Search results for: Greek public hospital sector

Authors: Mattia Testuzza

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Public health is a social endeavour, which involves many different actors: from extremely stratified, structured health systems to unofficial networks of people and knowledge. Health and diseases are an intertwined individual and social experiences. Both patients and health workers navigate this public space through relations of trust. Trust in healthcare goes from the personal trust between a patient and her/his doctor to the trust of both the patient and the health worker in the medical knowledge and the healthcare system. Trust it is not a given, but it is continuously negotiated, given and gained. The key to understand these essential relations of trust in health is to recognise them as a social practice, which therefore implies agency and power. In these terms, health is constantly public and made public, as trust emerges as a meaningfully political phenomenon. Trust as a power relation can be observed at play in the implementation of public health policies such as the WHO’s Directly-Observed Theraphy Short-course (DOTS), and with the increasing concern for drug-resistance that tuberculosis pose, looking at the role of trust in the healthcare delivery system and implementation of public health policies becomes significantly relevant. The ethnographic fieldwork was carried out in four months through observation of the daily practices at the National Tuberculosis Center of Nepal, and semi-structured interviews with MultiDrug-Resistant Tuberculosis (MDR-TB) patients at different stages of the treatment, their relatives, MDR-TB specialised nurses, and doctors. Throughout the research, the role which trust plays in tuberculosis treatment emerged as one fundamental ax that cuts through all the different factors intertwined with drug-resistance development, unfolding a tension between the DOTS policy, which undermines trust, and the day-to-day healthcare relations and practices which cannot function without trust. Trust also stands out as a key component of the solutions to unforeseen issues which develop from the overall uncertainty of the context - for example, political instability and extreme poverty - in which tuberculosis treatment is carried out in Nepal.

Keywords: trust, tuberculosis, drug-resistance, politics of health

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Authors: Tarathorn Podcharathitikull, Jirarat Teeravaraprug

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Transportation cost is the highest cost in logistics cost of Thailand, and truck transportation is counted as about 90% of the overall transportation cost. The main problem of truck transportation is backhauling. Backhauling has become an attractive cost-saving approach in logistics. To explore such opportunities, this paper investigated the current backhauling systems in Thailand. It was found that the backhauling problem is attracted to both governmental agencies and private sector. They gave attempts to build backhauling systems. This paper investigated two systems built by governmental agencies and one by private sector. Moreover, based on the interviews with the system representatives and users, pros and cons of the systems were found. The obstacles and challenges were obtained. This paper finally proposed a conceptual model of to-be backhauling system in Thailand.

Keywords: backhauling system, backhauls, interview, Thailand

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Authors: Yiu K. C. Jacky, Tang S. K. Eric, W. Y. Tsang, C. Y. Li, C. K. Leung

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Objectives : (1) To enhance the competence of nurses on using IPMOE for drug administration; (2) To ensure the transition on implementation of IPMOE in safer and smooth way hospital-wide. Methodology: (1) Well-structured Governance: To make provision for IPMOE implementation, multidisciplinary governance structure at Corporate and Local levels are well established. (2) Staff Engagement: A series of staff engagement events were conducted including Staff Forum, IPMOE Hospital Visit, Kick-off Ceremony and establishment of IPMOE Webpage for familiarizing the forthcoming implementation with frontline staff. (3) Well-organized training program: from Workshop to Workplace Two different IPMOE training programs were tailor-made which aimed at introducing the core features of administration module. Fifty-five identical training classes and six train-the-trainer workshops were organized at 2-3Q 2015. Lending Scheme on IPMOE hardware for hands-on practicing was launched and further extended the training from workshop to workplace. (4) Standard Guidelines and Workflow: the related workflow and guidelines are developed which facilitates users to acquire the competence towards IPMOE and fully familiarize with the standardized contingency plan. (5) Facilities and Equipment: The installations of IPMOE hardware were promptly arranged for rollout. Besides, IPMOE training venue was well-established for staff training. (6) Risk Management Strategy: UCH Medication Safety Forum is organized in December 2015 for sharing “Tricks & Tips” on IPMOE which further disseminate at webpage for arousal of medication safety. Hospital-wide annual audit on drug administration was planned to figure out the compliance and deliberate the rooms for improvement. Results: Through the comprehensive training plan, over 1,000 UCH nurses attended the training program with positive feedback. They agreed that their competence on using IPMOE was enhanced. By the end of November 2015, 28 wards (over 1,000 Inpatient-bed) involving departments of M&G, SUR, O&T and O&G have been successfully rolled out IPMOE in 5-month. A smooth and safe transition of implementation of IPMOE was achieved. Eventually, we all get prepared for embedding IPMOE into daily nursing and work altogether for medication safety at UCH.

Keywords: drug administration, inpatient medication order entry system, medication safety, nursing informatics

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Authors: J. Erina, I. Erins

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The goals of the present research are to estimate Six Sigma implementation in Latvian commercial banks and to identify the perceived benefits of its implementation. To achieve the goals, the authors used a sequential explanatory method. To obtain empirical data, the authors have developed the questionnaire and adapted it for the employees of Latvian commercial banks. The questions are related to Six Sigma implementation and its perceived benefits. The questionnaire mainly consists of closed questions, the evaluation of which is based on 5 point Likert scale. The obtained empirical data has shown that of the two hypotheses put forward in the present research Hypothesis 1 has to be rejected, while Hypothesis 2 has been partially confirmed. The authors have also faced some research limitations related to the fact that the participants in the questionnaire belong to different rank of the organization hierarchy.

