Search results for: healthcare policy instruments

Authors: Sumanta Meher, Gaurav Shukla

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The torments of the victims of terrorism have not only confined to loss of life and limp but also includes the physiological trauma to the innocent victims. The physical wounds may heal, but the trauma remains in the mind and heart of the victims and their loved ones; however, one should not deny that these terrorist activities affect to a major extent to their livelihood. To protect their human rights and restore the shattered lives of the victims of terrorism all the Nations beyond their differences have to show solidarity and frame a comprehensive restorative policy with an effective implementing mechanism. The General Assembly of United Nations, through its several resolutions, has appealed Nations to show solidarity and also committed to helping the Members State to frame the law and policy to support the victims of terrorism. To achieve the objectives of the resolutions adopted by the United Nations, the Indian legislators in 2008 amended the Code of Criminal Procedure, 1973 and incorporated Section 357A to provide financial assistance to the victims of terrorism. In India, the contemporary developments in the victims’ oriented studies have increased the dimension of the traditional criminal justice systems to protect the rights of the victims. In this regard, the paper has ascertained the Indian legal framework in respect to the restorative justice to the victims of terrorism and also addressed the question as to whether the statutory provisions and enforcement mechanisms are efficient enough to protect the human rights of the victims of terrorism. For that purpose, the paper has analyzed the International instruments and the reports with regard to the compensation to the victims of terrorist attacks, with that, the article also evaluates the initiatives of United Nations to help Members State to frame the law and policies to support the victims of terrorism. The study also made an attempt to critically analyze the legal provisions of compensation and rehabilitation of the victims of terrorist attacks in India and whether they are in alignment with the International standards. While concluding, the paper has made an endeavor for a robust legal framework towards the restorative justice for the victims of terrorism in India.

Keywords: victims of terrorism, restorative justice, human rights, criminal justice system of India

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Authors: Elizabeta Krstić Vukelja

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Digitization of personal data is a consequence of the development of information and communication technologies that create a new work environment with many advantages and challenges, but also potential threats to privacy and personal data protection. Regulation (EU) 2016/679 of the European Parliament and of the Council is becoming a law and obligation that should address the issues of personal data protection and information security. The existence of the Regulation leads to the conclusion that national legislation in the field of virtual environment, protection of the rights of EU citizens and processing of their personal data is insufficiently effective. In the health system, special emphasis is placed on the processing of special categories of personal data, such as health data. The healthcare industry is recognized as a particularly sensitive area in which a large amount of medical data is processed, the digitization of which enables quick access and quick identification of the health insured. The protection of the individual requires quality IT solutions that guarantee the technical protection of personal categories. However, the real problems are the technical and human nature and the spatial limitations of the application of the Regulation. Some conclusions will be drawn by analyzing the implementation of the basic principles of the Regulation on the example of the Croatian health care system and comparing it with similar activities in other EU member states.

Keywords: regulation, healthcare system, personal dana protection, quality data assurance

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Authors: Lourenço José, Elsa Melo, Sandra Viera, Ana Pinheiro

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Introduction: People with stroke in Angola face challenges in accessing appropriate healthcare and rehabilitation services. There is a lack of information on the quality of care provided and the development of early intervention plans Methods: Two different methods will be chosen. The exploratory, descriptive, and longitudinal study (E1) to characterize health care for people with stroke, housed in 2 hospitals in Luanda; the quality and transverse study (E2) concerning the development and evaluation of a strategic early intervention plan for a stroke patient. Ethical and deontological principles for an investigation will be proposed. Results: Contributor to the knowledge of the reality of providing care to the person after a stroke, in Angola; Propose and develop an early action plan. Contribute to integration to influence policy makers on the need for assistance with stroke, aiming at their functional, family and social rehabilitation, particularly in the labor market.

Keywords: stroke, functional recovery, quality of life, health

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Authors: Sibusiso Buthelezi, Rugira Regis Marie-Modeste, Deliwe Rene Phetlhu

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Introduction: Mother-to-child transmission persists owing to inadequate implementation of prevention of mother-to-child transmission programmes, particularly in rural areas. To achieve a target of zero new HIV infection in children born from women living with HIV, the involvement of mothers and caregivers is undeniable. Therefore, there is a need to explore the views of the mothers because of the role they play in their own right when it comes to preventing their children from contracting HIV by consistently adhering to the guidelines of the prevention of mother-to-child transmission programme. Thus, this study sought to explore and describe the perceptions of mothers on their role in the prevention of HIV to their children exposed to HIV and further explore their perceptions of the childcare received in the healthcare facility. Methods: The study was conducted in November-December 2019 in Ngaka Modiri Molema in North West Province in South Africa. A qualitative exploratory, descriptive research design was used. Purposive sampling was used to select the mothers of children exposed to HIV during the mother`s clinic attendance. Data collection was done through semi-structured individual interviews with mothers of children exposed to HIV. Colaizzi`s method of data analysis was used to analyse data in this study. Results: Seven themes emerged from data analysis, namely: health benefits from coming to the healthcare facility, communication, information needs, attitude of healthcare workers, healthcare administration system, the role of a mother, and disclosure of HIV status. Conclusion: This study revealed systematic gaps that exist in the programme, which hinder the childcare services of children exposed to HIV and socio-economically related hindrances. Mothers’ roles, such as exclusive breastfeeding, taking their own medication, and child follow-up visits, remain inadequate. The study findings show that there is a need to develop a contextual-tailored intervention strategy that would improve the implementation of prevention of mother-to-child transmission in rural areas.

