Search results for: healthcare policy instruments

Authors: Karish Thavabalan, Alistair Ovenell, Aman Sutaria, Annabelle Parkhouse, Numan Baydemir, Theodore Lally

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Background: Open discussions surrounding menopause are often associated with stigma, with many women feeling uncomfortable to engage in them with friends, colleagues, and healthcare professionals. Though the barriers regarding safe discussions of symptom management experienced by menopausal women are well documented, existing research offers little insight into whether these were shared by pre-menopausal women. This study aimed to explore the barriers regarding safe discussions about menopausal symptom management as perceived or experienced by pre-menopausal and menopausal women. Methods: This qualitative study was conducted over a 2-month period (March 2022 - April 2022) under the auspices of Imperial College Business School, London, UK. Snowball sampling was used to recruit both menopausal (age 45-70) and pre-menopausal participants (age <45), and sampling continued until data saturation was achieved. 16 semi-structured online interviews were conducted, and transcripts were thematically analyzed following Braun and Clarke’s six-step methodology. Results: A total of 7 higher themes regarding safe discussion of menopausal symptom management were identified by both pre-menopausal and menopausal women, including: “ineffective coping mechanisms”, “perceived onus to self-endure”, “lack of workplace support”, “poor knowledge of management approaches”, “poor healthcare infrastructure”, “poor support from friends and family”, “lack of knowledge and interest from a young age”. Conclusion: Identifying the barriers regarding safe discussion helped to highlight which areas require most significant intervention. Alongside tackling the barriers, menopausal women face, ultimately, there is a pertinent need to and address the lack of insight into menopause from a younger age and to encourage earlier discussions so as to not propagate the cycle of stigma.

Keywords: menopause, stigma, safe discussions, symptom management

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Authors: David A. Wallace, Salakjit J. Nilboworn

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Secure and reliable transmission and distribution of electrical power is crucial in today’s ever-increasing demand for electricity. Traditional methods of protecting the electrical grid have relied on relaying systems receiving voltage and current inputs from inductive instruments transformers (IT). This method has provided robust and stable performance throughout the years. Today with the advent of new non-conventional transformers (NCIT) and sensors, the electrical landscape is changing. These new systems have to ability to provide the same electrical performance as traditional instrument transformers with the added features of data acquisition, communication, smaller footprint, lower cost and resistance to GMD/GIC events.

Keywords: non-conventional instrument transformers, digital substations, smart grids, micro-grids

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Authors: Ahmed Al Ansari, Khalid Al Khalifa

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Objective: Multisource feedback (MSF), also called the 360-Degree evaluation is an evaluation process by which questionnaires are distributed amongst medical peers and colleagues to assess physician performance from different sources other than the attending or the supervising physicians. The aim of this study was to design, implement, and evaluate a 360-Degree process in assessing emergency physicians trainee in the Kingdom of Bahrain. Method: The study was undertaken in Bahrain Defense Force Hospital which is a military teaching hospital in the Kingdom of Bahrain. Thirty emergency physicians (who represent the total population of the emergency physicians in our hospital) were assessed in this study. We developed an instrument modified from the Physician achievement review instrument PAR which was used to assess Physician in Alberta. We focused in our instrument to assess professionalism, communication skills and collaboration only. To achieve face and content validity, table of specification was constructed and a working group was involved in constructing the instrument. Expert opinion was considered as well. The instrument consisted of 39 items; were 15 items to assess professionalism, 13 items to assess communication skills, and 11 items to assess collaboration. Each emergency physicians was evaluated with 3 groups of raters, 4 Medical colleague emergency physicians, 4 medical colleague who are considered referral physicians from different departments, and 4 Coworkers from the emergency department. Independent administrative team was formed to carry on the responsibility of distributing the instruments and collecting them in closed envelopes. Each envelope was consisted of that instrument and a guide for the implementation of the MSF and the purpose of the study. Results: A total of 30 emergency physicians 16 males and 14 females who represent the total number of the emergency physicians in our hospital were assessed. The total collected forms is 269, were 105 surveys from coworkers working in emergency department, 93 surveys from medical colleague emergency physicians, and 116 surveys from referral physicians from different departments. The total mean response rates were 71.2%. The whole instrument was found to be suitable for factor analysis (KMO = 0.967; Bartlett test significant, p<0.00). Factor analysis showed that the data on the questionnaire decomposed into three factors which counted for 72.6% of the total variance: professionalism, collaboration, and communication. Reliability analysis indicated that the instrument full scale had high internal consistency (Cronbach’s α 0.98). The generalizability coefficients (Ep2) were 0.71 for the surveys. Conclusions: Based on the present results, the current instruments and procedures have high reliability, validity, and feasibility in assessing emergency physicians trainee in the emergency room.

Keywords: MSF system, emergency, validity, generalizability

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Authors: Max Butler

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Melanoma accounts for 80% of skin cancer-related deaths globally. The poor prognosis and increasing incidence of melanoma impose a significant burden on global healthcare systems. Early detection, precise diagnosis, and preventative strategies are critical to improving patient outcomes. Dermoscopy is the gold standard for specialist assessments of pigmented skin lesions, as it can differentiate between benign and malignant growths with greater accuracy than visual inspection. In the United Kingdom, guidelines from the National Institute of Clinical Excellence (NICE) state dermoscopy should be used in all specialist assessments of pigmented skin lesions. Compliance with this guideline is low, resulting in missed and delayed melanoma diagnoses. To address this problem, a quality improvement project was initiated at Buckinghamshire Healthcare Trust (BHT) within the plastic surgery department. The target group was a trainee and consultant plastic surgeons conducting outpatient skin cancer clinics. Analysis of clinic documentation over a one-month period found that only 62% (38/61) of patients referred with pigmented skin lesions were examined using dermoscopy. To increase dermoscopy rates, teaching was delivered to the department highlighting national guidelines and the evidence base for dermoscopic examination. In addition, clinic paperwork was redesigned to include a text box for dermoscopic examination. Reauditing after the intervention found a significant increase in dermoscopy rates (52/61, p = 0.014). In conclusion, implementing a quality improvement project with targeted teaching and documentation template templates successfully increased dermoscopy rates. This is a promising step toward improving early melanoma detection and patient outcomes.

