout, while the use of passive, evasive strategies increases the risk of burnout. It may be worth considering implementing mindfulness intervention to effectively manage burnout symptoms in this group.

Keywords: burnout, medical doctors, mindfulness, physicians, resilience

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Authors: Tyler D. Cesarone, Tatiana M. Wugalter

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The movement of patients from the Global North to the Global South in pursuit of inexpensive healthcare and touristic experiences dominates the academic discourse on international medical travel (IMT). However, medical travel exists in higher numbers between Global South countries as patients who lack trust in, and feel disenfranchised by, their national healthcare systems seek treatment in nearby countries. Through a review of the existing literature, this paper examines patterns of IMT in the Middle East, Southeast Asia, and Southern Africa, distinguishing North-South medical tourism from South-South intra-regional medical mobility (IRMM). Evidence from these case studies demonstrates that notions of medical distrust and disenfranchisement, rooted in low-resourced and poor quality healthcare systems, are key drivers of IRMM in the Global South. The movement of patients from lower income to proximate higher income countries not only reveals tensions between patients and their healthcare systems but widens gaps in the quality of healthcare between departing and destination countries. In analyzing these cross-regional similarities, the paper moves beyond the current literature’s focus on singular case studies to expose global patterns of South-South IRMM. This presents a shift from the traditional focus on North-South medical tourism, demonstrating how disparities in healthcare systems both influence and are influenced by IRMM.

Keywords: global South, healthcare quality, international medical travel (IMT), intra-regional medical mobility (IRMM), medical disenfranchisement, medical distrust, medical tourism

Procedia PDF Downloads 387