Search results for: health district committee

Authors: Roya Morad, W. Eirik Heintz

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The identity of a neighborhood is inevitably shaped by the architecture and the people of that place. Conventionally the streets within each neighborhood served as a semi-public-private extension of the private living spaces. The street as a design element formed a hybrid condition that was neither totally public nor private, and it encouraged social interactions. Thus through creating a sense of community, one of the most basic human needs of belonging was achieved. Similar to major global cities, Tehran has undergone serious urbanization. Developing into a capital city of high rises has resulted in an increase in urban density. Although allocating more residential units in each neighborhood was a critical response to the population boom and the limited land area of the city, it also created a crisis in terms of social communication and place attachment. District 10 in Tehran is a neighborhood that has undergone the most urban transformation among the other 22 districts in the capital and currently has the highest population density. This paper will explore how the active streets in district 10 have changed into their current condition of high rises with a lack of meaningful social interactions amongst its inhabitants. A residential building can be thought of as a large group of people. One would think that as the number of people increases, the opportunities for social communications would increase as well. However, according to the survey, there is an indirect relationship between the two. As the number of people of a residential building increases, the quality of each acquaintance reduces, and the depth of relationships between people tends to decrease. This comes from the anonymity of being part of a crowd and the lack of social spaces characterized by most high-rise apartment buildings. Without a sense of community, the attachment to a neighborhood is decreased. This paper further explores how the neighborhood participates to fulfill ones need for social interaction and focuses on the qualitative aspects of alternative spaces that can redevelop the sense of place attachment within the community.

Keywords: high density, place attachment, social communication, street life, urban transformation

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Authors: Ndagi Salihu

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Corporate governance mechanisms are the control measures for ensuring that all the interests groups are equally represented and management are working towards wealth creation in the interest of all. Therefore, there are many empirical studies during the last three decades on corporate governance and firm performance. However, little is known about the effects of family ownership on the relationship between corporate governance and firm performance, especially in the developing economy like Nigeria. This limit our understanding of the unique governance dynamics of family ownership with regards firm performance. This study examined the impact of family ownership on the relationship between governance mechanisms and financial performance of publicly listed companies in Nigeria. The study adopted quantitative research methodology using correlational ex-post factor design and secondary data from annual reports and accounts of a sample of 23 listed companies for a period of 5 years (2014-2018). The explanatory variables are the board size, board composition, board financial expertise, and board audit committee attributes. Financial performance is proxy by Return on Assets (ROA) and Return on Equity (ROE). Multiple panel regression technique of data analysis was employed in the analysis, and the study found that family ownership has a significant positive effect on the relationships between corporate governance mechanisms and financial performance of publicly listed firms in Nigeria. This finding is the same for both the ROA and ROE. However, the findings indicate that board size, board financial expertise, and board audit committee attributes have a significant positive impact on the ROA and ROE of the sample firms after the moderation. Moreover, board composition has significant positive effect on financial performance of the sample listed firms in terms of ROA and ROE. The study concludes that the use of family ownership in the control of firms in Nigeria could improve performance by reducing the opportunistic actions managers as well as agency problems. The study recommends that publicly listed companies in Nigeria should allow significant family ownership of equities and participation in management.

Keywords: profitability, board characteristics, agency theory, stakeholders

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Authors: A. M. Ferrari, L. Volpi, M. Pini, C. Siligardi, F. E. Garcia Muina, D. Settembre Blundo

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A long tradition in the ceramic manufacturing since the 18th century, primarily due to the availability of raw materials and an efficient transport system, let to the birth and development of the Italian ceramic tiles district that nowadays represents a reference point for this sector even at global level. This economic growth has been coupled to attention towards environmental sustainability issues throughout various initiatives undertaken over the years at the level of the production sector, such as certification activities and sustainability policies. In this way, starting from an evaluation of the sustainability in all its aspects, the present work aims to develop a benchmarking helping both producers and consumers. In the present study, throughout the Life Cycle Sustainability Assessment (LCSA) framework, the sustainability has been assessed in all its dimensions: environmental with the Life Cycle Assessment (LCA), economic with the Life Cycle Costing (LCC) and social with the Social Life Cycle Assessment (S-LCA). The annual district production of stoneware tiles during the 2016 reference year has been taken as reference flow for all the three assessments, and the system boundaries cover the entire life cycle of the tiles, except for the LCC for which only the production costs have been considered at the moment. In addition, a preliminary method for the evaluation of local and indoor emissions has been introduced in order to assess the impact due to atmospheric emissions on both people living in the area surrounding the factories and workers. The Life Cycle Assessment results, obtained from IMPACT 2002+ modified assessment method, highlight that the manufacturing process is responsible for the main impact, especially because of atmospheric emissions at a local scale, followed by the distribution to end users, the installation and the ordinary maintenance of the tiles. With regard to the economic evaluation, both the internal and external costs have been considered. For the LCC, primary data from the analysis of the financial statements of Italian ceramic companies show that the higher cost items refer to expenses for goods and services and costs of human resources. The analysis of externalities with the EPS 2015dx method attributes the main damages to the distribution and installation of the tiles. The social dimension has been investigated with a preliminary approach by using the Social Hotspots Database, and the results indicate that the most affected damage categories are health and safety and labor rights and decent work. This study shows the potential of the LCSA framework applied to an industrial sector; in particular, it can be a useful tool for building a comprehensive benchmark for the sustainability of the ceramic industry, and it can help companies to actively integrate sustainability principles into their business models.