Keywords: melanoma, dermoscopy, plastic surgery, quality improvement

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Authors: Tsu-Yin Wu, Jenni Hoffman, Lydia McMurrows, Sarah Lally

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Recent events of the Flint Water Crisis and elevated lead levels in Detroit public school water have highlighted a specific public health disparity and shown the need for better education of healthcare providers on lead education. Identifying children and pregnant women with a high risk for lead poisoning and ensuring lead testing is completed is critical. The purpose of this study is to explore the impact of an educational intervention on knowledge and confidence levels among nursing students enrolled in the prelicensure Bachelor of Science in Nursing (BSN) and Registered Nurse to BSN program (R2B). The study used both quantitative and qualitative research methods to assess the impact of multi-modal pedagogy on knowledge and confidence of lead screening and prevention among prelicensure and R2B nursing students. The students received lead poisoning and prevention content in addition to completing an e-learning module developed by the Pediatric Environmental Health Specialty Units. A total of 115 students completed the pre-and post-test instrument that consisted of demographic, lead knowledge, and confidence items. Despite the increase of total knowledge, three dimensions of lead poisoning, and confidence from pre- to post-test scores for both groups, there was no statistical significance on the increase between prelicensure and R2B students. Thematic analysis of qualitative data showed five themes from participants' learning experiences: lead exposure, signs and symptoms of lead poisoning, screening and diagnosis, prevention, and policy and statewide issues. The study is limited by a small sample and participants recalling some correct answers from the pretest, thus, scoring higher on the post-test. The results contribute to the minimally existent literature examining a critical public health concern regarding lead health exposure and prevention education of nursing students. Incorporating such content area into the nursing curriculum is essential in ensuring that such public health disparities are mitigated.

Keywords: lead poisoning, emerging public health issue, community health, nursing edducation

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Authors: Mohammad Mushir Khan, C. Satyanarayana

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Education is considered as one of the prime bottlenecks in the economic growth of India. The Ministry of Human Resource & Development, Government of India has, therefore, given special attention to this issue and the Gross Enrollment Ratio (GER) in Higher Education has increased marginally during last five years, with the efforts and various policy decisions like Right to Education (RTE) and other fee reimbursement schemes, initiated by the State Governments. But still this is one of the lowest, if assessed at the global level. It is true that the GER has improved but the survey reveals that the quality has been badly affected. This paper tries to assess the impact of lack of quality education in various sectors that affects Indian Economy and thereby signifies the need of immediate policy decision at the government level. It is to be noted that in higher education, science, management, engineering and technology plays vital role as far as shaping country’s economy is concerned and as such the quality needs to be addressed, particularly, in these streams. The paper, after carefully studying lots of survey reports and other government/ non-government documents recommends measures to be initiated by the Central Government, on priority, for improving quality of education. The quality up-gradation in higher education single handedly provides real fuel to the India’s growth Engine, as it has potential to touch each and every sector that strengthens country’s economy.

Keywords: higher education, economy, accreditation, industry, technology

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Authors: Samuel Escandón, María J. Peñaherrera-Vélez, Signe Vargas-Rosvik, Carlos Jerves Córdova, Ximena Vélez-Calvo, Angélica Ochoa-Avilés

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Overweight and obesity are considered risk factors in childhood for developing nutrition-related non-communicable diseases (NCDs), such as diabetes, cardiovascular diseases, and cancer. In Ecuador, 35.4% of 5- to 11-year-olds and 29.6% of 12- to 19-year-olds are overweight or obese. Globally, unhealthy food environments characterized by high consumption of processed/ultra-processed food and rapid urbanization are highly related to the increasing nutrition-related non-communicable diseases. The evidence shows that in low- and middle-income countries (LMICs), fiscal policies and regulatory measures significantly reduce unhealthy food environments, achieving substantial advances in health. However, in some LMICs, little is known about the impact of governments' action to implement healthy food-environment policies. This study aimed to generate evidence on the state of implementation of public policy focused on food environments for the prevention of overweight and obesity in children and adolescents in Ecuador compared to global best practices and to target key recommendations for reinforcing the current strategies. After adapting the INFORMAS' Healthy Food Environment Policy Index (Food‐EPI) to the Ecuadorian context, the Policy and Infrastructure support components were assessed. Individual online interviews were performed using fifty-one indicators to analyze the level of implementation of policies directly or indirectly related to preventing overweight and obesity in children and adolescents compared to international best practices. Additionally, a participatory workshop was conducted to identify the critical indicators and generate recommendations to reinforce or improve the political action around them. In total, 17 government and non-government experts were consulted. From 51 assessed indicators, only the one corresponding to the nutritional information and ingredients labelling registered an implementation level higher than 60% (67%) compared to the best international practices. Among the 17 indicators determined as priorities by the participants, those corresponding to the provision of local products in school meals and the limitation of unhealthy-products promotion in traditional and digital media had the lowest level of implementation (34% and 11%, respectively) compared to global best practices. The participants identified more barriers (e.g., lack of continuity of effective policies across government administrations) than facilitators (e.g., growing interest from the Ministry of Environment because of the eating-behavior environmental impact) for Ecuador to move closer to the best international practices. Finally, within the participants' recommendations, we highlight the need for policy-evaluation systems, information transparency on the impact of the policies, transformation of successful strategies into laws or regulations to make them mandatory, and regulation of power and influence from the food industry (conflicts of interest). Actions focused on promoting a more active role of society in the stages of policy formation and achieving more articulated actions between the different government levels/institutions for implementing the policy are necessary to generate a noteworthy impact on preventing overweight and obesity in children and adolescents. Including systems for internal evaluation of existing strategies to strengthen successful actions, create policies to fill existing gaps and reform policies that do not generate significant impact should be a priority for the Ecuadorian government to improve the country's food environments.

