Search results for: Greek public hospital sector

Authors: Minhui Chiu

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According to relevant studies, clinical nurses have high work pressure and relatively high job adaptation needs. The nurses who work in oncology wards have more adaptation needs when they face repeating hospitalization patients. The aims of this study were to investigate the job stress adaptation and related factors of nurses in oncology wards and to understand the predictors of job stress adaptation needs. Convenience sampling was used in this study. The nurses in the oncology specialist ward of a regional teaching hospital in southern Taiwan were selected as the research objects. A cross-sectional survey was conducted using a structured questionnaire, random sampling, and the questionnaires were filled out by the participating nurses. A total of 68 people were tested, and 65 valid questionnaires (95.6%). One basic data questionnaire and nurses’ job stress adaptation needs questionnaire were used. The data was archived with Microsoft Excel, and statistical analysis was performed with JMP12.0. The results showed that the average age was 28.8 (±6.7) years old, most of them were women, 62 (95.38%), and the average clinical experience in the hospital was 5.7 years (±5.9), and 62 (95.38%) were university graduates. 39 people (60.0%) had no work experience. 39 people (60.0%) liked nursing work very much, and 23 people (35.3%) just “liked”. 47 (72.3%) people were supported to be oncology nurses by their families. The nurses' job stress adaptation needs were 119.75 points (±17.24). The t-test and variance analysis of the impact of nurses' job pressure adaptation needs were carried out. The results showed that the score of college graduates was 121.10 (±16.39), which was significantly higher than that of master graduates 96.67 (±22.81), and the degree of liking for nursing work also reached a Significant difference. These two variables are important predictors of job adaptation needs, and the R Square is 24.15%. Conclusion: Increasing the love of clinical nurses in nursing and encouraging university graduation to have positive effects on job pressure adaptation needs and can be used as a reference for the management of human resources hospitals for oncology nurses.

Keywords: oncology nurse, job stress, job stress adaptation needs, manpower

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Authors: Tareq Nikzad

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Since the first bank was established in 1933, Afghanistan's banking sector has seen a number of variations but hasn't been able to grow to its full potential because of the civil war. The implementation of dual banks in Afghanistan is investigated in this study in relation to the effects of inflation and interest rates. This research took data from World Bank Data (WBD) over a period of nineteen years. For the banking sector, inflation, which is the general rise in prices of goods and services over time, presents considerable difficulties. The objectives of this research are to analyze the effect of inflation and interest rates on conventional and Islamic banks in Afghanistan, identify potential differences between these two banking models, and provide insights for policymakers and practitioners. A mixed-methods approach is used in the research to analyze quantitative data and qualitatively examine the unique difficulties that banks in Afghanistan's economic atmosphere encounter. The findings contribute to the understanding of the relationship between interest rate, inflation rate, and the performance of both banking systems in Afghanistan. The paper concludes with recommendations for policymakers and banking institutions to enhance the stability and growth of the banking sector in Afghanistan. Interest is described as "a prefixed rate for use or borrowing of money" from an Islamic perspective. This "prefixed rate," known in Islamic economics as "riba," has been described as "something undesirable." Furthermore, by using the time series regression data technique on the annual data from 2003 to 2021, this research examines the effect of CPI inflation rate and interest rate of Banking in Afghanistan.

Keywords: inflation, Islamic banking, conventional banking, interest, Afghanistan, impact

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Authors: Gregor Moncrieff, Ursula Bahlmann

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A number of incident reports were filed from the intensive care unit with regards to adult patients admitted following operations who had a central venous catheter inserted of the incorrect length for the relevant anatomical site and catheters not compatible with pressurised injection inserted whilst in theatre. Incorrect catheter length can lead to a variety of complications and pressurised injection is a requirement for contrast enhanced computerised tomography scans. This led to several patients having a repeat procedure to insert a catheter of the correct length and also compatible with pressurised injection. This project aimed to identify the types of central venous catheters used in theatres and ensure the correct equipment would be stocked and used in future cases in accordance the existing Association of Anaesthetics of Great Britain and Northern Ireland guidelines. A questionnaire was sent out to all of the anaesthetic department in our hospital aiming to determine what types of central venous catheters were preferably used by anaesthetists and why these had been chosen. We also explored any concerns regarding introduction of standardised, pressure injectable central venous catheters to the theatre department which were already in use in other parts of the hospital and in keeping with national guidance. A total of 56 responses were collected. 64% of respondents routinely used a central venous catheter which was significantly shorter than the national recommended guidance with a further 4 different types of central venous catheters used which were different to other areas of the hospital and not pressure injectable. 75% of respondents were in agreement to standardised introduction of the pressure injectable catheters of the recommended length in accordance with national guidance. Reasons why 25% respondents were opposed to introduction of these catheters were explored and discussed. We were successfully able to introduce the standardised central catheters to the theatre department following presentation at the local anaesthetic quality and safety meeting. Reasons against introduction of the catheters were discussed and a compromise was reached that the existing catheters would continue to be stocked but would only be available on request, with a focus on encouraging use of the standardised catheters. Additional changes achieved included removing redundant catheters from the theatre stock. Ongoing data is being collected to analyse positive and negative feedback from use of the introduced catheters.