Keywords: benchmarking, Italian ceramic industry, life cycle sustainability assessment, porcelain stoneware tiles

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Authors: Sun Ailu, Zhao Wanmin

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Since the reform and opening, the urbanization process of China has entered a rapid development period. In recent years, the authors participated in some projects of urban master planning in China and found a phenomenon that the rapid urbanization area of China is experiencing frequent adjustment process of urban master planning. This phenomenon is not the natural process of urbanization development. It may be caused by different government roles from different levels. Through the methods of investigation, data comparison and case study, this paper aims to explore the reason why the rapid urbanization area is experiencing frequent adjustment of master planning and give some solution strategies. Firstly, taking Changshou district of Chongqing city as an example, this paper wants to introduce the phenomenon about frequent adjustment process in China. And then, discuss distinct roles in the process between national government, provincial government and local government of China. At last, put forward preliminary solutions strategies for this area in China from the aspects of land use, intergovernmental cooperation and so on.

Keywords: urban master planning, frequent adjustment, urbanization development, problems and strategies, China

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Authors: Eirini Oikonomopoulou

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Paper is dealing with gentrification of a poor central historic district of Fener and Balat in Istanbul, Turkey and propose ålans and principles of a neighborhood. Istanbul is located in a special geographic place, just in the meeting of Europe and Asia and it has a long and great history, facts that had affected the urban form of the city. Trough the time different civilizations inhabited in the city and they changed it by giving different character to its parts. The modernization of Istanbul brought western ideas into the historic organic urban fabric and put in the first priority the need for a clear and strong car-road/highway network in order to improve the car accessibility along the city. Following that model, transformation of public spaces was based on the driving experience. New public spaces was formulated to be the new symbol of Turkish Republic, to give a beautiful and clean image of the modern Turkish city, as well as work as landmarks across the highway network. Even if city is upgraded, bad quality neighborhoods still exist, far and near to the historic city center. One of them is Fener/Balat, which is located in Fatih district on the European side of Istanbul. This project aims to analyze the urban qualities of that neighborhood (mahalle) and propose a better, qualitative urban space towards a denser, greener and more inclusive neighborhood which could be an example for the whole city.

Keywords: urban design, upgrade neighborhood, Istanbul, sustanability

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Authors: Niringiye Fred

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Banyabunagana has always had access to land resources for grazing animals, sand mining, and farmland across the border in the Democratic Republic of Congo during the pre-colonial and colonial times, usually on an informal arrangement facilitated by kinship ties and rent transactions for these resources. However, in recent periods, the government of the Democratic Republic of the Congo (DRC) has been pursuing a policy of constructing barriers such as walls and fences so that Banyabunagana communities do not access the land on the DRC side of the border. This is happening in the background of increased and intensified demand for land use on the side of the Ugandan community. This paper will attempt to discuss the reasons behind the construction of walls, fences, and other barriers which deny access to land for Banyabunagana communities in Bunagana Parish, Muramba Sub-county- Kisoro district, Uganda. The research will attempt to answer the following main questions, among others, whether there are the factors that explain the construction of walls and fences which could limit or deny access to the informal use of land and other resources and whether policy options to ensure continued access to land and other resources for local communities.

Keywords: border, walls, fences, land resource access

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Authors: Berrin Şentürk

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In this study, due to the recurrence of bovine tuberculosis, in the same areas, the risk factors for the disease were determined and evaluated at the local level. This study was carried out in 32 farms where the disease was detected in the district and center of Samsun province in 2014. Predetermined risk factors, such as farm, environmental and economic risks, were investigated with the survey method. It was predetermined that risks in the three groups are similar to the risk variables of the disease on the global scale. These risk factors that increase the susceptibility of the infection must be understood by the herd owners. The risk-based contagious disease management system approach should be applied for bovine tuberculosis by farmers, animal health professionals and public and private sector decision makers.

Keywords: bovine tuberculosis, disease management, control, outbreak, risk analysis

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Authors: Isa Raquel Alves Soeiro, Cristina Isabel Branco de Sá

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In Portugal, since 2008, there has been a requirement to export the Standard Audit File for Tax Purposes (SAF-T) standard file (in XML format). This file thus gathers tax-relevant information from a company relating to a specific period of taxation. There are two types of SAF-T files that serve different purposes: the SAF-T of revenues and the SAF-T of accounting, which requires taxpayers and accounting firms to invest in order to adapt the accounting programs to the legal requirements. The implementation of the SAF-T accounting file aims to facilitate the collection of relevant tax data by tax inspectors as support of taxpayers' tax returns for the analysis of accounting records or other information with tax relevance (Portaria No. 321-A/2007 of March 26 and Portaria No. 302/2016 of December 2). The main objective of this research project is to verify, through quantitative analysis, what is the cost of compliance of Small and Medium Enterprises (SME) in the district of Leiria in the introduction and implementation of the tax obligation of SAF-T - Standard Audit File for Tax Purposes of accounting. The information was collected through a questionnaire sent to a population of companies selected through the SABI Bureau Van Dijk database in 2020. Based on the responses obtained to the questionnaire, the companies were divided into two groups: Group 1 -companies who are self-employed and whose main activity is accounting services; and Group 2 -companies that do not belong to the accounting sector. In general terms, the conclusion is that there are no statistically significant differences in the costs of complying with the accounting SAF-T between the companies in Group 1 and Group 2 and that, on average, the internal costs of both groups represent the largest component of the total cost of compliance with the accounting SAF-T. The results obtained show that, in both groups, the total costs of complying with the SAF-T of accounting are regressive, which appears to be similar to international studies, although these are related to different tax obligations. Additionally, we verified that the variables volume of business, software used, number of employees, and legal form explain the differences in the costs of complying with accounting SAF-T in the Leiria district SME.

