Search results for: health indicators

Authors: Muhammad Wahb

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Physical activity is increasingly recognized as a significant factor in maintaining optimal health and preventing chronic diseases. This research scrutinizes the long-term health benefits of sustained physical activity, employing a systematic review of epidemiological studies and randomized control trials conducted over the past decade. The study illuminates the protective effects of regular physical activity against cardiovascular disease, obesity, diabetes, and mental health disorders, with a special focus on the mechanisms involved. Furthermore, the paper provides insights into how public health initiatives can effectively promote physical activity among diverse populations, contributing to improved community health outcomes.

Keywords: physical activity, long-term health benefits, chronic disease prevention, public health

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Authors: Rui Lança, Elisa Silva, Fátima Farinha, Miguel José Oliveira, Manuel Duarte Pinheiro, Cátia Miguel

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Tourism has a great potential to bring up progress across the Sustainable Development Goals (SDGs). If well managed and monitored, the tourism sector can create quality jobs, reduce poorness and offer incentives for environmental preservation, helping on the transition towards more inclusive and resilient economies. However, without proper safeguards and investments, expansion of the tourism market will increase pressure on biodiversity and the ecosystems on which the livelihoods of local communities depend. Competitivity is a key dimension in tourism, sustainable tourism challenge new dimensions to competitivity, namely environmental, social, institutional and economic achieve a medium and long-term competitivity. It is undoubtedly clear on the tourism sector, the importance of the region sustainability in the current touristic destinations offer. The basis of a tourism region prosperity will depend on /of it. The OBSERVE project intends to be an instrument for monitoring and evaluating the sustainability levels of the Algarve region. Its main objective is to provide environmental, economic, social-cultural and institutional indicators to support the decision-making process for a sustainable growth of the region. The project´s main goal is a digital portal with the most relevant indicators to allow evaluating and communicating the performance of the region in a sustainable growth perspective. This paper presents the OBSERVE project and highlights the potential contribution to a broad perspective of competitivity and its contribution for different stakeholders and the touristic value chain. Limitations and opportunities are also discussed.

Keywords: sustainable tourism, competitivity, OBSERVE project, Algarve region

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Authors: Teodorica G. Ani

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Economic activity requires an encouraging regulatory environment and effective rules that are transparent and accessible to all. The World Bank has been publishing the annual Doing Business reports since 2004 to investigate the scope and manner of regulations that enhance business activity and those that constrain it. A streamlined business environment supporting the development of competitive small and medium enterprises (SMEs) may expand employment opportunities and improve the living conditions of low income households. Asia has emerged as one of the most attractive markets in the world. Economies in East Asia and the Pacific were among the most active in making it easier for local firms to do business. The study aimed to describe the ease of doing business and its effect to economic growth among selected economies in Asia for the year 2014. The study covered 29 economies in East Asia, Southeast Asia, South Asia and Middle Asia. Ease of doing business is measured by the Doing Business indicators (DBI) of the World Bank. The indicators cover ten aspects of the ease of doing business such as starting a business, dealing with construction permits, getting electricity, registering property, getting credit, protecting investors, paying taxes, trading across borders, enforcing contracts and resolving insolvency. In the study, Gross Domestic Product (GDP) was used as the proxy variable for economic growth. Descriptive research was the research design used. Graphical analysis was used to describe the income and doing business among selected economies. In addition, multiple regression was used to determine the effect of doing business to economic growth. The study presented the income among selected economies. The graph showed China has the highest income while Maldives produces the lowest and that observation were supported by gathered literatures. The study also presented the status of the ten indicators of doing business among selected economies. The graphs showed varying trends on how easy to start a business, deal with construction permits and to register property. Starting a business is easiest in Singapore followed by Hong Kong. The study found out that the variations in ease of doing business is explained by starting a business, dealing with construction permits and registering property. Moreover, an explanation of the regression result implies that a day increase in the average number of days it takes to complete a procedure will decrease the value of GDP in general. The research proposed inputs to policy which may increase the awareness of local government units of different economies on the simplification of the policies of the different components used in measuring doing business.

Keywords: doing business, economic growth, gross domestic product, Asia

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Authors: Yisong Cong, Mingming Guo, Xiaozan Wang, Yizhi Zhang, Qingqing Yuan

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This study is to test the correlation between the Physical Fitness (PF) of middle school students and their performance and sports grade of table tennis. Methods: 398 middle school students from Shanghai Tongji No.2 Middle School participated in the study, including 232 boys and 166 girls. Each participant participated in the Chinese Students’ Physical Fitness Test (CSPFT), including BMI, 50-meter running, vital capacity, sitting body flexion, standing long jump, 800-meter running, 1000-meter running, pull-ups, and sit-ups. Test scores were converted to a percentage score according to the CSPFT guidelines. In addition, each student participated in the Nation Junior Table Tennis grade test, and completed the table tennis sports grade assessment of 1-9. Results: There is a significant positive correlation between the scores of multiple PF tests and the total scores of table tennis, such as BMI (r = 0.15, p < 0.01), standing long jump (r = 0.15, p < 0.05), 800-meter run (r = 0.02, p <0.01); The scores of multiple PF are positively correlated with table tennis grade, such as vital capacity (r = 0.1, p < 0.01) and 50-meter running (r = 0.18, p < 0.05). At the same time, the sit-ups performance showed a significant negative correlation with the table tennis performance (r = -0.08, p < 0.01); There is no significant correlation between the other PF indicators and the performance and grade of table tennis. Conclusions: This study shows that there is a corresponding relationship between some PF indicators of middle school students and their table tennis performance and table tennis grade，but the specific form and reason of the relationship need to be further explored.

