Search results for: practice as policy

Authors: Nora Alomar, Bianca Alexandra Stefa, Saleh Bazi

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This research uncovers the determinants that drive millennial consumers to adhere to product return of fast-fashion products purchases via e-commerce and what effects it has on consumer experience and satisfaction. Online consumption has skyrocketed, with e-commerce being the only, most reliable, and safe method of shopping during and post Covid-19. It has been noted customers are demanding a wide variety of product characteristics and a generous optimal return policy. The authors have selected to examine millennial consumers as they are digital natives and have an affinity for researching, reading product reviews, and shopping online, with a great spending power due to a higher disposable income in comparison to other generations. A multi-study approach is adopted, where study one (interviews, sample of 20 respondents) investigates the factors that drive product return, and study two (PLS-SEM, sample of 250 respondents) looks into the relationships of product return management against behavioral outcomes by having the generated factors (from study one) as moderators. Five themes are generated from study one (return policies, product characteristics, delivery lead time, seasonality, product trial & overspending). The authors identify that two out of the five factors (seasonality, product trial & overspending) have not been highlighted by the literature. The paper examines 11 hypotheses, where 10 are supported. Findings highlight the quality of the product return management influences the overall millennial customer experience and satisfaction. Findings also indicate that product return management was identified to have a significant negative effect on customer experience. Additionally, seasonality has a significant but negative moderation, which means increasing seasonality decreases the relationship between product return management and customer experience and satisfaction. Results highlight that return policies have a significant negative influence on the relationship between returning a product and customer experience and satisfaction. Moreover, product characteristics are also identified to have a significant negative influence on the relationship between returning a product and customer experience and satisfaction. This study further examines the influence of the factors on direct e-commerce websites and third-party e-commerce websites. Findings showcase a strong statistical significance for the increased rate of return of fast-fashion products on third-party websites. This paper aids practitioners in taking strategic decisions related to return management, to improve the quality of logistical services and, in turn, increase profitability.

Keywords: customer experience, customer satisfaction, e-commerce, fast-fashion, product returns

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Authors: Kasra Afsahi, Maryam Soheilifar, S. Hossein Hosseini

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Background: There is growing evidence that Cerebral Vascular Accident (CVA) can be a consequence of Covid-19 infection. Understanding novel treatment approaches are important in optimizing patient outcomes. Case: This case explores the use of Virtual Reality (VR) in the treatment of a 23-year-old COVID-positive female presenting with left hemiparesis in August 2020. Imaging showed right globus pallidus, thalamus, and internal capsule ischemic stroke. Conventional rehabilitation was started two weeks later, with virtual reality (VR) included. This game-based virtual reality (VR) technology developed for stroke patients was based on upper extremity exercises and functions for stroke. Physical examination showed left hemiparesis with muscle strength 3/5 in the upper extremity and 4/5 in the lower extremity. The range of motion of the shoulder was 90-100 degrees. The speech exam showed a mild decrease in fluency. Mild lower lip dynamic asymmetry was seen. Babinski was positive on the left. Gait speed was decreased (75 steps per minute). Intervention: Our game-based VR system was developed based on upper extremity physiotherapy exercises for post-stroke patients to increase the active, voluntary movement of the upper extremity joints and improve the function. The conventional program was initiated with active exercises, shoulder sanding for joint ROMs, walking shoulder, shoulder wheel, and combination movements of the shoulder, elbow, and wrist joints, alternative flexion-extension, pronation-supination movements, Pegboard and Purdo pegboard exercises. Also, fine movements included smart gloves, biofeedback, finger ladder, and writing. The difficulty of the game increased at each stage of the practice with progress in patient performances. Outcome: After 6 weeks of treatment, gait and speech were normal and upper extremity strength was improved to near normal status. No adverse effects were noted. Conclusion: This case suggests that VR is a useful tool in the treatment of a patient with covid-19 related CVA. The safety of newly developed instruments for such cases provides new approaches to improve the therapeutic outcomes and prognosis as well as increased satisfaction rate among patients.

Keywords: covid-19, stroke, virtual reality, rehabilitation

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Authors: Abdul Ganiyu Iddrisu, Bei Chen

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Digitization is the process of transforming analog material into digital form, especially for storage and use in a computer. Significant development of information and communication technology (ICT) over the past years has encouraged many researchers to investigate its contribution to promoting economic growth and reducing poverty. Yet the compelling empirical evidence on the effects of digitization on economic growth remains weak, particularly in Africa. This is because extant studies that explicitly evaluate digitization and economic growth nexus are mostly reports and desk reviews. This points out an empirical knowledge gap in the literature. Hypothetically, digitization influences financial sector development which in turn influences economic growth. Digitization has changed the financial sector and its operating environment. Obstacles to access to financing, for instance, physical distance, minimum balance requirements, and low-income flows, among others can be circumvented. Savings have increased, micro-savers have opened bank accounts, and banks are now able to price short-term loans. This has the potential to develop the financial sector. However, empirical evidence on the digitization-financial development nexus is dearth. On the other hand, a number of studies maintained that financial sector development greatly influences growth of economies. We, therefore, argue that financial sector development is one of the transmission mechanisms through which digitization affects economic growth. Employing macro-country-level data from African countries and using fixed effects, random effects and Hausman-Taylor estimation approaches, this paper contributes to the literature by analysing economic growth in Africa, focusing on the role of digitization and financial sector development. First, we assess how digitization influences financial sector development in Africa. From an economic policy perspective, it is important to identify digitization determinants of financial sector development so that action can be taken to reduce the economic shocks associated with financial sector distortions. This nexus is rarely examined empirically in the literature. Secondly, we examine the effect of domestic credit to the private sector and stock market capitalization as a percentage of GDP as used to proxy for financial sector development on economic growth. Digitization is represented by the volume of digital/ICT equipment imported and GDP growth is used to proxy economic growth. Finally, we examine the effect of digitization on economic growth in the light of financial sector development. The following key results were found; first, digitalization propels financial sector development in Africa. Second, financial sector development enhances economic growth. Finally, contrary to our expectation, the results also indicate that digitalization conditioned on financial sector development tends to reduce economic growth in Africa. However, results of the net effects suggest that digitalization, overall, improve economic growth in Africa. We, therefore, conclude that, digitalization in Africa does not only develop the financial sector but unconditionally contributes the growth of the continent’s economies.

Keywords: digitalization, financial sector development, Africa, economic growth

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Authors: Yusuf U. Datti

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It is becoming increasingly clear that the consumption of resources now enjoyed in the developed nations will be impossible to be sustained worldwide. While developing countries still have the advantage of low consumption and a smaller ecological footprint per person, they cannot simply develop in the same way as other western cities have developed in the past. The severe reality of population and consumption inequalities makes it contentious whether studies done in developed countries can be translated and applied to developing countries. Additional to this disparities, there are few or no metabolism of energy studies in Nigeria. Rather more contentious majority of energy metabolism studies have been done only in developed countries. While researches in Nigeria concentrate on other aspects/principles of sustainability such as water supply, sewage disposal, energy supply, energy efficiency, waste disposal, etc., which will not accurately capture the environmental impact of energy flow in Nigeria, this research will set itself apart by examining the flow of energy in Nigeria and the impact that the flow will have on the environment. The aim of the study is to examine and quantify the metabolic flows of energy in Nigeria and its corresponding environmental impact. The study will quantify the level and pattern of energy inflow and the outflow of greenhouse emissions in Nigeria. This study will describe measures to address the impact of existing energy sources and suggest alternative renewable energy sources in Nigeria that will lower the emission of greenhouse gas emissions. This study will investigate the metabolism of energy in Nigeria through a three-part methodology. The first step involved selecting and defining the study area and some variables that would affect the output of the energy (time of the year, stability of the country, income level, literacy rate and population). The second step involves analyzing, categorizing and quantifying the amount of energy generated by the various energy sources in the country. The third step involves analyzing what effect the variables would have on the environment. To ensure a representative sample of the study area, Africa’s most populous country, with economy that is the second biggest and that is among the top largest oil producing countries in the world is selected. This is due to the understanding that countries with large economy and dense populations are ideal places to examine sustainability strategies; hence, the choice of Nigeria for the study. National data will be utilized unless where such data cannot be found, then local data will be employed which will be aggregated to reflect the national situation. The outcome of the study will help policy-makers better target energy conservation and efficiency programs and enables early identification and mitigation of any negative effects in the environment.

