Search results for: policy guidelines

Authors: Merav Hayakac, Orit Avidov-Ungarab

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The current study adopted an interpretive-constructivist approach to examine how senior academics from a large sample of Israeli teacher education colleges serving general or religious populations perceived the integration of digital games into their teacher instruction and what their policy and vision were in this regard in the context of the COVID-19 pandemic. Half the participants expressed a desire to integrate digital games into their teaching and learning but acknowledged that this practice was uncommon. Only a small minority believed they had achieved successful integration, with doubt and skepticism expressed by some religious colleges. Most colleges had policies encouraging technology integration supported by ongoing funding. Although a considerable gap between policy and implementation remained, the COVID-19 pandemic was viewed as having accelerated the integration of digital games into pre-service teacher instruction. The findings suggest that discussions around technology-related vision and policy and their translation into practice should relate to the specific cultural needs and academic preparedness of the population(s) served by the college.

Keywords: COVID-19, digital games, pedagogy, teacher education colleges

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Authors: Aneta Nitsch-Osuch, Damian Okrucinski, Magdalena Dawgialło, Izabela Gołębiak, Ernest Kuchar

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The Hospital Antibiotic Policy (HAP) should be implemented to rationalize the antibiotic use and to decrease the risk of spreading of spreading of resistant bacteria. The aim of our study was to describe the antibiotic consumption patterns at the single oncosurgery ward before and after implementation of the HAP. We conducted a retrospective analysis of the antibiotic use at the Oncosurgery Ward in Warsaw (Poland) in years 2011-2016. Calculations were based on daily defined doses (DDDs), DDDs/100 hospitalizations and DDDs/100 person-days, drug utilization rates (DU 90% and DU 100%) were also analysed. After implementation of the HAP, the total antibiotic consumption increased (365.35 DDD in 2011 vs. 1359,22 DDD in 2016). The significant change was observed in antibiotic consumption patterns: the use of amoxicillin clavulanate and carbapenems or glycopeptides decreased significantly (p < 0,05), while the use of ciprofloxacin and aminoglycosides increased (p < 0,05). The DU100% rate varied from 6 in 2011 to 12 in 2016; while DU 90% rate varied from 2 in 2011 to 3-5 in 2013-2016. Although the implementation of the HAP did not result in the decreased total antibiotic consumption, it provided favorable changes in the antibiotic consumption patterns.

Keywords: antibiotics, hospital, policy, stewardship

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Authors: Tzay-An Shiau, Kuan-Lin Ho

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This study developed sustainability and quality of life indicators for urban passenger transportation by using Social Construction of Technology (SCOT). The initial indicators were proposed by referring to literatures and were summarized by using impact-based framework. Subsequently, the stakeholders were defined according to their interest, power and then classified into scientific, operational, policy making, policy monitoring and nonprofessional frames. The scientific frame consisted of nine scholars in transportation field. Ten representatives from Taipei Rapid Transit Corporation (TRTC), Taiwan Railways Administration (TRA) and bus operators were grouped into the operational frame. The policy making frame comprised of ten representatives from Department of Transportation, Taipei City Government (DOT, TCG), Department of Railways and Highways, Ministry of Transportation and Communication (DORH, MOTC), Directorate General of Highways, Ministry of Transportation and Communication (DGOH, MOTC) and Institute of Transportation, Ministry of Transportation and Communication (IOT, MOTC). The policy monitoring frame consisted of 15 representatives from Taipei City Councilor, legislator and reporter. The nonprofessional frame comprised of 72 Taipei citizens. The stakeholders were asked to evaluate the relative importance of indicators using Delphi survey method. Social construction of 14 transport sustainability indicators and 12 transport quality of life indicators were obtained.

Keywords: sustainability, quality of life, Social Construction of Technology (SCOT), stakeholder

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Authors: Tsz Ching Jasmine Lam

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Linguistic landscape (LL) can serve as both top-down and bottom-up approaches to understanding language planning policy in various dimensions. It can reflect the language identities, motives and contestations perceived by stakeholders of different decision-making levels. Prior studies adopted the bottom-up approach to investigate the language practice and ideologies reflected by the design and linguistic features observed in the linguistic landscapes in ethnically and linguistically diverse areas, like Medan in Russia and Seoul in Korea. As Hong Kong is also a trilingual city with an inclusive combination of nationalities, this paper is intended to take it as a case study to explore the de facto language ideologies reflected by LL at the micro-level. We would look into the catering industry from a holistic perspective by reviewing the food menus of 66 restaurants located in diversified districts and serving different types of cuisines. This bottom-up LL research reveals that business owners and the public share the language ideologies of perceiving English as a prestigious language, multilingualism and traditional Chinese as a standard character.

Keywords: bottom-up, language ideologies, language planning policy, language policy, language identities, linguistic landscape

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Authors: Tahar Tayachi, Ahlam Alrehaili

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Purpose: The purpose of this paper is to investigate the relationship between the corporate board characteristics and the dividend policy among firms on the Saudi Stock Exchange. Design/Methodology/Approach: This paper uses a sample of 103 nonfinancial firms over a time period of 4 years from 2015 to 2018. To investigate how corporate governance mechanisms such as board independence, the board size, frequency of meetings, and free cash flow impact dividends, the study uses Logit and Tobit models. Findings: This paper finds that board size, board independence, and frequency of board meetings have no influence on a firm’s decision to pay dividends, while board size has a significantly positive impact on the levels of cash dividends paid to investors. This study also finds that the level of free cash flows has a positively significant influence on both the decision to pay dividends and the magnitude of dividend payouts. Research Limitations/Implications: This paper attempts to study the effectiveness of dividend policy among some firms on the Saudi Stock Exchange. Practical Implications: The findings reveal that board characteristics, which represent one of the crucial mechanisms of corporate governance, were found to be complementary to corporate laws and regulations imposed on the Saudi market in 2015. The findings also imply that capital market authorities should revise their corporate regulations and ensure that protection laws are adequate and strong enough to protect the interests of all shareholders. Originality/Value: This paper is among the few studies focusing on dividend policy in Saudi Arabia. Finally, these findings suggest that the improvements in corporate laws in Saudi Arabia led to such an outcome, and it has become prevalent in dividend policy decisions and behaviors of Saudi firms.

