Search results for: healthcare policies

Authors: Griaznova Svetlana, Umedov Mekhroz

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The current healthcare facilities trend is the creation of multidisciplinary large-scale centers to provide the maximum possible services in one place, minimizing the number of possible instances in the path of patient treatment. The multifunctional medical centers are mainly designed in urban infrastructure for good accessibility. However, many functions and connections define the building shape, often make it inharmonious, that greatly destroys the city's appearance. The purpose of the research is to scientifically substantiate the factors influencing the shaping, the formation of architectural solutions principles, the formation of recommendations and principles for the multifunctional medical centers' design. The result of the research is the elaboration of architectural and planning solutions principles and the determination of factors affecting the multifunctional healthcare facilities shaping. Research method: Study and generalization of international experience in scientific research, literature, standards, teaching aids, and design materials on the topic of research. An integrated approach to the study of existing international experience of multidisciplinary medical centers. Elaboration of graphical analysis and diagrams based on the system analysis of the processed information. Identification of methods and principles of functional zoning of nuclear medicine centers.

Keywords: health care, multifunctionality, form, medical center, hospital, PET, CT scan

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Authors: Ekhlas Al Gamal, Tony Long

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The impact on the parents of caring for a child with cancer was intense and wide-ranging. A high level of distress and low level or resilience remains during treatment. Even completion of treatment can be a time of increased anxiety and stress for parents particularly with worries about recurrence or relapse. The purpose of this study to examine the associations between parental satisfactions with healthcare provided for their child and the impact of being a caregiver for a child with cancer. Methodology: A descriptive, correlational and cross-sectional design was employed using data from Arabic versions of self-report questionnaires which were administered to 113 parents with children with cancer in Jordan during 2015. Findings: the result indicated that Family relationship functioning was ranked as the highest (better functioning) domain while daily activities were ranked as the lowest (poorer functioning) domain. Parents were generally satisfied with the health care provided, but their emotional needs were not met adequately. Parents with better social functioning were more satisfied in all areas of healthcare satisfaction other than emotional needs and communication. Parents who had a child with more emotional and behavioural problems were more likely to experience a negative impact on the family and a poor level of family functioning. Conclusion and Significance: Nurses and other health care providers should emphasis on family centred approach rather than child centred approach.

Keywords: parents, children, cancer, Jordan

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Authors: Michal Stelmach

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The aim of this paper is a critical analysis of the security policy in the field of the fight against transnational criminal groups in Central America in XXI century. We are analyzing all taken issues from several perspectives: political, anthropological, sociological and legal which allows me to confront behavior and the attitudes of the political elites against official legislative changes and declared actions, strategies and policies against practice. In the first part of paper we would like to present the genesis and characteristic of transnational gangs, called maras and next we would like to present their activities and roles within chosen sectors of organized crimes. In the second part we will analyze the government’s policy towards transnational criminal groups. The analysis will be concentrated on public safety policy implemented in specific Central American countries as well as regional international cooperation. The main intention of the author is to present the state of the security in Central America in XXI century by emphasizing failures and successes in the fight against transnational criminal organizations. Additionally we want to present and define the challenges currently facing the region now and to show the prediction of the situation’s development within next future and to define the recommendations on the design of public security policies in Central American countries.

Keywords: maras, public security, human rights, Central America

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Authors: Jaleh Shoshtarian Malak, Niloofar Mohamadzadeh

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Managing pre-hospital emergency patients requires real-time practices and efficient resource utilization. Since we are facing a distributed Network of healthcare providers, services and applications choosing the right resources and treatment protocol considering patient situation is a critical task. Delivering care to emergency patients at right time and with the suitable treatment settings can save ones live and prevent further complication. In recent years Multi Agent Systems (MAS) introduced great solutions to deal with real-time, distributed and complicated problems. In this paper we propose a multi agent based pre-hospital emergency management architecture in order to manage coordination, collaboration, treatment protocol and healthcare provider selection between different parties in pre-hospital emergency in a self-organizing manner. We used AnyLogic Agent Based Modeling (ABM) tool in order to simulate our proposed architecture. We have analyzed and described the functionality of EMS center, Ambulance, Consultation Center, EHR Repository and Quality of Care Monitoring as main collaborating agents. Future work includes implementation of the proposed architecture and evaluation of its impact on patient quality of care improvement.

Keywords: multi agent systems, pre-hospital emergency, simulation, software architecture

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Authors: Parisa Afshin, Terje Grønning

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Norway, similar to many other countries, has set the focus of its policies in creating new strong and highly innovative sectors in recent years, as the oil and gas sector profitability is declining. Biotechnology sector in Norway has a great potential, especially in marine-biotech and cancer medicine. However, Norway being a periphery faces especial challenges in the path of creating internationally well-known biotech sector and an international knowledge hub. The aim of this article is to analyze the progress of the Norwegian biotechnology industry, its pathway to build up an innovation network and conduct collaborative innovation based on its initial conditions and its own advantage and disadvantages. The findings have important implications not only for politicians and academic in understanding the infrastructure of biotechnology sector in the country, but it has important lessons for other periphery countries or regions aiming in creating strong biotechnology sector and catching up with the strong internationally-recognized regions. Data and methodology: To achieve the main goal of this study, information has been collected via secondary resources such as web pages and annual reports published by the officials and mass media along with interviews were used. The data were collected with the goal to shed light on a brief history and current status of Norway biotechnology sector, as well as geographic distribution of biotech industry, followed by the role of academic and industry collaboration and public policies in Norway biotech. As knowledge is the key input in innovation, knowledge perspective of the system such as knowledge flow in the sector regarding the national and regional innovation system has been studied. Primary results: The internationalization has been an important element in development of periphery regions' innovativeness enabling them to overcome their weakness while putting more weight on the importance of regional policies. Following such findings, suggestions on policy decision and international collaboration, regarding national and regional system of innovation, has been offered as means of promoting strong innovative sector.

