Search results for: public sector hospital

Authors: Desmond Wade, Alfredo Ormazabal

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Background: Ever since it commenced its registration process of pre-hospital practitioners in the year 2000 through the Irish Government Statute Instrument (SI 109 of 2000) process, the approach to education of its professionals has changed drastically. The progression from the traditional behaviouristic to the current constructivist approach has been based on experiences from other sectors and industries, nationally and internationally. Today, the delivery of a safe and efficient ambulance service heavily depends on its practitioners’ range of technical skills, academic knowledge, and overall competences. As these increase, so does the level of complexity of paramedics’ everyday practice. This has made it inevitable to consider the 'Human Factor' as a source of potential risk and made formative institutions like the National Ambulance Service College to include it in their curriculum. Methods: This paper used a mixed-method approach, where both, an online questionnaire and a set of semi-structured interviews were the source of primary data. An analysis of this data was carried out using qualitative and quantitative data analysis. Conclusions: The evidence presented leads to the conclusion that in the National Ambulance Service there is a considerable lack of education of Human Factors and the levels in understanding of how to manage Human Factors in practice vary across its spectrum. Paramedic Practitioners in Ireland seem to understand that the responsibility of patient care lies on the team, rather than on the most hierarchically senior practitioner present in the scene.

Keywords: human factors, ergonomics, stress, decision making, pre-hospital care, paramedic, education

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Authors: S. M. C. Kelly, M. Goulden

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Introduction: Chronic Pancreatitis is an increasing problem worldwide. Pain is the main symptom and the main reason for hospital readmission following diagnosis, despite the use of strong analgesics including opioids. Ketamine infusions reduce pain in complex regional pain syndrome and other neuropathic pain conditions. Our centre has trialed the use of ketamine infusions in patients with chronic pancreatitis. We have evaluated this service to assess whether ketamine reduces emergency department admissions and analgesia requirements. Methods: This study collected retrospective data from 2010 in all patients who received a ketamine infusion for chronic pain secondary to a diagnosis of chronic pancreatitis. The day-case ketamine infusions were initiated in theatre by an anaesthetist, with standard monitoring and the assistance of an anaesthetic practitioner. A bolus dose of 0.5milligrams/kilogram was given in theatre. The infusion of 0.5 milligrams/kilogram per hour was then administered over a 6 hour period in the theatre recovery area. A study proforma detailed the medical history, analgesic use and admissions to hospital. Patients received a telephone follow up consultation. Results: Over the last eight years, a total of 30 patients have received intravenous ketamine infusions, with a total of 92 ketamine infusions being administered. 53% of the patients were male with the average age of 47. A total of 27 patients participated with the telephone consultation. A third of patients reported a reduction in hospital admissions with pain following the ketamine infusion. Analgesia requirements were reduced by an average of 48.3% (range 0-100%) for an average duration of 69.6 days (range 0-180 days.) Discussion: This service evaluation illustrates that ketamine infusions can reduce analgesic requirements and the number of hospital admissions in patients with chronic pancreatitis. In the light of increasing pressures on Emergency departments and the increasing evidence of the dangers of long-term opioid use, this is clearly a useful finding. We are now performing a prospective study to assess the long-term effectiveness of ketamine infusions in reducing analgesia requirements and improving patient’s quality of life.

Keywords: acute-on-chronic pain, intravenous analgesia infusion, ketamine, pancreatitis

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Authors: Luxi Chen

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The land finance in China in recent years has propelled urban renewals in the name of historical conservation and led to massive gentrification and compulsory relocation. Such inequalities cause insurgence. Drawing on public planning information, ethnographic field notes, and online interview data about Guangzhou's Enninglu Area, this paper aims to present how such insurgence has been contained and put down gradually through depoliticization narratives represented by "improving living conditions," "conserving historical culture," and "public participation”. This paper's findings include that 1) Besides economic growth, maintaining social stability in alignment with the central government are equally important to local government, reveals the latter efforts to mediate the growth coalition, residents, media, and academics so as to reconstruct the interface between state and society; 2) To empower the insurgence, the media and academics use public interests for propaganda, that diverts attention away from its political dimension; 3) In response, the government introduces improved regulations and planning, turning social inequalities into technical inadequacy so as to become the defender of public interests, which justifies the incoming renewal and prevents public questioning. By comparing regime changes among governments, developers, residents, media, and academics caused by renewal policies, this paper presents the depoliticized narrative as a counter-insurgence strategy to contain social conflicts and to boost inner-city renewal.

Keywords: inner city renewal, depoliticization, historical conservation, public participation

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Authors: Osalina Toemapa, Rika Susanti, Husna Yetti

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In criminal offense case, such as homicide, investigators may request for an autopsy to the victim without family approval in Indonesia. Generally, there has been decreasing in autopsy rate in the world over past years. Family’s refusal is one of the most common problems. The purpose of this study is to find the correlation between knowledge level and public perception of autopsy on criminal offense victim. This cross-sectional study was done from April to May 2017 in subdistrict Pulau Punjung. Participants were asked to fill the questionnaire. There are 15 questions to asses knowledge level, perception, and factors influencing autopsy refusal. The chi-square test was used for the statistical analysis. Out of the total of 436 respondents, 54,5% were found to have poor knowledge level, and 56,7% were found to have poor perception. There was a significant correlation between knowledge level and public perception (p<0,001). There are 153 respondents who decline autopsy on criminal offense victim with the most factors influencing autopsy refusal is delays in victim’s funeral (92,2%). Conclusion, knowledge level is correlated with public perception in subdistrict of Pulau Punjung, district of Dharmasraya, West Sumatra, Indonesia. Most influencing factor in autopsy refusal is delays in victim’s funeral.