Keywords: built environment, energy metabolism, environmental impact, greenhouse gas emissions and sustainability

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Authors: Teodorica G. Ani

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

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

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Authors: Bessy Thuranira

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Buildings, as they are designed and used, may contribute to serious environmental problems because of excessive consumption of energy and other natural resources. Buildings in the informal settlements particularly, due to their unplanned physical structure and design, have significantly contributed the global energy problematic scenario typified by high-level inefficiencies. Energy used in buildings in Africa is estimated to be the highest of the total national electricity consumption. Over the last decade, assessments of energy consumption and efficiency/inefficiency has focused on formal and modern buildings. This study seeks to go off the beaten path, by focusing on energy use in informal settlements. Operationally, it sought to establish the contribution of informal buildings in the overall energy consumption in the city and the country at large. This study was carried out in Mukuru kwa Reuben informal settlement where there is distinct manifestation of different settlement morphologies within a small locality. The research narrowed down to three villages (Mombasa, Kosovo and Railway villages) within the settlement, that were representative of the different slum housing typologies. Due to the unpredictability nature and informality in slums, this study takes a multi-methodology approach. Detailed energy audits and measurements are carried out to predict total building consumption, and document building design and envelope, typology, materials and occupancy levels. Moreover, the study uses semi-structured interviews and to access energy supply, cost, access and consumption patterns. Observations and photographs are also used to shed more light on these parameters. The study reveals the high energy inefficiencies in slum buildings mainly related to sub-standard equipment and appliances, building design and settlement layout, poor access and utilization/consumption patterns of energy. The impacts of this inefficiency are high economic burden to the poor, high levels of pollution, lack of thermal comfort and emissions to the environment. The study highlights a set of urban planning and building design principles that can be used to retrofit slums into more energy efficient settlements. The study explores principles of responsive settlement layouts/plans and appropriate building designs that use the beneficial elements of nature to achieve natural lighting, natural ventilation, and solar control to create thermally comfortable, energy efficient, and environmentally responsive buildings/settlements. As energy efficiency in informal settlements is a relatively less explored area of efficiency, it requires further research and policy recommendations, for which this paper will set a background.

Keywords: energy efficiency, informal settlements, renewable energy, settlement layout

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Authors: N. Mahon, I. Crute, M. Di Bonito, E. Simmons, M. M. Islam

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Growing interest in the concept of the sustainable intensification (SI) of agriculture has been shown by, national governments, transnational agribusinesses, intergovernmental organizations and research institutes, amongst others. This interest may be because SI is seen as a ‘third way’ for agricultural development, between the seemingly disparate paradigms of ‘intensive’ agriculture and more ‘sustainable’ forms of agriculture. However, there is a lack of consensus as to what SI means in practice and how it should be measured using indicators of change. This has led to growing confusion, disagreement and skepticism regarding the concept, especially amongst civil society organizations, both in the UK and other countries. This has prompted the need for bottom-up, participatory approaches to identify indicators of SI. Our aim is to identify the views of British stakeholders regarding the areas of agreement and disagreement as to what SI is and how it should be measured in the UK using indicators of change. Data for this investigation came from 32 semi-structured interviews, conducted between 2015 and 2016, with stakeholders from throughout the UK food system. In total 110 indicators of SI were identified. These indicators covered a wide variety of subjects including biophysical, social and political considerations. A number of indicators appeared to be widely applicable and were similar to those suggested in the global literature. These include indicators related to the management of the natural resources on which agriculture relies e.g., ‘Soil organic matter’, ‘Number of pollinators per hectare’ and ‘Depth of water table’. As well as those related to agricultural externalities, e.g., ‘Greenhouse gas emissions’ and ‘Concentrations of agro-chemicals in waterways’. However, many of the indicators were much more specific to the context of the UK. These included, ‘Areas of high nature value farmland’, ‘Length of hedgerows per hectare’ and ‘Age of farmers’. Furthermore, tensions could be seen when participants considered the relative importance of agricultural mechanization versus levels of agricultural employment, the pros and cons of intensive, housed livestock systems and value of wild biodiversity versus the desire to increase agricultural yields. These areas of disagreement suggest the need to carefully consider the trade-offs inherent in the concept. Our findings indicate that in order to begin to resolve the confusions surrounding SI it needs to be considered in a context specific manner, rather than as a single uniform concept. Furthermore, both the environmental and the social parameters in which agriculture operates need to be considered in order to operationalize SI in a meaningful way. We suggest that participatory approaches are key to this process, facilitating dialogue and collaborative-learning between all the stakeholders, allowing them to reach a shared vision for the future of agricultural development.

Keywords: agriculture, indicators, participatory approach, sustainable intensification

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Authors: T. Suleiman, C. Mchugh, H. Ranu

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Background; Asthma continues to be associated with poor patient outcomes, including mortality. An audit of the management of acute asthma admissions in our hospital in 2020 found poor compliance with National Asthma and COPD Audit Project (NACAP) standards which set out to improve inpatient asthma care. Clinical nurse specialists have been shown to improve patient care across a range of specialties. In September 2021, an asthma Nurse Specialist (ANS) was employed in our hospital. Aim; To re-audit management of acute asthma admissions using NACAP standards and assess for quality improvement post-employment of an ANS. Methodology; NACAP standards are wide-reaching; therefore, we focused on ‘specific elements of good practice’ in addition to the provision of inhaled corticosteroids (ICS) on discharge. Medical notes were retrospectively requested from the hospital coding department and selected as per NACAP inclusion criteria. Data collection and entry into the NACAP database were carried out. As this was a clinical audit, ethics approval was not required. Results; Cycle 1 (pre-ANS) and 2 (post-ANS) of the audit included 20 and 32 patients, respectively, with comparable baseline demographics. No patients had a discharge bundle completed on discharge in cycle 1 vs. 84% of cases in cycle 2. Regarding specific components of the bundle, 25% of patients in cycle 1 had their inhaler technique checked vs. 91% in cycle 2. Furthermore, 80% of patients had maintenance medications reviewed in cycle 1 vs. 97% in cycle 2. Medication adherence was addressed in 20% of cases in cycle 1 vs. 88% of cases in cycle 2. Personalized asthma action plans were not issued or reviewed in any cases in cycle 1 as compared with 84% of cases in cycle 2. Triggers were discussed in 30% of cases in cycle 1 vs. 88% of cases in cycle 2. Tobacco dependence was addressed in 44% of cases in cycle 1 vs. 100% of cases in cycle 2. No patients in cycle 1 had community follow-up requested within 2 days vs. 81% of the patients in cycle 2. Similarly, 20% of the patients in cycle 1 vs. 88% of the patients in cycle 2 had a 4-week asthma clinic follow-up requested. 75% of patients in cycle 1 were the recipient of ICS on discharge compared with 94% of patients in cycle 2. Conclusion; Our quality improvement project demonstrates the utility of an ANS in improving performance in the management of acute asthma admissions, evidenced here through concordance with NACAP standards. Asthma is a complex condition with biological, psychological, and sociological components; therefore, ANS is a suitable intervention to improve concordance with guidelines. ANS likely impacted performance directly, for example, by checking inhaler technique, and indirectly as a safety net ensuring doctors included ICS on discharge.

