Search results for: maritime services

Authors: Shuen-Tai Wang, Ying-Chuan Chen, Hsi-Ya Chang

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Cloud computing is a paradigm of computing that shifts the way computing has been done in the past. The users can use cloud resources such as application software or storage space from the cloud without needing to own them. This paper is focused on solutions that are anticipated to introduce IaaS idea to build cloud base services and enable the individual remote user's applications in cloud environments, which appear as if they are running on the end user's local computer. The available features of application delivery solution have been developed based on our previous research on the virtualization technology to offer applications independent of location so that the users can work online, offline, anywhere, with appropriate device and at any time. This proposed effort has the potential to positively provide an efficient, resilience and elastic environment for cloud service. Users no longer need to burden the system managers and drastically reduces the overall cost of hardware and software licenses. Moreover, this flexible remote application virtualization service represents the next significant step to the mobile workplace, and it lets users access their applications remotely through cloud services anywhere. This is also made possible by the low administrative costs as well as relatively inexpensive end-user terminals and reduced energy expenses.

Keywords: cloud computing, IaaS, virtualization, application delivery

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Authors: Naeemeh Silvari

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The tourism industry is important for different nations in two ways. Apart from economic benefits, it provides a basis for getting acquainted with the culture of different regions of the world. Depending on the capacities and contexts of their geography, countries try to attract more people to their country in different ways. Health tourism has been an important branch of the tourism industry in recent years, and many countries around the world are trying to make progress in this field and attract many tourists from around the world. Iran, like many developing countries in the Middle East and East Asia, is trying to improve and develop tourist attractions in the field of health. Due to the cheapness of providing medical services to tourists, many people have traveled to Iran for medical and health care. However, there is a long way to go before recognizing and reaching the desired position in this field. Due to the direct relationship between tourism and culture, the negative attitude towards the context of Iran has caused foreign travelers not to choose this country as their tourist destination. In this article, we tried to study the change in their attitude towards Iran by using semi-structured interviews of foreign travelers who traveled to Iran for treatment and medical services. The text of the interviews was coded and analyzed by MAX QDA software. Many of the people in the sample were from Middle Eastern and Arabic-speaking countries. Influenced by the media, they felt rejected by the Iranians before the trip. During their stay in Iran and in connection with the health care staff, in the first stage, they pointed out that many of their anxieties about the kind of treatment of Iranians have been allayed. In addition to the satisfaction with the medical services provided, they considered the atmosphere of Iranians' interaction with foreign travelers to be relatively appropriate, and some stated that Iran would be the destination of their leisure trip in the future. At the end of the research, policymakers were suggested that in order to resolve cultural contradictions rooted in values, they should first be recognized and seek to use other opportunities to resolve contradictions and form interactions with other cultures.

Keywords: cultural conflict, health tourism, cultural prejudice, advertising and media

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Authors: Junaid Mahmood Alam

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Revalidating and harmonizing clinical chemistry analytical principles and optimizing methods through quality control programs and assessments is the preeminent means to attain optimal outcome within the clinical laboratory services. Present study reports revalidation of our existing IFCC regularized analytical methods, particularly hepatic and thyroid function tests, by optimization of precision analyses and processing through external and internal quality assessments and regression determination. Parametric components of hepatic (Bilirubin ALT, γGT, ALP), cardiac (LDH, AST, Trop I) and thyroid/pituitary (T3, T4, TSH, FT3, FT4) function tests were used to validate analytical techniques on automated chemistry and immunological analyzers namely Hitachi 912, Cobas 6000 e601, Cobas c501, Cobas e411 with UV kinetic, colorimetric dry chemistry principles and Electro-Chemiluminescence immunoassay (ECLi) techniques. Process of validation and revalidation was completed with evaluating and assessing the precision analyzed Preci-control data of various instruments plotting against each other with regression analyses R2. Results showed that: Revalidation and optimization of respective parameters that were accredited through CAP, CLSI and NEQAPP assessments depicted 99.0% to 99.8% optimization, in addition to the methodology and instruments used for analyses. Regression R2 analysis of BilT was 0.996, whereas that of ALT, ALP, γGT, LDH, AST, Trop I, T3, T4, TSH, FT3, and FT4 exhibited R2 0.998, 0.997, 0.993, 0.967, 0.970, 0.980, 0.976, 0.996, 0.997, 0.997, and R2 0.990, respectively. This confirmed marked harmonization of analytical methods and instrumentations thus revalidating optimized precision standardization as per IFCC recommended guidelines. It is concluded that practices of revalidating and harmonizing the existing or any new services should be followed by all clinical laboratories, especially those associated with tertiary care hospital. This is will ensure deliverance of standardized, proficiency tested, optimized services for prompt and better patient care that will guarantee maximum patients’ confidence.

