Search results for: stormwater quality

Authors: Liaquat Ali, Khurshid Natasha

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Low resource countries are not usually equipped with the organizational tools to implement health care for chronic diseases, and thus, providing effective diabetes care in such countries is a challenging task. Diabetic Association of Bangladesh (BADAS in Bengali acronym) has created a stimulating example to meet this challenge. Starting its journey in 1956 with 39 patients in a small tin shed clinic BADAS, and its affiliated associations now operate 90 hospitals and health centres all over the country. Together, these facilities provide integrated health care to about 1.5 million registered diabetic patients which constitute about 20% of the estimated diabetic population in the country. BADAS has also become a pioneer in health manpower generation in Bangladesh. Along with its affiliates, it now runs 3 Medical Colleges (to generate graduate physicians), 2 Nursing Institutes, and 2 Postgraduate Institutes which conduct 25 postgraduate courses (under the University of Dhaka) in various basic, clinical and public health disciplines. BADAS gives great emphasis on research, which encompasses basic, clinical as well as public health areas. BADAS is an ideal example of public-private partnership in health as most of its infrastructure has been created through government support but it is almost self-reliant in managing its revenue budget which approached approximately 40 million US dollar during 2010. BADAS raises resources by providing high-quality services to the people, both diabetic and non-diabetic. At the same time, BADAS has developed a cross financing model, to support diabetic patients in general and poor diabetic patients (identified through a social welfare network) in particular, through redistribution of the resources. Along with financial sustainability BADAS ensure organizational sustainability through a process of decentralization, community ownership, and democratic management. Presently a large scale pilot project (named as a Health Care Development Project or HCDP) is under implementation under BADAS umbrella with an objective to transform the diabetes care model to a health care model in general. It is expected to create further evidence on providing sustainable (with social safety net) health care delivery for diabetes, and other chronic illnesses as an integral part of general health care delivery in a resource constrained setting.

Keywords: Bangladesh, self sustain, health care, constrain

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Authors: Emanuela Zilli, Antonella Ruffatto, Davide Bonaldo, Stefano Bevilacqua, Tommaso Caputo, Luisa Fontana, Carmelina Saraceno, Antonio Sturaroo, Teodoro Sava, Antonio Madia

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The new Hospital in Cittadella - ULSS 6 Euganea Health Trust, in the North-East of Italy (400 beds, project completion date in 2026), will partially take the place of the existing building. Interesting features have been suggested in order to project a modern, “environmental-friendly” and “people-friendly” building. Specific multidisciplinary meetings (involving stakeholders and professionals with different backgrounds) have been organized on a periodic basis in order to guarantee the appropriate implementation of logistic and organizational solutions related to eco-sustainability, integration with the context, and the concept of “design for all” and “humanization of care.” The resulting building will be composed of organic shapes determined by the external environment (sun movement, climate, landscape, pre-existing buildings, roads) and the needs of the internal environment (areas of care and diagnostic-treatment paths reorganized with experience gained during the pandemic), with extensive use of renewable energy, solar panels, a 4th-generation heating system, sanitised and maintainable surfaces. There is particular attention to the quality of the staff areas, which include areas dedicated to psycho-physical well-being (relax points, yoga gym), study rooms, and a centralized conference room. Outdoor recreational spaces and gardens for music and watercolour therapy will be included; atai-chi gym is dedicated to oncology patients. Integration in the urban and social context is emphasized through window placement toward the gardens (maternal-infant, mental health, and rehabilitation wards). Service areas such as dialysis, radiology, and labs have views of the medieval walls, the symbol of the city’s history. The new building has been designed to pursue the maximum level of eco-sustainability, harmony with the environment, and integration with the historical, urban, and social context; the concept of humanization of care has been considered in all the phases of the project management.

Keywords: environmental-friendly, humanization, eco-sustainability, new hospital

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Authors: Arunai Nambi Raj N., Kaviarasu Karunakaran, Krishnamurthy K.

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The purpose of this study was to create American Association of Physicist in Medicine (AAPM) Task Group 119 (TG 119) benchmark plans for flattening filter free beam (FFF) deliveries of intensity modulated radiation therapy (IMRT) and volumetric arc therapy (VMAT) in the Eclipse treatment planning system. The planning data were compared with the flattening filter (FF) IMRT & VMAT plan data to verify the dosimetric commissioning accuracy of FFF deliveries. AAPM TG 119 proposed a set of test cases called multi-target, mock prostate, mock head and neck, and C-shape to ascertain the overall accuracy of IMRT planning, measurement, and analysis. We used these test cases to investigate the performance of the Eclipse Treatment planning system for the flattening filter free beam deliveries. For these test cases, we generated two sets of treatment plans, the first plan using 7–9 IMRT fields and a second plan utilizing two arc VMAT technique for both the beam deliveries (6 MV FF, 6MV FFF, 10 MV FF and 10 MV FFF). The planning objectives and dose were set as described in TG 119. The dose prescriptions for multi-target, mock prostate, mock head and neck, and C-shape were taken as 50, 75.6, 50 and 50 Gy, respectively. The point dose (mean dose to the contoured chamber volume) at the specified positions/locations was measured using compact (CC‑13) ion chamber. The composite planar dose and per-field gamma analysis were measured with IMatriXX Evaluation 2D array with OmniPro IMRT Software (version 1.7b). FFF beam deliveries of IMRT and VMAT plans were comparable to flattening filter beam deliveries. Our planning and quality assurance results matched with TG 119 data. AAPM TG 119 test cases are useful to generate FFF benchmark plans. From the obtained data in this study, we conclude that the commissioning of FFF IMRT and FFF VMAT delivery were found within the limits of TG-119 and the performance of the Eclipse treatment planning system for FFF plans were found satisfactorily.

Keywords: flattening filter free beams, intensity modulated radiation therapy, task group 119, volumetric modulated arc therapy

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Authors: Japhet N. Mwambusi

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High tropical forests deforestation for solid wood furniture industry is among of climate change contributing agents. This pressure indirectly is caused by furniture joints failure due to poor gluing technology based on improper use of different glues to different wood species which lead to low quality and weak wood-glue joints. This study was carried in order to run performance tests of wood glues on different wood species used in wood workshops: Morogoro Tanzania whereby three popular wood species of C. lusitanica, T. glandis and E. maidenii were tested against five glues of Woodfix, Bullbond, Ponal, Fevicol and Coral found in the market. The findings were necessary on developing a guideline for proper glue selection for a particular wood species joining. Random sampling was employed to interview carpenters while conducting a survey on the background of carpenters like their education level and to determine factors that influence their glues choice. Monsanto Tensiometer was used to determine bonding strength of identified wood glues to different wood species in use under British Standard of testing wood shear strength (BS EN 205) procedures. Data obtained from interviewing carpenters were analyzed through Statistical Package of Social Science software (SPSS) to allow the comparison of different data while laboratory data were compiled, related and compared by the use of MS Excel worksheet software as well as Analysis of Variance (ANOVA). Results revealed that among all five wood glues tested in the laboratory to three different wood species, Coral performed much better with the average shear strength 4.18 N/mm², 3.23 N/mm² and 5.42 N/mm² for Cypress, Teak and Eucalyptus respectively. This displays that for a strong joint to be formed to all tree wood species for soft wood and hard wood, Coral has a first priority in use. The developed table of guideline from this research can be useful to carpenters on proper glue selection to a particular wood species so as to meet glue-bond strength. This will secure furniture market as well as reduce pressure to the forests for furniture production because of the strong existing furniture due to their strong joints. Indeed, this can be a good strategy on reducing climate change speed in tropics which result from high deforestation of trees for furniture production.

