Search results for: health & development

Authors: Abdul Ganiyu Iddrisu, Bei Chen

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Digitization is the process of transforming analog material into digital form, especially for storage and use in a computer. Significant development of information and communication technology (ICT) over the past years has encouraged many researchers to investigate its contribution to promoting economic growth and reducing poverty. Yet the compelling empirical evidence on the effects of digitization on economic growth remains weak, particularly in Africa. This is because extant studies that explicitly evaluate digitization and economic growth nexus are mostly reports and desk reviews. This points out an empirical knowledge gap in the literature. Hypothetically, digitization influences financial sector development which in turn influences economic growth. Digitization has changed the financial sector and its operating environment. Obstacles to access to financing, for instance, physical distance, minimum balance requirements, and low-income flows, among others can be circumvented. Savings have increased, micro-savers have opened bank accounts, and banks are now able to price short-term loans. This has the potential to develop the financial sector. However, empirical evidence on the digitization-financial development nexus is dearth. On the other hand, a number of studies maintained that financial sector development greatly influences growth of economies. We, therefore, argue that financial sector development is one of the transmission mechanisms through which digitization affects economic growth. Employing macro-country-level data from African countries and using fixed effects, random effects and Hausman-Taylor estimation approaches, this paper contributes to the literature by analysing economic growth in Africa, focusing on the role of digitization and financial sector development. First, we assess how digitization influences financial sector development in Africa. From an economic policy perspective, it is important to identify digitization determinants of financial sector development so that action can be taken to reduce the economic shocks associated with financial sector distortions. This nexus is rarely examined empirically in the literature. Secondly, we examine the effect of domestic credit to the private sector and stock market capitalization as a percentage of GDP as used to proxy for financial sector development on economic growth. Digitization is represented by the volume of digital/ICT equipment imported and GDP growth is used to proxy economic growth. Finally, we examine the effect of digitization on economic growth in the light of financial sector development. The following key results were found; first, digitalization propels financial sector development in Africa. Second, financial sector development enhances economic growth. Finally, contrary to our expectation, the results also indicate that digitalization conditioned on financial sector development tends to reduce economic growth in Africa. However, results of the net effects suggest that digitalization, overall, improve economic growth in Africa. We, therefore, conclude that, digitalization in Africa does not only develop the financial sector but unconditionally contributes the growth of the continent’s economies.

Keywords: digitalization, financial sector development, Africa, economic growth

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Authors: Guenther Schuh, Michael Riesener, Jan Kantelberg

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Due to the fugacity of markets and the reduction of product lifecycles, manufacturing companies from high-wage countries are nowadays faced with the challenge to place more innovative products within even shorter development time on the market. At the same time, volatile customer requirements have to be satisfied in order to successfully differentiate from market competitors. One potential approach to address the explained challenges is provided by agile values and principles. These agile values and principles already proofed their success within software development projects in the form of management frameworks like Scrum or concrete procedure models such as Extreme Programming or Crystal Clear. Those models lead to significant improvements regarding quality, costs and development time and are therefore used within most software development projects. Motivated by the success within the software industry, manufacturing companies have tried to transfer agile mechanisms of action to the development of hardware products ever since. Though first empirical studies show similar effects in the agile development of hardware products, no comprehensive procedure model for the design of development iterations has been developed for hardware development yet due to different constraints of the domains. For this reason, this paper focusses on the design of agile product development processes by transferring mechanisms of action used in agile software development towards product development. This is conducted by decomposing the individual systems 'product development' and 'agile software development' into relevant elements and symbiotically composing the elements of both systems in respect of the design of agile product development processes afterwards. In a first step, existing product development processes are described following existing approaches of the system theory. By analyzing existing case studies from industrial companies as well as academic approaches, characteristic objectives, activities and artefacts are identified within a target-, action- and object-system. In partial model two, mechanisms of action are derived from existing procedure models of agile software development. These mechanisms of action are classified in a superior strategy level, in a system level comprising characteristic, domain-independent activities and their cause-effect relationships as well as in an activity-based element level. Within partial model three, the influence of the identified agile mechanism of action towards the characteristic system elements of product development processes is analyzed. For this reason, target-, action- and object-system of the product development are compared with the strategy-, system- and element-level of agile mechanism of action by using the graph theory. Furthermore, the necessity of existence of activities within iteration can be determined by defining activity-specific degrees of freedom. Based on this analysis, agile product development processes are designed in form of different types of iterations within a last step. By defining iteration-differentiating characteristics and their interdependencies, a logic for the configuration of activities, their form of execution as well as relevant artefacts for the specific iteration is developed. Furthermore, characteristic types of iteration for the agile product development are identified.

Keywords: activity-based process model, agile mechanisms of action, agile product development, degrees of freedom

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Authors: Giuliana Murfet, Heidi Behrens