Keywords: revalidation, standardized, IFCC, CAP, harmonized

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Authors: Mayank Mishra

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Market Economy can be broadly defined as economic system where supply and demand regulate the economy and in which decisions pertaining to production, consumption, allocation of resources, price and competition are made by collective actions of individuals or organisations with limited government intervention. On the other hand Market Society is one where instead of the economy being embedded in social relations, social relations are embedded in the economy. A market economy becomes a market society when all of land, labour and capital are commodified. This transition also has effect on people’s attitude and values. Such a transition commence impacting the non-material aspect of life such as public education, public health and the like. The inception of neoliberal policies in non-market norms altered the nature of social goods like public health that raised the following questions. What impact would the transition to a market society make on people in terms of accessibility to public health? Is healthcare a commodity that can be subjected to a competitive market place? What kind of private investments are being made in public health and how do private investments alter the nature of a public good like healthcare? This research problem will employ empirical-analytical approach that includes deductive reasoning which will be using the existing concept of market economy and market society as a foundation for the analytical framework and the hypotheses to be examined. The research also intends to inculcate the naturalistic elements of qualitative methodology which refers to studying of real world situations as they unfold. The research will analyse the existing literature available on the subject. Concomitantly the research intends to access the primary literature which includes reports from the World Bank, World Health Organisation (WHO) and the different departments of respective ministries of the countries for the analysis. This paper endeavours to highlight how the issue of commodification of public health would lead to perpetual increase in its inaccessibility leading to stratification of healthcare services where one can avail the better services depending on the extent of one’s ability to pay. Since the fundamental maxim of private investments is to churn out profits, these kinds of trends would pose a detrimental effect on the society at large perpetuating the lacuna between the have and the have-nots.The increasing private investments, both, domestic and foreign, in public health sector are leading to increasing inaccessibility of public health services. Despite the increase in various public health schemes the quality and impact of government public health services are on a continuous decline.

Keywords: commodity, India and Pakistan, market society, public health

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Authors: Esraa Moustafa, Gaetan Rey, Stephane Lavirotte, Jean-Yves Tigli

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With the development of Internet of Things and Web of Things, computing becomes more pervasive, invisible and present everywhere. In fact, in our environment, we are surrounded by multiple devices that deliver (web) services that meet the needs of the users. However, the mobility of these devices as the users has important repercussions that challenge software design of these applications because the variability of the environment cannot be anticipated at the design time. Thus, it will be interesting to dynamically discover the environment and adapt the application during its execution to the new contextual conditions. We, therefore, propose a model of a context-aware middleware that can address this issue through a monitoring service that is capable of reasoning and observation channels capable of calculating the context during the runtime. The monitoring service evaluates the pre-defined X-Query predicates in the context manager and uses Prolog to deduce the services needed to respond back. An independent Observation Channel for each different predicate is then dynamically generated by the monitoring service depending on the current state of the environment. Each channel sends its result directly to the context manager which consequently calculates the context based on all the predicates’ results while preserving the reactivity of the self-adaptive system.

Keywords: auto-adaptation, context-awareness, middleware, reasoning engine

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Authors: Astha Sinha, Anjali Kanagali

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The United Kingdom’s withdrawal from the European Union, also termed as “Brexit,” took place on June 23, 2016 and immediately had global repercussions on the stock markets of the world. It is however expected to have a greater impact on the Banking sector in the UK. There is a two-fold effect on the earnings of banks which is being expected. First is of the trading activity and investment banking businesses being hit due to global weakness in financial markets. Second is that the banks having a large presence in the European Union will have to restructure their operations in order to cover other European countries as well increase their operating costs. As per the analysis, banks are expected to face rate cuts, bad loans, and tight liquidity. The directives in the Brexit negotiations on the Markets in Financial Instruments Directive (MiFID) will be a major decision to be taken for the Banking sector. New regulations will be required since most of the regulations governing the financial services industry allowing for the cross-border transactions were at the EU level. This paper aims to analyze the effect of Brexit on the UK Banking sector and changes in regulations that are expected due to the same. It shall also lay down the lessons learnt from the 2008 financial crisis and draw a parallel in terms of potential areas to be focused on for revival of the financial sector of Britain.

Keywords: Brexit, Brexit impact on UK, impact of Brexit on banking, impact of Brexit on financial services

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Authors: Gururaj Bhajantri

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Financial sector is the backbone of any economy and it plays a crucial role in the mobilisation and allocation of resources. One of the main objectives of financial sector is inclusive growth. The constituents of the financial sector are banks, and financial Institutions, which mobilise the resources from the surplus sector and channelize the same to the different needful sectors in the economy. Micro Small and the Medium Enterprises sector in India cover a wide range of economic activities. These enterprises are divided on the basis of investment on equipment. The micro enterprises are divided into manufacturing and services sector. Micro Service enterprises have investment limit up to ten lakhs on equipment. Hairdresser is one who not only cuts and shaves but also provides different types of hair cut, hairstyles, trimming, hair-dye, massage, manicure, pedicure, nail services, colouring, facial, makeup application, waxing, tanning and other beauty treatments etc., hairdressing salons provide these services with the help of equipment. They need investment on equipment not more than ten lakhs. Hence, they can be considered as Micro service enterprises. Hairdressing salons require more than Rs 2.50,000 to start a moderate salon. Moreover, hairdressers are unable to access the organised finance. Still these individuals access finance from money lenders with high rate of interest to lead life. The socio economic conditions of hairdressers are not known properly. Hence, the present study brings a light on the role of financial institutions in promoting hairdressing salons. The study also focuses the socio-economic background of individuals in hairdressings salons, problems faced by them. The present study is based on primary and secondary data. Primary data collected among hairdressing salons in Davangere city. Samples selected with the help of simple random sampling techniques. Collected data analysed and interpreted with the help of simple statistical tools.

