Search results for: territorial civil service

Authors: Fouzieh Rouzmehr, Mehdi Mousavi

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Hot mix asphalt concrete (HMAC) is a mixture of aggregates and bitumen. The primary ingredient that determines the mechanical properties of HMAC is the bitumen in it, which displays viscoelastic behavior under normal service conditions. For simplicity, asphalt concrete is considered an elastic material, but this is far from reality at high service temperatures and longer loading times. Viscoelasticity means that the material's stress-strain relationship depends on the strain rate and loading duration. The goal of this paper is to simulate the mechanical response of flexible pavements using linear elastic and viscoelastic modeling of asphalt concrete and predict pavement performance. Falling Weight Deflectometer (FWD) load will be simulated and the results for elastic and viscoelastic modeling will be evaluated. The viscoelastic simulation is performed by the Prony series, which will be modeled by using ANSYS software. Inflexible pavement design, tensile strain at the bottom of the surface layer and compressive strain at the top of the last layer plays an important role in the structural response of the pavement and they will imply the number of loads for fatigue (Nf) and rutting (Nd) respectively. The differences of these two modelings are investigated on fatigue cracking and rutting problem, which are the two main design parameters in flexible pavement design. Although the differences in rutting problem between the two models were negligible, in fatigue cracking, the viscoelastic model results were more accurate. Results indicate that modeling the flexible pavement with elastic material is efficient enough and gives acceptable results.

Keywords: flexible pavement, asphalt, FEM, viscoelastic, elastic, ANSYS, modeling

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Authors: Sidiqat A. Aderinoye-Abdulwahab, Lateef L. Adefalu, Jubril O. Animashaun

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Pastoralists in Nigeria are situated in dry regions - where water and pasture for livestock are particularly scarce, as well as areas with poor availability of social amenities and infrastructure. This study therefore explored how extension service could be used to reduce the exposure of nomads to effects of seasonality, climate change, and the poor environmental conditions. The study was carried out in Northern guinea Savannah region of Nigeria because pastoralists have settled there in large numbers due to desertification and low rainfall in the arid regions. A multi-stage sampling procedure was used to arrive at the selection of two states (Kwara and Nassarawa) in the region. A total of 63 respondents were randomly chosen using simple random sampling. Focus group discussions and questionnaire were used to gather information while the data was analysed using content analysis. The facilities required by the sampled households are milking machine, cheese making machine, and preservatives to increase the shelf life of cheese. Whilst, the extension service required are demonstration on cheese making, training and seminars on animal husbandry. Additionally, livestock of pastoralists often encroach on farmers’ plots which usually result in pastoralist-farmer conflicts. The study thus recommends diversification of economic activity from livestock to non-livestock related activities as well as creation of grazing routes to reduce pastoralist/farmer conflict.

Keywords: arid region, coping strategies, livestock, livelihood

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Authors: Özgür Bahadir, Meltem Kurtuncu

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The study was designed as quasi-experimental and conducted to determine the effect of music therapy on anxiety, fear and pain management in 6-12-year-old children undergoing surgery. The present study was carried out between 01.01.2016 and 19.08.2016 in BEU. Application and Research Center. The children aged 6 -12 who applied for surgery between the mentioned dates constituted the universe of the study. In the quasi-experimental study that was conducted in the clinics where children received operational treatment, two groups were formed: experimental group (the children who received musical therapy before the surgery) and control group (the children who were administered surveys and the surgery service routines only). Each group consisted of 30 children, and the participants of the study were 60 children in total. Necessary permissions were obtained from the parents of the children hospitalized before the beginning of the implementation. The data was collected through Child Anxiety Sensitivity Index (CASI), “Fear In Medical Treatment Scale”, Face, Legs, Activity, Cry, Consolability Scale (FLACC), Visual Analog Scale (VAS) and Participant Information Form. In the analysis of the data, Kolmogorov-Smirnov distribution scale was used to examine the normality of the distribution along with descriptive statistics methods (Frequency, Percentage, Mean, Standard Deviation). Data was presented in the tables in numbers and percentages. Means were demonstrated along with the standard deviations. The research compared children received; case and control groups include socio-demographic perspective, non-significant difference statistically among similar groups are intertwined. The general level of fear regarding the medical processes before returning to service after the operation and 30 minutes before getting discharged was found to be significantly low in the experimental group compared to control group (p<0.05). No statistically significant difference was found between experimental and control groups in terms of general level of fear regarding the medical processes before the operation, during the operation day and in the recovery room after the operation (p>0.05). Total CASI AD (anxiety sensitivity) levels before the operation, day of the operation and 30 minutes before the discharge for patients in experimental group was found to be significantly higher than the control group (p>0.05). There was no statistically significant difference between the experimental and control groups in the total CASI AD levels for the post-operative recovery room and for returning to the service room after the operation (p>0.05). VAS levels for patients in the experimental group in the post-operative recovery room was significantly higher than the control group (p>0.05). There was no statistically significant difference between the groups in terms of VAS findings in returning to service room after the operation and in 30 minutes before the discharge (p>0.05). As a result of the research; applied children music therapy in the experimental group anxiety, fear, and pain of the scales, their scores average, is lower than the control group children in this situation an increase in the satisfaction of children and parents was observed. In line with this, music therapy preoperative anxiety, fear, and can be used as an effective method of decreasing postoperative pain clinics is suggested.

Keywords: anxiety, children, fear, music therapy, pain

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Authors: Ebeed A. Saleh, Kadry M. Sadek, Safaa H. Ghorbal

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Due to the determination of the pollution status of fresh resources in the Egyptian territorial waters is very important for public health, this study was carried out to reveal the levels of heavy metals in the shellfish and their environment and its relation to the highly developed industrial activities in those areas. A total of 100 shellfish samples from the Rosetta, Edku, El-Maadiya, Abo-Kir and El-Max coasts [10 crustaceans (shrimp) and 10 mollusks (oysters)] were randomly collected from each coast. Additionally, 10 samples from both the water and the sediment were collected from each coast. Each collected sample was analyzed for cadmium, chromium, copper, lead and zinc residues using a Perkin Elmer atomic absorption spectrophotometer (AAS). The results showed that the levels of heavy metals were higher in the water and sediment from Abo-Kir. The heavy metal levels decreased successively for the Rosetta, Edku, El-Maadiya, and El-Max coasts, and the concentrations of heavy metals, except copper and zinc, in shellfish exhibited the same pattern. For the concentration of heavy metals in shellfish tissue, the highest was zinc and the concentrations decreased successively for copper, lead, chromium and cadmium for all coasts, except the Abo-Kir coast, where the chromium level was highest and the other metals decreased successively for zinc, copper, lead and cadmium. In Rosetta, chromium was higher only in the mollusks, while the level of this metal was lower in the crustaceans; this trend was observed at the Edku, El-Maadiya and El-Max coasts as well. Herein, we discuss the importance of such contamination for public health and the sources of shellfish contamination with heavy metals. We suggest measures to minimize and prevent these pollutants in the aquatic environment and, furthermore, how to protect humans from excessive intake.

