Search results for: antenatal care services

Authors: Maria Del Mar Maira Vidal, Alvaro Briales

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In this paper, we will conduct an analysis of the results of the I+D+i research project “New types of socio-existential vulnerability, support and care in Spain” (VULSOCU) (2016-20). This project had the objective to analyze the new types of vulnerability that are the result of the combination of several factors as the economic crisis, the unemployment, the transformations of the Welfare State, the individualization, etc. We have, therefore, analyzed the way that Spanish long-term unemployed over 45 years experience vulnerability and its consequences on their lives. We have focused on long-term unemployed over 45 that had previously developed stable career paths and have been looking for a job for two years or more. In order to carry out this analysis, we will try to break the dichotomy between the social and the individual, between the socio-historical and the subjectivity, to overcome some of the limits of the research on unemployment. The fieldwork consisted of more than ten focus groups and fifty in-depth interviews. The work and life ethics completely changed at the turn of the nineteenth and twentieth centuries. In the nineteenth century, companies had trouble maintaining their staff, but in the 21st century, unemployed workers feel that they are useless people. Workers value themselves if they have a job. This unveils that labor is a comprehensive social relationship in capitalist societies. In general, unemployed workers are not able to analyze their unemployment as a social problem. They analyze their unemployment as an individual problem. They blame themselves for their unemployment; instead of taking into account that there are millions of unemployed, they talk about themselves as if they were on their own. And the problems caused by unemployment are explained as psychological problems and are medicalized. Anyway, it is important to highlight that this is the result of an ideology and a social relationship that is part of our historical time.

Keywords: life ethics, work ethics, unemployment, unemployed over 45 years old

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Authors: Poojitha Vemula

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Understanding how we use image manipulation to communicate through an audience’s perceptions and conceive visual intelligence. With the use of many software and high-end skills, designers have developed a third eye to combine two different visuals and create the desired image by using photoshop and other software skills. The purpose of visual intelligence is to convey a message to the targeted audience. For instance, the images of models are retouched on their skin to make it more convincing and draw attention from the audience. There are many ways of manipulating an image, such as double exposure, retouching photography inks or paint airbrushing and piecing photos together, or enhancing the brightness and contrast. To understand visual intelligence, a questionnaire survey as well as research was conducted on how image manipulation is used by both the audience and the designers. This depends on the message that needs to be conveyed by the brands. For instance, Fair & Lovely, a brightening cream for ladies use a lot of retouching and effects to show the dramatic change the cream takes effect on dark or dusky faces. Thus the designer’s role is to use their third eye to incorporate the message into visuals. The research and questionnaire survey concludes the perceptions and manipulations used in visual communication. However this is all to make an effortless communication between the designer and the audience by using the skills of the designer and the features provided by the software. The objective of visual intelligence is to covet the message of the brands that advertise their products or services by using visuals through softwares. Conveying a message through visual intelligence requires an audiences perceptions and understanding from the visuals created by the artists or designers. Visual intelligence determines how we use our technical skills to retouch and manipulate an image for a better understanding to convey the message to the targeted audience. This also bridges the communication between the brand and the audience.

Keywords: graphic design, visual communication, convey messages, photoshop, image manipulation

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Authors: Rowena Clemino Alcoba

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Thailand is host to the largest number of refugees in the region. The country has been one of the most accessible points of entry to refugees around the world because it has relatively lenient visa requirements, enabling asylum seekers to enter the country and subsequently search for legal assistance. However, because Thailand is not a signatory to the 1951 Geneva Convention on Refugees which governs the refugee status determination and safeguards several rights of the refugees, there are no national laws or administrative framework on the protection of refugees. Refugees are considered as illegal migrants, and certain groups are permitted to stay temporarily only upon executive discretion. Aside from the documented group of refugees from the Myanmar border, there are many others who came from different parts of the world. They are known as urban refugees believed to be in the thousands and are scattered in the impoverished areas of Bangkok and the suburbs. This study aims to advance understanding of the role of civil society organizations in supporting refugees, with particular focus on urban refugees. Using the method of triangulation in qualitative research, the study investigates the life journey of a refugee family from Pakistan, their difficulties and struggles to survive in perilous situations. The study presents the dynamics of how civil society works and collaborates to fill the gap for much-needed social services. It also discusses the depth and scope of the role of faith actors in the protection and support of this vulnerable sector. The engagement of civil society reveals framework and structure that aims to create long-term impact. The help provided is not merely monetary or material dole-outs but a platform for refugees to integrate with community, develop skills and make productive use of their time.

Keywords: asylum seeker, civil society, faith actors, refugees

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Authors: Eyup Dogan

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One criticism of the energy-growth-environment literature, to the best of our knowledge, is that only a few studies analyze the influence of tourism on CO₂ emissions even though tourism sector is closely related to the environment. The other criticism is the selection of methodology. Panel estimation techniques that fail to consider both heterogeneity and cross-sectional dependence across countries can cause forecasting errors. To fulfill the mentioned gaps in the literature, this study analyzes the impacts of real GDP, renewable energy and tourism on the levels of carbon dioxide (CO₂) emissions for the top 10 most-visited countries around the world. This study focuses on the top 10 touristic (most-visited) countries because they receive about the half of the worldwide tourist arrivals in late years and are among the top ones in 'Renewables Energy Country Attractiveness Index (RECAI)'. By looking at Pesaran’s CD test and average growth rates of variables for each country, we detect the presence of cross-sectional dependence and heterogeneity. Hence, this study uses second generation econometric techniques (cross-sectionally augmented Dickey-Fuller (CADF), and cross-sectionally augmented IPS (CIPS) unit root test, the LM bootstrap cointegration test, and the DOLS and the FMOLS estimators) which are robust to the mentioned issues. Therefore, the reported results become accurate and reliable. It is found that renewable energy mitigates the pollution whereas real GDP and tourism contribute to carbon emissions. Thus, regulatory policies are necessary to increase the awareness of sustainable tourism. In addition, the use of renewable energy and the adoption of clean technologies in tourism sector as well as in producing goods and services play significant roles in reducing the levels of emissions.