Keywords: climate change, deforestation, gluing technology, joint failure, wood-glue, wood species

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Authors: Chi-Feng Lai, Wen-Chun Liao Liao

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Many people are bothered by sleep difficulties in Taiwan’s society. However, majority of patients get medical treatments without a comprehensive sleep assessment. It is still a big challenge to formulate a comprehensive assessment of sleep difficulties in clinical settings, even though many assessment tools have existed in literature. This study tries to implement reliable and effective ‘comprehensive sleep assessment scales’ in a medical center and to explore differences in sleep-related factors between clinic clients with or without sleep difficulty complaints. The comprehensive sleep assessment (CSA) scales were composed of 5 dimensions: ‘personal factors’, ‘physiological factors’, ‘psychological factors’, ‘social factors’ and ‘environmental factors, and were first evaluated by expert validity and 20 participants with test-retest reliability. The Content Validity Index (CVI) of the CSA was 0.94 and the alpha of the consistency reliability ranged 0.996-1.000. Clients who visited sleep clinic due to sleep difficulties (n=32, 16 males and 16 females, ages 43.66 ±14.214) and gender-and age- matched healthy subjects without sleep difficulties (n=96, 47 males and 49 females, ages 41.99 ±13.69) were randomly recruited at a ratio of 1:3 (with sleep difficulties vs. without sleep difficulties) to compare their sleep and the CSA factors. Results show that all clinic clients with sleep difficulties did have poor sleep quality (PSQI>5) and mild to moderate daytime sleepiness (ESS >11). Personal factors of long working hours (χ2= 10.315, p=0.001), shift workers (χ2= 8.964, p=0.003), night shift (χ2=9.395, p=0.004) and perceived stress (χ2=9.503, p=0.002) were disruptors of sleep difficulties. Physiological factors from physical examination including breathing by mouth, low soft palate, high narrow palate, Edward Angle, tongue hypertrophy, and occlusion of the worn surface were observed in clinic clients. Psychological factors including higher perceived stress (χ2=32.542, p=0.000), anxiety and depression (χ2=32.868, p=0.000); social factors including lack of leisure activities (χ2=39.857, p=0.000), more drinking habits (χ2=1.798, p=0.018), irregular amount and frequency in meals (χ2=5.086, p=0.024), excessive dinner (χ2=21.511, p=0.000), being incapable of getting up on time due to previous poor night sleep (χ2=4.444, p=0.035); and environmental factors including lights (χ2=7.683, p=0.006), noise (χ2=5.086, p=0.024), low or high bedroom temperature (χ2=4.595, p=0.032) were existed in clients. In conclusion, the CSA scales can work as valid and reliable instruments for evaluating sleep-related factors. Findings of this study provide important reference for assessing clinic clients with sleep difficulties.

Keywords: comprehensive sleep assessment, sleep-related factors, sleep difficulties

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Authors: Ivan M. Taremwa, Scholastic Ashaba, Harriet O. Adrama, Carlrona Ayebazibwe, Daniel Omoding, Imelda Kemeza, Jane Yatuha, Thadeus Turuho, Noni E. MacDonald, Robert Hilliard

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Background: The burden of malaria in Uganda remains unacceptably high, especially among children and pregnant women. To prevent malaria related complications, household possession and use of Insecticide Treated mosquito Nets (ITNs) has become a common practice in the country. Despite the availability of ITNs, the number of malaria cases has not gone down. We sought to explore knowledge, attitude, and behaviour towards the use of ITNs as a nightly malaria prevention strategy among pregnant women and children under five years of age in rural southwest Uganda. Materials and Methods: This was a community based, descriptive cross-sectional study, in which households with children under 5 years, and/or pregnant women were enrolled. We used a structured questionnaire to collect data on participants’ understanding of the causes, signs and symptoms of malaria; use of ITNs to prevent malaria; attitudes and behaviours towards the use of ITNs. We also conducted key informant interviews (KIIs) to get in-depth understanding of responses from the participants. We analysed quantitative data using STATA version 12. Qualitative findings from the KIIs were transcribed and translated, and manually analysed using thematic content analysis. Results: Of the 369 households enrolled, 98.6% (N=363) households had children under five. Most participants (41.2%, N=152) were in the 21-30 years of age category (mean age; 32.2). 98.6% (N=362) of the respondents considered ITNs a key malaria prevention strategy. The ITN possession rate was 84.0% (N=310), of these, 67.0% (N=205) consistently used them. 39% of the respondents did not have a positive attitude towards ITNs, as they considered more the perceived effects of ITNs. Conclusions: Although 84.0% of the respondents possessed ITNs, many were not consistently using them. There is need to engage all stakeholders (including cultural leaders, community health workers, religious leaders and the government) in the malaria prevention campaigns using ITNs through: a) government’s concerted effort to ensure universal access of good quality ITNs, b) end-user directed education to correct false beliefs and misinformation, c) telling the ITN success stories to improve on the usage.

Keywords: ITNs use, malaria, pregnant women, rural Uganda

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Authors: Zahra Shokrolahi, Mohammad Reza Atashzar

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The goals of treating patients with breast cancer are to cure the disease, prolong survival, and improve quality of life. Immune cells in the tumor microenvironment have an important role in regulating tumor progression. The term of cellular immunotherapy refers to the administration of living cells to a patient; this type of immunotherapy can be active, such as a dendritic cell (DC) vaccine, in that the cells can stimulate an anti-tumour response in the patient, or the therapy can be passive, whereby the cells have intrinsic anti-tumour activity; this is known as adoptive cell transfer (ACT) and includes the use of autologous or allogeneic lymphocytes that may, or may not, be modified. The most important breast cancer cellular immunotherapies involving the use of T cells and natural killer (NK) cells in adoptive cell transfer, as well as dendritic cells vaccines. T cell-based therapies including tumour-infiltrating lymphocytes (TILs), engineered TCR-T cells, chimeric antigen receptor (CAR T cell), Gamma-delta (γδ) T cells, natural killer T (NKT) cells. NK cell-based therapies including lymphokine-activated killers (LAK), cytokine-induced killer (CIK) cells, CAR-NK cells. Adoptive cell therapy has some advantages and disadvantages some. TILs cell strictly directed against tumor-specific antigens but are inactive against tumor changes due to immunoediting. CIK cell have MHC-independent cytotoxic effect and also need concurrent high dose IL-2 administration. CAR T cell are MHC-independent; overcome tumor MHC molecule downregulation; potent in recognizing any cell surface antigen (protein, carbohydrate or glycolipid); applicable to a broad range of patients and T cell populations; production of large numbers of tumor-specific cells in a moderately short period of time. Meanwhile CAR T cells capable of targeting only cell surface antigens; lethal toxicity due to cytokine storm reported. Here we present the most popular cancer cellular immunotherapy approaches and discuss their clinical relevance referring to data acquired from clinical trials .To date, clinical experience and efficacy suggest that combining more than one immunotherapy interventions, in conjunction with other treatment options like chemotherapy, radiotherapy and targeted or epigenetic therapy, should guide the way to cancer cure.