Keywords: compliance costs, SAF-T accounting, SME, Portugal

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Authors: Maatouk Mohamed, Nouira Mariem

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Background and aims: Healthcare-associated infections (HAI) represent a major public health problem worldwide. They represent one of the most serious adverse events in health care. The objectives of our study were to estimate the prevalence of HAI at the Charles Nicolle Hospital (CNH) and to identify the main associated factors as well as to estimate the frequency of antibiotic use. Methods: It was a cross sectional study at the CNH with a unique passage per department (OctoberDecember 2018). All patients present at the wards for more than 48 hours were included. All patients from outpatient consultations, emergency and dialysis departments were not included. The site definitions of infections proposed by the Centers for Disease Control and Prevention (CDC) were used. Only clinically and/or microbiologically confirmed active HAIs were included. Results: A total of 318 patients were included with a mean age of 52 years and a sex ratio (Female/Male) of 1.05. A total of 41 patients had one or more active HAIs, corresponding to a prevalence of 13.1% (95% CI: 9.3%-16.9%). The most frequent sites infections were urinary tract infections and pneumonia. Multivariate analysis among adult patients (>=18 years) (n=261), revealed that infection on admission (p=0.01), alcoholism (p=0.01), high blood pressure (p=0.008), having at least one invasive device inserted (p=0.004), and history of recent surgery (p=0.03), increased significantly the risk of HAIs. More than 1 of 3 patients (35.4%) were under antibiotics on the day of the survey, of which more than half (57.4%) were under 2 or more types of antibiotics. Conclusion: The prevalence of HAIs and antibiotic prescriptions at the CNH were considerably high. An infection prevention and control committee, as well as the development of an Antibiotic stewardship program with continuous monitoring using repeated prevalence surveys must be implemented to limit the frequency of these infections effectively.

Keywords: tumors, oesophagectomy, esophagogastric junction, systematic review

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Authors: Fadwa Al Bawardi

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In March 2021, the Saudi Arabian Council of Ministers issued a decision to form a committee called the "Higher Committee for Research, Development and Innovation," a committee linked to the Council of Economic and Development Affairs, chaired by the Chairman of the Council of Economic and Development Affairs, and concerned with the development of the research, development and innovation sector in the Kingdom. In order to talk about the dimensions of this wonderful step, let us first try to answer the following questions. Is there a difference between creativity and innovation..? What are the factors of creativity in the individual. Are they mental genetic factors or are they factors that an individual acquires through learning..? The methodology included surveys that have been conducted on more than 500 individuals, males and females, between the ages of 18 till 60. And the answer is. "Creativity" is the creation of a new idea, while "Innovation" is the development of an already existing idea in a new, successful way. They are two sides of the same coin, as the "creative idea" needs to be developed and transformed into an "innovation" in order to achieve either strategic achievements at the level of countries and institutions to enhance organizational intelligence, or achievements at the level of individuals. For example, the beginning of smart phones was just a creative idea from IBM in 1994, but the actual successful innovation for the manufacture, development and marketing of these phones was through Apple later. Nor does creativity have to be hereditary. There are three basic factors for creativity: The first factor is "the presence of a challenge or an obstacle" that the individual faces and seeks thinking to find solutions to overcome, even if thinking requires a long time. The second factor is the "environment surrounding" of the individual, which includes science, training, experience gained, the ability to use techniques, as well as the ability to assess whether the idea is feasible or otherwise. To achieve this factor, the individual must be aware of own skills, strengths, hobbies, and aspects in which one can be creative, and the individual must also be self-confident and courageous enough to suggest those new ideas. The third factor is "Experience and the Ability to Accept Risk and Lack of Initial Success," and then learn from mistakes and try again tirelessly. There are some tools and techniques that help the individual to reach creative and innovative ideas, such as: Mind Maps tool, through which the available information is drawn by writing a short word for each piece of information and arranging all other relevant information through clear lines, which helps in logical thinking and correct vision. There is also a tool called "Flow Charts", which are graphics that show the sequence of data and expected results according to an ordered scenario of events and workflow steps, giving clarity to the ideas, their sequence, and what is expected of them. There are also other great tools such as the Six Hats tool, a useful tool to be applied by a group of people for effective planning and detailed logical thinking, and the Snowball tool. And all of them are tools that greatly help in organizing and arranging mental thoughts, and making the right decisions. It is also easy to learn, apply and use all those tools and techniques to reach creative and innovative solutions. The detailed figures and results of the conducted surveys are available upon request, with charts showing the %s based on gender, age groups, and job categories.

Keywords: innovation, creativity, factors, tools

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Authors: Laila Vivas

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Fossil Health is proposed as a value-concept to describe the hegemonic health paradigms that underpin health enactment. Such representation is justified by Foucaldian and related ideas on biopower and biosocialities, calling for the politicization of health and signalling the importance of narratives. This approach, hence, enables contemplating health paradigms as reflexive or co-constitutive of health itself or, in other words, conceiving health as a verb. Fossil health is a symbolic representation, influenced by Andreas Malm’s concept of fossil capitalism, that integrates environment and health as non-dichotomic areas. Fossil Health sustains that current notions of human and non-human health revolve around fossil fuel dependencies. Moreover, addressing disequilibria from established health ideals involves fossil-fixes. Fossil Health, therefore, represents causes and consequences of a health conception that has the agency to contribute to the functioning of a particular structural eco-social model. Moreover, within current capitalist relations, Fossil Health expands its meaning to cover not only fossil implications but also other dominant paradigms of the capitalist system that are (re)produced through health paradigms, such as the burgeoning of technoscience and biomedicalization, privatization of health, expertization of health, or the imposing of standards of uniformity. Overall, Fossil Health is a comprehensive approach to environment and health, where understanding hegemonic health paradigms means understanding our (human-non-human) nature paradigms and the structuring effect these narratives convey.