Keywords: agency theory, Tobit, corporate governance, dividend payout, Logit

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Authors: Kathryn Watson

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In 2020 North Carolina passed legislation mandating all educators be trained in identifying, referring, and supporting students showing signs of mental health issues, drug use, suicidal ideation, and sex trafficking. This study collected survey responses from 226 educators in North Carolina to better understand their perspectives on the legislation and their self-efficacy in supporting student mental health needs. Key findings of the study reveal that the mandated trainings increased educator awareness of student mental health, and higher awareness was linked to higher self-efficacy in supporting student mental health needs. Additionally, the results showed that educators who identify as Black had lower levels of self-efficacy in supporting student mental health. Additionally, rural educators were least likely to support the legislation in comparison to their urban and suburban counterparts. These findings can help inform policymakers in evaluating the policy and district decision-makers in selecting and implementing school-based mental health training.

Keywords: school-based mental health, education policy, student health, North Carolina, K-12 education

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Authors: Archil Undilashvili, Ketevan Stvilia, Dustin Gilbreath, Giorgi Dzneladze, Gordon Charchward

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Introduction: In recent years, diverse types of wheelchairs, both local production and imported, have been made available on the Georgian market for wheelchair users. Some types of wheelchairs are sold together with a service package, while the others, including the State Program, Supported locally-produced ones, don’t provide adjustment and maintenance service packages to users. Within the USAID Physical Rehabilitation Project in Georgia, a study was conducted to assess the impact of the wheelchair service provision in line with the WHO guidelines on the health and overall satisfaction of wheelchair users in Georgia. Methodology: A cross-sectional survey was conducted in May 2021. A structured questionnaire was used for telephone interviews that, along with socio-demographic characteristics, included questions for assessment of accessibility, availability, timeliness, cost and quality of wheelchair services received. Out of 1060 individuals listed in the census of wheelchair users, 752 were available for interview, with an actual response rate of 73.4%. 552 wheelchair users (31%) or their caregivers (69%) agreed to participate in the survey. In addition to using descriptive statistics, the study used multivariate matching of wheelchair users who received wheelchair services and who did not (control group). In addition, to evaluate satisfaction with service provision, respondents were asked to assess services. Findings: The majority (67%) of wheelchair users included in the survey were male. The average age of participants was 43. The three most frequently named reasons for using a wheelchair were cerebral palsy (29%), followed by stroke (18%), and amputation (12%). Users have had their current chair for four years on average. Overall, 60% of respondents reported that they were assessed before providing a wheelchair, but only half of them reported that their preferences and needs were considered. Only 13% of respondents had services in line with WHO guidelines and only 22% of wheelchair users had training when they received their current chair. 16% of participants said they had follow-up services, and 41% received adjustment services after receiving the chair. A slight majority (56%) of participants were satisfied with the quality of service provision and the service provision overall. Similarly, 55% were satisfied with the accessibility of service provision. A slightly larger majority (61%) were satisfied with the timeliness of service provision. The matching analysis suggests that users that received services in line with WHO guidelines were more satisfied with their chairs (the difference 17 point/0-100 scale) and they were four percentage points less likely to have health problems attributed to the chair. The regression analysis provides a similar finding of a 21 point increase in satisfaction attributable to services. Conclusion: The provision of wheelchair services in line with WHO guidelines and with follow-up services is likely to have a positive impact on the daily lives of wheelchair users in Georgia. Wheelchair services should be institutionalized as a standard component of wheelchair provision in Georgia.

Keywords: physical rehabilitation, wheelchair users, persons with disabilities, wheelchair production

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Authors: Nicolas Koslover, Tamara Levene

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Aims: Tonsilitis is one of the most common presentations to the A+E department. We aimed to assess whether patients presenting with tonsilitis are being managed in-line with current guidance. We then set out to educate A+E staff about tonsilitis management and then assessed for improvement in management. Methods: All patients presenting to A+E in one fortnight with a documented diagnosis of tonsilitis were included. We reviewed the notes to assess the choice of treatment in each case and whether a clinical score (CENTOR or FEVERPain score) was used to guide choice of treatment (in accordance with NICE guideline [NG84]). We designed and delivered an educational intervention for A+E staff covering tonsilitis guidelines. The audit was repeated two weeks later. Results: Over the study period, 49 patients were included; only 35% (n=17) had either a clinical score documented or had all components of a score recorded. In total, 39% (n=19) were treated with antibiotics. Of these, 63% (n=12) should not have been prescribed an antibiotic and 37% (n=7) were prescribed an inappropriate antibiotic. At re-audit, (n=50 cases), 58% (n=29) had a clinical score documented and 28% (n=14) were treated with antibiotics. Of these, 29% (n=4) should not have been prescribed antibiotics and 21% (n=3) were prescribed an inappropriate antibiotic. Thus, after this teaching session, there was a significant improvement in antibiotic prescribing practices (63% vs. 29%, p=0.026). Conclusions: A+E assessment and management of tonsilitis frequently deviated from guidelines, but a single teaching session vastly improved clinical scoring and antibiotic prescribing practices.

