Search results for: public administration

Authors: William Elnemer, Nauman Hussain, Samir Al-Ali, Henry Shu, Diane Ghanem, Babar Shafiq

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Introduction: The incidence of infection in open tibial shaft injuries varies depending on the severity of the injury, with rates ranging from 1.8% for Gustilo-Anderson type I to 42.9% for type IIIB fractures. The timely administration of antibiotics upon presentation to the emergency department (ED) is an essential component of fracture management, and evidence indicates that prompt delivery of antibiotics is associated with improved outcomes. The objective of this study is to identify factors that contribute to the expedient administration of antibiotics. Methods: This is a retrospective study of open tibial shaft fractures at an academic Level I trauma center. Current Procedural Terminology (CPT) codes identified all patients treated for open tibial shaft fractures between 2015 and 2021. Open fractures were identified by reviewing ED and provider notes, and with ballistic fractures were considered open. Chart reviews were performed to extract demographics, fracture characteristics, postoperative outcomes, time to operative room, time to antibiotic order, and delivery. Univariate statistical analysis compared patients who received early antibiotics (EA), which were delivered within one hour of ED presentation, and those who received late antibiotics (LA), which were delivered outside of one hour of ED presentation. A multivariate analysis was performed to investigate patient, fracture, and transport/ED characteristics contributing to faster delivery of antibiotics. The multivariate analysis included the dependent variables: ballistic fracture, activation of Delta Trauma, Gustilo-Andersen (Type III vs. Type I and II), AO-OTA Classification (Type C vs. Type A and B), arrival between 7 am and 11 pm, and arrival via Emergency Medical Services (EMS) or walk-in. Results: Seventy ED patients with open tibial shaft fractures were identified. Of these, 39 patients (55.7%) received EA, while 31 patients (44.3%) received LA. Univariate analysis shows that the arrival via EMS as opposed to walk-in (97.4% vs. 74.2%, respectively, p = 0.01) and activation of Delta Trauma (89.7% vs. 51.6%, respectively, p < 0.001) was significantly higher in the EA group vs. the LA group. Additionally, EA cases had significantly shorter intervals between the antibiotic order and delivery when compared to LA cases (0.02 hours vs. 0.35 hours, p = 0.007). No other significant differences were found in terms of postoperative outcomes or fracture characteristics. Multivariate analysis shows that a Delta Trauma Response, arrival via EMS, and presentation between 7 am and 11 pm were independent predictors of a shorter time to antibiotic administration (Odds Ratio = 11.9, 30.7, and 5.4, p = 0.001, 0.016, and 0.013, respectively). Discussion: Earlier antibiotic delivery is associated with arrival to the ED between 7 am and 11 pm, arrival via EMS, and a coordinated Delta Trauma activation. Our findings indicate that in cases where administering antibiotics is critical to achieving positive outcomes, it is advisable to employ a coordinated Delta Trauma response. Hospital personnel should be attentive to the rapid administration of antibiotics to patients with open fractures who arrive via walk-in or during late-night hours.

Keywords: antibiotics, emergency department, fracture management, open tibial shaft fractures, orthopaedic surgery, time to or, trauma fractures

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Authors: Noemia Bessa Vilela, Jose Caramelo Gomes

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All law student are familiarized, in the first years of their bachelor of laws with the concepts of “public goods” and “ private goods”; often, such legal concept does not exactly match such economic concept, and there are consequences are some sort of confusion being created. The list of goods that follow under each category is not exhaustive, nor are students given proper mechanisms to acknowledge that some legal fields can, on its own, be considered as a “public good”; this is the case of Competition. Legal authors consider that “competition law is used to promote public interest” and, as such, it is a “public good”; in economics theory, Competition is the first public good in a market economy, as the enabler of allocation efficiency. Competition law is the legal tool to support the proper functioning of the market economy and democracy itself. It is fact that Competition Law only applies to economic activities, still, competition is object of private litigation as an integral part of Public Law. Still, regardless of the importance of Competition Law in the economic activity and market regulation, most student complete their studies in law, join the Bar Associations and engage in their professional activities never having been given sufficient tools to deal with the increasing demands of a globalized world. The lack of knowledge of economics, market functioning and the mechanisms at their reach in order to ensure proper realization of their duties as lawyers/ attorneys-at-law would be tackled if Competition Law would be included as part of the curricula of Law Schools. Proper teaching of Competition Law would combine the foundations of Competition Law, doctrine, case solving and Case Law study. Students should to understand and apply the analytical model. Special emphasis should be given to EU Competition Law, namely the TFEU Articles 101 to 106. Damages Directive should also be part of the curriculum. Students must in the first place acquire and master the economic rationale as competition and the world of competition law are the cornerstone of sound and efficient market. The teaching of Competition Law in undergraduate programs in Law would contribute to fulfill the potential of the students who will deal with matters related to consumer protection, economic and commercial law issues both in private practice and as in-house lawyers for companies.

Keywords: higher education, competition law, legal education, law, market economy, industrial economics

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Authors: Ana-Maria Gheldiu, Bianca M. Abrudan, Maria A. Neag, Laurian Vlase, Dana M. Muntean

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Background information: The objective of this study was to investigate the effect of multiple-dose fluvoxamine on the pharmacokinetic profile of single-dose carvedilol in rats, in order to evaluate this possible drug-drug pharmacokinetic interaction. Methods: A preclinical study, in 28 white male Wistar rats, was conducted. Each rat was cannulated on the femoral vein, prior to being connected to BASi Culex ABC®. Carvedilol was orally administrated in rats (3.57 mg/kg body mass (b.m.)) in the absence of fluvoxamine or after a pre-treatment with multiple oral doses of fluvoxamine (14.28 mg/kg b.m.). The plasma concentrations of carvedilol were estimated by high performance liquid chromatography-tandem mass spectrometry. The pharmacokinetic parameters of carvedilol were analyzed by non-compartmental method. Results: After carvediol co-administration with fluvoxamine, an approximately 2-fold increase in the exposure of carvedilol was observed, considering the significantly elevated value of the total area under the concentration versus time curve (AUC₀₋∞). Moreover, an increase by approximately 145% of the peak plasma concentration was found, as well as an augmentation by approximately 230% of the half life time of carvedilol was observed. Conclusion: Fluvoxamine co-administration led to a significant alteration of carvedilol’s pharmacokinetic profile in rats, these effects could be explained by the existence of a drug-drug interaction mediated by CYP2D6 inhibition. Acknowledgement: This work was supported by CNCS Romania – project PNII-RU-TE-2014-4-0242.

