Search results for: public sector hospital

Authors: Ilham Benali, Nasser Hajji, Nawfel Acha

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The pharmaceutical sector is ongoing different constraints related to the Research and Development (R&D) costs, the patents extinction, the demand pressing, the regulatory requirement and the generics development, which drive leading firms in the sector to undergo technological change and to shift to biotechnological paradigm. Based on a large literature review, we present a background of innovation trajectory in pharmaceutical industry and reasons behind this technological transformation. Then we investigate the role that Information and Communication Technology (ICT) is playing in this revolution. In order to situate pharmaceutical firms in developing countries in this trajectory, and to examine the degree of their involvement in the innovation process, we did not find any previous empirical work or sources generating gathered data that allow us to analyze this phenomenon. Therefore, and for the case of Morocco, we tried to do it from scratch by gathering relevant data of the last five years from different sources. As a result, only about 4% of all innovative drugs that have access to the local market in the mentioned period are made locally which substantiates that the industrial model in pharmaceutical sector in developing countries is based on the 'license model'. Finally, we present another alternative, based on ICT use and big data tools that can allow developing countries to shift from status of simple consumers to active actors in the innovation process.

Keywords: biotechnologies, developing countries, innovation, information and communication technology, pharmaceutical firms

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Authors: Shota Gulbani

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At the present stage, for the countries with developing economies, studying, and researching financial markets, gains special importance, because the situation of financial markets shapes an exact views about the carried out economic policy of the country. Besides, it’s unimaginable any country with developed economy, without healthy and functioning financial markets, whereas, for any kind of business it has got a great importance in terms of finding diversified and alternative capital. In this regard; it should be noted that the segments of Georgian financial markets are developed quite unequally, as evidenced by the fact that the Georgian financial sector is represented by 93% of commercial banks, what does not create an conformable environment for non-bank financial institutions development. In spite of the fact that Georgia has got one of the best banking system of region, it is important to properly analyze that this system should not hinder the development of other participants of Georgian financial sector.

Keywords: financial markets, macroeconomics, investments, stock exchange

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Authors: Mohamed Adel Ahmed, Warda Youssef Morsy , Hanaa Ali El Feky

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Background: Literature review cited that sleep is absolutely essential for surviving and reclamation of the quality of life. Critically ill patients often have poor sleep quality with prolonged sleep latency, sleep fragmentation, decreased sleep efficiency and frequent arousals. Nurses have a unique role for the early diagnosis of sleep disorders, decreasing stressors levels and providing the necessary environmental regulations to create a therapeutic ambiance. The aim of the study: to assess perceived sleep quality and identify factors affecting sleep quality among adult critically ill patients At El Manial University Hospital. Research Design: A descriptive exploratory design was utilized. Research questions: a) how do adult critically ill patients perceive sleep quality in the Critical Care Department of El Manial University Hospital? b) What are the factors affecting sleep quality among adult critically ill patients at El Manial University Hospital? Setting: selected critical and cardiac care units at El Manial University Hospital. Sample: A samples of convenience consisting of 100 adult male and female patients were included in the study. Tools of data collection: tool 1: Socio-demographic and Medical Data Sheet, tool 2: Modified St Mary's Hospital Sleep Questionnaire tool 3: Factors Affecting Sleep Quality Questionnaire among ICU Patients Results: The current study revealed that 76.0% of the studied sample had lack of sleep disturbance before hospitalization. However, 84 % had sleep disturbances during ICU stay, of these more than two-thirds (67 %) had moderate sleep disturbance. Presence of strange and bad odors, noise, having pain, fear of death and a loud voice produced by the ICU personnel had the most significant negative impact on patients’ sleep in percentage of 52.4, 50, 61.9, 45.2, 52.4, respectively. Conclusion: Sleep disturbances in the ICU are multifactorial, and ICU patients’ perceived degrees of sleep disturbance as a moderate. Recommendations: Based on findings of the present study, the following are recommended to be done by ICU nurses; create a healing ICU environment that should incorporate noise, light and temperature controls; decrease stimuli during night time hours to promote regulation of the circadian rhythm, allow usage of sleeping aids such as relaxing music, eye patches and earplugs into their daily nursing practice; cluster nursing activities and eliminate non-essential treatments during night time hours to allow uninterrupted sleep periods of at least 90 minutes to complete one sleep cycle , and minimize staff conversation, alarm noise and light during the quiet night time hours.

Keywords: sleep quality, critically ill, patients, perception

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Authors: Ali Raza

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The dynamic landscape of communication has brought about significant advancements that intersect with the realms of public health and journalism. This abstract explores the evolving synergy between these fields, highlighting how their intersection has contributed to informed societies and improved public health outcomes. In the digital age, communication plays a pivotal role in shaping public perception, policy formulation, and collective action. Public health, concerned with safeguarding and improving community well-being, relies on effective communication to disseminate information, encourage healthy behaviors, and mitigate health risks. Simultaneously, journalism, with its commitment to accurate and timely reporting, serves as the conduit through which health information reaches the masses. Advancements in communication technologies have revolutionized the ways in which public health information is both generated and shared. The advent of social media platforms, mobile applications, and online forums has democratized the dissemination of health-related news and insights. This democratization, however, brings challenges, such as the rapid spread of misinformation and the need for nuanced strategies to engage diverse audiences. Effective collaboration between public health professionals and journalists is pivotal in countering these challenges, ensuring that accurate information prevails. The synergy between public health and journalism is most evident during public health crises. The COVID-19 pandemic underscored the pivotal role of journalism in providing accurate and up-to-date information to the public. However, it also highlighted the importance of responsible reporting, as sensationalism and misinformation could exacerbate the crisis. Collaborative efforts between public health experts and journalists led to the amplification of preventive measures, the debunking of myths, and the promotion of evidence-based interventions. Moreover, the accessibility of information in the digital era necessitates a strategic approach to health communication. Behavioral economics and data analytics offer insights into human decision-making and allow tailored health messages to resonate more effectively with specific audiences. This approach, when integrated into journalism, enables the crafting of narratives that not only inform but also influence positive health behaviors. Ethical considerations emerge prominently in this alliance. The responsibility to balance the public's right to know with the potential consequences of sensational reporting underscores the significance of ethical journalism. Health journalists must meticulously source information from reputable experts and institutions to maintain credibility, thus fortifying the bridge between public health and the public. As both public health and journalism undergo transformative shifts, fostering collaboration between these domains becomes essential. Training programs that familiarize journalists with public health concepts and practices can enhance their capacity to report accurately and comprehensively on health issues. Likewise, public health professionals can gain insights into effective communication strategies from seasoned journalists, ensuring that health information reaches a wider audience. In conclusion, the convergence of public health and journalism, facilitated by communication advancements, is a cornerstone of informed societies. Effective communication strategies, driven by collaboration, ensure the accurate dissemination of health information and foster positive behavior change. As the world navigates complex health challenges, the continued evolution of this synergy holds the promise of healthier communities and a more engaged and educated public.

