Search results for: international perspective

Authors: Mohammed Agbali, Claudia Trillo, Yusuf Arayici, Terrence Fernando

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The wide-spread adoption of the Smart City concept has introduced a new era of computing paradigm with opportunities for city administrators and stakeholders in various sectors to re-think the concept of urbanization and development of healthy cities. With the world population rapidly becoming urban-centric especially amongst the emerging economies, social innovation will assist greatly in deploying emerging technologies to address the development challenges in core sectors of the future cities. In this context, sustainable health-care delivery and improved quality of life of the people is considered at the heart of the healthy city agenda. This paper examines the Boston innovation landscape from the perspective of smart services and innovation ecosystem for sustainable development, especially in transportation and healthcare. It investigates the policy implementation process of the Healthy City agenda and eHealth economy innovation based on the experience of Massachusetts’s City of Boston initiatives. For this purpose, three emerging areas are emphasized, namely the eHealth concept, the innovation hubs, and the emerging technologies that drive innovation. This was carried out through empirical analysis on results of public sector and industry-wide interviews/survey about Boston’s current initiatives and the enabling environment. The paper highlights few potential research directions for service integration and social innovation for deploying emerging technologies in the healthy city agenda. The study therefore suggests the need to prioritize social innovation as an overarching strategy to build sustainable Smart Cities in order to avoid technology lock-in. Finally, it concludes that the Boston example of innovation economy is unique in view of the existing platforms for innovation and proper understanding of its dynamics, which is imperative in building smart and healthy cities where quality of life of the citizenry can be improved.

Keywords: computing paradigm, emerging technologies, equitable healthcare, healthy cities, open data, smart city, social innovation

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Authors: Humraaz Kaja, Kofi Mensah, Frasia Oosthuizen

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Background and Aim: Vilazodone was approved in 2011 as an antidepressant to treat the major depressive disorder. As a relatively new drug, it is not clear if all adverse effects have been identified. The aim of this study was to review the adverse effects reported to the WHO Programme for International Drug Monitoring (PIDM) in order to add to the knowledge about the safety profile and adverse effects caused by vilazodone. Method: Data on adverse effects reported for vilazodone was obtained from the database VigiAccess managed by PIDM. Data was extracted from VigiAccess using Excel® and analyzed using descriptive statistics. The data collected was compared to the patient information leaflet (PIL) of Viibryd® and the FDA documents to determine adverse drug reactions reported post-marketing. Results: A total of 9708 adverse events had been recorded on VigiAccess, of which 6054 were not recorded on the PIL and the FDA approval document. Most of the reports were received from the Americas and were for adult women aged 45-64 years (24%, n=1059). The highest number of adverse events reported were for psychiatric events (19%; n=1889), followed by gastro-intestinal effects (18%; n=1839). Specific psychiatric disorders recorded included anxiety (316), depression (208), hallucination (168) and agitation (142). The systematic review confirmed several psychiatric adverse effects associated with the use of vilazodone. The findings of this study suggested that these common psychiatric adverse effects associated with the use of vilazodone were not known during the time of FDA approval of the drug and is not currently recorded in the patient information leaflet (PIL). Conclusions: In summary, this study found several adverse drug reactions not recorded in documents emanating from clinical trials pre-marketing. This highlights the importance of continued post-marketing surveillance of a drug, as well as the need for further studies on the psychiatric adverse events associated with vilazodone in order to improve the safety profile.

Keywords: adverse drug reactions, pharmacovigilance, post-marketing surveillance, vilazodone

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Authors: Abeer K. Jameel, Harry Evdorides

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Iraq is a middle income country where the road safety issue is considered one of the leading causes of deaths. To control the road risk issue, the Iraqi Ministry of Planning, General Statistical Organization started to organise a collection system of traffic accidents data with details related to their causes and severity. These data are published as an annual report. In this paper, a review of the available crash data in Iraq will be presented. The available data represent the rate of accidents in aggregated level and classified according to their types, road users’ details, and crash severity, type of vehicles, causes and number of causalities. The review is according to the types of models used in road safety studies and research, and according to the required road safety data in the road constructions tasks. The available data are also compared with the road safety dataset published in the United Kingdom as an example of developed country. It is concluded that the data in Iraq are suitable for descriptive and exploratory models, aggregated level comparison analysis, and evaluation and monitoring the progress of the overall traffic safety performance. However, important traffic safety studies require disaggregated level of data and details related to the factors of the likelihood of traffic crashes. Some studies require spatial geographic details such as the location of the accidents which is essential in ranking the roads according to their level of safety, and name the most dangerous roads in Iraq which requires tactic plan to control this issue. Global Road safety agencies interested in solve this problem in low and middle-income countries have designed road safety assessment methodologies which are basing on the road attributes data only. Therefore, in this research it is recommended to use one of these methodologies.

Keywords: road safety, Iraq, crash data, road risk assessment, The International Road Assessment Program (iRAP)

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Authors: Serkan Tezgel

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Effectively managing threats and power that transcend national boundaries requires a reformulation from the traditional post-modern navy to an adaptive and institutional transnational navy. By analyzing existing soft power concept, post-modern navy, and sea power, this study proposes the transnational navy, founded on the triangle of main attributes of transnational companies, 'Global Competitiveness, Local Responsiveness, Worldwide Learning and Innovation Sharing', a new model which will lead to a positive peace with an institutional network. This transnational model necessitates 'Transnational Navies' to help establish peace with collective and transnational understanding during a transition period 'Reactive Postmodern Navy' has been experiencing. In this regard, it is fairly claimed that a new paradigm shift will revolve around sea power to establish good order at sea with collective and collaborative initiatives and bound to breed new theories and ideas in the forthcoming years. However, there are obstacles to overcome. Postmodern navies, currently shaped by 'Collective Maritime Security' and 'Collective Defense' concepts, can not abandon reactive applications and acts. States deploying postmodern navies to realize their policies on international platforms and seapower structures shaped by the axis of countries’ absolute interests resulted in multipolar alliances and coalitions, but the establishment of the peace. These obstacles can be categorized into three tiers in establishing a unique transnational model navy: Strategic, Organizational and Management challenges. To overcome these obstacles and challenges, postmodern navies should transform into cooperative, collective and independent soft transnational navies with the transnational mentality, global commons, and institutional network. Such an adaptive institution can help the world navigate to a positive peace.

