Search results for: Greek public hospital sector

Authors: Mateusz Mokrogulski, Piotr Śliwka

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The aim of this paper is the identification of periods of excessive credit growth in the Polish banking sector in years 2007-2014 using different methodologies. Due to the lack of precise guidance in CRD IV regarding methods of calculating the credit gap and related deviations from the long-term trends, a few filtering methods are applied, e.g. Hodrick-Prescott and Baxter-King. The solutions based on the switching model are also proposed. The next step represent computations of both the credit gap, and the counter cyclical capital buffer (CCB) rates on a quarterly basis. The calculations are carried out for the entire banking sector in Poland, as well as for its components (commercial and co-operative banks), and different types of loans. The calculations show vividly that in the analysed period there were the times of excessive credit growth. However, the results are different for the above mentioned sub-sectors. Of paramount importance here are mortgage loans, where the outcomes are distorted by high exchange rate fluctuations. The research on the CCB is now going to gain popularity as the buffer will soon become one of the tools of the macro prudential policy under CRD IV. Although the presented method is focused on the Polish banking sector, it can also be applied to other member states. Especially to the Central and Eastern European countries, that are usually characterized by smaller banking sectors compared to EU-15.

Keywords: countercyclical capital buffer, CRD IV, filtering methods, mortgage loans

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Authors: Mohamed Hendawy Mousa, Warda Youssef Mohamed Morsy

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Background: Sepsis is a major cause of mortality and morbidity in trauma patients. Body mass index as an indicator of nutritional status was reported as a predictor of injury pattern and complications among critically ill injured patients. Aim: The aim of this study is to investigate the relationship between body mass index and the development of sepsis, systemic inflammatory response syndrome among adult trauma patients at emergency hospital - Cairo University. Research design: Descriptive correlational research design was utilized in the current study. Research questions: Q1. What is the body mass index profile of adult trauma patients admitted to the emergency hospital at Cairo University over a period of 6 months?, Q2. What is the frequency of systemic inflammatory response syndrome and sepsis among adult trauma patients admitted to the emergency hospital at Cairo University over a period of 6 months?, and Q3. What is the relationship between the development of sepsis, systemic inflammatory response syndrome and body mass index among adult trauma patients admitted to the emergency hospital at Cairo University over a period of 6 months?. Sample: A purposive sample of 52 adult male and female trauma patients with revised trauma score 10 to 12. Setting: The Emergency Hospital affiliated to Cairo University. Tools: Four tools were utilized to collect data pertinent to the study: Socio demographic and medical data tool, Systemic inflammatory response syndrome assessment tool, Revised Trauma Score tool, and Sequential organ failure assessment tool. Results: The current study revealed that, (61.5 %) of the studied subjects had normal body mass index, (25 %) were overweight, and (13.5 %) were underweight. 84.6% of the studied subjects had systemic inflammatory response syndrome and 92.3% were suffering from mild sepsis. No significant statistical relationship was found between body mass index and occurrence of Systemic inflammatory response syndrome (2= 2.89 & P = 0.23). However, Sequential organ failure assessment scores were affected significantly by body mass index was found mean of initial and last Sequential organ failure assessment score for underweight, normal and obese where t= 7.24 at p = 0.000, t= 16.49 at p = 0.000 and t= 9.80 at p = 0.000 respectively. Conclusion: Underweight trauma patients showed significantly higher rate of developing sepsis as compared to patients with normal body weight and obese. Recommendations: based on finding of this study the following are recommended: replication of the study on a larger probability sample from different geographical locations in Egypt; Carrying out of further studies in order to assess the other risk factors influencing trauma outcome and incidence of its complications; Establishment of standardized guidelines for managing underweight traumatized patients with sepsis.

Keywords: body mass index, sepsis, systemic inflammatory response syndrome, adult trauma

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Authors: A. Brigitte Coles

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In order to be successful in a campaign against terror and maintain a favorable world order, we must recognize the effects of priming, framing, and agenda setting on the public sphere, and address how terrorist organizations are able to manipulate language and symbols to shift public opinion and increase recruitment success. Because of their unprecedented activity in the region and foreign recruitment success, this study specifically addresses how the Islamic State (IS/ISIS/ISIL) manipulates the public sphere to amplify support and increase western recruitment. By following a grounded theory methodology and coding triangulated data from IS propaganda, a model for the process of terrorist recruitment has emerged, concerning both environments and personalities susceptible to recruitment, and the steps by which an extremist can be created. This has resulted in the ability to reverse engineer a method by which counter recruitment operations can be facilitated in an effort to lessen the vulnerability of areas and individuals, as well as create dissent among current extremists.

Keywords: countering violent extremism, counter-terrorism, recruitment, overton window

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Authors: Babatunde Joel Todowede