Keywords: tonsilitis, education, emergency medicine, ENT

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Authors: Shreya Saxena, Felix Miller-Molloy, Phillipa Bowen, Greg Fellows, Elizabeth Bowen

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Background: Complex fluid balance abnormalities are well-established post-neurosurgery and traumatic brain injury (TBI). The triple-phase response requires fluid management strategies reactive to urine output and sodium homeostasis as patients shift between Diabetes Insipidus (DI) and Syndrome of Inappropriate ADH (SIADH). It was observed, at a tertiary paediatric center, a relatively high prevalence of the above complications within a cohort of paediatric post-neurosurgical and TBI patients. An audit of the clinical practice against set institutional guidelines was undertaken and analyzed to understand why this was occurring. Based on those results, new guidelines were developed with structured educational packages for the specialist teams involved. This was then reaudited, and the findings were compared. Methods: Two independent audits were conducted across two time periods, pre and post guideline change. Primary data was collected retrospectively, including both qualitative and quantitative data sets from the CQUIN neurosurgical database and electronic medical records. All paediatric patients post posterior fossa (PFT) or supratentorial surgery or with a TBI were included. A literature review of evidence-based practice, initial audit data, and stakeholder feedback was used to develop new clinical guidelines and nursing standard operation procedures. Compliance against these newly developed guidelines was re-assessed and a thematic, trend-based analysis of the two sets of results was conducted. Results: Audit-1 January2017-June2018, n=80; Audit-2 January2020-June2021, n=30 (reduced operative capacity due to COVID-19 pandemic). Overall, improvements in the monitoring of both fluid balance and electrolyte trends were demonstrated; 51% vs. 77% and 78% vs. 94%, respectively. The number of clear fluid management plans documented postoperatively also increased (odds ratio of 4), leading to earlier recognition and management of evolving fluid-balance abnormalities. The local paediatric endocrine team was involved in the care of all complex cases and notified sooner for those considered to be developing DI or SIADH (14% to 35%). However, significant Na fluctuations (>12mmol in 24 hours) remained similar – 5 vs six patients – found to be due to complex pituitary hypothalamic pathology – and the recommended adaptive fluid management strategy was still not always used. Qualitative data regarding useability and understanding of fluid-balance abnormalities and the revised guidelines were obtained from health professionals via surveys and discussion in the specialist teams providing care. The feedback highlighted the new guidelines provided a more consistent approach to the post-operative care of these patients and was a better platform for communication amongst the different specialist teams involved. The potential limitation to our study would be the small sample size on which to conduct formal analyses; however, this reflects the population that we were investigating, which we cannot control. Conclusion: The revised clinical guidelines, based on audited data, evidence-based literature review and stakeholder consultations, have demonstrated an improvement in understanding of the neuro-endocrine complications that are possible, as well as increased compliance to post-operative monitoring of fluid balance and electrolytes in this cohort of patients. Emphasis has been placed on preventative rather than treatment of DI and SIADH. Consequently, this has positively impacted patient safety for the center and highlighted the importance of educational awareness and multi-disciplinary team working.

Keywords: post-operative, fluid-balance management, neuro-endocrine complications, paediatric

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Authors: Zukhrof Romadhon, Nani Kurniati

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Availability of Spare parts is critical to support maintenance tasks and the production system. Managing spare part inventory deals with some parameters and objective functions, as well as the tradeoff between inventory costs and spare parts availability. Several mathematical models and methods have been developed to optimize the spare part policy. Many researchers who proposed optimization models need to be considered to identify other potential models. This work presents a review of several pertinent literature on spare part inventory optimization and analyzes the gaps for future research. Initial investigation on scholars and many journal database systems under specific keywords related to spare parts found about 17K papers. Filtering was conducted based on five main aspects, i.e., replenishment policy, objective function, echelon network, lead time, model solving, and additional aspects of part classification. Future topics could be identified based on the number of papers that haven’t addressed specific aspects, including joint optimization of spare part inventory and maintenance.

Keywords: spare part, spare part inventory, inventory model, optimization, maintenance

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Authors: Omolaja Akolade Oluwaseunfunmi

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This study seeks to ascertain the origin and history of terrorism in Nigeria, determine the causes of terrorism in Nigeria, examine Nigeria’s foreign policies from 1999 to 2015, evaluate how terrorist groups like Boko Haram and the Indigenous People of Biafra (IPOB) have affected Nigeria’s foreign policies in the international arena; ascertain the measures taken by the government in tackling terrorist acts in Nigeria and give recommendations on how to tackle this menace. The methodology used in this research is the analytical method. The study derives its data from both primary and secondary sources. Findings from fieldwork showed that terrorism has also become one of the most important fundamentals of Nigeria’s foreign policies and relations; respondents from the people interviewed showed that terrorism is a menace and that terrorism must be adequately tackled in other to achieve Nigeria’s foreign policy. Furthermore, results revealed that the fight against the scourge has increasingly gained legitimacy and justification among the international community particularly as many countries consider it to be their international obligation to support the global movement to ameliorate or eliminate the menace. In conclusion, this research made, among other recommendations, that the Nigerian government should ensure the provision of a good life for its citizens, the inter-connectivity of terrorist organizations must be defeated, the government should undergo a foreign policy drive designed at rebuilding its image in the international environment, and also the promotion of peace education among various government, religious institutions, private sector, and civil society groups should be encouraged.

