Search results for: antiracist healthcare policy

Authors: M. Chobotová, Ž. Rylková

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Time full of changes which is associated with globalization, tougher competition, changes in the structures of markets and economic downturn, that all force companies to think about their competitive advantages. These changes can bring the company a competitive advantage and that can help improve competitive position in the market. Policy of the European Union is focused on the fast growing innovative companies which quickly respond to market demands and consequently increase its competitiveness. To meet those objectives companies need the right conditions and support of their state.

Keywords: innovation, performance, measurements metrics, indices

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Authors: Isabelle Gobatto

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Based on an anthropological approach, this paper explores the medical profession and the construction of medical practices by considering the multiform articulations between structural poverty and the production of care from a low-resource francophone West African country, Burkina Faso. This country is considered in its exemplary dimension of culturally differentiated countries of the African continent that share the same situation of structural poverty. The objective is to expose the effects of structural poverty on the ways of constructing professional knowledge and thinking about the sense of the medical profession. If doctors are trained to have the same capacities in South and West countries, which are to treat and save lives whatever the cultural contexts of the practice of medicine, the ways of investing their role and of dealing with this context of action fracture the homogenization of the medical profession. In the line of anthropology of biomedicine, this paper outlines the complex effects of structural poverty on health care, care relations, and the moral economy of doctors. The materials analyzed are based on an ethnography including two temporalities located thirty years apart (1990-1994 and 2020-2021), based on long-term observations of care practices conducted in healthcare institutions, interviews coupled with the life histories of physicians. The findings reveal that disabilities faced by doctors to deliver care are interpreted as policy gaps, but they are also considered by physicians as constitutive of the social and cultural characteristics of patients, making their capacities and incapacities in terms of accompanying caregivers in the production of care. These perceptions have effects on know-how, structured around the need to act even when diagnoses are not made so as not to see patients desert health structures if the costs of care are too high for them. But these interpretations of highly individualizing dimensions of these difficulties place part of the blame on patients for the difficulties in using learned knowledge and delivering effective care. These situations challenge the ethics of caregivers but also of ethnologists. Firstly because the interpretations of disabilities prevent caregivers from considering vulnerabilities of care as constituting a common condition shared with their patients in these health systems, affecting them in an identical way although in different places in the production of care. Correlatively, these results underline that these professional conceptions prevent the emergence of a figure of victim, which could be shared between patients and caregivers who, together, undergo working and care conditions at the limit of the acceptable. This dimension directly involves politics. Secondly, structural poverty and its effects on care challenge the ethics of the anthropologist who observes caregivers producing, without intent to arm, experiences of care marked by an ordinary violence, by not giving them the care they need. It is worth asking how anthropologists could get doctors to think in this light in west-African societies.

Keywords: Africa, care, ethics, poverty

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Authors: Mumtaz Ali Baloch

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This article aims at to review the policies and gaps including the socioeconomic and institutional factors that affected the enrollment of disabled children and caused drop-outs. It provides insights to scrutinize the gaps in policies, socioeconomic, and institutional factors with the specific concern in enrollment and drop out of disabled children in Pakistan, and Balochistan in particular. The findings of this study revealed that the old-age centralized policies and a number of socio-economic and institutional factors seemed to have significantly affected the enrollment and quality education in the case of physically disabled children. There were only a few schools functional in entire Balochistan. For example, an entire province (Balochistan) there are only two schools for disabled children, established in Quetta city. In the other 31 districts, an estimated population of 300,000 people of each district there were no schools for the disabled children. The findings of this study revealed that there is a great distinction between the policy and practice in the case of physically disabled children in Quetta, Balochistan. Consequently, such children seemed to have been out of schools. Dropout after the class eighth grade is almost 100%, as there are no high schools available for physically/disabled children, in Balochistan. The concerned organizations and authorities need to develop and ratify specific policies, provide required) facilities to the schools including sufficient budget, streamline the academic planning, and an effective monitoring and evaluation system. Only awareness and motivation could not help in improving the enrollment rate and decreasing the dropout in the case of physically disabled children. There is an urgent need to provide the required facilities to the schools. Almost all students needed assistive equipment, effective physical therapy as well as regular medical facilities. Such measures can improve the enrolment and rehabilitation of children.

Keywords: education policy, practices, physically disabled children, challenges, Balochistan, Pakistan

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Authors: Adey Nigatu Mersha, Ilyas Masih, Charlotte de Fraiture, Tena Alamirew

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Conflicts over water are increasing mainly as a result of water scarcity in response to higher water demand and climatic variability. There is often not enough water to meet all demands for different uses. Thus, decisions have to be made as to how the available resources can be managed and utilized. Correspondingly water allocation goals, practically national water policy goals, need to be revised accordingly as the pressure on water increases from time to time. A case study is conducted in the Upper Awash Basin, Ethiopia, to assess and evaluate prioritized comprehensive water demand management options based on the framework of integrated water resources management in account of stakeholders’ knowledge and preferences as well as practical prominence within the Upper Awash Basin. Two categories of alternative management options based on policy analysis and stakeholders' consultation were evaluated against the business-as-usual scenario by using WEAP21 model as an analytical tool. Strong effects on future (unmet) demands are observed with major socio-economic assumptions and forthcoming water development plans. Water management within the basin will get more complex with further abstraction which may lead to an irreversible damage to the ecosystem. It is further confirmed through this particular study that efforts to maintain users’ preferences alone cannot insure economically viable and environmentally sound development and vice versa. There is always a tradeoff between these factors. Hence, all of these facets must be analyzed separately, related with each other in equal footing, and ultimately taken up in decision making in order for the whole system to function properly.