Keywords: postmodern navy, transnational navy, transnational mentality, institutional network

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Authors: Saimir Heta, Kers Kapaj, Rialda Xhizdari, Ilma Robo

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Despite the existence of different dental specialties, the dentist-patient relationship is unique, in the very fact that the treatment is performed by one doctor and the patient identifies the malpractice presented as part of that doctor's practice; this is in complete contrast to cases of medical treatments where the patient can be presented to a team of doctors, to treat a specific pathology. The rules of dental ethics are almost the same as the rules of medical ethics. The appearance of dental malpractice affects exactly this two-party relationship, created on the basis of professionalism, without deviations in this direction, between the dentist and the patient, but with very narrow individual boundaries, compared to cases of medical malpractice. Main text: Malpractice can have different reasons for its appearance, starting from professional negligence, but also from the lack of professional knowledge of the dentist who undertakes the dental treatment. It should always be seen in perspective that we are not talking about the individual - the dentist who goes to work with the intention of harming their patients. Malpractice can also be a consequence of the impossibility, for anatomical or physiological reasons of the tooth under dental treatment, to realize the predetermined dental treatment plan. On the other hand, the dentist himself is an individual who can be affected by health conditions, or have vices that affect the systemic health of the dentist as an individual, which in these conditions can cause malpractice. So, depending on the reason that led to the appearance of malpractice, the method of treatment from a legal point of view also varies, for the dentist who committed the malpractice, evaluating the latter if the malpractice came under the conditions of applying the rules of dental ethics. Conclusions: The deviation from the predetermined dental plan is the minimum sign of malpractice and the latter should not be definitively related only to cases of difficult dental treatments. The identification of the reason for the appearance of malpractice is the initial element, which makes the difference in the way of its treatment, from a legal point of view, and the involvement of the dentist in the assessment of the malpractice committed, must be based on the legislation in force, which must be said to have their specific changes in different states. Malpractice should be referred to, or included in the lectures or in the continuing education of professionals, because it serves as a method of obtaining professional experience in order not to repeat the same thing several times, by different professionals.

Keywords: dental ethics, malpractice, negligence, legal basis, continuing education, dental treatments

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Authors: Ramin Mirzada, Takuya Maruyama

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Kabul is the heart of political, commercial, cultural, educational and social life in Afghanistan and the fifth fastest growing city in the world. Minimum income inclined most of Kabul residents to use public transport, especially buses, although there is no proper bus system, beside that there is no proper fare exist in Kabul city Due to wars. From 1992 to 2001 during civil wars, Kabul suffered damage and destruction of its transportation facilities including pavements, sidewalks, traffic circles, drainage systems, traffic signs and signals, trolleybuses and almost all of the public transport system (e.g. Millie bus). This research is mainly focused on Kabul city’s transportation system. In this research, the data used have been gathered by Japan International Cooperation Agency (JICA) in 2008 and this data will be used to find demand and fare structure, additionally a survey was done in 2016 to find satisfaction level of Kabul residents for fare structure. Aim of this research is to observe the demand for Large Buses, compare to the actual supply from the government, analyze the current fare structure and compare it with the proposed fare (distance based fare) structure which has already been analyzed. Outcome of this research shows that the demand of Kabul city residents for the public transport (Large Buses) exceeds from the current supply, so that current public transportation (Large Buses) is not sufficient to serve public transport in Kabul city, worth to be mentioned, that in order to overcome this problem, there is no need to build new roads or exclusive way for buses. This research proposes government to change the fare from fixed fare to distance based fare, invest on public transportation and increase the number of large buses so that the current demand for public transport is met.

Keywords: transportation, planning, public transport, large buses, Kabul, Afghanistan

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Authors: Lovis Ingrid Hakala

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This paper provides an example of how the dating app Tinder can be used as a tool in queer research and what the use of the app among lesbians can tell us about the production of particular kinds of lesbian identities paired with technology. This study seeks to understand the ways in which the app is understood by lesbian women and how it is brought into their understandings of what being a lesbian means. Dating apps are becoming increasingly common as tools for meeting a potential partner and research has shown how these apps gain new meaning depending on the context. This paper will show both how Tinder has gained a particular meaning in a lesbian context in Bologna, and also how the use of Tinder produces specific ideas of what lesbians are and how they act. While doing ethnographic fieldwork among young lesbians (20-30 years old) in Bologna in the autumn of 2017, as a part of the research methodology, Tinder was used together with interviews and participant observation. By signing up on Tinder and contacting potential informants on the app the aim was to reach women who were not necessarily involved in the queer activist spaces in the city and who might thus provide a different perspective than their activist counterparts. Using Tinder as a tool in research proved to be a useful methodology both when it came to contacting potential informants as well as in gaining a better understanding for queer identity building, and the role Tinder played in defining lesbianism in Bologna. The app itself was often deemed useless, and informants often complained about the lack of women on the app who had their profile showing an interest in women. Apart from being away for the interlocutors to get in touch with potential romantic or sexual partners, the app did provide a concrete object around which to define particular lesbian behavior. Lesbians were described to be slow at answering and not being very eager to meet. This placed lesbian women, in contrast to gay men who were seen as doing the opposite, using dating apps a lot and be quick to propose meetings. Tinder among lesbians in Bologna thus proved to have a dual function as both a way of creating connections between queer women but also as a tool to define what a lesbian is. This paper provides insight into the ways in which dating apps provides a community and identity building function and how a certain behavior on said apps can be a part of defining identity. This work stands out among other literature on dating apps since it does not only focus on the methodological aspects of using Tinder as a tool in research but also provides an insight in how the way in which individuals use the app comes to add to an understanding of what a lesbian is.