Keywords: knowledge level, public perception, autopsy on criminal offense victim, autopsy refusal

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Authors: Maneesha Pahlani, Najmin Sultana

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A hospital is one of the most suitable places for acquiring an infection because it harbors a high population of virulent strains of microorganisms that may be resistant to antibiotics, especially the prevalence of Methicillin-Resistant Staphylococcus Aureus (MRSA) infections. The hospital-acquired infection has become a global challenge. In developed countries, healthcare-associated infections occur in 5-15% of hospitalized clients, affecting 9-37% of those admitted to intensive care units (ICU). A non-experimental descriptive study was conducted among 50 nursing officers working in a selected hospital in Bangalore to assess the nursing officers’ level of knowledge regarding the prevention and management of MRSA infections and to associate the pre-test knowledge mean scores of nursing officers with selected socio-demographic variables. Data was collected using a structured questionnaire consisting of socio-demographic data and a structured questionnaire on knowledge regarding the prevention and management of MRSA infections. The data was analyzed in terms of frequencies and percentages for the analysis of demographic variables and computing chi-square to determine the association between knowledge means scores and selected demographic variables. The study findings revealed that the nursing officer had an overall good level of knowledge (63.05%) regarding the prevention and management of MRSA infections, and there is no significant association found between the level of knowledge mean scores for prevention and management of MRSA infection with the selected socio-demographic variables. However, the categorization of knowledge items showed that the nursing officer must thoroughly receive education on correct guidance and information regarding MRSA infection control policy, including measures and practices on hygiene precautions and information regarding antibiotic resistance for effective nursing care to patients with MRSA infections. The conclusions drawn from the study findings showed that it is necessary that the nursing officer thoroughly receive education on correct guidance and information regarding MRSA infection control policy, including measures and practices on hygiene precautions and information regarding antibiotic resistance to provide effective nursing care to patients with MRSA infection as they constantly care for the patient who can be at risk for multi-drug resistance organisms to reduce the risk of MRSA infection in hospital care settings as well community settings.

Keywords: MRSA, nursing officers, knowledge, preventive and management

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Authors: Zain Khan, Steve Ahn, Kathy Monypenny, James Fink

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In Australian public hospitals, there were approximately 34,000 reported inpatient falls between 2015 to 2016. The gold standard for diagnosing intracranial injury is non-contrast enhanced brain computed tomography (CTB). Over a three-month timeframe, a total of one hundred and eighty (180) falls were documented between the hours of 4pm and 8am at a large metro hospital. Only three (3) of these scans demonstrated a positive intra-cranial finding. The rationale for scanning varied. The common indications included a fall with head strike, the presence of blood thinning medication, loss of consciousness, reduced Glasgow Coma Scale (GCS), vomiting and new neurological findings. There are several validated tools to aid in decision-making around ordering CTB scans in the acute setting, but no such accepted tool exists for the inpatient space. With further data collection, spanning a greater length of time and through involving multiple centres, work can be done towards generating such a tool that can be utilized for inpatient falls.

Keywords: computed tomography, falls, inpatient, intracranial hemorrhage

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Authors: Najmin Sultana, Maneesha Pahlani

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A hospital is one of the most suitable places for acquiring an infection because it harbors a high population of virulent strains of microorganisms that may be resistant to antibiotics, especially the prevalence of Methicillin-Resistant Staphylococcus Aureus (MRSA) infections. The hospital-acquired infection has become a global challenge. In developed countries, healthcare-associated infections occur in 5-15% of hospitalized clients, affecting 9-37% of those admitted to intensive care units (ICU). A non-experimental descriptive study was conducted among 50 nursing officers working in a selected hospital in bengaluru to assess the nursing officers’ level of knowledge regarding the prevention and management of MRSA infections and to associate the pre-test knowledge mean scores of nursing officers with selected socio-demographic variables. Data was collected using a structured questionnaire consisting of socio-demographic data and a structured questionnaire on knowledge regarding the prevention and management of MRSA infections. The data was analyzed in terms of frequencies and percentages for the analysis of demographic variables and computing chi-square to determine the association between knowledge means scores and selected demographic variables. The study findings revealed that the nursing officer had an overall good level of knowledge (63.05%) regarding the prevention and management of MRSA infections, and there is no significant association found between the level of knowledge mean scores for prevention and management of MRSA infection with the selected socio-demographic variables. However, the categorization of knowledge items showed that the nursing officer must thoroughly receive education on correct guidance and information regarding MRSA infection control policy, including measures and practices on hygiene precautions and information regarding antibiotic resistance for effective nursing care to patients with MRSA infections. The conclusions drawn from the study findings showed that it is necessary that the nursing officer thoroughly receive education on correct guidance and information regarding MRSA infection control policy, including measures and practices on hygiene precautions and information regarding antibiotic resistance to provide effective nursing care to patients with MRSA infection as they constantly care for the patient who can be at risk for multi-drug resistance organisms to reduce the risk of MRSA infection in hospital care settings as well community settings.

Keywords: MRSA, knowledge, nursing officers', prevention and management

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Authors: Sivilai Jayankura

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This research aims to study the religious economic behavior that effect the lifestyle of the people in Dusit area. The result shows that religious identity salience makes people increase contributions to public goods. Most of the Buddhism decrease contributions to public goods, expect others to contribute less to public goods, and become less risk averse. We find no evidence of religious identity salience effects on disutility of work effort, discount rates or generosity in life spending. Mostly the people like to make merit in the temple during special day of religion. The atmosphere in the temple leads the people like to travel and merit at the temple near their home.