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It is a public knowledge that lack of quality and qualitative education breeds problems besetting Nigeria as a nation today. This paper entitled “Quality and Qualitative Education for all, panacea for insecurity and political unrest in Nigeria” seeks to explore how quality and qualitative education for all will tends to put an end to insecurity and political unrest in Nigeria as a Nation. It may be pertinent to note at this juncture that the development of any modern society or nation is primarily hinged on the functionality of its educational system. There is no developed nation in the world today, which does not owe its advancement to quality and qualitative education. In other words, Education is a vital instrument in the nation’s economic competitiveness, in its people, and in its communities. Hence, Education is not luxury to be cut in difficult economic times – it is an essential element of growth. In fact, education is the bedrock of any society that hopes to be numbered among the developed economies in the world. Nigeria, as a nation, has made continual efforts to assume its rightful place in education on the African continent, but has not been quite lucky. Interestingly however, Quality and Qualitative Education for all will come about if all stakeholders in the Education Sector perform their roles with skill and efficiency. Education is a very sensitive area, hence, needs to be passionate about education, and focused on building a future for the sector.” Quality and qualitative education instill significant core values in every student, which shape them into mature, caring and independent individuals. These values include commitment, collaboration, integrity, responsibility and respect. By imbibing these values in every aspect of their life, they are able to contribute their skills and talents while supporting each other in attaining their lifelong goals. This paper identified lack of proper education as the bane of insecurity and political unrest in the Country and urged the government to review the policy in a way that there will be quality and standard to check insurgency in the Country. More so, until the fallen standard of education in Nigeria is fixed to engage out of school children, the incessant attack on innocent Nigerians, particularly in the North East may get worse.

Keywords: quality and qualitative education, panacea, insecurity, political unrest

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Authors: Adedayo B. Adegbaju, Carel B. Schoeman, Ilse M. Schoeman

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The unique urban contexts that emanated from the apartheid history of South Africa informed the transport landscape of the City of Johannesburg. Apartheid‘s divisive spatial planning and land use management policies promoted sprawling and separated workers from job opportunities. This was further exacerbated by poor funding of public transport and road designs that encouraged the use of private cars. However, the democratization of the country in 1994 and the hosting of the 2010 FIFA World Cup provided a new impetus to the city’s public transport-oriented urban planning inputs. At the same time, the state’s new approach to policy formulations that entails the provision of public transport as one of the tools to end years of marginalization and inequalities soon began to largely reflect in planning decisions of other spheres of government. The Rea Vaya BRT and the Gautrain were respectively implemented by the municipal and provincial governments to demonstrate strong political will and commitment to the new policy direction. While the Gautrain was implemented to facilitate elite movement within Gauteng and to crowd investments and economic growths around station nodes, the BRT was provided for previously marginalized public transport users to provide a sustainable alternative to the dominant minibus taxi. The aim of this research is to evaluate the spatial impacts of the Gautrain and Rea Vaya BRT on the City of Johannesburg and to inform future outcomes by determining the existing potentials. By using the case study approach with a focus on the BRT and fast rail in a metropolitan context, the triangulation research method, which combines various data collection methods, was used to determine the research outcomes. The use of interviews, questionnaires, field observation, and databases such as REX, Quantec, StatsSA, GCRO observatory, national and provincial household travel surveys, and the quality of life surveys provided the basis for data collection. The research concludes that the Gautrain has demonstrated that viable alternatives to the private car can be provided, with its satisfactory feedbacks from users; while some of its station nodes (Sandton, Rosebank) have shown promises of transit-oriented development, one of the project‘s key objectives. The other stations have been unable to stimulate growth due to reasons like non-implementation of their urban design frameworks and lack of public sector investment required to attract private investors. The Rea Vaya BRT continues to be expanded in spite of both its inability to induce modal change and its low ridership figures. The research identifies factors like the low peak to base ratio, pricing, and the city‘s disjointed urban fabric as some of the reasons for its below-average performance. By drawing from the highlights and limitations, the study recommends that public transport provision should be institutionally integrated across and within spheres of government. Similarly, harmonization of the funding structure, better understanding of users’ needs, and travel patterns, underlined with continuity of policy direction and objectives, will equally promote optimal outcomes.

Keywords: bus rapid transit, Gautrain, Rea Vaya, sustainable transport, spatial and transport planning, transit oriented development

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Authors: Hussain Ali Bekhet, Tuan Ab. Rashid Bin Tuan Abdullah, Tahira Yasmin

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The strong relationship between energy consumption and economic growth is widely recognised. Most countries’ energy demand declined during the economic depression known as the Global Financial Crisis (GFC) of 2008–2009. The objective of the current study is to investigate the energy consumption and performance of Malaysia’s manufacturing sectors during the GFC. We applied the output multiplier approach, which is based on the input-output model. Two input-output tables of Malaysia covering 2005 and 2010 were used. The results indicate significant changes in the output multipliers of the manufacturing sectors between 2005 and 2010. Moreover, the energy-to-manufacturing sectors’ output multipliers also decreased during the GFC due to a decline in export-oriented industries during the crisis. The increasing importance of the manufacturing sector to the development of Malaysian trade resulted in a noticeable decrease in the consumption of each energy sector’s output, especially the electricity and gas sector. Based on the research findings, the Malaysian government released several policy implementations in the form of stimulus packages to enhance these sectors’ performance and generally improve the Malaysian economy.

Keywords: global financial crisis, input-output model, manufacturing, output multipliers, energy, Malaysia

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Authors: Abdul-Dahiru El-Yuguda, Saka Saheed Baba, Tawa Monilade Adisa, Mustapha Bala Abubakar

