Search results for: public hospital unions

Authors: Mauricio Filho, Carina Castro

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The object of this project is to analyze long-time public agents that passed through several governments and see themselves in the position of having to deliberate with new agents, recently settled in the public administration. For theoretical ends, internal deliberation is understood as the one practiced on the public administration agencies, without any direct participation from the general public in the process. The assumption is: agents with longer periods of public service tend to step away from momentary political discussions that guide the current administration and seek to concentrate on institutionalized routines and procedures, making the most politically aligned individuals with the current government deliberate with less "passion" and more exchanging of knowledge and information. The theoretical framework of this research is institutionalism, which is guided by a more pragmatic view, facing the fluidity of reality in ways showing the multiple relations between agents and their respective institutions. The critical aspirations of this project rest on the works of professors Cass Sunstein, Adrian Vermeule, Philipp Pettit and in literature from both institutional theory and economic analysis of law, greatly influenced by the Chicago Law School. Methodologically, the paper is a theoretical review and pretends to be unfolded, in a future moment, in empirical tests for verification. This work has as its main analytical tool the appeal to theoretical and doctrinaire areas from the Juridical Sciences, by adopting the deductive and analytical method.

Keywords: institutions, state, law, agencies

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Authors: Kathryn Norgang, Sarah Howrath, Auni Idi Muhire, Pacifique Umubyeyi

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Description : A group of nurses address the shortage of trained staff to respond to critical patients at Rwanda Military Hospital (RMH) by developing a training program and a resuscitation response team. Members of the group who received the training when it first launched are now trainer of trainers; all components of the training program are organized and delivered by RMH staff-the clinical mentor only provides adjunct support. This two day training is held quarterly at RMH; basic life support and exposure to interventions for advanced care are included in the test and skills sign off. Seventy staff members have received the training this year alone. An increased number of admission/transfer to ICU due to successful resuscitation attempts is noted. Lessons learned: -Number of staff trained 2012-2014 (to be verified). -Staff who train together practice with greater collaboration during actual resuscitation events. -Staff more likely to initiate BLS if peer support is present-more staff trained equals more support. -More access to Advanced Cardiac Life Support training is necessary now that the cadre of BLS trained staff is growing. Conclusions: Increased access to training, peer support, and collaborative practice are effective strategies to strengthening resuscitation capacity within a hospital.

Keywords: resuscitation, basic life support, capacity building, resuscitation response teams, nurse trainer of trainers

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Authors: Lina Sinevičienė

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Arising problems of countries’ public finances, social and demographic changes motivate scientific and policy debates on public spending size, structure and efficiency in order to meet the changing needs of society and business. The concept of sustainable development poses new challenges for scientists and policy-makers in the field of public finance. This paper focuses on the investigation of the relationship between government expenditure and country’s economic development in the context of sustainable development. Empirical analysis focuses on the data of the European Union (except Croatia and Luxemburg) countries. The study covers 2003 – 2012 years, using annual cross-sectional data. Summarizing the research results, it can be stated that governments should pay more attention to the needs that ensure sustainable development in the long-run when formulating public expenditure policy, particularly in the field of environment protection.

Keywords: economic development, economic growth, government expenditure, sustainable development

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Authors: Saeed Ullah Jan

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This study has examined the e-readiness in libraries of public sector universities in Khyber Pakhtunkhwa. Efforts were made to evaluate the availability of human resources, electronic infrastructure, and network services and programs in the public sector university libraries. The population of the study was the twenty-seven public sector university libraries of Khyber Pakhtunkhwa. A quantitative approach was adopted, and a questionnaire-based survey was conducted to collect data from the librarian/in charge of public sector university libraries. The collected data were analyzed using Statistical Package for Social Sciences version 22 (SPSS). The mean score of the knowledge component interpreted magnitudes below three which indicates that the respondents are poorly or moderately satisfied regards knowledge of libraries. The satisfaction level of the respondents about the other components, such as electronic infrastructure, network services and programs, and enhancers of the networked world, was rated as average or below. The study suggested that major aspects of existing public-sector university libraries require significant transformation. For this purpose, the government should provide all the required resources and facilities to meet the population's informational and recreational demands. The Information Communication Technology (ICT) infrastructure of public university libraries needs improvement in terms of the availability of computer equipment, databases, network servers, multimedia projectors, digital cameras, uninterruptible power supply, scanners, and backup devices such as hard discs and Digital Video Disc/Compact Disc.

Keywords: ICT-libraries, e-readiness-libraries, e-readiness-university libraries, e-readiness-Pakistan

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Authors: Ibrahim Mahamid, A. Al-Ghonamy, M. Aichouni

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This study is conducted to identify causes of cost deviations in public construction projects in Saudi Arabia from contractors’ perspective. 41 factors that might affect cost estimating accuracy were identified through literature review and discussion with some construction experts. The factors were tabulated in a questionnaire form and a field survey included 51 contractors from the Northern Province of Saudi Arabia was performed. The results show that the top five important causes are: wrong estimation method, long period between design and time of implementation, cost of labor, cost of machinary and absence of construction-cost data.