Keywords: central venous catheter, medical equipment, medical safety, quality improvement

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Authors: Roman Kulikov, Svetlana Kolesnikova

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Last decade Cloud Computing technologies have been rapidly becoming ubiquitous. Each year more and more organizations, corporations, internet services and social networks trust their business sensitive information to Public Cloud. The data storage in Public Cloud is protected by security mechanisms such as firewalls, cryptography algorithms, backups, etc.. In this way, however, only outsider attacks can be prevented, whereas virtualization tools can be easily compromised by insider. The protection of Public Cloud’s critical elements from internal intruder remains extremely challenging. A hypervisor, also called a virtual machine manager, is a program that allows multiple operating systems (OS) to share a single hardware processor in Cloud Computing. One of the hypervisor's functions is to enforce access control policies. Furthermore, it prevents guest OS from disrupting each other and from accessing each other's memory or disk space. Hypervisor is the one of the most critical and vulnerable elements in Cloud Computing infrastructure. Nevertheless, it has been poorly protected from being compromised by insider. By exploiting certain vulnerabilities, privilege escalation can be easily achieved in insider attacks on hypervisor. In this way, an internal intruder, who has compromised one process, is able to gain control of the entire virtual machine. Thereafter, the consequences of insider attacks in Public Cloud might be more catastrophic and significant to virtual tools and sensitive data than of outsider attacks. So far, almost no preventive security countermeasures have been developed. There has been little attention paid for developing models to assist risks mitigation strategies. In this paper formal model of insider attacks on hypervisor is designed. Our analysis identifies critical hypervisor`s vulnerabilities that can be easily compromised by internal intruder. Consequently, possible conditions for successful attacks implementation are uncovered. Hence, development of preventive security countermeasures can be improved on the basis of the proposed model.

Keywords: insider attack, public cloud, cloud computing, hypervisor

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Authors: Mohamed Abdalla Khalil Mahmoud, Omnia Haidar Suliman

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Information and Communication technologies have revolutionized the way services are developed and offered to customers and have achieved evident success in a variety of vital sectors and widely contributed to the growth and resilience of the economy worldwide. Consequently, governments, especially of developing countries, have turned their attention to examine possible ways to utilize contemporary technology advances to offer essential governmental services to citizens, especially in areas where government agencies are not present. This paper investigates the challenges that impede governments of developing countries to provide basic services to its constituents nationwide. Sudan, as a case study, has taken major steps to provide essential governmental services via electronic channels. However, these services are still not widely used by the citizens, resulting in waste of financial and human resources and efforts that could have been invested more appropriately. This paper examines the challenges that hinder the Sudan’s government in their pursuit of availing its services via electronic channels. Different categories of e-government challenges, such as organizational, technological, social and, demographic, and financial and economic, have been explored in order to pinpoint the major challenges. A structured questionnaire is used to survey the target population of e-government professionals and executives who have direct involvement in the implementation of this nationwide endeavor in Sudan. The survey has successfully identified the main challenges that have high impact on the government’s effort to offer its services via electronic channels, such as Lack of coordination between public and private sectors and Lack of the benefits recognition of the e-government program. The findings of this paper can be used as a solid foundation for improving the way governmental services are offered to citizens in Sudan, resulting in a successful investment of financial and human resources and benefiting the targeted customers of all types.

Keywords: citizen, digital, e-channels, public sector, Sudan, technology

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Authors: Nikolaos Georgantzis, Efi Vasileiou

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We present results from experimental price-setting oligopolies in which green firms undertake different levels of energy-saving investments motivated by public subsidies and demand-side advantages. We find that consumers reveal higher willingness to pay for greener sellers’ products. This observation in conjunction to the fact that greener sellers set higher prices is compatible with the use and interpretation of energy-saving behaviour as a differentiation strategy. However, sellers do not exploit the resulting advantage through sufficiently high price-cost margins, because they seem trapped into “run to stay still” competition. Regarding the use of public subsidies to energy-saving sellers we uncover an undesirable crowding-out effect of consumers’ intrinsic tendency to support green manufacturers. Namely, consumers may be less willing to support a green seller whose energy-saving strategy entails a direct financial benefit. Finally, we disentangle two alternative motivations for consumer’s attractions to pro-social firms; first, the self-interested recognition of the firm’s contribution to the public and private welfare and, second, the need to compensate a firm for the cost entailed in each pro-social action. Our results show the prevalence of the former over the latter.

Keywords: corporate social responsibility, energy savings, public good, experiments, vertical differentiation, altruism

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Authors: Sireethorn Nimitvilai, Ussanee Poolvivatchaikarn, Nuchanart Tomeun

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Objective: To determine the simple laboratory parameters to predict disease severity among COVID-19 patients in resource-limited settings. Material and methods: A retrospective cohort study was conducted at Nakhonpathom Hospital, a 722-bed tertiary care hospital, with an average of 50,000 admissions per year, during April 15 and May 15, 2021. Eligible patients were adults aged ≥ 15 years who were hospitalized with COVID-19. Baseline characteristics, comorbid conditions ad laboratory findings at admission were collected. Predictive factors for severe COVID-19 infection were analyzed. Result: There were 207 patients (79 male and 128 female) and the mean age was 46.7 (16.8) years. Of these, 39 cases (18.8%) were severe and 168 (81.2%) cases were non-severe. Factors associated with severe COVID-19 were neutrophil to lymphocyte ratio ≥ 4 (OR 8.1, 95%CI 2.3-20.3, P < 0.001) and C-reactive protein to albumin ratio ≥ 10 (OR 3.49, 95%CI 1.3-9.1, p 0.01). Conclusions: Complete blood counts, C-reactive protein and albumin are simple, inexpensive, widely available tests and can be used to predict severe COVID-19 in resource-limited settings.

Keywords: COVID-19, predictor of severity, resource-limiting settings, simple laboratory parameters

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Authors: M. Otrusinova, E. Pastuszkova

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The article is addressing the currently ongoing reform processes of transforming the public finance accounting based on cash flow principle to accrual principle. The presented analysis concerns the issues associated with the introduction of the state accounting from the perspective of municipal employees in compiling the opinions of financial experts in conditions of the Czech Republic. The aim of this paper is to present outcomes of analysis focused on currently discussed topics which are related to introducing the accrual principle into accounting of selected entities, especially municipalities and municipality-funded institutions. The output of the paper consists of comparing the application of the accrual principle in the financial reporting of municipalities in the Czech Republic and Slovakia. In conclusion and based on the survey, respondents from Slovak municipalities that have already adopted the accrual accounting principle show better opinion than Czech municipalities.