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Background: Chikungunya (CHIK) virus, a previously anecdotally described arbovirus, is now assuming a worldwide public health burden. The CHIK virus infection is characterized by potentially life threatening and debilitating arthritis in addition to the high fever, arthralgia, myalgia, headache and rash. Method: Three hundred and seventy (370) serum samples were collected from outpatients with febrile illness attending University of Maiduguri Teaching Hospital, Nigeria, and was used to detect for Chikungunya (CHIK) virus IgG and IgM antibodies using the Enzyme Linked Immunosorbent Assays (ELISAs). Result: Out of the 370 sera tested, 39 (10.5%) were positive for presence of CHIK virus antibodies. A total of 24 (6.5%) tested positive for CHIK virus IgM only while none (0.0%) was positive for presence of CHIK virus IgG only and 15 (4.1%) of the serum samples were positive for both IgG and IgM antibodies. A significant difference (p<0.0001) was observed in the distribution of CHIK virus antibodies in relation to gender. The males had prevalence of 8.5% IgM antibodies as against 4.6% observed in females. On the other hand 4.6% of the females were positive for concurrent CHIK virus IgG and IgM antibodies when compared to a prevalence of 3.4% observed in males. Only the age groups ≤ 60 years and the undisclosed age group were positive for presence of CHIK virus IgG and/or IgM antibodies. No significant difference (p>0.05) was observed in the seasonal prevalence of CHIK virus antibodies among the study subjects Analysis of the prevalence of CHIK virus antibodies in relation to clinical presentation (as observed by Clinicians) of the patients revealed that headache and fever were the most frequently encountered ailments. Conclusion: The CHIK virus IgM and concurrent IgM and IgG antibody prevalence rates of 6.5% and 4.1% observed in this study indicates a current infection and the lack of IgG antibody alone observed shows that the infection is not endemic but sporadic. Recommendation: Further studies should be carried to establish the seasonal prevalence of CHIK virus infection vis-à-vis vector dynamics in the study area. A comprehensive study need to be carried out on the molecular characterization of the CHIK virus circulating in Nigeria with a view to developing CHIK virus vaccine.

Keywords: Chikungunya virus, IgM and IgG antibodies, febrile patients, enzyme linked immunosorbent assay

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Authors: Patrik Jangl, Milan Mikuláštík

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The objective of the paper is to measure and compare market orientation of Swiss and Czech banks, as well as examine statistically the degree of influence it has on competitiveness of the institutions. The analysis of market orientation is based on the collecting, analysis and correct interpretation of the data. Descriptive analysis of market orientation describe current situation. Research of relation of competitiveness and market orientation in the sector of big international banks is suggested with the expectation of existence of a strong relationship. Partially, the work served as reconfirmation of suitability of classic methodologies to measurement of banks’ market orientation. Two types of data were gathered. Firstly, by measuring subjectively perceived market orientation of a company and secondly, by quantifying its competitiveness. All data were collected from a sample of small, mid-sized and large banks. We used numerical secondary character data from the international statistical financial Bureau Van Dijk’s BANKSCOPE database. Statistical analysis led to the following results. Assuming classical market orientation measures to be scientifically justified, Czech banks are statistically less market-oriented than Swiss banks. Secondly, among small Swiss banks, which are not broadly internationally active, small relationship exist between market orientation measures and market share based competitiveness measures. Thirdly, among all Swiss banks, a strong relationship exists between market orientation measures and market share based competitiveness measures. Above results imply existence of a strong relation of this measure in sector of big international banks. A strong statistical relationship has been proven to exist between market orientation measures and equity/total assets ratio in Switzerland.

Keywords: market orientation, competitiveness, marketing strategy, measurement of market orientation, relation between market orientation and competitiveness, banking sector

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Authors: Gevorgianiene Violeta, Sumskiene Egle

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Background. Child removal is a profound and life-altering measure that significantly impacts both children and their mothers. Unfortunately, mothers with intellectual disabilities are disproportionately affected by the removal of their children. This action is often taken due to concerns about the mother's perceived inability to care for the child, instances of abuse and neglect, or struggles with addiction. In many cases, the failure to meet society's standards of a "good mother" is seen as a deviation from conventional norms of femininity and motherhood. From an institutional perspective, separating a child from their mother is sometimes viewed as a step toward restoring justice or doing what is considered "right." In another light, this act of child removal can be seen as the removal of a mother from her child, an attempt to shield society from the complexities and fears associated with motherhood for women with disabilities. This separation can be likened to the Greek legend of the Minotaur, a fearsome beast confined within an impenetrable labyrinth. By reimagining this legend, we can see the social fears surrounding 'mothering with intellectual disability' as deeply sealed within an unreachable place. The Aim of this Presentation. Our goal with this presentation is to draw from our research and the metaphors found in the Greek legend to delve into the profound challenges faced by mothers with intellectual disabilities in raising their children. These challenges often become entangled within an insurmountable labyrinth, including navigating complex institutional bureaucracies, enduring persistent doubts cast upon their maternal competencies, battling unfavorable societal narratives, and struggling to retain custody of their children. Coupled with limited social support networks, these challenges frequently lead to situations resulting in maternal failure and, ultimately, child removal. On a broader scale, this separation of a child from their mother symbolizes society’s collective avoidance of confronting the issue of 'mothering with disability,' which can only be effectively addressed through united efforts. Conclusion. Just as in the labyrinth of the Minotaur legend, the struggles faced by mothers with disabilities in their pursuit of retaining their children reveal the need for a metaphorical 'string of Ariadne.' This string symbolizes the support offered by social service providers, communities, and the loved ones these women often dream of but rarely encounter in their lives.

Keywords: motherhood, disability, child removal, support.