Keywords: middle school students, physical fitness, table tennis grade, table tennis performance

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Authors: Aena Iqbal

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The lack of access to maternal and reproductive health in Pakistan poses a great threat to global public health. Obstetric issues, including vesicovaginal fistulas (VVF), are the most common in South Asian countries, leaving women in a more vulnerable state. Koohi Goth Women’s Hospital offers free VVF operations, which draws in women from all over Pakistan. Although reproductive health is being handled, mental health is often neglected in these scenarios. Using a series of questions inspired by the Warwick Edinburgh Model, this paper builds on the results from interviewing women who have received vesicovaginal fistula repair surgery on their mental health, a taboo topic in Pakistan.

Keywords: obstetrics, VVF, Pakistan, reproductive health

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Authors: Ali Mohagheghzadeh, Samad Vaez Badiegard, Bita Shomali

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Nowadays, with the increase in population, the need for protein sources is increasing. Different bacteria can cause food poisoning while most of the symptoms of food poisoning are similar to those of gastrointestinal infections. As a result, the diagnosis of bacteria and viruses causing food poisoning would not be possible without a stool culture. Cases of food poisoning are often accompanied by gastrointestinal disorders such as diarrhea, vomit, and gastrointestinal stomach cramps. Thus, providing enough food, taking into account health issues has always been a concern of authorities. Since E. coli bacterium is one of the important indicators of food hygiene and quality, producing food without being contaminated by this bacterium is desired in the food industry. This study aimed at assessing the E. coli contamination of poultry meat produced in slaughterhouses. Samples were taken from critical areas of slaughterhouses, namely the feather picking area, viscera and carcass evacuation area the area after cooling chillers. The results showed that 60% of contamination occurs in feather picking area. Among antiseptic and detergent materials, the highest reduction belongs to Epimax.

Keywords: slaughterhouse, E. coli, Epimax, contamination

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Authors: Michaela Wang

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Since British established colonial settlements across the East Coast, Native Americans have suffered stark socio economic disparities in comparison to their neighboring communities. This paper employs the 1990, 2000, and 2010 United States Decennial Census to assess whether and to what extent the casino economy helped to close this socioeconomic gap between the Mohegan tribe and its surrounding community. These three Decennial Censuses cover two decades, from six years prior to the erection of Mohegan Sun casino to 14 years afterwards, including the Great Recession 2007-2009. Income, employment, education and housing parameters are selected as socio economic indicators. The profitable advent of the Mohegan Sun in 1996 dramatically improved the socio economic status of the Mohegan Tribe between 1990 and 2000. In fact, for most of these indicators––poverty, median household income, employment, home ownership, and car ownership––disparities shifted; tribal socioeconomic parameters improved from well below the level of New London County in 1990, to the same level or above the county rates in 2000. However, economic downturn in 2007-2009 Great Recession impacted Mohegan people remarkably. By 2010, disparities for household income, employment, home ownership, and car ownership returned. The casino bridged socio economic inequalities, but at the face of economic crises, the mono-product economy grew vulnerable.

Keywords: socio economic, indigenous, native American, disparity

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Authors: Antonio Boggia, Luisa Paolotti, Gianluca Massei, Lucia Rocchi, Elaine Pace, Maria Attard

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The aim of this paper is to present a methodology and a computer model for sustainability assessment based on the integration of Multi-criteria Decision Analysis (MCDA) with a Geographic Information System (GIS). It presents the result of a study for the implementation of a model for measuring sustainability to address the policy actions for the improvement of sustainability at territory level. The aim is to rank areas in order to understand the specific technical and/or financial support that is required to develop sustainable growth. Assessing sustainable development is a multidimensional problem: economic, social and environmental aspects have to be taken into account at the same time. The tool for a multidimensional representation is a proper set of indicators. The set of indicators must be integrated into a model, that is an assessment methodology, to be used for measuring sustainability. The model, developed by the Environmental Laboratory of the University of Perugia, is called GeoUmbriaSUIT. It is a calculation procedure developed as a plugin working in the open-source GIS software QuantumGIS. The multi-criteria method used within GeoUmbriaSUIT is the algorithm TOPSIS (Technique for Order Preference by Similarity to Ideal Design), which defines a ranking based on the distance from the worst point and the closeness to an ideal point, for each of the criteria used. For the sustainability assessment procedure, GeoUmbriaSUIT uses a geographic vector file where the graphic data represent the study area and the single evaluation units within it (the alternatives, e.g. the regions of a country, or the municipalities of a region), while the alphanumeric data (attribute table), describe the environmental, economic and social aspects related to the evaluation units by means of a set of indicators (criteria). The use of the algorithm available in the plugin allows to treat individually the indicators representing the three dimensions of sustainability, and to compute three different indices: environmental index, economic index and social index. The graphic output of the model allows for an integrated assessment of the three dimensions, avoiding aggregation. The presence of separate indices and graphic output make GeoUmbriaSUIT a readable and transparent tool, since it doesn’t produce an aggregate index of sustainability as final result of the calculations, which is often cryptic and difficult to interpret. In addition, it is possible to develop a “back analysis”, able to explain the positions obtained by the alternatives in the ranking, based on the criteria used. The case study presented is an assessment of the level of sustainability in the six regions of Malta, an island state in the middle of the Mediterranean Sea and the southernmost member of the European Union. The results show that the integration of MCDA-GIS is an adequate approach for sustainability assessment. In particular, the implemented model is able to provide easy to understand results. This is a very important condition for a sound decision support tool, since most of the time decision makers are not experts and need understandable output. In addition, the evaluation path is traceable and transparent.