Keywords: biotechnology sector, knowledge-based industry, national innovation system, regional innovation system

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Authors: Umedov Mekhroz, Griaznova Svetlana

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The quality of life and well-being of patients, staff and visitors are central to the delivery of health care. Architecture and design are becoming an integral part of the healing and recovery approach. The most significant point that can be implemented in hospital buildings is the therapeutic value of the artificial environment, the design and integration of plants to bring the natural world into the healthcare environment. The hospital environment should feel like home comfort. The techniques that therapeutic architecture uses are very cheap, but provide real benefit to patients, staff and visitors, demonstrating that the difference is not in cost but in design quality. The best environment is not necessarily more expensive - it is about special use of light and color, rational use of materials and flexibility of premises. All this forms innovative concepts in modern hospital architecture, in new construction, renovation or expansion projects. The aim of the study is to identify the methods and principles of therapeutic architecture. The research methodology consists in studying and summarizing international experience in scientific research, literature, standards, methodological manuals and project materials on the research topic. The result of the research is the development of graphic-analytical tables based on the system analysis of the processed information; 3d visualization of hospital interiors based on processed information.

Keywords: therapeutic architecture, healthcare interiors, sustainable design, materials, color scheme, lighting, environment.

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Authors: Ramzi Shawahna

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Background: Neonatal intensive care units are high-risk settings where medication errors can occur and cause harm to this fragile segment of patients. This multicenter qualitative study was conducted to describe medication errors that occurred in neonatal intensive care units in Palestine from the perspectives of healthcare providers. Methods: This exploratory multicenter qualitative study was conducted and reported in adherence to the consolidated criteria for reporting qualitative research checklist. Semi-structured in-depth interviews were conducted with healthcare professionals (4 pediatricians/neonatologists and 11 intensive care unit nurses) who provided care services for patients admitted to neonatal intensive care units in Palestine. An interview schedule guided the semi-structured in-depth interviews. The qualitative interpretive description approach was used to thematically analyze the data. Results: The total duration of the interviews was 282 min. The healthcare providers described their experiences with 41 different medication errors. These medication errors were categorized under 3 categories and 10 subcategories. Errors that occurred while preparing/diluting/storing medications were related to calculations, using a wrong solvent/diluent, dilution errors, failure to adhere to guidelines while preparing the medication, failure to adhere to storage/packaging guidelines, and failure to adhere to labeling guidelines. Errors that occurred while prescribing/administering medications were related to inappropriate medication for the neonate, using a different administration technique from the one that was intended and administering a different dose from the one that was intended. Errors that occurred after administering the medications were related to failure to adhere to monitoring guidelines. Conclusion: In this multicenter study, pediatricians/neonatologists and neonatal intensive care unit nurses described medication errors occurring in intensive care units in Palestine. Medication errors occur in different stages of the medication process: preparation/dilution/storage, prescription/administration, and monitoring. Further studies are still needed to quantify medication errors occurring in neonatal intensive care units and investigate if the designed strategies could be effective in minimizing medication errors.

Keywords: medication errors, pharmacist, pharmacology, neonates

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Authors: Simone Belli, Sergio Minniti, Valeria Santoro

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ICTs and technology transfer can benefit and move a country forward in economic and social development. However, ICT and access to the Internet have been inequitably distributed in most developing countries. In terms of science production and dissemination, this divide articulates itself also through the inequitable distribution of access to scientific knowledge and networks, which results in the exclusion of developing countries from the center of science. Developing countries are on the fringe of Science and Technology (S&T) production due not only to low investment in research but also to the difficulties to access international scholarly literature. In this respect, Open access (OA) initiatives and knowledge infrastructure represent key elements for both producing significant changes in scholarly communication and reducing the problems of developing countries. The spreading of the OA movement in the region, exemplified by the growth of regional and national initiatives, such as the creation of OA institutional repositories (e.g. SciELO and Redalyc) and the establishing of supportive governmental policies, provides evidence of the significant role that OA is playing in reducing the scientific gap between Latin American countries and improving their participation in the so-called ‘global knowledge commons’. In this paper, we map OA publications in Latin America and observe how Latin American countries are moving forward and becoming a leading force in widening access to knowledge. Our analysis, developed as part of the H2020 EULAC Focus research project, is based on mixed methods and consists mainly of a bibliometric analysis of OA publications indexed in the most important scientific databases (Web of Science and Scopus) and OA regional repositories, as well as the qualitative analysis of documents related to the main OA initiatives in Latin America. Through our analysis, we aim at reflecting critically on what policies, international standards, and best practices might be adapted to incorporate OA worldwide and improve the infrastructure of the global knowledge commons.