Keywords: breast cancer , cell therapy , CAR T cell , CIK cells

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Authors: Abdulkarim Yusuf

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Motivation: A crucial but difficult goal for governments and policymakers in Nigeria in recent years has been the sustainability of economic growth. This goal must be accomplished by regulating or lowering greenhouse gas emissions, which calls for switching to a low- or zero-carbon production system. The lack of in-depth empirical studies on the environmental impact of socioeconomic variables on Nigeria and a number of unresolved issues from earlier research is what led to the current study. Objective: This study fills an important empirical gap by investigating the existence of an Environmental Kuznets Curve hypothesis and the long and short-run dynamic impact of socioeconomic variables on ecological sustainability in Nigeria. Data and method: Annual time series data covering the period 1980 to 2020 and the Autoregressive Distributed Lag technique in the presence of structural breaks were adopted for this study. Results: The empirical findings support the existence of the environmental Kuznets curve hypothesis for Nigeria in the long and short run. Energy consumption and total import exacerbate environmental deterioration in the long and short run, whereas total export improves environmental quality in the long and short run. Financial development, which contributed to a conspicuous decrease in the level of environmental destruction in the long run, escalated it in the short run. In contrast, urbanization caused a significant increase in environmental damage in the long run but motivated a decrease in biodiversity loss in the short run. Implications: The government, policymakers, and all energy stakeholders should take additional measures to ensure the implementation and diversification of energy sources to accommodate more renewable energy sources that emit less carbon in order to promote efficiency in Nigeria's production processes and lower carbon emissions. In order to promote the production and trade of environmentally friendly goods, they should also revise and strengthen environmental policies. With affordable, dependable, and sustainable energy use for higher productivity and inclusive growth, Nigeria will be able to achieve its long-term development goals of good health and wellbeing.

Keywords: economic growth, energy consumption, environmental degradation, environmental Kuznets curve, urbanization, Nigeria

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Authors: Alireza Rahpeyma

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One of the most significant challenges faced by cities is inefficient and deteriorated urban fabric. Deteriorated areas bring about numerous issues, including economic, social, physical, and infrastructural problems, sewage management, environmental concerns, and security issues. One of the crucial necessities of modern urban life is the revitalization and renovation of these urban fabrics. Another important aspect is preserving a cohesive cultural and social identity during the urban renewal process. Urban renovation and upgrading are not a one-time occurrence but rather an ongoing process that ultimately needs to become ingrained in the system. This process is not swift; it involves sensitive and intricate stages that require well-designed plans within short, medium, and long-term timeframes. To revitalize dilapidated areas, a comprehensive understanding of the urban region's sustainability is essential. The goal of this study is to provide a suitable model for the upgrading and renewal of areas 2, 4, 5, 7, 8, and 10 in Tehran, preserving the heritage within these urban fabrics (urban assets), including the valuable morphologies of these areas, to prevent financial wastage. This study was conducted descriptively and analytically using the SWOT technique and GIS software. The research results regarding urban upgrading and renewal bring about the following points: 1) Urban upgrading and renewal ensure satisfactory efficiency, justice, environmental quality, safety and security, hygiene, sewage management, and the comfort and aesthetics of urban spaces. 2) Employing the above processes in old city centers re-establishes the historical and cultural connection between people and their past, a past that is evolving and improving and will not repeat itself. 3) Despite the expansion and growth of Iranian cities, cultural and national identity can be preserved by adhering to healthy urban revitalization principles. 4) Proper urban upgrading and renewal prevent social fragmentation, deviant behavioral patterns, psychological and occupational disorders, and financial losses. In general, preserving the identity and urban life in renovation and upgrading must be comprehensive, encompassing various dimensions, including physical, social, economic, political, and administrative aspects.

Keywords: dilapidated areas, renovation, sustainable reconstruction, Tehran-Iran

Procedia PDF Downloads 55

Authors: Yu-Shi Ye, Jia-Min Wu, Jhih-Ci Li

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Background: Most orthopedic inpatients and primary caregivers are elderly, and patients are at high risk of falls. We set up a quality control team to analyze the root cause and found the following issues: 1. The nursing staff did not conduct cognitive assessments of patients and their primary caregivers to ensure that health education content was understood. 2. Nurses prefer to use spoken language in health education but lack the skills to use diverse teaching materials. 3. Newly recruited nurses have insufficient awareness of fall prevention. Methods: The study subjects were 16 nurses in the orthopedic ward of a teaching hospital in central Taiwan. We implemented the following strategies: 1. Developed a fall simulation teaching plan and conducted teaching courses and assessments in the morning meeting; 2. Designed and used a "fall prevention awareness card" to improve the prevention awareness of elderly patients; 3. All staff (including new staff) received experiential education training. Results: In 2021, 40% of patients in the orthopedic wards were aged 60-79 years (792/1979) with a high risk of falls. According to data collection, the incidence of falls in hospitalized patients was 0.04% (5/12651), which exceeded the threshold of 0.02% in our ward. After completing the on-the-job education training in October, the nursing staff expressed that they were more aware of the special situation of fall prevention. Through practical sharing and drills, combined with experiential teaching strategies, nurses can reconstruct the safety awareness of fall prevention and deepen their cognitive memory. Participants scored between 30 and 80 on the pretest (16 students, mean: 72.6) and between 90 and 100 on the post-test (16 students, mean: 92.6), resulting in a 73.8% improvement in overall scores. We have a total of 4 new employees who have all completed the first 3 months of compulsory PGY courses. From January to April 2022, the incidence of falls in hospitalized patients was 0.025% (1/3969). We have made good improvements and will continue to track the outcome. Discussion: In addition to enhancing the awareness of falls among nursing staff, how-to guide patients and primary caregivers to prevent falls is also the focus of improvement. The proper way of health education can be better understood through practical exercises and case sharing.

Keywords: experiential teaching strategies, fall prevention, cognitive card, elderly patients, orthopedic wards

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Authors: Jinhoa Lee

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The relationships between environmental quality, energy use and economic output have created growing attention over the past decades among researchers and policy makers. Focusing on the empirical aspects of the role of carbon dioxide (CO2) emissions and energy use in affecting the economic output, this paper is an effort to fulfill the gap in a comprehensive case study at a country level using modern econometric techniques. To achieve the goal, this country-specific study examines the short-run and long-run relationships among energy consumption (using disaggregated energy sources: Crude oil, coal, natural gas, and electricity), CO2 emissions and gross domestic product (GDP) for Iran using time series analysis from the year 1980-2010. To investigate the relationships between the variables, this paper employs the Augmented Dickey-Fuller (ADF) test for stationarity, Johansen’s maximum likelihood method for cointegration and a Vector Error Correction Model (VECM) for both short- and long-run causality among the research variables for the sample. All the variables in this study show very strong significant effects on GDP in the country for the long term. The long-run equilibrium in VECM suggests that all energy consumption variables in this study have significant impacts on GDP in the long term. The consumption of petroleum products and the direct combustion of crude oil and natural gas decrease GDP, while the coal and electricity use enhanced the GDP between 1980-2010 in Iran. In the short term, only electricity use enhances the GDP as well as its long-run effects. All variables of this study, except the CO2 emissions, show significant effects on the GDP in the country for the long term. The long-run equilibrium in VECM suggests that the consumption of petroleum products and the direct combustion of crude oil and natural gas use have positive impacts on the GDP while the consumptions of electricity and coal have adverse impacts on the GDP in the long term. In the short run, electricity use enhances the GDP over period of 1980-2010 in Iran. Overall, the results partly support arguments that there are relationships between energy use and economic output, but the associations can be differed by the sources of energy in the case of Iran over period of 1980-2010. However, there is no significant relationship between the CO2 emissions and the GDP and between the CO2 emissions and the energy use both in the short term and long term.