Keywords: micro service enterprises, financial institutions, hairdressing salons, financial sector

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Authors: Mardi Falck, André Theron

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Traffic congestion on the Northern side of Table Bay is a major problem. In Gauteng, the implementation of the Gautrain between Pretoria and Johannesburg, solved their traffic congestion. In 2002 two entrepreneurs endeavoured to implement a hovercraft ferry service across the bay from Table View to the Port of Cape Town. However, the EIA process proved that disgruntled residents from the area did not agree with their location for a launch site. 17 years later the traffic problem has not gone away, but instead the congestion has increased. While property prices in the City Bowl of Cape Town are ever increasing, people tend to live more on the outskirts of the CBD and commute to work. This means more vehicles on the road every day and the public transport services cannot keep up with the demand. For this reason, the study area of the previous hovercraft plans is being extended further North. The study’s aim is thus to determine the feasibility of a launch site North of Bloubergstrand to launch and receive a public transport ferry across Table Bay. The feasibility is being established by researching ferry services across the world and on what makes them successful. Different types of ferries and their operational capacities in terms of weather and waves are researched and by establishing the offshore and nearshore wind and wave climate for the area, an appropriate protected launch site is determined. It was concluded that travel time could potentially be halved. A hovercraft proved to be the most feasible ferry type, because it does not require a conventional harbour. Other types of vessels require a protected launch site because of the wave climate. This means large breakwaters that influence the cost substantially. The Melkbos Cultural Centre proved to be the most viable option for the location of the launch site, because it already has buildings and infrastructure. It is recommended that, if a harbour is chosen for the proposed ferry service, it could be used for more services like fishing, eco-tourism and leisure. Further studies are recommended to optimise the feasibility of such a harbour.

Keywords: Cape Town, ferry, public, Table Bay

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Authors: Aziz Zulazmi Samsudin, Siti Norhedayah Abdul Latif

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The lack of normalization of mental health as a conversational topic is becoming increasingly evident in certain cultures. The fact that students underutilize mental health services in schools can be attributed to the presence of various barriers that impede their willingness to seek for help. Stigma surrounding mental health services continue to be the most prevalent barrier for help seeking behavior. Alternative barriers have emerged that are both personal and public in nature that can have a substantial impact on students’ preference to seek for help in schools. A sequential explanatory study was carried out among 256 Muslim students in a school with dual education system in exploring both their Self-Stigma of Seeking Help (SSOSH) and Mental Health Help-Seeking Attitude (MHSA). In addition, 12 students were interviewed in a focus group setting to explore further the phenomena of help seeking approach by students to understand the initial quantitative analysis. Preliminary findings indicated that the students’ level of self-stigma was only moderate, but they had a favorable attitude towards counselling help. There was no significant difference on gender for both variables; however, the lower the self-stigma, the higher the mental help-seeking attitude for this current study, which is a common trend of relationship between the two variables. The interview revealed that, apart from public stigma, the absence of a qualified counsellor, a lack of ethical principles of counselling, a confidentiality issue, and the emotional openness of the students were identified as other barriers to their help-seeking attitudes. This paper also discussed the recommendation made by students in addressing barriers to counselling and facilitating their counselling needs for the improvement of students' mental and academic well-being. Additionally, this research offers the most recent data about mental health in the context of schools with a dual education system in Brunei Darussalam. It is hoped to serve as a guide for policy makers to consider the provision of mental health services that is more appealing to the students’ mental and academic well-being.

Keywords: mental health help-seeking attitude (MHSA), public stigma, school counselling, self-stigma, self-stigma of seeking help (SSOSH), well-being.

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Authors: Derssie Mebratu

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As a large variety of micro services, web services, social graphic applications, and media applications are continuously developed, it is substantially vital to design and build a reliable, efficient, and faster memory tiering system. Despite limited design, implementation, and deployment in the last few years, several techniques are currently developed to improve a memory tiering system in a cloud. Some of these techniques are to develop an optimal scanning frequency; improve and track pages movement; identify pages that recently accessed; store pages across each tiering, and then identify pages as a hot, warm, and cold so that hot pages can store in the first tiering Dynamic Random Access Memory (DRAM) and warm pages store in the second tiering Compute Express Link(CXL) and cold pages store in the third tiering Non-Volatile Memory (NVM). Apart from the current proposal and implementation, we also develop a new technique based on a machine learning algorithm in that the throughput produced 25% improved performance compared to the performance produced by the baseline as well as the latency produced 95% improved performance compared to the performance produced by the baseline.

Keywords: machine learning, bayesian optimization, memory tiering, CXL, DRAM

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Authors: Anu Paul, Varghese Paul

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The focal aspire of e-Government (eGovt) is to offer citizen-centered service delivery. Accordingly, the citizenry consumes services from multiple government agencies through national portal. Thus, eGovt is an enterprise with the primary business motive of transparent, efficient and effective public services to its citizenry and its logical structure is the eGovernment Enterprise Architecture (eGEA). Since eGovt is IT oriented multifaceted service-centric system, EA doesn’t do much on an automated enterprise other than the business artifacts. Service-Oriented Architecture (SOA) manifestation led some governments to pertain this in their eGovts, but it limits the source of business artifacts. The concurrent use of EA and SOA in eGovt executes interoperability and integration and leads to Service-Oriented e-Government Enterprise (SOeGE). Consequently, agile eGovt system becomes a reality. As an IT perspective eGovt comprises of centralized public service artifacts with the existing application logics belong to various departments at central, state and local level. The eGovt is renovating to SOeGE by apply the Service-Orientation (SO) principles in the entire system. This paper explores IT perspective of SOeGE in India which encompasses the public service models and illustrated with a case study the Passport service of India.

Keywords: enterprise architecture, service-oriented e-Government enterprise, service interface layer, service model

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Authors: Laaziz El Hassan

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The Service Network Design Problem (SNDP) is a tactical issue in freight transportation firms. The existing formulations of the problem for intermodal rail-road transportation were not always adapted to the intermodality in terms of full asset utilization and modal shift reinforcement. The objective of the article is to propose a model having a more compliant formulation with intermodality, including constraints highlighting the imperatives of asset management, reinforcing modal shift from road to rail and reducing, by the way, road mode CO2 emissions. The model is a fixed charged, path based integer nonlinear program. Its objective is to minimize services total cost while ensuring full assets utilization to satisfy freight demand forecast. The model's main feature is that it gives as output both the train sizes and the services frequencies for a planning period. We solved the program using a commercial solver and discussed the numerical results.