Keywords: air pollution, tourism, renewable energy, income, panel data

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Authors: Rachel K. Cremona

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Forty years ago, Vila Autodromo was a small fishing settlement in southwest Rio de Janeiro. By 2012, Vila Autodromo had established itself into a working class neighborhood – certainly not a slum, but nonetheless designated as a ‘favela’ as a consequence of its history as an illegal settlement that was thus never provided with public services. Vila Autodromo sits on a large lagoon, adjacent to the Olympic Park being constructed for the 2016 Olympic Games to be held in Rio, and looks out over the expensive high rise condominiums that have sprouted across the water. In 2009, when Rio submitted their bid for the Olympic games, there were approximately 900 families that called Vila Autodromo home, and the original plans for the games clearly show their homes remaining in place. Today, only a handful of these homes remain. This paper will utilize the case study of Vila Autodromo to examine the broader issue of Favelas in 21st century Rio de Janeiro. While race and poverty have become synonymous with Brazil’s inegalitarian social order – and personified by the thousands of favelas scattered in and around large cities like Rio and Sao Paulo – much less attention has been given to the political status of the nation’s invisible majority. In particular, this research will examine the question of citizenship and argue that the most fundamental problem of inequality in Brazil is not simply a product of history, race and social order, but more specifically a problem of ‘personhood’. The political marginalization of Brazil’s poor does not simply reinforce their social marginalization, it institutionalizes it in a way that makes it almost impossible to escape. The story of Vila Autodromo captures this problem in a way that not only illustrates the clear (though ambiguous) role of the state in the perpetuation of Brazil’s underclass, but also the human resilience that it has fostered.

Keywords: citizenship, poverty, displacement, favela

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Authors: Artitaya Sabangbal, Darawan Augsornwan, Palakorn Surakunprapha, Lalida Petphai

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Background: Srinagarind Hospital Ward 3C has about 180 cases of patients with head and neck cancer per year. Almost all of these patients suffer with pain, fatigue, low self image, swallowing problem and when the tumor is larger they will have breathing problem. Many of them have complication after operation such as pressure sore, pneumonia, deep vein thrombosis. Nursing activity is very important to prevent the complication especially promoting patients early ambulation. The objective of this study was to develop early ambulation protocol for patients with head and neck cancer undergoing operation. Method: this study is one part of nursing system development in patients undergoing operation in Ward 3C. It is a participation action research divided into 3 phases Phase 1 Situation review: In this phase we review the clinical outcomes, process of care, from document such as nurses note and interview nurses, patients and family about early ambulation. Phase 2 Searching nursing intervention about early ambulation from previous study then establish protocol . This phase we have picture package of early ambulation. Phase 3 implementation and evaluation. Result: Patients with head and neck cancer after operation can follow early ambulation protocol 100%, 85 % of patients can follow protocol within 2 days after operation and 100% can follow protocol within 3 days. No complications occur. Patients satisfaction in very good level is 58% and in good level is 42% Length of hospital stay is 6 days in patients with wide excision and 16 day in patients with flap coverage. Conclusion: The early ambulation protocol is appropriate for patients with head and neck cancer who undergo operation. This can restore physical health, reduce complication and increase patients satisfaction.

Keywords: nursing system, early ambulation, head and neck cancer, operation

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Authors: Dušica Kovačević

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This study explores the influence of destructive groups on the mental health and social integration of high school students in Loznica, Serbia. Despite increasing concerns, there is a significant lack of research on the impact of these groups on adolescents in this region. This qualitative study aims to fill this gap by examining the prevalence of destructive groups, their psychological effects on students, and their broader social implications. Data were collected through surveys and in-depth interviews with high school students, educators, and mental health professionals. The study focuses on key mental health indicators, such as anxiety, depression, and identity formation, alongside social factors, including peer relationships and community engagement. Additionally, it defines coping mechanisms and supporting strategies employed by students affected by these groups. The findings reveal substantial psychological and social challenges faced by students exposed to destructive groups, including increased levels of anxiety and depression, disrupted identity development, and impaired social integration. Insights into the personal experiences of these students provide a detailed understanding of the groups’ impact, underscoring the need for targeted interventions. This research offers evidence-based recommendations for educators, mental health practitioners, and policymakers. It emphasizes the importance of developing effective educational programs and support services to enhance the well-being of high school advocates for proactive measures to protect adolescent mental health and promote healthy social values within educational and community settings.

Keywords: adolescents, mental health, destructive groups, social integration, qualitative study, high school students, Serbia

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Authors: Hossein Panahi, Firouz Fallahi, Sima Nasibparast

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Background & Aim: Unnecessary growth in health expenditures of developing countries in recent decades, and also the importance of physicians’ behavior in health market, have made the theory of physician-induced demand (PID) as one of the most important issues in health economics. Therefore, the main objective of this study is to investigate the hypothesis of induced demand among mental patients who receive services from either psychologists or psychiatrists in East Azerbaijan province. Methods: Using data from questionnaires in 2020 and employing the theoretical model of Jaegher and Jegers (2000) and hierarchical linear modeling (HLM), this study examines the PID hypothesis of selected psychologists and psychiatrists. The sample size of the study, after removing the questionnaires with missing data, is 45 psychologists and 203 people of their patients, as well as 30 psychiatrists and 160 people of their patients. Results: The results show that, although psychiatrists are ‘profit-oriented physicians’, there is no evidence of inducing unnecessary demand by them (PID), and the difference between the behavior of employers and employee doctors is due to differences in practice style. However, with regard to psychologists, the results indicate that they are ‘profit-oriented’, and there is a PID effect in this sector. Conclusion: According to the results, it is suggested that in order to reduce competition and eliminate the PID effect, the admission of students in the field of psychology should be reduced, patient information on mental illness should be increased, and government monitoring and control over the national health system must be increased.

