Search results for: obstacles to healthcare accessibility

Authors: Peter Okpamen

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Food security concentrates on the collective efforts of all nations to produce enough food to feed their people. Recently, though the emphasis shifted from food availability to accessibility constraints, which entails the difficulties undernourished people face in gaining access to food even when it is available. Broadly speaking, access to food depends on an individual’s access to resources, markets and food transfers. The opportunities to obtain food through these channels are entitlements, which when denied constitute food insecurity. Evidence shows that a significant percentage of Nigerians are undernourished with adverse implications for the fight against poverty. The greatest danger or consequence of food insecurity is malnutrition. Food insecurity as both an agent and consequence of poverty also increases the economic, political and social tensions in the country. The undernourished in Nigeria are marginalised in several ways to the extent that they are often ill; and because of illness, their work capacity is reduced with attendant reduction in their income. Without adequate income, they cannot save nor invest enough resources to take care of their basic needs. In this paper therefore, we used the political economy approach and statistical analysis to demonstrate that poverty alleviation in Nigeria would be a mirage if food security problems are not adequately resolved.

Keywords: alleviation, demographic, food insecurity, undernourished

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Authors: Roxan Venter

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Ombudsmen often face the challenge of a lack of authority to have their decisions and recommendations enforced. This lack of authority may be seen as one of the major obstacles in the way of the effectiveness of the institutions of Ombudsman and also the South African Public Protector. The paper will address the current legal position in South Africa with regard to the status of the decisions and recommendations of the South African Public Protector and the enforcement thereof. In addition, the paper will compare the South African position with the experiences of other jurisdictions, including Scandinavian countries like Sweden, Denmark and Norway, but also New Zealand and Northern Ireland, with regard to the enforcement of the decisions of Ombudsmen. Finally, the paper will make recommendations with regard to the enhancement of the power and authority of Ombudsmen in order to effectively enforce their decisions. It is submitted that the creation of the office of Ombudsman, and the Public Protector in the South African system, is an essential tool to ensure the protection of society against governmental abuse of power and it is therefore imperative to ensure that these watchdogs of democracy are not muzzled by a lack of powers of enforcement.

Keywords: enforcement of decisions of ombudsmen, governmental control, ombudsman, South African public protector

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Authors: Jiazhi Zeng, Leiyu Shi, Xia Zou, Wen Chen, Li Ling

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Background: China is facing the unprecedented challenge of rapidly increasing rural-to-urban migration. Due to the household registration system, migrants are in a vulnerable state when they attempt to access to primary care services. A strong primary care system can reduce health inequities and mitigate socioeconomic disparities in healthcare utilization. Literature indicated that migrants were more reliant on the primary care system than local residents. Although the Chinese government has attached great importance to creating an efficient health system, primary care services are still underutilized. The referral system between primary care institutions and hospitals has not yet been completely established in China. The general populations often go directly to hospitals instead of primary care institutions for their primary care. Primary care institutions generally consist of community health centers (CHCs) and community health stations (CHSs) in urban areas, and township health centers (THCs) and rural health stations (THSs) in rural areas. In addition, primary care services are also provided by the outpatient department of municipal hospitals and tertiary hospitals. A better understanding of migrants’ experiences with primary care in the above-mentioned medical institutions is critical for improving the performance of primary care institutions and providing indications of the attributes that require further attention. The purpose of this pioneering study is to explore rural-to-urban migrants’ experiences in primary care, compare their primary care experiences in four types of medical institutions in Guangzhou, China, and suggest implications for targeted interventions to improve primary care for the migrants. Methods: This was a cross-sectional study conducted with 736 rural-to-urban migrants in Guangzhou, China, in 2014. A multistage sampling method was employed. A validated Chinese version of Primary Care Assessment Tool - Adult Short Version (PCAT-AS) was used to collect information on migrants’ primary care experiences. The PCAT-AS consists of 10 domains. Analysis of covariance was conducted for comparison on PCAT domain scores and total scores among migrants accessing four types of medical institutions. Multiple linear regression models were used to explore factors associated with PCAT total scores. Results: After controlling for socio-demographic characteristics, migrant characteristics, health status and health insurance status, migrants accessing primary care in tertiary hospitals had the highest PCAT total scores when compared with those accessing primary care THCs/ RHSs (25.49 vs. 24.18, P=0.007) and CHCs/ CHSs(25.49 vs. 24.24, P=0.006). There was no statistical significant difference for PCAT total scores between migrants accessing primary care in CHCs/CHSs and those in municipal hospitals (24.24 vs. 25.02, P=0.436). Factors positively associated with higher PCAT total scores also included insurance covering parts of healthcare payment (P < 0.001). Conclusions: This study highlights the need for improvement in primary care provided by primary care institutions for rural-to-urban migrants. Migrants receiving primary care from THCs, RHSs, CHSs and CHSs reported worse primary care experiences than those receiving primary care from tertiary hospitals. Relevant policies related to medical insurance should be implemented for providing affordable healthcare services for migrants accessing primary care. Further research exploring the specific reasons for poorer PCAT scores of primary care institutions users will be needed.