Keywords: public awareness, journalism ethics, health promotion, media influence, health literacy

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Authors: Ledi Neçaj

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Introduction: Cardio-respiratory rehabilitation is the set of coordinated interventions needed to provide the best physical, psychological, and social conditions so that patients with chronic or post-acute cardiopulmonary disease, with their efforts, maintain or resume optimal functioning in society through improved health behaviors. Purpose: To study the effectiveness of the application of Cardio-Respiratory Rehabilitation in the typology of patients with chronic or post-acute cardiomyopathy and chronic respiratory diseases in order to facilitate their therapeutic use and to improve the overall quality of life. Material and Method: This is a prospective study including patients with COPD and cardiac disease who were included in the rehabilitation program during the period January 2019 - November 2021. The study was conducted at the University Hospital Center "Mother Teresa" in Tirana, University Hospital "SHEFQET NDROQI", AMERICAN Hospital, HYGEA Hospital, and "Our Lady of Good Counsel, Tirana". An individual chart was used to collect sociodemographic, physical, clinical, and functional examinations for each patient. Results: The study included 253 patients, with a mean age of 62.1 (± 7.9) years, ranging from 48 to 82 years. (67.6%) of the patients were males, and (32.4%) female. Male patients predominated in all age groups, with a statistically significant difference with females (p<0.01). The most common cardiac pathologies are coronary artery bypass (24%), cerebral stroke (9%), myocardial infarction (17%), Stent placement (8%) (p<0.01). Correlation matrix of risk factors found a significant correlation of alcohol consumption with diabetes, smoking, dyslipidemia, sedentary life, obesity, AVC, and hypertension. Functional capacity estimated by change in metabolic equivalents (MET) improved by 46% from 4. ±2.2 to 7.2± .8 METs (p<0.01). Duration of exercise after rehabilitation was increased by 21% compared to baseline (p<0.01). The mean score of all three subscales of the questionnaire: symptoms (p=0.03), activity (p<0.01), and impact (p<0.01) after rehabilitation, was lower compared to pre-rehabilitation. Conclusions: The rehabilitation program has impacted on improving the quality of life, reducing symptoms, reducing the impact of negative factors on daily life, and reducing dyspnea during daily activities.

Keywords: cardio-respiratory rehabilitation, physical exercise, quality of life, diseases

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Authors: Fergus Wade, Jasmine Makker, Matthew Jankinson, Aminah Qamar, Gemma Morrelli, Shayan Shah

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Background: Ambulance offload delays (AODs) affect patient outcomes. At baseline, the average AOD at Princess Royal University Hospital (PRUH) was 41 minutes, in breach of the 15-minute target. Aims: By February 2023, we aimed to reduce: the average AOD to 30 minutes percentage of AOD >30 minutes (PA30) to 25% and >60 minutes (PA60) to 10% Methods: Following a root-cause analysis, we implemented 2 Plan, Do, Study, Act (PDSA) cycles. PDSA-1 ‘Drop-and-run’: ambulances waiting >15 minutes for a handover left the patients in the Emergency Department (ED) and returned to the community. PDSA-2: Booking in the patients before the handover, allowing direct updates to online records, eliminating the need for handwritten notes. Outcome measures: AOD, PA30, and PA60, and process measures: total ambulances and patients in the ED were recorded for 16 weeks. Results: In PDSA-1, all parameters increased slightly despite unvarying ED crowding. In PDSA-2, two shifts in data were seen: initially, a sharp increase in the outcome measures consistent with increased ED crowding, followed by a downward shift when crowding returned to baseline (p<0.01). Within this interval, the AOD reduced to 29.9 minutes, and PA30 and PA60 were 31.2% and 9.2% respectively. Discussion/conclusion: PDSA-1 didn’t result in any significant changes; lack of compliance was a key cause. The initial upward shift in PDSA-2 is likely associated with NHS staff strikes. However, during the second interval, the AOD and the PA60 met our targets of 30 minutes and 10%, respectively, improving patient flow in the ED. This was sustained without further input and if maintained, saves 2 paramedic shifts every 3 days.

Keywords: ambulance offload, district general hospital, handover, quality improvement

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Authors: En-Tzu Wang, Ting-Ann Wang, Yi-Hui Shen, Yu-Min Chou, Chi-Tai Fang, Chin-Hui Yang

