Search results for: public sector hospital

Authors: Tom Ryan

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This paper investigates the rural mobility and accessibility challenges of a specific target group - Seniors. The target group is those over 66 years of age who are entitled to use the Public Transport (PT) Free Travel Scheme in rural Ireland. The paper explores at a high level some of the projected rural PT challenges and requirements over the next 10-15 years, noting that statistical predictions show that there will be a significant population demographic shift within the Senior's age profile. Using the PESTEL framework, the literature review explored existing research concerning mobility, accessibility challenges, and the opportunities Seniors face. Twenty-seven qualitative in-depth interviews with stakeholders within the ecosystem were undertaken. The stakeholders included: rural PT customers, Local-Link managers, NTA senior management, a Minister of State, and a European parliament policymaker. Tier 1 interviewee feedback spotlights that the PT network system does not exist for rural patients to access hospital facilities. There was no evidence from the Tier 2 research findings to show that health policymakers and transport planners are working to deliver a national solution to support patients getting access to hospital appointments. Several research interviewees discussed the theme of isolation and the perceived stigma of senior males utilising PT. The findings indicated that MaaS is potentially revolutionary in the PT arena. Finally, this paper suggests several short-, medium- and long-term recommendations based on the research findings. These recommendations are a potential springboard to ensure that rural PT is suitable for future Irish generations.

Keywords: accessibility, active ageing, car dependence, isolation, seniors health issues, behavioural changes, environmental challenges, internet of things, demand responsive, mobility as a service

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Authors: Hanan M. Taleb

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Energy consumption associated with buildings has a significant impact on the environment. To that end, and as a transaction between the inside and outside and between the building and urban space, the building skin plays an especially important role. It provides protection from the elements; demarcates private property and creates privacy. More importantly, it controls the admission of solar radiation. Therefore, designing the building skin sustainably will help to achieve optimal performance in terms of both energy consumption and thermal comfort. Unfortunately, with accelerating construction expansion, many recent buildings do not pay attention to the importance of the envelope design. This piece of research will highlight the importance of this part of the creation of buildings by providing evidence of a significant reduction in energy consumption if the envelopes are redesigned. Consequently, the aim of this paper is to enhance the performance of the hospital envelope in order to achieve sustainable performance. A hospital building sited in Abu Dhabi, in the UAE, has been chosen to act as a case study. A detailed analysis of the annual energy performance of the case study will be performed with the use of a computerised simulation; this is in order to explore their energy performance shortcomings. The energy consumption of the base case will then be compared with that resulting from the new proposed building skin. The results will inform architects and designers of the savings potential from various strategies.

Keywords: ASHREA, building skin, building envelopes, hospitals, Abu Dhabi, UAE, IES software

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Authors: Ndukwe, Chinedu O.

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Background: There are only a few epidemiological studies published on skin disorders in the elderly within the Nigerian context and none from the Southeast Region of the country. In addition, none of these studies has considered the pattern and frequency of histopathologically diagnosed geriatric skin lesions. Hence, we attempted to determine the frequency as well as the age and gender distributions of histologically diagnosed dermatological diseases in the geriatric population from skin biopsies submitted to the histopathology department of a tertiary care hospital in Southeast Nigeria. Material and methods: This is a cross-sectional retrospective hospital-based study involving all skin biopsies of patients 60 years and above, received at the Department of Histopathology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria from January 2004 to December 2019. Results: During the study period, 751 skin biopsies were received in the histopathology department. Of these, 142 were from patients who were older than 60 years. Thus, the overall share of geriatric patients was 18.9%. The mean age at presentation was 71.1 ± 8.6 years. The M: F was 1:1 and most of the patients belonged to the age group of 60–69 years (69 cases, 48.6%). The mean age of the male patients was 72.1±9.5 years. In the female patients, it was 70.1±7.5 years. The commonest disease category was neoplasms (91, 64.1%). Most neoplasms were malignant. There were 67/142 (47.2%) malignant lesions. Commonest was Squamous cell carcinoma (SCC) (30 cases) which is 21.1% of all geriatric skin biopsies and 44.8% of malignant skin biopsies. This is closely followed by melanoma (29 cases). Conclusion: Malignant neoplasms, benign neoplasms and papulosquamous disorders are the three commonest histologically diagnosed skin lesions in our geriatric population. The commonest skin malignancies in this group of patients are squamous cell carcinoma and malignant melanoma.

Keywords: geriatric, skin, Nigeria, histopathology

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Authors: Lie-Fen Lin, Tzu-Hsuan Lin, Ching-Heng Lin

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Hospice care for terminally ill patients provides not only a better quality of life but also cost-saving benefits. However, the utilization of home-based hospice care (HBH care) remains low even for countries covered by National Health Insurance (NHI) programs in Taiwan. In the current commercial insurance policy, only hospital-based hospice benefits were covered. It may have an influence on the insureds chosen to receive end-of-life care in a hospitalized manner. Thus, how to propose a feasible method to advocate HBH care utilization rate of public health policies is an important issue. A total of 130,219 cancer decedents in the year 2011-2013 from the National Health Insurance Research Database (NHIRD) in Taiwan were included in this study. By adding a day volume pays benefits of HBH care as a commercial insurance rider, will provide alternative benefits for the insureds. A multiple-state Markov chain model was incorporated to estimate the transition intensities of patients in different states at the end of their lives (Non-hospice, HBH, hospital-based hospice), and the premiums were estimated. HBH care insurance benefits provide financial support and reduce the burden of care for patients. The rate-making of this product is very sensitive while the utilization rate is rising, especially for high ages. The proposed HBH care insurance is a feasible way to reduce the financial burden, enhance the care quality and family satisfaction of insureds. Meanwhile, insurance companies can participate in advocating a good medical policy to enhance the social image. In addition, the medical costs of NHI can reduce effectively.