Keywords: open access, LAC countries, scientific publications, bibliometric analysis

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Authors: Wieke Ellen Bouwes

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This study aims to unravel which factors enhance accessibility of video consultations (VCs) for patients with low digital literacy. Thirteen in-depth interviews with patients, hospital employees, eHealth experts, and digital support organizations were held. Patients with low digital literacy received in-home support during real-time video consultations and are observed during the set-up of these consultations. Key findings highlight the importance of patient acceptance, emphasizing video consultations benefits and avoiding standardized courses. The lack of a uniform video consultation system across healthcare providers poses a barrier. Familiarity with support organizations – to support patients in usage of digital tools - among healthcare practitioners enhances accessibility. Moreover, considerations regarding the Dutch General Data Protection Regulation (GDPR) law influence support patients receive. Also, provider readiness to use video consultations influences patient access. Further, alignment between learning styles and support methods seems to determine abilities to learn how to use video consultations. Future research could delve into tailored learning styles and technological solutions for remote access to further explore effectiveness of learning methods.

Keywords: video consultations, digital literacy skills, effectiveness of support, intra- and inter-organizational relationships, patient acceptance of video consultations

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Authors: Muhittin Fatih Demirhan, Sibel Alapala Demirhan

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Agriculture, is also regarded as the primary activity area in all economies. When international comparisons are made Turkey has comparative advantages in agricultural potential. However, it is diffi cult to say that Turkey's agricultural productivity and use of technology is well developed in terms of sufficieny. Turkey, in terms of agricultural production, is one of the rare self-sufficient countries, but for supplying excessive demand of its domesticproduction to foreign markets to obtain the necessary income it is rather insufficient. On the basis of wrong policies implemented during the crisis and found that bottlenecks in agriculture and animal husbandry or agriculture policies of the IMF and World Bank are imposed on countries like Turkey. The IMF and the World Bank, the reduction of support in the agricultural and livestock Turkey, is known to put pressure for the abolition. Under these circumstances, our farmers, livestock producers and breeders of, not a chance to compete in the same market with EU producers. Animal products that capture the productivity levels of developed countries, seems to be our chance to compete with the quality and hygiene criteria. Thus, the discussion of the issue must be raised as for the sector's contribution to the economy in terms of further increasing production of the existing potential in mobilization.

Keywords: agricultural development, animal production, competition, economic crisis, food supply

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Authors: Mahmoud Hassan

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Understanding the impact of market- and non-market-based environmental policy instruments on renewable energy consumption (REC) is crucial for the design and choice of policy packages. This study aims to empirically investigate the effect of environmental policy stringency index (EPS) and its components on REC in 27 OECD countries over the period from 1990 to 2015, and then use the results to identify what the appropriate environmental policy mix should look like. By relying on the two-step system GMM estimator, we provide evidence that increasing environmental policy stringency as a whole promotes renewable energy consumption in these 27 developed economies. Moreover, policymakers are able, through the market- and non-market-based environmental policy instruments, to increase the use of renewable energy. However, not all of these instruments are effective for achieving this goal. The results indicate that R&D subsidies and trading schemes have a positive and significant impact on REC, while taxes, feed-in tariff and emission standards have not a significant effect. Furthermore, R&D subsidies are more effective than trading schemes for stimulating the use of clean energy. These findings proved to be robust across the three alternative panel techniques used.

Keywords: environmental policy stringency, renewable energy consumption, two-step system-GMM estimation, linear dynamic panel data model

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Authors: Salam Hadid, Mohammad Khatib

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The International Council of Nurses-ICN defined nursing as a sphere integrating autonomous and collaborative care intended for the individual, family and community within and outside of the care setting. Nursing as a care profession has developed broadly over recent decades in terms of its essentials, expertise and primarily academically. Despite the impressive growth of the profession, there is still extreme diversity in the public’s perceptions and opinions of the profession and its professionals and in the knowledge on the fundamentals of its true function and spheres of engagement. The current study examines the existing knowledge among the general population regarding the nursing profession. The population consisted of 498 respondents, 236 women and 262 men, age 18-81. The respondents noted that nursing focuses on the technical, and the emotional aspects and promotion of health for the patient are not the nurse’s responsibility. Most of the respondents saw nurses working mainly in hospital and community-based clinic settings. They considered nursing to be a high prestige profession in general, but less prestigious among respondents exposed to healthcare provision. Most of the respondents considered nursing to be a humane profession but without independence and with no need for academic studies. The findings are incompatible with the definition of nursing and its spheres of action as defined in the ICN Code of Ethics. Two suggestions are to work through nursing schools addressing the student nurses, as ambassadors for the profession. The second is using the healthcare encounter between the nursing staff and the public to improve the image of nurses.

Keywords: ethics, nurse image, public, nursing

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Authors: Loong Qing Zhe, Foo Jing Heng

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A variety of data files are now available on the internet due to the advancement of technology across the globe today. As more and more data are being uploaded on the internet, people are becoming more concerned that their private data, particularly medical health records, are being compromised and sold to others for money. Hence, the accessibility and confidentiality of patients' medical records have to be protected through electronic means. Blockchain technology is introduced to offer patients security against adversaries or unauthorised parties. In the blockchain network, only authorised personnel or organisations that have been validated as nodes may share information and data. For any change within the network, including adding a new block or modifying existing information about the block, a majority of two-thirds of the vote is required to confirm its legitimacy. Additionally, a consortium permission blockchain will connect all the entities within the same community. Consequently, all medical data in the network can be safely shared with all authorised entities. Also, synchronization can be performed within the cloud since the data is real-time. This paper discusses an efficient method for storing and sharing electronic health records (EHRs). It also examines the framework of roles within the blockchain and proposes a new approach to maintain EHRs with keyword indexes to search for patients' medical records while ensuring data privacy.