Keywords: water demand, water availability, WEAP21, scenarios

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Authors: Tuji Jemal Ahmed

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Food quality and safety challenges are prevalent in Ethiopia's food processing industry, which can have adverse effects on consumers' health and wellbeing. The country is known for its diverse range of agricultural products, which are essential to its economy. However, poor food quality and safety policies and management systems in the food processing industry have led to several health problems, foodborne illnesses, and economic losses. This paper aims to highlight the causes and effects of food safety and quality issues in the food processing industry of Ethiopia and discuss potential solutions to address these issues. One of the main causes of poor food quality and safety in Ethiopia's food processing industry is the lack of adequate regulations and enforcement mechanisms. The absence of comprehensive food safety and quality policies and guidelines has led to substandard practices in the food manufacturing process. Moreover, the lack of monitoring and enforcement of existing regulations has created a conducive environment for unscrupulous businesses to engage in unsafe practices that endanger the public's health. The effects of poor food quality and safety are significant, ranging from the loss of human lives, increased healthcare costs, and loss of consumer confidence in the food processing industry. Foodborne illnesses, such as diarrhea, typhoid fever, and cholera, are prevalent in Ethiopia, and poor food quality and safety practices contribute significantly to their prevalence. Additionally, food recalls due to contamination or mislabeling often result in significant economic losses for businesses in the food processing industry. To address these challenges, the Ethiopian government has begun to take steps to improve food quality and safety in the food processing industry. One of the most notable initiatives is the Ethiopian Food and Drug Administration (EFDA), which was established in 2010 to regulate and monitor the quality and safety of food and drug products in the country. The EFDA has implemented several measures to enhance food safety, such as conducting routine inspections, monitoring the importation of food products, and enforcing strict labeling requirements. Another potential solution to improve food quality and safety in Ethiopia's food processing industry is the implementation of food safety management systems (FSMS). An FSMS is a set of procedures and policies designed to identify, assess, and control food safety hazards throughout the food manufacturing process. Implementing an FSMS can help businesses in the food processing industry identify and address potential hazards before they cause harm to consumers. Additionally, the implementation of an FSMS can help businesses comply with existing food safety regulations and guidelines. In conclusion, improving food quality and safety policies and management systems in Ethiopia's food processing industry is critical to protecting public health and enhancing the country's economy. Addressing the root causes of poor food quality and safety and implementing effective solutions, such as the establishment of regulatory agencies and the implementation of food safety management systems, can help to improve the overall safety and quality of the country's food supply.

Keywords: food quality, food safety, policy, management system, food processing industry

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Authors: Umedov Mekhroz, Griaznova Svetlana

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In connection with the growth of oncological diseases, the design of centers for diagnostics and the production of radiopharmaceuticals is the most relevant area of healthcare facilities. The design of new nuclear medicine centers should be carried out from the standpoint of solving the following tasks: the availability of medical care, functionality, environmental friendliness, sustainable development, improving the safety of drugs, the use of which requires special care, reducing the rate of environmental pollution, ensuring comfortable conditions for the internal microclimate, adaptability. The purpose of this article is to substantiate architectural and planning solutions, formulate recommendations and principles for the design of nuclear medicine centers and determine the connections between the production and medical functions of a building. The advantages of combining the production of radiopharmaceuticals and the department of medical care: less radiation activity is accumulated, the cost of the final product is lower, and there is no need to hire a transport company with a special license for transportation. A medical imaging department is a structural unit of a medical institution in which diagnostic procedures are carried out in order to gain an idea of the internal structure of various organs of the body for clinical analysis. Depending on the needs of a particular institution, the department may include various rooms that provide medical imaging using radiography, ultrasound diagnostics, and the phenomenon of nuclear magnetic resonance. The production of radiopharmaceuticals is an object intended for the production of a pharmaceutical substance containing a radionuclide and intended for introduction into the human body or laboratory animal for the purpose of diagnosis, evaluation of the effectiveness of treatment, or for biomedical research. The research methodology includes the following subjects: study and generalization of international experience in scientific research, literature, standards, teaching aids, and design materials on the topic of research; An integrated approach to the study of existing international experience of PET / CT scan centers and the production of radiopharmaceuticals; Elaboration of graphical analysis and diagrams based on the system analysis of the processed information; Identification of methods and principles of functional zoning of nuclear medicine centers. The result of the research is the identification of the design principles of nuclear medicine centers with the functions of the production of radiopharmaceuticals and the department of medical imaging. This research will be applied to the design and construction of healthcare facilities in the field of nuclear medicine.

Keywords: architectural planning solutions, functional zoning, nuclear medicine, PET/CT scan, production of radiopharmaceuticals, radiotherapy

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Authors: Szymon Rutkowski, Tomasz Korbak

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We present a reinforcement-learning-based method of training neural machine translation models without parallel corpora. The standard encoder-decoder approach to machine translation suffers from two problems we aim to address. First, it needs parallel corpora, which are scarce, especially for low-resource languages. Second, it lacks psychological plausibility of learning procedure: learning a foreign language is about learning to communicate useful information, not merely learning to transduce from one language’s 'encoding' to another. We instead pose the problem of learning to translate as learning a policy in a communication game between two agents: the translator and the classifier. The classifier is trained beforehand on a natural language inference task (determining the entailment relation between a premise and a hypothesis) in the target language. The translator produces a sequence of actions that correspond to generating translations of both the hypothesis and premise, which are then passed to the classifier. The translator is rewarded for classifier’s performance on determining entailment between sentences translated by the translator to disciple’s native language. Translator’s performance thus reflects its ability to communicate useful information to the classifier. In effect, we train a machine translation model without the need for parallel corpora altogether. While similar reinforcement learning formulations for zero-shot translation were proposed before, there is a number of improvements we introduce. While prior research aimed at grounding the translation task in the physical world by evaluating agents on an image captioning task, we found that using a linguistic task is more sample-efficient. Natural language inference (also known as recognizing textual entailment) captures semantic properties of sentence pairs that are poorly correlated with semantic similarity, thus enforcing basic understanding of the role played by compositionality. It has been shown that models trained recognizing textual entailment produce high-quality general-purpose sentence embeddings transferrable to other tasks. We use stanford natural language inference (SNLI) dataset as well as its analogous datasets for French (XNLI) and Polish (CDSCorpus). Textual entailment corpora can be obtained relatively easily for any language, which makes our approach more extensible to low-resource languages than traditional approaches based on parallel corpora. We evaluated a number of reinforcement learning algorithms (including policy gradients and actor-critic) to solve the problem of translator’s policy optimization and found that our attempts yield some promising improvements over previous approaches to reinforcement-learning based zero-shot machine translation.

