Search results for: Islamic public policy

Authors: V. Rekha, Rama Pal

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The study examines the degree and magnitude of wealth-based inequalities in child health and its determinants in India. Despite making strides in economic growth, India has failed to secure a better nutritional status for all the children. The country currently faces the double burden of malnutrition as well as the problems of overweight and obesity. Child malnutrition, obesity, unsafe water, sanitation among others are identified as the risk factors for Non-Communicable Diseases (NCDs). Eliminating malnutrition in all its forms will catalyse improved health and economic outcomes. The assessment of the distributive dimension of child health across various segments of the population is essential for effective policy intervention. The study utilises the fourth round of District Level Health Survey for 2012-13 to analyse the inequalities among children in the age group 0-14 years in Maharashtra, a state in the western region of India with a population of 11.24 crores which constitutes 9.3 percent of the total population of India. The study considers the extent of health inequality by state, districts, sector, age-groups, and gender. The z-scores of four child health outcome variables are computed to assess the nutritional status of pre-school and school children using WHO reference. The descriptive statistics, concentration curves, concentration indices, correlation matrix, logistic regression have been used to analyse the data. The results indicate that magnitude of inequality is higher in Maharashtra and child health inequalities manifest primarily among the weaker sections of society. The concentration curves show that there exists a pro-poor inequality in child malnutrition measured by stunting, wasting, underweight, anaemia and a pro-rich overweight inequality. The inequalities in anaemia are observably lower due to the widespread prevalence. Rural areas exhibit a higher incidence of malnutrition, but greater inequality is observed in the urban areas. Overall, the wealth-based inequalities do not vary significantly between age groups. It appears that there is no gender discrimination at the state level. Further, rural-urban differentials in gender show that boys from the rural area and girls living in the urban region experience higher disparities in health. The relative distribution of undernutrition across districts in Maharashtra reveals that malnutrition is rampant and considerable heterogeneity also exists. A negative correlation is established between malnutrition prevalence and human development indicators. The findings of logistic regression analysis reveal that lower economic status of the household is associated with a higher probability of being malnourished. The study recognises household wealth, education of the parent, child gender, and household size as factors significantly related to malnutrition. The results suggest that among the supply-side variables, child-oriented government programmes might be beneficial in tackling nutrition deficit. In order to bridge the health inequality gap, the government needs to target the schemes better and should expand the coverage of services.

Keywords: child health, inequality, malnutrition, obesity

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Authors: Jothilakshmy Nagammal

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This research paper deals with the different case studies, where the Form-Based Codes are adopted in general and the different implementation methods in particular are discussed to develop a method for formulating a new planning model. The organizing principle of the Form-Based Codes, the transect is used to zone the city into various context specific transects. An approach is adopted to develop the new planning model, city Specific Planning Model (CSPM), as a tool to achieve sustainability for any city in general. A case study comparison method in terms of the planning tools used, the code process adopted and the various control regulations implemented in thirty two different cities are done. The analysis shows that there are a variety of ways to implement form-based zoning concepts: Specific plans, a parallel or optional form-based code, transect-based code /smart code, required form-based standards or design guidelines. The case studies describe the positive and negative results from based zoning, Where it is implemented. From the different case studies on the method of the FBC, it is understood that the scale for formulating the Form-Based Code varies from parts of the city to the whole city. The regulating plan is prepared with the organizing principle as the transect in most of the cases. The various implementation methods adopted in these case studies for the formulation of Form-Based Codes are special districts like the Transit Oriented Development (TOD), traditional Neighbourhood Development (TND), specific plan and Street based. The implementation methods vary from mandatory, integrated and floating. To attain sustainability the research takes the approach of developing a regulating plan, using the transect as the organizing principle for the entire area of the city in general in formulating the Form-Based Codes for the selected Special Districts in the study area in specific, street based. Planning is most powerful when it is embedded in the broader context of systemic change and improvement. Systemic is best thought of as holistic, contextualized and stake holder-owned, While systematic can be thought of more as linear, generalisable, and typically top-down or expert driven. The systemic approach is a process that is based on the system theory and system design principles, which are too often ill understood by the general population and policy makers. The system theory embraces the importance of a global perspective, multiple components, interdependencies and interconnections in any system. In addition, the recognition that a change in one part of a system necessarily alters the rest of the system is a cornerstone of the system theory. The proposed regulating plan taking the transect as an organizing principle and Form-Based Codes to achieve sustainability of the city has to be a hybrid code, which is to be integrated within the existing system - A Systemic Approach with a Systematic Process. This approach of introducing a few form based zones into a conventional code could be effective in the phased replacement of an existing code. It could also be an effective way of responding to the near-term pressure of physical change in “sensitive” areas of the community. With this approach and method the new Context Specific Planning Model is created towards achieving sustainability is explained in detail this research paper.

Keywords: context based planning model, form based code, transect, systemic approach

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Authors: Eliana Bergamin

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This philosophical inquiry, influenced by the seminal works of Annemarie Mol and Jeannette Pols, critically examines the transformative impact of artificial intelligence (AI) on emotional caregiving practices within virtual healthcare. Rooted in the traditions of philosophy of care, philosophy of emotions, and applied philosophy, this study seeks to unravel nuanced shifts in the moral and emotional fabric of healthcare mediated by AI-powered technologies. Departing from traditional empirical studies, the approach embraces the foundational principles of care ethics and phenomenology, offering a focused exploration of the ethical and existential dimensions of AI-mediated emotional caregiving. At its core, this research addresses the introduction of AI-powered technologies mediating emotional and care practices in the healthcare sector. By drawing on Mol and Pols' insights, the study offers a focused exploration of the ethical and existential dimensions of AI-mediated emotional caregiving. Anchored in ethnographic research within a pioneering private healthcare company in the Netherlands, this critical philosophical inquiry provides a unique lens into the dynamics of AI-mediated emotional practices. The study employs in-depth, semi-structured interviews with virtual caregivers and care receivers alongside ongoing ethnographic observations spanning approximately two and a half months. Delving into the lived experiences of those at the forefront of this technological evolution, the research aims to unravel subtle shifts in the emotional and moral landscape of healthcare, critically examining the implications of AI in reshaping the philosophy of care and human connection in virtual healthcare. Inspired by Mol and Pols' relational approach, the study prioritizes the lived experiences of individuals within the virtual healthcare landscape, offering a deeper understanding of the intertwining of technology, emotions, and the philosophy of care. In the realm of philosophy of care, the research elucidates how virtual tools, particularly those driven by AI, mediate emotions such as empathy, sympathy, and compassion—the bedrock of caregiving. Focusing on emotional nuances, the study contributes to the broader discourse on the ethics of care in the context of technological mediation. In the philosophy of emotions, the investigation examines how the introduction of AI alters the phenomenology of emotional experiences in caregiving. Exploring the interplay between human emotions and machine-mediated interactions, the nuanced analysis discerns implications for both caregivers and caretakers, contributing to the evolving understanding of emotional practices in a technologically mediated healthcare environment. Within applied philosophy, the study transcends empirical observations, positioning itself as a reflective exploration of the moral implications of AI in healthcare. The findings are intended to inform ethical considerations and policy formulations, bridging the gap between technological advancements and the enduring values of caregiving. In conclusion, this focused philosophical inquiry aims to provide a foundational understanding of the evolving landscape of virtual healthcare, drawing on the works of Mol and Pols to illuminate the essence of human connection, care, and empathy amid technological advancements.

Keywords: applied philosophy, artificial intelligence, healthcare, philosophy of care, philosophy of emotions

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Authors: E. Gaury, P. Mandausch, O. Picot, A. R. Thomas, L. Veisblat, L. Ralambozanany, C. Delsart

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In Dakar, demographic and spatial growth was accompanied by a 50% increase in household waste between 1988 and 2008 in the city. In addition, a change in the nature of household waste was observed between 1990 and 2007. The share of plastic increased by 15% between 2004 and 2007 in Dakar. Plastics represent the seventh category of household waste, the most produced per year in Senegal. The share of plastic in household and similar waste is 9% in Senegal. Waste management in the city of Dakar is a complex process involving a multitude of formal and informal actors with different perceptions and objectives. The objective of this study was to understand the motivations that could lead to sorting action, as well as the perception of plastic waste sorting within the Dakar population (households and institutions). The problematic of this study was as follows: what may be the factors playing a role in the sorting action? In an attempt to answer this, two approaches have been developed: (1) An exploratory qualitative study by semi-structured interviews with two groups of individuals concerned by the sorting of plastic waste: on the one hand, the experts in charge of waste management and on the other the households-producers of waste plastics. This study served as the basis for formulating the hypotheses and thus for the quantitative analysis. (2) A quantitative study using a questionnaire survey method among households producing plastic waste in order to test the previously formulated hypotheses. The objective was to have quantitative results representative of the population of Dakar in relation to the behavior and the process inherent in the adoption of the plastic waste sorting action. The exploratory study shows that the perception of state responsibility varies between institutions and households. Public institutions perceive this as a shared responsibility because the problem of plastic waste affects many sectors (health, environmental education, etc.). Their involvement is geared more towards raising awareness and educating young people. As state action is limited, the emergence of private companies in this sector seems logical as they are setting up collection networks to develop a recycling activity. The state plays a moral support role in these activities and encourages companies to do more. The study of the understanding of the action of sorting plastic waste by the population of Dakar through a quantitative analysis was able to demonstrate the attitudes and constraints inherent in the adoption of plastic waste sorting.Cognitive attitude, knowledge, and visible consequences have been shown to correlate positively with sorting behavior. Thus, it would seem that the population of Dakar is more sensitive to what they see and what they know to adopt sorting behavior.It has also been shown that the strongest constraints that could slow down sorting behavior were the complexity of the process, too much time and the lack of infrastructure in which to deposit plastic waste.

