Search results for: Greek public hospital sector

Authors: Kelechi Emmanuel, Kyaw Thein Aung, William Burch

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Introduction: Although rewarding in more ways than one, rural medicine can be challenging. The factors that lead to the challenges experienced in rural medicine include but are not limited to scarcity of resources, poor patient education inadequately trained professionals. This is the first single center study done on the challenges of and ways to improve diagnosis in rural medicine. Materials and Methods: Questionnaires were given to providers in a single hospital in rural Tennessee USA. In which providers were asked the question ‘In the past six months, what measures have you taken to improve your diagnostic accuracy given limited resources. Results: The questionnaire was passed to ten physicians working in a two hundred and twentyfive hospital bed. Physicians who participated included physicians in hospital medicine, emergency medicine, surgery, cardiology and gastroenterology. The study found that improved physical examination skills, access to specialist especially via telemedicine and affiliation to centers with more experienced professionals improved diagnosis and overall patient outcome in rural medicine. Conclusion: From this single center study, there is evidence to show that in addition to honing physical examination skills and having access to immediate results of testing done; hospital collaborations and access to highly trained specialist via telemedicine does improve diagnosis in rural medicine.

Keywords: rural medicine, diagnostic accuracy, diagnosis, telemedicine

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Authors: Chenxu Fang, Qikai Guan

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Riverside public space in mountainous cities has unique scenic resources and humanistic connotations and is an important place indispensable to the activities of urban residents. In recent years, with the continuous development of society and the expansion of the city, the public space along the riverside has been affected to a certain extent. Based on this, this study is based on the concept of health and safety through the study of riverfront space in the local section of Jialing River in Chongqing City; according to the actual use function of riverfront public space, the riverfront public space in mountainous cities is categorized into leisure and recreational riverfront space, ecological conservation waterfront space, and composite function waterfront space. Starting from the health and safety elements affecting the environment in the riverfront public space, the health and safety influencing factors of the riverfront public space are categorized into three major categories, namely, material, non-material, and social, and through the field research and questionnaire collection, combined with the analysis of the Likert scale, the important levels of the health and safety influencing factors of different types of the riverfront public space of the mountainous cities are clarified. We summarize the factors affecting the health and safety of mountainous riverside spaces, map their importance levels to the design of different types of riverside spaces, and put forward three representative paths for the governance of the safety and health of mountainous riverside public space.

Keywords: health and safety, mountain city, riverfront public space, spatial governance, Chongqing Jialing River

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Authors: Jacqueline R. Llamas, Agnes Regal

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Objective: To determine the breastfeeding knowledge and attitudes of fathers seen at the University of Santo Tomas Hospital. Design: Cross-sectional design. Setting: University of Santo Tomas Hospital (USTH). Participants: 156 fathers who were accompanying their wives/children at the USTH. Findings: Outcome of the Iowa Infant Feeding Attitude Scale showed fathers to be generally unbiased whether their child be fed breast milk or milk formula. About 85% agreed that breast milk is the ideal food for babies, 79% believed that breastfed babies are healthier than formula fed and 55% of them do not believe that breast milk lacks iron. About 80% agreed that it is easily digested, 87% are aware of the economical value and 57% agreed of its convenience. Breastfeeding support was noted when 55% of the fathers would encourage mothers to breastfeed so as not to miss the joys of motherhood, 91% believed that breastfeeding increased mother-infant bonding. About 57% do not feel left out whenever the mothers breastfeed. However, 46.6% support the decision of their wives to switch to formula feeding once they go back to work, 42% only find breastfeeding in public to be acceptable and 57% will not allow breast feeding to mothers who drink alcohol. Conclusion: In the study, although fathers’ attitude toward breastfeeding is unbiased towards breastfeeding or formula feeding, the majority of the fathers appreciate breastfeeding and its benefits. Also, how the father’s level of education, age, profession, household income and number of children had an effect on their attitude towards breastfeeding.

Keywords: father, breastfeeding, breast milk, knowledge

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Authors: Donna Erika E. De Jesus