Keywords: intermodal transport network, service network design, model, nonlinear integer program, path-based, service frequencies, modal shift

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Authors: Prasansha Kumari

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This paper intends to identify and analyze customer adoption and attitudes towards mobile banking facilities. The study uses six perceived characteristics of innovation that can be used to form a favorable or unfavorable attitude toward an innovation, namely: Relative advantage, compatibility, complexity, trailability, risk, and observability. Collected data were analyzed using Pearson Chi-Square test. The results showed that mobile bank users were predominantly males. There is a growing trend among young, educated customers towards converting to mobile banking in Sri Lanka. The research outcomes suggested that all the six factors are statistically highly significant in influencing mobile banking adoption and attitude formation towards mobile banking in Sri Lanka. The major reasons for adopting mobile banking services are the accessibility and availability of services regardless of time and place. Over the 75 percent of the respondents mentioned that savings in time and effort and low financial costs of conducting mobile banking were advantageous. Issue of security was found to be the most important factor that motivated consumer adoption and attitude formation towards mobile banking. Main barriers to mobile banking were the lack of technological skills, the traditional cash‐carry banking culture, and the lack of awareness and insufficient guidance to using mobile banking.

Keywords: compatibility, complexity, mobile banking, observability, risk

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Authors: Eric Lee G. Escobedo-Wu, Nidhi Rohatgi, Fouzel Dhebar

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It is challenging for patients to navigate through healthcare systems after-hours. This leads to delays in care, patient/provider dissatisfaction, inappropriate resource utilization, readmissions, and higher costs. It is important to provide patients and providers with effective clinical decision-making tools to allow seamless connectivity and coordinated care. In August 2015, patient-centric Stanford Health Care established Clinical Advice Services (CAS) to provide clinical decision support after-hours. CAS is founded on key Lean principles: Value stream mapping, empathy mapping, waste walk, takt time calculations, standard work, plan-do-check-act cycles, and active daily management. At CAS, Clinical Assistants take the initial call and manage all non-clinical calls (e.g., appointments, directions, general information). If the patient has a clinical symptom, the CAS nurses take the call and utilize standardized clinical algorithms to triage the patient to home, clinic, urgent care, emergency department, or 911. Nurses may also contact the on-call physician based on the clinical algorithm for further direction and consultation. Since August 2015, CAS has managed 228,990 calls from 26 clinical specialties. Reporting is built into the electronic health record for analysis and data collection. 65.3% of the after-hours calls are clinically related. Average clinical algorithm adherence rate has been 92%. An average of 9% of calls was escalated by CAS nurses to the physician on call. An average of 5% of patients was triaged to the Emergency Department by CAS. Key learnings indicate that a seamless connectivity vision, cascading, multidisciplinary ownership of the problem, and synergistic enterprise improvements have contributed to this success while striving for continuous improvement.

Keywords: after hours phone calls, clinical advice services, nurse triage, Stanford Health Care

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Authors: A. Šapkauskienė, A. Mačerinskienė, R. Andrulienė, R. Bruzgė, S. Masteika, K. Driaunys

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The COVID-19 pandemic has affected not only world markets and economies but also the daily lives of customers and their payment habits. The pandemic has accelerated the digital transformation, so the role of technology will become even more important post-COVID. Although the popularity of cryptocurrencies has reached unprecedented heights, there are still obstacles, such as a lack of consumer experience and distrust of these technologies, so exploring the role of cryptocurrency and blockchain in the context of international travel becomes extremely important. Research on tourists’ intentions to use cryptocurrencies for payment purposes is limited due to the small number of research studies. To fill this research gap, an exploratory study based on the analysis of survey data was conducted. The purpose of the research is to explore how the behavior of tourists has changed making their financial transactions when paying for the tourism services in order to determine the intention to pay in cryptocurrencies. Behavioral intention can be examined as a dependent variable that is useful for the study of the acceptance of blockchain as cutting-edge technology. Therefore, this study examines the intention of travelers to use cryptocurrencies in electronic payments for tourism services. Several studies have shown that the intention to accept payments in a cryptocurrency is affected by the perceived usefulness of these payments and the perceived ease of use. The findings deepen our understanding of the readiness of service users to apply for blockchain-based payment in the tourism sector. The tourism industry has to focus not only on the technology but on consumers who can use cryptocurrencies, creating new possibilities and increasing business competitiveness. Based on research results, suggestions are made to guide future research on the use of cryptocurrencies by tourists in the tourism industry. Therefore, in line with the rapid expansion of virtual currency users, market capitalization, and payment in cryptographic currencies, it is necessary to explore the possibilities of implementing a blockchain-based system aiming to promote the use of services in the tourism sector as the most affected by the pandemic.