Keywords: accrual principle, accounting, accounting reform, Czech Republic, municipalities, public finance

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Authors: P. P. S. Sifolo, P. Tladi, J. Maimela

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This article investigates technology used by Tshwane residents intended for tourism purposes. The aim is to contribute information to the Tshwane interested parties for planning and management concerning technology within the tourism sector. This study identified the types of tourist related technologies used by the Tshwane residents, be it for business purposes or personal use. The study connected the exploitation of technology for tourism purposes through unpacking the tourism sector as it utilizes technology. Quantitative research methodology was used whereby self-completed questionnaires were chosen as research instruments. The research study carried out a search for knowledge on technology for tourism and the Tshwane residents; however the study revealed that technology has certainly imprinted tourism massively because of its effectiveness and efficiency. Technology has assisted tourism businesses stay abreast of competition with ICT and because of that, SA is on the map as one the economically performing countries in Africa. Moreover, technology and tourism make a meaningful impact on job creation and Gross Domestic Product (GDP).

Keywords: tourism, information and communication technology, Tshwane residents, technology for tourism

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Authors: Abdon O. Makore

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The study analyses policy and institutional implications with regard to the successful implementation of IPTS in Harare. IPTS has widely been recommended as a rich solution to chaotic public transport operations, yet studies to determine the suitability or applicability of this concept have not been done in light of the existing transport institutions and policy framework in Harare. A predominantly qualitative research approach was employed backed by a deep scrutiny of the NTP and other subsidiary legislations and plans in place so as to ascertain the views and perceptions of various stakeholders regarding the proposed concept. As such, key informant interviews, unstructured interviews, and questionnaires were vital tools in gathering data and these were effectively buttressed by observations, photography, and documentary analysis. The study revealed from a policy perspective that there are high prospects for the implementation of IPTS in Harare as the existing NTP, subsidiary legislations and plans do have provisions for the concept backed by keen interest of all responsible urban public transport authorities. However, there is lack of coherent and systematic approach among other responsible institutions, as such recommendations formulated advocated for institutional integration and strong political will for the ultimate success of the concept.

Keywords: integrated public transport system, policy, legislation, institutions

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Authors: Pratibha Goyal, Nupur Mathur, Anuradha Singh

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Antibiotic resistance is the worldwide threat to human health in this century. Excessive use of antibiotic after their discovery in 1940 makes certain bacteria to become resistant against antibiotics. Most common antibiotic-resistant bacteria include Staphylococcus aureus, Salmonella typhi, E.coli, Klebsiella pneumonia, and Streptococcus pneumonia. Among all Staphylococcus resistant strain called Methicillin-resistant Staphylococcus aureus (MRSA) is responsible for several lives threatening infection in human commonly found in the hospital environment. Our study aimed to isolate bacteriophage against MRSA from the hospital sewage treatment plant and to analyze its efficiency In Vivo in Swiss albino mice model. Sewage sample for the isolation of bacteriophages was collected from SDMH hospital sewage treatment plant in Jaipur. Bacteriophages isolated by the use of enrichment technique and after characterization, isolated phages used to determine phage treatment efficiency in mice. Mice model used to check the safety and suitability of phage application in human need which in turn directly support the use of natural bacteriophage rather than synthetic chemical to kill pathogens. Results show the plaque formation in-vitro and recovery of MRSA infected mice during the experiment. Favorable lytic efficiency determination of MRSA and Salmonella presents a natural way to treat lethal infections caused by Multidrug-resistant bacteria by using their natural host-pathogen relationship.

Keywords: antibiotic resistance, bacteriophages, methicillin resistance Staphylococcus aureus, pathogens, phage therapy, Salmonella typhi

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Authors: Zeytu G. Asfaw, Serkalem K. Abrha, Demisew G. Degefu

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Background: HIV/AIDS remains a major public health problem in Ethiopia and heavily affecting people of productive and reproductive age. We aimed to compare the performance of Parametric Survival Analysis and Bayesian Survival Analysis using simulations and in a real dataset application focused on determining predictors of HIV patient survival. Methods: A Parametric Survival Models - Exponential, Weibull, Log-normal, Log-logistic, Gompertz and Generalized gamma distributions were considered. Simulation study was carried out with two different algorithms that were informative and noninformative priors. A retrospective cohort study was implemented for HIV infected patients under Highly Active Antiretroviral Therapy in Alamata General Hospital, North Ethiopia. Results: A total of 320 HIV patients were included in the study where 52.19% females and 47.81% males. According to Kaplan-Meier survival estimates for the two sex groups, females has shown better survival time in comparison with their male counterparts. The median survival time of HIV patients was 79 months. During the follow-up period 89 (27.81%) deaths and 231 (72.19%) censored individuals registered. The average baseline cluster of differentiation 4 (CD4) cells count for HIV/AIDS patients were 126.01 but after a three-year antiretroviral therapy follow-up the average cluster of differentiation 4 (CD4) cells counts were 305.74, which was quite encouraging. Age, functional status, tuberculosis screen, past opportunistic infection, baseline cluster of differentiation 4 (CD4) cells, World Health Organization clinical stage, sex, marital status, employment status, occupation type, baseline weight were found statistically significant factors for longer survival of HIV patients. The standard error of all covariate in Bayesian log-normal survival model is less than the classical one. Hence, Bayesian survival analysis showed better performance than classical parametric survival analysis, when subjective data analysis was performed by considering expert opinions and historical knowledge about the parameters. Conclusions: Thus, HIV/AIDS patient mortality rate could be reduced through timely antiretroviral therapy with special care on the potential factors. Moreover, Bayesian log-normal survival model was preferable than the classical log-normal survival model for determining predictors of HIV patients survival.