Keywords: carvedilol, fluvoxamine, drug-drug pharmacokinetic interaction, rats

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Authors: Stephane Maingard, Babu Paturi, Maura Daly, Finnola Armstrong

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Background: Perinatal optimization involves the implementation of twelve intervention bundles of care at Our Lady of Lourdes Hospital, reliably delivering evidence-based interventions in the antenatal, intrapartum, and neonatal period to improve preterm outcomes. These key interventions (e.g. Antenatal steroids, Antenatal counselling, Optimal cord management, Respiratory management etc.) are based on WHO (World Health Organization, BAPM (British Association of Perinatal Medicine), and the latest 2022 European Consensus guidelines recommendations. Methodology: In February 2023, a quality improvement project team (pediatricians, neonatologists, obstetricians, clinical skills managers) was established, and a project implementation plan was developed. The Program Study Act implemented the following: 1. Antenatal consultation pathway, 2. Creation and implementation of a perinatal checklist for preterm births less than 34 weeks of gestation, 3. Process changes to ensure the checklist is completed, 4. Completion of parent and staff surveys, 5. Ongoing training. We collected and compared a range of data before and after implementation. Results: Preliminary analysis so far at 1 month demonstrates improvement in the following areas: 50% increase in antenatal counselling. Right place of birth increased from 85% to 100%. Magnesium sulphate increased from 56% to 100%. No change was observed in buccal colostrum administration (28%), delayed cord clamping (75%), caffeine administration (100%), blood glucose level at one hour of life > 2,6mmol (85%). There was also no change noted in respiratory support at resuscitation, CPAP only (47%), IPPV with CPAP (45%), IPPV with intubation (20%), and surfactant administration (28%). A slight decrease in figures was noted in the following: steroid administration from 80% to 75% and thermal care obtaining optimal temperature on admission (65% to 50%). Discussion: Even though the findings are preliminary, the directional improvement shows promise. Improved communication has been achieved between all stakeholders, including our patients, who are key team members. Adherence to the bundles of care will help to improve survival and neurodevelopmental outcomes as well as reduce the length of stay, thereby overall reducing the financial cost, considering the lifetime cost of cerebral palsy is estimated at €800,000 and reducing the length of stay can result in savings of up to €206,000. Conclusion: Preliminary results demonstrate improvements across a range of patient, process, staff, and financial outcomes. Our future goal is a seamless pathway of patient centered care for babies and their families. This project is an interdisciplinary collaboration to implement best practices for a vulnerable patient cohort. Our two main challenges are changing our organization’s culture as well as ensuring the sustainability of the project.

Keywords: perinatal, optimization, antenatal, counselling, IPPV

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Authors: Peter Amobi Chiamogu

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Communication has subsisted as the basis for mass mobilization and political education through history with the media as a generic concept. Revolutions in ICTs have occasioned a limitless environment for the dissemination of information and ideas especially with the use of a seemingly pervasive access, penetration and use of the internet which has engendered a connected society. This study seeks to analyze the prospects and challenges for the adaptation of social media for free election and how this process can enhance public policy making, implementation and evaluation in a developing state.

Keywords: social media, e-participation, political mobilization, public policy, electioneering

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Authors: John Adeboye Oyeboade, Pius Olatunji Olaojo, Kuburay Folashade Yusuf, John Oluwaseye Adebayo

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Web-based Information Resources (WBIR) are increasingly becoming essential tools for students to accomplish academic tasks. Preliminary observation revealed that many polytechnic libraries in Southwestern Nigeria do not subscribe or renew subscriptions to WBIR academic databases, and students use free-based electronic resources. Hence, this study was carried out to investigate socioeconomic status and use of WBIR by public polytechnic students in Southwestern Nigeria. Six public polytechnics out of the 16 offerings of Higher National Diploma (HND) programs were selected by stratified random sampling to reflect federal and state polytechnics. A proportionate size sampling technique was used to select 1,463 HND students. The instruments used were Socioeconomic status (SeS) (α=0.81) and WBIR used for Academic Tasks (α=0.98) scales. Data were analyzed using descriptive statistics and Pearson’s product-moment correlation at a 0.05 level of significance. Students’ SeS ( =79.10) was moderate. Online reference sources ( =3.97), Web 2.0 ( =3.50), and social media ( =3.00) were regularly used WBIR. WBIR use ( =53.34) was moderate. The students used WBIR for project writing ( =3.46) and class assignments ( =3.42). The Students’ SeS (r=0.59) had significant relationships with WBIR use. Socioeconomic status directly influenced the use of WBIR for academic tasks. Management of polytechnics should provide WBIR subscriptions for students’ use in the polytechnic e-libraries.