Keywords: dating apps, identity, Italy, lesbian, queer

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Authors: Asharaf Abdul Salam, Ibrahim Elsegaey, Rshood Khraif, Abdullah AlMutairi, Ali Aldosari

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Arab World that comprises of 22 member states of Arab League undergoes rapid transition in demographic front - fertility, mortality and migration. A distinctive geographic region spread across West Asia and North East Africa unified by Arabic language shares common values and characteristics even though diverse in economic and political conditions. Demographic lag that characterizes Arab World is unique but the present trend of declining fertility combined with the existing relatively low mortality undergoes significant changes in its population size. The current research aimed at (i) assessing the growth of population, over a period of 3 decades, (ii) exploring the components and (iii) understanding the public health impact. Based on International Data Base (IDB) of US Census Bureau, for 3 time periods – 1992, 2002 and 2012; 21 countries of Arab World have been analyzed by dividing them into four geographic sectors namely Gulf Cooperation Council (GCC), West Asia, Maghreb and Nile Valley African Horn. Population of Arab World grew widely during the past both through natural growth and migration. Immigrations pronounced especially in the resource intensive GCC nations not only from East Asian and central African countries but also from resource thrifty Arab nations. Migrations within the Arab World as well as outside of the Arab World remark an interesting demographic phenomenon that requires further research. But the transformations on public health statistics – impact of demographic change – depict a new era in the Arab World.

Keywords: demographic change, public health statistics, net migration, natural growth, geographic sectors, fertility and mortality, life expectancy

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Authors: Fernando Seabra, Giulia P. Flores, Karolina C. Gomes

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Trade liberalizations measures, as import tariff cuts, are not a sufficient trigger for trade growth. Given that price margins are narrow, traders and cargo operators tend to opt out of markets where the process of goods clearance is slow and costly. Excess paperwork and slow customs dispatch not only lead to institutional breakdowns and corruption but also to increasing transaction cost and trade constraints. The objective of this paper is, therefore, two-fold: First, to evaluate the relationship between institutional and infrastructural performance indexes and trade growth in container throughput; and, second, to investigate the causes for differences in container demurrage and detention fees in Latin American countries (using other emerging countries as benchmarking). The analysis is focused on manufactured goods, typically transported by containers. Institutional and infrastructure bottlenecks and, therefore, the country logistics efficiency – measured by the Logistics Performance Index (LPI, World Bank-WB) – are compared with other indexes, such as the Doing Business index (WB) and the Corruption Perception Index (Transparency International). The main results based on the comparison between Latin American countries and the others emerging countries point out in that the growth in containers trade is directly related to LPI performance. It has also been found that the main hypothesis is valid as aspects that more specifically identify trade facilitation and corruption are significant drivers of logistics performance. The exam of port efficiency (demurrage and detention fees) has demonstrated that not necessarily higher level of efficiency is related to lower charges; however, reductions in fees have been more significant within non-Latin American emerging countries.

Keywords: corruption, logistics performance index, container throughput, Latin America

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Authors: Hassan Y. Kikhia, Jin P. Zhang, Khaldoon G. Albiatr

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The Enron and Arthur Andersen scandal has raised concerns internationally about auditor independence and audit quality. Furthermore, the debate continues about the relationship between audit fees, auditor tenure and audit quality in spite of extensive empirical evidence examining audit failures and earnings management. Therefore, the purpose of current research is to determine the effect of audit fee and audit tenure both partially and simultaneously on the audit quality. Using a sample of Chinese firms, an environment where we believe it provides us with an opportunity to test whether the development of market and legal institutions affects the impact of audit fees and auditor tenure on audit quality. We employ the standard deviation of residuals from regressions relating current accruals to cash flows as proxy for audit quality. The paper documents statistically significant negative association between audit fees and audit quality. These findings are consistent with economic bonding being a determinant of auditor behavior rather than auditor reputational concerns. Further, the current paper shows a positive association between auditor tenure and audit quality in the earlier years of audit tenure. These results support the proposition that when the Learning Effect dominates the Bonding Effect in the earlier years of tenure, then audit quality is likely to be higher. Taken audit fees and audit tenure together, the results suggest that there is positive association between audit fees and audit quality in the earlier years of auditor tenure. Interestingly, the findings of our study have important implications for auditors, policymakers, multinational firms, and users of financial reports. As the rapid growth of China's economy gains global recognition, the Chinese stock market is capturing the attention of international investors. To a lesser extent, our paper also differs from the prior studies in methodology and findings in the investigation of audit quality.

Keywords: audit quality, accruals quality, audit fees, auditor tenure

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Authors: Gabriela Lucas Sanchez

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The contemporary housing industry is dominated by tract houses, which prioritize uniformity and cost-efficiency over environmental and ecological considerations. However, as the world faces the growing challenges of climate change and resource depletion, there is an urgent need to rethink the residential paradigm. This essay explores how regenerative practices can be integrated into standard residential designs to create a shift that reduces the environmental impact of housing and actively contributes to ecological health. Passive sustainable practices, such as passive solar design, natural ventilation, and the use of energy-efficient materials, aim to maximize resource use efficiency, minimize waste, and create healthy living environments. Regenerative practices, on the other hand, go beyond sustainability to work in harmony with natural systems, actively restoring and enriching the environment. Integrating these two approaches can redefine the residential paradigm, creating homes that reduce harm and positively impact the local ecosystem. The essay begins by exploring the principles and benefits of passive sustainable practices, discussing how they can reduce energy consumption and improve indoor environmental quality in standardized housing. Passive sustainability minimizes energy consumption through strategic design choices, such as optimizing building orientation, utilizing natural ventilation, and incorporating high-performance insulation and glazing. However, while sustainability efforts have been important steps in the right direction, a more holistic, regenerative approach is needed to address the root causes of environmental degradation. Regenerative development and design seek to go beyond simply reducing negative impacts, instead aiming to create built environments that actively contribute to restoring and enhancing natural systems. This shift in perspective is critical, as it recognizes the interdependence between human settlements and the natural world and the potential for buildings to serve as catalysts for positive change.

Keywords: passive sustainability, regenerative architecture, residential architecture, community

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Authors: Muhammet Şahal, Oğuz Köklü

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As statistical thinking and problem-solving processes have become increasingly important, teachers need to be more rigorously prepared with statistical knowledge to teach their students effectively. This study examined preservice mathematics teachers' development of statistical investigation projects using data and exploratory data analysis tools, following a design-based research perspective and statistical investigation cycle. A total of 26 pre-service senior mathematics teachers from a public university in Turkiye participated in the study. They formed groups of 3-4 members voluntarily and worked on their statistical investigation projects for six weeks. The data sources were audio recordings of pre-service teachers' group discussions while working on their projects in class, whole-class video recordings, and each group’s weekly and final reports. As part of the study, we reviewed weekly reports, provided timely feedback specific to each group, and revised the following week's class work based on the groups’ needs and development in their project. We used content analysis to analyze groups’ audio and classroom video recordings. The participants encountered several difficulties, which included formulating a meaningful statistical question in the early phase of the investigation, securing the most suitable data collection strategy, and deciding on the data analysis method appropriate for their statistical questions. The data collection and organization processes were challenging for some groups and revealed the importance of comprehensive planning. Overall, preservice senior mathematics teachers were able to work on a statistical project that contained the formulation of a statistical question, planning, data collection, analysis, and reaching a conclusion holistically, even though they faced challenges because of their lack of experience. The study suggests that preservice senior mathematics teachers have the potential to apply statistical knowledge and techniques in a real-world context, and they could proceed with the project with the support of the researchers. We provided implications for the statistical education of teachers and future research.