Keywords: antiretroviral therapy (ART), Bayesian analysis, HIV, log-normal, parametric survival models

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Authors: Gleyce Assis Da Silva Barbosa

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In recent years, we have witnessed a vertiginous growth of large education companies. Daughters of national and world capital, these companies expand both through consolidated physical networks in the form of branches spread across the territory and through institutional networks such as business networks through mergers, acquisitions, creation of new companies and influence. They do this by incorporating small, medium and large schools and universities, teaching systems and other products and services. They are also able to weave their webs directly or indirectly in philanthropic circles, limited partnerships, family businesses and even in public education through various mechanisms of outsourcing, privatization and commercialization of products for the sector. Although the growth of these groups in basic education seems to us a recent phenomenon in peripheral countries such as Brazil, its diffusion is closely linked to higher education conglomerates and other sectors of the economy forming oligopolies, which began to expand in the 1990s with strong state support and through political reforms that redefined its role, transforming it into a fundamental agent in the formation of guidelines to boost the incorporation of neoliberal logic. This expansion occurred through the objectification of education, commodifying it and transforming students into consumer clients. Financial power combined with the neo-liberalization of state public policies allowed the profusion of social exclusion, the increase of individuals without access to basic services, deindustrialization, automation, capital volatility and the indetermination of the economy; in addition, this process causes capital to be valued and devalued at rates never seen before, which together generates various impacts such as the precariousness of work. Understanding the connection between these processes, which engender the economy, allows us to see their consequences in labor relations and in the territory. In this sense, it is necessary to analyze the geographic-economic context and the role of the facilitating agents of this process, which can give us clues about the ongoing transformations and the directions of education in the national and even international scenario since this process is linked to the multiple scales of financial globalization. Therefore, the present research has the general objective of analyzing the socio-spatial impacts of financialization and the formation of oligopolies in Brazilian basic education. For this, the survey of laws, data, and public policies on the subject in question was used as a methodology. As a methodology, the work was based on some data from these companies available on websites for investors. Survey of information from global and national companies that operate in Brazilian basic education. In addition to mapping the expansion of educational oligopolies using public data on the location of schools. With this, the research intends to provide information about the ongoing commodification process in the country. Discuss the consequences of the oligopolization of education, considering the impacts that financialization can bring to teaching work.

Keywords: financialization, oligopolies, education, Brazil

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Authors: Kalbende Krunal Ramesh

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The Carbon Capture and Storage Technology (CCS) provides a veritable platform to bridge the gap between the seemingly irreconcilable twin global challenges of ensuring a secure, reliable and diversified energy supply and mitigating climate change by reducing atmospheric emissions of carbon dioxide. Making its proper regulatory policy and making it flexible for the government and private company by law to regulate, also exploring the opportunity in this sector is the main aim of this paper. India's total annual emissions was 1725 Mt CO2 in 2011, which comprises of 6% of total global emission. It is very important to control the greenhouse gas emission for the environment protection. This paper discusses the various regulatory policy and technology adopted by some of the countries for successful using CCS technology. The brief geology of sedimentary basins in India is studied, ranging from the category I to category IV and deep water and potential for mature technology in CCS is reviewed. Areas not suitable for CO2 storage using presently mature technologies were over viewed. CSS and Clean development mechanism was developed for India, considering the various aspects from research and development, project appraisal, approval and validation, implementation, monitoring and verification, carbon credit issued, cap and trade system and its storage potential. The opportunities in oil and gas operations, power sector, transport sector is discussed briefly.

Keywords: carbon credit issued, cap and trade system, carbon capture and storage technology, greenhouse gas

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Authors: P. Sankar, P. James Daniel Paul, Siddhant Sahu

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A brief review of the empirical studies on the methodology of the stock market decision support would indicate that they are at a threshold of validating the accuracy of the traditional and the fuzzy, artificial neural network and the decision trees. Many researchers have been attempting to compare these models using various data sets worldwide. However, the research community is on the way to the conclusive confidence in the emerged models. This paper attempts to use the automotive sector stock prices from National Stock Exchange (NSE), India and analyze them for the intra-sectorial support for stock market decisions. The study identifies the significant variables and their lags which affect the price of the stocks using OLS analysis and decision tree classifiers.

Keywords: Indian automotive sector, stock market decisions, equity portfolio analysis, decision tree classifiers, statistical data analysis

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Authors: Ana Luiza Aranha

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This paper contributes to the discussions that consider corruption as a challenge to the establishment of more democratically inclusive societies in Latin America. The paper advocates an intrinsic connection between democratic principles and corruption control – it is only possible to achieve just forms of democratic life if accountability institutions are able to control corruption, and therefore control the political exclusions that it brings. Departing from a non-trivial approach to corruption, and recognizing a gap in democratic theory when thinking about this phenomenon, corruption is understood as the breakdown of the democratic inclusive rule, whereby political decisions are made (and actions were taken) in spite of those potentially affected by them. Based on this idea, this paper proposes a new way of measuring corruption, moving away from usual aggregate measures – such as the Corruption Perception Index – and case studies of corruption scandals. The main argument sustains that corruption is intrinsically connected with the ability to be accountable and to provide public justification for the political conduct. The point advocated is that corruption involves a dimension of political exclusion. It generates a private benefit which is, from a democratic point of view, illegitimate, since it benefits some at the expense of the decisions made by the political community. Corruption is then a form of exclusion based on deception and opacity - for corruption, there is no plausible justification. Empirically, the paper uses the audit reports produced by the Brazilian anti-corruption agency (the CGU - Office of the Comptroller General) in its Inspections From Public Lotteries Program to exemplify how we can use this definition to separate corruption cases from mismanagement irregularities. On one side, there is poor management and inefficiencies, and, on the other, corruption, defined by the implausibility of public justifications – because the public officials would have to publicize illegitimate privileges and undue advantages. CGU reports provide the justifications given by the public officials for the irregularities found and also the acceptance or not by the control agency of these justifications. The analysis of this dialogue – between public officials and control agents – makes it possible to divide the irregularities on those that can be publicly justified versus those that cannot. In order to hold public officials accountable for their actions, making them responsible for the exclusions that they may cause (such as corruption), the accountability institutions fulfil an important role in reinforcing and empowering democracy and its basic inclusive condition.