Keywords: public polytechnic students, polytechnic libraries, socioeconomic status, Web-based information resources

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Authors: Gabriel Montague, Max Vilgalys, Catherine H. Crawford, Jorge Ortiz, Dava Newman

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There has never been so much publicly accessible atmospheric and environmental data. The possibilities of these data are exciting, but the sheer volume of available datasets represents a new challenge for researchers. The task of identifying and working with a new dataset has become more difficult with the amount and variety of available data. Datasets are often documented in ways that differ substantially from the common English used to describe the same topics. This presents a barrier not only for new scientists, but for researchers looking to find comparisons across multiple datasets or specialists from other disciplines hoping to collaborate. This paper proposes a method for addressing this obstacle: creating a knowledge graph to bridge the gap between everyday English language and the technical language surrounding these datasets. Knowledge graph generation is already a well-established field, although there are some unique challenges posed by working with Earth data. One is the sheer size of the databases – it would be infeasible to replicate or analyze all the data stored by an organization like The National Aeronautics and Space Administration (NASA) or the European Space Agency. Instead, this approach identifies topics from metadata available for datasets in NASA’s Earthdata database, which can then be used to directly request and access the raw data from NASA. By starting with a single metadata standard, this paper establishes an approach that can be generalized to different databases, but leaves the challenge of metadata harmonization for future work. Topics generated from the metadata are then linked to topics from a collection of English queries through a variety of standard and custom natural language processing (NLP) methods. The results from this method are then compared to a baseline of elastic search applied to the metadata. This comparison shows the benefits of the proposed knowledge graph system over existing methods, particularly in interpreting natural language queries and interpreting topics in metadata. For the research community, this work introduces an application of NLP to the ecological and environmental sciences, expanding the possibilities of how machine learning can be applied in this discipline. But perhaps more importantly, it establishes the foundation for a platform that can enable common English to access knowledge that previously required considerable effort and experience. By making this public data accessible to the full public, this work has the potential to transform environmental understanding, engagement, and action.

Keywords: earth metadata, knowledge graphs, natural language processing, question-answer systems

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Authors: M. C. Theong, F. L. Ang, G. J. Muga

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Growth of firms is influenced by environmental changes such as the global and national economy. On the other hand, it indicates the economic situation of a country. Therefore, it is imperative for firms to be sensitive to changes and to stay competitive and remain compatible with the environment. The Malaysian construction industry is prone to environmental changes due to its complexity. In order to survive in the construction industry, focus on the development of the firms themselves to achieve long term their long term goals is vital besides maximizing profits. The objective of this paper is to measure growth of the public listed construction companies in Malaysia and to investigate the development of the companies with highest, moderate and lowest growth. Growth is measured based on the companies' sales between year 2008 and 2012 collected via secondary data collection method. Findings show that the highest average growth created is 235.20 % while the lowest average growth is -22.75%. The construction companies remained active in the construction industry by implementing different sets of strategies and involving in several types of construction projects.

Keywords: growth, Malaysian construction industry, public listed companies, sales

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Authors: Moleseng Claude Moshobane

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Alien species cause considerable negative impacts on biodiversity, economy and public health. Impacts of alien species on public health have received a degree of attention worldwide, largely in developed countries, but scarce in developing countries. Here, we provide a review of human exposures and poisonings cases from native and alien plant species reported to poison information centers. A retrospective review of the Tygerberg Poison Information Centre (TPIC) and Poisons Information Centre (PIC) at Red Cross War Memorial Children's Hospital (RCWMCH) was conducted over approximately 2-year period (1 June 2015 through to 06 March 2017). Combined, TPIC and PIC handled 626 cases during the 2-year period. Toxicity cases were more abundant in Gauteng (47.1%), followed by Western Cape (29.4%). The primary mechanism of injury was ingestion (96.7%), and all cases were predominantly accidental. Most reported cases involved infants (20.6%), with few fully-grown adults related cases (5.8%). Adults presented minor to moderate toxicity, while infants none to minor toxicity. We conclude that reported toxicity cases on human health are biased towards few alien species and that several cases relate to unknown species of mushrooms. Public awareness is essential to reducing the poisoning incidences.

Keywords: alien species, poisoning, invasive species, public health

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Authors: Osama M. Ahmed, Walaa G. Hozayen, Haidy Tamer Abo Sree

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Doxorubicin (DOX), an anthracycline antibiotic is a broad-spectrum antineoplastic agent, which is commonly used in the treatment of uterine, ovarian, breast and lung cancers, Hodgkin's disease and soft tissue sarcomas as well as in several other cancer types. The effect of doxorubicin (4 mg/kg b.w.week) without or with oral administration of ethanolic purslane (Portulaca oleracea) shoot (leaves and stems) extract (50 mg/kg b.w. day) or ethanolic purslane seeds extract (50 mg/kg b.w.day) co-treatments for 6 weeks was evaluated in adult male rats. Serum ALT, AST, ALP, GGT, total bilirubin, total protein, and albumin levels were assayed. Lipid peroxidation (indexed by MDA) and antioxidants like hepatic glutathine, glutathione transferase, peroxidase, SOD, and CAT were assessed. There was an increase in serum levels of ALT, AST, ALP, GGT and total bilirubin. In addition, hepatic glutathine, glutathione transferase, peroxidase, SOD, and CAT activities were decreased while lipid peroxidation in the liver was increased. Co-administration of ethanolic purslane and seed extracts successfully improved the adverse changes in the liver functions with an increase in antioxidants activities and reduction of lipid peroxidation. In conclusion, it can be supposed that dietary purslane extract supplementation may provide a cushion for a prolonged therapeutic option against DOX hepatopathy without harmful side effects. However, further clinical studies are required to assess the safety and efficacy of these extract in human beings.