Keywords: physician-induced demand, national health system, hierarchical linear modeling methods, multilevel modela

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Authors: Resham Lal Phuldel

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This study based on a bilateral development cooperation project funded by the governments of Nepal and Finland. The first phase of the project has been completed in August 2012 and the phase II started in September 2013 and will end September 2018. The project strengthens the capacity of local governments in 14 districts to deliver services in water supply, sanitation and hygiene in Western development region and in Mid-Western development region of Nepal. In recent days, several spring sources have been dried out or slowly decreasing its yield across the country due to changing character of rainfall, increasing evaporative losses and some other manmade causes such as land use change, infrastructure development work etc. To sustain the hilly communities, the sources have to be able to provide sufficient water to serve the population, either on its own or in conjunction with other sources. Phase III have measured all water sources in Tanahu district in 2004 and sources were located with the GPS. Phase II has repeated the exercise to see changes in the district. 3320 water sources as identified in 2004 and altogether 4223 including new water sources were identified and measured in 2014. Between 2004 and 2014, 50% flow rate (yield) deduction of point sources’ average yield in 10 years is found. Similarly, 21.6% and 34% deductions of average yield were found in spring and stream water sources respectively. The rainfall from 2002 to 2013 shows erratic rainfalls in the district. The monsoon peak month is not consistent and the trend shows the decrease of annual rainfall 16.7 mm/year. Further, the temperature trend between 2002 and 2013 shows warming of + 0.0410C/year.

Keywords: climate change, rainfall, source discharge, water sources

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Authors: Ayesha Iftikhar, Faisal Hafeez, Muhammad Jawad Saleem, Afifa Naeem, Muhammad Sohaib

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To further develop integrated pest management (IPM) tactics against insect pests, demographic toxicology is considered important and efficient to evaluate the long-term effects of pesticides on biological control agents. In this study, lethal and sub-lethal effects of Pyriproxyfen (insect growth regulator) two concentrations of LC10 and LC30 were tested on second instar larvae of convergent lady beetle, Hippodamia convergens (Goeze) in order to evaluate the effect of insecticide on demographic parameters of the predator under laboratory conditions. The life table parameters were analysed statistically by using age-stage, two sex life table procedure. The results of this study show that developmental time for immature was prolonged in treated population (LC30 and LC10) rather than in control. Similarly, male and female longevity was also longer in the control group as compared to the treated population. Adult pre-oviposition period and fecundity were also greater in control as compared to the treated population. In addition, population parameters such as net reproductive rate (R0), intrinsic rate of increase (r) and finite rate of increase (λ) were also greater in control group rather than treated population. However, mean generation time (T) was greater in the treated group. The results revealed that pyriproxyfen, even at low concentrations, has potential to greatly affect the population growth of predatory lady beetle, therefore care should be taken when insect growth regulators are used within an IPM framework.

Keywords: ladybird beetle, IGR, integrated pest management, population inhibition

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Authors: Amenah Galo, Mohammed Farid, Kareem Alsharkawy, Robert Warner, Karthikeyan Srinivasan, Haitham Khalil, Ruth Waters

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Introduction: The cessation of elective surgery, particularly breast reconstruction, continue to be affected by the COVID-19 pandemic. The restructuring of medical services and staff redeployment severely affected the ability to return to normality for surgical specialties. The aim of this study is to determine the decline in breast reconstruction affected by the COVID-19 pandemic in a tertiary center. Methods: A retrospective review of breast reconstruction cases (autologous, non-autologous) or mastectomies Pre- COVID (March 2019-March 2020) and during COVID (March 2020- March 2021) at Queen Elizabeth Hospital, Birmingham, were collated. Data included patient demographics, BMI, previous and recent reconstruction, length of hospital stay, and mastectomies, including risk-reducing. Results: The number of patients who had breast reconstruction was significantly lower during COVID (n=62) compared to pre-COVID (n=199). The mean age (pre-COVID 51, COVID 59 years), BMI (Pre-COVID and COVID = 27), previous reconstruction (pre-COVID n=101, 51%, COVID n=33, 53%) and length hospital stay was less during COVID (3 days) compared to Pre-COVID (4 days). The proportion of risk-reducing mastectomies and reconstruction during COVID (32%, n=20) were higher than pre-COVID (21%, n=41). A higher proportion rate of autologous reconstruction (DIEP 56, TRAM 17) Pre-COVID compared to COVID (DIEP 22, TRAM 7). Implant reconstructions were higher during COVID (n=19, 31%) than pre-COVID (n=31, 16%). Conclusion: The lack of regular provision for breast reconstruction continues to decline during the pandemic. This will have a tremendous impact on waiting lists without a timeline for reconstruction to offer patients. An international survey highlights the disparities in offering breast reconstruction and strategies to rectify this issue.