Keywords: fossil health, environment, paradigm, capitalism

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Authors: Harith Mohammed Benbouali

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The concept of sustainable development is becoming increasingly important in our society. The efforts of specialized agencies, cleverly portrayed in the media, allow a widespread environmental awareness. Far from the old environmental movement in the backward-looking nostalgia, the environment is combined with today's progress. Many areas now include these concerns in their efforts, this in order to try to reduce the negative impact of human activities on the environment. The quantitative dimension of development has given way to the quality aspect. However, this feature is not common, and the initial target was abandoned in favor of economic considerations. Specialists in the field of building and construction have constantly sought to further integrate the environmental dimension, creating a seal of high environmental quality buildings. The pursuit of well-being of neighborhood residents and the quality of buildings are also a hot topic in planning. Quality of life is considered so on, since financial concerns dominate to the detriment of the environment and the welfare of the occupants. This work concerns the development of an analytical method based on multiple indicators of objectives across the district. The quantification of indicators related to objectives allows the construction professional, the developer or the community, to quantify and compare different alternatives for development of a neighborhood. This quantification is based on the use of simulation tools and a multi-criteria aggregation.

Keywords: sustainable development, environment, district, indicators, multi-criteria analysis, evaluation

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Authors: Joe Dorbor Wuokolo

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Thousands of smallholder farmers in Todee District, Montserrado county, are currently vulnerable to the negative impact of climate change. The district, which is the agricultural hot spot for the county, is faced with unfavorable changes in the daily temperature due to climate change. Farmers in the district have observed a dramatic change in the ratio of rainfall to sunshine, which has caused a chilling effect on their crop yields. However, there is a lack of documentation regarding how farmers perceive and respond to these changes and challenges. A study was conducted in the region to examine the perceptions of smallholder farmers regarding the negative impact of climate change, the adaptation strategies practice, and the barriers that hinder the process of advancing adaptation strategy. On purpose, a sample of 41 respondents from five towns was selected, including five town chiefs, five youth leaders, five women leaders, and sixteen community members. Women and youth leaders were specifically chosen to provide gender balance and enhance the quality of the investigation. Additionally, to validate the barriers farmers face during adaptation to climate change, this study interviewed eight experts from local and international organizations and government ministries and agencies involved in climate change and agricultural programs on what they perceived as the major barrier in both local and national level that impede farmers adaptation to climate change impact. SPSS was used to code the data, and descriptive statistics were used to analyze the data. The weighted average index (WAI) was used to rank adaptation strategies and the perceived importance of adaptation practices among farmers. On a scale from 0 to 3, 0 indicates the least important technique, and 3 indicates the most effective technique. In addition, the Problem Confrontation Index (PCI) was used to rank the barriers that prevented farmers from implementing adaptation measures. According to the findings, approximately 60% of all respondents considered the use of irrigation systems to be the most effective adaptation strategy, with drought-resistant varieties making up 30% of the total. Additionally, 80% of respondents placed a high value on drought-resistant varieties, while 63% percent placed it on irrigation practices. In addition, 78% of farmers ranked and indicated that unpredictability of the weather is the most significant barrier to their adaptation strategies, followed by the high cost of farm inputs and lack of access to financing facilities. 80% of respondents believe that the long-term changes in precipitation (rainfall) and temperature (hotness) are accelerating. This suggests that decision-makers should adopt policies and increase the capacity of smallholder farmers to adapt to the negative impact of climate change in order to ensure sustainable food production.

Keywords: adaptation strategies, climate change, farmers’ perception, smallholder farmers

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Authors: Rossukhon Makaramani, Supanan Sittilerd, Wipada Prasarnsaph

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The study aimed to 1) examine management status of a Program in Education at the Faculty of Education, Suan Sunandha Rajabhat University (SSRU); 2) determine main components, indicators and criteria for constructing quality assessment framework; 3) assess quality of a SSRU Program in Education; and 4) provide recommendations to promote academic excellence. The program to be assessed was Bachelor of Education Program in Education (5 years), Revised Version 2009. Population and samples were stakeholders involving implementation of this program during an academic year 2012. Results were: 1) Management status of the Program in Education showed that the Faculty of Education depicted good level (4.20) in the third cycle of external quality assessment by the Office for National Education Standards and Quality Assessment (ONESQA). There were 1,192 students enrolling in the program, divided into 5 major fields of study. There were 50 faculty members, 37 holding master’s degrees and 13 holding doctorate degrees. Their academic position consisted of 35 lecturers, 10 assistant professors, and 5 associate professors. For program management, there was a committee of 5 members for the program and also a committee of 4 or 5 members for each major field of study. Among the faculty members, 41 persons taught in this program. The ratio between faculty and student was 1:26. The result of 2013 internal quality assessment indicated that system and mechanism of the program development and management was at fair level. However, the overall result yielded good level either by criteria of the Office of Higher Education Commission (4.29) or the NESQA (4.37); 2) Framework for assessing the quality of the program consisted of 4 dimensions and 15 indicators; 3) Assessment of the program yielded Good level of quality (4.04); 4) Recommendations to promote academic excellence included management and development of the program focusing on teacher reform toward highly recognized profession; cultivation of values, moral, ethics, and spirits of being a teacher; construction of specialized programs; development of faculty potentials; enhancement of the demonstration school’s readiness level; and provision of dormitories for learning.

Keywords: quality assessment, education program, Suan Sunandha Rajabhat University, academic excellence

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Authors: Mkhokheli Sithole, Brenda N. Muchapondwa

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Food security is becoming a critical issue for people residing mainly in the rural areas where frequent droughts interrupt food production, reduce income, compromise the ability to save and erode livelihoods. This tends to increase the vulnerability of poor households to food and income insecurity, hence, malnutrition. There is an emerging need for DRR strategies to complement the existing rain fed crop production based livelihoods. One of such strategies employed by the community of Nerumedzo in Bikita district is the harvesting of Encosternum delegorguei insect. This article analyses the livelihood impacts of Encosternum delegorguei insect as a DRR strategy. The research used a combination of qualitative and quantitative approaches. The insect samples were tested in the laboratory for their nutritional composition while surveys were done on a sample of 40 community members. Participatory observations and 5 focus group discussions were also done. The results revealed that harvesting the Encosternum delegorguei insects provides a livelihood for the locals by complementing crop production thereby mitigating potential negative effects of frequent droughts. The insects are now a significant source of income to poor households in the community.