Keywords: behavior, Dakar, plastic waste, waste management

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Authors: Bistra Kunovska, Kremena Ivanova, Jana Djounova, Desislava Djunakova, Zdenka Stojanovska

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The carcinogenic effects of radon as a radioactive noble gas have been studied and show a strong correlation between radon exposure and lung cancer occurrence, even in the case of low radon levels. The major part of the natural radiation dose in humans is received by inhaling radon and its progenies, which originates from the decay chain of U-238. Indoor radon poses a substantial threat to human health when build-up occurs in confined spaces such as homes, mines and caves and the risk increases with the duration of radon exposure and is proportional to both the radon concentration and the time of exposure. Tourist caves are a case of special environmental conditions that may be affected by high radon concentration. Tourist caves are a recognized danger in terms of radon exposure to cave workers (guides, employees working in shops built above the cave entrances, etc.), but due to the sensitive nature of the cave environment, high concentrations cannot be easily removed. Forced ventilation of the air in the caves is considered unthinkable due to the possible harmful effects on the microclimate, flora and fauna. The risks to human health posed by exposure to elevated radon levels in caves are not well documented. Various studies around the world often detail very high concentrations of radon in caves and exposure of employees but without a follow-up assessment of the overall impact on human health. This study was developed in the implementation of a national project to assess the potential health effects caused by exposure to elevated levels of radon in buildings with public access under the National Science Fund of Bulgaria, in the framework of grant No КП-06-Н23/1/07.12.2018. The purpose of the work is to assess the radon level in Bulgarian caves and the exposure of the visitors and workers. The number of caves (sampling size) was calculated for simple random selection from total available caves 65 (sampling population) are 13 caves with confidence level 95 % and confidence interval (margin of error) approximately 25 %. A measurement of the radon concentration in air at specific locations in caves was done by using CR-39 type nuclear track-etch detectors that were placed by the participants in the research team. Despite the fact that all of the caves were formed in karst rocks, the radon levels were rather different from each other (97–7575 Bq/m3). An assessment of the influence of the orientation of the caves in the earth's surface (horizontal, inclined, vertical) on the radon concentration was performed. Evaluation of health hazards and radon risk exposure causing by inhaling the radon and its daughter products in each surveyed caves was done. Reducing the time spent in the cave has been recommended in order to decrease the exposure of workers.

Keywords: tourist caves, radon concentration, exposure, Bulgaria

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Authors: Dmytro Symak

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The experience in other countries shows that, the role of accreditation of higher education as one of the types of quality assurance process for providing educational services increases. This was the experience of highly developed countries such as USA, Canada, France, Germany, because without proper quality assurance process is impossible to achieve a successful future of the nation and the state. In most countries, the function of Higher Education Accreditation performs public authorities, in particular, such as the Ministry of Education. In the US, however, the quality assurance process is independent on the government and implemented by private non-governmental organization - the Council of Higher Education Accreditation. In France, the main body that carries out accreditation of higher education is the Ministry of National Education. As part of the Bologna process is the mutual recognition and accreditation of degrees. While higher education institutions issue diplomas, but the ministry could award the title. This is the main level of accreditation awarded automatically by state universities. In total, there are in France next major level of accreditation of higher education: - accreditation for a visa: Accreditation second level; - recognition of accreditation: accreditation of third level. In some areas of education to accreditation ministry should adopt formal recommendations on specific organs. But there are also some exceptions. Thus, the French educational institutions, mainly large Business School, looking for non-French accreditation. These include, for example, the Association to Advance Collegiate Schools of Business, the Association of MBAs, the European Foundation for Management Development, the European Quality Improvement System, a prestigious EFMD Programme accreditation system. Noteworthy also German accreditation system of education. The primary here is a Conference of Ministers of Education and Culture of land in the Federal Republic of Germany (Kultusministerkonferenz or CCM) was established in 1948 by agreement between the States of the Federal Republic of Germany. Among its main responsibilities is to ensure quality and continuity of development in higher education. In Germany, the program of bachelors and masters must be accredited in accordance with Resolution Kultusministerkonerenz. In Ukraine Higher Education Accreditation carried out the Ministry of Education, Youth and Sports of Ukraine under four main levels. Ukraine's legislation on higher education based on the Constitution Ukraine consists of the laws of Ukraine ‘On osvititu’ ‘On scientific and technical activity’, ‘On Higher osvititu’ and other legal acts and is entirely within the competence of the state. This leads to considerable centralization and bureaucratization of the process. Thus, analysis of expertise shined can conclude that reforming the system of accreditation and quality of higher education in Ukraine to its integration into the global space requires solving a number of problems in the following areas: improving the system of state certification and licensing; optimizing the network of higher education institutions; creating both governmental and non-governmental organizations to monitor the process of higher education in Ukraine and so on.

Keywords: higher education, accreditation, decentralization, education institutions

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Authors: Nasim Hashemi, Abbas Sheikhtaheri

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Telemedicine is the use of telecommunication and information technologies to provide health care services that would often not be consistently available in distant rural communities to people at these remote areas. Teleophthalmology is a branch of telemedicine that delivers eye care through digital medical equipment and telecommunications technology. Thus, teleophthalmology can overcome geographical barriers and improve quality, access, and affordability of eye health care services. Since teleophthalmology has been widespread applied in recent years, the aim of this study was to determine the different applications of teleophthalmology in the world. To this end, three bibliographic databases (Medline, ScienceDirect, Scopus) were comprehensively searched with these keywords: eye care, eye health care, primary eye care, diagnosis, detection, and screening of different eye diseases in conjunction with telemedicine, telehealth, teleophthalmology, e-services, and information technology. All types of papers were included in the study with no time restriction. We conducted the search strategies until 2015. Finally 70 articles were surveyed. We classified the results based on the’type of eye problems covered’ and ‘the type of telemedicine services’. Based on the review, from the ‘perspective of health care levels’, there are three level for eye health care as primary, secondary and tertiary eye care. From the ‘perspective of eye care services’, the main application of teleophthalmology in primary eye care was related to the diagnosis of different eye diseases such as diabetic retinopathy, macular edema, strabismus and aged related macular degeneration. The main application of teleophthalmology in secondary and tertiary eye care was related to the screening of eye problems i.e. diabetic retinopathy, astigmatism, glaucoma screening. Teleconsultation between health care providers and ophthalmologists and also education and training sessions for patients were other types of teleophthalmology in world. Real time, store–forward and hybrid methods were the main forms of the communication from the perspective of ‘teleophthalmology mode’ which is used based on IT infrastructure between sending and receiving centers. In aspect of specialists, early detection of serious aged-related ophthalmic disease in population, screening of eye disease processes, consultation in an emergency cases and comprehensive eye examination were the most important benefits of teleophthalmology. Cost-effectiveness of teleophthalmology projects resulted from reducing transportation and accommodation cost, access to affordable eye care services and receiving specialist opinions were also the main advantages of teleophthalmology for patients. Teleophthalmology brings valuable secondary and tertiary care to remote areas. So, applying teleophthalmology for detection, treatment and screening purposes and expanding its use in new applications such as eye surgery will be a key tool to promote public health and integrating eye care to primary health care.