Keywords: six sigma, quality, commercial banking sector, latvian

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Authors: Mwamba Mwamini Ruth

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For many authors,the percentage of married or in union persons using family planning methods has increased significantly since the 1960s, despite this progress, important differences across régions are observer.These différences become even greater,to present a paradox,when studying the issue in smallest territorial entities in developing countries.In line with the above,the general objective of this research is to investigate into "knowledge , attitude and practice"of households from a basic territorial entity,here in"Murara Sector"(in the city of Goma, province of North Kivu,Democratic Republic of Congo,Africa)on family planning (as defined and provisioned by the four World Health Organization-WHO key texts on the matter)

Keywords: DRC, family planning methods, information technology, Murara

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Authors: Ese Urhie, Olabisi Popoola, Obindah Gershon, Olabanji Ewetan

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Modern agriculture involves the use of improved tools and equipment (instead of crude and ineffective tools) like tractors, hand operated planters, hand operated fertilizer drills and combined harvesters - which increase agricultural productivity. Farmers in Nigeria still have huge potentials to enhance their productivity. The study argues that the increase in agricultural output due to increased productivity, orchestrated by modern agriculture will promote forward linkages and opportunities in the processing sub-sector; both the manufacturing of machines and the processing of raw materials. Depending on existing incentives, foreign investment could be attracted to augment local investment in the sector. The availability of raw materials in large quantity – which prices are competitive – will attract investment in other industries. In addition, potentials for backward linkages will also be created. In a nutshell, adopting the unbalanced growth theory in favour of the agricultural sector could engender industrialization in a country with untapped potentials. The paper highlights the numerous potentials of modern agriculture that are yet to be tapped in Nigeria and also provides a theoretical analysis of how the realization of such potentials could promote industrialization in the country. The study adopts the Lewis’ theory of structural–change model and Hirschman’s theory of unbalanced growth in the design of the analytical framework. The framework will be useful in empirical studies that will guide policy formulation.

Keywords: modern agriculture, industrialization, structural change model, unbalanced growth

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Authors: Maria Amaia Iza Padilla, Ibai Ostolozaga

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The objective of this paper is to analyze how transportation costs between regions within a country can affect not only domestic trade but also the allocation of resources in a given region, aggregate productivity, and relative domestic prices (tradable versus non-tradable). On the one hand, there is a vast literature that analyzes the transportation costs faced by countries when trading with the rest of the world. However, this paper focuses on the effect of transportation costs on domestic trade. Countries differ in their domestic road infrastructure and transport quality. There is also some literature that focuses on the effect of road infrastructure on the price difference between regions but not on relative prices at the aggregate level. On the other hand, this work is also related to the literature on resource misallocation. Finally, the paper is also related to the literature analyzing the effect of trade on the development of the manufacturing sector. Using the World Bank Enterprise Survey database, it is observed cross-country differences in the proportion of firms that consider transportation as an obstacle. From the International Comparison Program, we obtain a significant negative correlation between GDP per worker and relative prices (manufacturing sector prices relative to the service sector). Furthermore, there is a significant negative correlation between a country’s transportation quality and the relative price of manufactured goods with respect to the price of services in that country. This is consistent with the empirical evidence of a negative correlation between transportation quality and GDP per worker, on the one hand, and the negative correlation between GDP per worker and domestic relative prices, on the other. It is also shown that in a country, the share of manufacturing firms whose main market is at the local (regional) level is negatively related to the quality of the transportation infrastructure within the country. Similarly, this index is positively related to the share of manufacturing firms whose main market is national or international. The data also shows that those countries with a higher proportion of manufacturing firms operating locally have higher relative prices. With this information in hand, the paper attempts to quantify the effects of the allocation of resources between and within sectors. The higher the trade barriers caused by transportation costs, the less efficient allocation, which causes lower aggregate productivity. Second, it is built a two-sector model where regions within a country trade with each other. On the one hand, it is found that with respect to the manufacturing sector, those countries with less trade between their regions will be characterized by a smaller variety of goods, less productive manufacturing firms on average, and higher relative prices for manufactured goods relative to service sector prices. Thus, the decline in the relative price of manufactured goods in more advanced countries could also be explained by the degree of trade between regions. This trade allows for efficient intra-industry allocation (traders are more productive, and resources are allocated more efficiently)).

Keywords: misallocation, relative prices, TFP, transportation cost

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Authors: Yoshitaka Ooya, Daishuke Furuya, Manabu Nemoto

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Some countries such as Canada and Australia have mandatory bicycle helmet laws for all citizens and age groups. As of 2008 Japan has also adopted a helmet law but it is restricted to people 13 years old and under. People over 13 years of age are not required to wear helmets in Japan. Currently, the rate that people 0-13 years old actually wear helmets is low. In 2013 a number of patients came to Saitama University Hospital International Medical Center for treatment due to bicycle-related trauma. The total number of patients was 89 (55 male and 34 female). The average age of the patients was 40.9 years old (eldest; 83 y/o, median; 40 y/o, youngest; 1 y/o with a standard deviation ± 2.8). 54 of these patients (61%) experienced head trauma as well as some experiencing multiple injuries associated with their accident. 13 patients were wearing helmets, 50 patients were not wearing helmets and it is unknown if the remaining 26 patients were wearing helmets. This information was acquired from the patient`s medical charts. Only one patient who was wearing a helmet had a severe head injury, and this patient also experienced other multiple injuries. 17 patients who were not wearing helmets had severe head injuries and out of the 17, two had multiple injuries. The mechanism for injury varied. 12 patients were injured in an accident with a vehicle, only one of which was wearing a helmet. This patient also had multiple injuries. Of the other 11 patients, two had multiple injuries. The remaining patient`s injuries were caused by other accidents (3; fell over while riding, 2; crashed into an inanimate object, 1; collided with a motorcycle). The ladder of which had a severe head injury. All of these patients had light energy accidents and were all over 13 years of age. In Japan it is not mandatory for people over the age of 13 years to wear a bicycle helmet. Research shows that light energy accidents were mostly present in people over the age of 13, to which the law does not require the wearing of helmets. It is important that all people in all age groups be required to wear helmets when operating a bicycle to reduce the rate of light energy severe head injuries.