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Introduction: Cardiac arrest occurs when abrupt cessation of cardiac function results in loss of effective circulation and complete cardiovascular collapse. For every minute of cardiac arrest without early intervention (cardiopulmonary resuscitation [CPR], defibrillation), chances of survival drop by 7-10%. It is crucial that CPR be initiated within 4-6 minutes to avoid brain death. Most out-of-hospital cardiac arrests (OHCA) occur in a residential setting where access to trained personnel and equipment is not readily available, resulting in poor victim outcomes. Methods: This is a descriptive study done from August to November 2021 using a prospective cohort design. Participants of the study include adult patients aged 18 years and above brought to the emergency room who suffered from out-of-hospital cardiac arrest. Out of the total 102 cases of OHCA, 63 participants were included in the study. Descriptive statistics were used to summarize the demographic and clinical characteristics of the patients. Results: 43 were male patients, comprising the majority at 73.02%. Hypertension was identified as the top co-morbidity, followed by diabetes mellitus, heart failure, and chronic kidney disease (CKD). Medical causes of arrest were identified in 96.83% of the cases. 90.48% of cardiac arrests occurred at home. Only 26 patients (41.27%) received pre-hospital intervention prior to ER arrival, which comprised only hands-only CPR. Twenty-three of which were performed by individuals with background knowledge of CPR. 60.32% were brought via self-conduction, the remainder by ambulances, which were noted to have no available equipment necessary to provide proper resuscitation. The average travel time from dispatch to ER arrival is 20 minutes. Conclusion: Overall survival of OHCA in our local setting remains dismal, as a return of spontaneous circulation was not achieved in any of the patients. The small number of patients having pre-hospital CPR indicates the need for emphasis on training and community education.

Keywords: out-of-hospital cardiac arrest, cardiopulmonary resuscitation, basic life support, emergency medical services

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Authors: Pedro Paulino

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The majority of the world’s population is already living in urban areas and the urban population is expected to keep increasing in the next decades. This exponential increase in urban population carries with it obvious mobility problems. Not only a new paradigm in the transport sector is needed in order to address these problems; effective regulatory policies to ensure the quality of services, passenger rights, competition between operators and consistency of the entire mobile ecosystem are needed as well. The purpose of this paper is to present the problems the world faces in this sector and contribute to their solution. Indeed, our study concludes that only through the active supervision of the markets and the activity of monitoring the various operators will it be possible to develop a sustainable and efficient transport system which meets the needs of a changing world.

Keywords: mobility, regulation policies, sanctioning powers, sustainable transport

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Authors: Po-Ching Wang

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Public art may be regarded as a social agenda. It is assumed that public art acts as an intermediate form that contributes significantly to community resurgence. That is, public art may be regarded as a verb/process or social intervention. It functions as a vanguard form, attacking boundaries and providing a sensibility for social strategy. Public art in tradition is generally expected to bring aesthetic pleasure to public. Contemporary public art, however, not only focuses on art installation, but it also often offers a process that aims to comment on, question, and challenge the socio-cultural status quo. During the last few decades, accelerated changes in the values and expectations brought to bear on varied urban issues, together with the destruction of the hegemony of traditional art and of museum authorities, has begun to contribute to freer and more democratic representations of public art. It is said that part of a public artwork’s role is to ruffle sacred feathers. In many cases, public art is created to address the dynamic social contradictions and mutability of public life; and artists and community participants approach public art from a variety of social critical perspectives and methodologies. Urban issues, such as social and environmental justice, health problems, violence, and political statements, provide plentiful source materials that fuel the performance of public art in many different settings. Further, public artworks have been extensively adopted to express social identity, make political statements, and/or to remedy social and environmental crises. Many murals on urban walls, for instance, reflect social conflicts and address civic rights, and these projects are usually the work of artists who though denied access to traditional gallery and museum channels are supported by community engagement and involvement. Public art as a social practice challenges the traditional western view of artistic practice. Art in the public realm creates a new media that provides a platform for a dialogical exchange between diverse social groups. It seems that public art has evolved as an arena for activism that addresses wide-ranging and highly controversial social issues and civilian concerns. The findings of this study indicate that public artworks are capable of playing a role of activist in facilitating community evolution via social progress.

Keywords: aesthetics, community regeneration, city development, publicness, public participation, social progress

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Authors: Ida Bruheim Jensen, Hulda Mjöll Gunnarsdottir, Ingunn T. Ellingsen

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Digital government is often seen as an enabler or even driver of transformation of public administration, with the objective of creating public value. The increasing use of digital solutions in public services comes with great expectations of new and/or more efficient service provision. Digitalizing public sector services involve multi-level implementation. It involves national policy negotiations and decisions of digital government solutions. It involves co-creation/-production of ideas where planning, design, and implementation involves several groups of actors targeting end-users. Norway is among the most digitalised countries in the world, and Government spendings on digital technologies in public services are high compared to other OECD countries. This contribution studies an ongoing digital transformation in the Norwegian child welfare services. DigiBarnevern (Digi child welfare) is a nationwide project promising better and more efficient child welfare services through various digital technologies. The digitalization process, which is managed by the state and municipalities, is still in its early stages, and as of 2022, only a few services are operative. Digital technologies such as DigiBarnevern are implemented with promises of qualitatively improving child protection work, making the services more effective, foster user participation, and increase availability. There is limited research on the implications of using digital technologies in child protection work. We aim to present findings from an ongoing research project (2022-2024). Drawing on data from focus group interviews with social workers in 5 municipal child welfare services in Norway, we explore social workers’ experiences and expectations towards using digital technologies in child welfare services. Technological solutions may change the services and child protection work in numerous ways. Potential points of departure for discussion are how technologies may change the relationships between social workers, children, youth, and their families, how technologies can alter and obscure responsibilities, and how technologies may demand digital competence among social workers and service recipients.