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Background and purpose: A mass varicella immunization program was established to provide free 1-dose vaccination for all 1-year-old children throughout Taiwan since 2004. The epidemiological characteristics and disease burden of varicella from 2000 to 2012 was investigated and the results will be essential to refine the national immunization policy. Method: We included patients (n = 17,838–164,245) with ICD-9-CM codes 052 (chickenpox) from the 2000 to 2012 National Health Insurance Database. The age, period, and cohort-specific incidence of varicella were calculated. The hospital admission rate, medical costs and indirect costs from the societal perspective of varicella including travel costs to the medical facility, registration fee, productivity losses of the patients and caregivers were also estimated. Result: There were 979,252 patients for medical treatment due to varicella from 2000 to 2012 in Taiwan. The implementation of a routine childhood varicella vaccination program has resulted in 87% decline in morbidity (881.49 to 115.17 per 100,000). The average age of patients increased from 7.9 years to 16.3 years. The overall varicella-related hospital admission rate was 15.5 per 1000 patients, and peaked in the groups of infants younger than 1 year, adults aged from 20 to 39 years and elders over 70 years. Among patients admitted to hospital, 33.5% of them had one or more complications. Patients with underlying diseases had higher admission rate (241.6 per 1,000) and longer duration of hospital stay (6.61 days vs. 4.76 days). The annual varicella-related medical expense declined after 2002 and the proportion of medical costs for admission has increased to 42%. The annual indirect costs from the societal perspective of varicella were 5.29 to 9.63 times higher than varicella-related medical costs. Every one dollar invested in the varicella immunization program, 2.97 dollars of medical and social costs were saved on average. Conclusion: The dramatic decline in morbidity, hospitalization, medical and social costs of varicella can be directly attributed to the implementation of the mass immunization program. Two-dose vaccination is recommended for both children with underlying diseases and susceptible adults to prevent serious complications and hospitalizations.

Keywords: disease burden, epidemiology, medical and social costs, varicella, varicella vaccine

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Authors: Ouazoul Abdelouahd, Jemjami Nadia

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The concept of well-being at work is one of today's major challenges in maintaining quality of life and managing psycho-social risks at work. Indeed, work in the sports sector has evolved over time, and this exponential evolution, marked by increasing demands and psychological, physical and/or social challenges, which sometimes exceed the resources of sports players, influences their sense of well-being at work. Well-being and burnout as antagonists provide information on the quality of working life in sports. The main objective of this literature review was to examine the scientific corpus dealing with the subject of psychological well-being at work in the sports sector and, more specifically, with sports coaches while exploring the link between sports burnout and well-being. The results reveal the richness of the conceptual approaches and the difficulties of putting them into practice. Prospects for future research were put forward.

Keywords: psychological well-being, burnout, quality of life, sports coaching

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Authors: Akhentoolove Corbin, Leta De Jonge, Charmaine De Jonge

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Introduction: Various writers have promoted the adoption of the 4th R in the education curricula (relationships, respect, reasoning, religion, computing, science, art, conflict management, music) and the 5th R (responsibility). They argue that the traditional 3 Rs are not adequate for the modern environment and the requirements for students to become functional citizens in society. In particular, the developing countries of the anglophone Caribbean (most of which are tiny islands) are susceptible to the dangers and complexities of climate change and global economic volatility. These proposed additions to the 3Rs do have some justification, but this research considers Resilience as even more important and relevant in a world that is faced with the negative prospects of climate change, poverty, discrimination, and economic volatility. It is argued that the foundation for resilient citizens, workers, and workplaces, must be built in the elementary and secondary/middle schools and then through the tertiary level, to achieve an outcome of more resilient students. Government, business, and society require widespread resilience to be capable of ‘bouncing back’ and be more adaptable, transformational, and sustainable. Methodology: The paper utilises a mixed-methods approach incorporating a questionnaire and interviews to determine participants’ opinions on the importance and relevance of resilience in the schools’ curricula and to government, business, and society. The target groups are as follows: educators at all levels, education administrators, members of the business sector, public sector, and 3rd sector. The research specifically targets the anglophone Caribbean developing countries (Barbados, Guyana, Jamaica, Trinidad, St. Lucia, and St Vincent, and the Grenadines). The research utilises SPSS for data analysis. Major Findings: The preliminary findings suggest that the majority of participants support the adoption of resilience as a 4th R in the curricula of the elementary, secondary/middle schools, and tertiary level in the anglophone Caribbean. The final results will allow the researchers to reveal more specific details on any variations among the islands in the sample andto engage in an in-depth discussion of the relevance and importance of resilience as the 4th R. Conclusion: Results seem to suggest that the education system should adopt the 4th R of resilience so that educators working in collaboration with the family and community/village can develop young citizens who are more resilient and capable of manifesting the behaviours and attitudes associated with ‘bouncing back,’ adaptability, transformation, and sustainability. These findings may be useful for education decision-makers and governments in these Caribbean islands, who have the authority and responsibility for the development of education policy, laws, and regulations.

Keywords: education, resilient students, adaptable, transformational, resilient citizens, workplaces, government

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Authors: Esther Simpson, Evans Addo Tetteh

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One of the most important sectors in Ghana’s economy is the oil and gas sector. Effective supply chain management is required to ensure the timely delivery of these products to the end users, given the rise in nationwide demand for petroleum products. Contrarily, freight forwarding plays a crucial role in facilitating intra- and intra-country trade, particularly the movement of oil goods. Nevertheless, there has not been enough scientific study done on how marketing, supply chain management, and freight forwarding are integrated in the oil business. By highlighting possible areas for development in the supply chain management of petroleum products, this article seeks to close this gap. The study was predominantly qualitative and featured semi-structured interviews with influential figures in the oil and gas sector, such as marketers, distributors, freight forwarders, and regulatory organizations. The purpose of the interviews was to determine the difficulties and possibilities for enhancing the management of the petroleum products supply chain. Thematic analysis was used to examine the data obtained in order to find patterns and themes that arose. The findings from the study revealed that the oil sector faced a number of issues in terms of supply chain management. Inadequate infrastructure, insufficient storage facilities, a lack of cooperation among parties, and an inadequate regulatory framework were among the obstacles. Furthermore, the study indicated significant prospects for enhancing petroleum product supply chain management, such as the integration of more advanced digital technologies, the formation of strategic alliances, and the adoption of sustainable practices in petroleum product supply chain management. The study's conclusions have far-reaching ramifications for the oil and gas sector, freight forwarding, and Ghana’s economy as a whole. Marketing, supply chain management, and freight forwarding has high prospects from being integrated to improve the efficiency of the petroleum product supply chain, resulting in considerable cost savings for the industry. Furthermore, the use of sustainable practices will improve the industry's sustainability and lessen the environmental effect of the petroleum product supply chain. Based on the findings, we propose that stakeholders in Ghana’s oil and gas sector work together and collaborate to enhance petroleum supply chain management. This collaboration should include the use of digital technologies, the formation of strategic alliances, and the implementation of sustainable practices. Moreover, we urge that governments establish suitable rules to guarantee the efficient and sustainable management of petroleum product supply chains. In conclusion, the integration and combination of marketing, supply chain management, and freight forwarding in the oil business gives a tremendous opportunity for enhancing petroleum product supply chain management. The study's conclusions have far-reaching ramifications for the sector, freight forwarding, and the economy as a whole. Using sustainable practices, integrating digital technology, and forming strategic alliances will improve the efficiency and sustainability of the petroleum product supply chain. We expect that this conference paper will encourage more study and collaboration among oil and gas sector stakeholders to improve petroleum supply chain management.