Keywords: atomic absorption, heavy metals, sediment, shellfish, water

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Authors: M. Mohan, J. P. Roise, G. P. Catts

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Despite living in an era where conservation zones are de-facto the central element in any sustainable wildlife management strategy, we still find ourselves grappling with several pareto-optimal situations regarding resource allocation and area distribution for the same. In this paper, a multi-objective decision making (MODM) model is presented to answer the question of whether or not we can establish mutual relationships between these contradicting objectives. For our study, we considered a Red-cockaded woodpecker (Picoides borealis) habitat conservation scenario in the coastal plain of North Carolina, USA. Red-cockaded woodpecker (RCW) is a non-migratory territorial bird that excavates cavities in living pine trees for roosting and nesting. The RCW groups nest in an aggregation of cavity trees called ‘cluster’ and for our model we use the number of clusters to be established as a measure of evaluating the size of conservation zone required. The case study is formulated as a linear programming problem and the objective function optimises the Red-cockaded woodpecker clusters, carbon retention rate, biofuel, public safety and Net Present Value (NPV) of the forest. We studied the variation of individual objectives with respect to the amount of area available and plotted a two dimensional dynamic graph after establishing interrelations between the objectives. We further explore the concept of interdependency by integrating the MODM model with GIS, and derive a raster file representing carbon distribution from the existing forest dataset. Model results demonstrate the applicability of interdependency from both linear and spatial perspectives, and suggest that this approach holds immense potential for enhancing environmental investment decision making in future.

Keywords: conservation, interdependency, multi-objective decision making, red-cockaded woodpecker

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Authors: Mubashra Shaheen

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The conflict over the South China Sea (SCS) is a complex imbroglio spanning over several territorial and maritime claims involving two major island groups, the Paracels and the Spratlys. It has become a major source of geopolitical competition between the United States and China. The study's overall objective is to understand China's land reclamations and assertive behavior in the South China Sea, which lies between both the Western Pacific and the Indian Ocean. Over half of global commerce passes through these waterways, which host a great amount of marine life and hydrocarbon deposits. China's sand-filling and island-building strategy in the South China Sea is motivated by its goal of privatizing all these riches as well as the routes. It would raise China to the pinnacle of world power status as well as allow it to threaten the dominance of the U.S. The study will examine China's assertive behavior and modernization plans as well as the United States' quest for supremacy through the lens of realists. While using a qualitative method of analysis, the study will examine China's nine-dash line claims and Exclusive Economic Zones (EEZs), UNCLOS, and U.S.-China divergence over international law considerations to pacify the tensions in the South China Sea. This paper is intended to explore the possible answers to the following questions: (1) Why does China’s rise necessitate the US's efforts to contain and encircle it through the lending of a hand to strategic partners and allies in the South China Sea? (2) Why South China Sea dispute is so complex imbroglio? (3) What are US-China international law considerations regarding the South China Sea? The study will further follow the bellow research procedure: 1: Comparative Legal Method: This method simply chalk-outs the follow of few steps that discarnate the positive and negative effects of the great power competitions. 2: Conceptualization: The conceptualization of the policies of containment defines and differentiates two different problems behind the persuasive means of hegemony and dominance in the strategic milieu.

Keywords: us, china, south china sea, unclos

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Authors: Lucia Perez, Maria Gaton y Santa Palella

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Starting from the etymology of the word culture, the Latin term ‘colere’, whose meaning is to cultivate, we understand that the society that cultivates its knowledge is laying the foundations for new possibilities. In this sense, art and fashion contain the same attributes: concept, aesthetic principles, and refined techniques. Both play a crucial role, communication, and this implies a sense of community, relationship with tradition, and innovation. This is the mirror in which to contemplate, but also the space that helps to grow. This is the framework where our object of study opens up: the anthropological management or the mission management model applied to fashion exhibitions in museums and cultural institutions. For this purpose, a bibliographic review has been carried out with its subsequent analysis, a case study of three successful exhibitions: ‘Christian Dior: designer of dreams’, ‘Balenciaga and the Spanish painting’, and ‘China: Through the Looking Glass’. The methodology has been completed with interviews focused on the curators. Amongst the results obtained, it is worth highlighting the fundamental role of transcendent leadership, which, in addition to being results-oriented, must align the motivations of the collaborators with the mission. The anthropological management model conceives management as a service, and it is oriented to the interests of the staff and the public, in short, of the person; this is what enables the objectives of effectiveness, efficiency, and social value to be achieved; dimensions, all necessary for the proper development of the mission of the exhibitions. Fashion, understood as art, is at the service of culture, and therefore of the human being, which defines a transcendent mission. We conclude that the profile of an anthropological management model applied to fashion exhibitions in museums is the ideal one to achieve the purpose of these institutions.

Keywords: art, culture, fashion, anthropological model, fashion exhibitions

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Authors: Carly Nesvat, Dominic Jarrett, Colin Thomson, Wilma Coltart, Thelma Bowers, Jan Thomson

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Introduction: Within Scotland, the Same As You strategy committed to moving people with learning disabilities out of long-stay hospital accommodation into homes in the community. Much of the focus of this movement was on the placement of people within individual homes. In order to achieve this, potentially excessive supports were put in place which created dependence, and carried significant ongoing cost primarily for local authorities. The greater focus on empowerment and community participation which has been evident in more recent learning disability strategy, along with the financial pressures being experienced across the public sector, created an imperative to re-examine that provision, particularly in relation to the use of expensive sleepover supports to individuals, and the potential for this to be appropriately scaled back through the use of telecare. Method: As part of a broader programme of redesigning overnight supports within North Ayrshire, a cluster of individuals living in close proximity were identified, who were in receipt of overnight supports, but who were identified as having the capacity to potentially benefit from their removal. In their place, a responder service was established (an individual staying overnight in a nearby service user’s home), and a variety of telecare solutions were placed within individual’s homes. Active and passive technology was connected to an Alarm Receiving Centre, which would alert the local responder service when necessary. Individuals and their families were prepared for the change, and continued to be informed about progress with the pilot. Results: 4 individuals, 2 of whom shared a tenancy, had their sleepover supports removed as part of the pilot. Extensive data collection in relation to alarm activation was combined with feedback from the 4 individuals, their families, and staff involved in their support. Varying perspectives emerged within the feedback. 3 of the individuals were clearly described as benefitting from the change, and the greater sense of independence it brought, while more concerns were evident in relation to the fourth. Some family members expressed a need for greater preparation in relation to the change and ongoing information provision. Some support staff also expressed a need for more information, to help them understand the new support arrangements for an individual, as well as noting concerns in relation to the outcomes for one participant. Conclusion: Developing a telecare response in relation to a cluster of individuals was facilitated by them all being supported by the same care provider. The number of similar clusters of individuals being identified within North Ayrshire is limited. Developing other solutions such as a response service for redesign will potentially require greater collaboration between different providers of home support, as well as continuing to explore the full range of telecare, including digital options. The pilot has highlighted the need for effective preparatory and ongoing engagement with staff and families, as well as the challenges which can accompany making changes to long-standing packages of support.