Keywords: Dusit province, identity, lifestyle, religious economic behavior

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Authors: Aneta Nitsch-Osuch, Katarzyna Zycinska, Ewa Gyrczuk, Agnieszka Topczewska-Cabanek, Kazimierz Wardyn

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Introduction: Influenza is an important clinical and epidemiological problem and should be considered as a possible nosocomial infection. The aim of the study was to determine the influenza vaccine coverage rates among Polish nurses and to find out drivers and barriers for influenza vaccination among this group of health care workers (HCWs). Material and methods: The self- fulfilled survey with 26 questions about the knowledge, perception, and influenza coverage rates was distributed among 461 nurses. Results: Only 15% of nurses were vaccinated against influenza in the consecutive seasons. The majority (75%) of the regularly vaccinated nurses were ambulatory careworkers. The difference between the number of vaccinated hospitals and ambulatory care nurses was statistically significant (p < 0.05). The main motivating factors for an influenza vaccination were: a fear of the illness and its complications (97%) and a free of charge vaccine available at the workplace (87%). Ambulatory care nurses more often declared that they were vaccinated mainly to protect themselves while hospital care nurses more often declared the will to protect their patients, these differences in the perception and attitudes to an influenza vaccination among hospital and ambulatory care nurses were statistically significant (p < 0.05). The main barriers for an influenza vaccination among the nursing staff were: a lack of reimbursement of the vaccine (95%), a lack of insufficient knowledge about the effectiveness, and safety of the influenza vaccine (54%). The ambulatory care nurses more often found influenza vaccination as the ethical duty compared to hospital care nurses (p < 0.05). Conclusions: The influenza vaccine coverage rates among the Polish nurses are low and must be improved in the future. More educational activities dedicated to HCWs may result in the increased awareness of influenza vaccination benefits for both medical professionals and patients.

Keywords: influenza, vaccination, nurses, ambulatory careworkers

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Authors: H. Malachova, A. Oulehlova, D. Rezac

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Crisis preparedness training is the best possible strategy for identifying weak points, understanding vulnerability, and finding possible strategies for mitigation of blackout consequences. Training represents an effective tool for developing abilities and skills to cope with crisis situations. This article builds on the results of the research carried out in the field of preparation, realization, process, and impacts of training on subjects of energy sector critical infrastructure as a part of crisis preparedness. The research has revealed that the subjects of energy sector critical infrastructure have not realized training and therefore are not prepared for the restoration of the energy supply and black start after blackout regardless of the fact that most subjects state blackout and subsequent black start as key dangers. Training, together with mutual communication and processed crisis documentation, represent a basis for successful solutions for dealing with emergency situations. This text presents the suggested model of SIMEX simulator as a tool which supports managing crisis situations, containing training environment. Training models, possibilities of constructive simulation making use of non-aggregated as well as aggregated entities and tools of communication channels of individual simulator nodes have been introduced by the article.

Keywords: communication, energetic critical infrastructure, training, simulation

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Authors: Nicholas Agyepong, Paul Gyan

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Inappropriate prescribing of antibiotic is a common healthcare concern globally resulted in an increased risk of adverse reactions and the emergence of antimicrobial resistance. The wrong antibiotic prescribing habits may lead to ineffective and unsafe treatment, worsening of disease condition, and thus increase in health care costs. The study was to examine the antibiotic prescribing pattern and associated risk factors at Regional Hospital in the Bono region of Ghana. A retrospective cross-sectional study was conducted to describe the current prescribing practices at the Hospital from January 2014 to December, 2021. A systematic random sampling method was used to select the participants for the study. STATA version 16 software was used for data management and analysis. Descriptive statistics and logistic regression analysis were used to analyze the data. Statistical significance set at p<0.05. Antibiotic consumption was equivalent to 11 per 1000 inhabitants consuming 1 DDD per day. Most common prescribed antibiotic was amoxicillin/clavulanic acid (14.39%) followed by erythromycin (11.44%), and ciprofloxacin (11.36%). Antibiotics prescription have been steadily increased over the past eight years (2014: n=59,280 to 2021: n=190,320). Prescribers above the age of 35 were more likely to prescribe antibiotics than those between the ages of 20 and 25 (COR=21.00; 95% CI: 1.78 – 48.10; p=0.016). Prescribers with at least 6 years of experience were also significantly more likely to prescribe antibiotics than those with at most 5 years of experience (COR=14.17; 95% CI: 2.39 – 84.07; p=0.004). Thus, the establishment of an antibiotic stewardship program in the hospitals is imperative, and further studies need to be conducted in other facilities to establish the national antibiotic prescription guideline.

Keywords: antibiotic, antimicrobial resistance, prescription, prescribers

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Authors: Olivia Kurucz

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Gamification is one of the outstanding new methodological possibilities of urban public participation processes to make the most informed decision possible for the future steps of urban development. This paper examines four Hungarian experimental projects in which gamified tools were applied during the public participation progresses by the Urban Future Laboratory (UFLab) research workshop of Budapest University of Technology and Economics (BUTE). The recently implemented future planning projects (in the cities of Pécel, Kistarcsa, Budapest, and Salgótarján) were initiated by various motives, but the multi-stakeholder dialogues were facilitated through physical gamified tools in all cases. Based on the urban gamification hypothesis, the use of gamified tools supported certain steps of participatory processes in several aspects: it helped to increase the attractiveness of public events, to create a more informal atmosphere, to ensure equal conditions for actors, to recall a design mindset, to bridge contrasting social or cultural differences, to fix opinions and to assist dialogue between city actors, designers, and residents. This statement is confirmed by assessing the applied tools, analyzing the case studies, and comparing them to perceive their effects and interrelations.