Keywords: design-based study, pre-service mathematics teachers, statistical investigation projects, statistical model

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Authors: Anjali Kanagali, Astha Sinha

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Climate change is the greatest threat being faced by mankind in the 21st century. It no longer is merely an environmental, scientific or economic issue but is a humanitarian issue as well. Paris Agreement put great pressure on the businesses to reduce carbon emissions and mitigate the impact of climate change. However, the already increased climate variability and extreme weather are aggravating emergency humanitarian needs. According to the Intergovernmental Panel on Climate Change (IPCC), if efficient policy changes are not made in time to combat the climate change issues, the situation will deteriorate with an estimated global temperature rise of 4 degrees. The existing international network of Humanitarian system is not adequately structured to handle the projected natural disasters and climate change crisis. The 2030 Agenda which embraces the 17 Sustainable Development Goals (SGDs) discussed the relationship between the climate change and humanitarian assistance. The Humanitarian law aims to protect, amongst other things, ‘internally displaced persons’ which includes people displaced due to natural hazard related disasters engulfing the hazards of climate change. ‘Legal protection’ of displaced people to protect their rights is becoming a pressing need in such times. In this paper, attempts will be made to analyze the causes of the displacement, identify areas where the effect of the climate change is most likely to occur and to examine the character of forced displacement triggering population movement. We shall discuss the pressure on the Humanitarian system and assistance due to climate change issues and the need for vesting powers to the local communities or local government players to deal with the climate changes. We shall also discuss the possibility of setting up a new framework where non-state actors could be set up for climate change impact and its governance.

Keywords: humanitarian assistance to climate change, humanitarian crisis, internally displaced person, legal framework for climate migrants, non-state actors

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Authors: Daryl Clement Knutt, Neela Badrie, Marsha Singh

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Quality assurance and product labelling are vital in the food and drink industry, as a tactical tool in a competitive environment. The food label is a principal marketing tool which also serves as a regulatory mechanism in the safeguarding of consumer well –being. The objective of this study was to evaluate the level of consumers’ use and understanding of food labeling information and knowledge pertaining to food quality assurance systems. The study population consisted of Trinidadian adults, who were over the age of 18 (n=384). Data collection was conducted via a self-administered questionnaire, which contained 31 questions, comprising of four sections: I. socio demographic information; II. food quality and quality assurance; III. use of Labeling information; and IV. laws and regulations. Sampling was conducted at six supermarkets, in five major regions of the country over a period of three weeks in 2014. The demographic profile of the shoppers revealed that majority was female (63.6%). The gender factor and those who were concerned about the nutrient content of their food, were predictive indicators of those who read food labels. Most (93.1%) read food labels before purchase, 15.4% ‘always’; 32.5% ‘most times’ and 45.2% ‘sometimes’. Some (42%) were often satisfied with the information presented on food labels, whilst 35.7% of consumers were unsatisfied. When the respondents were questioned on their familiarity with terms ‘food quality’ and ‘food quality assurance’, 21.3% of consumers replied positively - ‘I have heard the terms and know a lot’ whilst 37% were only ‘somewhat familiar’. Consumers were mainly knowledgeable of the International Standard of Organization (ISO) (51.5%) and Good Agricultural Practices GAP (38%) as quality tools. Participants ranked ‘nutritional information’ as the number one labeling element that should be better presented, followed by ‘allergy notes’ and ‘best before date’. Females were more inclined to read labels being the household shoppers. The shoppers would like better presentation of the food labelling information so as to guide their decision to purchase a product.

Keywords: food labels, food quality, nutrition, marketing, Trinidad, Tobago

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Authors: Ahmed M. Khedr, Saad M. Abdelrahman, Kareem M. Tonbol

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Two geo-referenced sea level datasets (September 2008 – November 2010) and (April 2012 – January 2014) were recorded at Alexandria Western Harbour (AWH). Accurate re-definition of tidal datum, referred to the latest International Terrestrial Reference Frame (ITRF-2014), was discussed and updated to improve our understanding of the old predefined tidal datum at Alexandria. Tidal and non-tidal components of sea level were separated with the use of Delft-3D hydrodynamic model-tide suit (Delft-3D, 2015). Tidal characteristics at AWH were investigated and harmonic analysis showed the most significant 34 constituents with their amplitudes and phases. Tide was identified as semi-diurnal pattern as indicated by a “Form Factor” of 0.24 and 0.25, respectively. Principle tidal datums related to major tidal phenomena were recalculated referred to a meaningful geodetic height datum. The portion of residual energy (surge) out of the total sea level energy was computed for each dataset and found 77% and 72%, respectively. Power spectral density (PSD) showed accurate resolvability in high band (1–6) cycle/days for the nominated independent constituents, except some neighbouring constituents, which are too close in frequency. Wind and atmospheric pressure data, during the recorded sea level time, were analysed and cross-correlated with the surge signals. Moderate association between surge and wind and atmospheric pressure data were obtained. In addition, long-term sea level rise trend at AWH was computed and showed good agreement with earlier estimated rates.