Keywords: CO2 emissions, energy consumption, GDP, Iran, time series analysis

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Authors: Merav Ben Natan, Yaniv Steinfeld, Sara Badash, Galina Shmilov, Milena Abramov, Danny Epstein, Yaniv Yonai, Eyal Berbalek, Yaron Berkovich

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Introduction: Postoperative pain management is crucial for effective rehabilitation, with the Visual Analog Scale (VAS) being a common tool for assessing pain intensity due to its sensitivity and accuracy. However, challenges such as misunderstanding of instructions and discrepancies in pain reporting can affect its reliability. Additionally, the mandatory use of face masks during the COVID-19 pandemic may impair nonverbal and verbal communication, potentially impacting pain assessment and overall care quality. Aims: This study examines the association between the type of mask worn by health care professionals and the assessment of pain intensity in patients after orthopedic surgery using the visual analog scale (VAS). Design: A nonrandomized controlled trial was conducted among 176 patients hospitalized in an orthopedic department of a hospital located in northern-central Israel from January to March 2021. Methods: In the intervention group (n = 83), pain assessment using the VAS was performed by a healthcare professional wearing a transparent face mask, while in the control group (n = 93), pain assessment was performed by a healthcare professional wearing a standard nontransparent face mask. The initial assessment was performed by a nurse, and 15 minutes later, an additional assessment was performed by a physician. Results: Healthcare professionals wearing a standard non-transparent mask obtained higher VAS scores than healthcare professionals wearing a transparent mask. In addition, nurses obtained lower VAS scores than physicians. The discrepancy in VAS scores between nurses and physicians was found in 50% of cases. This discrepancy was more prevalent among female patients, patients after knee replacement or spinal surgery, and when health care professionals were wearing a standard nontransparent mask. Conclusions: This study supports the use of transparent face masks by healthcare professionals in an orthopedic department, particularly by nurses. In addition, this study supports the assumption of problems involving the reliability of VAS.

Keywords: postoperative pain management, visual analog scale, face masks, orthopedic surgery

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Authors: Zhou Congling

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The integration of private tutoring has emerged as an indispensable facet in the acquisition of language proficiency beyond formal educational settings. Notably, there has been a discernible surge in the demand for private English tutoring, specifically geared towards the preparation for internationally recognized gatekeeping examinations, such as IELTS, TOEFL, GMAT, and GRE. This trajectory has engendered an escalating need for English Language Teaching Assistants (ELTAs) operating within the realm of Private Tutoring Schools (PTSs). The objective of this study is to unravel the intricate process by which these ELTAs formulate their professional identities in the nascent stages of their careers as English educators, as well as to delineate their perceptions regarding their professional trajectories. The construct of language teacher identity is inherently multifaceted, shaped by an amalgamation of individual, societal, and cultural determinants, exerting a profound influence on how language educators navigate their professional responsibilities. This investigation seeks to scrutinize the experiential and influential factors that mold the identities of ELTAs in PTSs, particularly post the culmination of their language-oriented academic programs. Employing a qualitative narrative inquiry approach, this study aims to delve into the nuanced understanding of how ELTAs conceptualize their professional identities and envision their future roles. The research methodology involves purposeful sampling and the conduct of in-depth, semi-structured interviews with ten participants. Data analysis will be conducted utilizing Barkhuizen’s Short Story Analysis, a method designed to explore a three-dimensional narrative space, elucidating the intricate interplay of personal experiences and societal contexts in shaping the identities of ELTAs. The anticipated outcomes of this study are poised to contribute substantively to a holistic comprehension of ELTA identity formation, holding practical implications for diverse stakeholders within the private tutoring sector. This research endeavors to furnish insights into strategies for the retention of ELTAs and the enhancement of overall service quality within PTSs.

Keywords: China, English language teacher, narrative inquiry, private tutoring school, teacher identity

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Authors: Franco Bruno Castaldo

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Aim: The term bioethics is a term coined by VanPotter R ., who in 1970 thought of a discipline, capable of contributing to a better quality of human life and the cosmos. At first he intended bioethics as a wisdom capable of creating a bridge between bios and ethos and between bio-experimental science and ethical-anthropological sciences.Similarly, the modern sport is presented as a polysemic phenomenon, multidisciplinary, pluris value. From the beginning, the sport is included in the discussion of bioethical problems with doping. Today, the ethical problems of the sport are not only ascribable to doping, the medicalization of society, Techniques for enhancement, violence, Fraud, corruption, even the acceptance of anthropological transhumanist theories. Our purpose is to shed light on these issues so that there is a discernment, a fine-tuning also in educational programs, for the protection of all the sport from a scientist adrift, which would lead to an imbalance of values. Method: Reading, textual and documentary analysis, evaluation of critical examples. Results: Harold VanderZwaag, (1929-2011) in ancient times, asked: how many athletic directors have read works of sport philosophy or humanities? Along with E.A. Zeigler (North American Society for Sport Management) are recognized as pioneers of educational Sport Management. Comes the need to leave the confines of a scientific field, In order to deal with other than itself. Conclusion: The quantitative sciences attracts more funds than qualitative ones, the philosopher M. Nussbaum, has relaunched the idea that the training of students will have to be more disinterested than utilitarian, Offering arguments against the choice of anti-classical, analyzing and comparing different educational systems. schools, universities must assign a prominent place in the program of study to the humanistic, literary and artistic subjects, cultivating a participation that can activate and improve the ability to see the world through the eyes of another person. In order to form citizens who play their role in society, science and technology alone are not enough, we need disciplines that are able to cultivate critical thinking, respect for diversity, solidarity, the judgment, the freedom of expression. According to A. Camelli, the humanities faculties prepare for that life-long learning, which will characterize tomorrow's jobs.

Keywords: bioethics, management, sport, transhumanist, medicalization

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Authors: Cláudia Moço, Maria Santos, Carlos Arsénio, Débora Mendes, Miguel Oliveira. José Paulo Da Silva

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Construction industry generates large amounts of waste all over the world. About 450 million tons of construction and demolition wastes (C&DW) are produced annually in the European Union. C&DW are highly heterogeneous materials in size and composition, which imposes strong difficulties on their management. Directive n.º 2008/98/CE, of the European Parliament and of the Council of 6 November establishes that 70 % of the C&DW have to be recycled by 2020. To evaluate possible applications of these materials, a detailed physical, chemical and environmental characterization is necessary. Multi Triagem, Lda. is a company located in Algarve (Portugal) and was supported by the European Regional Development Fund (grant QREN 30307 Multivalor) to quantify and characterize the received C&DW, in order to evaluate their possible applications. This evaluation, performed in collaboration with the University of Algarve, involves a physical, chemical and environmental detailed characterization of the received C&DW. In this work we report on the amounts, trial procedures and properties of the C&DW received over a period of fifteen month. In this period the company received C&DW coming from 393 different origins. The total amount was 32.458 tons, mostly mixtures containing concrete, masonry/mortar and soil/rock. Most of C&DW came from demodulation constructions and diggings. The organic/inert component, namely metal, glass, wood and plastics, were screened first and account for about 3 % of the received materials. The remaining materials were screened and grouped according to their origin and contents, the latter evaluated by visual inspection. Twenty five samples were prepared and submitted to a detailed physical, chemical and environmental analysis. The C&DW aggregates show lower quality properties than natural aggregates for concrete preparation and unbound layers of road pavements. However, chemical analyzes indicated that most samples are environmentally safe. A continuous monitoring of the presence of heavy metals and organic compounds is needed in order to perform a proper screening of the C&DW. C&DW aggregates provide a good alternative to natural aggregates.