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Authors: Yuguang Gao, Mingtao Deng

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The integration of independently operating hospitals into a unified healthcare service system has become a strategic imperative in the pursuit of hospitals’ high-quality development. Central to the concept of group governance over such transformation, exemplified by a collaborative medical alliance, is the delineation of shared value, vision, and goals. Given the inherent disparity in capabilities among hospitals within the alliance, particularly in the treatment of different diseases characterized by Disease Related Groups (DRG) in terms of effectiveness, efficiency and resource utilization, this study aims to address the centralized decision-making of intra-hospital patient referral within the medical alliance to enhance the overall production and quality of service provided. We first introduce the notion of production utility, where a higher production utility for a hospital implies better performance in treating patients diagnosed with that specific DRG group of diseases. Then, a Discrete-Event Simulation (DES) framework is established for patient referral among hospitals, where patient flow modeling incorporates a queueing system with fixed capacities for each hospital. The simulation study begins with a two-member alliance. The pivotal strategy examined is a "whether-to-refer" decision triggered when the bed usage rate surpasses a predefined threshold for either hospital. Then, the decision encompasses referring patients to the other hospital based on DRG groups’ production utility differentials as well as bed availability. The objective is to maximize the total production utility of the alliance while minimizing patients’ average length of stay and turnover rate. Thus the parameter under scrutiny is the bed usage rate threshold, influencing the efficacy of the referral strategy. Extending the study to a three-member alliance, which could readily be generalized to multi-member alliances, we maintain the core setup while introducing an additional “which-to-refer" decision that involves referring patients with specific DRG groups to the member hospital according to their respective production utility rankings. The overarching goal remains consistent, for which the bed usage rate threshold is once again a focal point for analysis. For the two-member alliance scenario, our simulation results indicate that the optimal bed usage rate threshold hinges on the discrepancy in the number of beds between member hospitals, the distribution of DRG groups among incoming patients, and variations in production utilities across hospitals. Transitioning to the three-member alliance, we observe similar dependencies on these parameters. Additionally, it becomes evident that an imbalanced distribution of DRG diagnoses and further disparity in production utilities among member hospitals may lead to an increase in the turnover rate. In general, it was found that the intra-hospital referral mechanism enhances the overall production utility of the medical alliance compared to individual hospitals without partnership. Patients’ average length of stay is also reduced, showcasing the positive impact of the collaborative approach. However, the turnover rate exhibits variability based on parameter setups, particularly when patients are redirected within the alliance. In conclusion, the re-structuring of diagnostic disease groups within the medical alliance proves instrumental in improving overall healthcare service outcomes, providing a compelling rationale for the government's promotion of patient referrals within collaborative medical alliances.

Keywords: collaborative medical alliance, disease related group, patient referral, simulation

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Authors: Sema Müge Özdemiray

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In line with the new public management approach to provide effective and efficient services necessary to achieve the social goals of public institutions, employees must have the knowledge and skills required by the age. In conjunction with the transition from personnel management to human resources management, it is seen that there is a change in the understanding of in-service training, the understanding of "required in-service training" has switched to the understanding of "continuous in-service training". However, in terms of in-service training in Turkey, it seems to be trouble at the point of adopting to change. The main purpose of this study is to primarily create a conceptual framework of in-service training and subsequently determine, analyze and discuss the developments and problems faced by in-service training in Turkey in the transition from personnel management to human resources management. In accordance with this purpose, the necessary data of this study were collected using qualitative approaches. Observation and document analysis was used and content analysis was performed on the data gathered in the study. The results of this study, according to data such as the number of institutions requesting in-service training, allocated budget of in-service training, the number of people participating in such training, transition of personnel management to human resources management should not lead to a paradigm shift in Turkey’s understanding of in-service training, although this is compulsory for public institutions in accordance with the law in Turkey. In-service training in Turkish public administration is still not implemented effectively and is seen as a social activity for employees and a formality for institutions.

Keywords: Human resources management, in service training, personnel management, public institutions

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Authors: Nour-Elhouda Lecheheb

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Despite substantial tourism potentials, the Algerian tourism industry has faced a number of challenges, including the government heavy dependence on the energy sector, negative perception in the West, and a lack of effective resource management and marketing. This paper attempts to discuss the challenges hindering the development of the Algerian tourism industry from the perspective of the official tourism suppliers in Algeria both in the public and private sectors. A total of 10 semi-structured interviews were conducted during a field-trip to Algiers, Algeria, in September 2019. From the analysis of the interviews, it is evident that the Algerian tourism suppliers face a number of challenges mainly the country’s negative image in the West and a significant lack of political and financial support to contest this negative image effectively and sufficiently.

Keywords: Algerian tourism, destination development, destination image, tourism suppliers

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Authors: Habib Alshuwaikhat, Nahid Hossain

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Residential sector consumes more than half of the produced electricity in Saudi Arabia, and fossil fuel is the main source of energy to meet growing household electricity demand in the Kingdom. Several studies forecasted and expressed concern that unless the domestic energy demand growth is controlled, it will reduce Saudi Arabia’s crude oil export capacity within a decade and the Kingdom is likely to be incapable of exporting crude oil within next three decades. Though the Saudi government has initiated to address the domestic energy demand growth issue, the demand side energy management policies and programs are focused on industrial and commercial sectors. It is apparent that there is an urgent need to develop a comprehensive energy efficiency strategy for addressing efficient energy use in residential sector in the Kingdom. Then again as Saudi Arabia is at its primary stage in addressing energy efficiency issues in its residential sector, there is a scope for the Kingdom to learn from global energy efficiency practices and design its own energy efficiency policies and programs. However, in order to do that sustainable, it is essential to address local contexts of energy efficiency. It is also necessary to find out the policies and programs that will fit to the local contexts. Thus the objective of this study was set to identify globally best practice energy efficiency policies and programs in residential sector that have replication potential in Saudi Arabia. In this regard two sets of multi-criteria decision analysis matrices were developed to evaluate the energy efficiency policies and programs. The first matrix was used to evaluate the global energy efficiency policies and programs, and the second matrix was used to evaluate the replication potential of global best practice energy efficiency policies and programs for Saudi Arabia. Wuppertal Institute’s guidelines for energy efficiency policy evaluation were used to develop the matrices, and the different attributes of the matrices were set through available literature review. The study reveals that the best practice energy efficiency policies and programs with good replication potential for Saudi Arabia are those which have multiple components to address energy efficiency and are diversified in their characteristics. The study also indicates the more diversified components are included in a policy and program, the more replication potential it has for the Kingdom. This finding is consistent with other studies, where it is observed that in order to be successful in energy efficiency practices, it is required to introduce multiple policy components in a cluster rather than concentrate on a single policy measure. The developed multi-criteria decision analysis matrices for energy efficiency policy and program evaluation could be utilized to assess the replication potential of other globally best practice energy efficiency policies and programs for the residential sector of the Kingdom. In addition it has potential to guide Saudi policy makers to adopt and formulate its own energy efficiency policies and programs for Saudi Arabia.