Keywords: foreign policy, Boko Haram, movement for the emancipation of Niger delta (MEND), terrorism

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Authors: Marzie Shahini, Rasoul Mirghaderi

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This paper describes collapse assessments of a steel moment-frame high-rise tower with setback irregularity, designed per the 2010 ASCE7 code, under spectral-matched ground motion records. To estimate a safety margin against life-threatening collapse, an analytical model of the tower is subjected to a suite of ground motions with incremental intensities from maximum considered earthquake hazard level to the incipient collapse level. Capability of the structural system to collapse prevention is evaluated based on the similar methodology reported in FEMA P695. Structural performance parameters in terms of maximum/mean inter-story drift ratios, residual drift ratios, and maximum plastic hinge rotations are also compared to the acceptance criteria recommended by the TBI Guidelines. The results demonstrate that the structural system satisfactorily safeguards the building against collapse. Moreover, for this tower, the code-specified requirements in ASCE7-10 are reasonably adequate to satisfy seismic performance criteria developed in the TBI Guidelines for the maximum considered earthquake hazard level.

Keywords: high-rise buildings, set back, residual drift, seismic performance

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Authors: Ramona Moldovan, Doina Cosman, Sebastian Moldovan, Radu Popp, Victor Pop

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MENTALICA is a project aimed at developing and evaluating a platform that can assist individuals diagnosed with severe mental disorders and their families in managing the consequences associated with severe mental disorders, recurrence risks, prevention strategies and treatment options. MENTALICA is a platform based on guidance issued by some of the most prominent scientific organizations in the world. In order to personalize the information provided, the program explores details about the personal and family history of mental disorders. MENTALICA summarizes the answers and gives respondents a personal assessment. This includes personalized information and support about schizophrenia, bipolar disorder and schizoaffective disorder. MENTALICA includes several modules: Family history tools, Risk assessment tools and Risk factor sheets, Practical guides for patients, Practical guides for families, Guidelines for clinicians. Currently, there are no available guidelines for genetic counselling for mental disorders. Respondents can print out their reports and discuss them with family members or their doctors. We will briefly present the current status of MENTALICA and its implications for patients, professionals and the community.

Keywords: genetic counseling, mental disorders, platform

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Authors: Z. A. Al Marhoon, H. S. Al Ramis, C. Teodoriu

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Well-integrity is one of the major elements considered for drilling geothermal, oil, and gas wells. Well-integrity is minimizing the risk of unplanned fluid flow in the well bore throughout the well lifetime. Well integrity is maximized by applying technical concepts along with practical practices and strategic planning. These practices are usually governed by standardization and regulation entities. Practices during well construction can affect the integrity of the seal at the time of abandonment. On the other hand, achieving a perfect barrier system is impracticable due to the needed cost. This results in a needed balance between regulations requirements and practical applications. The guidelines are only effective when they are attainable in practical applications. Various governmental regulations and international standards have different guidelines on what constitutes high-quality isolation from unwanted flow. Each regulating or standardization body differ in requirements based on the abandonment objective. Some regulation account more for the environmental impact, water table contamination, and possible leaks. Other regulation might lean towards driving more economical benefits while achieving an acceptable isolation criteria. The research methodology used in this topic is derived from a literature review method combined with a compare and contrast analysis. The literature review on various zonal isolation regulations and standards has been conducted. A review includes guidelines from NORSOK (Norwegian governing entity), BSEE (USA offshore governing entity), API (American Petroleum Institute) combined with ISO (International Standardization Organization). The compare and contrast analysis is conducted by assessing the objective of each abandonment regulations and standardization. The current state of well barrier regulation is in balancing action. From one side of this balance, the environmental impact and complete zonal isolation is considered. The other side of the scale is practical application and associated cost. Some standards provide a fair amount of details concerning technical requirements and are often flexible with the needed associated cost. These guidelines cover environmental impact with laws that prevent major or disastrous environmental effects of improper sealing of wells. Usually these regulations are concerned with the near future of sealing rather than long-term. Consequently, applying these guidelines become more feasible from a cost point of view to the required plugging entities. On the other hand, other regulation have well integrity procedures and regulations that lean toward more restrictions environmentally with an increased associated cost requirements. The environmental impact is detailed and covered with its entirety, including medium to small environmental impact in barrier installing operations. Clear and precise attention to long-term leakage prevention is present in these regulations. The result of the compare and contrast analysis of the literature showed that there are various objectives that might tip the scale from one side of the balance (cost) to the other (sealing quality) especially in reference to zonal isolation. Furthermore, investing in initial well construction is a crucial part of ensuring safe final well abandonment. The safety and the cost saving at the end of the well life cycle is dependent upon a well-constructed isolation systems at the beginning of the life cycle. Long term studies on zonal isolation using various hydraulic or mechanical materials need to take place to further assess permanently abandoned wells to achieve the desired balance. Well drilling and isolation techniques will be more effective when they are operationally feasible and have reasonable associated cost to aid the local economy.