Keywords: China, PCAT, primary care, rural-to-urban migrants

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Authors: Felyppe Blum Goncalves, Juliana Sebastiany

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In line with Brazilian legislation on the inclusion of persons with disabilities in the world of work, known as the 'quota law' (Law 8213/91) and in accordance with the prerogatives of the United Nations Convention on Human Rights of people with disabilities, which was ratified by Brazil through Federal Decree No. 6.949 of August 25, 2009, the SESI National Department, through Working Groups, structured the product Affordable Industry. This methodology aims to prepare the industries for the adequate process of inclusion of people with disabilities, as well as the development of an organizational culture that values and respects human diversity. All industries in Brazil with 100 or more employees must comply with current legislation, but due to the lack of information and guidance on the subject, they end up having difficulties in this process. The methodology brings solutions for companies through the professional qualification of the disabled person, preparation of managers, training of human resources teams and employees. It also advocates the survey of the architectural accessibility of the factory and the identification of the possibilities of inclusion of people with disabilities, through the compatibility between work and job requirements, preserving safety, health, and quality of life.

Keywords: inclusion, app, disability, management

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Authors: Maznieda Mahjom, Rohaida Ismail, Masita Arip, Mohd Shaiful Azlan, Nor’Ashikin Othman, Hafizah Abdullah, nor Zahrin Hasran, Joshita Jothimanickam, Syaqilah Shawaluddin, Nadia Mohamad, Raheel Nazakat, Tuan Mohd Amin, Mizanurfakhri Ghazali, Rosmanajihah Mat Lazim

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COVID-19 outbreak is particularly detrimental to the mental health of everyone as well as leaving a long devastating crisis in the healthcare sector. Daily increment of COVID-19 cases and close contact, necessitating the testing of a large number of samples, thus increasing the workload and burden to laboratory personnel. This study aims to determine the prevalence of personal-, work- and client-related burnout as well as to measure the concentration of salivary cortisol among laboratory personnel in the main laboratories in Klang Valley, Malaysia. This cross-sectional study was conducted in late 2021 and recruited a total of 404 respondents from three laboratories in Klang Valley, Malaysia. The level of burnout was assessed using Copenhagen Burnout Inventory (CBI) comprising three sub-dimensions of personal-, work- and client-related burnout. The cut-off score of 50% and above indicated possible burnout. Meanwhile, salivary cortisol was measured using a competitive enzyme immunoassay kit (Salimetrics, State College, PA, USA). Normal levels of salivary cortisol concentration in adults are within 0.094 to 1.551 μg/dl (morning) and can be none detected to 0.359 μg/dl (evening). The prevalence of personal-, work- and client-related burnout among laboratory personnel were 36.1%, 17.8% and 7.2% respectively. Meanwhile, the abnormal morning and evening cortisol concentration recorded were 29.5% and 21.8% excluding 6.9%-7.4% missing data. While the IgA level is normal for most of the respondents, which recorded at 95.53%. Laboratory personnel were at risk of suffering burnout during the COVID-19 pandemic. Thus, mental health programs need to be addressed at the department and hospital level by regularly screening healthcare workers and designing an intervention program. It is also vital to improve the coping skills of laboratory personnel by increasing the awareness of good coping skill techniques. The training must be in an innovative way to ensure that the lab personnel can internalise the technique and practise it in real life.

Keywords: burnout, COVID-19, laborotary personnel, salivary cortisol

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Authors: Akriti Kafle Baral, Ruixing Zhang, Dzifa K Lalit, Manthar M Alli

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Introduction: Hemodialysis is the most common type of dialysis globally approximately million are reported to receive this type of dialysis. Psychosocial issues in hemodialysis are the psychological and socioeconomic burdens emanating from the initiation and course of treatment and have the potential for gross deterioration in the quality of life and general well-being of patients. Understanding the psychosocial issues and needs of patients undergoing hemodialysis could pave the way for comprehensive support and therapies designed to reduce stress, improve social support, and foster mental resilience. Objectives: The aim of this study was to explore the psychosocial issues and support needs of patients undergoing hemodialysis at a tertiary care center in Nepal. Methods: A qualitative descriptive study was conducted among 20 purposefully selected patients attending hemodialysis treatment at Pokhara Academy of Health Sciences, Nepal. Data was analyzed via thematic analysis. Results: The study resulted in three major themes which included Emotional, psychological, and spiritual struggles, Social and economic impacts, and Support and information needs. Moreover, 16 sub-themes emerged which are Frustration with daily life, Constant fear of death, Thoughts of self-harm, Perceived Burden on Family, Sense of Divine Punishment, Sense of Unfairness, Fear about future uncertainties, Social avoidance, Social stigmatization, Loss of employment, Financial strain, Transportation challenges, Need for early, clear and comprehensive information, Need for support and reassurance from family, Support through peer connections, and Reassurance from healthcare providers. Conclusion: The findings of this study indicate that patients undergoing hemodialysis in Nepal experience numerous hardships and multifaceted struggles that require support from different dimensions. Establishing robust support systems that include family involvement, peer networks, and effective communication from healthcare professionals can significantly mitigate feelings of anxiety and isolation.