Keywords: children exposed to HIV, mothers’ role to prevent MTCT, mothers’ perceptions on childcare, PMTCT in rural areas

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Authors: Arun Kumar, Neelesh Haulder

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This paper identifies and resolves some key issues relating to a specific aspect within the supply chain logistics of the public health care industry in the Republic of Mauritius. The analysis and the proposed solution are performed using soft systems methodology (SSM). Through the application of this relevant systematic approach at problem solving, the aim is to obtain an in-depth analysis of the problem, incorporating every possible world view of the problem and consequently to obtain a well explored solution aimed at implementing relevant changes within the current supply chain logistics of the health care industry, with the purpose of tackling the key identified issues.

Keywords: soft systems methodology, CATWOE, healthcare, logistics

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Authors: Sachiko Hosoya

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Objectives: The purpose of this paper is to investigate the social policy of preventive genetic medicine in Iran, by following the legalization process of abortion law and the factors affecting the process in wider Iranian contexts. In this paper, ethical discussions of prenatal diagnosis and selective abortion in Iran will be presented, by exploring Iranian social policy to control genetic diseases, especially a genetic hemoglobin disorder called Thalassemia. The ethical dilemmas in application of genetic medicine into social policy will be focused. Method: In order to examine the role of the policy for prevention of genetic diseases and selective abortion in Iran, various resources have been sutudied, not only academic articles, but also discussion in the Parliament and documents related to a court case, as well as ethnographic data on living situation of Thalassemia patients. Results: Firstly, the discussion on prenatal diagnosis and selective abortion is overviewed from the viewpoints of ethics, disability rights activists, and public policy for lower-resources countries. As a result, it should be noted that the point more important in the discussion on prenatal diagnosis and selective abortion in Iran is the allocation of medical resources. Secondly, the process of implementation of national thalassemia screening program and legalization of ‘Therapeutic Abortion Law’ is analyzed, through scrutinizing documents such as the Majlis record, government documents and related laws and regulations. Although some western academics accuse that Iranian policy of selective abortion seems to be akin to eugenic public policy, Iranian government carefully avoid to distortions of the policy as ‘eugenic’. Thirdly, as a comparative example, discussions on an Iranian court case of patient’s ‘right not to be born’ will be introduced. Along with that, restrictive living environments of people with Thalassemia patients and the carriers are depicted, to understand some disabling social factors for people with genetic diseases in the local contexts of Iran.

Keywords: abortion, Iran, prenatal diagnosis, public health ethics, Thalassemia prevention program

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Authors: Min-Ming Wen

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Applying the U.S. lodging and tourism industry as a research sample, we examine the relation between the corporate governance structure and managerial risk-taking behavior. In light of the global financial crisis, the importance of effective governance structures is essential in protecting claimholder interests. We propose a governance structure consisting of shareholder governance measured by anti-takeover provisions to examine whether the governance structure has a significant impact on managerial risk-taking behaviors in terms of the investment policy. We will use capital expenditure and R&D investment to measure managerial risk-taking and the firm’s investment policy. In addition, we will examine whether the effects of governance on investment policy differ significantly between speculative and investment-grade firms.

Keywords: corporate governance, risk-taking, firm value, lodging industry

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Authors: Sonia Butalia, Huong Luu, Alexis Guigue, Karen J. B. Martins, Khanh Vu, Scott W. Klarenbach

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Obesity is associated with significant personal impacts on health and has a substantial economic burden on payers due to increased healthcare use. A contemporary estimate of the healthcare costs associated with obesity at the population level are lacking. This evidence may provide further rationale for weight management strategies. Methods: Adults who underwent a medical procedure between 2012 and 2019 in Alberta, Canada were categorized into the investigational cohort (had body mass index [BMI]-defined class 2 or 3 obesity based on a procedure-associated code) and the control cohort (did not have the BMI procedure-associated code); those who had bariatric surgery were excluded. Characteristics were presented and healthcare costs ($CDN) determined over a 1-year observation period (2019/2020). Logistic regression and a generalized linear model with log link and gamma distribution were used to assess total healthcare costs (comprised of hospitalizations, emergency department visits, ambulatory care visits, physician visits, and outpatient prescription drugs); potential confounders included age, sex, region of residence, and whether the medical procedure was performed within 6-months before the observation period in the partial adjustment, and also the type of procedure performed, socioeconomic status, Charlson Comorbidity Index (CCI), and seven obesity-related health conditions in the full adjustment. Cost ratios and estimated cost differences with 95% confidence intervals (CI) were reported; incremental cost differences within the adjusted models represent referent cases. Results: The investigational cohort (n=220,190) was older (mean age: 53 standard deviation [SD]±17 vs 50 SD±17 years), had more females (71% vs 57%), lived in rural areas to a greater extent (20% vs 14%), experienced a higher overall burden of disease (CCI: 0.6 SD±1.3 vs 0.3 SD±0.9), and were less socioeconomically well-off (material/social deprivation was lower [14%/14%] in the most well-off quintile vs 20%/19%) compared with controls (n=1,955,548). Unadjusted total healthcare costs were estimated to be 1.77-times (95% CI: 1.76, 1.78) higher in the investigational versus control cohort; each healthcare resource contributed to the higher cost ratio. After adjusting for potential confounders, the total healthcare cost ratio decreased, but remained higher in the investigational versus control cohort (partial adjustment: 1.57 [95% CI: 1.57, 1.58]; full adjustment: 1.21 [95% CI: 1.20, 1.21]); each healthcare resource contributed to the higher cost ratio. Among urban-dwelling 50-year old females who previously had non-operative procedures, no procedures performed within 6-months before the observation period, a social deprivation index score of 3, a CCI score of 0.32, and no history of select obesity-related health conditions, the predicted cost difference between those living with and without obesity was $386 (95% CI: $376, $397). Conclusions: If these findings hold for the Canadian population, one would expect an estimated additional $3.0 billion per year in healthcare costs nationally related to BMI-defined obesity (based on an adult obesity rate of 26% and an estimated annual incremental cost of $386 [21%]); incremental costs are higher when obesity-related health conditions are not adjusted for. Results of this study provide additional rationale for investment in interventions that are effective in preventing and treating obesity and its complications.