Keywords: cost deviation, public construction, cost estimating, Saudi Arabia, contractors

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Authors: M. T. Becerra, F. Martín, P. Gutiérrez, S. Cubo, E. Iglesias, A. A. Sáenz del Castillo, P. Cañamero

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The consolidation of the European Higher Education Area (EHEA) in universities has led to significant changes in student training. This paper, part of a Teaching Innovation Project, starts from new training requirements that are fit within Undergraduate Thesis Project, a subject that culminate student learning. Undergraduate Thesis Project is current assessment system that weigh the student acquired training in university education. Students should develop a range of cross curricular competences such as public presentation of ideas, problems and solutions both orally and writing in Undergraduate Thesis Project. Specifically, we intend with our innovation proposal to provide resources that enable university students from Teacher Degree in Education Faculty of University of Extremadura (Spain) to develop the cross curricular competence of public speaking.

Keywords: interaction, public speaking, student, university

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Authors: Basuki Supartono, Nunuk Nugrohowati, Ryan Gamma Andiraldi

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Osteoarthritis of the knee can occur due to scoliosis. The purpose of this study is to determine the effect of scoliosis cause secondary osteoarthritis on the knee. This research use an analytic cross-sectional design. The total sample of 92 athletes scoliosis taken by simple random sampling technique. The data obtained were analyzing with Chi-square test, Fisher and Prevalence Ratio. The results of analysis show that there are influences on the incidence of scoliosis secondary osteoarthritis on the knee in athletes at the National Sports Hospital. Based on the criteria in the Cobbs angle had the results (p = 0.022 (p <0.05)), moderate Cobbs angle degree were 7.5 times more at risk of causing secondary osteoarthritis on the knee than a mild degree. While the shape of the curve scoliosis is getting results (p = 0.038 (p <0.05)), the shape of the S curve scoliosis 3.2 times more at risk of causing secondary osteoarthritis on the knee than the curve C. It can be concluded that there is significant influence between the Cobbs angle, shape of the curve scoliosis on the incidence of secondary osteoarthritis on the knee in National Sports Cibubur Hospital on July 2013- April 2014

Keywords: Cobbs angle, curve shape scoliosis, secondary osteoarthritis on the knee, analytic cross-sectional design

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Authors: Laila Oubahman, Duleba Szabolcs

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Public transport stakeholders aim to increase the ridership ratio by encouraging citizens to use common transportation modes. For this sight, improving service quality is a crucial option to reach the quality desired by users and reduce the gap between desired and perceived quality. Multi-criteria decision aid has been applied in literature in recent decades because it provides efficient models to assess the most impacting criteria on the overall assessment. In this paper, the PROMETHEE method is combined with the best-worst approach to construct a consensual model that avoids rank reversal to support stakeholders in ameliorating service quality.

Keywords: best-worst method, MCDA, PROMETHEE, public transport

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Authors: Natalie Malone

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This study explores the role of a public library in the creation of social spaces for vulnerable populations. The data stems from a longitudinal ethnographic study of the Anderson Library community, which included field notes, artifacts, and interview data. Thematic analysis revealed multiple meanings and thematic relationships within and among the data sources -interviews, field notes, and artifacts. Initial analysis suggests the Anderson Library serves as a space for vulnerable populations, with the sub-themes of fostering interpersonal communication to create a social space for children and fostering interpersonal communication to create a social space for parents and adults. These findings are important as they illustrate the potential of public libraries to serve as community empowering institutions.

Keywords: capital, immigrant families, public libraries, space, vulnerable

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Authors: Asma Qudrat, Abid Ullah, Rafi Ullah, Ali Raza, Shah Zeb, Syed Ali Shan Ul-Haq, Shahkar Ahmed Shah, Attiya Hameed Khan, Saad Zaheer, Umama Qasim, Kiran Jamal, Zahoor khan

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Objectives: Coronary artery disease (CAD) is the major public health issue associated with high mortality and morbidity rate worldwide. Young patients with ACS have unique characteristics with different demographic profiles and risk factors. The precise diagnosis and early risk stratification is important in guiding treatment and predicting the prognosis of young patients with ACS. To evaluate the associated demographics, risk factors, and outcomes profile of ACS in young age patients. Methods: The research follow a retrospective design, the single centre study of patients diagnosis with the first event of ACS in young age (>18 and <40) were included. Data collection included demographic profiles, risk factors, and in-hospital outcomes of young ACS patients. The patient’s data was retrieved through Electronic Medical Records (EMR) of Peshawar Institute of Cardiology (PIC), and all characteristic were assessed. Results: In this study, 77% were male, and 23% were female patients. The risk factors were assessed with CAD and shown significant results (P < 0.01). The most common presentation was STEMI, with (45%) most in ACS young patients. The angiographic pattern showed single vessel disease (SVD) in 49%, double vessel disease (DVD) in 17% and triple vessel disease (TVD) was found in 10%, and Left Artery Disease (LAD) (54%) was present to be the most common involved artery. Conclusion: It is concluded that the male sex was predominant in ACS young age patients. SVD was the common coronary angiographic finding. Risk factors showed significant results towards CAD and common presentations.