Keywords: asthma, nurse specialist, clinical audit, quality improvement

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Authors: Dede Basturk, Metin Kaya, Halil Taskin, Nurtekin Erkmen

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In total, 29 students studying in Selçuk University Physical Training and Sports School who are recreationally active participated voluntarilyin this study which was carried out in order to examine effects of Vertimax trainings on agility, quickness and acceleration. 3 groups took their parts in this study as Vertimax training group (N=10), Ordinary training group (N=10) and Control group (N=9). Measurements were carried out in performance laboratory of Selçuk University Physical Training and Sports School. A training program for quickness and agility was followed up for subjects 3 days a week (Monday, Wednesday, Friday) for 8 weeks. Subjects taking their parts in vertimax training group and ordinary training group participated in the training program for quickness and agility. Measurements were applied as pre-test and post-test. Subjects of vertimax training group followed the training program with vertimax device and subjects of ordinary training group followed the training program without vertimax device. As to control group who are recreationally active, they did not participate in any program. 4 gate photocells were used for measuring and measurement of distances was carried out in m. Furthermore, single gate photocell and honi were used for agility test. Measurements started with 15 minutes of warm-up. Acceleration, quickness and agility tests were applied on subjects. 3 measurements were made for each subject at 3 minutes resting intervals. The best rating of three measurements was recorded. 5 m quickness pre-test value of vertimax training groups has been determined as 1,11±0,06 s and post-test value has been determined as 1,06 ± 0,08 s (P<0,05). 5 m quickness pre-test value of ordinary training group has been determined as 1,11±0,06 s and post-test value has been determined as 1,07±0,07 s (P<0,05).5 m quickness pre-test value of control group has been determined as 1,13±0,08 s and post-test value has been determined as 1,10 ± 0,07 s (P>0,05). Upon examination of 10 m acceleration value before and after the training, 10 m acceleration pre-test value of vertimax training group has been determined as 1,82 ± 0,07 s and post-test value has been determined as 1,76±0,83 s (P>0,05). 10 m acceleration pre-test value of ordinary training group has been determined as 1,83±0,05 s and post-test value has been determined as 1,78 ± 0,08 s (P>0,05).10 m acceleration pre-test value of control group has been determined as 1,87±0,11 s and post-test value has been determined as 1,83 ± 0,09 s (P>0,05). Upon examination of 15 m acceleration value before and after the training, 15 m acceleration pre-test value of vertimax training group has been determined as 2,52±0,10 s and post-test value has been determined as 2,46 ± 0,11 s (P>0,05).15 m acceleration pre-test value of ordinary training group has been determined as 2,52±0,05 s and post-test value has been determined as 2,48 ± 0,06 s (P>0,05). 15 m acceleration pre-test value of control group has been determined as 2,55 ± 0,11 s and post-test value has been determined as 2,54 ± 0,08 s (P>0,05).Upon examination of agility performance before and after the training, agility pre-test value of vertimax training group has been determined as 9,50±0,47 s and post-test value has been determined as 9,66 ± 0,47 s (P>0,05). Agility pre-test value of ordinary training group has been determined as 9,99 ± 0,05 s and post-test value has been determined as 9,86 ± 0,40 s (P>0,05). Agility pre-test value of control group has been determined as 9,74 ± 0,45 s and post-test value has been determined as 9,92 ± 0,49 s (P>0,05). Consequently, it has been observed that quickness and acceleration features were developed significantly following 8 weeks of vertimax training program and agility features were not developed significantly. It is suggested that training practices used for the study may be used for situations which may require sudden moves and in order to attain the maximum speed in a short time. Nevertheless, it is also suggested that this training practice does not make contribution in development of moves which may require sudden direction changes. It is suggested that productiveness and innovation may come off in terms of training by using various practices of vertimax trainings.

Keywords: vertimax, training, quickness, agility, acceleration

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Authors: Chinyama Lukama, Million Phiri, Namuunda Mutombo

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Background: Improving access and utilization to high-quality sexual and reproductive health (SRH) information and services, including family planning (FP) commodities, is central to the global developmental agenda of sub-Saharan Africa (SSA). Despite the importance of family planning use in enhancing maternal health outcomes and fertility reduction, the prevalence of adolescents and young women using modern contraception is generally low in SSA. Zambia is one of the countries in Southern Africa with a high prevalence of teenage pregnancies and fertility rates. Despite many initiatives that have been implemented to improve access and demand for family planning commodities, utilization of FP, especially among adolescents and young women, has generally been low. The objective of this research agenda was to better understand the determinants of modern contraceptive use in adolescents and young women in Zambia. This analysis produced findings that will be critical for informing the strengthening of sexual and reproductive health policy strategies aimed at bolstering the provision and use of maternal health services in order to further improve maternal health outcomes in the country. Method: The study used the recent data from the Demographic and Health Survey of 2018. A sample of 3,513 adolescents and young women (ADYW) were included in the analysis. Multilevel logistic regression models were employed to examine the association of individual and contextual factors with modern contraceptive use among adolescents and young women. Results: The prevalence of modern contraception among sexually active ADYW in Zambia was 38.1% [95% CI, 35.9, 40.4]. ADYW who had secondary or higher level education [aOR = 2.16, 95% CI=1.35–3.47], those with exposure to listening to the radio or watching television [aOR = 1.26, 95% CI=1.01–1.57], and those who had decision-making power at household level [aOR = 2.18, 95% CI=1.71–2.77] were more likely to use modern contraceptives. Conversely, strong neighborhood desire for large family size among ADYW [aOR = 0.65 95% CI = 0.47–0.88] was associated with less likelihood to use modern contraceptives. Community access to family planning information through community health worker visits increased the likelihood [aOR = 1.48, 95% CI=1.16–1.91] of using modern contraception among ADYW. Conclusion: The study found that both individual and community factors were key in influencing modern contraceptive use among adolescents and young women in Zambia. Therefore, when designing family planning interventions, the Government of Zambia, through its policymakers and sexual reproductive health program implementers at the Ministry of Health, in collaboration with stakeholders, should consider the community context. There should also be deliberate actions to encourage family planning education through the media.

Keywords: adolescents, young women, modern contraception use, fertility, family planning

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Authors: Mónika Ditta Tóth, Ádám Fritz, Balázs Hankó, György Purebl

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Communication training about depression and suicide prevention for pharmacists – A Hungarian pilot study Mónika Ditta Tóth1, Ádám Fritz2, Balázs Hankó2, György Purebl1 1: Semmelweis University, Institute of Behavioural Sciences 2: Semmelweis University, University Pharmacy Department of Pharmacy Administration Background: Suicide rates in Hungary have been one of the highest in the European Union. Depression is one of the main risk factors for suicide and recognizing and treating depression is an effective way to prevent suicidal behaviour. In their daily practice, pharmacists meet patients with high risk of mental health problems. Therefore they have a key role in the prevention of depression and suicide. Aim: The main aim of this study is to raise pharmacists’ awareness about depression and suicide to enable better recognation of verbal and non-verbal signs of these deseases. Another important objective is to reduce their stigma about depression and increase their confidence in communication with depressed and/or suicidal patients. Methods: A 3-hour communication workshop has been delivered in this pilot study about the reasons, trigger factors, verbal and non-verbal signs of depression and suicide. The training includes communication techniques which have been developed to patients needs, as well as role-playing scenarios. Depression Stigma and Morris Confidence Scales were applied before, after and 6 weeks following the training. The results of the training group are then compared with two of the following pharmacist groups: 1. written material only (N=15), 2. no material (N=15). Results: One-way ANOVA revealed significant differences in the training group regarding the level of confidence in treating and communicating with patients with depression and/or suicide following the training, and after 6 weeks (F(2, 24)= 7,135, p=,004; baseline: 20,37, after training: 30,00, follow up: 27,66). After the 3-hour workshop the personal stigma about depression decreased (baselin: 19,75 after training: 17,00, p=0,075) in the training group (N=9), whilst the perceived stigma did not change (before: 33.54, after: 33,44, p=NS). Trainees assessed the workshop as ‘useful’ and ‘gap filling’. No significant differences was found in the group of pharmacisists who got written material only. Conclusions: Despite the high rates of depression and suicide in Hungary, pharmacists do not receive lectures or seminars about mental health during their university studies. Such half-day workshops could fill this gap and give practical help to recognize and communicate with depressed and/or suicidal patients in a more effective way. This way pharmacists, as community gate-keepers, could contribute to a more effective suicide prevention program in Hungary.