Keywords: Alexandria, Delft-3D, Egypt, geodetic reference, harmonic analysis, sea level

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Authors: R. K. Yadav, S. Baral, H. R. Paudel, R. Basnet

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The Public-Private Mix (PPM) approach is a strategic initiative that involves engaging all private and public healthcare providers in the fight against tuberculosis using international healthcare standards. For tuberculosis control in Nepal, the PPM approach could be a milestone. This study aimed to explore the barriers to a public-private mix approach in the management of tuberculosis cases in Nepal. A total of 20 respondents participated in the study. Barriers to PPM were identified in the following three themes: 1) Obstacles related to TB case detection, 2) Obstacles related to patients, and 3) Obstacles related to the healthcare system. PPM implementation was challenged by following subthemes that included staff turnover, low private sector participation in workshops, a lack of training, poor recording and reporting, insufficient joint monitoring and supervision, poor financial benefit, lack of coordination and collaboration, and non-supportive TB-related policies and strategies. The study concludes that numerous barriers exist in the way of effective implementation of the PPM approach, including TB cases detection barriers such as knowledge of TB diagnosis and treatment, HW attitude, workload, patient-related barriers such as knowledge of TB, self-medication practice, stigma and discrimination, financial status, and health system-related barriers such as staff turnover and poor engagement of the private sector in workshops, training, recording, and re-evaluation. Government stakeholders must work together with private sector stakeholders to perform joint monitoring and supervision. Private practitioners should receive training and orientation, and presumptive TB patients should be given adequate time and counseling as well as motivation to visit a government health facility.

Keywords: barrier, tuberculosis, case finding, PPM, nepal

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Authors: Aisha Arshad, Samina Naz Mukry, Tahir Shamsi

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Background: Immune thrombocytopenia (ITP) is an autoimmune disorder. Besides platelets counts, immature platelets fraction (IPF) can be used as tool to predict megakaryocytic activity in ITP patients. The clinical biomarkers like Neutrophils to lymphocytes ratio (NLR) and platelet to lymphocytes ratio(PLR) predicts inflammation and can be used as prognostic markers.The present study was planned to assess the ratios in ITP and their utility in predicting prognosis after treatment. Methods: A total of 111 patients of ITP with same number of healthy individuals were included in this case control study during the period of January 2015 to December 2017.All the ITP patients were grouped according to guidelines of International working group of ITP. A 3cc blood was collected in EDTA tube and blood parameters were evaluated using Sysmex 1000 analyzer.The ratios were calculated by using absolute counts of Neutrophils,Lymphocytes and platelets.The significant (p=<0.05) difference between ITP patients and healthy control groups was determined by Kruskal wallis test, Dunn’s test and spearman’s correlation test was done using SPSS version 23. Results: The significantly raised total leucocytes counts (TLC) and IPF along with low platelets counts were observed in ITP patients as compared to healthy controls.In ITP groups,very low platelet count with median and IQR of 2(3.8)3x109/l with highest mean and IQR IPF 25.4(19.8)% was observed in newly diagnosed ITP group. The NLR was high with prognosis of disease as higher levels were observed in P-ITP. The PLR was significantly low in ND-ITP ,P-ITP, C-ITP, R-ITP and compared to controls with p=<0.001 as platelet were less in number in all ITP patients. Conclusion: The IPF can be used in evaluation of bone marrow response in ITP. The simple, reliable and calculated NLR and PLR ratios can be used in predicting prognosis and response to treatment in ITP and to some extend the severity of disease.

Keywords: neutrophils, platelets, lymphocytes, infection

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Authors: Sohail Bawani, Kausar S. Khan, Rozina Karmaliani, Shehnaz Mir

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Action research (AR) is one of the types of health systems research (HSR), and participatory action research (PAR) is known for being effective in health systems strengthening (HSS). The current literature on PAR for HSS cites numerous examples and case studies that led to improve health services; build child health information system; increase knowledge and awareness of people about health problems, and identify pathways for institutional and policy change by engaging people in research. But examples of marginalized communities being agents of change in health governance are not common in health systems research (HSR). This approach to PAR is at the heart of Paolo Freire’s Social Transformation Theory and Critical Consciousness building, which was used to design a community-based PAR study in the Northern/mountainous areas of Pakistan. The purpose of the study was to understand the place and role of marginalized communities in strengthening existing health governance structure (health facility and village health committees and health boards) by taking marginalized communities as partners. Community meetings were carried out to identify who is living at the social, political, cultural and economic margins in 40 different villages. Participatory reflection and analysis (PRA) tools were used during the meeting to facilitate identification. Focus group discussions were conducted with marginalized groups using PRA tools and family ethnographies with marginalized families identified through group discussions. Findings of the study revealed that for the marginalized health systems constitute more than just delivery of health services, but it also embraces social determinants that surround systems and its governance. The paper argues that from Frerian perspective people’s participation should not only be limited to knowledge generation. People must be seen active users of the knowledge that they generate for achieving better health outcomes that they want to achieve in the time to come. PAR provides a pathway to the marginalized in playing a role in health governance. The study dissemination planned shall engage the marginalized in a dialogue with service providers so that together a role for the marginalized can be outlined.

Keywords: participatory action research, health systems, marginalized, health services

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Authors: Anum Obaid, Iman Fatima, Wanisha Feroz, Haleema Imran, Hammad Tariq

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In Pakistan, the health of unmarried women over thirty is an emerging public health concern due to its increasing prevalence. Achieving the Sustainable Development Goals (SDGs) requires addressing nutrition and public health issues. This research investigates these goals through the lens of nutrition and public health, specifically examining the challenges faced by unmarried women over thirty in Faisalabad, Pakistan. According to a recent United Nations report, there are 10 million unmarried women over the age of 35 in Pakistan. The United Nations defines health as "a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity." Being unmarried and under constant societal pressure profoundly influences the dietary behaviors and nutritional status of these women, affecting their overall health, including physical, mental, and social well-being. A qualitative research approach was employed, involving interviews with both unmarried and married women over thirty. This research examines how marital status influences dietary practices, nutritional status, mental and social health, and their subsequent impacts. Factors such as physical health, mental and emotional status, societal pressure, social health, economic independence, and decision-making power were analyzed to understand the effect of singleness on overall wellness. Findings indicated that marital status significantly affects the dietary patterns and nutritional practices among women in Faisalabad. It was also revealed that unmarried women experienced more stress and had a less optimistic mindset compared to married women, due to loneliness or the absence of a spouse in their lives. Nutritional knowledge varied across marital status, impacting the overall health triangle, including physical, mental, and social health. Understanding these dynamics is crucial for developing targeted interventions to improve nutritional outcomes and overall health among unmarried women in Faisalabad. This study highlights the importance of fostering supportive environments and raising awareness about the health needs of unmarried women over thirty to enhance their overall well-being.