Keywords: coronary artery disease, Non-ST elevation myocardial infarction, ST elevation myocardial infarction, unstable angina, acute coronary syndrome

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Authors: Piyush Hajela

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Public spaces in Indian market places are vibrant, colorful and carry latent dimensions that make them attractive and popular gathering spaces. These markets satisfy the household needs of the people and also their social, cultural and traditional aspirations. Going to a market place for shopping in India is a great source of entertainment for the people. They would love to spend as much time as possible and stay for longer durations than otherwise required. It is this desire of the people that generates public spaces. Much of these public spaces emerge as squares, plazas, corners of varied shapes and sizes at different locations, and yet provide a conducive environment. Such public spaces grow organically and are discovered by the people themselves. Indian markets serve people of different culture, religion, caste, age, gender which keeps them alive all the year round. Indian is a diverse country and this diversity is reflected clearly in the market places. They hold the people together and promote harmony across cultures. Free access to these market places makes them magnets for social interaction. Public spaces are spread across a city and more or less have established their existence and prominence in a social set up. While few of them are created, others are discovered by the people themselves in their constant search for desirable interactive public spaces. These are the most sought after gathering spaces that have the quality of promoting social interaction, providing free accessibility, provide desirable scale etc. The paper aims at identifying these freely accessible public spaces and the dimensions within it that make these public spaces hold the people for significant duration of time. The dimensions present shall be judged through collective response of human senses in form of safety, comfort and so on through the expressions of the participants. The aim therefore would be to trace the freely accessible public spaces emerged in Indian markets and evaluate them for human response and behavior. The hierarchy of market places in the city of Bhopal is well established as, city center level, sub city-center level, community level, local and convenient level market places. While many city-centers are still referred to as the old or traditional or the core area of the city, the others are part of the planned city. These different levels of market places are studied for emerged public spaces. These emerged public spaces are then documented in detail for unveiling the dimensions they offer through, photographs, visual observations, questionnaires and response of the participants of these public spaces.

Keywords: human comfort, enclosure, safety, social interaction

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Authors: Dawit Assefa, Kassaye Tekie, Gebrie Alebachew, Degefu Beyene, Bikila Alemu, Naji Mohammed, Asnakech Agegnehu, Seble Tsehay, Geremew Tasew

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Background: Implementation of a Laboratory Quality Management System (LQMS) is critical to ensure accurate, reliable, and efficient laboratory testing of antimicrobial resistance (AMR). However, limited LQMS implementation and progress toward accreditation in the AMR surveillance laboratory testing setting exist in Ethiopia. By addressing non-conformances (NCs) and working towards accreditation, microbiology laboratories can improve the quality of their services, increase staff competence, and contribute to mitigate the spread of AMR. Methods: Using standard ISO 15189 horizontal and vertical assessment checklists, certified assessors identified NCs at Hawassa and Jimma Hospital microbiology laboratories. The Ethiopian Public Health Institute AMR mentors and IDDS staff prioritized closing the NCs through the implementation of an intensified mentorship program that included ISO 15189 orientation training, resource allocation, and action plan development. Results: For the two facilities to clear their NCs, an intensified mentorship approach was adopted by providing ISO 15189 orientation training, provision of buffer reagents, controls, standards, and axillary equipment, and facilitating equipment maintenance and calibration. Method verification and competency assessment were also conducted along with the implementation of standard operating procedures and recommended corrective actions. This approach enhanced the laboratory's readiness for accreditation. After addressing their NCs, the two laboratories applied to Ethiopian Accreditation Services for ISO 15189 accreditation. Conclusions: Clearing NCs through the implementation of intensified mentorship was crucial in preparing the two laboratories for accreditation and improving quality laboratory test results. This approach can guide other microbiology laboratories’ accreditation attainment efforts.

Keywords: non-conformance clearance, intensified mentorship, accreditation, ISO 15189

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Authors: Agodo Mugenyi Herbert

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Background: A high prevalence of both HIV infection and mental disorders exists in Sub-Saharan Africa, however there is little integration of care for mental health disorders among HIV-infected individuals. The study aimed at determining the management of common mental disorders among HIV/AIDS clients attending Antiretroviral clinic in Hoima regional referral hospital. Significancy of the study: The information generated by this study would help mental health advocates, ministry of health, Civil society organizations in HIV programming to advocate for enhanced mental health care for PLWHA. The result will be used in policy development and lobbying for integration of mental health care in HIV/AIDS care. Methods: This study applied a cross sectional design. It involved data collection from clients with HIV/AIDS attending ART clinic in Hoima regional referral hospital at one specific point in time. It aimed at providing data on the entire population under study. Data was collected from Hoima Regional Referral Hospital at the ART clinic. Data analysis was performed using SPSS version 24. Results: 66 HIV/AIDS clients and 10 health workers in the ART clinic who participated fully completed the study. The overall prevalence of at least one form of mental disorder was 83%. Majority of the health care practitioner do not use pharmacological, psychological, and social interventions to manage such disorders. Conclusion: These results are suggestive of a significant proportion of the HIV-infected patients experiencing psychological difficulty for which they do not receive treatment Recommendations: Current care practices applied to patients with HIV/AIDS should be integrated more generally to include treatment services to identify and manage common mental disorders.