Keywords: healthcare sectors, distributed system, blockchain, electronic health records (EHR)

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Authors: Kadio Valere R. Angaman, Birahim Bouna Niang

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Land degradation is a serious problem in developing countries, including Cote d’Ivoire, which has its economy focused on agriculture. It occurs in all kinds of ecosystems over the world. However, the drivers of land degradation vary from one region to another and from one ecosystem to another. Thus, identifying these drivers is an essential prerequisite to developing and implementing appropriate policies to reverse the trend of land degradation in the country, especially in the trays ecosystem. Using the binary logistic model with primary data obtained through 780 farmers surveyed, we analyze and identify the drivers of land degradation in the trays ecosystem. The descriptive statistics show that 52% of farmers interviewed have stated facing land degradation in their farmland. This high rate shows the extent of land degradation in this ecosystem. Also, the results obtained from the binary logit regression reveal that land degradation is significantly influenced by a set of variables such as sex, education, slope, erosion, pesticide, agricultural activity, deforestation, and temperature. The drivers identified are mostly local; as a result, the government must implement some policies and strategies that facilitate and incentive the adoption of sustainable land management practices by farmers to reverse the negative trend of land degradation.

Keywords: drivers, land degradation, trays ecosystem, sustainable land management

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Authors: Jakub Gren

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The recent transfer of banking supervision to the ECB has expanded its influence as of a non-majoritarian and technocratic policy-shaper in EU supervisory policies. To fulfil the main policy objectives of the Single Supervisory Mechanism, the ECB has been tasked with building a single supervisory approach to supervised banks across the euro area and is now exclusively responsible for direct supervision of the largest ‘significant’ euro area banks and the oversight of the remaining ‘less significant’ banks. This enhanced supranational position of the ECB significantly alters the EU institutional order and creates powerful incentives to actively pursue integrationist agenda by the ECB. However, this drastic shift has a little impact upon adapting the ECB’s new supervisory mandate to the requirements of democratic legitimacy. Whereas the ECB’s strong pre-crisis independence and limited accountability could be reconciled with democratic principles through a clearly articulated price stability mandate, independence and limited accountability in the context of a more complex supervisory mandate is problematic. Hence, in order to ensure the democratic legitimacy of the ECB/SSM’s supervisory policies, the ECB’s supervisory mandate requires both a lower scope of independence and higher accountability requirements. To address this situation, organizational separation (“Chinese Wall”) between the ECB monetary and supervisory arms was introduced. This separation includes different reporting lines and the relocation of the ECB’s monetary function to a new building complex while leaving its supervisory function at the Euro-tower (“Two Towers”). This paper argues that these measures are not sufficient to establish proper checks and balances on the ECB’s powers to pursue euro zone’s wide supervisory policies. As a remedy, this contribution suggests that the ECB’s Treaties-embedded independence, as set out by art. 130 TFEU, designed to carry out its monetary function shall not be fully applicable to its supervisory function. Indeed functional and conditional reading of this provision to ECB supervisory function could enhance the legitimacy of future ECB’s supervisory action.

Keywords: accountability and transparency, democratic governance, financial management, rule of law

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Authors: Fatemeh Abdollahi, Munn-Sann Lye, Jamshid Yazdani Charati, Mehran Zarghami

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Background: In March 2020, the World Health Organization (WHO) declared the outbreak of a new coronavirus disease, COVID-19, as a public health concern and pandemic. This situation is generating psychological consequences such as stress, anxiety, depression, and intimate partner violence (IPV) throughout the population. This is a brief note on the magnitude of this threat and different ways for abused women to minimize the effects of it in their daily life. Methods: A literature review was conducted using the MEDLINE, PSYCHINFO, and SCIENCE DIRECT databases. The keywords used included intimate partner violence, abuse, victims, pandemic, quarantine, coronavirus, and COVID-19. A Google search was also conducted using these words to identify reports published in non-indexed health care and social science journals. The literature search was restricted to English language studies. Results: The prevalence of IPV and its consequences are rising during such a pandemic. Having sufficient support from healthcare workers and acquaintances is critical for women in such circumstances. Conclusion: Community members, healthcare providers, governments, and policymakers should be informed of the increased risk of IPV during such a pandemic. They should provide a supporting structure for abused women. Social networking is also a good approach that could help abusive women during this situation.

Keywords: covid-19, intimate partner violence, pandemic, women

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Authors: Ryan J. Trefethen, Vincent H. Smith

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This study explores the relationship between national spending on the Medicaid program, and total Medicaid spending and enrollment in Montana, a state that ranks thirty-third in per capita income and thirty-seventh in median household income in the United States. The purpose of the research is to estimate the potential effects that specific changes to national healthcare policy would likely have on funding for the Montana Medicaid Program and enrollees in the program, members of families in poverty whose incomes are low, even though in many cases they have steady jobs. A particular concern is the effect on access to care for children in poverty who tend to be food insecure and, therefore, especially in need of access to health care. The research uses data collected from a variety of government publications, including the Medicaid Financial Management Report, the Medicaid Managed Care Enrollment Report, and the Centers for Medicare and Medicaid Services MSIS State Summaries for fiscal years 2000-2015. These data were examined using econometric analysis, to assess these impacts. The evidence indicates that the changes included in recent congressional legislative initiatives would potentially leave an additional 50,000 to 60,000 Montana residents, five to six percent of the state’s population, in poverty without access to health care. Impacts on children in poverty would potentially be substantial.