Keywords: behavioral intention, blockchain-based payment, cryptocurrency, tourism

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Authors: Gunnar Oskarsson, Irena Georgsdottir

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Tourism has been growing incredibly fast during the past years, including the cruise industry, which is gaining increasing popularity among various groups of travelers. It is a challenging task for companies serving cruise ship passengers with local products and services at the point of destination to reach them in due time with information about their offerings, as well learning how to adapt their offerings and messages to the type of customers arriving on each particular occasion. Although some research has been conducted in this sphere, there is still limited knowledge about many specifics within this sector of the tourist industry. The objective of this research is to examine one of these, with the main goal of studying the segmentation of cruise passengers and to learn about marketing practices directed towards them. A qualitative research method, based on in-depth interviews, was used, as this provides an opportunity to gain insight into the participants’ perspectives. Interviews were conducted with 10 respondents from different companies in the tourist industry in Iceland, who interact with cruise passengers on a regular basis in their work environment. The main objective was to gain an understanding of what distinguishes different customer groups, or segments, in this industry, and of the marketing approaches directed towards them. The main findings reveal that participants note the strongest difference between cruise passengers of different nationalities, passengers coming on different ships (size and type), and passengers arriving at different times of the year. A drastic difference was noticed between nationalities in four main segments, American, British, Other European, and Asian customers, although some of these segments could be divided into even further sub-segments. Other important differencing factors were size and type of ships, quality or number of stars on the ship, and travelling time of the year. Companies serving cruise ship passengers, as well as the customers themselves, could benefit if the offerings of services were designed specifically for particular segments within the industry. Concerning marketing towards cruise passengers, the results indicate that it is carried out almost exclusively through the Internet using; a reliable website and, search engine optimization. Marketing is also by word-of-mouth. This research can assist practitioners by offering a deeper understanding of the approaches that may be effective in marketing local products and services to cruise ship passengers, based on their segmentation and by identifying effective ways to reach them. The research, furthermore, provides a valuable contribution to marketing knowledge for the benefit of an increasingly important market segment in a fast growing tourist industry.

Keywords: capabilities, global integration, internationalisation, SMEs

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Authors: Atucungwiire Rwebiita

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Introduction: In Uganda, provision of adolescent sexual reproductive health and rights (SRHR) services for key population is still hindered by negative attitudes, stigma and discrimination (S&D) at both the community and facility levels. To address this barrier, Integrated Community Based Initiatives (ICOBI) with support from SIDA is currently implementing a quality improvement (QI) innovative approach for strengthening the capacity of key population (KP) peer leaders and health workers to deliver friendly SRHR services without S&D. Methods: Our innovative approach involves continuous mentorship and coaching of 8 QI teams at 8 health facilities and their catchment areas. Each of the 8 teams (comprised of 5 health workers and 5 KP peer leaders) are facilitated twice a month by two QI Mentors in a 2-hour mentorship session over a period of 4 months. The QI mentors were provided a 2-weeks training on QI approaches for reducing S&D against young key populations in the delivery of SRHR Services. The mentorship sessions are guided by a manual where teams base to analyse root causes of S&D and develop key performance indicators (KPIs) in the 1st and 2nd second sessions respectively. The teams then develop action plans in the 3rd session and review implementation progress on KPIs at the end of subsequent sessions. The KPIs capture information on the attitude of health workers and peer leaders and the general service delivery setting as well as clients’ experience. A dashboard is developed to routinely track the KPIs for S&D across all the supported health facilities and catchment areas. After 4 months, QI teams share documented QI best practices and tested change packages on S&D in a learning and exchange session involving all the teams. Findings: The implementation of this approach is showing positive results. So far, QI teams have already identified the root causes of S&D against key populations including: poor information among health workers, fear of a perceived risk of infection, perceived links between HIV and disreputable behaviour. Others are perceptions that HIV & STIs are divine punishment, sex work and homosexuality are against religion and cultural values. They have also noted the perception that MSM are mentally sick and a danger to everyone. Eight QI teams have developed action plans to address the root causes of S&D. Conclusion: This approach is promising, offers a novel and scalable means to implement stigma-reduction interventions in facility and community settings.

Keywords: key populations, sexual reproductive health and rights, stigma and discrimination , quality improvement approach

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Authors: Maisa Haj-Tas, Jehad Alaraifi

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The significance of the study: This retrospective study examined the speech and language profiles of patients who received clinical services at the University of Jordan Hearing and Speech Clinic (UJ-HSC) from 2009 to 2014. The UJ-HSC clinic is located in the capital Amman and was established in the late 1990s. It is the first hearing and speech clinic in Jordan and one of first speech and hearing clinics in the Middle East. This clinic provides services to an annual average of 2000 patients who are diagnosed with different communication disorders. Examining the speech and language profiles of patients in this clinic could provide an insight about the most common disorders seen in patients who attend similar clinics in Jordan. It could also provide information about community awareness of the role of speech therapists in the management of speech and language disorders. Methodology: The researchers examined the clinical records of 1140 patients (797 males and 343 females) who received clinical services at the UJ-HSC between the years 2009 and 2014 for the purpose of data analysis for this study. The main variables examined in the study were disorder type and gender. Participants were divided into four age groups: children, adolescents, adults, and older adults. The examined disorders were classified as either speech disorders, language disorders, or dysphagia (i.e., swallowing problems). The disorders were further classified as childhood language impairments, articulation disorders, stuttering, cluttering, voice disorders, aphasia, and dysphagia. Results: The results indicated that the prevalence for language disorders was the highest (50.7%) followed by speech disorders (48.3%), and dysphagia (0.9%). The majority of patients who were seen at the JU-HSC were diagnosed with childhood language impairments (47.3%) followed consecutively by articulation disorders (21.1%), stuttering (16.3%), voice disorders (12.1%), aphasia (2.2%), dysphagia (0.9%), and cluttering (0.2%). As for gender, the majority of patients seen at the clinic were males in all disorders except for voice disorders and cluttering. Discussion: The results of the present study indicate that the majority of examined patients were diagnosed with childhood language impairments. Based on this result, the researchers suggest that there seems to be a high prevalence of childhood language impairments among children in Jordan compared to other types of speech and language disorders. The researchers also suggest that there is a need for further examination of the actual prevalence data on speech and language disorders in Jordan. The fact that many of the children seen at the UJ-HSC were brought to the clinic either as a result of parental concern or teacher referral indicates that there seems to an increased awareness among parents and teachers about the services speech pathologists can provide about assessment and treatment of childhood speech and language disorders. The small percentage of other disorders (i.e., stuttering, cluttering, dysphasia, aphasia, and voice disorders) seen at the UJ-HSC may indicate a little awareness by the local community about the role of speech pathologists in the assessment and treatment of these disorders.