Keywords: health triangle, unmarried woman over thirty, socio-cultural barriers, women’s health

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Authors: Andriana E. Tran, Anna Chur-Hansen

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Sexual health is an important aspect of overall wellbeing. This study aimed to explore the sexual health experiences of men aged 50 years and over from the perspective of health care professional participants who were specializing in sexual health care and who consulted with older men. A total of ten interviews were conducted. Eleven themes were identified regarding men’s experiences with sexual health care as reported by participants. 1) Biologically focused: older male clients focus largely on the biological aspect of their sexual health without consideration of other factors which might affect their functioning. 2) Psychological concerns: there is an interaction between mental and sexual health but older male clients do not necessarily see this. 3) Medicalization of sexual functioning: advances in medicine that aid with erectile difficulties which consequently mean that older men tend to favor a medical solution to their sexual concerns. 4) Masculine identity: sexual health concerns are linked to older male clients’ sense of masculinity. 5) Penile functionality: most concerns that older male clients have center on their penile functionality. 6) Relationships: many male clients seek sexual help as they believe it improves relationships. Conversely, having supportive partners may mean older male clients focus less on the physicality of sex. 7) Grief and loss: men experience grief and loss – the loss of their sexual functioning, grief from loss of a long-term partner, and loss of intimacy and privacy when moving from independent living to residential care. 8) Social stigma: older male clients experience stigma around aging sexuality and sex in general. 9) Help-seeking behavior: older male clients will usually seek mechanistic solution for biological sexual concerns, such as medication used for penile dysfunction. 10) Dismissed by health care professionals: many older male clients seek specialist sexual health care without the knowledge of their doctors as they feel dismissed due to lack of expertise, lack of time, and the doctor’s personal attitudes and characteristics. Finally, 11) Lack of resources: there is a distinct lack of resources and training to understand sexuality for healthy older men. These findings may inform future research, professional training, public health campaigns and policies for sexual health in older men.

Keywords: ageing, biopsychosocial model, men's health, sexual health

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Authors: Anne Y. Faxer, Ellen Olausson, Jens Hagman, Ana Magazinius, Jenny J. Stier, Tommy Fransson, Oscar Enerback

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While electric vehicles (both battery electric vehicles and plug-in hybrids) have been on the market for around 6 years, they are still far from mainstream and the knowledge of them is still low among the public. This is likely one of the reasons that Sweden, having one of the highest penetrations of electric vehicles in Europe, still has a long way to go in reaching a fossil free vehicle fleet. Car dealerships are an important medium that connects consumers to vehicles, but somehow, their role in introducing electric vehicles has not yet been thoroughly studied. Research from other domains shows that salespeople can affect customer decisions in their choice of products. The aim of this study is to explore the role of car dealerships when it comes to promoting electric vehicles. The long-term goal is to understand how they could be a key in the effort of achieving a mass introduction of electric vehicles in Sweden. By emulating the customer’s experience, this study investigates the interaction between car salespeople and customers, particularly examining whether they present electric vehicles as viable options. Covert participatory observations were conducted for data collection from four different brands at in total twelve car dealers. The observers worked in pairs and played the role of a customer with needs that could be matched by an electric vehicle. The data was summarized in observation protocols and analyzed using thematic coding. The result shows that only one of twelve salespeople offered an electric vehicle as the first option. When environmental factors were brought up by the observers, the salespeople followed up with lower fuel consumption internal combustion engine vehicles rather than suggesting an electric vehicle. All salespeople possessed at least basic knowledge about electric vehicles but their interest of selling them were low in most cases. One of the reasons could be that the price of electric vehicles is usually higher. This could be inferred from the finding that salespeople tend to have a strong focus on price and economy in their dialogues with customers, regardless which type of car they were selling. In conclusion, the study suggests that car salespeople have the potential to help the market to achieve mass introduction of electric vehicles; however, their potential needs to be exploited further. To encourage salespeople to prioritize electric vehicles in the sales process, right incentives need to be in place.

Keywords: car dealerships, covert participatory observation, customer perspective , electric vehicle, market penetration

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Authors: Amit Kumar, Rajdeep Chakrabarty, Ganesh Gupta

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This paper illustrates the detailed accreditation process of Accreditation Board of Engineering and Technology (ABET) for accrediting engineering and Technology programs. ABET is a non-governmental agency that accredits engineering and technology, applied and natural sciences, and computing sciences programs. ABET was founded on 10th May 1932 and was founded by Institute of Electrical and Electronics Engineering. International industries accept ABET accredited institutes having the highest standards in their academic programs. In this accreditation, there are eight criteria in general; criterion 1 describes the student outcome evaluations, criteria 2 measures the program's educational objectives, criteria 3 is the student outcome calculated from the marks obtained by students, criteria 4 establishes continuous improvement, criteria 5 focus on curriculum of the institute, criteria 6 is about faculties of this institute, criteria 7 measures the facilities provided by the institute and finally, criteria 8 focus on institutional support towards staff of the institute. In this paper, we focused on the calculative part of each criterion with equations and suitable examples, the files and documentation required for each criterion, and the total workflow of the process. The references and the values used to illustrate the calculations are all taken from the samples provided at ABET's official website. In the final section, we also discuss the criterion-wise score weightage followed by evaluation with timeframe and deadlines.

Keywords: Engineering Accreditation Committee, Computing Accreditation Committee, performance indicator, Program Educational Objective, ABET Criterion 1 to 7, IEEE, National Board of Accreditation, MOOCS, Board of Studies, stakeholders, course objective, program outcome, articulation, attainment, CO-PO mapping, CO-PO-SO mapping, PDCA cycle, degree certificates, course files, course catalogue

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Authors: Frederick M. Dumisani Xaba, Nokuthula G. Khanyile

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There is a growing demand for greater accountability, transparency and ethical conduct based on sound governance principles in the developing world. Funders, donors and sponsors are increasingly demanding more transparency, better value for money and adherence to good governance standards. The drive towards improved governance measures is largely influenced by the need to ‘plug the leaks’, deal with malfeasance, engender greater levels of accountability and good governance and to ultimately attract further funding or investment. This is the case with the Non-Profit Organizations (NPOs) in South Africa in general, and in the province of KwaZulu-Natal in particular. The paper draws from the good governance theory, stakeholder theory and systems thinking to critically examine the requirements for good governance for the NPO sector from a theoretical and legislative point and to systematically looks at the contours of governance currently among the NPOs. The paper did this through the rigorous examination of the vignettes of cases of governance among selected NPOs based in KwaZulu-Natal. The study used qualitative and quantitative research methodologies through document analysis, literature review, semi-structured interviews, focus groups and statistical analysis from the various primary and secondary sources. It found some good cases of good governance but also found frightening levels of poor governance. There was an exponential growth of NPOs registered during the period under review, equally so there was an increase in cases of non-compliance to good governance practices. NPOs operate in an increasingly complex environment. There is contestation for influence and access to resources. Stakeholder management is poorly conceptualized and executed. Recognizing that the NPO sector operates in an environment characterized by complexity, constant changes, unpredictability, contestation, diversity and divergent views of different stakeholders, there is a need to apply legislative and systems thinking approaches to strengthen governance to withstand this turbulence through a capacity development model that recognizes these contextual and environmental challenges.