Keywords: children, healthcare, medicaid, montana, poverty

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Authors: Mahima Shrivastava, Soumya Kar, B. Swetha Malika, Lalu Saheb, M. Muthu Kumar, P. V. Ponambala Moorthi

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Natural hazards and manmade destruction causes both economic and societal losses. Generalized pre-mitigation strategies introduced and adopted for prevention of disaster all over the world are capable of augmenting the resiliency and optimizing the life-cycle cost of facilities. In countries like India where varied topographical feature exists requires location specific mitigation measures and strategies to be followed for better enhancement by event-driven and code-driven approaches. Present state of vindication measures followed and adopted, lags dominance in accomplishing the required development. In addition, serious concern and debate over climate change plays a vital role in enhancing the need and requirement for the development of time bound adaptive mitigation measures. For the development of long-term sustainable policies incorporation of future climatic variation is inevitable. This will further assist in assessing the impact brought about by the climate change on life-cycle cost of facilities. This paper develops more definite region specific and time bound pre-mitigation measures, by reviewing the present state of mitigation measures in India and all over the world for improving life-cycle cost of facilities. For the development of region specific adoptive measures, Indian regions were divided based on multiple-calamity prone regions and geo-referencing tools were used to incorporate the effect of climate changes on life-cycle cost assessment. This study puts forward significant effort in establishing sustainable policies and helps decision makers in planning for pre-mitigation measures for different regions. It will further contribute towards evaluating the life cycle cost of facilities by adopting the developed measures.

Keywords: climate change, geo-referencing tools, life-cycle cost, multiple-calamity prone regions, pre-mitigation strategies, sustainable policies

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Authors: Lorenza Sganzetta, Nunzia Borrelli

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The research intends to reflect on the current mapping of the Food Strategies, on the reasons why in the planning objectives panorama, such sustainability priorities are located in those geographic areas and on the evolutions of these priorities of the Mediterranean planning dispositions. The whirling population growth that is affecting global cities is causing an enormous challenge to conventional resource-intensive food production and supply and the urgent need to face food safety, food security and sustainability concerns. Urban or Territorial Food Strategies can provide an interesting path for the development of this new agenda within the imperative principle of sustainability. In the specific, it is relevant to explore what ‘sustainability’ means within these policies. Most of these plans include actions related to four main components and interpretations of sustainability that are food security and safety, food equity, environmental sustainability itself and cultural identity and, at the designing phase, they differ slightly from each other according to the degree of approximation to one of these dimensions. Moving from these assumptions, the article would analyze some practices and policies representatives of different Food Strategies of the world and focus on the Mediterranean ones, on the problems and negative externalities from which they start, on the first interventions that are implementing and on their main objectives. We will mainly use qualitative data from primary and secondary collections. So far, an essential observation could have been made about the relationship between these sustainability dimensions and geography. In statistical terms, the US and Canadian policies tended to devote a large research space to health issues and access to food; those northern European showed a special attention to the environmental issues and the shortening of the chain; and finally the policies that, even in limited numbers, were being developed in the Mediterranean basin, were characterized by a strong territorial and cultural imprint and their major aim was to preserve local production and the contact between the productive land and the end consumer. Recently, though, Mediterranean food planning strategies are focusing more on health related and food accessibility issues and analyzing our diets not just as a matter of culture and territorial branding but as tools for reducing public health costs and accessibility to fresh food for everyone. The article would reflect then on how Food Safety, Food Security and Health are entering the new agenda of the Mediterranean Food Strategies. The research hypothesis suggests that the economic crisis that in the last years invested both producers and consumers had a significant impact on the nutrition habits and on the redefinition of food poverty, even in the fatherland of the healthy Mediterranean diet. This trend and other variables influenced the orientation and the objectives of the food strategies.

Keywords: food security, food strategy, health, sustainability

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Authors: Abdelhafez Abdel Hafez

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Dependency theory was developed since 1950s, with economic concerns. It divided the world into two parts, the states of the peripheral (third world countries) and the states of the core (the developed capitalist countries). Another perspective developed to the theory with the implementation of the idea of semi-peripheral states in the new world order. With these divisions (core, peripheral, semi-peripheral) this study aims to develop a concept from the perspective of dependency theory, to understand the nature of the relationship of the U.S. with the Middle East Regions through its relation with Iran, Saudi Arabia, and Turkey. The tested countries (Saudi Arabia, Iran and Turkey) are seeking a foothold and influential role in the region. The paper argued that the U.S. directs its policies toward the region, in the way to guarantee no country of the region will be in semi-peripheral level (that could create competitions or danger on the U.S. interest). Therefore, U.S. policies in the region have varied from declaring war to diplomatic channels and sometimes ignoring. The paper is based on the dependency theory, and other international relations theories used to study the Middle East in the international context.