Keywords: bicycle helmet, head trauma, hospital, traumatic situation

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Authors: Sylwia Laba, Robert Laba, Krystian Szczepanski, Mikolaj Niedek, Anna Kaminska-Dworznicka

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Meat and its products are considered food products, having the most unfavorable effect on the environment that requires rational management of these products and waste, originating throughout the whole chain of manufacture, processing, transport, and trade of meat. From the economic and environmental viewpoints, it is important to limit the losses and food wastage and the food waste in the whole meat sector. The link to basic production includes obtaining raw meat, i.e., animal breeding, management, and transport of animals to the slaughterhouse. Food is any substance or product, intended to be consumed by humans. It was determined (for the needs of the present studies) when the raw material is considered as a food. It is the moment when the animals are prepared to loading with the aim to be transported to a slaughterhouse and utilized for food purposes. The aim of the studies was to determine the reasons for loss generation in the basic production of the meat sector in Poland during the years 2017 – 2018. The studies on food losses and waste in the meat sector in basic production were carried out in two areas: red meat i.e., pork and beef and poultry meat. The studies of basic production were conducted in the period of March-May 2019 at the territory of the whole country on a representative trial of 278 farms, including 102 pork production, 55–beef production, and 121 poultry meat production. The surveys were carried out with the utilization of questionnaires by the PAPI (Paper & Pen Personal Interview) method; the pollsters conducted direct questionnaire interviews. Research results indicate that it is followed that any losses were not recorded during the preparation, loading, and transport of the animals to the slaughterhouse in 33% of the visited farms. In the farms where the losses were indicated, the crushing and suffocations, occurring during the production of pigs, beef cattle and poultry, were the main reasons for these losses. They constituted ca. 40% of the reported reasons. The stress generated by loading and transport caused 16 – 17% (depending on the season of the year) of the loss reasons. In the case of poultry production, in 2017, additionally, 10.7% of losses were caused by inappropriate conditions of loading and transportation, while in 2018 – 11.8%. The diseases were one of the reasons for the losses in pork and beef production (7% of the losses). The losses and waste, generated during livestock production and in meat processing and trade cannot be managed or recovered. They have to be disposed of. It is, therefore, important to prevent and minimize the losses throughout the whole production chain. It is possible to introduce the appropriate measures, connected mainly with the appropriate conditions and methods of animal loading and transport.

Keywords: food losses, food waste, livestock production, meat sector

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Authors: Gulnara Moldasheva

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The research explores the relationship between management responsibility and corporate governance of listed companies in Kazakhstan. This research employs firm level data of randomly selected listed non-financial firms and firm level data “operational” financial sector, consisted from banking sector, insurance companies and accumulated pension funds using multivariate regression analysis under fixed effect model approach. Ownership structure includes institutional ownership, managerial ownership and private investor’s ownership. Management responsibility of the firm is expressed by the decision of the firm on amount of leverage. Results of the cross sectional panel study for non-financial firms showed that only institutional shareholding is significantly negatively correlated with debt to equity ratio. Findings from “operational” financial sector show that leverage is significantly affected only by the CEO/Chair duality and the size of financial institutions, and insignificantly affected by ownership structure. Also, the findings show, that there is a significant negative relationship between profitability and the debt to equity ratio for non-financial firms, which is consistent with pecking order theory. Generally, the found results suggest that corporate governance and a management responsibility play important role in corporate performance of listed firms in Kazakhstan.

Keywords: ownership, corporate governance, debt to equity ratio, corporate performance

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Authors: Luksanaporn Krungkraipetch

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Pterygium is a frequent ocular surface lesion that begins in the limbal conjunctiva within the palpebral fissure and spreads to the cornea. The lesion is more common in the nasal limbus than in the temporal, and it has a wing-like aspect. Indications for surgery, in decreasing order of significance, are growth over the corneal center, decreased vision due to corneal deformation, documented growth, sensations of discomfort, and esthetic concerns. The aim of this study is twofold: first, to determine the frequency of pterygium recurrence after surgery at the mentioned hospital, and second, to identify the factors that influence the recurrence of pterygium. The research design is a retrospective examination of 164 patient samples in an eastern Thai university hospital (Code 13766). Data analysis is descriptive statistics analysis, i.e., basic data details about pterygium surgery and the risk of recurrent pterygium, and for factor analysis, the inferential statistics chi-square and ANOVA are utilized. Twenty-four of the 164 patients who underwent surgery exhibited recurrent pterygium. Consequently, the incidence of recurrent pterygium after surgery was 14.6%. There were an equal number of men and women present. The participants' ages ranged from 41 to 60 years (62, 8 percent). According to the findings, the majority of patients were female (60.4%), over the age of 60 (51.2%), did not live near the beach (83.5%), did not have an underlying disease (92.1%), and 95.7% did not have any other eye problems. Gender (X² = 1.26, p = .289), age (X² = 5.86, p = .119), an address near the sea (X² = 3.30, p = .081)), underlying disease (X² = 0.54, p = .694), and eye disease (X² = 0.00, p = 1.00) had no effect on pterygium recurrence. Recurrences occurred in 79.1% of all surgical procedures and 11.6% of all patients using the bare sclera technique. The recurrence rate for conjunctival autografts was 20.9% for all procedures and 3.0% for all participants. Mitomycin-C and amniotic membrane transplant techniques had no recurrence following surgery. Comparing the surgeries done on people with recurrent pterygium did not show anything important (F = 1.13, p = 0.339). In conclusion, the prevalence of pterygium recurrence following pterygium, 14.6%, does not differ from earlier research. Underlying disease, other eye conditions, and surgical procedures such as pterygium recurrence are unaffected by pterygium surgery.