Keywords: challenges, change, engagement, telecare

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Authors: Lopamudra Bakshi Basu

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Transport is one of the most important characteristic features of Indian cities. The physical and societal requirements determine the selection of a particular transport system along with the uniqueness of road networks. Kolkata has a mixed traffic of which Paratransit system plays a crucial role. It is an indispensable transport system in Kolkata mainly because of its size and service flexibility which has led to a unique network character. The paratransit system, mainly the autorickshaws, is the most favoured mode of transport in the city. Its fast movement and comfortability make it a vital transport system of the city. Since the inception of the autorickshaws in Kolkata in 1981, this mode has gained popularity and presently serves nearly 80 to 90 percent of the total passenger trips. This employment generating mode of transport has increased its number rapidly affecting the city’s traffic. Minimal check on their growth by the authority has led to traffic snarls along many streets of Kolkata. Indiscipline behavior, violation of traffic rules and rash driving make situations even worse. The rise in the number and increasing popularity of the autorickshaws make it an interesting study area. Autorickshaws as a paratransit mode play its role as a leader or a follower. However, it is informal in its planning and operations, which makes it a problem area for the city. The entire research work deals with the growth and expansion of the number of vehicles and the routes within the city. The development of transport system has been interesting in the city, which has been studied. The growth of the paratransit modes in the city has been rapid. The network pattern of the paratransit mode within Kolkata has been analysed.

Keywords: growth, informal, network characteristics, paratransit, service flexibility

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Authors: Vinod Chovvayil Panengal

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The idea of secularism in India has taken a different direction after independence when religion became a reason for a great divide in, otherwise harmonious society. Since then the religious spaces became protected and more sacred and not shared. However, there is a larger threat on beliefs, rituals, and the spirituality of these religions in the form of technology, tourism and globalization. In a way, they weaken the importance of religion from our society over a period of time. The importance of religion to a sense of place has been overlooked or diminished. Religion provides symbolic meaning to places which distinguishes certain physical environments from otherwise similar ones. The rapid transformation of urban spaces, eliminating the territorial differences of sense, spirit and identity have started creating urban centers rooting out this genre of unique urban spaces from our cities. Indian cities, with a strong identity created by rich and colorful overlays of culture through its evolution, have been threatened by this de-territorialization. This paper enquires the relationship of the symbol of the identity and religiosity of a place, through spatial form, rituals and activity, and accommodating the technology and the changing social structure within the bounds of that relationship. The subjects for this enquiry are Sufism and the Sufi city- Ajmer. The internal transformations in the ideologies of Islam and Sufism and the changes in the society surround it triggered the phenomena of de- territorialization. The need for establishing a symbiotic relationship between the spiritual content and the social life, through the manifestation of space, time and activity derived from this concern on abated territory of Sufism inside the city. Redirecting transformation catalyst such as tourism, technology, etc, towards the improvement of physical and social conditions, preservation of the heritage and the expansion of the notional idea of religion over the city will help to re- territorialize city as a Sufi city.

Keywords: sense of place, religion, Islam, identity

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Authors: Rishana Bilimoria, Selina Tang, Sajni Shah, Marianne Henien, Christopher Sproat

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Temporomandibular disorders (TMD) may affect up to a third of the general population, and there is evidence demonstrating the majority of Myofascial TMD cases improve after education and conservative measures. In 2015 our department implemented a modified care pathway for myofascial TMD patients in an attempt to improve the patient journey. This involved the use of an interactive group therapy approach to deliver education, reinforce conservative measures and promote self-management. Patient reported experience measures from the new group clinic revealed 71% patient satisfaction. This service is efficient in improving aspects of health status while reducing health-care costs and redistributing clinical time. Since its’ establishment, 52 hours of clinical time, resources and funding have been redirected effectively. This Quality Improvement Project was initiated because it was felt that this new service was being underutilised by our surgical teams. The ‘Plan-Do-Study-Act cycle’ (PDSA) framework was employed to analyse utilisation of the service: The ‘plan’ stage involved outlining our aims: to raise awareness amongst clinicians of the unified care pathway and to increase referral to this clinic. The ‘do’ stage involved collecting data from a sample of 96 patients over 4 month period to ascertain the proportion of Myofascial TMD patients who were correctly referred to the designated clinic. ‘Suitable’ patients who weren’t referred were identified. The ‘Study’ phase involved analysis of results, which revealed that 77% of suitable patients weren’t referred to the designated clinic. They were reviewed on other clinics, which are often overbooked, or managed by junior staff members. This correlated with our original prediction. Barriers to referral included: lack of awareness of the clinic, individual consultant treatment preferences and patient, reluctance to be referred to a ‘group’ clinic. The ‘Act’ stage involved presenting our findings to the team at a clinical governance meeting. This included demonstration of the clinical effectiveness of the care-pathway and explaining the referral route and criteria. In light of the evaluation results, it was decided to keep the group clinic and maximize utilisation. The second cycle of data collection following these changes revealed that of 66 Myofascial TMD patients over a 4 month period, only 9% of suitable patients were not seen via the designated pathway; therefore this QIP was successful in meeting the set objectives. Overall, employing the PDSA cycle in this QIP resulted in appropriate utilisation of the modified care pathway for patients with myofascial TMD in Guy’s Oral Surgery Department. In turn, this leads to high patient satisfaction with the service and effectively redirected 52 hours of clinical time. It permitted adoption of a collaborative working style with oral surgery colleagues to investigate problems, identify solutions, and collectively raise standards of clinical care to ensure we adopt a unified care pathway in secondary care management of Myofascial TMD patients.