Keywords: common mental disorders, mental health, mental illness, and severe mental illness

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Authors: Mona Almanasef, Dalia Almaghaslah, Geetha Kandasamy, Rajalakshimi Vasudevan, Sadia Batool

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Background: Community pharmacists are one of the most accessible healthcare practitioners worldwide and their services are used by a large proportion of the population. Expanding the roles of community pharmacists could contribute to reducing pressure on general health practice and other areas of health services. This research aimed to evaluate the contribution of community pharmacists in the provision of public health services and to investigate the perceived barriers to the provision of these services in Saudi Arabia. Materials and Methods: This study followed a cross-sectional design using an online anonymous self-administered questionnaire. The study took place in the Asir region, Saudi Arabia, between September 2019 and February 2020. A convenience sampling strategy was used to select and recruit the study participants. The questionnaire was adapted from previous research and involved three sections: demographics, involvement in public health services and barriers to practicing public health roles. Results: The total number of respondents was 193. The proportion of respondents who reported that they were “very involved” or “involved” in each service was 61.7% for weight management, 60.6% for sexual health, 57.5% for healthy eating, 53.4% for physical activity promotion, 51.3% for dental health, 46.1% for smoking cessation, 39.4% for screening for diabetes, 35.7% for screening for hypertension, 31.1% for alcohol dependence and drug misuse counseling, 30.6% for screening for dyslipidaemia, and 21.8% for vaccination and immunization. Most of the barriers in the current research were rated as having low relevance to the provision of public health services. Conclusion: Findings in the current research suggest that community pharmacists in the Asir region have varying levels of involvement in public health roles. Further research needs to be undertaken to understand the barriers to the provision of public health services and what strategies would be beneficial for enhancing the public health role of community pharmacists in Saudi Arabia.

Keywords: community pharmacist, public health, Asir region, Saudi Arabia

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Authors: Csilla Paksi-Petró

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The Hungarian national public administration training system providing continuous, lifelong further training to some ten thousand executives in public administration was launched in 2014, adding skills and competency development to the previous training solutions, which had a mainly legal and professional approach. The executive training system is being continuously developed since tackling the existing qualitative, and quantitative challenges calls for the introduction of novel, innovative solutions. With a gap-filling character, this study presents, in brief, the last eight years of system of executive training in public administration, supported by the outcomes of the author's empirical research, makes suggestions for the possible directions of its further development. Through this article, the reader may obtain an overview of the current Hungarian civil service further training system, its institution system, the method of its application, its target groups, its results, and its development prospects. By reading the article, the reader will get acquainted with the good practices of the Hungarian civil service further training system.

Keywords: coaching, e-learning, executive development, further-training

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Authors: Preethi Sudarshanie Dassanayake, R. A. Sudath Weerasiri

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Objective: The objective of this study were to find out highest expectation and perception,highest gap between perception and expectation of service quality, and to find out such gaps between perception and expectation with regard to service quality dimensions were whether statistically significant. Methodology: This study carried out at the Out Patient Department (OPD) of the Veterinary Teaching Hospital (VTH), University of Peradeniya. Modified version of SERVQUAL with 22-pairs of items regarding expectation and perception of service quality in dimensions of tangible, reliability, responsiveness, assurance and empathy were included in Part 1 and the Part 2 of the questionnaire consisted of questions regarding socio-demographic factors. Sample size was 200 and sampling procedure was Systematic Random Sampling. Customers above 18 years of age, able to read, write and understand Sinhala or English language, visits more than twice in last six months and who willing to respond were selected. Findings: The analysis revealed customers expectations of service higher than the perceived for all 22- items of the SERVQUAL. This high expectation suggests that there is sufficient room for further improvement of service quality in all five dimensions. Originality/Value of the Paper: This study gave a new insight for poorly researched area of veterinary health service quality in Sri Lankan context. It provides hospital administrators and policy makers to develop strategies for further improvement of service quality according to customers' view.

Keywords: expectation, perception, service quality, SERVQUAL, veterinary health care

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Authors: Fernando Araujo, Sandra Cardoso, Fátima Fonseca, Sandra Cavaca