Keywords: agent-based language learning, low-resource translation, natural language inference, neural machine translation, reinforcement learning

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Authors: Yu Chen Su

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Introduction: Gestational diabetes mellitus (GDM) refers to impaired glucose tolerance in pregnant women, impacting both the mother and newborn with short and long-term effects. It increases risks of preeclampsia, hypertension, type 2 diabetes, cesarean section, and preterm birth. GDM is associated with fetal macrosomia, shoulder dystocia, neonatal hypoglycemia, and future type 2 diabetes risk. A study on 6,421 pregnant women found 12% experienced high stress, linked to maladaptive coping and depressive emotions. Women with high-risk pregnancies may experience greater stress and depression. Research suggests GDM increases depression prevalence. A study on 632 Hispanic women with GDM showed severe stress and depression tendencies. Involving 95 women with GDM, 33.4% exhibited depression symptoms. Another study compared 180 GDM women to 186 with normal glucose levels, revealing higher depression levels in GDM women. They found GDM women were 1.85 times more likely to receive antidepressants during pregnancy and 1.69 times more likely to experience postpartum depression. Maternal stress and depressive symptoms during pregnancy are significant factors. Early identification by healthcare professionals can greatly benefit GDM women, their infants, and their families. Objectives: The purpose of this study was to investigate the association between gestational diabetes mellitus (GDM) and the risk of depression. Methods: This study reviewed and analyzed relevant literature on gestational diabetes mellitus (GDM) and depression in 6,876 patients. The literature search followed PRISMA guidelines and included databases like Embase, PubMed, MEDLINE, CINAHL, and Cochrane Library. Prospective or retrospective studies with relevant risk ratios and estimates were included, using a random-effects model for the analysis of depression risk correlation. Studies without depression data or relevant risks were excluded. The search period extended until October 2022. Results: Systematic review of 7 studies (6,876 participants) found a significant association (OR = 8.77, CI: 7.98-9.64, p < 0.05) between gestational diabetes mellitus (GDM) and higher depression risk compared to healthy pregnant women. Conclusions: Pregnancy is a significant life transition involving physiological, psychological, and social changes. Gestational diabetes poses challenges to women's physical and mental well-being. Sensitive healthcare professionals identifying issues early can greatly benefit women, babies, and the family.

Keywords: gestational diabetes, depression, systematic review, neta-analysis

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Authors: Prima Fithri, Lusi Susanti, Karin Bestarina

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Indonesia's electrification ratio is still around 80.1%, which means that approximately 19.9% of households in Indonesia have not been getting the flow of electrical energy. Household electricity consumptions in Indonesia are generally still dominated by the public urban. In the city of Padang, West Sumatera, Indonesia, about 94.10% are power users of government services (PLN). The most important thing of the issue is human resources efficient energy. Consumer behavior in utilizing electricity becomes significant. Intensive questioner survey, in-depth interview and statistical analysis are carried out to collect scientific evidences of the behavioral based changes instruments to reduce electricity consumption in household sector. The questioner was developed to include five factors assuming affect the electricity consumption pattern in household sector. They are: attitude, energy price, household income, knowledge and other determinants. The survey was carried out in Padang, West Sumatra Province Indonesia. About 210 questioner papers were proportionally distributed to households in 11 districts in Padang. Stratified sampling was used as a method to select respondents. The results show that the household size, income, payment methods and size of house are factors affecting electricity saving behavior in residential sector. Household expenses on electricity are strongly influenced by gender, type of job, level of education, size of house, income, payment method and level of installed power. These results provide a scientific evidence for stakeholders on the potential of controlling electricity consumption and designing energy policy by government in residential sector.

Keywords: electricity, energy saving, household, behavior, policy

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Authors: Ernest Nweke

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This paper examines the changing trend in ownership of Mongolian companies and how this trend has influenced corporate governance mechanisms in Mongolian companies. A study of this magnitude is essential as it x-rays the systematic transformation of Mongolia’s corporate world from the public to private ownership and the tremendous impact it has had on firm governance mechanisms. Owing to Mongolia’s Soviet past, much of the companies in Mongolia were state-owned, state-directed and state-controlled resulting in serious inefficiencies in these companies. This scenario is antithetical to the economic growth and development of any nation as it is grossly at variance with the fundamental principles of good corporate governance that drive prosperity. Consequently, the Mongolian government has in the past decades fine-tuned government policy to prioritize private ownership, establishing various frameworks that will strengthen corporate governance structures in Mongolia. These efforts have paid off and gone a long way in changing the trend in the ownership of companies in Mongolia reversing the old order. The expectation locally and internationally is that companies in post-socialist Mongolia will be more closely aligned to generally accepted corporate governance mechanisms, generally improving company performance and ultimately returns to shareholders. To achieve the research objectives, the survey research method was employed utilizing a sample of seventy randomly selected listed companies representing 22% of Mongolian Stock Exchange listings. Research hypotheses formulated to guide the conduct of the study were tested using Chi-Square analysis, and results show that ownership trend has drastically changed in the post-socialist Mongolia leading to better corporate governance practices in Mongolian companies. This result has important policy implications.

Keywords: corporate disclosure, free market, private ownership, Mongolia

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Authors: Amine M. Benmehaia, Amine Oulmane

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The supply response of agricultural commodities to changes in price incentives is an important issue for the success of any policy reform in the agricultural sector. This study aims to quantify the responsiveness of producers of some livestock commodities to price incentives in Algerian context. Time series analysis is used on annual data for a period of 52 years (1966-2018). Both co-integration and vector error correction model (VECM) are used through the Nerlove model of partial adjustment. The study attempts to determine the long-run and short-run relationships along with the magnitudes of disequilibria in the selected commodities. Results show that the short-run price elasticities are low in cow and sheep meat sectors (8.7 and 8% respectively), while their respective long-run elasticities are 16.5 and 10.5, whereas eggs and milk have very high short-run price elasticities (82 and 90% respectively) with long-run elasticities of 40 and 46 respectively. The error correction coefficient, reflecting the speed of adjustment towards the long-run equilibrium, is statistically significant and have the expected negative sign. Its estimates are 12.7 for cow meat, 33.5 for sheep meat, 46.7 for eggs and 8.4 for milk. It seems that cow meat and milk producers have a weak feedback of about 12.7% and 8.4% respectively of the previous year's disequilibrium from the long-run price elasticity, whereas sheep meat and eggs producers adjust to correct long run disequilibrium with a high speed of adjustment (33.5% and 46.7 % respectively). The implication of this is that much more in-depth research is needed to identify those factors that affect agricultural supply and to describe the effect of factors that shift supply in response to price incentives. This could provide valuable information for government in the use of appropriate policy measures.

Keywords: Algeria, cointegration, livestock, supply response, vector error correction model

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Authors: Mahbub C. Mishu, Venktesh N. Dubey, Tamas Hickish, Jonathan Cole

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Pressure ulcer is a common problem for today's healthcare industry. It occurs due to external load applied to the skin. Also when the subject is immobile for a longer period of time and there is continuous load applied to a particular area of human body,blood flow gets reduced and as a result pressure ulcer develops. Body support surface has a significant role in preventing ulceration so it is important to know the characteristics of support surface under loading conditions. In this paper we have presented mathematical models of different types of viscoelastic materials and also we have shown the validation of our simulation results with experiments.