Keywords: GIS, multi-criteria analysis, sustainability assessment, sustainable development

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Authors: Yang L. Frances

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Women's health and wellness has been becoming an increasingly important issue in mass media in the age of globalization. In this context, the current research focuses on comparing the construction of healthy bodies in women's health magazines of China and U.S. Trends Health in China and Women's Health in U.S are chosen. Textual analysis and in depth interviews are combined to examine how the healthy bodies are constructed in two magazines through discursive strategies. The interviews with the Deputy Editorial Director, Creative Director and Senior Visual Design of two magazines are undertaken to make the further comparisons. In both Trends Health and Women's Health, women's subjectivity is realized in the construction of ideal healthy body; nevertheless in the process of constructing healthy body, the disciplinary practices imposed on women's bodies are different in two magazines. This paper argues that women's health magazines in both China and America provide an alternative discourse to speak their voices on the one hand, but on the other hand, Women's Health and Trends Health construct the healthy body through disparate disciplinary practices because of the different socio-cultural contexts in two societies.

Keywords: healthy body, women's health magazines, Foucault, textual analysis

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Authors: Natalie Cutler, Lorna Moxham, Moira Stephens

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Safety is a priority in mental health services, and no more so than in the acute inpatient setting. Mental health service policies and accreditation frameworks commonly approach safety from a risk reduction or elimination perspective leading to service approaches that are arguably more focused on risk than on safety. An exploration what safety means for people who have experienced admission to an acute mental health inpatient unit is currently under way in Sydney, Australia. Using a phenomenographic research approach, this study is seeking to understand the meaning of safety from the perspective of people who use, rather than those who deliver mental health services. Preliminary findings suggest that the meanings of safety for users of mental health services vary from the meanings inherent in the policies and frameworks that inform how mental health services and mental health practice are delivered. This variance has implications for the physical and environmental design of acute mental health inpatient facilities, the policies and practices, and the education and training of mental health staff in particular nurses, who comprise the majority of the mental health workforce. These variances will be presented, along with their implications for the way quality and safety in mental health services are evaluated.

Keywords: acute inpatient, mental health, nursing, phenomenography, recovery, safety

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Authors: Yahya N. Alfraidi, Abdel Halim Boussabaine

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Climate change risk impacts are one of the most challenging aspects that faces the built environment now and the near future. The impacts of climate change on buildings are considered in four different dimensions: physical, economic, social, and management. For each of these, the risks are discussed as they arise from various effects linked to climate change, including windstorms, precipitation, temperature change, flooding, and sea-level rise. For example, building assets in cities will be exposed to extreme hot summer days and nights due to the urban heat island effect and pollution. Buildings also could be vulnerable to water, electricity, gas, etc., scarcity. Building materials, fabric and systems could also be stressed by the emerging climate risks. More impotently the building users might experience extreme internal and extern comfort conditions leading to lower productivity, wellbeing and health problems. Thus, the main aim of this paper to document the emerging risks from climate change on building assets. An in-depth discussion on the consequences of these climate change risk is provided. It is expected that the outcome of this research will be a set of risk design indicators for developing and procuring resilient building assets.

Keywords: climate change, risks of climate change, risks on building from climate change, buildings

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Authors: Hanee Ryu

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The former president Lee Myung-bak's administration of Korea presented “green growth” as a catchphrase from 2008. He declared “low-carbon, green growth” the nation's vision for the next decade according to United Nation Framework on Climate Change. The government designed omnidirectional policy for low-carbon and green growth with concentrating all effort of departments. The structural change was expected because this slogan is the identity of the government, which is strongly driven with the whole department. After his administration ends, the purpose of this paper is to quantify the policy effect and to compare with the value of the other OECD countries. The major target values under direct policy objectives were suggested, but it could not capture the entire landscape on which the policy makes changes. This paper figures out the policy impacts through comparing the value of ex-ante between the one of ex-post. Furthermore, each index level of Korea’s low-carbon and green growth comparing with the value of the other OECD countries. To measure the policy effect, indicators international organizations have developed are considered. Environmental Sustainable Index (ESI) and Environmental Performance Index (EPI) have been developed by Yale University’s Center for Environmental Law and Policy and Columbia University’s Center for International Earth Science Information Network in collaboration with the World Economic Forum and Joint Research Center of European Commission. It has been widely used to assess the level of natural resource endowments, pollution level, environmental management efforts and society’s capacity to improve its environmental performance over time. Recently OCED publish the Green Growth Indicator for monitoring progress towards green growth based on internationally comparable data. They build up the conceptual framework and select indicators according to well specified criteria: economic activities, natural asset base, environmental dimension of quality of life and economic opportunities and policy response. It considers the socio-economic context and reflects the characteristic of growth. Some selected indicators are used for measuring the level of changes the green growth policies have induced in this paper. As results, the CO2 productivity and energy productivity show trends of declination. It means that policy intended industry structure shift for achieving carbon emission target affects weakly in the short-term. Increasing green technologies patents might result from the investment of previous period. The increasing of official development aids which can be immediately embarked by political decision with no time lag present only in 2008-2009. It means international collaboration and investment to developing countries via ODA has not succeeded since the initial stage of his administration. The green growth framework makes the public expect structural change, but it shows sporadic effect. It needs organization to manage it in terms of the long-range perspectives. Energy, climate change and green growth are not the issue to be handled in the one period of the administration. The policy mechanism to transfer cost problem to value creation should be developed consistently.