Keywords: Saudi Arabia, residential sector, energy efficiency, policy evaluation

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Authors: Nabiha Bouafia, Asma Ben Cheikh, Asma Ammar, Olfa Ezzi, Mohamed Mahjoub, Khaoula Meddeb, Imed Chouchene, Hamadi Boussarsar, Mansour Njah

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Background: Hospital acquired infections (HAI) cause significant morbidity, mortality, length of stay and hospital costs, especially in the intensive care unit (ICU), because of the debilitated immune systems of their patients and exposure to invasive devices. The aims of this study were to determine the rate and the risk factors of HAI in an ICU of a university hospital in Tunisia. Materials/Methods: A prospective study was conducted in the 8-bed adult medical ICU of a University Hospital (Sousse Tunisia) during 14 months from September 15th, 2015 to November 15th, 2016. Patients admitted for more than 48h were included. Their surveillance was stopped after the discharge from ICU or death. HAIs were defined according to standard Centers for Disease Control and Prevention criteria. Risk factors were analyzed by conditional stepwise logistic regression. The p-value of < 0.05 was considered significant. Results: During the study, 192 patients had admitted for more than 48 hours. Their mean age was 59.3± 18.20 years and 57.1% were male. Acute respiratory failure was the main reason of admission (72%). The mean SAPS II score calculated at admission was 32.5 ± 14 (range: 6 - 78). The exposure to the mechanical ventilation (MV) and the central venous catheter were observed in 169 (88 %) and 144 (75 %) patients, respectively. Seventy-three patients (38.02%) developed 94 HAIs. The incidence density of HAIs was 41.53 per 1000 patient day. Mortality rate in patients with HAIs was 65.8 %( n= 48). Regarding the type of infection, Ventilator Associated Pneumoniae (VAP) and central venous catheter Associated Infections (CVC AI) were the most frequent with Incidence density: 14.88/1000 days of MV for VAP and 20.02/1000 CVC days for CVC AI. There were 5 Peripheral Venous Catheter Associated Infections, 2 urinary tract infections, and 21 other HAIs. Gram-negative bacteria were the most common germs identified in HAIs: Multidrug resistant Acinetobacter Baumanii (45%) and Klebsiella pneumoniae (10.96%) were the most frequently isolated. Univariate analysis showed that transfer from another hospital department (p= 0.001), intubation (p < 10-4), tracheostomy (p < 10-4), age (p=0.028), grade of acute respiratory failure (p=0.01), duration of sedation (p < 10-4), number of CVC (p < 10-4), length of mechanical ventilation (p < 10-4) and length of stay (p < 10-4), were associated to high risk of HAIS in ICU. Multivariate analysis reveals that independent risk factors for HAIs are: transfer from another hospital department: OR=13.44, IC 95% [3.9, 44.2], p < 10-4, duration of sedation: OR= 1.18, IC 95% [1.049, 1.325], p=0.006, high number of CVC: OR=2.78, IC 95% [1.73, 4.487], p < 10-4, and length of stay in ICU: OR= 1.14, IC 95% [1.066,1.22], p < 10-4. Conclusion: Prevention of nosocomial infections in ICUs is a priority of health care systems all around the world. Yet, their control requires an understanding of epidemiological data collected in these units.

Keywords: healthcare associated infections, incidence, intensive care unit, risk factors

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Authors: Albert T. Akume, P. D. Dahida

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This paper examines the effect of various epochs of governments on policy making in Nigeria. The character of governance and public policy making of both epochs was exclusive, non-participatory and self-centric. As a consequence the interests of citizenry were not represented, neither protected nor sought to meet fairly the needs of all groups. The introduction of the post-1999 democratic government demand that the hitherto skewed pattern of policy making cease to be a character of governance. Hence, the need for citizen participation in the policy making process. The question then is what mode is most appropriate to engender public participation so as to make the policy making process functional? Given the prevailing social, economic and political dilemmas the utilization of the direct mode of citizen participation to affect policy outcome is doubtful if not unattainable. It is due to these predicament that this paper uses the documentary research design argues for the utilization of the indirect mode of citizen participation in the policy making process so as to affect public policy outcome appropriately and with less cost, acrimony and delays.