Keywords: pressure ulcer, viscoelastic material, mathematical model, experimental validation

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Authors: Chen Zhi-Wei, Hsieh Wei-Fang

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Taiwan annual rainfall is global average of 2.5 times, plus city excessive development, green constantly to reduced, instead of is big area of artificial base disc, makes Taiwan rainy season during occurred of storm cannot timely of emissions, led to flood constantly, and rain also cannot was retained again using, led to city hydrological balance suffered damage, and to Regulation city of by brings of negative effect, increased green covered rate became most effective of method, and city land limited, so roof green gradually became a alternative program. Green roofs have become one of the Central and local government policy initiatives for urban development, in foreign countries, such as the United States, and Japan, and Singapore etc. Development of roof greening as an important policy, has become a trend of the times. In recent years, many experts and scholars are also on the roof greening all aspects of research, mostly for green roof for the environmental impact of benefits, such as: carbon reduction, cooling, thermostat, but research on the benefits of green roofs under water cut but it is rare. Therefore, this research literature from green roof in to view and analyze what kind of medium suitable for roof greening and use of green base plate combination simulated green roof structure, via different proportions of the medium with water retention plate and drainage board, experiment with different planting base plate combination of water conservation performance. Research will want to test the effect of roof planting base mix, promotion of relevant departments and agencies in future implementation of green roofs, prompted the development of green roofs, which in the end Taiwan achieve sustainable development of the urban environment help.

Keywords: thin-layer roof greening and planting medium, water efficiency

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Authors: Neelima Rashmi Lakra

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India was among one of the highly developed economy up to 1850 due to its cottage industries. During the end of the 18th century, modern industrial enterprises began with the first cotton mill in Bombay, the jute mill near Calcutta and the coal mine in Raniganj. This was counted as the real beginning of industry in 1854 in India. Prior to this period people concentrated only to agriculture, menial service or handicraft, and the introduction of industries exposed them to the disciplines of factory which was very tedious for them. With increasing number of factories been setup adding on to mining and introduction of railway, World War Period (1914-19), Second World War Period (1939-45) and the Great Depression (1929-33) there were visible change in the nature of work for the people, which resulted in outburst of strike for various reasons in these factories. Here, with India’s independence there was emergence of public sector industries and labour legislations were introduced. Meanwhile, trade unions came to notice to the rescue of the oppressed but failed to continue till long. Soon after, with the New Economic Policy organisations came across to face challenges to perform their best, where social justice for the workmen was in question. On these backdrops, studies were found discussing the central human capabilities which could be addressed through Social Security schemes. Therefore, this study was taken up to look at the reforms and legislations mainly meant for the welfare of the labour. This paper will contribute to the large number of Indian population who are serving in public sectors in India since the introduction of industries and will complement the issue of social justice through social security measures among this huge crowd serving the nation. The objectives of the study include; to find out what labour Legislations have already been existing in India, the role of Trade Union Movement, to look at the effects of New Economic Policy on these reforms and its effects and measures taken for the workforce employed in the public sectors and finally, if these measures fulfil the social justice aspects for the larger society on whole. The methodology followed collection of data from books, journal articles, reports, company reports and manuals focusing mainly on Indian studies and the data was analysed following content analysis method. The findings showed the measures taken for Social Security, but there were also reflections of very few particular additions or amendments to these Acts and provisions with the onset of New Liberalisation Policy. Therefore, the study concluded examining the social justice aspects in the context of a developing economy and discussing the recommendations.

Keywords: public sectors, social justice, social security schemes, trade union movement

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Authors: Elizabeth R. LaFave, Grayson Sink, Anna Vassallo, Samantha Mills, Eli G. Hvastkovs

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Throughout history and into modern times, the continuation of male influence over female healthcare has created inadequacies in availability and access to treatments, often further limited in rural communities. The historical plight of women in healthcare can be understood by studying the advancements made by women in the field, both through their career arcs and by delving into the treatments they offer. An early example is the case of Martha Ballard (1735-1812), a midwife in New York who practiced when female practitioners were dismissed in favor of less educated male physicians, which was a well-accepted practice into the twentieth century. In order to overcome these setbacks, a strategy used by some female practitioners was to develop and market their own remedies in an attempt to better serve female patients. By highlighting the compromises and social manipulation of female entrepreneurs, in comparison with the medicines they developed and used, we can map their ability to carve a specific niche for themselves and their targeted customers. The application of modern chemical approaches in a historical context serves to enhance a variety of perspectives within the museum sphere necessary for the comprehension and understanding of the female plight in both medical care and service. In order to further examine the overall bias and scrutiny for women in the medical field, specifically those undertaking entrepreneurial roles, examples of alternative remedies from female founders will be analyzed utilizing these approaches. Modern analytical chemistry techniques, specifically mass spectrometry (MS), have been successful in offering compositional analyses for both labeled and unlabeled ingredients in old medicines. Previously, we have analyzed two forms of alternative treatment options created by male medical professionals to address lingering historical questions of purity and validity. Although primarily sugar based, both Humphreys’ Specifics and Boericke & Tafel remedies also contained unique ingredients, albeit in small quantities, with medicinal properties. Here, we applied the same methodology to study another highly politicized 19th-century debate surrounding the contribution and role of women in the medical profession through analyzing three remedies, each from a different female-led manufacturing company; Mrs. Joe Persons, Lydia Pinkham, and Winslow’s Syrups. Following MS analyses for both labeled and unlabeled ingredients, both Winslow’s and Pinkham’s remedies were similar to their male counterparts in advertisement strategy, targeted customer base, and overall composition of remedy (primarily sugar-based with small amounts of unique ingredients). In effect, these unbiased chemical assessments are used to dissect the rationality of both market and physician criticism for each individual manufacturer through assessment of authenticity, benefaction, and comparison among female entrepreneurs and their aims to enter the medical community (i.e., geographic location, market size). Our work aims to increase collaboration between STEM (Science, Technology, Engineering, Mathematics)-based fields and historical museum studies on a larger scale while also answering questions of potential bias towards females in the medical community as means of comparison to their male counterparts and in-depth historical analyses to unravel individual strategies to overcome the setback.