Keywords: administrative data, body mass index-defined obesity, healthcare cost, real world evidence

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Authors: Geetu Gahlawat, Manisha Singh

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In the recent years, the concept of media literacy is being extended from its traditional focus on print and audio-visual media to encompass the internet and other new media within academic and policy discourses. This article throws revolves around three significant queries which are to be dealt by the academia, general public and the policy-makers: What is media literacy? How is it changing? And what is the significance of media literacy? At the beginning of the article, the definition 'media literacy' is the ability to access, analyse, evaluate and create messages across a variety of contexts are given and then this is further being tested in connection with the internet and other information and communication technologies.Having advocated this skills-based approach to media literacy in relation to the internet, the article identifies some outstanding issues for new media literacy crucial to any policy of promoting media literacy among the population. The outcome is better understanding of media literacy and also the impact of ICT on media literacy by the public as well as media literate people.

Keywords: media literacy, ICT, internet, education

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Authors: Umamaheswari Shanmugam, Silvia Ronchi

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Software, artificial intelligence, and machine learning can improve healthcare through innovative and advanced technologies that can use the large amount and variety of data generated during healthcare services every day; one of the significant advantages of these new technologies is the ability to get experience and knowledge from real-world use and to improve their performance continuously. Healthcare systems and institutions can significantly benefit because the use of advanced technologies improves the efficiency and efficacy of healthcare. Software-defined as a medical device, is stand-alone software that is intended to be used for patients for one or more of these specific medical intended uses: - diagnosis, prevention, monitoring, prediction, prognosis, treatment or alleviation of a disease, any other health conditions, replacing or modifying any part of a physiological or pathological process–manage the received information from in vitro specimens derived from the human samples (body) and without principal main action of its principal intended use by pharmacological, immunological or metabolic definition. Software qualified as medical devices must comply with the general safety and performance requirements applicable to medical devices. These requirements are necessary to ensure high performance and quality and protect patients' safety. The evolution and the continuous improvement of software used in healthcare must consider the increase in regulatory requirements, which are becoming more complex in each market. The gap between these advanced technologies and the new regulations is the biggest challenge for medical device manufacturers. Regulatory requirements can be considered a market barrier, as they can delay or obstacle the device's approval. Still, they are necessary to ensure performance, quality, and safety. At the same time, they can be a business opportunity if the manufacturer can define the appropriate regulatory strategy in advance. The abstract will provide an overview of the current regulatory framework, the evolution of the international requirements, and the standards applicable to medical device software in the potential market all over the world.

Keywords: artificial intelligence, machine learning, SaMD, regulatory, clinical evaluation, classification, international requirements, MDR, 510k, PMA, IMDRF, cyber security, health care systems

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Authors: Sharda Kumari

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As the Covid-19 pandemic continues to leave its mark on the global business landscape, companies have had to adapt to new realities and find ways to sustain their operations amid social distancing measures, government restrictions, and heightened public health concerns. This unprecedented situation has placed considerable stress on both employees and employers, underscoring the need for innovative approaches to manage the risks associated with Covid-19 transmission in the workplace. In response to these challenges, the pandemic has accelerated the adoption of digital technologies, with an increasing preference for remote interactions and virtual collaboration. Customer relationship management (CRM) systems have risen to prominence as a vital resource for organizations navigating the post-pandemic world, providing a range of benefits that include acquiring new customers, generating insightful consumer data, enhancing customer relationships, and growing market share. In the context of pandemic management, CRM systems offer three primary advantages: (1) integration features that streamline operations and reduce the need for multiple, costly software systems; (2) worldwide accessibility from any internet-enabled device, facilitating efficient remote workforce management during a pandemic; and (3) the capacity for rapid adaptation to changing business conditions, given that most CRM platforms boast a wide array of remotely deployable business growth solutions, a critical attribute when dealing with a dispersed workforce in a pandemic-impacted environment. These advantages highlight the pivotal role of CRM systems in helping organizations remain resilient and adaptive in the face of ongoing global challenges.