Keywords: myofascial, quality Improvement, PDSA, TMD

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Authors: Mamiko Orii

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This study reports on primary school second language teachers’ sources of language insecurity. Furthermore, it aims to develop an in-service training course to reduce anxiety and build sufficient English communication skills. Language/Linguistic insecurity refers to a lack of confidence experienced by language speakers. In particular, second language/non-native learners often experience insecurity, influencing their learning efficacy. While language learner insecurity has been well-documented, research on the insecurity of language teaching professionals is limited. Teachers’ language insecurity or anxiety in target language use may adversely affect language instruction. For example, they may avoid classroom activities requiring intensive language use. Therefore, understanding teachers’ language insecurity and providing continuing education to help teachers to improve their proficiency is vital to improve teaching quality. This study investigated Japanese primary school teachers’ language insecurity. In Japan, teachers are responsible for teaching most subjects, including English, which was recently added as compulsory. Most teachers have never been professionally trained in second language instruction during college teacher certificate preparation, leading to low confidence in English teaching. Primary source of language insecurity is a lack of confidence regarding English communication skills. Their actual use of English in classrooms remains unclear. Teachers’ classroom speech remains a neglected area requiring improvement. A more refined programme for second language teachers could be constructed if we can identify areas of need. Two questionnaires were administered to primary school teachers in Tokyo: (1) Questionnaire A: 396 teachers answered questions (using a 5-point scale) concerning classroom teaching anxiety and general English use and needs for in-service training (Summer 2021); (2) Questionnaire B: 20 teachers answered detailed questions concerning their English use (Autumn 2022). Questionnaire A’s responses showed that over 80% of teachers have significant language insecurity and anxiety, mainly when speaking English in class or teaching independently. Most teachers relied on a team-teaching partner (e.g., ALT) and avoided speaking English. Over 70% of the teachers said they would like to participate in training courses in classroom English. Questionnaire B’s results showed that teachers could use simple classroom English, such as greetings and basic instructions (e.g., stand up, repeat after me), and initiate conversation (e.g., asking questions). In contrast, teachers reported that conversations were mainly carried on in a simple question-answer style. They had difficulty continuing conversations. Responding to learners’ ‘on-the-spot’ utterances was particularly difficult. Instruction in turn-taking patterns suitable in the classroom communication context is needed. Most teachers received grammar-based instruction during their entire English education. They were predominantly exposed to displayed questions and form-focused corrective feedback. Therefore, strategies such as encouraging teachers to ask genuine questions (i.e., referential questions) and responding to students with content feedback are crucial. When learners’ utterances are incorrect or unsatisfactory, teachers should rephrase or extend (recast) them instead of offering explicit corrections. These strategies support a continuous conversational flow. These results offer benefits beyond Japan’s English as a second Language context. They will be valuable in any context where primary school teachers are underprepared but must provide English-language instruction.

Keywords: english as a second/non-native language, in-service training, primary school, teachers’ language insecurity

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Authors: Muhammed Ordu, Eren Demir, Chris Tofallis

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Over the past decade, the non-elective admissions in the UK have increased significantly. Taking into account limited resources (i.e. beds), the related service managers are obliged to manage their resources effectively due to the non-elective admissions which are mostly admitted to inpatient specialities via A&E departments. Geriatric medicine is one of specialities that have long length of stay for the non-elective admissions. This study aims to develop a discrete event simulation model to understand how possible increases on non-elective demand over the next 12 months affect the bed occupancy rate and to determine required number of beds in a geriatric medicine speciality in a UK hospital. In our validated simulation model, we take into account observed frequency distributions which are derived from a big data covering the period April, 2009 to January, 2013, for the non-elective admission and the length of stay. An experimental analysis, which consists of 16 experiments, is carried out to better understand possible effects of case studies and scenarios related to increase on demand and number of bed. As a result, the speciality does not achieve the target level in the base model although the bed occupancy rate decreases from 125.94% to 96.41% by increasing the number of beds by 30%. In addition, the number of required beds is more than the number of beds considered in the scenario analysis in order to meet the bed requirement. This paper sheds light on bed management for service managers in geriatric medicine specialities.

Keywords: bed management, bed occupancy rate, discrete event simulation, geriatric medicine, non-elective admission

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Authors: Adamu Abdullahi, On Francisca, Saidu Isah Rambo, G. N. Obunadike, D. T. Chinyio

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The paper discusses the potential threat of Denial of Service (DoS) attacks in the Internet of Things (IoT) networks on constrained application protocols (CoAP). As billions of IoT devices are expected to be connected to the internet in the coming years, the security of these devices is vulnerable to attacks, disrupting their functioning. This research aims to tackle this issue by applying mixed methods of qualitative and quantitative for feature selection, extraction, and cluster algorithms to detect DoS attacks in the Constrained Application Protocol (CoAP) using the Machine Learning Algorithm (MLA). The main objective of the research is to enhance the security scheme for CoAP in the IoT environment by analyzing the nature of DoS attacks and identifying a new set of features for detecting them in the IoT network environment. The aim is to demonstrate the effectiveness of the MLA in detecting DoS attacks and compare it with conventional intrusion detection systems for securing the CoAP in the IoT environment. Findings: The research identifies the appropriate node to detect DoS attacks in the IoT network environment and demonstrates how to detect the attacks through the MLA. The accuracy detection in both classification and network simulation environments shows that the k-means algorithm scored the highest percentage in the training and testing of the evaluation. The network simulation platform also achieved the highest percentage of 99.93% in overall accuracy. This work reviews conventional intrusion detection systems for securing the CoAP in the IoT environment. The DoS security issues associated with the CoAP are discussed.

Keywords: algorithm, CoAP, DoS, IoT, machine learning

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Authors: Zikra Faiz, Nisar Abid, Muhammad Waqas

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This study aim to examine the challenges faced by teachers during teaching to those students who are intellectually disable, suffering from autism spectrum disorder, learning disability, and ADHD at the primary level. The descriptive research design of quantitative approach was adopted to conduct this study; a cross-sectional survey method was used to collect data. The sample was comprised of 258 (43 male and 215 female) teachers who teach at special education institutes of Lahore district selected through proportionate stratified random sampling technique. Self-developed questionnaire was used which was comprised of 22 closed-ended items. Collected data were analyzed through descriptive and inferential statistical techniques by using Statistical Package for Social Sciences (SPSS) version 21. Results show that teachers faced problems during group activities, to handle bad behavior and different disabilities of students. It is concluded that there was a significant difference between male and female teachers perceptions about challenges faced during teaching with developmental disable students. Furthermore, there was a significant difference exist in the perceptions of teachers regarding challenges faced during teaching to students with developmental disabilities in term of teachers’ age and area of specialization. It is recommended that developmentally disable student require extra attention so that, teacher should trained through pre-service and in-service training to teach developmentally disabled students.