Keywords: communication training, pharmacists, depression, suicide

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Authors: Mustafa Metin Donma

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Metabolic syndrome (MetS) components are noteworthy among children with obesity and morbid obesity because they point out the cases with MetS, which have the great tendency to severe health problems such as cardiovascular diseases both in childhood and adulthood. In clinical practice, considerable efforts are being observed to bring into the open the striking differences between morbid obese cases and those with MetS findings. The most privileged aspect is concerning cardiometabolic features. The aim of this study was to derive an index which behaves different in children with and without MetS from the cardiac point of view. For the purpose, aspartate transaminase (AST), a cardiac enzyme still being used independently to predict cardiac-related problems, was used. One hundred and twenty four children were recruited from the outpatient clinic of Department of Pediatrics in Tekirdag Namik Kemal University, Faculty of Medicine. Forty-three children with normal body mass index, forty-one and forty morbid obese (MO) children with MetS and without the characteristic features of MetS, respectively, were included in the study. Weight, height, waist circumference (WC), hip C (HC), head C (HdC), neck C (NC), systolic and diastolic blood pressure values were measured and recorded. Body mass index and anthropometric ratios were calculated. Fasting blood glucose (FBG), insulin (INS), triglycerides (TRG), high density lipoprotein cholesterol (HDL-C) analyses were performed. The values for AST, alanin transaminase (ALT) and AST/ALT were obtained. Advanced Donma cardiac index (ADCI) values were calculated. The formula for the index was [(TRG/HDL-C) * (INS/FBG)] * [(WC+HC)/Height] * [(HdC+NC)/Height]. Statistical evaluations including correlation analysis were done by a statistical package program. The statistical significance degree was accepted as p<0.05. The index, ADCI, was developed from both anthropometric and biochemical parameters. All anthropometric measurements except weight were included in the equation. Besides all biochemical parameters concerning MetS components were also added. This index was tested in each of three groups. Its performance was compared with the performance of cardiometabolic index (CMI). It was also checked whether it was compatible with AST activity. The performance of ADCI was better than that of CMI. Instead of double increase, the increase of three times was observed in children with MetS compared to MO children. The index was correlated with AST in MO group and with AST/ALT in MetS group. In conclusion, this index was superior in discovering cardiac problems in MO and in diagnosing MetS in MetS groups. It was also arbiter to point out cardiovascular and MetS aspects among the groups.

Keywords: aspartate transaminase, cardiac, children, index, obesity

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Authors: Luixa Reizabal, Inaki Garcia, Eneko Sansinenea, Ainize Sarrionandia, Karmele Lopez De Ipina, Elsa Fernandez

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Although the effects of incarceration in prisons close to prisoners’ and their families’ residences have been studied, little is known about the effects of remote incarceration. The present study shows the impact of secondary prisonization on mental health of elderly parents of Basque prisoners who are incarcerated in prisons located far away from prisoners’ and their families’ residences. Secondary prisonization refers to the effects that imprisonment of a family member has on relatives. In the study, psychological effects are analyzed by means of comparative methodology. Specifically, levels of psychopathology (depression, anxiety, and stress) and positive mental health (psychological, social, and emotional well-being) are studied in a sample of parents over 65 years old of prisoners incarcerated in prisons located a long distance away (concretely, some of them in a distance of less than 400 km, while others farther than 400 km) from the Basque Country. The dataset consists of data collected through a questionnaire and from a spontaneous speech recording. The statistical and automatic analyses show that levels of psychopathology and positive mental health of elderly parents of prisoners incarcerated in remote jails are affected by the incarceration of their sons or daughters. Concretely, these parents show higher levels of depression, anxiety, and stress and lower levels of emotional (but not psychological or social) wellbeing than parents with no imprisoned daughters or sons. These findings suggest that parents with imprisoned sons or daughters suffer the impact of secondary prisonization on their mental health. When comparing parents with sons or daughters incarcerated within 400 kilometers from home and parents whose sons or daughters are incarcerated farther than 400 kilometers from home, the latter present higher levels of psychopathology, but also higher levels of positive mental health (although the difference between the two groups is not statistically significant). These findings might be explained by resilience. In fact, in traumatic situations, people can develop a force to cope with the situation, and even present a posttraumatic growth. Bearing in mind all these findings, it could be concluded that secondary prisonization implies for elderly parents with sons or daughters incarcerated in remote jails suffering and, in consequence, that changes in the penitentiary policy applied to Basque prisoners are required in order to finish this suffering.

Keywords: automatic spontaneous speech analysis, elderly parents, machine learning, positive mental health, psychopathology, remote incarceration, secondary prisonization

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Authors: Jared R. Chapman

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This study introduces a type of motivational information system called an educational engagement information system (EEIS). An EEIS draws on principles of behavioral economics, motivation theory, and learning cognition theory to design information systems that help students want to improve their performance. This study compares academic outcomes for course sections taught by part- and full-time instructors both with and without an EEIS. Without an EEIS, students in the part-time instructor's course sections demonstrated significantly higher failure rates (a 143.8% increase) and dropout rates (a 110.4% increase) with significantly fewer students scoring a B- or higher (39.8% decrease) when compared to students in the course sections taught by a full-time instructor. It is concerning that students in the part-time instructor’s course without an EEIS had significantly lower academic outcomes, suggesting less understanding of the course content. This could impact retention and continuation in a major. With an EEIS, when comparing part- and full-time instructors, there was no significant difference in failure and dropout rates or in the number of students scoring a B- or higher in the course. In fact, with an EEIS, the failure and dropout rates were statistically identical for part- and full-time instructor courses. When using an EEIS (compared with not using an EEIS), the part-time instructor showed a 62.1% decrease in failures, a 61.4% decrease in dropouts, and a 41.7% increase in the number of students scoring a B- or higher in the course. We are unaware of other interventions that yield such large improvements in academic performance. This suggests that using an EEIS such as Delphinium may compensate for part-time instructors’ limitations of expertise, time, or rewards that can have a negative impact on students’ academic outcomes. The EEIS had only a minimal impact on failure rates (7.7% decrease) and dropout rates (18.8% decrease) for the full-time instructor. This suggests there is a ceiling effect for the improvements that an EEIS can make in student performance. This may be because experienced instructors are already doing the kinds of things that an EEIS does, such as motivating students, tracking grades, and providing feedback about progress. Additionally, full-time instructors have more time to dedicate to students outside of class than part-time instructors and more rewards for doing so. Using adjunct and other types of part-time instructors will likely remain a prevalent practice in higher education management courses. Given that using part-time instructors can have a negative impact on student graduation and persistence in a field of study, it is important to identify ways we can augment part-time instructors’ performance. We demonstrated that when part-time instructors use an EEIS, it can result in significantly lower students’ failure and dropout rates and an increase in the rate of students earning a B- or above; and bring their students’ performance to parity with the performance of students taught by a full-time instructor.

Keywords: gamification, engagement, motivation, academic outcomes

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Authors: Zehra Gencel Efe, Fatma Susam Ozsayın, Satı Tas

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Background and Aim: It is not possible to teach all the knowledge related to operating room nursing in the nursing education process. Certified courses are organized by the Ministry of Health to compensate the lack of postgraduate training and the theoretical and practical training needs of working nurses. In this study; It is aimed to investigate the participants’ opinions and recommendations attending the certified course of operating room nursing that organized in İKCU AtaturkTraining and Research Hospital. Method: Two operating room nursing courses were organized in 2016. The 1st Operating Room Nursing Certified Course Program was organized between March 07, 2016 and April 6, 2016and the 2nd Operating Room Nursing Certified Course Program was organized between 07 November 2016 - 06 December 2016 at the İKCU Ataturk Training and Research Hospital. The first program was accepted for 29 participants, the second program was accepted for 30 participants. In the collection of the data, the 'Operating Room Nursing Certified Training Program Evaluation Form', 'Operating Room Nursing Certified Training Program Theoretical Training Evaluation Form' were used. Three point Likert-type scale is used for responses in the 'Operating Room Nursing Certified Training Program Evaluation Form’ (1=verygood, 2=good, 3=poor). Data is collected in five areas related to training program, operation room practice, communication, responsibility, experiences of learning. Four point Likert-type scale is used for responses in the 'Operating Room Nursing Certified Training Program Theoretical Training Evaluation Form' (1=verysatisfied, 2=quitesatisfied, 3=satisfied, 4=dissatisfied). Data is collected in two areas include presentation and content. Data were analyzed with SPSS 16 program. Findings and Conclusion: It was found that 93,22% of participants were female in addition, 62,7% had bachelor degree. It was seen that 33,87% of the work group had 1-5 years of experience in their field. It was found that; 88% of trainees participating in the first group to the operating room nursing-certified course program stated the training program was very good, 12% of them stated the training program was good. Nobody was signed the ‘poor’ choice. 81% of the trainees who participated in the 2nd group to the operating room nursing-certified course program stated the training program was very good, 19% of them stated the training program was good. Nobody was signed the ‘poor’ choice. It was found that there was no meaningful difference between the achievement ratios of the trainees and the learning status of the trainees when compared with the t test in the groups with success level of the operating room nursing certified course program according to the learning status of the participants (p ˃ 0,05). The trainees noted that the course was satisfied with theoretical and practical steps but the support services (lunch, coffee breaks etc.) were in adequate.