Keywords: plug and abandon, P&A regulation, P&A standards, international guidelines, gap analysis

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Authors: Abhijit Trailokya

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Background: Cardiovascular diseases (CVD’s) are the major cause of morbidity and mortality in both developed and developing countries. Many clinical trials have demonstrated that low-density lipoprotein cholesterol (LDL-C) lowering, reduces the incidence of coronary and cerebrovascular events across a broad spectrum of patients at risk. Guidelines for the management of patients at risk have been established in Europe and North America. The guidelines have advocated progressively lower LDL-C targets and more aggressive use of statin therapy. In Indian patients, comprehensive data on dyslipidemia management and its treatment outcomes are inadequate. There is lack of information on existing treatment patterns, the patient’s profile being treated, and factors that determine treatment success or failure in achieving desired goals. Purpose: The present study was planned to determine the lipid control status in high-risk dyslipidemic patients treated with lipid-lowering therapy in India. Methods: This cross-sectional, non-interventional, single visit program was conducted across 483 sites in India where male and female patients with high-risk dyslipidemia aged 18 to 65 years who had visited for a routine health check-up to their respective physician at hospital or a healthcare center. Percentage of high-risk dyslipidemic patients achieving adequate LDL-C level (< 70 mg/dL) on lipid-lowering therapy and the association of lipid parameters with patient characteristics, comorbid conditions, and lipid lowering drugs were analysed. Results: 3089 patients were enrolled in the study; of which 64% were males. LDL-C data was available for 95.2% of the patients; only 7.7% of these patients achieved LDL-C levels < 70 mg/dL on lipid-lowering therapy, which may be due to inability to follow therapeutic plans, poor compliance, or inadequate counselling by physician. The physician’s lack of awareness about recent treatment guidelines also might contribute to patients’ poor adherence, not explaining adequately the benefit and risks of a medication, not giving consideration to the patient’s life style and the cost of medication. Statin was the most commonly used anti-dyslipidemic drug across population. The higher proportion of patients had the comorbid condition of CVD and diabetes mellitus across all dyslipidemic patients. Conclusion: As per the European Society of Cardiology guidelines the ideal LDL-C levels in high risk dyslipidemic patients should be less than 70%. In the present study, 7.7% of the patients achieved LDL-C levels < 70 mg/dL on lipid lowering therapy which is very less. Most of high risk dyslipidemic patients in India are on suboptimal dosage of statin. So more aggressive and high dosage statin therapy may be required to achieve target LDLC levels in high risk Indian dyslipidemic patients.

Keywords: cardiovascular disease, diabetes mellitus, dyslipidemia, LDL-C, lipid lowering drug, statins

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Authors: Valeria Piccioni, Matthias Leschok, Ina Cheibas, Illias Hischier, Benjamin Dillenburger, Arno Schlueter, Matthias Kohler, Fabio Gramazio

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The decarbonisation of the building sector requires the development of building components that provide energy efficiency while producing minimal environmental impact. Recent advancements in large-scale 3D printing have shown that it is possible to fabricate components with embedded performances that can be tuned for their specific application. We investigate the potential of polymer 3D printing for the fabrication of translucent facade components. In this study, we explore the effect of geometry on thermal insulation of printed cavity structures following a Hot Box test method. The experimental results are used to calibrate a finite-element simulation model which can support the informed design of 3D printed insulation structures. We show that it is possible to fabricate components providing thermal insulation ranging from 1.7 to 0.95 W/m2K only by changing the internal cavity distribution and size. Moreover, we identify design guidelines that can be used to fabricate components for different climatic conditions and thermal insulation requirements. The research conducted provides the first insights into the thermal behaviour of polymer 3DP facades on a large scale. These can be used as design guidelines for further research toward performant and low-embodied energy 3D printed facade components.

Keywords: 3D printing, thermal performance, polymers, facade components, hot-box method

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Authors: Linda Weinberg, Miriam Symon

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While few institutions of higher education in Israel offer international programs taught entirely in English, many Israeli students today can study at least one content course taught in English during their degree program. In particular, with the growth of international partnerships and opportunities for student mobility, English medium instruction is a growing phenomenon. There are however no official guidelines in Israel for how to develop and implement content courses in English and no training to help lecturers prepare for teaching their materials in a foreign language. Furthermore, the implications for the students and the nature of the courses themselves have not been sufficiently considered. In addition, the institution must have lecturers who are able to teach these courses effectively in English. An international project funded by the European Union addresses these issues and a set of guidelines which provide guidance for lecturers in adapting their courses for delivery in English have been developed. A train-the-trainer approach is adopted in order to cascade knowledge and experience in English medium instruction from experts to language teachers and on to content teachers thus maximizing the scope of professional development. To accompany training, a model English medium course has been created which serves the dual purpose of highlighting alternatives to the frontal lecture while integrating language learning objectives with content goals. This course can also be used as a standalone content course. The development of the guidelines and of the course utilized backwards, forwards and central design in an iterative process. The goals for combined language and content outcomes were identified first after which a suitable framework for achieving these goals was constructed. The assessment procedures evolved through collaboration between content and language specialists and subsequently were put into action during a piloting phase. Feedback from the piloting teachers and from the students highlight the need for clear channels of communication to encourage frank and honest discussion of expectations versus reality. While much of what goes on in the English medium classroom requires no better teaching skills than are required in any classroom, the understanding of students' abilities in achieving reasonable learning outcomes in a foreign language must be rationalized and accommodated within the course design. Concomitantly, preparatory language classes for students must be able to adapt to prepare students for specific language and cognitive skills and activities that courses conducted in English require. This paper presents findings from the implementation of a purpose-designed English medium instruction course arrived at through an iterative backwards, forwards and central design process utilizing feedback from students and lecturers alike leading to suggested guidelines for English medium instruction in higher education.