Keywords: collaboration, logistics, sustainability, supply chain management

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Authors: Beata Ślusarczyk, Sebastian Kot

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In subjective terms, Polish SME sector occupies a prominent position in the national economic development, in which planning of the management strategies should be primarily based on identifying and meeting the innovation needs. As a research sample, there is chosen a printing sector of industry. SMEs share in printing sector in Poland is estimated at the level of 81% of all enterprises. In recent years, the printing industry achieved one of the highest levels of EU support in Poland. There is a relatively high increase in the development of technological innovations in equipment and the associated significant increase in production capacity. It can be also noticed that on average, every third enterprise belonging to the printing industry has implemented innovations, but not all of them effected in better economic results. Therefore, the aim of this article is to evaluate the impact of the implementation of innovation projects financed from the EU funds for performance of SMEs in the printing industry. As the results of research of EU funds co-financing effects on the development of innovation in the printing industry, it was specified that examined SMEs prefer to implement product innovation to receive a grant to the project at a level between 40% to 60%, the remaining part of the investment is usually covered with equity. The most common type of innovation had indicated a single implementation, related only to the change in process, technology, or organization. The relationship between variables of the EU funds and management of innovative activities was verified. It has been observed that the identified variables arising from the support in a form of the EU funds had a positive effect on the level of earned revenue, the increase in margin and in increase in employment as well. It was confirmed that the implemented innovations supported by the European funds have a positive impact on the performance of the printing companies. Although there is a risk that due to the decreasing demand for printing services such a high level of funding the companies in this sector will significantly increase competition in the long term, that may also contribute to the economic problems of the enterprises belonging to the analyzed branch.

Keywords: innovations, SMEs, performance, results

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Authors: Margaret Denise P. Del Rosario, Geraldine Alcantara

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Background: The declaration of the COVID-19 pandemic has impacted hospital visits of child abuse cases with less consults but more severe injuries. Objective: The study aims to identify the clinical profiles of patients seen in the hospital ng Makati Women and Children Protection Unit before and during the pandemic. Design: A cross-sectional analytic study design through review of records that underwent quantitative analysis. Results: 264 cases pre-pandemic and 208 cases during the pandemic were reviewed. Most reported cases were neglect comprising of 47% of the pre-pandemic cases and 68% of cases during the pandemic. Supervisory neglect was most commonly reported. An equal distribution between males and females were seen among victims and alleged perpetrators. The age group of both victims and alleged perpetrators during the pandemic was significantly younger compared to the pre-pandemic period. Children belonging to larger family groups were commonly encountered with most of them being the eldest amongst siblings. Alleged perpetrators were mostly secondary graduates for both time periods. A significant increase of cases during the pandemic occurred at home. More patients required hospitalization during the pandemic period with 37% compared to the 23% of admissions prior to the pandemic. Furthermore, a three-fold increase of injuries sustained during the pandemic required intensive care. Conclusion: The study reflects increased severity of injuries related to abuse during the pandemic compared to pre-pandemic times. A significant increase in injuries requiring intensive care were also seen despite less reported cases.

Keywords: child abuse, COVID-19, violence against children, WCPU, neglect

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Authors: Michal Stelmach

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The aim of this paper is a critical analysis of the security policy in the field of the fight against transnational criminal groups in Central America in XXI century. We are analyzing all taken issues from several perspectives: political, anthropological, sociological and legal which allows me to confront behavior and the attitudes of the political elites against official legislative changes and declared actions, strategies and policies against practice. In the first part of paper we would like to present the genesis and characteristic of transnational gangs, called maras and next we would like to present their activities and roles within chosen sectors of organized crimes. In the second part we will analyze the government’s policy towards transnational criminal groups. The analysis will be concentrated on public safety policy implemented in specific Central American countries as well as regional international cooperation. The main intention of the author is to present the state of the security in Central America in XXI century by emphasizing failures and successes in the fight against transnational criminal organizations. Additionally we want to present and define the challenges currently facing the region now and to show the prediction of the situation’s development within next future and to define the recommendations on the design of public security policies in Central American countries.

Keywords: maras, public security, human rights, Central America

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Authors: Monalisha Ghosh, Asit Mohanty

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The lack of sanitation increases living costs, decreases spend on education and nutrition, lowers income earning potential, and threatens safety and welfare. This is especially true for rural India. Only 32% of rural households have their own toilets and that less than half of Indian households have a toilet at home. Of the estimated billion people in the world who defecate in the open, more than half reside in rural India. It is empirically established that poor sanitation leads to high infant mortality rate and low income generation in rural India. In India, 1,600 children die every day before reaching their fifth birthday and 24% of girls drop out of school as the lack of basic sanitation. Above all, lack of sanitation is not a symptom of poverty but a major contributing factor. According to census 2011, 67.3% of the rural households in the country still did not have access to sanitation facilities. India’s sanitation deficit leads to losses worth roughly 6% of its gross domestic product (GDP) according to World Bank estimates by raising the disease burden in the country. The dropout rate for girl child is thirty percent in schools in rural areas because of lack of sanitation facilities for girl students. The productivity loss per skilled labors during a year is calculated at Rs.44, 160 in Odisha. The performance of the state of Odisha has not been satisfactory in improving sanitation facilities. The biggest challenge is triggering behavior change in vast section of rural population regarding need to use toilets. Another major challenge is funding and implementation for improvement of sanitation facility. In an environment of constrained economic resources, Public Private Partnership in form of performance based management or maintenance contract will be all the more relevant to improve the sanitation status in rural sector.