Keywords: children and adolescents, food-EPI, food policies, healthy food environment

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Authors: Qurratulain Faheem

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The human body often serves as a reference point to analyse the notions of self and society. Situating on Merleau-Ponty and Bourdieu theories of embodiments, this research explores the notions around the human body and its influence on the ethical considerations in regards to organ transplantation among the Muslim communities in Pakistan. The context of Pakistan makes an intriguing case study as cadaveric organ transplantation is not in practise. Whereas living organ transplantation is commonly is practised between family members only. These contradictory practices apparently rests on the ideologies around the human body and religious beliefs as well the personal judgements and authority of healthcare professionals. This research is a year-long ethnographic study carried out as part of doctoral studies. An anthropological approach towards organ transplantation in Pakistan brought forward various socio-cultural notions around the human body and selfhood that serve as a framework around biomedical ethical issues in various societies. Further, it surface the contradictions and issues associated with organ transplantation that makes it a dilemma situated in a nexus of various socio-cultural and political factors rather seeing it as an isolated health concern. This research is a novel study on the subject of organ transplantation in the context of Pakistan but also put forward ethnographic data that could serve as a reference in other religious societies. Further, the ethnographic data bring forward experiences and stories of organ receivers, organ donors, religious leaders, healthcare professionals, and the general public, which aspire to encourage biomedical ethicists and social-scientists to consider ethnography as a research methodology and rely upon people’s lived experiences while establishing policies and practices around biomedical ethical issues.

Keywords: Gender, organ transplantation, muslims, pakistan, organ donation, bioethics, culture and religion, gender

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Authors: Jill Hanass-Hancock, Bradley Carpenter, Samantha Willan, Kristin Dunkle

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Access to quality health care for persons with disabilities is the litmus test in our strive toward universal health coverage. Persons with disabilities experience a variety of health disparities related to increased health risks, greater socioeconomic challenges, and persistent ableism in the provision of health care. In low- and middle-income countries, the support needed to address the diverse needs of persons with disabilities and close the gaps in inclusive and accessible health care can appear overwhelming to staff with little knowledge and tools available. An action-orientated disability inclusion toolkit for health facilities was developed through consensus-building consultations and field testing in South Africa. The co-creation of the toolkit followed a bottom-up approach with healthcare staff and persons with disabilities in two developmental cycles. In cycle one, a disability facility assessment tool was developed to increase awareness of disability accessibility and service delivery gaps in primary healthcare services in a simple and action-orientated way. In cycle two, an intervention menu was created, enabling staff to respond to identified gaps and improve accessibility and inclusion. Each cycle followed five distinct steps of development: a review of needs and existing tools, design of the draft tool, consensus discussion to adapt the tool, pilot-testing and adaptation of the tool, and identification of the next steps. The continued consultations, adaptations, and field-testing allowed the team to discuss and test several adaptations while co-creating a meaningful and feasible toolkit with healthcare staff and persons with disabilities. This approach led to a simplified tool design with ‘key elements’ needed to achieve universal health coverage: universal design of health facilities, reasonable accommodation, health care worker training, and care pathway linkages. The toolkit was adapted for paper or digital data entry, produces automated, instant facility reports, and has easy-to-use training guides and online modules. The cyclic approach enabled the team to respond to emerging needs. The pilot testing of the facility assessment tool revealed that healthcare workers took significant actions to change their facilities after an assessment. However, staff needed information on how to improve disability accessibility and inclusion, where to acquire accredited training, and how to improve disability data collection, referrals, and follow-up. Hence, intervention options were needed for each ‘key element’. In consultation with representatives from the health and disability sectors, tangible and feasible solutions/interventions were identified. This process included the development of immediate/low-cost and long-term solutions. The approach gained buy-in from both sectors, who called for including the toolkit in the standard quality assessments for South Africa’s health care services. Furthermore, the process identified tangible solutions for each ‘key element’ and highlighted where research and development are urgently needed. The cyclic and consultative approach enabled the development of a feasible facility assessment tool and a complementary intervention menu, moving facilities toward universal health coverage for and persons with disabilities in low- or better-resourced contexts while identifying gaps in the availability of interventions.