Keywords: accountability, brazil, corruption, democracy

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Authors: Hassan Medaghri Alaoui

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The accounting and financial reporting system in use today is over 500 years old and has failed to capture the new knowledge and innovation economy in which intangible assets are becoming increasingly valuable. Yet, there has been a growing acknowledgment among the research community as to the relevance of intellectual capital as a major enhancer of an organization’s well-being. Much of the research provides great support for how the IC is instrumental in determining financial and stock performances. As far as we know, this article is one of the earliest exploratory attempts to examine the intellectual capital impact on the corporate performance of the IT sector in Morocco. The purpose of this study is to verify empirically the influence of intellectual capital on firm performance. We have undertaken, over a fifteen-year period, a longitudinal (2005–2019) case study of a prominent payment-solutions company based in a developing economy with global operations.

Keywords: intellectual capital, IT sector, measuring intellectual capital, modified value added intellectual capital coefficient, Morocco

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Authors: M. A. T. AlSudairi, T. G. K. Vasista

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The concept of social media is becoming the top of the agenda for many business executives and public sector executives today. Decision makers as well as consultants, try to identify ways in which firms and enterprises can make profitable use of social media and network related applications such as Wikipedia, Face book, YouTube, Google+, Twitter. While it is fun and useful to participating in this media and network for achieving the communication effectively and efficiently, semantic and sentiment analysis and interpretation becomes a crucial issue. So, the objective of this paper is to provide literature review on social media, network and related technology related to semantics and sentiment or opinion analysis covering business and governance perspectives. In this regard, a case study on the use and adoption of Social media in Saudi Arabia has been discussed. It is concluded that semantic web technology play a significant role in analyzing the social networks and social media content for extracting the interpretational knowledge towards strategic decision support.

Keywords: CRASP methodology, formative assessment, literature review, semantic web services, social media, social networks

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Authors: Hannes Groeneweg

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Myanmar is considered one of the largest fishing nations in the world. The country’s rapid economic and political reform process since 2011 entails both challenges and opportunities for its marine fishing sector. The development pathway of the sector remains unclear. Which future will eventually materialize is shaped and determined by the various visions and actions of the stakeholders engaging in political debates and decision-making. These visions can be conceptualized through the Science and Technology Studies (STS) concept of sociotechnical imaginaries. The research of this article is guided by the question of which imaginaries are currently relevant, who is propagating these imaginaries, and how are these imaginaries produced and contested. Using qualitative documentary analysis of policy documents, reports, and media articles as well as in-depth interviews with key stakeholders, three archetypical national sociotechnical imaginaries of Myanmar’s future marine fisheries were identified: The industrial scale extractivism imaginary views marine fishing sector as a driver for national economic growth and focuses on the industrial and technological development of the production chain, increasing yield and exports. Sustainable fishing management encompasses the vulnerability of marine ecosystems and views increasing efficient sustainability governance, planning, and management into existing fishing practices. In the traditional sufficiency fishing imaginary, small-scale fishing practices are viewed as an important livelihood practice for millions of coastal dwellers. The need to conserve them through strengthening the self-reliance, autonomy, and resilience of these communities is stressed. In national debates, the first two imaginaries are currently dominant. The imaginaries, as well as their contestations, are also linked to other critical political issues. The paper suggests that participatory decision-making processes are needed to create an inclusive imaginary of the future marine fishing sector.

Keywords: science and technology studies, sociotechnical imaginaries, marine fishing, knowledge coproduction, Myanmar

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Authors: Elena Bellini, Daniele Mugnaini, Michele Boschetto

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People with an Autistic Spectrum Disorder and an Intellectual Disability who need to attend a Hospital Emergency Waiting Room frequently present high levels of discomfort and challenging behaviors due to stress-related hyperarousal, sensory sensitivity, novelty-anxiety, communication and self-regulation difficulties. Increased agitation and acting out also disturb the diagnostic and therapeutic processes, and the emergency room climate. Architectural design disciplines aimed at reducing distress in hospitals or creating autism-friendly environments are called for to find effective answers to this particular need. A growing number of researchers are considering the physical environment as an important point of intervention for people with autism. It has been shown that providing the right setting can help enhance confidence and self-esteem and can have a profound impact on their health and wellbeing. Environmental psychology has evaluated the perceived quality of care, looking at the design of hospital rooms, paths and circulation, waiting rooms, services and devices. Furthermore, many studies have investigated the influence of the hospital environment on patients, in terms of stress-reduction and therapeutic intervention’ speed, but also on health professionals and their work. Several services around the world are organizing autism-friendly hospital environments which involve the architecture and the specific staff training. In Italy, the association Spes contra spem has promoted and published, in 2013, the ‘Chart of disabled people in the hospital’. It stipulates that disabled people should have equal rights to accessible and high-quality care. There are a few Italian examples of therapeutic programmes for autistic people as the Dama project in Milan and the recent experience of Children and Autism Foundation in Pordenone. Careggi’s Emergency Waiting Room in Florence has been built to satisfy this challenge. This project of research comes from a collaboration between the technical staff of Careggi Hospital, the Center for autism PAMAPI and some architects expert in the sensory environment. The methodology of focus group involved architects, psychologists and professionals through a transdisciplinary research, centered on the links between the spatial characteristics and clinical state of people with ASD. The relationship between architectural space and quality of life is studied to pay maximum attention to users’ needs and to support the medical staff in their work by a specific program of training. The result of this research is a sum of criteria used to design the emergency waiting room, that will be illustrated. A protected room, with a clear space design, maximizes comprehension and predictability. The multisensory environment is thought to help sensory integration and relaxation. Visual communication through Ipad allows an anticipated understanding of medical procedures, and a specific technological system supports requests, choices and self-determination in order to fit sensory stimulation to personal preferences, especially for hypo and hypersensitive people. All these characteristics should ensure a better regulation of the arousal, less behavior problems, improving treatment accessibility, safety, and effectiveness. First results about patient-satisfaction levels will be presented.