Keywords: experimental projects, future planning, gamification, gamified tools, Hungary, public participation, UFLab, urban gamification

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Authors: Charles Bijjah Nkhata, Memory Nekati Mvula, Milton Masautso Kalongonda, Martha Masamba, Isaac Thom Shawa

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Viral Hepatitis is a serious public health concern globally with deaths estimated at 1.4 million annually due to liver fibrosis, cirrhosis, and hepatocellular carcinoma. Hepatitis B and C are the most common viruses that cause liver damage. However, the majority of infected individuals are unaware of their serostatus. Viral Hepatitis has contributed to maternal and neonatal morbidity and mortality. There is no updated data on the Epidemiology of hepatitis B and C among pregnant mothers in Malawi. To assess the epidemiology of Hepatitis B and C viruses among pregnant women at Queen Elizabeth Central Hospital. Specific Objectives • To determine sero-prevalence of HBsAg and Anti-HCV in pregnant women at QECH. • To investigate risk factors associated with HBV and HCV infection in pregnant women. • To determine the distribution of HBsAg and Anti-HCV infection among pregnant women of different age group. A descriptive cross-sectional study was conducted among pregnant women at QECH in last quarter of 2021. Of the 114 pregnant women, 96 participants were consented and enrolled using a convenient sampling technique. 12 participants were dropped due to various reasons; therefore 84 completed the study. A semi-structured questionnaire was used to collect socio-demographic and behavior characteristics to assess the risk of exposure. Serum was processed from venous blood samples and tested for HBsAg and Anti-HCV markers utilizing Rapid screening assays for screening and Enzyme Linked Immunosorbent Assay for confirmatory. A total of 84 pregnant consenting pregnant women participated in the study, with 1.2% (n=1/84) testing positive for HBsAg and nobody had detectable anti-HCV antibodies. There was no significant link between HBV and HCV in any of the socio-demographic data or putative risk variables. The findings indicate a viral hepatitis prevalence lower than the set range by the WHO. This suggests that HBV and HCV are rare in pregnant women at QECH. Nevertheless, accessible screening for all pregnant women should be provided. The prevention of MTCT is key for reduction and prevention of the global burden of chronic viral Hepatitis.

Keywords: viral hepatitis, hepatitis B, hepatitis C, pregnancy, malawi, liver disease, mother to child transmission

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Authors: Kulwinder Singh Mann

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The innovative features of information system, known as Radiology Information System (RIS), for electronic medical records has shown a good impact in the hospital. The objective is to help and make their work easier; such as for a physician to access the patient’s data and for a patient to check their bill transparently. The interoperability of RIS with the other intra-hospital information systems it interacts with, dealing with the compatibility and open architecture issues, are accomplished by two novel mechanisms. The first one is the particular message handling system that is applied for the exchange of information, according to the Health Level Seven (HL7) protocol’s specifications and serves the transfer of medical and administrative data among the RIS applications and data store unit. The second one implements the translation of information between the formats that HL7 and Digital Imaging and Communication in Medicine (DICOM) protocols specify, providing the communication between RIS and Picture and Archive Communication System (PACS) which is used for the increasing incorporation of modern medical imaging equipment.

Keywords: RIS, PACS, HIS, HL7, DICOM, messaging service, interoperability, digital images

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Authors: Mohammad Ali Farrokhpour

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In the current decade and sustainable transportation systems, scooter sharing has attracted widespread attention as an environmentally-friendly means of public transportation which can help develop public transportation. The combination of scooters and subway in the area of sustainable transportation systems can provide a great many opportunities for developing access to public transportation. Of the challenges which have arisen and initiated discussions of interest about the implementation of a scooter-subway system to replace personal vehicles is the issue of routing in the aforementioned system. This has been chosen as the main subject of the present paper. Thus, the present paper provides an account for routing in this system. Because the issue of routing includes multiple factors such as time, costs, traffic, green spaces, etc., the above-mentioned problem is considered to be a multi-objective NP-hard optimization problem. For this purpose, the hybrid optimization approach of PSO-GA has been put forward in the present paper for the provided answers to be of higher accuracy and validity than those of normal optimization methods. The results obtained from modeling and problem solving for the case study in the MATLAB software are indicative of the efficiency and desirability of the model and the proposed approach for solving the model

Keywords: route planning, scooter sharing, public transportation, sharing system

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Authors: Malik Imtiaz Ahmad

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The prime sources of Islamic Law or Shariah are Quran and Sunnah and is applied to the personal and public affairs of Muslims. Islamic law is deemed to be divine and furnishes a complete code of conduct based upon universal values to build honesty, trust, righteousness, piety, charity, and social justice. The primary focus of this paper was to examine the development of Islamic jurisprudence (Fiqh) over time and its relevance to the field of Islamic finance. This encompassed a comprehensive analysis of the historical context, key legal principles, and their application in contemporary financial systems adhering to Islamic principles. This study aimed to elucidate the deep-rooted connection between Islamic law and finance, offering valuable insights for practitioners and policymakers in the Islamic finance sector. Understanding the historical context and legal underpinnings is crucial for ensuring the compliance and ethicality of modern financial systems adhering to Islamic principles. Fintech solutions are developing fields to accelerate the digitalization of Islamic finance products and services for the harmonization of global investors' mandate. Through this study, we focus on institutional governance that will improve Sharia compliance, efficiency, transparency in decision-making, and Islamic finance's contribution to humanity through the SDGs program. The research paper employed an extensive literature review, historical analysis, examination of legal principles, and case studies to trace the evolution of Islamic law and its contemporary application in Islamic finance, providing a concise yet comprehensive understanding of this intricate relationship. Through these research methodologies, the aim was to provide a comprehensive and insightful exploration of the historical evolution of Islamic law and its relevance to contemporary Islamic finance, thereby contributing to a deeper understanding of this unique and growing sector of the global financial industry.