Keywords: hemodialysis, psychosocial issues, support needs, chronic kidney disease, end stage renal disease, Nepal

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Authors: Tahsien Mohamed Okasha

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Simulation is one of the emerging educational strategies that depend on the creation of scenarios to imitate what could happen in real life. At the time of COVID, we faced big obstacles in medical education, specially the clinical part and how we could apply it, the simulation was the golden key. Simulation is a very important tool of education for medical sector students, through creating a safe, changeable, quiet environment with less anxiety level for students to practice and to have repeated trials on their competencies. That impacts the level of practice, achievement, and the way of acting in real situations and experiences. A blind Random sample of students from different specialties and colleges who came and finished their training in an integrated environment was collected and tested, and the responses were graded from (1-5). The results revealed that 77% of the studied subjects agreed that dealing and interacting with different medical sector candidates in the same place was beneficial. 77% of the studied subjects agreed that simulations were challenging in thinking and decision-making skills .75% agreed that using high-fidelity manikins was helpful. 75% agree .76% agreed that working in a safe, prepared environment is helpful for realistic situations.

Keywords: simulation, clinical training, education, medical sector students

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Authors: Enu Anand, Jayakant Singh

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Menstruation among women is an integral part and a natural process that starts with menarche and stops at menopause. Women use sanitary pad, clothes and other methods to prevent blood stain from becoming evident. This paper examines the prevalence and discrepancies in use of hygienic method during menstruation among unmarried women in India using nationally representative District Level Household and facility Survey data (2007-08). The findings suggest that only one-third of the study population used hygienic method during menstruation. Rural-urban and poor-non poor disparity persists across all background characteristics in use of hygienic method. Women with high school and above education (OR=8.8, p<0.001), from richest wealth quintile (OR=5.2, p<0.001) and women following Christian religion (OR=3.6, p<0.001) are more likely to use hygienic method as compared to women with no education, poor household and Hindu women respectively. Locally prepared, low-cost sanitary pads can be promoted across the country for easy accessibility and affordability. Efforts should be made to produce locally prepared low-cost sanitary napkins in bulk and supply it through female health workers such as ANM and Anganwadi worker across the country.

Keywords: menstrual hygiene, sanitary pad, unmarried women, India

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Authors: Rozo D. Juan Felipe, Ramírez L. Leonardo Juan, Puerta A. Gabriel Alberto

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The telemedicine services require correct computing resource management to guarantee productivity and efficiency for medical and non-medical staff. The aim of this study was to examine web management strategies to ensure the availability of resources and services in telemedicine so as to provide medical information management with an accessible strategy. In addition, to evaluate the quality-of-service parameters, the followings were measured: delays, throughput, jitter, latency, available bandwidth, percent of access and denial of services based of web management performance map with profiles permissions and database management. Through 24 different test scenarios, the results show 100% in availability of medical information, in relation to access of medical staff to web services, and quality of service (QoS) of 99% because of network delay and performance of computer network. The findings of this study suggest that the proposed strategy of web management is an ideal solution to guarantee the availability, reliability, and accessibility of medical information. Finally, this strategy offers seven user profile used at telemedicine center of Bogota-Colombia keeping QoS parameters suitable to telemedicine services.

Keywords: availability, medical information, QoS, strategy, telemedicine

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Authors: Elena Even-Simkin

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Attention Deficit Hyperactivity Disorder (ADHD) is one of the most frequently diagnosed disorders in children, but in many cases, the diagnosis is not provided until adulthood. Diagnosing adults with ADHD faces different obstacles due to numerous factors, such as educational or under-resourced familial environment, high intelligence compensating for stress-inducing difficulties, and additional comorbidities. Undiagnosed children and adolescents with ADHD may become undiagnosed adults with ADHD, who miss out on the early treatment and may experience significant social and pragmatic difficulties, leading to functional problems that subsequently affect their lifestyle, education, and occupational functioning. The proposed study presents a cost-effective and unique consideration of the pragmatic aspect among adults with ADHD. It provides a systematic and standardized evaluation of the pragmatic level in adults with ADHD, based on a comprehensive approach introduced by Arcara & Bambini (2016) for the assessment of pragmatic abilities in neuro-typical individuals. This assessment tool can promote the inclusion of pragmatic skills in the cognitive profile in the diagnostic practice of ADHD, and, thus, the proposed instrument can help not only identify the pragmatic difficulties in the ADHD population but also advance effective intervention programs that specifically focus on pragmatic skills in the targeted population.

Keywords: ADHD, adults, assessment, pragmatics

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Authors: Shruti Chopra, Vikas Rao Vadi

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In the era of the digital world, the Internet of Things (IoT) has been receiving significant attention. Its ubiquitous connectivity between humans, machines to machines (M2M) and machines to humans provides it a potential to transform the society and establish an ecosystem to serve new dimensions to the economy of the country. Thereby, this study has attempted to identify the challenges that seem prevalent in IoT adoption in India through the literature survey. Further, the data has been collected by taking the opinions of experts to conduct the foresight analysis and it has been analyzed with the help of scenario planning process – Micmac, Mactor, Multipol, and Smic-Prob. As a methodology, the study has identified the relationship between variables through variable analysis using Micmac and actor analysis using Mactor, this paper has attempted to generate the entire field of possibilities in terms of hypotheses and construct various scenarios through Multipol. And lastly, the findings of the study include final scenarios that are selected using Smic-Prob by assigning the probability to all the scenarios (including the conditional probability). This study may help the practitioners and policymakers to remove the obstacles to successfully implement the IoT in India.