Keywords: child welfare, social work, technology, digitalisation

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Authors: Jose Francisco Ferreira Ribeiro, Alexandre Bevilacqua Leoneti, Andre Lucirton Costa

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This paper presents a mathematical model in binary variables 0/1 to make the assignment of surgical procedures to the operating rooms in a hospital. The proposed mathematical model is based on the generalized assignment problem, which maximizes the sum of preferences for the use of the operating rooms by doctors, respecting the time available in each room. The corresponding program was written in Visual Basic of Microsoft Excel, and tested to schedule surgeries at St. Lydia Hospital in Ribeirao Preto, Brazil.

Keywords: generalized assignment problem, logistics, optimization, scheduling

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Authors: Marina Kapsali, John S. Anagnostopoulos

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Greek islands’ interconnection (IC) with larger power systems, such as the mainland grid, is a crucial issue that has attracted a lot of interest; however, the recent economic recession that the country undergoes together with the highly capital intensive nature of this kind of projects have stalled or sifted the development of many of those on a more long-term basis. On the other hand, most of Greek islands are still heavily dependent on the lengthy and costly supply chain of oil imports whilst the majority of them exhibit excellent potential for wind energy (WE) applications. In this respect, the main purpose of the present work is to investigate −through a parametric study which varies both in wind farm (WF) and submarine IC capacities− the impact of large-scale WE development on the IC of the third in size island of Greece (Lesbos) with the mainland system. The energy and economic performance of the system is simulated over a 25-year evaluation period assuming two possible scenarios, i.e. S(a): without the contribution of the local Thermal Power Plant (TPP) and S(b): the TPP is maintained to ensure electrification of the island. The economic feasibility of the two options is investigated in terms of determining their Levelized Cost of Energy (LCOE) including also a sensitivity analysis on the worst/reference/best Cases. According to the results, Lesbos island IC presents considerable economic interest for covering part of island’s future electrification needs with WE having a vital role in this challenging venture.

Keywords: electricity generation cost, levelized cost of energy, mainland grid, wind energy rejection

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Authors: Victor Oyewumi Ogunbiyi

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Food waste is a global sustainability issue that demands that multiple stakeholders participate in solving it. This article examines how different food system stakeholders are held responsible in the policy debate related to food waste reduction. The study adopts a qualitative approach, paying attention to the views of both public and private policymakers and constructing their views relating to opportunities and policy initiatives towards waste reduction. The data consists of a list of opportunities and food policy initiatives in the development process in Nigeria. The authors identify three emerging opportunities: sectoral growth, technological demands in food service, and sustainable collaborative behaviour. The findings also revealed key policy initiatives for development: law and regulations, multi-stakeholder collaboration, economic incentives, research, and new knowledge. The study extends the marketing literature on food sustainability by investigating several stakeholders’ roles beyond the practical management of the food services sector. Additionally, considering policy initiative development for food waste mitigation sheds light on how stakeholders’ policy initiatives can sustain the food service sector. Finally, the authors outline policy implications.

Keywords: multistakeholder engagement, food services, food waste, policy initiatives, Nigeria

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Authors: Muhammad Faizan Butt, Maria Ambreen Tahir, Joshua James Pilkington, A. A. Warsi

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Background: Total parenteral nutrition (TPN) use within the NHS is crucial in the prevention of malnourishment. TPN prescriptions are tailored to an individual patient’s needs. TPN bags come in fixed sizes, and minimizing wastage has financial and sustainability implications for the health service. The aim of the study is to assess current prescribing practices, look at the volume of TPN wastage and identify reasons for it. Methodology: A retrospective cohort study on TPN prescriptions over a period of 1 year (Jan-Dec 2022) was performed. All patients prescribed TPN that had been admitted under a general surgery consultant in a small district hospital were included. Data were extracted from hospital electronic records and dietician charts. Data were described, and reasons for TPN wastage were explored. Results: 49 patients were identified. The average length of TPN prescription was 8 days (median). This totaled 608 prescriptions. Of the bags prescribed, 258, 169, and 181 were 10g (2500ml), 14g (2000ml), and 18g (2000ml), respectively. The mean volume wasted from each type of bag was 634ml, 634ml, and 648ml, respectively. Reasons for TPN wastage identified were: no loss (25%), smaller bags not available (53.6%), step-down regime (8.1%), and other (12.2%). Conclusion: This study has identified that the current stocking and prescribing of TPN within a district general hospital leads to a significant wastage of 638.2ml (average). The commonest reason for wastage is the non-availability of a more appropriate sized bag.