Keywords: nineteenth-century medicine, alternative remedies, female healthcare, chemical analyses, mass spectrometry

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Authors: Roland F. Karthaus, Rachel S. O'Brien

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Over the past decade, the authors have undertaken applied research aimed at enabling transformation within the prison service to improve conditions and outcomes for those living, working and visiting in prisons in the UK and the communities they serve. The research has taken place against a context of reducing resources and public discontent at increasing levels of violence, deteriorating conditions and persistently high levels of re-offending. Top-down governmental policies have mainly been ineffectual and in some cases counter-productive. The prison service is characterised by hierarchical organisation, and the research has applied design thinking at multiple levels to challenge and precipitate change: top-down, middle-out and bottom-up. The research employs three distinct but related approaches, system design (top-down): working at the national policy level to analyse the changing policy context, identifying opportunities and challenges; engaging with the Ministry of Justice commissioners and sector organisations to facilitate debate, introducing new evidence and provoking creative thinking, place-based design (middle-out): working with individual prison establishments as pilots to illustrate and test the potential for local empowerment, creative change, and improved architecture within place-specific contexts and organisational hierarchies, everyday design (bottom-up): working with individuals in the system to explore the potential for localised, significant, demonstrator changes; including collaborative design, capacity building and empowerment in skills, employment, communication, training, and other activities. The research spans a series of projects, through which the methodological approach has developed responsively. The projects include a place-based model for the re-purposing of Ministry of Justice land assets for the purposes of rehabilitation; an evidence-based guide to improve prison design for health and well-being; capacity-based employment, skills and self-build project as a template for future open prisons. The overarching research has enabled knowledge to be developed and disseminated through policy and academic networks. Whilst the research remains live and continuing; key findings are emerging as a basis for a new methodological approach to effecting change in the UK prison service. An interdisciplinary approach is necessary to overcome the barriers between distinct areas of the prison service. Sometimes referred to as total environments, prisons encompass entire social and physical environments which themselves are orchestrated by institutional arms of government, resulting in complex systems that cannot be meaningfully engaged through narrow disciplinary lenses. A scalar approach is necessary to connect strategic policies with individual experiences and potential, through the medium of individual prison establishments, operating as discrete entities within the system. A reflexive process is necessary to connect research with action in a responsive mode, learning to adapt as the system itself is changing. The role of individuals in the system, their latent knowledge and experience and their ability to engage and become agents of change are essential. Whilst the specific characteristics of the UK prison system are unique, the approach is internationally applicable.

Keywords: architecture, design, policy, prison, system, transformation

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Authors: A. F. Alves, L. Schmidt, J. Ferrao

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Portugal is one of the more vulnerable European countries to the impacts of climate change. These include: temperature increase; coastal sea level rise; desertification and drought in the countryside; and frequent and intense extreme weather events. Hence, adaptation strategies to climate change are of great importance. This is what was addressed by ClimAdaPT.Local. This policy-oriented project had the main goal of developing 26 Municipal Adaptation Strategies for Climate Change, through the identification of local specific present and future vulnerabilities, the training of municipal officials, and the engagement of local communities. It is intended to be replicated throughout the whole territory and to stimulate the creation of a national network of local adaptation in Portugal. Supported by methodologies and tools specifically developed for this project, our paper is based on the surveys, training and stakeholder engagement workshops implemented at municipal level. In an 'adaptation-as-learning' process, these tools functioned as a social-learning platform and an exercise in knowledge and policy co-production. The results allowed us to explore the nature of local vulnerabilities and the exposure of gaps in the context of reappraisal of both future climate change adaptation opportunities and possible dysfunctionalities in the governance arrangements of municipal Portugal. Development issues are highlighted when we address the sectors and social groups that are both more sensitive and more vulnerable to the impacts of climate change. We argue that a pluralistic dialogue and a common framing can be established between them, with great potential for transformational adaptation. Observed climate change, present-day climate variability and future expectations of change are great societal challenges which should be understood in the context of the sustainable development agenda.

Keywords: adaptation, ClimAdaPT.Local, climate change, Portugal, sustainable development

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Authors: Sang-Ju Yu

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This paper examines the changing essences and effects of ‘affective atmosphere’ during the COVID-19 pandemic crisis, which have been facilitated and shaped the ‘affective governance’ in Taiwan. Due to long-term uncertainty and unpredictability, the COVID-19 pandemic not only caused unprecedented global crisis but triggered the public’s negative emotional responses. This paper unravels how the shortage of Personal Protective Equipment and the proliferating fake news heightened people’s fear and anxiety and how specific affective atmospheres can be provoked and manipulated to harness emotional appeals of citizens strategically in Taiwan. Through the in-depth interviews with diverse stakeholders involved, it unfolds the dynamics and strategies of affective governance, wherein public emotions and concerns are now given significant consideration in both policy measures and the affective expression of leadership, spatial arrangement, service delivery, and the interaction with citizens. Addressing psychosocial and emotional needs has become the core of crisis response mechanisms suited to dynamic affective atmospheres and pandemic situation. This paper also demonstrates that epidemic prevention and control is not merely the production of neutral or rational policy-making processes, as it is dominated by multiple emotions resulted from unexpected and salient events at different moments. It provides explicit insight into how different prevention scenarios operated effectively through political and affective mobilisation to strengthen emotional bonding and collective identity which energises collective action. Basically, successful affective governance calls for both negative and positive emotions, for both scientific and political decision-making, for both community and bureaucracy, and both quality and efficiency of private–public collaboration.

Keywords: affective atmospheres, affective governance, COVID-19 pandemic, private-public collaboration