Keywords: home-based hospice care, commercial insurance, Markov chain model, the day volume pays

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Authors: Louis Nwachi

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Urban planning systems in most countries still rely on expert-driven, top-down technocratic plan-making processes rather than a public and people-led process. This paper set out to evaluate the need for public participation in the plan-making process and to highlight the factors that affect public participation in the plan-making process. In doing this, it adopted a qualitative approach based on document review and interviews taken from real-world phenomena. A case study strategy using the Metropolitan Area of Abuja, the capital of Nigeria, as the study sample was used in carrying out the research. The research finds that participation is an important tool in the plan-making process and that public engagement in the process contributes to the identification of key urban issues that are unique to the specific local areas, thereby contributing to the establishment of priorities and, in turn, to the mobilization of resources to meet the identified needs. It also finds that the development of a participation model by city authorities encourages public engagement and helps to develop trust between those in authority and the different key stakeholder groups involved in the plan-making process.

Keywords: plan-making, participation, urban planning, city

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Authors: Ipek Krom, Nurdan Tumbek Tekeoglu

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In our globalizing world increased competition between cities have resulted in expanding investments in marketing activities. In order to promote tourism and reinvestments, the cities have been using marketing activities to create more attractive sites and make use of their resources more efficiently. In becoming a branded city marketing activities play a major role in building brand value, which in turn results in the attraction of newcomers, revisits, settlements, reinvestments and the development of the city. This paper focuses on the Istanbul brand, which carries an important role in the promotion of Turkey as being its cultural, economic and financial center. As one of the most historical and appealing metropolitans in the world with remains of ancient civilizations, Istanbul has attracted 11 million 843 thousand tourists in 2014. Increasing number of marketing activities developed by numerous actors of private and public sector are among the reasons why tourists prefer Istanbul. Among these reasons we can list the increasing number of hotels, developed infrastructure and better transportation, modern shopping malls, international festivals, exportation of Turkish TV series, gastronomy investments, congress tourism, health tourism, student exchange programs, expatriation opportunities, recreational activities and new tourism destinations. In this paper we explore the marketing activities in Istanbul in order to make the city of the most visited metropolitans in the world. Decision making people in the tourism sector have been interviewed to provide better insight to the addressed topics.

Keywords: brand cities, marketing, tourism in istanbul, tourism marketing

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Authors: Yang Ye, Hongfei Qiu, Yaqi Li

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The planning and construction of traditional cities are oriented by cars, which leads to the problems of insufficient urban public space, fragmentation, and low utilization efficiency. With the development of driverless technology, the urban structure will change from the traditional single-core grid structure to the multi-core model. In terms of traffic organization, with the release of land for traffic facilities, public space will become more continuous and integrated with traffic space. In the context of driverless technology, urban public reconstruction is characterized by modularization and high efficiency, and its planning and layout features accord with points (service facilities), lines (smart lines), surfaces (activity centers). The public space of driverless urban roads will provide diversified urban public facilities and services. The intensive urban layout makes the commercial public space realize the functions of central activities and style display, respectively, in the interior (building atrium) and the exterior (building periphery). In addition to recreation function, urban green space can also utilize underground parking space to realize efficient dispatching of shared cars. The roads inside the residential community will be integrated into the urban landscape, providing conditions for the community public activity space with changing time sequence and improving the efficiency of space utilization. The intervention of driverless technology will change the thinking of traditional urban construction and turn it into a human-oriented one. As a result, urban public space will be richer, more connected, more efficient, and the urban space justice will be optimized. By summarizing the frontier research, this paper discusses the impact of unmanned driving on cities, especially urban public space, which is beneficial for landscape architects to cope with the future development and changes of the industry and provides a reference for the related research and practice.

Keywords: driverless, urban public space, construction strategy, urban design

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Authors: Mazoun Nasser Rashid Al Kharusi, Nada Al Siyabi

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Objectives: The main aim of this study is to Find the rate of susceptibility of ESBL E. coli causing UTI to oral antibiotics. Secondary objectives: Prevalence of ESBL E. coli from community urine samples, identify the best empirical oral antibiotics with the least resistance rate for UTI and identify alternative oral antibiotics for testing and utilization. Methods: This study is a retrospective descriptive study of the last three years in five major hospitals in Oman (Khowla Hospital, AN’Nahdha Hospital, Rustaq Hospital, Nizwa Hospital, and Ibri Hospital) equipped with a microbiologist. Inclusion criteria include all eligible outpatient urine culture isolates, excluding isolates from admitted patients with hospital-acquired urinary tract infections. Data was collected through the MOH database. The MOH hospitals are using different types of testing, automated methods like Vitek2 and manual methods. Vitek2 machine uses the principle of the fluorogenic method for organism identification and a turbidimetric method for susceptibility testing. The manual method is done by double disc diffusion for identifying ESBL and the disc diffusion method is for antibiotic susceptibility. All laboratories follow the clinical laboratory science institute (CLSI) guidelines. Analysis was done by SPSS statistical package. Results: Total urine cultures were (23048). E. coli grew in (11637) 49.6% of the urine, whereas (2199) 18.8% of those were confirmed as ESBL. As expected, the resistance rate to amoxicillin and cefuroxime is 100%. Moreover, the susceptibility of those ESBL-producing E. coli to nitrofurantoin, trimethoprim+sulfamethoxazole, ciprofloxacin and amoxicillin-clavulanate is progressing over the years; however, still low. ESBL E. coli was predominating in the female gender and those aged 66-74 years old throughout all the years. Other oral antibiotic options need to be explored and tested so that we add to the pool of oral antibiotics for ESBL E. coli causing UTI in the community. Conclusion: High rate of ESBL E. coli in urine from the community. The high resistance rates to oral antibiotics highlight the need for alternative treatment options for UTIs caused by these bacteria. Further research is needed to identify new and effective treatments for UTIs caused by ESBL-E. Coli.