Keywords: certified courses, nursing certified courses, operating room nursing, training program

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Authors: Baqir Khawari

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This study critically examines the influence of remittances on household poverty and income inequality in Mazar-i-Sharif, Balkh Province, Afghanistan, utilizing robust OLS and Logit models with a rigorous multi-random sampling method. The empirical findings reveal that a 1% increase in per capita international remittances is associated with a substantial 0.071% and 0.059% rise in per capita income during the fiscal years 2019/20 and 2020/21, respectively. Furthermore, this increase significantly mitigates the per capita depth of poverty by 0.0272% and 0.025% and the severity of poverty by 0.0149% and 0.0145% over the same periods. Notably, the impact of international remittances on poverty alleviation surpasses that of internal remittances. In addressing income inequality, the analysis demonstrates that remittances contribute to a reduction in the Gini coefficient by 2% in 2019/20 and 7% in 2020/21, underscoring their pivotal role in promoting equitable economic distribution. However, the COVID-19 pandemic has posed significant challenges, diminishing remittance flows and, consequently, their positive effects on household welfare. The logistic regression results further corroborate these findings, indicating that increased per capita remittances, both international and internal, markedly decrease the likelihood of households falling below the poverty line. Specifically, a 1% rise in per capita external remittances reduces this likelihood by 4.5% in 2019/20 and by 3.7% in 2020/21, while internal remittances decrease it by 3% and 2.4%, respectively. The study also explores the demographic determinants of poverty. Larger household sizes and older household heads correlate positively with poverty, whereas higher education levels among household heads and members, and a greater proportion of male members, correlate negatively with poverty incidence and severity. Female-headed households are disproportionately affected by poverty, exacerbated by socio-cultural restrictions. Despite these adversities, the data suggest that remittances are a crucial instrument for poverty alleviation and income inequality reduction in Afghanistan. The findings advocate for policy interventions aimed at enhancing formal remittance channels, promoting education, and empowering women. Effective governance and sustained international assistance are essential to harness the full potential of remittances in combating poverty and inequality. This study highlights the need for strategic, multifaceted approaches to foster sustainable economic development in Afghanistan’s challenging socio-political context.

Keywords: migration, remittances, poverty, inequality, COVID-19, Afghanistan

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Authors: Lily Farris, Chantel E. Canessa, Rena Heathcote, Susan Shumay, Suzanna V. McRae, Alissa Collingridge, Minna K. Miller

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Objective: To describe how the Lean approach can be applied to improve access, quality and safety of care in an ambulatory pediatric primary care setting. Background: Lean was originally developed by Toyota manufacturing in Japan, and subsequently adapted for use in the healthcare sector. Lean is a systematic approach, focused on identifying and reducing waste within organizational processes, improving patient-centered care and efficiency. Limited literature is available on the implementation of the Lean methodologies in a pediatric ambulatory care setting. Methods: A strategic continuous improvement event or Rapid Process Improvement Workshop (RPIW) was launched with the aim evaluating and structurally supporting clinic workflow, capacity building, sustainability, and ultimately improving access to care and enhancing the patient experience. The Lean process consists of five specific activities: Current state/process assessment (value stream map); development of a future state map (value stream map after waste reduction); identification, quantification and prioritization of the process improvement opportunities; implementation and evaluation of process changes; and audits to sustain the gains. Staff engagement is a critical component of the Lean process. Results: Through the implementation of the RPIW and shifting workload among the administrative team, four hours of wasted time moving between desks and doing work was eliminated from the Administrative Clerks role. To streamline clinic flow, the Nursing Assistants completed patient measurements and vitals for Nurse Practitioners, reducing patient wait times and adding value to the patients visit with the Nurse Practitioners. Additionally, through the Nurse Practitioners engagement in the Lean processes a need was recognized to articulate clinic vision, mission and the alignment of NP role and scope of practice with the agency and Ministry of Health strategic plan. Conclusions: Continuous improvement work in the Pediatric Primary Care NP Clinic has provided a unique opportunity to improve the quality of care delivered and has facilitated further alignment of the daily continuous improvement work with the strategic priorities of the Ministry of Health.

Keywords: ambulatory care, lean, pediatric primary care, system efficiency

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Authors: Hayley Lawrence, Nabi Shah, Sarah Dyer

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Aims: Lumbar punctures are a common bedside procedure performed in acute medicine. Published guidance exists on the standardised documentation of invasive procedures in order to reduce the risk of complications. The audit aim was to assess current standards of documentation in accordance with both the GMC and the National Standards for Invasive Procedures guidelines. A second cycle was conducted after introducing a standardised sticker created using current guidelines. This would assess whether the sticker improved documentation, aiming for 100% standard in each step of the procedure. Methods: An initial prospective audit of current practice was conducted over a 3-month period. Patients were identified by their presenting complaints and by colleagues assessing acute medical patients. Initial findings were presented locally, and a further prospective audit was conducted following the implementation of a standardised sticker. Results: 19 lumbar punctures were included in the first cycle and 13 procedures in the second. Pre-procedure documentation was collected for each cycle, whereby documentation of ‘Indication’ improved from 5.3% to 84.6%, ‘Consent’ from 84.2% to 100%, ‘Coagulopathy’ from 0% to 61.5%, ‘Drug Chart checked’ from 0% to 100%, ‘Position of patient’ from 26.3% to 100% and use of ‘Aseptic Technique’ from 83.3% to 100% from the first to the second cycle respectively. ‘Level of Doctor’ and ‘Supervision’ decreased from 53% to 31% and 53% to 46%, respectively, in the second cycle. Documentation of the procedure itself also demonstrated improvements, with ‘Level of Insertion’ 15.8% to 100%, ‘Name of Antiseptic Used’ 11.1% to 69.2%, ‘Local Anaesthetic Used’ 26.3% to 53.8%, ‘Needle Gauge’ 42.1% to 76.9%, ‘Number of Attempts’ 78.9% to 100% and ‘Traumatic/Atraumatic’ procedure 26.3% to 92.3%, respectively. A similar number of opening pressures were documented in each cycle at 57.9% and 53.8%, respectively, but its documentation was deemed ‘Not Applicable’ in a higher number of patients in the second cycle. Post-procedure documentation improved, with ‘Number of Samples obtained’ increasing from 52.6% to 92.3% and documentation of ‘Immediate Complications’ increasing from 78.9% to 100%. ‘Dressing Applied’ was poorly documented in the first cycle at 16.7%. This was not included on the standardised sticker, resulting in 0% documentation in the second cycle. Documentation of Clinicians’ Name and Bleep reduced from 63.2% to 15.4%, but when the name only was analysed, this increased to 84.6%. Conclusions: Standardised stickers for lumbar punctures do improve documentation and hence should result in improved patient safety. There is still room for improvement to reach 100% standard in each area, especially with respect to the clinician’s name and contact details being documented. Final adjustments will be made to the sticker before being included in a lumbar puncture kit, which will be made readily available in the acute medical wards. Future audits could be extended to include other common bedside procedures performed in acute medicine to ensure documentation of all these procedures reaches 100% standard.

Keywords: invasive procedure, lumbar puncture, medical record keeping, procedure checklist, procedure documentation, standardised documentation

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Authors: Teresa Wills, Geraldine Mccarthy, Nicola Cornally

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Background: Obesity is an emerging healthcare epidemic affecting virtually all age and socio-economic groups and is one of the most serious and prevalent diseases of the 21st century. It is a public health challenge because of its prevalence, associated costs and health effects. The increasing prevalence of obesity has created a social perception that overweight body sizes are healthy and normal. This normalization of obesity within our society and the acceptance of higher body weights have led to individuals being unaware of the reality of their weight status and gravity of this situation thus impeding recognition of obesity. Given the escalating global health problem of obesity and its co-morbidities, the need to re-appraise its management is more compelling than ever. It is widely accepted that the causes of obesity are complex and multi-factorial. Engagement of individuals in weight management programmes is difficult if they do not perceive they have a problem with their weight. Recognition of the problem is a key component of obesity management and identifying the main predictors of behaviour is key to designing health behaviour interventions. Aim: The aim of the research was to determine factors relating to motivation to change behaviours in individuals who perceive themselves to be overweight. Method: The research design was quantitative, correlational and cross-sectional. The design was guided by the Health Belief Model. Data were collected online using a multi-section and multi-item questionnaire, developed from a review of the theoretical and empirical research. A sample of 202 men and women who perceived themselves to be overweight participated in the research. Descriptive and inferential statistical analyses were employed to describe relationships between variables. Findings: Following multivariate regression analysis, perceived barriers to weight loss and perceived benefits of weight loss were significant predictors of motivation to change behaviour. The perceived barriers to weight loss which were significant were psychological barriers to weight loss (p = < 0.019) and environmental barriers to physical activity (p= < 0.032).The greatest predictor of motivation to change behaviour was the perceived benefits of weight loss (p < 0.001). Perceived susceptibility to obesity and perceived severity of obesity did not emerge as significant predictors in this model. Total variance explained by the model was 33.5%. Conclusion: Perceived barriers to weight loss and perceived benefits of weight loss are important determinants of motivation to change behaviour. These findings have important implications for health professionals to help inform their practice and for the development of intervention programmes to prevent and control obesity.