Keywords: applications, telehealth, telemedicine, teleophthalmology

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Authors: Gadinga Walter Forje, Martin Ngankam Tchamba, Nyong Princely Awazi, Barnabas Neba Nfornka

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Ecotourism is viewed as a double edge sword for the enhancement of conservation and local livelihood within a protected landscape. The Campo Ma’an National Park (CMNP) adopted ecotourism in its management plan as a strategic axis for better management of the park. The growing importance of ecotourism as a strategy for the sustainable management of CMNP and its environs requires adequate information to bolster the sector. This study was carried out between November 2018 and September 2021, with the main objective to contribute to the sustainable management of the CMNP through suggestions for enhancing the capacity of ecotourism in and around the park. More specifically, the study aimed at; 1) Analyse the governance of ecotourism in the CMNP and its surrounding; 2) Assessing the impact of ecotourism on local livelihood around the CMNP; 3) Evaluating the contribution of ecotourism to biodiversity conservation in and around the CMNP; 4) Evaluate the determinants of ecotourism possibilities in achieving sustainable livelihood and biodiversity conservation in and around the CMNP. Data were collected from both primary and secondary sources. Primary data were obtained from household surveys (N=124), focus group discussions (N=8), and key informant interviews (N=16). Data collected were coded and imputed into SPSS (version 19.0) software and Microsoft Excel spreadsheet for both quantitative and qualitative analysis. Findings from the Chi-square test revealed overall poor ecotourism governance in and around the CMNP, with benefit sharing (X2 = 122.774, p <0.01) and conflict management (X2 = 90.839, p<0.01) viewed to be very poor. For the majority of the local population sampled, 65% think ecotourism does not contribute to local livelihood around CMNP. The main factors influencing the impact of ecotourism around the CMNP on the local population’s livelihood were gender (logistic regression (β) = 1.218; p = 0.000); and level of education (logistic regression (β) = 0.442; p = 0.000). Furthermore, 55.6% of the local population investigated believed ecotourism activities do not contribute to the biodiversity conservation of CMNP. Spearman correlation between socio-economic variables and ecotourism impact on biodiversity conservation indicated relationships with gender (r = 0.200, p = 0.032), main occupation (r = 0.300 p = 0.012), time spent in the community (r = 0.287 p = 0.017), and number of children (r =-0.286 p = 0.018). Variables affecting ecotourism impact on biodiversity conservation were age (logistic regression (β) = -0.683; p = 0.037) and gender (logistic regression (β) = 0.917; p = 0.045). This study recommends the development of ecotourism-friendly policies that can accelerate Public Private Partnership for the sustainable management of the CMNP as a commitment toward good governance. It also recommends the development of gender-sensitive ecotourism packages, with fair opportunities for rural women and more parity in benefit sharing to improve livelihood and contribute more to biodiversity conservation in and around the Park.

Keywords: biodiversity conservation, Campo Ma’an national park, ecotourism, ecotourism governance, rural livelihoods, protected area management

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Authors: Fahad Ibrahim, Raphaël Akamavi

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Bangladesh has encountered several industrial disasters (e.g. fire and building collapse tragedies) leading to the loss of valuable human lives. Irrespective of various institutions’ making effort to improve the safety situation, industry compliance and safety behaviour have not yet been improved. Hence, one question remains, to what extent does the institutional elements efficient enough to make any difference in improving safety behaviours? Thus, this study explores the relationship between institutional perspective and safety performance. Structural equation modelling results, using survey data from 256 RMG workers’ of 128 garments manufacturing factories in Bangladesh, show that institutional facets strongly influence management safety commitment to induce workers participation in safety activities and reduce workplace accident rates. The study also found that by upholding industrial standards and inspecting the safety situations, institutions facets significantly and directly affect workers involvement in safety participations and rate of workplace accidents. Additionally, workers involvement to safety practices significantly predicts the safety environment of the workplace. Subsequently, our findings demonstrate that institutional culture, norms, and regulations enact play an important role in altering management commitment to set-up a safer workplace environment. As a result, when workers’ perceive their management having high level of commitment to safety, they are inspired to be involved more in the safety practices, which significantly alter the workplace safety situation and lessen injury experiences. Due to the fact that institutions have strong influence on management commitment, legislative members should endorse, regulate, and strictly monitor workplace safety laws to be exercised by the factory owners. Further, management should take initiatives for adopting OHS features and conceive strategic directions (i.e., set up safety committees, risk assessments, innovative training) for promoting a positive safety climate to provide a safe workplace environment. Arguably, an inclusive public-private partnership is recommended for ensuring better and safer workplace for RMG workers. However, as our data were under a cross-sectional design; the respondents’ perceptions might get changed over a period of time and hence, a longitudinal study is recommended. Finally, further research is needed to determine the impact of improvement mechanisms on workplace safety performance, such as how workplace design, safety training programs, and institutional enforcement policies protect the well-being of workers.

Keywords: institutional perspective, management commitment, safety participation, work injury, safety performance, occupational health and safety

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Authors: Bhargavi G. Iyer, Ojaswi Bhagat

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It is often noted that the value of a novel idea lies in its successful implementation. However, successful implementation requires the nurturing and encouragement of innovation. Nascent competitors are a true representation of innovation in any given industry. A nascent competitor is an entity whose prospective innovation poses a future threat to an incumbent dominant competitor. While a nascent competitor benefits in several ways, it is also exposed significantly and is at greater risk of facing the brunt of exclusionary practises and abusive conduct by dominant incumbent competitors in the industry. This research paper aims to explore the risks and threats faced by nascent competitors and analyse the benefits they accrue as well as the advantages they proffer to the economy; through an analytical, critical study. In such competitive market environments, a rise of the acquisitions of nascent competitors by the incumbent dominants is observed. Therefore, this paper will examine the dynamics of nascent acquisition. Further, this paper hopes to specifically delve into the role of antitrust bodies in regulating nascent acquisition. This paper also aspires to deal with the question how to distinguish harmful from harmless acquisitions in order to facilitate ideal enforcement practice. This paper proposes mechanisms of scrutiny in order to ensure healthy market practises and efficient merger control in the context of nascent acquisitions. Taking into account the scope and nature of the topic, as well as the resources available and accessible, a combination of the methods of doctrinal research and analytical research were employed, utilising secondary sources in order to assess and analyse the subject of research. While legally evaluating the Killer Acquisition theory and the Nascent Potential Acquisition theory, this paper seeks to critically survey the precedents and instances of nascent acquisitions. In addition to affording a compendious account of the legislative framework and regulatory mechanisms in the United States, the United Kingdom, and the European Union; it hopes to suggest an internationally practicable legal foundation for domestic legislation and enforcement to adopt. This paper hopes to appreciate the complexities and uncertainties with respect to nascent acquisitions and attempts to suggest viable and plausible policy measures in antitrust law. It additionally attempts to examine the effects of such nascent acquisitions upon the consumer and the market economy. This paper weighs the argument of shifting the evidentiary burden on to the merging parties in order to improve merger control and regulation and expounds on its discovery of the strengths and weaknesses of the approach. It is posited that an effective combination of factual, legal, and economic analysis of both the acquired and acquiring companies possesses the potential to improve ex post and ex ante merger review outcomes involving nascent companies; thus, preventing anti-competitive practises. This paper concludes with an analysis of the possibility and feasibility of industry-specific identification of anti-competitive nascent acquisitions and implementation of measures accordingly.

Keywords: acquisition, antitrust law, exclusionary practises merger control, nascent competitor

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Authors: Cherrie Lowe

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The TrendCare Patient Dependency System is currently utilized by a large number of Maternity Services across Australia, New Zealand and Singapore. In 2012, 2013, and 2014 validation studies were initiated in all three countries to validate the acuity tools used for Women in Labour, and Postnatal Mothers and Babies. This paper will present the findings of the validation study. Aim: The aim of this study was to; Identify if the care hours provided by the TrendCare Acuity System was an accurate reflection of the care required by Women and Babies. Obtain evidence of changes required to acuity indicators and/or category timings to ensure the TrendCare acuity system remains reliable and valid across a range of Maternity care models in three countries. Method: A non-experimental action research methodology was used across four District Health Boards in New Zealand, two large public Australian Maternity services and a large tertiary Maternity service in Singapore. Standardized data collection forms and timing devices were used to collect Midwife contact times with Women and Babies included in the study. Rejection processes excluded samples where care was not completed/rationed. The variances between actual timed Midwife/Mother/Baby contact and actual Trend Care acuity times were identified and investigated. Results: 87.5% (18) of TrendCare acuity category timings matched the actual timings recorded for Midwifery care. 12.5% (3) of TrendCare night duty categories provided less minutes of care than the actual timings. 100% of Labour Ward TrendCare categories matched actual timings for Midwifery care. The actual times given for assistance to New Zealand independent Midwives in Labour Ward showed a significant deviation to previous studies demonstrating the need for additional time allocations in Trend Care. Conclusion: The results demonstrated the importance of regularly validating the Trend Care category timings with the care hours required, as variances to models of care and length of stay in Maternity units have increased Midwifery workloads on the night shift. The level of assistance provided by the core labour ward staff to the Independent Midwife has increased substantially. Outcomes: As a consequence of this study changes were made to the night duty TrendCare Maternity categories, additional acuity indicators developed and times for assisting independent Midwives increased. The updated TrendCare version was delivered to Maternity services in 2014.