Keywords: sharia, sequencing Islamic jurisprudence, Islamic congruent marketing, social development goals of Islamic finance

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Authors: Thampi Rawther, Jack Cecire, Andrew Sutherland

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Introduction: CT facilitates the diagnosis of potentially life-threatening injuries and facilitates early management. There is evidence that reduced CT acquisition time reduces mortality and length of hospital stay. Currently, there are variable recommendations for ideal timing. Indeed, the NHS standard contract for a major trauma service and STAG both recommend immediate access to CT within a maximum time of 60min and appropriate reporting within 60min of the scan. At Coffs Harbour Health Campus (CHHC), a CT radiographer is on site between 8am-11pm. Aim: To investigate the average time to CT at CHHC and assess for any significant relationship between time to CT and injury severity score (ISS) or time of triage. Method: All major trauma calls between Jan 2021-Oct 2021 were audited (N=87). Patients were excluded if they went from ED to the theatre. Time to CT is defined as the time between triage to the timestamp on the first CT image. Median and interquartile range was used as a measure of central tendency as the data was not normally distributed, and Chi-square test was used to determine association. Results: The median time to CT is 51.5min (IQR 40-74). We found no relationship between time to CT and ISS (P=0.18) and time of triage to time to CT (P=0.35). We compared this to other centres such as John Hunter Hospital and Gold Coast Hospital. We found that the median CT acquisition times were 76min (IQR 52-115) and 43min, respectively. Conclusion: This shows an avenue for improvement given 35% of CT’s were >30min. Furthermore, being proactive and aware of time to CT as an important factor to trauma management can be another avenue for improvement. Based on this, we will re-audit in 12-24months to assess if any improvement has been made.

Keywords: imaging, rural surgery, trauma surgery, improvement

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Authors: Medya Fathi

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Today, success in the construction industry is not merely about project completion in a timely manner within an established budget and meeting required quality considerations. Management practices and partnerships need to be emphasized as well. In this regard, critical success factors (CSFs) cover necessary considerations for a successful project beyond the traditional success definition, which vary depending on project outcomes, delivery methods, project types, and partnering processes. Despite the extensive research on CSFs, there is a paucity of studies that examine CSFs for public-private partnership (PPP); the delivery method, which has gained increasing attention from researchers and practitioners over the last decade with a slow but growing adoption in the transportation infrastructure, particularly, highway industry. To fill this knowledge gap, data are collected through questionnaire surveys among private and public parties involved in PPP transportation projects in the United States. Then, the collected data are analyzed to explore the causality relationships between CSFs and PPP project success using structural equation model and provide a list of factors with the greatest influence. This study advocates adopting a critical success factor approach to enhance PPP success in the U.S. transportation industry and identify elements essential for public and private organizations to achieve this success.

Keywords: project success, critical success factors, public-private partnership, transportation

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Authors: Giorgi Bregadze

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Tourism is the most viable and sustainable economic development option for Georgia and one of the main sources of foreign exchange earnings. Events are considered as one of the most effective ways to attract foreign visitors to the country, and, recently, the government of Georgia has begun investing in this sector very actively. This article stresses the necessity of research based economic policy in the tourism sector. In this regard, it is of paramount importance to measure the economic effects of the events which are subsidized by taxpayers’ money. The economic effect of events can be analyzed from two perspectives; financial perspective of the government and perspective of economic effects of the tourism administration. The article emphasizes more realistic and all-inclusive focus of the economic effect analysis of the tourism administration as it concentrates on the income of residents and local businesses, part of which generate tax revenues for the government. The public would like to know what the economic returns to investment are. In this article, the methodology used to describe the economic effects of UEFA Super Cup held in Tbilisi, will help to answer this question. Methodology is based on three main principles and covers three stages. Using the suggested methodology article estimates the direct economic effect of UEFA Super cup on Georgian economy. Although the attempt to make an economic effect analysis of the event was successful in Georgia, some obstacles and insufficiencies were identified during the survey. The article offers several recommendations that will help to refine methodology and improve the accuracy of the data. Furthermore, it is very important to receive the correct standard of measurement of events in Georgia. In this caseü non-ethical acts of measurement which are widely utilized by different research companies will not trigger others to show overestimated effects. It is worth mentioning that to author’s best knowledge, this is the first attempt to measure the economic effect of an event held in Georgia.