Keywords: rural sanitation, infant mortality rate, income, granger causality, pooled OLS method test public private partnership

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Authors: Rebecca Rumbul

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The operation of the state can often appear opaque to citizens wishing to access official information, who have to negotiate a path through numerous levels of bureaucracy rationalized through institutional policy to acquire what information they want. Even where individual states have 'Right to Information' legislation guaranteeing citizen access to information, public sector conformity to such laws vary between states and between state organizations. In response to such difficulties in bringing citizens and information together, many NGO's around the world have begun designing and hosting digital portals to facilitate the requesting and receiving of official information. How then, are these 'civic technology' tools affecting the behavior of the state? Are they increasing the transparency of the state? This study looked at 5 Right to Information civic technology sites in Chile, Uruguay, Ukraine, Hungary and the UK, and found that such sites were providing a useful platform to publish official information, but that states were still reluctant to comply with all requests. It concludes that civic technology can be an important tool in increasing the transparency of the state, but that the state must have an institutional commitment to information rights for this to be fully effective.

Keywords: digital, ICT, transparency, civic technology

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Authors: Gong Zhang

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The villages surrounding protected areas of the Sites are a unique vernacular heritage due to their geographical location, long history, and the combination of nature and humanity. With the construction of more and more heritage sites, the villages around them are faced with the conflict between conservation and development. How to carry out sustainable micro-renewal while preserving the authenticity of the vernacular heritage is of great importance for the co-growth of the village residents and the site. This paper focuses on the process of revitalization of the villages nearby the Erlitou Site Park in China, aiming to study how sustainable village regeneration and conservation can be carried out through the activation of public culture. Firstly, through field research and literature review, this paper studies the vernacular morphology and architecture types of more than ten historical villages around the Erlitou site and investigates the traditional vernacular culture and the daily public activities of the local villagers. Secondly, taking the nearest village to the site area, Ranzhuang Village, as an example, the paper studies the role of public cultural activity interventions on the three different stages of vernacular heritage renewal: master planning, architecture group, and acupuncture-style micro-renewal of individual buildings, aiming to summarise its impact on villagers' lives and vernacular heritage. This paper concludes that a living regeneration with a moderate public cultural activity intervention can promote the symbiosis between the heritage site and the life of the villagers and increase the vitality of the village. This study aims to use the example of village regeneration in Henan, China, as a sustainable reference for the co-development of heritage sites and villages in other parts of the world.

Keywords: Erlitou site, public culture intervention, sustainable, vernacular heritage

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Authors: Chaiyaporn Yuksen, Tapanawat Chaiwan

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Introduction: Emergency medical service (EMS) care for trauma patients must be provided on-scene assessment and essential treatment and have appropriate transporting to the trauma center. The shock index (SI), reverse shock index Glasgow Coma Scale (rSIG), and National Early Warning Score (NEWS) triage tools are easy to use in a prehospital setting. There is no standardized on-scene triage protocol in prehospital care. The primary objective was to determine the accuracy of SI, rSIG, and NEWS to predict the severity of trauma patients in the emergency department (ED). Methods: This was a retrospective cross-sectional and diagnostic research conducted on trauma patients transported by EMS to the ED of Ramathibodi Hospital, a university-affiliated super tertiary care hospital in Bangkok, Thailand, from January 2015 to September 2022. We included the injured patients receiving prehospital care and transport to the ED of Ramathibodi Hospital by the EMS team from January 2015 to September 2022. We compared the on-scene parameter (SI, rSIG, and NEWS) and ED (Emergency Severity Index) with the area under ROC. Results: 218 patients were traumatic patients transported by EMS to the ED. 161 was ESI level 1-2, and 57 was level 3-5. NEWS was a more accurate triage tool to discriminate the severity of trauma patients than rSIG and SI. The area under the ROC was 0.743 (95%CI 0.70-0.79), 0.649 (95%CI 0.59-0.70), and 0.582 (95%CI 0.52-0.65), respectively (P-value <0.001). The cut point of NEWS to discriminate was 6 points. Conclusions: The NEWs was the most accurate triage tool in prehospital seeing in trauma patients.

Keywords: on-scene triage, trauma patient, ED triage, accuracy, NEWS

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Authors: Raymond K. Dziwornu

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Lending rate of agriculture loan has persistently been high and attributed to risk in the sector. This study examined how food inflation and agriculture lending rate react to each other in Ghana using vector autoregressive approach. Quarterly data from 2006 to 2018 was obtained from the Bank of Ghana quarterly bulletin and the Ghana Statistical Service reports. The study found that a positive standard deviation shock to food inflation causes lending rate of agriculture loan to react negatively in the short run, but positively and steadily in the long run. This suggests the need to direct appropriate policy measures to reduce food inflation and consequently, the cost of credit to the agricultural sector for its growth.

Keywords: food inflation, agriculture, lending rate, vector autoregressive, Ghana

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Authors: Zelalem B. Gurmessa, Ignatius W. Ferreira, Henry F. Wissink

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The aim of this paper is to critically examine the factors contributing to academic brain drain in the Sub-Saharan Africa with specific reference to the higher education sector. Africa in general and Sub-Saharan African (SSA) countries, in particular, are experiencing an exodus of highly trained, qualified and competent human resources to other developing and developed countries thereby threatening the overall development of the relevant regions and impeding both public and private service delivery systems in the nation states. The region is currently in a dire situation in terms of health care services, education, science, and technology. The contribution of SSA countries to Science, Technology and Innovation is relatively minimal owing to the migration of skilled professionals due to both push and pull factors. The phenomenon calls for both international and trans-boundary, regional, national and institutional interventions to curb the exodus. Based on secondary data and the review of the literature, the article conceptualizes the antecedents and impacts of human capital flight or brain drain in the SSA countries from a higher education perspective. To this end, the article explores the magnitude, causes, and impacts of brain drain in the region. Despite the lack of consistent data on the magnitude of academic brain drain in the region, a critical analysis of the existing sources shows that pay disparity between developing and developed countries, the lack of enabling working conditions at source countries, fear of security due to political turmoil or unrest, the availability of green pastures and opportunity for development in the receiving countries were identified as major factors contributing to academic brain drain in the region. This hampers the socio-economic, technological and political development of the region. The paper also recommends that further research can be undertaken on the magnitude, causes, characteristics and impact of brain drain on the sustainability and competitiveness of SSA higher education institutions in the region.