Keywords: accessibility of care, autism-friendly architecture, personalized therapeutic process, sensory environment

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Authors: Degineh Belachew Andarge, Tariku Lambiyo Anticho, Getamesay Mulatu Jara, Musa Mohammed Ali

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Introduction: Tuberculosis (TB) is a communicable chronic disease causedby Mycobacterium tuberculosis (MTB). About one-third of the world’s population is latently infected with MTB. TB is among the top 10 causes of mortality throughout the globe from a single pathogen. Objective: The aim of this study was to determine the prevalence of tuberculosis,rifampicin-resistant/multidrug-resistant Mycobacterium tuberculosis, and associated factors among presumptive tuberculosis cases attending the tuberculosis clinic of Adare General Hospital located in Hawassa city. Methods: A hospital-based cross-sectional study was conducted among 321 tuberculosis suspected patients from April toJuly 2018. Socio-demographic, environmental, and behavioral data were collected using a structured questionnaire. Sputumspecimens were analyzed using GeneXpert. Data entry was made using Epi info version 7 and analyzed by SPSS version 20. Logistic regression models were used to determine the risk factors. A p-value less than 0.05 was taken as a cut point. Results: In this study, the prevalence of Mycobacterium tuberculosis was 98 (30.5%) with 95% confidence interval (25.5–35.8), and the prevalence of rifampicin-resistant/multidrug-resistantMycobacterium tuberculosis among the 98 Mycobacteriumtuberculosis confirmed cases was 4 (4.1%). The prevalence of rifampicin-resistant/multidrug-resistant Mycobacterium tuberculosisamong the tuberculosis suspected patients was 1.24%. Participants who had a history of treatment with anti-tuberculosisdrugs were more likely to develop rifampicin-resistant/multidrug-resistant Mycobacterium tuberculosis. Conclusions: This study identified relatively high rifampicin-resistant/multidrug-resistant Mycobacterium tuberculosis amongtuberculosis suspected patients in the study area. Early detection of drug-resistant Mycobacterium tuberculosis should be givenenough attention to strengthen the management of tuberculosis cases and improve direct observation therapy short-course and eventually minimize the spread of rifampicin-resistant tuberculosis strain in the community.

Keywords: rifampicin resistance, mycobacterium tuberculosis, risk factors, prevalence of TB

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Authors: Etta Conteh, Tracy Macintosh

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Introduction: Restraints are often used in the Emergency Department when it is necessary for a patient to be restrained in order to decrease their agitation and better treat them. Chemical and physical restraints may be used on these patients at the discretion of the medical provider. Racism and injustice are rampant within our country, and medicine and healthcare are not spared. While racism and racial bias in medicine and healthcare have been studied, information on the differences in the use of restraints by race are scarce. Objective: The objective of this study is to determine if African Americans and Hispanic-American patients are restrained at higher rates compared to their White counterparts. Methods: This study will be carried out through a retrospective analysis utilizing the Hospital Corporation of America (HCA) national Emergency Department (ED) and inpatient database with patient visits from 2016-2019. All patient visits, with patients aged 18 years or older, will be reviewed, looking specifically for the race and the use and type of restraints. Other factors, such a pre-existing psychiatric condition, will be used for sub-analysis. Rationale: The outcome of this project will demonstrate the absence or presence of a racial disparity in the use of restraints in the Emergency Department. These results can be used as a foundation for improving racial equity in healthcare treatment.

Keywords: emergency medicine, public health, racism, restraint use

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Authors: Isaac Kofi Mensah

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Public sector organizations, ministries, departments and local government agencies are adopting e-government as a means to provide efficient and quality service delivery to citizens. The purpose of this research paper is to examine the extent to which perceived usefulness (PU) of e-government services moderates between perceived ease-of-use (PEOU) of e-government services and intention to use (IU) e-government services in Ghana. A structured research questionnaire instrument was developed and administered to 700 potential respondents in Ghana, of which 693 responded, representing 99% of the questionnaires distributed. The Technology Acceptance Model (TAM) was used as the theoretical framework for the study. The Statistical Package for Social Science (SPSS) was used to capture and analyze the data. The results indicate that even though predictors such as PU and PEOU are main determiners of citizens’ intention to adopt and use e-government services in Ghana, it failed to show that PEOU and IU e-government services in Ghana is significantly moderated by the PU of e-government services. The implication of this finding on theory and practice is further discussed.