Keywords: disaster risk reduction, livelihoods, human, social sciences

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Authors: Jaskaran Singh Sidhu

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Aim: The purpose of this study is to find the relationship between wellness among sportsmen and non sportsmen. Methodology: The present study is an experimental study for 80 senior secondary volleyball players of 16-19 years of age from Ludhiana District of Punjab (India), and 80 non-sportsperson were taken from senior secondary school of Ludhiana district. The sample for this study was taken through a random sampling technique. Tools: A five point scale havinf 50 items was used to acess the wellness Statistical Analysis: To find out the relationship among the variables exists or not, a t-test was used to test the significance of the difference between the means. Statistics for each characteristic were calculated; Mean, Standard deviation, Standard error of Mean. Data were analyzed using SPSS (statistical package for the social sciences). Statistical significance was set at p < 0.05. Results: Substantial deviations were noted at p<0.5 in the totality of wellness. Sportsmen show significant differences exist at p<0.5 in three parameters of wellness i.e., physical wellness, mental wellness, and social wellness. In spiritual and emotional wellness attributes, non-sportsmen shows significant difference at p<0.5. Conclusion: From the data interpretation it reflects that overall wellness can be improved by participation in sports. It further noted in study that participation in sports promote the attributes of wellness i.e., physical wellness, mental wellness, emotional wellness and social wellness.

Keywords: physical, mental, social, emotional, wellness, spiritual

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Authors: Baluku Nathan

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Transferring critically ill patients from one health facility to another poses a major risk to the patient because of increased oxygen demands. transferring patients with critical COVID-19 from a rural health canter in a rural district to a national referral hospital over 350 km in 7 hours would require three size H oxygen cylinders for successful transfer. It was always difficult to arrange the three size cylinders in the ambulance as workspace was greatly compromised for the ambulance assistant. Purpose: The purpose of this study was to investigate the impact and effectiveness of transport ventilators on the transportation of the critically ill patients from rural health canters to national referral hospitals in Uganda. Methodology: This was a descriptive cross-sectional study conducted in sept 2022 among critical care nurses and ambulance assistants who had used both methods of transportation (ventilators and cylinders). A semi structured questionnaire was used to collect quantitative data after informed consent. Results: From the findings, distribution of transport ventilators to the regional referral hospitals by the Ministry of Health has gradually improved patient transfer as the team requires less than one size oxygen cylinder to successfully transfer a patient. We use two ambulance assistants (a critical care nurse and another nurse who has been trained on use of the ventilator) when transferring patients with critical COVID-19 as the teams have to interchange over the long distance. Conclusions: Transport ventilators are effective and efficient in transferring critically ill patients, therefore should be rolled out to lower levels coupled with user training to improve outcomes of patients transferred in ambulances in lower income countries.

Keywords: emergency medical technician, critically ill, COVID-19, transport ventilator

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Authors: Tiago Sigal Linhares, Ana Amélia Nascimento da Silva Bones, Juliana Miola, McArthur Alexander Barrow, Airton Tetelbom Stein

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Introduction: As a result of increased globalization and changing migration trends, it is expected that a significant portion of People Living with HIV/AIDS (PLWHA) will change their place of residence over time. In order to provide better health care, monitor the HIV epidemic and plan urban public health care and policies, there is a growing need to formulate a strategy for monitoring PLWHA care, location and migration patterns. The Porto Alegre District is characterized by a high prevalence of PLWHA and is considered one of the epicenters of HIV epidemic in Latin America. Objectives: The aim of this study is to create a digital and easily editable map in order to create a visual representation of the location of PLWHA and to monitor their migration within the city and the country in an effort to promote longitudinal care. Methods: This Experience Report used Google Maps Map Creator to generate an active digital map showing the location and changes in residence of 165 PLWHA who received care at two Primary Health Care (PHC) clinics, which attended an estimated population of five thousand patients, in downtown Porto Alegre over the last four years. Their current addresses were discovered in the unified Brazilian health care system digital records (e-SUS) and updated on the map. Results: A digital map with PLWHA current residence location was created. It was possible to demonstrate visually areas with a large concentration of PLWHA and the migration of the population within the city as wells as other cities, regions and states. Conclusions: An easily reproducible and free map could aid in PLWHA monitoring, urban public health planning, target interventions and situational diagnosis. Moreover, a visual representation of PLWHA location and migration could help bring more attention and investments to areas with geographic inequities or higher prevalence of PLWHA. It also enables notification of local PHC units of monitored patients inside their area, which are in clinical risk or with treatment abandonment through active case findings, improving the care of PLWHA.

Keywords: health care, medical public health, theoretical and conceptual innovations, urban public health

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Authors: Miladi Yasmine, Bouhlel Salah, David Banks

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The Hammam Zriba (F-Ba-Sr-Pb-Zn) ore deposits of the Zaghouan district are located in northeast Tunisia, 60 Km south of Tunis. The host rocks belong to the Ressas Formation (Tithonian age) and lower Cretaceous layers. Mineralization occurs as stratiform replacement heaps and lenses. The mineral assemblage is composed of fluorite, barite, sphalerite, and galena. Primary fluid inclusions in sphalerite have homogenization temperatures ranging from 83 to 140°C, final melting temperature range from −18 to −7.0, corresponding to salinities of 5 to 21 wt % NaCl equivalent. Fluid inclusions in fluorite homogenize to the liquid phase between 132 and 178°C. Final ice melting temperatures range from −25 to −6.8 °C, corresponding to salinities between 17 and 24 wt% NaCl Equivalent. The LA-ICP-MS analyses of the fluid inclusions in fluorite show that these fluids are dominated by Na>Ca>K>Mg, with the concentration of Fe being equivalent to that of Mg. Microthermometric analyses of the fluid inclusions observed in fluorite and sphalerite show that two distinct fluids were involved in the mineralization deposition: a warmer saline fluid (132-178°C, 17-24 wt % NaCl equivalent) and cooler saline fluid (83°C-140, 5-21 wt %NaCl equivalent). The ore fluid result from highly saline and Na-Ca dominated with lower Mg concentrations come from the leaching of the dolomitic host rocks by the fluids.