Keywords: UTI, ESBL, oral antibiotics, E. coli, susceptibility

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Authors: Adekunle Kolawole Ojo, Idowu Peter Adebayo, Egwuche Sylvester O.

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Chronic Kidney Disease (CKD) is a significant cause of morbidity and mortality across developed and developing nations and is associated with increased risk. There are no existing electronic means of capturing and monitoring CKD in Nigeria. The work is aimed at developing a spatial data model that can be used to implement renal registries required for tracking and monitoring the spatial distribution of renal diseases by public health officers and patients. In this study, we have developed a spatial data model for a functional renal registry.

Keywords: renal registry, health informatics, chronic kidney disease, interface

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Authors: Mohammad Reza Ramezani, Shahriyar Afandizadeh

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Since the intersections play a crucial role in traffic delay, it is significant to evaluate them precisely. In this paper, three critical intersections in Tehran (Capital of Iran) had been simulated. The main purpose of this paper was to optimize the public transit delay. The simulation had three different phase in three intersections of Tehran. The first phase was about the current condition of intersection; the second phase was about optimized signal timing and the last phase was about prioritized public transit access. The Aimsun software was used to simulate all phases, and the Synchro software was used to optimization of signals as well. The result showed that the implement of optimization and prioritizing system would reduce about 50% of delay for public transit.

Keywords: transit signal priority, intersection optimization, public transit, simulation

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Authors: Manvelidze irakli, Iashvili Genadi

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Research has shown that public institutions in Autonomous Republic of Ajara try their best to make their official electronic data (web-pages, social websites) more informative and improve them. Part of public institutions offer interesting electronic services and initiatives to the public although they are seldom used in communication process. The statistical analysis of the use of web-pages and social websites of public institutions for example their facebook page show lack of activity. The reason could be the fact that public institutions give people less possibility of interaction in official web-pages. Second reason could be the fact that these web-pages are less known to the public and the third reason could be the fact that heads of these institutions lack awareness about the necessity of strengthening citizens’ involvement. In order to increase people’s involvement in this process it is necessary to have at least 23 e-services in one web-page. The research has shown that 11 of the 16 public institutions have only 5 services which are contact, social networks and hotline. Besides introducing innovative services government institutions should evaluate them and make them popular and easily accessible for the public. It would be easy to solve this problem if public institutions had concrete strategic plan of public relations which involved matters connected with maximum usage of electronic services while interaction with citizens. For this moment only one governmental body has a functioning action plan of public relations. As a result of the research organizational, social, methodological and technical problems have been revealed. It should be considered that there are many feedback possibilities like forum, RSS, blogs, wiki, twitter, social networks, etc. usage of only one or three of such instruments indicate that there is no strategy of regional electronic governance. It is necessary to develop more mechanisms of feedback which will increase electronic interaction, discussions and it is necessary to introduce the service of online petitions. It is important to reduce the so-called “digital inequality” and increase internet access for the public. State actions should decrease such problems. In the end if such shortcomings will be improved the role of electronic interactions in democratic processes will increase.

Keywords: e-Government, electronic services, information technology, regional government, regional government

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Authors: Dainius Genys, Vylius Leonavicius, Ricardas Krikstolaitis

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Energy security problems in Lithuania are analyzed on a regular basis; however, there is no comprehensive research on the very issue of the concept of public energy security. There is a lack of attention not only to social determinants of perception of energy security, but also a lack of a deeper analysis of the public opinion. This article aims to research the Lithuanian public perception of energy security. Complex tasks were set during the sociological study. Survey questionnaire consisted of different sets of questions: view of energy security (risk perception, political orientation, and energy security; comprehensiveness and energy security); view of energy risks and threats (perception of energy safety factors; individual dependence and burden; disobedience and risk); view of the activity of responsible institutions (energy policy assessment; confidence in institutions and energy security), demographic issues. In this article, we will focus on two aspects: a) We will analyze public opinion on the most important aspects of energy security and social factors influencing them; The hypothesis is made that public perception of energy security is related to value orientations: b) We will analyze how public opinion on energy policy executed by the government and confidence in the government are intertwined with the concept of energy security. Data of the survey, conducted on May 10-19 and June 7-17, 2013, when Seimas and the government consisted of the coalition dominated by Social Democrats with Labor, Order and Justice Parties and the Electoral Action of Poles, were used in this article. It is important to note that the survey was conducted prior to Russia’s occupation of the Crimea.