Keywords: doxorubicin, purslane, hepatotoxicity, antioxidants

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Authors: Khalid Almarri

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The UAE is currently developing a peaceful nuclear energy program as part of its low Carbon energy strategy to meet future energy demands. Research of nuclear energy technologies is required to support nuclear energy generation projects and maximize their performance. Research of this type will require building an operating a research reactor (RR), a costly undertaking in most circumstances. Collaboration between government and private parties through public, private partnerships (PPP) can maximize the benefits expected from the adoption of an RR project. The aim of this research is to establish the critical success factors (CSF) for developing an RR project for newcomer countries, with the UAE taken as a case study, through the utilization of public, private partnerships (PPP). The results of this study were arrived at through the use of semi-structured interviews conducted with ten experts in the field of research reactors, using grounded theory method. Underutilization was identified as the main stumbling block that impairs the success of research reactors.

Keywords: public private partnerships, research reactors, grounded theory, critical success factors

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Authors: Tonny Ograh, Joshua Ayarkwa, Dickson Osei-Asibey, Alex Acheampong, Peter Amoah

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Theories are used to improve the conceptualization of research ideas. These theories enhance valuable elucidations that help us to grasp the meaning of research findings. Nevertheless, the use of theories to promote studies in green supplier selection in procurement decisions has attracted little attention. With the emergence of sustainable procurement, public procurement practitioners in Ghana are yet to achieve relevant knowledge on green supplier selections due to insufficient knowledge and inadequate appropriate frameworks. The flagrancy of the consequences of public procurers’ failure to integrate environmental considerations into supplier selection explains the adoption of a multi-theory approach for comprehension of the dynamics of green integration into supplier selection. In this paper, the practicality of three theories for improving the understanding of the influential factors enhancing the integration of environmental sustainability into supplier selection was reviewed. The three theories are Resource-Based Theory, Human Capital Theory and Absorptive Capacity Theory. This review uncovered knowledge management, top management commitment, and environmental management capabilities as important elements needed for the integration of environmental sustainability into supplier selection in public procurement. The theoretical review yielded a framework that conceptualizes knowledge and capabilities of practitioners relevant to the incorporation of environmental sustainability into supplier selection in public procurement.

Keywords: environmental, sustainability, supplier selection, environmental procurement, sustainable procurement

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Authors: Wan Azuati Wan Omar, Selva Rani John Jasudass, Siti Rohaiza Md. Saad

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Introduction & objective: The objectives of this study were to assess patient’s knowledge of appropriate sublingual glyceryl trinitrate (GTN) use as well as to investigate how patients commonly store and carry their sublingual GTN tablets. Methodology: This was a cross-sectional survey, using a validated researcher-administered questionnaire. The study involved cardiac patients receiving sublingual GTN attending the outpatient and inpatient departments of Taiping Hospital, a non-academic public care hospital. The minimum calculated sample size was 92, but 100 patients were conveniently sampled. Respondents were interviewed on 3 areas, including demographic data, knowledge and use of sublingual GTN. Eight items were used to calculate each subject’s knowledge score and six items were used to calculate use score. Results: Of the 96 patients who consented to participate, majority (96.9%) were well aware of the indication of sublingual GTN. With regards to the mechanism of action of sublingual GTN, 73 (76%) patients did not know how the medication works. Majority of the patients (66.7%) knew about the proper storage of the tablet. In relation to the maximum number of sublingual GTN tablets that can be taken during each angina episode, 36.5% did not know that up to 3 tablets of sublingual GTN can be taken during each episode of angina. Fifty four (56.2%) patients were not aware that they need to replace sublingual GTN every 8 weeks after receiving the tablets. Majority (69.8%) of the patients demonstrated lack of knowledge with regards to the use of sublingual GTN as prevention of chest pain. Conclusion: Overall, patients’ knowledge regarding the self administration of sublingual GTN is still inadequate. The findings support the need for more frequent reinforcement of patient education, especially in the areas of preventive use, storage and drug stability.

Keywords: glyceryl trinitrate, knowledge, adherence, patient education

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Authors: Ahmed Mousa, Huda Mazeed

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The research aims to determine the appropriate songs and artistic indications for the kindergarten child. In addition, it aims to use the songs of folk to develop expressive visual drawings with artistic connotations for the kindergarten child. The current research used a one group semi-experimental approach to identify the impact of songs on expressive children's drawings. The research community is represented in the educational administration in Giza Governorate for the academic year (2018 - 2019). The sample was taken from the kindergarten of Gamal Abdel Nasser School of Dokki Educational Administration in Giza Governorate. The study was applied to the second level children sample (5-6 years), where they numbered 20 children, males and females. The research results show that there are statistically significant differences between the average scores of the children of the experimental group in the pre and post-measurements on the observation card for children after hearing the songs of social and national folk in favor of post measurement. Moreover, the results demonstrate that there are no statistically significant differences between the average scores of children in the experimental group in the measurements, the post and follow-up, on the observation card of children's drawings for social and national folk.