Keywords: clinic, disorders, language, profile, speech

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Authors: Nefi Aris Ambar Asmara

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This paper discusses gender equality and career opportunities among female civil servants for better public services in a regency in West Java, Indonesia. Those two areas have not been considered comprehensively in terms of the goals of gender equality and career opportunities. The purposes of this paper are to describe (1) the number of available positions in relation to the number of female civil servants, (2) the socio-cultural outlook on female civil servants in relation to gender equality and career opportunities, and (3) socio-cultural views on gender equality and a career in politics. To achieve these three objectives, this paper used a qualitative approach with survey and interview techniques. The results showed that (1) only 37% of the official positions were presided by female civil servants. In contrast, male civil servants occupy 63% of the available positions, (2) the sociocultural view of female civil servants affirms that they are still regarded as male companions; (3) in addition, female civil servants do not need to compete with gender opponents, including the fact that women enter politics because the political world is considered dirty for women.

Keywords: gender equality, career opportunities, female civil servants, Indonesia

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Authors: Nefi Aris Ambar Asmara

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This paper discusses gender equality and career opportunities among female civil servants for better public services in a regency in West Java, Indonesia. Those two areas have not been considered comprehensively in terms of the goals of gender equality and career opportunities. The purposes of this paper are to describe (1) the number of available positions in relation to the number of female civil servants, (2) the socio-cultural outlook on female civil servants in relation to gender equality and career opportunities and (3) socio-cultural views on gender equality and a career in politics. To achieve these three objectives, this paper used a qualitative approach with survey and interview techniques. The results showed that (1) only 37% of the official positions were presided by female civil servants. In contrast, male civil servants occupy 63% of the available positions, (2) the sociocultural view of female civil servants affirms that they are still regarded as male companions; (3) in addition, female civil servants do not need to compete with gender opponents, including the fact that women enter politics because the political world is considered dirty for women.

Keywords: gender equality, career opportunities, female civil servants, indonesia

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Authors: Panagodage Janaka Sampath Fernando

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Brain circulation has become a buzzword in the skilled migration literature. However, promoting brain circulation; returning of skilled migrants is challenging. Success stories in Asia, for instances, Taiwan, and China, are results of rigorous policy interventions of the respective governments. Nonetheless, the same policy mix has failed in other countries making it skeptical to attribute the success of brain circulation to the policy interventions per se. The paper seeks to answer whether the success of brain circulation within the Knowledge Services Industry (KSI) in Sri Lanka is a policy driven or a market driven process. Mixed method approach, which is a combination of case study and survey methods, was employed. Qualitative data derived from ten case studies of returned entrepreneurs whereas quantitative data generated from a self-administered survey of 205 returned skilled migrants (returned skilled employees and entrepreneurs) within KSI. The pull factors have driven the current flow of brain circulation within KSI but to a lesser extent, push factors also have influenced. The founding stone of the industry has been laid by a group of returned entrepreneurs, and the subsequent growth of the industry has attracted returning skilled employees. Sri Lankan government has not actively implemented the reverse brain drain model, however, has played a passive role by creating a peaceful and healthy environment for the industry. Therefore, in contrast to the other stories, brain circulation within KSI has emerged as a market driven process with minimal government interventions. Entrepreneurs play the main role in a market-driven process of brain circulation, and it is free from the inherent limitations of the reverse brain drain model such as discriminating non-migrants and generating a sudden flow of low-skilled migrants. Thus, to experience a successful brain circulation, developing countries should promote returned entrepreneurs by creating opportunities in knowledge-based industries.

Keywords: brain circulation, knowledge services industry, return migration, Sri Lanka

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Authors: Patience Oluchi Silas, Yemi Adeshina

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Financial transactions involving the use of the internet has become an important practice among commercial banks in Nigeria with the introduction of internet banking and this has improved banking efficiency in rending services to customers. However, customers in Lagos State are enslaved in the fear of insecurity, technical failure, inadequate operational facilities, including improper telecommunications and poor power supply. It is in line with this that this paper explores the obstacles faced by Lagosians, tourists, small scale business owners, companies, customers and the government's attitude in addressing the challenges associated with online banking system in Nigeria through relevant legislations. Internet banking has the potential to transform economic activity and achieve developmental goals. If the associated Challenges are addressed quickly, then it will have the desired impact on the Nigerian economy. In this study, Respondents, mostly bank employees and customers were issued well designed and structured questionnaires to effectively examine the new developments brought about by the introduction of Internet banking and the challenges inhibiting its adoption. Hypotheses were formulated to test assumptions and claims generated from the study. The results were statistically analyzed to address the issues of errors and chances, and at the end, the result of the statistical analysis shows that all especially insecurity, inadequate operational facilities and poor power supply are the significant factors affecting the adoption of internet banking services in Nigeria. The study recommends that for internet banking to assume a developmental dimension in Nigeria and for the country to be fully integrated and respected in global financial environment, the prevalent level of frauds in Lagos State and among Nigerians must first be addressed and the relevant local laws should be put in place and in consonance with international laws and conventions; get the citizens well educated on the intricacies of Internet usage and frauds.