Keywords: pterygium, recurrence pterygium, pterygium surgery, excision pterygium

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Authors: E. Kharaishvili, G. Erkomaishvili, M. Chavleishvili

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The importance of agribusiness development is proved in accordance with the trends in the agricultural sector of Georgia. Agribusiness environment and the consequences of the agricultural reforms are evaluated. The factors hindering the development of agribusiness are revealed and the ways for overcoming these problems are suggested. SWOT analysis is done in order to identify the needs of agribusiness. The needs of agribusiness development in Georgia are evaluated by priorities: prevention of diseases and reduction of the harm caused by these diseases, accessibility of long-term agricultural loans with low interest rates, improving qualification of farmers, the level of education and usage of modern technologies, changes in legislation, accessibility to high quality agricultural machinery, and the development of infrastructure. Based on the outcomes of the research, agribusiness development strategies in Georgia are suggested and appropriate priorities of economic policy are determined. Conclusions are made and based on these conclusions, some recommendations are suggested.

Keywords: agribusiness development, agribusiness strategy, agribusiness in Georgia

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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: Daniel Afolayan, Christina Olawepo, Francis Olowookanga, Nguhemen Tingir, Olawale Fadare, John Oko

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In Nigeria, traditional birth attendants (TBAs) can play an important role in the prevention of mother-to-child transmission of HIV. However, their role in improving access to antiretroviral therapy (ART) is unclear. Catholic Caritas Foundation of Nigeria (Caritas Nigeria) is an implementing agency supporting increased access to HIV testing and treatment services in Lagos state through health facilities including Mother Theresa Hospital. Despite intra-facility testing and community outreaches, ART uptake at Mother Theresa Hospital, Lagos was low with 6 individuals on antiretroviral drugs 3 months post-activation. This study explored improving access to ART through linkages with TBAs for ART uptake at the facility. Plan-Do-Study-Act model was used. The goal was to improve uptake of ART from 6 to 80 in 5 months (end of project year). Scanning revealed a network of 15 TBAs with potential as satellites for HIV testing. Caritas Nigeria linked the facility with 15 TBAs who were provided with HIV test kits and trained on HIV testing services for provider-initiated testing and outreaches. Weekly reports and referrals of positives were received, tracked and feedback given on testing yield. These TBAs serve individuals of various age and gender at their trado-medical centres. At the end of 5 months, HIV testing increased by 10,575 (78% from TBAs) and HIV positives obtained improved by 77 (44.2% from TBAs). 55 new individuals were enrolled and commenced on ART (61.8% from TBAs). There was a successful linkage of all clients with escort services due to incentives. Total uptake of ART was 61 (76.3% of target). Structured partnerships between TBAs and HIV care and treatment centers should be strengthened to improve access to ART.

Keywords: access improvement, antiretroviral therapy, traditional birth attendants, uptake

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Authors: Domagoj Hruska, Drazen Milkovic, Maja Darabos

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This paper empirically investigates the performance of Croatian initial public offerings (IPOs) throughout 20 years period, from 1996 until 2016. By proving the comprehensive evaluation of reasons and consequences of IPO initiatives in Croatia we give analytic evidence on the influence of this corporate action on the development of corporate governance. Furthermore, the paper discusses the relationship between internal and external corporate governance mechanisms in companies that initialize entering the financial markets. The paper will provide a synthesis of evidence of IPO-s in Croatia based on in-depth case studies of 13 cases of IPO-s. The major findings of the paper include identification of reasons for conducting IPO-s and calculation of underpricing effect and change of market capitalization. To the best of the author's knowledge, the results of the paper provide the analytical framework for understanding the impact of IPOs on the corporate governance system in transition countries.

Keywords: corporate governance, Croatia, initial public offering, transition economy

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Authors: Tirthankar Chakraborty, Indranil Mukherjee

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The environmental aspect had a major effect on industrial decisions after the deteriorating condition of our surroundings dsince the industrial activities became apparent. Green buildings have been seen as a possible solution to reduce the carbon emissions from construction projects and the housing industry in general. Though this has been established in several areas, with many commercial buildings being designed green, the scope for expansion is still significant and further information on the importance and advantages of green buildings is necessary. Several commercial green building projects have come up and the green buildings are mainly implemented in the residential sector when the residential projects are constructed to furnish amenities to a large population. But, residential buildings, even those of medium sizes, can be designed to incorporate elements of sustainable design. In this context, this paper attempts to give a theoretical appraisal of the use of renewable energy systems in residential buildings of different sizes considering the weather conditions (solar insolation and wind speed) of the metropolis, Kolkata, India. Three cases are taken; one with solar power, one with wind power and one with a combination of the two. All the cases are considered in conjunction with conventional energy, and the efficiency of each in fulfilling the total energy demand is verified. The optimum combination for reducing the carbon footprint of the residential building is thus established. In addition, an assessment of the amount of money saved due to green buildings in metered water supply and price of coal is also mentioned.