Keywords: healthcare, CRM, customer relationship management, customer experience, digital transformation, pandemic response, patient monitoring, patient management, healthcare automation, electronic health record, patient billing, healthcare information systems, remote workforce, virtual collaboration, resilience, adaptable business models, integration features, CRM in healthcare, telehealth, pandemic management

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Authors: D. Velayadum, P. Sthandiwe , N. Maharaj, T. Munien, S. Ndamase, G. Zulu, S. Xulu, F. Oosthuizen

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Introduction and aims of the study: It is the responsibility of the pharmacist to manage drug-related problems in order to ensure the greatest benefit to the patient. In order to prevent drug-related morbidity, pharmacists should be aware of medicines that may contribute to certain drug-related problems due to their pharmacological action. In an attempt to assist healthcare practitioners to prevent drug-related morbidity (PDRM), indicators for prevention have been designed. There are currently no indicators available for primary health care in developing countries like South Africa, where the majority of the population access primary health care. There is, therefore, a need to develop such indicators, specifically with the aim of assisting healthcare practitioners in primary health care. Methods: A literature study was conducted to compile a comprehensive list of PDRM indicators as developed internationally using the search engines Google Scholar and PubMed. MESH term used to retrieve suitable articles was 'preventable drug-related morbidity indicators'. The comprehensive list of PDRM indicators obtained from the literature study was further evaluated for face validity. Face validity was done in duplicate by 2 sets of independent researchers to ensure 1) no duplication of indicators when compiling a single list, 2) inclusion of only medication available in primary healthcare, and 3) inclusion of medication currently available in South Africa. Results: The list of indicators, compiled from PDRM indicators in the USA, UK, Portugal, Australia, India, and Canada contained 324 PDRM. 184 of these indicators were found to be duplicates, and the duplications were omitted, leaving a final list of 140. The 140 PDRM indicators were evaluated for face-validity, and 97 were accepted as relevant to primary health care in South Africa. 43 indicators did not comply with the criteria and were omitted from the final list. Conclusion: This study is a first step in compiling a list of PDRM indicators for South Africa. It is important to take cognizance to the fact the health systems differ vastly internationally, and it is, therefore, important to develop country-specific indicators.

Keywords: drug-related morbidity, primary healthcare, South Africa, developing countries

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Authors: Ossai Paulinus Edwin

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Cash Management is a broad area having to do with the collection, concentration, and disbursement of cash including measuring the level of liquidity and managing the cash balance and short-Term Investments. Cash Management involves the efficient collection and disbursement of cash and cash equivalents. It also includes management of marketable securities because, in modern Terminology, money comprises marketable securities and actual cash in hand or in a bank. This cash management is concerned with management of cash inflow and cash outflow of a business especially as it concerns a developing nation like Nigeria. The paper throws light on the impact of cashless policy in Nigeria as it was introduced by the Central Bank of Nigeria (CBN) in December 2011 and was kick-started in Lagos in January 2012. Survey research was adopted with the questionnaires as data collection instrument. Responses show that cashless policy if adopted generally shall increase employment opportunities, reduce cash related robbery thereby reducing risk of carrying cash; it shall also reduce cash related corruption and attract more foreign investors to the country. It is expected that the introduction of cashless policy in Nigeria is a step in the right direction as it shall bring about modernization of Nigeria payment system, reduction in the cost of banking services, reduction in high security and safety risk and also curb banking related corruptions.

Keywords: cashless economy, cash management, cashless policy, e-banking, Nigeria

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Authors: Muhammad Shahbaz Akhtar

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Background; Tuberculosis remains a significant public health challenge in Pakistan, with high incidence and prevalence rates, particularly among vulnerable populations. Addressing the TB burden requires comprehensive efforts to improve healthcare infrastructure, increase access to quality diagnosis and treatment services, raise public awareness, and address socioeconomic determinants of health. Objective; To assess the knowledge and practices of healthcare workers and patients regarding prevention of tuberculosis at a tertiary care hospital of Southern Punjab.Material and methods; Data will be collected from 135 healthcare workers and 135 TB patients visiting Nishtar Hospital, Multan in this descriptive cross – sectional study using non – probability consecutive sampling technique. Proper approval will be taken from Hospital authorities to conduct this study. Study participants will be recruited after taking informed written consent, describing them objectives of this study. The study participants will be ensured of their confidentiality of the data and interviewed to assess their knowledge and practices regarding prevention of tuberculosis. Data Analysis Procedure; Data will be entered and analyzed by using SPSS version 25 to calculated mean and standard deviation for the numerical data such as age, duration of disease and duration of experience. Frequencies and percentages will be calculated for gender, age groups, level of knowledge, qualification, designation and practices. Impact of confounders like gender, age groups, duration of experience, disease duration, years of experience and designation will be assessed by stratification. Post stratification chi – square test will be applied at 0.05 level of significance at 95 % CI.

Keywords: tuberculosis, data analysis, HIV/AIDS, preventable

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Authors: Yiling Shao, Megan Dai

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This paper attempts to explore whether the cultural infrastructure supported by the Chinese government is still subject to a logic of “strict regulation”.Previous studies have pointed out that the "paternalism" tendency of China's cultural policy always leads to excessive government intervention in cultural development, while Chinese cultural practitioners can only seek cultural autonomy in the cracks of supervision. This can also explain why Chinese cultural policies sometimes have different effects than the official expectations.But this only reflects one aspect of China's cultural policy. In fact, the welfare cultural infrastructure funded by the government seems to highlight the principles of "safeguarding citizens' cultural rights" and "citizens' voluntary" rather than "indoctrination" and "enlightenment", What new features of China's cultural policy are reflected behind this policy orientation that is completely different from the logic of "regulation", which has also become an important issue in this paper. Based on the field survey of a cultural infrastructure (Gao ming District Cultural Center) in Gao ming District, Fo shan City, Guangdong Province, China, for nearly one year, the authors have obtained many text and picture materials.The paper discusses the dual role of cultural centers in China's cultural policy -both as a formal commitment by the state to protect citizens' basic cultural rights and as a social space for citizens to use preferential policies to obtain cultural capital. All in all, the author have conclued three operational logics of the cultural infrastructure currently supported by the Chinese government (at least in developed areas): first, the cultural center has become a versatile cultural space; second, grass-roots cultural cadres can be described as "policy entrepreneurs"; third, ordinary citizens will use the officially supported cultural infrastructure to increase cultural capital. This paper argues that, in comparison to the common “regulatory hand” in the field of cultural industries, in cultural infrastructure supported by state, the authorities and citizens are not in conflict. On the contrary, authorities must adopt a de-regulatory "pleasing" strategy to gain the support of citizens.