Keywords: energy security, public opinion, risk, energy threat, energy security policy

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Authors: Wen Shyong Hsieh, Chih Hsueh Lin

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In this paper, we combine the concepts of chameleon hash function (CHF) and identification based cryptography (IBC) to build a message authentication environment for VANET under sparse RSUs. Based on the CHF, TA keeps two common secrets that will be embedded to all identities to be as the evidence of mutual trusting. TA will issue one original identity to every RSU and vehicle. An identity contains one public ID and one private key. The public ID, includes three components: pseudonym, random key, and public key, is used to present one entity and can be verified to be a legal one. The private key is used to claim the ownership of the public ID. Based on the concept of IBC, without any negotiating process, a CHF pairing key multiplied by one private key and other’s public key will be used for mutually trusting and to be utilized as the session key of secure communicating between RSUs and vehicles. To help the vehicles to do message authenticating, the RSUs are assigned to response the vehicle’s temple identity request using two short time secretes that are broadcasted by TA. To light the loading of request information, one day is divided into M time slots. At every time slot, TA will broadcast two short time secretes to all valid RSUs for that time slot. Any RSU can response the temple identity request from legal vehicles. With the collected announcement of public IDs from the neighbor vehicles, a vehicle can set up its neighboring set, which includes the information about the neighbor vehicle’s temple public ID and temple CHF pairing key that can be derived by the private key and neighbor’s public key and will be used to do message authenticating or secure communicating without the help of RSU.

Keywords: Internet of Vehicles (IOV), Vehicular Ad-hoc Networks (VANETs), Chameleon Hash Function (CHF), message authentication

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Authors: Wabinyai Fidel Raja, Gideon Lubisa

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Air pollution is becoming a growing concern in Africa due to rapid industrialization and urbanization, leading to implications for public health and the environment. Establishing a comprehensive air quality monitoring network is crucial to combat this issue. However, conventional methods of monitoring are insufficient in African cities due to the high cost of setup and maintenance. To address this, low-cost sensors (LCS) can be deployed in various urban areas through the use of participatory air quality network siting (PAQNS). PAQNS involves stakeholders from the community, local government, and private sector working together to determine the most appropriate locations for air quality monitoring stations. This approach improves the accuracy and representativeness of air quality monitoring data, engages and empowers community members, and reflects the actual exposure of the population. Implementing PAQNS in African cities can build trust, promote accountability, and increase transparency in the air quality management process. However, challenges to implementing this approach must be addressed. Nonetheless, improving air quality is essential for protecting public health and promoting a sustainable environment. Implementing participatory and data-informed air quality monitoring can take a significant step toward achieving these important goals in African cities and beyond.

Keywords: low-cost sensors, participatory air quality network siting, air pollution, air quality management

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Authors: M. Sohrabi Narciss

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Urban spaces of Tehran, the capital of Iran, have witnessed many revolts, movements, and protests during the past few decades. After the Iranian Constitutional Revolution, the 1979 Revolution has had a profound impact on Tehran’s urban space. In 1979, the world watched as Iranians demonstrated en masse against the Pahlavi dynastdy which eventually led to its overthrow. Tehran’s public space is replete with images and artwork that depict the overthrow of the Pahlavi regime and the establishment of an Islamic government in Iran. The public artworks related to the 1979 Islamic Revolution reflect the riots, protests, and strikes that the Iranians underwent during the revolution. Many of these artworks try to revitalize the events that occurred in the 1970s by means of collective memory. Almost 4 decades have passed since the revolution and ever since the public artwork has been affected either directly or indirectly by the Iran-Iraq War, the Green Movement, and the rise and fall of various political forces. The present study is an attempt to investigate Tehran’s urban artwork such as urban sculptures and mural paintings organized and supervised by the government and the graffiti drawn by the critics or the opposition groups. To this end, in addition to the available documents, field research and questionnaires were used to qulaitatively analyze the data. This paper tries to address the following questions: 1) what changes have occurred in Tehran’s urban art? 2) Does the public, revolution-related artwork have an effect on people’s vitality? 3) do Iranians find these artworks appealing or not?

Keywords: public space, Tehran, public art, movement, Islamic revolution

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Authors: Orapan Thosingha, Tassana Boontong, Prapa Yuttatri, Vilaivan Thongcharoen, Soparn Potaya, Mattika Chaichan, Chanin Chakkrapopyodhin, Khwanthida Phimphakarn, Taddao Nabnean

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This research aimed to explore symptom experiences among Thai adults with chronic illnesses living in an urban community area of Bangkok. The sample was 670 adults with ages ranging from 20-59 years. The majority of them (65.2%) had more than one disease. Hypertension, dyslipidemia, and diabetes were the first three diseases among them. About 58% were female, and 51.1 % stayed with their couples. The studied sample had relatively low socioeconomic status; 33.7% were wage workers, 15.2% were street vendors, and 10.4% were unemployed. About 54 % had family incomes less than 10,000 baht (300 US Dollars) per month, and 41.6% addressed that their incomes were not adequate for daily living. Although the majority of them (63.7%) did not have to pay for hospital visits, they still had to pay for public transportation and could not earn a wage or any income on the hospital visit day. The first three physical symptoms they experienced were knee pain (60.5%) due to being overweight, headache (47.0%), and insomnia (44.6%). About 45% stated that their incomes decreased after having chronic illnesses and 37.2% expressed that having lower incomes affected their living, 34.5% perceived being a burden, and 34.3% regret about depending on others. It can be concluded that adults with low socioeconomic status who experienced chronic illnesses and resided in an urban community area had complex needs. While caring for them, nurses should pay attention not only to a disease-related domain but also to a social-related domain. Reached-out clinics led by professional nurses who are well-prepared for primary medical care and home visit are strongly recommended. National Health Security Office should adopt this policy and develop an action plan to serve the needs of chronically ill adults with low socioeconomic status.