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A debureaucratization strategy for the Portuguese Health Service was assumed by the Executive Board of the SNS, in deep articulation with the Shared Services of the Ministry of Health. Two of the main dimensions were focused on sick leaves (SL), that transform primary health care (PHC) in administrative institutions, limiting access to patients. The self-declaration of illness (SDI) project, through the National Health Service Contact Centre (SNS24), began on May 1, 2023, and has already resulted in the issuance of more than 300,000 SDI without the need to allocate resources from the National Health Service (NHS). This political decision allows each citizen, in a maximum 2 times/year, and 3 days each time, if ill, through their own responsibility, report their health condition in a dematerialized way, and by this way justified the absence to work, although by Portuguese law in these first three days, there is no payment of salary. Using a digital approach, it is now feasible without the need to go to the PHC and occupy the time of the PHC only to obtain an SL. Through this measure, bureaucracy has been reduced, and the system has been focused on users, improving the lives of citizens and reducing the administrative burden on PHC, which now has more consultation times for users who need it. The second initiative, which began on March 1, 2024, allows the SL to be issued in emergency departments (ED) of public hospitals and in the health institutions of the social and private sectors. This project is intended to allow the user who has suffered a situation of acute urgent illness and who has been observed in an ED of a public hospital or in a private or social entity no longer need to go to PHC only to apply for the respective SL. Since March 1, 54,453 SLs have been issued, 242 in private or social sector institutions and 6,918 in public hospitals, of which 134 were in ED and 47,292 in PHC. This approach has proven to be technically robust, allows immediate resolution of problems and differentiates the performance of doctors. However, it is important to continue to qualify the proper functioning of the ED, preventing non-urgent users from going there only to obtain SL. Thus, in order to make better use of existing resources, it was operationalizing this extension of its issuance in a balanced way, allowing SL to be issued in the ED of hospitals only to critically ill patients or patients referred by INEM, SNS24, or PHC. In both cases, an intense public campaign was implemented to explain the way it works and the benefits for patients. In satisfaction surveys, more than 95% of patients and doctors were satisfied with the solutions, asking for extensions to other areas. The administrative simplification agenda of the NHS continues its effective development. For the success of this debureaucratization agenda, the key factors are effective communication and the ability to reach patients and health professionals in order to increase health literacy and the correct use of NHS.

Keywords: debureaucratization strategy, self-declaration of illness, sick leaves, SNS24

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Authors: Liong-Rung Liu, Yu-Hui Chiu, Wen-Han Chang

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Firearm injuries are high-energy injuries. The ballistic pathways could cause severe burns or chemical damages to vessels, musculoskeletal or other major organs. The high mortality rate is accompanied by complications such as sepsis. As laws prohibit gun possession, civilian gunshot wounds (GSW) are relatively rare in Taiwan. Our hospital, Mackay Memorial Hospital, located at the center of Taipei city is surrounded by nightclubs and red-light districts. Due to this unique location, our hospital becomes the first-line trauma center managing gunshot victims in Taiwan. To author’s best knowledge, there are few published research articles regarding this unique situation. We hereby analyze the distinct characteristics and length of stay (LOS) of GSW patients in the emergency room (ER) at Mackay Memorial Hospital. A 6-year retrospective analysis of 27 patients treated for GSW injuries from January 2012 to December 2017 was performed. The patients’ records were reviewed for the following analyses, 1) wound position and the correlated clinical presentations; 2) the LOS in ED of patients receiving emergency surgery for major organ or vascular injuries. We found males (96.3%) were injured by guns more often than females (3.7%) in all age groups. The most common injured site was in the extremities. With regards to the ER LOS, the average time were 72.2 ± 34.5 minutes for patients with triage I and 207.4 ± 143.9 minutes for patients with triage II. The ED LOS of patients whose ISS score were more than 15 was 59.9 ± 25.6 minutes, and 179.4 ± 119.8 minutes for patients whose ISS score were between 9 to 15, respectively. Among these 27 patients, 10 patients had emergency surgery and their average ED stay time was 104.5 ± 33.3 minutes. Even more, the average ED stay time could be shortened to 88.8 ± 32.3 minutes in the 5 patients with trauma team activation. In conclusion, trauma team activation in severe GSW patients indeed shortens the ED LOS and might initially improve the quality of patient care. This is the result of better trauma systems, including advances in care from emergency medical services and acute care surgical management.

Keywords: gunshot, length of stay, trauma, mortality

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Authors: Marie Louis

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Even though many stakeholders are doing their very best to promote public transportation around the world, many areas are still public transportation non-accessible. With travelers purchasing and driving their private vehicles can be considered as a threat to all three aspects of the sustainability (e.g., economical, social, environmental). However, most studies that considered simultaneously all three aspects of the sustainability concept when planning and designing public transportation for a corridor have found tradeoffs among the said three aspects.One of the tradeoffs was identified by looking at tipping points of the travel demands to question whether transit agencies/and or transportation policymakers should either operate smaller buses or provide incentives to purchase Leadership in Energy and Environmental Design (LEED)-Qualified low-emission vehicles or greener vehicles (e.g., hybrid). However, how and when do the department of environmental protection (DEP) and the department of revenue (DOR) figure out how much incentives to give to each traveler who lives in a zoning that is considered as public transportation inaccessible or accessible? To answer this policy question, this study aims to compare the greenhouse gases (GHGs) emissions when hybrid and conventional cars are used to access public transportation stops/stations. Additionally, this study also intends to review previous states that have already adopted low-emissions vehicle (LEVs) or Zero-Emissions Vehicles (ZEVs) to diminish the daily GHGs pollutants.

Keywords: LEED-qualified vehicles, public transit accessibility, hybrid vehicles incentives, sustainability trade-offs

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Authors: Juan Carlos Briones Macias

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Currently, the Huancavilca City Park in Guayaquil is an abandoned public space that is discovering a growing problem of insecurity, where various problems have been perceived, such as the lack of green areas, deteriorating furniture, insufficient lighting, the use of inadequate cladding materials and very sunny areas due to the lack of planning in the design of green areas. The objective of this scientific article is to redesign Huancavilca Park through public space design strategies for more attractive and comfortable areas, becoming a point of interaction in a safe and accessible way. A mixed methodology (qualitative and quantitative) was applied, obtaining information based on surveys, interviews, field observations, and systematizing the data in the traditional weighting of the structuring aspects of the park. The results were obtained from the methodological design scheme of iterative analysis of public spaces by Jan Güell. It is concluded that the use of urban strategies in the structuring elements of the park, such as vegetation, furniture, generating new activities, and security interventions, will specifically solve all the problems of the Huancavilca Park tested in a Pareto 80/20 Diagram.