Keywords: cultural infrastructure, cultural capital, deregulation, policy entrepreneur

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Authors: Mai Ali

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The abstract underscores the critical importance of junior paediatricians acquiring expertise in handling paediatric emergencies, with a particular focus on Diabetic Ketoacidosis (DKA). Existing literature reveals a wealth of research on healthcare professionals' knowledge regarding DKA, encompassing diverse cultural backgrounds and medical specialties. Consistently, challenges such as the absence of standardized protocols and inadequacies in training emerge as common issues across healthcare centres. This research proposal seeks to conduct a thematic analysis of the proficiency of paediatric trainees in the United Kingdom in managing DKA within various clinical contexts. The primary objective is to assess their level of competence and propose effective strategies to enhance DKA training comprehensively.

Keywords: DKA, knowledge, Junior paediatricians, local protocols

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Authors: Abidemi C. Adegboye, Nosakhare Ikponmwosa, Rogers A. Akinsokeji

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For many resource-rich developing countries, fiscal policy has become a key tool used for short-run fiscal management since it is considered as playing a critical role in injecting part of resource rents into the economies. However, given its instability, reliance on revenue from commodity exports renders fiscal management, budgetary planning and the efficient use of public resources difficult. In this study, the linkage between commodity prices and fiscal operations among a sample of commodity-exporting countries in sub-Saharan Africa (SSA) is investigated. The main question is whether commodity price fluctuations affects the effectiveness of fiscal policy as a macroeconomic stabilization tool in these countries. Fiscal management effectiveness is considered as the ability of fiscal policy to react countercyclically to output gaps in the economy. Fiscal policy is measured as the ratio of fiscal deficit to GDP and the ratio of government spending to GDP, output gap is measured as a Hodrick-Prescott filter of output growth for each country, while commodity prices are associated with each country based on its main export commodity. Given the dynamic nature of fiscal policy effects on the economy overtime, a dynamic framework is devised for the empirical analysis. The panel cointegration and error correction methodology is used to explain the relationships. In particular, the study employs the panel ECM technique to trace short-term effects of commodity prices on fiscal management and also uses the fully modified OLS (FMOLS) technique to determine the long run relationships. These procedures provide sufficient estimation of the dynamic effects of commodity prices on fiscal policy. Data used cover the period 1992 to 2016 for 11 SSA countries. The study finds that the elasticity of the fiscal policy measures with respect to the output gap is significant and positive, suggesting that fiscal policy is actually procyclical among the countries in the sample. This implies that fiscal management for these countries follows the trend of economic performance. Moreover, it is found that fiscal policy has not performed well in delivering macroeconomic stabilization for these countries. The difficulty in applying fiscal stabilization measures is attributable to the unstable revenue inflows due to the highly volatile nature of commodity prices in the international market. For commodity-exporting countries in SSA to improve fiscal management, therefore, fiscal planning should be largely decoupled from commodity revenues, domestic revenue bases must be improved, and longer period perspectives in fiscal policy management are the critical suggestions in this study.

Keywords: commodity prices, ECM, fiscal policy, fiscal procyclicality, fully modified OLS, sub-saharan africa

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Authors: Yue Wang

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Five years passed since the newest English curriculum reform policy was published in China, hand-wringing spread among teachers who accused that this is another 'Wearing New Shoes to Walk the Old Road' policy. This paper provides a thoroughly philosophical policy analysis of serious efforts that had been made to support this reform and reveals the hindrances that bridled the reform to yield the desired effect. Blame could be easily put on teachers for their insufficient pedagogical content knowledge, conservative resistance, and the handicaps of large class sizes and limited teaching times, and so on. However, the underlying causes for this implementation failure are the interrelated factors in the NCEE-centred education system, such as the reluctant from students, the lack of school and education bureau support, and insufficient teacher training. A further discussion of 2017 to 2020’s NCEE reform on English prompt new possibilities for the authentic pedagogical approach reform in secondary English classes. In all, the pedagogical approach reform at the secondary level is heading towards a brighter future with the initiation of new NCEE reform.