Keywords: general surgery, TPN, sustainability, wastage

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Authors: Prateep Wajeetongratana

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This research aims to study the audit quality that affected to the reputation of the certified public accountants in Thailand. The researcher defined the population for this research as a group of the certified public accountants in Thailand who are the member of the federation of accounting professions under the royal patronage of his majesty the king also disclose their information .The total sampling size is 325. The results showed the audit quality factor has influence to the reputation of the certified public accountants in Thailand by accuracy auditing, objectiveness auditing and clearness auditing .These factors show by y1 = 1.381 + .372x1.1 + .309x1.2 + .305x1.3 can be describe as professional standard strictly factor (Y.1.1) and the new clients raised from word of mount of old clients regularly factor (Y.1.2) by regression coefficient (R2) as.242, this shows that such variables could predict the audit quality variable as 24.2 percent.

Keywords: audit quality, certified public accountants in Thailand, reputation

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Authors: Bilgehan Gultekin, Tuba Gultekin

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Diplomatic public relations gives an ideal concept for recognition of palestine state in all over the europe. The first step of official recognition is approval of palestine state in international political organisations such as United Nations and Nato. So, diplomatic public relations provides a recognition process in communication scale. One of the aims of the study titled “Diplomatic Public Relations Techniques for Recognition of Palestine State in Europe” is to present some communication projects on diplomatic way. The study also aims at showing communication process at diplomatic level. The most important level of such kind of diplomacy is society based diplomacy. Moreover,The study provides a wider perspective that gives some creative diplomatic communication strategies for attracting society. To persuade the public for official recognition also is key element of this process. The study also finds new communication routes including persuasion techniques for society. All creative projects are supporting parts in original persuasive process of official recognition of Palestine.

Keywords: diplomatic public relations, diplomatic communication strategies, diplomatic communication, public relations

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Authors: Carlos Marden Cabral Coutinho, Jose Luis Bolzan de Morais

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The article proposed intends to analyze the possibility (and conditions) of a media regulation law in a democratic rule of law in the twenty-first century. To do so, will be presented initially the idea of the public sphere (by Jürgen Habermas), showing how it is presented as an interface between the citizen and the state (or the private and public) and how important is it in a deliberative democracy. Based on this paradigm, the traditional perception of the role of public information (such as system functional element) and on the possibility of media regulation will be exposed, due to the public nature of their activity. A critical argument will then be displayed from two different perspectives: a) the formal function of the current media information, considering that the digital age has fragmented the information access; b) the concept of a constructive democracy, which reduces the need for representation, changing the strategic importance of the public sphere. The question to be addressed (based on the comparative law) is if the regulation is justified in a polycentric democracy, especially when it operates under the digital age (with immediate and virtual communication). The proposal is to be presented in the sense that even in a twenty-first century the media in a democratic rule of law still has an extremely important role and may be subject to regulation, but this should be on terms very different (and narrower) from those usually defended.

Keywords: constructive democracy, media, digital age, public sphere

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Authors: Sasha Goodwin

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Sex offenders are often viewed as a homogenous group, but they encompass a diverse range of individuals with varying characteristics and offenses. The principal aim of this study was to ascertain how members of the Australian public perceive and define a sex offender while also investigating the emotional underpinnings associated with these attitudes and definitions. To assess public attitude, this study used the innovative utilization of visual methodologies to assess the public's perception of sex offenders. The study employed the iSquare approach, a visual methodology framework that offers unique viewpoints and insights into public attitudes toward sex offenders. Through the utilization of this approach, this study established an academic foundation for a deeper understanding of the public's perception of sex offenders. The data analysis revealed that most participants associated sex offenders with strong negative emotions, primarily disgust and anger. The findings of this research point towards the potential for fostering a social environment characterized by evidence-based discussions instead of reactionary punitive responses. Promoting a comprehensive understanding of the diverse nature of sexual offenders aims to broaden perceptions, fostering constructive attitudes.