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Chronic disease is Australia’s biggest health concern and obesity the leading risk factor for many. Obesity and chronic disease have a higher representation in rural Tasmania, where levels of socio-disadvantage are also higher. People living outside major cities have less access to health services and poorer health outcomes. To help primary healthcare professionals manage obesity, the Australian NHMRC evidence-based clinical practice guidelines for management of overweight and obesity in adults were developed. They include recommendations for practice and models for obesity management. To our knowledge there has been no research conducted that investigates translation of these guidelines into practice in rural-regional areas; where implementation can be complicated by limited financial and staffing resources. Also, the systematic review that informed the guidelines revealed a lack of evidence for chronic disease models of obesity care. The aim was to establish and evaluate a multidisciplinary model for obesity management in a group of adult people with type 2 diabetes in a dispersed rural population in Australia. Extensive stakeholder engagement was undertaken to both garner support for an obesity clinic and develop a sustainable model of care. A comprehensive nurse practitioner-led outpatient model for obesity care was designed. Multidisciplinary obesity clinics for adults with type 2 diabetes including a dietitian, psychologist, physiotherapist and nurse practitioner were set up in the north-west of Tasmania at two geographically-rural towns. Implementation was underpinned by the NHMRC guidelines and recommendations focused on: assessment approaches; promotion of health benefits of weight loss; identification of relevant programs for individualising care; medication and bariatric surgery options for obesity management; and, the importance of long-term weight management. A clinical pathway for adult weight management is delivered by the multidisciplinary team with recognition of the impact of and adjustments needed for other comorbidities. The model allowed for intensification of intervention such as bariatric surgery according to recommendations, patient desires and suitability. A randomised controlled trial is ongoing, with the aim to evaluate standard care (diabetes-focused management) compared with an obesity-related approach with additional dietetic, physiotherapy, psychology and lifestyle advice. Key barriers and enablers to guideline implementation were identified that fall under the following themes: 1) health care delivery changes and the project framework development; 2) capacity and team-building; 3) stakeholder engagement; and, 4) the research project and partnerships. Engagement of not only local hospital but also state-wide health executives and surgical services committee were paramount to the success of the project. Staff training and collective development of the framework allowed for shared understanding. Staff capacity was increased with most taking on other activities (e.g., surgery coordination). Barriers were often related to differences of opinions in focus of the project; a desire to remain evidenced based (e.g., exercise prescription) without adjusting the model to allow for consideration of comorbidities. While barriers did exist and challenges overcome; the development of critical partnerships did enable the capacity for a potential model of obesity care for rural regional areas. Importantly, the findings contribute to the evidence base for models of diabetes and obesity care that coordinate limited resources.

Keywords: diabetes, interdisciplinary, model of care, obesity, rural regional

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Authors: Michel Mikhail

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Introduction: Values, which are the guiding principles and beliefs of our lives, have an influence on one’s psychological health. This study aims to investigate how Schwartz’s four higher-order values (conservation, openness to change, self-transcendence, and self-enhancement) and religious values influence psychological health among the Arab population. Methods: A total of 1,023 respondents from nine Arab countries aged 18 to 71 filled out an online survey with measures of the following constructs: Schwartz’s four higher-order values (Portrait Value Questionnaire-21), religious values (Sahin’s Index of Islamic Moral Values), and general psychological health (General Health Questionnaire-28). Results: Two models of multiple regression were conducted to investigate the relationships between values and psychological health. Higher conservation, self-enhancement, and religious values were significantly associated with better psychological health, with conservation losing significance after adding religious values to the model. All of Schwartz’s four values were found to have a significant relationship with religious values. More self-enhancement and conservation values were associated with higher identification of religious values, and the opposite was true for the other two values. Conclusion: The findings challenged existing assumptions that conservation values relate negatively to psychological health. This finding could be explained by the congruence of conservation values and the Arab culture. The most powerful relationships were those of self-enhancement and religious values, both of which were positively associated with psychological health. As such, therapists should be aware to reconsider biases against religious or conservation values and rather pay attention to their potential positive influence over one’s psychological health.

Keywords: counseling psychology, counseling and cultural values, counseling and religious values, psychotherapy and Arab values

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Authors: Raghavi C. Janaswamy

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In the healthcare sector, heterogenous data elements such as patients, diagnosis, symptoms, conditions, observation text from physician notes, and prescriptions form the essentials of the Electronic Health Record (EHR). The data in the form of clear text and images are stored or processed in a relational format in most systems. However, the intrinsic structure restrictions and complex joins of relational databases limit the widespread utility. In this regard, the design and development of realistic mapping and deep connections as real-time objects offer unparallel advantages. Herein, a graph neural network-based classification of EHR data has been developed. The patient conditions have been predicted as a node classification task using a graph-based open source EHR data, Synthea Database, stored in Tigergraph. The Synthea DB dataset is leveraged due to its closer representation of the real-time data and being voluminous. The graph model is built from the EHR heterogeneous data using python modules, namely, pyTigerGraph to get nodes and edges from the Tigergraph database, PyTorch to tensorize the nodes and edges, PyTorch-Geometric (PyG) to train the Graph Neural Network (GNN) and adopt the self-supervised learning techniques with the AutoEncoders to generate the node embeddings and eventually perform the node classifications using the node embeddings. The model predicts patient conditions ranging from common to rare situations. The outcome is deemed to open up opportunities for data querying toward better predictions and accuracy.

Keywords: electronic health record, graph neural network, heterogeneous data, prediction

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Authors: Sabri Sulaiman, Siti Hajar Abu Bakar Ah, Haris Abd Wahab

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Street children is a global phenomenon and declared as a social problem by social researcher and scholars across the world. The insecure street environment exposes street children into various risk factors. One of them is the health and psychological problem. The objective of this study is to assess the health problem and psychological wellbeing of street children in Kuala Lumpur, Malaysia. The cross-sectional study involved 303 street children in Chow Kit, Kuala Lumpur. The study confirmed that the majority (95.7%) of street children who participated in the study have a health problem. The findings also demonstrated that the majority of them have issues related to their psychological wellbeing. The inputs from this study are instrumental for the suggestion of specific intervention to improve the health and psychology wellbeing of street children in Malaysia. Agencies which are responsible for the street children well-being can utilise the inputs to framing and improving the social care programmes for the children.