Keywords: intellectual disability, autism spectrum disorder, ADHD, learning disability

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Authors: Sarah A. Tobin

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Social justice outcomes, derived from customer satisfaction, serve as a main pathway and conduit for achieving Sustainable Development Goals (SDGs) because they prompt democratizing and socially-inclusive effects that are consistent with Islamic economic values. This paper argues that achieving higher levels of social justice and the SGDs is possible only through the realization of Islamic banking and finance customer satisfaction that aligns with Islamic values in the tradition of the Shari`a (or Islamic law). Through this key manifestation of Shari`a in the banks, social justice aims of achieving SDGs become possible. This paper utilizes a case study of a large-scale survey (N=127) comparing customer satisfaction between a conventional and an Islamic bank in Amman, Jordan. Based on a series of linear regressions, the statistically-significant findings suggest that when overall customer satisfaction is high, customers are more likely to become empowered citizens demanding inclusive, quality services and corruption-free management, as well as attribute their experiences to the Islamic nature of the financial endeavors. Social justice interests and expectations increase (and SDGs are more likely met) when a customer has high levels of satisfaction. The paper concludes with policy recommendations for Islamic financial institutions that enhance customer service experiences for better achieving the social justice aims of the Islamic economy and SDGs, including transparency in transactions, exemplary customer service and follow up, and attending to Islamic values in the aesthetics of bank.

Keywords: customer satisfaction, Islamic economy, social justice, sustainable development goals

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Authors: Mai Anh Tuan, Wenlong Liu, Meng Li

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Despite warnings and concerns about the use of fast food that has health effects, the fast-food industry is actually a source of profit for the global food industry. Obviously, in the face of such huge economic benefits, investors will not hesitate to continuously add recipes, processing methods, menu diversity, etc., to improve and apply information technology in enhancing the diners' experience; the ultimate goal is still to attract diners to find their brand and give them the fastest, most convenient and enjoyable service. In China, as the achievements of the industrial revolution 4.0, big data and artificial intelligence are reaching new heights day by day, now fast-food diners can instantly pay the bills only by identifying the biometric signature available on the self-ordering kiosk, using their own face without any additional form of confirmation. In this study, the author will evaluate the acceptance level of customers with this new form of payment through a survey of customers who have used and witnessed the use of smart kiosks and biometric payments within the city of Nanjing, China. A total of 200 valid volunteers were collected in order to test the customers' intentions and feelings when choosing and experiencing payment through AI services. 55% think that it bothers them because of the need for personal information, but more than 70% think that smart kiosk brings out many benefits and convenience. According to the data analysis findings, perceived innovativeness has a positive influence on satisfaction which in turn affects behavioral intentions, including reuse and word-of-mouth intentions.

Keywords: artificial intelligence, catering industry, smart kiosks, technology acceptance

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Authors: Ammar Younas

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This paper is an attempt to explore the legal progression in procedural laws related to “intellectual property protection for the autonomous output of artificial intelligence” in Post-Colonial, Post-Communist and Socialist Countries. An in-depth study of legal progression in Pakistan (Common Law), Uzbekistan (Post-Soviet Civil Law) and China (Socialist Law) has been conducted. A holistic attempt has been made to explore that how the ideological context of the legal systems can impact, not only on substantive components but on the procedural components of the formal laws related to IP Protection of autonomous output of Artificial Intelligence. Moreover, we have tried to shed a light on the prospective IP laws and AI Policy in the countries, which are planning to incorporate the concept of “Digital Personality” in their legal systems. This paper will also address the question: “How far IP of autonomous output of AI can be protected with the introduction of “Non-Human Legal Personality” in legislation?” By using the examples of China, Pakistan and Uzbekistan, a case has been built to highlight the legal progression in General Provisions of Civil Law, Artificial Intelligence Policy of the country and Intellectual Property laws. We have used a range of multi-disciplinary concepts and examined them on the bases of three criteria: accuracy of legal/philosophical presumption, applying to the real time situations and testing on rational falsification tests. It has been observed that the procedural laws are designed in a way that they can be seen correlating with the ideological contexts of these countries.

Keywords: intellectual property, artificial intelligence, digital personality, legal progression

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Authors: A. Chandra, M. Arthur, L. Mize, A. Pomeroy-Stevens

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Background: Lower and middle-income countries (LMICs) in Asia face rapid urbanization resulting in both economic opportunities (the urban advantage) and emerging health challenges. Urban health risks are magnified in informal settlements and include infectious disease outbreaks, inadequate access to health services, and poor air quality. Over the coming years, urban spaces in Asia will face accelerating public health risks related to migration, climate change, and environmental health. These challenges are complex and require multi-sectoral and multi-stakeholder solutions. The Building Health Cities (BHC) program is funded by the United States Agency for International Development (USAID) to work with smart city initiatives in the Asia region. BHC approaches urban health challenges by addressing policies, planning, and services through a health equity lens, with a particular focus on informal settlements and migrant communities. The program works to develop data-driven decision-making, build inclusivity through stakeholder engagement, and facilitate the uptake of appropriate technology. Methodology: The BHC program has partnered with the smart city initiatives of Indore in India, Makassar in Indonesia, and Da Nang in Vietnam. Implementing partners support municipalities to improve health delivery and equity using two key approaches: political economy analysis and participatory systems mapping. Political economy analyses evaluate barriers to collective action, including corruption, security, accountability, and incentives. Systems mapping evaluates community health challenges using a cross-sectoral approach, analyzing the impact of economic, environmental, transport, security, health system, and built environment factors. The mapping exercise draws on the experience and expertise of a diverse cohort of stakeholders, including government officials, municipal service providers, and civil society organizations. Results: Systems mapping and political economy analyses identified significant barriers for health care in migrant populations. In Makassar, migrants are unable to obtain the necessary card that entitles them to subsidized health services. This finding is being used to engage with municipal governments to mitigate the barriers that limit migrant enrollment in the public social health insurance scheme. In Indore, the project identified poor drainage of storm and wastewater in migrant settlements as a cause of poor health. Unsafe and inadequate infrastructure placed residents of these settlements at risk for both waterborne diseases and injuries. The program also evaluated the capacity of urban primary health centers serving migrant communities, identifying challenges related to their hours of service and shortages of health workers. In Da Nang, the systems mapping process has only recently begun, with the formal partnership launched in December 2019. Conclusion: This paper explores lessons learned from BHC’s systems mapping, political economy analyses, and stakeholder engagement approaches. The paper shares progress related to the health of migrants in informal settlements. Case studies feature barriers identified and mitigating steps, including governance actions, taken by local stakeholders in partner cities. The paper includes an update on ongoing progress from Indore and Makassar and experience from the first six months of program implementation from Da Nang.