Keywords: Internet of Thing (IoT), foresight analysis, scenario planning, challenges, policymaking

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Authors: Flutura Tahiraj, Emine Abdyli

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As a new alternative, mediation is integrated in the legislation of both developed and developing countries in Europe. Various researches in member states of the Council of Europe revealed obstacles, particularly related to the implementation of mediation in criminal matters. They are addressed through several recommendations and non-binding guidelines. However, there is limited empirical research on how the mediation in criminal matters is being implemented in the contexts of developing countries in South-Eastern Europe. Hence, the purpose of this qualitative study is to assess mediation in criminal matters in Kosovo by exploring how the main stakeholders describe the legal basis and implementation process and what it indicates for future practices. The data were gathered through 11 semi-structured interviews with judges, prosecutors, mediation clerks and mediators. Results show that laws and other guidelines that have been introduced since 2008 constitute a solid legal ground that facilitates mediation in criminal matters. The stakeholders are well aware of benefits mediation brings and express their willingness to advance its application to criminal matters. Results also indicate uncertainty among judges and prosecutors regarding the assessment and referral of certain criminal offences to mediation. To address it, specialized trainings, exchange programs and continuous monitoring and evaluation of the process could be supportive.

Keywords: mediation in criminal matters, legislation, implementation of mediation

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Authors: Freya Harding, Anne Gatuguta, Chi Eziefula

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Introduction Research shows the quality of experiences of pregnancy, birth, and postpartum impacts the health and well-being of the mother and baby. This is recognised by the WHO in their recommendations ‘Intrapartum care for a positive childbirth experience’. The COVID-19 pandemic saw the transformation of the NHS Maternity services to prevent the transmission of COVID-19. Physical and social isolation may have affected women’s experiences of pregnancy, birth and postpartum; especially those of healthcare. Examples of such changes made to the NHS include both the reduction in volume of face-to-face consultations and restrictions to visitor time in hospitals. One notable detriment due to these changes was the absence of a partner during certain stages of birth. The aim of this study was to explore women’s experiences of pregnancy, birth, and postnatal period during the COVID-19 pandemic in the UK. Methods We collected qualitative data from women who had given birth during the COVID-19 pandemic. In-depth, semi-structured interviews were conducted with twelve participants recruited from mother and baby groups in Southeast England. Data were audio-recorded, transcribed verbatim, and analysed thematically using both inductive and deductive approaches. Ethics permission was granted from Brighton and Sussex Medical School (ER/BSMS9A83/1). Results Interviews were conducted with 12 women who gave birth between May 2020 and February 2021. Ages of the participants ranged between 28 and 42 years, most of which were white British, with one being Asian British. All participants were heterosexual and either married or co-habiting with their partner. Five participants worked in the NHS, and all participants had professional occupations. Women felt inadequately supported both socially and medically. An appropriate sense of control over their own birthing experience was lacking. Safety mechanisms, such as in-person visits from the midwife, had no suitable alternatives in place. Serious health issues were able to “slip through the net.” Mental health conditions in some of those interviewed worsened or developed. Similarly, reduced support from partners during birth and during the immediate postpartum period at the hospital, coupled with reduced ward staffing, resulted in some traumatic experiences; particularly for women who had undergone caesarean section. However, some unexpected positive effects were reported; one example being that partners were able to spend more time with their baby due to furlough schemes and working from home. Similarly, emergency care was not felt to have been compromised. Overall, six themes emerged: (1) Self-reported traumatic experiences, (2) Challenges of caring for a baby with reduced medical and social support, (3) Unexpected benefits to the parenting experience, (4) The effects of a sudden change in medical management (5) Poor communication from healthcare professionals (6) Social change; with subthemes of support accessing medical care, the workplace, family and friends, and antenatal & baby groups. Conclusions The results indicate that the healthcare system was unable to adequately deliver maternity care to facilitate positive pregnancy, birth, and postnatal experiences during the heights of the pandemic. The poor quality of such experiences has been linked an increased risk of long-term health complications in both the mother and child.

Keywords: pregnancy, birth, postpartum, postnatal, COVID-19, maternity, social support, qualitative, pandemic

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Authors: Wafa Nouari

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The paper investigates the advantages and drawbacks of online creative writing courses for Algerian university students, particularly in light of the COVID-19 pandemic. The paper employs a mixed-methods approach, using both quantitative and qualitative data from surveys, interviews, and online course evaluations. The paper examines three online creative writing courses offered by Oxford University, Stanford University, and Coursera. The paper shows that online creative writing courses can improve the student's writing abilities, enthusiasm, and self-confidence, as well as introduce them to various literary forms and cultures. However, the paper also highlights some challenges and obstacles that the students encounter, such as technical problems, language difficulties, cultural gaps, and lack of feedback and interaction. The paper argues that online creative writing courses can be a useful alternative or addition to conventional classroom instruction, especially during the pandemic. The paper also offers some suggestions for enhancing the quality and effectiveness of online creative writing courses, such as giving more direction, support, and feedback to the students, as well as creating a sense of community and cooperation among them.

Keywords: online creative writing courses, Algerian university students, mixed methods approach, benefits and chanllenges

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Authors: K. K. Riabchenko, T. V Rybitskaya, A. A. Starostenko

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Sper Charm-Tau Factory is a double ring e+e- collider to be operated in the center-of-mass energy range from 2 to 6 GeV, with a peak luminosity of about 1035 cm-2s-1 (Crab Waist collision) and with longitudinally polarized electrons at the IP (interaction point). One of the important elements of the cτ-factory is the superconducting two-aperture quadrupole of the final focus. It was decided to make a full-scale prototype quadrupole. The main objectives of our study included: 1) 3D modeling of the quadrupole in the Opera program, 2) Optimization of the geometry of the quadrupole lens, 3) Study of the influence of magnetic properties and geometry of a quadrupole on integral harmonics. In addition to this, the ways of producing unwanted harmonics have been studied. In the course of this work, a 3D model of a two-aperture iron superconducting quadrupole lens was created. A three-dimensional simulation of the magnetic field was performed, and the geometrical parameters of the lens were selected. Calculations helped to find sources of possible errors and methods for correcting unwanted harmonics. In addition to this, calculations show that there are no obstacles to the production of a prototype lens.