Keywords: comparing ex-ante between ex-post indicator, green growth indicator, implication for green growth policy, measuring policy effect

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Authors: M. Aboalazayem, Essam A. Gouda, Ahmed M. Moussa, Amr E. Flifl

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Field data collecting is considered one of the most difficult work due to the difficulty of accessing large zones such as large lakes. Also, it is well known that the cost of obtaining field data is very expensive. Remotely monitoring of lake water quality (WQ) provides an economically feasible approach comparing to field data collection. Researchers have shown that lake WQ can be properly monitored via Remote sensing (RS) analyses. Using satellite images as a method of WQ detection provides a realistic technique to measure quality parameters across huge areas. Landsat (LS) data provides full free access to often occurring and repeating satellite photos. This enables researchers to undertake large-scale temporal comparisons of parameters related to lake WQ. Satellite measurements have been extensively utilized to develop algorithms for predicting critical water quality parameters (WQPs). The goal of this paper is to use RS to derive WQ indicators in Aswan High Dam Reservoir (AHDR), which is considered Egypt's primary and strategic reservoir of freshwater. This study focuses on using Landsat8 (L-8) band surface reflectance (SR) observations to predict water-quality characteristics which are limited to Turbidity (TUR), total suspended solids (TSS), and chlorophyll-a (Chl-a). ArcGIS pro is used to retrieve L-8 SR data for the study region. Multiple linear regression analysis was used to derive new correlations between observed optical water-quality indicators in April and L-8 SR which were atmospherically corrected by values of various bands, band ratios, and or combinations. Field measurements taken in the month of May were used to validate WQP obtained from SR data of L-8 Operational Land Imager (OLI) satellite. The findings demonstrate a strong correlation between indicators of WQ and L-8 .For TUR, the best validation correlation with OLI SR bands blue, green, and red, were derived with high values of Coefficient of correlation (R2) and Root Mean Square Error (RMSE) equal 0.96 and 3.1 NTU, respectively. For TSS, Two equations were strongly correlated and verified with band ratios and combinations. A logarithm of the ratio of blue and green SR was determined to be the best performing model with values of R2 and RMSE equal to 0.9861 and 1.84 mg/l, respectively. For Chl-a, eight methods were presented for calculating its value within the study area. A mix of blue, red, shortwave infrared 1(SWR1) and panchromatic SR yielded the greatest validation results with values of R2 and RMSE equal 0.98 and 1.4 mg/l, respectively.

Keywords: remote sensing, landsat 8, nasser lake, water quality

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Authors: Shiksha Thakur, Rashmi Jain

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Maternal health is the most crucial element in the primary health care delivery system of any healthy society. We aware that the maternal health situation in India has been a cause of concern for us, in spite of the rapidly progressing socio-economic environment overall. India has realized impressive gains in Mother & Child survival over the last two decades. MMR as per 2012-2013 in India is 167 as per MMR bulletin, though there are variations between states in the Country. In 2013, an estimated 2,89,000 women worldwide died from complications arising from pregnancy & childbirth. In view of the above facts, a study was conducted in Indore to analyse the maternal health status among urban slums and non-slums women.

Keywords: antenatal care, postnatal care, JSY, maternal health, child health, reproductive health

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Authors: William Albeiro Alvarez, Gloria Patricia Jaramillo, Ivan Reinaldo Sarmiento

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Understanding the behavior of individuals and the different human factors that influence the choice when faced with a complex system such as transportation is one of the most complicated aspects of measuring in the components that constitute the modeling of route choice due to that various behaviors and driving mode directly or indirectly affect the choice. During the last two decades, with the development of information and communications technologies, new data collection techniques have emerged such as GPS, geolocation with mobile phones, apps for choosing the route between origin and destination, individual service transport applications among others, where an interest has been generated to improve discrete choice models when considering the incorporation of these developments as well as psychological factors that affect decision making. This paper implements a discrete choice model that proposes and estimates a hybrid model that integrates route choice models and latent variables based on the observation on the route of a sample of public taxi drivers from the city of Medellín, Colombia in relation to its behavior, personality, socioeconomic characteristics, and driving mode. The set of choice options includes the routes generated by the individual service transport applications versus the driver's choice. The hybrid model consists of measurement equations that relate latent variables with measurement indicators and utilities with choice indicators along with structural equations that link the observable characteristics of drivers with latent variables and explanatory variables with utilities.

Keywords: behavior choice model, human factors, hybrid model, real time data

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Authors: Broto Seno

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This study aims to describe and examine more in the implementation of educational partnerships for undergraduate students at Yogyakarta State University (YSU), which is more focused on educational partnerships abroad. This study used descriptive qualitative approach. The study subjects consisted of a vice-rector, two staff education partnerships, four vice-dean, nine undergraduate students and three foreign students. Techniques of data collection using interviews and document review. Validity test of the data source using triangulation. Data analysis using flow models Miles and Huberman, namely data reduction, data display, and conclusion. Results of this study showed that the implementation of educational partnerships abroad for undergraduate students at YSU meets six of the nine indicators of the success of strategic partnerships. Six indicators are long-term, strategic, mutual trust, sustainable competitive advantages, mutual benefit for all the partners, and the separate and positive impact. The indicator has not been achieved is cooperative development, successful, and world class / best practice. These results were obtained based on the discussion of the four formulation of the problem, namely: 1) Implementation and development of educational partnerships abroad has been running good enough, but not maximized. 2) Benefits of the implementation of educational partnerships abroad is providing learning experiences for students, institutions of experience in comparison to each faculty, and improving the network of educational partnerships for YSU toward World Class University. 3) The sustainability of educational partnerships abroad is pursuing a strategy of development through improved management of the partnership. 4) Supporting factors of educational partnerships abroad is the support of YSU, YSU’s partner and society. Inhibiting factors of educational partnerships abroad is not running optimally management.