Keywords: informal settlements, migration, stakeholder engagement mapping, urban health

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Authors: Ganiyat Soliu, Glen Bright, Chiemela Onunka

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Performance optimization plays a key role in controlling the waiting time during manufacturing in an advanced manufacturing environment to improve productivity. Queuing mathematical modeling theory was used to examine the performance of the multi-stage production line. Robotics as a disruptive technology was implemented into a virtual manufacturing scenario during the packaging process to study the effect of waiting time on productivity. The queuing mathematical model was used to determine the optimum service rate required by robots during the packaging stage of manufacturing to yield an optimum production cost. Different rates of production were assumed in a virtual manufacturing environment, cost of packaging was estimated with optimum production cost. An equation was generated using queuing mathematical modeling theory and the theorem adopted for analysis of the scenario is the Newton Raphson theorem. Queuing theory presented here provides an adequate analysis of the number of robots required to regulate waiting time in order to increase the number of output. Arrival rate of the product was fast which shows that queuing mathematical model was effective in minimizing service cost and the waiting time during manufacturing. At a reduced waiting time, there was an improvement in the number of products obtained per hour. The overall productivity was improved based on the assumptions used in the queuing modeling theory implemented in the virtual manufacturing scenario.

Keywords: performance optimization, productivity, queuing theory, robotics

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Authors: Muzamil Mahmood, Afshan Naseem, Muhammad Zeeshan Mirza, Yasir Ahmad, Masood Raza

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The purpose of this research is to analyze how aviation maintenance workers’ characteristics and work demand affect their development of work-related musculoskeletal disorders (WMSDs). Guided by literature on task characteristics, work demand, and WMSDs, data is collected from 128 aviation maintenance workers of private and public airlines. Data is then analyzed through descriptive and inferential statistics. It is found that task characteristics have a significant positive effect on WMSDs and an increase in tasks performed by aviation maintenance workers leads to increase in WMSDs. Work demand did not have a significant effect on WMSDs. The task characteristics of aviation maintenance workers moderates the relationship between their work demand and WMSDs. This reveals that task characteristics of aviation maintenance workers enhance the effect of work demand on WMSDs. The task characteristics of aviation maintenance workers are challenging and unpredictable. Subsequently, WMSDs are prevalent among aviation maintenance workers. The work demand of aviation maintenance workers does not influence their development of WMSDs. Pakistan Civil Aviation Authority should minimize the intensity of tasks assigned to aviation maintenance workers by introducing work dynamisms such as task sharing, job rotation, and probably teleworking to enhance flexibility. Human Resource and Recruitment Department need to consider the ability and fitness levels of potential aviation maintenance workers during recruitment. In addition, regular physical activities and ergonomic policies should be put in place by the management of the Pakistan Civil Aviation Authority to reduce the incidences of WMSDs.

Keywords: work related musculoskeletal disorders, ergonomics, occupational health and safety, human factors

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Authors: Saimir Heta, Rialda Xhizdari, Kers Kapaj, Ilma Robo

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Background: The interests of both individuals involved, both the dentist with his professionalism, and the patient who claims and expects the proper professional dental service, are determined in cases of dental malpractice. The latter is a phenomenon that is also wearing the "cloak" of bilateral manipulations, which in themselves require strong legal control to regulate the relations between the involved parties. The two individuals are involved both individually and even professionally and emotionally, with support in the "ultimate" interests of the two people, which in the case of conflicts or grievances, which as a result are transported to the family or society of the affected individual. Main text: The reason for malpractice is the most difficult part to find and then to interpret. It can be professional in the view of "so much I know how to do, so much done", or in the view of the impossibility of individual health conditions to achieve high professional expectations. But, the reason can also be individual with the intention of doing bad without reason or with the source of an unhealthy mind and the source of malicious thinking. The professional himself is a human being and as such may be under the effect of individual treatments or vices, therefore causing misuse, a case that must be distinguished from intentional misuse and which must be judged for the results or damages caused by the professional based on criminal law. Conclusions: Malpractice in some cases may be unavoidable, beyond the good intention of the dental intervention, which should be well understood by both parties involved in this relationship. Malpractice is not necessarily related only to difficult clinical cases, but sometimes also appears as a random deviation of a dental treatment with a welldefined professional protocol. The legal support in the interpretation of malpractice cases should be much more specific according to previous cases, this practice specifically, perhaps also according to different religious states.

Keywords: dental ethics, malpractice, professional dental service, legal support

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Authors: Eduardo Costa

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Hospital strikes in the Portuguese National Health Service (NHS) are becoming increasingly frequent, raising concerns in what respects patient safety. In fact, data shows that mortality rates for patients admitted during strikes are up to 30% higher than for patients admitted in other days. This paper analyses the effects of hospital strikes on patients’ outcomes. Specifically, it analyzes the impact of different strikes (physicians, nurses and other health professionals), on in-hospital mortality rates, readmission rates and length of stay. The paper uses patient-level data containing all NHS hospital admissions in mainland Portugal from 2012 to 2017, together with a comprehensive strike dataset comprising over 250 strike days (19 physicians-strike days, 150 nurses-strike days and 50 other health professionals-strike days) from 135 different strikes. The paper uses a linear probability model and controls for hospital and regional characteristics, time trends, and changes in patients’ composition and diagnoses. Preliminary results suggest a 6-7% increase in in-hospital mortality rates for patients exposed to physicians’ strikes. The effect is smaller for patients exposed to nurses’ strikes (2-5%). Patients exposed to nurses strikes during their stay have, on average, higher 30-days urgent readmission rates (4%). Length of stay also seems to increase for patients exposed to any strike. Results – conditional on further testing, namely on non-linear models - suggest that hospital operations and service levels are partially disrupted during strikes.