Keywords: maternity, acuity, research, nursing workloads

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Authors: Toslim Uddin Khan, Jesmin Akter, Mohiuddin Ahmed

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Menstrual hygiene management (MHM) and personal health-care practice is a critical issue to prevent morbidity and other reproductive health complications among adolescent girls in Bangladesh. Inadequate access to water, sanitation and hygiene (WASH) facilities lead to unhealthy MHM practices that resulted in poor reproductive health outcomes. It is evident from different studies that superstitions and misconception are more common in rural communities that limit young girls’ access to and understanding of the menstrual hygiene and self care practices. The state-of-the-art approach of Social Marketing Company (SMC) is proved to be instrumental in delivering reinforcing health messages, making public health and hygiene products available at the door steps of the community through community mobilization programs in rural Bangladesh. School health program is one of the flagship interventions of SMC to equip adolescent girls and boys with correct knowledge of health and hygiene practices among themselves, their families and peers. In Bangladeshi culture, adolescent girls often feel shy to ask fathers or male family members about buying sanitary napkin from local pharmacy and they seem to be reluctant to seek help regarding their menstrual problems. A recent study reveals that 48% adolescent girls are using sanitary napkins while majority of them are unaware of menstrual hygiene practices in Bangladesh. Under school adolescent program, SMC organizes health education sessions for adolescent girls from grade seven to ten using enter-educate approach with special focus on sexual and reproductive health and menstrual hygiene issues including delaying marriage and first pregnancy. In addition, 2500 rural women entrepreneurs branded as community sales agents are also involved in disseminating health messages and selling priority health products including sanitary napkin at the household level. These women entrepreneurs are serving as a source of sustainable supply of the sanitary napkins for the rural adolescent girls and thereby they are earning profit margins on the sales they make. A recent study on the impact of adolescent program activities reveals that majority (71%) of the school adolescent girls are currently using sanitary napkins. Health education equips and empowers adolescent girls with accurate knowledge about menstrual hygiene practices and self-care as well. Therefore, engagement of female entrepreneurs in school adolescent health program at the community level is one of the promising ways to improve menstrual hygiene practices leading to increased use of sanitary napkin in rural and semi-rural communities in Bangladesh.

Keywords: school adolescent program, social marketing, women entrepreneurs, menstrual hygiene management

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Authors: Ashleigh Dawn Moeller

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This is a comparative case study which examines the language attitudes and behaviors of descendants of Volga German immigrants in North America and how these attitudes combined with surrounding social conditions have caused their heritage language to develop differently within each community. Of particular interest for this study are the accounts of second- and third-generation descendants in Oregon, Kansas, and North Dakota regarding their parents’ and grandparents’ attitudes toward their language and how this correlates with the current sentiment as well as visibility of their heritage language and culture. This study discusses the point at which cultural identity could diverge from language identity and what elements play a role in this development, establishing the potential for environments (linguistic landscapes) which uphold their heritage yet have detached from the language itself. Emigrating from Germany in the 1700s, these families settled for over a hundred years along the Volga Region of Imperial Russia. Subsequently, many descendants of these settlers immigrated to the Americas in the 1800-1900s. Identifying neither as German nor Russian, they called themselves Wolgadeutche (Volga Germans). During their time in Russia, the German language was maintained relatively homogenously, yet the use and status of their heritage language diverged considerably upon settlement across the Americas. Data shows that specific conditions, such as community isolation, size, religion, location as well as language policy established prior to and following the Volga German immigration to North America have had a substantial impact on the maintenance of their heritage language—causing complete loss in some areas and peripheral use or even full rebirth in others. These past conditions combined with the family accounts correlate directly with the general attitudes and ideologies of the descendants toward their heritage language. Data also shows that in many locations, despite a strong presence of German within the linguistic landscape, minimal to no German is spoken nor understood; the attitude toward the language is indifferent while a staunch holding to the heritage is maintained and boasted. Data for this study was gathered from historical accounts, archived records and newspapers, and published biographies as well as from formal interviews with second- and third-generation descendants of Volga German immigrants conducted in Oregon and Kansas. Through the interviews, members of the community have shared and provided their family genealogies as well as biographies published by family members. These have helped to trace their relatives back to specific locations, thus allowing for comparisons within the same families residing in distinctly different areas of North America. This study is part of a larger ongoing project which researches the immigration of Volga and Black Sea Germans to North America and diachronically examines the over-arching sociological factors which have directly impacted the maintenance, loss, or rebirth of their heritage language. This project follows specific families who settled in areas of Colorado, Kansas, Nebraska, Illinois, Minnesota, North and South Dakota, Saskatchewan, and Manitoba, and who later had relatives move west to areas of Oregon and Washington State. Interviews for the larger project will continue into the following year.

Keywords: heritage language, immigrant language, language change, language contact, linguistic landscape, Volga Germans, Wolgadeutsche

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Authors: Ching-Yi Yiu, Hui-Chen Hsu

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Objectives: Head and neck cancer (HNC) is a big global health problem in the world. Despite the development of diagnosis and treatment, the overall survival of HNC is still low. The well recognition of the interaction of the host immune system and cancer cells has led to realizing the processes of tumor initiation, progression and metastasis. Many systemic inflammatory responses have been shown to play a crucial role in cancer progression. The pre and post-treatment nutritional and immunological status of HNC patients is a reliable prognostic indicator of tumor outcomes and survivors. Methods: Between July 2020 to June 2022, We have enrolled 60 HNC patients, including 59 males and 1 female, in Chi Mei Medical Center, Liouying, Taiwan. The age distribution was from 37 to 81 years old (y/o), with a mean age of 57.6 y/o. We evaluated the pre-and post-treatment nutritional and immunological status of these HNC patients with body weight, body weight loss, body mass index (BMI), whole blood count including hemoglobin (Hb), lymphocyte, neutrophil and platelet counts, biochemistry including prealbumin, albumin, c-reactive protein (CRP), with the time period of before treatment, post-treatment 3 and 6 months. We calculated the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) to assess how these biomarkers influence the outcomes of HNC patients. Results: We have carcinoma of the hypopharynx in 21 cases with 35％, carcinoma of the larynx in 9 cases, carcinoma of the tonsil and tongue every 6 cases, carcinoma soft palate and tongue base every 5 cases, carcinoma of buccal mucosa, retromolar trigone and mouth floor every 2 cases, carcinoma of the hard palate and low lip each 1 case. There were stage I 15 cases, stage II 13 cases, stage III 6 cases, stage IVA 10 cases, and stage IVB 16 cases. All patients have received surgery, chemoradiation therapy or combined therapy. We have wound infection in 6 cases, 2 cases of pharyngocutaneous fistula, flap necrosis in 2 cases, and mortality in 6 cases. In the wound infection group, the average BMI is 20.4 kg/m2; the average Hb is 12.9 g/dL, the average albumin is 3.5 g/dL, the average NLR is 6.78, and the average PLR is 243.5. In the PC fistula and flap necrosis group, the average BMI is 21.65 kg/m2; the average Hb is 11.7 g/dL, the average albumin is 3.15 g/dL, average NLR is 13.28, average PLR is 418.84. In the mortality group, the average BMI is 22.3 kg/m2; the average Hb is 13.58 g/dL, the average albumin is 3.77 g/dL, the average NLR is 6.06, and the average PLR is 275.5. Conclusion: HNC is a big challenging public health problem worldwide, especially in the high prevalence of betel nut consumption area Taiwan. Besides the definite risk factors of smoking, drinking and betel nut related, the other biomarkers may play significant prognosticators in the HNC outcomes. We concluded that the average BMI is less than 22 kg/m2, the average Hb is low than 12.0 g/dL, the average albumin is low than 3.3 g/dL, the average NLR is low than 3, and the average PLR is more than 170, the surgical complications and mortality will be increased, and the prognosis is poor in HNC patients.

Keywords: nutritional, immunological, neutrophil-to-lymphocyte ratio, paltelet-to-lymphocyte ratio.

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Authors: Marjorie Miguel

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Globalization offers better career opportunities hence demands more competent professionals efficient for the job. With the transformation of the world industry from competition to collaboration coupled with the rapid development in the field of science and technology, engineers need not only to be technically proficient, but also multilingual-skilled: two characteristics that a global engineer possesses. English often serves as the global language between people from different cultures being the medium mostly used in international business. Ironically, most universities worldwide adapt engineering curriculum heavily built around the language of mathematics not realizing that the goal of an engineer is not only to create and design, but more importantly to promote his creations and designs to the general public through effective communication. This premise led to some developments in the teaching process of English subjects in the tertiary level which include the integration of the technical knowledge related to the area of specialization of the students in the English subjects that they are taking. This is also known as English for Specific Purposes. This study focused on the development of English for Specific Purposes-Based Instructional Materials for Engineering Students of Bulacan State University (BulSU). The materials were tailor-made in which the contents and structure were designed to meet the specific needs of the students as well as the industry. Based on the needs analysis, the needs of the students and the industry were determined to make the study descriptive in nature. The major respondents included fifty engineering students and ten professional engineers from selected institutions. The needs analysis was done and the results showed the common writing difficulties of the students and the writing skills needed among the engineers in the industry. The topics in the instructional materials were established after the needs analysis was conducted. Simple statistical treatment including frequency distribution, percentages, mean, standard deviation, and weighted mean were used. The findings showed that the greatest number of the respondents had an average proficiency rating in writing, and the much-needed skills that must be developed by the engineers are directly related to the preparation and presentation of technical reports about their projects, as well as to the different communications they transmit to their colleagues and superiors. The researcher undertook the following phases in the development of the instructional materials: a design phase, development phase, and evaluation phase. Evaluations are given by some college instructors about the instructional materials generally helped in its usefulness and significance making the study beneficial not only as a career enhancer for BulSU engineering students, but also creating the university one of the educational institutions ready for the new millennium.