Keywords: super cτ-factory, final focus, twin aperture quadrupole lens, integral harmonics

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Authors: Botirjon Kosimov

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This work sheds light on the reforms towards the independence of the judiciary in Uzbekistan, as well as issues of further ensuring judicial independence in the country based on international values, particularly the legal practice of the United States. In every democratic state infringed human rights are reinstated and violated laws are protected by the help of justice based on the strict principle of judicial independence. The realization of this principle in Uzbekistan has been paid much attention since the proclamation of its independence. In the country, a series of reforms have been implemented in the field of the judiciary in order to actualize the principle of judicial independence. Uzbekistan has been reforming the judiciary considering both international and national values and practice of foreign countries. While forming a democratic state based on civil society, Uzbekistan shares practice with the most developed countries in the world. The United States of America can be a clear example which is worth learning how to establish and ensure an independent judiciary. It seems that although Uzbekistan has reformed the judiciary efficiently, it should further reform considering the legal practice of the United States.

Keywords: dependent judges, independent judges, judicial independence, judicial reforms, judicial life tenure, obstacles to judicial independence

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Authors: Agastya Pratap Singh

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This review paper examines the emerging applications of generative adversarial networks (GANs) in the fields of image recognition and anomaly detection. With the rapid growth of digital image data, the need for efficient and accurate methodologies to identify and classify images has become increasingly critical. GANs, known for their ability to generate realistic data, have gained significant attention for their potential to enhance traditional image recognition systems and improve anomaly detection performance. The paper systematically analyzes various GAN architectures and their modifications tailored for image recognition tasks, highlighting their strengths and limitations. Additionally, it delves into the effectiveness of GANs in detecting anomalies in diverse datasets, including medical imaging, industrial inspection, and surveillance. The review also discusses the challenges faced in training GANs, such as mode collapse and stability issues, and presents recent advancements aimed at overcoming these obstacles.

Keywords: generative adversarial networks, image recognition, anomaly detection, synthetic data generation, deep learning, computer vision, unsupervised learning, pattern recognition, model evaluation, machine learning applications

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Authors: Neda Rezvanisanijouybari

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Cities are living and dynamic organisms that can play an essential role in meeting people's psychological and mental needs. The green and blue spaces, including parks, play an important role in meeting those needs, and therefore they should be prioritised in urban planning and designing. Sari city had several city designs and planning projects to expand the green spaces. These included adding more parks and open spaces with new urban furniture in the city and were an important step forward in creating a pleasant urban landscape in the north of Iran. This research used quantitative and qualitative methods to examine whether the citizens of Sari were satisfied with green and blue spaces and new urban furniture in the city or not. From a questionnaire of 120 Sari citizens, it was found that the citizens were generally satisfied with the green and blue spaces and new urban furniture in Sari. It was also found that the favourite park was Mellal park, and the least favourite was Azadegan park. Accessibility, safety, design, facilities, and water source were the most important reason to visit the parks.

Keywords: satisfaction, green, blue, urban furniture

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Authors: Mamadou Diop, Florence Crick, Momadou Sow, Kate Elizabeth Gannon

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Understanding SME leaders’ responses to climate is essential to cope with ongoing changes in temperature and rainfall. This study analyzes the response of SME leaders to the adverse effects of climate change in semi-arid lands (SAL) in Senegal. Based on surveys administrated to 161 SME leaders, this research shows that 91% of economic units are affected by climatic conditions, although 70% do not have a plan to deal with climate risks. Economic actors have striven to take measures to adapt. However, their efforts are limited by various obstacles accentuated by a lack of support from public authorities. In doing so, substantial political, institutional and financial efforts at national and local levels are needed to promote an enabling environment for economic actors to adapt. This will focus on information and training about the threats and opportunities related to global warming, the creation of an adaptation support fund to support local initiatives and the improvement of the institutional, regulatory and political framework.

Keywords: small and medium-sized enterprises, climate change, adaptation, semi-arid lands

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Authors: Khodijah Ismail, Elfindri

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Tourism development have many environmental, economically and sociocultural benefits. Small islands have a lot of potential for marine tourism development. But, stereotype gender issues still dominate the social and cultural life of rural communities that have an impact on the gap in benefits of local development. The purpose of this study is to found development strategy concept of marine tourism in small islands gender-based. This study found in the marine tourism development of small islands not involved women, from planning to monitor marine tourism development in small islands. It's affects to the low of socio-economic of women in the coastal village and small islands. This condition is not advantage for sustainable development of marine tourism in small islands. Therefore, strengthening of livelihood assets by gender based through the marine tourism development in small islands is very important to attention, that women can contributed to household welfare, bargaining positioned in social culture was better and increase broad access to local government development policies. To realize it requires the full support of the government and relevant stakeholders through gender empowerment and strengthening of accessibility, connectivity, regulation, and design institution.