Keywords: public health, disability, accessibility, inclusive health care, universal health coverage

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Authors: Ricardo Pinto Mario Covele, Patricio V. Langa, Patrick Swanzy

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The English language has been recognized as a universal medium of instruction in academia, especially in Higher Education Institutions (HEIs) hence exerting enormous influence within the context of research and publication. By extension, the English Language has been embraced by scholars from non-English speaking countries. The purpose of this review was to synthesize the discussions using four databases. Discussion in the English language in the career development of academics, particularly in non-English speaking universities, is largely less visible. This paper seeks to fill this gap and to improve the visibility of the English language in the career development of academics focusing on non-English language speaking universities by undertaking a systematic literature review. More specifically, the paper addresses the language policy, English language learning model as a second language, sociolinguistic field and career development, methods, as well as its main findings. This review analyzed 75 relevant resources sourced from Western Cape’s Library, Scopus, Google scholar, and web of science databases from November 2020 to July 2021 using the PQRS framework as an analytical lens. The paper’s findings demonstrate that, while higher education continues to be under-challenges of English language usage, literature targeting non-English speaking universities remains less discussed than it is often described. The findings also demonstrate the dominance of English language policy, both for knowledge production and dissemination of literature challenging emerging scholars from non-English speaking HEIs. Hence, the paper argues for the need to reconsider the context of non-English language speakers in the English language in the career development of academics’ research, both as empirical fields and as emerging knowledge producers. More importantly, the study reveals two bodies of literature: (1) the instrumentalist approach to English Language learning and (2) Intercultural approach to the English Language for career opportunities, classified as the appropriate to explain the English language learning process and how is it perceived towards scholars’ academic careers in HEIs.

Keywords: English language, public and private universities, language policy, career development, non-English speaking countries

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Authors: Bikram Jung Kunwar, Pralhad Kunwor

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The Community-Based Forest Management (CBFM) approach is often glorified as the best forest management alternatives in the developing countries. However, how the approach has been understood by the local user households, who implement it is remained unanswered for many planners, policy makers, and sometimes researcher as well. The study attempts to assess the understanding of ecology and economics of CBFM in Nepal, where community forest program has been implemented since the 1970s. In order to understand the impacts of the program, eight criteria and sixteen indicators for ecological conservation and similarly same number of criteria and indicators for socio-economic impacts of the program were designed and compared between before and after the program implementation. The community forestry program has positive effects in forest ecology conservation and at the same time rural livelihood improvement of local people. The study revealed that collective understanding of forest ecology and economics leads the CBFM approach towards the sustainability of the program in a win-win situation. The recommendations of the study are expected to be useful to natural resource managers, planners, and policy makers.

Keywords: community, forest management, ecology, economics, Nepal

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Authors: Emy Nayana Pinto, Denise Bomtempo Birche De Carvalho

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In the present study, the harmful use of illicit drugs is seen as a public health problem and as one of the expressions of the social question, since its consequences fall mainly on the poorer classes of the population. This perspective is a counterpoint to the dominant paradigm on illicit drug policy at the global level, whose centrality lies within the criminal justice arena. The 'drug problem' is internationally combated through fragmented approaches that focus its actions on banning and criminalizing users. In this sense, the research seeks to answer the following key questions: What are the influences of the prohibitionism in the recommendations of the United Nations (UN), the World Health Organization (WHO), and the formulation of drug policies in member countries? What are the actors that have been provoking the prospect of breaking with the prohibitionist paradigm? What is the WHO contribution to the rupture with the prohibitionist paradigm and the displacement of the drug problem in the field of public health? The general objective of this work is to seek evidence from the perspective of rupture with the prohibitionist paradigm in the field of drugs policies at the global and regional level, through analysis of documents of the World Health Organization (WHO), between the years of 2001 to 2016. The research was carried out in bibliographical and documentary sources. The bibliographic sources contributed to the approach with the object and the theoretical basis of the research. The documentary sources served to answer the research questions and evidence the existence of the perspective of change in drug policy. Twenty-two documents of the UN system were consulted, of which fifteen had the contribution of the World Health Organization (WHO). In addition to the documents that directly relate to the subject of the research, documents from various agencies, programs, and offices, such as the Joint United Nations Program on HIV/AIDS (UNAIDS) and the United Nations Office on Drugs and Crime (UNODC), which also has drugs as the central or transversal theme of its performance. The results showed that from the 2000s it was possible to find in the literature review and in the documentary analysis evidence of the critique of the prohibitionist paradigm parallel to the construction of a new perspective for drug policy at the global level and the displacement of criminal justice approaches for the scope of public health, with the adoption of alternative and pragmatic interventions based on human rights, scientific evidence and the reduction of social damages and health by the misuse of illicit drugs.

Keywords: illicit drugs, international organizations, prohibitionism, public health, World Health Organization

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Authors: Karish Thavabalan, Aman Sutaria, Alistair Ovenell, Annabelle Parkhouse, Numan Baydemir, Theodore Lally

Abstract:

Background: Open discussions surrounding menopause are often associated with stigma, with many women feeling uncomfortable engaging in them with friends, colleagues, and healthcare professionals. Though the barriers regarding safe discussions of symptom management experienced by menopausal women are well documented, existing research offers little insight into whether these were shared by pre-menopausal women. This study aimed to explore the barriers regarding safe discussions about menopausal symptom management as perceived or experienced by pre-menopausal and menopausal women. Methods: This qualitative study was conducted over a 2-month period (March 2022 - April 2022) under the auspices of Imperial College Business School, London, UK. Snowball sampling was used to recruit both menopausal (age 45-70) and pre-menopausal participants (age <45) and sampling continued until data saturation was achieved. Sixteen semi-structured online interviews were conducted, and transcripts were thematically analyzed following Braun and Clarke’s six-step methodology. Results: A total of 7 higher themes regarding safe discussion of menopausal symptom management were identified by both pre-menopausal and menopausal women, including: “ineffective coping mechanisms,” “perceived onus to self-endure,” “lack of workplace support,” “poor knowledge of management approaches,” “poor healthcare infrastructure,” “poor support from friends and family,” “lack of knowledge and interest from a young age.” Conclusion: Identifying the barriers regarding safe discussion helped to highlight which areas require the most significant intervention. Alongside tackling the barriers, menopausal women face, ultimately, there is a pertinent need to address the lack of insight into menopause from a younger age and to encourage earlier discussions so as to not propagate the cycle of stigma.