Keywords: construction and demolition wastes, waste classification, waste composition, waste screening

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Authors: Swati Rajput

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Environmental psychology explains that the person is a social agent that seeks to extract meaning from their built and natural environment to behave in a particular manner. It also shows the attachment or detachment of people to their environment. Assessing environmental psychology of people is imperative for planners and policy makers for urban planning. The paper investigates the environmental psychology of people living in nine districts of Delhi by calculating and assessing their Environmental Emotional Quotient (EEQ). Emotional Quotient deals with the ability to sense, understand, attach and respond according to the power of emotions. An Environmental Emotional Quotient has been formulated based upon the inventory administered to them. The respondents were asked questions related to their view and emotions about the green spaces, water resource conservation, air and environmental quality. An effort has been made to assess the feeling of belongingness among the residents. Their views were assessed on green spaces, reuse, and recycling of resources and their participation level. They were also been assessed upon health awareness level by considering both preventive and curative segments of health care. It was found that only 12 percent of the people is emotionally attached to their surroundings in the city. The emotional attachment reduces as we move away from the house to housing complex to neighbouring areas and rest of the city. In fact, the emotional quotient goes lower to lowest from house to other ends of the city. It falls abruptly after the radius of 1 km from the residence. The result also shows that nearly 54% respondents accept that there is environment pollution in their area. Around 47.8% respondents in the survey consider that diseases occur because of green cover depiction in their area. Major diseases are to airborne diseases like asthma and bronchitis. Seasonal disease prevalent, which specially occurred from last 3-4 years are malaria, dengue and chikengunya. Survey also shows that only 31 % of respondents visit government hospitals while 69% respondents visit private hospitals or small clinics for healthcare services. The paper suggests the need for environmental sensitive policies and need for green insurance in mega cities like Delhi.

Keywords: environmental psychology, environmental emotional quotient, preventive health care and curative health care, sustainable living

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Authors: J. Wozniak-Holecka, T. Holecki, P. Romaniuk

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Spa facilities are being perceived as the ways of healing treatment in Poland and are guaranteed within the public financing. The universal health insurance (National Health Fund, NFZ), and the disability prevention programme held by Social Insurance Institution (ZUS) are the main sources of financing spa facilities. The dominant public payer of spa services is the NFZ. The Social Insurance Institution covers the cost of health treatment realized in spa facilities as medical rehabilitation, in the field of disability prevention. Health services delivered in the spa resorts are characterized by complexity, and the combination of various methods, typical for health prevention, education, balneotherapy, and physiotherapy. Healing with natural methods, believed to enhance the therapeutic effect, is also involved in health spa treatment. Regardless of the type of facility, each form of spa treatment includes health promotion, health education, prevention at all levels, including rehabilitation. The aim of the study was to determine the optimal organization of health education process. Its efficiency strongly depends on the type of service provider and the funding institution (NFZ vs ZUS). It results from the use of different measures of the effectiveness, the quality and the evaluation of the process being assessed by funding institutions. The methods of the study include a comparative and descriptive quantitative and qualitative analysis. In the empirical part, a questionnaire had been developed. It was then distributed among spa personnel, responsible directly for the health promotion, and among patients who are beneficiaries of health services in spa centers. The quantitative part of the study was based on interviews carried with the use of the online survey (CAWI: Computer-Assisted Web Interview), telephone survey (CATI: Computer-Assisted Telephone Interview) and a conventional questionnaire (PAPI: Paper over Pencil Interview). As a result of the conducted research, it was found that the effectiveness of health education activities in spa resort facilities in Poland is higher when the services are organized using structured tools for managerial control. This applies to formalized procedures implemented by one of the dominant payers covering costs of services (ZUS) and involves the application of health education as one of the mandatory elements of treatment, subjected to the process of control during the course of spa therapy and evaluation after it is completed.

Keywords: effectiveness, health education, public health system, spa treatment

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Authors: Danar Agus Susanto, Hermawan Febriansyah, Meilinda Ayundyahrini

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The availability of spring water to meet people demand is often a problem, especially in tropical areas with very limited surface water sources, or very deep underground water. Although the technology and equipment of pumping system are available and easy to obtain, but in remote areas, the availability of pumping system is difficult, due to the unavailability of fuel or the lack of electricity. Solar Water Pumping System (SWPS) became one of the alternatives that can overcome these obstacles. In the tropical country, sunlight can be obtained throughout the year, even in remote areas. SWPS were already widely built in Indonesia, but many encounter problems during operations, such as decreased of efficiency; pump damaged, damaged of controllers or inverters, and inappropriate photovoltaic performance. In 2011, International Electrotechnical Commission (IEC) issued the IEC standard 62253:2011 titled Photovoltaic pumping systems - Design qualification and performance measurements. This standard establishes design qualifications and performance measurements related to the product of a solar water pumping system. National Standardization Agency of Indonesia (BSN) as the national standardization body in Indonesia, has not set the standard related to solar water pumping system. This research to study operational procedures of SWPS by adopting of IEC Standard 62253:2011 to be Indonesia Standard (SNI). This research used literature study and field observation for installed SWPS in Indonesia. Based on the results of research on SWPS already installed in Indonesia, IEC 62253: 2011 standard can improve efficiency and reduce operational failure of SWPS. SWPS installed in Indonesia still has GAP of 51% against parameters in IEC standard 62253: 2011. The biggest factor not being met is related to operating and maintenance handbooks for personnel that included operation and repair procedures. This may result in operator ignorance in installing, operating and maintaining the system. The Photovoltaic (PV) was also the most non-compliance factor of 71%, although there are 22 Indonesia Standard (SNI) for PV (modules, installation, testing, and construction). These research samples (installers, manufacturers/distributors, and experts) agreed on the parameter in the IEC standard 62253: 2011 able to improve the quality of SWPS in Indonesia. Recommendations of this study, that is required the adoption of IEC standard 62253:2011 into SNI to support the development of SWPS for remote areas in Indonesia.

Keywords: efficiency, inappropriate installation, remote areas, solar water pumping system, standard

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Authors: Evgeni Baratashvili, Giorgi Sulashvili, Malkhaz Sulashvili, Bela Khotenashvili, Irma Makharashvili

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The most investment decision-making principle of regional travel firm's management and its partner is the formulation of the aims of investment programs. The investments can be targeted in order to reduce the firm's production costs and to purchase good transport equipment. In attractive region, in order to develop firm’s activities, the investment program can be targeted for increasing of provided services. That is the case where the sales already have been used in the market. The investment can be directed to establish the affiliate firms, branches, to construct new hotels, to create food and trade enterprises, to develop entertainment enterprises, etc. Economic development is of great importance to regional development. International experience shows that inclusive economic growth largely depends on not only the national, but also regional development planning and implementation of a strong and competitive regions. Regional development is considered as the key factor in achieving national success. Establishing a modern institute separate entities if the pilot centers will constitute a promotion, international best practice-based public-private partnership to encourage the use of models. Regional policy directions and strategies adopted in accordance with the successful implementation of major importance in the near future specific action plans for inclusive development and implementation, which will be provided in accordance with the effective monitoring and evaluation tools and measurable indicators combined. All of these above-mentioned investments are characterized by different levels, which are related to the following fact: How successful tourism marketing service is, whether it is able to determine the proper market's reaction according to the particular firm's actions. In the sphere of regional tourism industry and in the investment decision possible variants it can be developed the some specter of models. Each of the models can be modified and specified according to the situation, and characteristic skills of the existing problem that must be solved. Besides, while choosing the proper model, the process is affected by the regulation system of economic processes. Also, it is influenced by liberalization quality and by the level of state participation.