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Authors: Dorota M. Michalak

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The agricultural sector, due to the growing demand for food and over-exploitation of the natural environment, contributes to the deepening of climate change, on the one hand, and on the other hand, shrinking freshwater resources, as a negative effect of climate change, threaten the food security of each country. Therefore, adaptation measures to climate change should take into account effective water management and seek solutions ensuring food production at an unchanged or higher level, while not burdening the environment and not contributing to the worsening of the negative consequences of climate change. The problems of Poland's water management result not only from relatively small, natural water resources but to a large extent on the low efficiency of their use. Appropriate agricultural practices and state solutions in this field can contribute to achieving significant benefits in terms of economical water management in agriculture, providing a greater amount of water that could also be used for other purposes, including for purposes related to environmental protection. The aim of the article is to determine the level of use of water resources in Polish agriculture and the advancement of measures aimed at adapting Polish agriculture in the field of water management to climate change. The study provides knowledge about Polish legal regulations and water management tools, the shaping of water policy of Polish agriculture against the background of EU countries and other sources of energy, and measures supporting Polish agricultural holdings in the effective management of water resources run by state budget institutions. In order to achieve the above-mentioned goals, the author used research tools such as the analysis of existing sources and a survey conducted among five groups of entities, i.e. agricultural advisory centers and departments, agricultural, rural and environmental protection departments, regional water management boards, provincial agricultural chambers and restructuring and modernization of agriculture. The main conclusion of the analyses carried out is the low use of water in Polish agriculture in relation to other EU countries, other sources of intake in Poland, as well as irrigation. The analysis allows us to observe another problem, which is the lack of reporting and data collection, which is extremely important from the point of view of the effectiveness of adaptation measures to climate change. The results obtained from the survey indicate a very low level of support for government institutions in the implementation of adaptation measures to climate change and the water management of Polish farms. Some of the basic problems of the adaptation policy to change climate with regard to water management in Polish agriculture include a lack of knowledge regarding climate change, the possibilities of adapting, the available tools or ways to rationalize the use of water resources. It also refers to the lack of ordering procedures and the separation of responsibility with a proper territorial unit, non-functioning channels of information flow and practically low effects.

Keywords: water management, adaptation policy, agriculture, climate change

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Authors: Lie-Fen Lin, Tzu-Hsuan Lin, Ching-Heng Lin

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Hospice care for terminally ill patients provides not only a better quality of life but also cost-saving benefits. However, the utilization of home-based hospice care (HBH care) remains low even for countries covered by National Health Insurance (NHI) programs in Taiwan. In the current commercial insurance policy, only hospital-based hospice benefits were covered. It may have an influence on the insureds chosen to receive end-of-life care in a hospitalized manner. Thus, how to propose a feasible method to advocate HBH care utilization rate of public health policies is an important issue. A total of 130,219 cancer decedents in the year 2011-2013 from the National Health Insurance Research Database (NHIRD) in Taiwan were included in this study. By adding a day volume pays benefits of HBH care as a commercial insurance rider, will provide alternative benefits for the insureds. A multiple-state Markov chain model was incorporated to estimate the transition intensities of patients in different states at the end of their lives (Non-hospice, HBH, hospital-based hospice), and the premiums were estimated. HBH care insurance benefits provide financial support and reduce the burden of care for patients. The rate-making of this product is very sensitive while the utilization rate is rising, especially for high ages. The proposed HBH care insurance is a feasible way to reduce the financial burden, enhance the care quality and family satisfaction of insureds. Meanwhile, insurance companies can participate in advocating a good medical policy to enhance the social image. In addition, the medical costs of NHI can reduce effectively.

Keywords: home-based hospice care, commercial insurance, Markov chain model, the day volume pays

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Authors: Carlos M. Goncalves, Luisa Duarte, Teresa Cartaxo

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The aim of this work was to understand the reasons behind the underutilization of electroconvulsive therapy (ECT) in the younger population and raise possible solutions. We conducted a non-systematic review of literature throughout a search on PubMed, using the terms ‘children’, ‘adolescents’ and ‘electroconvulsive’, ‘therapy’. Candidate articles written in languages other than English were excluded. Articles were selected according to title and/or abstract’s content relevance, resulting in a total of 5 articles. ECT is a recognized effective treatment in adults for several psychiatric conditions. As in adults, ECT in children and adolescents is proven most beneficial in the treatment of severe mood disorders, catatonia, and, to a lesser extent, schizophrenia. ECT in adults has also been used to treat autism’s self-injurious behaviours, Tourette’s syndrome and resistant first-episode schizophrenia disorder. Despite growing evidence on its safety and effectiveness in children and adolescents, like those found in adults, ECT remains a controversial and underused treatment in patients this age, even when it is clearly indicated. There are various possible reasons to this; limited awareness among professionals (lack of knowledge and experience among child psychiatrists), stigmatic public opinion (despite positive feedback from patients and families, there is an unfavourable and inaccurate representation in the media, contributing to a negative public opinion), legal restrictions and ethical controversies (restrictive regulations such as a minimum age for administration), lack of randomized trials (the currently available studies are retrospective, with small size samples, and most of the publications are either case reports or case series). This shows the need to raise awareness and knowledge, not only for mental health professionals, but also to the general population, through the media, regarding indications, methods and safety of ECT in order to provide reliable information to the patient and families. Large-scale longitudinal studies are also useful to further demonstrate the efficacy and safety of ECT and can aid in the formulation of algorithms and guidelines as without these changes, the availability of ECT to the younger population will remain restricted by regulations and social stigma. In conclusion, these results highlight that lack of adequate knowledge and accurate information are the most important factors behind the underutilization of ECT in younger population. Mental healthcare professionals occupy a cornerstone position; if data is given by a well-informed healthcare professional instead of the media, general population (including patients and their families) will probably regard the procedure in a more favourable way. So, the starting point should be to improve health care professional’s knowledge and experience on this choice of treatment.

Keywords: adolescents, children, electroconvulsive, therapy

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Authors: Deepak L. Waikar

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Unprecedented natural as well as human made disasters have been responsible for loss of hundreds of thousands of lives, injury & displacement of millions of people and damages in billions of dollars in various parts of the world. Scientists, experts, associations and united nation have been warning about colossal disregard for human safety and environment in exploiting natural resources for insatiable greed for economic growth and rising lavish life style of the rich. Usual blame game is routinely played at international forums & summits by vested interests in developing and developed nations, while billions of people continue to suffer in abject energy poverty. Energy security, on the other hand, is becoming illusive with the dominance of few players in the market, poor energy governance mechanisms, volatile prices and geopolitical conflicts in supply chain. Conflicting scenarios have been cited as one of the major barriers for transformation to a low carbon economy. Policy makers, researchers, academics, businesses, industries and communities have been evaluating sustainable alternatives, albeit at snail’s pace. This presentation focuses on technologies, energy governance, policies & practices, economics and public concerns about safe, prudent & sustainable harnessing of energy resources. Current trends and potential research & development projects in power & energy sectors which students can undertake will be discussed. Speaker will highlight on how youths can be engaged in meaningful, safe, enriching, inspiring and value added self-development programmes in our quest for sustainability in the midst of conflict between climate and energy security.