Keywords: breast reconstruction, COVID-19 pandemic, mastectomy, autologous, implant

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Authors: Angalabiri-Owei E. Bekekeme, Brambaifa Nelson

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In view of the peculiar environment of the Niger Delta, access to modern health care is limited, hence the inhabitants especially those in the swampy areas resorts to sourcing for alternatives cure for their ailments using plants commonly found in this area without scientific evaluation. Rhizophora racemosa, G. F. Meyer (Rhizophoraceae) is the most abundant mangrove plant in the Niger Delta Area of Nigeria. The plant has been observed to be used for relief of a toothache and dysmenorrhoea among some Ijaw communities in the region. This work has revealed the likely potential of the plant in drug discovery and development. The crude methanol extract at doses of 300 mg/kg and 600 mg/kg (intraperitoneal) were tested for analgesic effect using fresh egg albumin induced inflammatory pain and Randall–Sellito method to assess the pain threshold. The anti-inflammatory effect was also evaluated with the extract at doses of 300 mg/kg and 600 mg/kg (intraperitoneal) using acute inflammatory model; fresh egg albumin induced paw oedema and assessed using Plethysmometer in rats. The methanol extracts 300 mg/kg and 600 mg/kg exhibited a significant (P < 0.001) and dose-dependent analgesic activity compared with the negative control and a standard drug diclofenac using ANOVA with Least Significant Difference post hoc test as evidenced by increased pain threshold. Also, the extract significantly (P < 0.001) reduced the rat paw oedema induced by the sub plantar injection of fresh egg albumin when compared with the negative control and a standard diclofenac using above statistical methods. This study revealed that the plant possesses analgesic and anti-inflammatory activities hence provide scientific bases for use as medicine.

Keywords: analgesic, anti-inflammatory, plethysmometer, Rhizophora racemosa

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Authors: David Cook, Brynhildur Davidsdottir, Dadi. M. Kristofersson

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The approval of development projects with significant environmental impacts implies that the economic costs of the affected environmental resources must be less than the financial benefits, but such irreversible decisions are frequently made without ever attempting to estimate the monetary value of the losses. Due to this knowledge gap in the processes informing decision-making, development projects are commonly approved despite the potential for social welfare to be undermined. Heeding a repeated call by the OECD to commence economic accounting of environmental impacts as part of the cost-benefit analysis process for Icelandic energy projects, this paper sets out the results pertaining to the nation’s first two contingent valuation studies of geothermal areas likely to be developed in the near future. Interval regression using log-transformation was applied to estimate willingness to pay (WTP) for the preservation of the high-temperature Eldvörp and Hverahlíð fields. The estimated mean WTP was 8,333 and 7,122 ISK for Eldvörp and Hverahlíð respectively. Scaled up to the Icelandic population of national taxpayers, this equates to estimated total economic value of 2.10 and 1.77 billion ISK respectively. These results reinforce arguments in favour of accounting for the environmental impacts of Iceland’s future geothermal power projects as a mandatory component of the exploratory and production license application process. Further research is necessary to understand the economic impacts to specific ecosystem services associated with geothermal environments, particularly connected to changes in recreational amenity. In so doing, it would be possible to gain greater comprehension of the various components of total economic value, evolving understanding of why one geothermal area – in this case, Eldvörp – has a higher preservation value than another.

Keywords: decision-making, contingent valuation, geothermal energy, preservation

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Authors: Masoud Safdari, Jacob Fish

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Despite vast amount of existing theoretical knowledge, the implementation of a universal multiscale modeling, analysis, and simulation software framework remains challenging. Existing multiscale software and solutions are often domain-specific, closed-source and mandate a high-level of experience and skills in both multiscale analysis and programming. Furthermore, tools currently existing for Atomistic-to-Continuum (AtC) multiscaling are developed with the assumptions such as accessibility of high-performance computing facilities to the users. These issues mentioned plus many other challenges have reduced the adoption of multiscale in academia and especially industry. In the current work, we introduce Multiscale Hub (MsHub), an effort towards making AtC more accessible through cloud services. As a joint effort between academia and industry, MsHub provides a universal web-enabled framework for practical multiscaling. Developed on top of universally acclaimed scientific programming language Python, the package currently provides an open-source, comprehensive, easy-to-use framework for AtC coupling. MsHub offers an easy to use interface to prominent molecular dynamics and multiphysics continuum mechanics packages such as LAMMPS and MFEM (a free, lightweight, scalable C++ library for finite element methods). In this work, we first report on the design philosophy of MsHub, challenges identified and issues faced regarding its implementation. MsHub takes the advantage of a comprehensive set of tools and algorithms developed for AtC that can be used for a variety of governing physics. We then briefly report key AtC algorithms implemented in MsHub. Finally, we conclude with a few examples illustrating the capabilities of the package and its future directions.

Keywords: atomistic, continuum, coupling, multiscale

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Authors: Hamzeh Awad

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Disability is considered to be a worldwide complex phenomenon which rising at a phenomenal rate and caused by many different factors. Chronic diseases such as cardiovascular disease and diabetes can lead to mobility disability in particular and disability in general. The ICF is an integrative bio-psycho-social model of functioning and disability and considered by the World Health Organization (WHO) to be a reference for disability classification using its categories and core set to classify disorder’s functional limitations. Specialist programs at Sultan Bin Abdul Aziz Humanitarian City (SBAHC) are providing both inpatient and outpatient services have started to implement the ICF and use it as a problem solving tool in Rehab. Diabetes is leading contributing factor for disability and considered epidemic in several Gulf countries including the Kingdom of Saudi Arabia (KSA), where its prevalence continues to increase dramatically. Metabolic disorders, mainly diabetes are not well covered in Rehab field. The purpose of this study is present to research and clinical rehabilitation field of DREAM and ICF as a framework in clinical and research setting in Rehab service. Also, shed the light on using the ICF as problem solving tool at SBAHC. There are synergies between disability causes and wider public health priorities in relation to both chronic disease and disability prevention. Therefore, there is a need for strong advocacy and understanding of the role of ICF as a reference in Rehab settings in Middle East if we wish to seize the opportunity to reverse current trends of acquired disability in the region.