Keywords: English curriculum, failure, NCEE, new possibilities, pedagogical, policy analysis, reform

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Authors: Buhari Samaila, Buhari Maidamma

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Background: The use of ionizing radiation in medical diagnostics and treatment is indispensable for accurate imaging and effective cancer therapies. However, radiation exposure carries inherent risks, necessitating strict protection measures to safeguard both patients and healthcare workers. This review critically examines the existing radiation protection measures in diagnostic radiology and radiotherapy, highlighting technological advancements, regulatory frameworks, and challenges. Objective: The objective of this review is to critically evaluate the effectiveness of current radiation protection measures in diagnostic and therapeutic radiology, focusing on minimizing patient and staff exposure to ionizing radiation while ensuring optimal clinical outcomes and propose future directions for improvement. Method: A comprehensive literature review was conducted, covering scientific studies, regulatory guidelines, and international standards on radiation protection in both diagnostic radiology and radiotherapy. Emphasis was placed on ALARA principles, dose optimization techniques, and protective measures for both patients and healthcare workers. Results: Radiation protection measures in diagnostic radiology include the use of shielding devices, minimizing exposure times, and employing advanced imaging technologies to reduce dose. In radiotherapy, accurate treatment planning and image-guided techniques enhance patient safety, while shielding and dose monitoring safeguard healthcare personnel. Challenges such as limited infrastructure in low-income settings and gaps in healthcare worker training persist, impacting the overall efficacy of protection strategies. Conclusion: While significant advancements have been made in radiation protection, challenges remain in optimizing safety, especially in resource-limited settings. Future efforts should focus on enhancing training, investing in advanced technologies, and strengthening regulatory compliance to ensure continuous improvement in radiation safety practices.

Keywords: radiation protection, diagnostic radiology, radiotherapy, ALARA, patient safety, healthcare worker safety

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Authors: Clive Sealey

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This article will analyse the impact that the increasingly multicultural nature of the UK has had on the nature and direction of social policy. The increasingly multicultural nature of the UK is being driven by a variety of demographic changes, particularly increased net migration from EU10 and the EU 2 enlargement. This has become an increasingly political issue, as exemplified by the specific rise of the United Kingdom Independence Party as a political force with the primary intention of restricting such migration. Perhaps not surprisingly, this has also had a significant impact on the nature and direction of social policies, as evident in the prominence given to efforts to reducing immigration and to restrict welfare benefits paid to such migrants. These policies have largely reflected the retreat away from the emphasis in UK policy on multiculturalism towards assimilation for all migrants, both prior and newly domiciled. Linking these two main policy emphases of reducing immigration and limiting entitlement to benefits is the concept of citizenship. An important point that this article will highlight, is that this changed citizenship does not just relate to new migrants, but also to existing domiciled migrants, such as in relation to specifying the assimilation of ‘Britishness’ and ‘British values’ in their daily life. Additionally, the article also analyses how the changes in welfare entitlements for new migrants is also impacting in an exclusionary way on the living standards of the native population, and therefore also their social rights as citizens. The article discusses the implication that this change presents for social work practice, particularly in terms of both migrants and native population changed citizenship.

Keywords: migration, citizenship, exclusion, social policy, migrant welfare

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Authors: A.Beril Tugrul, Selahattin Cimen

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Dependency of humanity on the energy is ever-increasing today and the energy policies are reaching undeniable and un-ignorable dimensions steering the political events as well. Therefore, energy has the highest priority for Turkey like any other country. In this study, the energy supply security for Turkey evaluated according to the strategic criteria of energy policy. Under these circumstances, different alternatives are described and assessed with in terms of the energy expansion of Turkey. With this study, different opportunities in the energy expansion of Turkey is clarified and emphasized.

Keywords: energy policy, energy strategy, future projection, Turkey

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Authors: In Su Na, Gunwon Lee, Seiyong Kim

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This study analyzed the effect of area variables and economic variables on the length of each period of the project in order to analyze the effect of agreement rate on project implementation in housing renewal projects. In conclusion, as can be seen from these results, a low agreement rate may not translate into project promotion, and a higher agreement rate may not translate into project delay. The expectation of the policy is that the lower the agreement rate, the more projects would be promoted, but that is not the actual effect. From a policy consistency viewpoint, changing the agreement rate frequently, depending on the decision of the public, is not reasonable. The policy of using agreement rate as a necessary condition for project implementation should be reconsidered.

Keywords: Area and Economic Variables, Elapsed time, Housing Renewal Project

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Authors: Halimat M. Ajose-Adeogun, Zaynab A. Bello

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Artificial Intelligence (AI) and Natural Language Processing (NLP) have transformed computer language comprehension, allowing computers to comprehend spoken and written language with human-like cognition. NLP, a multidisciplinary area that combines rule-based linguistics, machine learning, and deep learning, enables computers to analyze and comprehend human language. NLP applications in medicine range from tackling issues in electronic health records (EHR) and psychiatry to improving diagnostic precision in orthopedic surgery and optimizing clinical procedures with novel technologies like chatbots. The technology shows promise in a variety of medical sectors, including quicker access to medical records, faster decision-making for healthcare personnel, diagnosing dysplasia in Barrett's esophagus, boosting radiology report quality, and so on. However, successful adoption requires training for healthcare workers, fostering a deep understanding of NLP components, and highlighting the significance of validation before actual application. Despite prevailing challenges, continuous multidisciplinary research and collaboration are critical for overcoming restrictions and paving the way for the revolutionary integration of NLP into medical practice. This integration has the potential to improve patient care, research outcomes, and administrative efficiency. The research methodology includes using NLP techniques for Sentiment Analysis and Emotion Recognition, such as evaluating text or audio data to determine the sentiment and emotional nuances communicated by users, which is essential for designing a responsive and sympathetic chatbot. Furthermore, the project includes the adoption of a Personalized Intervention strategy, in which chatbots are designed to personalize responses by merging NLP algorithms with specific user profiles, treatment history, and emotional states. The synergy between NLP and personalized medicine principles is critical for tailoring chatbot interactions to each user's demands and conditions, hence increasing the efficacy of mental health care. A detailed survey corroborated this synergy, revealing a remarkable 20% increase in patient satisfaction levels and a 30% reduction in workloads for healthcare practitioners. The poll, which focused on health outcomes and was administered to both patients and healthcare professionals, highlights the improved efficiency and favorable influence on the broader healthcare ecosystem.