Keywords: brain drain, higher education, sub-Saharan Africa, sustainable development

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Authors: G. Sridevi, Amalendu Jyotishi, Sushanta Mahapatra, G. Jagadeesh, Satyasiba Bedamatta

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Climate change is a main challenge for agriculture, food security and rural livelihoods for millions of people in India. Agriculture is the sector most vulnerable to climate change due to its high dependence on climate and weather conditions. Among India’s population of more than one billion people, about 68% are directly or indirectly involved in the agricultural sector. This sector is particularly vulnerable to present-day climate variability. In this contest this paper examines the Socio-economic and climate analytical study of the vulnerability index in Indian states of Andhra Pradesh and Karnataka. Using secondary data; it examines the vulnerability through five different sub-indicator of socio-demographic, agriculture, occupational, common property resource (CPR), and climate in respective states among different districts. Data used in this paper has taken from different sources, like census in India 2011, Directorate of Economics and Statistics of respective states governments. Rainfall data was collected from the India Meteorological Department (IMD). In order to capture the vulnerability from two different states the composite vulnerability index (CVI) was developed and used. This indicates the vulnerability situation of different districts under two states. The study finds that Adilabad district in Andhra Pradesh and Chamarajanagar in Karnataka had highest level of vulnerability while Hyderabad and Bangalore in respective states have least level of vulnerability.

Keywords: vulnerability, agriculture, climate change, global warming

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Authors: Jacob Livingston Slosser, Naja Holten Moller, Thomas Troels Hildebrandt, Henrik Palmer Olsen

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In this paper, we propose a model for human-AI interaction in public administration that involves legal decision-making. Inspired by Alan Turing’s test for machine intelligence, we propose a way of institutionalizing a continuous working relationship between man and machine that aims at ensuring both good legal quality and higher efficiency in decision-making processes in public administration. We also suggest that our model enhances the legitimacy of using AI in public legal decision-making. We suggest that case loads in public administration could be divided between a manual and an automated decision track. The automated decision track will be an algorithmic recommender system trained on former cases. To avoid unwanted feedback loops and biases, part of the case load will be dealt with by both a human case worker and the automated recommender system. In those cases an experienced human case worker will have the role of an evaluator, choosing between the two decisions. This model will ensure that the algorithmic recommender system is not compromising the quality of the legal decision making in the institution. It also enhances the legitimacy of using algorithmic decision support because it provides justification for its use by being seen as superior to human decisions when the algorithmic recommendations are preferred by experienced case workers. The paper outlines in some detail the process through which such a model could be implemented. It also addresses the important issue that legal decision making is subject to legislative and judicial changes and that legal interpretation is context sensitive. Both of these issues requires continuous supervision and adjustments to algorithmic recommender systems when used for legal decision making purposes.

Keywords: administrative law, algorithmic decision-making, decision support, public law

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Authors: P. H. Tee, S. M. Zamri, K. M. Kasim, S. K. Tiew

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This study evaluates the management of osteoporosis in a tertiary care government hospital in Malaysia. As the number of admitted patients having osteoporotic fractures is on the rise, osteoporotic medications are an increasing financial burden to government hospitals because they account for half of the orthopedic budget and expenditure. Comprehensive knowledge among practitioners is important to detect early and avoid this preventable disease and its serious complications. The purpose of this study is to evaluate the awareness, knowledge, and practices in managing osteoporosis among practitioners in Hospital Tengku Ampuan Rahimah (HTAR), Klang. A questionnaire from an overseas study in managing osteoporosis among primary care physicians is adapted to Malaysia’s Clinical Practice Guideline of Osteoporosis 2012 (revised 2015) and international guidelines were distributed to all orthopedic practitioners in HTAR Klang (including surgeons, orthopedic medical officers), endocrinologists, rheumatologists and geriatricians. The participants were evaluated on their expertise in the diagnosis, prevention, treatment decision and medications for osteoporosis. Collected data were analyzed for all descriptive and statistical analyses as appropriate. All 45 participants responded to the questionnaire. Participants scored highest on expertise in prevention, followed by diagnosis, treatment decision and lastly, medication. Most practitioners stated that own-initiated continuing professional education from articles and books was the most effective way to update their knowledge, followed by attendance in conferences on osteoporosis. This study confirms the importance of comprehensive training and education regarding osteoporosis among tertiary care physicians and surgeons, predominantly in pharmacotherapy, to deliver wholesome care for osteoporotic patients.

Keywords: awareness, knowledge, osteoporosis, practices

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Authors: Radia Bernaoui, Mohamed Hassoun

Abstract:

Our survey deals a theme of the measurement of the management knowledge of actors in Algerian agricultural sector, through a study carried out with professionals affiliated to agro-alimentary 'agribusinesses'. Taking into account the creation of a national device of information on the agronomic research in Algeria, the aim is to analyze their informational practices and to assess how they rate the sharing of knowledge and the process of collective intelligence. The results of our study reveal a more crucial need: The creation a suitable framework to the division of the knowledge, to produce 'knowledge shared social' where the scientific community could interact with firms. It is a question of promoting processes for the adaptation and the spreading of knowledge, through a partnership between the R&D sector and the production one, to increase the competitiveness of the firms, even the sustainable development of the country.