Keywords: governance, public policy, participation, representation, civil society

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Authors: Kay-Anne Haykal, Issack Biyong

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The post-traumatic stress disorder (PTSD) rises from exposure to a traumatic event and appears by a persistent experience of this event. Several psychiatric co-morbidities are associated with PTSD and include mood disorders, anxiety disorders, and substance abuse. The main objective was to compare the criteria for PTSD according to the literature to those used to diagnose a patient in a francophone hospital and to check the correspondence of these two criteria. 700 medical charts of admitted patients on the medicine or psychiatric unit at the Montfort Hospital were identified with the following diagnoses: major depressive disorder, bipolar disorder, anxiety disorder, substance abuse, and PTSD for the period of time between April 2005 and March 2006. Multiple demographic criteria were assembled. Also, for every chart analyzed, the PTSD criteria, according to the Manual of Mental Disorders (DSM) IV were found, identified, and grouped according to pre-established codes. An analysis using the receiver operating characteristic (ROC) method was elaborated for the study of data. A sample of 57 women and 50 men was studied. Age was varying between 18 and 88 years with a median age of 48. According to the PTSD criteria in the DSM IV, 12 patients should have the diagnosis of PTSD in opposition to only two identified in the medical charts. The ROC method establishes that with the combination of data from PTSD and depression, the sensitivity varies between 0,127 and 0,282, and the specificity varies between 0,889 and 0,917. Otherwise, if we examine the PTSD data alone, the sensibility jumps to 0.50, and the specificity varies between 0,781 and 0,895. This study confirms the presence of an underdiagnosed and treated PTSD that causes severe perturbations for the affected individual.

Keywords: post-traumatic stress disorder, co-morbidities, diagnosis, mental health disorders

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Authors: Napatsorn Suput-Anyaporn

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This paper aimed to investigate multilateral relationships across the factors which included labor shortage, trade union, turnover rate of employee, labor law and regulation, and effectiveness of foreign worker administration in the scope of foreign workers in the industrial manufacturing sector of Thailand. The research employed both quantitative and qualitative approaches, in which foreign workers from Myanmar, Laos and Cambodia in the industrial manufacturing sector in selected areas of Thailand were sampled for the quantitative data collection, and persons in the chief executive management and the supervisor levels, and persons in the academic area in relation with foreign workers were selected as the sample for the qualitative data collection method. Thus, a questionnaire, in-depth interview and focus group were utilized as tools in this research paper. The discussion placed an emphasis on the fact that Thailand should design more effective law and regulations for the foreign workers administration and management in response to preparing for the coming ASEAN Economic Community with the declaration of the free- flow labor movement policy.

Keywords: industrial manufacturing sector, labor law and regulation, labor shortage, migrant worker, trade union, turnover rate of employee

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Authors: Deginet Aklilu, Tianqi Wang, Endwoke Amsalu, Wei Feng, Zhiwei Li, Xia Li, Lixin Tao, Yanxia Luo, Moning Guo, Xiangtong Liu, Xiuhua Guo

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Extreme temperature-related cardiovascular diseases (CVDs) have become a growing public health concern. However, the impact of temperature on the cause of specific CVDs has not been well studied in the study area. The objective of this study was to assess the impact of temperature on cause-specific cardiovascular hospital admissions in Beijing, China. We obtained data from 172 large general hospitals from the Beijing Public Health Information Center Cardiovascular Case Database and China. Meteorological Administration covering 16 districts in Beijing from 2013 to 2017. We used a time-stratified case crossover design with a distributed lag nonlinear model (DLNM) to derive the impact of temperature on CVD in hospitals back to 27 days on CVD admissions. The temperature data were stratified as cold (extreme and moderate ) and hot (moderate and extreme ). Within five years (January 2013-December 2017), a total of 460,938 (male 54.9% and female 45.1%) CVD admission cases were reported. The exposure-response relationship for hospitalization was described by a "J" shape for the total and cause-specific. An increase in the six-day moving average temperature from moderate hot (30.2 °C) to extreme hot (36.9 °C) resulted in a significant increase in CVD admissions of 16.1%(95% CI = 12.8%-28.9%). However, the effect of cold temperature exposure on CVD admissions over a lag time of 0-27 days was found to be non significant, with a relative risk of 0.45 (95% CI = 0.378-0.55) for extreme cold (-8.5 °C)and 0.53 (95% CI = 0.47-0.60) for moderate cold (-5.6 °C). The results of this study indicate that exposure to extremely high temperatures is highly associated with an increase in cause-specific CVD admissions. These finding may guide to create and raise awareness of the general population, government and private sectors regarding on the effects of current weather conditions on CVD.

Keywords: admission, Beijing, cardiovascular diseases, distributed lag non linear model, temperature

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Authors: Wilfred Emmannuel Dzasu, Sani Usman Kunya, Inuwa Yusuf Mohammed, Moses Jonathan Gambo

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The research aimed at investigating and identifying the strategies for enhancing access to microfinance for housing provision in the informal sector of North East Nigeria, with a focus on addressing the critical issue of housing poverty and lack of access to affordable housing finance among low-income households in the informal sector. The study employed an exploratory sequential mixed method design, combining both qualitative and quantitative data collection and analysis techniques. In the qualitative phase, 12 participants from microfinance institutions (MFIs) in four selected states (Adamawa, Bauchi, Gombe, and Taraba) were interviewed. The interviews were conducted using an interview guide with open-ended questions and were recorded with the consent of the respondents. In the quantitative phase, a survey strategy was adopted to collect data from 500 questionnaires distributed to informal sector workers (ISWs) in the study area. A total of 350 questionnaires were returned, representing a 70.0% response rate. The most preferred strategy for improving access to housing microfinance among ISWs is aggressive awareness of housing financing options by MFIs, with a mean score of 4.213; the most important strategy for improving access to housing microfinance among MFIs is close monitoring and adequate supervision of housing loan beneficiaries by MFIs, with a mean score of 4.675. The study identified several government-related strategies that are necessary for enhancing access to housing microfinance, including the provision of grants and subsidized intervention funds for housing, improvement in infrastructures to aid housing developments, and adequate measures for checking inflation/price fluctuation of building materials. The study also identified several MFI-related strategies that are necessary for enhancing access to housing microfinance, including deliberate expansion in the capital bases of MFIs, adequate training and capacity development of MFIs staff on relevant skills in housing micro-financing, and introduction of loan products that suit the incremental building needs of informal sector workers. Overall, the study highlights the need for a combination of government-related and MFI-related strategies to enhance access to microfinance for housing provision in the informal sector of North East Nigeria.