Keywords: natural language processing, artificial intelligence, healthcare communication, electronic health records, patient care

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Authors: O. Zlatkin-Troitschanskaia, J. Fischer, C. Lautenbach, H. A. Pant

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In 21st century higher education (HE), the diversity among students has increased in recent years due to the internationalization and higher mobility. Offering and providing equal and fair opportunities based on students’ individual skills and abilities instead of their social or cultural background is one of the major aims of HE. In this context, valid, objective and transparent assessments of students’ preconditions and academic competencies in HE are required. However, as analyses of the current states of research and practice show, a substantial research gap on assessment practices in HE still exists, calling for the development of effective solutions. These demands lead to significant conceptual and methodological challenges. Funded by the German Federal Ministry of Education and Research, the research program 'Modeling and Measuring Competencies in Higher Education – Validation and Methodological Challenges' (KoKoHs) focusses on addressing these challenges in HE assessment practice by modeling and validating objective test instruments. Including 16 cross-university collaborative projects, the German-wide research program contributes to bridging the research gap in current assessment research and practice by concentrating on practical and policy-related challenges of assessment in HE. In this paper, we present a differentiated overview of existing assessments of HE at the national and international level. Based on the state of research, we describe the theoretical and conceptual framework of the KoKoHs Program as well as results of the validation studies, including their key outcomes. More precisely, this includes an insight into more than 40 developed assessments covering a broad range of transparent and objective methods for validly measuring domain-specific and generic knowledge and skills for five major study areas (Economics, Social Science, Teacher Education, Medicine and Psychology). Computer-, video- and simulation-based instruments have been applied and validated to measure over 20,000 students at the beginning, middle and end of their (bachelor and master) studies at more than 300 HE institutions throughout Germany or during their practical training phase, traineeship or occupation. Focussing on the validity of the assessments, all test instruments have been analyzed comprehensively, using a broad range of methods and observing the validity criteria of the Standards for Psychological and Educational Testing developed by the American Educational Research Association, the American Economic Association and the National Council on Measurement. The results of the developed assessments presented in this paper, provide valuable outcomes to predict students’ skills and abilities at the beginning and the end of their studies as well as their learning development and performance. This allows for a differentiated view of the diversity among students. Based on the given research results practical implications and recommendations are formulated. In particular, appropriate and effective learning opportunities for students can be created to support the learning development of students, promote their individual potential and reduce knowledge and skill gaps. Overall, the presented research on competency assessment is highly relevant to national and international HE practice.

Keywords: 21st century skills, academic competencies, innovative assessments, KoKoHs

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Authors: Ana L. Martins, Luis Orfão

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Healthcare systems have been subject to various research efforts aiming at process improvement under a lean approach. Another perspective, agility, has also been used, though in a lower scale, in order to analyse the ability of different hospital services to adapt to demand uncertainties. Both perspectives have a common denominator, the improvement of effectiveness and efficiency of the services in a healthcare setting context. Mixing the two approached allows, on one hand, to streamline the processes, and on the other hand the required flexibility to deal with demand uncertainty in terms of both volume and variety. The present research aims to analyse the impacts of the combination of both perspectives in the effectiveness and efficiency of an hospital service. The adopted methodology is based on a case study approach applied to the process of the ambulatory surgery service of Hospital de Lamego. Data was collected from direct observations, formal interviews and informal conversations. The analyzed process was selected according to three criteria: relevance of the process to the hospital, presence of human resources, and presence of waste. The customer of the process was identified as well as his perception of value. The process was mapped using flow chart, on a process modeling perspective, as well as through the use of Value Stream Mapping (VSM) and Process Activity Mapping. The Spaghetti Diagram was also used to assess flow intensity. The use of the lean tools enabled the identification of three main types of waste: movement, resource inefficiencies and process inefficiencies. From the use of the lean tools improvement suggestions were produced. The results point out that leagility cannot be applied to the process, but the application of lean and agility in specific areas of the process would bring benefits in both efficiency and effectiveness, and contribute to value creation if improvements are introduced in hospital’s human resources and facilities management.

Keywords: case study, healthcare systems, leagility, lean management

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Authors: Madhvi Bhayani

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Introduction: Due to the rapid pace of urbanization, the urban health issues have become one of the significant threats to future development in India. It also poses serious repercussions on the citizen’s health. As urbanization in India is increasing at an unprecedented rate and it has generated the urban health crisis among the city dwellers especially the urban poor. The increasing proportion of the urban poor and vulnerable to the health indicators worse than the rural counterparts, they face social and financial barriers in accessing healthcare services and these conditions make human health at risk. The Local as well as the State and National governments are alike tackling with the challenges of urbanization as it has become very essential for the government to provide the basic necessities and better infrastructure that make life in cities safe and healthy. Thus, the paper argues that if no major realistic steps are taken with immediate effect, the citizens will face a huge burden of health hazards. Aim: This paper attempts to analyze the current infrastructure, government planning, and its future policy, it also discusses the challenges and outcomes of urbanization on health and its impact on it and it will also predict the future trend with regard to disease burden in the urban areas. Methods: The paper analyzes on the basis of the secondary data by taking into consideration the connection between the Rapid Urbanization and Public Health Challenges, health and health care system and its services delivery to the citizens especially to the urban poor. Extensive analyses of government census reports, health information and policy, the government health-related schemes, urban development and based on the past trends, the future status of urban infrastructure and health outcomes are predicted. The social-economic and political dimensions are also taken into consideration from regional, national and global perspectives, which are incorporated in the paper to make realistic predictions for the future. Findings and Conclusion: The findings of the paper show that India suffers a lot due to the double burden of rapidly increasing in diseases and also growing health inequalities and disparities in health outcomes. Existing tools of governance of urban health are falling short to provide the better health care services. They need to strengthen the collaboration and communication among the state, national and local governments and also with the non-governmental partners. Based on the findings the policy implications are then described and areas for future research are defined.