Keywords: knowledge management, pole of competitiveness, knowledge management, economy of knowledge, agro-alimentary, agribusiness, information system, Algeria

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Authors: C. Greenstone, R. Hansmann, L. Mbandla, J. Houghton, G. Lincoln

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All beach areas in South Africa are constituted as public land, open to all to walk on or swim in these spaces. With the completed development of the Durban promenade in 2023 from the Umgeni estuary to the harbour entrance, Durban’s beachfront promenade is a notable example of innovative urban design that has transformed formerly segregated spaces into a paved public walkway linking over 15 beaches. Public spaces, however, are not all created equally, with ideas on how individuals and groups become the producers of space can be a useful tool for designing future public spaces. It is the role of planners, architects, and other built environment specialists to ensure inclusivity and symbiosis between how spaces are separated and then created. Lefebvre’s ideas about space and social practice provide a foundation for this research, specifically on how spaces like the Durban promenade function as democratic spaces, highlighting questions of what draws individuals and groups to certain areas on the promenade are important. Some public spaces are well designed, accessible, and inclusive, while others create more contestation amongst users. In this research article, Durban’s beachfront promenade is used as a case study to better understand the creation of public spaces, more specifically regarding who uses the beachfront promenade and for what reasons. This research adopts a phenomenological and descriptive approach to understanding place by exploring human experiences, emotions and meanings individuals attach to the beachfront promenade and how social processes and interactions shape our understanding, experience, and meaning of places. This research will collect both qualitative and quantitative data along specific nodes located on the beachfront promenade to determine the number of visitors based on demographics such as age, race and gender and the perceptions of visitors to these nodes. The aim is to coordinate and give meaning through surveys and visitor observations to better understand the type of perceptions people have of these spaces, for example, the rationale for utilising space, which already encompasses several activities ranging from cultural, social, economic, environmental, spiritual, physical as well as numerous others.

Keywords: perceptions of space, social practice, identity, urban planning, public space

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Authors: Baluku Nathan

Abstract:

Infection prevention and control (IPC) is a practical, evidence-based approach that prevents patients and emergency health workers from being harmed by avoidable infections as a result of antimicrobial resistance; all hospital infection control programs put together various practices which, when used appropriately, restrict the spread of infection. A breach in these control practices facilitates the transmission of infections from patients to health workers, other patients and attendants. It is, therefore, important for all EMTs and patients to adhere to them strictly. It is also imperative for administrators to ensure the implementation of the infection control program for their facilities. Purpose: The purpose of this study was to investigate the influencing factors of prevention practices against Infection exposure among emergency medical technicians (EMTs) in the emergency department at Mbarara hospital. Methodology: This was a descriptive cross-sectional study that employed a self-reported questionnaire that was filled out by 32 EMTs in the emergency department from 12th February to 3rd march 2022. The questionnaire consisted of items concerning the defensive environment and other Factors influencing Infection prevention and control practices in the accident and emergency department of Mbarara hospital. Results: From the findings, majority16(50%) always used protective gear when doing clinical work,14 (43.8%) didn’t use protective gear, citing they were only assisting those performing resuscitations, gumboots were the least used protective gear with only3(9.4%) usage. Regarding disposal techniques of specific products like blood and sharps, results showed 10 (31.3%) said blood is disposed of in red buckets, 5(15.6%) in yellow buckets and only5(15.6%) in black buckets and 12(37.5%) didn’t respond. However, 28(87.5%) said sharps were disposed of in a sharps container. The majority, 17(53.1%), were not aware of the infection control guidelines even though they were pinned on walls of the emergency rooms,15(46.9%) said they had never had quality assurance monitoring events,14(43.8%) said monitoring was continuous while15(46.9 %) said it was discrete. Conclusions: The infection control practices at the emergency department were inadequate in view of less than 100% of the EMTs observing the five principles of infection prevention, such as the use of personal protective equipment and proper waste disposal in appropriate color-coded bins. Dysfunctional infection prevention and control committees accompanied by inadequate supervision to ensure infection control remained a big challenge.

Keywords: infection prevention, influencing factors, emergency medical technician (EMT), emergency unit

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Authors: Baluku Nathan

Abstract:

Infection prevention and control (IPC) is a practical, evidence-based approach that prevents patients and emergency health workers from being harmed by avoidable infections as a result of antimicrobial resistance; all hospital infection control programs put together various practices which, when used appropriately, restrict the spread of infection. A breach in these control practices facilitates the transmission of infections from patients to health workers, other patients, and attendants. It is, therefore important for all emergency medical technicians (EMTs) and patients to strictly adhere to them. It is also imperative for administrators to ensure the implementation of the infection control programme for their facilities. Purpose: The purpose of this study was to investigate the influencing factors of prevention practices against infection exposure among emergency medical technicians (EMTs) in the emergency department at Mbarara hospital. Methodology: This was a descriptive cross-sectional study that employed a self-reported questionnaire that was filled out by 32 EMTs in the emergency department from 12th February to 3rd march 2022. The questionnaire consisted of items concerning the defensive environment and other factors influencing infection prevention and control practices in the accident and emergency department of Mbarara hospital. Results: From the findings, the majority 16 (50%) always used protective gear when doing clinical work, 14 (43.8%) didn’t use protective gear, citing they were only assisting those performing resuscitations, gumboots were the least used protective gear with only3(9.4%) usage. About disposal techniques of specific products like blood and sharps, results showed 10 (31.3%) said blood is disposed of in red buckets, 5 (15.6%) in yellow buckets, and only 5(15.6%) in black buckets, and 12(37.5%) didn’t respond, however, 28(87.5%) said sharps were disposed of in a sharps container. The majority, 17 (53.1%), were not aware of the infection control guidelines even though they were pinned on walls of the emergency rooms, 15(46.9%) said they have never had quality assurance monitoring events, 14(43.8%) said monitoring was continuous while 15(46.9 %) said it was discrete. Conclusions: The infection control practices at the emergency department were inadequate in view of less than 100% of the EMTs observing the five principles of infection prevention, such as the use of personal protective equipment and proper waste disposal in appropriate color-coded bins. Dysfunctional infection prevention and control committees accompanied by inadequate supervision to ensure infection control remained a big challenge.