Keywords: renewable energy, green buildings, solar power, wind power, energy hybridization, residential sector

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Authors: Claudia Rodríguez Espinosa, Erika Elizabeth Pérez Múzquiz

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The Pueblos Mágicos federal program tries to preserve the traditional environment of small towns (under 20,000 inhabitants), through economic investments, legislation, and legal aid. To access the program, it’s important to cover 8 requirements; one of them is the fourth, which considers ‘Promotion of symbolic and differentiated touristic attractions, such as architecture, emblematic buildings, festivities and traditions, artisan production, traditional cuisine, and touristic services that guarantee their commercialization along with assistantship and security services’. With this objective in mind, the Federal government of Mexico had developed local programs to protect emblematic public buildings in each of the 83 towns included in the Pueblos Mágicos program that involved federal and local administrations as well as local civil associations, like Adopte una Obra de Arte. In this paper, we present 3 different intervention cases: first the restoration project (now concluded) of the 16th century monastery of Santa María Magdalena in Cuitzeo, an enormous building which took 6 years to be completely restored. Second case, the public spaces intervention in Pátzcuaro, included the Plaza Grande or Vasco de Quiroga square, and the access to the arts and crafts house known as Casa de los once patios or eleven backyards house. The third case is the recovery project of the 16th century atrium of the Tzintzuntzan monastery that included the original olive trees brought by Franciscans monks to this town in the middle 1500’s. This paper tries to present successful preservation projects in 3 different scales: building, urban spaces and landscape; and in 3 different towns with the objective to preserve public architecture, public spaces and cultural traditions. Learn from foreign experiences, different ways to manage preservation projects focused on public architecture and public spaces.

Keywords: cultural tourism, heritage preservation, traditional architecture, public policies

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Authors: Marco Camilli

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This article examines the impact of the pandemic outbreak of COVID-19 in the tourism sector in Italy, analyzing the current scenario, the government decisions and the private company reaction for the summer season 2020. The framework of the data analyzed shows how massive it’s the impact of the pandemic outbreak in the tourism revenue, and the weaknesses of the measures proposed. Keywords Travel &Tourism, Transportation, Sustainability, COVID-19, Businesses Introduction The current COVID-19 scenario shows a shocking situation for the tourism and transportation sectors: it could be the most affected by the Coronavirus in Italy. According to forecasts, depending on the duration of the epidemic outbreak and the lockdown strategy applied by the Government, businesses in the supply chain could lose between 24 and 66 billion in turnover in the period of 2020-21, with huge diversified impacts at the national and regional level. Many tourist companies are on the verge of survival and if there are no massive measures by the government they risk closure. Data analysis The tourism and transport sector could be among the sectors most damaged by Covid-19 in Italy. Considering the two-year period 2020-21, companies operating in the travel & tourism sector (Tour operator, Travel Agencies, Hotel, Guides, Bus Company, etc..) could in suffer losses in revenues of 24 to 64 billion euros, especially in the sectors such as the travel agencies, hotel and rental. According to Statista Research Department, from April 2020 estimated that the coronavirus (COVID-19) pandemic will have a significant impact on revenues of the tourism industry in Italy. Revenues are expected to decrease by over 40 billion euros in the first semester of 2020, compared to the same period of the previous year. According to the study, hotel and non-hotel accommodations will experience the highest loss. Revenues of this sector are expected to decrease by 13 billion euros compared to the first semester of 2019 when accommodations registered revenues for about 17 billion euros. According to Statista.com, in 2020, Italy is expected to register a decrease of roughly 28.5 million tourist arrivals due to the impact of coronavirus (COVID-19) on the country's tourist sector. According to the estimate, the region of Veneto will record the highest drop with a decrease of roughly 4.61 million arrivals. Similarly, Lombardy is expected to register a decrease of about 3.87 million arrivals in 2020.

Keywords: travel and tourism, sustainability, COVID-19, businesses, transportation

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Authors: Bahareh Mostofian

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Foreign Direct Investment (FDI) has long been recognized as a crucial driver of economic growth and development in less-developed countries and their integration into Global Production Networks (GPNs). FDI not only brings capital from the core countries but also technology, innovation, and know-how knowledge that can upgrade the capabilities of host automotive industries. On the other hand, FDI can also have negative impacts on host countries if it leads to significant import dependency. In the case of the Iranian automotive sector, the industry greatly benefited from FDI, with Western carmakers dominating the market. Over time, various types of know-how knowledge, including joint ventures (JVs), trade licenses, and technical assistance, have been provided, helping Iran upgrade its automotive industry. While after the severe geopolitical obstacles imposed by both the EU and the U.S., the industry became over-reliant on the car and spare parts imports, and the lack of emphasis on knowledge transfer further affected the growth and development of the Iranian automotive sector. To address these challenges, current research has adopted a descriptive-analytical methodology to illustrate the gradual changes accrued with foreign suppliers through FDI. The research finding shows that after the two-phase imposed sanctions, the detrimental linkages created by overreliance on the car and spare parts imports without any industrial upgrading negatively affected the growth and development of the national and assembled products of the Iranian automotive sector.