Keywords: finanace, microfinance, housing, North East Nigeria

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Authors: So-Young Lee, Myoung-Won Oh, Soon-Cheol Eom, Yeon-Won Suh

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Buildings produce more than one thirds of the total energy consumption and CO₂ emissions. Korean government agency pronounced and initiated Zero Energy Buildings policy for construction as of 2025. The net zero energy design features include passive (daylight, layout, materials, insulation, finishes, etc.) and active (renewable energy sources) elements. The Zero Energy House recently built in Nowon-gu, Korea is provided for 121 households as a public rental housing complex. However most of public rental housing did not include sustainable features which can reduce housing maintaining cost significantly including energy cost. It is necessary to implement net zero design features to the obsolete public rental housing during the remodeling procedure since it can reduce housing cost in long term. The purpose of this study is to investigate sustainable design elements implemented in Net Zero Energy House in Korea and passive and active housing design features in order to apply the sustainable features to the case public rental apartment for remodeling. Housing complex cases in this study are Nowan zero Energy house, Gangnam Bogemjari House, and public rental housings built in more than 20 years in Seoul areas. As results, energy consumption in public rental housing built in 5-years can be improved by exterior surfaces. Energy optimizing in case housing built in more than 20 years can be enhanced by renovated materials, insulation, replacement of windows, exterior finishes, lightings, gardening, water, renewable energy installation, Green IT except for sunlight and layout of buildings. Further life costing analysis is needed for energy optimizing for case housing alternatives.

Keywords: affordable housing, remodeling, sustainable design, zero-energy house

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Authors: Dalhatu, Musa Yusha’u, Shuaibu Sidi Safiyanu, Haliru Musa Hussaini

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This study examined budget and performance of public enterprises in Nasarawa State, Nigeria in a period of 2009-2013. The study utilized secondary sources of data obtained from four selected parastatals’ budget allocation and revenue generation for the period under review. The simple correlation coefficient was used to analyze the extent of the relationship between budget allocation and revenue generation of the parastatals. Findings revealed varying results. There was positive (0.21) and weak correlation between expenditure and revenue of Nasarawa Investment and Property Development Company (NIPDC). However, the study further revealed that there was strong and weak negative relationship in the revenue and expenditure of the following parastatals over the period under review. Viz: Nasarawa State Water Board, -0.27 (weak), Nasarawa State Broadcasting Service, -0.52 (Strong) and Nasarawa State College of Agriculture, -0.36 (weak). The study therefore, recommends that government should increase its investments in NIPDC to enhance efficiency and profitability. It also recommends that government should strengthen its fiscal responsibility, accountability and transparency in public parastatals.

Keywords: budget, public enterprises, revenue, enterprise

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Authors: Dan Li, Hao Tang

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The idea of “public bonds” was foreign to Qing China because it went against the traditional political ideology that supported that the emperor had absolute ownership over the nation. When a new fiscal crisis emerged out of the First Sino-Japanese War in 1894, the Qing rulers had no better option than to issue domestic bonds. This article documents the processes of issuance, distribution, and reimbursement for a total of three bonds issued by the Qing. These processes reveal how a well-established Western fiscal instrument could be extremely awkward and difficult to implant in China—a culturally, politically, and institutionally different society. Our paper sheds light on why Qing China failed to rise as a modern fiscal state.

Keywords: public bond, Qing China, fiscal crisis, fiscal state, the first Sino-Japanese war

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Authors: Maria Luisa Nozawa Ribeiro, Maria Teresa Miceli Kerbauy

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This paper aims to present the theories of public participation in order to understand the context of the public GMO (Genetic Modified Organisms) policies in Brazil, highlighting the characteristics of its configuration and the dialog with the experts. As a controversy subject, the commercialization of GMO provoked manifestation of some popular and environmental representative groups questioning the decisions of policy makers and experts on the matter. Many aspects and consequences of the plantation and consumption of this crops emerged and the safety of this technology was questioned. Environmentalists, Civil Right's movement, representatives of rural workers, farmers and organics producers, etc. demonstrated their point of view, also sustained by some experts of medical, genetical, environmental, agronomical sciences, etc. fields. Despite this movement, the precautionary principle (risk management), implemented in 1987, suggested precaution facing new technologies and innovations in the sustainable development society. This principle influenced many legislation and regulation on GMO around the world, including Brazil, which became a reference among the world regulatory GMO systems. The Brazilian legislation ensures the citizens participation on GMO discussion, characteristic that was important to establish the connection between the subject and the participation theory. These deliberation spaces materialized in Brazil through the "Public Audiences", which are managed by the National Biosafety Technical Commission (CTNBio), the department responsible for controlling the research, production and commercialization of GMOs in Brazil.