Keywords: international classification of functioning, disability and health (ICF), prototype, rehabilitation and diabetes

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Authors: Noof Eid Al Shammari

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Background: Living with haemodialysis (HD) can impose several physical and social restrictions on the lives of individuals. Usually, the patient has three dialysis sessions per week that each run for three to four hours. This limits the social life of patients and causes a lower quality of life, in conjunction with the fact that people with chronic kidney disease must follow strict fluid and food regimens and use multiple medications. Given these factors, patients undergoing HD generally need psychological support. Objective: This scoping review study aims to evaluate the effectiveness of physical and breathing exercises on quality of life (QOL) and psychophysical status in patients undergoing HD. Methodology: Searches for relevant studies were performed in four databases (MEDLINE, CINAHL, Google Scholar, and PubMed) for articles published between 2011 and 2021. Out of all the searched literature, ten studies met the inclusion criteria (8 randomised controlled trials, one quasi-experimental study, and one pilot study), with a total of 588 patients. Different types of physical and breathing exercises were used (breathing, cardiopulmonary, and physical exercises). Results: All included studies in this scoping review revealed that most of the aerobic or anaerobic exercises, as well as breathing exercises, had a positive effect and significantly improved patients’ QOL, physical functioning, and psychological status. Conclusions: In this review, most of the articles demonstrated a positive effect of physical and breathing exercises on the QOL and psychophysical status of HD patients. Based on the findings of these studies, physical and breathing exercises were shown to improve muscle strength and other health-related aspects of QOL, including sexual, social, cognitive, and physical functions. However, more studies will need to be conducted with a larger sample to determine the best intervention that could be implemented and standardised in nursing care for patients undergoing HD.

Keywords: physical exercise, breathing exercises, quality of life, depression, hemodialysis

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Authors: Anil Anand

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Despite enormous strides made during the past decade, particularly with the adoption and expansion of community policing, there remains much that police leaders can do to improve police-public relations. The urgency is particularly evident in cities across the United States and Europe where an increasing number of police interactions over the past few years have ignited large, sometimes even national, protests against police policy and strategy, highlighting a gap between what police leaders feel they have archived in terms of public satisfaction, support, and legitimacy and the perception of bias among many marginalized communities. The decision on which one policing strategy is chosen over another, how many resources are allocated, and how strenuously the policy is applied resides primarily with the police and the units and subunits tasked with its enforcement. The scope and opportunity for police officers in impacting social attitudes and social policy are important elements that cannot be overstated. How do police leaders, for instance, decide when to apply one strategy—say community-based policing—over another, like intelligence-led policing? How do police leaders measure performance and success? Should these measures be based on quantitative preferences over qualitative, or should the preference be based on some other criteria? And how do police leaders define, allow, and control discretionary decision-making? Mending Broken Fences Policing provides police and security services leaders with a model based on social cohesion, that incorporates intelligence-led and community policing (IP-CP), supplemented by a quality/quantity/crime (QQC) framework to provide a four-step process for the articulable application of police intervention, performance measurement, and application of discretion.

Keywords: social cohesion, quantitative performance measurement, qualitative performance measurement, sustainable leadership

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Authors: Emmanuel Larbi Offei, Felix Agyei-Sasu, Maura Naa Densua Ashong

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Ghana has 26 universal banks and several banking and non-banking financial institutions operating in the country. The growing number of banks has heightened competition among banks to attract and retain customers more customers to ensure sustainability. Hence the need to identify and understand factors that influences customers’ choice of banks cannot be overemphasised. This study investigates the determinants of bank selection criteria by banking customers in Ghana. Four banks were purposively sampled for this study namely Barclays, Standard Chartered, Sahel Sahara and Unibank. Convenience sampling was then used to select 114 bank customers in Accra and interviewed. Questionnaires were used to collect data that were analysed in tables and charts with the use of STATA software. The findings of the study revealed that quick/prompt services and complaint handling, safety of funds, networked branches, easy access to functional Automated Teller Machines (ATMs) and low/moderate service charges were the major determinants of customers’ choice of banks. The results further show that 89.5 percent of all deposits are held in either current or savings accounts. About 22.1 percent of the respondents indicated that they have plans of changing their banks in the near future because they are not satisfied with their banks. A gender analysis of the choice criteria showed differences between the choice criteria of the male as compared to the female. The study recommends that banks in Ghana should focus on products and policies that will not compromise on the safety of funds of their customers. Again, banks must address customer complaints and dissatisfactions as promptly as possible by taking pragmatic steps to address administrative bureaucracies and infrastructural challenges that prolong the duration of banking transactions.

Keywords: Ghana, banks, determinants, customers’ choice, competition

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Authors: Orapan Thosingha, Tassana Boontong, Prapa Yuttatri, Vilaivan Thongcharoen, Soparn Potaya, Mattika Chaichan, Chanin Chakkrapopyodhin, Khwanthida Phimphakarn, Taddao Nabnean

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This research aimed to explore symptom experiences among Thai adults with chronic illnesses living in an urban community area of Bangkok. The sample was 670 adults with ages ranging from 20-59 years. The majority of them (65.2%) had more than one disease. Hypertension, dyslipidemia, and diabetes were the first three diseases among them. About 58% were female, and 51.1 % stayed with their couples. The studied sample had relatively low socioeconomic status; 33.7% were wage workers, 15.2% were street vendors, and 10.4% were unemployed. About 54 % had family incomes less than 10,000 baht (300 US Dollars) per month, and 41.6% addressed that their incomes were not adequate for daily living. Although the majority of them (63.7%) did not have to pay for hospital visits, they still had to pay for public transportation and could not earn a wage or any income on the hospital visit day. The first three physical symptoms they experienced were knee pain (60.5%) due to being overweight, headache (47.0%), and insomnia (44.6%). About 45% stated that their incomes decreased after having chronic illnesses and 37.2% expressed that having lower incomes affected their living, 34.5% perceived being a burden, and 34.3% regret about depending on others. It can be concluded that adults with low socioeconomic status who experienced chronic illnesses and resided in an urban community area had complex needs. While caring for them, nurses should pay attention not only to a disease-related domain but also to a social-related domain. Reached-out clinics led by professional nurses who are well-prepared for primary medical care and home visit are strongly recommended. National Health Security Office should adopt this policy and develop an action plan to serve the needs of chronically ill adults with low socioeconomic status.