Keywords: public space, green areas, vegetation, street furniture, urban analysis

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Authors: Margaret Elaine J. Villamayor, Lobert A. Padua, Neil S. Bacaltos, Virgilio P. Bañez

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Significance: This study aimed to determine the prevalence of Hepatobiliary Tuberculosis (HBTB) with biliary obstruction and to compare the outcomes of ERCP versus PTBD in these patients. Methodology: This is a cross-sectional study involving patients from PGH who underwent biliary drainage from HBTB from January 2009 to June 2014. HBTB was defined as having evidence of TB (culture, smear, PCR, histology) or clinical diagnosis with the triad of jaundice, fever, and calcifications on imaging with other causes of jaundice excluded. The primary outcome was successful drainage and secondary outcomes were mean hospital stay and complications. Simple logistic regression was used to identify factors associated with success of drainage, z-test for two proportions to compare outcomes of ERCP versus PTBD and t-test to compare mean hospital stay post-procedure. Results: There were 441 patients who underwent ERCP and PTBD, 19 fulfilled the inclusion criteria. 11 underwent ERCP while 8 had PTBD. There were more successful cases in PTBD versus ERCP but this was not statistically significant (p-value 0.3615). Factors such as age, gender, location and nature of obstruction, vices, coexisting pulmonary or other extrapulmonary TB and presence of portal hypertension did not affect success rates in these patients. The PTBD group had longer mean hospital stay but this was not significant (p-value 0.1880). There were no complications reported in both groups. Conclusion: HBTB comprises 4.3% of the patients undergoing biliary drainage in PGH. Both ERCP and PTBD are equally safe and effective in the management of biliary obstruction from HBTB.

Keywords: cross-sectional, hepatobiliary tuberculosis, obstructive jaundice, endoscopic retrograde cholangiopancreatography, percutaneous transhepatic biliary drainage

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Authors: Naima Nur, Safa Islam, Saeema Islam, Faridul Alam

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Background: Drug-resistant pulmonary tuberculosis (DR-PTB), particularly multidrug-resistant tuberculosis (MDR-TB) and pre-extensive drug-resistant (pre-XDR), is a major challenge in effectively controlling TB, especially in developing. This study aimed to identify the strains of M. tuberculosis complex (MTC) and drug resistance patterns among the pulmonary tuberculosis patients. Methods: The study used a cross-sectional design, and 815 patients were recruited randomly in three study periods. In the first-period, 210 treated PTB patients, who were completed their treatment, received their diagnoses using light microscopy, fluorescence microscopy and cultured on Lowenstein-Jensen (L-J) slant, and then strains were identified as MTC by biochemical tests, and then sensitivity test in National Institute of Diseases of the Chest and Hospital. In the second-period, 220 re-treated PTB patients, who were completed their treatment, received their diagnoses using culture on L-J slant, line probe assay (LPA), and GeneXpert in the same hospital. In the last-period, during treatment, 385 MDR-PTB patients received their diagnoses using culture on L-J slant and LPA in the same hospital. Results: Among sixty-two (29.5%) PTB patients, 13% were sensitive to all first-line anti-TB drugs, 26% were MDR-TB patients, and 14.2% were pre-XDR-TB among 14 MDR-TB patients. After three years, 31% were MDR-TB among 220 re-treated PTB patients. After five years, 16.4% was pre-XDR-TB among 385 MDR-TB patients. Compared to females, male patients were significantly higher at all times. Conclusion: The current study demonstrated that in three study periods, the proportions of DR-TB, MDR-TB, and pre-XDR patients were an alarming issue and increasing daily.

Keywords: multi-drug resistant, drug-resistant, pre-extensive drug resistant, pulmonary tuberculosis

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Authors: Huizi Zeng

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This paper delineates the historical retrospective and current status of school choice in China. Focusing on analyzing the similarities and differences in origin, evolution, public dispute, policy dynamics between China and the United States, the article depicts a panorama and explores possible causes. Both China and the United States continue to learn from historical legacy and invent new programs to perfect school choice policy but the outcomes are so different. On the one hand, the percentage of public schools in China remains high all along, while there is a considerably significant reduction in the United States. On the other hand, there is more governmental intervention in the United States with continuous and constant policy updates and adjustment. Finally, this article adopts public-private partnerships (PPP) to seek to provide insights into differences between the two countries and argue that school choice is not only the production of education marketization and corporation but also driven by political mechanism.