Keywords: folk songs, visual expressive, artistic connotations, early childhood

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Authors: Opemiposi Adegbulu

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The research investigates the existence of a public interest consideration or rationale for the management of directors’ conflicts of interest within large public corporations. This is conducted through extensive literature review and theories on the definition of conflicts of interest, the firm and purposes of the fiduciary duty of loyalty under which the management of these conflicts of interest find their foundation. Conflicts of interest is an elusive, diverse and engaging subject, a cross-cutting problem of governance which involves all levels of governance, ranging from local to global, public to corporate or financial sectors. It is a common issue that affects corporate governance and corporate culture, having a negative impact on the reputation of corporations and their trustworthiness. It is clear that addressing this issue is imperative for good governance of corporations as they are increasingly becoming and are powerful global economies with significant power and influence in the society. Similarly, the bargaining power of these powerful corporations has been recognised by international organisations such as the UN and the OECD. This is made evident by the increasing calls and push for greater responsibility of these corporations for environmental and social disasters caused by their corporate activities and their impact in various parts of the world. Equally, in the US, the Sarbanes-Oxley Act like other legislation and regulatory efforts made to manage conflicts of interest linked to corporate governance, in many countries indicates that there is a (global) public interest in the maintenance of the orderly functioning of commerce. Consequently, the governance of these corporations is tremendously pivotal to the society as it touches upon a key aspect of the good functioning of society. This is because corporations, particularly large international corporations can be said to be the plumbing of the global economy. This study will employ theoretical, doctrinal and comparative methods. The research will make use largely of theory-guided methodology and theoretical framework – theories of the firm, public interest, regulation, conflicts of interest in general, directors’ conflicts of interest and corporate governance. Although, the research is intended to be narrowed down to the topic of conflicts of interest in corporate governance, the subject of company directors’ duty of loyalty and the management of conflicts of interest, an examination of the history, origin and typology of conflicts of interest in general will be carried out in order to identify some specific challenges to understanding and identifying these conflicts of interest; origin, diverging theories, psychological barrier to definition, similarities with public sector conflicts of interest due to the notions of corrosion of trust, the effect on decision-making and judgment, “being in a particular kind of situation”, etc. The result of this research will be useful and relevant in the identification of the rationale for the management of directors’ conflicts of interest, contributing to the understanding of conflicts of interest in the private sector and the significance of public interest in corporate governance of large corporations.

Keywords: conflicts of interest, corporate governance, corporate law, directors duty of loyalty, public interest

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Authors: Vahid Changizi, Aram Rostami, Akbar Mosavi

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Purpose of study: Critical macromolecules of cells such as DNA are in exposure to damage of free radicals that induced from interaction of ionizing radiation with biological systems. Selenium and vitamin-E are natural compound that has been shown to be a direct free radical scavenger. The aim of this study was to investigate the in vivo/in vitro radioprotective effect of selenium and vitamin-E separately and synergistically against genotoxicity induced by 6MV x-rays irradiation in cultured blood lymphocytes from 15 human volunteers. Methods: Fifteen volunteers were divided in three groups include A, B and C. These groups were given slenium(800 IU), vitamin-E(100 mg) and selenium(400 IU) + vitamin-E(50 mg), respectively. Peripheral blood samples were collected from each group before(0 hr) and 1, 2 and 3 hr after selenium and vitamin-E administration (separately and synergistically). Then the blood samples were irradiated to 200 cGy of 6 Mv x-rays. After that, lymphocyte samples were cultured with mitogenic stimulation to determine the chromosomal aberrations wih micronucleus assay in cytokinesis-blocked binucleated cells. Results: The lymphocytes in the blood samples collected at 1 hr after ingestion selenium and vitamin-E, exposed in vitro to x-rays exhibited a significant decrease in the incidence of micronuclei, compared with control group at 0 hr. The maximum protection and decrease in frequency of micronuclei(50%) was observed at 1 hr after administration of selenium and vitamin-E synergistically. Conclusion: The data suggest that ingestion of selenium and vitamin-E as a radioprotector substances before exposures may reduce genetic damage caused by x-rays irradiation.

Keywords: x-rays, selenium, vitamin-e, lymphocyte, micronuclei

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Authors: Abeer Alkhwaldi, Mumtaz Kamala

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On the inception of the third millennium, there is much evidence that cloud technologies have become the strategic trend for many governments not only developed countries (e.g., UK, Japan, and USA), but also developing countries (e.g. Malaysia and the Middle East region), who have launched cloud computing movements for enhanced standardization of IT resources, cost reduction, and more efficient public services. Therefore, cloud-based e-government services considered as one of the high priorities for government agencies in Jordan. Although of their phenomenal evolution, government cloud-services still suffering from the adoption challenges of e-government initiatives (e.g. technological, human-aspects, social, and financial) which need to be considered carefully by governments contemplating its implementation. This paper presents a pilot study to investigate the citizens' perception of the extent in which these challenges affect the acceptance and use of cloud computing in Jordanian public sector. Based on the data analysis collected using online survey some important challenges were identified. The results can help to guide successful acceptance of cloud-based e-government services in Jordan.

Keywords: challenges, cloud computing, e-government, acceptance, Jordan

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Authors: Rowena R. De Guzman

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Association of Southeast Asian Nations (ASEAN) integration requires that higher education institutions (HEIs) must adjust the quality of their educational services and develop a global mindset, through various quality assurance (QA) activities to a level producing global graduates and encouraging human resource mobility. For Philippine HEIs, QA involves enormous tasks and responsibilities, whereby the implementation of which involves various parties, agencies and stakeholders; and in that case innovations have to be installed to engage the whole system in the QA process. In this study, collaborative governance (CG), a concept from the field of public administration, is introduced in educational management, particularly in the area of QA management. The paper suggests that the exercise of and attitude toward CG in QA is relevant to the practice of activities across QA indicators in higher educational services among stakeholders from participating HEIs. Participants representing different interests are collectively empowered, and this compelled them to participate and support the QA activities of the HEIs. It is recommended to embed CG model in the system for HEIs undergoing or intending to undergo QA achieve their desired QA outcomes. The study supports the commitment of the Philippine government to the evolving policy and efforts to achieve comparable qualifications across the Asia-Pacific region under the auspices of the UNESCO.