Keywords: chronic illnesses, urban community, socioeconomic status, symptom experiences, low incomes

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Authors: Asghar Zamani, Mostafa Falahmorad

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Virtualization is established to combine and use the unique capabilities of employees to increase productivity and agility to provide services regardless of location. Adapting to fast and continuous change and getting maximum access to human resources are reasons why virtualization is happening. The distance problem is solved by information. Flexibility is the most important feature of virtualization, and information will be the main focus of virtualized companies. In this research, we used the Covid-19 opportunity window to assess the productivity of the companies that had been going through more virtualized management before the Covid-19 in comparison with those that just started planning on developing infrastructures on virtual management after the crises of pandemic occurred. The research process includes financial (profitability and customer satisfaction) and behavioral (organizational culture and reluctance to change) metrics assessment. In addition to financial and CRM KPIs, a questionnaire is devised to assess how manager and employees’ attitude has been changing towards the migration to virtualization. The sample companies and questions are selected by asking from experts in the IT industry of Iran. In this article, the conclusion is that companies open to virtualization based on accurate strategic planning or willing to pay to train their employees for virtualization before the pandemic are more agile in adapting to change and moving forward in recession. The prospective companies in this research, not only could compensate for the short period loss from the first shock of the Covid-19, but they could also foresee new needs of their customer sooner than other competitors, resulting in the need to employ new staff for executing the emerging demands. Findings were aligned with the literature review. Results can be a wake-up call for business owners especially in developing countries to be more resilient toward modern management styles instead of continuing with traditional ones.

Keywords: virtual management, virtual organization, competitive advantage, KPI, profit

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Authors: Nannapus Saramad, Rewwadee Petsirasan, Jom Suwanno

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Background: This retrospective study design was to describe average blood pressure, blood pressure level, target blood pressure control rate post-stroke BP control in the year following discharge from Sichon hospital, Sichon District, Nakhon Si Thammarat province. The secondary data analysis was employed from the patient’s health records with patient or caregiver interview. A total of 232 eligible post-acute ischemic strokes in the year following discharge (2017-2018) were recruited. Methods: Data analyses were applied to identify the relationship values of single variables were determined through univariate analyses: The Chi-square test, Fisher exact test, the variables found to have a p-value < 0.2 were analyzed by the binary logistic regression Results: Most of the patients in this study were men 61.6%, an average age of 65.4 ± 14.8 years. Systolic blood pressure levels were in the grade 1-2 hypertension and diastolic pressure at optimal and normal at all times during the initial treatment through the present. The results revealed 25% among the groups under the age of 60 achieved BP control; 36.3% for older than 60 years group; and 27.9% for diabetic group. The multivariate analysis revealed the final relationship of four significant variables: 1) receiving calcium-channel blocker (p =.027); 2) medication adherence of antihypertensive (p = .024) 3) medication adherence of antiplatelet ( p = .020); and 4) medication behavior ( p = . 010) . Conclusion: The medical nurse and health care provider should promote their adherence to behavior to improve their blood pressure control.

Keywords: acute ischemic stroke, target blood pressure control, medication adherence, recurrence stroke

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Authors: Catarina Ramos Pereira, Jorge Rodrigues, Natália Oliveira, Jorge Machado, Maria Begoña Criado, Jorge Machado, Henri J. Greten

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Background: Parkinson's disease is a multi-system neurodegenerative disorder characterized by motor and non-motor symptoms. To slow disorder progression, different treatment options are now available, but in most cases, these therapeutic strategies also involve the presence of important side effects. This has led many patients to pursue complementary therapies, such as acupuncture, to alleviate PD symptoms. Therefore, an update on the efficacy of this treatment for patients of PD is of great value. This work presents a systematic review of the efficacy of acupuncture treatments in relieving PD symptoms. Methods: EMBASE, Medline, Pubmed, Science Direct, The Cochrane Library, Cochrane Central Register of Controlled Trials (Central), and Scielo databases were systematically searched from January 2011 through July 2021. Randomized controlled trials (RCTs) published in English with all types of acupuncture treatment were included. The selection and analysis of the articles were conducted by two blinding authors through the Rayyan application. Results: 720 potentially relevant articles were identified; 52 RCTs met our inclusion criteria. After the exclusion of 35, we found 17 eligible. The included RCTs reported positive effects for acupuncture plus conventional treatment compared with conventional treatment alone in the UPDRS score. Conclusions: Additional evidence should be supported by rigorous methodological strategies. Although firm conclusions cannot be drawn, acupuncture treatment, in the framework of an interdisciplinary care team, appears to have positive effects on PD symptoms.