Keywords: clean energy, energy policy, energy security, sustainable energy

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Authors: Lin Tang, Xiaoxia Guo, Lingling Zhang

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Recent vaccine scandals overshadowed China’s accomplishment of public health, triggering discussions on the causes of vaccine incidents. Through legal interpretation of selected vaccine incidents and analysis of systemic vulnerabilities in vaccine circulation and lot release, a panoramic review of legislative progresses in the vaccine administration sheds the light on this debate. In essence, it is the combination of the lagging legal system and the absence of information technology infrastructure in the process of vaccine administration reform that has led to the recurrence of vaccine incidents. These findings have significant implications for further improvement of vaccine administration and China’s participation in global healthcare.

Keywords: legislation, lot release, public health, reform, vaccine administration, vaccine circulation

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Authors: Francine Morales Tavares, Jose Alberto Rio Fernandes

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The expanding concept of Heritage and the increased relevance of how heritage places relate to their surroundings is associated with an important shift in public heritage policies and how they consider the development of cities and communities, with an increasingly relevant role of management. Within the current discussions, management plans, mandatory since the year 2005 in areas classified by UNESCO as World Heritage, it is a tool for the reconciliation of cultural heritage demands with the needs of multiple users of a certain area, being especially critical in the case of urban areas with intense touristic pressure. Considering the transformations of the heritage policy management model, this paper discusses the practices on the integration of cultural heritage in urban policies through indicators which were selected from resource manual 'Managing Cultural World Heritage (2013)' and analyzed two case studies: The Management Plan of the Historic Centre of Porto (Portugal) and The Management Plan for the Historic Site of Olinda (Brazil). The empirical evidence concluded that for the historic centre of Porto the increase of tourism is the main aim driver in the management plan, with positive and negative aspects on the heritage management point of view, unlike Olinda, where the plan for the development of local urban policies was identified as essential. Plans also differ in form, content and process but coincide on being unaligned with committed local political leaders’ agendas, with the consequent misunderstandings between theory and practice, planning and management, and critically missing in the field integration of urban policies. Therefore, more debate about management plans, more efficient tools and also, appropriate methodologies to correlate cultural heritage and urban public policy are still lacking.

Keywords: world heritage, management plan, planning, urban policies

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Authors: D. Tedesco, G. Feletti, P. Trucco

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The present study aims to develop a Decision Support System (DSS) to support the operational decision of the Emergency Medical Service (EMS) regarding the assignment of medical emergency requests to Emergency Departments (ED). In the literature, this problem is also known as “hospital selection” and concerns the definition of policies for the selection of the ED to which patients who require further treatment are transported by ambulance. The employed research methodology consists of the first phase of revision of the technical-scientific literature concerning DSSs to support the EMS management and, in particular, the hospital selection decision. From the literature analysis, it emerged that current studies are mainly focused on the EMS phases related to the ambulance service and consider a process that ends when the ambulance is available after completing a request. Therefore, all the ED-related issues are excluded and considered as part of a separate process. Indeed, the most studied hospital selection policy turned out to be proximity, thus allowing to minimize the transport time and release the ambulance in the shortest possible time. The purpose of the present study consists in developing an optimization model for assigning medical emergency requests to the EDs, considering information relating to the subsequent phases of the process, such as the case-mix, the expected service throughput times, and the operational capacity of different EDs in hospitals. To this end, a Discrete Event Simulation (DES) model was created to evaluate different hospital selection policies. Therefore, the next steps of the research consisted of the development of a general simulation architecture, its implementation in the AnyLogic software and its validation on a realistic dataset. The hospital selection policy that produced the best results was the minimization of the Time To Provider (TTP), considered as the time from the beginning of the ambulance journey to the ED at the beginning of the clinical evaluation by the doctor. Finally, two approaches were further compared: a static approach, which is based on a retrospective estimate of the TTP, and a dynamic approach, which is based on a predictive estimate of the TTP determined with a constantly updated Winters model. Findings reveal that considering the minimization of TTP as a hospital selection policy raises several benefits. It allows to significantly reduce service throughput times in the ED with a minimum increase in travel time. Furthermore, an immediate view of the saturation state of the ED is produced and the case-mix present in the ED structures (i.e., the different triage codes) is considered, as different severity codes correspond to different service throughput times. Besides, the use of a predictive approach is certainly more reliable in terms of TTP estimation than a retrospective approach but entails a more difficult application. These considerations can support decision-makers in introducing different hospital selection policies to enhance EMSs performance.

Keywords: discrete event simulation, emergency medical services, forecast model, hospital selection

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Authors: Ademilade J. Aboginije, Clinton O. Aigbavboa

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South Africa is among the emerging economy, which has a policy and suitable environment that dynamically stimulates waste management practices of diverting waste away from landfill through prevention, reuse, recycling, and recovery known as the 4R-approaches. The focus of this paper is to investigate the existing structures and processes that are environmentally responsible, then determine the resource-efficiency of the waste management practices in the South Africa construction industry. This paper indicates the results of an investigation carried out by using a systematic review of several related literatures to assess the sustainability of waste management scenarios with secondary material recovery to pinpoint all influential criteria and consequently, highlights a step by step approach to adequately analyze the process by using the indicators that can clearly and fully value the waste management practices in South Africa. Furthermore, a life cycle Analytical tool is used to support the development of a framework which can be applied in measuring the sustainability of existing waste management practices in South Africa. Finding shows that sustainable C&D waste management practices stance a great prospect far more noticeable in terms of job creation and opportunities, saving cost and conserving natural resources when incorporated, especially in the process of recycling and reusing of C&D waste materials in several construction projects in South Africa. However, there are problems such as; inadequacy of waste to energy plants, low compliances to policies and sustainable principles, lack of enough technical capacities confronting the effectiveness of the current waste management practices. Thus, with the increase in the pursuit of sustainable development in most developing countries, this paper determines how sustainability can be measured and used in top-level decision-making policy within construction and demolition waste management for a sustainable built environment.

Keywords: construction industry, green-star rating, life-cycle analysis, sustainability, zero-waste hierarchy

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Authors: Dinesh N. Kurup, Celine Perriera

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The economic development of any country is based on the policies adopted by the government from time to time. If these policies are framed by the opinion of the people of the country, there is need for having strong knowledge base, right from the school level. There should be emphasis to provide in education, an ability to take informed decisions regarding socio-scientific issues. It would be better to adopt this practice in high school classrooms to build capacity among future citizens. This study is an attempt to provide a different approach of teaching and learning in classrooms at the high school level in Indian schools for providing opportunity for informed decision making regarding nuclear power use. A unit of work based on the 5E instructional model about the use of nuclear energy is used to build knowledge base and find out the effectiveness in terms of its influence for taking decisions as a future citizen. A sample of 120 students from three high schools using different curricula and teaching and learning methods were chosen for this study. This research used a design based research method. A pre and post questionnaire based on the theory of reasoned action, structured observations, focus group interviews and opportunity for decision making were used during the intervention. The data analysed qualitatively and quantitatively, and the qualitative data were coded into categories based on responses. The results of the study show that students were able to make informed decisions and could give reasons for their decisions. They were enthusiastic in formulating policy making based on their knowledge base and have strong held views and reasoning for their choice.