Keywords: health sector strikes, in-hospital mortality rate, length of stay, readmission rate

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Authors: Aditya Purohit, Neha Bansal

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Unplanned urbanization and multidirectional sprawl of the cities have resulted in increased motorization and deteriorating transport conditions like traffic congestion, longer commuting, pollution, increased carbon footprint, and above all increased fatalities. In order to overcome these problems, various practices have been adopted including– promoting and implementing mass transport; traffic junction channelization; smart transport etc. However, these methods are found to be primarily focusing on vehicular mobility rather than people accessibility. With this research gap, this paper tries to resolve the mobility issues for Ahmedabad city in India, which being the economic capital Gujarat state has a huge commuter and visitor inflow. This research aims to resolve the traffic congestion and urban mobility issues focusing on Gujarat State Regional Transport Corporation (GSRTC) for the city of Ahmadabad by analyzing the existing operations and network structure of GSRTC followed by finding possibilities of integrating it with other modes of urban transport. The network restructuring (NR) methodology is used with appropriate variations, based on commuter demand and growth pattern of the city. To do these ‘scenarios’ based on priority issues (using 12 parameters) and their best possible solution, are established after route network analysis for 2700 population sample of 20 traffic junctions/nodes across the city. Approximately 5% sample (of passenger inflow) at each node is considered using random stratified sampling technique two scenarios are – Scenario 1: Resolving mobility issues by use of Special Purpose Vehicle (SPV) in joint venture to GSRTC and Private Operators for establishing feeder service, which shall provide a transfer service for passenger for movement from inner city area to identified peripheral terminals; and Scenario 2: Augmenting existing mass transport services such as BRTS and AMTS for using them as feeder service to the identified peripheral terminals. Each of these has now been analyzed for the best suitability/feasibility in network restructuring. A desire-line diagram is constructed using this analysis which indicated that on an average 62% of designated GSRTC routes are overlapping with mass transportation service routes of BRTS and AMTS in the city. This has resulted in duplication of bus services causing traffic congestion especially in the Central Bus Station (CBS). Terminating GSRTC services on the periphery of the city is found to be the best restructuring network proposal. This limits the GSRTC buses at city fringe area and prevents them from entering into the city core areas. These end-terminals of GSRTC are integrated with BRTS and AMTS services which help in segregating intra-state and inter-state bus services. The research concludes that absence of integrated multimodal transport network resulted in complexity of transport access to the commuters. As a further scope of research comparing and understanding of value of access time in total travel time and its implication on generalized cost on trip and how it varies city wise may be taken up.

Keywords: mass transportation, multi-modal integration, network restructuring, travel behavior, urban transport

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Authors: Stephanie Lehmann, Esther Ruf, Sabina Misoch

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Background: Due to demographic change and shortage of skilled nursing staff, assistive robots are built to support older adults at home and nursing staff in care institutions. When assistive robots facilitate tasks that are usually performed by humans, user acceptance is essential. Even though they are an important aspect of acceptance, emotions towards different assistive robots and different situations of robot-use have so far not been examined in detail. The appearance of assistive robots can trigger emotions that affect their acceptance. Acceptance of robots is assumed to be greater when they look more human-like; however, too much human similarity can be counterproductive. Regarding different groups, it is assumed that older adults have a more negative attitude towards robots than younger adults. Within the framework of a simulated robot study, the aim was to investigate emotions of older adults compared to students towards robots with different appearances and in different situations and so contribute to a deeper view of the emotions influencing acceptance. Methods: In a questionnaire study, vignettes were used to assess emotions toward robots in different situations and of different appearance. The vignettes were composed of two situations (service and care) shown by video and four pictures of robots varying in human similarity (machine-like to android). The combination of the vignettes was randomly distributed to the participants. One hundred forty-two older adults and 35 bachelor students of nursing participated. They filled out a questionnaire that surveyed 30 positive and 30 negative emotions. For each group, older adults and students, a sum score of “positive emotions” and a sum score of “negative emotions” was calculated. Mean value, standard deviation, or n for sample size and % for frequencies, according to the scale level, were calculated. For differences in the scores of positive and negative emotions for different situations, t-tests were calculated. Results: Overall, older adults reported significantly more positive emotions than students towards robots in general. Students reported significantly more negative emotions than older adults. Regarding the two different situations, the results were similar for the care situation, with older adults reporting more positive emotions than students and less negative emotions than students. In the service situation, older adults reported significantly more positive emotions; negative emotions did not differ significantly from the students. Regarding the appearance of the robot, there were no significant differences in emotions reported towards the machine-like, the mechanical-human-like and the human-like appearance. Regarding the android robot, students reported significantly more negative emotions than older adults. Conclusion: There were differences in the emotions reported by older adults compared to students. Older adults reported more positive emotions, and students reported more negative emotions towards robots in different situations and with different appearances. It can be assumed that older adults have a different attitude towards the use of robots than younger people, especially young adults in the health sector. Therefore, the use of robots in the service or care sector should not be rejected rashly based on the attitudes of younger persons, without considering the attitudes of older adults equally.

Keywords: emotions, robots, seniors, young adults

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Authors: Višnjica Vučetić, Mislav Anić, Jelena Bašić, Petra Sviličić, Ivana Tomašević

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The Agroclimatic Atlas of Croatia (Atlas) for the periods 1981–2010 and 1991–2020 is monograph of six chapters in digital form. Detailed descriptions of particular agroclimatological data are given in separate chapters as follows: agroclimatic indices based on air temperature (degree days, Huglin heliothermal index), soil temperature, water balance components (precipitation, potential evapotranspiration, actual evapotranspiration, soil moisture content, runoff, recharge and soil moisture loss) and fire weather indices. The last chapter is a description of the digital methods for the spatial interpolations (R and GIS). The Atlas comprises textual description of the relevant climate characteristic, maps of the spatial distribution of climatological elements at 109 stations (26 stations for soil temperature) and tables of the 30-year mean monthly, seasonal and annual values of climatological parameters at 24 stations. The Atlas was published in 2021, on the seventieth anniversary of the agrometeorology development at the Meteorological and Hydrological Service of Croatia. It is intended to support improvement of sustainable system of agricultural production and forest protection from fire and as a rich source of information for agronomic and forestry experts, but also for the decision-making bodies to use it for the development of strategic plans.