Keywords: emergency medical technician, infection prevention, influencing factors, infection control

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Authors: Wesam Hamed

Abstract:

This paper contributes to the existing literature by investigating the impact of political risks on the capital adequacy ratio in the banking sector of Gulf Cooperation Council (GCC) countries, which is the first attempt for this nexus to the best of our knowledge. The dynamic panel data model (System‐GMM) showed that political risks significantly decrease the capital adequacy ratio in the banking sector. For this purpose, we used political risks, bank-specific, profitability, and macroeconomic variables that are utilized from the data stream database for the period 2005-2017. The results also actively support the “too big to fail” hypothesis. Finally, the robustness results confirm the conclusions derived from the baseline System‐GMM model.

Keywords: capital adequacy ratio, system GMM, GCC, political risks

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Authors: Kira Merigan

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BACKGROUND- Fertility preservation (FP) measures are increasingly recognised as an important consideration for children and adolescents planned to undergo potentially damaging gonadotoxic therapy. Worldwide, there are very few documented cases of FP in young females by way of ovarian stimulation and oocyte cryopreservation.AIM – To report a case series of mature oocyte cryopreservation in 5post-pubertal adolescents aged 14-17 years old, with varied medical conditions requiring gonadotoxic treatment. SETTING-These cases took place via a multidisciplinary team approach at The Royal Children’s Hospital, a large tertiary centre in Melbourne, Australia. INTERVENTION– Ovarian stimulation and oocyte collection was performed as detailed in each case. RESULTS –Across the 5 patients, 3-28 oocytes were retrieved. We report pre-treatment workup, complications, and delays to treatment. CONCLUSION- Oocyte cryopreservation may be a safe alternative to ovarian tissue cryopreservation (OTC) in the adolescent population

Keywords: fertility preservation, adolescent, ovarian stimulation, oocyte cryopreservation

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Authors: Henry Gonzalo Acurio Flores, Alvaro Nicolas Corral Naveda, Juan Francisco Fonseca Palacios

Abstract:

In Ecuador, subventions on fossil fuels for the road transportation sector have always been part of its economy throughout time, mainly because of demagogy and populism from political leaders. It is clearly seen that the government cannot maintain the subsidies anymore due to its commercial balance and its general state budget; subsidies are a key barrier to implementing the use of cleaner technologies. However, during the last few months, the elimination of subsidies has been done gradually with the purpose of reaching international prices. It is expected that with this measure, the population will opt for other means of transportation, and in a certain way, it will promote the use of private electric vehicles and public, e.g., taxis and buses (urban transport). Considering the three main elements of sustainable development, an analysis of the social, economic, and environmental impacts of eliminating subsidies will be generated at the country level. To achieve this, four scenarios will be developed in order to determine how the subsidies will contribute to the promotion of electro-mobility. 1) A Business as Usual BAU scenario; 2) the introduction of 10 000 electric vehicles by 2025; 3) the introduction of 100 000 electric vehicles by 2030; 4) the introduction of 750 000 electric vehicles by 2040 (for all the scenarios buses, taxis, lightweight duty vehicles, and private vehicles will be introduced, as it is established in the National Electro Mobility Strategy for Ecuador). The Low Emissions Analysis Platform (LEAP) will be used, and it will be suitable to determine the cost for the government in terms of importing derivatives for fossil fuels and the cost of electricity to power the electric fleet that can be changed. The elimination of subventions generates fiscal resources for the state that can be used to develop other kinds of projects that will benefit Ecuadorian society. It will definitely change the energy matrix, and it will provide energy security for the country; it will be an opportunity for the government to incentivize a greater introduction of renewable energies, e.g., solar, wind, and geothermal. At the same time, it will also reduce greenhouse gas emissions (GHG) from the transportation sector, considering its mitigation potential, which as a result, will ameliorate the inhabitant quality of life by improving the quality of air, therefore reducing respiratory diseases associated with exhaust emissions, consequently, achieving sustainability, the Sustainable Development Goals (SDGs), and complying with the agreements established in the Paris Agreement COP 21 in 2015. Electro mobility in Latin America and the Caribbean can only be achieved by the implementation of the right policies at the central government, which need to be accompanied by a National Urban Mobility Policy (NUMP) and can encompass a greater vision to develop holistic, sustainable transport systems at local governments.

Keywords: electro mobility, energy, policy, sustainable transportation

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Authors: Wadsana Sarakarn, Pimonpan Charoensri, Baliya Chaiyara

Abstract:

Objectives: To study the outcomes of the developed nursing model to prevent early postpartum hemorrhage (PPH). Materials and Methods: The analytical study was conducted in Sunpasitthiprasong Hospital during October 1st, 2015, until May 31st, 2017. After review the prevalence, risk factors, and outcomes of postpartum hemorrhage of the parturient who gave birth in Sunpasitthiprasong Hospital, the nursing model was developed under research regulation of Kemmis&McTaggart using 4 steps of operating procedures: 1) analyzing problem situation and gathering 2) creating the plan 3) noticing and performing 4) reflecting the result of the operation. The nursing model consisted of the screening tools for risk factors associated with PPH, the clinical nursing practice guideline (CNPG), and the collecting bag for measuring postpartum blood loss. Primary outcome was early postpartum hemorrhage. Secondary outcomes were postpartum hysterectomy, maternal mortality, personnel’s practice, knowledge, and satisfaction of the nursing model. The data were analyzed by using content analysis for qualitative data and descriptive statistics for quantitative data. Results: Before using the nursing model, the prevalence of early postpartum hemorrhage was under estimated (2.97%). There were 5 cases of postpartum hysterectomy and 2 cases of maternal death due to postpartum hemorrhage. During the study period, there was 22.7% prevalence of postpartum hemorrhage among 220 pregnant women who were vaginally delivered at Sunpasitthiprasong Hospital. No maternal death or postpartum hysterectomy was reported after using the nursing model. Among 16 registered nurses at the delivery room who evaluated using of the nursing model, they reported the high level of practice, knowledge, and satisfaction Conclusion: The nursing model for the prevention of early PPH is effective to decrease early PPH and other serious complications.

Keywords: the development of a nursing model, prevention of postpartum hemorrhage, pregnant women, postpartum hemorrhage

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