Keywords: informed decision making, socio-scientific issues, nuclear energy use, policy making

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Authors: Anthony John Walker, Glen Bright

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The challenge faced by manufactures, when producing custom products, is that each product needs exact components. This can cause work-in-process instability due to component matching constraints imposed on assembly cells. Clearing type flow control policies have been used extensively in mediating server access between multiple arrival processes. Although the stability and performance of clearing policies has been well formulated and studied in the literature, the growth in arrival to departure sequence disorder for each arriving job, across a serving resource, is still an area for further analysis. In this paper, a closed form industrial model has been formulated that characterizes arrival-to-departure sequence disorder through stable manufacturing systems under clearing type flow control policy. Specifically addressed are the effects of sequence disorder imposed on a downstream assembly cell in terms of work-in-process instability induced through component matching constraints. Results from a simulated manufacturing system show that steady state average sequence disorder in parallel upstream processing cells can be balanced in order to decrease downstream assembly system instability. Simulation results also show that the closed form model accurately describes the growth and limiting behavior of average sequence disorder between parts arriving and departing from a manufacturing system flow controlled via clearing policy.

Keywords: assembly system constraint, custom products, discrete sequence disorder, flow control

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Authors: Kiyanoush Ghalavand, Ali Ferydooni

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Fars province Fārs or Pārs is a vast land located in the southwest of Iran. All over the province, you can see and feel the glory of Ancient Iranian culture and civilization. There are many monuments from pre-historical to the Islamic era within this province. The existence of ancient cultural and historical monuments in Fars province including the historical complex of Persepolis, the tombs of Persian poets Hafez and Saadi, and dozens of other valuable cultural and historical works of this province as a symbol of Iranian national identity and the manifestation of transcendent cultural values of this national identity. Fars province is quintessentially Persian. Its name is the modern version of ancient Parsa, the homeland, if not the place of origin, of the Persians, one of the great powers of antiquity. From here, the Persian Empire ruled much of Western and Central Asia, receiving ambassadors and messengers at Persepolis. It was here that the Persian kings were buried, both in the mountain behind Persepolis and in the rock face of nearby Naqsh-e Rustam. We have a complex paradox in Persian and Islamic ideology in the age of technology in Iran. The main purpose of the present article is to identify and describe the problems and prospects of origin and development of the modern approach to the conservation and restoration of ancient monuments and historic buildings, the influence that this development has had on international collaboration in the protection and conservation of cultural heritage, and the present consequences worldwide. The definition of objects and structures of the past as heritage, and the policies related to their protection, restoration, and conservation, have evolved together with modernity, and are currently recognized as an essential part of the responsibilities of modern society. Since the eighteenth century, the goal of this protection has been defined as the cultural heritage of humanity; gradually this has included not only ancient monuments and past works of art but even entire territories for a variety of new values generated in recent decades. In its medium-term program of 1989, UNESCO defined the full scope of such heritage. The cultural heritage may be defined as the entire corpus of material signs either artistic or symbolic handed on by the past to each culture and, therefore, to the whole of humankind. As a constituent part of the affirmation and enrichment of cultural identities, as a legacy belonging to all humankind, the cultural heritage gives each particular place its recognizable features and is the storehouse of human experience. The preservation and the presentation of the cultural heritage are therefore a corner-stone of any cultural policy. The process, from which these concepts and policies have emerged, has been identified as the ‘modern conservation movement’.

Keywords: tradition, modern, heritage, historical building, protection, cultural policy, fars province

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Authors: Liya Abraham

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Eritrea is located along the Red Sea, north of the Horn of Africa, between Djibouti and Sudan and has a population of about 3.2 million as of 2010. It has six administrative regions; Anseba, Debub, Debubawi K’eyih Bahri, Gash-Barka, Ma'akel, and Semenawi K’eyih Bahri. Eritrea has got its independence in 1991 after 30 years war of liberation. The country is blessed with various medicinal flora and fauna, and marine and terrestrial biodiversity. Traditional Medicine (TM) has been an integral part of the Eritrean culture for centuries. So far, more than 19 TM modalities have been recognized, and are broadly categorized as; herbal, procedure-based and spiritual. Despite the availability of modern medicine to the majority of the population, TM is still widely practiced. The rationale behind widespread use is accessibility, affordability and cultural acceptability. Hence, TM is of great contribution to the Eritrean health care system. As a matter of fact, harnessing the potential contribution of effective and safe TM in order to attain Universal Health Coverage (UHC) has been emphasized in the WHO TM strategy 2014-2023. The Eritrean TM, however, was operating without regulation and reliable scientific justification behind its safety and efficacy. Thus, the Ministry of Health (MoH), in recognition of the role of TM in primary healthcare and safeguard public health, established a regulatory body for TM so-called as Traditional Medicine Unit (TMU) in 2012. The mission of the unit is to ensure rational TM use through an integrated health service delivery system and contribute to the country’s economic and social development. The unit has established its national TM policy in 2017. The activities of the unit are guided by the National TM Advisory Committee (TMAC), responsible for the provision of technical assistance and advisory role. Moreover, the Legal Framework and Code of Ethics and Practice which provide a legal basis for the regulation of TM have also been drafted. In recognition of the importance of TM research and development, the unit launched a nationwide TM survey in 2017 and had surveyed two zones (Gash-Barka and Debub). The findings of the survey were subjected to a research dissemination workshop and publication in international journals. Furthermore, TM-related adverse events reporting tool (Green Form) aiming to guide regulatory interventions and researches have been established by the unit, and ever since reports are flowing. The unit has also been offering training to THPs, pharmacy students and health care professionals regarding TM and its regulatory activities. In addition, as part of the establishment of the national medicinal plants' database and herbal monograph, more than 329 and 30 medicinal plants, have been compiled respectively. In conclusion, TM is still widely accepted and practiced in Eritrea. The TMU ever since its establishment is endeavoring to ensure the safety and efficacy of the TM, and its integration in the mainstream health service delivery system.

Keywords: efficacy, regulation, safety, traditional medicine, traditional medicine unit, universal health coverage

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