Keywords: good governance, non-profit organizations, stakeholder theory, systems theory

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Authors: Mahmoud Ashraf Farouk

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Shipping transportation is the foremost imperative mode of transportation in universal coordination. At display, more than 2/3 of the full worldwide exchange volume accounts for shipping transportation. Ships are utilized as an implies of marine transportation, introducing large-power diesel motors with exhaust containing nitrogen oxide NOx, sulfur oxide SOx, carbo di-oxide CO₂, particular matter PM10, hydrocarbon HC and carbon mono-oxide CO which are the most dangerous contaminants found in exhaust gas from ships. Ships radiating a large amount of exhaust gases have become a significant cause of pollution in the air in coastal areas, harbors and oceans. Therefore, IMO (the International Maritime Organization) has established rules to reduce this emission. This experiment shows the measurement of the exhaust gases emitted from the Aida IV ship's main engine using marine diesel oil fuel (MDO). The measurement is taken by the Sensonic2000 device on 85% load, which is the main sailing load. Moreover, the paper studies different emission reduction technologies as an alternative fuel, which as liquefied natural gas (LNG) applied to the system and reduction technology which is represented as selective catalytic reduction technology added to the marine diesel oil system (MDO+SCR). The experiment calculated the amount of nitrogen oxide NOx, sulfur oxide SOx, carbon-di-oxide CO₂, particular matter PM10, hydrocarbon HC and carbon mono-oxide CO because they have the most effect on the environment. The reduction technologies are applied on the same ship engine with the same load. Finally, the study found that MDO+SCR is the more efficient technology for the Aida IV ship as a training and supply ship due to low consumption and no need to modify the engine. Just add the SCR system to the exhaust line, which is easy and cheapest. Moreover, the differences between them in the emission are not so big.

Keywords: marine, emissions, reduction, shipping

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Authors: Hyeon-Kyo Lim, Hyunjung Kim, Kune-Woo Lee

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Decommissioning process of nuclear facilities can be said to consist of a sequence of problem solving activities, partly because there may exist working environments contaminated by radiological exposure, and partly because there may also exist industrial hazards such as fire, explosions, toxic materials, and electrical and physical hazards. As for an individual hazard factor, risk assessment techniques are getting known to industrial workers with advance of safety technology, but the way how to integrate those results is not. Furthermore, there are few workers who experienced decommissioning operations a lot in the past. Therefore, not a few countries in the world have been trying to develop appropriate counter techniques in order to guarantee safety and efficiency of the process. In spite of that, there still exists neither domestic nor international standard since nuclear facilities are too diverse and unique. In the consequence, it is quite inevitable to imagine and assess the whole risk in the situation anticipated one by one. This paper aimed to find out an appropriate technique to integrate individual risk assessment results from the viewpoint of experts. Thus, on one hand the whole risk assessment activity for decommissioning operations was modeled as a sequence of individual risk assessment steps, and on the other, a hierarchical risk structure was developed. Then, risk assessment procedure that can elicit individual hazard factors one by one were introduced with reference to the standard operation procedure (SOP) and hierarchical task analysis (HTA). With an assumption of quantification and normalization of individual risks, a technique to estimate relative weight factors was tried by using the conventional Analytic Hierarchical Process (AHP) and its result was reviewed with reference to judgment of experts. Besides, taking the ambiguity of human judgment into consideration, debates based upon fuzzy inference was added with a mathematical case study.

Keywords: decommissioning, risk assessment, analytic hierarchical process (AHP), fuzzy inference

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Authors: M. Feliciano, F. Maia, A. Gonçalves

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Olive oil production sector plays an important role in Portuguese economy. It had a major growth over the last decade, increasing its weight in the overall national exports. International market penetration for Mediterranean traditional products is increasingly more demanding, especially in the Northern European markets, where consumers are looking for more sustainable products. Trying to support this growing demand this study addresses olive oil production under the environmental and eco-efficiency perspectives. The analysis considers two consecutive product life cycle stages: olive trees farming; and olive oil extraction in mills. Addressing olive farming, data collection covered two different organizations: a middle-size farm (~12ha) (F1) and a large-size farm (~100ha) (F2). Results from both farms show that olive collection activities are responsible for the largest amounts of Green House Gases (GHG) emissions. In this activities, estimate for the Carbon Footprint per olive was higher in F2 (188g CO2e/kgolive) than in F1 (148g CO2e/kgolive). Considering olive oil extraction, two different mills were considered: one using a two-phase system (2P) and other with a three-phase system (3P). Results from the study of two mills show that there is a much higher use of water in 3P. Energy intensity (EI) is similar in both mills. When evaluating the GHG generated, two conditions are evaluated: a biomass neutral condition resulting on a carbon footprint higher in 3P (184g CO2e/Lolive oil) than in 2P (92g CO2e/Lolive oil); and a non-neutral biomass condition in which 2P increase its carbon footprint to 273g CO2e/Lolive oil. When addressing the carbon footprint of possible combinations among studied subsystems, results suggest that olive harvesting is the major source for GHG.