Keywords: health care, urbanization, urban health, service delivery

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Authors: Abida Zanib

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Social entrepreneurship is an attention-grabbing area to meet social needs. Stakeholders in the social sector of Pakistan, particularly investors, development activists and policy makers are considering it as an engine to economic growth and powerful tool to address social issues in inventive ways. However, absence of specific policy and legitimacy issues create hurdles in the way of success for emerging start-ups. The review of the literature reveals that research in this emerging phenomenon particularly in the case of Pakistan is inadequate. To fill this gap in the literature, this study aims to scrutinize characteristics of nascent social enterprises. The study collects data from 65-emerging social enterprises using questionnaire. The results of factor analysis highlight optimistic and driving qualities of Pakistani social entrepreneurs, which help them to survive and grow in the business world. Moreover, the study identifies several areas for improvements such as information disclosure, networking, corporate governance, mentorship programs, and trainings. The study notes that despite the absence of specific policy, dynamic entrepreneurial culture is fostering in Pakistan and recommends re-framing the education policy to support the development of social entrepreneurship.

Keywords: emerging, entrepreneurs, Pakistan, social, start-ups

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Authors: Hamza Iftikhar

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The intersex person’s social isolation condition is the leading concern in inclusive educational practices. It provides for the relevance of intersex communities with the influence of social isolation on their education and well-being. Given the underlying concern, this paper stresses the isolation-free condition of the intersex community by facilitating inclusive education. The Atkinson and Shiffrin Model and Behaviorism-Based Intersex Theory supports inclusive education by extending the desire for the significant management of stereotypes, quality teaching, parental beliefs, expressions, physique, and intersex attribution. The reducing role of social isolation for inclusive education is analyzed using the qualitative research method. The semi-structured interview research instrument is used for the data collection from the Ministry of Human Rights, Educational Institutions, and inter-sex Representatives. The results show that managing directors and heads of educational institutions frame policy management for the free social isolation of intersex persons, which is relevant through inclusive education. The implication of this paper is to provide a better social condition for intersex persons towards inclusive education through effective policy management.

Keywords: social isolation, inter-sex, relevance, inclusive education, policy management

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Authors: Morteza Maleki

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In the present study is that it tried to behave in the environment to be monitored and the respective roles of environment (assumed as a vessel) and human beings (assumed as occupants of this vessel) inevitably create effects which can be expressed as various behaviors on the part of human being. The mutual relationship between man and his environment is exhibited through perceptions, behaviors, subjective images, activities, etc. This study investigates the conceptual dimension in the form of the four components of readability, sense of place, identity, and Tenability (tenability) at the Ahmadabad Axis in Mashhad. The theoretical fundamentals and the data regarding the status quo were presented through the descriptive method and the proposed policies were derived through analyzing the available status quo information. The required data were gathered from library resources and documents related to the studied area as well as from instruments used in field methods such as questionnaires. Upon conducting the necessary investigation, the conceptual dimension within the design area was analyzed. The SWOT table was presented, and the results obtained for improving environmental perception were arranged in the form of policy-making tables and operational projects tables for improving the sense of place, creating imagery, and other investigated components.

Keywords: public space, perception, environment, behavior

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Authors: Shahryar Eslamitabar

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Currently, the internet plays an important role in the various scientific, commercial and service practices. Thanks to information and communication technology, the healthcare industry via the internet, generally known as cyber-medicine, can offer professional medical service in a wider geographical area. Having some appealing benefits such as convenience in offering healthcare services, improved accessibility to the services, enhanced information exchange, cost-effectiveness, time-saving, etc. Tele-health has increasingly developed innovative models of healthcare delivery. However, it presents many potential hazards to cyber-patients, inherent in the use of the system. First, there are legal issues associated with the communication and transfer of information on the internet. These include licensure, malpractice, liabilities and jurisdictions as well as privacy, confidentiality and security of personal data as the most important challenge brought about by this system. Additional items of concern are technological and ethical. Although, there are some rules to deal with pitfalls associated with cyber-medicine practices in the USA and some European countries, yet for all developments, it is being practiced in a legal vacuum in many countries. In addition to the domestic legislations to deal with potential problems arisen from the system, it is also imperative that some international or regional agreement should be developed to achieve the harmonization of laws among countries and states. This article discusses some implications posed by the practice of cyber-medicine in the healthcare system according to the experience of some developed countries using a comparative study of laws. It will also review the status of tele-health laws in Iran. Finally, it is intended to pave the way to outline a plan for countries like Iran, with newly-established judicial system for health laws, to develop appropriate regulations through providing some recommendations.

Keywords: tele-health, cyber-medicine, telemedicine, criminal laws, legislations, time-saving

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