Keywords: menopause, safe discussion, symptom management, stigma

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Authors: Delband Yekta Moazami

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Background: For proper care and treatment of HIV patients and drug users, the medical staff and physicians must have a correct and positive attitude and knowledge towards such patients. We aimed to assess the attitudes in a sample of health care workers (HCW) working in different hospitals and clinics and medical students in Georgia towards HIV infected people and drug users in Tbilisi. Method: We conducted a cross-sectional study to assess attitudes of health care workers towards people living with HIV and drug users in hospitals and clinics in Tbilisi. The study was carried out from 1st of May 2020 till 30th of September 2020. Data were collected using a self-administered structured online questionnaire. With this tool we evaluated four facets of attitudes: Discrimination, Acceptance of HIV/AIDS patients, Acceptance of drug users and Fear. All data were imported and analyzed with the software SPSS 22 for windows. Results: In total data was collected from168 respondents, that among them 107 (65%) were women and majority of the participants were medical doctors. Women had more acceptance attitudes rather than men towards drug abusers. We found significant differences regarding expressing negative attitudes among HCW who were more than 50 years old comparing with other age groups in all four aspects. Medical doctors expressed more acceptances towards people with HIV and drug users comparing two other groups. Also our study revealed that the group with working experience 21 years and more, showed more discriminatory attitudes comparing other groups. Conclusion: Based on our study findings, there are significant differences regarding respondent’s attitudes based on gender, medical specialty and working experience in health care system. People struggling with HIV and drug use need nonjudgmental and positive behaviors from health care workers and physicians in order to help them for harm reduction and receiving appropriate treatment.

Keywords: hiv, addiction, attitudes, healthcare workers

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Authors: Wann-Ming Wey

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In today's popularity and progress of information technology, the big data set and its analysis are no longer a major conundrum. Now, we could not only use the relevant big data to analysis and emulate the possible status of urban development in the near future, but also provide more comprehensive and reasonable policy implementation basis for government units or decision-makers via the analysis and emulation results as mentioned above. In this research, we set Taipei City as the research scope, and use the relevant big data variables (e.g., population, facility utilization and related social policy ratings) and Analytic Network Process (ANP) approach to implement in-depth research and discussion for the possible reduction of land use in primary and secondary schools of Taipei City. In addition to enhance the prosperous urban activities for the urban public facility utilization, the final results of this research could help improve the efficiency of urban land use in the future. Furthermore, the assessment model and research framework established in this research also provide a good reference for schools or other public facilities land use and adaptive reuse strategies in the future.

Keywords: adaptive reuse, analytic network process, big data, land use strategy

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Authors: Romisaa Ali

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This paper presents a comparison between twin-delayed Deep Deterministic Policy Gradient (TD3) and Soft Actor-Critic (SAC) reinforcement learning algorithms in the context of training robust navigation policies for Jackal robots. By leveraging an open-source framework and custom motion control environments, the study evaluates the performance, robustness, and transferability of the trained policies across a range of scenarios. The primary focus of the experiments is to assess the training process, the adaptability of the algorithms, and the robot’s ability to navigate in previously unseen environments. Moreover, the paper examines the influence of varying environmental complexities on the learning process and the generalization capabilities of the resulting policies. The results of this study aim to inform and guide the development of more efficient and practical reinforcement learning-based navigation policies for Jackal robots in real-world scenarios.

Keywords: Jackal robot environments, reinforcement learning, TD3, SAC, robust navigation, transferability, custom environment

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Authors: Farshad Zeinali, Sajedeh Norouzi, Nader Mokari, Eduard Jorswieck

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The capacity of fifth-generation (5G) vehicle-to-everything (V2X) networks poses significant challenges. To ad- dress this challenge, this paper utilizes New Radio (NR) and New Radio Unlicensed (NR-U) networks to develop a heterogeneous vehicular network (HetNet). We propose a new framework, named joint BS assignment and resource allocation (JBSRA) for mobile V2X users and also consider coexistence schemes based on flexible duty cycle (DC) mechanism for unlicensed bands. Our objective is to maximize the average throughput of vehicles while guaranteeing the WiFi users' throughput. In simulations based on deep reinforcement learning (DRL) algorithms such as deep deterministic policy gradient (DDPG) and deep Q network (DQN), our proposed framework outperforms existing solutions that rely on fixed DC or schemes without consideration of unlicensed bands.