Keywords: motivation to change behaviours, obesity, predictors of behavior, interventions, overweight

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Authors: Pierre Mintom, Ebai Patricia, Merlin Dasse, Marlyse Chantal Nyangon Ndongo, Aicha Aretouyap Kouotou, Felix Essiben, Christine Fernande Nyangono Biyegue

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Background: The death of women during and after pregnancy remains a major concern in public health policy in Cameroon. Among the causes of this mortality is eclampsia which is a consequence of the Pre-eclampsia characterized by the double burden of pregnancy-induced hypertension and albuminuria in pregnant women. Objective: To determine the various factors associated with the pre-eclampsia in pregnant women of Foumban. Methodology: A cross-sectional and analytical study was carried out during the period from July to August 2020 and supplemented by another study carried out from August 05 to September 05, 2022, at the Foumban district hospital. A questionnaire was administered to pregnant women. It focused on socio-demographic parameters, the state nutritional, health status, and maternal parameters. Blood pressure was taken using an electronic blood pressure monitor, and urinary albumin was measuring using urine dipstick. Pre-eclampsia was defined by three types of double burden: double burden systolic hypertension–hyperalbuminuria (SHH), defined for SBP≥140 mmHg and hyperalbuminuria ≥1+ on urine dipstick, double burden diastolic hypertension–hyperalbuminuria (DHH), defined for PAD≥90 mmHg and hyperalbuminuria ≥1+ on the urine dipstick, and the double burden systolodiastolic arterial hypertension– hyperalbuminuria (SDHH), defined for SBP ≥ 140mmHg, PAD≥90 mmHg and hyperalbuminuria ≥1+ on urine dipstick. IBM SPSS Software was used for statistical analysis. Results: The results of this study show that the prevalence of pre-eclampsia was 17.3% for the double burden SHH, 19.9% for the double burden DHH and 14.1% for double burden SDHH. Associated factors with pre-eclampsia according to the three types of double burden were marital status (P<0.05), religion (P<0.05), history of hypertension before pregnancy (P<0.05). Associated factors for the double burden of DHH and SDHH were the nutritional status before the pregnancy (P<0.05) and the number of prenatal consultations (P<0.05). In terms of food groups, regular consumption of spices significantly increased the risk of pre-eclampsia by 5.318, 6.277 and 11.271 times respectively for the SHH, DHH and SDHH double burdens, while regular consumption of sweets regular consumption of sweets increased by 2.42 times and 2.053 times respectively the double DHH and SDHH burdens respectively. Conclusion: Our study made it possible to redefine pre-eclampsia by considering the subtypes of hypertension. Certain socio-demographic parameters and certain dietary habits influence the occurrence of pre-eclampsia characterized by the double burden Hypertension-hyperalbuminuria in pregnant women, which may later lead to the occurrence of eclampsia. Moreover, albuminemia could be a good predicitive factor of pre-eclampsia and could be explored.

Keywords: hypertension, hyperalbuminuria, pregnant women, foumban

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Authors: Gamze Safak, Umut Arslanoglu

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Cultural and tourism conservation and development zones and tourism centers are the boundaries declared for the purpose of protecting, using, and evaluating the sectoral development and planned development in areas where historical and cultural values are heavily involved and/or where tourism potential is high. The most rapidly changing regions in Turkey are tourism areas, especially the coastal areas. Planning these regions is not about only an economic gain but also a natural and physical environment and refers to a complex process. If the tourism sector is not well controlled, excessive use of natural resources and wrong location choices may cause damage to natural areas, historical values, and socio-cultural structure. Since the strategic decisions taken in the environmental order and zoning plans, which are the means of guiding the physical environment of the Ministry of Culture and Tourism, which have the authority to make plans in tourism centers, are transformed into plan decisions that find the spatial expression, comprehensive evaluation of all kinds of data, following the historical development and based on the correct and current data is required. In addition, the authority has a number of competences in tourism promotion as well as the authority to plan, leading to the necessity of taking part in the applications requiring complex analysis such as the management and integration of the country's economic, political, social and cultural resources. For this purpose, Tourism Inventory System (TES) project, which consists of a series of subsystems, has been developed in order to solve complex planning and method problems in the management of site-related information. The scope of the project is based on the integration of numerical and verbal data in the regions within the jurisdiction of the authority, and the monitoring of the historical development of urban planning studies, making the spatial data of the institution easily accessible, shared, questionable and traceable in international standards. A dynamic and continuous system design has been put into practice by utilizing the advantage of the use of Geographical Information Systems in the planning process to play a role in making the right decisions, revealing the tools of social, economic, cultural development, and preservation of natural and cultural values. This paper, which is prepared by the project team members in TES (Tourism Inventory System), will present a study regarding the applicability of GIS in cultural and natural heritage conservation.

Keywords: cultural conservation, GIS, geographic information system, tourism inventory system, urban planning

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Authors: Erine van Niekerk, Jason Holland

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In Māori culture water is considered to be the foundation of all life and has its own mana (spiritual power) and mauri (life force). Water classification for cultural values therefore includes categories like waitapu (sacred water), waimanawa-whenua (water from under the land), waipuna (freshwater springs), the relationship between water quantity and quality and the relationship between surface and groundwater. Particular rivers and lakes have special significance to iwi and hapu for their rohe (tribal areas). The Mararoa River, including its freshwater springs and wetlands, is an example of such an area. There is currently little information available about the sources, characteristics and behavior of these important water resources and this study on the water quality of the Mararoa River and adjacent freshwater springs will provide valuable information to be used in informed decisions about water management. The regional council of Southland, Environment Southland, is required to make changes under their water quality policy in order to comply with the requirements for the New National Standards for Freshwater to consult with Maori to determine strategies for decision making. This requires an approach that includes traditional knowledge combined with scientific knowledge in the decision-making process. This study provided the scientific data that can be used in future for decision making on fresh water springs combined with traditional values for this particular area. Several parameters have been tested in situ as well as in a laboratory. Parameters such as temperature, salinity, electrical conductivity, Total Dissolved Solids, Total Kjeldahl Nitrogen, Total Phosphorus, Total Suspended Solids, and Escherichia coli among others show that recorded values of all test parameters fall within recommended ANZECC guidelines and Environment Southland standards and do not raise any concerns for the water quality of the springs and the river at the moment. However, the destruction of natural areas, particularly due to changes in farming practices, and the changes to water quality by the introduction of Didymosphenia geminate (Didymo) means Māori have already lost many of their traditional mahinga kai (food sources). There is a major change from land use such as sheep farming to dairying in Southland which puts freshwater resources under pressure. It is, therefore, important to draw on traditional knowledge and spirituality alongside scientific knowledge to protect the waters of the Mararoa River and waipuna. This study hopes to contribute to scientific knowledge to preserve the cultural values of these significant waters.