Keywords: biased economic effect analysis, expenditure of local citizens, time switchers and casuals, UEFA super cup

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Authors: Taufik Hidayat, Yudha Nurhantari, Bambang U. D. Rianto

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Introduction: The examination of the Short Tandem Repeats (STR) locus on nuclear DNA is very useful in solving the paternity cases. The purpose of this study is to know the description of paternity cases and paternity index/probability of paternity analysis based on Indonesian allele frequency at Sardjito Hospital Yogyakarta. Method: This was an observational study with cross-sectional analytic method. Population and sample were all cases of disputed paternity from January 2011 to June 2015 that fulfill the inclusion and exclusion criteria and were examined at Forensic Medicine Unit of Sardjito Hospital, Medical Faculty of Gadjah Mada University. The paternity index was calculated with EasyDNA Program by Fung (2013). Analysis of the study was conducted by comparing the results through unpaired categorical test using Kolmogorov-Smirnov test. This study was designed with 95% confidence interval (CI) with α = 5% and significance level is p < 0,05. Results: From 42 disputed paternity cases we obtained trio paternity cases were 32 cases (76.2%) and duo without a mother was 10 cases (23.8%). The majority of the fathers' estimated ages were 21-30 years (33.3%) and the mother's age was 31-40 years (38.1%). The majority of the ages of children examined for paternity were under 12 months (47.6%). The majority of ethnic clients are Javanese. Conclusion of inclusion was 57.1%, and exclusion was 42.9%. The Kolmogorov-Smirnov test obtained p-value = 0.673. Conclusion: There is no significant difference between paternity index/probability of paternity based on Indonesian allele frequency between trio and duo of paternity.

Keywords: disputed paternity, paternity index, probability of paternity, short tandem

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Authors: Tess Howard, Lily Owens, Maneesha De Silva, Russell Hodgson

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Purpose: This study aims to evaluate the cost-effectiveness of laparoscopic common bile duct exploration (CBDE) compared to endoscopic retrograde cholangiopancreatography (ERCP) and cholecystectomy for the emergency management of common bile duct (CBD) stones. Methodology: A retrospective case note review was conducted on consecutive patients undergoing emergency management of CBD stones using either CBDE, or ERCP and cholecystectomy at a single centre between January 2014-October 2014. Data on admission and procedural costs, length of hospital stay, postoperative complications and further stone related interventions were analysed. Results: A total of 350 patients were analysed. Among them, 299 patients underwent CBDE at the time of cholecystectomy, while the remaining 51 underwent ERCP either pre-, intra- or post cholecystectomy. CBDE was associated with lower overall costs compared to ERCP with an average hospital stay cost of $13,093 vs $22,930 respectively. This was largely attributed to shorter hospital stays (6.5 vs 10.3 days), decreased need for intensive care unit admission and fewer postoperative interventions within the CBDE group. Notably, single procedure laparoscopic cholecystectomy with CBDE demonstrated decreased operative costs compared to laparoscopic cholecystectomy combined with ERCP pre-/intra- or post-operatively ($3,747 vs. $4,641). Conclusion: Emergent CBDE is a cost-effective alternative to ERCP for managing CBD stones when combined with cholecystectomy. The upfront investment in equipment for CBDE and increased cholecystectomy procedural time is counterbalanced by reduced hospital stay, fewer procedures and subsequent cost savings. Economic considerations, in conjunction with clinical outcomes, should inform the selection of the optimal approach for CBD stone management in emergency settings.

Keywords: choledocolithiasis, management, cost-effectiveness, endoscopic retrograde cholangiopancreatography, ERCP, CBDE, common bile duct exploration

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Authors: Rohini Sharma, Chandan Kumar Sahoo, Rama Krishna Gupta Potnuru

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Strong competitive forces and requirements to achieve efficiency are forcing the organizations to realize the necessity and inevitability of change. What's more, the trend does not appear to be abating. Researchers have estimated that about two thirds of change project fails. Empirical evidences further shows that organizations invest significantly in the planned change but people side is accounted for in a token or instrumental way, which is identified as one of the important reason, why change endeavours fail. However, whatever be the reason for change, organizational change readiness must be gauged prior to the institutionalization of organizational change. Hence, in this study the influence of employee voice and employee involvement on organizational change readiness via commitment-to-change is examined, as it is an area yet to be extensively studied. Also, though a recent study has investigated the interrelationship between leadership, organizational change readiness and commitment to change, our study further examined these constructs in relation with employee voice and employee involvement that plays a consequential role for organizational change readiness. Further, integrated conceptual model weaving varied concepts relating to organizational readiness with focus on commitment to change as mediator was found to be an area, which required more theorizing and empirical validation, and this study rooted in an Indian public sector organization is a step in this direction. Data for the study were collected through a survey among employees of Rourkela Steel Plant (RSP), a unit of Steel Authority of India Limited (SAIL); the first integrated Steel Plant in the public sector in India, for which stratified random sampling method was adopted. The schedule was distributed to around 700 employees, out of which 516 complete responses were obtained. The pre-validated scales were used for the study. All the variables in the study were measured on a five-point Likert scale ranging from “strongly disagree (1)” to “strongly agree (5)”. Structural equation modeling (SEM) using AMOS 22 was used to examine the hypothesized model, which offers a simultaneous test of an entire system of variables in a model. The study results shows that inter-relationship between employee voice and commitment-to-change, employee involvement and commitment-to-change and commitment-to-change and organizational change readiness were significant. To test the mediation hypotheses, Baron and Kenny’s technique was used. Examination of direct and mediated effect of mediators confirmed that commitment-to-change partially mediated the relation between employee involvement and organizational change readiness. Furthermore, study results also affirmed that commitment-to-change does not mediate the relation between employee involvement and organizational change readiness. The empirical exploration therefore establishes that it is important to harness employee’s valuable suggestions regarding change for building organizational change readiness. Regarding employee involvement, it was found that sharing information and involving people in decision-making, leads to a creation of participative climate, which educes employee commitment during change and commitment-to-change further, fosters organizational change readiness.