Keywords: street children, health status, psychology wellbeing, homeless

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Authors: Mohd Ibrahim K. Azeez, Mohammed Sani Ibrahim, Rosemawati Mustapa, Maisarah A. Malik, Chandrakala Varatharajoo, Wee Akina Sia Seng Lee

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The leadership of the principals is known to be a key indicator in development and school performance. Therefore, this study was undertaken to assess the extent of the influence of instructional leadership in the field of supervision and curriculum focus on capacity development competence in the field of communication and teamwork. In addition, this study also examines self-efficacy mediator school leadership in the field of self-improvement and self-management of school principals. The study involved 383 guest teachers from 55 secondary schools for leadership in schools. Data was analyzed using SEM aid program AMOS 21. The final result shows partial mediation model was the best model fit to obtain the best goodness of fit of (X2/df = 4.663, CFI = 0.922, GFI = 0.778, TLI = 0914, NFI = 0.903, and RMSEA = 0.098) compared to the direct effect model of the findings (X2/df = 5.319, CFI = 0.908, GFI = 0755, TLI = 0.899, NFI = 0.889, and RMSEA = 0.106). While the findings of the fully mediator model with a self-efficacy refers principals as a mediator as follows (X2/df = 4.838, CFI = 0918, GFI = 0772, TLI = 0.910, NFI = 0.899, and RMSEA = 0.100). Therefore, it can be concluded that the findings clearly demonstrate self-efficacy variables principals become a mediator in the relationship between instructional leadership capacity and competency development.

Keywords: instructional leadership, capacity development, self-efficacy, competency

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Authors: Ayodeji Adebayo, Tolulope Soyannwo, Oluwakemi A. Sigbeku

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Intimate Partner Violence (IPV) is a significant public health problem with adverse health consequences. There is increasing evidence of association of IPV with mental health problems. Understanding the association between IPV and mental health status of women of reproductive aged group in the rural communities in Nigeria can provide information to improve maternal health status. Therefore, this study was conducted to examine the relationship between experience of IPV and mental health status of women of reproductive aged group in a rural community in Southwest Nigeria. A community based cross-sectional survey was conducted using a cluster sampling technique to select 283 non-pregnant women of reproductive age group (15-49 years Mental health was assessed based on respondents’ experience of any symptoms of depression, anxiety and/or low self-esteem. IPV was assessed over a period of 12 months and the forms of IPV assessed were emotional, physical and sexual. An interviewer administered questionnaire was used to collect information on experience of IPV, reproductive history and factors influencing mental health. Data was analyzed using descriptive statistics, Chi-square and multivariate logistic regression at 5% level of significance. The mean age of respondents was 26.1± 7.8 with 57.1% aged 15-24years. More than half (58.0%) were married. Overall, 60.7% of respondents had mental health problems while 84.8% experienced all categories of violence. The pattern of IPV includes physical violence (10.7%), emotional violence (82.7%) and sexual violence (20.8%). Women who experienced sexual violence by a partner are most likely to suffer from all mental issues. Also, gynaecological morbidities are associated with increasing risk of mental health problems. The research demonstrates an urgent need for mental health policies to recognize the relationship between intimate partner violence, gynaecological morbidities and mental health problems in women in Nigeria.

Keywords: intimate partner violence, mental health, reproductive age group, women

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Authors: Sara Mohammad Atef Sabaika

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Background: The development of factor VIII (FVIII) inhibitor and hemophilic arthropathy in patients with hemophilia A (PWHA) are a great challenge for hemophilia care. Both genetic and environmental factors led to complications in PWHA. The development of inhibitory antibodies is usually induced by the immune response. Tumor necrosis factor α (TNF-α), one of the cytokines, might contribute to its polymorphism. Aim: Study the association between tumor necrosis alpha level and genotypes in pediatric patients with hemophilia A and its relation to inhibitor development and joint status. Methods: A cross-sectional study was conducted among a sufficient number of PWHA attending the Pediatric Hematology and Oncology Unit, Pediatric department in Menoufia University hospital. The clinical parameters, FVIII, FVIII inhibitor, and serum TNF-α level were assessed. The genotyping of −380G > A TNF-α gene polymorphism was performed using real time polymerase chain reaction. Results: Among the 50 PWHA, 28 (56%) were identified as severe PWHA. The FVIII inhibitor was identified in 6/28 (21.5%) of severe PWHA. There was a significant correlation between serum TNF-α level and the development of inhibitor (p = 0:043). There was significant correlation between polymorphisms of −380G > A TNF-α gene and hemophilic arthropathy development (p = 0:645). Conclusion: The prevalence of FVIII inhibitor in severe PWHA in Menoufia was 21.5%. The frequency of replacement therapy is a risk factor for inhibitor development. Serum TNF-α level and its gene polymorphism might be used to predict inhibitor development and joint status in pediatric patients with hemophilia A.

Keywords: hemophilic arthropathy, TNF alpha., patients witb hemophilia A PWHA, inhibitor

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Authors: Sultanbayeva Gulmira Serikbayevna, Golovchun Aleftina Anatolyevna

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The development of any nation is directly related to the development of human capital in it. A human development is an increase its intellectual potential, its compliance with the requirements of time, present and future society. Demands of globalization cannot limit the processes of national traditions. The education system must be formed on the basis of international practice of cultural development. In Kazakhstan, where modernization changes are rapidly developing, the education system should be formed in two ways: first, on a national basis, and secondly, based on global best practices. There is the need to recognize and promote the importance of education as a value. The world community considers the problem of spiritual values. Along with individual values, spiritual values are also universal values. Formation of values such as the presence in young people a sense of respect for their homeland, social responsibility, respect the culture and traditions of its people is the most important task than the possession of material goods. When forming the intellectual nation, values in the field of education and science become investments for the development of the society, as well as education and science today transformed into the most important capital.

Keywords: human capital, humanitarian technology, intangible assets, intelligent nation, society of knowledge

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Authors: Nazira Kakulia, Tsotne Zhghenti

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The institutional development is one of the actual topics in economics science. New trends and directions of institutional development mostly depend on its structure and framework. Transformation of institutions is an important problem for every economy, especially for developing countries. The first research goal is to determine the importance and interactions between different institutions in Georgia. Using World Governance Indicators and Economic Freedom indexes it can be calculated the size for each institutional group. The second aim of this research is to evaluate Georgian institutional backwardness in comparison to other post-communist economies. We use statistical and econometric methods to evaluate the difference between the levels of institutional development in Georgia and in leading post-communist economies. Within the scope of this research, major findings are coefficients which are an assessment of their deviation (i.e. lag) of institutional indicators between Georgia and leading post-communist country which should be compared. The last part of the article includes analysis around the selected coefficients.