Keywords: China, United States, school choice, comparative analysis, policy, public private partnerships

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Authors: Bello Abdullahi, Kabir Bala, Yahaya M. Ibrahim, Ahmed D. Ibrahim

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Public sector tendering has traditionally been conducted using manual paper-based processes which are known to be inefficient, less transparent, and more prone to manipulations and errors. However, the advent of the Internet and its associated technologies has led to the development of numerous e-Tendering systems that addressed many of the problems associated with the manual paper-based tendering system. Currently, in Nigeria, the public tendering processes are largely conducted based on manual paper-based system that is bedevilled by a number of problems such as inordinate delays, inefficiencies, manipulation of the tender evaluation process, corruption, lack of transparency and competition, among other problems. These problems can be addressed through the adoption of existing web-based e-Tendering systems which are known to address most of these problems. However, these existing e-Tendering systems that have been developed are not based on the Nigerian legal procurement processes and as such their suitability for local application is very limited. This paper is part of a larger study that attempt to address this problem through the development of an e-Tendering system that is based on the requirements of the Nigerian public procuring entities. In this paper, the identified tendering processes commonly used by Nigerian public procuring entities in the selection of construction sources are presented. A multi-methods research approach was used to identify those tendering processes. Specifically, 19 existing business use cases used by Nigerian public procuring entities were identified and 61 system use cases were prescribed based on the identified business use cases. The use cases were used as the basis for the development of domain and software conceptual models. The models were successfully used to guide the development of an e-Tendering system called NPS-eTender. Ripple and Unified Process were adopted as the software development methodologies.

Keywords: e-tendering, e-procurement, requirement model, conceptual model, public sector tendering, public procurement

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Authors: Pushplata Garg

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Mobility, is an integral part of living and sustainability of urban mobility, is essential not only for, but also for addressing global warming and climate change. However, very little is understood about the obstacles/hurdles and likely challenges in the success of plans for sustainable urban mobility in Indian cities from the public perspective. Whereas some of the problems and issues are common to all cities, others vary considerably with financial status, function, the size of cities and culture of a place. Problems and issues similar in all cities relate to availability, efficiency and safety of public transport, last mile connectivity, universal accessibility, and essential planning and design requirements of pedestrians and cyclists are same. However, certain aspects like the type of means of public transportation, priority for cycling and walking, type of roadside activities, are influenced by the size of the town, average educational and income level of public, financial status of the local authorities, and culture of a place. The extent of public awareness, civic sense, maintenance of public spaces and law enforcement vary significantly from large metropolitan cities to small and medium towns in countries like India. Besides, design requirements for shading, location of public open spaces and sitting areas, street furniture, landscaping also vary depending on the climate of the place. Last mile connectivity plays a major role in success/ effectiveness of public transport system in a city. In addition to the provision of pedestrian footpaths connecting important destinations, sitting spaces and necessary amenities/facilities along footpaths; pedestrian movement to public transit stations is encouraged by the presence of quality roadside public spaces. It is not only the visual attractiveness of streetscape or landscape or the public open spaces along pedestrian movement channels but the activities along that make a street vibrant and attractive. These along with adequate spaces to rest and relax encourage people to walk as is observed in cities with successful public transportation systems. The paper discusses problems and issues of pedestrians for last mile connectivity in the context of Delhi, Chandigarh, Gurgaon, and Roorkee- four Indian cities representing varying urban contexts, that is, of metropolitan, large and small cities.

Keywords: pedestrianisation, roadside public spaces, last mile connectivity, sustainable urban mobility

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Authors: Adnan Sahin, Ufuk Uylas, Ercument Pasaoglu, Tarik Caga, Enver Ihtiyar, Serdar Erkasap, Ersin Ates, Fatih Yasar

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Background: In this study, it was evaluated the demographic features, etiological factors and the management of acute pancreatitis. Methods: 106 patient hospitalized due to acute pancreatitis were retrospectively examined from 1 January 2015 to 31 December 2015 in Department of General Surgery of ESOGUMF. The data of gender, signs and symptoms, etiological factors, WBC, AST, ALT, Amilase, USG and CT findings treatment options ERCP, and complications, mortality rate were analysed. Results: The mean age of patients were 58.8 (53 men and 53 women). The causes of acute pancreatitis were as follows: gallbladder stone was 89, hyperlipidemia was 5 and idiopathic were 16 patients. Severe pancreatitis was developed in 16 patients in the biliary pancreatitis group and ERCP was performed. Cholecystectomy was performed to all biliary pancreatitis group patients after acute pancreatitis subside. The mean hospital stay period was 9.33 (2-37) day. Discussion and conclusion: Severe acute pancreatitis is a mortal disease. The most common etiological cause of acute pancreatitis is biliary origin. The first line treatment modality of acute pancreatitis is medical. Cholecystectomy should be planned to the all-biliary caused acute pancreatitis patients after the attack subside. ERCP is a useful treatment modality in the case of clinical worsening and suspicion of acute cholangitis. ERCP procedure used 16 patients in our series and these patients have a good morbidity and mean hospital period is lower than the others. We suppose that ERCP procedure should be planned selectively and conservatively.