Keywords: carbon footprint, environmental indicators, farming subsystem, industrial subsystem, olive oil

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Authors: Wanying Xie

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Under the background of the increasing Sino-US trade friction, the two nations pay more attention to the medias’ words. This paper mainly studies the causality, effectiveness, and influence of discourse construction between traditional media and social media. Based on the Network Agenda Setting theory, a kind of associative memory pattern in Psychology, who focuses on how media affect audiences’ cognition of issues and attributes, as well as the significance of the relation between people and matters. The date of the sample chosen in this paper ranges from March 23, 2018, to April 30, 2019. A total of 395 Tweets of Donald Trump are obtained, and 731 related reports are collected from the mainstream American newspapers including New York Times, the Washington Post and the Washington Street, by using Factiva and other databases. The sample data are processed by MAXQDA while the media discourses are analyzed by SPSS and Cite Space, with an aim to study: 1) whether the inter-media discourse construction exists; 2) which media (traditional media V.S. social media) is dominant; 3) the causality between two media. The results show: 1) the discourse construction between three American mainstream newspapers and Donald Trump's Twitter is proved in some periods; 2) the dominant position is extremely depended on the events; 3) the causality between two media is decided by many reasons. New media technology shortens the time of agenda-setting effect to one day or less. By comparing the specific relation between the three major American newspapers and Donald Trump’s Twitter, whose popularity and influence could be reflected. Hopefully, this paper could enable readers to have a more comprehensive understanding of the international media language and political environment.

Keywords: discourse construction, media language, network agenda-setting theory, sino-us trade friction

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Authors: Manpreet Kaur, Cheol-Hong Min

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The increasing advancement in the robotics equipped with machine vision sensors applied to precision agriculture is a demanding solution for various problems in the agricultural farms. An important issue related with the machine vision system concerns crop row and weed detection. This paper proposes an automatic furrow detection system based on real-time processing for identifying crop rows in maize fields in the presence of weed. This vision system is designed to be installed on the farming vehicles, that is, submitted to gyros, vibration and other undesired movements. The images are captured under image perspective, being affected by above undesired effects. The goal is to identify crop rows for vehicle navigation which includes weed removal, where weeds are identified as plants outside the crop rows. The images quality is affected by different lighting conditions and gaps along the crop rows due to lack of germination and wrong plantation. The proposed image processing method consists of four different processes. First, image segmentation based on HSV (Hue, Saturation, Value) decision tree. The proposed algorithm used HSV color space to discriminate crops, weeds and soil. The region of interest is defined by filtering each of the HSV channels between maximum and minimum threshold values. Then the noises in the images were eliminated by the means of hybrid median filter. Further, mathematical morphological processes, i.e., erosion to remove smaller objects followed by dilation to gradually enlarge the boundaries of regions of foreground pixels was applied. It enhances the image contrast. To accurately detect the position of crop rows, the region of interest is defined by creating a binary mask. The edge detection and Hough transform were applied to detect lines represented in polar coordinates and furrow directions as accumulations on the angle axis in the Hough space. The experimental results show that the method is effective.

Keywords: furrow detection, morphological, HSV, Hough transform

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Authors: Mona Vijayaran, Gurleen Oberoi, Sanjay Mishra

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Introduction: p190 BCR‐ABL1 in CML is often associated with monocytosis. In the case described here, monocytosis is associated with coexisting p210 BCR‐ABL and CMML clones. Mutation analysis using next‐generation sequence (NGS) in our case showed TET2 and SRSF2 mutations. Aims & Objectives: A 75-year male was evaluated for monocytosis and thrombocytopenia. CBC showed Hb-11.8g/dl, TLC-12,060/cmm, Monocytes-35%, Platelets-39,000/cmm. Materials & Methods: Bone marrow examination showed a hypercellular marrow with myeloid series showing sequential maturation up to neutrophils with 30% monocytes. Immunophenotyping by flow cytometry from bone marrow had 3% blasts. Making chronic myelomonocytic leukemia as the likely diagnosis. NGS for myeloid mutation panel had TET2 (48.9%) and SRSF2 (32.5%) mutations. This report further supported the diagnosis of CMML. To fulfil the WHO diagnostic criteria for CMML, a BCR ABL1 by RQ-PCR was sent. The report came positive for p210 (B3A2, B2A2) Major Transcript (M-BCR) % IS of 38.418. Result: The patient was counselled regarding the unique presentation of the presence of 2 clones- P210 CML and CMML. After discussion with an international faculty with vast experience in CMML. It was decided to start this elderly gentleman on Imatinib 200mg and not on azacytidine, as ASXL1 was not present; hence, his chances of progressing to AML would be less and on the other end, if CML is left untreated then chances of progression to blast phase would always be a possibility. After 3 months on Imatinib his platelet count improved to 80,000 to 90,000/cmm, but his monocytosis persists. His 3rd month BCR-ABL1 IS% is 0.004%. Conclusion: After searching the literature, there were no case reports of a coexisting CML p210 with CMML. This case might be the first case report. p190 BCR ABL1 is often associated with monocytosis. There are few case reports of p210 BCR ABL1 positivity in patients with monocytosis but none with coexisting CMML. This case highlights the need for extensively evaluating patients with monocytosis with next-generation sequencing for myeloid mutation panel and BCR-ABL1 by RT-PCR to correctly diagnose and treat them.

Keywords: CMML, NGS, p190 CML, Imatinib

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Authors: G. Stamatopoulou, M. Symeonaki, C. Michalopoulou

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In this work, we study the intergenerational social mobility in Greece, in order to provide up-to-date evidence on the changes in the mobility patterns throughout the years. An analysis for both men and women aged between 25-64 years old is carried out. Three main research objectives are addressed. First, we aim to examine the relationship between the socio-economic status of parents and their children. Secondly, we investigate the evolution of the mobility patterns between different birth cohorts. Finally, the role of education is explored in shaping the mobility patterns. For the analysis, we draw data on both parental and individuals' social outcomes from different national databases. The social class of origins and destination is measured according to the European Socio-Economic Classification (ESeC), while the respondents' educational attainment is coded into categories based on the International Standard Classification of Education (ISCED). Applying the Markov transition probability theory, and a range of measures and models, this work focuses on the magnitude and the direction of the movements that take place in the Greek labour market, as well as the level of social fluidity. Three-way mobility tables are presented, where the transition probabilities between the classes of destination and origins are calculated for different cohorts. Additionally, a range of absolute and relative mobility rates, as well as distance measures, are presented. The study covers a large time span beginning in 1940 until 1995, shedding light on the effects of the national institutional processes on the social movements of individuals. Given the evidence on the mobility patterns of the most recent birth cohorts, we also investigate the possible effects of the 2008 economic crisis.

Keywords: cohort analysis, education, Greece, intergenerational mobility, social class

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