Keywords: cultural values, freshwater springs, Maori, water quality

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Authors: Mostafa Shahriari, Theophile Chaumont-Frelet, David Pardo

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Resistivity measurements are used to characterize the Earth’s subsurface. They are categorized into two different groups: (a) those acquired on the Earth’s surface, for instance, controlled source electromagnetic (CSEM) and Magnetotellurics (MT), and (b) those recorded with borehole logging instruments such as Logging-While-Drilling (LWD) devices. LWD instruments are mostly used for geo-steering purposes, i.e., to adjust dip and azimuthal angles of a well trajectory to drill along a particular geological target. Modern LWD tools measure all nine components of the magnetic field corresponding to three orthogonal transmitter and receiver orientations. In order to map the Earth’s subsurface and perform geo-steering, we invert measurements using a gradient-based method that utilizes the derivatives of the recorded measurements with respect to the inversion variables. For resistivity measurements, these inversion variables are usually the constant resistivity value of each layer and the bed boundary positions. It is well-known how to compute derivatives with respect to the constant resistivity value of each layer using semi-analytic or numerical methods. However, similar formulas for computing the derivatives with respect to bed boundary positions are unavailable. The main contribution of this work is to provide an adjoint-based formulation for computing derivatives with respect to the bed boundary positions. The key idea to obtain the aforementioned adjoint state formulations for the derivatives is to separate the tangential and normal components of the field and treat them differently. This formulation allows us to compute the derivatives faster and more accurately than with traditional finite differences approximations. In the presentation, we shall first derive a formula for computing the derivatives with respect to the bed boundary positions for the potential equation. Then, we shall extend our formulation to 3D Maxwell’s equations. Finally, by considering a 1D domain and reducing the dimensionality of the problem, which is a common practice in the inversion of resistivity measurements, we shall derive a formulation to compute the derivatives of the measurements with respect to the bed boundary positions using a 1.5D variational formulation. Then, we shall illustrate the accuracy and convergence properties of our formulations by comparing numerical results with the analytical derivatives for the potential equation. For the 1.5D Maxwell’s system, we shall compare our numerical results based on the proposed adjoint-based formulation vs those obtained with a traditional finite difference approach. Numerical results shall show that our proposed adjoint-based technique produces enhanced accuracy solutions while its cost is negligible, as opposed to the finite difference approach that requires the solution of one additional problem per derivative.

Keywords: inverse problem, bed boundary positions, electromagnetism, potential equation

Procedia PDF Downloads 178

Authors: Jay Raval

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Sports and physical fitness have been a vital component of our civilization. It is such a power which, motivates and inspires every individual, communities and even countries to be aware of the physical and mental health. All though, sports play vital role in the overall development of the nation, but in the developing countries such as India, this culture of sports is yet to be motivated. However, in India lack of sporting culture has held back the growth of a similar industry in the past, despite the growing awareness and interest in various different sports besides cricket. Hence, due to a lack of sporting culture, corporate investments in India’s sports have traditionally been limited to only non-profit corporate social responsibility activities and initiatives. From past couple of years, India has come up with new initiatives such as Indian Premier League (Cricket), Hockey India League, Indian Badminton League, Pro Kabaddi League, and Indian Super League (Football) which help to boost Indian sports culture and thereby increase economy of the country. Out of 29 states of India, among all of those competitive states, Gujarat is showing very rapid increase in sports participation. Khel Mahakumbh, the competition conducted for the last six years has been a giant step in this direction and covers rural and urban areas of Gujarat. The objective of the research is to address the overall development of the sports system. Sports system includes infrastructure, coaches, resources, and participants. The current existing system is not disabled friendly. This research paper highlights adequate steps in order to improve and sort out pressing issues in the sports system. Education system is highly academic-centric with a definite trend towards reducing school sports and extra-curricular sports in the Gujarat state. Constituents of this research work make an attempt to evaluate the framework of the Olympic Charter, the Sports Authority of India, the Indian Olympics Association and the National Sports Federations. It explores the areas that need to be revamped, rejuvenated and reoriented to function in an open, democratic, equitable, transparent and accountable manner. Research is based on mixed method approach. It is used for the data collection which includes the personal interviews, document analysis and the use of news article. Quality assurance is also tested by conducting the trustworthiness of the paper. Mixed method helps to strengthen the analysis part and give strong base for the discussion during the analysis.

Keywords: physical development, sports authority of India, sports policy, women empowerment

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Authors: Rozanne Janet Smith

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This article examined the corporate governance disclosures of the large and medium-sized auditing firms in South Africa. It is important that auditing firms disclose their practice of good corporate governance to the public, as they serve the public interest. The auditing profession has been criticized due to many corporate scandals in recent years. This has undermined the reputation of the profession, with experts and the public questioning whether auditing firms have corporate governance structures in place, and whether they are taking public interest into consideration. In South Africa there is no corporate governance code specifically for audit firms. Auditing firms are encouraged by IRBA to issue a transparency report in which they disclose corporate governance structures and application, but this is not compulsory in South Africa. Moreover, the information issued in these transparency reports is limited and often only focuses on audit quality, and not governance. Through a literature review it was found that the UK is one of only a few countries who has a corporate governance code for audit firms. As South Africa initially used the UK Cadbury report to develop the King IV Code, it was fitting to use the UK Audit Firm Governance Code as a benchmark to determine if audit firms in South Africa are disclosing relevant corporate governance information in their transparency reports and/or integrated reports. This study contributes to the existing body of knowledge by pursuing the following objective: To determine the improvement in the corporate governance disclosures of large and medium-sized auditing firms in South Africa through comparative research. Available data from 2019 will be used and compared to the disclosures in the 2023/2024 transparency and or integrated reports of the large and medium-sized auditing firms in South Africa. To achieve this objective a constructivist research paradigm was applied. Qualitative secondary information was gathered for the analysis. A content analysis was selected to collect the qualitative data by analyzing the integrated reports and/or transparency reports of large and medium-sized auditing firms with 20 or more partners and to determine what is disclosed on their corporate governance practices. These transparency reports and integrated reports were then read and analyzed in depth and compared to the principles stated in the UK Code. Since there are only nine medium-sized and large auditing firms in South Africa, the researcher was able to conduct the content analysis by reading each report in depth. The following six principles which are found in the UK Code were assessed for disclosure. (1) Leadership, (2) Values, (3) INED, (4) Operations, (5) Reporting, and (6) Dialogue. The results reveal that the auditing firms are not disclosing the corporate governance principles and practices to the necessary extent. Although there has been some improvement, the disclosure is not to the extent which it should be. There is still a need for a South African audit firm governance code.

Keywords: auditing firms, corporate governance, South Africa, disclosure

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Authors: Okanlawon Simon Ayorinde, Odunjo Oluronke Omolola, Fadamiro Joseph Akinlabi, Adedibu Afolabi Adebgite

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A road is a path established over land, especially prepared way between places for the use of pedestrian, riders, and vehicles: a hard surface built for vehicles to travel on. The social, economic and health importance of roads in any community and nation cannot be underestimated. Roads provide access to properties and they also provide mobility which is ability to transport goods and services from one place to another. In the residential zones of many indigenous cities in Nigeria, roads are usually blocked for social ceremonies. Road blocked for ceremonies as used in this study are a temporary barrier across a road, used to stop or hinder traffic from passing through to the other side. Social ceremonies that could warrant road blockage include marriage, child naming, funeral, celebration of life’s achievement, birthday anniversary etc. These activities are likely to generate environmental hazards and their attendant risks. The assessment of these hazards and risks in residential zones of indigenous cities in Nigeria becomes imperative. The study is focused on Ogbomoso, Oyo State, Nigeria. The town has two local government councils namely Ogbomoso North and Ogbomoso South. Urban tracts that are easy to identify are political wards in the absence of land use segregation, houses numbering and street naming. The wards that had residential having a minimum of 60% of their land use components were surveyed and fifteen out of twenty wards identified in the town were surveyed. The study utilized primary data collected through questionnaire administration The three major road categories (Trunk A-Federal; Trunk B- State; Trunk C-Local) were identified and trunk C-Local roads were purposively selected being the concern of this study because they are the ones often blocked for social activities. The major stakeholders interviewed and the respective sampling methods are residents (random and systematic), social ceremony organizers (purposive), government officials (purposive) and road users namely commercial motorists and commercial motor cyclists (random and incidental). Data analysis was mainly descriptive. Two indices to measure respondents’ perception were developed. These are ‘Hazard Severity Index’ (HSI) and ‘Relative Awareness Index’ (RAI).Thereafter, policy implications and recommendations were provided.