Keywords: vehicle-to-everything (V2X), resource allocation, BS assignment, new radio (NR), new radio unlicensed (NR-U), coexistence NR-U and WiFi, deep deterministic policy gradient (DDPG), deep Q-network (DQN), joint BS assignment and resource allocation (JBSRA), duty cycle mechanism

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Authors: Sandra Figueiredo, Alexandra Pereira, Ana Oliveira, Idia Brito, Ivaniltan Jones, Joana Moreira, Madalena Silva, Maria Paraíba, Milene Silva, Tânia Pinho

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In the present society, we are facing behaviours mainly in young individuals that might be considered trends of culture or psychopathology. Both contexts are challenges for Education, Psychology and Health. This paper examines nine case studies specifically in Educational Psychology with the main goal to identify and define phenomena contexts in school culture, the psychopathology involved and to present a psychological intervention for each case. The research was conducted by university students in the period of March 2017-June 2017, in Portugal, and the childhood was focused. The case studies explored the cyberbullying; the bullying - victims and bullies’ perspectives; the obsessive compulsive disorder; perception and inclusion of children from homoparental families; inclusion of foreign students in the higher education system; blindness and the inclusion in physical curricular activities; influence of doc-reality and media in attitudes and self-esteem; and the morningness and eveningness types learning in the same school timetables. The university students were supervised during their research analysis and two methods were available for the intervention research study: the meta-analysis and the empirical study. In the second phase, the pedagogical intervention was designed for the different educational contexts in analysis, especially concerning the school environments. The evidence of literature and the empirical studies showed new trends of school’ behaviours and educational disturbances that require further research and effective (and adequate to age, gender, nationality and culture) pedagogical instruments. Respecting the instruments, on the one hand, to identify behaviors, habits or pathologies and highlight the role and training of teachers, psychologists and health professionals, on the other hand, to promote the early intervention and to enhance healthy child development and orientation of the families. To respond to both milestones, this paper present nine pedagogical techniques and measures that will be discussed on their impact concerning advances for the psychological and educational intervention, centered in the individual and in the new generations of family’ cultures.

Keywords: behaviour, culture trends, educational intervention, psychopathology, obsessive compulsive disorder, cyberbullying, bullying, homoparental families, sleep influence, blindness and sports at school, inclusion of foreign students, media influence in behaviour

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Authors: Nasir Haruna Soba

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In addition to sustaining poverty and inequality, the issue of out-of-school children impedes efforts to accomplish the sustainable development goals (SDGs), especially Goal 4, which is to guarantee inclusive, egalitarian, and high-quality education for everyone. However, a number of social, cultural, and infrastructure barriers mean that millions of children in Nigeria are denied this privilege. This paper presents the findings of a case study conducted in Nigeria. The findings of this study revealed that out of school children in Nigeria are the most common causes of poverty; inadequate school facilities, long distances to schools, and poor road networks make it difficult for children, especially in rural areas, to access education. Social Disparities: Social inequality is sustained by differences in education, especially when it comes to financing, governance, and coordination amongst stakeholders. These differences are especially pronounced along gender and socioeconomic lines. The study recommended that policymakers and stakeholders should consider addressing the root causes, enhancing existing interventions, and implementing targeted policy measures. Nigeria can make significant strides towards ensuring inclusive and quality education for all children, thereby fostering sustainable development and reducing poverty.

Keywords: poverty, inequality, funding, education, development

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Authors: M. Kosandi, V. Susanti, N. I. Subono, E. Kartini

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This paper discusses the risk of glorification trap in combating human trafficking, as it is shown in the case of Indonesia. Based on a research on Indonesian combat against trafficking in 2017-2018, this paper shows the tendency of misinterpretation and misapplication of the Indonesian anti-trafficking law into misusing the law for glorification, to create an image of certain extent of achievement in combating human trafficking. The objective of this paper is to explain the persistent occurrence of human trafficking crimes despite the significant progress of anti-trafficking efforts of Indonesian government. The research was conducted in 2017-2018 by qualitative approach through observation, depth interviews, discourse analysis, and document study, applying the three-dimensional model for analyzing human trafficking in the source country. This paper argues that the drive for glorification of achievement in the combat against trafficking has trapped Indonesian government in the loop of misinterpretation, misapplication, and misuse of the anti-trafficking law. In return, the so-called crime against humanity remains high and tends to increase in Indonesia.

Keywords: human trafficking, anti-trafficking policy, transnational crime, source country, glorification trap

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Authors: Edy Wahyu Susilo

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This research discusses a comparative analysis of various anti-corruption responses of three Indonesian City Governments (Jakarta, Surabaya, and Medan) and completes previous findings on the effectiveness of the city anti-corruption program. Some factors (transparency, accountability, leadership, law enforcement, and bureaucratic reform) have been chosen in this study to diagnose the main role in the success and the failure of anti-corruption programs in these cities. These factors diagnose the relationship between factors and their dominancy, which is then utilized to create the city’s strategic anti-corruption programs. Although this study found leadership had a dominant influence both in encouraging and discouraging the performance of city transformation drastically, however, it is not the only factor that determined the performance of the city in the fight against corruption. It needs other factors as an ideal balancing element to achieve an anti-corruption program, namely KPK’s intervention and public engagement. Based on the dominance factors found, this research then develops an appropriate strategy using a policy evaluation approach to create a real practical guide regardless of the existence of good or bad leadership in the city. This research is expected to be a useful reference for stakeholders, especially the government, as a blueprint to prevent corruption by considering several important steps and guidance in efforts to eradicate corruption in the city, especially in Indonesia.