Keywords: acute pancreatitis, ERCP, morbidity, treatment

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Authors: Ramin Mirzada, Takuya Maruyama

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

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

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Authors: Anne Eugenia Wright

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This study examines issues in accessibility to maritime cultural heritage. Using the Pillar Dollar Wreck in Biscayne National Park, Florida, this study presents an approach to public outreach based on the concept of Design for All. Design for All advocates creating products that are accessible and functional for all users, including those with visual, hearing, learning, mobility, or economic impairments. As a part of this study, a small exhibit was created that uses 3D products as a way to bring maritime cultural heritage to the public. It was presented to the public at East Carolina University’s Joyner Library. Additionally, this study presents a methodology for 3D printing scaled photogrammetry models of archaeological sites in full color. This methodology can be used to present a realistic depiction of underwater archaeological sites to those who are incapable of accessing them in the water. Additionally, this methodology can be used to present underwater archaeological sites that are inaccessible to the public due to conditions such as visibility, depth, or protected status. This study presents a practical use for 3D photogrammetry models, as well as an accessibility strategy to expand the outreach potential for maritime archaeology.

Keywords: Underwater Archaeology, 3D Printing, Photogrammetry, Design for All

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Authors: Kimberly Winnie Achieng Otieno

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The Nairobi Hospital plays a pivotal role in healthcare provision in East and Central Africa, yet it faces challenges in providing accessible dialysis care. This paper explores strategic interventions to enhance dialysis care, improve access and streamline health information management, with an aim of fostering an integrated and patient-centered healthcare system in our region. Challenges at The Nairobi Hospital The Nairobi Hospital currently grapples with insufficient dialysis machines which results in extended turn around times. This issue stems from both staffing bottle necks and infrastructural limitations given our growing demand for renal care services. Our Paper-based record keeping system and fragmented flow of information downstream hinders the hospital’s ability to manage health data effectively. There is also a need for investment in expanding The Nairobi Hospital dialysis facilities to far reaching communities. Setting up satellite clinics that are closer to people who live in areas far from the main hospital will ensure better access to underserved areas. Community Outreach and Education Implementing education programs on kidney health within local communities is vital for early detection and prevention. Collaborating with local leaders and organizations can establish a proactive approach to renal health hence reducing the demand for acute dialysis interventions. We can amplify this effort by expanding The Nairobi Hospital’s corporate social responsibility outreach program with weekend engagement activities such as walks, awareness classes and fund drives. Enhancing Efficiency in Dialysis Care Demand for dialysis services continues to rise due to an aging Kenyan population and the increasing prevalence of chronic kidney disease (CKD). Present at this years International Nursing Conference are a diverse group of caregivers from around the world who can share with us their process optimization strategies, patient engagement techniques and resource utilization efficiencies to catapult The Nairobi Hospital to the 21st century and beyond. Plans are underway to offer ongoing education opportunities to keep staff updated on best practices and emerging technologies in addition to utilizing a patient feedback mechanisms to identify areas for improvement and enhance satisfaction. Staff empowerment and suggestion boxes address The Nairobi Hospital’s organizational challenges. Current financial constraints may limit a leapfrog in technology integration such as the acquisition of new dialysis machines and an investment in predictive analytics to forecast patient needs and optimize resource allocation. Streamlining Health Information Management Fully embracing a shift to 100% Electronic Health Records (EHRs) is a transformative step toward efficient health information management. Shared information promotes a holistic understanding of patients’ medical history, minimizing redundancies and enhancing overall care quality. To manage the transition to community-based care and EHRs effectively, a phased implementation approach is recommended. Conclusion By strategically enhancing dialysis care access and streamlining health information management, The Nairobi Hospital can strengthen its position as a leading healthcare institution in both East and Central Africa. This comprehensive approach aligns with the hospital’s commitment to providing high-quality, accessible, and patient-centered care in an evolving landscape of healthcare delivery.

Keywords: Africa, urology, diaylsis, healthcare

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Authors: Zixuan Zhao, Lingbin Du, Le Wang, Youqing Wang, Yi Yang, Jingjun Chen, Hengjin Dong

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Objectives: Few results from public attitudes for lung cancer screening are available both in China and abroad. This study aimed to identify preferred lung cancer screening modalities in a Chinese population and predict uptake rates of different modalities. Materials and Methods: A discrete choice experiment questionnaire was administered to 392 Chinese individuals aged 50–74 years who were at high risk for lung cancer. Each choice set had two lung screening options and an option to opt-out, and respondents were asked to choose the most preferred one. Both mixed logit analysis and stepwise logistic analysis were conducted to explore whether preferences were related to respondent characteristics and identify which kinds of respondents were more likely to opt out of any screening. Results: On mixed logit analysis, attributes that were predictive of choice at 1% level of statistical significance included the screening interval, screening venue, and out-of-pocket costs. The preferred screening modality seemed to be screening by low-dose computed tomography (LDCT) + blood test once a year in a general hospital at a cost of RMB 50; this could increase the uptake rate by 0.40 compared to the baseline setting. On stepwise logistic regression, those with no endowment insurance were more likely to opt out; those who were older and housewives/househusbands, and those with a health check habit and with commercial endowment insurance were less likely to opt out from a screening programme. Conclusions: There was considerable variance between real risk and self-perceived risk of lung cancer among respondents, and further research is required in this area. Lung cancer screening uptake can be increased by offering various screening modalities, so as to help policymakers further design the screening modality.

Keywords: lung cancer, screening, China., discrete choice experiment

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