Keywords: post-communist transition, institutions, economic growth, institutional development

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Authors: Elisabeth Mamani-Mategula

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Background: Anaemia has significant consequences on both the mother and child's health as it results in maternal haemorrhage, low childbirth weight, premature delivery, poor organ development, and infections at birth and hence the need for treatment. In low-middle income countries, anaemic pregnant women are recommended to take 30 mg to 60 mg of elemental iron daily throughout pregnancy which are often poorly tolerated and adhered to. A potential alternative to oral iron is intravenous (IV) iron which allows the saturation of the body’s iron stores quickly. Currently, a randomised controlled trial on the Effect of intravenous iron on Anaemia in Malawian Pregnant women (REVAMP) is underway. Since this is new in Africa and Malawi is the second country to implement it, its acceptability to both the providers and end-users is not known. Suppose the use of IV iron during pregnancy would be acceptable in Malawi, it could change how we treat and manage pregnant women with anaemia and be scaled up throughout Malawi to improve maternal and child health. Objectives: To identify the barriers and facilitators of implementing IV iron in the Malawian healthcare system and identify ‘touchpoints’ and co-develop strategies to support and inform the implementation of the trial Methodology: A qualitative study was conducted with policymakers, government partners, and health managers through in-depth interviews to identify barriers and facilitators relating to the implementation of IV iron in the health system of Malawi. From the interviews, touchpoints were identified that formed the basis of the discussion in further discussing the barriers and suggested solutions in the co-design workshops with the community members and the health workers, respectively. We purposively recruited 20 health workers (10 male, 10 Female). 20 community members (10 male, 10 female) were recruited randomly. Data was collected through group discussions and interactive sessions and was recorded through audios, flip charts, and sticky notes. We familiarized ourselves with the data and identified themes. Results: Two co-design workshops were conducted with different community members and different health worker carders. Identified individual factors included lack of knowledge about anaemia, lack of male involvement, the attitude of health workers and patient non-compliance with appointments. Community factors included myths and misconceptions about IV iron, including associating the use of IV iron with vampirism and covid 19 vaccination. Health system factors identified were a shortage of staff and equipment, unfamiliarity with IV iron and its cost. Discussion: The use of IV iron, as suggested by the community members and health workers, demands civic education through bringing awareness to end-users and training to providers. Through these co-design workshops, community sensitization and awareness, briefing and training of health workers and creation of educational materials were done.

Keywords: acceptability, IV iron, barriers, facilitators, co-design

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Authors: Edna Roseline Dede Tetteh

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Reproductive health research and discussions have, over the years, placed a special focus on Africa. This is partly due to the significant relationship between African cultures and reproductive health. Several studies have also acknowledged the economic impact of reproductive health in Africa, because of which reproductive health, particularly family planning, has featured prominently in many economic discussions about Africa. Gender, which is a major element of most African cultures, inspired this study. Given that gender has a significant cultural influence in Africa, the study examined the effect of gender inequality on reproductive health in Africa, with a special focus on Ghana. Specifically, the study examined whether there exists any relationship between gender inequality and reproductive health and, if there is, what the nature and the effect of the relationship are. The study's findings were based on data gathered from 2304 respondents, randomly selected from Ghana's different tribes and ethnic groups. Given that the study was focused on the influence of gender in sexual relationships, the study’s population was people 16 years and above since 16 is the legal age of sexual consent in Ghana. Data was collected through questionnaires and interviews. It was found that the beliefs and practices of the traditional Ghanaian society, like most African societies, have direct and significant impacts on reproductive health. Males in these cultures have more control over reproductive health decisions and choices than females. The study found that it was culturally condemnable for a wife to refuse her husband’s request for sex, even when she is not in the mood for sex, or she is unwell. It was further found that, when it comes to the decision of birth control, males have more power. Consequently, females with reproductive health conditions have no control over choices that support their reproductive health conditions; they must always satisfy their husbands’ sexual needs. Most of the female respondents indicated they had less or no control over protecting themselves from reproductive health risks unless they had the understanding and support of their sexual partners.

Keywords: culture, gender, Ghana, inequality, reproductive health

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Authors: Pascal Rey, Anaïs Weber

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Many mining projects are being developed in Africa the last decades. Due to the economic opportunities they offer, these projects result in a massive and rapid influx of migrants to the surrounding area. In areas where central government representation is low and local administration lack financial resources, urban development is often anarchical, beyond all public control. It leads to socio-spatial segregation, insecurity and the risk of social conflicts rising. Aware that their economic development is very correlated with local situation, mining companies get more and more involved in regional planning in setting up tools and Strategic Directions document. One of the commonly used tools in this regard is the “Influx Management Plan”. It consists in looking at the region’s absorption capacities in order to ensure its coherent development and by developing several urban centers than one macrocephalic city. It includes many other measures such as urban governance support, skills transfer, creation of strategic guidelines, financial support (local taxes, mining taxes, development funds etc.) local development projects. Through various examples of mining projects in Guinea, A country that is host to many large mining projects, we will look at the implications of regional and urban planning of which mining companies are key playor as well as public authorities. While their investment capacity offers advantages and accelerates development, their actions raise questions of the unilaterality of interests and local governance. By interfering in public affairs are mining companies not increasing the risk of central and local government shirking their responsibilities in terms of regional development, or even calling their legitimacy into question? Is such public-private collaboration really sustainable for the region as a whole and for all stakeholders?