Keywords: English medium instruction, higher education, iterative design process, train-the-trainer

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Authors: Haluk Özparlak, Murad Aydın Şanda, Gülşin Arslan

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Phoxinellus anatolicus, Carassius gibelio, Sander lucioperca, Vimba vimba tenella, Capoeta capoeta, Tinca tinca from Suğla Lake (Turkey) and Phoxinellus anatolicus, Scardinius erythrophthalmus, Tinca tinca from Beyşehir Lake (Turkey) are economically important fish species and these fish have been consumed as food by local people. P. anatolicus is also endangered and endemic species from Turkey. In this study, concentrations of Cd, Co, Cr, Fe, Mn, Ni, Pb and Zn were determined in muscle tissue of these fish by using atomic absorption spectrophotometer. Levels of metals in the muscle tissue of all the fish specimens were compared with results of previous studies, the tolerance levels of national and international guidelines and the levels of Provisional Tolerable Weekly Intake (PTWI) limits set by FAO/WHO. Concentrations of Cd, Cr, Ni and Pb in the muscle tissue of all the fish specimens from Suğla and Beyşehir Lakes exceeded the tolerance levels of national and international guidelines. However, concentrations of Cd, Fe, Pb and Zn were below PTWI limits. Therefore, in terms of these metal levels, consumption of fresh filet of examined seven fish species (weekly up to about 300 g/person) doesn’t seem to be objectionable for human health.

Keywords: Beyşehir Lake, fish, metal levels, Suğla Lake

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Authors: Alexandra M. Kriofske Mainella

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This paper will examine the need for more aggressive public policies around bodily, reproductive and sexual health education for young people with disabilities in the United States. This paper will consider the policies around sexuality education for students in the United States and the recommendation for national standards around sexuality education. We will investigate the intersection of these policies and recommendations for students with disabilities and the Individuals with Disabilities Education Act (IDEA): what this means for students with disabilities’ access to comprehensive sexuality education and how it affects their behaviors and outcomes.

Keywords: disability, sexuality, education, policy

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Authors: Karl Mabiala Dondia, Jing Ma

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In recent years, networks based on the 802.11 standards have gained a prolific deployment. The reason for this massive acceptance of the technology by both home users and corporations is assuredly due to the "plug-and-play" nature of the technology and the mobility. The lack of physical containment due to inherent nature of the wireless medium makes maintenance very challenging from a security standpoint. This study examines via continuous monitoring various predictable threats that 802.11 networks can face, how they are executed, where each attack may be executed and how to effectively defend against them. The key goal is to identify the key components of an effective wireless security policy.

Keywords: wireless LAN, IEEE 802.11 standards, continuous monitoring, security policy

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Authors: M. Moiz

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Family planning has been known and accepted as a key tool to decrease fertility, provides birth spacing and plays a vital role to attain better outcomes for maternal and child health. Pakistan initiated various family planning programs to preserve maternal and child health for six decades. However, less contraceptive use leading to high fertility and low birth spacing is ultimately a risk for increasing morbidity and mortality. As an outcome of 2012 London Summit on Family Planning where 20 countries including Pakistan made its commitment to increase contraceptive prevalence rate by 55% and provide a universal access to reproductive health to protect human rights of women and ensure safe, choice informed and affordable contraceptives throughout the country. This paper will assess some of the factors of service delivery, coverage and the role of Ministry of Health and Population Welfare Department in providing Family Planning services and how it can be improved in Pakistan. In view of Pakistan Demographic Health Survey 2017-18, there are total nine million potential users of contraceptives and one third among them never used with unmet need while every fifth pregnancy ends into abortion indicates need for Family Planning services. In order to explain this concern, a comprehensive analysis has been done on role of governance in implementing family planning policy and its limitations are discussed. Moreover, this paper highlights policy options and recommendations for improving service provision through public and private sector in creating demand for Family Planning services in Pakistan.

Keywords: contraceptive prevalence rate, family planning, maternal and child health, policy options

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Authors: Nattanon Peerapen, Wanwisa Insang, Lanlalin Khumman, Wipada Juanprajak, Sikan Na Chiangmai, Wacharin Suksanan, Thanasak Tantinakom

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This research was intended to study guidelines from elderly care businesses that are continuously growing and rapidly benefitting because these businesses respond to the needs of those who cannot find time to in take care of their elderly people, including intimate care services from the caregivers, thus rapidly expanding elderly care businesses to have recently become interesting domestically and internationally. Chiang Mai is a popular choice for the businesses because of excellent weathers and simple and peaceful ways of living, thus making the businesses grow rapidly and continuously. The sample group consisted of 5 persons, executives and staff, from each of the 4 businesses that provide elderly cares chosen to interview by the researches, which were Vivo Bene Village, Baan Donsuk, PT Nursing Home, and PD Nursing Home. The interviews indicated that most elderly care businesses are located in rural areas with moving traffics, shady environments, and far from crowded urban areas since elderly people need peacefulness and clean environments that will affect their physical and mental health directly. The sections within the businesses are distinctly divided with definite duties assigned to each personnel, including welfares, remunerations, uniforms, accommodations, food and social occasions, such as birthdays or New Year festivities.

Keywords: elderly, elderly care, business strategy, success factors

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Authors: Cai Qianyi

Abstract:

In the midst of global digital revolution, the flow of data poses security threats that call China's existing legislative framework for protecting personal information into question. As a preliminary procedure for risk analysis and prevention, the risk assessment of personal data transmission lacks detailed guidelines for support. Existing provisions reveal unclear responsibilities for network operators and weakened rights for data subjects. Furthermore, the regulatory system's weak operability and a lack of industry self-regulation heighten data transmission hazards. This paper aims to compare the regulatory pathways for data information transmission risks between China and Europe from a legal framework and content perspective. It draws on the “Data Protection Impact Assessment Guidelines” to empower multiple stakeholders, including data processors, controllers, and subjects, while also defining obligations. In conclusion, this paper intends to solve China's digital security shortcomings by developing a more mature regulatory framework and industry self-regulation mechanisms, resulting in a win-win situation for personal data protection and the development of the digital economy.