Keywords: less-developed country, FDI, GPNs, automotive industry, Iran

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Authors: Chernet Mulugeta, Girma Seyoum, Yeshineh Demrew, Kehabtimer Shiferaw

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Background: Obstetric fistula (OF) is a serious medical condition that includes an abnormal opening between the vagina and bladder (vesico-vaginal fistula) or the vagina and rectum (recto-vaginal fistula). It is usually caused by prolonged obstructed labour. Despite its serious health and psychosocial consequences, there is a paucity of evidence regarding the time it takes to heal from OF. Objective: The aim of this study was to assess the time to cure from obstetric fistula and its predictors among women admitted to Addis Ababa Hamlin Fistula Hospital, Addis Ababa, Ethiopia. Methodology: An institution-based retrospective cohort study was conducted from January 2015 to December 2020 among a randomly selected 434 women with OF in Addis Ababa Hamlin Fistula Hospital. Data was collected using a structured checklist adapted from a similar study. The open data kit (ODK) collected data was exported and analyzed by using STATA (14.2). Kaplan Meir was used to compare the recovery time from OF. To identify the predictors of OF, a Cox regression model was fitted, and an adjusted hazard ratio with a 95% confidence interval was used to estimate the strength of the associations. Results: The average time to recover from obstetric fistula was 3.95 (95% CI: 3.0-4.6) weeks. About ¾ of the women [72.8% (95% CI - 0.65-1.2)] were physically cured of obstetric fistula. Having secondary education and above [AHR=3.52; 95% CI (1.98, 6.25)] compared to no formal education, having a live birth [AHR=1.64; 95% CI (1.22, 2.21)], having an intact bladder [AHR=2.47; 95% CI (1.1, 5.54)] compared to totally destructed, and having a grade 1 fistula [AHR=1.98; 95% CI (1.19, 3.31)] compared to grade 3 were the significant predictors of shorter time to cure from an obstetric fistula. Conclusion and recommendation: Overall, the proportion of women with OF who were not being cured was unacceptably high. The time it takes for them to recover from the fistula was also extended. It connotes us to work on the identified predictors to improve the time to recovery from OF.

Keywords: time to recovery, obstetric fistula, predictors, Ethiopia

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Authors: Douglas Arthur, Oluwayemisi Ekor, Ernest Obese, Andrew Kissi Agyei, Elvis Ofori Ameyaw

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bjective: Pain negatively impacts every aspect of health, and patients with pain disorders create enormous demands on healthcare systems globally, costing economies up to $635 billion annually. The study was therefore conducted at the Cape Coast Teaching Hospital (CCTH), the only Tertiary Hospital in the Central Region of Ghana and was designed to assess pain disorders in patients between 18 and 90 years attending Urology Clinic. Methods: The study employed a descriptive cross-sectional design, and 149 subjects (16-24, 25-34, 35-44, 45-54, 55-64, 65-90 years) were conveniently selected. The McGill Pain Questionnaire (MPQ), a multidimensional instrument that assesses several aspects of pain by the use of words (descriptors) that the patient chooses to express his/her pain, was used as the primary instrument for data collection. A patient profile form (PPF) was also designed to document the demographics and history of patients. Results: The prevalence of pain disorders was higher among females compared to males. The univariate and multivariate analysis showed that females were more likely to experience pain while being married correlated with a lower likelihood of pain. Again, the 45-54 age group exhibited the highest prevalence of pain disorders. Results from the MPQ showed that half of the patients experienced pain on a daily basis, 15.91% had experienced pain for 3-6 months and 37% experienced pain for more than one year. Pain intensity was described by 25% of the subjects as excruciating for their worst pain experience, followed by 21% for the distressing experience. The most frequently reported area of pain was the abdominal region (22.72%). The co-administration of NSAIDs and opioid compounds was provided for 17.46% of the patients with chronic pain. Conclusion: The treatment interventions improved the pain and associated symptoms such as nausea, improved daily activities and ability to sleep. However, attention and resources should be devoted to 45-54 age group.

Keywords: pain, opioids, distressing, excruciating

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Authors: Mohamed Elkashouty, Mohamed Elkammar, Mohamed Gomma, Menal Elminiami

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Lake Bardawil is considered as one of the major morphological features of northern Sinai. It represents the largest fish production lake for export in Egypt. Nineteen and thirty one samples were collected from lake water during winter and summer (2005). TDS, cations, anions, Cd, Cu, Fe, Mn, Zn, Ni, Co and Pb concentrations were measured within winter and summer seasons. During summer, in the eastern sector of the lake, TDS concentration is decreased due northeastern part (38000 ppm), it is attributed to dilution from seawater through Boughaz II. The TDS concentration increased generally in the central and southern parts of the lake (44000 and 42000 ppm, respectively). It is caused by they are far from dilution from seawater, disconnected water body, shallow depth (mean 2 m), and high evaporation rate. In the western sector, the TDS content ranged from low (38000 ppm) in the northeastern part to high (50000 ppm) in the western part. Generally, the TDS concentration in the western sector is higher than those in the eastern. It is attributed to low volume of water body for the former, high evaporation rate, and therefore increase in TDS content in the lake water.During winter season, in the eastern sector, the wind velocity is high which enhance the water current to inflow into the lake through Boughaz I and II. The resultant water lake is diluted by seawater and rainfall in the winter season. The TDS concentration increased due southern part of the lake (42000 ppm) and declined in the northern part (36000 ppm). The concentration of Co, Ni, Pb, Fe, Cd, Zn, Cu, Mn and Pb within winter and summery seasons, in lake water are low, which considered as background concentrations with respect to seawater. Therefore, there are no industrial, agricultural and sanitary wastewaters dump into the lake. This confirms the statement that has been written at the entrance of Lake Bardawil at El-Telool area "Lake Bardawil, one of the purest lakes in the world". It indicate that the Lake Bardawil is excellent area for fish production for export (current state) and is the second main fish source in Egypt after the Mediterranean Sea after the illness of Lake Manzala.