Keywords: partnership, education, YSU, institutions and faculties

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Authors: I. Szer, J. Szer, K. Czarnocki, E. Błazik-Borowa

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People on construction scaffoldings work in dynamically changing, often unfavourable climate. Additionally, this kind of work is performed on low stiffness structures at high altitude, which increases the risk of accidents. It is therefore desirable to define the parameters of the work environment that contribute to increasing the construction worker occupational safety level. The aim of this article is to present how changes in microclimate parameters on scaffolding can impact the development of dangerous situations and accidents. For this purpose, indicators based on the human thermal balance were used. However, use of this model under construction conditions is often burdened by significant errors or even impossible to implement due to the lack of precise data. Thus, in the target model, the modified parameter was used – apparent environmental temperature. Apparent temperature in the proposed Scaffold Use Risk Assessment Model has been a perceived outdoor temperature, caused by the combined effects of air temperature, radiative temperature, relative humidity and wind speed (wind chill index, heat index). In the paper, correlations between component factors and apparent temperature for facade scaffolding with a width of 24.5 m and a height of 42.3 m, located at south-west side of building are presented. The distribution of factors on the scaffolding has been used to evaluate fitting of the microclimate model. The results of the studies indicate that observed ranges of apparent temperature on the scaffolds frequently results in a worker’s inability to adapt. This leads to reduced concentration and increased fatigue, adversely affects health, and consequently increases the risk of dangerous situations and accidental injuries

Keywords: apparent temperature, health, safety work, scaffoldings

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Authors: Hamid Hanifi, Adel Azar, Alireza Booshehri

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In order to know about the capability level of R & D units in automotive industry, it is essential that organizations always compare themselves with standard level and higher than themselves so that to be improved continuously. In this research, with respect to the importance of this issue, we have tried to present an assessment model for R & D capabilities having reviewed on new products development in automotive industry of Iran. Iran Khodro Company was selected for the case study. To this purpose, first, having a review on the literature, about 200 indicators effective in R & D capabilities and new products development were extracted. Then, of these numbers, 29 indicators which were more important were selected by industry and academia experts and the questionnaire was distributed among statistical population. Statistical population was consisted of 410 individuals in Iran Khodro Company. We used the 410 questionnaires for exploratory factor analysis and then used the data of 308 questionnaires from the same population randomly for confirmatory factor analysis. The results of exploratory factor analysis led to categorization of dimensions in 9 secondary dimensions. Naming the dimensions was done according to a literature review and the professors’ opinion. Using structural equation modeling and AMOS software, confirmatory factor analysis was conducted and ultimate model with 9 secondary dimensions was confirmed. Meanwhile, 9 secondary dimensions of this research are as follows: 1) Research and design capability, 2) Customer and market capability, 3) Technology capability, 4) Financial resources capability, 5) Organizational chart, 6) Intellectual capital capability, 7) NPD process capability, 8) Managerial capability and 9) Strategy capability.

Keywords: research and development, new products development, structural equations, exploratory factor analysis, confirmatory factor analysis

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Authors: Parvin Malhami

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The purpose of the present study was to investigate the effects of two functional and functional stretching methods of the leg muscles on a selection of kinematical and kinetic indicators among women with ankle instability. Twenty-four persons were targeted and randomly divided into the functional exercise (8 persons), extra-functional exercise (8 persons) and control (8 persons) groups on the basis of inclusion and exclusion criteria. The experimental groups received stretching for eight weeks, 3 sessions each week, and the control group merely performed its daily activities. Then, in order to measure the pre -test and post -test variables, the dorsi flexion, Plantar flexion and ground reaction force were investigated and measured. Data were analyzed using paired T-test and independent T-tests at a significant level of 0.05. All statistical analyses were conducted using SPSS 25 software. The results of the T-test showed the significant effect of eight weeks of functional and Extra functional exercises on dorsi Flexion, Plantar Flexion and ground reaction force. (P≤ 0/001). The results of this study showed that the implementation of the functional and Extra-functional exercise protocol had an impact on the amount of Ankle dorsi Flexion and the Plantar felxion of women with an ankle instability. It was also found that muscle flexibility following the stretch ability of the gastrocnemius muscles facilitates the walking of the wrist installation by affecting the amount of wrist flexion, so these people are recommended to use the functional and extra-functional exercise protocol.

Keywords: functional stretching, extra functional stretching, dorsi flexion, plantar flexion

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Authors: Rajiv Ratan Singh, Sachin Kumar Tripathi, Pradeep Kumar Yadav

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The timely evaluation, diagnosis, and treatment of people who have been exposed to toxic chemicals is a crucial component of emergency poison management in the medical field. The various substances that can poison include chemicals, medications, and naturally occurring poisons. The toxicology of the particular drug involved, as well as the symptoms and indicators of poisoning, must be thoroughly understood to handle poisoning emergencies effectively. One of the most important aspects of emergency poison management in medicine is the prompt examination, diagnosis, and treatment of persons who have been exposed to dangerous substances. To properly manage poisoning crises, one must have a good understanding of the toxicology of the particular medication concerned, as well as the signs and indicators of poisoning. Emergency management of poisoning includes not only prompt medical attention but also patient education, follow-up care, and monitoring for any long-term consequences. To achieve the greatest results for patients, the management of poisoning is a complicated and dynamic process that calls for collaboration between medical professionals, first responders, and toxicologists. All poisoned patients who present to the emergency room are assessed and diagnosed based on a collection of symptoms and a biochemical diagnosis, and they are then provided targeted, specialized treatment for the toxin identified. This article focuses on the loxodromic strategy as the primary method of treatment for poisoned patients. The authors of this article conclude that mortality and morbidity can be reduced if patients visit the emergency room promptly and receive targeted treatment.

Keywords: antidotes, blood poisoning, emergency medicine, gastric lavage, medico-legal aspects, patient care

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Authors: Schröde C., Rodriguez D., Sánchez A., Abdul Malak, Churchill J., Boksmati T., Alharbi, Alsulmi H., Maghrabi S., Mowalad, Mutwalli R., Abualnaja Y.