Keywords: English for specific purposes, instructional materials, needs analysis, write (right) job description

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Authors: Emma Pope, Demos Parapanos

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Rural tourism has become more obvious and prevalent, with tourists’ increasingly seeking authentic experiences. This movement accelerated post-Covid, putting destinations in danger of reaching levels of saturation called ‘overtourism’. Whereas the phenomenon of overtourism has been frequently discussed in the urban context by academics and practitioners over recent years, it has hardly been referred to in the context of rural tourism, where perhaps it is even more difficult to manage. Rural tourism was historically considered small-scale, marked by its traditional character and by having little impact on nature and rural society. The increasing number of rural areas experiencing overtourism, however, demonstrates the need for new approaches, especially as the impacts and enablers of overtourism are context specific. Cumbria, with approximately 47 million visitors each year, and 23,000 operational enterprises, is one of these rural areas experiencing overtourism in the UK. Using the county of Cumbria as an example, this paper aims to explore better planning and management in rural destinations by clustering the area into rural and ‘urban-rural’ tourism zones. To achieve the aim, this study uses secondary data from a variety of sources to identify variables relating to visitor economy development and demand. These data include census data relating to population and employment, tourism industry-specific data including tourism revenue, visitor activities, and accommodation stock, and big data sources such as Trip Advisor and All Trails. The combination of these data sources provides a breadth of tourism-related variables. The subsequent analysis of this data draws upon various validated models. For example, tourism and hospitality employment density, territorial tourism pressure, and accommodation density. In addition to these statistical calculations, other data are utilized to further understand the context of these zones, for example, tourist services, attractions, and activities. The data was imported into ARCGIS where the density of the different variables is visualized on maps. This study aims to provide an understanding of the geographical context of visitor economy development and tourist behavior in rural areas. The findings contribute to an understanding of the spatial dynamics of tourism within the region of Cumbria through the creation of thematized maps. Different zones of tourism industry clusters are identified, which include elements relating to attractions, enterprises, infrastructure, tourism employment and economic impact. These maps visualize hot and cold spots relating to a variety of tourism contexts. It is believed that the strategy used to provide a visual overview of tourism development and demand in Cumbria could provide a strategic tool for rural areas to better plan marketing opportunities and avoid overtourism. These findings can inform future sustainability policy and destination management strategies within the areas through an understanding of the processes behind the emergence of both hot and cold spots. It may mean that attract and disperse needs to be reviewed in terms of a strategic option. In other words, to use sector or zonal policies for the individual hot or cold areas with transitional zones dependent upon local economic, social and environmental factors.

Keywords: overtourism, rural tourism, sustainable tourism, tourism planning, tourism zones

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Authors: Judith Sue Hwa Joo

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Guanyin (Avalokiteśvara in Sanskrit), the Bodhisattva of Mercy and Compassion, is the most widely worshipped Buddhist Divinity in Chinese societies and is also believed by more than half of Asian populations across various countries. The most overwhelming reason for the popularity of Guanyin in Chinese societies is, according to the Lotus Sutra, that Guanyin would apperceive voices of those suffering from immense afflictions and troubles, and liberate them upon crying for his/her holy name with wholeheartedness. Its pervasive social influence has spanned more than two thousand years and is still deeply affecting the lives of most Chinese people. This study aimed to investigate whether Guanyin Worship has evolved and changed in modern Chinese societies across the Taiwan Strait. Taiwan and China, albeit having the same language and culture, have been territorially divided and governed by two different political regimes for over 70 years. It would be scientifically intriguing to unveil any substantial changes in religious behaviors in the context of Guanyin Worship. A comprehensive anonymous questionnaire survey in Chinese communities was conducted from October 2017 to May 2019 across various countries, mostly in China, Taiwan, and Hong Kong areas. Since the religious survey is officially prohibited in China, the study was difficult and could only be exercised by means of snowball sampling. Demographic data (age, sex, education, religious belief) were registered and Guanyin’s salvation functions under various confronting situations were investigated. Psychological dimensions of religious belief in Guanyin were probed in terms of the worship experience, the willingness of veneration, and egoistic or altruistic ideations. A literature review on documented functional attributes was carried out in parallel for comparison analyses with traditional roles. Effective 1123 out of 1139 samples were obtained. Statistical analysis revealed that Guanyin Worship is still commonly practiced and deeply rooted in the hearts of all Chinese people regardless of gender, age, education, and residential area, even though they may not enshrine Guanyin at home nowadays. The conventional roles of Guanyin Bodhisattva are still valid and best satisfy the real interests of lifestyles in modern times. When comparing the traditional Buddhist Sutra and the documented literature, the divine power of modern Guanyin has notably empowered to recover, protect and transform fetal and infant spirits due to the sexual liberation, increased abortion rate, gender awakening and enhanced female autonomy in the reproductive decision. However, the One-Child policy may have critically impacted the trajectory of Guanyin Worship so that people in China prevail over those in Taiwan praying for aborted lives or premature deaths. Furthermore, particularly in Hong Kong and Macao, Guanyin not only serves as the sea guardian for the fishermen but also additional services a new function as the God of Wealth. The divine powers and salvation functions of Guanyin are indeed evolving and expanding to comply with the modern psychosocial, cultural and societal needs. This study sheds light on the modernization process of the two-thousand-year-old Guanyin Worship of contemporary Chinese societies.

Keywords: Buddhism, Guanyin, religious behavior, salvation function

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Authors: Karl Erickson I. Ebora

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Science and technology are two inseparable terms which bring wonders to all aspects of life such as education, medicine, food production and even the environment. In education, technology has become an integral part as it brings many benefits to the teaching-learning process. However, in the Philippines, being one of the developing countries resources are scarce and not all schools enjoy the fruits brought by technology. Much of this ordeal impacts that of multigrade instruction. These schools are often the last priority in resources allocation since these have limited number of students. In fact, it is not surprising that these schools do not have even a single computer unit much more a computer laboratory. This paper sought to present a plan on how public schools would receive its e-classroom. Specifically, this paper sought to answer questions like the level of the school readiness in terms of facilities and equipment; the attitude of the respondents towards the use of e-classroom; level of teacher’s familiarity in using different e-classroom software and the plans of interventions undertaken by the school to make it e-classroom ready. After gathering and analysing the necessary data, this paper came up with the following conclusions that in terms of facilities and equipment, Guisguis Talon Elementary School (Main), though a multigrade school, is ready to receive e-classroom.; that the respondents show positive disposition in technology utilization in teaching after they strongly agree that technology plays essential role in the teaching-learning process. Also, they strongly agree that technology is a good motivator; it makes the teaching and learning more interesting and effective; it makes teaching easy; and that technology enhances student’s learning. Additionally, Teacher-respondents in Guisguis Talon Elementary School (Main) show familiarity in using software. They are very familiar with MS Word; MS Excel; MS PowerPoint; and internet and email. Moreover, they are very familiar with basic e-classroom computer operations and basic application software. They are very familiar with MS office and can do simple editing and formatting; in accessing and saving information from CD/DVD, external hard drives, USB and the like; and in browsing effectively different search engines and educational sites, download and upload files. Likewise respondents strongly agree to the interventions undertaken by the school to make it e-classroom ready. They strongly agree that funding and support are needed by the school; that stakeholders should be encouraged to consider donating of equipment; and that school and community should try to mobilize their resources in order to help the school; that the teachers should be provided with trainings in order for them to be technologically competent; and that principals and administrators should motivate their teachers to undergo continuous professional development.

Keywords: e-classroom, multi-grade school, DCP, classroom computers

Procedia PDF Downloads 203

Authors: Jia Wang, Wanting Zhang, Yutong Xv, Zihan Guo, Weiguang Ma

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Background: Before becoming qualified nurses, newly graduated nurses(NGNs) must experience a painful transition period, even transition shocks. Transition shocks are public health issues. To address the transition issue of NGNs, many programs or interventions have been developed and implemented. However, there are no studies to understand and assess the transition state of newly graduated nurses from work to life, from external abilities to internal emotions. Aims: Assess the transition status of newly graduated nurses in China. Identify the factors influencing the transition status of newly graduated nurses. Methods: The multi-center cross-sectional study design was adopted. From May 2022 to June 2023, 1261 newly graduated nurse in hospitals were surveyed online with the the Demographic Questionnaire and Transition Status Scale for Newly Graduated Nurses. SPSS 26.0 were used for data input and statistical analysis. Statistic description were adopted to evaluate the demographic characteristics and transition status of NGNs. Independent-samples T-test, Analysis of Variance and Multiple regression analysis was used to explore the influencing factors of transition status. Results: The total average score of Transition Status Scale for Newly Graduated Nurses was 4.00（SD = 0.61）. Among the various dimensions of Transition Status, the highest dimension was competence for nursing work, while the lowest dimension was balance between work and life. The results showed factors influencing the transition status of NGNs include taught by senior nurses, night shift status, internship department, attribute of working hospital, province of work and residence, educational background, reasons for choosing nursing, types of hospital, and monthly income. Conclusion: At present, the transition status score of new nurses in China is relatively high, and NGNs are more likely to agree with their own transition status, especially the dimension of competence for nursing work. However, they have a poor level of excess in terms of life-work balance. Nursing managers should reasonably arrange the working hours of NGNs, promote their work-life balance, increase the salary and reward mechanism of NGNs, arrange experienced nursing mentors to teach, optimize the level of hospitals, provide suitable positions for NGNs with different educational backgrounds, pay attention to the culture shock of NGNs from other provinces, etc. Optimize human resource management by intervening in these factors that affect the transition of new nurses and promote a better transition of new nurses.