Keywords: road, residential zones, indigenous cities, blocked, social ceremonies

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Authors: Anne Prip, Kirsten Alling Møller, Dorte Lisbet Nielsen, Mary Jarden, Marie-Helene Olsen, Anne Kjaergaard Danielsen

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Background: The development in cancer care has shifted towards shorter hospital stays and more outpatient treatment. Today, cancer care and treatment predominantly takes place in outpatient settings where encounters between patients and health care professionals are often brief. This development will probably continue internationally as the global cancer burden seems to be growing significantly. Furthermore, the number of patients who require ambulatory treatments such as chemotherapy is increasing. Focusing on the encounters between health care professionals and patients during oncology treatment has thus become increasingly important due to a growing trend in outpatient cancer management. Objective: The aim of the systematic review was to summarize the literature from the perspective of the patient, on experiences of and the need for communication and relationships with the health care professional during chemotherapy treatment in an outpatient setting. Method: The review was designed and carried out according to the PRISMA guidelines and PICO framework. The systematic search was conducted in Medline, CINAHL, The Cochrane Library and Joanna Briggs Institute Evidence Based Practice Database. Results: In all, 1174 studies were identified by literature search. After duplicates were removed, the remaining studies (n = 1053) were screened for inclusion. Nine studies were included; qualitative (n = 5) and quantitative (n = 4) as they met the inclusions criteria. The review identified that communication and relationships between health care professionals and patients were important for the patients’ ability to cope with cancer and also had an impact on patients’ satisfaction with care in the outpatient clinic. Furthermore, the review showed that hope and positivity was a need and strategy for patients with cancer and was facilitated by health care professionals. Finally, it revealed that outpatient clinic visits framed and influenced communication and relationships. Conclusions: This review identified the significance of communication and the relationships between patients and health care professionals in the outpatient setting as it supports patients’ ability to cope with cancer. The review showed the need for health care professionals to pay attention to the relational aspects of communication in an outpatient clinic as encounters are often brief. Furthermore, the review helps to specify which elements of the communication are central in the patient-health care professional interaction from the patients' perspective. Finally, it shows a need for more research to investigate which type of interaction and intervention would be the most effective in supporting patients’ coping during chemotherapy in an outpatient clinic.

Keywords: ambulatory chemotherapy, communication, health care professional-patient relation, nurse-patient relation, outpatient care, systematic review

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Authors: Lori Lioce, Gary Maddux, Norven Goddard, Ishella Fogle, Bernard Schroer

Abstract:

This paper presents the integration of technologies into nursing education. The collaborative effort includes the College of Nursing (CoN) at the University of Alabama in Huntsville (UAH) and the UAH Systems Management and Production Center (SMAP). The faculty at the CoN conducts needs assessments to identify education and training requirements. A team of CoN faculty and SMAP engineers then prioritize these requirements and establish improvement/development teams. The development teams consist of nurses to evaluate the models and to provide feedback and of undergraduate engineering students and their senior staff mentors from SMAP. The SMAP engineering staff develops and creates the physical models using 3D printing, silicone molds and specialized molding mixtures and techniques. The collaboration has focused on developing teaching and training, or clinical, simulators. In addition, the onset of the Covid-19 pandemic has intensified this relationship, as 3D modeling shifted to supplied personal protection equipment (PPE) to local health care providers. A secondary collaboration has been introducing students to clinical benchmarking through the UAH Center for Management and Economic Research. As a result of these successful collaborations the Model Exchange & Development of Nursing & Engineering Technology (MEDNET) has been established. MEDNET seeks to extend and expand the linkage between engineering and nursing to K-12 schools, technical schools and medical facilities in the region to the resources available from the CoN and SMAP. As an example, stereolithography (STL) files of the 3D printed models, along with the specifications to fabricate models, are available on the MEDNET website. Ten 3D printed models have been developed and are currently in use by the CoN. The following additional training simulators are currently under development:1) suture pads, 2) gelatin wound models and 3) printed wound tattoos. Specification sheets have been written for these simulations that describe the use, fabrication procedures and parts list. These specifications are available for viewing and download on MEDNET. Included in this paper are 1) descriptions of CoN, SMAP and MEDNET, 2) collaborative process used in product improvement/development, 3) 3D printed models of training and teaching simulators, 4) training simulators under development with specification sheets, 5) family care practice benchmarking, 6) integrating the simulators into the nursing curriculum, 7) utilizing MEDNET as a pandemic response, and 8) conclusions and lessons learned.

Keywords: 3D printing, nursing education, simulation, trainers

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Authors: Tamar Lazariashvili

Abstract:

Introduction: The growth and development of the economy in the country depend on many factors, the most important of which is the use of innovation. The article analyzes the innovations and the potential of agricultural development in Georgia, presents the problems in the field, justifies the need to introduce innovations, shows the policy of innovation development, evaluates the positive and negative factors of the use of innovations in agriculture. Methodology: The article uses general and specific research methods, namely, analysis, synthesis, induction, deduction, comparison and statistical ones: selection, grouping, observation, trend. All these methods used together in the article reveal the main problems and challenges and their development trends. Main Findings: The introduction of innovations for the country has an impact if there is established state support system for business development and the State creates an effective environment for innovation development. As a result, the appropriate establishment gives incentives to increase budget revenues, create new jobs, increase export turnover and improve the overall economic situation in the country. Georgia has sufficient resource potential to create and develop new businesses in agriculture by introducing innovations and contribute to the further socio-economic development of the country. Political and economic stability, the existing legislation in the country, infrastructure, the proper functioning of financial institutions and the qualification of the workforce are crucial for the development of innovations. These criteria determine the political and economic ratings of all countries of the world, which are of great importance to foreign investors in the implementation of innovations. Conclusion: Enactment of agro-insurance will increase the interest and confidence of financial institutions in the farming sector, financial resources will be accessible to the farmers that will facilitate the stable development of the sector in the country. The size of the agro-insurance market in the country should be increased and the new territories should be covered. The State must have an obligation to ensure the risk of farmers and subsidize insurance companies. Based on an analysis of the insurance market the conclusions on agro-insurance issues and the relevant recommendations are proposed. The introduction of innovations in agriculture will have a great impact on the Georgian economy: it will improve the technological base, establish enterprises equipped with modern equipment and methodologies, retrain existing enterprises, promote to improve skills of workers and improve management systems. Based on the analysis, conclusions are made about the prospects for the development of innovation in agriculture and relevant recommendations are proposed.

Keywords: agriculture, development potential, innovation, optimal environment

Procedia PDF Downloads 180

Authors: Chidiebere Joy Nwankwo, Benjamin S. C. Uzochukwu, Florence T. Sibeudu

Abstract:

Background: Family planning is one of the most cost-effective ways to prevent maternal, infant, and child mortality. It can decrease maternal mortality by reducing the number of unintended pregnancies, the number of abortions, and the proportion of births at high risk. It has been seen to improve the health and economic well-being of families and communities and ensures women’s planned childbearing in order to achieve education and career goals which could raise family income thereby reducing poverty. The choice and use of a particular family planning method and their sources vary globally. Rural Communities often face significant challenges in accessing and utilizing family planning services. Aim: This study set out to assess Access and Utilization of Family Planning Services among Women of Reproductive Age in a Rural Community of Enugu state, Nigeria. Rural communities were chosen for this study because past demographic surveys have shown that women in urban areas are more likely to accept and practice family planning compared to those in rural areas. Method: A Descriptive Cross-sectional Research design was employed to achieve the aim and objectives of the study. Data collected from 177 consenting participants using interviewer-administered questionnaires was analysed using Descriptive statistics to summarize the Socio-demographic characteristics of the participants and Access and Utilization of Family Planning Services among the participants including Reasons for using different Family Planning Methods and Barriers encountered in Access and Utilization of these services. A Cross-tabulation between Socio-demographic Characteristics of respondents and the use of Family Planning services was carried out. Result: The findings of this study revealed that majority of the participants (72.9%) have not utilized any family planning service. Out of those (27.1%) that have used any family planning service, majority of them are still currently using a form of family planning service and have access to them in health facilities, patent medicine vendors and others based on multiple responses. Male condoms were the most utilized modern family planning service. Based on multiple responses, inaccessibility, personal beliefs and partner’s objection were the most identified barriers encountered in accessing family planning services. Conclusion: Access and uptake of family planning services in rural communities is lower than the national average. Increasing access to family planning is an urgent priority for rural areas Interventions that will scale up Access and Utilization of family planning services in rural communities should be intensified.

Keywords: access, family planning, rural community, utilization

Procedia PDF Downloads 45