Keywords: chronic illnesses, urban community, socioeconomic status, symptom experiences, low incomes

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Authors: Charlie Jeffkins

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Sickle cell disease is a serious life-limiting condition which can reduce the quality of life for many patients. Public Health England (PHE), in partnership with the Sickle Cell Society (SCS), has created guidelines to prevent severe complications from sickle cell disease. Data was collected from Children’s Hospital for Wales between 15/03/21-26/03/21. Methods: A manual search of patient records for children under the care of Rocket Ward and a key term search of online records was used. Results: Penicillin prophylaxis was given at 90 days for 89%, 77% of TCDs scans were done at 2-3 years, and 72% have had a scan in the last year. 53% of patients have had discussions about hydroxycarbamide, whilst 65% have started it. PPV vaccination was documented for 19%. Conclusion: Overall, none of the four standards were reached; however, TCD uptake has improved. There is a need for better documentation of treatment and annual re-audits.

Keywords: paediatric, haematology, sickle cell, audit

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Authors: Muhammad Naveed Babur, Maria Liaqat

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Background & Objective: People with disabilities especially neurological disabilities have many unmet health and rehabilitation needs, face barriers in accessing mainstream health-care services, and consequently have poor health. There are not sufficient epidemiological studies from Pakistan which assess barriers to neurorehabilitation and ways to counter it. Objectives: The objective of the study was to determine the challenges and to evaluate the barriers for neuro-rehabilitation services in developing countries. Methods: This is Exploratory sequential qualitative study based on the Panel discussion forum in International rehabilitation sciences congress and national rehabilitation conference 2017. Panel group discussion has been conducted in February 2017 with a sample size of eight professionals including Rehabilitation medicine Physician, Physical Therapist, Speech Language therapist, Occupational Therapist, Clinical Psychologist and rehabilitation nurse working in multidisciplinary/Interdisciplinary team. A comprehensive audio-videography have been developed, recorded, transcripted and documented. Data was transcribed and thematic analysis along with characteristics was drawn manually. Data verification was done with the help of two separate coders. Results: After extraction of two separate coders following results are emerged. General category themes are disease profile, demographic profile, training and education, research, barriers, governance, global funding, informal care, resources and cultural beliefs and public awareness. Barriers identified at the level are high cost, stigma, lengthy course of recovery. Hospital related barriers are lack of social support and individually tailored goal setting processes. Organizational barriers identified are lack of basic diagnostic facilities, lack of funding and human resources. Recommendations given by panelists were investment in education, capacity building, infrastructure, governance support, strategies to promote communication and realistic goals. Conclusion: It is concluded that neurorehabilitation in developing countries need attention in following categories i.e. disease profile, demographic profile, training and education, research, barriers, governance, global funding, informal care, resources and cultural beliefs and public awareness. This study also revealed barriers at the level of patient, hospital, organization. Recommendations were also given by panelists.

Keywords: disability, neurorehabilitation, telerehabilitation, disability

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Authors: Zintle Sikhunyana

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Management of public finance in many countries such as South Africa is affected by political decisions and by policies around fiscal decentralization amongst the government spheres. Economic success is said to be determined by efficient management of public finance and by the policies or strategies that are implemented to support efficient public finance management. Policymakers focus on pay attention to how economic policies have been implemented and how they are directed into ensuring stable development. This will allow policymakers to address economic challenges through the usage of fiscal policy parameters that are linked to the achieved rate of economic growth and development. Efficient public finance management reduces the likelihood of corruption and corruption is said to have negative effects on economic growth and development. Corruption in public finance refers to an act of using funds for personal benefits. To achieve macroeconomic objectives, governments make use of government expenditure and government expenditure is financed through tax revenue. The main aim of this paper is to investigate the potential impact of public finance management on economic growth and development in South Africa. The secondary data obtained from the South African Reserve Bank (SARB) and World Bank for 1980- 2020 has been utilized to achieve the research objectives. To test the impact of public finance management on economic growth and development, the study will use Seeming Unrelated Regression Equation (SURE) Modelling that allows researchers to model multiple equations with interdependent variables. The advantages of using SUR are that it efficiently allows estimation of relationships between variables by combining information on different equations and SUR test restrictions that involve parameters in different equations. The findings have shown that there is a positive relationship between efficient public finance management and economic growth/development. The findings also show that efficient public finance management has an indirect positive impact on economic growth and development. Corruption has a negative impact on economic growth and development. It results in an efficient allocation of government resources and thereby improves economic growth and development. The study recommends that governments who aim to stimulate economic growth and development should target and strengthen public finance management policies or strategies.

Keywords: corruption, economic growth, economic development, public finance management, fiscal decentralization

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Authors: Nicholas Bayfield, Liam Bibo, Charley Budgeon, Robert Larbalestier, Tom Briffa