Keywords: Africa, guinea, mine, urban planning

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Authors: Eman Tadros, Natasha Finney

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The following case study involving a high-conflict, Children’s Services Bureau (CSB) referred couple is analyzed and reviewed through an integrated lens of structural family therapy and dialectical behavior therapy. In structural family therapy, normal family development is not characterized by a lack of problems, but instead by families’ having developed a functional structure for dealing with their problems. Whereas, in dialectical behavioral therapy normal family development can be characterized by having a supportive and validating environment, where all family members feel a sense of acceptance and validation for who they are and where they are in life. The clinical case conceptualization highlights the importance of conceptualizing how change occurs within a therapeutic setting. In the current case study, the couple did not only experience high-conflict, but there were also issues of substance use, health issues, and other complicating factors. Clinicians should view their clients holistically and tailor their treatment to fit their unique needs. In this framework, change occurs within the family unit, by accepting each member as they are, while at the same time working together to change maladaptive familial structures.

Keywords: couples, dialectical behavior therapy, high-conflict, structural family therapy

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Authors: Lori Lioce, Gary Maddux, Norven Goddard, Ishella Fogle, Bernard Schroer

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This paper presents the integration of technologies into nursing education. The collaborative effort includes the College of Nursing (CoN) at the University of Alabama in Huntsville (UAH) and the UAH Systems Management and Production Center (SMAP). The faculty at the CoN conducts needs assessments to identify education and training requirements. A team of CoN faculty and SMAP engineers then prioritize these requirements and establish improvement/development teams. The development teams consist of nurses to evaluate the models and to provide feedback and of undergraduate engineering students and their senior staff mentors from SMAP. The SMAP engineering staff develops and creates the physical models using 3D printing, silicone molds and specialized molding mixtures and techniques. The collaboration has focused on developing teaching and training, or clinical, simulators. In addition, the onset of the Covid-19 pandemic has intensified this relationship, as 3D modeling shifted to supplied personal protection equipment (PPE) to local health care providers. A secondary collaboration has been introducing students to clinical benchmarking through the UAH Center for Management and Economic Research. As a result of these successful collaborations the Model Exchange & Development of Nursing & Engineering Technology (MEDNET) has been established. MEDNET seeks to extend and expand the linkage between engineering and nursing to K-12 schools, technical schools and medical facilities in the region to the resources available from the CoN and SMAP. As an example, stereolithography (STL) files of the 3D printed models, along with the specifications to fabricate models, are available on the MEDNET website. Ten 3D printed models have been developed and are currently in use by the CoN. The following additional training simulators are currently under development:1) suture pads, 2) gelatin wound models and 3) printed wound tattoos. Specification sheets have been written for these simulations that describe the use, fabrication procedures and parts list. These specifications are available for viewing and download on MEDNET. Included in this paper are 1) descriptions of CoN, SMAP and MEDNET, 2) collaborative process used in product improvement/development, 3) 3D printed models of training and teaching simulators, 4) training simulators under development with specification sheets, 5) family care practice benchmarking, 6) integrating the simulators into the nursing curriculum, 7) utilizing MEDNET as a pandemic response, and 8) conclusions and lessons learned.

Keywords: 3D printing, nursing education, simulation, trainers

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Authors: Kim H. K. Choy, Oliva H. K. Chu, W. Y. Keung, B. Lim, Winnie P. Y. Tang

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Background: Health care providers have been identified as an at-risk group for obesity. Mobile health technology can be used to motivate lifestyle behavioral changes. The aim of this study was to investigate hospital-based health care providers’ perceptions of mHealth Workplace Nutrition Wellness Program. Methods: This qualitative study was conducted at a regional hospital in Hong Kong. Ten health care providers were purposively selected for the study. Qualitative data was collected by individual face-to-face semi-structured interviews which were audio-taped, transcribed verbatim and analyzed by thematic analysis. Results: Four themes were identified: (1) mobile health technology motivates lifestyle changes, (2) self-perceived body weight initiates health behavioral changes, (3) organizational support promotes healthy behavior, (4) lack of self-confidence hinders lifestyle modification. The health care providers’ perceptions of mobile health technology, barriers, and facilitators to participation in the mHealth Workplace Nutrition Wellness Program were discussed in the study. Conclusions: Barriers, facilitators, self-perceived body weight and experiences of mobile health technology were associated with intention of participation in mHealth Workplace Nutrition Wellness Program. The knowledge generated from the study could be used to guide the design and implementation of effective interventions, strategies and policies of workplace wellness programs to promote participation for hospital’s employees.

Keywords: workplace wellness program, mobile health, barriers, facilitators, qualitative

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Authors: Erhan Berk

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The purpose of this study is to examine the efficiency and productivity of the health care sector in Turkey based on four years of health care cross-sectional data. Efficiency measures are calculated by a nonparametric approach known as Data Envelopment Analysis (DEA). Productivity is measured by the Malmquist index. The research shows how DEA-based Malmquist productivity index can be operated to appraise the technology and productivity changes resulted in the Turkish hospitals which are located all across the country.