Keywords: Hammam Zriba , fluid inclusions, LA-ICP-MS, Zaghouan district

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Authors: Patrice Conner

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Nanotechnologies have enormous potential to contribute to human flourishing in responsible and sustainable ways. They are rapidly developing field of science, technology and innovation. As enabling technologies, their full scope of applications is potentially very wide. Major implications are expected in many areas, e.g. healthcare, information and communication technologies, energy production and storage, materials science/chemical engineering, manufacturing, environmental protection, consumer products, etc. However, nanotechnologies are unlikely to realize their full potential unless their associated societal and ethical issues are adequately attended. Namely nanotechnologies and nanoparticles may expose humans and the environment to new health risks, possibly involving quite different mechanisms of interference with the physiology of human and environmental species. One of the building blocks of the ‘safe, integrated and responsible’ approach is standardization. Both the Economic and Social Committee and the European Parliament have highlighted the importance to be attached to standardization as a means to accompany the introduction on the market of nanotechnologies and nanomaterials, and a means to facilitate the implementation of regulation. ISO and CEN have respectively started in 2005 and 2006 to deal with selected topics related to this emerging and enabling technology. In the beginning of 2010, EC DG ‘Enterprise and Industry’ addressed the mandate M/461 to CEN, CENELEC and ETSI for standardization activities regarding nanotechnologies and nanomaterials. Thus CEN/TC 352 ‘Nanotechnologies’ has been asked to take the leadership for the coordination in the execution of M/461 (46 topics to be standardized) and to contact relevant European and International Technical committees and interested stakeholders as appropriate (56 structures have been identified). Prior requests from M/461 deal with characterization and exposure of nanomaterials and any matters related to Health, Safety and Environment. Answers will be given to: - What are the structures and how they work? - Where are we right now and how work is going from now onwards? - How CEN’s work and targets deal with and interact with global matters in this field?

Keywords: characterization, environmental protection, exposure, health risks, nanotechnologies, responsible and sustainable ways, safety

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Authors: Nouira Mariem, Ennigrou Samir

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Background and aims: Healthcare-associated infections (HAI) represent a major public health problem worldwide. They represent one of the most serious adverse events in health care. The objectives of our study were to estimate the prevalence of HAI at the Charles Nicolle Hospital (CNH) and to identify the main associated factors as well as to estimate the frequency of antibiotic use. Methods: It was a cross-sectional study at the CNH with a unique passage per department (October-December 2018). All patients present at the wards for more than 48 hours were included. All patients from outpatient consultations, emergency, and dialysis departments were not included. The site definitions of infections proposed by the Centers for Disease Control and Prevention (CDC) were used. Only clinically and/or microbiologically confirmed active HAIs were included. Results: A total of 318 patients were included, with a mean age of 52 years and a sex ratio (female/male) of 1.05. A total of 41 patients had one or more active HAIs, corresponding to a prevalence of 13.1% (95% CI: 9.3%-16.9%). The most frequent site infections were urinary tract infections and pneumonia. Multivariate analysis among adult patients (>=18 years) (n=261) revealed that infection on admission (p=0.01), alcoholism (p=0.01), high blood pressure (p=0.008), having at least one invasive device inserted (p=0.004), and history of recent surgery (p=0.03), increased the risk of HAIs significantly. More than 1 of 3 patients (35.4%) were under antibiotics on the day of the survey, of which more than half (57.4%) were under two or more types of antibiotics. Conclusion: The prevalence of HAIs and antibiotic prescriptions at the CNH were considerably high. An infection prevention and control committee, as well as the development of an antibiotic stewardship program with continuous monitoring using repeated prevalence surveys, must be implemented to limit the frequency of these infections effectively.

Keywords: prevalence, healthcare associated infection, antibiotic, Tunisia

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Authors: Titir Bhattacharya, Tanika Chakraborty, Prabal K. De

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Maternal and child health continue to be a significant policy focus in developing countries, including India. An emerging model in health care is the creation of public and private partnerships. Since the construction of physical infrastructure is costly, governments at various levels have tried to implement social health insurance schemes where a trust calculates insurance premiums and medical payments. Typically, qualifying families get full subsidization of the premium and get access to private hospitals, in addition to low cost public hospitals, for their tertiary care needs. We analyze one such pioneering social insurance scheme in the Indian state of Andhra Pradesh (AP). The Rajiv Aarogyasri program (RA) was introduced by the Government of AP on a pilot basis in 2007 and implemented in 2008. In this paper, we first examine the extent to which access to reproductive health care changed. For example, the RA scheme reimburses hospital deliveries leading us to expect an increase in institutional deliveries, particularly in private hospitals. Second, we expect an increase in institutional deliveries to also improve child health outcomes. Hence, we estimate if the program improved infant and child mortality. We use District Level Health Survey data to create annual birth cohorts from 2000-2015. Since AP was the only state in which such a state insurance program was implemented, the neighboring states constituted a plausible control group. Combined with the policy timing, and the year of birth, we employ a difference-indifference strategy to identify the effects of RA on the residents of AP. We perform several checks against threats to identification, including testing for pre-treatment trends between the treatment and control states. We find that the policy significantly lowered infant and child mortality in AP. We also find that deliveries in private hospitals increased, and government hospitals decreased, showing a substitution effect of the relative price change. Finally, as expected, out-of-pocket costs declined for the treatment group. However, we do not find any significant effects for usual preventive care such as vaccination, showing that benefits of insurance schemes targeted at the tertiary level may not trickle down to the primary care level.