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Introduction: Stress hyperglycaemia is common following cardiac surgery. Its optimal management is uncertain and may differ by diabetic status. This study assesses the in-hospital glycaemic management of cardiac surgery patients and associated postoperative outcomes. Methods: A retrospective cohort analysis of all patients undergoing cardiac surgery at Fiona Stanley Hospital from February 2015 to May 2019 was undertaken. Management and outcomes of hyperglycaemia following cardiac surgery were assessed. Follow-up was assessed to 1 year postoperatively. Multivariate regression modelling was utilised. Results: 1050 non-diabetic patients and 689 diabetic patients were included. In the non-diabetic cohort, patients with mild (peak blood sugar level [BSL] < 14.3), transient stress hyperglycaemia managed without insulin were not at an increased risk of wound-related morbidity (P=0.899) or mortality at 1 year (P=0.483). Insulin management was associated with wound-related readmission to hospital (P=0.004) and superficial sternal wound infection (P=0.047). Prolonged or severe stress hyperglycaemia was predictive of hospital re-admission (P=0.050) but not morbidity or mortality (P=0.546). Diabetes mellitus was an independent risk factor 1-year mortality (OR; 1.972 [1.041–3.736], P=0.037), graft harvest site wound infection (OR; 1.810 [1.134–2.889], P=0.013) and wound-related readmission (OR; 1.866 [1.076–3.236], P=0.026). In diabetics, postoperative peak BSL > 13.9mmol/L was predictive of graft harvest site infections (OR; 3.528 [1.724-7.217], P=0.001) and wound-related readmission OR; 3.462 [1.540-7.783], P=0.003) regardless of modality of management. A peak BSL of 10.0-13.9 did not increase the risk of morbidity/mortality compared to a peak BSL of < 10.0 (P=0.557). Diabetics with a peak BSL of 13.9 or less did not have significantly increased morbidity/mortality outcomes compared to non-diabetics (P=0.418). Conclusion: In non-diabetic patients, transient mild stress hyperglycaemia following cardiac surgery does not uniformly require treatment. In diabetic patients, postoperative hyperglycaemia with peak BSL exceeding 13.9mmol/L was associated with wound-related morbidity and hospital readmission following cardiac surgery.

Keywords: cardiac surgery, pulmonary embolism, pulmonary embolectomy, cardiopulmonary bypass

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Authors: Yessenia Parrado, Ana Barbosa, Daniela Mahe, Sebastian Toro, Jhon Garcia

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The purpose of this work is to present the identification and characterization of the barriers and enablers to public innovation in the Central Region of Colombia from a mixed methodology in a research carried out in 2020 by the Laboratory of Innovation, Creativity and New Technologies of the National University of Colombia in alliance with the National Planning Department. Based on the research, the index of barriers to regional and departmental public innovation was built, which reflects the level of difficulty of the territorial entities to overcome the barriers present around three dimensions: organizational structure of the entity, generation of public value, and governance processes. The index was built from the item response methodology and the multiple correspondence analysis from the application of an institutional information form for public entities and a perception form for public servants. This investigation had the participation of 36 entities and 1038 servers and servants from the departments of Huila, Meta, Boyacá, Cundinamarca, Tolima, and the Capital District. In this exercise, it was identified that the departmental indices range between 13 and 44 and that the regional index was 30 out of 100. From the analysis of the information, it was possible to establish that the main barriers are the lack of specialized agencies for public innovation exercises, lack of qualified personnel and work methodologies for public innovation, inadequate information management, lack of feedback between the learning from governmental and non-governmental entities, the inability of the initiatives to generate binding participation mechanisms and the lack of qualification of citizens to participate in these processes.

Keywords: item response, public innovation, quantitative analysis, compared analysis

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Authors: Vanlounni Sibounheuang, Wanarat Anusornsangiam, Pattarin Kittiboonyakun, Chanthanom Manithip

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In worldwide, one of the most common use of oral anticoagulant is warfarin. Its margin between therapeutic inhibition of clot formation and bleeding complications is narrow. Mahosot Hospital, warfarin clinic had not been established yet. The descriptive study was conducted by investigating drug-related problems of outpatients using warfarin, the value of the international normalized ratio (INR) higher than normal ranges (25.40 % of the total 272 outpatients) were mostly identified at Lao-Luxembourg Heart Centre, Mahosot Hospital, Lao PDR. This result led to the present study conducting qualitative interviews in order to help establish a warfarin clinic at Mahosot Hospital for the better outcomes of patients using warfarin. The purpose of this study was to explore perspectives of healthcare professional providing services for outpatients using warfarin. The face to face, in-depth interviews were undertaken among nine healthcare professionals (doctor=3, nurse=3, pharmacist=3) working at out-patient clinic, Lao-Luxembourg Heart Centre, Mahosot Hospital, Lao PDR. The interview guides were developed, and they were validated by the experts in the fields of qualitative research. Each interview lasted approximately 20 minutes. Three major themes emerged; healthcare professional’s experiences of current practice problems with warfarin therapy, healthcare professionals’ views of medical problems related to patients using warfarin, and healthcare professionals’ perspectives on ways of service improvement. All healthcare professionals had the same views that it’s difficult to achieve INR goal for individual patients because of some important patient barriers especially lack of knowledge about to use warfarin properly and safety, patients not regularly follow-up due to problems with transportations and financial support. Doctors and nurses agreed to have a pharmacist running a routine warfarin clinic and provided counselling to individual patients on the following points: how to take drug properly and safety, drug-drug and food-drug interactions, common side effects and how to manage them, lifestyle modifications. From the interviews, some important components of the establishment of a warfarin clinic included financial support, increased human resources, improved the system of keeping patients’ medical records, short course training for pharmacists. This study indicated the acceptance of healthcare professionals on the important roles of pharmacists and the feasibility of setting up warfarin clinic by working together with the multidisciplinary health care team in order to help improve health outcomes of patients using warfarin at Mahosot Hospital, Lao PDR.