Keywords: data envelopment analysis, efficiency, health care, Malmquist Index

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Authors: Zurina Mahadi, Hukil Sino

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United Nations resolved 2030 Sustainable Development Goals (SDGs) in 2015 to complete what Millennium Development Goals did not achieve. Accommodating 17 goals and 169 targets, Sustainable Development Goals are designated to be achieved over the next 15 years. A survey was conducted in July 2019 among the undergraduate students of a public university in Selangor, Malaysia, to learn their selection over Sustainable Development Goals, which they think is the most critical in the Malaysian scenario. This study adopted a qualitative approach, and data is gathered from a single instruction questionnaire administered to a purposive sample of participants. 13 goals were selected by the participants which are Goal 1, 2, 3, 4, 5, 6, 8, 10, 11, 12, 13, 16 and 17 while none has selected Goal 7, 9, 14 and 15 which are ‘Affordable and Clean Energy’; ‘Industry, Innovation and Infrastructure’; ‘Life Below Water’ and ‘Life On Land’ respectively. The selected goals are then ranked according to the number of participants who chose that particular goal. Goal 8 is found to be at the highest position of the ranking while Goal 5, 6, 10, and 13 accommodating the lowest position. Goal 8, which is ‘Decent Work and Economic Growth’ is chosen by 13 participants as the most critical goal in Malaysia while Goal 5,6 10, and 13, which are ‘Gender Equality’; ‘Clean Water and Sanitation’; ‘Reduced Inequalities’ and ‘Climate Action’ respectively, are chosen by only one participant each. Issues highlighted by the participants are themed into 10 themes, which are job availability, cost of living, well-being, corruption, education, environment, gender, development planning, consumption, and partnership. The theme of the cost of living has the highest number of issues, followed by the theme of job availability and the environment. The theme of gender has the least number of issues, followed by the theme of corruption and development planning. In principle, these findings, therefore, conclude that from a public university students’ point of view, the most critical sustainable development goal is decent work and economic growth while the most concerning issue is the cost of living. The implications of these findings are students’ knowledge towards the current issues of development, and their views of future sustainable development are considerably high. This study, therefore, suggests their views be inculcated into local, sustainable development frameworks to increase the inclusiveness of the young generation as they are the future SDGs stakeholders.

Keywords: cost of living, inclusiveness, job availability, sustainable development goals

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Authors: Saman Kumara, Duminda Guruge, Krishani Jayasinghe

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Introduction: Nutrition strongly influences good health and development in early life. This study, based on a health promotion approach, used a community-based intervention to improve child nutrition. The approach provides the community with control of interventions, thereby building its capacity and empowering individuals and communities. The aim of this research was to reduce stunting, low birth weight and underweight in communities from Anuradhapura District in Sri Lanka, by identifying and addressing the underlying determinants of under-nutrition and strengthening families and communities to address them. Methods: A health promotion intervention was designed and implemented-based on a logical framework developed in collaboration with members of targeted community. Community members’ implements action, so they fully own the process. Members of the community identify and address the most crucial determinants of health including child health and development and monitor the initial results of their action and modify action to optimize outcomes as well as future goals. Group Discussion, group activities, awareness programs, cluster meetings, community tools and sharing success stories were major activities to address determinants. Continuous data collection was planned at different levels. Priority was given to strengthening the ability of families and groups or communities to collect meaningful data and analyze these themselves. Results: Enthusiasm and interest of the mother, happiness of the child/ family, dietary habits, money management, tobacco and alcohol use of fathers, media influences, illnesses in the child or others, hygiene and sanitary practices, community sensitiveness and domestic violence were the major perceived determinants elicited from the study. There were around 1000 well-functioning mothers groups in this district. ‘Happiness calendar’, ‘brain calendar’, ‘money tool’ and ‘stimulation books’ were created by the community members, to address determinants and measure the process. Evaluation of the process has shown positive early results, such as improvement of feeding habits among mothers, innovative ways of providing early stimulation and responsive care, greater involvement of fathers in childcare and responsive feeding. There is a positive movement of communities around child well-being through interactive play areas. Family functioning and community functioning improved. Use of alcohol and tobacco declined. Community money management improved. Underweight was reduced by 40%. Stunting and low birth weight among under-fives also declined within one year. Conclusion: The health promotion intervention was effective in changing the determinants of under-nutrition in early childhood. Addressing the underlying determinants of under-nutrition in early childhood can be recommended for similar contexts.

Keywords: birth-weight, community, determinants, stunting, underweight

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Authors: M. Al Zallouha, Y. Landkocz, J. Brunet, R. Cousin, J. M. Halket, E. Genty, P. J. Martin, A. Verdin, D. Courcot, S. Siffert, P. Shirali, S. Billet

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Toluene is one of the most used Volatile Organic Compounds (VOCs) in the industry. Amongst VOCs, Benzene, Toluene, Ethylbenzene and Xylenes (BTEX) emitted into the atmosphere have a major and direct impact on human health. It is, therefore, necessary to minimize emissions directly at source. Catalytic oxidation is an industrial technique which provides remediation efficiency in the treatment of these organic compounds. However, during operation, the catalysts can release some compounds, called byproducts, more toxic than the original VOCs. The catalytic oxidation of a gas stream containing 1000ppm of toluene on Pd/α-Al2O3 can release a few ppm of benzene, according to the operating temperature of the catalyst. The development of new catalysts must, therefore, include chemical and toxicological validation phases. In this project, A549 human lung cells were exposed in air/liquid interface (Vitrocell®) to gas mixtures derived from the oxidation of toluene with a catalyst of Pd/α-Al2O3. Both exposure concentrations (i.e. 10 and 100% of catalytic emission) resulted in increased gene expression of Xenobiotics Metabolising Enzymes (XME) (CYP2E1 CYP2S1, CYP1A1, CYP1B1, EPHX1, and NQO1). Some of these XMEs are known to be induced by polycyclic organic compounds conventionally not searched during the development of catalysts for VOCs degradation. The increase in gene expression suggests the presence of undetected compounds whose toxicity must be assessed before the adoption of new catalyst. This enhances the relevance of toxicological validation of such systems before scaling-up and marketing.

Keywords: BTEX toxicity, air/liquid interface cell exposure, Vitrocell®, catalytic oxidation

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Authors: Jin Chuhao

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Sustainable design is the key for the human to realize the harmonious development. However, sustainable design requires localization that combines their own regional culture’s characteristics, then forms the most common cultural identity. As a result, the concept of sustainable design integrates into social behavior and promotes the harmonious development. Chinese Confucian doctrine is one of the important thoughts of human culture, which is accepted by more and more people. This paper summarizes the sustainable concept from the Chinese traditional culture and local design, discusses how they change the life of human being and produces enlightenment and significance to China and world.