Keywords: public health insurance, maternal and child health, public-private choice

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Authors: Souhir Chelly, Chahida Harizi, Aicha Hechaichi, Sihem Aissaoui, Leila Ben Ayed, Maha Bergaoui, Mohamed Kouni Chahed

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Introduction: The International Classification of Primary Care (ICPC) is part of the morbidity classification system. It had 17 chapters, and each is coded by an alphanumeric code: the letter corresponds to the chapter, the number to a paragraph in the chapter. The objective of this study is to show the utility of this classification in the coding of the reasons for demand for care in Primary health care (PHC), its advantages and limits. Methods: This is a cross-sectional descriptive study conducted in 4 PHC in Ariana district. Data on the demand for care during 2 days in the same week were collected. The coding of the information was done according to the CISP. The data was entered and analyzed by the EPI Info 7 software. Results: A total of 523 demands for care were investigated. The patients who came for the consultation are predominantly female (62.72%). Most of the consultants are young with an average age of 35 ± 26 years. In the ICPC, there are 7 rubrics: 'infections' is the most common reason with 49.9%, 'other diagnoses' with 40.2%, 'symptoms and complaints' with 5.5%, 'trauma' with 2.1%, 'procedures' with 2.1% and 'neoplasm' with 0.3%. The main advantage of the ICPC is the fact of being a standardized tool. It is very suitable for classification of the reasons for demand for care in PHC according to their specificity, capacity to be used in a computerized medical file of the PHC. Its current limitations are related to the difficulty of classification of some reasons for demand for care. Conclusion: The ICPC has been developed to provide healthcare with a coding reference that takes into account their specificity. The CIM is in its 10th revision; it would gain from revision to revision to be more efficient to be generalized and used by the teams of PHC.

Keywords: international classification of primary care, medical file, primary health care, Tunisia

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Authors: Aditi Madan, Jayant Kumar Routray

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Purpose: Over the years flood related risks have compounded due to increasing vulnerability caused by rapid urbanisation and growing population. This increase is an indication of the need for enhancing the preparedness of institutions to respond to floods. The study describes disaster management structure and its linkages with institutions involved in managing disasters. It addresses issues and challenges associated with readiness of disaster management institutions to respond to floods. It suggests policy options for enhancing the current state of readiness of institutions to respond by considering factors like institutional, manpower, financial, technical, leadership & networking, training and awareness programs, monitoring and evaluation. Methodology: The study is based on qualitative data with statements and outputs from primary and secondary sources to understand the institutional framework for disaster management in India. Primary data included field visits, interviews with officials from institutions managing disasters and the affected community to identify the challenges faced in engaging national, state, district and local level institutions in managing disasters. For focus group discussions, meetings were held with district project officers and coordinators, local officials, community based organisation, civil defence volunteers and community heads. These discussions were held to identify the challenges associated with preparedness to respond of institutions to floods. Findings: Results show that disasters are handled by district authority and the role of local institutions is limited to a reactive role during disaster. Data also indicates that although the existing institutional setup is well coordinated at the district level but needs improvement at the local level. Wide variations exist in awareness and perception among the officials engaged in managing disasters. Additionally, their roles and responsibilities need to be clearly defined with adequate budget and dedicated permanent staff for managing disasters. Institutions need to utilise the existing manpower through proper delegation of work. Originality: The study suggests that disaster risk reduction needs to focus more towards inclusivity of the local urban bodies. Wide variations exist in awareness and perception among the officials engaged in managing disasters. In order to ensure community participation, it is important to address their social and economic problems since such issues can overshadow attempts made for reducing risks. Thus, this paper suggests development of direct linkages among institutions and community for enhancing preparedness to respond to floods.

Keywords: preparedness, response, disaster, flood, community, institution

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Authors: Elaheh Ezami, Behzad Mohammadian, Elham Aznab

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Health service design will need to change due to bringing in new digital health tools. This highlights the importance of innovation in adopting Health Information Technology (HIT). It can be argued that innovation in the health sector correlates with entrepreneurship. Various reasons exist for health entrepreneurs to advocate increased investment in HIT to compensate for shortcomings in the health sector and improve the quality of healthcare. Furthermore, every innovative program presents challenges and motivations for entrepreneurs that may distract or encourage the adoption of technology. Our study used a systematic literature review to identify relevant articles that defined the frustrations and promotions of using health information technology in organizations or enterprises. A meta-analysis of the articles was conducted to identify the factors driving or pulling entrepreneurs to use HIT.

Keywords: health information technology, health entrepreneurship, health enterprise, health entrepreneurs' innovation

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Authors: Mahmood Iqbal, Khalid Nawab, Tachibana Satoshi

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Farmer Field School (FFS) is constantly aims to assist farmers to determine and learn about field ecology and integrated crop management. The study was conducted to examine the change in productivity of tomato crop in the study area; to determine increase in per acre yield of the crop, and find out reduction in per acre input cost. A study of tomato crop was conducted in ten villages namely Jabban, Bijligar Colony, Palonow, Heroshah, Zara Maira, Deghar Ghar, Sidra Jour, Anar Thangi, Miangano Korona and Wartair of district Malakand. From each village 15 respondents were selected randomly on the basis of identical allocation making sample size of 150 respondents. The research was based on primary as well as secondary data. Primary data was collected from farmers while secondary data were taken from Agriculture Extension Department Dargai, District Malakand. Interview schedule was planned and each farmer was interviewed personally. The study was based on comparison of cost, yield and income of tomato before and after FFS. Paired t-test and Statistical Package for Social Sciences (SPSS) was used for analysis; outcome of the study show that integrated pest management project has brought a positive change in the attitude of farmers of the project area through FFS approach. In district Malakand 66.0% of the respondents were between the age group of 31-50 years, 11.3% of respondents had primary level of education, 12.7% of middle level, 28.7% metric level, 3.3% of intermediate level and 2.0% of graduate level of education while 42.0% of respondents were illiterate and have no education. Average land holding size of farmers was 6.47 acres, cost of seed, crop protection from insect pest and crop protection from diseases was reduced by Rs. 210.67, Rs. 2584.43 and Rs. 3044.16 respectively, the cost of fertilizers and cost of farm yard manure was increased by Rs.1548.87 and Rs. 1151.40 respectively while tomato yield was increased by 1585.03 kg/acre from 7663.87 to 9248.90 kg/acre. The role of FFS initiate by integrated pest management project through department of agriculture extension for the development of agriculture was worth mentioning. It has brought enhancement in crop yield of tomato and their income through FFS approach. On the basis of results of the research studies, integrated pest management project should spread their developmental activities for maximum participation of the complete rural masses through participatory FFS approach.