Keywords: visual methodologies, public perception, sex offenders, offender characteristics, emotional attitudes, isquare approach, attitudes

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Authors: Li Hua Li, Ling Ling Li

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With the National Fitness Program being established as a national strategy by the Chinese government, Chinese old planning strategies of sports facilities which are based on the purpose for hosting high-level sports events have been failed to meet the rapid growth of Chinese residents’ healthy needs. As the most important carrier for promoting the health of citizens in China, public sports facilities may have further conflicts when they are planned without considering the characteristics of the city itself and the fitness needs of the urban residents. With the planning practice in Songyuan in northeastern China, this paper explores the key planning strategies of public sports facilities through the field investigation to obtain the current situation of public sports facilities in Songyuan and the questionnaire to get the date of Songyuan residents’ fitness characteristics and needs. Findings from this investigation suggest that the planning of public sports facilities in Songyuan should first increase the quantities of public sports facilities at the community level, which could match the fitness population and meet the fitness needs in Songyuan. Secondly, the planning should combine with other available resources, such as urban parks, squares and other places where Songyuan residents often choose to do physical activities to enhance the vitality of public sports facilities. Finally, the planning should also link the urban transportation system in Songyuan to improve the accessibility and efficiency of public sports facilities. All these planning strategies could provide essential information for updating the urban and regional design of Songyuan.

Keywords: field investigation, healthy needs, public sports facilities, planning strategies, questionnaire

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Authors: James A. Bryant Jr

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This article examines the far-reaching consequences of the mainstreaming of the Christian Dominionist philosophy on public schools all across the United States of America. Under the guise of “school choice,” and the ever-growing influence and legacy of its most vocal proponent, R.J. Rushdoony, the American right has declared an all-out war on public education, public schools, and the men and women who staff these institutions. For the purposes of this paper, the term “school choice” encompasses both the efforts to use public money to support private, religious education as well as the move to dramatically expand the number of children and youth who are home schooled. This article examines both the history and dangers of the homeschool movement and the vouchers-for-religious school's scheme, with particular attention to the philosophy and words of its most renowned advocate, the missionary Rousas John Rushdoony.

Keywords: history education, multicultural education, public education, Christian Dominionism

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Authors: Andrei-Marius Sandu

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This study aims to analyze the bovine meat and milk sector for the period 2007-2013. For the period analyzed, it is known that Romania has benefited from EU funding through the National Rural Development Programme 2007-2013. In this programme, there were measures that addressed exclusively the animal husbandry sector in Romania. This paper presents data on bovine production of meat, milk and livestock in Romania, but also data on the price and impact the European Funds implementation had on them.

Keywords: European funds, measures, national rural development programme, price

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Authors: Fanniyah Anis, Bram Kilapong

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Myocardial reperfusion injury is defined as the cellular damage that results from a period of ischemia, followed by the reestablishment of the blood supply to the infarcted tissue. Ventricular tachycardia is one of the most commonly encountered reperfusion arrhythmia as one of the types of myocardial perfusion injury. Prompt and early treatment can reduce mortality, despite limited resources of the hospital in high risk patients with history of triple vessel disease. Case report, Male 53 years old has been diagnosed with NSTEMI with 3VD and comorbid disease of Hypertension and has undergone revascularization management with Percutaneous coronary intervention. Ventricular tachycardia leading to cardiac arrest occurred right after the stent was inserted. Resuscitation was performed for almost 2 hours until spontaneous circulation returned. Patient admitted in ICU with refractory cardiac shock despite using combination of ionotropic and vasopressor agents under standard non-invasive monitoring due to the limitation of the hospital. Angiography was performed again 5 hours later to exclude other possibilities of blockage of coronary arteries and conclude diagnosis of myocardial reperfusion injury. Patient continually managed with combination of antiplatelet agents and maintenance dose of anti-arrhythmia agents. The handling of the patient was to focus more on supportive and preventive from further deteriorating of the condition. Patient showed clinically improvement and regained consciousness within 24 hours. Patient was successfully discharged from ICU within 3 days without any neurological sequela and was discharge from hospital after 3 days observation in general ward. Limited Resource of hospital did not refrain the physician from attaining a good outcome for this myocardial reperfusion injury case and angiography alone can be used to confirm the diagnosis of myocardial reperfusion injury.

Keywords: limited resources hospital, myocardial reperfusion injury, prolonged resuscitation, refractory cardiogenic shock, reperfusion arrhythmia, revascularization, triple-vessel disease

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Authors: Geoffrey J. Blanford, Christoph Weissbart

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The prospects for the European power sector indicate that it has to almost fully decarbonize in order to reach the economy-wide target of CO₂-emission reduction. We apply the EU-REGEN model to explain the penetration of RES from an economic perspective, their spatial distribution, and the complementary role of conventional generation technologies. Furthermore, we identify economic consequences of national energy and climate targets. Our study shows that onshore wind power will be the most crucial generation technology for the future European power sector. Its geographic distribution is driven by resource quality. Gas power will be the major conventional generation technology for backing-up wind power. Moreover, a complete phase out of coal power proves to be not economically optimal. The paper demonstrates that existing national targets have a negative impact, especially on the German region with higher prices and lower revenues. The remaining regions profit are hardly affected. We encourage an EU-wide coordination on the expansion of wind power with harmonized policies. Yet, this requires profitable market structures for both, RES and conventional generation technologies.