Keywords: sustainable design, Chinese traditional culture, harmonious development, Confucianism

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Authors: Maciej Czarnecki

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Even though growth is one of the most important strategic objectives for many enterprises, we know relatively little about this phenomenon. This research contributes to broaden our knowledge of managerial consequences of growth. Scales for measuring organizational development and growing pains were developed. Conceptual model of connections among growth, organizational development, growing pains, selected development factors and financial performance were examined. The research process contained literature review, 20 interviews with managers, examination of 12 raters’ opinions, pilot research and 7 point Likert scale questionnaire research on 138 Polish enterprises employing 50-249 people which increased their employment at least by 50% within last three years. Factor analysis, Pearson product-moment correlation coefficient, student’s t-test and chi-squared test were used to develop scales. High Cronbach’s alpha coefficients were obtained. The verification of correlations among the constructs was carried out with factor correlations, multiple regressions and path analysis. When the enterprise grows, it is necessary to implement changes in its structure, management practices etc. (organizational development) to meet challenges of growing complexity. In this paper, organizational development was defined as internal changes aiming to improve the quality of existing or to introduce new elements in the areas of processes, organizational structure and culture, operational and management systems. Thus; H1: Growth has positive effects on organizational development. The main thesis of the research is that if organizational development does not catch up　with growing complexity of growing enterprise, growing pains will arise (lower work comfort, conflicts, lack of control etc.). They will exert a negative influence on the financial performance and may result in serious organizational crisis or even bankruptcy. Thus; H2: Growth has positive effects on growing pains, H3: Organizational development has negative effects on growing pains, H4: Growing pains have negative effects on financial performance, H5: Organizational development has positive effects on financial performance. Scholars considered long lists of factors having potential influence on organizational development. The development of comprehensive model taking into account all possible variables may be beyond the capacity of any researcher or even statistical software used. After literature review, it was decided to increase the level of abstraction and to include following constructs in the conceptual model: organizational learning (OL), positive organization (PO) and high performance factors (HPF). H1a/b/c: OL/PO/HPF has positive effect on organizational development, H2a/b/c: OL/PO/HPF has negative effect on growing pains. The results of hypothesis testing: H1: partly supported, H1a/b/c: supported/not supported/supported, H2: not supported, H2a/b/c: not supported/partly supported/not supported, H3: supported, H4: partly supported, H5: supported. The research seems to be of a great value for both scholars and practitioners. It proved that OL and HPO matter for organizational development. Scales for measuring organizational development and growing pains were developed. Its main finding, though, is that organizational development is a good way of improving financial performance.

Keywords: organizational development, growth, growing pains, financial performance

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Authors: Daniella Hirwa

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Attention Deficit Hyperactivity Disorder (ADHD) is associated with several risk-taking behaviors, including drug use and smoking. Such risk-taking behaviors are often a result of an attempt to self-manage symptoms associated with ADHD. The present review investigates the effects of nicotine on symptoms associated with ADHD. This systematic literature review was conducted for 2017-2024 using keywords associated with ADHD, smoking, and nicotine. The results indicate that individuals with ADHD start smoking earlier than those without ADHD, and it is believed that this prevalence and the higher rates of smoking are due to improvements in cognitive and executive function, attention, and impulsivity due to the effect that nicotine has on dopamine release. Longitudinal studies with larger sample sizes and comprehensive health history and cognitive testing are required to gain more insight into the ways that nicotine affects ADHD symptoms and the context by which smoking is used as a method of self-treatment to help aid the development of nicotine-based treatment options that do not pose the same health risks as smoking.

Keywords: ADHD, nicotine, risk-taking behaviors, smoking

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Authors: Christina Cheong, Naomi Keena

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In the face of growing urbanization the construction of new buildings is inevitable and with current construction methods leading to environmental degradation much questioning is needed around reducing the environmental impact of buildings. This paper explores the global environmental issue of concrete production in parallel with the problem of plastic waste, and questions if new solutions into plastic waste additions in concrete is a viable sustainable solution with positive systematic implications to living systems, both human and non-human. We investigate how certification programs can be used to access the sustainability of the new concrete composition. With this classification we look to the health impacts as well as reusability of such concrete in a second or third life cycle. We conclude that such an approach has benefits to the environment and that taking a circular approach to its development, in terms of the overall life cycle of the new concrete product, can help understand the nuances in terms of the material’s environmental and human health impacts.

Keywords: Concrete, Plastic waste additions to concrete, sustainability ratings, sustainable materials

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Authors: Muhammad Ridho Fakhrin, Leni Sagita Riantini, Yusuf Latief

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Based on the 2015-2019 RPJMN data, the realization of toll road infrastructure development in Indonesia experienced a delay of 49% or 904 km of the total plan. One of the major causes of delays in development is caused by institutional factors. The case study taken in this research is the construction of the Trans Sumatra Toll Road (JTTS). The purpose of this research is to identify the institutional forms, functions, roles, duties, and responsibilities of each stakeholder and the risks that occur in the Trans Sumatra Toll Road Infrastructure Development. Risk analysis is implemented on functions, roles, duties, responsibilities of each existing stakeholder and is carried out at the Funding Stage, Technical Planning Stage, and Construction Implementation Stage in JTTS. This research is conducted by collecting data through a questionnaire survey, then processed using statistical methods, such as homogeneity, data adequacy, validity, and reliability test, continued with risk assessment based on a risk matrix. The results of this study are the evaluation and development of institutional functions in risk-based JTTS development can improve time performance and minimize delays in the construction process.