Keywords: commitment-to-change, change management, employee voice, employee involvement, organizational change readiness

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Authors: Dimakatso Machetele, Clare Kelso, Thea Schoeman

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In developing countries such as India, China, and South Africa, disposal of household solid waste in rural areas is of great concern. Rural communities face numerous challenges that include the absence of waste collection services and sanitation facilities. The inadequate provision of waste collection and sanitation services results to the occurrence of infectious diseases e.g., malaria. The gap in the management of household solid waste between rural and urban communities, whereby urban communities have better waste management services compared to rural areas is an environmental injustice towards rural communities. The unequal distribution of infrastructure in South Africa’s waste management is a concern that stems from the spatial inequalities of the country’s apartheid history. The Limpopo province has a higher proportion of households without waste collection services from the municipality. The present research objectives are to investigate the public’s perceptions and factors contributing to the management of household solid waste in two contrasting rural Wards in the Greater Tzaneen Municipality. There is limited data and studies that have been conducted to understand the management of household solid waste in rural areas, and specifically, for the Greater Tzaneen Municipality located in the Limpopo province, South Africa. The findings of the study will propose recommendations to the Greater Tzaneen Municipality, rural municipalities in South Africa, and globally to explore sustainable methods to manage household solid waste and explore economic opportunities within the waste management sector to alleviate poverty in rural communities.

Keywords: rural, household solid wase, perceptions, waste management

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Authors: Saba Arif, Anam Nadeem, Roman Kalvin, Muzaffar Ali, Burhan Ali, Juntakan Taweekun

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Globally transportation sector accounts for around 25% of energy demand and nearly 62% of oil consumed. Therefore, new energy sources are required to introduce for this huge demand replenishment of depleting conventional energy sources. Currently, biofuels such as Jatropha trees as an energy carrier for transportation sector are being utilized effectively round the globe. However, climate conditions at low altitudes with an average annual temperature above 20 degrees Celsius and rainfall of 300-1000mm are considered the most suitable environment for the efficient growth of Jatropha trees. The current study is providing a theoretical survey-based analysis to investigate the effect of rate of cultivation of jatropha trees on the reduction of fuel prices and its environmental benefits. The resulted study shows that jatropha tree’s 100 kg seeds give 80kg oil and the conversion process cost is very small as 890 PKR. Moreover, the extraction of oil from Jatropha tree is tax-free compared to other fuels. The analysis proved very essential for potential assessment of Jatropha regarding future energy fuel for transportation sector at global level. Additionally, it can be very beneficial for increment in the total amount of transportation fuel in Pakistan.

Keywords: jatropha tree, environmental impact, energy contents, theoretical survey

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Authors: Deepika Biswas

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Acinetobacter baumannii, a hospital-acquired pathogen, causes nosocomial infections including pneumonia, urinary tract infection, and secondary meningitis. Carbapenem is most effective antibiotics against it. Its increased resistance to carbapenems has been a rising global concern. Antibiotics such as carbapenem are unable to use on hospital setups to eradicate A. baumannii, hence different concentrations of disinfectants including phenol; sodium hypochlorite and ethanol are increasingly being used. The objective of the present study is to find an effective concentration of above disinfectants against carbapenem-resistant strain RS307 of A. baumannii. Growth kinetics of RS307 has been determined using UV-Vis spectrophotometer in the presence and absence of disinfectants in triplicate and its standard deviation has also been calculated which make the results more reliable. Differential growth curves were plotted, which showed the effective concentration among all the concentrations of phenol, sodium hypochlorite and ethanol. On disc diffusion assay, antimicrobial effect was observed by comparing all the concentrations of disinfectants to check its synergy with imipenem, most effective carbapenem. All the results collectively revealed that 0.5% phenol, 0.5% sodium hypochlorite, and 70% ethanol could preferably be used as disinfectant for hospital setup against the carbapenem-resistant strain of A. baumannii. SDS PAGE analysis showed differential expression in the protein profile of A. baumannii after treatment. The present study highlighted that few disinfectants even in low concentration had shown better antimicrobial activity hence may be recommended for regular use in the hospitals, which will be cost effective and less harmful.

Keywords: Acenatobacter bomunii, phenol, sodium hypoclirite, ethanol, carbapenem resistance, disinfectant

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Authors: Doaa Nounou

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This research examines the public policy energy subsidies reform efforts in Egypt since 2014. Egypt’s widely used energy subsidies have been controversial since they were first introduced, as they inadequately target the poorest part of the population. Also, their effect on economic development and democratic transition became very challenging in recent years. This research argues that although subsidy reform is a highly politicalized issue in democratizing countries, there are still a number of pragmatic public policies that can be applied to make the subsidy system function more efficiently and at the same time decrease inequality which could facilitate a more orderly and peaceful transition to democracy. Therefore, this research attempts to study the role of the executive branch in reforming the subsidy programmes to support the poor and bring about structural changes to achieve social justice and economic growth. This research also attempts to analyze the role of the military and civil society in reforming the subsidy system. Moreover, it attempts to discuss the role of the state media in social mobilization to rationalize consumption and its contribution to subsidies reform.