Keywords: internet-banking, adoption, challenges, insecurity, legislation, fraud, Lagos state, statistics

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Authors: Eveline Muika Kabongo, Peter Delobelle, Ferdinand Mukumbang, Edward Nicol

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Introduction: Studies have been conducted to establish the effect of the MomConnect program in South Africa, but these studies did not focus on the stakeholders' and implementers' perspectives and the underlying program theory of the MomConnect initiative program. We strived to obtain stakeholders’ perspectives and assumptions on the MomConnect program and develop an initial program theory (IPT) of how the MomConnect initiative was expected to work. Methods: A realist-informed explanatory design used. The interviewer was performed with 10 key informants selected purposively among MomConnect key informants at the a national level of NDoH South Africa. The interview was done via zoom and lasted for 30 to 60 minutes. Introduction and abduction inferencing approaches were applied. The deductive and inductive approaches were performed during the analysis. ICAMO hereustic framework was used to analysed the data in order to get key informants expectations on how the MomConnect will work or not. Results: We developed three folk’s theories illustrating how the key informants’ expected the MomConnect to work. These theories showed that the MomConnect intended to provide users with health information and education that will empower and motivate them with knowledge which will allow the improvement of health services delivery among HCPs and improvement of the uptake of MCH services among pregnant women and mothers and decrease the rate of maternal and child mortality in the country. The lack of an updated mechanism to link women to the outcome was an issue. Another problem enlightened was the introduction of the WhatsApp program instead of SMS messaging, which was free of charge to women. Conclusion: The Folk’s theory developed from this study provided an insight into how the MomConnect was expected to work and what did not work. The folk’s theory will be merged with information from candidate theories on synthesis review and document review to develop our initial program theory of the MomConnect initiative.

Keywords: mHealth, MomConnect program, realist evaluation, maternal and child health, maternal and child health services, introduction, theory-driven

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Authors: Shola Haruna Adeosun, F. Adebiyi Ajoke, Odedeji Adeoye

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Video billboard advertising by networks and brand switching was conceived out of inquisition at the huge billboard advertising expenditures made by the three major GSM network operators in Nigeria. The study was anchored on Lagos State Metropolis with a current census population over 1,000,000. From this population, a purposive sample of 400 was adopted, and the questionnaire designed for the survey was carefully allocated to members of this ample in the five geographical zones of the city so that each rung of the society was well represented. The data obtained were analyzed using tables and simple percentages. The results obtained showed that subscribers of these networks were hardly influenced by the video billboard advertisements. They overwhelmingly showed that rather than the slogans of the GSM networks carried on the video billboards, it was the incentives to subscribers as well as the promotional strategies of these organizations that moved them to switch from one network to another. These switching lasted only as long as the incentives and promotions were in effect. The results of the study also seemed to rekindle the age-old debate on media effects, by the unyielding schools of the theory of ‘all-powerful media’, ‘the limited effects media’, ‘the controlled effects media’ and ‘the negotiated media influence’.

Keywords: evaluation, impact, video billboard, marketing, services

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Authors: Michaels Aibangbee, Sowbhagya Micheal, Pranee Liamputtong, Elias Mpofu, Tinashe Dune

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Background: The challenges migrants and refugee youth (MRY) experience in maintaining their sexual and reproductive health and rights (SRHR) continues to be a global public health issue. Consequently, MRY is more likely to encounter adverse SRH experiences due to limited access to and knowledge of SRH services. Using a socio-ecological framework, this study examined the MRY’s SRHR micro-level experiences to macro-levels analyses of SRH-related social systems and constructions. Methods: Eighteen focus groups were conducted using participatory action research (PAR) methodology to understand the phenomena. The focus groups included MRY participants (ages 16-26) living in Greater Western Sydney and facilitated by youth project liaisons (YPL). The data was afterward synthesised and analysed using the thematic-synthesis method. Results: In total, 86 MRY (male n= 25, female n= 61) MRY (across 20 different cultural backgrounds) participated in the focus groups. The findings identified socio-ecological factors characterising MRY SRHR, highlighting facilitators such as social media and significant barriers such as lack of access to services and socio-cultural dissonance, and the under-implementation of SRHR support and services by MRY. Key themes from the data included traditional and institutional stigma, lack of SRH education, high reliance on social media for SRH information, anonymity, and privacy concerns. Conclusion: The data shows a limited extent to which MRY SRHR is considered and the intergenerational understanding and stigma affecting the rights of MRY. Therefore, these findings suggest a need for policies and practices to empower MRY’s agency through a collaborative SRHR strategy and policy design to maintain relevance in multicultural contexts.

Keywords: migrant and refugee youth, sexual health, reproductive health, sexual and reproductive health and rights, culture, agency

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Authors: Mazlynda Md Yusuf, Wafa' Mahadzir, Mohamad Yazis Ali Basah

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Nowadays, financing long-term care for elderly people is a crucial issue, either towards the family members or the care institution. Corresponding with the growing number of ageing population in Malaysia, there’s a need of concern on the uncertaintiness of future family care and the need for long-term care services. Moreover, with the increasing cost of living, children feels the urge of needing to work and receive a fixed monthly income that results to sending their elderly parents to care institutions. Currently, in Malaysia, the rates for private nursing homes can amount up to RM 4,000 per month excluding medical treatments and other recurring expenses. These costs are expected to be paid using their Employees Provident Fund (EPF) savings that they accumulate during their working years, especially for those working under private sectors. Hence, this study identifies the adequacy of EPF in funding the cost of long-term care service during old age. This study used a hypothetical simulation model to simulate different scenarios. The findings of this study could be used for individuals to prepare on the importance of planning for retirement, especially with the increasing cost of long-term care services.