Keywords: public engagement, public participation, science and technology studies, transgenic politics

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Authors: Mohammed Sani Abdulai

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Ghana’s Public Financial Management reforms have been going on for some two decades now (1997/98 to 2017/18). Given this long period of reforms, Ghana in 2019 is putting together both a Public Financial Management (PFM) strategy and a Ghana Integrated Financial Management Information System (GIFMIS) strategy for the next 5-years (2020-2024). The primary aim of these dual strategies is assisting the country in moving beyond reforms to consolidation and sustainability. In this paper we, first, examined the evolution of Ghana’s PFM reforms. We, secondly, reviewed the legal and institutional reforms undertaken to strengthen the country’s key PFM institutions. Thirdly, we summarized the strengths and weaknesses identified by the 2018 Public Expenditure and Financial Accountability (PEFA) assessment of Ghana’s PFM system relating to its macro-fiscal framework, budget preparation and approval, budget execution, accounting and fiscal reporting as well as external scrutiny and audit. We, finally, considered what the country should be doing to achieve its intended goal of PFM consolidation and sustainability. Using a qualitative method of review and analysis of existing documents, we, through this paper, brought to the fore the lessons that could be learnt by other developing countries from Ghana’s PFM reforms experiences. These lessons included the need to: (a) undergird any PFM reform with a comprehensive PFM reform strategy; (b) undertake a legal and institutional reforms of the key PFM institutions; (c) assess the strengths and weaknesses of those reforms using PFM performance evaluation tools such as PEFA framework; and (d) move beyond reforms to consolidation and sustainability.

Keywords: public financial management, public expenditure and financial accountability, reforms, consolidation, sustainability

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Authors: Asem M. Othman

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The expansion of the hospitality industry is unmistakable. Services, by nature, are intangible. Hence, service quality, in general, is a complicated process to be measured and evaluated. Hotels, as a service sector and part of the hospitality industry, are growing rapidly. This research paper was carried out to identify the quality determinants that may affect hotel guests’ service quality perception. In this research paper, each quality determinant will be discussed, illustrated, and justified thoroughly via a systematic literature review. The purpose of this paper is to set the stage to measure the significant influence of the service quality determinants on guest satisfaction. The knowledge produced from this study will assist practitioners and/or hotel service providers to imply into their policies.

Keywords: service quality, hotel service, quality management, quality determinants

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Authors: Isahakyan Heghine

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Intertextuality, being in the centre of attention of both linguists and literary critics, is vividly expressed in the outstanding British novelist and philosopher J. Fowles' works. 'The Magus’ is a deep psychological and philosophical novel with vivid intertextual links with the Greek mythology and authors from different epochs. The aim of the paper is to show how intertextuality might serve as a dialogue between two authors (J. Fowles and J. Donne) disguised in the dialogue of two protagonists of the novel : Conchis and Nicholas. Contrastive viewpoints concerning man's isolation, loneliness are stated in the dialogue. Due to the conceptual analysis of the text it becomes possible both to decode the conceptual information of the text and find out its intertextual links.

Keywords: dialogue, conceptual analysis, isolation, intertextuality

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

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

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

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Authors: A. Wahid Uddin

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Obstetric anal sphincter injury carries significant morbidity for a woman and affects the quality of life to the extent of permanent damage to anal sphincter musculature. The study was undertaken in a district general hospital by retrospectively reviewing random 63 case notes of patients diagnosed with a significant third or fourth-degree perineal tear admitted between the year of 2015 to 2018. The observations were collected by a pre-designed questionnaire. All variables were expressed as percentages. The major risk factors noted were nulliparity (37%), instrumental delivery (25%), and birth weight of more than 4 kg (14%). Forceps delivery with or without episiotomy was the major contributing factor (75%). In the majority of the cases (71%), no record of any perineal protection measures undertaken. The study concluded that recommended perineal protection measures should be adopted as a routine practise.

Keywords: forceps, obstetrics, perineal, sphincter

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Authors: Pia Moschall, Kathrin Sackmann

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Considering a purchasing volume of around two trillion Euros per year, which equals about 14% of the European Union’s gross domestic product, European public authorities have significant market power. Making use of this market power by prioritizing the procurement of green products and services offers a great potential to contribute to the Green New Deal. The market demand that is created by Green Public Procurement (GPP) sets incentives for European producers to design and develop Green Products and Eco-Innovations. However, most procurement still does not consider environmental criteria. The goal of the work is to encourage the adaptation of GPP in the European Union. To this end, the drivers for the adaptation were investigated over different case studies. The paper analyzes good-practice cases from European authorities from 2010 to 2020 that were provided by the European Commission. This analysis was guided by Philipp Mayring’s method of qualitative content analysis, whereby the inductively formed categories led to the identification of nine major drivers. The most important ones are ‘use of official guidelines and standards, ‘political support and requirements as well as ‘market research and involvement.’ Further, the paper discusses mutual dependencies between several drivers and how to exploit them. A supporting infrastructure was identified as a crucial factor for the successful adaption of green public procurement. In the next step, the work aims to examine on which administrative level the single drivers can be implemented most effectively. Practical implications of this research are recommendations on how to create a supporting structure on a municipal, federal and national level, including training for the responsible staff, support tools, as well as guidelines and standards for involved stakeholders.

Keywords: content analysis, green public procurement, public authorities, sustainable procurement

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Authors: Saad Bin Nasir

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The research will examine the role of corporate governance (CG) practices on firm’s financial performance. Population of this research will be manufacture sector of Pakistan. For the purposes of measurement of impact of corporate governance practices such as board size, board independence, ceo/chairman duality, will take as independent variables and for the measurement of firm’s performance return on assets and return on equity will take as dependent variables. Panel data regression model will be used to estimate the impact of CG on firm performance.

Keywords: corporate governance, board size, board independence, leadership

Procedia PDF Downloads 525