Keywords: agrometeorology, agroclimatic indices, soil temperature, water balance components, fire weather index, meteorological and hydrological service of Croatia

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Authors: Rani Danavath, V. B. Narsimha

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Cloud computing is emerging as a new paradigm of large scale distributed computing. Cloud computing is a model for enabling ubiquitous, convenient, on-demand network access to a shared pool of configurable computing resources (e.g., three service models, and four deployment networks, servers, storage, applications, and services) that can be rapidly provisioned and released with minimal management effort or service provider interaction. This cloud model is composed of five essential characteristics models. Load balancing is one of the main challenges in cloud computing, which is required to distribute the dynamic workload across multiple nodes, to ensure that no single node is overloaded. It helps in optimal utilization of resources, enhancing the performance of the system. The goal of the load balancing is to minimize the resource consumption and carbon emission rate, that is the direct need of cloud computing. This determined the need of new metrics energy consumption and carbon emission for energy-efficiency load balancing techniques in cloud computing. Existing load balancing techniques mainly focuses on reducing overhead, services, response time and improving performance etc. In this paper we introduced a Technique for energy-efficiency, but none of the techniques have considered the energy consumption and carbon emission. Therefore, our proposed work will go towards energy – efficiency. So this energy-efficiency load balancing technique can be used to improve the performance of cloud computing by balancing the workload across all the nodes in the cloud with the minimum resource utilization, in turn, reducing energy consumption, and carbon emission to an extent, which will help to achieve green computing.

Keywords: cloud computing, distributed computing, energy efficiency, green computing, load balancing, energy consumption, carbon emission

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Authors: Jennifer McNeill

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Over the years UK Governments have extended the use of welfare conditionality to more marginalised groups. Whereas in the past, disabled people’s rights to unconditional welfare were defended, significant numbers of disabled people have in recent years been re-classified as ‘fit for work’ as a result of this policy shift towards increased conditionality targeting more welfare service user groups. This paper discusses findings from a five-year project exploring the ethics and efficacy of welfare conditionality. Drawing on repeat interviews over three years with 58 disabled welfare service users across England and Scotland, the paper explores the experience of, and impact of conditionality upon, disabled participants. In particular, participants described the process of claiming disability-related benefits as stigmatising, with some describing the medical assessments as demeaning, traumatic and even painful. The medical assessments are conducted by private contractors and participants felt they were treated unfairly, under suspicion and under surveillance. This finding is important in line with a recent UN report concerned with the practice of such assessments. The findings reveal that notions of ‘deservedness’ are embedded in this system as disabled recipients argue for their entitlement to welfare claims relative to what are deemed to be less deserving groups of benefit claimants. This indicates an increasing competition ethic within different sections of the most marginalised social groups that facilitate further forms of social fragmentation, particularly in relation to opposition to benefit cuts and other changes requiring concerted and organised forms of resistance. The impact of media and political scapegoating of the most marginal has generated divisions within even those who position themselves as legitimate recipients.

Keywords: disability, medical assessments, stigma, welfare conditionality

Procedia PDF Downloads 195

Authors: Sakapas Saengchai, Wilasinee Jintalikitdee, Matinee Kongsatit, Natapol Puaprasert

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The study on promotion of public participation in community planning is a qualitative research. The data collection tools included participating observation, in-depth interview and focus group of executives of sub-district administrative organizations, sub-district headmen, community leaders of 5 villages, including civil society forums for exchanging ideas of village members. The study results revealed that key promotions of public participation in community planning were as follows: 1) Perception on public authorities’ information: Public relations should be set and information on community planning, key principles of local people participation should be prepared. Collaboration with community leaders in each village via sub-district administrative organizations should be established. 2) Discussion: In civil society forums, village members should brainstorm their opinions towards community development, village development, quality of life, current situation and problems to be revolved. 3) Participation: Members of each village should jointly participate, with community leaders, in setting sub-district development policies and community development projects. 4) Collaboration: To achieve goals, communities of each member should participate in project implementation and activities of community plans. 5) People power promotion: In each stage of communication planning, community leaders, village committees, local people should jointly set directions of village development and make decisions. This will enhance their joint learning and create community driving power. Community will become strong leading to sustainable self-reliance.

Keywords: people participation, community plans, community development, community driving power

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Authors: Veenapani Rajeev Verma

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Context: Assessing facility readiness is paramount as it can indicate capacity of facilities to provide essential care for resilience to health challenges. In the context of decentralization, estimation of supply side readiness indices at sub national level is imperative for effective evidence based policy but remains a colossal challenge due to lack of dependable and representative data sources. Setting: District Poonch of Jammu and Kashmir was selected for this study. It is remote, rural district with unprecedented topographical barriers and is identified as high priority by government. It is also a fragile area as is bounded by Line of Control with Pakistan bearing the brunt of cease fire violations, military skirmishes and sporadic militant attacks. Hilly geographical terrain, rudimentary/absence of road network and impoverishment are quintessential to this area. Objectives: Objective of the study is to a) Evaluate the service readiness of health facilities and create a concise index subsuming plethora of discrete indicators and b) Ascertain supply side barriers in service provisioning via stakeholder’s analysis. Study also strives to expand analytical domain unravelling context and area specific intricacies associated with service delivery. Methodology: Mixed method approach was employed to triangulate quantitative analysis with qualitative nuances. Facility survey encompassing 90 Subcentres, 44 Primary health centres, 3 Community health centres and 1 District hospital was conducted to gauge general service availability and service specific availability (depth of coverage). Compendium of checklist was designed using Indian Public Health Standards (IPHS) in form of standard core questionnaire and scorecard generated for each facility. Information was collected across dimensions of amenities, equipment, medicines, laboratory and infection control protocols as proposed in WHO’s Service Availability and Readiness Assesment (SARA). Two stage polychoric principal component analysis employed to generate a parsimonious index by coalescing an array of tracer indicators. OLS regression method used to determine factors explaining composite index generated from PCA. Stakeholder analysis was conducted to discern qualitative information. Myriad of techniques like observations, key informant interviews and focus group discussions using semi structured questionnaires on both leaders and laggards were administered for critical stakeholder’s analysis. Results: General readiness score of health facilities was found to be 0.48. Results indicated poorest readiness for subcentres and PHC’s (first point of contact) with composite score of 0.47 and 0.41 respectively. For primary care facilities; principal component was characterized by basic newborn care as well as preparedness for delivery. Results revealed availability of equipment and surgical preparedness having lowest score (0.46 and 0.47) for facilities providing secondary care. Presence of contractual staff, more than 1 hr walk to facility, facilities in zone A (most vulnerable) to cross border shelling and facilities inaccessible due to snowfall and thick jungles was negatively associated with readiness index. Nonchalant staff attitude, unavailability of staff quarters, leakages and constraint in supply chain of drugs and consumables were other impediments identified. Conclusions/Policy Implications: It is pertinent to first strengthen primary care facilities in this setting. Complex dimensions such as geographic barriers, user and provider behavior is not under precinct of this methodology.

Keywords: effective coverage, principal component analysis, readiness index, universal health coverage

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