Keywords: personal information data transmission, risk assessment, DPIA, internet service provider, personal information data transimission, risk assessment

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Authors: Freda E. Asem, R. D. Osei, D. B. Sarpong, J. K. Kuwornu

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While market access remains important, Ghana’s major handicap is her inability to sustain export growth on the open market. The causes of these could be attributed to inefficiency, lack of competitiveness and supply-side constraints. This study examined the challenges faced by smallholder horticultural farmers and how it relates to their technical efficiency. The study employed mixed methods to address the problem. Using the Millennium Development Account (MiDA) Farmer Based Organization survey data on farm households in 23 districts in Ghana, the study assessed the technical efficiency of smallholder horticultural farmers (taking into account production risks). Focus group discussions (FGDs) and in-depth interviews were also conducted on smallholder mango, pineapple, and chilli pepper farmers selected districts in Ghana. Results revealed the constraints faced by smallholder horticultural farmers to be marketing, training, funding, accessibility, and affordability of inputs, land, access to credit, and the disconnect between themselves and policy makers and implementers.

Keywords: productivity, gender, policy, efficiency, constraints

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Authors: Chiung-Ju Huang, Yuan-Hong Ho

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This study utilizes the International Monetary Fund (IMF) Fiscal Rules Dataset focusing on four specific fiscal rules such as expenditure rule, revenue rule, budget balance rule, and debt rule and five main characteristics of each fiscal rule those are monitoring, enforcement, coverage, legal basis, and escape clause to construct the Fiscal Rule Index for nine countries in the Asia-Pacific region from 1996 to 2015. After constructing the fiscal rule index for each country, we utilize the Panel Generalized Method of Moments (Panel GMM) by using the constructed fiscal rule index to examine the effectiveness of fiscal rules in reducing procyclicality. Empirical results show that national fiscal rules have a significantly negative impact on procyclicality of government expenditure. Additionally, stricter fiscal rules combined with high government effectiveness are effective in reducing procyclicality of government expenditure. Results of this study indicate that for nine Asia-Pacific countries, policymakers’ use of fiscal rules and government effectiveness to reducing procyclicality of fiscal policy are effective.

Keywords: counter-cyclical policy, fiscal rules, government efficiency, procyclical policy

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Authors: Tanapond S.

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Typically, most of the controlling firms are relate to family firms which are widespread and important for economic growth particularly in Asian Pacific region. The unique characteristics of the controlling families tend to play an important role in determining the corporate policies such as dividend policy. Given the complexity of the family business phenomenon, the empirical evidence has been unclear on how the families behind business groups influence dividend policy in Asian markets with the prevalent existence of cross-shareholdings and pyramidal structure. Dividend policy as one of an important determinant of firm value could also be implemented in order to examine the effect of the controlling families behind business groups on strategic decisions-making in terms of a governance perspective and agency problems. The purpose of this paper is to investigate the impact of ownership structure and concentration which are influential internal corporate governance mechanisms in family firms on dividend decision-making. Using panel data and constructing a unique dataset of family ownership and control through hand-collecting information from the nonfinancial companies listed in Stock Exchange of Thailand (SET) between 2000 and 2015, the study finds that family firms with large stakes distribute higher dividends than family firms with small stakes. Family ownership can mitigate the agency problems and the expropriation of minority investors in family firms. To provide insight into the distinguish between ownership rights and control rights, this study examines specific firm characteristics including the degrees of concentration of controlling shareholders by classifying family ownership in different categories. The results show that controlling families with large deviation between voting rights and cash flow rights have more power and affect lower dividend payment. These situations become worse when second blockholders are families. To the best knowledge of the researcher, this study is the first to examine the association between family firms’ characteristics and dividend policy from the corporate governance perspectives in Thailand with weak investor protection environment and high ownership concentration. This research also underscores the importance of family control especially in a context in which family business groups and pyramidal structure are prevalent. As a result, academics and policy makers can develop markets and corporate policies to eliminate agency problem.

Keywords: agency theory, dividend policy, family control, Thailand

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Authors: Andrey Makarov

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This article will focus on the development of antitrust policy in transition economies in the context of preventing explicit and tacit collusion. Experience of BRICS, CIS (Ukraine, Kazakhstan) and CEE countries (Bulgaria, Hungary, Latvia, Lithuania, Poland, Romania, Slovakia, Slovenia, Czech Republic, Estonia) in the creation of antitrust institutions was analyzed, including both legislation and enforcement practice. Most of these countries in the early 90th were forced to develop completely new legislation in the field of protection of competition and it is important to compare different ways of building antitrust institutions and policy results. The article proposes a special approach to evaluation of preventing collusion mechanisms. This approach takes into account such enforcement problems as: classification problems (tacit vs explicit collusion, vertical vs horizontal agreements), flexibility of prohibitions (the balance between “per se” vs “rule of reason” approaches de jure and in practice), design of sanctions, private enforcement challenge, leniency program mechanisms, the role of antitrust authorities etc. The analysis is conducted using both official data, published by competition authorities, and expert assessments. The paper will show how the integration process within the EU predetermined some aspects of the development of antitrust policy in CEE countries, including the trend of the use of "rule of reason" approach. Simultaneously was analyzed the experience of CEE countries in special mechanisms of government intervention. CIS countries in the development of antitrust policy followed more or less original ways, without such a great impact from the European Union, more attention will be given to Russian experience in this field, including the analysis of judicial decisions in antitrust cases. Main problems and challenges for transition economies in this field will be shown, including: Legal uncertainty problem; Problem of rigidity of prohibitions; Enforcement priorities of the regulator; Interaction of administrative and criminal law, limited effectiveness of criminal sanctions in the antitrust field; The effectiveness of leniency program design; Private enforcement challenge.