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Formulating a strategy for sustainable development of the Kingdom of Saudi Arabia’s coastal and marine environment is at the core of the “Marine and Coastal Protection Assessment Study for the Kingdom of Saudi Arabia Coastline (MCEP)”; that was set up in the context of the Vision 2030 by the Saudi Arabian government and aimed at providing a first comprehensive ‘Status Quo Assessment’ of the Kingdom’s marine environment to inform a sustainable development strategy and serve as a baseline assessment for future monitoring activities. This baseline assessment relied on scientific evidence of the drivers, pressures and their impact on the environments of the Red Sea and Arabian Gulf. A key element of the assessment was the cumulative pressure hotspot analysis developed for both national waters of the Kingdom following the principles of the Driver-Pressure-State-Impact-Response (DPSIR) framework and using the cumulative pressure and impact assessment methodology. The ultimate goals of the analysis were to map and assess the main hotspots of environmental pressures, and identify priority areas for further field surveillance and for urgent management actions. The study identified maritime transport, fisheries, aquaculture, oil, gas, energy, coastal industry, coastal and maritime tourism, and urban development as the main drivers of pollution in the Saudi Arabian marine waters. For each of these drivers, pressure indicators were defined to spatially assess the potential influence of the drivers on the coastal and marine environment. A list of hotspots of 90 locations could be identified based on the assessment. Spatially grouped the list could be reduced to come up with of 10 hotspot areas, two in the Arabian Gulf, 8 in the Red Sea. The hotspot mapping revealed clear spatial patterns of drivers, pressures and hotspots within the marine environment of waters under KSA’s maritime jurisdiction in the Red Sea and Arabian Gulf. The cascading assessment approach based on the DPSIR framework ensured that the root causes of the hotspot patterns, i.e. the human activities and other drivers, can be identified. The adapted CPIA methodology allowed for the combination of the available data to spatially assess the cumulative pressure in a consistent manner, and to identify the most critical hotspots by determining the overlap of cumulative pressure with areas of sensitive biodiversity. Further improvements are expected by enhancing the data sources of drivers and pressure indicators, fine-tuning the decay factors and distances of the pressure indicators, as well as including trans-boundary pressures across the regional seas.

Keywords: Arabian Gulf, DPSIR, hotspot, red sea

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Authors: Xuan Dinh Vu, Elmar Csaplovics

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There has been an increasing need for methods to define priority areas for biodiversity conservation since the effectiveness of biodiversity conservation in protected areas largely depends on the availability of material resources. The identification of priority areas requires the integration of biodiversity data together with social data on human pressures and responses. However, the deficit of comprehensive data and reliable methods becomes a key challenge in zoning where the demand for conservation is most urgent and where the outcomes of conservation strategies can be maximized. In order to fill this gap, the study applied an environmental model Condition–Pressure–Response to suggest a set of criteria to identify priority areas for biodiversity conservation. Our empirical data has been compiled from 185 respondents, categorizing into three main groups: governmental administration, research institutions, and protected areas in Vietnam by using a well - designed questionnaire. Then, the Analytic Hierarchy Process (AHP) theory was used to identify the weight of all criteria. Our results have shown that priority level for biodiversity conservation could be identified by three main indicators: condition, pressure, and response with the value of the weight of 26%, 41%, and 33%, respectively. Based on the three indicators, 7 criteria and 15 sub-criteria were developed to support for defining priority areas for biodiversity conservation and zoning protected areas. In addition, our study also revealed that the groups of governmental administration and protected areas put a focus on the 'Pressure' indicator while the group of Research Institutions emphasized the importance of 'Response' indicator in the evaluation process. Our results provided recommendations to apply the developed criteria for identifying priority areas for biodiversity conservation in Vietnam.

Keywords: biodiversity conservation, condition–pressure–response model, criteria, priority areas, protected areas

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Authors: Mohamed Elhadi M. Sharif, Mona Masood

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The usage of e-health facilities is seen to be the first priority by the Libyan government. As such, this paper focuses on how the key factors or elements of working size in terms of technological availability, structural environment, and other competence-related matters may affect nurses’ sharing of knowledge in e-health. Hence, this paper investigates learning readiness assessment to raise e-health for Libyan regional hospitals by using e-health services in nursing education.

Keywords: Libyan nurses, e-learning readiness, e-health, nursing education

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Authors: Vittorio Astarita, Giuseppe Guido, Vincenzo Pasquale Giofre, Alessandro Vitale