Keywords: European, policy evaluation, power sector investment, technology choices

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Authors: Swadhin Mondal

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While safe drinking water is an effective defense against the infection of water borne diseases, a large number of populations suffering from these diseases do not have access to safe drinking water due inadequacy of supply. Private entrepreneurs entered this sector and made bottled drinking water available by supplying various kinds of bottled water. In this study we found that the bottled drinking water industry has experienced a spectacular growth over the past two decades and it has a huge growth potential because of rising demand for safe drinking. High profit margin (217 %) is the main attraction to the entrepreneur to invest in this industry. Health awareness, lack of safe drinking water facilities, rising income, urbanization, migration and rising trend in tourism industries are the major influencing factors of demand for bottled drinking water (BDW). This industry also partially fulfills the demand for drinking water. More than 2 percent of household’s demands were met by this industry and many more households (additional 4 percent) coping with BDW during water crisis. Poor households spend around 4 percent of their total monthly household’s consumption expenditure on BDW which may have an adverse impact on household because households could have spent this for purchasing other goods. Like other developed counties, a large section of Indian households are shifting from their traditional sources of water to BDW. However, there are some concerns about the quality of BDW. Many cases, BDW contains chemical toxins at more than permissible level that can be harmful for health. Hence, there is an urgent need for appropriate intervention to regulate price, reduce potential harm and improve the quality of water provided by this industry.

Keywords: drinking water, public health public failure, privatization, development, public policy

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Authors: Shyam lamsal

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Introduction: Karnali Academy of Health Sciences (KAHS) has been established in 2011, by an Act of parliament of Nepal, in Jumla, to provide health services in easy way in backward areas, to produce skilled health professionals & conduct research. The backward areas mentioned in act of KAHS are Humla, Jumla, Kalikot, Dolpa, Mugu districts of Karnali zone, Jajarkot district of Bheri zone & Bajura, Baghang & Achham districts of Seti zone in Nepal occupying around 25 % of the total national geography. Backward area of Nepal is specific to having worst health indicators with life expectancy (47 years), HDI (0.35), Literacy rate (58%), global acute malnutrition (13%), crude birth rate (33.6), crude death rate (9.6), Total fertility rate (4.2), infant mortality rate (61.5 per 1000 live births), under five mortality rate (59 per 1000 live births) and maternal mortality ratio (400 per 1000 live births). History of health facilities in backward region: All the nine districts of this region have a district hospital with very few grass root level health manpower. Government of Nepal regularly deploys one or two medical officers to each district who generally are not regular to their care. Jumla district itself was having one medical officer before the establishment of KAHS. Development activities: Establishment of 100 bedded specialty teaching hospital with 10 medical officers and five specialists, accredited its own nursing school for running diploma nursing programme, started “Karnali health survey” which covers 55 thousand households of backward region, started community care and school health camps, planning phase completed for 300 bedded teaching hospital construction. Future Plan: Expansion of the teaching hospital to 300 beds within 3 years, start health assistant and bachelor midwifery course in 2015 AD, start bachelor in laboratory and bachelor in public health course in 2016 AD and start MBBS course in 2018 AD. Deploy the medical officers and family physicians to all the district hospitals within 3 years. KAHS provides reservation up to 45% students from backward region with the commitment to stay for at least five years of their service period. Conclusion: This institution may be the example for the rest of the world in providing nursing care, education in remote areas as well as the best model for nursing manpower retention in remote areas of developing countries.

Keywords: backward area, nursing school

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Authors: Krisada Sungkhamanee

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The objectives of this research are to search the management pattern of one district lodging entrepreneurs by sufficient economy ways, to know the constrains that affects this sector and design fit arrangement shape to sustain their business with Samut Songkram style. What will happen if they do not use this approach? Will they have a monetary crisis? The data and information are collected by informal discussions with 8 managers and 400 questionnaires. A mixed methods of both qualitative research and quantitative research are used and Bent Flyvbjerg’s phronesis is utilized for this analysis. Our paper will prove that sufficient economy can help small business firms to solve their problems. We think that the results of our research will be a financial pattern to solve many problems of the entrepreneurs and this way will can be a super model for other provinces of Thailand.