Keywords: gender inequality, marine tourism, development, tourism management

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Authors: Supriyo Das, Elbir Jove, Ajay Singh, Sophie Corbet, Noel Carr, Martin Deetz

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Water is a critical commodity in the healthcare and medical field. The utility of medical-grade water spans from washing surgical equipment, drug preparation to the key element of life-saving therapy such as hydrotherapy and hemodialysis for patients. A properly treated medical water reduces the bioburden load and mitigates the risk of infection, ensuring patient safety. However, any compromised condition during the production of medical-grade water can create a favorable environment for microbial growth putting patient safety at high risk. Therefore, proper upstream treatment of the medical water is essential before its application in healthcare, pharma and medical space. Reverse Osmosis (RO) is one of the most preferred treatments within healthcare industries and is recommended by all International Pharmacopeias to achieve the quality level demanded by global regulatory bodies. The RO process can remove up to 99.5% of constituents from feed water sources, eliminating bacteria, proteins and particles sizes of 100 Dalton and above. The combination of RO with other downstream water treatment technologies such as Electrodeionization and Ultrafiltration meet the quality requirements of various pharmacopeia monographs to produce highly purified water or water for injection for medical use. In the reverse osmosis process, the water from a liquid with a high concentration of dissolved solids is forced to flow through an especially engineered semi-permeable membrane to the low concentration side, resulting in high-quality grade water. However, these specially engineered RO membranes need to be sanitized either chemically or at high temperatures at regular intervals to keep the bio-burden at the minimum required level. In this paper, we talk about Dupont´s FilmTec Heat Sanitizable Reverse Osmosis membrane (HSRO) for the production of medical-grade water. An HSRO element must be pre-conditioned prior to initial use by exposure to hot water (80°C-85°C) for its stable performance and to meet the manufacturer’s specifications. Without pre-conditioning, the membrane will show variations in feed pressure operations and salt rejection. The paper will discuss the critical variables of pre-conditioning steps that can affect the overall performance of the HSRO membrane and demonstrate the data to support the need for pre-conditioning of HSRO elements. Our preliminary data suggests that there can be up to 35 % reduction in flow due to initial heat treatment, which also positively affects the increase in salt rejection. The paper will go into detail about the fundamental understanding of the performance change of HSRO after the pre-conditioning step and its effect on the quality of medical water produced. The paper will also discuss another critical point, “regular hot water sanitization” of these HSRO membranes. Regular hot water sanitization (at 80°C-85°C) is necessary to keep the membrane bioburden free; however, it can negatively impact the performance of the membrane over time. We will demonstrate several data points on hot water sanitization using FilmTec HSRO elements and challenge its robustness to produce quality medical water. The last part of this paper will discuss the construction details of the FilmTec HSRO membrane and features that make it suitable to pre-condition and sanitize at high temperatures.

Keywords: heat sanitizable reverse osmosis, HSRO, medical water, hemodialysis water, water for Injection, pre-conditioning, heat sanitization

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Authors: Hamidrza Joodaki

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The most complex issue in urban land use planning is site selection that needs to assess the verity of elements and factors. Multi Criteria Decision Making (MCDM) methods are the best approach to deal with complex problems. In this paper, combination of the analytical hierarchy process (AHP) model and FUZZY logic was used as MCDM methods to select the best site for gas station in the 4th gas zone of Tehran. The first and the most important step in FUZZY-AHP model is selection of criteria and sub-criteria. Population, accessibility, proximity and natural disasters were considered as the main criteria in this study. After choosing the criteria, they were weighted based on AHP by EXPERT CHOICE software, and FUZZY logic was used to enhance accuracy and to approach the reality. After these steps, criteria layers were produced and weighted based on FUZZY-AHP model in GIS. Finally, through ARC GIS software, the layers were integrated and the 4th gas zone in TEHRAN was selected as the best site to locate gas station.

Keywords: multiple criteria decision making (MCDM), analytic hierarchy process (AHP), FUZZY logic, geographic information system (GIS)

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Authors: Abigail Kusi Amponsah, Evans Frimpong Kyei, John Bright Agyemang, Hanson Boakye, Joana Kyei-Dompim, Collins Kwadwo Ahoto, Evans Oduro

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Staff shortages, deficient knowledge, inappropriate attitudes, demanding workloads, analgesic shortages, and low prioritization of pain management have been identified in earlier studies as the nursing-related barriers to optimal children’s pain management. These studies have mainly been undertaken in developed countries, which have different healthcare dynamics than those in developing countries. The current study, therefore, sought to identify and understand the nursing-related barriers to children’s pain management in the Ghanaian context. A descriptive qualitative study was conducted among 28 purposively sampled nurses working in the pediatric units of five hospitals in the Ashanti region of Ghana. Over the course of three months, participants were interviewed on the barriers which prevented them from optimally managing children’s pain in practice. Recorded interviews were transcribed verbatim and deductively analysed based on a conceptual interest in pain assessment and management-related barriers. NVivo 12 plus software guided data management and analyses. The mean age of participating nurses was 30 years, with majority being females (n =24). Participants had worked in the nursing profession for an average of five years and in the pediatric care settings for an average of two years. The nursing-related barriers identified in the present study included communication difficulties in assessing and evaluating pain management interventions with children who have nonfunctional speech, insufficient training, misconceptions on the experience of pain in children, lack of assessment tools, and insufficient number of nurses to manage the workload and nurses’ inability to prescribe analgesics. The present study revealed some barriers which prevented Ghanaian nurses from optimally managing children’s pain. Nurses should be educated, empowered, and supported with the requisite material resources to effectively manage children’s pain and improve outcomes for families, healthcare systems, and the nation. Future studies should explore the facilitators and barriers from other stakeholders involved in pediatric pain management