Keywords: long-term care cost, employees provident fund Malaysia, ageing population, Malaysian elderly

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Authors: Ahmed Rashad Harb Riad Ismail

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The purpose of this research is to study the potential of Dynamic Pricing if deployed by mobile operators and analyse its effects from both operators and consumers side. Furthermore, to conclude, throughout the research study, the recommended conditions for successful Dynamic Pricing deployment, recommended factors identifying the type of markets where Dynamic Pricing can be effective, and proposal for a Dynamic Pricing stakeholders’ framework were presented. Currently, the mobile telecommunications industry is witnessing a dramatic growth rate in the data consumption, being fostered mainly by higher data speed technology as the 4G LTE and by the smart devices penetration rates. However, operators’ revenue from data services lags behind and is decupled from this data consumption growth. Pricing strategy is a key factor affecting this ecosystem. Since the introduction of the 4G LTE technology will increase the pace of data growth in multiples, consequently, if pricing strategies remain constant, then the revenue and usage gap will grow wider, risking the sustainability of the ecosystem. Therefore, this research study is focused on Dynamic Pricing for 4G LTE data services, researching the drivers, benefits and challenges of 4G LTE Dynamic Pricing and the feasibility of its deployment in practice from different perspectives including operators, regulators, consumers, and telecommunications equipment manufacturers point of views.

Keywords: LTE, dynamic pricing, EPC, research

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Authors: Mohammad Ranjbar, Mohammad Bazyar, Blake Angell, Thomas Lung, Yibeltal Assefa

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Background: Current health insurance programs in Iran suffer from low enrolment and are not sufficient to attain the country to universal health coverage (UHC). We hypothesize that improving the enrollment rate and moving towards a more sustainable UHC can be achieved by improving the benefits package and providing new incentives. The objective of this study is to assess public preferences and willingness to pay (WTP) for social health insurance (SHI) in Iran. Methods: A discrete choice experiment (DCE) was conducted in 2021, using a self-administered questionnaire on 500 participants to estimate WTP and determine individual preferences for the SHI in Yazd, Iran. Respondents were presented with an eight-choice set and asked to select their preferred one. In each choice set, scenarios were described by eight attributes with varying levels. The conditional logit regression model was used to analyze the participants' preferences. Willingness to pay for each attribute was also calculated. Results: Most included attributes were significant predictors of the choice of a health insurance package. The maximum coverage of hospitalization costs in the private sector, ancillary services such as glasses, canes, etc., as well as coverage for hospitalization costs in the public sector and drug costs, were the most important determining factors for this choice. Coverage of preventive dental care did not significantly influence respondent choices. Estimating WTP showed that individuals are willing to pay more for higher financial protection, particularly against private sector costs; the WTP to increase the coverage of hospitalization costs in the private sector from 50% to 90% is estimated at 362,068 IR, Rials per month. Conclusion: This study identifies the key factors that the population value with regard to health insurance and the tradeoffs they are willing to make between them. Hospitalization, drugs, and ancillary services were the most important determining factors for their choice. The data suggest that additional resources coming into the Iranian health system might best be prioritized to cover hospitalization and drug costs and those associated with ancillary services.

Keywords: social health insurance, preferences, discrete choice experiment, willingness to pay

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Authors: Adrian J. Forca, Simeon J. Cainday III

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The Jordan Water District Interactive Billing and Accounting Information Systems is designed for Jordan Water District to uplift the efficiency and effectiveness of its services to its customers. It is designed to process computations of water bills in accurate and fast way through automating the manual process and ensures that correct rates and fees are applied. In addition to billing process, a mobile app will be integrated into it to support rapid and accurate water bill generation. An interactive feature will be incorporated to support electronic billing to customers who wish to receive water bills through the use of electronic mail. The system will also improve, organize and avoid data inaccuracy in accounting processes because data will be stored in a database which is designed logically correct through normalization. Furthermore, strict programming constraints will be plunged to validate account access privilege based on job function and data being stored and retrieved to ensure data security, reliability, and accuracy. The system will be able to cater the billing and accounting services of Jordan Water District resulting in setting forth the manual process and adapt to the modern technological innovations.

Keywords: accounting, bill, information system, interactive

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Authors: Yonathan Audhitya Suthihono, Ratih Dyah Kusumastuti

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The radiology department in a tertiary referral hospital faces service operation challenges such as huge and various patient arrival, which can increase the probability of patient queuing. During the COVID-19 pandemic, it is mandatory to apply social distancing protocol in the radiology department. A strategy to prevent the accumulation of patients at one spot would be required. The aim of this study is to identify an alternative solution which can reduce the patient’s waiting time in radiology department. Discrete event simulation (DES) is used for this study by constructing several improvement scenarios with Arena simulation software. Statistical analysis is used to test the validity of the base case scenario model and to investigate the performance of the improvement scenarios. The result of this study shows that the selected scenario is able to reduce patient waiting time significantly, which leads to more efficient services in a radiology department, be able to serve patients more effectively, and thus increase patient satisfaction. The result of the simulation can be used by the hospital management to improve the operational performance of the radiology department.

Keywords: discrete event simulation, hospital management patient queuing model, radiology department services

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