Keywords: ASEAN integration, collaborative governance, global education, government policy, higher education, international demands, quality assurance

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Authors: Carlos M. Goncalves, Luisa Duarte, Teresa Cartaxo

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The aim of this work was to understand the reasons behind the underutilization of electroconvulsive therapy (ECT) in the younger population and raise possible solutions. We conducted a non-systematic review of literature throughout a search on PubMed, using the terms ‘children’, ‘adolescents’ and ‘electroconvulsive’, ‘therapy’. Candidate articles written in languages other than English were excluded. Articles were selected according to title and/or abstract’s content relevance, resulting in a total of 5 articles. ECT is a recognized effective treatment in adults for several psychiatric conditions. As in adults, ECT in children and adolescents is proven most beneficial in the treatment of severe mood disorders, catatonia, and, to a lesser extent, schizophrenia. ECT in adults has also been used to treat autism’s self-injurious behaviours, Tourette’s syndrome and resistant first-episode schizophrenia disorder. Despite growing evidence on its safety and effectiveness in children and adolescents, like those found in adults, ECT remains a controversial and underused treatment in patients this age, even when it is clearly indicated. There are various possible reasons to this; limited awareness among professionals (lack of knowledge and experience among child psychiatrists), stigmatic public opinion (despite positive feedback from patients and families, there is an unfavourable and inaccurate representation in the media, contributing to a negative public opinion), legal restrictions and ethical controversies (restrictive regulations such as a minimum age for administration), lack of randomized trials (the currently available studies are retrospective, with small size samples, and most of the publications are either case reports or case series). This shows the need to raise awareness and knowledge, not only for mental health professionals, but also to the general population, through the media, regarding indications, methods and safety of ECT in order to provide reliable information to the patient and families. Large-scale longitudinal studies are also useful to further demonstrate the efficacy and safety of ECT and can aid in the formulation of algorithms and guidelines as without these changes, the availability of ECT to the younger population will remain restricted by regulations and social stigma. In conclusion, these results highlight that lack of adequate knowledge and accurate information are the most important factors behind the underutilization of ECT in younger population. Mental healthcare professionals occupy a cornerstone position; if data is given by a well-informed healthcare professional instead of the media, general population (including patients and their families) will probably regard the procedure in a more favourable way. So, the starting point should be to improve health care professional’s knowledge and experience on this choice of treatment.

Keywords: adolescents, children, electroconvulsive, therapy

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Authors: Nur Inayah Ismaniar, Sukri Palutturi, Ansariadi, Atjo Wahyu

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Background: In various countries in the world, the problem of smoking is now considered something serious because of the effects of smoking which can not only lead to addiction but also have the potential to harm health. Public health authorities have concluded that one solution that can be done to protect the public from active smokers is to issue a policy that requires public facilities to be completely smoke-free. The hospital is one of the public facilities that has been designated as a smoke-free area. However, the implementation and maintenance of a successful program based on a smoke-free hospital are still considered an ongoing challenge worldwide due to the very low level of adherence. The low level of compliance with this smoke-free policy is also seen in other public facilities. The purpose of the literature review is to review the level of compliance with the application of the Non-Smoking Area policy, how this policy has succeeded in reducing smoking activity in hospitals, and what factors lead to such compliance in each country in the world. Methods: A literature review of articles was carried out on all types of research methods, both qualitative and quantitative. The sample is all subjects who are in the research location, which includes patients, staff and hospital visitors. Results: Various variations in the level of compliance were found in various kinds of literature. The literature with the highest level of compliance is 88.4%. Furthermore, several determinants that are known to affect the compliance of the Non-Smoking Area policies in hospitals include communication, information, knowledge, perceptions, interventions, attitudes and support. Obstacles to its enforcement are the absence of sanctions against violators of the Non-Smoking Area policy, the ineffectiveness of the function of policymakers in hospitals, and negative perceptions of smoking related to mental health. Conclusion: Violations of the Non-Smoking Area policy are often committed by the hospital staff themselves, which makes it difficult for this policy to be fully enforced at various points in the hospital.

Keywords: health policy, non-smoking area, hospital, implementation

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Authors: Y. Y. Babanyara, D. B. Ibrahim, T. Garba

Abstract:

Proper management of medical waste is a crucial issue for maintaining human health and the environment. The waste generated in the hospitals has the potential for spreading infections and causing diseases. The study is aimed at assessing the medical waste management practices in Nigeria. Three instruments, questionnaire administration, in-depth interview and observation method for data collection were adopted in the study. The results revealed that the hospital does not quantify medical waste. Segregation of medical wastes is not conducted according to definite rules and standards. Wheeled trolleys are used for on-site transportation of waste from the points of production to the temporary storage area. Offsite transportation of the hospital waste is undertaken by a private waste management company. Small pickups are mainly used to transport waste daily to an off-site area for treatment and disposal. The main treatment method used in the final disposal of infectious waste is incineration. Non-infectious waste is disposed off using land disposal method. The study showed that the hospital does not have a policy and plan in place for managing medical waste. The study revealed number of problems the hospital faces in terms of medical waste management, including; lack of necessary rules, regulations and instructions on the different aspects of collections and disposal of waste, failure to quantify the waste generated in reliable records, lack of use of coloured bags by limiting the bags to only one colour for all waste, the absence of a dedicated waste manager, and no committee responsible for monitoring the management of medical waste. Recommendations are given with the aim of improving medical waste management in the hospital.

Keywords: medical waste, treatment, disposal, public health

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Authors: Atul Khurana, Rajul Rastogi, Hans-Joachim Gamperl

Abstract:

The pharmaceutical companies are getting more inclined towards patient support programs (PSPs) which assist patients and/or healthcare professionals (HCPs) in more desirable disease management and cost-effective treatment. The utmost objective of these programs is patient care. The PSPs may include financial assistance to patients, medicine compliance programs, access to HCPs via phone or online chat centers, etc. The PSP has a crucial role in terms of customer acquisition and retention strategies. During the conduct of these programs, Marketing Authorisation Holder (MAH) may receive information related to concerned medicinal products, which is usually reported by patients or involved HCPs. This information may include suspected adverse reaction(s) during/after administration of medicinal products. Hence, the MAH should design PSP to comply with regulatory reporting requirements and avoid non-compliance during PV inspection. The emergence of wireless health devices is lowering the burden on patients to manually incorporate safety data, and building a significant option for patients to observe major swings in reference to drug safety. Therefore, to enhance the adoption of these programs, MAH not only needs to aware patients about advantages of the program, but also recognizes the importance of time of patients and commitments made in a constructive manner. It is indispensable that strengthening the public health is considered as the topmost priority in such programs, and the MAH is compliant to Pharmacovigilance (PV) requirements along with regulatory obligations.