Keywords: collusion, antitrust policy, leniency program, transition economies, Russia, CEE

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Authors: Noorulain Khalid, Unsaar Hayat, Muhammad Chaudhary, Christos Iosifidis, Felipe Dhawahir-Scala, Fiona Carley

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Dry eye disease (DED) is a common condition seen in the emergency eye department (EED) at Manchester Royal Eye Hospital (MREH). However, there is variability in the prescription of lubricating eye drops among different healthcare providers. The aim of this study was to develop an up-to-date, standardized algorithm for the prescription of lubricating eye drops in the EED at MREH based on international and national guidelines. The study also aimed to assess the impact of implementing the guideline on the rate of inappropriate lubricant prescriptions. Primarily, the impact was to be assessed in the form of the appropriateness of prescriptions for patients’ DED. The impact was secondary to be assessed through analysis of the cost to the hospital. Data from 845 patients who attended the EED over a 3-month period were analyzed, and 157 patients met the inclusion and exclusion criteria. After conducting a review of the literature and collaborating with the corneal team, an algorithm for the prescription of lubricants in the EED was developed. Three plan-do-study-act (PDSA) cycles were conducted, with interventions such as emails, posters, in-person reminders, and education for incoming trainees. The appropriateness of prescriptions was evaluated against the guidelines. Data were collected from patient records and analyzed using statistical methods. The appropriateness of prescriptions was assessed by comparing them to the guidelines and by clinical correlation with a specialized registrar. The study found a substantial improvement in the number of appropriate prescriptions, with an increase from 55% to 93% over the three PDSA cycles. There was additionally a 51% reduction in expenditure on lubricant prescriptions, resulting in cost savings for the hospital (approximate saving of £50/week). Theoretical importance: Appropriate prescription of lubricating eye drops improves disease management for patients and reduces costs for the hospital. The development and implementation of a standardized guideline facilitate the achievement of these goals. Conclusion: This study highlights the inconsistent management of DED in the EED and the potential lack of training in this area for healthcare providers. The implementation of a standardized, easy-to-follow guideline for lubricating eye drops can help to improve disease management while also resulting in cost savings for the hospital.

Keywords: lubrication, dry eye disease, guideline, prescription

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Authors: Mujeeb Saif Mohsen Al-Absy, Ku Nor Izah Ku Ismail, Sitraselvi Chandren

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This study examines whether corporate governance (CG) mechanisms in firms that have a whistle-blowing policy (WHBLP) are more effective in constraining earnings management (EM), than those without. A sample of 288 Malaysian firms for the years 2013 to 2015, amounting to 864 firm-years were grouped into firms with and without WHBLP. Results show that for firms without WHBLP, the board chairman tenure would minimize EM activities. Meanwhile, for firms with WHBLP, board chairman independence, board chairman tenure, audit committee size, audit committee meeting and women in the audit committees are found to be associated with less EM activities. Further, it is found that ownership concentration and Big 4 auditing firms help to reduce EM activities in firms with WHBLP, while not in firms without WHBLP. Hence, functional and effective governance can be achieved by having a WHBLP, which is in line with agency and resource dependent theories. Therefore, this study suggests that firms should have a WHBLP in place, and policymakers should come up with enhanced criteria to strengthen the mechanisms of WHBLP.

Keywords: corporate governance, earnings management, whistle-blowing policy, audit committee, board of directors

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Authors: Guan-Ying Chen, Han-Tsung Liou, Shou-Ren Hu

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To address traffic congestion problems and encourage the use of public transportation systems in the Taipei metropolitan area, the Taipei City Government and the New Taipei City Government implemented a monthly ticket policy on April 16, 2018. This policy offers unlimited rides on the Taipei MRT, Taipei City Bus, New Taipei City Bus, Danhai Light Rail, and Public Bike (YouBike) on a monthly basis. Additionally, both city governments replaced the smart card discount policy with a new frequent flyer discount program (referred to as the loyal customer program) on February 1, 2020, introducing a differential pricing policy. Specifically, the more frequently the Taipei MRT system is used, the greater the discounts users receive. To analyze the impact of the Taipei public transport monthly ticket policy and the frequent user discount program on the passenger volume of the Taipei MRT system and the transferring behaviors of MRT users, this study conducts a trip-chain analysis using transaction data from Taipei MRT smart cards between September 2017 and December 2020. To achieve these objectives, the study employs four indicators: 1) number of passengers, 2) average number of rides, 3) average trip distance, and 4) instances of multiple consecutive rides. The study applies the t-test and Mann-Kendall trend test to investigate whether the proposed indicators have changed over time due to the implementation of the discount policy. Furthermore, the study examines the travel behaviors of passengers who use monthly tickets. The empirical results of the study indicate that the implementation of the Taipei public transport monthly ticket policy has led to an increase in the average number of passengers and a reduction in the average trip distance. Moreover, there has been a significant increase in instances of multiple consecutive rides, attributable to the unlimited rides offered by the monthly tickets. The impact of the frequent user discount program on changes in MRT passengers is not as pronounced as that of the Taipei public transportation monthly ticket policy. This is partly due to the fact that the frequent user discount program is only applicable to the Taipei MRT system, and the passenger volume was greatly affected by the COVID-19 pandemic. The findings of this research can serve as a reference for Taipei MRT Corporation in formulating its fare strategy and can also provide guidance for the Taipei and New Taipei City Governments in evaluating differential pricing policies for public transportation systems.

Keywords: frequent user discount program, mass rapid transit, monthly ticket, smart card

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