Keywords: newly graduated nurse, transition, humanistic car, nursing management, nursing practice education

Procedia PDF Downloads 92

Authors: Yonas Shuke Kitawa

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Background: Although malaria incidence has substantially fallen sharply over the past few years, the rate of decline varies by district, time, and malaria type. Despite this turn-down, malaria remains a major public health threat in various districts of Ethiopia. Consequently, the present study is aimed at developing a predictive model that helps to identify the spatio-temporal variation in malaria risk by multiple plasmodium species. Methods: We propose a multivariate spatio-temporal Bayesian model to obtain a more coherent picture of the temporally varying spatial variation in disease risk. The spatial autocorrelation in such a data set is typically modeled by a set of random effects that assign a conditional autoregressive prior distribution. However, the autocorrelation considered in such cases depends on a binary neighborhood matrix specified through the border-sharing rule. Over here, we propose a graph-based optimization algorithm for estimating the neighborhood matrix that merely represents the spatial correlation by exploring the areal units as the vertices of a graph and the neighbor relations as the series of edges. Furthermore, we used aggregated malaria count in southern Ethiopia from August 2013 to May 2019. Results: We recognized that precipitation, temperature, and humidity are positively associated with the malaria threat in the area. On the other hand, enhanced vegetation index, nighttime light (NTL), and distance from coastal areas are negatively associated. Moreover, nonlinear relationships were observed between malaria incidence and precipitation, temperature, and NTL. Additionally, lagged effects of temperature and humidity have a significant effect on malaria risk by either species. More elevated risk of P. falciparum was observed following the rainy season, and unstable transmission of P. vivax was observed in the area. Finally, P. vivax risks are less sensitive to environmental factors than those of P. falciparum. Conclusion: The improved inference was gained by employing the proposed approach in comparison to the commonly used border-sharing rule. Additionally, different covariates are identified, including delayed effects, and elevated risks of either of the cases were observed in districts found in the central and western regions. As malaria transmission operates in a spatially continuous manner, a spatially continuous model should be employed when it is computationally feasible.

Keywords: disease mapping, MSTCAR, graph-based optimization algorithm, P. falciparum, P. vivax, waiting matrix

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Authors: Hasan Alrashid

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The 2005 Hague Convention seeks to ensure legal certainty and predictability between parties in international business transactions. It harmonies exclusive choice of court agreements at the international level between parties to commercial transactions and to govern the recognition and enforcement of judgments resulting from proceedings based on such agreements to promote international trade and investment. Although the choice of court agreements is significant in international business transactions, the United Arab Emirates refuse to recognise it by Article 24 of the Federal Law No. 11 of 1992 of the Civil Procedure Code. A review of judicial judgments in United Arab Emirates up to the present day has revealed that several cases appeared before the Court in different states of United Arab Emirates regarding the recognition of exclusive choice of court agreements. In all the cases, the courts regarded the exclusive choice of court agreements as a direct assault on state authority and sovereignty and refused categorically to recognize choice of court agreements by refusing to stay proceedings in favor of the foreign chosen court. This has created uncertainty and unpredictability in international business transaction in the United Arab Emirates. In June 2011, the first Gulf Judicial Seminar on Cross-Frontier Legal Cooperation in Civil and Commercial Matters was held in Doha, Qatar. The Permanent Bureau of the Hague Conference attended the conference and invited the states of the Gulf Cooperation Council (GCC) namely, The United Arab Emirates, Bahrain, Saudi Arabia, Oman, Qatar and Kuwait to adopt some of the Hague Conventions, one of which was the Hague Convention on Choice of Court Agreements. One of the recommendations of the conference was that the GCC states should research ‘the benefits of predictability and legal certainty provided by the 2005 Convention on Choice of Court Agreements and its resulting advantages for cross-border trade and investment’ for possible adoption of the Hague Convention. Up to today, no further step has been taken by the any of the GCC states to adapt the Hague Convention nor did they conduct research on the benefits of predictability and legal certainty in international business transactions. This paper will argue that the approach regarding the recognition of choice of court agreements in United Arab Emirates states can be improved in order to help the parties in international business transactions avoid parallel litigation and ensure legal certainty and predictability. The focus will be the uncertainty and gaps regarding the choice of court agreements in the United Arab Emirates states. The Hague Convention on choice of court agreements and the importance of harmonisation of the rules of choice of court agreements at international level will also be discussed. Finally, The feasibility and desirability of recognizing choice of court agreements in United Arab Emirates legal system by becoming a party to the Hague Convention will be evaluated.

Keywords: choice of court agreements, party autonomy, public authority, sovereignty

Procedia PDF Downloads 249

Authors: Omar Id Moulid

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For more than a decade, Morocco has been confronted with the issue of sub-Saharan immigration. The closure of European borders and the crises on the African continent have amplified the pressure on Morocco and therefore on Europe. The migration phenomenon seems to act fully on these borders. Indeed, Morocco’s burgeoning role as a both transit hub and a destination for tens of thousands of sub-Saharan migrants has prompted a shift in Moroccan literature. Morocco’s current reality is increasingly baked into the country’s multifarious literary and cultural production, which have begun to encapsulate complex social and cultural dynamics of this migratory shift over past decades. In this vein, literary Moroccans have shifted their focus on Europe and Middle East to the importance and effects of sub-Saharan immigrants on the construction of Moroccan national Identity and Memory. In fact, this shift is driven and informed by cultural, social and historical changes that Morocco has experienced. This paper seeks to explore the effects of sub-Saharan immigration, whether settled or transient, on the individual and collective construction of Identity and Memory in Morocco. The underlying leitmotifs of this paper is to grasp and investigate the dynamics that mark the (dis)continuity of Moroccan self with the regards to cultural shifts the presence of sub-Saharan immigrants embody through their presence in the public realms. To attend to these shifts, this paper will focus M’barek Rabi’s 2018 novel Gharb al-mutawassiṭ (West of the Mediterranean). The novel delves deeply into this sub-Saharan literary shift. It claims that the ubiquitous presence of sub-Saharan African migrants and the discursive practices around their presence highlight the intricate ways in which the collective past is discursively etched on bodies and topographies of the Moroccan subject. In short, it emphasizes that the past is not mere remembrance of an event; instead, it survives, lives on, and is mediated through the subject positions of immigrants. The novel Gharb al-mutawassiṭ deciphers a quest inside the complicated world of transgressive migration. It provides a look at the entangling webs of agents who trade on the fate of immigrants looking for a better life conditions beyond the constrains of geography, history and culture. Within this ambit, this paper seeks to investigate how Morocco has morphed from ‘transit hub’ into a destination. That is, a site wherein immigrants’ experiences and memories are rewritten and sprout de novo under the rubric of ambiance and hope that Morocco seeks to provide by introducing modern legislative frameworks and policies that treat people equally.

Keywords: literature, transit migration, memory, identity, transculturality, mobility, self

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Authors: Rabia Genc, Aysun Eksioglu, Emine Serap Sarican, Sibel Icke

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Today the habit of cigarette smoking is among one of the most important public health concerns because of the health problems it leads to. The most important and hazardous group to use tobacco and tobacco products is adolescents and teenagers. And one of the most effective ways to prevent them from starting to smoke is education. This research is a kind of educational intervention study which was carried out in order to evaluate the effect of peer education on the teenagers' knowledge about smoking. The research was carried out between October 15, 2013 and September 9, 2015 at Ege University Ataturk Vocational Health School. The population of the research comprised of the students that have been studying at Ege University Atatürk Vocational Health School, Midwifery Department (N=390). The peer educator group that would give training on smoking consisted of 10 people, and the peer groups that would be trained were divided into two groups via simple randomization as experimental group (n=185) and control group (n=185). Questionnaire, information evaluation form, and informed consent forms were used as date collection tools. The analysis of the data which were collected in the study was carried out on Statistical Package for Social Science (SPSS 15.0). It was found out that 62.5 % of the students who were in peer educator group had smoked in some period of their lives; however, none of them continued to smoke. When they were asked about their reasons to start smoking, 25% said they just wanted to try it, and 25% of them answered that it was because of their friend groups. When the pre-peer education and post-peer education point averages of peer educator group were evaluated, the results showed that there was a significant difference between the point averages (p < 0.05). When the cigarette use of experimental group and the control group were evaluated, it was clear that 18.2% of the experimental group and 24.2%of the control group still smokes. 9.1% of the experimental group and 14.8% of control group stated that they started smoking because of their friend groups. Among the students who smoke 15.9% of the ones who belongs to the experimental group and 21.9% of the ones who belong to the control group stated they are thinking of quitting smoking. It was clear that there is a significant difference between the pre-education and post-education point averages of experimental group statistically (p ≤ 0.05); however, in terms of control group, there were no significant differences between the pre-test post-test averages statistically. Between the pre-test post-test averages of experimental and control groups there were not any statistically significant differences (p > 0.05). It was found out in the study that the peer education programme is not effective on the smoking habit of Vocational Health School students. When the future studies are being planned in order to evaluate the peer education activity, it can be taken into consideration that the peer education takes a long term and the students in the educator group will be more enthusiastic and a kind of leader in their environment.