Keywords: net income of travel firm, economic growth, Investment profitability, regional development, tourist product, tourism development

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Authors: Alive Ntunja, Wilma ten Ham-Baloyi, June Teare, Oyedele Opeoluwa, Paula Melariri

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Sanitation workers are also known as “garbage workers” who play a significant role in the sanitation chain. For many generations sanitation workers’ level of knowledge regarding hygiene practices remains low due to a lack of educational programs on hygiene. As a result, they are widely exposed to hygiene-related diseases such as cholera, skin infections and various other diseases, increasing their risk of mortality to 40%. This review aimed to explore the global impact of educational programs on the hygiene knowledge and practices of sanitation workers. The systematic literature search was conducted for studies published between 2013 and 2023 using the following databases: MEDLINE (via EBSCOHost), PubMed, and Google Scholar to identify quantitative studies on the subject. Study quality was assessed using the Joanna Briggs Institute Critical Evaluation Instruments. Data extracted from the included articles was presented using a summary of findings table and presented graphically through charts and tables, employing both descriptive and inferential statistical methods. A one-way repeated measures ANOVA assessed the pooled effect of the intervention on mean scores across studies. Statistical analysis was performed using Microsoft Office 365 (2019 version), with significance set at p<0.05. The PRISMA flow diagram was used to present the article selection process. The systematic review included 15 eligible studies from a total of 2 777 articles. At least 60% (n=9) of the reviewed studies found educational program relating to hygiene to have a positive impact on sanitation workers’ hygiene knowledge and practices. The findings further showed that the stages (pre-post) of knowledge intervention used lead to statistically significant differences in mean score obtained [F (1,7) = 22.166, p = 0.002]. Likewise, it can be observed that the stages of practice intervention used lead to statistically significant differences in mean score obtained [F (1,7) = 21.857, p = 0.003]. However, most (n=7) studies indicated that, the efficacy of programs on hygiene knowledge and practices is indirectly influenced by educational background, age and work experience (predictor factors). Educational programs regarding hygiene have the potential to significantly improve sanitation workers knowledge and practices. Findings also suggest the implementation of active and intensive intervention programs, to improve sanitation workers hygiene knowledge and practices.

Keywords: educational programs, hygiene knowledge, practices, sanitation workers

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Authors: Claudia Carbajal, Jija Dutt, Smriti Pahwa, Sumukhi Vaid, Karishma Vats

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ASER Centre, the research and assessment arm of Pratham Education Foundation sees measurement as the first stage of action. ASER uses primary research to push and give empirical foundations to policy discussions at a multitude of levels. At a household level, common citizens use a simple assessment (a floor-level test) to measure learning across rural India. This paper presents the evidence on the applicability of an ASER approach to the health sector. A citizen-led assessment was designed and executed that collected information from young mothers with children up to a year of age. The pilot assessments were rolled-out in two different models: Paid surveyors and student volunteers. The survey covered three geographic areas: 1,239 children in the Jaipur District of Rajasthan, 2,086 in the Rae Bareli District of Uttar Pradesh, and 593 children in the Bhuj Block in Gujarat. The survey tool was designed to study knowledge of health-related issues, daily practices followed by young mothers and access to relevant services and programs. It provides insights on behaviors related to infant and young child feeding practices, child and maternal nutrition and supplementation, water and sanitation, and health services. Moreover, the survey studies the reasons behind behaviors giving policy-makers actionable pathways to improve implementation of social sector programs. Although data on health outcomes are available, this approach could provide a rapid annual assessment of health issues with indicators that are easy to understand and act upon so that measurements do not become an exclusive domain of experts. The results give many insights into early childhood health behaviors and challenges. Around 98% of children are breastfed, and approximately half are not exclusively breastfed (for the first 6 months). Government established diet diversity guidelines are met for less than 1 out of 10 children. Although most households are satisfied with the quality of drinking water, most tested households had contaminated water.

Keywords: citizen-led assessment, rapid health assessment, Infant and Young Children Feeding, water and sanitation, maternal nutrition, supplementation

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Authors: Chiqian Zhang, Kyle D. McIntosh, Nathan Sienkiewicz, Ian Struewing, Erin A. Stelzer, Jennifer L. Graham, Jingrang Lu

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Phytoplankton plays an essential role in freshwater aquatic ecosystems and is the primary group synthesizing organic carbon and providing food sources or energy to ecosystems. Therefore, the identification and quantification of phytoplankton are important for estimating and assessing ecosystem productivity (carbon fixation), water quality, and eutrophication. Microscopy is the current gold standard for identifying and quantifying phytoplankton composition and abundance. However, microscopic analysis of phytoplankton is time-consuming, has a low sample throughput, and requires deep knowledge and rich experience in microbial morphology to implement. To improve this situation, quantitative polymerase chain reaction (qPCR) was considered for phytoplankton identification and quantification. Using qPCR to assess phytoplankton composition and abundance, however, has not been comprehensively evaluated. This study focused on: 1) conducting a comprehensive performance comparison of qPCR and microscopy techniques in identifying and quantifying phytoplankton and 2) examining the use of qPCR as a tool for assessing eutrophication. Twelve large rivers located throughout the United States were evaluated using data collected from 2017 to 2019 to understand the relation between qPCR-based phytoplankton abundance and eutrophication. This study revealed that temporal variation of phytoplankton abundance in the twelve rivers was limited within years (from late spring to late fall) and among different years (2017, 2018, and 2019). Midcontinent rivers had moderately greater phytoplankton abundance than eastern and western rivers, presumably because midcontinent rivers were more eutrophic. The study also showed that qPCR- and microscope-determined phytoplankton abundance had a significant positive linear correlation (adjusted R² 0.772, p-value < 0.001). In addition, phytoplankton abundance assessed via qPCR showed promise as an indicator of the eutrophication status of those rivers, with oligotrophic rivers having low phytoplankton abundance and eutrophic rivers having (relatively) high phytoplankton abundance. This study demonstrated that qPCR could serve as an alternative tool to traditional microscopy for phytoplankton quantification and eutrophication assessment in freshwater rivers.

Keywords: phytoplankton, eutrophication, river, qPCR, microscopy, spatiotemporal variation

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Authors: Dianne Lyneth Alavado

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At the turn of the millennium, development paradigms in the international scene revolved around one goal: elimination of global poverty without comprising human rights. One measure which achieved high endorsement and visibility in the world of work is the Decent Work Agenda (DWA) championed by the United Nation’s (UN) specialized agency for work, the International Labour Organization (ILO). The DWA has been thoroughly promoted and recommended as an ingredient of development planning and a poverty reduction strategy, particularly in developing countries such as the Philippines. The global imperative of economic growth is measurable not only in the numbers raked in by countries in terms of expanding economy but also by the development and realization of the full capacities of their people. Decent work (DW), as an outcome and not just a development approach, promises poverty eradication by means of providing both quantity and quality work that is accompanied by rights, representation, and protection. As a party to these international pacts, the Philippines is expected to heed the call towards a world free from poverty through well-endorsed measures such as the DWA with the aid of multilateral and donor organizations such as the ILO. This study aims to assess the capacity and readiness of the Philippines to achieve the goals of the DWA. This is a qualitative research using the sociological and juridical lens in the desk analysis of existing Philippine laws, policies, and programs vis-à-vis decent work indicators set forth by the ILO. Interview with experts on the Philippine labor situation is conducted for further validation. The paper identifies gaps within the Philippine legal system and its collection of laws, acts, presidential decrees, department orders and other policy instruments aimed towards achieving the goals of the DWA. Among the major findings of this paper are: the predisposition of Philippine labor laws towards the formal sector; the need for alternative solutions for the informal sector veering away from the usual dole-outs and livelihood projects; the needs for evaluation of policies and programs that are usually self-evaluated; the minimal reach of the labour inspectorate which ensures decent work; and the lack of substantial penalty for non-compliance with labor laws. The paper concludes with policy implications and recommendations towards addressing the potholes on the road to Decent Work.