Keywords: perspectives, healthcare professional, warfarin therapy, Mahosot Hospital

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Authors: Yu Zhang, Mingxue Lang, Li Dong

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The hundreds of years of slow succession of living environment in rural area is a crucial carrier of China’s long history of culture and national wisdom. In recent years, the space evolution of traditional rural settlements has been promoted by the intervention of tourism development, among which the public architecture and outdoor activity areas together served as the major places for villagers, and tourists’ social activities are an important characterization for settlement spatial evolution. Traditional public space upgrade and layout study of new public space can effectively promote the tourism industry development of traditional rural settlements. This article takes Qi County, one China Traditional Culture Village as the exemplification and uses the technology of Remote Sensing (RS), Geographic Information System (GIS) and Space Syntax, studies the evolution features of public space of tourism-oriented traditional rural settlements in four steps. First, acquire the 2003 and 2016 image data of Qi County, using the remote sensing application EDRAS8.6. Second, vectorize the basic maps of Qi County including its land use map with the application of ArcGIS 9.3 meanwhile, associating with architectural and site information concluded from field research. Third, analyze the accessibility and connectivity of the inner space of settlements using space syntax; run cross-correlation with the public space data of 2003 and 2016. Finally, summarize the evolution law of the public space of settlements; study the upgrade pattern of traditional public space and location plan for new public space. Major findings of this paper including: first, location layout of traditional public space has a larger association with the calculation results of space syntax and further confirmed the objective value of space syntax in expressing the space and social relations. Second, the intervention of tourism development generates remarkable impact on public space location of tradition rural settlements. Third, traditional public space produces the symbols of both strengthening and decline and forms a diversified upgrade pattern for the purpose of meeting the different tourism functional needs. Finally, space syntax provides an objective basis for location plan of new public space that meets the needs of tourism service. Tourism development has a significant impact on the evolution of public space of traditional rural settlements. Two types of public space, architecture, and site are both with changes seen from the perspective of quantity, location, dimension and function after the intervention of tourism development. Function upgrade of traditional public space and scientific layout of new public space are two important ways in achieving the goal of sustainable development of tourism-oriented traditional rural settlements.

Keywords: public space evolution, Qi county, space syntax, tourism oriented, traditional rural settlements

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Authors: Mohammad Safaeipour, Yousef Amer

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This study directs its focus on developing a conceptual model to offer a systematic and integrated method to weigh the related measures and evaluate a competence of hospitals and rank of the selected hospitals that involve and consider the stakeholders’ key performance indicators (KPI’s). The Analytical Hierarchy Process (AHP) approach will use to weigh the dimensions and related sub- components. The weights and performance scores will combine by using the Technique for Order Performance by Similarity to Ideal Solution (TOPSIS) and rank the selected hospitals. The results of this study provide interesting insight into the necessity of process improvement implementation in which hospital that received the lowest ranking score.

Keywords: performance measurement system, PMS, hospitals, AHP, TOPSIS

Procedia PDF Downloads 369

Authors: Murad Al-Rajab, Sherin Hazboun, Azhar Al-Hamamreh, Nirmeen Odeh, Siham Halaseh

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Tourism is considered an important sector for most countries, while maintaining good tourism attractions can promote national economic development. The State of Palestine is historically considered a wealthy country full of many archaeological places. In the city of Bethlehem, for example, the Church of the Nativity is the most important touristic site, but it does not have enough technology development to attract tourists. In this paper, we propose a smart mobile application named “Pal-STAR” (Palestine Smart Tourist Augmented Reality) as an innovative solution which targets tourists and assists them to make a visit inside the Church of the Nativity. The application will use augmented reality and feature a virtual tourist guide showing views of the church while providing historical information in a smart, easy, effective and user-friendly way. The proposed application is compatible with multiple mobile platforms and is considered user friendly. The findings show that this application will improve the practice of the tourism sector in the Holy Land, it will also increase the number of tourists visiting the Church of the Nativity and it will facilitate access to historical data that have been difficult to obtain using traditional tourism guidance. The value that tourism adds to a country cannot be denied, and the more technological advances are incorporated in this sector, the better the country’s tourism sector can be served. Palestine’s economy is heavily dependent on tourism in many of its main cities, despite several limitations, and technological development is needed to enable this sector to flourish. The proposed mobile application would definitely have a good impact on the development of the tourism sector by creating an Augmented Reality environment for tourists inside the church, helping them to navigate and learn about holy places in a non-traditional way, using a virtual tourist guide.

Keywords: smartphones, tourism, tourists guide, augmented reality, Palestine

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Authors: Kathaleeya Chanda

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The objectives of the research on the development of printed media for public relations of community products in Bang Khonthi District, Samut Songkram Province were to; 1) develop printed media for public relations of community products in Bang Khonthi District, Samut Songkram Province and 2) study the satisfaction towards the printed media for public relations of community products in Bang Khonthi District, Samut Songkram Province. The study was on the satisfaction focused on content, illustration, design, and quality. The sampling group of this study included 30 local community producers selected by probability sampling and simple random sampling. The research procedure consisted of 4 phases; 1) problem and situation study, 2) the development of printed media for public relations, 3) research tool development, and 4) data collection. Questionnaires to evaluate the satisfaction of local community producers towards the printed media for public relation were used to collect data which were analysed to find percentage, arithmetic means, and standard deviation. The results showed that the informants reported their satisfaction on 4 aspects as follows: 1) very high satisfaction on the content, 2) high satisfaction on the illustration, 3) very high satisfaction on the design, and 4) very high satisfaction on the product quality. This can be concluded that the developed printed media for public relations of community products can be used effectively with high satisfaction.