Keywords: midwifery, peer, peer education, smoking

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Authors: Isidro Perez, Maryam Nazari

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Numerous earthquakes, which have taken place across the world, led to catastrophic damage and collapse of structures (e.g., 1971 San Fernando; 1995 Kobe-Japan; and 2010 Chile earthquakes). Engineers are constantly studying methods to moderate the effect this phenomenon has on structures to further reduce damage, costs, and ultimately to provide life safety to occupants. However, there are regions where structures, cities, or water reservoirs are built near fault lines. When an earthquake occurs near the fault lines, they can be categorized as near-field earthquakes. In contrary, a far-field earthquake occurs when the region is further away from the seismic source. A near-field earthquake generally has a higher initial peak resulting in a larger seismic response, when compared to a far-field earthquake ground motion. These larger responses may result in serious consequences in terms of structural damage which can result in a high risk for the public’s safety. Unfortunately, the response of structures subjected to near-field records are not properly reflected in the current building design specifications. For example, in ASCE 7-10, the design response spectrum is mostly based on the far-field design-level earthquakes. This may result in the catastrophic damage of structures that are not properly designed for near-field earthquakes. This research investigates the knowledge that the effect of near-field earthquakes has on the response of structures. To fully examine this topic, a structure was designed following the current seismic building design specifications, e.g. ASCE 7-10 and ACI 318-14, being analytically modeled, utilizing the SAP2000 software. Next, utilizing the FEMA P695 report, several near-field and far-field earthquakes were selected, and the near-field earthquake records were scaled to represent the design-level ground motions. Upon doing this, the prototype structural model, created using SAP2000, was subjected to the scaled ground motions. A Linear Time History Analysis and Pushover analysis were conducted on SAP2000 for evaluation of the structural seismic responses. On average, the structure experienced an 8% and 1% increase in story drift and absolute acceleration, respectively, when subjected to the near-field earthquake ground motions. The pushover analysis was ran to find and aid in properly defining the hinge formation in the structure when conducting the nonlinear time history analysis. A near-field ground motion is characterized by a high-energy pulse, making it unique to other earthquake ground motions. Therefore, pulse extraction methods were used in this research to estimate the maximum response of structures subjected to near-field motions. The results will be utilized in the generation of a design spectrum for the estimation of design forces for buildings subjected to NF ground motions.

Keywords: near-field, pulse, pushover, time-history

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Authors: Christi Jackson, Chuka Onaga

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Introduction: We report a case of delayed diagnosis of extra-pulmonary INH-mono-resistant Tuberculosis (TB) in a South African patient with drug-resistant HIV. Case Presentation: A 36-year old male was initiated on 1st line (NNRTI-based) anti-retroviral therapy (ART) in September 2009 and switched to 2nd line (PI-based) ART in 2011, according to local guidelines. He was following up at the outpatient wellness unit of a public hospital, where he was diagnosed with Protease Inhibitor resistant HIV in March 2016. He had an HIV viral load (HIVVL) of 737000 copies/mL, CD4-count of 10 cells/µL and presented with complaints of productive cough, weight loss, chronic diarrhoea and a septic buttock wound. Several investigations were done on sputum, stool and pus samples but all were negative for TB. The patient was treated with antibiotics and the cough and the buttock wound improved. He was subsequently started on a 3rd-line ART regimen of Darunavir, Ritonavir, Etravirine, Raltegravir, Tenofovir and Emtricitabine in May 2016. He continued losing weight, became too weak to stand unsupported and started complaining of abdominal pain. Further investigations were done in September 2016, including a urine specimen for Line Probe Assay (LPA), which showed M. tuberculosis sensitive to Rifampicin but resistant to INH. A lymph node biopsy also showed histological confirmation of TB. Management and outcome: He was started on Rifabutin, Pyrazinamide and Ethambutol in September 2016, and Etravirine was discontinued. After 6 months on ART and 2 months on TB treatment, his HIVVL had dropped to 286 copies/mL, CD4 improved to 179 cells/µL and he showed clinical improvement. Pharmacy supply of his individualised drugs was unreliable and presented some challenges to continuity of treatment. He successfully completed his treatment in June 2017 while still maintaining virological suppression. Discussion: Several laboratory-related factors delayed the diagnosis of TB, including the unavailability of urine-lipoarabinomannan (LAM) and urine-GeneXpert (GXP) tests at this facility. Once the diagnosis was made, it presented a treatment dilemma due to the expected drug-drug interactions between his 3rd-line ART regimen and his INH-resistant TB regimen, and specialist input was required. Conclusion: TB is more difficult to diagnose in patients with severe immunosuppression, therefore additional tests like urine-LAM and urine-GXP can be helpful in expediting the diagnosis in these cases. Patients with non-standard drug regimens should always be discussed with a specialist in order to avoid potentially harmful drug-drug interactions.

Keywords: drug-resistance, HIV, line probe assay, tuberculosis

Procedia PDF Downloads 175

Authors: H. Hruschka

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This paper presents the first comparison of the performance of the restricted Boltzmann machine and the deep belief net on binary market basket data relative to binary factor analysis and the two best-known topic models, namely Dirichlet allocation and the correlated topic model. This comparison shows that the restricted Boltzmann machine and the deep belief net are superior to both binary factor analysis and topic models. Managerial implications that differ between the investigated models are treated as well. The restricted Boltzmann machine is defined as joint Boltzmann distribution of hidden variables and observed variables (purchases). It comprises one layer of observed variables and one layer of hidden variables. Note that variables of the same layer are not connected. The comparison also includes deep belief nets with three layers. The first layer is a restricted Boltzmann machine based on category purchases. Hidden variables of the first layer are used as input variables by the second-layer restricted Boltzmann machine which then generates second-layer hidden variables. Finally, in the third layer hidden variables are related to purchases. A public data set is analyzed which contains one month of real-world point-of-sale transactions in a typical local grocery outlet. It consists of 9,835 market baskets referring to 169 product categories. This data set is randomly split into two halves. One half is used for estimation, the other serves as holdout data. Each model is evaluated by the log likelihood for the holdout data. Performance of the topic models is disappointing as the holdout log likelihood of the correlated topic model – which is better than Dirichlet allocation - is lower by more than 25,000 compared to the best binary factor analysis model. On the other hand, binary factor analysis on its own is clearly surpassed by both the restricted Boltzmann machine and the deep belief net whose holdout log likelihoods are higher by more than 23,000. Overall, the deep belief net performs best. We also interpret hidden variables discovered by binary factor analysis, the restricted Boltzmann machine and the deep belief net. Hidden variables characterized by the product categories to which they are related differ strongly between these three models. To derive managerial implications we assess the effect of promoting each category on total basket size, i.e., the number of purchased product categories, due to each category's interdependence with all the other categories. The investigated models lead to very different implications as they disagree about which categories are associated with higher basket size increases due to a promotion. Of course, recommendations based on better performing models should be preferred. The impressive performance advantages of the restricted Boltzmann machine and the deep belief net suggest continuing research by appropriate extensions. To include predictors, especially marketing variables such as price, seems to be an obvious next step. It might also be feasible to take a more detailed perspective by considering purchases of brands instead of purchases of product categories.