Keywords: subsidies, public policy, political economy, democratization, equality

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Authors: Helia Moayedi, Mahdi Moaidi

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Nowadays, the managing and planning of hospitals is facing many problems. Failure to recognize the main criteria for strategic management to ensure long-term hospital performance can lead to many health problems. To achieve this goal, a qualitative-quantitate method titled Delphi-Fuzzy has been applied. This strategy makes it possible for experts to screen among the most important criteria in strategic management. To conduct this operation, a statistical society consisting of 20 experts in Ahwaz hospitals has been questioned. The final model confirms the key criterions after three stages of Delphi. This model provides the possibility to focus on the basic criteria and can determine the organization’s main orientation.

Keywords: Delphi-fuzzy method, hospital management, long-term planning, qualitative-quantitate method, screening of strategic criteria, strategic planning

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Authors: Muhammad Asif Syed, Mirza Amir Baig

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Background: Pakistan is one of the two remaining polio-endemic countries, posing a significant public health challenge for global polio eradication due to failure to interrupt polio transmission. Country specific seroprevalence studies help in the evaluation of immunization program performance, the susceptibility of population against polio virus and identification of existing level of immunity with factors that affect seroconversion of the oral polio vaccine (OPV). The objective of the study was to find out factors associated with seroconversion of the OPV among children 6-59 months in Pakistan. Methods: A Hospital based cross-sectional serosurvey was undertaken in May-June 2015 at District Mirpurkhas, Sindh-Pakistan. Total 180 children aged 6–59 months were selected by using systematic random sampling from Muhammad Medical College Hospital, Mirpurkhas. Demographic, vaccination history and risk factors information were collected from the parents/guardian. Blood sample was collected and tested for the detection of poliovirus IgG antibodies by using ELISA Kit. The IgG titer <10 IU/ml, 50 to <150 IU/ml and >150 IU/ml was defined as negative, weak positive and positive immunity respectively. Pearson Chi-square test was used to determine the difference in seroprevalence in univariate analysis. Results: A total of 180 subjects were enrolled mean age was 23 months (7 -59 months). Off these 160 (89%) children were well and 18 (10%) partially protected against polio virus. Two (1.1%) children had no protection against polio virus as they had <10 IU/ml poliovirus IgG antibodies titer. Both negative cases belong from the female gender, age group 12-23 months, urban area and BMI <50 percentile. There was a difference between normal and the wasting children; it did attain statistical significance (χ2= 35.5, p=0.00). The difference in seroconversion was also observed in relation to the gender (χ2=6.23, p=0.04), duration of breast feeding (χ2=18.6, p=0.04), history of diarrheal disease before polio vaccine administration (χ2=7.7, p=0.02), and stunting (χ2= 114, p=0.00). Conclusion: This study demonstrated that near 90% children achieve seroconversion of OPV and well protected against polio virus. There is an urgent need to focus on factors like duration of breast feeding, diarrheal diseases and malnutrition (acute and chronic) among the children as an immunization strategy.

Keywords: seroconversion, oral polio vaccine, Polio, Pakistan

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Authors: Naman Jain, Shaun Fernandes

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With the increasing prevalence of online healthcare services, selecting the most suitable doctor has become a complex task, requiring careful consideration of both public sentiment and personal preferences. This paper proposes a sentiment analysis-driven method that integrates public reviews with user-specific criteria and correlated attributes to recommend online doctors. By leveraging Natural Language Processing (NLP) techniques, public sentiment is extracted from online reviews, which is then combined with user-defined preferences such as specialty, years of experience, location, and consultation fees. Additionally, correlated attributes like education and certifications are incorporated to enhance the recommendation accuracy. Experimental results demonstrate that the proposed system significantly improves user satisfaction by providing personalized doctor recommendations that align with both public opinion and individual needs.

Keywords: sentiment analysis, online doctors, personal preferences, correlated attributes, recommendation system, healthcare, natural language processing

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Authors: Abudjana Babiker

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The middle of twenty century witnessed an explosion in public housing. After the great depression, some of the capitalists and communist countries have launched policies and programs to produce public housing in the urban areas. Concurrently, modernity was the leading architecture style at the time excessively supported the production, and principally was the instrument for the success of the public housing program due to the modernism manifesto for manufactured architecture as an international style that serves the society and parallelly connect it to the other design industries which allowed for the production of the architecture elements. After the second world war, public housing flourished, especially in communist’s countries. The idea of public housing was conceived as living spaces at the time, while the Workplaces performed as the place for production and labor. Michel Foucault - At the end of the twenty century- the introduction of biopolitics has had highlighted the alteration in the production and labor inter-function. The house does not precisely perform as the sanctuary, from the production, for the family, it opens the house to be -part of the city as- a space for production, not only to produce objects but to reproduce the family as a total part of the production mechanism in the city. While the public housing kept altering from one country to another after the failure of the modernist’s public housing in the late 1970s, the society continued changing parallelly with the socio-economic condition in each political-economical system, and the public housing thus followed. The family structure in the major cities has been dramatically changing, single parenting and the long working hours, for instance, have been escalating the loneliness in the major cities such as London, Berlin, and Tokyo and the public housing for the families is no longer suits the single lifestyle for the individuals. This Paper investigates the performance of both the single/individual lifestyle and the family/society structure in Tokyo and Berlin in a relation to the utilization of public housing under economical policies and the socio-political environment that produced the individuals and the collective. The study is carried through the study of the undercurrent individual/society and case studies to examine the performance of the utilization of the housing. The major finding is that the individual/collective are revolving around the city; the city identified and acts as a system that magnetized and blurred the line between production and reproduction lifestyle. The mass public housing for families is shifting to be a combination between neo-liberalism and socialism housing.

Keywords: loneliness, production reproduction, work live, publichousing

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