Keywords: Samut Songkram, service sector, sufficient economy, management pattern

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Authors: Nour Wehbe

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The Lebanese electricity sector is at the heart of a deep crisis. Electricity in Lebanon is supplied by Électricité du Liban (EdL) which has to suffer from technical and financial deficiencies for decades and proved to be insufficient and deficient as the demand still exceeds the supply. As a result, backup generation is widespread throughout Lebanon. The sector costs massive government resources and, on top of it, consumers pay massive additional amounts for satisfying their electrical needs. While the developed countries have been investing in renewable energy for the past two decades, the Lebanese government realizes the importance of adopting such energy sourcing strategies for the upgrade of the electricity sector in the country. The diversification of the national electricity generation mix has increased considerably in Lebanon's energy planning agenda, especially that a detailed review of the energy potential in Lebanon has revealed a great potential of solar and wind energy resources, a considerable potential of biomass resource, and an important hydraulic potential in Lebanon. This paper presents a review of the energy status of Lebanon, and illustrates a detailed review of the EDL structure with the existing problems and recommended solutions. In addition, scenarios reflecting implementation of policy projects are presented, and conclusions are drawn on the usefulness of a proposed evaluation methodology and the effectiveness of the adopted new energy policy for the electrical sector in Lebanon.

Keywords: EdL Electricite du Liban, portfolio optimization, electricity generation mix, mean-variance approach

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Authors: Eric Neidhardt

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A well-functioning public transport system that is accepted and used by the general population contributes a lot to a sustainable city. Especially young and elderly people rely on public transport to get to work, go shopping, visit a doctor, and take advantage of entertainment options. The sustainability of a public transport system can be considered from different points of view. In urban areas, acceptance is particularly important. As many people as possible should use public transport and not their private vehicle. This reduces traffic jams and increases air quality. In rural areas, the cost efficiency of public transport is especially important. Longer distances and a low population density mean that these modes of transportation can rarely be used cost-effectively. It is crucial to avoid a low utilization, because empty rides are neither sustainable nor cost-effective. With a demand-oriented approach, we try to both improve flexibility and therefore attractiveness for the user and improve cost- efficiency. The vehicles only operate when they are needed and only where they are needed. Empty rides are avoided to improve sustainability. In the subproject "Autonomous public driving" of the project RealLabHH, such a system was implemented and tested in Hamburg-Bergedorf, a suburb of Hamburg. In this paper, some of the steps necessary for this are considered from a technical point of view, and problems that arose in real-life use are addressed.

Keywords: public transport, demand-oriented, autonomous driving, RealLabHH

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Authors: Asma Mehan

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Under the thrust of technological changes, population growth and vehicular traffic, Iranian historical squares have lost their significance and they are no longer the main social nodes of the society. This research focuses on how historical public squares can inspire designers to enhance social interactions among citizens in Iranian urban context. Moreover, the recent master plan of Tehran demonstrates the lack of public spaces designed for the purpose of people’s social gatherings. For filling this gap, first the current situation of 7 selected primary historical public squares in Tehran including Sabze Meydan, Arg, Topkhaneh, Baherstan, Mokhber-al-dole, Rah Ahan and Hassan Abad have been compared. Later, the influencing elements on social interactions of the public squares such as subjective factors (human relationships and memories) and objective factors (natural and built environment) have been investigated. As a conclusion, some strategies are proposed for improving social interactions in historical public squares like; holding cultural, national, athletic and religious events, defining different and new functions in public squares’ surrounding, increasing pedestrian routs, reviving the collective memory, demonstrating the historical importance of square, eliminating visual obstacles across the square, organization the natural elements of the square, appropriate pavement for social activities. Finally, it is argued that the combination of all influencing factors which are: human interactions, natural elements and built environment criteria will lead to enhance the historical public squares’ potential for social interaction.

Keywords: historical square, Iranian public square, social interaction, Tehran

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Authors: Victor Au, Khin Maung Than, Zaw Win Aung, Linawati Jumat

Abstract:

Background & Objectives: Cardiac arrests can occur anywhere or anytime, and most of the cases will be brought to the emergency department except the cases that happened in at in-patient setting. Raja IsteriPangiran Anak Saleha (RIPAS) Hospital is the only tertiary government hospital which located in Brunei Muara district and received all referral from other Brunei districts. Data of cardiac arrests in Brunei Darussalam scattered between Emergency Medical Ambulance Services (EMAS), Emergency Department (ED), general inpatient wards, and Intensive Care Unit (ICU). In this audit, we only focused on cardiac arrest cases which had happened or presented to the emergency department RIPAS Hospital. Theobjectives of this audit were to look at demographic of cardiac arrest cases and the survival to discharge rate of In-Hospital Cardiac Arrest (IHCA) and Out-Hospital Cardiac Arrest (OHCA). Methodology: This audit retrospective study was conducted on all cardiac arrest cases that underwent Cardiopulmonary Resuscitation (CPR) in ED RIPAS Hospital, Brunei Muara, in the year 2019-2020. All cardiac arrest cases that happened or were brought in to emergency department were included. All the relevant data were retrieved from ED visit registry book and electronic medical record “Bru-HIMS” with keyword diagnosis of “cardiac arrest”. Data were analyzed and tabulated using Excel software. Result: 313 cardiac arrests were recorded in the emergency department in year 2019-2020. 92% cases were categorized as OHCA, and the remaining 8% as IHCA. Majority of the cases were male with age between 50-60 years old. In OHCA subgroup, only 12.4% received bystander CPR, and 0.4% received Automatic External Defibrillator (AED) before emergency medical personnel arrived. Initial shockable rhythm in IHCA group accounted for 12% compare to 4.9% in OHCA group. Outcome of ED resuscitation, 32% of IHCA group achieved return of spontaneous circulation (ROSC) with a survival to discharge rate was 16%. For OHCA group, 12.35% achieved ROSC, but unfortunately, none of them survive till discharge. Conclusion: Standardized registry for cardiac arrest in the emergency department is required to provide valid baseline data to measure the quality and outcome of cardiac arrest. Zero survival rate for out hospital cardiac arrest is very concerning, and it might represent the significant breach in cardiac arrest chains of survival. Systematic prospective data collection is needed to identify contributing factors and to improve resuscitation outcome.

Keywords: cardiac arrest, OHCA, IHCA, resuscitation, emergency department

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Authors: Hakeem Ade Omokayode Idowu

Abstract:

The extent of the role played by human capabilities developments as well as knowledge management on employees’ performance in the nuclear energy sector of Nigeria remains unclear. This is in view of the important role which human resource capabilities could play in the desire to generate energy using nuclear resources. This study appraised the extent of human resource capabilities available in the nuclear energy sector of Nigeria. It further examined the relationship between knowledge management and employees’ performance in the nuclear energy sector. The study adopted a descriptive research design with a population that comprised all the 1736 members of staff of the selected centres, institutes, and the headquarters of the Nigeria Atomic Energy Commission (NAEC), Nigerian Nuclear Regulatory Authority (NNRA), and Energy Commission of Nigeria (ECN) and a sample size of 332 employees was selected using purposive and convenience sampling techniques. Data collected were subjected to analysis using frequency counts and simple regression. The results showed that majority of the employees perceived that they have to a high extent of availability of knowledge (118, 35.5%), credibility (134, 40.4%), alignment (130, 39.2%), performance (126, 38%) and innovation (138, 41.6%) The result of the hypothesis tested indicated that knowledge management has a positive and significant effect on employees’ performance (Beta weight = 0.336, R2 =0.113, F-value = 41.959, p-value = 0.000< 0.05). The study concluded that human resource capabilities and knowledge management could enhance employee performance within the nuclear energy sector of Nigeria.

Keywords: human resource capabilities, knowledge management, employees productivity, national development

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Authors: Kiseob Chung, Hyeonmin Kang

Abstract:

This study aims to explore what is intercultural competency needed for teacher through their experience at the public multicultural alternative school. The public alternative multicultural school is an accredited school for immigrants or students from multicultural families who have experienced school maladjustment at public school. This school has self-regulation in curriculum and function of bridge to public school by helping their adaptation. In particular, this study answers the following questions: What are the most difficulties for teacher at the multicultural alternative school in comparison to public school? What competencies are required for teacher at the multicultural alternative school? Which competencies in cognitive, emotional and practical area should be more required in order for teacher to communicate with student effectively (successfully) in class and other activities in school? What is the background of that we called these competencies especially as ‘intercultural’? This study focuses to clarify teacher’s competency to help immigrants of students from multicultural background to adjust to school life with the term of intercultural competency.

Keywords: intercultural competency for teacher, multicultural alternative school, multicultural students, school maladjustment

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Authors: Tayfun Cay, Fazil Nacar

Abstract:

Energy investments have increased in North Mediterranean Ceyhan and Yumurtalık districts of Turkey in the last years because of the treaties which are signed between Turkey and other countries for petroleum and natural gas transmission. Authority of land use has passed to district and metropolitan municipalities from town municipalities because of changes in coast legislation and local management legislation. Also Ministry of Environment and Urban Planning and Ministry of Industry and Commerce have had a right to comment on planning unofficially. Public investments increase in area and related planning and expropriation services continue. On the other hand, a lot of private sectors invest in organised industrial sites and industrial areas and it causes a rapid change in ownership status. Also Ceyhan-yumurtalık region is the tourism centre of North Mediterranean. Tourism investments continue in this district. Especially construction sector gain speed and a lot of country sites and apartments are built. In these studies, changes in planning activities in management of different administrative organisations and changes in ownership status and changes in private properties will be presented.

Keywords: coast management, land management, land use, property, public interest

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