Keywords: binary factor analysis, deep belief net, market basket analysis, restricted Boltzmann machine, topic models

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Authors: Mohamed Gaafar, Evan Davies

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Many municipalities within Canada and abroad use chloramination to disinfect drinking water so as to avert the production of the disinfection by-products (DBPs) that result from conventional chlorination processes and their consequential public health risks. However, the long-lasting monochloramine disinfectant (NH2Cl) can pose a significant risk to the environment. As, it can be introduced into stormwater sewers, from different water uses, and thus freshwater sources. Little research has been undertaken to monitor and characterize the decay of NH2Cl and to study the parameters affecting its decomposition in stormwater networks. Therefore, the current study was intended to investigate this decay starting by building a stormwater model and validating its hydraulic and hydrologic computations, and then modelling water quality in the storm sewers and examining the effects of different parameters on chloramine decay. The presented work here is only the first stage of this study. The 30th Avenue basin in Southern Edmonton was chosen as a case study, because the well-developed basin has various land-use types including commercial, industrial, residential, parks and recreational. The City of Edmonton has already built a MIKE-URBAN stormwater model for modelling floods. Nevertheless, this model was built to the trunk level which means that only the main drainage features were presented. Additionally, this model was not calibrated and known to consistently compute pipe flows higher than the observed values; not to the benefit of studying water quality. So the first goal was to complete modelling and updating all stormwater network components. Then, available GIS Data was used to calculate different catchment properties such as slope, length and imperviousness. In order to calibrate and validate this model, data of two temporary pipe flow monitoring stations, collected during last summer, was used along with records of two other permanent stations available for eight consecutive summer seasons. The effect of various hydrological parameters on model results was investigated. It was found that model results were affected by the ratio of impervious areas. The catchment length was tested, however calculated, because it is approximate representation of the catchment shape. Surface roughness coefficients were calibrated using. Consequently, computed flows at the two temporary locations had correlation coefficients of values 0.846 and 0.815, where the lower value pertained to the larger attached catchment area. Other statistical measures, such as peak error of 0.65%, volume error of 5.6%, maximum positive and negative differences of 2.17 and -1.63 respectively, were all found in acceptable ranges.

Keywords: stormwater, urban drainage, simulation, validation, MIKE URBAN

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Authors: Antonio Boggia, Luisa Paolotti, Gianluca Massei, Lucia Rocchi, Elaine Pace, Maria Attard

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The aim of this paper is to present a methodology and a computer model for sustainability assessment based on the integration of Multi-criteria Decision Analysis (MCDA) with a Geographic Information System (GIS). It presents the result of a study for the implementation of a model for measuring sustainability to address the policy actions for the improvement of sustainability at territory level. The aim is to rank areas in order to understand the specific technical and/or financial support that is required to develop sustainable growth. Assessing sustainable development is a multidimensional problem: economic, social and environmental aspects have to be taken into account at the same time. The tool for a multidimensional representation is a proper set of indicators. The set of indicators must be integrated into a model, that is an assessment methodology, to be used for measuring sustainability. The model, developed by the Environmental Laboratory of the University of Perugia, is called GeoUmbriaSUIT. It is a calculation procedure developed as a plugin working in the open-source GIS software QuantumGIS. The multi-criteria method used within GeoUmbriaSUIT is the algorithm TOPSIS (Technique for Order Preference by Similarity to Ideal Design), which defines a ranking based on the distance from the worst point and the closeness to an ideal point, for each of the criteria used. For the sustainability assessment procedure, GeoUmbriaSUIT uses a geographic vector file where the graphic data represent the study area and the single evaluation units within it (the alternatives, e.g. the regions of a country, or the municipalities of a region), while the alphanumeric data (attribute table), describe the environmental, economic and social aspects related to the evaluation units by means of a set of indicators (criteria). The use of the algorithm available in the plugin allows to treat individually the indicators representing the three dimensions of sustainability, and to compute three different indices: environmental index, economic index and social index. The graphic output of the model allows for an integrated assessment of the three dimensions, avoiding aggregation. The presence of separate indices and graphic output make GeoUmbriaSUIT a readable and transparent tool, since it doesn’t produce an aggregate index of sustainability as final result of the calculations, which is often cryptic and difficult to interpret. In addition, it is possible to develop a “back analysis”, able to explain the positions obtained by the alternatives in the ranking, based on the criteria used. The case study presented is an assessment of the level of sustainability in the six regions of Malta, an island state in the middle of the Mediterranean Sea and the southernmost member of the European Union. The results show that the integration of MCDA-GIS is an adequate approach for sustainability assessment. In particular, the implemented model is able to provide easy to understand results. This is a very important condition for a sound decision support tool, since most of the time decision makers are not experts and need understandable output. In addition, the evaluation path is traceable and transparent.

Keywords: GIS, multi-criteria analysis, sustainability assessment, sustainable development

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Authors: Khlood F. Salman, Richard Zoucha, Hani Nawafleh

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Introduction: Jordan ranks the fourth highest breast cancer prevalence after Lebanon, Bahrain, and Kuwait. Considerable evidence showed that cultural, ethnic, and economic differences influence a woman’s practice to early detection and prevention of breast cancer. Objectives: To understand women’s health beliefs and values in relation to early detection of breast cancer; and to explore the impact of these beliefs on their decisions regarding reluctance or acceptance of early detection measures such as mammogram screening. Design: A qualitative focused ethnography was used to collect data for this study. Settings: The study was conducted in the second largest city surrounded by a large rural area in Ma’an- Jordan. Participants: A total of twenty seven women, with no history of breast cancer, between the ages of 18 and older, who had prior health experience with health providers, and were willing to share elements of personal health beliefs related to breast health within the larger cultural context. The participants were recruited using the snowball method and words of mouth. Data collection and analysis: A short questionnaire was designed to collect data related to socio demographic status (SDQ) from all participants. A Semi-structured interviews guide was used to elicit data through interviews with the informants. Nvivo10 a data manager was utilized to assist with data analysis. Leininger’s four phases of qualitative data analysis was used as a guide for the data analysis. The phases used to analyze the data included: 1) Collecting and documenting raw data, 2) Identifying of descriptors and categories according to the domains of inquiry and research questions. Emic and etic data is coded for similarities and differences, 3) Identifying patterns and contextual analysis, discover saturation of ideas and recurrent patterns, and 4) Identifying themes and theoretical formulations and recommendations. Findings: Three major themes were emerged within the cultural and religious context; 1. Fear, denial, embarrassment and lack of knowledge were common perceptions of Ma’anis’ women regarding breast health and screening mammography, 2. Health care professionals in Jordan were not quick to offer information and education about breast cancer and screening, and 3. Willingness to learn about breast health and cancer prevention. Conclusion: The study indicated the disparities between the infrastructure and resourcing in rural and urban areas of Jordan, knowledge deficit related to breast cancer, and lack of education about breast health may impact women’s decision to go for a mammogram screening. Cultural beliefs, fear, embarrassments as well as providers lack of focus on breast health were significant contributors against practicing breast health. Health providers and policy makers should provide resources for the establishment health education programs regarding breast cancer early detection and mammography screening. Nurses should play a major role in delivering health education about breast health in general and breast cancer in particular. A culturally appropriate health awareness messages can be used in creating educational programs which can be employed at the national levels.

Keywords: breast health, beliefs, cultural context, ethnography, mammogram screening

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Authors: Marie Boost

Abstract:

Despite activation policies, forced personal initiative to step out of unemployment and a general prosper economic situation, poverty and financial hardship constitute a crucial role in the daily lives of many families in Germany. In 2015, ~16 million persons (20.2%) of the German population are at risk of poverty or social exclusion. This is illustrated by an unemployment rate of 13.3% in the research area, located in East Germany. Despite this high amount of persons living in vulnerable households, we know little about how they manage to stabilize their lives or even overcome poverty – apart from solely relying on welfare state benefits or entering in a stable, well-paid job. Most of them are struggling in precarious living circumstances, switching from one or several short-term, low-paid jobs into self-employment or unemployment, sometimes accompanied by welfare state benefits. Hence, insecurity and uncertain future expectation form a crucial part of their lives. Within the EU-funded project “RESCuE”, resilient practices of vulnerable households were investigated in nine European countries. Approximately, 15 expert interviews with policy makers, representatives from welfare state agencies, NGOs and charity organizations and 25 household interviews have been conducted within each country. It aims to find out more about the chances and conditions of social resilience. The research is based on the triangulation of biographical narrative interviews, followed by participatory photo interviews, asking the household members to portray their typical everyday life. The presentation is focusing on the explanatory strength of this mixed-methods approach in order to show the potential of household practices to overcome financial hardship. The methodological combination allows an in-depth analysis of the families and households everyday living circumstances, including their poverty and employment situation, whether formal and informal. Active household budgeting practices, such as saving and consumption practices are based on subsistence or Do-It-Yourself work. Especially due to the photo-interviews, the importance of inherent cultural and tacit knowledge becomes obvious as it pictures their typical practices, like cultivation and gathering fruits and vegetables or going fishing. One of the central findings is the multiple purposes of these practices. They contribute to ease financial burden through consumption reduction and strengthen social ties, as they are mostly conducted with close friends or family members. In general, non-commodified practices are found to be re-commodified and to contribute to ease financial hardship, e.g. by the use of commons, barter trade or simple mutual exchange (gift exchange). These practices can substitute external purchases and reduce expenses or even generate a small income. Mixing different income sources are found to be the most likely way out of poverty within the context of a precarious labor market. But these resilient household practices take its toll as they are highly preconditioned, and many persons put themselves into risk of overstressing themselves. Thus, the potentials and risks of resilient household practices are reflected in the presentation.

Keywords: consumption practices, labor market, qualitative research, resilience

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