Keywords: agriculture, Farmers field schools, extension education, tomato

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Authors: Sukanya Sripho

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This paper aims to examine the level of roles performed in tourism development by local people residing in Chiang Khan Sub-District Municipality, Loei Province in Northeast of Thailand. In addition, this study also tested whether personal factors had a relationship with the level of roles performed in tourism development. These personal factors included gender, age, educational level, career, position and duty in the community, average income per month, length of residence and involvement in the tourism industry. The findings revealed a high level in each role performed. These roles were ranked from the highest mean score to the lowest mean score as follows: (1) improving and rejuvenating tourist attractions; (2) improving tourist facilities; (3) promoting people participation; (4) publicizing tourist attractions; (5) protecting for safety and security; and (6) surveying and managing the information of tourist attractions. Furthermore, it was found that position and duty in the community, length of residence and involvement in tourism industry had a relationship with the level of roles performed in tourism development at a significance level of 0.05.

Keywords: Role, local municipality administration, tourism development, Thailand

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Authors: Vidya Padmakumar, N. C. Tharavathy

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The study was conducted from July 2015 to July 2017 to determine and understand the occurrence, frequency and diversity of avifauna in the Mallathahalli Lake of Bangalore Urban district. During the study period, 46 species of both terrestrial, as well as, aquatic birds belonging to 30 families were identified out of which 9 families were aquatic birds and 21 families were terrestrial birds. There were 4 species of migratory birds out of 46, showing diurnal migration. There was a significant reduce in the number of bird species both terrestrial and aquatic during the summer season and also varied greatly during winters and monsoon. Of the total 24 species of aquatic birds, Fulica atra and Tachybaptus ruficolis were the most common with 100% frequency and the least frequent species with 3.02% frequency was identified as Threskiornis melanocephalus. Among the 22 species of terrestrial birds, Acridotheres tristis had a frequency of 89% and the least frequent was Pycnonotus cafer (4.45%). The most commonly encountered bird species were from the families- Anatidae, Podicipedidae, Ardeidae, Phalacrocoracidae, Rallidae, Accipitridae, Scolopacidae, Charadridae, Laridae, Meropidae, Hirudinidae. All the birds surviving around the area are dependent on the wetland and crop vegetation surrounding the lake, which are deteriorating due to anthropogenic interventions and urbanization which are rising to its peak gradually causing the decline in the avifaunal diversity.

Keywords: Avifaunal diversity, Mallathahalli lake, seasonal migration, urbanization

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Authors: Viktória Sugár, Orsolya Frick, Gabriella Horváth, A. Bendegúz Vöröss, Péter Leczovics, Géza Baráth

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Urban greenery has multiple positive effects both on the city and its residents. Apart from the visual advantages, it changes the micro-climate by cooling and shading, also increasing vapor and oxygen, reducing dust and carbon-dioxide content at the same time. The above are all critical factors of livability of an urban fabric. Unfortunately, in a dense, historical district there are restricted possibilities to build green surfaces. The present study collects and systemizes the applicable green solutions in the case of a historical downtown district of Budapest. The study contains a GIS-based measurement of the eligible surfaces for greenery, and also calculates the potential of oxygen production, carbon-dioxide reduction and cooling effect of an increased green surface.  It can be concluded that increasing the green surface has measurable effects on a densely built urban fabric, including air quality, micro-climate and other environmental factors.

Keywords: urban greenery, green roof, green wall, green surface potential, sustainable city, oxygen production, carbon-dioxide reduction, geographical information system

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Authors: Brigita Mieziene, Arunas Emeljanovas, Vida Cesnaitiene, Ingunn Fjortoft, Lise Kjonniksen

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Background. Health-related physical fitness refers to the favorable health status, i.e. ability to perform daily activities with vigor, as well as capacities that are associated with a low risk for development of chronic diseases and premature death. However, in school-aged children it is constantly declining, while some aspects of fitness declined as much as 50 percent during the last two decades, which prognosticates increasingly earlier onset of health problems, decreasing the quality of life of the population and financial burden for the society. Therefore, the goal of the current study was to indicate nationally representative age- and gender-specific reference values of anthropometric measures, musculoskeletal, motor and cardiorespiratory fitness in Lithuanian primary school children from 6 to 10 years. Methods. The study included 3556 students in total, from 73 randomly selected schools. Ethics approval for research by the Kaunas Regional Ethics Committee (No. BE-2-42) was obtained. Physical fitness was measured by the 9-item test battery, developed by Fjørtoft and colleagues. Height and weight were measured and body mass index calculated. Smoothed centile charts were derived using the LMS method. Results. The numerical age- and gender-specific percentile values (3rd, 10th, 25th, 50th, 75th, 90th, and 97th percentile) for anthropometric measures, musculoskeletal, motor and cardiorespiratory fitness were provided. The equivalent smoothed LMS curves were performed. The study indicated 12.5 percent of overweight and 5 percent of obese children in accordance with international gender and age specific norms of body mass index. This data could be used in clinical and educational settings in order to identify the level of individual physical fitness within its different components.

Keywords: fitness, overweight, primary school children, reference values, smoothed percentile curves

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