Keywords: Nursing-Related Barriers, Children, Pain Management, Ghana

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Authors: Mokrani Mohamed Amine

Abstract:

In this paper, we have implemented successive interference cancellation algorithms in the 5G downlink. We have calculated the maximum throughput in Frequency Division Duplex (FDD) mode in the downlink, where we have obtained a value equal to 836932 b/ms. The transmitter is of type Multiple Input Multiple Output (MIMO) with eight transmitting and receiving antennas. Each antenna among eight transmits simultaneously a data rate of 104616 b/ms that contains the binary messages of the three users; in this case, the Cyclic Redundancy Check CRC is negligible, and the MIMO category is the spatial diversity. The technology used for this is called Non-Orthogonal Multiple Access (NOMA) with a Quadrature Phase Shift Keying (QPSK) modulation. The transmission is done in a Rayleigh fading channel with the presence of obstacles. The MIMO Successive Interference Cancellation (SIC) receiver with two transmitting and receiving antennas recovers its binary message without errors for certain values of transmission power such as 50 dBm, with 0.054485% errors when the transmitted power is 20dBm and with 0.00286763% errors for a transmitted power of 32 dBm(in the case of user 1) as well as with 0.0114705% errors when the transmitted power is 20 dBm also with 0.00286763% errors for a power of 24 dBm(in the case of user2) by applying the steps involved in SIC.

Keywords: 5G, NOMA, QPSK, TBS, LDPC, SIC, capacity

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Authors: Indraj Singh, Xuan Lee, Yu-Chieh Cheng

Abstract:

Scientists are very keen on biomimetic research that mimics biological species to micro-robotic devices with the novel functionalities and accessibility. The source of inspiration is the complexity, sophistication, and intelligence of the biological systems. In this work, we design a light-driven star-shaped microgripper, an autonomous soft device which can change the shape under the external stimulus such as light. The design is based on light-responsive Liquid Crystal Elastomers which fabricated onto the polymer coated aligned substrate. The change in shape, controlled by the anisotropicity and the molecular orientation of the Liquid Crystal Elastomer, based on the external stimulus. This artificial star-shaped microgripper is capable of autonomous closure and capable to grab the objects in response to an external stimulus. This external stimulus-responsive materials design, based on soft active smart materials, provides a new approach to autonomous, self-regulating optical systems.

Keywords: liquid crystal elastomers, microgripper, smart materials, robotics

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Authors: Aminu Fagge Muhammad

Abstract:

The digital economy is fast becoming the most innovative and widest reaching economy in the world, especially in developing countries. The paper aimed at examining role of digital economy in the emerging countries like Nigeria. The methodology used in the study is Business Model Perspective: lying between the process and structural perspectives, bring in the idea of the new business models that are being enabled e.g. e-business or e-commerce. The paper concluded that, the policy objectives and measures, and processes and structures necessary to enhance digital economy growth and its contribution to socio-economic development. The finding reveals that, digital infrastructure is in part incomplete, costly and poorly-performing in emerging economies like Nigeria. The wider digital ecosystem suffers a shortfall in human capabilities, weak financing, and poor governance. It is also found that, Growth in the digital economy is exacerbating digital exclusion, inequality, adverse incorporation and other digital harms. It is recommended that, government in partnership with private sector should build strong local infrastructure to enable broadband availability and accessibility and to create an enabling environment for strong competition in the telecom and technology ecosystem.

Keywords: Digital Economy, Emerging Countries, Business Model , Nigeria

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Authors: Thomas Suarez, Anne-Sophie Grenouilleau, Erwan Autin, Alexandre Biosse-Duplan, Emmanuelle Blondet, Laurence Chazalette, Marie Coniel, Agnes Dessaigne, Sylvie Lascols, Andrea Lasserre, Candice Legris, Pierre Liot, Aline Metais, Karine Petitprez, Christophe Varlet, Christian Saout

Abstract:

Background: The role of biological sex and gender identity -whether assigned or chosen- as health determinants are far from a recent discovery: several reports have stressed out how being a woman or a man could affect health on various scales. However, taking it into consideration beyond stereotypes and rigid binary assumptions still seems to be a work in progress. Method: The report is a synthesis on a variety of specific topics, each of which was studied by a specialist from the French National Authority for Health (HAS), through an analysis of existing literature on both healthcare policy construction process and instruments (norms, data analysis, clinical trials, guidelines, and professional practices). This work also implied a policy analysis of French recent public health laws and a retrospective study of guidelines with a gender mainstreaming approach. Results: The analysis showed that though sex and gender were well-known determinants of health, their consideration by both public policy and health operators was often incomplete, as it does not incorporate how sex and gender interact, as well as how they interact with other factors. As a result, the health and social care systems and their professionals tend to reproduce some stereotypical and inadequate habits. Though the data available often allows to take sex and gender into consideration, such data is often underused in practice guidelines and policy formulation. Another consequence is a lack of inclusiveness towards transgender or intersex persons. Conclusions: This report first urges for raising awareness of all the actors of health, in its broadest definition, that sex and gender matter beyond first-look conclusions. It makes a series of recommendations in order to reshape policy construction in the health sector on the one hand and to design public health instruments to make them more inclusive regarding sex and gender on the other hand. The HAS finally committed to integrate sex and gender preoccupations in its workings methods, to be a driving force in the spread of these concerns.