Keywords: dependency, hegemony, imperialism, middle east

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Authors: Raquel Vianna Duarte Cardoso, Eduarda Lobato Faria, José Jorge Boueri

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Rapid urbanization has transformed the global landscape, presenting significant challenges to public health. This article delves into the impact of urbanization on the spread of infectious diseases in cities and identifies crucial strategies to enhance urban community resilience. Massive urbanization over recent decades has created conducive environments for the rapid spread of diseases due to population density, mobility, and unequal living conditions. Urbanization has been observed to increase exposure to pathogens and foster conditions conducive to disease outbreaks, including seasonal flu, vector-borne diseases, and respiratory infections. In order to tackle these issues, a range of cross-disciplinary approaches are suggested. These encompass the enhancement of urban healthcare infrastructure, emphasizing the need for robust investments in hospitals, clinics, and healthcare systems to keep pace with the burgeoning healthcare requirements in urban environments. Moreover, the establishment of disease monitoring and surveillance mechanisms is indispensable, as it allows for the timely detection of outbreaks, enabling swift responses. Additionally, community engagement and education play a pivotal role in advocating for personal hygiene, vaccination, and preventive measures, thus playing a pivotal role in diminishing disease transmission. Lastly, the promotion of sustainable urban planning, which includes the creation of cities with green spaces, access to clean water, and proper sanitation, can significantly mitigate the risks associated with waterborne and vector-borne diseases. The article is based on a review of scientific literature, and it offers a comprehensive insight into the complexities of the relationship between urbanization and health. It places a strong emphasis on the urgent need for integrated approaches to improve urban resilience in the face of health challenges.

Keywords: infectious diseases dissemination, public health, urbanization impacts, urban resilience

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Authors: Siti Indati Mustapa, Hussain Ali Bekhet

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Global CO2 emission and increasing fuel consumption to meet energy demand requirement has become a threat in recent decades. Effort to reduce the CO2 emission is now a matter of priority in most countries of the world including Malaysia. Transportation has been identified as the most intensive sector of carbon-based fuels and achievement of the voluntary target to meet 40% carbon intensity reduction set at the 15th Conference of the Parties (COP15) means that the emission from the transport sector must be reduced accordingly. This posed a great challenge to Malaysia and effort has to be made to embrace suitable and appropriate energy policy for sustainable energy and emission reduction of this sector. The focus of this paper is to analyse the trends of Malaysia’s energy consumption and emission of four different transport sub-sectors (road, rail, aviation and maritime). Underlying factors influencing the growth of energy consumption and emission trends are discussed. Besides, technology status towards energy efficiency in transportation sub-sectors is presented. By reviewing the existing policies and trends of energy used, the paper highlights prospective policy options towards achieving emission reduction in the transportation sector.

Keywords: CO2 emissions, transportation sector, fuel consumption, energy policy, Malaysia

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Authors: A. Saimen, E. Armstrong, C. Manitshana

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Intimate partner violence (IPV) has been recognised as a global human rights violation. It is universally under diagnosed and the institution of timeous multi-faceted interventions has been noted to benefit IPV victims. Currently, the concept of using a screening tool to detect IPV has not been widely explored in a primary healthcare setting in South Africa, and it was for this reason that this study has been undertaken. A systematic random sampling of 1 in 8 women over a period of 3 months was conducted prospectively at the OPD of a Level 1 Hospital. Participants were asked about their experience of IPV during the past 12 months. The WAST-short, a two-question tool, was used to screen patients for IPV. To verify the result of the screening, women were also asked the remaining questions from the WAST. Data was collected from 400 participants, with a response rate of 99.3%. The prevalence of IPV in the sample was 32%. The WAST-short was shown to have the following operating characteristics: sensitivity 45.2%, specificity 98%,positive predictive value 98%, negative predictive value 79%. The WAST-short lacks sufficient sensitivity and therefore is not an ideal screening tool for this setting. Improvement in the sensitivity of the WAST-short in this setting may be achieved by lowering the threshold for a positive result for IPV screening, and modification of the screening questions to better reflect IPV as understood by the local population.

Keywords: domestic violence, intimate partner violence, screening, screening tools

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Authors: Isa Muhammad Zumo

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The African Great Green Wall (GGW) is a significant initiative in northern Nigeria because it promotes land restoration and conservation utilizing both commercial and species of forest trees while also helping to mitigate desertification and hazards from the sand dunes and shifting Sahara deserts. Conflicts and weather, however, pose a significant danger to the achievement of these goals. The scientific method for monitoring the vegetation dynamics since inception has not received the required attention, despite the African Development Bank (ADB)'s help in funding the project and its integration into the state's development plans for GGW initiatives. This study will monitor the changes in the vegetation cover of the great green wall within Yobe State Nigeria from 2014 to 2023. The vegetation dynamics will be monitored using Landsat 8 Operational Land Imager (OLI) for 6 years at 2 years intervals. The result will show the fluctuations in the vegetation cover density within the period of study. This will guide the design and implementation of policies of the GGW in achieving its objectives. The result can also contribute to the realization of Sustainable Development Goal (SDG) Target 13.2: Integrate climate change measures into national policies, strategies, and planning.