Keywords: systematic review, Parkinson disease, acupuncture, traditional Chinese medicine

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Authors: Nur Bella Octoria Bella, Ayomi Dita Rarasati

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DKI Jakarta is Indonesia's capital city with the 10th highest congestion rate in the world based on the 2019 traffic index. Other than that based on World Air Quality Report in 2019 showed DKI Jakarta's air pollutant concentrate 49.4 µg and the 5th highest air pollutant in the world. In the urban city nowadays, the mobility rate is high enough and the efficiency for sustainability assessment in transport infrastructure development is needed. This efficiency is the important key for sustainable infrastructure development. DKI Jakarta is nowadays in the process of constructing the railway infrastructure to support the transportation system. The problems appearing are the railway infrastructure networks and the service in DKI Jakarta already planned based on sustainability factors or not. Therefore, the aim of this research is to make the evaluation of railways infrastructure networks performance and services in DKI Jakarta regards on the railway sustainability key factors. Further, this evaluation will be used to make the railway sustainability assessment framework and to offer some of the alternative solutions to improve railway transportation sustainability in DKI Jakarta. Firstly a very detailed literature review of papers that have focused on railway sustainability factors and their improvements of railway sustainability, published in the scientific journal in the period 2011 until 2021. Regarding the sustainability factors from the literature review, further, it is used to assess the current condition of railway infrastructure in DKI Jakarta. The evaluation will be using a Likert rate questionnaire and directed to the transportation railway expert and the passenger. Furthermore, the mapping and evaluation rate based on the sustainability factors will be compared to the effect factors using the Analytical Hierarchical Process (AHP). This research offers the network's performance and service rate impact on the sustainability aspect and the passenger willingness for using the rail public transportation in DKI Jakarta.

Keywords: transportation sustainability, railway transportation, sustainability, DKI Jakarta

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Authors: Jumana Majdi Qutub

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Rationale: Cloud computing has rapidly developed the past few years. Because of the importance of providing protection for personal data used in cloud computing, the role of data protection in promoting trust and confidence in users’ data has become an important policy priority. This research examines key regulatory challenges rose by the growing use and importance of cloud computing with focusing on protection of individuals personal data. Methodology: Describing and analyzing governance challenges facing policymakers and industry in Saudi Arabia, with an account of anticipated governance responses. The aim of the research is to describe and define the regulatory challenges on cloud computing for policy making in Saudi Arabia and comparing it with potential complied issues rose in respect of transported data to EU member state. In addition, it discusses information privacy issues. Finally, the research proposes policy recommendation that would resolve concerns surrounds the privacy and effectiveness of clouds computing frameworks for data protection. Results: There are still no clear regulation in Saudi Arabia specialized in legalizing cloud computing and specialty regulations in transferring data internationally and locally. Decision makers need to review the applicable law in Saudi Arabia that protect information in cloud computing. This should be from an international and a local view in order to identify all requirements surrounding this area. It is important to educate cloud computing users about their information value and rights before putting it in the cloud to avoid further legal complications, such as making an educational program to prevent giving personal information to a bank employee. Therefore, with many kinds of cloud computing services, it is important to have it covered by the law in all aspects.

Keywords: cloud computing, cyber crime, data protection, privacy

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Authors: Mark Linden, Michael Brown, Lynne Marsh, Maria Truesdale, Stuart Todd, Nathan Hughes, Trisha Forbes, Rachel Leonard

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Background: Family carers of people with intellectual disabilities (ID) face ongoing challenges in accessing services and often experience poor mental health. Online support programmes may prove effective in addressing the mental health and well-being needs of family carers. This study sought to test the acceptability of a newly developed online support programme for carers of people with intellectual disabilities called Carers-ID. Methods A sequential mixed-methods explanatory design was utilised. An adapted version of the Acceptability of Health Apps among Adolescents (AHAA) Scale was distributed to family carers who had viewed the Carers-ID.com intervention. Following this, participants were invited to take part in an online interview. Interview questions focused on participants’ experiences of using the programme and its acceptability. Qualitative and quantitative data were analysed separately and then brought together through the triangulation protocol developed by Farmer et al (2006). Findings: Seventy family carers responded to the acceptability survey, whilst 10 took part in interviews. Six themes were generated from interviews with family carers. Based on our triangulation, four areas of convergence were identified, these included, programme usability and ease, attitudes towards the programme, perceptions of effectiveness, and programme relatability. Conclusions: In order to be acceptable, online interventions for carers of people with ID need to be accessible, understandable and easy to use, as carers time is precious. Further research is needed to investigate the effectiveness of online interventions for family carers, specifically considering which carers the intervention works for, and for whom it may not.

Keywords: intellectual disability, family carer, acceptability study, online intervention

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Authors: R. Chinyakata, N. R. Raselekoane

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Migration has always been part of human history. Migration is spurred by globalisation which connects nations by encouraging the flow of goods, services, ideas and people across borders. Migration does not only involve movement of adults from one country to another. It also affects and involves the youth as they are the most mobile group. Musina area, like many other border areas, experiences a variety of challenges as a result of the influx of people from the neighbouring Zimbabwe and other African countries. Of great concern about this migration is the fact that the host country or area may become unsafe and unstable as a result of huge influx of migrants. There may also be tensions between local people and migrants over the resources. The study sought to investigate the effects of the Zimbabwean youth migration on Musina area. The study was undertaken in Musina area which is situated 18km from the Beit-Bridge border post. A qualitative research approach was used. Semi-structured interviews were used to collect data. Non-probability quota sampling technique was used to select the respondents. The study sample consisted of sixteen female and male respondents. Thematic coding was used to analyse the data. Ethical considerations such as informed consent, confidentiality, anonymity and voluntary participation were taken into account to protect the participants. The study found that the effects of the Zimbabwean youth migration on the Musina area include, among others, tensions between locals and the Zimbabwean youth migrants over resources, job and business opportunities, overcrowding and crime. Multi-pronged strategies which involve different stakeholders should be applied to address tensions over job and business opportunities, overcrowding and crime in the Musina area.