Keywords: biological sex, determinants of health, gender, healthcare policy instruments, social accompaniment

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Authors: Randa El Bedawy

Abstract:

Exchanging best practices in the scope of entrepreneurship education and the use of experiential learning approaches are growing lately at a very fast pace. Educators should be challenged to promote such a learning approach to bridge the gap between entrepreneurship students and the actual business work environment. The study aims to share best practices, experiences, and knowledge to support entrepreneurship education. The study is exploratory qualitative research based on a case study approach to demonstrate how experiential learning can be used for supporting learning effectiveness in entrepreneurship education through demonstrating a set of fourteen tasks that were used to engage practically the students who were studying a course of entrepreneurship at the American University in Cairo. The study sheds the light on the rational process of using experiential learning to endorse entrepreneurship education through the illustration of each task along with its learning outcomes. The study explores the benefits and obstacles that educators may face when implementing such an experiential approach. The results of the study confirm that developing an experiential learning approach based on constructing a set of well designed practical tasks that complement the overall intended learning outcomes has proven very effective for promoting the students’ learning of entrepreneurship education. However, good preparation for both educators and students is needed primarily to ensure the effective implementation of such an experiential learning approach.

Keywords: business education, entrepreneurship, entrepreneurship education, experiential learning

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Authors: Carlos David Carrillo Trujillo, Rebelín Echeverría Echeverría, Nancy Evia Alamilla, Rocío Quintal López

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Gender as a social construct is a term now widely studied. Within the social sciences it has become very important. In this sense, psychology tries to make some contributions from your area. The intention is to promote equal opportunities for men and women. Social, employment and educational inequities perpetuate sexism, violence and other important social problems in Mexico. The gender perspective is conceptualized as a tool to promote laws, policies, plans, programs and procedures where women are made ​​visible and empowered. The aim of this is the pursuit of equality. Thus, gender mainstreaming is one of the main challenges of education in Mexico. Only a few universities have programs, research or subjects related to the topic. Human resources, and time allocated to teachers are identified as obstacles to the institutionalization of gender. The objective was to make a diagnosis on course offerings and policies on gender. A documentary study and interviews with managers of at least 20 higher education institutions (IES's) were performed. The results indicate the need for greater gender courses, research projects and intervention. The need to promote policies that seek equal opportunities between men and women is also noted.

Keywords: gender mainstreaming, institutionalization, universities, intervention

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Authors: Yaser Ghasemi Aryan, Firoozeh Moghiminejad, Mohammadreza Shahraki

Abstract:

Background: The cooperative institution is considered the first and most essential pillar of strengthening social capital, whose sustainability is the main guarantee of survival and continued participation of local communities in natural resource management projects. The Village Development Group and the Microcredit Fund are two important social and economic institutions in the implementation of the International Project for the Restoration of Degraded Forest Lands (RFLDL) in Sarayan City, South Khorasan Province, which has learned positive lessons from the participation of the beneficiaries in the implementation. They have brought more effective projects to deal with desertification. However, the low activity or liquidation of some of these institutions has become one of the important challenges and concerns of project executive experts. The current research was carried out with the aim of explaining the main components of the instability of these institutions. Materials and Methods: This research is descriptive-analytical in terms of method, practical in terms of purpose, and the method of collecting information is two documentary and survey methods. The statistical population of the research included all the members of the village development groups and microcredit funds in the target villages of the RFLDL project of Sarayan city, based on the Kochran formula and matching with the Karjesi and Morgan table. Net people were selected as a statistical sample. After confirming the validity of the expert's opinions, the reliability of the questionnaire was 0.83, which shows the appropriate reliability of the researcher-made questionnaire. Data analysis was done using SPSS software. Results: The results related to the extraction of obstacles to the stability of social and economic networks were classified and prioritized in the form of 5 groups of social-cultural, economic, administrative, educational-promotional and policy-management factors. Based on this, in the socio-cultural factors, the items ‘not paying attention to the structural characteristics and composition of groups’, ‘lack of commitment and moral responsibility in some members of the group,’ and ‘lack of a clear pattern for the preservation and survival of groups’, in the disciplinary factors, The items ‘Irregularity in holding group meetings’ and ‘Irregularity of members to participate in meetings’, in the economic factors of the items "small financial capital of the fund’, ‘the low amount of loans of the fund’ and ‘the fund's inability to conclude contracts and attract capital from other sources’, in the educational-promotional factors of the items ‘non-simultaneity of job training with the granting of loans to create jobs’ and ‘insufficient training for the effective use of loans and job creation’ and in the policy-management factors of the item ‘failure to provide government facilities for support From the funds, they had the highest priority. Conclusion: In general, the results of this research show that policy-management factors and social factors, especially the structure and composition of social and economic institutions, are the most important obstacles to their sustainability. Therefore, it is suggested to form cooperative institutions based on network analysis studies in order to achieve the appropriate composition of members.

Keywords: cooperative institution, social capital, network analysis, participation, Sarayan.

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