Keywords: decent work agenda, labor laws, millennium development goals, poverty eradication, sustainable development goal

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Authors: Mohamad Mahdi Namdari

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In today's rapidly changing and evolving business competition, companies and organizations require advanced and efficient tools to manage their markets and sales networks. Big data analysis, quick response in competitive markets, process and operations optimization, and forecasting customer behavior are among the concerns of executive managers. Artificial intelligence, as one of the emerging technologies, has provided extensive capabilities in this regard. The use of artificial intelligence in market and sales network management can lead to improved efficiency, increased decision-making accuracy, and enhanced customer satisfaction. Specifically, AI algorithms can analyze vast amounts of data, identify complex patterns, and offer strategic suggestions to improve sales performance. However, many companies are still distant from effectively leveraging this technology, and those that do face challenges in fully exploiting AI's potential in market and sales network management. It appears that the general public's and even the managerial and academic communities' lack of knowledge of this technology has caused the managerial structure to lag behind the progress and development of artificial intelligence. Additionally, high costs, fear of change and employee resistance, lack of quality data production processes, the need for updating structures and processes, implementation issues, the need for specialized skills and technical equipment, and ethical and privacy concerns are among the factors preventing widespread use of this technology in organizations. Clarifying and explaining this technology, especially to the academic, managerial, and elite communities, can pave the way for a transformative beginning. The aim of this research is to elucidate the capacities of artificial intelligence in market and sales network management, identify its opportunities and benefits, and examine the existing challenges and obstacles. This research aims to leverage AI capabilities to provide a framework for enhancing market and sales network performance for managers. The results of this research can help managers and decision-makers adopt more effective strategies for business growth and development by better understanding the capabilities and limitations of artificial intelligence.

Keywords: artificial intelligence, market management, sales network, big data analysis, decision-making, digital marketing

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Authors: Rana Alkhamra

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Background: Child's earliest experiences with books and stories during the first years of his life are strongly linked with the development of his early language and literacy skills. Interacting in routine learning activities, such as shared book reading, storytelling, and teaching about the letters of the alphabet make a critical foundation for early learning, language growth and emergent literacy. Aim: The current study explores family and preschool early interactive literacy practices in families and preschools (nursery and kindergarten) in Jordan. It highlights the importance of early interactive literacy activities on child language and literacy growth and development. Methods: This is a cross sectional study that surveyed 243 Jordanian families. The survey investigated literacy routine practices, largely shared books reading, at home and at preschool; child speech and language development; and family demographics. Results: Around 92.5% of the families read books and stories to their children, as frequently as 1-2 times weekly or monthly (75%). Only 19.6% read books on daily basis. Many families reported preferring story-telling (97%). Despite that families acknowledged the importance of early literacy activities, on language, reading and writing, cognitive, and academic development, 45% asked for education and training pertaining to specific ways and ideas to help their young children develop language and literacy skills. About 69% of the families reported reading books and stories to their children for 15 minutes a day, while 71.2% indicated having their children watch television for 3 to > 6 hours a day. At preschool, only 52.8% of the teachers were reported to read books and stories. Factors like parent education, monthly income, living inside (33.6%) or outside (66.4%) the capital city of Amman significantly (p < 0.05) affected child early literacy interactive activities whether at home or at preschool. Conclusion: Early language and literacy skills depend largely on the opportunities and experiences provided to children in the home and in preschool environment. Family literacy programs can play an important role in bridging the gap in early literacy experiences for families that need help. Also, speech therapists can work in collaboration with families and educators to ensure that young children have high quality and sufficient opportunities to participate in early literacy activities both at home and in preschool environments.

Keywords: literacy, interactive activities, language, practices, family, preschool, Jordan

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Authors: Baluku Nathan

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Infection prevention and control (IPC) is a practical, evidence-based approach that prevents patients and emergency health workers from being harmed by avoidable infections as a result of antimicrobial resistance; all hospital infection control programs put together various practices which, when used appropriately, restrict the spread of infection. A breach in these control practices facilitates the transmission of infections from patients to health workers, other patients and attendants. It is, therefore, important for all EMTs and patients to adhere to them strictly. It is also imperative for administrators to ensure the implementation of the infection control program for their facilities. Purpose: The purpose of this study was to investigate the influencing factors of prevention practices against Infection exposure among emergency medical technicians (EMTs) in the emergency department at Mbarara hospital. Methodology: This was a descriptive cross-sectional study that employed a self-reported questionnaire that was filled out by 32 EMTs in the emergency department from 12th February to 3rd march 2022. The questionnaire consisted of items concerning the defensive environment and other Factors influencing Infection prevention and control practices in the accident and emergency department of Mbarara hospital. Results: From the findings, majority16(50%) always used protective gear when doing clinical work,14 (43.8%) didn’t use protective gear, citing they were only assisting those performing resuscitations, gumboots were the least used protective gear with only3(9.4%) usage. Regarding disposal techniques of specific products like blood and sharps, results showed 10 (31.3%) said blood is disposed of in red buckets, 5(15.6%) in yellow buckets and only5(15.6%) in black buckets and 12(37.5%) didn’t respond. However, 28(87.5%) said sharps were disposed of in a sharps container. The majority, 17(53.1%), were not aware of the infection control guidelines even though they were pinned on walls of the emergency rooms,15(46.9%) said they had never had quality assurance monitoring events,14(43.8%) said monitoring was continuous while15(46.9 %) said it was discrete. Conclusions: The infection control practices at the emergency department were inadequate in view of less than 100% of the EMTs observing the five principles of infection prevention, such as the use of personal protective equipment and proper waste disposal in appropriate color-coded bins. Dysfunctional infection prevention and control committees accompanied by inadequate supervision to ensure infection control remained a big challenge.