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Traffic microsimulation has been used extensively to evaluate consequences of different traffic planning and control policies in terms of travel time delays, queues, pollutant emissions, and every other common measured performance while at the same time traffic safety has not been considered in common traffic microsimulation packages as a measure of performance for different traffic scenarios. Vehicle conflict techniques that were introduced at intersections in the early traffic researches carried out at the General Motor laboratory in the USA and in the Swedish traffic conflict manual have been applied to vehicles trajectories simulated in microscopic traffic simulators. The concept is that microsimulation can be used as a base for calculating the number of conflicts that will define the safety level of a traffic scenario. This allows engineers to identify unsafe road traffic maneuvers and helps in finding the right countermeasures that can improve safety. Unfortunately, most commonly used indicators do not consider conflicts between single vehicles and roadside obstacles and barriers. A great number of vehicle crashes take place with roadside objects or obstacles. Only some recent proposed indicators have been trying to address this issue. This paper introduces a new procedure based on the simulation of potential crash events for the evaluation of safety levels in microsimulation traffic scenarios, which takes into account also potential crashes with roadside objects and barriers. The procedure can be used to define new conflict indicators. The proposed simulation procedure generates with the random perturbation of vehicle trajectories a set of potential crashes which can be evaluated accurately in terms of DeltaV, the energy of the impact, and/or expected number of injuries or casualties. The procedure can also be applied to real trajectories giving birth to new surrogate safety performance indicators, which can be considered as “simulation-based”. The methodology and a specific safety performance indicator are described and applied to a simulated test traffic scenario. Results indicate that the procedure is able to evaluate safety levels both at the intersection level and in the presence of roadside obstacles. The procedure produces results that are expressed in the same unity of measure for both vehicle to vehicle and vehicle to roadside object conflicts. The total energy for a square meter of all generated crash can be used and is shown on the map, for the test network, after the application of a threshold to evidence the most dangerous points. Without any detailed calibration of the microsimulation model and without any calibration of the parameters of the procedure (standard values have been used), it is possible to identify dangerous points. A preliminary sensitivity analysis has shown that results are not dependent on the different energy thresholds and different parameters of the procedure. This paper introduces a specific new procedure and the implementation in the form of a software package that is able to assess road safety, also considering potential conflicts with roadside objects. Some of the principles that are at the base of this specific model are discussed. The procedure can be applied on common microsimulation packages once vehicle trajectories and the positions of roadside barriers and obstacles are known. The procedure has many calibration parameters and research efforts will have to be devoted to make confrontations with real crash data in order to obtain the best parameters that have the potential of giving an accurate evaluation of the risk of any traffic scenario.

Keywords: road safety, traffic, traffic safety, traffic simulation

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Authors: Gudakesh Yadav

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Utter Pradesh, which is one of the largest states of India with unequal distribution of resources and different socioeconomic and cultural characteristics, level of different new born health care indicators varies a lot from one district to another district. State shared more than 21 percent of total live births of India; whereas, it accounts for 28 percent of total infant deaths of the country, with the 53 per thousand infant mortality rate. The present paper attempts to examine tempo-spatial changes in new born care practices during NFHS-1 to NFHS-3 and DLHS-2 to DLHS-3 in Uttar Pradesh and different regions. Descriptive statistics, rate-ratios, concentration index, multivariate and decomposition analysis has been used for the study. Findings of the study reveal that new born care practices have improved over the time in the state and across all the regions because of giving more emphasis on venerable groups like poor, rural, less educated mothers and scheduled caste & tribes but still it did not achieve the desired successes. Regional analysis of third rounds of DLHS shows that, coverage of intuitional delivery was the lowest in the central region. Performance of the southern region was the lowest in terms of initiation of breastfeeding, keeping baby warm and dry after the birth. The study calls for proper follow up of new born children to accelerate new born and child health care service and prioritises increasing antenatal check-ups and institutional delivery, which helps to improve level of other new born care services. At the policy level there is need to reach venerable groups like scheduled caste and tribes, poor and uneducated, and new mother especially in rural areas. High focused district should be allocated for better implementation of new born care promotion programme in low performing districts. Partnership with the private sector health professional is necessary to reach the every part of population.

Keywords: decomposition, inequality, initiation of breastfeeding, institutional delivery

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Authors: Helena Costa Oliveira, Carmem Oliveira, Rita Moutinho

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The Balanced Scorecard (BSC) is a continuous strategic monitoring model focused not only on financial issues but also on internal processes, patients/users, and learning and growth. Initially dedicated to business management, it currently serves organizations of other natures - such as hospitals. This paper presents a BSC designed for a Portuguese Acute Pain Unit (APU). This study is qualitative and based on the experience of collaborators at the APU. The management of APU is based on four perspectives – users, internal processes, learning and growth, and financial and legal. For each perspective, there were identified strategic objectives, critical factors, lead indicators and initiatives. The strategic map of the APU outlining sustained strategic relations among strategic objectives. This study contributes to the development of research in the health management area as it explores how organizational insufficiencies and inconsistencies in this particular case can be addressed, through the identification of critical factors, to clearly establish core outcomes and initiatives to set up.

Keywords: acute pain unit, balanced scorecard, hospital management, organizational performance, Portugal

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Authors: Vanita Singh

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In developing countries, there are conflicting political agendas; policy makers have to prioritize issues from a list of issues competing for the limited resources. Thus, it is imperative to understand how some issues gain attention, and others lose in the policy circles. Multiple-Streams Theory of Kingdon (1984) is among the influential theories that help to understand the public policy process and is utilitarian for health policy makers to understand how certain health issues emerge on the policy agendas. The issue of maternal mortality was long standing in India and was linked with high birth rate thus the focus of maternal health policy was on family planning since India’s independence. However, a paradigm shift was noted in the maternal health policy in the year 1992 with the launch of Safe Motherhood Programme and then in the year 2005, when the agenda of maternal health policy became universalizing institutional deliveries and phasing-out of Traditional Birth Attendants (TBAs) from the health system. There were many solutions proposed by policy communities other than universalizing of institutional deliveries, including training of TBAs and improving socio-economic conditions of pregnant women. However, Government of India favored medical community, which was advocating for the policy of universalizing institutional delivery, and neglected the solutions proposed by other policy communities. It took almost 15 years for the advocates of institutional delivery to transform their proposed solution into a program - the Janani Suraksha Yojana (JSY), a safe-motherhood program promoting institutional delivery through cash incentives to pregnant women. Thus, the case of safe motherhood policy in India is worth studying to understand how certain issues/problems gain political attention and how advocacy work in policy circles. This paper attempts to understand the factors that favored the agenda of safe-motherhood in the policy circle in India, using John Kingdon’s Multiple-Stream model of agenda-setting. Through document analysis and literature review, the paper traces the evolution of safe motherhood program and maternal health policy. The study has used open source documents available on the website of Ministry of Health and Family Welfare, media reports (Times of India Archive) and related research papers. The documents analyzed include National health policy-1983, National Health Policy-2002, written reports of Ministry of Health and Family Welfare Department, National Rural Health Mission (NRHM) document, documents related to Janani Suraksha Yojana and research articles related to maternal health programme in India. The study finds that focusing events and credible indicators coupled with media attention has the potential to recognize a problem. The political elites favor clearly defined and well-accepted solutions. The trans-national organizations affect the agenda-setting process in a country through conditional resource provision. The closely-knit policy communities and political entrepreneurship are required for advocating solutions high on agendas. The study has implications for health policy makers in identifying factors that have the potential to affect the agenda-setting process for a desired policy agenda and identify the challenges in generating political priorities.