Keywords: institutional, risk management, time performance, toll road

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Authors: Chengfang Wang, Zichao Wu, Jianying Zhou

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At present, much attention is paid to the development of new industrial parks in the era of inventory planning. Generally speaking, there are two types of development models: incremental development models and stock development models. The former relies on key projects to build a value innovation park, and the latter relies on the iterative update of the park to build a value innovation park. Take the Baiyun Western Digital Park as an example, considering the growth model of value units, determine the evaluation target. Based on a GIS platform, comprehensive land-use status, regulatory detailed planning, land use planning, blue-green ecological base, rail transit system, road network system, industrial park distribution, public service facilities, and other factors are used to carry out the land use within the planning multi-factor superimposed comprehensive evaluation, constructing a value unit evaluation system, and delineating value units based on implementation orientation and combining two different development models. The research hopes to provide a reference for the planning and construction of new domestic industrial parks.

Keywords: value units, GIS, multi-factor evaluation, implementation orientation

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Authors: Hancy Issac, Gerben Keijzers, Ian Yang, Clint Moloney, Jackie Lea, Melissa Taylor

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Introduction: Chronic obstructive pulmonary disease guideline non-adherence is associated with a reduction in health-related quality of life in patients (HRQoL). Improving guideline adherence has the potential to mitigate fragmented care thereby sustaining pulmonary function, preventing acute exacerbations, reducing economic health burdens, and enhancing HRQoL. The development of an electronic proforma stemming from expert consensus, including digital guideline resources and direct interdisciplinary referrals is hypothesised to improve guideline adherence and patient outcomes for emergency department (ED) patients with COPD. Aim: The aim of this study was to develop consensus among ED and respiratory staff for the correct composition of a COPD electronic proforma that aids in guideline adherence and management in the ED. Methods: This study adopted a mixed-method design to develop the most important indicators of care in the ED. The study involved three phases: (1) a systematic literature review and qualitative interdisciplinary staff interviews to assess barriers and solutions for guideline adherence and qualitative interdisciplinary staff interviews, (2) a modified Delphi panel to select interventions for the proforma, and (3) a consensus process through three rounds of scoring through a quantitative survey (ED and Respiratory consensus) and qualitative thematic analysis on each indicator. Results: The electronic proforma achieved acceptable and good internal consistency through all iterations from national emergency department and respiratory department interdisciplinary experts. Cronbach’s alpha score for internal consistency (α) in iteration 1 emergency department cohort (EDC) (α = 0.80 [CI = 0.89%]), respiratory department cohort (RDC) (α = 0.95 [CI = 0.98%]). Iteration 2 reported EDC (α = 0.85 [CI = 0.97%]) and RDC (α = 0.86 [CI = 0.97%]). Iteration 3 revealed EDC (α = 0.73 [CI = 0.91%]) and RDC (α = 0.86 [CI = 0.95%]), respectively. Conclusion: Electronic proformas have the potential to facilitate direct referrals from the ED leading to reduced hospital admissions, reduced length of hospital stays, holistic care, improved health care and quality of life and improved interdisciplinary guideline adherence.

Keywords: COPD, electronic proforma, modified delphi study, interdisciplinary, guideline adherence, COPD-X plan

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Authors: Ademoyegun Olusegun

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The advancement of industry in any given state involves a range of processes that entail entrepreneurship and innovative skill attainment, among others, for the development of an economy. This article studied the impact of innovative and entrepreneurship skill attainment as the panacea of the growth of industry for economic development in Nigeria. Content analysis was employed as an instrument on data obtained from secondary resources which include journals, magazines, Workshop Articles, the Internet, interviewing etc. this is preferred because of the absence of sequential data related to entrepreneurship and innovation on sustainable economic growth in Nigeria. The theory of innovative Entrepreneurship was used as a theoretical framework. Findings revealed that Entrepreneurship skill attainment will induce innovation that will accelerate the growth of Industry for the advancement of the Economy. The study recommended that the government should invest adequately in entrepreneurship skill attainment and create an enabling environment for innovation.

Keywords: entrepreneurship, innovation, skill attainment, panacea, sustainable development

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Authors: Rajinder Singh, Ram Valluru

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Chain Ladder (CL) method, Expected Loss Ratio (ELR) method and Bornhuetter-Ferguson (BF) method, in addition to more complex transition-rate modeling, are commonly used actuarial reserving methods in general insurance. There is limited published research about their relative performance in the context of Mortgage Insurance (MI). In our experience, these traditional techniques pose unique challenges and do not provide stable claim estimates for medium to longer term liabilities. The relative strengths and weaknesses among various alternative approaches revolve around: stability in the recent loss development pattern, sufficiency and reliability of loss development data, and agreement/disagreement between reported losses to date and ultimate loss estimate. CL method results in volatile reserve estimates, especially for accident periods with little development experience. The ELR method breaks down especially when ultimate loss ratios are not stable and predictable. While the BF method provides a good tradeoff between the loss development approach (CL) and ELR, the approach generates claim development and ultimate reserves that are disconnected from the ever-to-date (ETD) development experience for some accident years that have more development experience. Further, BF is based on subjective a priori assumption. The fundamental shortcoming of these methods is their inability to model exogenous factors, like the economy, which impact various cohorts at the same chronological time but at staggered points along their life-time development. This paper proposes an alternative approach of parametrizing the loss development curve and using logistic regression to generate the ultimate loss estimate for each homogeneous group (accident year or delinquency period). The methodology was tested on an actual MI claim development dataset where various cohorts followed a sigmoidal trend, but levels varied substantially depending upon the economic and operational conditions during the development period spanning over many years. The proposed approach provides the ability to indirectly incorporate such exogenous factors and produce more stable loss forecasts for reserving purposes as compared to the traditional CL and BF methods.

Keywords: actuarial loss reserving techniques, logistic regression, parametric function, volatility

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