Keywords: lake Bardawil, water quality, major ions, toxic metals

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Authors: Mariem Meddeb Sidhom, Souhayel Hedfi, Rjaibia Houda, Mehdi Dridi, Mohamed Ali Yousfi, Sâadia Gargouri

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Considering the important increase in costs of caspofungin treatments and ahead the evolution of its indication, pharmacy department was prompted to realize a review of the adequacy of prescriptions in the medical intensive care units (ICU). A retrospective observational study was conducted in Tunis military hospital concerning ICU prescriptions of caspofungin from 2008 until 2013. A pharmacist had returned to the patient’s medical records to collect data and to the microbiology department for parasitological results. The adequacy of prescriptions was evaluated by a pharmacist and an infectiologist parasitologist, referring to predefined scale of criteria resuming the indications of the marketing authorization (MA) and grade AI-AII of the guidelines of the Infectious Diseases Society of America (IDSA). Sixty two ICU patients have been treated with caspofungin during the period of study; however, 8 files were lost. Thus, 54 patients were included in the study having received 55 prescriptions of caspofungin. Males were a majority with 64.8% of the population. Mean age was 51 years. Caspofungin was indicated in accordance with the IDSA recommendations in 43.6% of the cases. The most case of non respect to the guidelines was the indication of caspofungin as empirical treatment in non neutropenic patients. Caspofungin was utilized as a first line treatment in 9 cases where it was possible to give fluconazole first, as germs were fluconazole- sensitive. Caspofungin was indicated in 2 patients with good renal function and in which nor amphotericin B, liposomal ampho B neither itraconazole had been previously used, as indicates the MA. The posology of caspofungin was respected in all prescriptions with a loading dose of 70 mg in the first day and a maintenance dose of 50 mg daily. Seven patients had received a daily dose of 70 mg, the recommended dose for people weighing more than 80 Kg. Caspofungin prescriptions are far to be adequately done. There is a clear need of optimization in indicating this molecule and that must be done in collaboration between the pharmacy department, the ICUs and parasitology department.

Keywords: caspofungin, prescription, intensive care units, marketing authorization, Tunisian hospital cohort

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Authors: Mursidin Yusuf, Fitri Wulandari

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Indonesia has changed its curriculum ten times, starting from 1947 to 2022, and it might change in upcoming years. This comprehensive study delves into the global perspectives of educational leadership, with a specific focus on examining curriculum changes within the context of Indonesia. Against the backdrop of an increasingly interconnected educational landscape, the necessity to comprehend diverse leadership approaches becomes paramount. By employing a qualitative case study methodology, this research meticulously scrutinizes ten notable curriculum modifications within the Indonesian educational framework and evaluates their impacts on the sector. Utilizing document analysis, pertinent literature, and interviews with school principals, the study thoroughly explores the leadership dynamics that have influenced these alterations. The findings offer multifaceted insights into the strategies, challenges, and outcomes associated with curriculum reform initiatives in Indonesia, providing a nuanced understanding of the effects of these changes on the education sector.

Keywords: curriculum changes, educational leadership, global perspectives, Indonesia

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Authors: Onyia Comfort Ngozi, Iketaku Ifeoma Roseline

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Inspite of the laudable goals and objectives in education, Nigerian women, still face a lot of challenges that hinder the personal and national development. There are unbalances between males and females at all levels of the science education sector in Nigeria. Educate a woman, and you educate a nation, and if you educate a man, you educate an individual. It is on this note that the paper focuses on bridging the gender gap as it concerns science education in Nigeria. Suggestions were made as measures of bridging the gender gap in Nigerian education sector. The researchers concluded that achieving gender equality will promote greater equality in employment, help postpone early marriages, reduce infant mortality rates and improve health and education for a future generation. Thus, the paper recommended that government should involve women in policy making to take care of any gender issue and bias that may be included either consciously or not, during formulation stage.

Keywords: education, gender, science education, women, equality

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Authors: Arpita Sabath, Jytoika Samuel

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Emotional Intelligence is conceptualized as a confluence of learned abilities resulting in wise behavior, high achievement and mental health. This case study is done on IT Sector employees of CAREERNET consultancy at Bangalore. Thus the present study intends to find out the difference in different dimensions of El and Js Scales among male and female employees and the existing relationship between emotional intelligence and job satisfaction for the beginner age group of employees (25 yrs - 40 yrs) in order to enhance the employees productivity level in the present scenario of recession in employment. It is observed that all promotions and increment are achieved at these 25 yrs - 40 yrs age group employees. Therefore, the sample is selected randomly and grouped. Survey method with the administration of Emotional Intelligence Scale and opinionScedule is used. The findings of the study has revealed that there is a positive relationship between emotional intelligence and performance excellence. The study is concluded with a remark that the relevance of this study should be followed by the administrative body of IT sectors to motivate them and to get more productive work from their employees

Keywords: emotional intelligence, job satisfaction, organisational behavior, IT sector

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Authors: S. Kaira, S. Mohamed, A. Rahman

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Traditionally, highway infrastructure projects are initiated based on their economic benefits, thereafter environmental, social and governance impacts are addressed discretely for the selected project from a set of pre-determined alternatives. When opting for cost-benefit analysis (CBA), multi-criteria decision-making (MCDM) has been used as the default assessment tool. But this tool has been critiqued as it does not mimic the real-world dynamic environment. Indeed, it is because of the fact that public sector projects like highways have to experience intense exposure to dynamic environments. Therefore, it is essential to appreciate the impacts of various dynamic factors (factors that change or progress with the system) on project performance. Thus, this paper presents various sustainability assessment tools that have been globally developed to determine sustainability performance of infrastructure projects during the design, procurement and commissioning phase. Indeed, identification of the current gaps in the available assessment methods provides a potential to add prominent part of knowledge in the field of ‘road project development systems and procedures’ that are generally used by road agencies.