Keywords: e-government services, intention to use, moderating role, perceived ease of use, perceived usefulness, Ghana, technology acceptance model

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Authors: Merly Patiño Villanueva, Dubys Villarreal Torres, Eduardo Salazar Araujo, Lezly Ramos Macedo

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The concept of sustainability has been influencing business thinking from the perspective of various economic sectors and their environment, looking for concerns related to the risks associated with the indiscriminate consumption of the planet's resources, which have been widely studied and exposed by different public and private organizations. Tourism is not outsider to this reality; therefore, the concept of sustainable tourism evolves towards the integral management of resources, attending the needs of tourists, host communities and service providers, protecting ecosystems and assuring the conservation of the environment and its biodiversity. Considering the above, the purpose of this paper is to identify trends aimed at promoting sustainable tourism in the destinations of Barranquilla (Colombia) and Nayarit (Mexico). This study is part of the realistic epistemological paradigm, based on the existence of a specific environment for the development of tourism activity and the best sustainability practices associated with this industry, which can be observed and studied, therefore, this research contemplates qualitative research techniques such as the focus group and the interview, applied to 8 experts who are part of the value chain of the sector under study, added to a documentary review taken from the scientific databases Wos and Scopus, as well as statistical information published by official bodies. The data obtained were processed with the qualitative analysis software N-VIVO version 13. As a result, trends and actions to promote tourism are identified for the positioning of the cities of Barranquilla (Colombia) and Nayarit (Mexico) as sustainable destinations: first, the recovery of green areas and environmental spaces, as well as the realization of cultural events; promotion and encouragement of the creative industry and finally the realization of international events. It is concluded that both cities develop activities, projects and investments of public initiative, aimed at positioning them as sustainable tourist destinations.

Keywords: marketing, sustainability, tourism management, policies

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Authors: Charles Atkins

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Anakainosis-desmios is the experience of spiritual renewal during incarceration. "Anakainosis” is a Greek word for “renovation or renewal" that has taken on profound meaning in Christocentric theology where it is defined as the phenomenon of spiritual renewal or a change of heart that is achieved by God’s power. “Desmios” is another Greek word found in the Bible which stands for “one who is bound or a prisoner. Anakainosis-desmios occurs when a person, while residing in an environment of surveillance and coercion, has his consciousness renewed in such a way that he generates unexpected emancipatory and hospitable attitudes. They expressed an awareness of the prison environment and a willingness to engage that environment through their transformed relationships with time, space, matter, and people. By the end of the 20th century, Open Theism, gained the attention of many American evangelicals and theologians. Open Theism was born out of the concerns people had about those scriptures which demonstrate a dynamic God who has unparalled wisdom instead of omniscience; liberating power instead of omnipotence; and abiding faithfulness instead of immutability—all of these attributes being aspects of God’s love for humanity. Scriptural exegesis is one of the primary factors that informed the creation of the open view of God and many who hold this view claim that the divine attributes of omniscience, omnipotence and immutability are not necessarily Scriptural but rather philosophical attempts to define the nature of God. Scriptures that do not support such divine attributes have been a source of distress for many. Some would say that open theists have created lenses that enable a Bible student to gain comfort from those scriptures which seem to show God demonstrating repentance, disappointment and a readiness to learn. This paper will bring Open Theism into conversation with anakainosis-desmios. For open theists the reading of Scripture is an important part of the foundation of their perspectives. Open theists focus on certain Scriptures which demonstrate God showing repentance, disappointment and a readiness to learn. This focus led to their questioning of the systematic theologies that have been created and the biblical hermeneutics that have been used historically as lenses for interpreting such Scriptures. The perspective of anakainosis-desmios is also significantly influenced by the reading of Scripture. Spiritual renewal while incarcerated can occur largely through the religious practice of Bible study. Studying Scriptures during incarceration has supported many people who are seeking to develop new renderings of reality that empower them to flourish in some way despite the hostile environment of prisons. A conversation between the two points of view on the God of the Bible will lead to an expansion of both and to a deepening of a person's experience of Scripture Study.

Keywords: open theism, anakainosis-desmios, religion in prison, open theology, practical theology, Bible, scripture, openness of God, incarceration, prison

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Authors: Mohammed Jamilu Haruna, Kawu Adamu Sule

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This paper examines the evolution of modern policing in Nigeria to the present day, with a focus on the newly introduced community policing, which seeks to cement the operational vacuum created by the repressive and oppressive approach of the Nigeria Police Force (NPF), which renders the police incapable of addressing the twin problems of crime and disorder. Thus, the primary purpose for the implementation of community policing was to use it as a mechanism for building the lost trust between the police and the public, perhaps due to the long history of antagonistic and repressive relationships between them. If properly implemented, community policing has the prospect of empowering Nigerian citizens with the skills to protect themselves against invaders of their private security so that crimes can be prevented before anyone is victimized. Other prospects include, but are not limited to, (i) a favorable public view of the police, (ii) building of mutual trust, (iii) increased information flow through effective communication between the police and the public, and above all, (iv) increased police accountability. Unfortunately, problems such as aged suspicious and distrustful relationships, inadequate funding, poor training of officers, poor monitoring and evaluation of the community policing project, lack of public awareness of the benefits of the program, and sabotage by some of the personnel of the police who benefits from the status quo, were some of the reasons that troubled the implementation of community policing.

Keywords: community, policing, problems, prospects, problem solving

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Authors: Choon Seong Ng, P. Petrick, C. L. Lau

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Background: Carbapenem-resistant isolates have been increasingly reported recently. Carbapenem stewardship is designed to optimize its usage particularly among medical wards with high prevalence of carbapenem prescriptions to combat such emerging resistance. Carbapenem stewardship programmes (CSP) can reduce antibiotic use but clinical outcome of such measures needs further evaluation. We examined this in a prospective manner using feedback mechanism. Methods: Our single-center prospective cohort study involved all carbapenem prescriptions across the medical wards (including medical patients admitted to intensive care unit) in a tertiary university hospital setting. The impact of such stewardship was analysed according to the accepted and the rejected groups. The primary endpoint was safety. Safety measure applied in this study was the death at 1 month. Secondary endpoints included length of hospitalisation and readmission. Results: Over the 19 months’ period, input from 144 carbapenem prescriptions was analysed on the basis of acceptance of our CSP recommendations on the use of carbapenems. Recommendations made were as follows : de-escalation of carbapenem; stopping the carbapenem; use for a short duration of 5-7 days; required prolonged duration in the case of carbapenem-sensitive Extended Spectrum Beta-Lactamases bacteremia; dose adjustment; and surgical intervention for removal of septic foci. De-escalation, shorten duration of carbapenem and carbapenem cessation comprised 79% of the recommendations. Acceptance rate was 57%. Those who accepted CSP recommendations had no increase in mortality (p = 0.92), had a shorter length of hospital stay (LOS) and had cost-saving. Infection-related deaths were found to be higher among those in the rejected group. Moreover, three rejected cases (6%) among all non-indicated cases (n = 50) were found to have developed carbapenem-resistant isolates. Lastly, Pitt’s bacteremia score appeared to be a key element affecting the carbapenem prescription’s behaviour in this trial. Conclusions: Carbapenem stewardship program in the medical wards not only saves money, but most importantly it is safe and does not harm the patients with added benefits of reducing the length of hospital stay. However, more time is needed to engage the primary clinical teams by formal clinical presentation and immediate personal feedback by senior Infectious Disease (ID) personnel to increase its acceptance.