Keywords: agenda-setting, focusing events, Kingdon’s model, safe motherhood program India

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Authors: Kharaishvili Eteri

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The article highlights the importance of small and medium-sized enterprises in achieving the goals of sustainable development of the economy and increasing the well-being of the population. The opinion is put forward that it is necessary to adapt the activities of small and medium-sized firms in Georgia to sustainable business models. Therefore, it is important to identify the challenges that will ensure compliance with the goals and requirements of sustainable development of small and mediumsized enterprises. Objectives. The goal of the study is to reveal the challenges of sustainable development in small and medium-sized enterprises in Georgia and to develop recommendations for strategic development opportunities. Methodologies The challenges of sustainable development of small and medium-sized enterprises are investigated with the following methodology: bibliographic research of scientific works and reports of organizations is carried out; Based on the grouping of sustainable development goals, the performance indicators of these goals are studied; Differences with respect to the corresponding indicators of European countries are determined by the comparison method; The matrix scheme establishes the conditions and tools for sustainable development; Challenges of sustainable development are identified by factor analysis. Contributions Trends in the sustainable development of small and medium-sized enterprises are studied from the point of view of economic, social and environmental factors; To ensure sustainability, the conditions and tools for sustainable development are established (certified supply chains and global markets, allocation of financial resources necessary for sustainable development, proper public procurement, highly qualified workforce, etc.); Several main challenges have been identified in the sustainable development of small and medium-sized enterprises, including: limited internal resources; Institutional factors, especially vague and imperfect regulations, bureaucracy; low level of investments; Low level of qualification of human capital and others.

Keywords: small and medium-sized enterprises, sustainable development, conditions of sustainable development, strategic directions of sustainable development.

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Authors: Kate Crinion, Martin Haran, Stanley McGreal, David McIlhatton

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Past research has demonstrated that disasters are continuing to escalate in frequency and magnitude worldwide, representing a key concern for the global community. Understanding and responding to the increasing risk posed by disaster events has become a key concern for disaster managers. An emerging trend within literature, acknowledges the need to move beyond a state of coping and reinstatement of the status quo, towards incremental adaptive change and transformational actions for long-term sustainable development. As such, a growing interest in research concerns the understanding of the change required to address ever increasing and unpredictable disaster events. Capturing transformational capacity and resilience, however is not without its difficulties and explains the dearth in attempts to capture this capacity. Adopting a case study approach, this research seeks to enhance an awareness of transformational resilience by identifying key components and indicators that determine the resilience of flood-affected communities within Cumbria. Grounding and testing a theoretical resilience framework within the case studies, permits the identification of how perceptions of risk influence community resilience actions. Further, it assesses how levels of social capital and connectedness impacts upon the extent of interplay between resources and capacities that drive transformational resilience. Thus, this research seeks to expand the existing body of knowledge by enhancing the awareness of resilience in post-disaster affected communities, by investigating indicators of community capacity building and resilience actions that facilitate transformational resilience during the recovery and reconstruction phase of a flood disaster.

Keywords: capacity building, community, flooding, transformational resilience

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Authors: Salma Akter, Md. Kamal Uddin

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Quality of life is a vast and comprehensive concept refers overall well-being of society. Current research and efforts of policymakers and planners are concerned to increase the urban quality of life through the sustainable development of city and country. While such efforts effectively improve the quality of life of urban dwellers through improved social, economic and housing infrastructures, very little has been paid to improve low-income settlement users more specifically government provided shelter projects. The top-down shelter policies and its objective indicators (physical design elements and physical environmental elements) indicators on low-income groups merely can ensure grassroots needs, aspiration and well-being refer as subjective qualities obliged to compromise with the quality of life. This research, therefore, aims to measure the quality of life of such government-provided low-income settlements. To do so, a conceptual framework has been developed to measure quality of life with arguing that quality of life depends on both objective and subjective indicators and needs to measure across three scales of living environment refers to macro (community), meso (neighborhood or shelter/built environment), and micro (family). The top-down shelter project, Dakshin Chandani Mahal Ashrayan Prakalpa is a resettlement/housing project of Government of Bangladesh for providing shelters and human resources development activities like education, microcredit, and training programme to landless, homeless and rootless people has been taken as case study. The study area is located at Dighalia Upazila, Khulna Bangladesh. In terms of methodology, this research is primarily exploratory and adopts a case study method and deductive approach for evaluating the quality of life. Data have been obtained from relevant literature review, key informant interview, focus group discussion, necessary drawings, photographs and participant observation across dwelling, neighborhood, and community level. Findings have revealed that Shelter users mostly compromise the quality of life at community level due to insufficient physical design elements and facilities while neighborhood and dwelling level have been manifested similar result like former ones. Thus, the outcome of this study can be beneficial for a global-level understating of the compromising the ‘quality of life’ under top-down shelter policy. Locally, for instance, in the context of Bangladesh, it can help policymakers and concerned authorities to formulate the shelter policies and take initiatives to improve the well-being of marginalized.

Keywords: Ashrayan Prakalpa, compromise, displaced people, quality of life

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