Keywords: host country, effects, migrant, migration, Musina, youth, Zimbabwe

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Authors: Bryce Benson, Sooin Lee, Ashwin Belle

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Unrecognized or delayed identification of patient deterioration is a key cause of in-hospitals adverse events. Clinicians rely on vital signs monitoring to recognize patient deterioration. However, due to ever increasing nursing workloads and the manual effort required, vital signs tend to be measured and recorded intermittently, and inconsistently causing large gaps during patient monitoring. Additionally, during deterioration, the body’s autonomic nervous system activates compensatory mechanisms causing the vital signs to be lagging indicators of underlying hemodynamic decline. This study analyzes the predictive efficacy of the Analytic for Hemodynamic Instability (AHI) system, an automated tool that was designed to help clinicians in early identification of deteriorating patients. The lead time analysis in this retrospective observational study assesses how far in advance AHI predicted deterioration prior to the start of an episode of hemodynamic instability (HI) becoming evident through vital signs? Results indicate that of the 362 episodes of HI in this study, 308 episodes (85%) were correctly predicted by the AHI system with a median lead time of 57 minutes and an average of 4 hours (240.5 minutes). Of the 54 episodes not predicted, AHI detected 45 of them while the episode of HI was ongoing. Of the 9 undetected, 5 were not detected by AHI due to either missing or noisy input ECG data during the episode of HI. In total, AHI was able to either predict or detect 98.9% of all episodes of HI in this study. These results suggest that AHI could provide an additional ‘pair of eyes’ on patients, continuously filling the monitoring gaps and consequently giving the patient care team the ability to be far more proactive in patient monitoring and adverse event management.

Keywords: clinical deterioration prediction, decision support system, early warning system, hemodynamic status, physiologic monitoring

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Authors: M. F. Nawaz, S. Gul, T. H. Farooq, M. T. Siddiqui, M. Asif, I. Ahmad, N. K. Niazi

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In Pakistan, major demands of fuel wood and timber wood are fulfilled by agroforestry. However, the information regarding economic significance of agroforestry and its productivity in Pakistan is still insufficient and unreliable. Survey of field conditions to examine the agroforestry status at local level helps us to know the future trends and to formulate the policies for sustainable wood supply. The objectives of this research were to examine the actual status and potential of agroforestry and to point out the barriers that are faced by farmers in the adoption of agroforestry. Research was carried out in Chiniot district, Pakistan because it is the famous city for furniture industry that is largely dependent on farm trees. A detailed survey of district Chiniot was carried out from 150 randomly selected farmer respondents using multi-objective oriented and pre-tested questionnaire. It was found that linear tree planting method was more adopted (45%) as compared to linear + interplanting (42%) and/or compact planting (12.6%). Chi-square values at P-value <0.5 showed that age (11.35) and education (17.09) were two more important factors in the quick adoption of agroforestry as compared to land holdings (P-value of 0.7). The major reason of agroforestry adoption was to obtain income, fodder and fuelwood. The most dominant species in farmlands was shisham (Dalbergia sissoo) but since last five years, mostly farmers were growing Sufeida (Eucalyptus camaldulensis), kikar (Acacia nilotica) and popular (Populus deltoides) on their fields due to “Shisham die-back” problem. It was found that agro-forestry can be increased by providing good quality planting material to farmers and improving wood markets.

Keywords: agroforestry, trees, services, agriculture, farmers

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Authors: M. Yosra, A. Mohamed, T. Sami

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Over the past few years, mobile communication technologies have seen significant evolution. This fact promoted the implementation of many systems in a multi-technological setting. From one system to another, the Quality of Service (QoS) provided to mobile consumers gets better. The growing number of normalized standards extends the available services for each consumer, moreover, most of the available radio frequencies have already been allocated, such as 3G, Wifi, Wimax, and LTE. A study by the Federal Communications Commission (FCC) found that certain frequency bands are partially occupied in particular locations and times. So, the idea of Cognitive Radio (CR) is to share the spectrum between a primary user (PU) and a secondary user (SU). The main objective of this spectrum management is to achieve a maximum rate of exploitation of the radio spectrum. In general, the CR can greatly improve the quality of service (QoS) and improve the reliability of the link. The problem will reside in the possibility of proposing a technique to improve the reliability of the wireless link by using the CR with some routing protocols. However, users declared that the links were unreliable and that it was an incompatibility with QoS. In our case, we choose the QoS parameter "bandwidth" to perform a supervised classification. In this paper, we propose a comparative study between some routing protocols, taking into account the variation of different technologies on the existing spectral bandwidth like 3G, WIFI, WIMAX, and LTE. Due to the simulation results, we observe that LTE has significantly higher availability bandwidth compared with other technologies. The performance of the OLSR protocol is better than other on-demand routing protocols (DSR, AODV and DSDV), in LTE technology because of the proper receiving of packets, less packet drop and the throughput. Numerous simulations of routing protocols have been made using simulators such as NS3.

Keywords: cognitive radio, multi technology, network simulator (NS3), routing protocol

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Authors: Ezgiamn Abraha Hagos

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Higher education is important for college students to develop their authentic identity by means of getting exposure to diverse ideas and experiences. However, current college students are not successfully achieving a satisfying sense of meaning and purpose in their lives, which often places them in a state of existential vacuum. Thus, this study uncovers the existential concerns of youth in higher education by means of assessing their view on meaningful life and integration of it as a guide into their lives and challenges faced in doing so. Data were procured from thirty undergraduate students of Addis Ababa University, Ethiopia via interview, naïve sketch method, and content analysis of selected magazines and newspapers. Data were analyzed using organization, immersion, generating themes, coding, offering interpretation as well as checking the data. Relationship, education, and belief were found to be main sources of meaning. But, many of the study participants failed to articulate their meaning in life explicitly and identified to be in a state of drifting. Moreover, hopelessness, economic problems and quality of training impinge their sense of meaning in life negatively. The content analysis principally embodied the youth in higher education as a group of people confronted with rafts of challenges such as debauchery, moral crisis, self-destructive behaviors and hankering for support and direction. Thus, crafting the asset-based approach and counseling services that will prepare the youth for the future and develop holistically in terms of body and mind are tremendously vital.

Keywords: higher education institutions; meaning in life; youth

Procedia PDF Downloads 110