Keywords: intervention, KPK (corruption eradication commission), law enforcements, leadership, policy evaluation

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Authors: Desiree Vandenberghe, Johan Albrecht

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Non-communicable diseases (NCDs) are responsible for the vast majority of deaths in the European Union (EU) and represent a large share of total health care spending. A future increase in this health and financial burden is likely to be driven by population ageing, lifestyle changes and technological advances in medicine. Without adequate prevention measures, this burden can severely threaten population health and economic development. To tackle this challenge, a correct assessment of the current burden of NCDs is required, as well as a projection of potential increases of this burden. The contribution of this paper is to offer perspective on the evolution of the NCD burden towards the future and to give an indication of the potential of prevention policy. A Non-Homogenous, Semi-Markov model for the EU was constructed, which allowed for a projection of the cost burden for the four main NCDs (cancer, cardiovascular disease, chronic respiratory disease and diabetes mellitus) towards 2030 and 2050. This simulation is done based on multiple baseline scenarios that vary in demand and supply factors such as health status, population structure, and technological advances. Finally, in order to assess the potential of preventive measures to curb the cost explosion of NCDs, a simulation is executed which includes increased efforts for preventive health care measures. According to the Markov model, by 2030 and 2050, total costs (direct and indirect costs) in the EU could increase by 30.1% and 44.1% respectively, compared to 2015 levels. An ambitious prevention policy framework for NCDs will be required if the EU wants to meet this challenge of rising costs. To conclude, significant cost increases due to Non-Communicable Diseases are likely to occur due to demographic and lifestyle changes. Nevertheless, an ambitious prevention program throughout the EU can aid in making this cost burden manageable for future generations.

Keywords: non-communicable diseases, preventive health care, health policy, Markov model, scenario analysis

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Authors: G. Aloh Obianuju, C. Chukwu Kelvin, Henry Aloh

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The study was undertaken to assess the environmental and socio-economic impact of quarrying in Umuoghara quarrying community of Ebonyi State, South East Nigeria. Questionnaires were distributed targeting quarry workers and people living within the community; personal interviews with other key informants were also conducted. All these were used as data gathering instruments. The study reveals that there were actually some benefits as well as marked environmental impacts in the community as a result of quarrying activities. Recommendations that can assist in mitigating these adverse impacts were suggested.

Keywords: environment, quarrying, environmental degradation, mitigation

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Authors: Betül Sönmez, Aytolan Yıldırım

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Objective: This systematic review aims to methodically analyze studies regarding mobbing behavior prevalence, individuals performing this behavior and the effects of mobbing on Turkish nurses. Background: Worldwide reports on mobbing cases have increased in the past years, a similar trend also observable in Turkey. It has been demonstrated that among healthcare workers, mobbing is significantly widespread in nurses. The number of studies carried out in this regard has also increased. Method: The main criteria for choosing articles in this systematic review were nurses located in Turkey, regardless of any specific date. In November 2014, a search using the keywords 'mobbing, bullying, psychological terror/violence, emotional violence, nurses, healthcare workers, Turkey' in PubMed, Science Direct, Ebscohost, National Thesis Centre database and Google search engine led to 71 studies in this field. 33 studies were not met the inclusion criteria specified for this study. Results: The findings were obtained using the results of 38 studies carried out in the past 13 years in Turkey, a large sample consisting of 8,877 nurses. Analysis of the incidences of mobbing behavior revealed a broad spectrum, ranging from none-slight experiences to 100% experiences. The most frequently observed mobbing behaviors include attacking personality, blocking communication and attacking professional and social reputation. Victims mostly experienced mobbing from their managers, the most common consequence of these actions being psychological effects. Conclusions: The results of studies with various scales indicate exposure of nurses to similar mobbing behavior. The high frequency of exposure of nurses to mobbing behavior in such a large sample highlights the importance of considering this issue in terms of individual and institutional consequences that adversely affect the performance of nurses.

Keywords: mobbing, bullying, workplace violence, nurses, Turkey

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Authors: Chananporn Areekul

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The purpose of this study was to study the experimental result of using board games for enhancing the active citizen of the undergraduate students. The research methodology of this study was the quasi experimental research. The sample was 30 undergraduate students that were chosen by the purposive sampling. The instruments were board games for enhancing the active citizen and the questionnaire for measuring the active citizen levels. The result of the mean difference test was found that there were statistically significant differences at the .05 level (t = 2.028, p = 0.047) between before and after using board game for enhancing the active citizen of undergraduate students.

Keywords: active citizen, board game, learning innovation, undergraduate students

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Authors: Yvonne Ayerki Lamptey

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The expanding informal sector in developing countries and in Ghana in particular from the 1980s has now been aggravated by the growing population and downsizing in both the public and private sectors, with displaced workers finding alternative livelihoods in the informal sector. Youth and graduate unemployment also swell the numbers and further promote the continuity of the sector. Formal workers and institutions facilitate the growth and complicate demarcations between informality within the formal and informal sectors. In spite of its growth and increasing importance, the informal economy does not feature in policy debates and has often been neglected by the Ghana government. The phenomenon has evolved with modernity into myriad unimaginable forms. Indeed, actors within the sector often clash with the interventions provided by policy makers - because neither the operatives nor the activities they perform can be clearly defined. This study uses in-depth interviews to explore the behavioural nature of the informal workers in Ghana to understand how the operatives describe and perceive the sector, and to identify the factors that influence their drive to stay within the sector. This paper concludes that the operatives clearly distinguish between the formal and informal sectors and identify the characteristics and conditions that constitute the informal sector. Other workers are trapped between formality and informality. The findings also enumerate the push and pull factors contributing to the growth of the sector.

Keywords: informal employment, informal sector, informal work, informality

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Authors: Salvador Antelmo Casanova Valencia

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This study documents the use of the Minecraft Education Edition application to explore immersive game-based learning environments. We analyze the contributions of fourth-year university students who are pursuing a degree in Administrative Computing at the Universidad Michoacana de San Nicolas de Hidalgo. In this study, descriptive data and statistical inference are detailed using a quasi-experimental design using the Wilcoxon test. The instruments will provide data validation. Game-based learning in immersive environments necessarily implies greater student participation and commitment, resulting in the study, motivation, and significant improvements, promoting cooperation and autonomous learning.