Keywords: monitoring, green wall, Landsat 8, Nigeria

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Authors: Maria Inês Faria, João Miguel Simão

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Frequently, the Sustainable Development paradigm is considered the contemporary societies flag and is has been assuming different nuances on local and global dialogues. This reveals the ambivalent character associated to its implementation due, namely, to the kind of synergies that political institutions, social organizations and citizenry can actually create. The Sustainable Development concept needs further discussion so that it can be useful in decision-making processes. In fact, the polysemic nature of this concept has consistently undermined its credibility leading, among other factors, to the talk and action gap, as well as to misappropriations of this notion. The present study focuses on the importance in questioning the sustainable development operationalization, "To walk the talk", and intends, in a broad sense, identify prospects and the elements of sustainability that are included in strategic plans (global, national and local) and, in the strict sense, confront discourse and practice in the context of local public policies for sustainable development, in particular with regard to the implementation of Local Agenda 21 in the municipality of Beja (Portugal) in order to analyze at what extent the strategies adopted and implemented are aligned with the paradigm of sustainable development. The method is based on critical analysis of literature and official documentation, using three complementary approaches: a) exploratory review of literature in order to identify publications on sustainability and sustainable development; b) this second approach complements the first, focused on the official documentation for the adoption and implementation of sustainable development, which is produced in the global plan, regional, national and local levels; c) and the approach which is focused on official documentation that expresses the policy options, the strategic lines and actions for sustainable development implementation Beja´s Municipality. The main results of this study highlight the type of alignment of the Beja´s Municipality sustainable policies, concerning the officially stipulated for the promotion of sustainable development on the international agenda, stressing the potentialities, constraints and challenges of Agenda 21 Local implementation.

Keywords: sustainable development, Local Agenda 21, sustainable local public policies, Beja

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Authors: Lourenco Camnahas, Eileen Willis, Greg Fisher, Jessie Gunson, Pascale Dettwiller, Charlene Thornton

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Stock-out of pharmaceuticals is a common issue at all level of health services in Timor-Leste, a small post-conflict country. This lead to the research questions: what are the current methods used to quantify pharmaceutical supplies; what factors contribute to the on-going pharmaceutical stock-out? The study examined factors that influence the pharmaceutical supply chain system. Methodology: Privett and Goncalvez dependency model has been adopted for the design of the qualitative interviews. The model examines pharmaceutical supply chain management at three management levels: management of individual pharmaceutical items, health facilities, and health systems. The interviews were conducted in order to collect information on inventory management, logistics management information system (LMIS) and the provision of pharmaceuticals. Andersen' behavioural model for healthcare utilization also informed the interview schedule, specifically factors linked to environment (healthcare system and external environment) and the population (enabling factors). Forty health professionals (bureaucrats, clinicians) and six senior officers from a United Nations Agency, a global multilateral agency and a local non-governmental organization were interviewed on their perceptions of factors (healthcare system/supply chain and wider environment) impacting on stock out. Additionally, policy documents for the entire healthcare system, along with population data were collected. Findings: An analysis using Pozzebon’s critical interpretation identified a range of difficulties within the system from poor coordination to failure to adhere to policy guidelines along with major difficulties with inventory management, quantification, forecasting, and budgetary constraints. Weak logistics management information system, lack of capacity in inventory management, monitoring and supervision are additional organizational factors that also contributed to the issue. There were various methods of quantification of pharmaceuticals applied in the government sector, and non-governmental organizations. Lack of reliable data is one of the major problems in the pharmaceutical provision. Global Fund has the best quantification methods fed by consumption data and malaria cases. There are other issues that worsen stock-out: political intervention, work ethic and basic infrastructure such as unreliable internet connectivity. Major issues impacting on pharmaceutical quantification have been identified. However, current data collection identified limitations within the Andersen model; specifically, a failure to take account of predictors in the healthcare system and the environment (culture/politics/social. The next step is to (a) compare models used by three non-governmental agencies with the government model; (b) to run the Andersen explanatory model for pharmaceutical expenditure for 2 to 5 drug items used by these three development partners in order to see how it correlates with the present model in terms of quantification and forecasting the needs; (c) to repeat objectives (a) and (b) using the government model; (d) to draw a conclusion about the strength.

Keywords: inventory management, pharmaceutical forecasting and quantification, pharmaceutical stock-out, pharmaceutical supply chain management

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Authors: Linda Márcia Mendes Delazeri, Dênis Antônio Da Cunha

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Over the past few years, the evidence that human activities have altered the concentration of greenhouse gases in the atmosphere have become stronger, indicating that this accumulation is the most likely cause of climate change observed so far. The risks associated with climate change, although uncertain, have the potential to increase social vulnerability, exacerbating existing socioeconomic challenges. Developing countries are potentially the most affected by climate change, since they have less potential to adapt and are those most dependent on agricultural activities, one of the sectors in which the major negative impacts are expected. In Brazil, specifically, it is expected that the localities which form the semiarid region are among the most affected, due to existing irregularity in rainfall and high temperatures, in addition to economic and social factors endemic to the region. Given the strategic limitations to handle the environmental shocks caused by climate change, an alternative adopted in response to these shocks is migration. Understanding the specific features of migration flows, such as duration, destination and composition is essential to understand the impacts of migration on origin and destination locations and to develop appropriate policies. Thus, this study aims to examine whether climatic factors have contributed to rural-urban migration in semiarid municipalities in the recent past and how these migration flows will be affected by future scenarios of climate change. The study was based on microeconomic theory of utility maximization, in which, to decide to leave the countryside and move on to the urban area, the individual seeks to maximize its utility. Analytically, we estimated an econometric model using the modeling of Fixed Effects and the results confirmed the expectation that climate drivers are crucial for the occurrence of the rural-urban migration. Also, other drivers of the migration process, as economic, social and demographic factors were also important. Additionally, predictions about the rural-urban migration motivated by variations in temperature and precipitation in the climate change scenarios RCP 4.5 and 8.5 were made for the periods 2016-2035 and 2046-2065, defined by the Intergovernmental Panel on Climate Change (IPCC). The results indicate that there will be increased rural-urban migration in the semiarid region in both scenarios and in both periods. In general, the results of this study reinforce the need for formulations of public policies to avoid migration for climatic reasons, such as policies that give support to the productive activities generating income in rural areas. By providing greater incentives for family agriculture and expanding sources of credit for the farmer, it will have a better position to face climate adversities and to settle in rural areas. Ultimately, if migration becomes necessary, there must be the adoption of policies that seek an organized and planned development of urban areas, considering migration as an adaptation strategy to adverse climate effects. Thus, policies that act to absorb migrants in urban areas and ensure that they have access to basic services offered to the urban population would contribute to the social costs reduction of climate variability.