Keywords: infection prevention, influencing factors, emergency medical technician (EMT), emergency unit

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Authors: Baluku Nathan

Abstract:

Infection prevention and control (IPC) is a practical, evidence-based approach that prevents patients and emergency health workers from being harmed by avoidable infections as a result of antimicrobial resistance; all hospital infection control programs put together various practices which, when used appropriately, restrict the spread of infection. A breach in these control practices facilitates the transmission of infections from patients to health workers, other patients, and attendants. It is, therefore important for all emergency medical technicians (EMTs) and patients to strictly adhere to them. It is also imperative for administrators to ensure the implementation of the infection control programme for their facilities. Purpose: The purpose of this study was to investigate the influencing factors of prevention practices against infection exposure among emergency medical technicians (EMTs) in the emergency department at Mbarara hospital. Methodology: This was a descriptive cross-sectional study that employed a self-reported questionnaire that was filled out by 32 EMTs in the emergency department from 12th February to 3rd march 2022. The questionnaire consisted of items concerning the defensive environment and other factors influencing infection prevention and control practices in the accident and emergency department of Mbarara hospital. Results: From the findings, the majority 16 (50%) always used protective gear when doing clinical work, 14 (43.8%) didn’t use protective gear, citing they were only assisting those performing resuscitations, gumboots were the least used protective gear with only3(9.4%) usage. About disposal techniques of specific products like blood and sharps, results showed 10 (31.3%) said blood is disposed of in red buckets, 5 (15.6%) in yellow buckets, and only 5(15.6%) in black buckets, and 12(37.5%) didn’t respond, however, 28(87.5%) said sharps were disposed of in a sharps container. The majority, 17 (53.1%), were not aware of the infection control guidelines even though they were pinned on walls of the emergency rooms, 15(46.9%) said they have never had quality assurance monitoring events, 14(43.8%) said monitoring was continuous while 15(46.9 %) said it was discrete. Conclusions: The infection control practices at the emergency department were inadequate in view of less than 100% of the EMTs observing the five principles of infection prevention, such as the use of personal protective equipment and proper waste disposal in appropriate color-coded bins. Dysfunctional infection prevention and control committees accompanied by inadequate supervision to ensure infection control remained a big challenge.

Keywords: emergency medical technician, infection prevention, influencing factors, infection control

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Authors: Kseniia Zviagintseva, Brett Buttliere

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Science is fundamentally a problem-solving enterprise, and scientists pay more attention to the negative things, that cause them dissonance and negative affective state of uncertainty or contradiction. While this is agreed upon by philosophers of science, there are few empirical demonstrations. Here we examine the keywords from those papers published by PLoS in 2014 and show with several sentiment analyzers that negative keywords are studied more than positive keywords. Our dataset is the 927,406 keywords of 32,870 scientific articles in all fields published in 2014 by the journal PLOS ONE (collected from Altmetric.com). Counting how often the 47,415 unique keywords are used, we can examine whether those negative topics are studied more than positive. In order to find the sentiment of the keywords, we utilized two sentiment analysis tools, Hu and Liu (2004) and SentiStrength (2014). The results below are for Hu and Liu as these are the less convincing results. The average keyword was utilized 19.56 times, with half of the keywords being utilized only 1 time and the maximum number of uses being 18,589 times. The keywords identified as negative were utilized 37.39 times, on average, with the positive keywords being utilized 14.72 times and the neutral keywords - 19.29, on average. This difference is only marginally significant, with an F value of 2.82, with a p of .05, but one must keep in mind that more than half of the keywords are utilized only 1 time, artificially increasing the variance and driving the effect size down. To examine more closely, we looked at those top 25 most utilized keywords that have a sentiment. Among the top 25, there are only two positive words, ‘care’ and ‘dynamics’, in position numbers 5 and 13 respectively, with all the rest being identified as negative. ‘Diseases’ is the most studied keyword with 8,790 uses, with ‘cancer’ and ‘infectious’ being the second and fourth most utilized sentiment-laden keywords. The sentiment analysis is not perfect though, as the words ‘diseases’ and ‘disease’ are split by taking 1st and 3rd positions. Combining them, they remain as the most common sentiment-laden keyword, being utilized 13,236 times. More than just splitting the words, the sentiment analyzer logs ‘regression’ and ‘rat’ as negative, and these should probably be considered false positives. Despite these potential problems, the effect is apparent, as even the positive keywords like ‘care’ could or should be considered negative, since this word is most commonly utilized as a part of ‘health care’, ‘critical care’ or ‘quality of care’ and generally associated with how to improve it. All in all, the results suggest that negative concepts are studied more, also providing support for the notion that science is most generally a problem-solving enterprise. The results also provide evidence that negativity and contradiction are related to greater productivity and positive outcomes.

Keywords: bibliometrics, keywords analysis, negativity bias, positive and negative words, scientific papers, scientometrics

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Authors: Sabyasachi Behera, Shiv Kumar, Pramod Gautam, Anisur Rahman, Pawan Pathak, Rahul Bhadouria

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Background: The increasing proportion of population especially urban poor and vulnerable groups or groups with specific needs, with health indicators worse than their rural counterparts in India face various issues related with availability and quality of health care. The reasons are myriad, starting from information and awareness of the community, especially, in a scenario wherein the needs and challenges of floating and migrant urban populations remain poorly understood. Weak linkages between health care facilities and slum dwellers and vulnerable populations hinder the improvement of health services for urban poor. Method: To address this issue, TCIHC program is helping health department of Indore city of Madhya Pradesh to establish a referral mechanism with a dual approach: at both community and facility level. The former is based on the premise of ‘building social capital’, i.e. norms and networks within a community facilitating collective action, helps improve the demand and supply of health services at appropriate levels of care (Minus 2: Accredited Social Health Activist and Community Health Groups; Minus 1: Urban Health Nutrition Days; Zero: Urban Primary Health Center; Plus 1: secondary facility with BEmONC services; Plus 2: secondary facilities with CEmONC services; Plus 3: tertiary level facility) for the urban poor. The latter focuses on encouraging the provision of all services at various levels of service delivery points and stakeholders to function in a coordinated manner to ensure better health service availability and coverage in underserved slum areas. Results: This initiative has enhanced the utilization of community based, primary and secondary level services through defined referral pathways that are clearly known to a community dweller. Conclusion: An ideal referral mechanism should begin with referral at the community level wherein services of a frontline health care provider are accessed by them at their door-step, causing no delay in both understanding and decision on the health issues faced by them.

Keywords: levels of care, linkages, referral mechanism, service delivery

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Authors: Armen Grigoryan, Milena Arakelyan

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The idea of smart logistics is still quite a complicated one. It can be used to market products to a large number of customers or to acquire raw materials of the highest quality at the lowest cost in geographically dispersed areas. The use of smart contracts in logistics and supply chain management has the potential to revolutionize the way that goods are tracked, transported, and managed. Smart contracts are simply computer programs written in one of the blockchain programming languages (Solidity, Rust, Vyper), which are capable of self-execution once the predetermined conditions are met. They can be used to automate and streamline many of the traditional manual processes that are currently used in logistics and supply chain management, including the tracking and movement of goods, the management of inventory, and the facilitation of payments and settlements between different parties in the supply chain. Currently, logistics is a core area for companies which is concerned with transporting products between parties. Still, the problem of this sector is that its scale may lead to detainments and defaults in the delivery of goods, as well as other issues. Moreover, large distributors require a large number of workers to meet all the needs of their stores. All this may contribute to big detainments in order processing and increases the potentiality of losing orders. In an attempt to break this problem, companies have automated all their procedures, contributing to a significant augmentation in the number of businesses and distributors in the logistics sector. Hence, blockchain technology and smart contracted legal agreements seem to be suitable concepts to redesign and optimize collaborative business processes and supply chains. The main purpose of this paper is to examine the scope of blockchain technology and smart contracts in the field of logistics and supply chain management. This study discusses the research question of how and to which extent smart contracts and blockchain technology can facilitate and improve the implementation of collaborative business structures for sustainable entrepreneurial activities in smart supply chains. The intention is to provide a comprehensive overview of the existing research on the use of smart contracts in logistics and supply chain management and to identify any gaps or limitations in the current knowledge on this topic. This review aims to provide a summary and evaluation of the key findings and themes that emerge from the research, as well as to suggest potential directions for future research on the use of smart contracts in logistics and supply chain management.

Keywords: smart contracts, smart logistics, smart supply chain management, blockchain and smart contracts in logistics, smart contracts for controlling supply chain management

Procedia PDF Downloads 96