Keywords: game-based learning, gamification, higher education, Minecraft

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Authors: Sie Long Kek, Wah June Leong, Kok Lay Teo

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Linear quadratic Gaussian model is a standard mathematical model for the stochastic optimal control problem. The combination of the linear quadratic estimation and the linear quadratic regulator allows the state estimation and the optimal control policy to be designed separately. This is known as the separation principle. In this paper, an efficient computational method is proposed to solve the linear quadratic Gaussian problem. In our approach, the Hamiltonian function is defined, and the necessary conditions are derived. In addition to this, the output error is defined and the least-square optimization problem is introduced. By determining the first-order necessary condition, the gradient of the sum squares of output error is established. On this point of view, the stochastic approximation approach is employed such that the optimal control policy is updated. Within a given tolerance, the iteration procedure would be stopped and the optimal solution of the linear-quadratic Gaussian problem is obtained. For illustration, an example of the linear-quadratic Gaussian problem is studied. The result shows the efficiency of the approach proposed. In conclusion, the applicability of the approach proposed for solving the linear quadratic Gaussian problem is highly demonstrated.

Keywords: iteration procedure, least squares solution, linear quadratic Gaussian, output error, stochastic approximation

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Authors: Fatima Saeed, Abdullah Mudassar

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Introduction: Patient safety remains a global priority in the ever-evolving healthcare landscape. At the forefront of this endeavor are the International Patient Safety Goals (IPSGs), a standardized framework designed to mitigate risks and elevate the quality of care. Doctors, positioned as primary caregivers, wield a pivotal role in upholding and adhering to IPSGs, underscoring the critical significance of their knowledge and understanding of these goals. This research embarks on a comprehensive exploration into the depth of Doctors ' comprehension of IPSGs, aiming to unearth potential gaps and provide insights for targeted educational interventions. Established by influential healthcare bodies, including the World Health Organization (WHO), IPSGs represent a universally applicable set of objectives spanning crucial domains such as medication safety, infection control, surgical site safety, and patient identification. Adherence to these goals has exhibited substantial reductions in adverse events, fostering an overall enhancement in the quality of care. This study operates on the fundamental premise that an informed Doctors workforce is indispensable for effectively implementing IPSGs. A nuanced understanding of these goals empowers Doctors to identify potential risks, advocate for necessary changes, and actively contribute to a safety-centric culture within healthcare institutions. Despite the acknowledged importance of IPSGs, there is a growing concern that nurses may need more knowledge to integrate these goals into their practice seamlessly. Methodology: A Comprehensive research methodology covering study design, setting, duration, sample size determination, sampling technique, and data analysis. It introduces the philosophical framework guiding the research and details material, methods, and the analysis framework. The descriptive quantitative cross-sectional study in teaching care hospitals utilized convenient sampling over six months. Data collection involved written informed consent and questionnaires, analyzed with SPSS version 23, presenting results graphically and descriptively. The chapter ensures a clear understanding of the study's design, execution, and analytical processes. Result: The survey results reveal a substantial distribution across hospitals, with 34.52% in MTIKTH and 65.48% in HMC MTI. There is a notable prevalence of patient safety incidents, emphasizing the significance of adherence to IPSGs. Positive trends are observed, including 77.0% affirming the "time-out" procedure, 81.6% acknowledging effective healthcare provider communication, and high recognition (82.7%) of the purpose of IPSGs to improve patient safety. While the survey reflects a good understanding of IPSGs, areas for improvement are identified, suggesting opportunities for targeted interventions. Discussion: The study underscores the need for tailored care approaches and highlights the bio-socio-cultural context of 'contagion,' suggesting areas for further research amid antimicrobial resistance. Shifting the focus to patient safety practices, the survey chapter provides a detailed overview of results, emphasizing workplace distribution, patient safety incidents, and positive reflections on IPSGs. The findings indicate a positive trend in patient safety practices with areas for improvement, emphasizing the ongoing need for reinforcing safety protocols and cultivating a safety-centric culture in healthcare. Conclusion: In summary, the survey indicates a positive trend in patient safety practices with a good understanding of IPSGs among participants. However, identifying areas for potential improvement suggests opportunities for targeted interventions to enhance patient safety further. Ongoing efforts to reinforce adherence to safety protocols, address identified gaps, and foster a safety culture will contribute to continuous improvements in patient care and outcomes.

Keywords: infection control, international patient safety, patient safety practices, proper medication

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Authors: Mahvish Anwaar

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Research Question: In this paper, we explore the causal relationship between banking competition, banking stability, and economic growth. Research Findings: The unbalanced panel data starting from 2000 to 2018 is collected to analyze the causality among banking competition, banking stability, and economic growth. The main focus of the study is to check the direction of causality among selected variables. The results of the study support the demand following, supply leading, feedback, and neutrality hypothesis conditional to different measures of banking competition, banking stability, and economic growth. Theoretical Implication: Jayakumar, Pradhan, Dash, Maradana, and Gaurav (2018) proposed a theoretical model of the causal relationship between banking competition, banking stability, and economic growth by using different indicators. So, we empirically test the proposed indicators in our study. This study makes a contribution to the literature by showing the defined relationship between developing and developed countries. Policy Implications: The study covers various policy implications regarding investors to analyze how to properly manage their finances, and government agencies will take help from the present study to find the best and most suitable policies by examining how the economy can grow concerning its finances.

Keywords: competition, stability, economic growth, vector auto-regression, granger causality

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