Keywords: climate change, migration, rural productivity, semiarid region

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Authors: Karimeh Alnuaimi, Manal Kassab, Reem Ali, Khitam Mohammad, Kholoud Shattnawi

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Aim: To compare pregnancy outcomes of Syrian refugee women and Jordanian women. Background and introduction: The current conflict in Syria continues to displace thousands to neighboring countries, including Jordan. Pregnant refugee women are therefore facing many difficulties are known to increase the prevalence of poor reproductive health outcomes and antenatal complications. However, there is very little awareness of whether Syrian refugee women have different risks of pregnancy outcomes than Jordanian women. Methods: Using a retrospective cohort design, we examined pregnancy outcomes for Syrian refugee (N = 616) and Jordanian women (N = 644) giving birth at two governmental Hospitals in the north of Jordan, between January 1, 2014, and December 31, 2014. A checklist of 13 variables was utilized. The primary outcome measures were delivery by Caesarean section, maternal complications, low birth weight (< 2500 g), Apgar score and preterm delivery (< 37 weeks' gestational age). Results: Statistical analysis revealed that refugee mothers had a significant increase in the rate of cesarean section and the higher rate of anemia, a lower neonates’ weight, and Apgar scores when compared to their Jordanian counterparts. Discussion and Conclusion: Results were congruent with findings from other studies in the region and worldwide. Minimizing inequalities in pregnancy outcomes between Syrian refugees and Jordan women is a healthcare priority. Implications for nursing and health policy: The findings could guide the planning and development of health policies in Jordan that would help to alleviate the situation regarding refugee populations. The action is required by the policy makers, specifically targeting public and primary health care services, to address the problem of adequately meeting the need for antenatal care of this vulnerable population.

Keywords: pregnancy, Syrian refugee, Jordanian women, comparative study

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Authors: Sathiya Susuman Appunni

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Background: This article reviews the self-reported pregnancies among teenage girls currently attending secondary school in South Africa. The study aim is to examine the demographic and socio-economic factors associated with self-reported pregnancies among teenage girls currently attending secondary school in the study area. Data and Methods: Secondary data drawn from the General Household Surveys 2016 and Community Survey 2016 as well as 10 % sample data from the 2011 South African census were used. Bivariate, and Multivariate analyses were carried in order to meet the aims of the study. Results: The independent variable identified was the number of economically active people in the household, which indicated 3.3% in 2011 and 3.6% in 2016 for the household with no economically active member. Among the provinces, Limpopo has been leading by 5.2% of self-reported pregnancies among the girls currently attending secondary school in South Africa. Conclusion: It is recommended that the needs to be special health policies and strategies in place to address this epidemic and such policies need to be targeted to the different needs of teenagers in the different demarcations of the country.

Keywords: pregnancy prevalence, demographic, household, teenage girls, socio-economic

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Authors: Km Tanu

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It has been widely accepted that the learning style of adults and children is different, the learning motivation among adults vary, and even their learning preferences cannot be predetermined. In India, where the population is widely diverse and socio-economic and cultural disparities are there, the learning strategies should also be according to their needs and preferences. The present study explores the concept of adult learners in India in order to understand their needs and styles better. The adult learning principles of Malcolm Knowles have been analyzed, and its presence in the different policies and programs has been traced. To what extent these principles and other such concepts would be beneficial for the Indian population and for effective learning strategies, and what contextual understanding is needed, has been argued in the study. Descriptive research methodology, along with content and thematic analyses, has been used for the paper. It has been argued that there are four areas that play crucial roles in making learning effective. These are the learner, the facilitator, the resources and the policy. The prior experiences of the learners, their motivation, the group to which they belong (i.e., the learning styles and the strategies can be varied for the group of farmers and migrant laborers), and their expected outcome play an important role in making any adult education program successful but along with this, the role of facilitator or the educator is also very important as it is not easy to deal with the adult learners, the understanding that the task is not to teach the adult learners but to make them learn and to use their prior knowledge is a task in itself, proper training is needed for that matter. Many times, it has been seen that adult education programs are poorly funded, or even if they are funded, the fund is not utilized well; the unavailability of the resources is one of the reasons for the failure of adult education programs, and if we see these four points as a triangle, at the bottom, there is a policy document. A well-stated and described doable policy document is also equally important.

Keywords: adult education, Indian adult learner, effective learning styles, Malcolm Knowles learning principles, adult education policies and program

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