Keywords: dynamic impact factors, micro and macro factors, sustainability assessment framework, sustainability performance

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Authors: Michael Adebayo, Saheed Lawal

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The Comprehensive Geriatric Assessment (CGA) is the multidimensional tool used to assess elderly, frail patients either on admission to hospital care or at a community level in primary care. It is a tool designed with the aim of using a holistic approach to managing patients. A Cochrane review of CGA use in 2011 found that the likelihood of being alive and living in their own home rises by 30% post-discharge. RCTs have also discovered 10–15% reductions in readmission rates and reductions in institutionalization, and resource use and costs. Past audit cycles at King’s College Hospital, Denmark Hill had shown inconsistent evidence of CGA completion inpatient discharge summaries (less than 50%). Junior Doctors in the Health and Ageing (HAU) wards have struggled to sustain the efforts of past audit cycles due to the quick turnover in staff (four-month placements for trainees). This 7th cycle created a multi-faceted approach to solving this problem amongst staff and creating lasting change. Methods: 1. We adopted multidisciplinary team involvement to support Doctors. MDT staff e.g. Nurses, Physiotherapists, Occupational Therapists and Dieticians, were actively encouraged to fill in the CGA document. 2. We added a CGA Document Pro-forma to “Sunrise EPR” (Trust computer system). These CGAs were to automatically be included the discharge summary. 3. Prior to assessing uptake, we used a spot audit questionnaire to assess staff awareness/knowledge of what a CGA was. 4. We designed and placed posters highlighting domains of CGA and MDT roles suited to each domain on geriatric “Health and Ageing Wards” (HAU) in the hospital. 5. We performed an audit of % discharge summaries which include CGA and MDT role input. 6. We nominated ward champions on each ward from each multidisciplinary specialty to monitor and encourage colleagues to actively complete CGAs. 7. We initiated further education of ward staff on CGA's importance by discussion at board rounds and weekly multidisciplinary meetings. Outcomes: 1. The majority of respondents to our spot audit were aware of what a CGA was, but fewer had used the EPR document to complete one. 2. We found that CGAs were not being commenced for nearly 50% of patients discharged on HAU wards and the Frailty Assessment Unit.

Keywords: comprehensive geriatric assessment, CGA, multidisciplinary team, quality of life, mortality

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Authors: Abdullah M. Alzahrani, Abdel Halim Boussabaine

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There is an international consensus on the climate change in the entire world and this is as a result of the combination of the natural factors, such as volcanoes and hurricanes with increased of human activity on the earth, such as industrial renaissance. Where this solidarity increases emissions of greenhouse gases GHGs that considered as the main driver of climate change scenarios and related emerging risks and impacts on buildings. These climatic risks including damages, disruption and disquiet are set to increase and it is considered as the main challenges and difficulties facing built environment due to major implications on assets sector. Consequently, the threat from climate change patterns has a significant impact on a variety of complex human decisions, which affect all aspects of living. Understanding the relationship between buildings and such risks arising from climate change scenarios on buildings are the key in insuring the optimal timing and design of policies and systems, which affect all aspects of the built environment. This paper will uncovering this correlation between emerging climate change risks and the building assets. In addition, how these emerging risks can be classified in practical way in terms of their impact type on buildings. Hence, this mapping will assist professionals and interested parties in the building sector to cope with such risks in several systematic ways including development and designing of mitigation and adaptation strategies and processes of design, specification, construction, and operation; all these leads to successful management of assets.

Keywords: climate change, climate change risks, built environment, building sector, impacts

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Authors: Warda Jabeen, Romaisa Shamim Khan, Osama Shakeel, Ahmed Faraz Bhatti, Raza Hussain

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Background: The worldwide incidence of cutaneous melanoma (CM) has been on the rise over the past few decades. Primary prevention and early treatment remain the focus of management to reduce the burden of disease. This entails identification of risk factors to prompt early diagnosis. In Pakistan, there is a scarcity of clinico-pathological data relating to cutaneous malignant melanoma. Objective: The purpose of this study was to analyze the epidemiological and clinical characteristics of patients presenting with cutaneous malignant melanoma in Pakistan, and to compare the results with other studies. Method: Shaukat Khanum Memorial Cancer Hospital and Research Centre is currently the only dedicated cancer hospital in the country, accepting patients from all over Pakistan. Majority of the patients, however, belong to the northern half of the country. From the recorded data of the hospital, all cutaneous melanoma cases were identified and evaluated. Results: Between 1997 and 2017, a total of 169 cutaneous melanoma patients were registered at Shaukat Khanum. Mean age was 47.5 years. The highest incidence of melanoma was seen in the age group 40-59 years (n=69, 40.8%). Most commonly reported clinical subtype was unspecified melanoma (n=154, 91%). Amongst those in which T stage was reported, the most frequently observed T-stage at presentation was T4 (n=23, 13.6%). With regards to body distribution, in our study CM was seen most commonly in the lower limb including the hip. The yearly incidence of melanoma has increased/remained stable from 2007 to 2017. Conclusion: cutaneous malignant melanoma is a fairly common disease in Pakistan. Patients tend to present at a more advanced stage as compared to patients in developed countries. Identification of risk factors and tumor characteristics is therefore of paramount importance to deal with these patients.

Keywords: epidemiology of cutaneous malignant melanoma, cutaneous malignant melanoma, Pakistan, skin cancer

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