Keywords: drug safety, good pharmacovigilance practice, patient support program, pharmacovigilance

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Authors: Seyed Fakhreddin Hejazi, Leili Iranirad, Mohammad Sadeghi, Mohsen Talebizadeh

Abstract:

Background: Contrast-induced nephropathy (CIN) remains to be a potentially serious complication of radiographic procedures. We performed this clinical trial to assess the preventive effect of allopurinol against CIN in high-risk patients undergoing coronary angiography. Methods: In this prospective randomized controlled trial, 140 patients with at least two risk factors for CIN undergoing coronary angiography were randomly assigned to either the allopurinol group or the control group. Patients in the allopurinol group received 300 mg allopurinol 24 hours before a procedure and intravenous hydration for 12 hours before and after coronary angiography, whereas patients in the control group received intravenous hydration. Serum creatinine (SCr), blood urea nitrogen (BUN) and uric acid were measured before contrast exposure and at 48 hours. CIN was defined as an increase of 25% in serum creatinine (SCr) or >0.5 mg/dl 48 hours after contrast administration. Results: CIN occurred in 11 out of 70 (7.9%) patients in the control group and in 8 out of 70 (5.7%) patients in the allopurinol group. There was no significant difference in the incidence of CIN between the two groups at 48 hours after administering the radiocontrast agent (p = 0.459). However, there were significant differences between the two groups in SCr, BUN, uric acid, and eGFR 48 hours after radiocontrast administration (p < 0.05). Conclusion: Our findings revealed that allopurinol had no substantial efficacy over hydration protocol in high-risk patients for the development of CIN.

Keywords: contrast-induced nephropathy, allopurinol, coronary angiography, contrast agent

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Authors: Xiyue Wen

Abstract:

With the rapid development of the city, old communities in the city are facing a series of problems. On one hand, aging facilities, obsolete spatial patterns, aging populations arouse in the aging of the community. On the other hand, public space is reduced and is taking up by cars parking or facilities setting, which lead to the collapse of traditional life in the old communities. That is to say, modern amenities haven’t helped to reform the old community, but have leading to tedious and inefficient, when it is not accommodated in the traditional space. Exploring a way is imminent to the east the contradiction between modern living facilities and spatial patterns of traditional. We select a typical site-GeDa Community in Xi’an, built in 70-80s，and carry out a concept calling 'Raising Landscape', which enables a convenient and efficient space for parking, as well as a high-quality yard for activities. In addition, the design implements low cost, simple construction, resident participation, so that it can be spread in the same texture of urban space.

Keywords: old communities, renewal strategy, raising landscape, public space, parking space

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Authors: Carlos Gonzalez

Abstract:

When communicating using private and secure keys, there is always the doubt as to the identity of the message creator. We introduce an algorithm that uses the personal typing rhythm (keystroke dynamics) of the message originator to increase the trust of the authenticity of the message originator by the message recipient. The methodology proposes the use of a Rhythm Certificate Authority (RCA) to validate rhythm information. An illustrative example of the communication between Bob and Alice and the RCA is included. An algorithm of how to communicate with the RCA is presented. This RCA can be an independent authority or an enhanced Certificate Authority like the one used in public key infrastructure (PKI).

Keywords: authentication, digital signature, keystroke dynamics, personal rhythm, public-key encryption

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Authors: Anh Dao Vu, Bill Ryan

Abstract:

The Vietnamese government struggles to grapple with the problem of rampant corruption, one of the most challenging difficulties the country faces. According to Transparency International’s Corruption Perceptions Index (CPI) 2014, Vietnam ranks 119 out of 175 countries. The CPI gives Vietnam a score of 31 on a scale from 0 to 100, where 0 indicates ‘highly corrupt’ and 100 represents ‘very clean’. Corruption eats into the national GDP of Vietnam, causing a loss of 3% to 4% of GDP per annum. In general, the Vietnamese people’s trust in their government to wage an effective fight against corruption, especially in the public sector, has been greatly eroded in recent years. Some substantial public demonstrations persuaded the government to implement strong anti-corruption measures. However, so far those measures have not been particularly successful. One of the main reasons for this shortcoming is that neither the Communist Party of Vietnam nor the government has demonstrated sufficiently strong ‘political will’ in fighting corruption. There remains a large gap between rhetoric and reality. This paper will examine the reasons why insufficient ‘political will’ is displayed in the ostensible fight against public sector corruption, and how certain anti-corruption strategies will both strengthen levels of political commitment to the fight against corruption while enhancing the effectiveness of that essential national endeavor.

Keywords: corruption, political will, Vietnam, anti-corruption

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Authors: Laura Cochrane

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The United States Centers for Disease Control and Prevention has established three categories of biological agents based on their ease of spread and the severity of the disease they cause. Category A biological agents are the highest priority because of their high degree of morbidity and mortality, ease of dissemination, the potential to cause social disruption and panic, special requirements for public health preparedness, and past use as a biological weapon. Despite the threat of Category A biological agents, opportunities for medical intervention exist. This work summarizes public information, consolidated and reviewed across the situational usefulness and disease awareness to offer discussion to three specific Category A agents: anthrax (Bacillus anthracis), botulism (Clostridium botulinum toxin), and smallpox (variola major), and provides an overview on the management of medical countermeasures available to treat these three (3) different types of pathogens. The medical countermeasures are discussed in the setting of pre-exposure prophylaxis, post-exposure prophylaxis, and therapeutic treatments to provide a framework for requirements in public health preparedness.