Keywords: audit and feedback, carbapenem stewardship, medical wards, university hospital

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Authors: Esther Friedlander, Philip Friedlander

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The use of immunotherapy that inhibits programmed death-1 (PD-1) or its ligand PD-L1 confers survival benefits in patients with non-small cell lung cancer (NSCLC). However, approximately 45% of patients experience primary treatment resistance, necessitating the development of strategies to improve efficacy. While the renin-angiotensin system (RAS) has systemic hemodynamic effects, tissue-specific regulation exists along with modulation of immune activity in part through regulation of myeloid cell activity, leading to the hypothesis that RAS inhibition may improve anti-PD-1/L-1 efficacy. A retrospective analysis was conducted that included 173 advanced solid tumor cancer patients treated at Valley Hospital, a community Hospital in New Jersey, USA, who were treated with a PD-1/L-1 inhibitor in a defined time period showing a statistically significant relationship between RAS pathway inhibition (RASi through concomitant treatment with an ACE inhibitor or angiotensin receptor blocker) and positive efficacy to the immunotherapy that was independent of age, gender and cancer type. Subset analysis revealed strong numerical benefit for efficacy in both patients with squamous and nonsquamous NSCLC as determined by documented clinician assessment of efficacy and by duration of therapy. A PUBMED literature search was now conducted to identify studies assessing the effect of RAS pathway inhibition on anti-PD-1/L1 efficacy in advanced solid tumor patients and compare these findings to those seen in the Valley Hospital retrospective study with a focus on NSCLC specifically. A total of 11 articles were identified assessing the effects of RAS pathway inhibition on the efficacy of checkpoint inhibitor immunotherapy in advanced cancer patients. Of the 11 studies, 10 assessed the effect on survival of RASi in the context of treatment with anti-PD-1/PD-L1, while one assessed the effect on CTLA-4 inhibition. Eight of the studies included patients with NSCLC, while the remaining 2 were specific to genitourinary malignancies. Of the 8 studies, two were specific to NSCLC patients, with the remaining 6 studies including a range of cancer types, of which NSCLC was one. Of these 6 studies, only 2 reported specific survival data for the NSCLC subpopulation. Patient characteristics, multivariate analysis data and efficacy data seen in the 2 NSLCLC specific studies and in the 2 basket studies, which provided data on the NSCLC subpopulation, were compared to that seen in the Valley Hospital retrospective study supporting a broader effect of RASi on anti-PD-1/L1 efficacy in advanced NSLCLC with the majority of studies showing statistically significant benefit or strong statistical trends but with one study demonstrating worsened outcomes. This comparison of studies extends published findings to the community hospital setting and supports prospective assessment through randomized clinical trials of efficacy in NSCLC patients with pharmacodynamic components to determine the effect on immune cell activity in tumors and on the composition of the tumor microenvironment.

Keywords: immunotherapy, cancer, angiotensin, efficacy, PD-1, lung cancer, NSCLC

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Authors: A. A. Ghanim

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The Kingdom of Saudi Arabia (KSA) is heading towards a severe and rapidly expanding water crisis, which can have negative impacts on the country’s environment and economy. Of the total water consumption in KSA, the agricultural sector accounts for nearly 87% of the total water use and, therefore, any attempt that overlooks this sector will not help in improving the sustainability of the country’s water resources. KSA Vision 2030 gives priority of water use in the agriculture sector for the regions that have natural renewable water resources. It means that there is little concern for making reuse of municipal wastewater for irrigation purposes in any region in general and in water-scarce regions in particular. The use of treated wastewater is very limited in Saudi Arabia, but it has very considerable potential for future expansion due its numerous beneficial uses. This study reviews the current situation of water resources in Saudi Arabia, providing more highlights on agriculture and wastewater reuse. The reviewed study is proposing some corrective measures for development and better management of water resources in the Kingdom. Suggestions also include consideration of treated water as an alternative source for irrigation in some regions of the country. The study concluded that a sustainable solution for the water crisis in KSA requires implementation of multiple measures in an integrated manner. The integrated solution plan should focus on two main directions: first, improving the current management practices of the existing water resources; second, developing new water supplies from both conventional and non-conventional sources.

Keywords: Saudia Arabia, water resources, water crises, wastewater reuse

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Authors: Murat Sarı, Emin Gundogar, Mumtaz Ipek

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Nowadays, in a furniture sector, competition of market share (portion) and production variety and changeability enforce the firm to reengineer operations on manufacturing line to increase the productivity. In this study, spring mattress manufacturing line of the furniture manufacturing firm is analyzed analytically. It’s intended to search and find the bottlenecks of production to balance the semi-finished material flow. There are four base points required to investigate in bottleneck elimination process. These are bottlenecks of Method, Material, Machine and Man (work force) resources, respectively. Mentioned bottlenecks are investigated and varied scenarios are created for recruitment of manufacturing system. Probable near optimal alternatives are determined by system models built in Arena simulation software.

Keywords: bottleneck search, buffer stock, furniture sector, simulation

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