Keywords: printed media, public relations, community products in Bang Khonthi district, Samut Songkram Province

Procedia PDF Downloads 445

Authors: Lady Salvador Purganan, Jojo M. Villamin, Noel L. Lansang

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Tourism is a multifaceted but interdependent industry. This industry is composed of four major players, the public sector, the private sector, the local community, and the tourists. Each player has a vital role in the success of delivering high-quality tourism products and activities. There are various manifestations of positive economic outcomes that benefit the local community. Pro-poor tourism development approach has a great potential to serve as an avenue for capacity building leading to economic independence since natural attractions and cultural resources are assets that can be capitalized on, especially by the poor, because it is more accessible to them compared to financial resources. In the National Tourism Development Plan 2016-2022, specific mechanisms are not reflected to combat and lower poverty incidence through tourism. The researcher used the multidimensional poverty theory and sustainable tourism theory to formulate indicators in the research instrument and social exchange theory. The expected output of the study is to unlock opportunities, specifically in Brgy. Sta. Lucia, Guimba, Nueva Ecija, by crafting policies taking into utmost consideration local community involvement and participation in the process of tourism development which is essential in attaining inclusive growth and sustainability. This study will apply the sequential explanatory design mixed-method approach.

Keywords: pro-poor tourism, poverty alleviation, livelihood opportunities, tourism development plan

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Authors: Dana Mohammed, Fatemah Abdullah, Hawraa Ali, Najat Al-Shaer, Rawan Al-Awadhi, , Magdy Helal

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We study the patient service performance at the emergency department of a major Kuwaiti public hospital, using discrete simulation and lean concepts. In addition to the common problems in such health care systems (over crowdedness, facilities planning and usage, scheduling and staffing, capacity planning) the emergency department suffered from several cultural and patient behavioural issues. Those contributed significantly to the system problems and constituted major obstacles in maintaining the performance in control. This led to overly long waiting times and the potential of delaying providing help to critical cases. We utilized the visual management tools to mitigate the impact of the patients’ behaviours and attitudes and improve the logistics inside the system. In addition a proposal is made to automate the date collection and communication within the department using RFID-based barcoding system. Discrete event simulation models were developed as decision support systems; to study the operational problems and assess achieved improvements. The simulation analysis resulted in cutting the patient delays to about 35% of their current values by reallocating and rescheduling the medical staff. Combined with the application of the visual management concepts, this provided the basis to improving patient service without any major investments.

Keywords: simulation, visual management, health care system, patient

Procedia PDF Downloads 469

Authors: Le-Quyen Nguyen, Hoang Van Bui, Ngoc Thi Tran, Binh Thanh Le, Linus Olson, Thanh Quang Le

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Objective: We compared of outcomes between infected and non-infected COVID-19 pregnant at the largest obstetrics and gynecology hospital in southern Vietnam. Materials and Methods: A retrospective study was conducted at gestational age (GA) 28-42 weeks, who terminated pregnancy and had a real-time PCR test for SARS-CoV-2 at Tu Du Hospital. Demographic, clinical, laboratory, and epidemiological data were collected from hospital electronic-medical-records. Diagnosis and screening of SARS-CoV-2 used Real-time-PCR. Results: From July to October 2021, 9,246 pregnant with GA of 28-42 weeks were delivered, including 664 infected with COVID-19 and 8,582 non-infected. The cesarean section (CS) rates of pregnant with and without COVID-19 were 47.3% and 46.0%. At GA 32-34 weeks, the rate of CS with COVID-19 was 5.07 times higher than without. The rate of postpartum hemorrhage (PPH) and the Apgar score between these two groups were similar. The mortality rate of infected pregnants was 2.26%. Conclusions: COVID-19 infection increased the CS rate in the group of preterm pregnancies from 32 to less than 34 weeks. COVID-19 did not increase the risk of complications related to adverse pregnancy outcomes such as PPH, Apgar scores, the ratio of stillbirths, deaths due to malformation, and fetal deaths in labor.

Keywords: COVID-19, SARS-CoV-2, pregnancy, outcome, vietnam

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Authors: J. J. Mathew

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Pulmonary tuberculosis is highly prevalent in the Indian subcontinent. Most cases of pulmonary tuberculosis are diagnosed with sputum examinations and the vast majority of these are undertaken by the government run establishments. However, mycobacterial cultures are not routinely done, unless drug resistance is detected based on clinical response. Modern diagnostic tests like bronchoscopy and Genexpert are not routinely employed in the government institutions for the diagnosis of pulmonary tuberculosis, but have been accepted widely by good private institutions. The utility of these investigations in the private sector is not yet well recognized. This retrospective study aims to assess the usefulness of bronchoscopy and Genexpert in the diagnosis of pulmonary tuberculosis in quaternary care private hospital in India. 30 patients with respiratory symptoms raising the possibility of tuberculosis based on clinical and radiological features, but without any significant sputum production, were subject to bronchoscopy and BAL samples taken for microbiological studies, including Genexpert. 6 out of the 30 patients were found to be Genexpert positive and none of them showed Rifampicin resistance. All the 6 cases had upper zone predominant disease. One of the 6 cases of tuberculosis had another co-existent bacterial infection according to the routine culture studies. 6 other cases were proven to be due to other bacterial infections alone, 2 had a malignant diagnosis and the remaining cases were thought to be non-infective pathologies. The Genexpert results were made available within 48 hours in the 6 positive cases. All of them were commenced on standard anti-tuberculous regimen with excellent clinical response. The other infective cases were also managed successfully based on the drug susceptibilities. The study has shown the usefulness of these investigations as early intervention enabled diagnosis facilitating treatment and prevention of any clinical deterioration. The study lends support to early bronchoscopy and Genexpert testing in suspected cases of pulmonary tuberculosis without significant sputum production, in a high prevalence country which normally relies on sputum examination for the diagnosis of pulmonary tuberculosis.

Keywords: pulmonary, tuberculosis, bronchoscopy, genexpert

Procedia PDF Downloads 243