Keywords: anthrax, botulism, smallpox, medical countermeasures

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Authors: N. Nalini, Bhanu Prakash Gopularam

Abstract:

The term data security refers to the degree of resistance or protection given to information from unintended or unauthorized access. The core principles of information security are the confidentiality, integrity and availability, also referred as CIA triad. Cloud computing services are classified as SaaS, IaaS and PaaS services. With cloud adoption the confidential enterprise data are moved from organization premises to untrusted public network and due to this the attack surface has increased manifold. Several cloud computing platforms like OpenStack, Eucalyptus, Amazon EC2 offer users to build and configure public, hybrid and private clouds. While the traditional encryption based on PKI infrastructure still works in cloud scenario, the management of public-private keys and trust certificates is difficult. The Identity based Public Key Cryptography (also referred as ID-PKC) overcomes this problem by using publicly identifiable information for generating the keys and works well with decentralized systems. The users can exchange information securely without having to manage any trust information. Another advantage is that access control (role based access control policy) information can be embedded into data unlike in PKI where it is handled by separate component or system. In OpenStack cloud platform the keystone service acts as identity service for authentication and authorization and has support for public key infrastructure for auto services. In this paper, we explain OpenStack security architecture and evaluate the PKI infrastructure piece for data confidentiality. We provide method to integrate ID-PKC schemes for securing data while in transit and stored and explain the key measures for safe guarding data against security attacks. The proposed approach uses JPBC crypto library for key-pair generation based on IEEE P1636.3 standard and secure communication to other cloud services.

Keywords: data confidentiality, identity based cryptography, secure communication, open stack key stone, token scoping

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Authors: A. Sottomayor, M. Perez Duque, M. C. Henriques

Abstract:

Introduction: Migration is not a new phenomenon; nomads often traveled, seeking better living conditions, including food and water. The increase of migrations affects all countries, rising health-related challenges. In Portugal, we have had migrant movements in the last decades, pairing with economic behavior. Irregular immigrants are detained in Santo António detention center from Portuguese Immigration and Borders Service (USHA-SEF) in Porto until court decision for a maximum of 60 days. It is the only long stay officially designated detention center for immigrants in Portugal. Immigrant health is important for public health (PH). It affects and is affected by the community. The XXVII Portuguese Government considered immigrant integration, including access to health, health promotion, protection and reduction of inequities a political priority. Many curative, psychological and legal services are provided for detainees, but until 2015, no structured health promotion or prevention actions were being held at USHA-SEF. That year, Porto Occidental PH Local Unit started to provide vaccination and health literacy on this theme for detainees and SEF workers. Our activities include a vaccine lecture, a medical consultation with vaccine prescription and administration, along with documented proof of vaccination. All vaccines are volunteer and free of charge. This action reduces the risk of importation and transmission of diseases, contributing to world eradication and elimination programs. We aimed to characterize the demography of irregular immigrant detained at UHSA-SEF and describe our activity. Methods: All data was provided by Porto Occidental Public Health Unit. All paper registers of vaccination were uploaded to MicrosoftExcel®. We included all registers and collected demographic variables, nationality, vaccination date, category, and administered vaccines. Descriptive analysis was performed using MicrosoftExcel®. Results: From 2015 to 2018, we delivered care to 256 individuals (179 immigrants; 77 workers). Considering immigrants, 72% were male, and 8 (16%) women were pregnant. 85% were between 20-54 years (ᵡ=30,8y; 2-71y), and 11 didn’t report any age. Migrants came from 48 countries, and India had the highest number (9%). MMR and Tetanus vaccines had > 90% vaccination rate and Poliomyelitis, hepatitis B and flu vaccines had around 85% vaccination rates. We had a consistent number of refusals. Conclusion: Our irregular migrant population comes from many different countries, which increases the risk of disease importation. Pregnant women are present as a particular subset of irregular migrants, and vaccination protects them and the baby. Vaccination of migrant is valuable for them and for the countries in which they pass. It contributes to universal health coverage, for eradication programmes and accomplishment of the Sustainable Development Goals. Peer influence may present as a determinant of refusals so we must consistently educate migrants before vaccination. More studies would be valuable, particularly on the migrant trajectory, duration of stay, destiny after court decision and health impact.

Keywords: migrants, public health, universal health coverage, vaccination

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Authors: Olusegun Adeleke Adenuga

Abstract:

The study examined effect of fishbone creative thinking strategy on problem-solving skills of public teachers in Ogun state, Nigeria. A 2x2x2 factorial design was employed for the study which consisted of 80 participants made up of 40 male and 40 female public teachers randomly selected among public teaching personnel from the two local government area headquarters (Ijebu-ode and Ijebu-Igbo) within Ogun East Senatorial District. Each treatment group received 45minutes instructions and training per week for 8weeks. Data was collected from participants with the use of standardized instrument tagged ‘Problem Solving Inventory’ (PSI) developed by the researchers prior to the training to form a pre-test and immediately after eight weeks of training to form a post-test. One hypothesis was tested; the data obtained was analyzed using Analysis of Covariance (ANCOVA) tested at significance level of 0.05. The result of the data analysis shows that there was a significant effect of the fishbone creative thinking technique on the participants (F (2,99) = 12.410; p <.05). Based on the findings, it is therefore recommended that the report of this study be used to effect organizational change and development of teaching service in Nigeria through teachers’ retraining and capacity building.

Keywords: fishbone, creative thinking strategy, and problem-solving skills, public teachers

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